RxPG News : Obesity

Burning fat can lead to a longer life in worms

Tue, 11 Nov 2008 15:40:29 PST

( from http://www.rxpgnews.com ) Washington, Nov 7 - Burning fat can lead to a longer life at least in case of worms, according to a new study.

A fat-burning enzyme in C. elegans increases its activity after the worm's reproductive stem cells stop proliferating, and the result is a longer lifespan, said Meng Wang of Harvard Medical School, Boston, and colleagues.

Their findings offer a tantalising glimpse into how regulation of metabolism, lifespan and reproduction are linked, a relationship that longevity studies are increasingly focusing on, said Ting Xie a colleague.

Wang and colleagues show that reproductive stem cells in adult worms actively control levels of the lipase K04A8.5, which reduces intestinal fat. When the stem cells stop proliferating, levels of lipase rise significantly and zap the fat, said a Harvard release.

Worms with the lipase activated in the intestine lived 24 percent longer than their siblings, the researchers found.

The report appeared in Thursday issue of Science.

New obesity drug, Tesofensine, seems promising

Thu, 23 Oct 2008 14:28:57 PST

( from http://www.rxpgnews.com ) According to trials, a new obesity drug, Tesofensine, which may be launched on the world market in a few years, can produce weight loss twice that of currently approved obesity drugs. The Danish company Neurosearch and a number of researchers at the Faculty of Life Sciences at University of Copenhagen are behind the promising findings.

Tesofensine can produce weight loss twice that of currently approved obesity drugs, and should be studied in phase III trials. These are the conclusions of an Article published early Online and in an upcoming edition of The Lancet, written by Professor Arne Astrup, Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Denmark, and colleagues.

Increased obesity prevalence worldwide, in both developed and developing countries, results in more people with cardiovascular disease, diabetes, musculoskeletal disorders, and cancer. Whilst gastric bypass surgery substantially reduces bodyweight and obesity-related disease, the researchers believe a treatment gap exists between the effectiveness of currently marketed obesity drugs and gastric-bypass surgery. Tesofensine – which inhibits the presynaptic uptake of the neurotransmitters noradrenaline, dopamine and serotonin in the brain – has been shown to be safe and effective in animal models. It also caused unintended weight loss when it was given obese patients with Parkinson's or Alzheimer's disease when it was researched for those conditions. The drug works by suppressing hunger, leading to an energy deficit which burns off excess body fat.

This randomised, placebo-controlled phase II study was done in five Danish obesity management centres, and involved 203 obese patients (body mass index 30-40 kg/m2), weighing a mean of just over 100kg. They were prescribed a limited-energy diet and assigned to tesofensine 0.25mg (52 patients), 0.5 mg (50), 1.0 mg (49), or placebo (52), all once daily for 24 weeks. The primary outcome was percentage change in bodyweight. A total of 161 patients completed the study, and an analysis showed that the mean weight loss recorded for placebo and diet was 2.2kg and for tesofensine 0.25mg, 0.5mg and 1.0mg it was 6.7kg, 11.3kg, and 12.8kg respectively. For the 0.5mg and 1.0mg doses, this represented a weight loss around twice that attained using sibutramine or rimonabant*, the currently-approved therapies in Europe. Blood pressure was increased in the 1.0mg group.The most common side-effects caused by tesofensine were dry mouth, nausea, constipation, hard stools, diarrhoea, and insomnia.

The authors conclude that the 0.5mg dose of tesofensine is more promising than the 1.0mg dose because it produces a similar weight loss with less side-effects. They say: "We conclude that tesofensine 0.5 mg, once daily for 6 months, has the potential to produce twice the weight loss as currently approved drugs; however, larger phase III studies are needed to substantiate our findings."

Can slowing down 'fat burning' genes reduce obesity?

Sat, 04 Oct 2008 14:06:00 PST

( from http://www.rxpgnews.com ) Washington, Oct 4 - Inactivating a pair of key genes involved in 'fat burning' actually increases energy expenditure and helps lower obesity, according to a new study.

Humans and other warm-blooded animals need to continually 'burn fat' in order to maintain body temperature, and it's currently believed that an individual's fat-burning capacity, or thermogenic potential, is connected with obesity risk. In fact, bodybuilders and dieters looking to burn fat commonly use thermogenic supplements like ephedra.

In theory, lowering thermogenesis should increase the chances of obesity, but Leslie Kozak and colleagues at Pennington Biomedical Research Centre found that this may not be the case, according to a release of the centre.

They knocked-out two thermogenic genes in mice, Ucp1 - and Gdm - and then fed the mice a high-fat diet while rearing them at a cool 20 degrees Celsius.

Surprisingly, these mice were actually quite resistant to obesity, which resulted from the mice turning on backup heat generators, so to speak. Lacking Ucp1 and Gdm, genes that have been designed for the efficient production of heat, their white fat cells activated alternate, and more inefficient, fat burning pathways.

In this case the inefficiency was beneficial, as the mice had to burn more fat than normal to stay warm -.

Importantly, after spending 10 weeks at 20 degrees Celsius the mice retained these alternate pathways even after transferring to 28 degrees, suggesting their bodies had adapted to the change.

Thus, Kozak and colleagues noted, fat burning does not necessarily require making thermogenesis easier; by making it harder and forcing the body to use inefficient methods to stay warm, the same goals can be reached.

Personal counseling helps in maintaining weight loss

Tue, 11 Mar 2008 15:16:35 PST

( from http://www.rxpgnews.com ) People who shed weight and want to keep it off might benefit from monthly personal contact interventions, researchers reported at the American Heart Association’s Conference on Nutrition, Physical Activity and Metabolism.

Results of the study will also be simultaneously published in the Journal of the American Medical Association.

In a test of three ways that might help people maintain weight loss, those who received monthly personal counseling were best at keeping off unwanted pounds. Overall, 42 percent of the study members maintained at least a 4-kilogram (9-pound) weight loss for 30 months.

“We know how to help people lose weight in a healthy way, but we know very little about how to help them to keep the weight off,” said Laura P. Svetkey, M.D, lead author of the study and professor of medicine at Duke University Medical Center in Durham, N.C. “This study is the longest and largest to test strategies for long-term weight loss maintenance, and it suggests that long-term weight control is an achievable goal.

“The United States is in the midst of an obesity epidemic, one that portends serious future health consequences. Overweight and obesity are the leading cause of high blood pressure, diabetes and abnormal cholesterol, which are leading causes of cardiovascular disease, which is, in turn, the leading cause of death in this country,” Svetkey said. “So if we really want to get to the root causes of these disorders, we need to address the obesity epidemic.”

Despite the importance of obesity control, few studies have tested strategies to maintain weight loss over long periods. Svetkey and her colleagues enrolled 1,685 participants in the two-phase Weight Loss Maintenance trial, which was conducted at four clinical centers in the United States.

Phase I consisted of 20 weekly group sessions of 18-25 participants held over six months, during which trained counselors emphasized three key elements to weight loss — consuming fewer calories, increasing moderate physical activity, and eating a healthy diet.

Researchers recommended DASH (Dietary Approaches to Stop Hypertension), a diet rich in fruits, vegetables, whole-grain and high fiber foods, that uses low-fat and fat-free dairy products and is low in total and saturated fat and sodium. DASH lowers blood pressure and cholesterol even without weight loss.

Counselors helped participants use tools like self-monitoring and goal-setting, and helped them remember why they wanted to lose weight in the first place. The group sessions also provided study members with social support from other participants.

At the end of Phase I, 61 percent of the participants in the trial were eligible for Phase II, which lasted for 30 months, because they had lost at least nine pounds and as much as 66 pounds.

Thirty-eight percent of people in Phase II were African-American and 37 percent were male. “This is important because men are often underrepresented in weight loss studies, and obesity disproportionately affects African Americans,” Svetkey said.

Researchers randomly assigned the volunteers to one of three groups:

Personal contact (PC) — Participants talked with an interventionist (monthly, nine times by telephone and three times face-to-face each year) who provided personal counseling and encouragement.
Interactive technology (IT) — Study members had access to an interactive Web site on which they could record and track their exercise and calorie intake; set goals and monitor their progress toward them; and communicate with others in the IT group.
Self-directed (SD) — Participants were urged to maintain their weight loss and then sent off without further intervention.
Results from the trial after 30 months included:

Overall, 71 percent weighed less than when they began Phase I. The difference in the percentage of each group that weighed less was statistically significant — PC group (77 percent); IT group (69 percent) and SD group (67 percent).
Thirty-seven percent of enrollees weighed at least 5 percent below their beginning weight. Again, the PC participants (42 percent) significantly out-performed those in the SD (34 percent) and IT (29 percent) groups.
Among all study members, 32 percent weighed no more than 3 percent above their weight at randomization. However, differences between the three groups — SD (29 percent), IT (29 percent) and PC (36 percent) — were not significantly different statistically.
Although at 24 months the average weight regained by the IT group was less than that of the SD arm, researchers found no difference between the two at 30 months.
“The effects we observed were modest,” Svetkey said. “The personal contact group regained about 3.3 pounds less than the self-directed group.”

Even a small weight loss can have potential health benefits, she noted.

“Each pound of weight loss can lower blood pressure by as much as a millimeter of mercury, and the more weight you lose, the bigger the blood pressure effect,” Svetkey said. “Each pound of weight loss is estimated to lower the risk of developing diabetes by 8 percent, which is quite impressive.

“Clearly more research is needed to refine these maintenance interventions to make them more effective, but this study is an important step in the right direction.”

Type 2 muscle important in body metabolism and obesity

Tue, 05 Feb 2008 23:07:10 PST

( from http://www.rxpgnews.com ) When it comes to losing weight, pumping iron may be just as important as running on the treadmill, suggests a new study in the February issue of Cell Metabolism, a publication of Cell Press.

Researchers used a genetic trick in obese mice that caused the mice’s muscles to bulk up as though they had been lifting weights. The researchers found that the “genetically reprogrammed” mice lost fat and showed other signs of metabolic improvement throughout the body. What’s more, those benefits were seen even though the mice continued eating a diet high in both fat and sugar and didn’t increase their physical activity at all.

“We’ve shown that type II muscle does more than allow you to pick up heavy objects,” said Kenneth Walsh of Boston University School of Medicine. “It is also important in controlling whole-body metabolism.”

The type II, or fast, muscle fibers found plentifully in body builders are well suited to dealing with abrupt and heavy loads. On the other hand, the muscles of long-distance runners are rich in type I, or slow, fibers that can endure lesser loads over longer periods of time. Earlier studies focused primarily on the importance of type I muscle, with its abundance of energy-burning mitochondria, for regulating metabolism, Walsh said. Indeed, those studies have indicated that an increase in “energy burn” in muscle can protect against weight gain and metabolic dysfunction.

“Resistance training builds the white meat,” Walsh said, referring to the relatively mitochondria-poor type II muscle. “There is some evidence it’s good for you, but it’s not immediately clear why. Now, we’ve provided a scientific rationale.”

Walsh’s group developed mice in which they could turn type II muscle growth on or off by flipping a genetic switch specifically in skeletal muscle. The gene they manipulated, known as Akt1, is preferentially activated in skeletal muscle in response to resistance training, but not endurance training, the researchers knew.

Rather than becoming strong and fat “sumo mice” as some of the researchers had expected, the modified mice gained type II muscle and strength while they lost fat. The mice also showed a resolution of hepatic steatosis, otherwise known as fatty liver, and improvements in a variety of other metabolic parameters. The Akt1-driven growth of skeletal muscle counteracted the usual effects of a high-fat, high-sucrose diet on patterns of gene activity in the liver and increased the breakdown of fatty acids there, the researchers showed.

“These findings indicate that type II muscle has a previously unappreciated role in regulating whole-body metabolism through its ability to alter the metabolic properties of remote tissues,” the researchers concluded. “These data also suggest that strength training, in addition to the widely prescribed therapy of endurance training, may be of particular benefit to overweight individuals.”

“The work of [Walsh and his colleagues] reveals the intricate interplay between diet, energy balance, and the function/morphology of diverse tissue systems such as skeletal muscle and liver,” said Brooke Harrison and Leslie Leinwand of the University of Colorado at Boulder in a commentary. “These findings indicate that interventions designed to increase skeletal muscle mass in at-risk human populations may prove to be critical weapons in the fight against obesity and obesity-related comorbidities including diabetes, heart disease, stroke, hypertension, and cancer.”

A Predisposition to Obesity

Tue, 05 Feb 2008 15:11:04 PST

( from http://www.rxpgnews.com ) A predisposition for obesity might be wired into the brain from the start, suggests a new study of rats in the February issue of Cell Metabolism, a publication of Cell Press.

Rats selectively bred to be prone to obesity show abnormalities in a part of the brain critical for appetite control, the researchers found. Specifically, the researchers show that the obese rats harbor defects in neurons of the arcuate nucleus (ARH) of the hypothalamus, which leaves their brains less responsive to the hunger-suppressing hormone leptin.

“The neurodevelopmental differences in these animals can be seen as early as the first week,” said Sebastien Bouret of the University of Southern California. “The results show that obesity can be wired into the brain from early life. The three-million-dollar question now is how to get around this problem.”

It is increasingly accepted that obesity results from a combination of genetic and environmental factors, the researchers said. Rodent models of obesity can provide valuable insights into the biological processes underlying the development of obesity in humans. The “diet-induced obese” (DIO) rats used in the current study are particularly suited to the task, according to Bouret, because their tendency to become overweight shares several features with human obesity, including the contribution of many genes.

Previous studies had suggested that the brains of DIO rats are insensitive to leptin, the researchers added. Circulating leptin, produced by fat tissue, acts as a signal to the brain about the body’s energy status. Leptin is also critical for the initial development of ARH neurons.

In the new study, the researchers examined the obesity-prone rats for signs of abnormal brain development. They found that the animals’ brains had fewer neural projections from the ARH, a deficiency that persisted into adulthood. Those projections are needed to relay the leptin signal received by the ARH to other parts of the hypothalamus, Bouret said.

The researchers found further evidence that those changes in brain wiring stem from a reduced responsiveness of the brain to leptin’s action during development.

“It seems [in the case of these rats] that appetite and obesity are built into the brain,” Bouret said. While their condition might be ameliorated by exercising and eating right, he added, the findings suggest that the propensity to gain weight can’t be reversed.

But there is hope yet. It’s possible that treatments delivered during a critical early period of development might be capable of rewiring the brain, Bouret said.

Obesity in mothers responsible for obese offspring

Thu, 03 Jan 2008 14:58:43 PST

( from http://www.rxpgnews.com ) The number of overweight and obese Americans continues to grow rapidly. Today, 50 percent of adults are overweight and up to 20 percent are obese. While the number of overweight/obese children is at an all time high, the steady increase of overweight infants -- individuals under 11 months old -- is alarming.

Research studies have found that pregnant women who are overweight/obese are more likely to give birth to heavier babies, and the risk of overweight children becoming obese adults is nearly nine times greater than for children who are not overweight. Studies also show that greater body-weight at birth and weight gain early in life increases the risk of becoming overweight or obese as an adult. Inheritance studies show that a child's body mass index (BMI) correlates more closely with the mother's BMI than with it's father's, suggesting that an interaction of both genetic and intrauterine influences, may contribute to later-life obesity risk in the offspring.

Armed with these and other data, a team of researchers from the USDA-Arkansas Children's Nutrition Center has examined whether the subtle effects of fetal exposure to the mother's obesity can have a latent effect on the offspring. In a new report, investigators studied whether fetal exposure to gestational obesity leads to a self-reinforcing viscious cycle of excessive weight gain and body fat which passes from mother to child. The results of the new study suggest they do.

The Study

The study is entitled, "Maternal Obesity at Conception Programs Obesity in the Offspring." It was conducted by the research team of Kartik Shankar, Amanda Harrell, Xiaoli Liu, Janet M. Gilchrist, Martin J.J. Ronis and Thomas M. Badger, all of the Arkansas Children's Nutrition Center, Little Rock, AR. Their findings appear in the online edition of the American Journal of Physiology -- Regulatory, Integrative and Comparative Physiology (doi:10.1152/ajpregu.00316.2007). The journal is one of 11 published each month by the American Physiological Society (APS; http://www.the-aps.org/).

To test the theory that obesity in adulthood may be subject to programming during fetal development, the researchers developed an overfeeding model which was used in rats. The model allowed the investigators to replicate many of the metabolic and hormonal features of overweight human individuals. They were also able to exclude parental genetic influences, match gestational weight gain, limit the exposure of maternal obesity in utero, and control lactation efficiency, all of which can be difficult confounding variables in studies with human subjects.

Summary of Methodology

Virgin female rats were fed liquid diets via enteral nutrition at one of two caloric levels: (1) the caloric level recommended by the National Research Council (187 kcal/kg3/4/day) or (2) a level of 15 percent overfeeding (220 kcal/kg3/4/day). In the preliminary experiments, the rats consuming the normal caloric intake had weight gains similar to controls while those being fed the obesegenic diet had become substantially overweight. Body weights were monitored three times a week and body composition was analyzed non-invasively on a regular basis.

To examine the long-term gestational effects of maternal obesity on the offspring, lean (n=7) and obese (n=15) rats were allowed to mate with normal (lean) male rats for a period of one week. Following mating, all female rats (lean and obese) received respective diets at 15 percent excess calories per day in order to ensure adequate caloric intake for pregnancy. Maternal body weights were monitored three times a week and all rats gave birth naturally. Offspring born to lean or obese rats were raised by surrogates who were fed regular rodent diets to ascertain the pups' obesity exposure was limited only during gestation.

The male offspring from each group were weaned from the surrogate mother at 21 days after birth and fed (by giving unlimited access to) either a normal diet or a high-fat diet. The pups' body weight, body composition and other factors were analyzed for 130 days. At day 130 additional samples were taken and analyzed, to include organ weights, glucose and triglyceride levels, fat cell size, body composition and hormones.

Key Findings

The researchers found the following:

at birth, the weight of the offspring from both groups was similar. The number and size of pups and the ratio of males to females did not differ significantly.

the amount of calories the pups consumed (relative to their body-weight) at the 60- and 120-day mark suggested that both groups consumed the same amount of calories, indicating no effect of maternal obesity on the offspring's food intake.

when both the lean and obese offspring were fed a control diet, their body weights remained similar. However, when both groups were fed a high-fat diet, the obese offspring gained remarkably more weight, suggesting that exposure to maternal obesity led to programming of increased susceptibility to obesity in the offspring, which was revealed following an obesegenic challenge despite a normal birth weight.

when both groups were fed a control diet, obese offspring had a ~ 1.6 times greater fat ratio compared to their lean offspring counterparts. Further, obese offspring fed a high-fat diet had a 26 percent greater percent fat ratio and a 60 percent increase in subcutaneous fat mass vs. lean offspring.

high fat feeding significantly increased serum glucose, triglyceride, insulin and leptin levels in both groups. Strikingly, the serum insulin and leptin levels increased by 2.2 and 2.3 fold in obese offspring compared to lean offspring fed the same diet.

Conclusions

These findings add to the existing body of evidence showing that both maternal obesity and genetic background influence offspring's susceptibility to obesity. It goes further, to highlight the role of post-natal obesegenic diet as a determinant in revealing subtle programming imposed by maternal obesity. The results also demonstrate that high levels of adiposity (body fat) occur in the offspring of obese mothers despite consuming similar calories as their lean-offspring counterparts and that offspring obesity is associated with insulin resistance.

The "programming" of susceptibility to obesity occurs in the absence of changes in birth weights and other fetal outcomes.

According to Dr. Kartik Shankar of the Arkansas Children's Nutrition Center, "The mother's body composition at conception has important implications for the metabolism and risk of obesity in the offspring in later years. Not only do these findings help us appreciate the reasons for the rapid rise in obesity, this novel model will allow us to understand the underlying mechanisms and should provide fertile opportunity for translational type research."

Obesity increases risk of injury on the job

Tue, 15 May 2007 18:57:48 PST

( from http://www.rxpgnews.com ) Having a body mass index (BMI) in the overweight or obese range increases the risk of traumatic workplace injury, according to researchers at the Johns Hopkins Bloomberg School of Public Healthâs Center for Injury Research and Policy. Employer-sponsored weight loss and maintenance programs should be considered as part of a well-rounded workplace safety plan. The study was Advance Access published on May 7, 2007, by the American Journal of Epidemiology.

BMI is a measure of body fat based on an adultâs height and weight. It is used to screen for weight categories that may lead to health problems. According to the Centers for Disease Control and Prevention, a BMI below 18.5 is considered underweight, 18.5â24.9 is normal; 25â29.9 is overweight and over 30 is obese.

âClearly, limited resources for workplace injury prevention and control should target the most prominent and modifiable risk factors, but we cannot neglect the fact that our study and other recently published studies support an association between BMI and the risk, distribution and prevalence of workplace injury,â said Keshia M. Pollack, PhD, MPH, lead author of the study and an assistant professor in the Bloomberg School of Public Healthâs Department of Health Policy and Management.

The researchers used medical and injury surveillance data on hourly workers employed in eight plants of the same aluminum manufacturer to determine whether increased BMI was a risk factor for workplace injury. The plants were scattered across the United States. BMI was calculated using National Institutes of Health criteria. Employees were grouped into five categories: underweight, normal, overweight, obesity levels I and II and obesity level III.

Of the 7,690 workers included in the study, 29 percent were injured at least once between January 2, 2002, and December 31, 2004. Approximately 85 percent of the injured workers were classified as overweight or obese. More than 28 percent of injuries occurred among employees classified as overweight, 30 percent in the obese I and II category and almost 34 percent in the obese III category.

The severely obese group who had a BMI of greater than 40 also had the most injuries to the hand/wrist/finger (22 percent) when compared to the same injuries in the other weight categories. Almost 10 percent of all injuries in the obese III group were to the leg/knee, compared to 7 percent of workers classified as overweight, which was the next highest injury rate.

âWe know that obesity prevention policies and programs in the workplace are important simply because of likely improvements in employee health,â said Pollack, the Leon S. Robertson Faculty Development Chair in Injury Prevention. âWhat we do not know is if obesity prevention in the workplace will also have the added benefit of improving injury rates and reducing lost work time. Evaluations of worksite health promotion and obesity prevention efforts should measure changes not only in employee health, but also traumatic injury.â

The researchers say that more work will be needed to test the effectiveness for reducing weight among hourly (non-office) employees who face a number of barriers to participating in worksite physical activity programs, such as the need to remove protective clothing for midday exercise and a lack of time because of additional employment or home responsibilities.

Major genetic study identifies gene for obesity

Sat, 14 Apr 2007 03:35:28 PST

( from http://www.rxpgnews.com ) Scientists have identified the most clear genetic link yet to obesity in the general population as part of a major study of diseases funded by the Wellcome Trust, the UK's largest medical research charity. People with two copies of a particular gene variant have a 70 per cent higher risk of being obese than those with no copies.

Obesity is a major cause of disease, associated with an increased risk of type 2 diabetes, heart disease and cancer. It is typically measured using body mass index (BMI). As a result of reduced physical activity and increased food consumption, the prevalence of obesity is increasing worldwide. According to the 2001 Health Survey for England, over a fifth of males and a similar proportion of females aged 16 and over in England were classified as obese. Half of men and a third of women were classified as overweight.

Scientists from the Peninsula Medical School, Exeter, and the University of Oxford first identified a genetic link to obesity through a genome-wide study of 2,000 people with type 2 diabetes and 3,000 controls. This study was part of the Wellcome Trust Case Control Consortium, one of the biggest projects ever undertaken to identify the genetic variations that may predispose people to or protect them from major diseases. Through this genome-wide study, the researchers identified a strong association between an increase in BMI and a variation, or "allele", of the gene FTO. Their findings are published online today in the journal Science.

The researchers then tested a further 37,000 samples for this gene from Bristol, Dundee and Exeter as well as a number of other regions in the UK and Finland. Bristol Universityâs ALSPAC study (also known as Children of the 90s), which has followed the development of 14,000 children since before birth, made a significant contribution to this work.

The study found that people carrying one copy of the FTO allele have a 30 per cent increased risk of being obese compared to a person with no copies. However, a person carrying two copies of the allele has a 70 per cent increased risk of being obese, being on average 3kg heavier than a similar person with no copies. Amongst white Europeans, approximately one in six people carry both copies of the allele.

"As a nation, we are eating more but doing less exercise, and so the average weight is increasing, but within the population some people seem to put on more weight than others," explains Professor Andrew Hattersley from the Peninsula Medical School. "Our findings suggest a possible answer to someone who might ask 'I eat the same and do as much exercise as my friend next door, so why am I fatter?' There is clearly a component to obesity that is genetic."

The researchers currently do not know why people with copies of the FTO allele have an increased BMI and rates of obesity.

"Even though we have yet to fully understand the role played by the FTO gene in obesity, our findings are a source of great excitement," says Professor Mark McCarthy from the University of Oxford. "By identifying this genetic link, it should be possible to improve our understanding of why some people are more obese, with all the associated implications such as increased risk of diabetes and heart disease. New scientific insights will hopefully pave the way for us to explore novel ways of treating this condition."

The findings were welcomed by Dr Mark Walport, Director of the Wellcome Trust.

"This is an exciting piece of work that illustrates why it was so important to sequence the human genome," says Dr Walport. "Obesity is one of the most challenging problems for public health in the UK. The discovery of a gene that influences the development of obesity in the general population provides a new tool for understanding how some people appear to gain weight more easily than others. This discovery, along with further results expected from the Wellcome Trust Case Control Consortium later this year, will open up a wealth of new avenues to understand and treat common diseases."

The FTO gene was first discovered whilst studying the DNA of a cohort of patients with type 2 diabetes. The risk of developing type 2 diabetes increases significantly for obese people. Through its effect on BMI, having one copy of the FTO allele increases the risk of developing type 2 diabetes by 25 per cent, having two by 50 per cent.

"We welcome this result, which holds promise for tackling rising levels of obesity and the associated risk of developing type 2 diabetes," says Professor Simon Howell, Chair of Diabetes UK, which funded the original collection of samples from people with diabetes. "The discovery has been possible not only because of exemplary team work of scientists from a large number of institutions but also because of the cooperation of the 5,000 diabetes patients and 37,000 people without diabetes who gave blood samples for the study."

Incidence of Fatty Liver Disease rises as obesity in children increases

Thu, 15 Mar 2007 06:11:32 PST

( from http://www.rxpgnews.com ) Indiana University School of Medicine researchers are taking a closer look at a disease whose incidence is rising as obesity in children increases. Non-Alcoholic Steatohepatitis, more popularly known as Fatty Liver Disease, occurs in approximately 15% of obese children. Fatty Liver Disease, in which fat accumulates in the liver, while not life threatening in children, can lead to cirrhosis (scarring) of the liver, sometimes requiring transplantation by adulthood.

"Until now the only treatment for Fatty Liver Disease has been to offer diet and exercise counseling, but this is often not effective. As part of a national multicenter research network, we are now looking at Vitamin E and at metformin, a drug used to treat Type II diabetes, as possible therapies" said Jean Molleston, M.D., clinical professor of pediatrics at IU School of Medicine and director of pediatric gastroenterology at Riley Hospital for Children. Dr. Molleston is the pediatric principal investigator for the IU School of Medicine site of TONIC, an eight-center Phase III study funded by the National Institute of Diabetes and Digestive and Kidney Disease, which is investigating treatment options for Fatty Liver Disease in 8 to 17 year olds and is the largest study of its type to date.

"We are seeing a growing number of young people with Fatty Liver Disease, and we need to tackle the disease before it becomes full blown in adulthood," said Dr. Molleston. "We routinely test children for conditions with much lower incidence such as scoliosis. Although we do not yet have formal guidelines for screening for Fatty Liver Disease, I personally think that all obese children should be screened for Fatty Liver Disease so we can intervene before it damages the liver."

A simple blood test to determine if liver enzyme levels are elevated alerts pediatricians that the child needs to be evaluated for Fatty Liver Disease.

Approximately a third of children and teens in the United States are overweight and 15% of children and teens are obese. Fatty Liver Disease may exist in 15% or more of obese children.

The American Liver Foundation estimates that 10-20% of Americans have Fatty Liver Disease.

Acquired obesity primarily relates to increases in lysophosphatidylcholines

Wed, 14 Feb 2007 10:15:11 PST

( from http://www.rxpgnews.com ) Obesity and its many related health hazards have become a serious and growing problem worldwide. While environmental and lifestyle factors play a key role in the development of obesity, genetic variation may determine an individual's susceptibility to weight gain and to the rise of obesity-related health risks. Obesity increases the risk of cardiovascular diseases and diabetes especially when the extra fat is accumulated to central and intra-abdominal depots and when obesity is accompanied by an atherogenic dyslipidemia.

A Finnish team from the Finnish Twin Cohort, Helsinki University Central Hospital, and VTT Technical Research Centre of Finland performed a metabolomic analysis of lipids in 14 monozygous twins highly discordant for obesity, and 10 control pairs concordant for weight. They found that acquired obesity, independent of genetic influences, primarily relates to increases in lysophosphatidylcholines, constituents of an atherogenic lipid profile and decreases in ether phospholipids, lipids with anti-oxidative properties.

The origin of obesity and related dyslipidemias is multifactorial, involving complex genetic and environmental networks. Not all obese individuals develop dyslipidemia and not all dyslipidemic patients are obese. Cross-sectional studies comparing lipid profiles in obese vs. non-obese humans do not permit unequivocal distinction between genetic versus environmental and life-style effects. This can best be done by studying monozygotic (MZ) twins discordant for obesity. MZ twins are genetically identical at the sequence level and any differences between the co-twins are thus attributable to environmental factors. The co-twin design controls for age, gender, childhood socioeconomic background and other environmental experiences and exposures.

Serum patterns of small molecules such as lipids reflect the homeostasis of the organism. However, classical measurements of lipids in the clinical setting are unable to detect early changes and abnormalities in specific metabolites. Recent advances have made broad screening of metabolites, i.e. metabolomics, feasible, therefore opening new possibilities for discoveries of sensitive biomarkers for different diseases.

The study convincingly demonstrates the sensitivity of the metabolomics platforms since subtle pathophysiological changes were detected well prior to changes in commonly utilized clinical measures. Of special interest and clinical relevance is the finding that the atherogenic lipid profile of the obese co-twins was associated with whole body insulin resistance, something that could not be detected using classical lipid measures only.

Obese children risk damaging feet structure

Fri, 24 Nov 2006 23:53:39 PST

( from http://www.rxpgnews.com ) London, Nov 24 - Obesity at childhood could damage the feet bones, leading to deformities, says a new study.

Each foot is made up of 26 bones, around 19 muscles, a large number of ligaments, tendons, blood vessels and nerves and is designed to absorb the shock of walking and running.

Excess weight and obesity can damage the delicate, immature nature of children's feet, leaving them at particular risk of deformities and abnormalities, said Stewart Morrison, a lecturer from the University of East London, who carried out the research found.

Researchers looked at 200 children from Glasgow aged nine to 12 years - 54 were obese and 15 were severely obese. Another 30 were overweight.

Obese children had feet that were up to 15 mm longer and seven mm wider than feet in normal weight children. In children with severe obesity, their feet were on average 18 mm longer and 15 mm wider, it said.

A second study of 44 nine-11 year olds, half of whom were obese, found that the obese children were unstable when they walked. They spent more time balancing on two feet when walking and less time on one foot than normal weight children. They also walked at a slower pace, it said.

'Obese children are less stable when walking and cannot walk efficiently,' Morrison said.

He added: 'The findings are interesting because previous research suggested that foot problems limit obese children's ability to take part in physical activity - so encouraging them to carry out exercise might not be the best thing.'

'This typifies the problems of obesity, showing it affects every part of the body,' Ian Campbell of the charity Weight Concern said.

Foot problems limiting the ability of obese children to exercise put them in a 'catch 22 situation' because they need to be more active, he said. 'This reinforces the need for prevention rather than cure, and for early intervention'.

Childrens Belly Fat Increases More Than 65 Percent

Tue, 07 Nov 2006 22:09:37 PST

( from http://www.rxpgnews.com ) Abdominal obesity increased more than 65 percent among boys and almost 70 percent among girls between 1988 and 2004. The finding of growing girth is significant because abdominal obesity has emerged as a better predictor of cardiovascular disease and type 2 diabetes risk than the more commonly used Body Mass Index, a weight to height ratio that can sometimes be misleading.

As the first nationally representative study to document the increase in childrens belly fat, the study in todays Pediatrics paints a bleak picture for these children who have a higher risk of heart disease, adult-onset diabetes and metabolic syndrome. The good news is that, for children and adolescents, the health effects are often reversible through improved lifestyle for weight loss.

Kids, teens and adults who have early stages of atherosclerosis in their arteries can have a healthy cardiovascular system again, said Stephen Cook, M.D., an assistant professor of Pediatrics at the University of Rochester Medical Centers Golisano Childrens Hospital at Strong and an author of the study about childhood abdominal obesity. Older adults who have plaque build up have a much harder battle, especially if the plaque has calcified.

Measuring waist circumference is not a vital sign normally taken in a visit to the doctor. A BMI is commonly calculated at a well visit, but there are limitations to those measurements. A very muscular person may register a high BMI score, even if he is very healthy and has an average waist circumference. On the flip side, a sedentary child may not register a very high BMI score, but if he carries a lot of fat around his middle, he may be at a higher risk for health problems than other children with the same BMI score.

Cook said there is no gold standard yet for how waist circumference should be measured and no consensus yet on the cut-off point for abdominal obesity. However, he added, the study should be a warning for physicians and parents to limit sedentary activities, such as TV and computer time, and to teach and model healthy eating and exercise behaviors; childhood obesity is a serious and growing problem perhaps even more than people already believe.

Although increases in Body Mass Index scores have raised concerns about U.S. childrens short- and long-term health, the increase in the percentage of abdominally obese in children appears to have increased even faster than overweight measured by BMI scores. According to data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004, the percentage of 6- to 11 year-old children with high BMI scores rose about 25 percent (15.1 percent in 1999-2000 to 18.8 percent in 2003-04). But the increase in abdominal obesity of the same group over the same period was even more dramatic, more than 35 percent (14.2 percent in 1999-2000 to 19.2 percent in 2003-04).

Those increases only grow more alarming as you tease out specific age groups over longer periods of time, Cook said. For example, between the 1988-1994 data and the 1999-2004 data, the largest relative increase in the prevalence of abdominal obesity occurred among 2- to 5-year old boys 84 percent and 18- to 19-year-old girls 126 percent.

Rising abdominal obesity among kids causes concern

Mon, 06 Nov 2006 16:43:37 PST

( from http://www.rxpgnews.com )

Abdominal obesity increased more than 65 percent among boys and almost 70 percent among girls between 1988 and 2004.

Abdominal obesity increased more than 65 percent among boys and almost 70 percent among girls between 1988 and 2004. The finding of growing girth is significant because abdominal obesity has emerged as a better predictor of cardiovascular disease and type 2 diabetes risk than the more commonly used Body Mass Index, a weight to height ratio that can sometimes be misleading.

As the first nationally representative study to document the increase in children's belly fat, the study in today's Pediatrics paints a bleak picture for these children who have a higher risk of heart disease, adult-onset diabetes and metabolic syndrome. The good news is that, for children and adolescents, the health effects are often reversible through improved lifestyle for weight loss.

"Kids, teens and adults who have early stages of atherosclerosis in their arteries can have a healthy cardiovascular system again," said Stephen Cook, M.D., an assistant professor of Pediatrics at the University of Rochester Medical Center's Golisano Children's Hospital at Strong and an author of the study about childhood abdominal obesity. "Older adults who have plaque build up have a much harder battle, especially if the plaque has calcified."

Measuring waist circumference is not a "vital sign" normally taken in a visit to the doctor. A BMI is commonly calculated at a well visit, but there are limitations to those measurements. A very muscular person may register a high BMI score, even if he is very healthy and has an average waist circumference. On the flip side, a sedentary child may not register a very high BMI score, but if he carries a lot of fat around his middle, he may be at a higher risk for health problems than other children with the same BMI score.

Cook said there is no gold standard yet for how waist circumference should be measured and no consensus yet on the cut-off point for abdominal obesity. However, he added, the study should be a warning for physicians and parents to limit sedentary activities, such as TV and computer time, and to teach and model healthy eating and exercise behaviors; childhood obesity is a serious and growing problem perhaps even more than people already believe.

Although increases in Body Mass Index scores have raised concerns about U.S. children's short- and long-term health, the increase in the percentage of abdominally obese in children appears to have increased even faster than overweight measured by BMI scores. According to data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004, the percentage of 6- to 11 year-old children with high BMI scores rose about 25 percent (15.1 percent in 1999-2000 to 18.8 percent in 2003-04). But the increase in abdominal obesity of the same group over the same period was even more dramatic, more than 35 percent (14.2 percent in 1999-2000 to 19.2 percent in 2003-04).

"Those increases only grow more alarming as you tease out specific age groups over longer periods of time," Cook said. "For example, between the 1988-1994 data and the 1999-2004 data, the largest relative increase in the prevalence of abdominal obesity occurred among 2- to 5-year old boys 84 percent and 18- to 19-year-old girls 126 percent."

Link between short sleep duration and obesity uncovered

Fri, 20 Oct 2006 22:50:37 PST

( from http://www.rxpgnews.com ) Soaring levels of obesity might be linked to children sleeping fewer hours at night than they used to, claims Dr Shahrad Taheri of the University of Bristol.

Dr Taheri, reporting in the Archives of Disease in Childhood, blames the increasing availability of computers, mobile phones, TVs and other such gadgets on the diminishing nightly quota of sleep, and suggests they should be banned from children's bedrooms.

Dr Taheri cites the emerging body of research on the impact on the body of a fall in the nightly quota of sleep, which reflects circumstances in real life, rather than sustained sleep deprivation, which tends to be more extreme.

This research shows that shorter sleep duration disturbs normal metabolism, which may contribute to obesity, insulin resistance, diabetes, and cardiovascular disease. Even two to three nights of shortened sleep can have profound effects, the laboratory data suggest.

One study indicated that insufficient sleep at the age of 30 months was associated with obesity at the age of seven, suggesting that this could programme the part of the brain regulating appetite and energy expenditure, says Dr Taheri.

But it is also a problem for teenagers in whom the need for sleep increases during this critical developmental period, he says.

Another piece of research shows that levels of leptin, a hormone produced by fat tissue when energy stores are low, were more than 15% lower in those sleeping five hours compared with those clocking up eight.

Similarly, ghrelin, a hormone released by the stomach to signal hunger was almost 15% higher in those with a five hour sleep quota.

Sleep loss also disturbs other hormones, including insulin, cortisol (stress hormone), and growth hormone, says Dr Taheri, who adds that hormonal changes could boost the desire for calorie rich foods.

And poor sleep sets up a vicious cycle. It leads to fatigue, which leads to reduced levels of physical activity, .which leads to lower energy expenditure, which leads to obesity, which itself leads to poor sleep, explains Taheri.

Dr Taheri acknowledges that the mechanisms behind obesity are likely to be complex. "Sleep is probably not the only answer to the obesity pandemic, but its effect should be taken seriously, as even small changes in energy balance are beneficial," he says. "Good sleep could be promoted by removal of gadget distractions from bedrooms and restricting their use," he suggests.

'Portion Distortion' may contribute to expanding waistlines

Sat, 02 Sep 2006 15:58:37 PST

( from http://www.rxpgnews.com ) New research shows that people's perceptions of normal portion sizes have changed in the past 20 years. A study out of Rutgers published in the September issue of the Journal of the American Dietetic Association reports that Portion Distortion may be the cause1. This phenomenon occurs when consumers perceive large portion sizes as appropriate amounts to eat at a single eating occasion.

"It has previously been established that portion sizes of virtually all foods and beverages served at restaurants and packaged for single-serve have dramatically increased over the last two decades," said Jaime Schwartz MS, RD, who was a graduate student at Rutgers at the time of this study. "Our study compared what people perceive to be a typical portion size now to what was perceived as typical two decades ago, before portions began to grow. We also compared current perceptions of typical portions to reference portion sizes, defined in this study as the serving size on the Nutrition Facts panel."

This study replicated one that was done 20 years ago in which participants were asked to serve themselves the amount they considered to be a typical portion of each meal item on a buffet table2. To follow this model, Schwartz and co-author, Carol Byrd-Bredbenner, PhD, RD, enrolled 177 young adults to participate. All were invited to attend one meal, selecting typical portions of a total of eight meal items at breakfast or six at lunch and dinner. Food and beverage choices mirrored the study of 20 years ago as to permit valid comparisons between typical portions over time.

Interestingly, most foods with drastically different portion sizes over the two decades were all served from and consumed from a cup or bowl. For example, typical portions of orange juice were more than 40 percent larger in the present day study than they were 20 years ago. In nutritional terms, this larger amount of orange juice provides 50 additional calories and could equal a five pound weight gain over the course of one year if consumed on a daily basis. Participants in the present study served themselves nearly 20 percent more cornflakes and poured almost 30 percent more milk on their cereal than participants 20 years ago.

On average, less than 45 percent of portions selected at the breakfast meal were within 25 percent of the reference portion size. For the lunch and dinner meals, around 30 percent of portions were within 25 percent of the reference portion size. This strongly suggests that the amount of food thought to be appropriate to eat at one sitting is different than what the Nutrition Facts panel indicates to be a single serving size. "With portions being distorted to this degree, it's no surprise that people's waistlines are expanding." Byrd-Bredbenner remarked.

The good news is that efforts to educate the public to limit certain foods that add excess calories may have been successful. For example, the typical portion size of salad dressing was significantly smaller in the current study than typical portions selected in the study done 20 years ago. The message that even nutritious foods (e.g., tossed salad) can become less healthy when calorically dense items (e.g., salad dressing) are used excessively, may have become well understood over the past two decades.

Although the causes of obesity are multifactorial, the incidence of obesity has increased over the past two decades in parallel with increasing portion sizes, and Portion Distortion may be a contributing factor. "Our society wants the 'bang for our buck' and when portions are served to us that we think are small we feel short-changed," commented Schwartz. "But we need to start 'undistorting' what we perceive to be a typical portion and begin to listen to our stomachs, not our eyes, to determine when to put the fork down."

Obese men are more likely to be infertile

Fri, 01 Sep 2006 18:07:37 PST

( from http://www.rxpgnews.com ) Men with increased body mass index (BMI) were significantly more likely to be infertile than normal-weight men, according to research conducted at the National Institute of Environmental Health Sciences (NIEHS), one of the National Institutes of Health.

"The data suggest that a 20-pound increase in men's weight may increase the chance of infertility by about 10 percent," says Markku Sallmen, lead author on the paper who is now at the Finnish Institute of Occupational Health. BMI is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.

The researchers studied couples enrolled in the Agricultural Health Study (AHS), a large project that began in 1993 examining factors that impact the health of farmers and their families in agricultural communities.

"Women who are overweight or obese tend to have a more difficult time becoming pregnant than normal-weight women, but whether men who are overweight or obese also have fertility problems had not been studied," says Donna Baird, Ph.D., an NIEHS epidemiologist with the study. The study is published in the September 2006 issue of Epidemiology.

The data on infertility and body mass came from questionnaires that 1,468 farmers and their wives completed when they enrolled in the study. The wives completed a family health questionnaire, which included information about the couple's reproductive history. The men reported their weight and height on a questionnaire about their health. The analysis was limited to couples with a pregnancy attempt during the four years before enrollment, and to women under the age of 40.

The researchers divided the couples into infertile and fertile groups. The infertile couples were those that tried for longer than a year to conceive, and the fertile couples were those that conceived within a year. The majority of men and women were more than 30 years old. Twenty-eight percent of the couples had experienced infertility.

Researchers found that men's BMI was an independent risk factor for infertility. The researchers adjusted for other factors that could affect fertility, including high BMI of the woman, age, cigarette smoking, alcohol intake, and solvent and pesticide exposure. After adjustment, there was a general increase in infertility with increased BMI, reaching a nearly 2-fold increase among obese men.

When researchers divided the sample into two equal groups by men's age, they found that men's BMI was a risk factor for infertility in both the older and younger men.

The researchers did not have data on frequency of sexual intercourse, so it is possible that overweight men have less sexual intercourse than their normal weight counterparts and this could influence fertility. However, there have been recent studies looking at semen characteristics that show lower semen quality for overweight and obese men, as well as hormonal differences.

"This study provides data on some additional health problems associated with obesity," said David A. Schwartz, M.D., director of the National Institute of Environmental Health Sciences. "Preventing obesity can help improve men's overall health, perhaps even their reproductive health."

The NIEHS unveiled a new strategic plan, "New Frontiers in Environmental Sciences and Human Health," in May aimed at challenging and energizing the scientific community to use environmental health sciences to understand the causes of disease and to improve human health. The plan can be accessed at http://www.niehs.nih.gov/external/plan2006.

Early-onset morbid obesity linked with low IQ scores

Fri, 01 Sep 2006 17:38:37 PST

( from http://www.rxpgnews.com ) University of Florida researchers have discovered a link between morbid obesity in toddlers and lower IQ scores, cognitive delays and brain lesions similar to those seen in Alzheimer's disease patients, a new study shows.

Although the cause of these cognitive impairments is still unknown, UF researchers suspect the metabolic disturbances obesity causes could be taking a toll on young brains, which are still developing and not fully protected, they write in an article published in the Journal of Pediatrics this month.

"It's well-known that obesity is associated with a number of other medical problems, such as diabetes, hypertension and elevated cholesterol," said Daniel J. Driscoll, M.D., Ph.D., a UF professor of pediatrics and molecular genetics and microbiology in the College of Medicine and the lead author of the study. "Now, we're postulating that early-onset morbid obesity and these metabolic, biochemical problems can also lead to cognitive impairment."

Researchers compared 18 children and adults with early-onset morbid obesity, which means they weighed at least 150 percent of their ideal body weight before they were 4, with 19 children and adults with Prader-Willi syndrome, and with 24 of their normal-weight siblings. Researchers chose lean siblings as a control group "because they share a socioeconomic group and genetic background," Driscoll said.

The links between cognitive impairments and Prader-Willi syndrome, a genetic disorder that causes people to eat nonstop and become morbidly obese at a very young age if not supervised, are well-established. But researchers were surprised to find that children and adults who had become obese as toddlers for no known genetic reason fared almost as poorly on IQ and achievement tests as Prader-Willi patients. Prader-Willi patients had an average IQ of 63 and patients with early-onset morbid obesity had an average of 78. The control group of siblings had an average IQ of 106, which falls within the range of what is considered normal intelligence.

"It was surprising to find that they had an average IQ score of 78, whereas their control siblings were 106," Driscoll said. "We feel this may be another complication of obesity that may not be reversible, so it's very important to watch what children eat even from a very young age. It's not just setting them up for problems later on, it could affect their learning potential now."

While performing head MRI scans of subjects, researchers also discovered white-matter lesions on the brains of many of the Prader-Willi and early-onset morbidly obese patients. White-matter lesions are typically found on the brains of adults who have developed Alzheimer's disease or in children with untreated phenylketonuria, the researchers wrote.

These lesions could be affecting food-seeking centers of the brain, causing the children to feel hungrier. But they are most likely a result of metabolic changes that damage the young, developing brain, Driscoll said.

More studies are needed to understand what is causing these cognitive impairments, said Merlin Butler, M.D., Ph.D., a professor of pediatrics at the University of Missouri and chief of genetics and molecular medicine at Children's Mercy Hospital and Clinics.

"This could be a really significant observation," Butler said. "It's an interesting concept. It's a whole new area of investigation."

The findings are preliminary and additional studies are planned, Driscoll said. Jennifer Miller, M.D., a UF assistant professor of pediatric endocrinology and the first author of the study, and other researchers from UF, All Children's Hospital in St. Petersburg, Fla., and Baylor College of Medicine also took part in the research.

Although there was no known genetic cause for early-onset morbid obesity in the subjects studied, Driscoll said there are likely genetic and hormonal factors at play that researchers have yet to discover, particularly since these children are becoming obese at a time when their parents still control what they eat. The researchers studied several sets of fraternal twins where one twin was lean and the other morbidly obese, yet their parents reported that each ate the same amount of food. In one case, the obese child actually ate less, Driscoll said.

Driscoll is also careful to point out that adults or children who become obese later in childhood are not at-risk for these cognitive impairments because their brains are sufficiently developed to fend off damage from obesity.

"We're all mindful that this is an obese society," he said. "We all need to be more careful with respect to what we eat, but in particular, that's very important for children under 4."

BMI is an unreliable indicator of obesity

Sat, 19 Aug 2006 17:33:37 PST

( from http://www.rxpgnews.com ) Body mass index (BMI) -- the commonly used measure of obesity - cannot reliably predict the outcome for patients with heart disease, concludes an Article in this week's issue of The Lancet. This is because BMI is an unreliable indicator of obesity, say the researchers.

Doctors already know that obesity is a risk factor for developing heart disease. However, how obesity affects people with established heart disease has been unclear because previous studies have had contradictory results.

To investigate, Francisco Lopez-Jimenez (Mayo Clinic College of Medicine, Rochester, MN, USA) and colleagues combined data from 40 studies involving about 250,000 people with heart disease; the average follow-up was four years. Most of the studies used BMI as a measure of obesity. (See Notes to editors) The investigators found that patients with a low BMI had a higher risk of death than those with a normal BMI. Overweight patients had better survival and fewer heart problems than those with a normal BMI. Obese people who had had bypass surgery had a higher death rate when compared with people with a normal BMI, while severely obese people had a higher risk of a heart-related death but not death from other causes.

The better outcomes for overweight people may be because they have more muscle than normal weight people, state the authors. The results therefore demonstrate the inability of BMI to discriminate between body fat and lean muscle, they conclude.

"Rather than proving that obesity is harmless, our data suggest that alternative methods might be needed to better characterise individuals who truly have excess body fat, compared with those in whom BMI is raised because of preserved muscle mass," explains Dr Lopez-Jimenez.

In an accompanying Comment Maria Grazia Franzosi (Istituto Mario Negri, Milan, Italy) states: "BMI can definitely be left aside as a clinical and epidemiological measure of cardiovascular riskUncertainty about the best index of obesity should not translate into uncertainty about the need for a prevention policy against excess bodyweight, which must be strongly supported."

Exercise important in reducing size of abdominal fat cells

Tue, 08 Aug 2006 04:30:37 PST

( from http://www.rxpgnews.com ) Reducing the size of abdominal fat cells which are a risk factor for diabetes and heart disease takes more than cutting calories, according to new research from Wake Forest University Baptist Medical Center. Early results from a five-year study show that exercise should be added to the equation.

"The message is very clear," said Tongjian You, Ph.D., instructor in geriatric medicine at Wake Forest Baptist and lead author. "Exercise is important to reducing the size of these cells, and may one day be part of a prescription for treating the health complications associated with abdominal fat."

The study is reported in the August issue of the International Journal of Obesity. The results from 45 obese, middle-age women with excess abdominal fat are part of an ongoing study of up to 125 women. The goal is to determine what lifestyle changes are needed to reduce the size of abdominal fat cells.

It is well known that overall obesity is a risk factor for diabetes and heart disease. Not all obese people develop these diseases, of course. Obese people who have more abdominal fat (an apple shape) are at a higher risk than people who store excess fat in their hips and thighs (a pear shape).

Abdominal fat is associated with metabolic syndrome, a cluster of symptoms that increases the risk for heart disease and diabetes. The syndrome is diagnosed when someone has at least three of the following: abdominal obesity, high triglycerides, low levels of high-density liprorotein ("good") cholesterol, high blood pressure and increased levels of sugar in the blood.

The current research studied a lesser-known risk factor for the syndrome the size of fat cells just under the surface of the skin, known as subcutaneous fat.

"The size of these fat cells predicts type 2 diabetes, independent of whether the patient is obese," said You.

Earlier studies had shown that exercise can reduce fat cell size, but it is not known if the intensity of exercise matters during dietary weight loss. For the current study, all women had a deficit of 2,800 calories a week, either through dieting or a combination of dieting and exercise.

One group cut their calorie levels through diet, but did not exercise. A second group walked at about 1 to 2 miles per hour on a treadmill for 50 minutes three times a week. A third group also walked three times a week, but at 3.5 to 4 miles per hour for 30 minutes. Both exercise groups burned 400 calories each week through walking.

The women were provided food for their lunch and supper, which was selected by a registered dietician. Body size and weight, as well as total fat and abdominal fat cell size were measured both before and after the 20-week study period. The results showed that all groups lowered their fat mass, body weight (by 19 to 23 pounds), percent fat, and waist and hip girths (by 3 to 4 inches in hips and 4 inches in waists) to a similar degree.

The diet-alone group had no changes in abdominal fat cell size. However, both exercise groups had decreases of about 18 percent in the size of their abdominal fat cells.

"It is important to complete our larger study to see if these results hold true," said You. "But, these early findings do point to the importance of exercise in treating the complications of abdominal fat."

You said it's possible that because of the small size of the study, women in the diet-alone group did have small reductions in fat cell size that weren't detected. "However, considering the important role of abdominal fat cell size in predicting diabetes and heart disease, our study does indicate that addition of exercise to dietary weight loss is more beneficial than weight loss alone," he said.

High BMI doesn't always spell obesity

Sat, 22 Jul 2006 19:25:37 PST

( from http://www.rxpgnews.com ) For years doctors have used the body mass index (BMI), a ratio of height and weight, to characterize the clinical weight status of their patients. The lower the number, the presumption goes, the leaner the person, and anyone with a BMI above 30 is characterized as obese and at high risk for the associated complications.

But the BMI has come under scrutiny lately, and other techniques that measure how the weight is distributed on the body are thought to provide a better way to assess risk. Now a study in mice by scientists at The Jackson Laboratory indicates that the usefulness of the BMI is suspect even at the genetic level.

In research published in PLoS Genetics, the investigators from Jackson and the J.L. Pettis VA Medical Center and led by Dr. Gary Churchill of Jackson used a combination of computational, molecular and genetic tools to identify locations on the mouse genome that influence adiposity (amount of body fat), overall body size and bone structure. Applying an analytical technique called "structural equation modeling" to the genetic and physical characteristics of mouse inbred crosses, the scientists went beyond the one-gene, one-trait approach to reveal the networks of effects created by the influence of multiple genes.

"We found that the genetic network affecting adiposity is separate from that affecting overall body size," Churchill says, "providing strong evidence that a high weight is not necessarily directly associated with a high percentage of fat."

At the clinical level, the research suggests that more refined measurements are needed to distinguish individuals with a large body mass from those who are truly obese and consequently at high risk for diabetes, heart disease and other disorders.

Churchill and colleagues at Jackson recently received a 5-year, $15.1 million National Institute of General Medical Sciences grant to form an interdisciplinary Center for Genome Dynamics to study complex biomedical problems. "The most common diseases and health disorders, including obesity as well as heart disease, diabetes and cancer, result from an interaction of multiple genes and environmental factors that add up to a dauntingly complex mix of variables," Churchill says. "We're working to unravel those factors to lay the groundwork for improved treatments."

Health Risks in Obesity are Underestimated

Wed, 05 Jul 2006 19:03:37 PST

( from http://www.rxpgnews.com ) The health risks for women who are extremely obese may be underestimated as a new study indicates they have a higher prevalence of hypertension, diabetes, and high cholesterol than women at lower levels of obesity, according to a study in the July 5 issue of JAMA.

Obesity diagnosis and treatment are typically based on body mass index (BMI) of at least 30. BMI is calculated as weight in kilograms divided by height in meters squared. However, three categories of obesity are defined: obesity 1 (30-34.9); obesity 2 (35-39.9); and extreme obesity (40 and greater). (A 54 person would have a BMI of 40 if they weighed 233 lbs). The latter 2 categories, sometimes termed severe obesity, are reported to be increasing especially rapidly in the United States, according to background information in the article. From 1986 to 2000, prevalence of BMI of 30 or higher approximately doubled, while that of BMI of 40 or higher quadrupled and that of BMI of 50 or higher increased 5-fold. In 2000, 2.8 percent of all U.S. women, and 6 percent of black women reported measurements consistent with extreme obesity. Estimates of obesity-related risks in women have generally been based on weight data that preceded the increase in extreme obesity. It has been unclear whether health risk increases or plateaus as body weight increases throughout the obese range.

Kathleen McTigue, M.D., M.S., M.P.H., of the University of Pittsburgh, and colleagues conducted a study to examine the relationship between weight category and risk of death and coronary heart disease (CHD) in a large population-based sample of U.S. women, focusing on risk across degree of obesity. The researchers analyzed data on incident death and cardiovascular outcomes by weight status in 90,185 women recruited from 40 U.S. centers for the Womens Health Initiative-Observational Study who were followed-up for an average of 7.0 years (Oct. 1993 to Aug. 2004).

The researchers found that extreme obesity prevalence differed with race/ethnicity, from 1 percent among Asian and Pacific Islanders to 10 percent among black women. In this diverse population-based sample of older women, we found that obesity was linked with considerable health risk and that accounting for degree of excess weight is important in understanding weight-related health risk. Overall, extremely obese women were more likely to die over the average 7.0 years of follow-up than were women in other examined weight categories. Modeling analyses adjusted for age, smoking status, educational achievement, U.S. region, and physical activity level showed that weight-related risk for all-cause mortality, CHD mortality, and CHD incidence did not differ by race/ethnicity.

There was a positive trend in all-cause mortality risk and CHD incidence with increasing weight category. This trend had borderline significance for CHD mortality among black women, likely reflecting sample size limitations. Much of the obesity-related mortality and CHD risk was mediated by diabetes, hypertension, and hyperlipidemia [high cholesterol levels]. In white women, as other studies have found, weight-related all-cause mortality risk was modified by age, with obesity conferring less risk among older women. Smoking may modify weight-related risk in black women, but further study is needed to understand the nature of this relationship, the authors write.

Our findings have important clinical and policy implications. The escalating prevalence of extreme obesity may exacerbate the health effects and health-related expenditures resulting from the U.S. obesity epidemic. Calculating the weight-related risks of morbidity and mortality based on findings in earlier population samples, which tended to reflect lower degrees of obesity, may underestimate the risks for extremely obese individuals and overestimate the risks for mildly obese individuals in diverse groups, the researchers write. More accurately assessing weight-related health risk may both improve policy decisions about obesity and assist women in making informed decisions about their health.

Significant link between obesity and depression

Wed, 05 Jul 2006 18:59:37 PST

( from http://www.rxpgnews.com ) There is a strong link between obesity and mood and anxiety disorders, especially among Caucasian Americans and those with more education and higher income, according to an analysis conducted by researchers from Group Health Center for Health Studies.

The study, published in the July issue of the Archives of General Psychiatry, found that an obese person is about 25 percent more likely than a non-obese person to have a mood or anxiety disorder, such as depression. It also indicated that among Caucasian Americans and more educated people who are obese, that likelihood may be as high as 44 percent.

While the study did not show whether obesity leads to depression or vice versa, its almost certain that the association works in both directions, said Greg Simon, MD, MPH, a Group Health psychiatrist and the lead author of the study.

The researchers also found a negative association between obesity and substance abuse. That is, an obese person is 25 percent less likely than a non-obese person to have had a substance abuse disorder sometime in their lives.

Understanding the connection between obesity and depression is an important public health issue because both of these conditions are so common and have a significant impact on our health care systems, Dr. Simon explained.

He pointed to the evidence that an average American has a 30 percent chance of being obese. This study shows that when a person is depressed, the odds of also becoming obese are as high as 40 percent.

About 20 percent of Americans are diagnosed sometime in their lives with depression. Among those who are obese, that likelihood of depression jumps to 28 percent, said Dr. Simon.

The study is based on an in-person survey that the researchers from Harvard Medical School conducted among a nationally representative sample of 9,125 adult men and women. Obesity is defined in the study as having a body mass index (BMI) of 30 or more.

While previous studies have shown a connection between obesity and depression, this is the largest and most representative study of the two problems in U.S. population. Also, this study included a much more careful assessment of mental health problems than earlier research, according to Dr. Simon.

Unlike many previous studies that show a link between obesity and depression among women only, this study revealed a strong link in both genders. There were significant differences among social and cultural groups. In groups where obesity is more commonthat is, among non-white and less educated groupsthere is less depression among the people who are obese. But in groups where there is less obesity, it is accompanied by more depression.

This may indicate that stigma accounts for some of the relationship between obesity and depression, said Dr. Simon. Perhaps in groups where obesity is less socially normative, its less acceptable and thats why theres a greater association with depression, he suggested. But in groups where it is less stigmatized, obesity doesnt seem to be as depressing.

Strong Heart study (SHS): Bigger, heavier hearts portend heart disease risk even before adulthood

Sat, 03 Jun 2006 08:59:37 PST

( from http://www.rxpgnews.com ) The effects of excess weight on heart health can be seen even in adolescents, with abnormal enlargement and impaired pumping function evident in subjects by age 20, according to a new study in the June 6, 2006, issue of the Journal of the American College of Cardiology.

"Heart damage starts very early in the natural history of obesity. We need to work on our young people, to prevent catastrophic effects later on," said Giovanni de Simone, M.D., F.A.C.C. from the New York Presbyterian Hospital-Weill Medical College of Cornell University in New York, New York and the Federico II University Hospital School of Medicine in Naples, Italy.

The Strong Heart study (SHS) is a longitudinal study of cardiovascular risk factors and cardiovascular disease that enrolled 4,549 people in American Indian communities in Arizona, Oklahoma, and North and South Dakota. This analysis included data from examinations of 460 participants age 14 to 20 years (245 girls and 215 boys). The researchers used ultrasound and other methods to measure the size, shape and pumping function of the teenagers' hearts.

The left ventricles of the hearts of both overweight and obese teenagers were larger and heavier than those of normal weight participants; but the obese teenagers also showed signs of impaired heart function. The changes were not entirely explained by changes by high blood pressure.

"Our findings demonstrate that, even among adolescents at a mean age under 18, severity of abnormality in body build also parallels early cardiac changes, including high prevalence of left ventricular hypertrophy and increased hemodynamic load, paralleling previous findings and suggesting that increased left ventricular mass occurs to sustain the increased cardiac workload," the study authors wrote.

"The main findings are that, when obesity is present, something happens in our hearts to increase its size and wall thickness, which cannot be understood by measurement of blood pressure. This excess of cardiac mass, which we call 'inappropriate' in connection to cardiac workload, is also associated with a general impairment of the function of the heart to push blood into the arterial tree and also to distend its cavity to receive the blood returning from the periphery," Dr. de Simone said.

He said that these results underscore the need to fight excess weight in children, since the damaging effects are evident even before adulthood.

Although the participants in this study were all members of American Indian communities, Dr. de Simone said that he believes similar effects would be seen in overweight and obese children from other communities.

"The analysis was performed in an American Indian population and whether these results can be generalized to other ethnic groups needs to be demonstrated. However, similar analyses previously performed in other ethnic groups, such as Caucasians and African Americans, have suggested similar association between left ventricular mass and adiposity, independently of other cardiovascular risk factors," the authors wrote.

In an editorial in the journal, Stephan von Haehling, M.D., Wolfram Doehner, M.D., Ph.D., and Stefan D. Anker, M.D., Ph.D. from the Imperial College School of Medicine in London, United Kingdom and the Charité Medical School and Campus Virchow-Klinikum in Berlin, Germany wrote that the results from this study are in line with those from other studies that have documented that overweight and obese children and adolescents tend to have enlarged hearts and that enlarged hearts are a sign of increased risk of chronic heart failure.

"But patients with chronic heart failure, who have a poor prognosis per se, appear to benefit from being overweight. The most intriguing question in this respect is to define a time point after which obesity does not pose as a risk factor anymore," the editorial authors wrote.

"For young people with presence of established risk factors for future cardiovascular illness (like hypertension, hyperlipidemia or diabetes), it seems very likely that obesity confers a somewhat higher risk for death compared with such people with normal weight. Whether the same is true for older people is not known. We hypothesize that obesity carries no adverse mortality impact above the age of 60 years--possibly even from age 55 to 50 years. This remains to be tested," they added.

Robert J Bryg, M.D. from the University of Nevada School of Medicine, who was not connected to this study, said it demonstrates that there are significant cardiac consequences of childhood obesity.

"The increased left ventricular mass and left ventricular hypertrophy would suggest that long term consequences will occur in this cohort. Even though this is a population of Native Americans, I still believe that it is generalizable to the overall US population. This suggests that the epidemic of obesity in the US will have long term consequences on heart disease in this country," Dr. Bryg said.

Commercial diets are a useful way to lose weight

Fri, 02 Jun 2006 23:01:37 PST

( from http://www.rxpgnews.com ) Commercial diets are a useful way to lose weight. And those based on group support seem to fare better at keeping the weight off in the long term, finds a study in this weeks BMJ.

Researchers compared the effectiveness of four popular commercial weight loss programmes with a control group. The study was sponsored by the BBC as part of its reality TV series, BBC Diet Trials.

The diets were the Slim-Fast Plan (a meal replacement approach), Weight Watchers pure points programme (an energy controlled diet with weekly group meetings), Dr Atkins new diet revolution (a self-monitored low carbohydrate eating plan), and Rosemary Conleys eat yourself slim diet and fitness plan (a low fat diet and weekly exercise class). The control group was asked to maintain their current diet and exercise pattern.

Weight and body fat changes were monitored over six months and dieting behaviour was checked again at 12 months.

After six months, all diets resulted in significant loss of body fat and weight compared to the control group. Average weight loss was 5.9 kg and average fat loss was 4.4. kg (5-10% of body weight). The Atkins diet resulted in significantly higher weight loss during the first four weeks, but by the end, was no more or less effective than the other diets.

There were no significant differences in cardiac risk factors between the diet groups and the control group. The Atkins diet did not lead to substantial increases in cholesterol levels.

At 12 months, 158 participants (54% of the original sample) returned data. Only 58 (45%) were still keeping to their allocated diets (nine to Atkins, 20 to Weight Watchers, nine to Slim-Fast, 20 to Rosemary Conley). More participants in the unsupported programmes (Atkins diet and Slim-Fast) withdrew from the study than in the supported group based programmes, and weight rebound after the initial six months was higher in the unsupported programmes.

The authors conclude that clinically useful weight loss and fat loss can be achieved in adults who are motivated to follow commercial diets for a substantial period. People need to find a diet that best suits them.

Our study provides data on how much weight patients can expect to lose by dieting, they write. These data could help practitioners in managing patients expectations of weight loss targets.

An accompanying editorial suggests that the challenge to researchers is to take weight loss studies to the next level by evaluating long term health outcomes, cost effectiveness, and novel strategies of improving adherence and weight maintenance.

New study shows some people just cant resist food

Fri, 02 Jun 2006 22:50:37 PST

( from http://www.rxpgnews.com ) Scientists have discovered why some peoples brains are particularly vulnerable to food advertising and product packaging, putting them at risk of overeating and becoming overweight. The research provides fresh insight into one of the neurobiological factors underlying obesity by showing how some people are more attracted to the prospect of being rewarded with tasty food than others. The findings from a group of scientists at the Medical Research Councils Cognition and Brain Sciences Unit in Cambridge led by Andy Calder and Andrew Lawrence are published in the Journal of Neuroscience.

Different people have higher or lower reward sensitivity, a personality trait that reflects a general desire to pursue rewarding or pleasurable experiences. The research shows that individuals with higher reward sensitivity, show increased activity in the parts of the brain implicated in motivation or reward when simply looking at pictures of appetizing food.

Previous research has shown that people with high reward sensitivity have stronger food cravings and are more likely to be overweight, but until now, the biological basis of this effect was unknown. This new research identifies how this relationship operates in the human brain, resulting in greater susceptibility to food advertising.

The study used the latest technology in brain imaging. The researchers showed people pictures of highly appetizing foods (e.g. chocolate cakes), bland foods (e.g. broccoli), and disgusting foods (e.g. rotten meat) while measuring brain activity using an fMRI scanner. After testing, the study participants completed a questionnaire that assessed their general desire to pursue rewarding items or goals. The results showed that the participants scores on the reward sensitivity questionnaire predicted the extent to which the appetizing food images activated their brains reward network.

Previous studies in this area have assumed that brain activation patterns are similar in all healthy individuals. But the new findings demonstrate that even in healthy individuals some peoples brain reward centers are more sensitive to appetizing food cues. This helps explain why some individuals are more vulnerable to developing certain disorders like binge-eating, said Dr John Beaver, lead author of the study.

This is particularly pertinent in understanding the rapidly increasing prevalence of obesity, as people are constantly bombarded with images of appetizing food items in order to promote food intake through television advertising, vending machines, or product packaging.

According to Dr Beaver the findings may also have broader implications for understanding vulnerability to multiple forms of addiction and compulsive behaviors.

Research demonstrates that an individuals reward sensitivity may also relate to their vulnerability to substance abuse, and the brain network we have identified is hyper-responsive to drug cues in addicts, he said.

Development of adiposity in adolescence in Britain

Wed, 10 May 2006 02:46:37 PST

( from http://www.rxpgnews.com ) The idea that puppy fat in children disappears as they progress to adolescence is a myth which may put the future health of children at risk, says a paper published on bmj.com.

And girls from some ethnic minorities and lower socioeconomic groups are more likely to be overweight or obese, putting them at even more danger of long-term health problems, say the authors.

Previous studies have shown that adolescence is a key time, since excess weight during teenage years pre-disposes adults to continued weight problems - with all the associated health risks.

But todays study, tracking 5863 children as they developed into young adults, shows that the problems are established before teenage years - since those with excess weight by the age of 11 continued with it during adolescence.

Researchers looked at annual measurements of weight, height, Body Mass Index (BMI) and waist circumferences of children aged between 11/12 and 16/17 throughout 36 schools across South London, giving them a broad ethnic and social mix.

They found that overall, girls had higher rates of excess weight problems than boys. Black girls had particularly high levels, with an average of 38% being overweight or obese over the study period, compared to 28% for white girls or 20% for Asian girls.

For boys, however, ethnicity made little difference to excess weight levels.

The findings were less clear cut for economic status. 35% of the most deprived girls were overweight or obese compared with 28% of other girls, but other economic categories showed less consistency.

Children who are obese when they enter secondary school will very likely leave it obese, say the authors. More monitoring is crucial if rising tides of obesity are to be tackled effectively, they conclude.

Obesity may increase diabetes risk

Sat, 22 Apr 2006 17:47:37 PST

( from http://www.rxpgnews.com ) People who are obese may be at increasing risk of getting diabetes, says a study that reiterates the belief that a change in lifestyle could help.

Linda S. Geiss from US' Center for Disease Control and Prevention and other researchers analysed data collected every year from a national sample of 31,000 Americans, reported the online edition health magazine WebMD.

In addition to detailed health and demographic data, they also asked each person if he or she had ever been told by a health professional that they have diabetes.

The researchers found that people with diabetes overwhelmingly tend to have one thing in common: being obese or overweight.

From 1997 to 2003, there was a 41 percent increase in the incidence of diagnosed diabetes. In 2003, two out of every 1,000 normal weight people had diabetes.

In the same year, diabetes struck 18.3 out of every 1,000 obese people, and 5.5 out of every 1,000 overweight people, the researchers said.

Obesity is by far the best predictor of being newly diagnosed with diabetes. But it's not the only one.

"Age, race, and educational level all are associated with diabetes," Geiss says. There's not much you can do about your race or your age. There is a lot you can do about your weight-related diabetes risk.

"Diabetes can be prevented among people at high risk." It will take some minor but admittedly difficult lifestyle changes: becoming active, and losing a little bit of weight.

Study finds crucial link between obesity, heart disease

Tue, 18 Apr 2006 07:12:37 PST

( from http://www.rxpgnews.com ) Fat cells around coronary arteries release chemicals that could trigger inflammation leading to deterioration of the vessels, says a new study that may provide the crucial link between obesity and heart disease.

The study by researchers at University of Iowa found that fat cells lying close to blood vessels in the heart are highly active, releasing many chemicals that influence biological processes within the body, reported the online edition of BBC News.

Fat cells or adipocytes, were once thought to do nothing other than simply store excess fat tissue.

Most large blood vessels in the body are enveloped in a layer of fat cells. The researchers suspect that the chemicals pumped out by the fat cells surrounding the coronary arteries might play a role in triggering heart disease by contributing to the deterioration of these vessels.

Lead researcher Lynn Stoll said: "The fat cells surrounding coronary arteries may ultimately prove to be an important link between obesity, type two diabetes, and coronary artery disease, all of which are increasing at epidemic rates."

The findings were presented to the Experimental Biology 2006 conference in San Francisco.

"It has been recognised for several years that fat cells stored up around the body secrete hormones that affect blood vessel function, but this is the first time that researchers have paid careful attention to fat cells lying close to blood vessels in the heart," said Jeremy Pearson, associate medical director of the British Heart Foundation.

INSIG2 - Genetic component in obesity identified

Fri, 14 Apr 2006 22:33:37 PST

( from http://www.rxpgnews.com ) US scientists have identified a genetic change in a region of the DNA related to fat production, which they say could help in new treatments for obesity.

More than one-third of people in the US are obese and the population of other countries are increasingly facing similar weight issues.

Albert Herbert and fellow researchers at the Boston University Medical School identified a small genetic change in a region of DNA near a gene known as INSIG2 as being linked to obesity, reported the online edition of New Scientist.

The DNA code is made up of four bases, or "letters". A single change in this particular region, from a G to a C, makes a person more prone to obesity, the study says.

The researchers looked at almost 87,000 points in the human genome which show variation between individuals, and related this to the body mass index (BMI) of over 900 people.

The team found one particular genetic variation near the INSIG2 gene. This change somehow affects the regulation of the gene INSIG2, which they say has a role in fat production.

In follow-up studies involving about 9,000 individuals in total, they also found the same association.

The researchers said that an individual with two copies of the C variant is 22 percent more likely to have a BMI greater than 30 - the point where people move from being "overweight" to "obese".

They hope that their discovery will open doors to new treatments for the condition.

Selective photothermolysis - US scientists on path towards 'fat seeking' laser

Tue, 11 Apr 2006 14:13:37 PST

( from http://www.rxpgnews.com ) Scientists in the US have developed a laser that can melt pig fat and possibly be used to treat heart disease, cellulite and acne in humans in the future.

Professor Rox Anderson and other researchers at the Massachusetts General Hospital used pig fat and skin samples about two inches thick in their experiment and found that a laser is, for the first time, able to heat up fat in the body without harming the overlying skin, reported the online edition of BBC News.

Using the Free-Electron Laser at selected wavelengths, they were able to heat the fat up, which was then broken down and excreted by the body, it said.

Selective photothermolysis - heating tissues with light - could have medical applications in the future, including for treating acne, Anderson said.

The root cause of acne is the lipid-rich sebaceous gland, which sits a few millimetres below the surface of the skin.

"We want to be able to selectively target the sebaceous gland and this research shows that, if we can build lasers at this region of the spectrum, we may be able to do that, Anderson said.

Cellulite and body fat could also be targeted as well as the fatty plaques that form in arteries, leading to heart attacks, he said.

"We can envision a fat-seeking laser, and we're heading down that path now," he added.

However, researchers said it would be several years before the technique could be tested on humans.

Excess Television May Lead To Extra Weight For Preschoolers

Wed, 05 Apr 2006 19:22:37 PST

( from http://www.rxpgnews.com ) In a national study of more than one thousand preschool-age children, those who were exposed to more than two hours of television per day were more likely to be overweight at ages 36 and 54 months than those who were exposed to less than two hours of television per day, according to a study in the April issue of the Archives of Pediatrics & Adolescent Medicine, a theme issue on children and the media.

The American Academy of Pediatrics recommends that children aged 2 years and older be limited to less than two hours of total media time per day, according to background information in the article. Studies have linked excessive television viewing to a variety of problems, including risk of being overweight. However, most research has focused on school-aged rather than preschool-aged children.

Julie C. Lumeng, M.D., University of Michigan, Ann Arbor, and colleagues studied 1,016 children from 10 urban and rural areas of the United States. The families were recruited shortly after the birth of a child in 1991. Mothers reported how many hours the children were exposed to television-defined as "being awake in the room when the television is on"-on two specific weekdays and two specific weekend days when their children were aged 36 months. Researchers recorded the children's height and weight during visits at age 36 and 54 months, and calculated body mass index (BMI) by dividing weight in kilograms by the square of height in meters. If a child had a BMI that was greater than or equal to the 95th percentile for children of their age and sex, he or she was considered overweight.

Fewer than one-third (31.7 percent, 322 children) were exposed to less than two hours of television per day, while 694 (68.3 percent) were exposed to more than two hours. About 5.5 percent of the children were overweight at the beginning of the study, 5.8 percent at age 36 months and 10 percent at age 54 months. Children exposed to more than two hours of television per day were more likely than those exposed to less than two hours to be overweight at age 36 months and age 54 months. The association between excessive television viewing and weight at age 36 months remained when the researchers considered other factors, including the mother's age, educational level and marital status.

Television exposure could contribute to increased weight in many ways, including through the advertising of unhealthy foods or the tendency of children to snack while watching TV, the authors suggest. Television's effect appears powerful even when children aren't giving it their full attention. "Our findings suggest that exposing children to TV even as 'background noise' while they engage in other activities may increase overweight risk," they conclude. "It may be equally relevant in clinical practice to ask parents how often the child is in the presence of a TV that is 'on' as it is to ask how much time the child spends 'watching TV'."

Prevalence Of Overweight Children, Teens And Men In U.S. Continues To Rise

Wed, 05 Apr 2006 19:00:37 PST

( from http://www.rxpgnews.com ) The prevalence of overweight and obesity among children and adolescents and obesity among men increased significantly between 1999 and 2004, according to a study in the April 5 issue of JAMA.

Obesity continues to be a leading public health concern in the United States. Between 1980 and 2002, obesity prevalence doubled in adults aged 20 years or older and overweight prevalence tripled in children and adolescents aged 6 to 19 years, according to background information in the article.

Cynthia L. Ogden, Ph.D., of the Centers for Disease Control and Prevention, Hyattsville, Md., and colleagues examined data on national measurements of weight and height in 2003-2004 and compared these data with estimates from 1999-2000 and 2001-2002 to determine if the overweight trend is continuing. The data consisted of weight and height measurements from 3,958 children and adolescents aged 2 to 19 years and 4,431 adults aged 20 years or older obtained in 2003-2004 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the U.S. population. Overweight among children and adolescents was defined as at or above the 95th percentile of the sex-specific body mass index (BMI) for age growth charts based on data collected between 1963 and 1994. Body mass index is calculated as weight in kilograms divided by the square of height in meters. Obesity among adults was defined as a BMI of 30 or higher; extreme obesity was defined as a BMI of 40 or higher.

The researchers found that 17.1 percent of children and adolescents aged 2 to 19 years were overweight and 32.2 percent of adults aged 20 years or older were obese in 2003-2004. The prevalence of extreme obesity among adults was 4.8 percent. There was a significant increase in the prevalence of overweight in female children and adolescents from 13.8 percent in 1999-2000 to 16 percent in 2003-2004. There was also an increase in the prevalence of overweight in male children and adolescents from 14.0 percent to 18.2 percent.

Among men, the prevalence of obesity increased significantly between 1999-2000 (27.5 percent) and 2003-2004 (31.1 percent). Among women, no significant increase in obesity was observed between 1999-2000 (33.4 percent) and 2003-2004 (33.2 percent). The prevalence of extreme obesity in 2003-2004 was 2.8 percent in men and 6.9 percent in women.

In 2003-2004, significant differences in obesity prevalence remained by race/ethnicity and by age. Approximately 30 percent of non-Hispanic white adults were obese as were 45 percent of non-Hispanic black adults and 36.8 percent of Mexican Americans. Among adults aged 20 to 39 years, 28.5 percent were obese while 36.8 percent of adults aged 40 to 59 years and 31.0 percent of those aged 60 years or older were obese in 2003-2004.

There is little indication that the prevalence is decreasing in any subgroup of the population. These prevalence estimates, based on a 6-year period (1999-2004), suggest that the increases in body weight may be leveling off in women, the authors write.

Adolescent Dieting May Predict Obesity and Eating Disorders

Wed, 05 Apr 2006 13:44:37 PST

( from http://www.rxpgnews.com ) Dieting and "unhealthful weight-control behaviors" among adolescents can predict the development of eating disorders in years to come, according to researchers at the University of Minnesota.

In a follow-up to a 1999 study of more than 2,500 junior high and high school students, the researchers found that students who engaged in unhealthy weight-control behaviors such as dieting and binge eating were three times more likely five years later to be overweight than adolescents who did not engage in those behaviors. They were also at significantly increased risk for binge eating with loss of control as well as extreme weight-control behaviors such as self-induced vomiting and the use of diet pills, laxatives and diuretics.

"Findings from this study suggest that dieting, and particularly unhealthful weight control, is either causing weight gain, disordered eating or eating disorders; serving as an early marker for the development of these later problems or is associated with some other unknown variable that is leading to these problems," the researchers write. They add that "unknown variables" may include personality characteristics or genetic factors.

"None of the behaviors being used by adolescents (in 1999) for weight-control purposes predicted weight loss," the researchers write.

"Of greater concern were the negative outcomes associated with dieting and the use of unhealthful weight-control behaviors, including significant weight gain. These findings demonstrate that these behaviors should not be viewed as innocuous and should be addressed in primary and secondary prevention efforts."

Lipin is a key fat-regulating enzyme

Tue, 21 Mar 2006 02:34:37 PST

( from http://www.rxpgnews.com ) Rutgers researchers have identified a gene and the molecular function of its protein product that provides an important clue to further understanding obesity and may point the way to new drugs to control fat metabolism.

The scientists found that the human protein known as lipin is a key fat-regulating enzyme. "Lipin activity may be an important pharmaceutical target for the control of body fat in humans, treating conditions that range from obesity to the loss of fat beneath the skin, as seen in HIV patients, " said George M. Carman, a professor in Rutgers' department of food science.

In a paper published online by the Journal of Biological Chemistry (print version, April 7), Carman and his research team at Rutgers' Cook College describe their scientific detective work, moving from clue to clue in a series of logical connections to reach their discoveries.

Previous studies with mice showed that a lack of lipin causes a loss of body fat, whereas an excess of lipin promotes extra body fat. So researchers knew that lipin was involved in fat metabolism; they just didn't know how.

The Carman team's first revelation came with the discovery that lipin is an enzyme (phosphatidic acid phosphatase or PAP), a protein catalyst that is required for the formation of fats triglycerides, specifically.

The breakthrough for Carman's group grew out of work with ordinary baker's yeast; a simple single cell organism. "We isolated the PAP enzyme from yeast that corresponds in form to lipin in mammals and showed that yeast cells lacking the enzyme exhibited a 90 percent reduction in the yeast's version of fat loss," Carman said.

The group worked out the sequence of the amino acids that make up the PAP enzyme, allowing them to backtrack along the path to its origin the gene that coded it linking the enzyme to the yeast gene PAH1 that made it. Carman and his group went on to confirm the link by introducing the yeast gene into bacteria, with similar results.

The researchers showed that the enzyme encoded by the PAH1 gene looks and acts very much like the lipin found in mammals. The yeast PAP enzyme shares a high resemblance to the lipin protein in mammals so they logically deduced the link between PAP enzyme function and lipin.

"These findings are of major importance to the AIDS community as well as to those concerned with the obesity epidemic," said Jean Chin, a program director at the National Institute of General Medical Sciences (NIGMS), the part of the National Institutes of Health that funded the research. Carman's research is also supported by the New Jersey Agricultural Experiment Station.

Dairy is not associated with weight gain - Research

Wed, 08 Mar 2006 21:54:37 PST

( from http://www.rxpgnews.com ) Calcium intake was not associated with weight gain in men over a 12-year period, according to a new study published in the American Journal of Clinical Nutrition1. The study included more than 19,000 healthy men aged 40-75 years who were enrolled in the Health Professionals Follow-up Study. The researchers evaluated the relationship between total calcium intake from diet and supplements and changes in body weight based on self reported weight at the beginning and end of the 12-year study period. Study participants followed their normal diets, not calorie-restricted diets.

This research is consistent with the 2005 Dietary Guidelines for Americans which recommend 3 servings of low-fat dairy foods each day and recognize that intake of dairy foods does not contribute to extra weight gain.

In addition to research that demonstrates dairy foods do not contribute to extra weight gain, dozens of studies provide compelling evidence that consuming 3 servings a day of milk, cheese and yogurt as part of a reduced-calorie weight loss plan may help adults achieve better results than just cutting calories with little or no dairy, according to Greg Miller, PhD, executive vice president, National Dairy Council.

The current body of evidence includes randomized clinical trials (considered the "gold standard" of science), observational, animal and cellular studies conducted by leading research institutions throughout the country. This intriguing connection also is being studied worldwide with positive results reported in Denmark, Greece, Italy and other countries.

"The good news for the public is that you can follow the MyPyramid recommendation for 3 servings of dairy foods each day and get the nutrition benefits without concern of extra weight gain," Miller said. "If you're cutting calories to lose weight, it's important to get your 3 servings of dairy foods each day for good health and to enhance your weight loss efforts."

Though more research is needed to fully understand the relationship between dairy and weight, experts suggest this emerging role for dairy foods is another good reason for people to meet current Dietary Guidelines for Americans of 3 servings a day of low-fat or fat-free milk, yogurt or cheese.

Additional benefits to dairy consumption noted by this study include findings that dairy eaters were less likely to have high blood pressure or elevated cholesterol levels and tended to have a higher intake of cereal fiber and vitamin D.

The authors of this observational study acknowledge that the results regarding calcium and weight gain are not conclusive, noting that "whether calcium supplementation or increased dairy intake is beneficial in preventing weight gain needs to be further studied in long-term randomized trials."

Studies published in Obesity Research showed that adults on a reduced-calorie diet who consumed 3 servings of milk, cheese or yogurt each day lost significantly more weight and more body fat than those who just cut calories and consumed little or no dairy2,3,4.

Numerous observational studies exploring dietary intake patterns and body weight in various population groups have suggested that getting adequate amounts of dairy not only promotes an overall healthy diet, but may also promote a healthy weight.

Bottle-feeding could make infants obese

Wed, 08 Mar 2006 21:50:37 PST

( from http://www.rxpgnews.com ) Bottle-feeding could make your baby obese later in life, finds a University of Bristol study.

Researchers said babies feeding on formula milk who were weaned on to solid foods too early were heavier than expected by the age of five, putting them at an increased risk of obesity as they grow older, reported the online edition of Daily Mail.

The feeding habits of 881 babies at four months were examined and compared to their weight gain later in childhood by the researchers.

The study, published in the US journal Paediatrics, found that babies drinking formula milk rather than breast milk took in more calories and experienced weight gain at a crucial stage of growth.

"It seems that breast-fed infants are better able to regulate their energy intake than formula-fed infants, nutritionist doctor Pauline Emmett stated.

"It could be because parents feeding formula milk make sure that the baby finishes the bottle and do not necessarily reduce the quantity offered once weaning is established."

She added that excessive weight gain might lead to increased risk of obesity later in life.

"While there are obvious benefits in avoiding poor growth, excessive weight gain during infancy is also a problem."

Obese drivers face greater risk of crash deaths

Mon, 06 Mar 2006 17:21:37 PST

( from http://www.rxpgnews.com ) Male drivers who are obese are more likely to die in a car crash, suggests a US study.

Researchers of the Medical College of Wisconsin said the deaths could be due to the drivers' greater momentum in a crash and because of the effect obesity has on the body's ability to recover.

The researchers looked at information on 22,000 people from a nationwide crash data collection programme sponsored by the US Department of Transportation.

They found that drivers who had a body mass index that was either higher than 35 or lower than 22 had a "significantly increased risk of death" compared to those with an intermediate body mass index (BMI), reported the online edition of BBC News.

While the fatality rate for motor vehicle crashes was 0.87 percent for male drivers, it was 0.43 percent for women drivers, the researchers found.

Adventure Therapy effective in maintaining weight-loss

Wed, 01 Mar 2006 17:32:37 PST

( from http://www.rxpgnews.com ) Some overweight teens may have new hope for shedding pounds. A new study suggests that weight-loss programs that encourage peer-support, and focus on building confidence through challenges are effective in helping some adolescents lose weight. This is the finding of a research paper appearing in the January 2005 issue of the International Journal of Obesity by researchers at the Bradley Hasbro Children's Research Center (BHCRC) and The Miriam Hospital.

"Since weight gain in adolescence has been associated with a number of health problems in adulthood, we wanted to find a program that could offer teens an effective weight-loss strategy," says lead author Elissa Jelalian, PhD, a child psychologist with the BHCRC and Brown Medical School.

Seventy-six overweight adolescents (ages 13 to 16) were randomly assigned to one of two treatment plans for 16 weeks: cognitive-behavioral group treatment with Adventure Therapy based on Outward Bound (an educational program that promotes adventure and peer-building activities), or cognitive-behavioral group treatment in conjunction with aerobic exercise.

"We found that the older teens in our sample lost more weight through the Adventure Therapy regimen, and many kept it off at the 10 month follow-up," says Jelalian.

While average weight loss was similar for both groups, the authors saw significant differences between the groups six months after completion of the active intervention. Over twice as many adolescents in the Adventure Therapy group maintained their weight loss. Even more impressive, they found that older adolescents in the adventure therapy group demonstrated more than four times the weight loss of their counterparts in the aerobics group at follow-up.

"This study supports the idea that at ages 15 and 16, adolescents may benefit significantly from peer support. The Adventure Therapy model embraces positive peer encouragement which is why it's so effective," says Jelalian.

Rather than participating in a supervised exercise session together, adolescents assigned to the Adventure Therapy group were asked to work together in cooperative games, trust-building exercises, and problem solving challenges. The final challenge was for adolescents to participate in a ropes course.

Obesity in children and adolescents is a significant public health concern, the authors write. Data from the most recent National Health and Nutrition Examination Survey data (NHANES 1999-2000) indicate that approximately 15 percent of children and adolescents are overweight. The recent Surgeon General's "Call to Action" describes overweight and obesity as a public health epidemic, with specific focus on the impact of overweight for children and adolescents.

"The obesity epidemic our country is facing has created a tremendous need for innovative, effective weight loss strategies for overweight teens," says co-author Elizabeth Lloyd-Richardson, PhD, psychologist at The Miriam Hospital and Brown Medical School. The rise in prevalence of pediatric obesity has been associated with a rise in the diagnosis of non-insulin-dependent diabetes, as well as risk factors for heart disease. Weight increases during adolescence have also been associated with fasting insulin, HDL-cholesterol, and systolic blood pressure in young adulthood.

"Evidence suggests that losing even small amounts of weight (5 to 10 percent of body weight) can have a significant impact on health," says co-author Rena Wing, PhD, director of the Weight Control and Diabetes Research Center at The Miriam Hospital and Brown Medical School.

Furthermore, childhood and adolescent obesity are significant predictors of overweight status in adulthood and pose a risk factor for adult morbidity and mortality, particularly for males, the authors write.

Obesity increases the risk of cancers

Tue, 28 Feb 2006 21:10:37 PST

( from http://www.rxpgnews.com ) Obesity increases the risk of contracting cancer, states Dr. Javier Salvador, Director of the Department of Endocrinology and Nutrition at the University Hospital of the University of Navarra.

Overweight has become a worldwide epidemic, not only in industrialised countries, but also in developing ones where problems of malnutrition go hand in glove with high percentages of obesity. The rates are currently rising at an alarming pace. In Spain some 15% of the population suffer from obesity and 54% from an excess of weight. Rates are going up because of the imbalance between ingestion and calorie consumption - due both to the growth and proliferation of unhealthy eating habits and an increase in sedentary life habits and styles.

One of the main problems in Western society is the rise in infant obesity the incidence of which has now reached that of obesity amongst adults. It is known that a very high proportion of these children will be obese when they become adults. Treatment is complicated and so we have to take action on prevention and on encouraging healthy lifestyles and habits in the home, at school and so on.

Clinical repercussion

Overweight produces significant changes in health, particularly those of a cardiovascular nature such as high arterial (blood) pressure, cardiopathy and ischemia; but also problems of a metabolic nature such as diabetes type 2 and changes in blood fat, apnea during sleep, alterations in the joints, and so on. Obesity is also involved in changes in hepatic function as a consequence of the infiltration of fat, the liver deteriorates and may end up with hepatic cirrhosis.

Society at large is aware that obesity is damaging in these ways to our health. What has not been known to date is that it is associated with certain cancers. This is important, for example, for women with a family history of breast cancer obese members of these families are more likely to contract the disease.

Apart from clinical pathologies overweight causes psychological problems of self-esteem, symptoms of depression, anxiety, and so on. Thus, dealing with and treating all these means high health costs.

No risk reduction from reducing total dietary fat - Women's Health Initiative (WHI) study

Wed, 08 Feb 2006 11:14:37 PST

( from http://www.rxpgnews.com ) Despite findings being announced this week that a low-fat diet introduced in the middle-age years didn't reduce the risk of breast cancer, heart disease, stroke or colon cancer, one of the researchers says people still need to focus on the types of fat they eat. The national diet study of almost 50,000 healthy postmenopausal women was part of the massive Women's Health Initiative (WHI) study.

The hypothesis that low-fat diets could help reduce the risk of certain diseases had been assumed, but never tested. But, do the findings mean that what we eat doesn't matter?

"Nutrition knowledge has progressed dramatically since the study began," said Mara Vitolins, Dr.Ph., associate professor of public health sciences at Wake Forest University Baptist Medical Center. "Today, we know that reducing total fat may not be enough we need to focus on the types of fat we eat."

Vitolins, a registered dietician, is an author on the three papers that report the results in the Feb. 8 edition of the Journal of the American Medical Association. Wake Forest was a Vanguard Center, one of 16 university sites chosen to launch the WHI.

The study compared a group of women who followed their normal eating patterns with a group who followed a study diet designed to reduce total fat. At the end of the first year, the low-fat diet group was consuming about 24 percent of calories from fat, compared to 35 percent in the normal-diet group.

At the end of the study's sixth year, the low-fat diet group consumed about 29 percent of calories from fat, compared to 37 percent in the normal-diet group. The low-fat diet group also increased their consumption of vegetables, fruits and grains.

Researchers found no difference between the two groups in terms of risk of breast cancer, colon cancer, heart disease or stroke.

Vitolins said one explanation for the results is that the low-fat diet was designed to reduce total fat and didn't make a distinction between good fats, such as those found in nuts, fish, and vegetables oils, and bad fats, such as the saturated fat in meats and the trans fat used in baked goods and potato chips.

"The study was testing the belief that lowering total fat would reduce the risk of cancer," said Vitolins. "Since the study began, we've learned a lot more about how the types of fats we consume make a difference."

Vitolins and others said the study's findings should not change recommendations for staying healthy.

"The results of this study do not change established recommendations on disease prevention," said National Heart, Lung, and Blood Institute Director Elizabeth G. Nabel, M.D., in an NIH press release. "Women should continue to get regular mammograms and screenings for colorectal cancer, and work with their doctors to reduce their risks for heart disease including following a diet low in saturated fat, trans fat and cholesterol."

Current dietary guidelines call for keeping saturated fats to less than 10 percent of calories, with most fats coming from fish, nuts and vegetable oils. They also call for limiting levels of trans fat. Vitolins said that only recently has trans fat become recognized as harmful it must now be listed on food labels.

Vitolins also said it's important to remember that participants began the low-fat diet later in life. Women were 50 to 79 years old when the study began and were followed for an average of 8.1 years.

"Our diets start when we are born and it makes sense that what you eat over a lifetime will make a difference," she said.

About 3,300 women in the Piedmont Triad were participants in the Women's Health Initiative, according to local principal investigator Denise E. Bonds, M.D., M.P.H., assistant professor of public health sciences at Wake Forest University Baptist Medical Center. Of those, 988 participated in the diet study, which was one of three WHI trials. The other trials evaluated hormone therapy and the effects of calcium and vitamin D on prevention of osteoporosis-related bone fractures and colon cancer.

Nationally, the WHI enrolled 157,000 women between 50 and 79 years old at 40 clinical centers, making it the largest clinical trial ever undertaken in the United States.

Babies of obese mothers have higher risk of some birth defects

Sun, 05 Feb 2006 00:29:37 PST

( from http://www.rxpgnews.com ) Compared to normal-weight women, overweight and obese women suffer more pregnancy complications and their babies have more medical problems at birth, according to a position paper of the Public Affairs Committee of the Teratology Society.

Obesity afflicts men and women of all ages across the United States and it is on the rise. Among women aged 20 to 39, more than half are overweight and nearly a third are obese, according to the National Health and Nutrition Examination Survey.

Obese women face increased risk of infertility and problems during pregnancy, including hypertension, gestational diabetes and thromboembolic events and are more likely to need a cesarean section. One French study found that overweight women had higher prenatal medical costs, and spent more time in the hospital recovering from childbirth.

In addition, the babies of obese mothers are more likely to be admitted to neonatal intensive care units. They also have a higher incidence of neural tube defects. "The literature suggests that compared to normal weight women, women whose body mass index (BMI) is greater than or equal to 30 have approximately double the risk of having an affected child," according to the Public Affairs Committee. The increased risk cannot be explained by folic acid intake, or by maternal diabetes.

The relationship between obesity and other birth defects remains unclear, according to the paper, because limited data is available, though some studies suggest a correlation.

"The Public Affairs Committee views obesity as a pregnancy risk factor and supports the public health initiatives identified by the FDA and the research initiatives identified by the NIH," the Committee writes. The national agencies are addressing the problem of obesity and acknowledging pregnancy as an important subject of further study.

The paper suggests that weight reduction efforts should be made well before conception is attempted, and dieters should avoid pregnancy. "Adequate nutrition is important for pregnant women and women planning pregnancy," the paper says. The committee recommends that clinicians counsel pregnant women about appropriate caloric intake and exercise.

While weight reduction surgery can improve the health and also the fertility of overweight women, the committee does not make a recommendation regarding surgery. They note that some recent reports have shown that women with gastric banding can have normal pregnancies and better pregnancy outcomes than obese women who do not have the surgery.

"Because some weight loss procedures can result in nutritional deficiencies, it appears reasonable to recommend that pregnancy be delayed until surgery-related weight loss has stabilized," writes the Committee.

Lastly, the paper recommends that all parents be educated about appropriate childhood nutrition, including the value of breastfeeding, which has been shown to have a protective effect against childhood obesity. "Prevention of childhood obesity is expected to be important in the prevention of obesity during the reproductive years," the paper concludes.

FDA questions on long term benefits of Orlistat

Sat, 21 Jan 2006 17:12:37 PST

( from http://www.rxpgnews.com ) Efficacy concerns surrounding GlaxoSmithKline's orlistat may prove to be a bigger hurdle to overcome than safety or self-selection issues as the firm pursues an Rx-to-OTC switch of the drug.

Although the proposed OTC dose of 60 mg shows statistically significant weight loss, 'there is no evidence presented that a modest, transient weight loss due to orlistat will afford any long-term clinical benefit through either a change in behavior or a reduced risk of serious clinical diseases manifested by being overweight,' an FDA review of studies on the drug finds.

The FDA documents, released Jan. 20, question whether GSK's proposed six-month treatment submitted under the trade name Alli would be beneficial for a 'chronic' condition such as obesity.

The documents were released in advance of a Jan. 23 review of the switch proposal by the agency's Nonprescription Drugs and Endocrinologic & Metabolic Drugs advisory committees.

GSK filed the orlistat switch application in June after purchasing licensing rights to the drug's OTC version from Roche in July 2004.

According to the agency, drug treatment for chronic conditions 'must be maintained long-term or chronically' to result in clinical benefit.

"It is difficult to define the clinical benefits of short-term treatment with orlistat," FDA states.

"Although not studied by the sponsor, it is well known that once weight-loss treatment is stopped, lost weight is quickly regained and improvements in co-morbidities become undone."

Efficacy of orlistat use in �mildly overweight� people with a Body Mass Index of 25-28 also was questioned in the agency's review.

Comparing studies conducted for orlistat's Rx approval and proposed switch "raise[s] the possibility that orlistat may be less effective in mildly overweight individuals than in obese subjects," the agency states.

The prescription NDA study was conducted in people with a BMI of at least 28. Among the subjects, a 5% or greater weight loss was achieved by 42% of those who took a 60 mg dose, 45% of subjects who took a 120 mg dose and 23% of those taking placebo.

In a more recent study conducted to support an orlistat switch, participants had a BMI of 25-28. A 5% or more weight loss was achieved in 36% of those taking the 60 mg dose and 28% taking placebo.

The difficulty in determining the benefits of short-term treatment is "further complicated," the agency states, because "some evidence suggests that the overweight BMI range of 25- <30 is not associated with increased mortality

Fat overload kills mammalian cells

Thu, 19 Jan 2006 15:45:37 PST

( from http://www.rxpgnews.com ) Investigating the harmful health effects of excess fat, researchers at Washington University School of Medicine in St. Louis have identified a protein that triggers death in mammalian cells overloaded with saturated fat.

The internal "skeleton" (in red) of cells is altered by exposure to high fat.

When the researchers halted production of this protein, called EF1A-1, the cells were able to thrive in ordinarily damaging amounts of the saturated fat palmitate, a fat abundant in Western diets. At the same concentration of palmitate, normal cells still producing EF1A-1 rapidly died. The study will be published in the February 2006 issue of Molecular Biology of the Cell.

"When lipids (fats) accumulate in tissues other than adipose tissue, cellular dysfunction or cell death results," says senior author Jean Schaffer, M.D., associate professor of medicine and of molecular biology and pharmacology. "For example, preliminary studies on animals suggest that the accumulation of fat in the pancreas contributes to the development of diabetes, and accumulation of lipids in skeletal muscle of leads to insulin resistance."

Other studies have linked the genesis of heart failure to fat-induced cell dysfunction and cell death in the heart. "As physicians our primary focus in diabetic patients is on glucose control," says Schaffer, a member of the Center for Cardiovascular Research at the School of Medicine and a cardiologist at Barnes-Jewish Hospital. "But it appears we should also be more aggressive with respect to lowering lipids such as triglycerides and fatty acids."

With the discovery of EF1A-1's role, this study is the first to identify a critical step in the pathway that leads from high cellular fat to cell death, according to Schaffer. EF1A-1 is an extremely abundant protein with several diverse functions within cells, including protein synthesis and maintenance of the cytoskeleton, the cell's internal support structure.

In mammalian cells grown in culture, the researchers saw that EF1A-1 and the fat palmitate work hand in hand: the presence of EF1A-1 dictated sensitivity to palmitate-induced cell death, and palmitate caused a rapid increase of the amount of EF1A-1 produced.

Schaffer's laboratory earlier had developed a transgenic mouse that accumulates fat in its heart muscle cells resulting in the death of cells, heart failure and premature death. They found that EF1A-1 was increased nearly three-fold in the hearts of these animals.

Removal of EF1A-1 protected cells from palmitate-induced death, and its absence allowed cells to withstand assault by highly reactive oxygen molecules. According to study authors, this indicates that EF1A-1 probably contributes to cell death from oxidative stress, which is known to stem from high lipid levels. Cytoskeletal changes seen in cells missing EF1A-1 suggested to the researchers that EF1A-1's cytoskeletal role also is important in cell death resulting from fat overload.

"Cells have a lot of mechanisms for incorporating fatty acids into storage forms, for metabolizing them or for using them in cellular membranes," Schaffer says. "But saturated fats like palmitate are poorly stored in the tiny fat droplets normally found in most cells and therefore are more likely to enter into pathways that lead to cell death such as the one in which EF1A-1 is involved."

In the process of identifying the role of EF1A-1, the lab members uncovered other proteins implicated in the toxicity of excess fats. They are now investigating each to find out what part it plays.

Future investigations by Schaffer's research team will study the EF1A-1 protein to see whether fatty molecules directly alter the protein, or if they cause it to relocate within the cell.

Teen Weight Control Behaviour May Reflect Mothers' Attitudes On Weight

Thu, 08 Dec 2005 15:13:38 PST

( from http://www.rxpgnews.com ) Teenagers are more likely to think about wanting to be thin, and to be frequent dieters, if they accurately perceive that being thin is important to their mothers, according to a study in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The association between body weight of children and their parents is known to be affected by genetic and cultural factors. However, less is known about the relationship between the weight concerns and weight control practices of parents and their children. Mothers are thought to play a role in the transmission of cultural values about body weight and shape. Studies show that girls whose mothers diet and are concerned with their weight and shape are more likely than their peers to develop unhealthy weight control practices, according to background information in the article.

Alison E. Field, Sc.D., of Harvard-affiliated Brigham and Womens Hospital and Childrens Hospital, Boston, and colleagues assessed the association between weight concerns and weight control practices of adolescents and their mothers. The authors conducted a cross-sectional study of 5,331 girls and 3,881 boys, with a mean [average] age of 14.9 years (range, 11.8 to 18.4 years), and their mothers. Participants were included in the analysis if both the adolescent and his or her mother returned a questionnaire mailed in 1999 and provided information on weight, height, and weight concerns.

Weight concerns were more common among girls, with 33 percent of girls and 8 percent of boys thinking frequently about wanting to be thinner. Approximately 54 percent of mothers reported that they thought about wanting to be thinner a lot or always, and 22 percent reported frequently attempting to lose weight during the past year. Also, 0.4 percent of girls and 3.7 percent of boys accurately perceived that their weight was important to their mother. Eight percent of girls had frequently dieted during the past year.

Although few adolescents accurately perceived that their weight was important to their mother, adolescent boys and adolescent girls who accurately perceived that their weight was important to their mother were more likely to think frequently about wanting to be thinner and to frequently diet than their peers who accurately perceived that their weight was not important to their mother, the authors report.

Being overweight is associated with many adverse health consequences, so parents are justified in not wanting their adolescents to be overweight, the authors write. However, it is essential to strike a balance between promoting a healthy weight and not placing too much emphasis on the importance of weight.

Parents should be encouraged to be role models in incorporating physical activity and healthy nutrition into everyday lifestyle patterns, rather than implementing them as weight control strategies, they conclude. In addition, it would be advisable for clinicians who treat overweight and weight-concerned adolescents and young adults to promote physical activity for benefits other than weight control, such as helping to improve self-esteem.

Food Incentives In Middle Schools Associated With Overweight Students

Thu, 08 Dec 2005 15:09:38 PST

( from http://www.rxpgnews.com ) Schoolwide food practices and policies that allow frequent snacking and consumption of foods and beverages high in calories and low in nutrients throughout the school day, and that permit use of food as incentives and rewards, were associated with higher body mass index in middle school students, according to an article in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Obesity has become one of the more complex and challenging public health issues of this decade, affecting two thirds of adults and almost one third (30 percent) of children according to background information in the article. School environmental factors have been implicated in the rising childhood obesity rates. A la carte and vending programs that sell foods and beverages high in calories and low in nutrients are pervasive in schools, and other school food practices that may contribute to childhood obesity, such as fundraising and student incentives, are also documented.

Martha Y. Kubik, Ph.D., R.N., and colleagues from the University of Minnesota, Minneapolis, examined data from sixteen middle schools and their eighth-grade students (n = 3,088) to investigate the association between body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) in young adolescents and schoolwide food practices. BMI was calculated from students self-reported height and weight. School administrators were interviewed about food-related school policies and practices, schoolwide food use guidelines and school-based health promotion activities. Based on interview answers, a food practice score was determined for each school, higher scores indicating more practices were allowed.

The researchers found that students BMI increased ten percent for every additional food practice permitted in their school. Average BMI of the students was 21. Eight percent of students were classified as overweight, while fifteen percent were categorized as being at risk for overweight. The average number of food practices allowed was three (range, 0 7). Of the seven food practice scale items, the most prevalent was the use of food as incentive and rewards (69 percent) and in classroom fundraising (56 percent). Thirty-one percent of schools allowed food in the classroom, while 38 percent allowed beverages in the classroom. Nineteen percent of schools allowed beverages in hallways, while 31 percent allowed snacks in the hallway.

Food choice at school includes more than the foods and beverages offered as a part of school meal programs, a la carte, and in vending machines. Similarly, opportunities for eating during the school day extend well beyond the school lunchroom and breakfast and lunch, the authors write. Adolescence is a critical period for the development of obesity that persists into adulthood.School nutrition policies that consistently promote and support healthy dietary practices among young adolescents are urgently needed, they conclude.

Family meals cut teenage fatness

Wed, 02 Nov 2005 13:06:38 PST

( from http://www.rxpgnews.com ) They might prefer to be in front of the TV or Playstation, but Brisbane teenagers are likely to be healthier if they eat meals with mum and dad.

University of Queensland researchers working on the world's longest health study found teens who ate regularly with their family were less likely to be overweight.

Lead researcher, Dr Abdullah Al Mamun from UQ's School of Population Health said regular family meals could reduce snacking and make for healthier food and social habits.

"Eating together will enable the parent to have better knowledge of the child's food choices and amount that they tend to eat," Dr Mamun said of the study, which appears in the latest edition of American journal, Obesity Research.

The study found having a healthy maternal attitude to family eating and diet was more important than the frequency of shared meals.

Even though most mothers said they had a family meal at least once a day, only 43 percent of them said eating together was very or quite important.

The findings have been drawn from the world's longest running health study -- the Mater-University of Queensland Study of Pregnancy, which has followed the progress of Brisbane mothers and their families since 1981.

The survey of 3795 mothers and their teenagers was collected in Brisbane when the teenagers were at age 14, in 1995.

It showed about half the families ate red meat most days and one-fourth had fast food most days or two to three times per week.

Even though more than half of the families had children who played sports four to seven days a week about 40 percent still found enough time to watch five or more hours of TV a day.

Dr Mamun's paper was co-written, with Mater and University of Bristol researchers and fellow UQ researcher and Mater Study founder, Professor Jake Najman.

The Mater Study was started in 1981 by Professor Najman as a health and social study of 7223 pregnant women.

Researchers have followed the children's growth over the decades and study was widened to include prenatal, postnatal, childhood and adolescent periods of the child with those babies now in their early 20s.

Systematic review of size and growth in infancy and later obesity

Fri, 14 Oct 2005 21:42:38 PST

( from http://www.rxpgnews.com ) Large infants, and those who grow rapidly during the first two years of life, are at increased risk of obesity in childhood and adulthood, a study published online by the BMJ today (14 October 2005) has found.

There is an urgent need to tackle rising levels of obesity in the population. However it is not clear how early in life prevention could begin. This study examines the relation between infant size and growth and later obesity.

Researchers analysed 24 studies which assessed the relation between infant size and growth and the development of obesity at any later age. They found that the heaviest infants, those with the highest body mass index, and those who gained weight rapidly during the first and second year of life, were more likely to be obese in childhood, adolescence, and early adulthood than other infants.

The authors believe that factors during or before infancy that are related to infant growth probably influence the risk of later obesity.

They suggest that future studies need to investigate what determines these patterns of growth, and to explore whether interventions to alter infant growth could be associated with other benefits or harms.

It will also be important to assess whether factors influencing infant growth are amenable to change, to establish which strategies might alter infant growth, and to find out whether these are acceptable to parents, they conclude.

Is School-Based Enchanced Physical Activity Relevant?

Thu, 06 Oct 2005 21:12:38 PST

( from http://www.rxpgnews.com ) Overweight children who took part in lifestyle-focused, fitness-oriented gym classes showed significant improvement in body composition, fitness, and insulin levels, according to a study in the October issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Obesity and poor physical fitness constitute a health problem affecting an increasing number of children. Childhood obesity and poor physical fitness are associated with insulin resistance, type 2 diabetes mellitus, blood lipid abnormalities, and high blood pressure in later life, according to background information in the article. The causes of childhood obesity include a pervasive "toxic" environment that facilitates increased caloric intake and reduced physical activity. In order to alter the children's environment, the authors suggest, an effective strategy for prevention and treatment of childhood obesity must be pervasive and collaborative. The school setting is an attractive starting point for a collaborative effort.

Aaron L. Carrel, M.D., and colleagues at the University of Wisconsin, Madison, conducted a randomized, controlled study to determine whether a school-based fitness program can improve body composition, cardiovascular fitness level, and insulin sensitivity in overweight children. Fifty overweight middle school children were randomized to lifestyle-focused, fitness-oriented gym classes (the treatment group) or standard gym classes (the control group) for nine months. The children were evaluated for fasting insulin and glucose levels, body composition, and maximum oxygen consumption treadmill testing before the school year, and at the end of the school year. There were no differences in age, body mass index, or sex distribution between the groups at baseline.

Fitness-oriented gym classes were designed to make fitness and good nutrition fun and achievable and to maximize the amount of movement during the class period. Class size was limited to 14 students to allow for increased instructor attention, increased opportunity for motivation, and less time standing in line.

"Children enrolled in fitness-oriented gym classes showed greater loss of body fat, increase in cardiovascular fitness, and improvement in fasting insulin levels than control subjects," the authors report.

The authors say the study results suggest that school curricula may be an effective vehicle for increasing physical activity and improving cardiovascular health for children, and they believe further study is warranted. "In this study, even a small change in the amount of physical activity showed beneficial effects on body composition, fitness, and insulin levels in children. Similar benefits have been shown by lifestyle improvements in adults with known glucose intolerance," they write.

The authors emphasize that it is important to develop and evaluate interventions designed to start in childhood, because childhood obesity is predictive of adult obesity. They suggest partnering with school districts should be part of a public health approach to improving the health of overweight children.

"These findings should help to encourage the development of physical education programs that are effective in providing children with substantial amounts of physical activity," they conclude. "Clearly, however, an effective public health approach must promote increased physical activity inside and outside of school, as physical activity recommendations cannot be met through physical education alone."

In an editorial accompanying the article, Oded Bar-Or, M.D., of the Children's Exercise and Nutrition Centre, Hamilton, Ontario, writes that enhanced physical activity is a major pillar in the treatment of juvenile obesity. "To the practicing physician, who is not conversant with exercise sciences, a simple exercise prescription would be an increment of 30 minutes daily, above and beyond the activity already preformed by the patient. To free time for this added activity, the prescription should also include a 30-minute reduction in 'screen time' (computer, video, and, in particular, television). The detailed content of the added activity-preferably outdoors-is not important, as long as the child moves from one place to another and, especially, finds it FUN."

Effective diet with no limits on portion size

Mon, 12 Sep 2005 23:07:38 PST

( from http://www.rxpgnews.com ) The study, involving 59 overweight, postmenopausal women, was conducted by Neal D. Barnard, M.D., president of the Physicians Committee for Responsible Medicine (PCRM), together with colleagues at Georgetown University Hospital and George Washington University. Half of the study participants followed a vegan diet; the other half followed a control diet based on National Cholesterol Education Program guidelines.

"The study participants following the vegan diet enjoyed unlimited servings of fruits, vegetables, whole grains, and other healthful foods that enabled them to lose weight without feeling hungry," says Dr. Barnard, the lead author. "As they began to experience the positive effects, weight loss and improved insulin sensitivity, the women in the intervention group became even more motivated to follow the plant-based eating plan."

Scientific studies show that obesity and overweight are far less prevalent in populations following a plant-based diet. In a recent study of more than 55,000 Swedish women, Tufts University researcher P. Kirstin Newby and her colleagues found that 40 percent of meat-eaters were overweight or obese while only 25 to 29 percent of vegetarians and vegans were. Worldwide, vegetarian populations experience lower rates of heart disease, diabetes, high blood pressure, and other life-threatening diseases. A new study appearing in September's Journal of Urology shows that a low-fat, primarily vegan diet may slow the progression of prostate cancer.

The simplicity of a vegan diet appeals to people who are busy with work and family, and many familiar recipes are easy to adapt. At least four studies published in peer-reviewed journals show that patients give the low-fat vegetarian diet a high rating in terms of acceptability, and that the transition only takes about three weeks or less.

Is suburban life making people overweight?

Sat, 10 Sep 2005 23:20:38 PST

( from http://www.rxpgnews.com ) In a study recently published in the Journal of Regional Science, researchers from Oregon State University found that the relationship between obesity and urban sprawl may be a two-way street.

Economists Andrew Plantinga from OSU's Department of Agricultural and Resource Economics and Stephanie Bernell from OSU's Department of Public Health expanded previous studies that showed that people living in areas of urban sprawl tend to have higher body mass indices. Their analysis suggests that the relationship between obesity and urban sprawl may be due to personal preferences when choosing a home location rather than to direct impacts of the suburban environment on physical activity and weight.

Location, location, location. Research by Plantinga and Bernell suggests that an individual's body weight is a factor determining the desirability of a residential location. They found the relationship between obesity and urban sprawl can be explained by the way people sort themselves by personal preference.

In a follow-up study, Plantinga and Bernell used a national data set to test whether body mass index influences the decisions of adults to locate in counties with a high or low degree of sprawl. To measure body weight, the researchers used data from the U.S. Department of Labor's National Longitudinal Survey of Youth, which has tracked statistics on thousands of individuals since their youth in 1979. The researchers examined many factors, among them ethnicity, gender, age, income, education, marital status and body weight.

"Among people who moved recently, we find that in addition to a high body mass index, being female, younger, and married increases the probability of choosing to reside in a sprawling county," Bernell said.

"In many sprawling areas, distances are too great for people to walk to work or to the store," Plantinga explained. "Transportation infrastructure is often designed for automobiles, with the result that walking and bicycling are impractical and unsafe. The incentives are for people to drive instead of walk. In contrast, in urban neighborhoods like the Pearl District in Portland, Ore., people can walk to work, school, or shopping. In many cases, it's easier to walk to the store than to drive."

Previous studies had suggested that the relationship between obesity and urban sprawl is related to suburban environments that discourage routine physical activity such as walking and biking. However, previous studies did not consider the choices people make in selecting where to live.

"When you select a residential location, you are really choosing a bundle of attributes," Plantinga said. "The house you choose may be near a shopping center or a park, or it may have a three-car garage and a bonus room. The market prices each of these attributes. It follows that individuals, given their income, will choose locations that provide the attributes of greatest value to them. People who value walking will tend to choose walkable neighborhoods. People who do not care for walking will tend not to."

These findings have implications for urban planners and public health officials, according to Plantinga. Many recent planning initiatives include funding for bicycle and pedestrian facilities in order to increase physical activity. However, making communities more exercise-friendly may simply attract people who are predisposed to physical activity.

Potential health risks from 'Ephedra-free' dietary supplements

Sat, 10 Sep 2005 23:07:38 PST

( from http://www.rxpgnews.com ) The research examined the effects on blood pressure and heart rate of two dietary supplements containing bitter orange extract -- a substance that has rapidly replaced ephedra in weight-loss products since it was banned by the FDA in 2004 because of concerns about serious health effects.

The study involved 10 healthy adults given single doses of one of the two supplements or a placebo. The two supplements tested were Advantra Z and Xenadrine EFX. Single doses of both products increased heart rate by an average of 11 to 16 beats per minute over baseline, the scientists found. This would be the equivalent of an 18 percent increase if baseline rate is 80 beats per minute.

In addition, Xenadrine EFX also significantly increased blood pressure by 7 to 12 percent (9-10 mm Hg), the researchers reported. Xenadrine EFX appears to have similar acute cardiovascular stimulant actions as banned ephedra products, according to their report.

"These findings indicate that ephedra-free dietary supplements could have some of the same adverse health effects associated with previously available ephedra products, such as Metabolife 356 and Ripped Fuel," said Christine Haller, MD, UCSF assistant professor of medicine and lead author of the paper.

The scientists call for further research on the safety and effectiveness of bitter orange- containing supplements -- particularly among those most likely to take them: overweight people who may have other health conditions.

Bitter orange extract, or Citrus aurantium, is extracted from the dried fruit peel of bitter orange. Known in Chinese herbal medicine as Zhi shi, it is a traditional remedy for gastrointestinal ailments, the scientists said.

The predominant constituent of bitter orange is synephrine, which in pharmaceutical form is commonly used to treat low blood pressure and nasal congestion.

Advantra Z contains only bitter orange, while one dose of Xenadrine EFX contains several other ingredients, including caffeine equivalent to the amount in 3 cups of coffee, the researchers found. The increased blood pressure from taking Xenadrine EFX is likely not due to caffeine alone, they concluded, but potentially related to the actions or interaction of other constituents in the multi-ingredient supplement.

The scientists call for longer term dosing studies to determine whether the blood pressure effects of Xenadrine EFX persist with repeated use. Until such data are available, they conclude, doctors should caution patients about using ephedra-free weight-loss dietary supplements and should monitor blood pressure in those who choose to use the products.

In particular, people with hypertension, heart disease or other pre-existing conditions that could be aggravated by the supplements should avoid them.

"Consumers should be aware that ephedra-free dietary supplements have not been extensively tested for safety and the health effects are not well known," Haller noted.

Among other physiological measures, heart rate and blood pressure were recorded in the study for an hour before dosing and then at several intervals afterwards.

To rate physical symptoms, moods and emotions, questionnaires were administered one, two and six hours six hours after taking the supplements or placebo.

The caffeine-containing Xenadrine EFX product also increased alertness according to responses on the questionnaire. But neither product appears to have a significant effect on mood, the study found.

Obesity strongly linked to DVT & PE

Sat, 10 Sep 2005 15:07:38 PST

( from http://www.rxpgnews.com ) Since 1927, obesity has been thought to be a risk factor for fatal pulmonary embolism (PE). Because of the high proportion of obesity in the general population, previous studies have not determined whether obesity is an independent risk factor for PE or deep venous thrombosis (DVT). In an extensive study published in the September issue of The American Journal of Medicine, researchers from St. Joseph Mercy Oakland Hospital, Pontiac, Michigan; Wayne State University, Detroit, Michigan; and Oakland University, Rochester, Michigan; analyzed over 20 years of patient records compiled by the National Hospital Discharge Survey (NHDS) to further investigate the potential risk of obesity in venous thromboembolism. The investigators concluded that obesity is a risk factor for venous thromboembolic disease in men as well as women, particularly those under age 40.

The NHDS is comprehensive in its scope including data on patients of all races and ages obtained annually from 181,000 to 307,000 sampled patient abstracts from 400 to 494 non-Federal short-stay hospitals in 50 states and the District of Columbia. There were more than 12,000,000 obese patients and almost 700,000,000 non-obese patients in the sampled data.

The relative risk of DVT, comparing obese patients with non-obese patients, was 2.50. The relative risk of PE was 2.21. Obese females had a greater relative risk for DVT than obese males, 2.75 versus 2.02. Obesity had the greatest impact on patients aged less than 40 years, in whom the relative risk for PE in obese patients was 5.19 and the relative risk for DVT was 5.20. In females aged less than 40 years, the relative risk for DVT comparing obese with non-obese patients was 6.10. In males less than 40 years of age, the relative risk for DVT was 3.71.

Paul D. Stein, MD, writes "Now that we know with certainty that obesity is a risk factor for PE, particularly in men and women under age 40, the presence of obesity may alert physicians to a possibility of the diagnosis. The diagnosis of PE is frequently missed even though PE is the third most common acute cardiovascular disease after myocardial infarction and stroke."

A Genetic Link to Obesity: The Numbers Don't Add Up for GAD2

Wed, 31 Aug 2005 02:08:38 PST

( from http://www.rxpgnews.com ) Obesity is a leading cause of preventable death and is often linked to type II diabetes and heart disease. Being a complex trait, obesity is likely caused by the interplay of multiple environmental factors and many genes. Common genetic differences between individuals within a region of Chromosome 10 have previously been associated with obesity. This region contains several genes with the potential to be directly involved in the disease. One of these genes, GAD2, has been the subject of many studies. A new study by Michael Swarbrick, Björn Waldenmaier, Christian Vaisse, and their colleagues takes a new look at GAD2 and provides strong evidence that the gene might not be as relevant to obesity as previously thought.

GAD2 encodes a protein (called GAD-65) involved in the production of GABA, a neurotransmitter involved in a variety of brain functions, including appetite stimulation and energy consumption. Studies in mice have shown that increased levels of GABA result in hunger and overeating. In healthy mice, the levels of GAD2, and hence, GABA, are controlled, making sure that the balance between weight gain and loss is maintained. A 2003 study of a French population found that three genetic mutations in and around the GAD2 gene occurred at a high level in individuals with obesity. The 2003 study, conducted by different researchers, was also published in PLoS Biology. When Swarbrick et al. surveyed German, Caucasian-American, and Canadian populations for this genetic correlation, however, they found no statistically significant link between obesity and any of the mutations.

There are many possible reasons why different studies may show different results: ethnic differences between populations, as well as behavioral and dietary differences, could account for varying results when it comes to studying a trait as complex as obesity. Also, studies that seek to show an association between genetic differences and complex diseases rely heavily on the statistical power of their tests, which depends on the number of subjects involved. Swarbrick et al. have not only studied 2,359 German, 729 US, and 1,137 Canadian subjects, but also conducted a meta-analysisa statistical analysis of a collection of individual studiesof their data and the previously published data from 1,221 French subjects. Meta-analyses help identify patterns from multiple individual studies that may not be visible in any one study alone, and also help rule out chance differences that may be apparent in one single study. In this case, the meta-analysis showed that when the results from French subjects are put together with the results from other ethnic populations, there is no evidence for a link between changes in GAD2 and obesity.

Although GAD2's role in controlling appetite made it an exciting candidate for a link to obesity-related conditions, Swarbrick et al. show that the numbers simply don't add up. The search for serious obesity gene contenders in this region of Chromosome 10 is all set to continueand attention can now turn to several other potential gene candidates located nearby.

Graffiti linked to obesity in city dwellers

Fri, 19 Aug 2005 13:56:38 PST

( from http://www.rxpgnews.com ) City dwellers living in areas with little greenery and high levels of graffiti and litter are more likely to be obese than those living in pleasant areas with lots of greenery, say researchers in a study published on bmj.com today.

Obesity levels are high and increasing worldwide, and studies have suggested that place of residence may be associated with levels of obesity and physical activity. Evidence also suggests that levels of incivilities, such as litter and graffiti, are linked to poorer health.

Based on this work, the team set out to test the theory that areas which are pleasant with lots of greenery and few incivilities might encourage people to take exercise and thereby influence levels of obesity.

They analysed data from a large housing and health survey conducted in eight European cities in 2002-3. Questionnaires captured information on height and weight, which was then used to calculate body mass index, and level of physical activity.

Surveyors then assessed the immediate residential environment, including the amount of graffiti, litter, and dog mess, as well as the level of vegetation and greenery visible on the dwelling and streets immediately surrounding it. Factors such as age, sex, and social status, were also taken into account.

For respondents whose residential environment contained high levels of greenery, the likelihood of being more physically active was over three times as high, and the likelihood of being overweight and obese was about 40% less.

In contrast, for respondents whose residential environment contained high levels of incivilities, the likelihood of being more physically active was about 50% less, and the likelihood of being overweight or obese was about 50% higher.

Despite some limitations, these findings suggest that efforts to promote physical activity and reduce weight should take into account environmental facilitators and barriers as well as individual factors, conclude the authors.

Obesity interventions in children have limited effect

Wed, 20 Jul 2005 15:06:38 PST

( from http://www.rxpgnews.com ) Many diet and exercise interventions aimed at preventing childhood obesity promote healthy diets and increased physical activity, but do not appear to have radical impacts on reducing overweight and obesity gain.

The epidemic of child obesity demands serious action, and around the world many people have looked at ways of helping children eat less and exercise more. In preparing this review, the Cochrane Review Authors identified 22 studies that between them tested a variety of different approaches involving changes to diet, exercise, or diet and exercise. By pooling data, the review drew on findings from about 10,000 participants who were under 18 years old and came from Asia, South America, Europe and North America.

While the authors were unable to identify one particular program that could prevent obesity in children lead-author, Carolyn Summerbell, a Professor of Human Nutrition who works at the University of Teesside, England, believes that any intervention that leads to a better lifestyle will reduce obesity if it is kept up for long enough.

Summerbell believes that the most effective programmes are the ones that put fun into fitness and good food. This means that features like dance and martial arts should be included alongside traditional sports and physical exercise in the school curriculum.

Despite the importance of childhood obesity, the review was only able to find a limited number of studies to draw findings from and some of these were pilot projects that showed great promise but were not designed to be able to measure changes in body weight.

"It is becoming increasingly clear that decision-makers need much more information on which to base policy and program decisions," says Professor Elizabeth Waters, who is a professor of Public Health based at Deakin University, Melbourne, Australia.

The authors note that there are many different programmes underway at the moment, and look forward to seeing the outcomes. "We believe that programmes aimed at creating environments that enable and support long-term behaviour change are likely to make more of a positive impact than the interventions that people have studied so far," Waters adds.

"This review made a central contribution to the WHO Expert Consultation on childhood obesity at Kobe, Japan, in June 2005, and the report of this consultation will be published in June 2006. As one of a number of reviews where a controlled evaluation has been used it makes a valuable contribution to our understanding of childhood obesity. But given the importance of tackling childhood obesity it is clear that there is a need for much more research in the area, and research that is thoroughly designed so that it generates useful data," says Summerbell

Positive Clinical Trial Results of Novel Anti-Obesity Compound

Thu, 12 May 2005 18:08:38 PST

( from http://www.rxpgnews.com ) Arena Pharmaceuticals, Inc. (Nasdaq: ARNA) announced today positive top-line results from its Phase 2 clinical trial of APD356, Arena's orally administered, internally discovered drug candidate for the treatment of obesity. Over the 28 day treatment period, there was a highly statistically significant (p=.0002) average weight loss of 2.9 pounds in patients taking the 15 mg dose of APD356 versus 0.7 pounds for the placebo group. APD356 was generally well tolerated at all doses investigated in the trial. APD356 is a selective agonist of 5-HT2C serotonin receptors, which are located in the hypothalamus, an area of the brain known to play an important role in regulating food intake and metabolism.

"The prevalence of obesity has increased substantially in recent years and has reached alarming rates. Obesity is a serious health risk and is associated with several conditions, including diabetes, stroke and heart disease. Patients and their physicians need novel methods to treat obesity," stated Steven Smith, M.D., Principal Investigator and Associate Professor of the Pennington Biomedical Research Center. "The results of this trial are very supportive of further study and provide hope that obese individuals could have a new therapeutic option in the future to help control their weight in an effective, safe and controlled manner."

This Phase 2 clinical trial of APD356 was a randomized, double-blinded, multiple-dose study examining 352 obese volunteers at 24 clinical sites in the United States. The trial was to enroll otherwise healthy male and female patients with a body mass index (BMI) of between 30 and 45. Patients were randomized into four groups to compare doses of 1, 5 and 15 mg of APD356 versus placebo. The trial evaluated safety and weight loss after oral administration of APD356 once daily for 28 days. The trial protocol provided that patients should maintain their normal diet and level of activity, but required that patients abstain from consuming alcohol. In addition to standard safety evaluations, patients were assessed by echocardiogram upon enrollment, and were scheduled for follow-up echocardiograms at 29 and 90 days after receiving their first dose.

Patient demographic characteristics at baseline were well balanced across treatment groups. Eighty percent of participants were women, 55% were Caucasian, 25% African-American and 18% Hispanic. At baseline, the average age was 40 years, the average weight was 223 pounds (range 158-468 pounds), and the average BMI was 36.

The primary efficacy endpoint of the Phase 2 study was a reduction in weight in patients completing the 28 day treatment period (Day 29). Compared to placebo, treatment with APD356 was associated with a highly statistically significant average weight loss of 2.9 pounds in the 15 mg group versus 0.7 pounds in the placebo group. No statistically significant weight loss was observed in the 1 mg or 5 mg groups. Similar results were observed in the intent-to-treat, last observation carried forward (LOCF) analysis. The table below summarizes the mean weight change for all patients completing the study in each group.

Group Mean Weight Change p value
from Baseline
(pounds) (relative to placebo)

Placebo (n=71) -0.7 --
1.0 mg (n=75) -0.7 Not statistically significant
5.0 mg (n=72) -0.9 Not statistically significant
15.0 mg (n=69) -2.9 p = 0.0002

APD356 was generally well tolerated at all doses investigated, and there were no serious adverse events in the trial. Events that occurred in 5% or more of patients in a treatment group are listed below.

Event Placebo 1 mg 5 mg 15 mg

Nausea 3.5% 5.6% 5.6% 6.9%
Nasopharyngitis 5.8% 4.4% 3.4% 1.1%
Headache 14.0% 15.6% 7.9% 20.7%
Cough 1.2% 5.6% 2.2% 1.1%

There was no apparent drug effect on the heart as assessed by Day 29 echocardiograms. Post day 29 echocardiograms are pending.

"All of us at Arena are excited with these results, and we would like to thank all the patients, clinicians and nurses participating in our study. We intend to use these results to build on our APD356 clinical program and soon initiate a Phase 2b trial enrolling approximately 300 to 400 patients in a study designed to investigate the efficacy and safety of APD356 over a three- month period," stated Jack Lief, Arena's President and CEO. "In addition to supporting the continued development of APD356, these top-line results should strongly support our partnering efforts and further validate our research and development capabilities."

Oleoyl estrone in Phase Ib Trial

Wed, 04 May 2005 21:50:38 PST

( from http://www.rxpgnews.com ) Manhattan Pharmaceuticals, Inc. ("Manhattan" OTCBB: MHTT), has concluded its Phase Ia trial and begun patient dosing in the Phase Ib trial to evaluate the safety and tolerability of defined doses of orally administered Oleoyl estrone (OE) in obese adults. Like the Phase Ia trial, the Phase Ib trial will be conducted in Basel, Switzerland under Swiss Medic Approval.

The Phase Ia trial, conducted with the approval of the U.S. Food & Drug Administration (FDA) and SwissMedic, the Swiss regulatory authority, was a single-dose, dose-escalation trial that evaluated six cohorts of six patients, randomized 2:1 study drug to placebo. Manhattan is currently reviewing and analyzing the results of the trial, which will ultimately be used to obtain approval to move forward with Phase II studies.

The recently commenced Phase Ib trial is a repeat-dose, dose-escalation trial that will evaluate four cohorts of six patients each, randomized 2:1 study drug to placebo. Results from this study will also be used, in conjunction with extensive preclinical work, to establish the protocol and obtain approval from the US FDA to begin Phase II clinical trials.

"We are pleased that OE's clinical development is proceeding according to our anticipated timeline," said Douglas Abel, CEO of Manhattan Pharmaceuticals. "This Phase I trial will provide needed additional information about OE's tolerability and move us closer to securing the approvals necessary to bring this treatment to a patient population clearly in need of an alternative to the current therapeutics."

Oleoyl estrone - Targeting the Obesity Epidemic

Oleoyl estrone is believed to be a signaling molecule that acts on the hypothalamus to communicate satiety. It is hypothesized that, in healthy individuals, levels of naturally occurring OE are related to the size of the body's fat stores, while in obese individuals circulating OE levels are lower than would be expected for the level of body fat. Orally administered formulations of OE has been demonstrated, in extensive preclinical animal studies, to cause significant weight loss and reduced caloric consumption without the need for dietary modifications.

In such studies, OE appears to be safe and effective without side effects or evidence of rebound weight gain after treatment was stopped. The Company believes that OE may prove to be a safe and effective treatment for obesity, representing a significant advantage over currently available anti-obesity medications.

Manhattan believes OE could help address the obesity epidemic - one of the world's top health concerns. Nearly two-thirds of the U.S. adult population is estimated to be overweight and at least half of these are clinically obese. Though there are currently two FDA approved therapeutics on the market for the long-term treatment of obesity, market penetration remains low, possibly as a result of the modest efficacy (an average of 8-10% weight loss in the first year), and side effects reported with use of these treatment options.

Manhattan has reported favorable, peer-reviewed preclinical safety and pharmacokinetic data regarding OE at the 2004 annual meetings of the European Congress on Obesity, and the North American Association for the Study of Obesity.

New Erchonia Laser Revolutionizes Liposuction

Sun, 24 Apr 2005 08:06:38 PST

( from http://www.rxpgnews.com ) The Stern Center for Aesthetic Surgery, PC, a Bellevue based practice focused on staying on the cutting edge of new cosmetic surgery advances announced their use of the new Erchonia laser during liposuction.

The Stern Center for Aesthetic Surgery, PC, led by Dr. Fredric A. Stern, uses the Erchonia 4L laser, the first and only low-level laser approved by the FDA for use during liposuction.

The painless laser treatment is administered a few minutes prior to liposuction, and works by liquefying the fat. As a result, fat removal is made easier and quicker, and there is less post-op pain and bruising, with a speedier recovery time. Less pain medication is required for this procedure compared to traditional liposuction methods.

The FDA approved the laser based on the results of an IRB approved, multi-center, double blind randomized study. The comparison between the actively treated patients and the placebo-treated patients resulted in an impressive difference between groups in the emulsification of fat, ease of extraction, amount of swelling, and degree of pain.

Use of the Erchonia laser during liposuction offers our patients tremendous benefits, and will revolutionize the procedure, making liposuction as close to a no down time cosmetic surgical procedure as there is. We are excited to incorporate this new FDA approved device into our practice, states Dr. Stern.

Dr. Fredric A. Stern has been in practice since 1987, and established The Stern Center for Aesthetic Surgery, PC, in Bellevue in 1997. Erchonia was founded in 1996 and is dedicated to advancing the science of health through the development of superior bio-medical laser products.

Excess Deaths Associated with Underweight, Overweight and Obesity

Thu, 21 Apr 2005 17:19:38 PST

( from http://www.rxpgnews.com ) Using data collected from the most recent NHANES, Katherine Flegal, Ph.D., CDCs National Center for Health Statistics, and her co-authors from CDC and the National Cancer Institute, part of the National Institutes of Health, found that both obesity and being underweight are associated with excess deaths when compared with the normal weight population.

The study found:

* There were 112,000 more deaths than expected in 2000 among obese individuals (BMI of 30 or higher).

* Underweight individuals (BMI of less than 18.5) had a higher risk of death with nearly 34,000 more deaths than expected.

* Most of the excess deaths among the underweight occurred in people age 70 or older. Among the obese, the increased risk of death was most pronounced among people younger than 70.

* Being overweight (BMI of 25-29.9) was not associated with excess mortality. The study found that 87,000 fewer deaths than expected were associated with being overweight.