Weight Loss Blog

Yes, high-fat, high-carb meals are much more harmful to obese people and - of course - kids.

Eating a high-fat, high-carb fast food meal produces damaging cellular changes that are greater and longer-lasting in obese people than in normal-weight people, a new study shows.

Dr. Paresh Dandona and colleagues from Kaleida Health in Buffalo, New York looked at inflammation and oxidative stress, which occurs when levels of normal byproducts of metabolism known as free radicals exceed the body’s ability to neutralize them.

In previous research they found that obese individuals have higher levels of oxidative stress and inflammation than normal-weight individuals. They also demonstrated that eating a high-fat, high-carb meal increased oxidative stress and inflammation in normal-weight people.

To test whether these increases might be greater in obese people, Dandona and his team had 10 normal-weight and 8 obese people eat a 1,800-calorie meal consisting of a large hamburger, a large serving of fries, a large cola, and a slice of apple pie.

Both groups showed increases in oxidative stress two hours after eating the meal. By three hours, oxidative stress had returned to baseline levels in the normal-weight individuals, but it continued to climb in the obese individuals. The same pattern was seen for inflammation.

“If obese people who already have oxidative and inflammatory stress take the same meal, they get far greater and more prolonged levels of oxidative and inflammatory stress,” Dandona told Reuters Health. “Since oxidative and inflammatory stress predispose you to atherosclerosis (hardening of the arteries), heart attack and stroke, this risk is far greater in obese people.”

In another study, Dandona and his colleagues demonstrated that a high-fruit, high-fiber meal with the same calorie content as the fast food meal tested in the current study produced no increase in oxidative or inflammatory stress.

The findings provide yet more evidence that people should avoid high-fat, high carb fast food meals and consume as much fruit and vegetables as possible, Dandona said.

The Super-sizing of America: Are Fast Food Chains to Blame for the Nation’s Obesity?

Americans are getting fatter and fatter every year. It is estimated that as many as one in five Americans is obese, a condition defined as being more than 30 percent above the ideal weight based on height. Even more alarming is that fact that obesity rates for children have doubled over the past 20 years, and overweight children are being diagnosed with obesity-related illnesses such as diabetes, sleep apnea and respiratory illnesses that in the past have only afflicted adults.

As the health care costs of treating obesity-related illnesses mount, some are looking to place the blame for increasing obesity rates on the purveyors of fast food. Facing fierce competition for customer loyalty, fast food chains such as McDonalds, Burger King and Wendy’s have promoted their over-sized burgers, extra-large servings for fries, and buckets of soda, all at low prices. Busy and cash-strapped families increasingly rely on take-out food for family dinners, and regular consumption of over-sized portions of fatty foods can leads to widespread obesity.

Some trial lawyers, fresh from a $90 million (and growing) windfall from the tobacco lawsuits, have set their sites on fast food companies. Following the tobacco lawsuit model, some argue that these companies should be held liable for the health care costs of treating illnesses associated with obesity, since they peddle dangerously unhealthy foods to unwitting consumers. The combination of the staggering number of obese Americans and the fat wallets of the fast food companies makes such lawsuits a tantalizing prospect for many trial lawyers and their potential clients.

On One Hand

The portions served by fast food chains and other restaurants are far larger than the recommended portion size for most foods. Food costs for restaurants are relatively low, compared to the costs of rent and labor, so it makes sense for them to offer larger portions that make their customers feel like they are getting a bang for the buck.

As American eat out more and more frequently, they become accustomed to those oversized portion, and think that such portions are normal. The high caloric content of these large servings leads to weight gain for regular fast food customers, and obesity can lead to many dangerous health problems.

Fast food chains do not alert their customers to the hazardously high calorie and fat content of the food they offer. They deserve some of the blame for the epidemic of obesity, and lawsuits brought by victims of their toxic food would force these companies to take some responsibility for their dangerous products.

On the Other Hand

Cigarettes contain substances that are addictive to smokers, and tobacco companies have been made to pay the price for selling a product that is dangerous to the health of their customers. But no one can claim that a Big Mac or a Whopper is addictive. They may be tasty, and people may eat too many of them, but McDonalds and Burger King are not responsible for their customers’ lack of self-control.

Lawsuits against fast food companies on behalf of obese “victims” would say more about the greed of trial lawyers than about any real danger posed by fast food. Most people choose to eat fast food even though they know it’s bad for them. Individuals have to take responsibility for that choice, not the company that provides the food.

• The US Department of Agriculture estimates the cost at more than $ 71 billion a year in added health-care and related expenses.
• In 1991, one in eight Americans were obese. In 1999, the number had increased to one in five.
• A study by Policy Analysis Inc. concluded that overweight people cost their employers $12.7 billion in sick time and insurance coverage in 1994 alone.
• It is estimated that kids get up to 40 percent of their meals from fast-food chains, convenience stores and restaurants.
• There are fast-food franchise outlets in 13 percent of the nation’s schools.
• One American Medical Association study estimates that 300,000 Americans die each year from obesity-related causes such as heart disease, diabetes and stroke.
• Obesity levels are sky-rocketing despite the fact that $33 billion a year is spent on weight-loss aids.

A startling number of parents may be in denial about their youngsters’ weight.

A survey found that many Americans whose children are obese do not see them that way.

That is worrisome because obese children run the risk of diabetes, high blood pressure, cholesterol problems and other ailments more commonly found in adults. And overweight children are likely to grow up to be overweight adults.

“It suggests to me that parents of younger kids believe that their children will grow out of their obesity, or something will change at older ages,” said Dr. Matthew M. Davis, a University of Michigan professor of pediatrics and internal medicine who led the study, released earlier this month.

“When I see a child that is obese at these younger ages, I take that as a sign of ways nutrition can be improved, a child’s activity level can be improved.”

Among parents with an obese, or extremely overweight, child ages 6 to 11, 43 percent said their child was “about the right weight,” 37 percent responded “slightly overweight,” and 13 percent said “very overweight.” Others said “slightly underweight.”

For those with an obese child ages 12 to 17, the survey found more awareness that weight was a problem. Fifty-six percent said their child was “slightly overweight,” 31 percent responded “very overweight,” 11 percent said “about the right weight” and others said “slightly underweight.”

Dr. Goutham Rao, clinical director of the Weight Management and Wellness Center at Children’s Hospital of Pittsburgh, said obesity in children isn’t as easy to identify as in adults. “Plus, because of the social stigma, it’s not something that parents are willing to admit to readily,” Rao said.

The survey of 2,060 adults, conducted over the summer by Internet research firm Knowledge Networks, collected height and weight measurements on the children from their parents, then used that to calculate body mass index.

When a child’s BMI was higher than the 95th percentile for children who are the same age and gender, the child was considered obese.

Based on what the parents reported, 15 percent of the children ages 6 to 11, and 10 percent of the children ages 12 to 17, were obese.

The Michigan researchers said that, too, suggests parents underestimate their children’s weight. National estimates indicate about 17 percent of U.S. children are obese under the standard used by the researchers.

Dr. Reginald Washington, a member of the American Academy of Pediatrics and part of the AAP’s committee on childhood obesity, noted that in about half of cases where a child is obese, one or both parents are overweight, too — and parents can take a pediatrician’s concerns as a personal affront.

Experts said doctors need to help parents better understand the health risks of childhood obesity.

“Obesity isn’t just something that affects the clothes that you buy or how you are perceived by your friends and your schoolmates,” Davis said. “It is something that can have health effects, not only in adulthood but in childhood.”

Defining Obesity in Children and Adolescents

Obesity is defined as an excessive accumulation of body fat. Obesity is present when total body weight is more than 25 percent fat in boys and more than 32 percent fat in girls (Lohman, 1987). Although childhood obesity is often defined as a weight-for-height in excess of 120 percent of the ideal, skinfold measures are more accurate determinants of fatness (Dietz, 1983; Lohman, 1987).

A trained technician may obtain skinfold measures relatively easily in either a school or clinical setting. The triceps alone, triceps and subscapular, triceps and calf, and calf alone have been used with children and adolescents. When the triceps and calf are used, a sum of skinfolds of 10-25mm is considered optimal for boys, and 16-30mm is optimal for girls (Lohman, 1987).

The Problem With Childhood Obesity

One in 10 six-year-olds is obese. The total number of obese children has doubled since 1982. On present trends half of all children in England in 2020 could be obese. So is this just harmless puppy fat or something more serious?

What is the problem?
If a child becomes obese their body processes can change. Some of these may be difficult or even impossible to alter in adulthood.

Fat cells are laid down in the first few years of life. If fat is stored quickly, more fat cells are created. So an obese child can have up to three times as many as a normal child. Eventually, fat cells stop multiplying and an adult has a fixed number for the rest of their life. The existing cells simply swell or shrink to accommodate more fat.

The amount of fat the body wants to store is thought to be proportional to the total number of fat cells. So if you were overweight as a child, your body is programmed to carry more fat. This doesn’t mean that you can’t lose weight through diet and exercise, but it will be harder.

Health problems for kids
Few health problems are observed in obese children. But they may develop conditions that cause problems later in life, such as high blood pressure.

They may also suffer from ’sleep apnoea’. When this happens, soft tissue in the throat blocks the airways during sleep. This can stop their breathing for up to a minute. This process can happen hundreds of times a night, leading to cardiovascular disease, memory problems, headaches and fatigue.

Diabetes risk
Some obese children may develop type II diabetes. Normally this condition only starts much later in life. When it strikes, the body stops being able to process sugar properly and the cells are starved of energy. Type II diabetes cannot be cured, but it can be treated. It may lead to complications such as nerve damage, heart disease, kidney disease and blindness. Children with this condition will have to live with it all their lives, increasing the chance of complications.

Negative body image can cause depression and social problems - overweight children are often teased. Low self-esteem may not directly affect physical health, but it is the biggest problem encountered. It may even lead to ‘comfort eating’, exacerbating the situation. If our culture placed less emphasis on the ‘perfect body’, then at least one set of issues associated with obesity would vanish.

Obese children in the United States

The percentage of overweight children in the United States is growing at an alarming rate. On the whole, kids are spending less time exercising and more time in front of the TV, computer, or video-game console. And today’s busy families have fewer free moments to prepare nutritious, home-cooked meals, day in and day out. From fast food to electronics, quick and easy seems to be the mindset of many people, young and old, in the new millennium.

Since the 1970s, the percentage of overweight kids and adolescents in the United States has more than doubled. Today, 10% of 2- to 5-year-olds and more than 15% of children between the ages of 6 and 19 are overweight. If you combine the percent of kids who are overweight with the percent of kids who are at risk of becoming overweight, about one out of three children are affected.

Preventing your children from becoming overweight means adapting the way you and your family eat and exercise and the way you spend time together. Helping your children lead healthy lifestyles begins with you, the parent, and leading by example.
Is Your Child Overweight?

A child with a body mass index at or above the 95th percentile for age and sex is considered overweight. BMI uses height and weight measurements to estimate how much body fat a person has. To calculate your child’s BMI, divide his or her weight by his or her height squared, or wt/ht2. (Important: To use this formula for BMI, the child’s weight and height measurements must be in kilograms and meters, respectively. If you use pounds and inches, multiply the result by the conversion factor 703.)

An easier way to get your child’s BMI is to use a BMI calculator. Once you know your child’s BMI, it can be plotted on a standard BMI chart. Your child will fall into one of 4 categories:

• Underweight: BMI below the 5th percentile
• Normal weight: BMI falls between the 5th and the 85th percentiles
• At risk for overweight: BMI between the 85th and 95th percentiles
• Overweight: BMI at or above 95th percentile

BMI is not a perfect measure of body fat and there are situations where BMI may be misleading. For example, a very muscular person may have a high BMI without being overweight (because extra muscle adds to a person’s body weight - but not fatness). In addition, BMI may be difficult to interpret during puberty when kids are experiencing periods of rapid growth. It’s important to remember that BMI is usually a good indicator - but is not a direct measurement - of body fat.

These days, you may be hearing more about BMI. Doctors are using BMI during routine check-ups and many school districts are including BMI in their annual health assessments.

If you’re worried that your child or teen may be overweight, make an appointment with your child’s doctor. If your child is overweight, your doctor may ask about your child’s eating and activity habits and make suggestions on how to make positive changes. He or she may also decide to screen for some of the medical conditions that can be associated with obesity (see below). Depending on the child’s BMI, age, and health, the doctor may refer you to a registered dietitian for additional advice. For some overweight children, your doctor may recommend a comprehensive weight management program.

The Effects of Overweight

Overweight children are at risk for serious health conditions like type 2 diabetes, high blood pressure, and high cholesterol - all once considered exclusively adult diseases. But overweight children may also be prone to low self-esteem that stems from being teased, bullied, or rejected by peers. Overweight children are often the last to be chosen as playmates, even as early as preschool. Children who are unhappy with their weight may be more likely than average-weight children to develop unhealthy dieting habits and eating disorders, such as anorexia nervosa and bulimia, and they may be more prone to depression, as well as substance abuse.

Overweight children are at risk of developing medical problems that affect a child’s present and future health and have direct impact on quality of life including:

• high blood pressure, high cholesterol and abnormal blood lipid levels, insulin resistance, and type 2 diabetes
• bone and joint problems
• shortness of breath that makes exercise, sports, or any physical activity more difficult and may aggravate the symptoms or increase the chances of developing asthma
• restless or disordered sleep patterns
• tendency to mature earlier (overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are; overweight girls may have irregular menstrual cycles and have fertility problems in adulthood)
• liver and gall bladder disease
• depression

Risk factors present in childhood (including high blood pressure, high cholesterol, and diabetes) can lead to serious adult medical conditions like heart disease, heart failure, and stroke. Preventing or treating obesity in children may reduce the risk of developing these conditions as they get older.

What Causes Overweight?

There are a number of factors that contribute to becoming overweight, either alone or together. Genetic factors, lifestyle habits, or both may be involved. In some instances, endocrine problems, genetic syndromes, and medications can be associated with excessive weight gain.

Much of what we eat is quick and easy - from fat-laden fast food to microwave and prepackaged meals. Daily schedules are so jam-packed that there’s little time to prepare healthier meals or to squeeze in some exercise. Portion sizes, in the home and out, have drastically increased.

Plus, now, more than ever, life is sedentary - children spend more time playing with electronic devices, from computers to handheld video game systems, than actively playing outside. Television is a major culprit.

Kids younger than 8 spend an average of 2.5 hours watching TV or playing video games, and kids 8 and up spend 4.5 hours plopped in front of the TV or wriggling a joystick. Kids who watch more than 4 hours a day are more likely to be overweight compared with kids who watch 2 hours or less. Not surprisingly, TV in the bedroom is also linked to increased likelihood of being overweight. In other words, once many kids get home from school, virtually all of their free time before dinner, doing homework, and getting ready for bed is spent in front of one screen or another!

And although physical education (PE) in schools can help kids get up and moving, more and more schools are cutting PE programs altogether or cutting down on the amount of time spent actually doing fitness-building physical activities. One study showed that gym classes offered third graders just 25 minutes of vigorous activity each week.

Genetics also plays a role - genes help determine your body type and how your body stores and burns fat just like they help determine other traits. Because both genes and habits can be passed down from one generation to the next, multiple members of a family may struggle with weight.

A greater reliance on “food fixes” to deal with emotions can also contribute to weight gain. Some people tend to eat more when they’re feeling sad, stressed, or bored. People in the same family tend to have similar eating patterns, maintain the same levels of physical activity, and adopt the same attitudes toward being overweight. Studies have shown that a child’s risk of obesity greatly increases if one or more parent is overweight or obese.
Overcoming Overweight and Obesity in Your Child

The key to keeping kids of all ages at a healthy weight is taking a whole-family approach. It’s the “practice what you preach” mentality. Make eating and exercise a family affair. Get your children involved by letting them help you plan and prepare healthy meals, and take them along when you go grocery shopping, so they can learn how to make good food choices.

Avoid falling into some common food/eating behavior traps:

Read the rest of this entry »

The balance between calorie intake and energy expenditure determines a person’s weight. If a person eats more calories than he or she burns, the person gains weight (the body will store the excess energy as fat). If a person eats fewer calories than he or she burns, he or she will lose weight. Therefore the most common causes of obesity are overeating and physical inactivity. At present, we know that there are many factors that contribute to obesity, some of which have a genetic component:

Genetics. A person is more likely to develop obesity if one or both parents are obese. Genetics also affect hormones involved in fat regulation. For example, one genetic cause of obesity is leptin deficiency. Leptin is a hormone produced in fat cells, and also in the placenta. Leptin controls weight by signaling the brain to eat less when body fat stores are too high. If, for some reason the body cannot produce enough leptin, or leptin cannot signal the brain to eat less, this control is lost, and obesity occurs. The role of leptin replacement as a treatment for obesity is currently being explored.
Overeating. Overeating leads to weight gain, especially if the diet is high in fat. Foods high in fat or sugar (e.g., fast food, fried food and sweets,) have high energy density (foods that have a lot of calories in small amount of food). Epidemiology studies have shown that diets high in fat contribute to weight gain.

A diet high in simple carbohydrates. The role of carbohydrates in weight gain is not clear. Carbohydrates increase blood glucose levels, which in turn stimulate insulin release by the pancreas, and insulin promotes the growth of fat tissue and can cause weight gain. Some scientists believe that simple carbohydrates (sugars, fructose, desserts, soft drinks, beer, wine, etc.) contribute to weight gain because they are more rapidly absorbed into the blood stream than complex carbohydrates (pasta, brown rice, grains, vegetables, raw fruits, etc.) and thus cause a more pronounced insulin release after meals than complex carbohydrates. This higher insulin release, some scientists believe, contribute to weight gain.

Frequency of eating. The relationship between frequency of eating (how often you eat) and weight is somewhat controversial. There are many reports of overweight people eating less often than people with normal weight. Scientists have observed that people who eat small meals four or five times daily, have lower cholesterol levels and lower and/or more stable blood sugar levels than people who eat less frequently (two or three) large meals daily. One possible explanation is that small frequent meals produce stable insulin levels, whereas large meals cause large spikes of insulin after meals.

Slow metabolism. Women have less muscle than men. Muscle burns more calories than other tissue (which includes fat). As a result, women have a slower metabolism than men, and hence, have a tendency to put on more weight than men, and weight loss is more difficult for women. As we age, we tend to lose muscle and our metabolism slows, therefore, we tend to gain weight as we get older particularly if we do not reduce our daily caloric intake.
Physical inactivity. Sedentary people burn fewer calories than people who are active. The National Health and Examination Survey (NHANES) showed that physical inactivity was strongly correlated with weight gain in both sexes.

Medications. Medications associated with weight gain include certain antidepressants (medications used in treating depression), anti-convulsants (medications used in controlling seizures such as carbamazepine and valproate), diabetes medications (medications used in lowering blood sugar such as insulin, sulfonylureas and thiazolidinediones), certain hormones such as oral contraceptives and most corticosteroids such as Prednisone. Weight gain may also be seen with some high blood pressure medications and antihistamines.

Psychological factors. For some people, emotions influence eating habits. Many people eat excessively in response to emotions such as boredom, sadness, stress or anger. While most overweight people have no more psychological disturbances than normal weight people, about 30 percent of the people who seek treatment for serious weight problems have difficulties with binge eating.
Diseases such as hypothyroidism, insulin resistance, polycystic ovary syndrome and Cushing’s syndrome are also contributors to obesity.

Why Are Some People Obese? - Trends in Obesity Research

Endocrine researchers are actively investigating the root causes of obesity. Recent trends currently being studied aim to identify why obesity affects some people, but not others. The trends of why obesity affects some people include:

Investigating obesity as an energy imbalance: Over an extended period of time, some people may ingest more carbon- and nitrogen-containing compounds from the food they eat than they need for energy (ideally, energy in = energy out), causing them to gain weight. This finding has led to ongoing research to determine how energy imbalance relates to such important overweight and obesity issues such as how food intake is regulated, where fat is stored and how genes control these processes.

Exploring the epidemiological model of obesity: An epidemiological model is a model that includes an environmental agent that acts on a host to produce a disease. In the case of obesity, the environmental agent is food and the host is the obese individual. In affluent societies, such as those of the Western world, foods, particularly foods high in fat, are abundant and physical activity has gradually been reduced. For the individual who may also be genetically susceptible to developing obesity, this excess of food energy leads to an accumulation of fat in cells, and, eventually to obesity. Some endocrine researchers believe that an epidemiological model may be a more comprehensive way to look at obesity than the energy balance model to conceptualize obesity as a disease.

Identifying the impact of select environmental agents on obesity:Environmental agents that have been shown to impact an individual’s risk for gaining and maintaining weight, resulting in overweight or obesity issues include:

• Intrauterine factors such as maternal diabetes, maternal smoking and intra-uterine nutrition;
• Neonatal environmental factors, such as breast-feeding; infants breast fed for more than 3 months may have a reduced risk of future obesity;
• Adiposity rebound, or the age in childhood when body mass index (BMI) stops falling and begins to rise. Early adiposity rebound predicts future obesity;
• Medications; drug-induced weight gain has been linked to many medications that are designed to treat various diseases such as psychosis, depression, allergies and diabetes;
• Portion size, fat intake and high fructose corn syrup; all have been implicated as contributors to obesity. Research has found a correlation between the consumption of soft drinks and future weight gain in children and adults;
• Activity; low levels of physical activity have been shown to correlate with weight gain and the issue of obesity;
• Smoking; smokers tend to have a lower body weight, and cessation of smoking is generally associated with weight gain (Note: Smoking is discouraged. Research addresses why the weight correlation exists and how to aid patients in quitting without weight gain.); and
• Viruses and obesity; one laboratory has reported that obese humans have higher antibody levels to one strain of adenovirus (AD-36), a viral infection possibly linked to obesity.

Researching host agents and obesity: Host agents, or characteristics, have been found through research to impact an individual’s risk for gaining and maintaining weight, and therefore may affect overweight and obesity issues. They include genetic causes and physiological factors.

Obese people find it harder to fight infections, and a weakened immune response may be to blame, suggests a new study from Boston University researchers.

In experiments with mice infected with the bacteria Porphyromonas gingivalis, obese mice had less ability to battle gum infection than their normal-weight counterparts, according to the report in this week’s early online edition of the Proceedings of the National Academy of Sciences.

“For years, we have had difficulty understanding why obese people have difficulty clearing an infection,” said lead researcher Dr. Salomon Amar, associate dean for research at the university’s School of Dental Medicine.

“Now we understand that dysfunction in some of the mechanisms, as a result of the obesity, explain difficulty in clearing the infection and also the difficulty in wound healing,” Amar said.

In the study, Amar’s team tied silk threads infected with the bacteria around the molars of obese and normal-weight mice. They then compared the animals’ responses to infection, by measuring both the amount of bone loss and the growth of the bacteria around their teeth.

The researchers found that the obese mice had a compromised immune response to the bacteria, which made the animals more susceptible to the infection.

Amar’s group also looked at the animals’ white blood cells, which are the main line of defense against infection. The white cells of obese mice had lower levels of an important signaling molecule, and some of the genes that fight inflammation were altered, the researchers found.

Why obesity has this effect isn’t clear, but the researchers think it may involve a signaling pathway that controls a protein called NF-kB. Alterations in this protein may be caused by constant exposure to food, Amar explained. “At some point, the body doesn’t respond properly to infection,” he said.

The same mechanism is at work in humans, Amar added. In fact, studies in obese people have shown they are more likely to have gum disease than non-obese people. The disease is caused by bacteria, which causes inflammation and destruction of the bone underlying teeth.

Amar thinks that obese people need to be treated differently to help them fight infections. “We need to be more aggressive in the use of targeted antibiotics in infections among obese people,” he said. “Also, we need to boost the immune response.”

One expert agreed the finding sheds light on the connection between obesity and infection.

“Very interesting paper,” said Dr. Sara G. Grossi, a senior research scientist at the Brody School of Medicine of East Carolina University. “This is a study that needed to be done, with very interesting results and implications for both obesity and periodontal disease — two diseases that are easier to prevent than to treat.”

Obesity linked to weaker immunity in animals

Obese mice are less able to fight off bacterial infection than lean mice, according to a study released Monday that supports emerging evidence of a link between obesity and a dysfunctional immune system.

In a study on laboratory mice infected with a bug that causes periodontal disease, obese mice had a blunted immune response to the infection and increased susceptibility to gum disease compared to lean mice.

The obese mice also had much higher rates of bone loss.

When researchers examined the rodents 10 days after they were infected with the bacterium Porphyromonas gingivalis, the heavier mice had a 40 percent increase in alveolar bone loss than the lean mice.

The alveolar bone is the bone or ridge that contains the tooth sockets on the upper and lower jaw.

Previous studies have shown that obese people are more likely to suffer from periodontal disease than their leaner counterparts and this study provided some clues as to why that is.

Blood tests on mice that had been infected with the bacterium P. gingivalis revealed irregularities in the production of cytokines in the obese mice, compared to the “control” or lean mice.

Cytokines are proteins or peptides that signal immune cells such as T-cells and macrophages to travel to the site of infection.

Researchers also analysed the macrophages, the white blood cells that form a major line of antibacterial defense.

They found that levels of key signaling molecules were significantly lower in the macrophages from the obese rodents and the expression profile of inflammation-related genes was altered compared to the control mice.

The researchers said it’s not clear how obesity compromises the immune system, but they suspect a particular signaling pathway involving a transcription factor NF-kB may be involved. NF-kB plays a key role in the immune response to infection.

The study appears in the journal, The Proceedings of the National Academy of Sciences, and was conducted by scientists in the School of Dental Medicine at the University of Boston Medical Center.

Emotional eaters — people who eat when they are lonely or blue — tend to lose the least amount of weight and have the hardest time keeping it off, U.S. researchers said.

They said the study may explain why so many people who lose weight gain it all back.

“We found that the more people report eating in response to thoughts and feelings, the less weight they lost,” Heather Niemeier, an obesity researcher at The Miriam Hospital and The Warren Alpert Medical School of Brown University, said in a statement.

“Amongst successful weight losers, those who report emotional eating are more likely to regain,” said Niemeier, whose study appears in the journal Obesity.

The study included 286 overweight men and women who were participating in a behavioral weight loss program.

A second group consisted of more than 3,300 adults who have lost at least 30 pounds and kept it off for at least one year.

Niemeier and her team analyzed responses to an eating inventory questionnaire.

Emotion Eaters are often at a loss to explain why the pounds they’ve lost creep back again, and they may blame themselves for their lack of willpower. But, in truth, it’s really a lack of self-awareness that’s to blame — not being aware of what it is that drives them to eat so much.

Here are the characteristics:

The Emotion Eater only overeats when she’s feeling a strong emotion, such as anger or depression.

The Emotion Eater frequently overeats immediately after getting home from work.

The Emotion Eater tends to eat whenever she is bored.

Sometimes, out of the blue, the Emotion Eater finds that she is incredibly hungry, and she almost feels as if she’s starving for food.
The Emotion Eater usually feels uncomfortable openly displaying or talking about her feelings.

The metaphysical basis of emotion eating is a belief that other people keep interfering with her attempts to fulfill her life purpose. She believes that if only her children, neighbors, boss, co-workers, teachers, parents, and lover would cooperate, she could get to work on her purpose.

The affirmation for the Emotion Eater is:

“I am the sole creator of my life. I choose now to put loving, creative, and consistent energy and enthusiastic effort into discovering and fulfilling my life purpose. I take total responsibility for structuring my time.”

One of the main “problems” that Emotion Eaters face is that they feel hungry a great deal of the time. Their solution in the past has been to eat every time they felt hungry. Unfortunately, since they were often so hungry, this meant that they would eat a lot of food and gain a lot of weight in the process.

They focused on people who ate because of external influences, such as people who eat too much at parties, and people who ate because of internal influences, such as feeling lonely or as a reward.

What they found is that the more a person ate for internal reasons, the less weight they lost over time.

“Our results suggest that we need to pay more attention to eating triggered by emotions or thoughts as they clearly play a significant role in weight loss,” Niemeier said.

Emotion Eaters must become acutely aware of their motivations for wanting to eat. You need this awareness in order to tell whether your stomach’s actually empty or you’re upset about something and just want to eat to feel better. First, spend the next week analyzing the feelings you have when you’re hungry. The best way to do this is to keep a journal recording how you feel before, during, and after you eat. The journal is a black-and-white way of finding patterns in the emotional reasons why you overeat.

Second, the next time you feel like eating, ask yourself if you could possibly be upset instead of hungry. Don’t go to the kitchen automatically when you feel hunger pangs. Instead — and this is important — give yourself a mandatory 15-minute “time out” whenever you think you’re hungry.

The high-fat, high-protein and low-carbohydrate Atkins diet may put practitioners at risk for heart disease in as little as one month, a new study suggests.

When individuals followed the maintenance phase of the diet — without weight loss — they experienced increased “bad” cholesterol and other markers for heart disease, experts report.

“I think the Atkins diet is potentially detrimental for cardiovascular health, if maintained for a long duration and without attempts to lose weight,” said lead researcher Dr. Michael Miller, lead author of the study, director of preventive cardiology at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine in Baltimore. “A stabilizing Atkins diet is not the way to go,” he said.

It’s also unclear if the popular South Beach or Ornish diets, also studied in the trial, actually promote heart health.

This was just one of several studies involving diet and nutrition slated for presentation at this week’s annual meeting of the American Heart Association in Orlando, Fla.

A second study, conducted primarily among Mormons in Utah, found that routine fasting was associated with a lower risk of coronary artery disease.

And yet another trial found that moderate drinking might help ward off angina after heart attack.

“Nutrition continues to be an area of interest, and, clearly, there is conflicting information out there,” said Dr. Robert Bonow, immediate past president of the American Heart Association. “With the Atkins diet, you do lose weight and experience a short-term beneficial effect on lipid parameters, but the concern would be long-term. Saturated fats are not good for heart health, and many people experience rebound weight gain which is not good.”

Although much research has been done on the Atkins diet, no one has yet looked at the effects of the diet when the person is not losing weight.

“During the process of weight loss, we would expect to see a benefit on various [cardiovascular] parameters,” Miller said. In other words, the weight loss that can come with these diets will help the heart.

But how does the cardiovascular system fare on a high-fat regimen when weight remains stable? “Weight loss confounds the results, and we wanted to compare these diets without that possible confounder,” Miller explained.

For this trial, 18 healthy adults completed four weeks each on the Atkins (50 percent fat), South Beach (30 percent fat) and Ornish (10 percent fat) diets.

People on the Atkins diet had increased levels of LDL (”bad”) cholesterol, more constricted blood vessels and an increase in blood markers for inflammation, some by as much as 30 percent or 40 percent, the researchers said.

The results were less clear for the Ornish or South Beach regimens. In those diets, markers for inflammation remained stable or dipped by up to 20 percent, the researchers found.

Another study followed up on reports from the 1970s that Mormons experience fewer deaths from heart disease.

Previous researchers had assumed that a prohibition on tobacco use among Mormons was the reason, but the current researchers hypothesized that there were additional factors at play.

Indeed, people who reported fasting regularly had a lower risk of developing coronary artery disease. The study adjusted for various factors including resting on the Sabbath, avoiding tea and tobacco, and age and body mass index.

The study did not put a time limit on fasting, but the religious teachings of Mormons do include fasting once a month for about 24 hours.

It could be that self-proclaimed fasters have better control of their diet in general, or fasting may prompt some kind of protective biological mechanism, said Benjamin Horne, senior author of the study, director of cardiovascular and genetic epidemiology at Intermountain Medical Center and adjunct assistant professor of biomedical informatics at the University of Utah in Salt Lake City.

Still, the study has raised more questions than it has answered, including whether to fast at all and for how long, he said. Horne warned that diabetics, in particular, should not start fasting until more is known.

A final study, this one of almost 2,500 individuals, confirmed that moderate alcohol consumption (one to two drinks daily) was associated with a reduced risk of angina one year after having a heart attack, compared to both abstinence or heavy alcohol consumption. Drinking too much (more than four drinks a day) was associated with an increased risk of angina, said researchers from St. Luke’s Hospital in Kansas City.

How does one find the healthiest lifestyle in the midst of all this information?

“We recommend weight loss in a slow and consistent manner rather than a crash course,” said Bonow, who is also Goldberg Distinguished professor at Northwestern University Feinberg School of Medicine, and chief of the division of cardiology at Northwestern Memorial Hospital in Chicago.

Bonow offered what he believes is a quick nutritional checklist for health: “Exercise and paying attention to calories in and out, lots of fruits and vegetables, less saturated fat, milk products should be skim, fried foods are bad, omega-3 fatty acids are good.”

What is Atkins diet?

The Atkins Nutritional Approach, popularly known as the Atkins Diet or just Atkins, is the most marketed and well-known low-carbohydrate diet. It was adapted by Dr. Robert Atkins in the 1960s from a diet he read in the Journal of the American Medical Association and utilized to resolve his own overweight condition following medical school and graduate medical training. After successfully treating over ten thousand patients, he popularized the Atkins diet in a series of books, starting with Dr. Atkins’ Diet Revolution in 1972. In his revised book, Dr. Atkins’ New Diet Revolution, Atkins updated some of his ideas, but remained faithful to the original concepts.

The Atkins franchise, a business formed that provides products to those individuals on the diet, has been highly successful due to the popularity of the diet, and is considered the iconic and driving entity of the larger “low-carb craze”. However, various factors have led to its dwindling success and the company founded by Dr. Atkins in 1989, Atkins Nutritionals of Ronkonkoma, New York, filed for Chapter 11 bankruptcy in July of 2005, two years after the death of Dr. Atkins. The company re-emerged in January 2006, and the Atkins logo is still highly visible through licensed-proprietary branding for food products and related merchandise.

The Atkins Diet represents a departure from prevailing theories. Atkins claimed there are two main unrecognized factors about Western eating habits, arguing firstly that the main cause of obesity is eating refined carbohydrates, particularly sugar, flour, and high-fructose corn syrups; and secondly, that saturated fat is overrated as a nutritional problem, and that only trans fats from sources such as hydrogenated oils need to be avoided. Consequently, Dr. Atkins rejects the advice of the food pyramid, instead asserting that the tremendous increase in refined carbohydrates is responsible for the rise in metabolic disorders of the 20th century, and that the focus on the detrimental effects of dietary fat has actually contributed to the obesity problem by increasing the proportion of insulin-inducing foods in the diet. While most of the emphasis in Atkins is on the diet, nutritional supplements and exercise are considered equally important elements.

Atkins involves the restriction of carbohydrates in order to switch the body’s metabolism from burning glucose to burning stored body fat. This process (called lipolysis) begins when the body enters the state of ketosis as a consequence of running out of excess carbohydrates to burn. Dr. Atkins in his book New Diet Revolution claimed that the low-carb diet produces a “metabolic advantage” where the body burns more calories, overall, than on normal diets, and also expels some unused calories. He cited one study where he estimated this advantage to be 950 calories a day.

Atkins restricts “net carbs”, or carbs that have an effect on blood sugar. Net carbohydrates can be calculated from a food source by subtracting sugar alcohols and fiber (which are shown to have a negligible effect on blood sugar levels) from total carbohydrates. Sugar alcohols need to be treated with caution, because while they may be slower to convert to glucose, they can be a significant source of glycemic load and can stall weight loss. Fructose (eg, as found in many industrial sweeteners) also contributes to caloric intake, though outside of the glucose-insulin control loop.

Preferred foods in all categories are whole, unprocessed foods with a low glycemic load. Atkins Nutritionals, the company responsible for marketing the Atkins Diet, recommends that no more than 20% of calories eaten while on the diet come from saturated fat.

Bad news

When Dr. Atkins Diet Revolution was first published, the President of the American College of Nutrition said, “Of all the bizarre diets that have been proposed in the last 50 years, this is the most dangerous to the public if followed for any length of time.”

When the chief health officer for the State of Maryland, was asked “What’s wrong with the Atkins Diet?” He replied “What’s wrong with… taking an overdose of sleeping pills? You are placing your body in jeopardy.” He continued “Although you can lose weight on these nutritionally unsound diets, you do so at the risk of your health and even your life.”

The Chair of Harvard’s nutrition department went on record before a 1973 U.S. Senate Select Committee investigating fad diets: “The Atkins Diet is nonsense… Any book that recommends unlimited amounts of meat, butter, and eggs, as this one does, in my opinion is dangerous. The author who makes the suggestion is guilty of malpractice.”

The Chair of the American Medical Association’s Council on Food and Nutrition testified before the Senate Subcommittee as to why the AMA felt they had to formally publish an official condemnation of the Atkins Diet: “A careful scientific appraisal was carried out by several council and staff members, aided by outside consultants. It became apparent that the [Atkins] diet as recommended poses a serious threat to health.

The warnings from medical authorities continue to this day. “People need to wake up to the reality,” former U.S. Surgeon General C. Everett Koop writes, that the Atkins Diet is “unhealthy and can be dangerous.”

The world’s largest organization of food and nutrition professionals, calls the Atkins Diet “a nightmare of a diet.” The official spokesperson of the American Dietetic Association elaborated: “The Atkins Diet and its ilk–any eating regimen that encourages gorging on bacon, cream and butter while shunning apples, all in the name of weight loss–are a dietitian’s nightmare.” The ADA has been warning Americans about the potential hazards of the Atkins Diet for almost 30 years now. Atkins dismissed such criticism as “dietician talk”. “My English sheepdog,” Atkins once said, “will figure out nutrition before the dieticians do.”

The problem for Atkins (and his sheepdog), though, is that the National Academy of Sciences, the most prestigious scientific body in the United States, agrees with the AMA and the ADA in opposing the Atkins Diet. So does the American Cancer Society; and the American Heart Association; and the Cleveland Clinic; and Johns Hopkins; and the American Kidney Fund; and the American College of Sports Medicine; and the National Institutes of Health.

In fact there does not seem to be a single major governmental or nonprofit medical, nutrition, or science-based organization in the world that supports the Atkins Diet. As a 2004 medical journal review concluded, the Atkins Diet “runs counter to all the current evidence-based dietary recommendations.”

A 2003 review of Atkins “theories” in the Journal of the American College of Nutrition concluded: “When properly evaluated, the theories and arguments of popular low carbohydrate diet books… rely on poorly controlled, non-peer-reviewed studies, anecdotes and non-science rhetoric. This review illustrates the complexity of nutrition misinformation perpetrated by some popular press diet books. A closer look at the science behind the claims made for [these books] reveals nothing more than a modern twist on an antique food fad.”

“Massive Health Risk”

The downfall of the Atkins Diet is also its one saving grace–people may not be able to tolerate the diet for long enough to suffer the long-term consequences. The American Heart Association states: “Individuals who follow these diets are therefore at risk for compromised vitamin and mineral intake, as well as potential cardiac, renal [kidney], bone, and liver abnormalities overall.” Low carb diets like the Atkins diet may also hasten the onset of type II diabetes. In short, concluded the September 2004 review in The Lancet, “low-carbohydrate diets cannot be recommended.”

In Europe, hospitals have already started banning the Atkins Diet after the British government’s Medical Research Council, backed up by the British Nutrition Foundation and the British Dietetic Association, condemned the Atkins Diet as “negligent” “nonsense and pseudo-science” posing a “massive health risk.”

An article out of the Cleveland Clinic Journal of Medicine entitled “Physician’s Guide to Popular Low Carbohydrate Weight-Loss Diets” noted that the Atkins Diet “can jeopardize health in a variety of ways.” Let us count the ways.

Cancer

Atkins’ followers also risk cancer. Studies at Harvard and elsewhere involving tens of thousands of women and men have shown that regular meat consumption may increase colon cancer risk as much as 300 percent. As one Harvard School of Public health researcher noted, because of the meat content, two years on the Atkins Diet “could initiate a cancer. It could show up as a polyp in 7 years and as colon cancer in ten.” Another Harvard study showed that women with the highest intake of animal fat seem to have over a 75% greater risk of developing breast cancer.

It’s tragically ironic that after McDonalds’ CEO apparently dropped dead of a heart attack in 2004, their new CEO was in the operating room with colo-rectal cancer only 16 days later.

The most comprehensive report on diet and cancer in history was published in 1997. It took over four years to complete, reviewing 4500 studies from thousands of researchers across the globe–a landmark scientific consensus document written by the top cancer researchers in the world. After all that work, what was their number one recommendation? “Choose a diet that is predominantly plant based, rich in a variety of fruits, vegetables, nuts, and beans with minimally processed starchy foods.” In other words, essentially the opposite of the Atkins Diet.

In the January issue of Scientific American it was noted: “Cancer is most frequent among those branches of the human race where carnivorous habits prevail.” That was the January issue in 1892! This is nothing new. What’s the number one recommendation of the American Institute for Cancer Research? Plant based diets. The number one recommendation of the World Cancer Research Fund? Plant-based diets. The number one recommendation of the National Cancer Institute, the World Health Organization and the Food and Agriculture Organization of the United Nations? More fruits and vegetables. The number one recommendation of the American Cancer Society? More plants, less meat. In fact the American Cancer Society has officially condemned diets high in animal grease, concluding that “a low carb diet can be a high-risk option when it comes to health.”

Peeing Your Bones Down the Toilet

A 2003 review of the safety of low carbohydrate diets reeled off an alarming list of potential problems: “Complications such as heart arrhythmias, cardiac contractile function impairment, sudden death, osteoporosis, kidney damage, increased cancer risk, impairment of physical activity and lipid [cholesterol] abnormalities can all be linked to long-term restriction of carbohydrates in the diet.”

There is a particular concern that children who go on the Atkins Diet might suffer permanent physical and mental damage as a result of starving their bodies of critical nutrients. As one U.S. child nutrition specialist explained, “The effect can be to dull the mind, stunt growth, and soften bones…I wouldn’t want to risk it by putting my child on a low carbohydrate diet.”

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Weight management, exercise and proper nutrition are key to reducing your risk of cancer. And the earlier in life you adopt these practices, the better off you’ll be, a new study suggests.

Factors such as birth weight, childbearing, breast-feeding, and adult height and weight also influence cancer risk, according to the report released Wednesday by the American Institute for Cancer Research and the Britain-based World Cancer Research Fund. Understanding how these factors affect cancer risk, and how to put this information to use to prevent the disease, offer promising new directions for cancer research, the study authors said.

“We need to think about cancer as the product of many long-term influences, not as something that ‘just happens,’ ” Dr. Walter J. Willett said in a prepared statement. Willett, a professor of epidemiology and nutrition at the Harvard School of Public Health, was one of 21 authors of the report, Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective.

“Examining the causes of cancer this way, across the entire lifetime, is called the life course approach,” he added.

The report, an analysis by scientists from around the world of more than 7,000 studies, offers 10 recommendations to help prevent cancer. They include staying lean, getting at least 30 minutes of exercise daily, limiting your intake of red meat and alcohol, and avoiding processed meats.

“These findings are right on,” said Colleen Doyle, director of nutrition and physical activity at the American Cancer Society. “They are consistent with our own nutrition and physical activity guidelines. They clearly put the emphasis where the emphasis needs to be, and that’s on controlling your weight.”

“This is a good-news report,” added Karen Collins, a nutrition adviser at the American Institute for Cancer Research. “If we are watching our weight, working regular physical activity into our daily life and eating a healthy balance of foods, we could prevent a third of cancers,” she said. “Extra weight is not dead weight,” she said. “It’s an active metabolic tissue that produces substances that promote the development of cancer.”

“People should take this message to be empowering,” Collins said.

The analysis of the studies found a definite link between excess fat and cancers of the esophagus, pancreas, colon and rectum, endometrium, kidney as well as breast cancer in postmenopausal women.

The risk from excess weight begins at birth, according to the report. The reason for the link between birth weight and breast cancer has to do with body fat. Excess body fat influences the body’s hormones, and these changes can make it more likely for cells to undergo the kind of abnormal growth that leads to cancer, the researchers said.

In addition, overweight girls can start menstruating at an earlier age. So, over their lifetime, they will have more menstrual cycles. This extended exposure to estrogen is associated with increased risk for premenopausal breast cancer, the report found.

Not smoking is the most important thing one can do to reduce the risk of cancer, Doyle said. But, she added, “there are estimates that obesity will overtake smoking as the leading preventable cause of death.

“It’s great to see another report that emphasizes being active, watching your weight and eating a healthy diet are not only going to help you reduce your risk of cancer but heart disease and diabetes as well,” Doyle said.

The report also found that breast-feeding can lower a mother’s risk for developing breast cancer. In addition, breast-fed infants have a lower risk of becoming overweight or obese, and this means a lower risk of developing cancer.

“The evidence is uniformly strong on breast-feeding, and the fact that it offers cancer protection to both mothers and their children is why we made breast-feeding one of our 10 Recommendations to Prevent Cancer,” Willett said.

In addition, tall people seem to have a higher risk of colorectal and postmenopausal breast cancer, according to the report.

“We found that tallness is also probably linked to increased risk for ovarian, pancreatic and premenopausal cancer as well,” Willett said. Although the association between height and cancer is convincing, tall people are not destined to get cancer, he added.

Willett noted that being at increased risk is not a guarantee that you are going to develop cancer. “Risk isn’t fate,” he said. “The evidence clearly shows that risk can be changed.

“We wanted to point these emerging links out, because we now believe them to be more important than the scientific community, much less the public, has yet realized,” Willett added. “Whether or not we get cancer has to do with our genes and with the choices we make everyday. Our cancer risk is also influenced by our whole accumulated life experience, from conception onwards.”

Body weight and composition is a big factor, one expert said.

“This report really reinforces the connection between being overweight or obese and the increased risk of many, if not all, cancers,” said Carolyn Lammersfeld, the national director of nutrition at Cancer Treatment Centers of America. “The majority of Americans are not aware of that connection. They are more concerned with pesticides and environmental contaminants, but obesity is a much greater risk factor,” she said.

But risks can be minimized, she added. “If you don’t have cancer, it’s never too late to try to do what you can to lower your risk,” Lammersfeld said. “In addition, cancer survivors should follow the diet and weight recommendations to prevent a return of cancer.”

The report said that people should not use dietary supplements to try to offset cancer risk — something Lammersfeld agreed with. “You can’t fix a crappy diet with supplements,” she said.

Report stresses link between obesity and cancer

Keeping slim is one of the best ways of preventing cancer, as is avoiding excessive amounts of red meat and wine, a landmark study has revealed.

The World Cancer Research Fund (WCRF) said the link between body fat and cancer is closer than generally realized.

It found convincing evidence of a link to six types of cancer, five more than in its last report, 10 years ago.

Among the new types are colorectal (bowel) and post-menopausal breast cancer.

Professor Michael Marmot, chair of the panel of 21 eminent scientists who compiled the report, said: “We are recommending that people aim to be as lean as possible within the healthy range, and that they avoid weight gain throughout adulthood.”

The report, which selected 7,000 studies from a worldwide pool of 500,000 written since records began in the 1960s, includes five key findings.

They are that processed meats, such as ham and bacon, increase the risk of colorectal cancer, and should be eaten sparingly.

Another is the link between red meat and colorectal cancer, for which the evidence is stronger than ever. People should not eat more than 500g of cooked red meat a week — or between 700g and 750g for “blue” or uncooked meat.

A further finding was the strongest evidence yet that alcohol is a cause of cancer. If people must drink, the report said, they should limit their intake to two units a day for a man or one for a woman. A unit is a half pint of beer or a small glass of wine.

The report recommended mothers breastfeed exclusively for the first six months after birth followed by complementary breastfeeding, after evidence showed breastfeeding protects the mother against breast cancer.

It did not recommend dietary supplements as prevention.

“This report is a real milestone in the fight against cancer, because its recommendations represent the most definitive advice on preventing cancer that has ever been available anywhere in the world,” said Professor Martin Wiseman, project director of the report.

Scientists believe there are several reasons for the link between body fat and cancer.

One is the relationship between excess fat and the hormonal balance in the body.

Research has shown that fat cells release hormones such as estrogen, which increases the risk of breast cancer, while fat around the waist encourages the body to produce growth hormones, which can increase levels of risk.

Evidence of a link is most convincing for cancer of the esophagus, pancreas, colorectum, endometrium (womb), kidney and post-menopausal breast cancer.

The report makes 10 recommendations including 30 minutes of moderate activity a day, rising to 60 minutes; drinking water rather than sugary drinks; eating fruit, vegetables and fiber and limiting salt consumption.

Obese people face bigger cancer risk

Obese people have a higher risk of certain kinds of cancer, according to a report Wednesday which found that red meat and processed meats cause bowel cancer.

The World Cancer Research Fund (WCRF) report, based on analysis of some 7,000 cancer studies from around the world, said there was “convincing” evidence that excess fat can cause breast, bowel and pancreatic cancer.

“We are recommending that people aim to be as lean as possible within the healthy range, and that they avoid weight gain throughout adulthood,” said Professor Michael Marmot, who chaired the panel which drew up the report.

“This might sound difficult but this is what the science is telling us more clearly than ever before. The fact is that putting on weight can increase your cancer risk, even if you are still within the healthy range.

The 360-page report, available on the website www.dietandcancerreport.org and launched in London, lists specific cancer risks for a range of foodstuffs.

For vegetables and fruit there were no “convincing” evidence of a link to particular cancers, it said, but for meat and fish there were clear indications of increased risks.

“The strongest evidence, corresponding to judgements of convincing’ and probable’, shows that red meat and processed meat are causes of colorectal cancer,” said the report.

The findings will fuel particular concern amid signs of increasing obesity levels in the Western world.

According to recent government-backed forecasts, 60 percent of men, 50 percent of women and a quarter of children in Britain will be obese by the year 2050. In 2004 nearly a quarter of men and women in England were obese.

The report, including recommendations by a panel of 21 experts, found a strong link between fat around the abdomen and bowel cancer, and a “probable” connection between body fat and gall bladder cancer.

“So the best advice for cancer prevention is to avoid weight gain, and if you are already overweight then you should aim to lose weight,” said Marmot.

Clinical obesity is defined as a Body Mass Index (BMI) of 30 or more, where BMI is calculated by dividing a person’s weight in kilograms by height in metres squared.

Normal weight corresponds to a BMI of 18.5-24.9, while 25-29.9 is “overweight”.

Drunks swimming in gin, smokers in body bags and dopers living with their parents deep into adulthood. Those are among the public service ads shown in the past. But the government’s new batch of obesity spots declines even to show a fat person, let alone wag a finger for gluttony or sloth.

No one is advocating public service announcements that ridicule fat people; experts say such spots would do more harm than good. But critics complain that the three new spots premiering this month are a wimpy attack on the costly and deadly explosion of obesity in America.

“It’s so namby-pamby I think people will shrug it off,” said Michael Jacobson of the Center for Science in the Public Interest, a Washington-based advocacy organization.

The three new spots are the latest in a series created by the Ad Council and the U.S. Department of Health and Human Services, which try to tackle the nation’s obesity problem with ads that encourage healthy snacking and taking the stairs.

Creators of the “Small Steps” campaign, funded by the government at more than $1.5 million a year, cite survey data for 467 adults which showed those who saw the ads did more walking and adopted some other healthy habits than those who didn’t see the ads.

But critics say such a survey is hardly proof of success, and the nation’s fat problem is clearly getting worse — more than one in three U.S. children are overweight or obese, and two in three adults are.

“I think ‘Small Steps’ is a euphemism for small vision,” said Kelly Brownell, director of Yale University’s Center for Eating and Weight Disorders.

The “Small Steps” campaign began in 2004. It was created for free by McCann Erickson New York, the ad agency that created the MasterCard “Priceless” campaign. Six TV spots have aired so far, all professionally produced and humorous, highlighting tips to healthier living.

This month, three more spots joined the rotation, along with a multimedia campaign focusing on exercise. The new anti-obesity TV spots show trim or slightly pudgy people noticing blobs of fat on a hotel room floor or in a theater. They comment that someone must have lost it by eating healthy snacks.

The spots’ creators say they learned in focus groups that many people are intimidated — hopeless, even — about the sustained changes needed to slim down.

“So many people, when they think about losing weight, see it as a Sisyphean task — ‘I have to lose weight but I can’t fit it into my busy schedule,’” said Peggy Conlon, president of the Ad Council.

The ads offer easily achievable tips that empower people to make positive changes, she added.

The ads targeting smoking aren’t as tame. A recent one by the New York City Department of Health and Mental Hygiene shows smokers’ decayed and tumored bodies.

Young viewers pay more attention to ads that evoke feelings of personal loss, sadness, anger, disgust or fear, according to an analysis by the Centers for Disease Control and Prevention. Kids also tend to remember such ads longer.

That drama is lacking in the obesity spots — for example, none have offered a surgeon’s view of fat, or dramatized a death from Type 2 diabetes, or shown a person complaining about how a fat neighbor’s medical bills are costing taxpayers.

In the past, the vegan advocacy group, Physicians Committee for Responsible Medicine, has taken a somewhat confrontational approach.

In 2005, the group put out a spot in which doctors yank a pizza and jumbo-sized soda away from an intently eating fat boy and toss him an apple. They put out another in which the same doctors haul away fatty foods from a restaurant called Chubby’s.

The group has no data on whether the ads are working, but the government ads “don’t address the obesity problem in a vivid enough way to get people’s attention,” said Patrick Sullivan, the group’s communications director.

That raises a second complaint with the government’s campaign: It sidesteps what some feel are the real causes of the obesity epidemic, the abundance of cheap and large portions of sugary and high-calorie foods.

“The U.S. government doesn’t have the guts to go after junk food producers,” Jacobson said.

Tied in with the “Small Steps” campaign, the Ad Council and federal health department are part of the “Coalition for Healthy Children,” whose members include Coca Cola, PepsiCo, the Hershey Co. and the National Confectioners Association. Critics say the partnership suggests a conflict of interest that might dissuade efforts to discourage soft drinks or candy bars.

Food and soda companies did not alter what was said in spots, said Ellyn Fisher, an Ad Council spokeswoman. The content was shaped by advertising research, which concluded the spots were humorous and motivating, she said.

Small Steps campaing

The Small Steps Campaign is a multi-media campaign to fight obesity with ads in print, on television, and online (specifically ads for TV, radio, newspaper, magazine, out of home, i.e. bus and subway, and web banners, all in both English and Spanish). The idea is that people can lose large amounts of weight permanently by taking small steps towards healthier living.

The simple truth is that Americans are getting fatter at an alarming rate, and that’s not good for anyone, whether you’re looking at it from a personal health standpoint, or at the economic impact of the costs of preventable diseases due to obesity. This is a VERY serious problem for our country and, more increasingly, the world.

This campaign attempted to target overweight people as they are most at risk of becoming obese, but the team felt that they are still likely to feel that they can affect their weight positively.

Families were also targeted, as the group hoped that they could influence the largest number of people, long-term, by marketing towards families with children.

In their own words:

It’s hard to stay in shape these days. Our entire lives are built around driving cars, eating on the run, and spending our free time relaxing in front of the TV or computer. We live in neighborhoods without sidewalks; we are surrounded by high calorie and high fat foods; we drive more than we walk or ride bikes.

All of these factors may contribute to the fact that two out of every three Americans are now overweight or obese — defined as having a body mass index over 25 — and that number is rising. While this problem is widely recognized as a public health crisis, we don’t have nearly enough information about realistic ways that regular people can actually change their lives and bodies. For many of us, a vigorous workout regimen or restrictive diet is just not possible.

At the same time, we want to be healthy not just for ourselves, but for our children and grandchildren. And we all know that if we don’t follow established healthy eating patterns, and continue to decrease our activity levels, we might not be able to do that.

Overweight Now a Global Problem

Worldwide, 40 percent of men and 30 percent of women are now overweight, and 24 percent of men and 27 percent of women are obese, say researchers who looked at data from 63 countries.

The study included information on more than 168,000 men and women ages 18-80 (average age 48), living on five continents. All of them were evaluated by their family doctors.

The findings are published in this week’s issue of the journal Circulation.

“The study results show that excess body weight is pandemic, with one-half to two-thirds of the overall study population being overweight or obese,” lead author Beverley Balkau, director of research at INSERM in France, said in a prepared statement. INSERM is the French equivalent of the U.S. National Institutes of Health.

She noted that obesity has become a major clinical and public health problem in many countries.

The data collected from the International Day for Evaluation of Abdominal Obesity also found that 56 percent of men and 71 percent of women had abdominal adiposity (excess fat), which significantly increases the risk of developing heart disease and diabetes.

In this study, abdominal adiposity was determined by measuring waist circumference.

“For men, each increase (in waist circumference) of approximately 5.5 inches (14 centimeters) means an increased frequency of about 35 percent for heart disease and for women an increase of approximately six inches (15 centimeters) equates to a 40 percent increase for heart disease. Even in people who are lean, an increasing waist circumference means increasing risk for heart disease and diabetes,” Balkau said.

Rates of obesity — a body mass index of 30 or more — varied between regions, ranging from a low of 7 percent in men and women in South and East Asia to 36 percent in Canadian men and women, the study found.

Other findings from the study:

• Overall frequency of heart disease was 16 percent in men and 13 percent in women.
• Eastern Europe had high rates of heart disease (27 percent in men, 24 percent in women), while Canada had low rates (16 percent in men, 8 percent in women).
• Overall, 13 percent of men and 11 percent of women had diabetes.

Governments need to take more preventive measures — such as encouraging people to exercise and providing more access to physical activity — in order to halt rising rates of overweight and obesity, Balkau said.

“Physical activity and good nutrition are key. A change is needed or the public health situation for heart disease and diabetes will become worse,” she warned.

Armchair fans star in obesity ad

The European Commission and Uefa have teamed up to launch an anti-obesity TV campaign - featuring a group of armchair-ridden couch potatoes struggling to play football - that will run during this year’s Champions League coverage.

The 30-second ad, “Go on, get out of your armchair”, is scheduled to run 2,023 times during the half-time breaks in each match over the course of the September to May competition.

“Tackling rising levels of obesity across Europe is a major public health priority for the European Commission,” said Philip Tod, spokesman for health at the EC.

“This advert will spearhead the Get Active Campaign and hopefully bring the issue front of mind.”

The advert, which aims to encourage people of all ages to get out and play sport, is expected to reach between 80 million and 100 million viewers during each match week of the Champions League.

The TV campaign, created by advertising agency Abbott Mead Vickers BBDO, will break across 48 European markets when the competition kicks-off on September 18.

The ad, in which the armchair-bound fans attempt to play football against a backdrop of La Donna e Mobile from Verdi’s Rigoletto, is being run free of charge through a deal with the Union of European Football Associations, which retains the right to use 30 seconds of airtime in matches for “social initiatives”.

The 30-second advert cost €550,000 (?372,000) to make. AMV BBDO provided its services free of charge.

Child obesity is of particular concern in Europe. According to the International Obesity Task Force an estimated 3 million children in Europe are obese, a figure that climbs by 85,000 each year.

Up to 27% of European men and 38% of women are considered to be obese, according to the European Commission.

What are the consequences of obesity?

Obesity is more than a cosmetic problem. Many serious medical conditions have been linked to obesity, including type 2 diabetes, heart disease, high blood pressure, and stroke. Obesity is also linked to higher rates of certain types of cancer. Men who are obese are more likely than nonobese men to develop cancer of the colon, rectum, or prostate. Women who are obese are more likely than nonobese women to develop cancer of the gallbladder, uterus, cervix, or ovaries. Esophageal cancer has also been associated with obesity.

Other diseases and health problems linked to obesity include:

• Gallbladder disease and gallstones.
• Fatty liver disease (also called nonalcoholic steatohepatitis or NASH).
• Gastroesophageal reflux, or what is sometimes called GERD. This problem occurs when the lower esophageal sphincter does not close properly and stomach contents leak back—or reflux—into the esophagus.
• Osteoarthritis, a disease in which the joints deteriorate. This is possibly the result of excess weight on the joints.
• Gout, another disease affecting the joints.
• Pulmonary (breathing) problems, including sleep apnea, which causes a person to stop breathing for a short time during sleep.
• Reproductive problems in women, including menstrual irregularities and infertility.

Health care providers generally agree that the more obese a person is, the more likely he or she is to develop health problems.

Health risks of being overweight

Weighing too much may increase your risk for developing many health problems. If you are overweight or obese on a body mass index (BMI) chart, you may be at risk for:

• Type 2 diabetes
• Heart disease and stroke
• Cancer
• Sleep apnea
• Osteoarthritis
• Gallbladder disease
• Fatty liver disease.

You can lower your health risks by losing as little as 10 to 20 pounds.

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Today, more than 65 percent of adults in the United States are overweight or obese. Obesity puts people at increased risk for chronic diseases such as heart disease, type 2 diabetes, high blood pressure, stroke, and some forms of cancer.

The large number of people with obesity and the serious health risks that come with it make understanding its causes and treatment crucial. This fact sheet provides basic information about obesity: What is it? How is it measured? What causes it? What are the health risks? What can you do about it?

What is obesity?

“Obesity” specifically refers to an excessive amount of body fat. “Overweight” refers to an excessive amount of body weight that includes muscle, bone, fat, and water. As a rule, women have more body fat than men. Most health care professionals agree that men with more than 25 percent body fat and women with more than 30 percent body fat are obese. These numbers should not be confused with the body mass index (BMI), however, which is more commonly used by health care professionals to determine the effect of body weight on the risk for some diseases.

How is obesity measured?

Measuring the exact amount of a person’s body fat is not easy. The most accurate measures are to weigh a person underwater or in a chamber that uses air displacement to measure body volume, or to use an X-ray test called Dual Energy X-ray Absorptiometry, also known as DEXA. These methods are not practical for the average person, and are done only in research centers with special equipment.

There are simpler methods to estimate body fat. One is to measure the thickness of the layer of fat just under the skin in several parts of the body. Another involves sending a harmless amount of electricity through a person’s body. Results from these methods, however, can be inaccurate if done by an inexperienced person or on someone with extreme obesity.

Because measuring a person’s body fat is difficult, health care professionals often rely on other means to diagnose obesity. Weight-for-height tables, used for decades, have a range of acceptable weights for a person of a given height. One problem with these tables is that there are many versions, all with different weight ranges. Another problem is that they do not distinguish between excess fat and muscle. According to the tables, a very muscular person may be classified obese when he or she is not. The BMI is less likely to misidentify a person’s appropriate weight-for-height range.

Body Mass Index

The BMI is a tool used to assess overweight and obesity and monitor changes in body weight. Like the weight-for-height tables, BMI has its limitations because it does not measure body fat or muscle directly. It is calculated by dividing a person’s weight in pounds by height in inches squared and multiplied by 703.

Two people can have the same BMI but different body fat percentages. A bodybuilder with a large muscle mass and low percentage of body fat may have the same BMI as a person who has more body fat. However, a BMI of 30 or higher usually indicates excess body fat.

The BMI table below provides a useful guideline to check your BMI. First, find your weight on the bottom of the graph. Go straight up from that point until you come to the line that matches your height. A BMI of 25 to 29.9 indicates a person is overweight. A person with a BMI of 30 or higher is considered obese. Please review your findings with your health care provider if your BMI is outside of the normal range.

* Without Shoes
**Without Clothes

Body Fat Distribution

Health care providers are concerned not only with how much fat a person has, but also where the fat is located on the body. Women typically collect fat in their hips and buttocks, giving them a “pear” shape. Men usually build up fat around their bellies, giving them more of an “apple” shape. Of course some men are pear-shaped and some women become apple-shaped, especially after menopause.

Excess abdominal fat is an important, independent risk factor for disease. Research has shown that waist circumference is directly associated with abdominal fat and can be used in the assessment of the risks associated with obesity or overweight. If you carry fat mainly around your waist, you are more likely to develop obesity-related health problems. Women with a waist measurement of more than 35 inches and men with a waist measurement of more than 40 inches may have more health risks than people with lower waist measurements because of their body fat distribution.

What causes obesity?

Obesity occurs when a person consumes more calories from food than he or she burns. Our bodies need calories to sustain life and be physically active, but to maintain weight we need to balance the energy we eat with the energy we use. When a person eats more calories than he or she burns, the energy balance is tipped toward weight gain and obesity. This imbalance between calories-in and calories-out may differ from one person to another. Genetic, environmental, and other factors may all play a part.

Genetic Factors

Obesity tends to run in families, suggesting a genetic cause. However, families also share diet and lifestyle habits that may contribute to obesity. Separating genetic from other influences on obesity is often difficult. Even so, science does show a link between obesity and heredity.

Environmental and Social Factors

Environment strongly influences obesity. Consider that most people in the United States alive today were also alive in 1980, when obesity rates were lower. Since this time, our genetic make-up has not changed, but our environment has.

Environment includes lifestyle behaviors such as what a person eats and his or her level of physical activity. Too often Americans eat out, consume large meals and high-fat foods, and put taste and convenience ahead of nutrition. Also, most people in the United States do not get enough physical activity.

Environment also includes the world around us—our access to places to walk and healthy foods, for example. Today, more people drive long distances to work instead of walking, live in neighborhoods without sidewalks, tend to eat out or get “take out” instead of cooking, or have vending machines with high-calorie, high-fat snacks at their workplace. Our environment often does not support healthy habits.

In addition, social factors including poverty and a lower level of education have been linked to obesity. One reason for this may be that high-calorie processed foods cost less and are easier to find and prepare than healthier foods, such as fresh vegetables and fruits. Other reasons may include inadequate access to safe recreation places or the cost of gym memberships, limiting opportunities for physical activity. However, the link between low socio-economic status and obesity has not been conclusively established, and recent research shows that obesity is also increasing among high-income groups.

Although you cannot change your genetic makeup, you can work on changing your eating habits, levels of physical activity, and other environmental factors. Try these ideas:

• Learn to choose sensible portions of nutritious meals that are lower in fat.
• Learn to recognize and control environmental cues (like inviting smells or a package of cookies on the counter) that make you want to eat when you are not hungry.
• Engage in at least 30 minutes of moderate-intensity physical activity (like brisk walking) on most, preferably all, days of the week.
• Take a walk instead of watching television.
• Eat meals and snacks at a table, not in front of the TV.
• Keep records of your food intake and physical activity.

Other Causes of Obesity

Some illnesses may lead to or are associated with weight gain or obesity. These include:

• Hypothyroidism, a condition in which the thyroid gland fails to produce enough thyroid hormone. It often results in lowered metabolic rate and loss of vigor.
• Cushing’s syndrome, a hormonal disorder caused by prolonged exposure of the body’s tissues to high levels of the hormone cortisol. Symptoms vary, but most people have upper body obesity, rounded face, increased fat around the neck, and thinning arms and legs.
• Polycystic ovary syndrome, a condition characterized by high levels of androgens (male hormone), irregular or missed menstrual cycles, and in some cases, multiple small cysts in the ovaries. Cysts are fluid-filled sacs.

A doctor can tell whether there are underlying medical conditions that are causing weight gain or making weight loss difficult.

Lack of sleep may also contribute to obesity. Recent studies suggest that people with sleep problems may gain weight over time. On the other hand, obesity may contribute to sleep problems due to medical conditions such as sleep apnea, where a person briefly stops breathing at multiple times during the night. You may wish to talk with your health care provider if you have difficulty sleeping.

Certain drugs such as steroids, some antidepressants, and some medications for psychiatric conditions or seizure disorders may cause weight gain. These drugs may slow the rate at which the body burns calories, stimulate appetite, or cause the body to hold on to extra water. Be sure your doctor knows all the medications you are taking (including over-the-counter medications and dietary supplements). He or she may recommend a different medication that has less effect on weight gain.

Obesity in America.

America is one of the richest, most progressive countries in the world. Shouldn’t it be one of the healthiest too? Maybe it should, but the sad truth is that Americans are some of the unhealthiest people in the world. Even though we are living in a country with great economic power and technological advancement, we are also living in a country with the smallest fund of practical nutritional knowledge. We are living in a land plagued with obesity.
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