Heart Disease Appears Early in Obese Children

A new study published in the Winter 2007 issue of the Journal of Cardiometabolic Syndrome finds that early signs of heart disease  appear in obese children or in children at risk for obesity.

"Based on this study, these subtle markers can help us predict who could be at risk for heart disease and heart attacks," said Angela Sharkey, M.D., associate professor of pediatrics at Washington University School of Medicine and a pediatric cardiologist at St. Louis Children’s Hospital.

Nationally, 19% of children in the 6 to 11 age group and 17% of children aged 12 to 19 are overweight, which amounts to an epidemic says the Centers for Disease Control (CDC). Being overweight during childhood means a higher risk of adult obesity, with the possibility of diabetes, elevated blood pressure and heart disease.

Dr. Sharkey and Dr. Steven M. Lorch of the University of Texas Health Science Center at Houston reviewed data from 168 children aged 10 to 18 who suffer from heart murmur, chest pain, acid reflux or hiogh blood cholesterol. CDC guidelines for BMIA indicated that 33 patients were obese, 20 had a BMIA putting them at risk for obesity, and 115 were considered normal.

The obese children’s hearts were evaluated by Drs. Sharkey and Lorch using a new tissue Doppler imaging technique called vector velocity imaging. This tracks the movement of the heart’s muscular wall: changes in the rate of motion of heart muscle were averaged within each group and compared to the normal rate of motion.

"In the patients who are obese, the rate of motion of heart muscle changed," Sharkey said. "As a child’s BMIA increases, we see alterations in both the relaxation and contraction phase of the heartbeat. Many of these changes that have been seen in adults were assumed to be from long-standing obesity, but it may be that these changes start much earlier in life than we thought."

The results of the study, said Dr. Sharkey, help physicians in counseling patients and parents about the risks of obesity and the importance of achieving a normal weight.

"Even in teenagers, obesity leads to decreased myocardial performance and abnormal diastolic function," she said.

Source: Washington University in St. Louis

Hormonal Components in Some Dietary Supplements May Promote Progression of Prostate Cancer

A recent study by researchers at UT Southwestern Medical Center concludes that hormonal components in over-the-counter dietary supplements may actually accelerate the progression of prostate cancer, at the same time decreasing the effectiveness of anti-cancer drugs.

The study, published in the January 11, 2008 issue of Clinical Cancer Research, strongly advises patients to tell their doctor if they are taking any herbal or hormonal dietary supplements. It is also recommended that the use of such supplements is routinely documented as part of the patient’s health assessment.

"Physicians need to ask their patients not only about the prescription drugs they may be taking, but—perhaps even more importantly—about the over-the-counter drugs and supplements, which may have a profound impact on certain health conditions," said Dr. Claus Roehrborn, chairman of urology at UT Southwestern and one of the study’s authors.

The research commenced when two UT Southwestern patients developed aggressive prostate cancer mere months after starting daily use of the same dietary supplement—one for muscular development, the other for sexual enhancement. When Dr. Roehrborn and Dr.Shariat, a resident in urology and the study’s lead author, and their colleagues analyzed the product (not named in the study) they found that the label listed ingredients not present, misrepresented the concentrations of the ingredients that were present, and did not list all the steroid hormones in the product.

Hormone analysis showed the presence of testosterone and estradiol, a sex hormone. Testing of the product’s effect on human prostate cancer-cell lines revealed that the product was a more potent stimulator of cancer-cell growth than testosterone. Use of the anti-cancer drug bicalutamide, in increasing concentrations, proved ineffective.

"Bicalutamide is an oral nonsteroidal anti-androgen used to treat prostate cancer," Dr. Shariat said. "The fact that this supplement caused the drug to be less effective is very troubling." The researchers filed an adverse event report with the Food and Drug Administration, which in turn issued a warning letter to the manufacturer, who withdrew the product from the market.

"Unlike prescription and over-the-counter drugs, the law does not require nutritional supplements to undergo pre-market approval for safety and efficacy," Dr. Shariat said. "The current FDA regulatory system provides little oversight or assurances that dietary supplements will have predictable pharmacological effects or even that product labels provide accurate information for consumers."

It is estimated that 42% – 69% of U.S. adults use dietary supplements, at an estimated cost of $34 billion. People often use supplements in the belief that these natural products are safe and drug-free. The sale of androgenic steroids meanwhile is increasing exponentionally, with 2004 sales U.S. expenditures on testosterone supplements totalling an estimated $425 million.

"Given that testosterone supplements are in high demand, there is significant concern that supplements, in addition to the one we evaluated, may pose an urgent human health risk," Dr. Shariat said.

Researchers from Baylor College of Medicine in Houston also contributed to the research.

"The current FDA regulatory system provides little oversight or assurances that dietary supplements will have predictable pharmacological effects or even that product labels provide accurate information for consumers."

Gastric Inhibitory Polypeptide (GIP) Can Reverse Diabetes and Promote Weight Loss

A new study was designed to find whether prolonged receptor antagonism using daily injections of GIP was capable of reversing diet-induced obesity and related metabolic abnormalities in an animal model.

The 8-week old mice selected for the study were given access to drinking water and a high fat diet—20% protein and 35% protein, percent of total energy 26.15kg/g. Control mice were fed a standard rodent maintenance diet—10% fat, 30% protein, 60% carbohydrate, percent of total energy of 12.99.

Before the study, mice were fed a high-fat diet for 160 days. Another set of mice were given a high-fat diet for 112 days before measuring circulating GIP and GLP-1 levels. For both samples, obesity and diabetes were unmistakably evident.

Among the key findings were that consumption of the high-fat diet produced progressive weight gain and elevations of plasma and gyrated hemoglobin, resulting in impaired insulin sensitivity and glucose intolerance within 10 days. (Pro3)GIP countered many of the detrimental effects of high fat diet on body weight and indices of glucose and lipid metabolism.

This study showed that blocking GIP activity using (Pro3)GIP in mice with established, high fat diet-induced obesity and diabetes results in significant weight loss, improvement of insulin resistance and amelioration of diabetes. These findings represent an interesting new approach to the treatment of obesity and metabolic disturbances.

Nigel Irwin, PH.D., of the research team said that possible parallels exist with the benefits of gastric bypass surgery in treating gross obesity and diabetes in people. In this procedure nutrients surgically bypass the area of the small intestine, resulting in a deficiency of circulating GIP.

Source: American Physiological Society (APS)

What You Don’t Want for Christmas: Weight Gain and Back Pain

In a recent survey conducted by SpineUniverse, 69%
of people estimated that they typically gain up to 8 pounds during the
holiday season. Another 9% put their weight gain at over 8 pounds.

 Those extra pounds from sugar cookies and big family dinners don’t come
off easily, either: it takes 60% of the people surveyed up to 10 months
to lose their holiday weight. 11% said that they never lose the weight.
A study published in the New England Journal of Medicine agrees: most
people can’t shake their holiday weight until the next fall–just in
time for the Halloween candy.

 So year after year, people add on weight during the holidays, and in
the long-term, that holiday weight gain can add up–to back pain. Dr.
Steven Richeimer, a member of the SpineUniverse Editorial Board and
Chief of Pain Medicine at the University of Southern California, Keck
School of Medicine, explains, "If you’re overweight, your spine may be
overworked as it tries to carry that extra weight. This can produce
injury and back pain."

He continues, "When you’re overweight, you’re more likely to injure
your back, and it is more difficult to recover–the result can be
chronic back pain. Additionally, being overweight can exacerbate or
even lead to symptoms of degenerative disc disease, compression
fracture, osteoporosis, osteoarthritis, spinal stenosis, and
spondylolisthesis."

Thinking about back pain isn’t exactly full of holiday cheer. But
suffering excruciating back pain is even less cheerful. For some simple
steps to follow this holiday season to prevent the typical holiday
weight gain, visit Spine Universe.

Insufficient Sleep Could Lead to Overweight Kids

Research findings from the University of Michigan C.S. Mott Children’s Hospital indicate that kids who don’t get enough sleep may be at increased risk of being overweight.

A study researching the connection between length of sleep and weigh for third and sixth grade children showed that kids who got less than 9 hours sleep per day were at greater risk of being overweight—regardless of their gender, race, socioeconomic status, or home environment quality.

The study showed that sixth graders short on sleep were more likely to be overweight. Third graders who got fewer hours of sleep—regardless of their BMI—were more likely to become overweight in sixth grade. The findings of this study appear in the November issue of the journal Pediatrics.

"Many children aren’t getting enough sleep, and that lack of sleep may not only be making them moody or preventing them from being alert and ready to learn at school, it may also be leading to a higher risk of being overweight," says study lead author Julie C. Lumeng, M.D., assistant research scientist at the U-M Center for Human Growth and Development. "This study suggests that an increased risk for overweight is yet another potential consequence of short sleep duration, providing an additional reason to ensure that children are receiving adequate sleep, primarily through enforcing an age-appropriate bed time."

Data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development on reported sleep problems, sleep duration and BMI for 785 elementary school children, aged 9 to 12, was reviewed . 50% were male, 81% were white, 18% were overeight in the sixth grade. The overweight sixth grade lids slept fewer hours than those were not overweight, with boys in the majority of overweight sixth grade children.

"Even more important," Lumeng says, "is emerging research that shows a connection between sleep disruption and the hormones that regulate fat storage, appetite and glucose metabolism. Short sleep duration alters carbohydrate metabolism, and leads to impaired glucose tolerance, which can affect a person’s weight. Circadian rhythms, too, affect the body’s leptin, glucose and insulin levels."

So weight gain may not be a result of sleep’s effect on behavior, notes Dr. Lumeng, but rather sleep’s effect on hormone secretion in the body, specifically leptin and grehlin.

The National Sleep Foundation recommends these basic daily sleep requirements for children, adolescents, pre-teens and teens:

  • Preschoolers: 11-13 hours
  • Elementary school students: 10-12 hours
  • Pre-teens: 9 – 11 hours
  • Teens: 8 ½ – 9 hours

In addition to Lumeng, co-authors from the U-M Center for Human Growth and Development are Deepak Somashekar, B.S., and Niko Kaciroti, Ph.D.; Danielle Appugliese, MPH, with the Data Coordinating Center, Boston University; and Robert F. Corwyn, Ph.D., and Robert H. Bradley, Ph.D., with the Center for Applied Studies in Education, University of Arkansas.

The study was supported by the American Heart Association Fellow-to-Faculty Transition Award, and the American Heart Association Midwest Affiliate Grant-in-Aid.

Reference: Pediatrics, November 2007, Vol. 120, Issue 5.

Researchers ID Brain Circuits Responsible for Hunger

A team of researchers has identified the brain circuits controlling hunger that are influenced by a hormone called leptin. The research, published in Proceedings of the National Academy of Science, found that leptin reduced activation in regions of the brain linked to hunger, while enhancing activation in regions linked to inhibition and satiety. The study suggests possible new targets for the treatment of obesity.

Three Turkish adults who lacked the leptin (ob) hormone were used in the study, and magnetic resonance imaging (MRI) was used to measure brain activity before and after leptin supplementation in them. The subjects were shown images of food before and after leptin treatment, while MRI imaging was in progress.

After leptin replacement, the subjects had feelings of hunger induced by the images, and activity in brain regions associated with hunger—the insula, parietal and temporal cortex—were reduced, while brain activity increased in the prefrontal cortex, previously associated with feeling full.

Despite the limitations in having only three subjects with the ob mutation, Prof. London says, "We think knowing the mechanisms by which leptin alters brain function in congential leptin deficiency can provide understanding of normal leptin physiology. Ultimately, that may help identify new targets for the treatment of obesity and related metabolic disorders."

The research was conducted by Edythe London, a professor of psychiatry in the UCLA Semel Institute for Neuroscience & Human Behavior, and Kate Baicy, a graduate student in Professor London’s lab. Other authors involved with the study were ohn Monteroso, Tuncay Delibasi, and Anil Sharma from the Semel Institute and the UCLA David Geffen School of Medicine, and Ma-Li Wong and Julio Licinio of the University of Miami Miller School of Medicine. The research was supported in part by the National Institutes of Health and the UCLA General Clinical Research Center. During the course of this study Amgen, Inc. provided leptin; Amylin, Inc. now provides leptin to these patients. Neither Amgen, Inc., nor Amylin, Inc., contributed to the design, analysis, or writing of this study.

Source: Proceedings of the National Academy of Science,October 29, 2007

Can Viruses Increase Obesity Risk?

According to an article published by Dr. Richard Atkinson in the journal Mayo Clinic Proceedings, "the growing body of evidence that viruses produce human obesity supports the concept that at least some of the worldwide epidemic of obesity in the past 25 years is due to viral infections."

Dr. Atkinson views the pattern of spread of obesity since 1980 as an epidemic compatible with "infectious origin." Although noting that lack of exercise and food intake were obviously of great importance to this epidemic, he has focused on various animal and human viruses that have been shown to increase obesity. For instance, the SMAN-1, an avian adenovirus from India, is the only animal virus "associated with human obesity."

The clinical implications of this research, if it stands up, would point to development of infection controls. "Ideally," Dr. Atkinson noted, "we could prevent infection and virus-induced obesity with a vaccine for the obesity viruses. Development of a human vaccine will take several years.” .

Obesity linked to increased risk of esophageal cancer

Writing in the aptly named online journal Gut, Australian researchers have discovered a disproportionate incidence of increased esophageal cancers in overweight individuals.

According to the researchers, those with a "body mass index (BMI) of 40 or more, were six times as likely than those with a BMI of between 18.25 and 25."

Gastric reflux increased the incidence of this cancer 5X, and combined with obesity, the risk increased 15X.

Men 50 years old and younger were particularly vulnerable.

Increased Waist Circumference Flags Health Problems

The consequences of growing a "spare tire" means more than having to wear an oversize Hawaiian shirt to the pool.

According to a recently published study by Dr. Steven Kaplan, professor of urology at Cornell University, increased waist circumference provides "powerful correlation" for predicting whether male patients have an increased incidence of erectile and ejaculatory problems, diabetes, hypertension increased blood pressure, a high lipid level and an enlarged prostate.

Obesity May be a “Contagious” Disease

According to researchers at Harbard University, obesity is socially contagious. And, it can spread through your social ties. The research is actually inclined toward finding methods that can help in controlling the obesity and overweight epidemic.

The study reports that obesity cannot be cured just by treating the person suffering from it. For more effective treatment, it’s necessary to  treat the entire social network of the patient.
This is because people have a natural inclination of being influenced by the habits and appearance of those who are around them. Therefore, weight gain of one person in a particular social circle may encourage weight gain in others within the same group.

This new revelation supports the efforts to promote and educate people about the benefits of a nutritional diet in a workplace where many of us find social circles.

Source: Washington Post (7/25/07)