Obesity is due to a mismatch between the number of calories we consume and the amount of physical activity we undertake. In the brain, a region called the hypothalamus control ours eating behavior through its metabolism of fat molecules called fatty acids. Interestingly, eating too much in the short-term can result in a severe drop in the ability of the body (and brain) to be satisfied by fat and to control blood sugar levels. In a study appearing online on March 9 in advance of print publication in the April issue of the Journal of Clinical Investigation, Luciano Rossetti and colleagues at Albert Einstein College of Medicine in New York report that inhibiting an enzyme in the liver called carnitine palmitoyltransferase-1 (CPT1A), which is involved in metabolizing fatty acids, inhibits feeding.

The researchers placed normal rats on a lard-based diet, which stimulated the animals to voluntarily overeat and gain weight. When the researchers inhibited CPT1A by delivering special molecules called “ribozymes” into the brain of the rats, the animals ate dramatically less. The treatment also improved the blood sugar levels of these animals, who suffered from a common metabolic impairment known as insulin resistance, in which the body is unable to respond properly to insulin. The authors report that this animal model of diet-induced obesity and insulin resistance displayed defective adaptation to an increase in fat availability coupled with a severe impairment in the ability of the brain to sense fat intake. Further studies will be required to establish the critical role of this biochemical pathway in nutrient sensing in other animal models and, critically, in humans.

New guidelines on obesity in the US may end up harming children, says an article in this week’s BMJ. And an accompanying article goes on to question the financial links between the organisation promoting these proposals and the pharmaceutical industry. If implemented, the proposals would see many more children classified as overweight or obese - and thus eligible for treatment with obesity drugs.

The article outlines how an influential expert committee of the American Medical Association has “tentatively decided” to reclassify obesity definitions. This will result in healthy children being categorized as medically overweight or obese, says the author, and mean that approximately a quarter of toddlers and two fifths of children aged 6-11 in America will be classed as having the disease.

Author of the articles is Ray Moynihan, who has previously written about drug companies promoting an increasing reliance on medications to the public. His report reveals that the US proposals have been greeted with alarm by some senior public health academics who have written to the committee. Dr Jenny O’Dea from the University of Sydney, for instance, warned that labelling children as overweight or obese can lead to stigmatisation, eating problems, and avoidance of exercise.

Mr Moynihan points out that one of the prime movers behind the proposed changes being considered by the expert committee is Dr William Dietz, a senior member of the International Obesity Task Force. In the second article Mr Moynihan reveals how the high profile and highly influential Task Force, which has close ties to the World Health Organisation, was set up in the mid-1990s with the help of grants from three drug companies and continues to benefit from drug company sponsorship.

Now merged with another international obesity forum, the Task Force gets two thirds of its funding from pharmaceutical giants Roche and Abbott. Roche makes the anti-obesity drug Xenical (orlistat), and Abbott makes the appetite suppressant Reductil (sibutramine hydrochloride). Over recent years, the article states, drug company sponsorship is likely to have amounted to “millions

Obese patients who are treated for chronic hepatitis C virus (HCV) infection are more likely to have a better outcome if the underlying abnormalities caused by excessive fat tissue are corrected first, according to a review published in the medical journal Hepatology.

The lead author, Dr. Michael R. Charlton of the Mayo Clinic, Rochester, Minnesota, and colleagues point out that obesity is considered to be a metabolic condition, not simply a matter of being very overweight.

Obesity in patients with HCV infection is associated inflammation and insulin resistance, a “prediabetic” abnormality of blood sugar. These patients may also have steatosis, “fatty liver disease;” progression of fibrosis, scarring of the liver; and poor response to interferon and ribavirin, the standard treatment for HCV infection.

Patients with hepatitis C and obesity-related fatty liver disease are also at greater risk for more advanced liver disease.

Weight loss to reduce fat tissue is an important first step in improving response to treatment, the investigators advise. Also important is treatment with diabetes drugs, such as metformin and pioglitazone, to improve insulin sensitivity and reduce fat accumulation in the liver. This might reverse disease progression, the researchers note.

Other approaches to enhance patients’ response to combination drug therapy may include longer duration of treatment and higher doses to counteract the decreased response to the drugs. Rather than basing doses on weight, they suggest, drug doses could be based on body mass index, a ratio of height to weight.

“Treatment strategies that focus on improving underlying metabolic factors associated with poor response to combination therapy,” conclude the researchers, are “more likely to overcome the low sustained viral response rates observed in obese patients infected with HCV.”

Obesity in adolescence is associated with reduced heart function and excessive cardiac mass, according to a new study.

“Many of these kids will become hypertensive and the association of obesity with hypertension might be devastating,” Dr. Giovanni de Simone from “Federico II” University Hospital School of Medicine, Naples, told Reuters Health. “This is only partially a medical problem, but a social and political problem.”

The researcher and his colleagues in Italy and the USA examined heart dimensions and function in 460 adolescents from American Indian communities in Arizona, Oklahoma, North Dakota and South Dakota as part of the Strong Heart Study.

Of the 460 participants, 113 were overweight and 223 were obese. Also, 110 had high-normal blood pressure and 27 had high blood pressure. Ten were diagnosed with diabetes, the team reports in the Journal of the American College of Cardiology.

The size of the left ventricle, the main pumping chamber of the heart, was enlarged in the obese and overweight adolescents compared to the normal-weight adolescents, the findings indicate, and one third of the obese teenagers were classified as having an actual medical condition called left ventricular hypertrophy.

“Early intervention during childhood and adolescence to reduce the prevalence of obesity and prevent the transition from overweight to overt obesity might represent a crucial step,” the investigators say, in order to avert the development of heart disease.

“Obesity has been recognized as an important risk factor that contributes to the development of many different disease states worldwide,” write Dr. Stephan von Haehling from Imperial College School of Medicine, London, and colleagues in a related editorial.

“For young people with…established risk factors for future cardiovascular illness (like hypertension, hyperlipidemia or diabetes), it seems very likely that obesity confers a somewhat higher risk for death compared to people with normal weight,” the editorialists conclude.

The number of new cases of type 2 diabetes among middle-aged Americans has doubled over the past 30 years, researchers report.

“There has been tremendous concern, but probably not enough concern, about the emerging epidemic of diabetes,” said Dr. Robert Rizza, a professor of medicine at the Mayo Clinic and president of the American Diabetes Association. “It doesn’t take long to be doubling before the numbers are simply too great to be even conceived of.”

“We’ve got to stop this, and, of course, it’s obesity which is driving it,” Rizza added. “This is a biologic weapon which has been unleashed on our population — its name is diabetes.”

Experts agree that the great increase in obesity over the same time frame appears to be responsible for the growing incidence of diabetes. An estimated two-thirds of adult Americans are now overweight or obese.

“These [diabetes numbers] warrant monitoring, especially if we continue to see increases in the trends of obesity,” said study lead author Dr. Caroline S. Fox, a medical officer at the National Heart, Lung, and Blood Institute’s Framingham Heart Study.

The study findings appear in the June 19 issue of the journal Circulation.

In type 2 diabetes, the body either doesn’t produce enough insulin — the hormone that converts blood sugar to energy for cells — or the cells ignore the insulin. Left untreated, the disease can produce complications such as heart disease, blindness, nerve and kidney damage.

In their study, Fox and her colleagues collected data on 3,104 men and women, ages 40 to 55, who participated in the Framingham Offspring study. All participants were diabetes-free at the start of the study, and they received a routine physical examination during the 1970s, the 1980s, and the 1990s. They were also followed for eight years to track new cases of diabetes.

The researchers found that the odds of developing type 2 diabetes increased 40 percent from the 1970s to the ’80s, and doubled between the ’70s and ’90s. The data revealed that among women, there was an 84 percent increase in the incidence of type 2 diabetes in the ’90s, compared with the ’70s. In men, the incidence of type 2 diabetes more than doubled in the ’90s compared with the ’70s.

This trend must be reversed to avoid serious repercussions for the U.S. economy and health-care system, Rizza said.

“It requires a concerted effort by our health-care system, by our government, by all parts of society to realize that this epidemic is endangering not only all the people alive, but our children and our children’s children,” Rizza said. “Our health-care system and our nation’s economy cannot tolerate one in three people having diabetes.”

One expert thinks the only way to correct the problem is by making a total lifestyle change.

“This epidemic results, almost entirely, from obesity and sedentary behavior,” said Cathy Nonas, director of the obesity and diabetes program at North General Hospital, in New York City, and a spokeswoman for the American Dietetic Association.

“The more sedentary we are, the fatter we get, the more insulin resistance we get, the more at risk we are for type 2 diabetes,” Nonas said. “We have to maintain healthier weights. We have to be active.”

(NaturalNews) A recent editorial in the British Medical Journal says that Chinese people are becoming overweight and obese at an “alarming” rate, with the country experiencing a 28-fold increase in obesity over a 15-year period from 1985 to 2000.

Experts blame the Chinese obesity epidemic on lifestyles that include less exercise and increased meat consumption and car use. Today there are 20 million cars on the roads in China; six years ago there were only 6 million. Chinese people also increased their dietary intake of meat from 8 percent in 1982 to 25 percent in 2002, which experts warn could result in an upcoming epidemic of heart disease or diabetes.

“China was once considered to have one of the leanest populations, but it is fast catching up with the west,” writes Wu Yangfeng of the Chinese Academy of Medical Sciences. “Disturbingly, this has occurred in a remarkably short time.”

Tony Barnett, head of the diabetes and obesity group at Birmingham University in the UK, calls the rise in obesity “incredibly dramatic” and says that part of the problem is “urbanization” in China. “What goes with urbanization is changes in diet and changes in lifestyle, but particularly exercise,” says Barnett. “All of the evidence that we have is that it is the reduction of activity that is contributing more, or at least as much, as changes in diet to the epidemic.”

China’s 2002 national nutrition health survey revealed that 14.7 percent of Chinese people are overweight, with 2.6 percent obese. While those numbers do not compare with U.S. obesity — where two-thirds of the population is overweight with one-third obese — Wu says China is catching up quickly. Currently one-fifth of the world’s obese people are Chinese.

Wu also says the Chinese cultural attitude that excess body fat represents prosperity and health only makes the obesity problem worse. “This is perhaps a consequence of China’s recent history, where famine and chronic malnutrition caused the deaths of millions of people,” Wu says.

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As the nation’s collective waistline has swelled in recent decades, rates of asthma diagnoses also have accelerated. Indeed, much research has affirmed a link between the two conditions.

But doctors also recognize that asthma may not behave the same way among people who have different body types. With a variety of asthma medications on the market, what kinds work best for lean people and what kinds work best for obese people? The answer may be different for each group.

A new study suggests that people who are overweight or obese may have better results with the prescription pill sold as Singulair than with a type of inhaled steroid, while leaner people may have better luck with an inhaled steroid, called beclomethasone and sold as beclovent, vanceril and other brand names. The findings appear in the new issue of the European Respiratory Journal.

“It is increasingly recognized that obese people are more prone to develop asthma, but there is no information about whether obesity influences people’s responses to particular asthma medications,” says lead author Marc Peters-Golden, M.D., professor of internal medicine and director of the Fellowship Program in Pulmonary and Critical Care Medicine at the University of Michigan Medical School.

“Our findings are the first to suggest the possibility that obesity might be a factor that influences how well asthmatics respond to particular medications,” Peters-Golden says.

Singulair is the brand name of montelukast sodium and is sold by Merck & Co., which funded this study.

Researchers looked at data from four previous multi-center, randomized clinical trials from 3,073 patients with moderate asthma. The data included the patients’ responses to Singulair/montelukast, a beclomethasone inhaled steroid and a placebo, and the participants’ body mass index numbers, which placed them in the categories of normal, overweight and obese.

In general, the severity of people’s asthma was found to be greater among those in the overweight and obese groups, which supports findings from other studies.

In addition, the inhaled steroid was found to be better than Singulair at increasing the number of asthma control days (ACD) among people in the normal weight category. An ACD is defined as a day with no more than two puffs of an inhaler, no night-time awakenings and no asthma attacks.

On the other hand, the inhaled steroid resulted in a reduced effect in the percentage of ACDs among obese people in the study – that is, the benefit of the inhaled steroid declined with increasing body mass index.

In contrast, the positive impact of Singulair did not decrease in obese and overweight people when compared to its impact on people of normal weight. The research also suggests that the higher a person’s body mass index, the greater his or her response to Singulair compared to a placebo, a pill with no medicinal benefit. This is an indication, Peters-Golden says, that obese and overweight people may in fact respond better to this medication.

Still, he is not inclined to suggest that doctors change the way in which they prescribe medication – not yet, anyway.

“Our study looks back at material from previous trials. I’d like to see a prospective study in which lean patients and heavy patients are enrolled at the outset, and you compare both types of medications in both groups,” Peters-Golden says. If verified by other studies, this insight may help physicians to better tailor medication regimens to meet individual patient needs.

Peters-Golden also notes that much research about asthma and other conditions is exploring the possibility that genetic factors might explain individual variations in responses to medications. He says it is likely that a variety of factors, including genetic ones and acquired factors such as weight, combine in a complex and intertwined manner to influence a person’s reaction to medications.

Information about Singulair/montelukast: This medication, usually taken once a day, is a type of leukotriene antagonist – that is, it blocks leukotrienes in the body. Leukotrienes are chemicals in the human body that can affect the breathing passages. Information about the beclomethasone inhaled steroid: Beclomethasone is a steroid that prevents the release of substances in the body that cause inflammation. Inhalation of beclomethasone prevents asthma attacks and other conditions involving inflammations of the lung tissues.

The number of obese “baby boomers” in Canada today is 60 per cent higher than it was just a decade ago, according to a new report by the Heart and Stroke Foundation. In fact, says Queen’s epidemiologist Ian Janssen, boomers are in even worse shape than Canadian seniors.

“Rising obesity combined with physical inactivity - less than half of Canada’s baby boomers meet physical activity recommendations - is putting boomers at higher risk for a number of chronic health conditions, including heart disease, stroke, diabetes and some types of cancer,” says Dr. Janssen, a professor in the School of Physical and Health Education and member of a national expert think tank on reducing obesity in Canada.

Currently about one in three Canadian baby boomers aged 45 to 59 is obese, as compared to one in four Canadian seniors aged 65 to 74. Ten years ago, one in four boomers was obese.

The percentage of boomers who smoke is also at twice the rate of seniors (21 per cent compared to 11 per cent), another factor associated with serious diseases, notes the Heart and Stroke Foundation’s Annual Report on Canadians’ Health. In Canada a third of all deaths are caused by heart disease and stroke.

The report predicts that today’s baby boomers may become the first generation to see a decline in their health and quality of life. Yet 80 per cent of them think they will enjoy a longer life expectancy than previous generation. And 58% think their weight has little or no effect on their heart health.

What boomers are concerned with, the survey notes, is the ability of our health care system to provide cardiovascular care. With an unhealthy aging population and about a quarter of our medical workforce retiring in the next dozen years, the heart health crunch may become a heart health crisis.

“This report should be a wake-up call to Canadians, especially those in their middle years, that they need to change their activity patterns and eating choices now to prevent chronic disease. No matter what your age, even little changes can have a substantial impact on your health risk, ” says Dr. Janssen.

The Heart and Stroke Foundation also calls upon the new federal government to make this issue a priority. “It’s clear the time has come for a national strategy to promote healthy living and chronic disease prevention,” the report states.

As childhood obesity continues to grow on an epidemic scale in the United States, experts are suggesting a number of simple ways parents can encourage healthy eating early in life. One of the simplest ways is integrating whole grains into a child’s diet.

Whole grains provide significant health benefits and the USDA’s MyPyramid recommends that all adults and children older than age two get half of their daily grains (at least three ounces) from whole-grain products. Researchers at the USDA have determined that whole grains are significantly under represented in the average American’s diet. According to Jeanne Kandra, a registered dietitian who works with school- aged children in Mt. Joy, Pa., there’s a huge back-to-basics interest in less refined foods.

“Whole-grain choices provide a full, rich, nutty, comfort-food flavor,” Kandra said. “And, whole-grain products are typically nutrient-dense, with fiber, antioxidants, vitamins and minerals.”

Furthermore, medical research has found that integrating whole grains into a healthy diet can help reduce an individual’s likelihood of developing heart disease, high blood pressure, cancer, stroke, diabetes and obesity.

Considering the numerous benefits of whole grains, it’s important that parents add whole grain products to their children’s diets and work to defeat the stereotype that whole-grain foods don’t taste good.

“Parents can integrate whole grains into the family repertoire by modeling their own acceptance of these foods,” Kandra said. “Students are going to start seeing more whole grains at school as well, since public schools are incorporating whole grains into their daily menus to comply with the new Federal Student Wellness Mandate addressing the childhood obesity epidemic in our country. Mainstream availability is going to gradually make more children accept whole-grain products.”

Outside of school, parents can add whole grains to the dinner menu by adding whole-grain pasta like RONZONI HEALTHY HARVEST(R), which is available in eight varieties and has been featured as a highly recommended product in Family Circle and is a Cook’s Illustrated favorite. After all, pasta is one of the foods kids most frequently eat at home. According to statistics from a custom research group; the NPD Group, kids eat 62 pounds of pasta each year, more than any other age group.

According to renowned light-cooking chef Kathleen Daelemans, author of New York Times best-selling cookbook Cooking Thin with Kathleen Daelemans, making a child’s favorite pasta dish with whole-grain pasta is easy.

“What your children don’t know won’t hurt them,” Daelemans said. “It’s easy to substitute whole-grain pasta into your child’s favorite pasta dish- whether it’s spaghetti with meatballs or fresh pasta salad. Pastas like RONZONI HEALTHY HARVEST that have a taste and texture similar to regular pasta can be slipped into family meals without even a second look.”

“When it comes to integrating whole grains, it’s easy to start young,” Daelemans added. “Pasta is a great, first finger-food for toddlers. Giving them whole-grain pastas now can be the beginning of a lifetime of healthy eating.”

Middle-age individuals without high blood pressure or high cholesterol levels but who are obese have an increased risk in older age for hospitalization or death from coronary heart disease, cardiovascular disease, or diabetes, compared to individuals of normal weight, according to a study in the January 11 issue of JAMA.

Obesity adversely affects a large array of health outcomes, including coronary heart disease (CHD), other cardiovascular disease (CVD), and diabetes mellitus, according to background information in the article. Obesity is also associated with established cardiovascular risk factors, particularly diabetes and elevated levels of blood pressure and serum cholesterol. However, controversies persist as to whether excess weight has additional impact on CVD outcomes beyond its effects on established risk factors. Direct evidence on this issue is limited. In clinical settings, patients sometimes ask if they still need to control their weight if their blood pressure and cholesterol levels are not high. Therefore, in light of the worsening obesity epidemic, further research is warranted to examine whether obesity carries additional risks in the absence or presence of other major risk factors.

Lijing L. Yan, Ph.D., M.P.H., of the Feinberg School of Medicine, Northwestern University, Chicago, and colleagues examined the relationship of body mass index (BMI) earlier in life with illness and death outcomes in older age, i.e., 65 years and older, among individuals without and with other major risk factors at baseline. The Chicago Heart Association Detection Project in Industry study included 17,643 men and women aged 31 through 64 years, who were free of CHD, diabetes, or major electrocardiographic abnormalities at baseline (1967-1973). Cardiovascular risk was classified as low: systolic blood pressure 120 or less and diastolic blood pressure 80 mm Hg or less, serum total cholesterol level less than 200 mg/dL, and not currently smoking; moderate risk: nonsmoking and systolic blood pressure 121-139 mm Hg, diastolic blood pressure 81-89 mm Hg, and/or total cholesterol level 200-239 mg/dL; or having any 1, any 2, or all 3 of the following risk factors: blood pressure 140 or greater/90 mm Hg, total cholesterol level 240 mg/dL or greater, and current cigarette smoking. Body mass index was classified as normal weight (18.5-24.9), overweight (25.0-29.9), or obese (30 or greater). Average follow-up was 32 years.

In multivariable analyses that included adjustment for systolic blood pressure and total cholesterol level, the researchers found that the risk for CHD death for obese participants, compared with those of normal weight in the same risk category, was 43 percent higher for the low risk group and nearly 2.1 times higher for the moderate risk group. Compared to those of normal weight, obese individuals in the low risk group had a 4.2 times higher risk for CHD hospitalization; for the moderate risk obese group, the risk of CHD hospitalization was twice as high. Results were similar for other risk groups and for cardiovascular disease, but stronger for diabetes (low risk, 11 times increased risk for death and 7.8 times increased risk for hospitalization).

“In this predominantly white cohort who survived to age 65 years and older, persons who were overweight, and particularly those who were obese earlier in life (aged 31-64 years), had significantly higher risks of hospitalization and mortality in older age compared with persons of normal weight with similar other cardiovascular risk factors at baseline. Elevated risk was present for individuals both with and without other major cardiovascular risk factors (smoking, high blood pressure, and/or serum total cholesterol level) in young adulthood and middle age,” the authors write. “In general, relationships were qualitatively consistent for both sexes for both hospitalization for and mortality from CHD, CVD, and diabetes in older age.”

“Convincing evidence from our findings and other studies provides strong support for population-wide, multifaceted, primary prevention starting at young age of all major risk factors, including overweight and obesity, as a key element for the national effort to continue the progress already achieved toward ending the epidemic of CHD and CVD. The success of smoking cessation campaigns and national blood pressure and cholesterol programs can be used as models to combat and reverse the worsening obesity epidemic. The real challenge is to apply the extensive knowledge already gained in the practice of medical care and public health for the benefit of individuals and society,” the researchers conclude.