Category Archives: Overweight

Obesity Soon to Affect Average Life Span in U.S.

That excess weight can shorten your life

That excess weight can shorten your life

“The medical community seems to be under a fog that we can constantly and forever reduce death rates, and that’s simply not true,” said Professor Olshansky, who published a study in 2012 showing that life spans for white women without a high school diploma had declined, a rare event in developed countries.

“You need to look at the health status of the living,” not the mortality statistics of the dead, he said, adding that obesity is afflicting younger generations in a way that will eventually make the numbers worse.

RTWT at The New York Times. 

Do something about your obesity before it’s too late.

Steve Parker, M.D.

 

Paleobetic Diet-FrontCover_300dpi_RGB_5.5x8.5

Bariatric Surgery Linked To Increased Suicide Attempts

according to an article at MedPageToday.

Steve Parker MD, bariatric surgery

Band Gastric Bypass Surgery

Self-harm emergencies rose by 50% after gastric bypass surgery in the Canadians in this study.

Folks on my diets lose weight without an increase in suicide risk, as far as I know. Click on my name for the diets.

For God’s sake, if you do nothing else, call the National Suicide Prevention Lifeline if you’re thinking about killing yourself. What have you got to lose? Suicide really is a permanent “solution” for a temporary problem.

Steve Parker, M.D.

No link to suicide

No link to suicide

Is Food Insecurity Really a Problem in the U.S.?

I’m hearing ads on the radio that many in the U.S., including children, are suffering from hunger. Nutrition science journals in the last few years are covering “food insecurity,” which many would assume means not having enough food or fearing the lack of food.

These concerns seem at odds with the fact that two-thirds of us are overweight or obese. So how many of us at normal or below-average weights suffer from food insecurity or hunger?

James Bovard breaks it down for you in an excellent article. Read the whole thing. Some morsels (heh):

  • seven times as many (low income) children are obese as are underweight
  • 40% of food stamp (SNAP) users are obese, compared to 30% in the overall U.S. adult population
  • if the food stamp program would prohibit purchase of sugary drinks, it would prevent 141,000 children from becoming fat and save a quarter million adults from type 2 diabetes

Fat hungry people would be less hungry if they’d cut way back on refined, nutrient-poor carbohydrates, replacing with protein and healthy fats.

Steve Parker, M.D.

Getting Bariatric Surgery to Improve Your Type 2 Diabetes? RYGB May Beat LAGB

An article at Diabetes Care suggests that insulin-treated T2 diabetics getting bariatric surgery were almost twice as likely to get off insulin if they had roux-en-Y gastric bypass rather than laparoscopic adjustable gastric banding. The former procedure is also generally more effective for weight loss.

If you think bariatric surgery is a sure-fire cure for type 2 diabetes, it’s not. I would go as far as I could with diet and exercise before going under the knife.

Steve Parker, M.D.

Paleolithic Diet May Help Reduce Risk of Obesity

…according to a basic science study published in the British Journal of Nutrition. The mechanism for reducing obesity risk would be increased satiety. We’ve seen that before with the paleo diet as compared to a Mediterranean-style diet. Disappointingly, the researchers didn’t see any paleo diet benefits in these healthy study participants in terms of glucose and insulin metabolism.

I haven’t read the report, don’t have it, don’t know when I’ll read it.

Abstract

There is evidence for health benefits from ‘Palaeolithic’ diets; however, there are a few data on the acute effects of rationally designed Palaeolithic-type meals. In the present study, we used Palaeolithic diet principles to construct meals comprising readily available ingredients: fish and a variety of plants, selected to be rich in fibre and phyto-nutrients. We investigated the acute effects of two Palaeolithic-type meals (PAL 1 and PAL 2) and a reference meal based on WHO guidelines (REF), on blood glucose control, gut hormone responses and appetite regulation. Using a randomised cross-over trial design, healthy subjects were given three meals on separate occasions. PAL2 and REF were matched for energy, protein, fat and carbohydrates; PAL1 contained more protein and energy. Plasma glucose, insulin, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP) and peptide YY (PYY) concentrations were measured over a period of 180 min. Satiation was assessed using electronic visual analogue scale (EVAS) scores. GLP-1 and PYY concentrations were significantly increased across 180 min for both PAL1 (P= 0·001 and P< 0·001) and PAL2 (P= 0·011 and P= 0·003) compared with the REF. Concomitant EVAS scores showed increased satiety. By contrast, GIP concentration was significantly suppressed. Positive incremental AUC over 120 min for glucose and insulin did not differ between the meals. Consumption of meals based on Palaeolithic diet principles resulted in significant increases in incretin and anorectic gut hormones and increased perceived satiety. Surprisingly, this was independent of the energy or protein content of the meal and therefore suggests potential benefits for reduced risk of obesity.

Steve Parker, M.D.

Reference: Bligh H.F., et al. British J Nutr. 2015 Feb 28;113(4):574-84. doi: 10.1017/S0007114514004012. Epub 2015 Feb 9.
Plant-rich mixed meals based on Palaeolithic diet principles have a dramatic impact on incretin, peptide YY and satiety response, but show little effect on glucose and insulin homeostasis: an acute-effects randomised study.

Is Estrogen Poisoning the Cause of the Obesity Epidemic?

Eating too much tofu?

Too much tofu?

James P. Grantham and Maciej Henneberg of the School of Medical Sciences (University of Adelaide, Adelaide, Australia) suggest that estrogen-like compounds in the environment are causing obesity. Read about their hypothesis in PLOS One. I don’t know if they’re right, but their idea deserves consideration.

A couple estrogen-like substances they mention are in soy and polyvinyl chloride (PVC). We ingest these xenoestrogens. I had not been aware that soy consumption is positively linked to obesity.

The authors don’t instill confidence by using weak references such as #22.

I didn’t see the trendy “endocrine disruptors” moniker in the article.

Read the whole enchilada.

Steve Parker, M.D.

Do Sugar Substitutes Cause Overweight and T2 Diabetes?

We don’t know with certainty yet. But a recent study suggests that non-caloric artificial sweeteners do indeed cause overweight and type 2 diabetes in at least some folks. The study at hand is very small, so I wouldn’t bet the farm on it. I’m not changing any of my recommendations at this point.

exercise for weight loss and management, dumbbells

Too many diet sodas?

 

The proposed mechanism for adverse metabolic effects of sugar substitutes is that they alter the mix of germs that live in our intestines. That alteration in turn causes  the overweight and obesity. See MedPageToday for the complicated details. The first part of the article is about mice; humans are at the end.

Some quotes:

“Our results from short- and long-term human non-caloric sweetener consumer cohorts suggest that human individuals feature a personalized response to non-caloric sweeteners, possibly stemming from differences in their microbiota composition and function,” the researchers wrote.

The researchers further suggested that these individualized nutritional responses may be driven by personalized functional differences in the micro biome [intestinal germs or bacteria].

***

Diabetes researcher Robert Rizza, MD, of the Mayo Clinic in Rochester, Minn., who was not involved with the research, called the findings “fascinating.”

He noted that earlier research suggests people who eat large amounts of artificial sweeteners have higher incidences of obesity and diabetes. The new research, he said, suggests there may be a causal link.

“This was a very thorough and carefully done study, and I think the message to people who use artificial sweeteners is they need to use them in moderation,” he said. “Drinking 17 diet sodas a day is probably a bad idea, but one or two may be OK.”

I won’t argue with that last sentence! (Unless you have phenylketonuria and want to use aspartame.)

Finally, be aware that several clinical studies show no linkage between human consumption of non-caloric artificial sweeteners and overweight, obesity, and T2 diabetes.

Steve Parker, M.D.

This Just In! Obesity Reduces Lifespan

I'm worried about the kid's future health

I’m worried about the kid’s future health, too

MedPageToday has the details. A quote:

In a computer modeling study, very obese men lost just over 8 years of life compared with normal-weight men, and very obese women lost as many as 6 years, Steven Grover, PhD, of McGill University, and colleagues reported online in the Lancet Diabetes and Endocrinology.

They also found that very obese men and women (defined as a body mass index [BMI] of 35 and higher) lost about 19 years of healthy life, defined as living free of chronic disease such as diabetes and cardiovascular disease.

Note that “very obese” in this context has a specific definition: body mass index 35 or higher. Calculate yours.

The number of life years lost to obesity and disease were highest for those who were very obese in young adulthood and presumably stayed obese for years. In other words, becoming very obese at age 25 is more threatening than onset 60.

I first got interested in weight loss in the 1990s when I had an office-based primary care medical practice. It was obvious that many of the medical problems I was treating were related to years of obesity. Believe me, you’re much better off preventing those problems via diet and exercise.

Click for The Lancet study abstract.

Steve Parker, M.D.

Low-Carb Diet Beats Low-Fat for Weight Loss While Improving Cardiovascular Risk Factors

…according to an article at MedPageToday.

Many physicians have been reluctant to recommend low-carb diets out of fear that they increase cardiovascular risk. How could that happen? By replacing carbohydrates with fats, especially saturated fats, leading to atherosclerosis. I don’t buy that theory (here’s why).

medical clearance, treadmill stress test

This treadmill stress test is looking for atherosclerotic heart disease, aka coronary artery disease and coronary heart disease

A recent study compared low-carb to low-fat dieting over 12 months and actually found better improvements in cardiovascular disease risk factors on the low-carb diet (max of 40 grams a day).

After 12 months, folks on a low-carbohydrate diet had lost 5.3 kg (11.7 lb), while those on a low-fat diet with similar caloric value had lost 1.8 kg (3.9 lb). Both groups showed lowering of LDL cholesterol, while the low-carbers had better improvements in HDL cholesterol and triglycerides.

DietDoctor Andreas Eenfeldt can add this study to his list of others that show better weight loss with low-carb diets compared to low-fat.

Steve Parker, M.D.

Americans Eat Too Much

The U.S. adult population in the 1970s ate an average of 2400 calories a day. By the 2000s, our calories were up to 2900.

Putting a face on the statistics

Putting a face on the statistics

What did average adult weight do as we increased daily calories by 500? It increased by 8.6 kg, from 72.2 to 80.6 kg. In U.S. units, that’s a 19 lb gain, from 159 to 178 lb.

Children increased their average intake by 350 cals/day over the same time frame.

If I recall correctly, I’ve seen other research suggesting the daily calorie consumption increase has been more like 150 to 350 per day (lower end for women, higher for men). I suspect these latter figures are more accurate.

Details are in the American Journal of Clinical Nutrition.

The study authors don’t say for sure why we’re eating more, but offhand mention an “obesogenic food environment.”  They don’t think decreased physical activity is the cause of our weight gain; we’re fatter because we eat too much.

Steve Parker, M.D.

h/t Ivor Goodbody