Monthly Archives: February 2016

Obesity: Children and teens who become or stay obese may quickly face up to three times the risk of developing high blood pressure compared to their slimmer peers, a new study says.

These findings are of particular concern because the high blood pressure in kids who went from overweight to obese, or those who stayed obese, developed in a short time — the study only lasted three years.

“These findings underscore the importance of developing and implementing early and effective clinical and public health strategies for obesity prevention,” said lead researcher Emily Parker. She is a research investigator at the HealthPartners Institute for Education and Research in Bloomington, Minn.

For the study, Parker and her colleagues collected data on more than 100,000 children and teens listed in the records of three major health systems in California, Colorado and Minnesota between 2007 and 2011. The children ranged in age from 3 and 17 years old.

During the three-year study, 0.3 percent of the children and teens developed high blood pressure.

“Having high blood pressure in children and adolescents is pretty rare, and we still need to know more about whether or not high blood pressure leads to greater risk of cardiovascular events later in life for these kids,” Parker said.

The researchers found that kids between 3 and 11 years old who went from overweight to obese had more than twice the odds of developing high blood pressure during the short study period. For older kids — those from 12 to 17 — the odds of high blood pressure were more than tripled, the research revealed.

When the researchers looked at the difference between children who were obese and severely obese throughout the study period, they found that the risk of high blood pressure was doubled for those who were obese. But for those who were severely obese, the risk more than quadrupled.

Children who were severely obese fell into the 99th percentile for higher body mass index (BMI, a ratio of weight to height) for their age and gender. Obese kids were those whose BMI fell in the 95th to 98th percentile for their age and gender, the study said.

The report was published online Feb. 19 in the journal Pediatrics.

Dr. William Muinos, a pediatric gastroenterologist and director of the weight management program at Nicklaus Children’s Hospital in Miami, said he sees these findings in his own clinic. “We see this in children as young as 8,” he said.

High blood pressure in children can damage their kidney function, and increase the risk of type 2 diabetes, high cholesterol and triglycerides, and fatty liver disease, which can damage the liver, he said.

“The beauty of high blood pressure in children is that it goes down as soon as they start losing weight,” Muinos said. In addition, all the other problems associated with high blood pressure also clear up, he said.

However, if kids don’t lose the weight, high blood pressure remains and increases as they gain more weight, he said.

“The risk of these problems is higher in children who gain weight and develop high blood pressure,” Muinos said. Parents have to make lifestyle changes for their children with the help of a doctor or a weight loss clinic, he said.

Changes include eating a healthy diet rich in vegetables, fruits and whole grains, and being physically active regularly, Muinos said.

“These problems really exist and they are not going to go away when children reach their teens — that doesn’t happen anymore. They just become overweight or obese adolescents,” he said.

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Overweight young adults may have poorer episodic memory – the ability to recall past events – than their peers, suggests new research from the University of Cambridge, adding to increasing evidence of a link between memory and overeating.

In a preliminary study published in The Quarterly Journal of Experimental Psychology, researchers from the Department of Psychology at Cambridge found an association between high body mass index (BMI) and poorer performance on a test of episodic memory.

Although only a small study, its results support existing findings that excess bodyweight may be associated with changes to the structure and function of the brain and its ability to perform certain cognitive tasks optimally. In particular, obesity has been linked with dysfunction of the hippocampus, an area of the brain involved in memory and learning, and of the frontal lobe, the part of the brain involved in decision making, problem solving and emotions, suggesting that it might also affect memory; however, evidence for memory impairment in obesity is currently limited.

Around 60% of UK adults are overweight or obese: this number is predicted to rise to approximately 70% by 2034. Obesity increases the risk of physical health problems, such as diabetes and heart disease, as well as psychological health problems, such as depression and anxiety.

“Understanding what drives our consumption and how we instinctively regulate our eating behaviour is becoming more and more important given the rise of obesity in society,” says Dr Lucy Cheke. “We know that to some extent hunger and satiety are driven by the balance of hormones in our bodies and brains, but psychological factors also play an important role – we tend to eat more when distracted by television or working, and perhaps to ‘comfort eat’ when we are sad, for example.

“Increasingly, we’re beginning to see that memory – especially episodic memory, the kind where you mentally relive a past event – is also important. How vividly we remember a recent meal, for example today’s lunch, can make a difference to how hungry we feel and how much we are likely to reach out for that tasty chocolate bar later on.”

The researchers tested 50 participants aged 18-35, with body mass indexes (BMIs) ranging from 18 through to 51 – a BMI of 18-25 is considered healthy, 25-30 overweight, and over 30 obese. The participants took part in a memory test known as the ‘Treasure-Hunt Task’, where they were asked to hide items around complex scenes (for example, a desert with palm trees) across two ‘days’. They were then asked to remember which items they had hidden, where they had hidden them, and when they were hidden. Overall, the team found an association between higher BMI and poorer performance on the tasks.

The researchers say that the results could suggest that the structural and functional changes in the brain previously found in those with higher BMI may be accompanied by a reduced ability to form and/or retrieve episodic memories. As the effect was shown in young adults, it adds to growing evidence that the cognitive impairments that accompany obesity may be present early in adult life.

This was a small, preliminary study and so the researchers caution that further research will be necessary to establish whether the results of this study can be generalised to overweight individuals in general, and to episodic memory in everyday life rather than in experimental conditions.

“We’re not saying that overweight people are necessarily more forgetful,” cautions Dr Cheke, “but if these results are generalizable to memory in everyday life, then it could be that overweight people are less able to vividly relive details of past events – such as their past meals. Research on the role of memory in eating suggests that this might impair their ability to use memory to help regulate consumption.

“In other words, it is possible that becoming overweight may make it harder to keep track of what and how much you have eaten, potentially making you more likely to overeat.”

Dr Cheke believes that this work is an important step in understanding the role of psychological factors in obesity. “The possibility that there may be episodic memory deficits in overweight individuals is of concern, especially given the growing evidence that episodic memory may have a considerable influence on feeding behaviour and appetite regulation,” she says.

Co-author Dr Jon Simons adds: “By recognising and addressing these psychological factors head-on, not only can we come to understand obesity better, but we may enable the creation of interventions that can make a real difference to health and wellbeing.”

The study was funded by the Medical Research Council and Girton College, University of Cambridge, and the James S McDonnell Foundation.

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It is no surprise that where we live affects our health, but this is the first major study to use online street views to assess the exercise and dietary habits of neighborhoods.

The study took 4 years to complete and involved data from nearly 6,000 people living in major cities across Europe.

It looked at the nature of local neighborhoods, tallying self-reported perceptions of the environment by residents with objective measures based on Google Street View.

It also involved estimates of individual health behaviors, social integration and community support.

Your neighborhood impacts your health

Many measures related to the local environment appear to be linked to health behavior and the risk of developing obesity, according to the study results.

Levels of physical activity, self-rated health, happiness and neighborhood preference were closely associated with residents’ perception and use of their neighborhood.

People living in socioeconomically deprived areas were less likely to see their area as conducive to healthy behaviors, compared with residents of wealthier areas.

The researchers noted a significant variation in the presence of food outlets, outdoor recreation facilities and green spaces between the cities surveyed.

Residents who reported higher levels of social integration also rated their health more highly, were less likely to be obese and consumed more fruit.

However, the same group also tended to spend more time sitting down and were less involved in physical activity that required transportation.

Community, gender, age and education influence perceptions of space

As part of the study, participants had to describe the boundaries of their residential neighborhood using a map and a web-based tool.

Older adults tended to define smaller neighborhoods than younger adults. Women mostly defined smaller neighborhoods than men, while higher educational levels were mostly associated with larger self-defined neighborhoods.

Prof. Jean-Michel Oppert, of Pitie-Salpetriere University Hospital, Paris, France, speculates that younger residents, men and those with a higher educational level move around more or live in places with greater access to urban opportunities such as services, transport and social activities. This would increase the space where activities are performed.

The space of the self-defined neighborhood also expanded the longer a person lived in an area, possibly because longer residency implies more social activities and relationships in the community and greater awareness of local facilities.

The researchers point out that the findings have implications for health behaviors and outcomes such as obesity. They urge architects and urban planners to consider such factors when designing residential areas.

Lead researcher Jeroen Lakerveld, of the VU University Medical Center in Amsterdam, the Netherlands, says:

“Urban planners and policy makers have a responsibility to ensure that the neighborhoods they design and the facilities and businesses that the neighborhoods contain will promote healthy behavior and is protective against unhealthy behaviors.”

He explains that focusing on “upstream determinants of healthy behaviors,” such as promoting healthy food purchases and physical exercise, could mean huge savings on health care costs.

Lakerveld adds: “The best neighborhoods are those which have the facilities to support good health and also can encourage social networking and community support.”

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