Category: Weight Loss & Obesity News
Too hot to handle: how to avoid heat-related illness

Hot weather can be extremely pleasant and relaxing, but it also comes with its dangers. Sometimes, the human body is unable to handle exposure to extreme heat and maintain the stable core temperature essential for normal bodily functioning.

According to the Centers for Disease Control and Prevention (CDC), there was a total of 7,415 deaths in the US between 1999-2010 as a result of extreme heat. Despite being highly preventable, heat-related illness can be lethal.

In Europe in 2003, unprecedented heatwaves were responsible for an increase in deaths. In England, temperatures reached record highs (101 degrees) over a period of 9 days.

“There is considerable evidence that heatwaves are dangerous and can kill,” states Graham Bickler of Public Health England. “In the 2003 heatwave, there were 2,000 to 3,000 excess deaths in England. Across Europe, there were around 30,000 excess deaths.”

Extreme heat is defined by the CDC as “summertime temperatures that are substantially hotter and/or more humid than average for location at that time of year.” Although certain groups of people are more susceptible to these temperatures than others, anyone can be affected in the wrong situation.

In this Spotlight, we take a look at the effects extreme heat have on the body and the measures that can be taken to prevent dangerous conditions such as heat stroke from occurring.

Regulating core internal temperature

Problems begin to occur in extreme heat when the body struggles to cool itself down properly. The human body has a very precise core internal temperature that needs to be maintained – a state that is known as homeostasis. A healthy core temperature should sit between 98 degrees and 100 degrees.

A part of the brain known as the hypothalamus is responsible for controlling the way in which the body regulates its temperature. If the body’s core internal temperature starts to get too low or too high, then it can send signals to glands, muscles, nerves and organs activating mechanisms to adjust the body temperature.

The mechanism the body normally uses to cool itself is sweating. Liquid containing salt is released from the sweat glands, and when this sweat evaporates from the body, the body cools down. However, on some occasions, sweating is not enough.

For example, if humidity is high – when large amounts of damp air are trapped near the ground – sweat will not evaporate as quickly as it normally would, meaning that the body’s ability to cool itself down is compromised.

A number of other factors limit how well the body can regulate temperature and, therefore, increase the risk of heat-related illness. These include the following:

  • Old age
  • Youth (age 0-4)
  • Overweight and obesity
  • Heart disease
  • Mental illness affecting judgment
  • Medical conditions that limit activity or restrain blood flow
  • Sunburn
  • Use of certain medications
  • Use of alcohol.

In terms of medication, there are a number of different reasons why these can increase the risk of heat-related illnesses. Some, such as those taken for Parkinson’s disease, can inhibit sweating while others, such as diuretic medications or “water pills,” alter the balance of fluids in the body.

When the body is struggling or unable to regulate temperature properly, a number of different illnesses can occur. These vary in severity from heat rash – a common problem in hot work environments – to heat stroke, a medical emergency that can kill.

What types of heat-related illnesses are there?

Heat-related illnesses come in all shapes, sizes and levels of severity. Some present solely external symptoms, some only internal symptoms and some a combination of the two. Some can be debilitating, some can be lethal and some require nothing more than keeping an affected area of skin dry.

Heat rash

Probably the least problematic of the heat-related illnesses, heat rash is caused when the skin becomes irritated due to excessive sweating and sweat that does not evaporate. The rash is formed by clusters of red bumps or small blisters on the skin, commonly in areas such as the groin, the upper chest and in folds of the skin.

Man sleeping in the shade of a tree.
Moving to a cooler location such as the shade of a tree can help cool the body down and reduce the risk of heat-related illness.

Young children are most likely to be affected by the condition. Heat rash is best treated by keeping the affected area as dry as possible and moving to a cooler, less humid environment.

Heat cramps

Heat cramps are muscle spasms and pains that typically occur in the abdomen, arms and legs. Sweating decreases the level of salt and moisture in the body, and it is low salt levels that cause heat cramps.

These cramps normally occur in association with strenuous activity and exercise, affecting those who sweat a lot during these pursuits. Drinking water and other cool beverages helps, as does stopping strenuous activity for a few hours. If heat cramps persist for an hour, medical attention should be sought.

Heat cramps can also be a sign of more advanced heat-related illnesses – heat exhaustion and heat stroke.

Heat exhaustion

Heat exhaustion takes a little longer to develop than the forms of illness above, occurring after several days of exposure to extreme heat and imbalanced body fluid levels. The condition is due to the loss and inadequate replacement of water and salt from heavy sweating.

People with heat exhaustion can appear pale and sweat heavily, leaving their skin cool and moist. Their heartbeat will be fast but weak, and their breathing is likely to be quick and shallow. In addition to muscle cramps, people with heat exhaustion can experience headaches, nausea or vomiting, fainting and fatigue.

Heat exhaustion is most likely to affect older people, people with hypertension and people carrying out activities in hot environments. People with heat exhaustion should cool their bodies by drinking plenty of water or other cool beverages, taking a cool shower or bath and resting in a cooler environment.

Heat stroke

Heat stroke is the most dangerous of all the heat-related illnesses and occurs when the body is unable to regulate its core internal temperature. Within 10-15 minutes, the core internal temperature can rise to over 106 degrees, a dangerous increase that can lead to permanent disability or death if untreated.

The symptoms of heat stroke are far more extreme than those of heat exhaustion. The individual will no longer be able to sweat and, therefore, have red, hot and often dry skin. Their heartbeat will be rapid and strong. Other symptoms include dizziness, throbbing headaches, seizures and unconsciousness.

As heat stroke is a medical emergency, action should be taken as quickly as possible. While immediate medical assistance is summoned, the person’s body must be cooled down rapidly by whatever means are available.

Removing clothing, applying ice packs, immersing the individual in cool water, spraying them with a hose, wrapping them in damp sheets, fanning them: all are methods that can help lower body temperature to safer levels.

In all instances of heat-related illness, including heat stroke, moving to a cooler location is one measure that should be taken to improving the situation. This is just one common step that everyone can take to reduce the risk of developing these illnesses.

How to keep your cool

When the body is struggling to cool itself down, cooling down the location that the body is in is a great way to prevent heat-related illness. In fact, the CDC state that “air conditioning is the number one protective factor against heat-related illness and death.”

If a person’s home is not air conditioned, they can derive benefit from visiting public spaces that are, such as shopping malls or libraries. Exposure to air conditioning for just a few hours a day is enough to reduce the risk of heat-related illness.

Woman drinking a glass of water.
The body requires more liquid in extreme heat. Do not wait until feeling thirsty before drinking.

To improve the body’s chances of cooling itself down, it is important that people drink enough fluids. In extreme heat, people should drink more water than they normally would and should not wait until feeling thirsty before drinking.

If exercising, the CDC recommend drinking two to four glasses (16-32 ounces) of cool nonalcoholic fluid every hour. Drinking sports beverages can also help by replacing the salt and minerals that are also lost through sweating.

Outdoor exercise is best carried out in the morning and evening rather than the afternoon, as these are the times of day when outdoor temperatures are coolest. Resting in shaded areas will give the body more of a chance to regulate its temperature. It is also important that people take care to pace themselves when exercising or carrying out strenuous activities in hot environments.

Wearing appropriate clothing helps. Loose, lightweight and light-colored clothing is best, as is wearing as little as you can get away with. Accessories that shade the body such as hats and umbrellas are useful. Of course, any skin that is exposed to the sun will need to be adequately protected from its rays.

As sunburn disrupts the skin’s ability to cool itself and results in the loss of body fluid, apply sunscreen of SPF 15 or higher around 30 minutes before venturing outside. Be sure to follow the directions on the sunscreen’s packaging concerning how frequently it should be reapplied.

In terms of keeping cool, a lot of what can be done is common sense. Large, hot meals should be avoided as they heat the body, as does the use of appliances such as ovens. To cool down, take cold showers or baths or have a swim. Keep an eye on weather reports so you can be prepared for a day of extreme heat if one is forecast.

Look out for each other!

Some of the people who are most at risk from heat-related illnesses are vulnerable individuals who depend on others for care. Be sure to look out for young children, people older than 65, people with chronic and mental disorders and pets during times of extreme heat.

Do not leave children or animals alone in cars, where interior temperatures can rise suddenly in a very short space of time, even when the windows are open slightly.

If working or exercising in hot environments, be sure to monitor the condition of your colleagues and teammates and have them do the same for you. Some heat-induced illnesses can lead to confusion and visible symptoms that others may be better placed to identify.

Most heat-related illnesses are avoidable. By keeping cool, drinking plenty of fluids and being alert, these health conditions should not stop you and others from enjoying a lovely warm summer.

 

 


Daily weigh-in helps keep the weight off

A study recently published in the Journal of Obesity suggests that frequently weighing oneself and looking at the progress on a chart every day is an effective way to lose a modest amount of weight and – just as importantly – keep it off.

The researchers say measuring and charting our weight daily makes us see the link between what we eat and our weight.

However, for reasons they could not explain, the researchers found this method seems to work better for men than for women.

“You just need a bathroom scale and an excel spreadsheet or even a piece of graph paper,” explains senior author David Levitsky, a professor of nutrition and psychology at Cornell University, Ithaca, NY.

He says this forces you to be aware of the link between your weight and what you eat, and notes that this goes against what we used to be told:

“It used to be taught that you shouldn’t weigh yourself daily, and this is just the reverse.”

In the 2-year study, participants who lost weight in the first year were able to keep it off through the second year. The result is significant because many studies show that around 40% of weight lost through dieting is often put back on within a year, and within 5 years, all of it is regained.

For their study, Prof. Levitsky and first author Carly Pacanowski, a nutritional sciences PhD candidate, randomly assigned 162 overweight men and women to an intervention group and a control group.

All participants attended an initial educational session where they learned about evidence-based strategies for weight loss, including specific approaches based on choosing one’s own weight loss method – with an emphasis on making small changes.

The small changes suggested included skipping dessert a few times per week, using a meal replacement for lunch three times a week and avoiding snacks between meals most of the time.

Members of the control group then left the session, which went on to give the intervention group instructions and equipment for daily self-monitoring.

They were given a typical bathroom scale and asked to weigh themselves at the same time every day – preferably first thing in the morning – and record the result on a website chart set up by the researchers.

Self-monitoring men more successful than women at losing weight

The intervention group were then given a target of losing 1% of their weight, in any manner they chose. This is roughly the equivalent of consuming around 150 calories a day less than usual for around 2 weeks.

Once the participants had maintained their 1% weight loss for 10 days, they were asked to lose another 1%. This pattern continued with a long-term goal of losing 10% of their starting body weight in the first year.

Prof. Levitsky says each participant devised his or her own way of losing weight – some reduced portion size, others stopped snacking, and some skipped meals.

After the first year, the control group was then given bathroom scales and briefed on self-monitoring, as the intervention group had been at the start of the first year.

During the second year, the intervention group were asked to just monitor their weight every day by stepping on the scales and plotting the result on the website chart. On average, the intervention group members measured and plotted their weight four times a week.

Even though weight loss is modest, self-monitoring seems to be effective

The results in the first year showed that on average, the intervention group lost more weight than the controls (2.6 kg versus 0.5 kg). The researchers also found that men were significantly more successful than women at losing weight in the first year, and keeping it off in the second year.

Commenting on the findings, Prof. Levitsky says the self-monitoring approach “seems to work better for men than women, for reasons we cannot figure out yet.”

The authors suggest that by stepping on a scale and seeing the results tracked on a chart every day acts as a reinforcer of behavior that helps reduce weight and keep it off – such as eating less, and taking exercise. Prof. Levitsky adds:

“We think the scale also acts as a priming mechanism, making you conscious of food and enabling you to make choices that are consistent with your weight.”

The authors conclude that even though the intervention group on average only managed to lose 2% of their starting weight and keep it off over the 2-year period, it is enough to show that self-weighing and visual feedback could be a useful weight management strategy, combined with other techniques.

They note that as little as 5% weight loss has been shown to be clinically significant in overweight people.

It is well-known that obesity is linked to type 2 diabetes – fat cells help spur the disease by changing metabolism and inducing chronic inflammation. However, less well-known is that a possible route through which this happens is via the microbiome – the diverse colonies of bacteria that inhabit our bodies.

As people gain weight, they are likely to have large amounts of staph bacteria living on their skin. MNT recently learned that this could help trigger type 2 diabetes because the staph bacteria release toxins that interact with fat cells and the immune system to cause inflammation.

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High salt in high-fat diet found to prevent weight gain in mice

A new study has found, contrary to researchers’ expectations, that adding a high level of salt to a high-fat diet prevented weight gain in mice.

The findings of the study, published in Scientific Reports, may suggest that public health efforts to continue lowering sodium intake might have unexpected and unintended consequences, according to one of the study’s authors.

“People focus on how much fat or sugar is in the food they eat, but [in our experiments] something that has nothing to do with caloric content – sodium – has an even bigger effect on weight gain,” says co-senior author Justin Grobe, an assistant professor of pharmacology at the University of Iowa Carver College of Medicine.

The team began their research wanting to test the hypothesis that fat and salt would act together to increase both food consumption and weight gain, following on from suggestions that fast food and processed foods could stimulate reward mechanisms in the body.

To test the theory, the researchers fed groups of mice different diets and assessed the amount of weight each group gained. One group of mice consumed a diet of standard rodent food, while other groups consumed food with a high-fat content and varying concentrations of salt, ranging from 0.25-4%.

The researchers found the mice that gained the most weight were those given high-fat food with the lowest salt content, gaining around 15 grams over the 16-week study period. In contrast, the mice on the high-fat, highest salt diet had a level of weight gain – around 5 grams – similar to that experienced by the mice eating standard rodent food.

“We found out that our ‘french fry’ hypothesis was perfectly wrong,” admits Grobe.

Weight gain suppression attributed to reduced digestive efficiency

The researchers then set out to investigate why high levels of dietary salt led to minimal weight gain. After analyzing four key factors that affect energy balance in animals, they found that the level of dietary salt influenced how effective the mice digested their food and how much fat was absorbed by the body.

“This suppression of weight gain with increased sodium was due entirely to a reduced efficiency of the digestive tract to extract calories from the food that was consumed,” explains Grobe. He believes that the finding could also explain why certain fast foods high in both fat and salt can cause digestive ill effects.

Although the findings of the study might initially suggest that there are positives to be taken from a diet containing high levels of salt, the researchers are keen to point out that there are significant dangers that come with such a diet, including an increased risk for cardiovascular disease.

Instead, the findings could potentially lead to the development of new anti-obesity treatments. The team was already aware that salt levels affect the activity of an enzyme in the body called renin, part of the renin-angiotensin hormone system that is frequently targeted in the treatment of cardiovascular diseases.

The new study indicates that adjusting the renin-angiotensin system can in turn reduce dietary efficiency, and this discovery could give researchers a new target for obesity treatment.

Dr. Michael Lutter, co-senior study author and assistant professor of psychiatry at the University of Iowa, says that it is important for scientists researching the health effects of diets to analyze diets that more accurately reflect normal human eating behaviors, rather than simplified ones often used in animal experiments.

“Our findings, in conjunction with other studies, are showing that there is a wide range of dietary efficiency, or absorption of calories, in the populations,” he states, “and that may contribute to resistance or sensitivity to weight gain.”


Shift work linked to sleep problems, poor metabolic health

Dolly Parton once sang that working 9-5 is “all taking and no giving,” but working outside of these hours may take away much more – when it comes to our health, at least. A new study finds people who work shifts are more likely to have sleep problems than people who follow conventional work schedules, which may raise their risk of metabolic disorders such as obesity and diabetes.

Lead investigator Dr. Marjory Givens, an associate scientist at the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues published their findings in Sleep Health – a journal of the National Sleep Foundation.

The link between shift work and poor health is not new. In July 2014, a study linked shift work – particularly rotating shifts – to increased risk of type 2 diabetes, while a more recent study found people who work rotating night shifts for at least 5 years are at higher risk of all-cause and cardiovascular mortality.

Using 2008-12 data from the Survey of the Health Wisconsin (SHOW), Dr. Givens and colleagues set out to investigate the health implications of shift work further – specifically, how shift work affects sleep, weight and diabetes risk.

For SHOW, all participants were subject to home- and clinical-based physical assessments and interviews.

The team analyzed 1,593 participants who underwent a physical examination, using the data to calculate their body mass index (BMI) in order to establish their overweight or obesity status.

The data of a further 1,400 participants with type 2 diabetes was assessed. Their condition was determined by either a self-reported physician diagnosis or by the presence of glycated hemoglobin (HbA1c) in the blood at levels of 6.5% or higher at physical assessment.

The working patterns of participants were recorded during interviews.

Getting sufficient sleep ‘may reduce shift workers’ risk of metabolic disorders

Compared with individuals who worked traditional 9-5 schedules, those who worked shifts were more likely to be overweight, at 34.7% and 47.9%, respectively.

Shift workers were also more likely experience sleep problems than 9-5 workers. Around 23.6% of shift workers had insomnia, compared with 16.3% of people who worked standard hours. Insufficient sleep was reported by 53% of shift workers and 42.9% of 9-5 workers, while 31.8% of shift workers experienced excessive wake-time sleepiness, compared with 24.4% of 9-5 workers.

The researchers were not surprised that shift workers had more sleep problems. “Shiftwork employees are particularly vulnerable to experiencing sleep problems as their jobs require them to work night, flex, extended, or rotating shifts,” explains Dr. Givens.

“Shift workers are more commonly men, minorities, and individuals with lower educational attainment and typically work in hospital settings, production, or shipping industries,” she adds.

Further investigation revealed that the increase in sleep problems among shift workers correlated with an increase in obesity and diabetes, with this association being strongest among shift workers who reported insufficient sleep – defined as less than 7 hours each day.

This finding, the researchers say, indicates that by getting sufficient sleep, shift workers may be able to reduce their risk of obesity and diabetes.

Dr. Givens adds:

“This study adds to a growing body of literature calling attention to the metabolic health burden commonly experienced by shift workers and suggests that obtaining sufficient sleep could lessen this burden.

More research in this area could inform workplace wellness or health care provider interventions on the role of sleep in addressing shift worker health disparities.”

The team notes, however, that the positive association between sleep problems and metabolic disorders among shift workers does not fully explain why shift work raises the risk of metabolic disorders.

While this study is strengthened by the fact it drew its conclusions from a population-based sample and objective markers of overweight and diabetes, the researchers say there are some limitations.

They did not account for confounding factors, for example, and sleep duration and sleep quality of participants was self-reported. Finally, the team says that because they used cross-sectional data, they are unable to establish a causal relationship between shift work and poor metabolic health.


‘Slimming chocolate’ study fools the world media

A miracle study received significant worldwide media coverage after finding that people following a low-carbohydrate diet lost weight 10% faster if they ate one chocolate bar every day. The problem? The real aim of the study was to see how easy it would be to get bad science into the news.

A woman tempted to eat chocolate.
Although many news sources have reported about a study finding chocolate could help people lose weight, the study is significantly and purposefully flawed.

The mastermind behind the study can be identified as either journalist John Bohannon or Johannes Bohannon, PhD, research director of the Institute of Diet and Health. Both are one and the same person.

Bohannon was approached by a German television reporter named Peter Onneken, who was working at the time on producing a documentary film examining the junk-science diet industry. Bohannon had previously investigated how rigorously fee-charging open access journals checked the submissions of flawed papers, making him an ideal candidate for such an investigative project.

It appears as though the project was a resounding success. The findings of the study were reported by newspapers such as Bild in Germany – Europe’s largest daily newspaper – The Daily Mail and The Daily Express in the UK, websites such as the Times of India and the Huffington Post and television shows in the US and Australia.

The study was submitted to 20 journals and was ultimately published by the International Archives of Medicine. Backed with a very helpful news release, the team sent word out about the study and swiftly news outlets began to cover the research.

A clinical trial had been conducted, providing actual data that indicate eating a bar of chocolate every day while following a low-carbohydrate diet can speed up weight loss.

Volunteers aged 19-67 were split into three groups. One group followed a low-carbohydrate diet, one followed a low-carbohydrate diet augmented with 42 g of dark chocolate each day and one control group followed their normal diets. The researchers tracked the participants’ body weights as well as measuring their blood and assessing sleep quality and well-being.

Participants eating chocolate were found to lose weight 10% quicker than those following the diet without chocolate. Additionally, this weight loss remained after 3 weeks, unlike the weight loss of those who followed the low-carbohydrate diet without the chocolate.

A small number of participants, a large number of measurements

Unfortunately, there were a number of key flaws with the study that were significant enough to render the results largely meaningless. Notably, only 16 volunteers participated in the study, which ran for just 3 weeks. The researchers also assessed 18 different measurements, planning to base their story around whichever provided them with a statistically significant result.

With such a small number of participants and such a wide variety of measurements being taken, the researchers had a 60% chance of finding something that could be described as “significant” and turned into the cornerstone of their story for the media.

The paper has since been removed from the International Archives of Medicine website.

Gary Schweitzer, publisher of HealthNewsReview.org, told Retraction Watch what he felt the main point to be taken from this story is:

“John Bohannon claims he ‘fooled millions into thinking chocolate helps weight loss.’ But he may have directly fooled only a few – not millions. And those few – whom I will politely call ‘journalists’ – did the rest of the fooling for him. And they do it all the time, gobbling up crumbs from a steady diet of weak, hyped studies.”

There are countless studies such as this that are produced every day and reported on by the media. Journalists should be careful to check studies and news releases to make sure that what they are reporting is accurate and informed.

Unfortunately, as this study proves, sometimes the lure of an eye-catching headline and provocative findings can be enough to distract from shortcomings that can be obscured by numbers, symbols and highly specific language.

This story should serve as a cautionary tale, both to readers and reporters, reminding us all to be extra discerning when it comes to evaluating the worth of studies that appear in the news.


Balancing protein and carbs equal in benefit to cutting calories

While reducing the amount of calories consumed is known to delay the onset of aging and improve metabolic health, maintaining a high level of caloric reduction in the long-term can be dangerous. A new mouse study, however, suggests that a low protein, high carbohydrate diet could provide the same benefits.

“We’ve shown that when compared head-to-head, mice got the same benefits from a low protein, high carbohydrate diet as a 40% caloric restriction diet,” says Prof. Stephen Simpson, senior author of the study and Academic Director of the University of Sydney’s Charles Perkins Centre in Australia.

According to the study authors, reducing the amount of calories consumed by around 30-50% increases health span, delays the onset of age-associated diseases and improves metabolic health. Unfortunately, this level of caloric reduction is unsustainable for most humans.

“Except for the fanatical few, no one can maintain a 40% caloric reduction in the long term,” says Prof. Simpson, “and doing so can risk loss of bone mass, libido, and fertility.”

Additionally, other studies have indicated that when animals have unrestricted access to food, caloric reduction (through dietary dilution) did not improve lifespan. Conversely, in such situations, diets low in protein and high in carbohydrates were found to improve lifespan and metabolic health in later life.

These findings suggest that a low protein, high carbohydrate diet could be a more feasible dietary intervention for humans than caloric reduction although previous research has also found an associated risk of increased food intake with this diet.

To investigate which dietary intervention is most effective at improving metabolic health, the researchers compared three different diets with varying protein-to-carbohydrate ratios:

  • High protein, low carbohydrates
  • Medium protein, medium carbohydrates
  • Low protein, high carbohydrates.

The researchers tested each diet for 8 weeks twice; once under conditions where calories were restricted and once where food was freely available.

‘Modest protein intake with plenty of carbohydrates is beneficial’ according to authors

Mice that followed a low protein, high carbohydrate diet where food was always available derived the same benefits as mice following the same diet where the number of calories consumed was restricted. Improvements relating to blood sugar, cholesterol and insulin levels were recorded even with increased food consumption.

Despite increased consumption when food was freely available, mice following a low protein, high carbohydrate diet also had higher metabolism than mice on the calorie-restricted diet without gaining extra weight. No extra benefits were observed in the mice following the low protein, high carbohydrate diet with caloric restriction.

The study, published in Cell Reports, is an observational one and so further work will be required investigating the mechanisms behind these findings. Currently, the researchers do not know precisely how the type and quality of proteins and carbohydrates consumed affect metabolic health and long-term survival.

“An important next step will be to determine exactly how specific amino acids, the building blocks of proteins, contribute to overall health span and lifespan,” says lead author Dr. Samantha Solon-Biet, also of the University of Sydney.

The researchers also do not know whether these findings apply to humans as well as mice. If they do, it means that adjusting the quantities of carbohydrates and protein consumed could be a more realistic approach for improving metabolic health and reducing the risk of certain chronic diseases than cutting calories.

“According to these mouse data and emerging human research, it appears that including modest intakes of high-quality protein and plenty of healthy carbohydrates in the diet will be beneficial for health as we age,” Prof. Simpson concludes.

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Link observed between waist size and noise pollution

Traffic noise raises the risk of central obesity, suggests a Swedish study that surveyed over 5,000 men and women, collecting information on decibels of exposure and markers of obesity.

Living near a busy road, railroad or under aircraft noise was associated with bigger waist sizes and waist-to-hip ratios, and there was a cumulative risk found for being exposed to all three noise factors in the study published in Occupational and Environmental Medicine, a journal from The BMJ.

The researchers assessed how much environmental noise pollution from road traffic, trains, and planes had been experienced by 5,075 people living in five suburban and rural areas around Stockholm – using official measures tied to where the respondents lived since 1999.

During assessments between 2002 and 2006, the respondents aged 43 to 66 answered questions on lifestyle, state of health, psychological distress, insomnia and strain in their jobs.

The participants also underwent a medical examination, which included measures of central body fat using waist circumference along with hip size. Overall levels of obesity were also measured by body mass index (BMI).

While the study found no association for living near the sources of noise against BMI, it did find a link against abdominal obesity, in these ways:

  • There was an increase in waist size of 0.21 cm (0.08 in) for every 5 dB increase in noise exposure above 45 dB (noise was considered harmless below this threshold). This was a statistically significant trend for women but not men
  • A stronger association for the males was found with the waist-to-hip ratio, which went up overall by 0.16 for every 5 dB rise in road traffic noise exposure
  • Any of the three sources of noise correlated with a larger waist size, but the link was strongest for aircraft noise
  • Only road traffic and aircraft noise were associated with the waist-to-hip ratio measure of central obesity.

The ratio of the chances of finding people with a big waist size among those exposed to only one of the three sources of noise, over the chances among those without any noise pollution, was 1.25. This odds ratio increased for people exposed to all three sources of noise, to an odds ratio of 1.95.

Just over half of all the participants (2,726 or 54%) had been exposed to one source of traffic noise above 45 dB, 15% (740) to two sources, and 2% (90) to all three sources.

The findings were not influenced by socioeconomic factors, lifestyle or exposure to ambient air pollution from local road traffic. But age was an influential factor, with associations between central obesity and road traffic noise found only for those below the age of 60.

Noise stress may be linked to central fat deposits by hormone effects

The study was not designed to establish any cause-and-effect relationship between the factors and outcomes observed. Its measures of noise exposure were based on location and did not take account of any sound insulation measures that might have been taken, nor of the location of the participants’ bedrooms.

The authors do propose why noise exposure could be an important physiological stressor, however.

They suggest high levels of noise pollution could result in higher levels of the hormone cortisol, which are thought to have a role in fat deposition around the middle of the body.

“This may explain why the effects of noise were mainly seen for markers of central obesity, such as waist circumference and waist-hip ratio, rather than for generalised obesity, measured by BMI.”

Traffic noise may also affect metabolic as well as cardiovascular functions, through sleep disturbance, the researchers also suggest, altering appetite control and use of energy.

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Tackling obesity needs a number of magic bullets

No one health issue has the most impact on human health, or engenders more debate about how to tackle it, than obesity.

Tackling Obesity Needs a Combination of Magic Bullets
The diversity of expertise at an obesity, diabetes and metabolic syndrome conference in the UK could hold the key to tackling the issue of obesity.
Credit: Plymouth University

It has become the scourge of the health agenda, especially in the west, and it is a growing problem. According to the latest figures from the World Health Organisation, almost three-quarters of British men and two-thirds of women will be overweight or obese by 2030 – a staggering 39 million adults in total. We have one of the worst obesity records in Europe, with just six of the 52 countries in the WHO’s European region with worse obesity rates for women.

We know that obesity has a highly detrimental effect on health and well-being. As a result of its consequences obesity places an enormous burden on the NHS and other social services. Take diabetes as an example – not all cases of diabetes are caused directly by obesity or an unhealthy lifestyle, but the vast majority are. According to the Impact Diabetes report, the cost of treating diabetes will rise from £9.8 billion to £16.9 billion in 25 years’ time – which will equate to 17 per cent of the total NHS budget. Treatment for cardiovascular disease, another condition exacerbated by obesity, already costs the UK health system around £9 billion. These are staggering sums of money that the UK will probably not be able to afford.

The cost implications of obesity are not just confined to health care expenditure – there are ramifications for the wider economy too. In 2013, the Office for National Statistics estimates that 131 million days were lost to UK businesses through absences due to sickness and many of those illnesses can be linked to obesity. According to the CBI, absence from work through sickness is costing the UK £14 billion a year.

While there are many possible approaches to tackling obesity and its consequences in the population, it is clear that there is no single magic bullet. Rather, an arsenal of different approaches needs to be brought to bear on the complex challenge posed by obesity. For some people, there is a need to embrace treatments that clearly work. For certain types of treatments there is still a need to understand better how these treatments can work more effectively so that more people can benefit from them. However, many fundamental questions also remain about the causes of weight gain obesity, which clearly affect only a proportion of the population – although a growing proportion.

This is why this year’s Plymouth Obesity, Diabetes and Metabolic Syndrome Symposium, our fifteenth, has brought together some of the UK’s leading experts and opinion leaders to discuss their work in this field. Entitled “New Ideas and Controversies in Obesity”, we are showing the latest thinking in a number of areas related to obesity including:

  • the potential appropriateness, for some people, of bariatric surgical solutions as a primary approach to treating diabetes.
  • the latest ideas and developments in important clinical trials.
  • whether obesity is a psychological disorder
  • new insights into the role of the gut in regulating blood glucose levels and influencing the risk of developing diabetes,
  • using groups in delivering group therapy as an approach to the treatment of obesity
  • new ideas on the importance of adipose (fat) tissue in health and disease.
  • new insights into the causes of diabetes in women with Polycystic Ovary Syndrome.
  • challenges ahead for the implementation of the latest NICE guidance on obesity.
  • latest findings and developments from the Plymouth EarlyBird study, which is now following up Plymouth children as adults

Our experts include: Professor Francesco Rubino, Chair of Metabolic and Bariatric Surgery at Kings College London; Dr. Jennifer Logue, Clinical Senior Lecturer at the Institute of Cardiovascular and Medical Sciences, Glasgow; Professor Jason Halford from Psychology Sciences at the University of Liverpool; Dr. Royce Vincent, Consultant Chemical Pathologist at King’s College Hospital; Dr. Mark Tarrant, Senior Lecturer in Psychology Applied to Health and Dr. Katarina Kos, both at the University of Exeter; Dr. Joanne Hosking, PhD Statistician at Plymouth University Peninsula Schools of Medicine and Dentistry; and Professor Jonathan Pinkney, Consultant Endocrinologist from Plymouth University Peninsula Schools of Medicine and Dentistry and Plymouth Hospitals NHS Trust.

By bringing together such a spectrum of experts we are capturing the series of challenges faced by everyone in the field of obesity care and study: from environmental and personal factors to biology, behaviour, cutting edge science, politics and public health.

It is fair to say that it is unlikely that all these august and knowledgeable individuals will be in one place at one time any time soon, so the discussions we have here in Plymouth will have ramifications for tackling obesity worldwide.

What will be the answer? There is some work to do yet before that is clear, but our conference shows that we must accept that the problem of obesity is multi-facetted, and as a consequence requires a multi-disciplinary approach.

That is why we need expert opinion and input from across the full ‘life story’ of obesity – from science in the laboratory to an investigation of social influences, surgical options, psychological factors and ultimately health policy.

As world leaders in diabetes, obesity, metabolic syndrome and endocrinology, we in Plymouth are well-placed to contribute to a round of debate and action which in time and with appropriate resource could tackle the problem of obesity once and for all.

Professor Jonathan Pinkney is Professor of Endocrinology and Diabetes at Plymouth University Peninsula Schools of Medicine and Dentistry and a Consultant Physician in Endocrinology and Diabetes at Plymouth Hospitals NHS Trust.

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Maternal obesity linked to reduced immunity in newborns that may last a lifetime

Maternal obesity raises the risk of a number of health conditions for offspring that can persist well into adulthood, including heart disease and asthma. Now, a new study reveals why this may be; maternal obesity weakens an infant’s immune system at the time of birth, increasing their susceptibility to illness.

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Infants born to obese mothers were found to have reduced immune cell response compared with infants whose mothers were lean.

Study leader Ilhem Messaoudi, of the University of California-Riverside, and colleagues publish their findings in the journal Pediatric Allergy and Immunology.

Around 60% of women of childbearing age in the US are overweight or obese – a risk factor for poor health during pregnancy.

Maternal obesity has been linked to increased risk of gestational diabetes, preeclampsia and preterm birth. Studies have also suggested a greater risk of birth defects, type 2 diabetes, asthma and heart disease among children born to obese mothers.

While previous research has indicated that maternal obesity dysregulates an infant’s immune system to make them more prone to illness, Messaoudi and colleagues say the mechanisms behind this are poorly understood.

For their study, the team set out to investigate what effect maternal body weight has on the immune system of newborns.

Reduced immune cell response among babies born to obese mothers

To reach their findings, the researchers enrolled 39 mothers and their infants to the study. Each mother’s body mass index (BMI) was recorded – calculated by their height and weight – before they were allocated to one of three groups: lean, overweight or obese. Overweight was defined as a BMI of 25-29.9, while obese was defined as a BMI of 30 or higher.

Eleven of the mothers were lean, 14 were overweight and 14 were obese. All women were nonsmokers and had no complications during pregnancy.

The team collected umbilical cord blood samples from the mothers’ infants, assessing the samples for immune cell population and circulation.

Compared with infants born to lean mothers, the researchers found that specific immune cells – monocytes and dendritic cells – among infants born to obese mothers showed much lower responses to bacterial antigens.

“Such babies also showed a reduction in CD4 T cells,” adds Messaoudi. “Both of these changes could result in compromised responses to infection and vaccination.”

The umbilical cord blood samples also showed lower levels of eosinophils (cells involved in allergic response and asthma development) among infants born to obese mothers. The researchers say these cells may have already traveled into the infants’ lungs, which may explain why children born to obese mothers are at greater risk of asthma later in life.

The team says their study shows that maternal obesity can influence changes in an infant’s immune system that are detectable at birth and may persist throughout their lifetime.

Messaoudi adds that the findings raise a number of questions about how children should be vaccinated:

“This could change how we respond to vaccination and how we respond to asthma-inducing environmental antigens. As we know, in the first 2 years of life, children typically receive plenty of vaccines.

“The questions that arise are: Are the responses to vaccines in infants born to obese moms also impaired in the first 2 years of life? Should we change how often we vaccinate children born to obese moms? Should we change practices of how much and how often we vaccinate?”

While further studies are warranted to assess the link between maternal obesity and the neonatal immune system, Messaoudi believes their findings indicate that more focus is needed on combating weight gain before and during pregnancy.

“When moms come in for prenatal visits, doctors tell them about smoking, recreational drug use, and alcohol. But they should be talking also about weight and weight management,” says Messaoudi.

“Obesity has serious repercussions for maternal health. It is associated with low fertility and success with pregnancy,” she adds. “Rates of gestational diabetes, preeclampsia, placental abruption – all of these risks increase dramatically with weight gain and obesity. So it is important to talk to your doctor about ideal weight entering into pregnancy and throughout pregnancy.”

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Is diet or exercise the best way to reduce diabetes risk?

In a paper recently published in Diabetes Care, Saint Louis University associate professor of nutrition and dietetics Edward Weiss, Ph.D, and colleagues found that, though people often think of the benefits from exercise, calorie restriction and weight loss as interchangeable, it appears that they may all offer distinct and cumulative benefits when it comes to managing Type 2 diabetes risk.

The SLU study enrolled sedentary, overweight, middle-aged men and women who were assigned to one of three groups designed to reduce weight by 6-8 percent through calorie restriction, exercise or a combination of both.

Researchers recorded the participants’ insulin sensitivity levels, a marker for diabetes risk that measures how effectively the body is able to use insulin.

“Your blood sugar may be perfectly normal, but if your insulin sensitivity is low, you are on the way to blood sugar issues and, potentially, Type 2 diabetes,” Weiss said.

The investigators found that both exercise and calorie restriction had positive effects on insulin sensitivity. Most interestingly, the group that did both saw two times the improvement in insulin sensitivity than either of the single-approach groups.

The study suggests that both exercise and calorie restriction have additive beneficial effects on glucoregulation (the steady maintenance of glucose, or sugar, in the body).

“The exercise group was, in a way, our control group. It was already known that exercise can improve glucoregulation, both through weight loss and through mechanisms that are independent of weight loss,” Weiss said. “This means that even if you don’t lose weight, exercise helps.

“On the other hand, it often has been assumed that calorie restriction improves glucoregulation simply because it leads to weight loss.”

For this reason, it was somewhat surprising to researchers when they found that exercise-induced weight loss did not lead to greater improvements in glucoregulation than calorie restriction alone.

“What we found is that calorie restriction, like exercise, may be providing benefits beyond those associated with weight loss alone,” Weiss said.

If this is true, researchers would expect that the combination of exercise and calorie restriction (with participants still losing between 6 and 8 percent of their weight, like the other groups) would lead to even more improved glucoregulation than either of the other groups alone.

This is, in fact, what the results of the third, exercise and calorie restriction combination group confirmed.

“On the surface it may seem obvious, and yet there are a lot of people who believe that if they maintain a healthy weight, it doesn’t matter what they eat,” Weiss said. “And others have an appropriate food intake but don’t exercise.

“This study says you can be healthier if you exercise and eat the right amount of food. There is more to be gained by including both approaches in your life.”

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