For Very Obese, Gastric Bypass May Extend Life

For Very Obese, Gastric Bypass May Extend Life

CINCINNATI – Gastric bypass surgery could have life-extending benefits for most of the five percent of Americans who are very obese, a new study suggests.

The study, led by researchers at the University of Cincinnati, concluded that the benefits of this form of weight-loss surgery far outweigh the risks for most people who are morbidly obese, which is defined as having a body mass index of 40 or higher.

But individual decisions on the surgery rely on factors such as age, and a special program to help physicians and obese people balance the benefits and risks of weight-loss surgery is on the way, the researchers said.

“In the future, we plan on having a Web-based decision support tool,” said Dr. Daniel P. Schauer, assistant professor of internal medicine at the University of Cincinnati Academic Health Center. “Hopefully, it will be available some time in the next year. It is in the development and testing phase.”

The program is based on a study reported by Schauer and his colleagues in the January issue of Archives of Surgery. They examined data on more than 23,000 people who underwent bariatric surgery. The study compared that data to the immediate risk of death from the procedure and the years of life expectancy added by having the surgery.

Obesity is a major risk factor for heart attack, stroke and other cardiovascular problems. An increasing number of Americans who cannot control their weight by diet or behavioral changes have turned to bariatric surgery. Gastric bypass is one of several forms of bariatric surgery, which work by either preventing food from entering the stomach or diverting it past the stomach, thereby reducing food intake and absorption.

Current data indicate that a 42-year-old woman with a BMI of 45 would gain three years of life expectancy through gastric bypass, while a 44-year-old man with the same BMI would gain 2.6 years of life, according to the study. For reference, a 5-foot-9-inch man or woman weighing 305 pounds has a BMI of 45.

The 30-day mortality from the surgery has ranged from almost zero to as high as 2 percent in some studies, but it can be higher for some selected populations, the report said.

“The patients who benefit the most are younger patients who have a lower risk of dying from the surgery and a higher BMI,” Schauer said. “The patients who benefit the least are older patients with a higher surgical risk because of a combination of age and comorbidities [other illnesses].”

Their model does not calculate the risk added by specific comorbidities, such as coronary disease, he said. “We are working on that for the next generation of models,” Schauer said.

The most recent data used comes from 2007, and there is also reason to believe that the surgical risk has decreased since then, Schauer said. “That is something we are working on, updating the model as it becomes available,” he said.

Dr. T. Karl Byrne, professor of surgery and director of bariatric surgery at the Medical University of South Carolina, said he would like to see more information on the cost benefits and health improvements associated with gastric bypass.

Every diabetic costs the health care system $13,000 a year, Byrne said. If you are diabetic and have bariatric surgery, in six months your diabetes goes away. So there is more to it than just life years obtained. There is a huge cost issue that is not addressed in these studies, and bariatric surgery should cost the health care system less in the long term, he said.

A second report in the same issue of the journal reported a marked change in the sites doing bariatric surgery after the federal government approved Medicare and Medicaid payment for the procedure in February 2006.

That coverage required that surgery be done at a medical center certified by the American College of Surgeons or the American Society for Metabolic and Bariatric Surgery. For approval, a center must perform at least 125 operations a year.

The study by physicians at the University of California at Irvine compared results of almost 3,200 operations done just before approval and almost 3,100 done just after approval. It found that the number of facilities doing such surgery decreased from 60 to 45, indicating a shift to certified, high-volume centers.

People who had surgery after approval had shorter hospital stays (3.5 days vs. 3.1 days) and lower rates of complications (12.2 percent vs. 10 percent). No significant difference was seen in the in-hospital mortality rate (0.28 percent vs. 0.2 percent).

“Although we only examined the Medicare beneficiaries population in this survey, we suspect that the improvement in outcomes will also be extrapolated to the population that is not eligible for Medicare,” the researchers wrote.

Bariatric surgeries have increased steadily in the United States — from 16,800 in 1992 to about 205,000 in 2007, according to the American Society for Metabolic and Bariatric Surgery.

Can Sweeteners Be Blamed For Rise In Obesity?

Can Sweeteners Be Blamed For Rise In Obesity?

LOS ANGELES – Researchers have claimed that a cheap form of sugar used in thousands of food products and soft drinks can damage human metabolism and is fuelling the obesity crisis.

Dangerous growth of fat cells

The study by a team at the University of California claimed fructose, a sweetener derived from corn, can cause dangerous growths of fat cells around vital organs has increasingly been used as a substitute for more expensive types of sugar in yoghurts, cakes, salad dressing and cereals.

Over 10 weeks, 16 volunteers on a strictly controlled diet, including high levels of fructose, produced new fat cells around their heart, liver and other digestive organs. It was reported that they also showed signs of food-processing abnormalities linked to diabetes and heart disease. Another group of volunteers on the same diet, but with glucose sugar replacing fructose, did not have these problems.

People in both groups put on a similar amount of weight. However, the researchers said the levels of weight gain among the fructose consumers would be greater over the long term.

Fructose is not responsible for obesity

Dr. Iain Frame, Director of Research at Diabetes UK, however was dismissive of the study’s findings and said:

“The results reported from this study do not support the claim that high doses of fructose are responsible for childhood obesity or the increasing prevalence of Type 2 diabetes.

“This study used a small number of participants over a short period of time and the results are inconclusive. As the authors of the study say, further long-term and carefully controlled studies are needed to investigate the effects of fructose, sucrose, and high-fructose corn syrup.”

Antidepressant Found to be Just as Effective as Placebo in Child Pain Relief

Antidepressant Found to be Just as Effective as Placebo in Child Pain Relief

WASHINGTON – A new study has shown that the antidepressant amitriptyline is just as effective as placebo in treating pain-predominant gastrointestinal disorders in children.

“Many pharmaceutical products are prescribed for off-label use in children due to the lack of clinical trials testing the efficacy of the drugs in children and adolescents. Therefore, the pediatric gastroenterologist frequently has to make treatment decisions without the evidence of how drugs work in children,” said Dr. Miguel Saps, of Children’s Memorial Hospital and lead author of the study.

“The high placebo effect we identified in this study suggests that further studies of the use of certain antidepressants in children with functional bowel disorders are needed. While several trials have demonstrated a beneficial effect of antidepressants, including amitriptyline, for the treatment of irritable bowel syndrome (IBS) in adults, more research is needed to determine how effective this drug is, if at all, in children,” Dr. Saps added.

According to background information in an article on the study, published in the journal Gastroenterology, amitriptyline is used to treat symptoms of depression, but it is some times prescribed to children for pain relief from pain-predominant functional gastrointestinal disorders (FGIDs).

Pain-predominant FGIDs are among the most common causes for medical consultation in children. Such disorders include three common conditions: IBS, functional dyspepsia and functional abdominal pain.

For their study, the researchers designed a large prospective, multi-centre, randomised placebo-controlled trial in which children, ages eight to 17, with IBS, functional abdominal pain or functional dyspepsia were randomised to four weeks of placebo or amitriptyline.

Of the 83 children who completed the study, 63 percent of those who took amitriptyline reported feeling better, while 5 percent reported feeling worse.

Among those given a placebo, 57.5 percent felt better, while 2.5 percent felt worse.

Pain relief was excellent (7 percent), good (38 percent) in children on placebo and excellent (15 percent), good (35 percent) in children on amitriptyline.

The researchers observed that both amitriptyline and placebo were associated with excellent therapeutic response, although patients with mild to moderate intensity of pain responded better to treatment.

According to them, there was no significant difference between amitriptyline and placebo after four weeks of treatment.

In children, the use of drugs to treat pain-predominant FGIDs is mostly empirical and based on adult data.

There have been only a few small, randomized clinical trials evaluating the efficacy of drugs for the treatment of pain-predominant FGIDs in children.  

Soluble Fiber Effective in Treating Irritable Bowel Syndrome

Soluble Fiber Effective in Treating Irritable Bowel Syndrome

UTRECHT – A new study by researchers from Utrecht University in the Netherlands has suggested that a soluble fiber supplement called psyllium should be the first line of attack in treating irritable bowel syndrome (IBS).

In the study, researchers compared adding bran, psyllium and a dummy supplement to sufferers’ diets.

They found psyllium was the most effective, warning that bran may even worsen the symptoms of the condition.

IBS is characterized by abdominal pain and an irregular bowel habit.

Its exact cause is unknown and recommendations for treatment include dietary advice, antidepressants and drug treatments.

Many relying on dietary adjustments still turn to bran in a bid to help improve the way the intestines work.

However, the new study of 275 patients questions the wisdom of this approach.

The researchers gave patients 10g of either psyllium, bran or rice flour twice a day for 12 weeks.

At the end of the study, those on psyllium, a naturally occurring vegetable fibre, reported symptom severity had been reduced by 90 points using a standard scale of rating problems.

For bran it was 58 points and for the placebo group, 49.

The study also showed that patients seemed less tolerant of bran, with more than half of the group dropping out during the trial, mostly because their symptoms worsened.

Soluble fiber can also be found in fruit such as apples and strawberries, as well as barley and oats.

“I think adding psyllium to the diet is the best treatment option to start with. In the study, people did this by adding it to things such as yoghurt and it had a real effect,” the BBC quoted Dr Niek de Wit, one of the researchers, as saying.

The study has been described in the British Medical Journal.

STILL TRYING TO BURN OFF HOLIDAY WEIGHT?

STILL TRYING TO BURN OFF HOLIDAY WEIGHT? 

BEVERLY HILLS – Try ‘interval exercise’ – which purportedly burns fat up to “nine times higher” than aerobic exercise “with effects continued for 24 hours,” according to studies reported in Metabolism Journal.

A program of “two minutes at 97% of maximum heart rate followed by a recovery period of three minutes at low intensity… is also better for conditioning the heart and improving overall circulation than lower-intensity, long-duration exercise like walking and jogging… because with interval training you transition back and forth between aerobic and anaerobic states, using fuel… As muscles require more oxygen than is available, muscle cells must rely on other reactions to continue contractions.” Then, because interval training also “helps reset your body’s temperature thermostat higher, it continues to burn more fuel even after you stop the exercise.”                                                                                                                                     

Long Lasting Weight Loss

BEVERLY HILLS – Weight loss diet tip – it’s hard to have lasting weight loss without taking steps to increase your healthy habits and reduce unhealthy ones. Losing weight is about burning energy – more than what is taken in.

This is how the low-carb/Atkins diets work… a low-carbohydrate diet reduces food intake, since the ketones produced by fat-burning really do curb ones appetite! It’s really not complicated – if you burn up your fat stored in the body – you WILL lose weight!

One of the most important and effective ways for losing weight and getting healthier is to avoid two kinds of foods.

Both of these foods have been linked to deteriorating health, and specifically weight gain and obesity.

The unhealthy ingredients in these foods have quietly and steadily been used in greater amounts over the last two decades in the USA…and most of us don’t know it!

Partially hydrogenated oils and trans fatty acids…

One group of the foods to avoid are those that contain “Trans Fatty Acids”. These fats are found in partially hydrogenated oils – manufactured and unhealthy fats. These are oils that have had hydrogen added to them to prolong their shelflife.

They are a quiet killer hidden in food and they have been directly linked to the escalating rates of obesity in both adults and children all over the world.

There is a clear statistical increase in obesity over the last 20 years as these types of hydrogenated oils have become an increasing part of the typical American diet.

The U.S. government states that manufactured hydrogenated oils have no safe level for human consumption! There is no safe level of consumption, but it’s still in most of the products Americans eat every day.

In the USA, most of our food dollars is spent on processed foods. Government reports say that over 40% of foods found in an average grocery store contain these kinds of hydrogenated oils.

Most fast foods contain hydrogenated oils. Snacks, chips, candy bars, cookies, crackers, commercial baked goods, pastries and cakes…almost all of these processed foods contain hydrogenated oil.

How can you avoid hydrogenated oil and its effect on your health? What do you look out for?

• 1 – The first thing to do is to read the labels. Read the labels of foods you buy and look for partially hydrogenated oils. If you see those words, avoid that food. Any food that contains partially hydrogenated oils is unhealthy and will affect your weight loss program in a negative way.

Here are examples of foods that contain partially hydrogenated oils:

• cereals • cookies • cake mixes • candy bars • chips, pretzels • snacks • commercial pastries • processed foods • fast foods

What is known for sure is – you can’t lose weight and regularly eat foods containing partially hydrogenated oils.

• 2 – Ask questions. When eating out, ask if the foods you are ordering contain partially hydrogenated oils.

• 3 – Find alternative foods.The good news is – because of more media exposure about the dangers of hydrogenated oils, companies are starting to replace partially hydrogenated oils with other healthier ingredients and creating healthier versions of some of your favorite products.

McDonalds has had legal actions taken against it by concerned consumers attempting to force McDonalds to reduce or eliminate hydrogenated oils in its products. Restaurants are starting to add more natural oils and are removing partially hydrogenated oils from their kitchens.

Try to get as many organic whole foods included in your daily diet as possible. Fruits and vegetables, whole grains, healthy fats and organic meats and dairy products will mean you won’t be filling your body with hydrogenated oils, growth hormones and antibiotics. Try to avoid processed and fast foods as much as possible.

Avoiding these hidden oils in the food you eat every day will make an important impact on your health, and will help you in reaching your weight loss goals. Add some lifestyle changes and imagine where you will be on your trip towards better health in the future!

Refined white flour products.

The other common weight loss ingredient is refined white flour. Refined white flour products stimulate the highest production of insulin.

When we consume these kinds of products, our blood sugar levels spike upward dramatically at first within the hour, then plummet downward an hour or so after…creating mood swings, hunger cravings, and pushing us toward diabetes and obesity.

Did you know that refined white flour converts into glucose in the body FASTER than white sugar? It’s true! Once you understand how the body functions in weight gain and weight loss, you can then understand what to do to have lasting weight loss without dieting.

 

Eat the Butter: Study Finds Fatty Foods Help Pilots on Mental, Flying Tests

GRAND FORKS — Running a marathon, grab a carbohydrate bar. Lifting weights, gulp a protein shake. But climbing into a fighter jet? Butter-soaked lobster might help.

That was the surprising finding of a new military-funded study that sought to figure out what types of foods were best for pilots when missions restricted when or what they could eat. University of North Dakota researchers found that pilots who ate the fattiest foods such as butter or gravy had the quickest response times in mental tests and made fewer mistakes when flying in tricky cloud conditions.

High-carb diets trumped high-protein in performance tests.

“We wound up analyzing the data every which way but upside down. It came out consistent every time,” said psychology professor Tom Petros, who conducted and reviewed the tests.

Fat has been considered a villain by some nutritionists. Earlier research in humans and animals has linked diets high in saturated fats to mental decline and shorter-term problems with memory and learning.

Athletes and others with physically demanding jobs generally focus on a high-carbohydrate diet for improved performance. The study’s researchers aren’t saying people should now load up on biscuits and gravy, in fact researchers said it’s hard to draw conclusions from their study because more tests are needed to figure out what’s behind the results. Follow-up studies begin this spring.

Researchers said the study is not aimed at weight control and noted that because the pilots are young, they’re able to absorb a high amount of fatty acids for brain development.

Military experts hope the research will eventually help improve pilots’ performance. National Transportation Safety Board statistics show 80 percent of civil and military accidents are caused by human error.

The study tracked 45 student pilots to assess how different foods affect a pilot’s performance. Every three weeks, each pilot spent one week on four different diets: high-fat, high-carbohydrate, high-protein and a control diet.

The menus were similar so the type of diet wouldn’t become obvious to participants. In some cases, the difference was in the drinks, condiments, gravy, salad, vegetables and desserts.

“They loved the day they got brownies,” said Glenda Lindseth, who helped lead the project. “They all got them, but some of them were a little smaller and some of them didn’t have frosting.”

One typical meal was thin crusted extra meat and cheese pizza for the fat diet, a thin crusted chicken supreme pizza for the carbohydrate diet, and a grilled chicken breast with mixed salad greens, fat-free salad dressing and fat-free shredded cheese for the protein diet.

The study used a flight simulator that required students to descend in cloudy weather when the runway wasn’t visible and using only the plane’s computers. The pilots then had to climb into a holding pattern. They also took tests that required memorizing and repeating numbers and comparing shapes.

“I could tell the difference on how well I was doing on the different diets,” said Jeremy Ternes, who participated in the study. “There were times I thought, ‘Wow, I was a lot more on today as compared to last week.’”

He added: “I think a lot of people felt they did better when they got the lobster and the good stuff.”

Based on their test scores, pilots on the high-fat and high-carb diets performed substantially better than the high-protein eaters. The high-fat dieters did slightly better than the high-carb dieters.

“With additional research, these findings may help decrease the number of aviation accidents due to pilot error, which is especially important for the war fighter,” Lindseth said.

More study is needed to determine whether the findings will have a lasting effect.

“Most of the studies indicate that a diet of saturated fats like those found in junk food reduces cognitive performance,” said Fernando Gomez-Pinilla, a physiological science professor at UCLA who was not involved in the study. “I will be more interested to see what they find when they monitor the composition of the diet.”

How Proximity to Convenience Stores Promotes Child Obesity

MONTREAL – The proximity of convenience stores to kids is connected to childhood obesity, according to a new study.

As part of the study 632 children and their families from Montreal in Canada were recruited in 2005.

The children belonged to family incomes ranging from 31,000 dollars to 141,000 dollars.

Of the underage participants, 42 percent were overweight and 22 percent were outright obese.

The researchers noted that access to green spaces may have little influence on the size of 8 to 10-year-olds.

However, proximity of parks can affect how much children walk, but impact on weight remains to be seen.

Families who took part in the quality study will continue to be monitored to verify if proximity to the park has an impact on the long-term weight of children.

Senior researcher Tracie Ann Barnett, a professor at the Université de Montréal Department of Social and Preventive Medicine and researcher at the Sainte Justine University Hospital Research Center, said: “Access to convenience stores seems more relevant in obesity than access to fast food restaurants.”

She further suggested that schools should establish zones that are free of convenience stores.

Researchers Find a Way to Block Fat Consumption

ST. LOUIS – Researchers have discovered a way to block fatty diet consumption by deactivating a part of the brain that regulates emotion. But the blockade will not affect people who are hungry.

“It appears that two different brain circuits control the motivation to seek and consume,” said Matthew Will, assistant psychological science professor at the University of Missouri (U-M) College of Arts and Science.

“Understanding how this circuit in the brain works may provide insight into the exact networks and chemicals in our brain that determine the factors influencing our feeding habits,” he said.

The release of opioids, pleasure chemicals that can lead to euphoria, into the brain produces binge eating in non-hungry people. Will and his team of researchers determined that deactivating the basolateral amygdala – the brain region that regulates emotion – blocked this type of binge eating.

“A key to curbing the obesity epidemic in America is controlling the desire to binge eat,” Will said.

“Humans have more programming to start and continue eating than to stop eating, especially when they have a bowl of ice cream in front of them. Most of us would finish it even if we weren’t hungry.”

Researchers said deactivating the basolateral amygdala had no effect on feeding in rats that were simply deprived of food for 24 hours, said an U-M release.

This suggests that the basolateral amygdala is specifically involved in the overconsumption of food based on its palatability or pleasure driven by opioids rather than the level of hunger.

The study was published in Behavioural Neuroscience.

Common Abbreviations Used in Nutrition

When you read about nutrition, diet and nutritional supplements, you are likely to come across some abbreviations that may not look familiar to you. Here are some common abbreviations used in nutrition:

AA

Amino Acids, the individual components of proteins.

ADEK

Vitamins A, D, E and K, fat-soluble vitamins sometimes grouped together and designated by the abbreviation ADEK.

AI

Adequate Intake , amount of a nutrient that will meet the requirements of everybody. It is used when a RDA can’t be determined.

BMI

Body Mass Index, a measurement that indicates obesity by calculating the relative percentages of fat and muscle in the body.

Ca

Calcium, a dietary mineral needed for healthy bones, muscle function and many other functions in the body.

DRI

Dietary Reference Intake, the levels of nutrients needed for dietary consumption. They replaced the Recommended Dietary Allowance (RDA) in 1989.

EAR

Estimated Average Requirement, the intake of a nutrient that will meet the requirements of one half of all healthy individuals.

Energy RDA

Energy Recommended Dietary Allowance, the average number of calories needed, differing by gender and age. Note: The Energy RDA is an average, so any person may actually need more calories or fewer calories than what the calorie charts show.

Fe

Iron, a dietary mineral needed for transportation of oxygen throughout the body.

FTT

Failure To Thrive, a significant delay in growth of an infant or young child.

g

Gram, a metric unit of measure. Carbohydrates, fats and proteins are measured in grams. It would take about 29 grams to equal one ounce.

IU

International Unit, a measure of the activity of vitamins and drugs. Vitamins A, D and E are often measured in this way. Conversion from IU to mg is different for each vitamin.

K

Potassium, a dietary mineral that is needed for water balance and healthy muscle function in the body.

kcal

Kilocalorie, a measure of energy that we commonly refer to as a “calorie.”

mcg

Microgram, a metric unit of measure. Some vitamins and minerals are measured in micrograms, for example, 1,000 micrograms equal one milligram.

mg

Milligram, another metric unit of measure. Many vitamins and minerals are measured in milligrams, for example, 1,000 milligrams equal one gram.

Mg

Magnesium, a dietary mineral needed for healthy muscle function and other processes in the body.

mEq

Milliequivalent, a measurement that is equal to one-thousandth of a gram equivalent.

Na

Sodium, a dietary mineral that is needed for water balance in the body.

RDA

Recommended Dietary Allowance designates the amount of a nutrient that will meet the requirements of 97.5% of healthy individuals. It is based on the EAR plus two standard deviations.

REE

Resting Energy Expenditure, number of calories you would burn if you stayed at rest all day.

RNI

Reference Nutrient Intake, used in the UK and stands for the daily nutrient recommendations to meet the needs for the majority of the population.

UL

Tolerable Upper Limit, highest level of a nutrient that is safe for all individuals.