Sunday, September 23, 2012

Sugary drinks linked to obesity

Health experts the world over have long believed that the dramatic rise in the consumption of sugary drinks during the past few decades has paralleled the equally dramatic rise in obesity.

A new study in the U.S. now reinforces that notion, giving public health officials the much-needed evidence to consider clamping down on the consumption of sodas and other sweetened beverages that are high in calories but provide next to nil nutrition.

The study, published in the New England Journal of Medicine, follows research involving more than 33,000 American men and women, which proved that sweetened drinks raise the genetic risk of obesity, as they interact with genes that affect weight.

The researchers selected 32 variations of genes that are known to be associated with Body Mass Index to establish a genetic profile of the participants. They also determined the participants’ eating habits, their consumption of sweetened beverages and exercise habits.
The decades-long research involved three long-running studies that separately and collectively reached the same conclusions.

In all the three studies, “the combined genetic effects on Body Mass Index and obesity risk among persons consuming one or more servings of sugar-sweetened beverages per day were approximately twice as large as those among persons consuming less than one serving per month”, the researchers said.

Obesity has today become a major threat to people’s health all over the world. So great is the threat that it has been classified as an epidemic.

Obesity and overweight are the fifth leading risk for global deaths. They are linked to more deaths than underweight.

The World Health Organisation defines obesity and overweight as abnormal or excessive fat accumulation that may impair health.

The good news is that these conditions are preventable.

Experts believe that changes to our diet and lifestyle in the past three decades have contributed to the obesity epidemic.

Consumption of junk food and calorie-laded sugary drinks, a sedentary lifestyle and lack of physical activity are the three main causes of people piling on the pounds.

Of the three, the largest blame goes to sugar-sweetened beverages that are high in calories but low in nutrition but whose consumption has increased dramatically in the past few years.

In the U.S. diet, sugary drinks are the single biggest source of calories. They are blamed for the fact that a third of the U.S. children and teens and more than two-thirds of adults are obese or overweight.

A new damning report says that if the current trend continues then by 2030 more than half the population of the U.S. will be obese!

The new study vindicates what New York Mayor Michael Bloomberg is trying to do in his city. In a trend-setting move, the city’s Board of Health has passed legislation banning the sale of super-sized colas in most public outlets.

The ban does not come into effect until March 2013 but whether this limited clamp will have the desired result of reducing the consumption of colas and thereby bringing down the obesity rate remains to be seen but it seems a well-intentioned measure.

At least, well worth adopting in other cities in the U.S. and around the world where cola consumption is high.

Thursday, September 20, 2012

Obesity in the US: A Burgeoning Crisis

It makes for frightening reading, really.

In the past few years, obesity has been rising rapidly in the United States with the result that today it has reached epidemic proportions.

To make matters worse, a new damning report says that if the current trend continues then by 2030 more than half the population of the United States will be obese!

The report, aptly titled F as in Fat: How Obesity Threatens America’s Future 2012, says that the number of obese adults will increase dramatically in every state in the country over the next two decades – and along with it related disease rates and health care costs.

The report follows analyses of state-by-state data from the Centers for Disease Control and Prevention commissioned by Trust for America’s Health and the Robert Wood Johnson Foundation and conducted by the National Heart Forum.

Obesity is defined as having a Body Mass Index above 30, while overweight means a Body Mass Index of between 25 and 29.9.

Obesity increases the risk of heart diseases, diabetes, hypertension and other chronic illnesses.

Key findings of the study:
  • If the obesity rise continues on its current path, 13 states could have adult obesity rates above 60 per cent, 39 states about 50 per cent, and all 50 states could have rates above 44 per cent by 2030.
  • By 2030, Mississippi could become the fattest state in the United States with an obesity rate of 66 per cent with Colorado at the bottom of the ladder with 44.8 per cent – in 2011, the rates were 34.9 per cent and 20.7 per cent, respectively.
  • There could be a 10-fold increase in new cases of Type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis between 2010 and 2020 – and double that by 2030.
  • Obesity could contribute to more than 6 million case of Type 2 diabetes, 5 million cases of coronary heart disease and stroke, and more than 400,000 cases of cancer in the next two decades. Currently, more than 25 million Americans have Type 2 diabetes, 27 million have chronic heart disease, 69 million have hypertension and 50 million have arthritis. Besides, 795,000 Americans suffer a stroke each year and nearly a third of the cancer deaths are related to obesity, poor nutrition and lack of physical activity.
  • Medical costs associated with treating preventable obesity-related diseases are estimated to increase by $48 billion to $66 billion per year.
  • Loss in economic productivity could be between $390 billion and $580 billion annually.
  • Nine states could see their obesity-related health care costs shoot up by more than 20 per cent with New Jersey seeing the highest increase of 34.5 per cent.
A grim picture, no doubt. However, all is not lost.

The report suggests that the doomsday scenario can be avoided if only the states could reduce the average Body Mass Index of their residents by just 5 per cent by 2030.

“The study shows us two futures for America’s health,” says Risa Lavizzo-Mourey, president and CEO of Robert Wood Johnson Foundation.

“At every level, we must pursue policies that prevent health, prevent disease and reduce health care costs.

“Nothing less is acceptable.”

Trust for America’s health executive director Jeff Levi says increasing physical activity times in schools and making fresh fruits and vegetables more affordable can help make healthier choices easier.

“Small changes can add up to a big difference,” he says.

“Policy changes can help make healthier choices easier for Americans in their daily lives.”

Not a tall order, surely. But there needs to be a national commitment and will.

What more do you think Americans should do to tackle the obesity crisis? Please, leave your comments below.

Saturday, September 15, 2012

Michael Bloomberg: A modern-day Don Quixote?

Love him or hate him, you just can't ignore him!
New York City Mayor Michael Bloomberg has been vilified and pilloried for steamrolling through legislation that clamps down on the sale of super-sized colas and sugary drinks in many large outlets in the city’s five boroughs.
His justification?
More than half of adult New Yorkers are obese or overweight and annually nearly 6,000 New Yorkers lose their lives to the burgeoning epidemic of obesity.
Bloomberg has made curbing obesity a top goal of his administration. Obesity increases the risk of heart diseases, diabetes, hypertension and other chronic illnesses.
"We cannot continue to have our kids come down with diabetes at age 6."
Rising obesity among children is of specific concern as it puts them at greater risk of serious health problems as they age. Doctors believe that children who are extremely obese may continue to be extremely obese as adults.
Despite his good, some call it misguided, intention Bloomberg is being seen in some quarters as a modern-day Don Quixote tilting at windmills represented, in this case, by large fast-food chain restaurants!
Up in arms are those who will be badly hit by the 16-ounce limit on sodas and other sugary drinks at restaurants, delis and theaters – the soft drinks and restaurant industries and the large movie chains.
Backing them are 60 per cent of New Yorkers who oppose the restrictions, according to a New York Times poll.
They believe the measure is:
  • An assault on personal liberty. At the best of times New Yorkers don’t like to be told what to do. Bloomberg has been accused of being overbearing, over-reacting and turning New York into a 'nanny’ state.
  • Self-defeating. According to the ban refills are permitted. Even by Bloomberg's admission "restaurant customers can still buy as much soda as they want, as long as they are willing to carry it in multiple containers".
  • The regulation has its limits. The restrictions do not apply to supermarkets or most convenience stores since they are not subject to New York City Board of Health regulations.
However, let’s count the calories.
A 20-ounce Coke has 24o calories and a 16-ounce Coke 200 calories.
If you drink a Coke a day, choosing a 16-ounce bottle over the 20-ounce would say you 14,600 calories over a year. That is enough to add about 1.8 kilograms of fat to your body!
New York City Health Commissioner Dr. Thomas Farley believes that if New Yorkers reduced their cola consumption from 20 ounces to 16 ounces every other week, it would help them avoid gaining some 2.3 million pounds a year.
Bloomberg has been instrumental in introducing a number of health measures in New York, including:
  • A ban on smoking in public places;
  • Forcing chain restaurants to post calories on their menus;
  • A ban on artificial trans fats in french fries and other restaurant food;
  • Promoting breast-feeding over formula.

Though the ban on super-sized cola does not take effect until March 2013, the big corporations have already declared their intention to fight the regulation.
"This is a political solution and not a health solution," said Eliot Hoff, a spokesman for an industry-sponsored group called New Yorkers for Beverage Choices, which claims to have gathered more than 250,000 signatures on petitions against the plan.
“This is not the end,” said Eliot Hoff, a spokesman for the group, after the vote. “We are exploring legal options, and all other avenues available to us.”

Only time will tell whether the initiative will bear the desired results and help New Yorkers lead healthier lives.

For sure, city officials, health experts around the nation, and beverage and restaurant industries will be closely how this pans out.

Do you think Michael Bloomberg is on the right track? Please leave your comments below.

New York calls time on super-sized cola

Okay, it’s official now. New York City has added one more weapon in its armory against its war on obesity.

In a groundbreaking move, the city’s Board of Health unanimously passed, by an 8-0 vote, the first U.S. ban on super-sized sodas and other sugary soft drinks.

The ban applies to any establishment, in the city’s five boroughs, with a food-service license, including fast-food restaurants, workplace cafeterias, delis, movie and Broadway theaters, the concession stands at Yankee Stadium and the pizzerias of Little Italy.

Exceptions include supermarkets, groceries and convenience stores because such establishments do not come under the jurisdiction of the board.

Any of the above mentioned establishments caught selling colas larger than 16 ounces (0.47 liters) face a fine of $200.

Exceptions include diet sodas, alcohol (which is regulated by the state), beverages made mostly of milk or unsweetened fruit juice.

The measure will take effect on March 12, 2013, provided no court action is taken against the move.

After the vote, New York City Mayor Michael Bloomberg, who pioneered the move, tweeted: “NYC’s new sugary drink policy is the single biggest step any gov’t has taken to curb #obesity. It will help save lives.”

Health Commissioner Thomas Farley said the move is likely to be copied by other cities in the U.S. – or even the world.

“If this new step leads to New Yorkers simply reducing the size of one sugary drink from 20 ounces to 16 ounces every other week, it would help them avoid gaining some 2.3 million pounds a year,” he wrote in the New York Daily News on the eve of the vote.

“This would slow the obesity epidemic and prevent much needless illness.”

Obesity increases the risk of heart diseases, diabetes, hypertension and other chronic illnesses.

It is a growing crisis in New York City and sugary drinks are a leading cause of the obesity epidemic, says a city statement.

Nearly 60 per cent of the city’s adults are overweight or obese, as are 40 per cent of the city’s public elementary school students. One in eight adult New Yorkers now has Type 2 diabetes.

Annually, 5,800 New Yorkers are losing their lives to obesity.

Nearly 10 per cent of the nation’s health care bill is tied to obesity-related illnesses such as Type 2 diabetes, heart disease and hypertension, according to the Organisation for Economic Co-operation and Development.

Health experts believe that colas are high in calories, cheap, served in large sizes and have no nutritional value.

Not all New Yorkers are happy at the ban, though. They hate being told what to do!

A New York Times poll last month showed that six in 10 New Yorkers opposed the restrictions. Some have likened the ban to Prohibition, others have called the clamp an affront to personal liberty and some others have accused Bloomberg of over-reacting and turning New York into a ‘nanny’ state!

Fuelling the opposition are the restaurant, the soft-drinks industry and major theater chains.

A group called New Yorkers for Beverage Choices claims to have gathered more than 250,000 signatures on petitions and is examining legislative and legal challenges to the ban.

“This is not the end,” said Eliot Hoff, a spokesman for the group, after the vote. “We are exploring legal options, and all other avenues available to us.”

When Bloomberg’s proposal was up for public comments, the Board of Health received 38,000 comments of which 32,000 were in favour. However, it also received a petition opposing the ban with 90,000 names on it.

Theatre chains like the AMC and Regal mounted a massive public relations campaign, displaying banners and posters and airing commercials arguing that New Yorkers should be allowed to make their own drink choices.

However, the last word must certainly go to Dr. Deepthiman Gowda, an internist who teaches at Columbia University and a member of the New York City Board of Health, who said:

“(The initiative) is a small step but a bold step and an important one.”

What more do you think New York should do to cut down the obesity rates? Please leave your comments below.

Wednesday, September 12, 2012

New item on McDonald's menu: Calorie count!

McDonald's, the world's largest and most popular fast-food chain, has announced that, starting as early as next week, it will start listing calorie information on its menus in nearly 14,000 restaurants and drive-thrus across the United States.

This welcome move comes on the eve of a crucial vote on New York Mayor Michael Bloomberg's controversial proposal to ban super-sized colas at local restaurants and, more pertinently, ahead of the introduction of a national health law that will mandate restaurants, with 20 or more locations, to mention calories and other nutrition details on their menus.

The state of California and cities like New York already require restaurants to clearly list calorie information on the menus but many major chains have ignored the call, in the absence of legislation and threat of fines.

Requiring to post calorie counts of Big Macs and french fries is one of many measures US officials are contemplating as they seek to combat the burgeoning obesity crisis.

The problems of overweight people and obesity have worsened sharply in the US since the 1980s with the result that America is today called one of the fattest nations on earth – two-thirds of American adults are overweight or obese as are a third of the children.

Obesity increases the risk of heart diseases, diabetes, hypertension and other chronic illnesses.

McDonald's has been vilified for refusing to assess the impact of its foods on childhood obesity.

McDonald’s has responded to any criticism by claiming that it has incorporated changes to its menu, introducing more fruits and vegetables, reducing the French fry portion by more than half and including apples in Happy Meals for children.

The US Food and Drug Administration (FDA) has issued two proposed regulations that would ensure calorie labeling on menus and menu boards in chain restaurants, retail food establishments, and vending machines with 20 or more locations.

But the million-dollar question is: Does calorie labeling help diners make informed choices?

No, according to a New York University study which found that menu labeling, which came into force in March 2011, has had no impact on consumers' food choices. Even 18 months after the rule took effect, there's no discernible change in the food habits.

Taste almost always triumphed over calories!

Do you think McDonald's has done the right thing, or is there something more it can do? Please leave your comments below.

Thursday, September 6, 2012

Migraines do not lead to weight gain

It's long been thought that women who have migraines run a greater risk of becoming overweight as compared to women who are not afflicted by this debilitating illness.

Migraines are recurring and severe headaches that may also include nausea, vomiting, dizziness, eyesight changes and and sensitivity to light and noise.

They are widespread among women and severe migraine attacks have been classified by the World Health Organization as among the most disabling illnesses, comparable to dementia, quadriplegia and active psychosis.

Up to now, it was thought that migraines could contribute to weight gain indirectly – with, for instance, frequent or severe headaches keeping a person from exercising regularly.

However, an international study has now found "no consistent association between migraine and incident overweight, obesity or relevant weight gain".

The current study, published in the journal Cephalalgia, looked at data from 19,162 participants in the Women's Health Study who were aged 45 or older, and of normal weight, when the research began. A total of 3,483 women reported incidences of migraines.

"After 12.9 years of follow-up, 7,916 incident overweight and 730 incident obesity cases occurred," says the study.

But the likelihood of becoming obese was no greater among women with a history of migraines, and the risk of being overweight was only slightly higher.

Researchers also found that women who had migraines daily to weekly were at no greater risk of becoming overweight or obese that those who had migraine attacks only a few times a year.

However, the study did not look at the opposite scenario – whether overweight or obese women are at increased risk of migraines or severe headaches.

Several studies have indicated a strong association between obesity and increased migraine frequency with some even suggesting that weight contributed to developing migraines in the first place.

Being fat and fit

Obesity is no bar to being healthy, a new study reveals.
It seeks to dispel the notion that being fat or overweight means you are not physically fit.
Researchers, who studied data from 43,625 people in the United States, conclude that some obese people are ‘metabolically healthy’.
These people showed no greater risk of developing or dying from cardiovascular disease or cancer than people who were of normal weight.
However, it is important to remember that being ‘metabolically healthy’ means that you have no high blood pressure, high cholesterol or raised blood sugar, and that you are getting enough exercise.
The findings, following the study at the University of South Carolina, are published in the European Heart Journal.
“Current knowledge on the prognosis of metabolically healthy but obese phenotype is limited due to the exclusive use of the body mass index to define obesity and the lack of information on cardio-respiratory fitness,” says the study.
According to the World Health Organisation, someone who has a body mass index equal to or greater than 25 is overweight and equal to or greater than 30 is obese.
Researchers sought to test the following hypotheses:
  • metabolically healthy but obese individuals have a higher fitness level than their metabolically abnormal and obese peers;
  • after accounting for fitness, metabolically healthy but obese phenotype is a benign condition, in terms of cardiovascular disease and mortality.

Fitness was assessed by a maximal exercise test on a treadmill and body fat percentage by hydrostatic weighing or skinfolds.

Metabolically healthy was considered if meeting 0 or 1 of the criteria for metabolic syndrome.

More than a third of the participants in the study were obese. Of these 18,500, half were assessed as metabolically healthy.

These people, who did not suffer from health problems such as diabetes, high cholesterol or high blood pressure, were generally more fit and exercised more than other obese people.

The risk of these people developing or dying from cardiovascular disease or cancer was the same as those of people of normal weight and half of metabolically less fit obese people.

Lead author of the study Dr. Francisco Ortega, currently a research associate affiliated to the Department of Physical Activity and Sport, University of Granada in Spain, said the findings show that getting more exercise can keep you healthier, even if you are overweight.

"The research highlights once again the important role of physical fitness as a health marker."

Tuesday, September 4, 2012

Is organic food healthier than conventional food?

Not really! That is, if you compare the nutritional benefits. Considering that sometimes you may have to pay as much as twice what conventional food costs.

The only benefit that organic food has over conventionally grown produce is that it may reduce your exposure to pesticide residues and antibiotic-resistant bacteria. And even that is marginal – since pesticide levels found in conventionally grown produce were found to be within safety limits.

Bursting the myth that organic food is healthier than the conventional alternative is a paper published in the September 4 issue of Annals of Internal Medicine.

"There isn't much difference between organic and conventional foods, if you're an adult making a decision based solely on your health," said Dr Dena Bravata, a senior research affiliate with Stanford University's Centre for Health Policy and senior author of the paper.

"People choose to buy organic foods for many different reasons. One of them is perceived health benefits," added Crystal Smith-Spangler, who led the team of researchers from the university and Veteran Affairs Palo Alto Health Care.

More than 200 studies were reviewed, comparing either the health of people who consumed organic or conventional foods or nutrient and contaminant levels in unprocessed foods such as fruits, vegetables, grains, milk, eggs, chicken, pork and meat.

Key findings:
  • No significant differences between populations by food type for allergic reactions;
  • Two studies reported significantly lower urinary pesticide levels among children consuming organic versus conventional foods;
  • Biomarker and nutrient levels in serum, urine, breast milk and semen in adults did not show clinically meaningful differences;
  • Phosphorus levels were significantly higher than in conventional foods, although this difference is not clinically significant;
  • Organic produce had a 30 per cent lower risk of containing detectable pesticide levels;
  • E-coli contamination risk did not differ between organic and conventional foods;
  • Bacterial contamination of retail chicken and pork was common but not related to farming methods. But when bacteria did lurk in chicken and pork, germs in non-organic meats had a 33 per cent higher risk of being resistant to multiple antibiotics.

"The published literature lacks strong evidence that organic foods are significantly more nutritious than conventional foods," the research team concluded. "Consumption of organic foods may reduce exposure to pesticide residues and antibiotic-resistant bacteria."

Organic products have soared in popularity in the United States, with sales skyrocketing from $3.6 billion in 1997 to $31.4 billion in 2011. Today, organic foods account for 4.2 per cent of retail food sales, according to the United States Department of Agriculture (USDA).

This is because of a general perception that organic foods are safer and healthier. And this may be true, to a point.

USDA standards stipulated that organic farms avoid the use of synthetic pesticides and fertilizers, hormones and antibiotics. The regulations also require organic livestock to have access to pastures during grazing season.

The US Organic Trade Association was quick to capitalize on some of the findings with its executive director and CEO, saying on its  website: "Consumers seeking to minimize their exposure to pesticide residues will find that foods bearing the USDA Organic label are the gold standard."

"And, because organic livestock practices forbid the use of antibiotics, including the routine use of low level antibiotics for growth, organic meat contains less antibiotic-resistance bacteria."

However, sounding a word of caution, some nutrition experts have called for more research to fully explore the potential health and safety differences between organic and conventional foods, saying it was premature to say organic foods are not any healthier than non-organic foods.

"Right now I think it's all based on anecdotal evidence," said Chensheng Lu, who studies environmental health and exposure at the Harvard School of Public Health.

"If I was a smart consumer, I would choose food that has no pesticides. I think that's the best way to protect your health."