Posts Tagged ‘nutrition’

The Messenger or the Message? Part I

September 27th, 2009

July 30, 2009 :: By Morgan Downey

The ongoing furor over President Obama’s pick of Dr. Regina Benjamin as the next Surgeon General is to prejudice and obesity as the Harvard Professor Henry Lewis Gates’s arrest by Sergeant James Crowley in Cambridge, Mass., is to prejudice and race.

In both cases, it seems that a great magnet pulls part of the population to one side and part to the other side. After positions are staked out, we sort out the facts to fix our positions or, in some rare cases, to actually change our mind.

Dr. Benjamin’s opponents say that an overweight person cannot carry the message of healthy living. An ABC News report Is Regina Bejamin, Surgeon General Nominee, Overweight? – ABC News quotes former editor of the New England Journal of Medicine Dr. Marcia Angell stating, “I think it (the Surgeon General nominee’s weight) is an issue but then the president is said to still smoke cigarettes. It tends to undermine her credibility. We don’t know how much she weighs and just looking at her I would not say she is grotesquely obese or even overweight enough to affect her health. But I do think at a time when a lot of public health concern is about the national epidemic of obesity, having a surgeon general who is noticeably overweight raises questions in people’s minds.”“Grotesquely obese?” Is this not the crassest view of obesity that it offends my sense of beauty? And, is Dr. Angell aware of the scientific literature that even modest amounts of overweight may lead to increased risk of disease such as hypertension and type 2 diabetes? Does this mean that the Surgeon General cannot be a disabled person or someone with HIV/AIDS? I doubt she would say that.

The ABC NEWS piece neglected to mention Dr. Angell’s controversial editorial of January 1998 in the New England Journal of Medicine. In this editorial, Dr. Angell observed that weight loss efforts (which she acknowledged were nearly impossible) were “virtually ubiquitous among adolescent girls and young women. In middle schools and colleges throughout the country, girls who are far from overweight believe they are obese, or “gross.” (No citations in original). While dissing weight-loss efforts and physician counseling, she advised physicians, “Until we have better data about the risks of being overweight and the benefits and risks of trying to lose weight, we should remember that the cure for obesity may be worse than the condition.” Really, Dr. Angell? Eleven years later with obesity rates going through the roof, do you want to revisit that advice? Contrary to her statements to ABC NEWS, Dr. Angell closed by stating, “Finally, doctors should do their part to help end discrimination against overweight people in schools and workplaces. We should also speak out against the public’s excessive infatuation with being thin and the extreme, expensive, and potentially dangerous measures taken to attain that goal.”

Dr. Angell’s editorial produced strong reactions from obesity experts. William Dietz, MD and director of the CDC Division of Nutrition and Physical Activity wrote prophetically,

“You endorse the prevention of obesity but suggest that physicians “should provide advice if an overweight patient asks for help in planning a weight-loss program and recommend weight loss if a patient is suffering from health problems that can be ameliorated by weight loss.” This passive approach will not prevent weight gain in those at risk, nor will it prevent further weight gain in those who are already overweight. Furthermore, the rapid increase in body-mass index in the U.S. population over the past 15 years will most likely continue unabated if this passive approach is used.

The Massachusetts Medical Society Committee on Nutrition went on record opposing Dr. Angell’s editorial. In addition, the Committee took issue with an interview Dr. Angell gave to the Wall Street Journal on Feb. 9, 1998, in which she stated that some people “just like to eat — and in that case, it (obesity) is no more of a disease than bank robbery is a disease.” The Committee stated that such broad, unsubstantiated statements are inaccurate, inappropriate and irresponsible. The committee, whose members are physicians with extensive training and expertise in the fields of nutrition and obesity treatment, stands firm in its belief that obesity cannot be blamed solely on lack of willpower to control eating and activity. It also results from genetic factors affecting energy metabolism and eating behavior. Statements that belittle the life-threatening disease of obesity make a mockery of the plight of obese patients and undermine the medical profession.

Doctor Angell, you should take your own advice and unequivocally support Dr. Benjamin as Surgeon General regardless of her BMI.

Latest News

September 27th, 2009

October 21, 2009

FDA plans revision to nutrition label. FDA seeks to improve nutrition labeling on food products – washingtonpost.com

October 20, 2009

Women with obesity at risk for in vitro fertilization failure The Press Association: Obesity cuts IVF success – study

October 19,2009

Can anyone get insurance? Now an underweight girl is excluded. Underweight Girl Denied Insurance Coverage – Denver News Story – KMGH Denver

October 18, 2009

Washington Post columnist Robin Givhan address the Fashion industry and thinness in the culture.Robin Givhan on Fashion: Size of the Model vs. Size of the Customer – washingtonpost.com

Great Idea: solve obesity by making people taller. Idea Lab – Should a War on Shortness Be One of the Goals of Health Care Reform? – NYTimes.com

October 17, 2009

NYT reports on prospects for new drugs for obesity Arena, Orexigen and Vivus Are Chasing an Effective Diet Drug – NYTimes.com

Why can’t CDC find obese swine flu patients? Pneumonia, Susceptibility of Young Among Traits of Swine Flu – washingtonpost.com

October 15, 2009             

Family Physicians Ink deal with Coke Family Doctors Sign Educational Deal With Coca-Cola – NPR Health Blog : NPR

October 14, 2009

First Lady Michelle Obama tackles childhood obesity Michelle Obama’s Weight Loss Tips: Watch TV Standing Up — Politics Daily

North Carolina Plan criticized Obesity penalty isn’t fair or effective – Columnists/Blogs – News & Observer

Ralph Lauren model fired for being too fat Photoshopped Ralph Lauren Model Filippa Hamilton Fired For Being Fat – WPIX

Dr. Bernandine Healy hits punitive steps against the obese The Obesity Epidemic Isn’t Just About Willpower – US News and World Report

October 13, 2009

Candidate’s weight becomes important issue in NJ Governor Race Is Chris Christie Too Fat to Be the Next Governor of New Jersey? – The Gaggle Blog – Newsweek.com

October 12, 2009

Infant denied health care for  pre-existing conditions Why we need health-care reform: ‘Obese’ infant denied insurance!

Colorado Insurer caves The Associated Press: Colo. insurer changes course on fat infants

Baby denied health insurance for obesity as pre-existing condition 17-Pound, 4-Month-Old Baby Denied Health Insurance for Being Too Fat – Children’s Health – FOXNews.com

October 9, 2009

Groups push back on premium increases in Senate Finance Bill If Your Waistline Grows, Should Your Premiums, Too? – Prescriptions Blog – NYTimes.com

October 8, 2009

Corzine attacked as bigot Is Corzine A Bigot? | The New Republic

October 7, 2009

Physicians lead the way in treating obesity Doctors join fight against obesity – USATODAY.com

NJ Governor Corzine accused of attacking opponents weight Corzine Points Spotlight at Christie’s Weight – NYTimes.com

North Carolina to punish overweight state workers North Carolina state health plan to penalize smokers, obese

October 6, 2009

Study showing restaurant calorie labeling doesn’t change habits sure to add fuel to labeling debate Calorie Postings Don’t Change Habits, Study Finds – NYTimes.com

October 2, 2009,

New York Board of Education bans bake sales Bake Sales Are Banned in New York Schools – NYTimes.com

October 1, 2009

After 20 years USDA program for Women Infants and Children adds fruits and vegetables to its voucher program WIC nutrition program expands to cover fruits, vegetables — latimes.com

September 17, 2009 NEJM publishes study on taxing sugar-sweetened beverages NEJM — The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages

September 11, 2009

Indiana Court allows workers comp coverage of bariatric surgery Indiana Appeals Court Affirms Work Comp Coverage for Obesity Surgery

September 9, 2009

STOP Obesity Alliance presents health care reform proposals Curbing Obesity Epidemic Key to Health Care Reform: Experts – US News and World Report See 16th and 17th U.S. Surgeons General, STOP Obesity Alliance Announce America has Reached Tipping Point on Obesity, Call for Direct Action – STOP Obesity Alliance

September 1, 2009

Institute of Medicine issues recommendations for combating childhood obesity Report maps out solutions to child obesity – USATODAY.com

USDA announces child nutrition grants Release No. 0416.09

More employers trying financial incentives As Federal Healthcare Reform Debate Continues, New Survey Reveals More Companies Turn to Financial Rewards to Tackle Soaring Employee Healthcare Costs

August 31, 2009

New target for therapies identified Study may lead to new obesity therapies – UPI.com

New York City targets sugar-sweetened drinks New Salvo in City’s War on Sugary Drinks – City Room Blog – NYTimes.com

Risk of infant mortality rises with mother’s weight Mom’s obesity tied to higher infant mortality

August 30, 2009

Obesity linked to swine flu deaths Obesity linked to swine flu deaths | World news | The Observer

August 27, 2009

Extreme obesity shortens lives by 12 years Extreme obesity can shorten people’s lives by 12 years – USATODAY.com

New drug claims ability to fight obesity and diabetes New fat-fighting drug has anti-diabetes action too | Health | Reuters

Obesity deniers come out http://www.newsweek.com/id/213807

August 24, 2009

American Heart Association raises alarm about sugar Heart Association recommends limits on added sugars – White Coat Notes – Boston.com

Interesting graph plots out contribution of obesity, age and health status on costs. A Concentration of Health Expenses – Prescriptions Blog – NYTimes.com

GE introduces new MRI geared for larger patients GE Healthcare shows off latest MRI – The Business Review (Albany):

Obesity a risk for swine flu deaths Half of swine flu deaths in high-risk people -study | Reuters

August 18, 2009

Sleep apnea on increase Sleep Apnea Rises With Obesity, Boosts Deaths in Middle-Aged – Bloomberg.com; PLoS Medicine: Sleep-Disordered Breathing and Mortality: A Prospective Cohort Study

Push back on doctor’s campaign against obesity Anti-Obesity Dr. Jason Newsom Chomps Down on Dunkin’ Donuts « Vitals Spotlight – We Give the Doctor an Exam

August 11, 2009

President Obama calls for health insurance reform to cover obesity treatments, stating, “All I’m saying is let’s take the example of something like diabetes, one of — a disease that’s skyrocketing, partly because of obesity, partly because it’s not treated as effectively as it could be. Right now if we paid a family — if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they’re taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that’s $30,000, $40,000, $50,000 — immediately the surgeon is reimbursed. Well, why not make sure that we’re also reimbursing the care that prevents the amputation, right? That will save us money. Text – Obama’s Health Care Town Hall in Portsmouth – NYTimes.com

August 10, 2009

Nominee for Surgeon General attacked over body weight Does it matter what the doctor weighs? — latimes.com

Arena preparing to submit new obesity drug to FDA San Diego Business Journal Online – business news for San Diego, California

August 7, 2009

Recession could worsen obesity prevalence Recession could have negative impact on obesity levels | News | Nursing Times

July 17, 2009

Minorities, blacks hardest hit by obesity reports CDC Atlanta health, diet and fitness news | ajc.com

July 16, 2009

AHA: severe obesity increases risks in surgery Severe obesity increases risks of health problems during surgery

AHA: Clarity on the overweight mortality confusion Mortality, Health Outcomes, and Body Mass Index in the Overweight Range: A Science Advisory From the American Heart Association — Lewis et al. 119 (25): 3263 — Circulation

July 14, 2009

Excess weight speeds up osteoarthritis Excess Weight Speeds Up Osteoarthritis: MedlinePlus

July 14, 2009

RWJ releases report on taxes for sugar sweetened beverages Sugar-Sweetened Beverage Taxes and Public Health – RWJF

July 14, 2009 WHO addresses swine flu vaccine for persons with obesity. Swine Flu Vaccine Recommendations from World Health Organization – Health Blog – WSJ

July 10, 2009 CDC finds high prevalence of obesity in swine flu patients. Intensive-Care Patients With Severe Novel Influenza A (H1N1) Virus Infection — Michigan, June 2009

July 2009 Study finds insulin resistance in overeating lean humans for the first time. Short-term overeating induces insulin resistance i…[Mol Med. 2009 Jul-Aug] – PubMed Result

July 10,2009

The economy, stress and overeating Job Stress, Economy Weighing on Americans: MedlinePlus

June 24, 2009

Obesity: Africa’s Next Big Killer Africa’s newest silent killer: obesity | FP Passport

July 2, 2009

Connecticut Governor Vetoes Labeling Bill

Rell rejects nutritional labeling for chain restaurants – The Connecticut Post Online

July 1, 2009

Obama Address Obesity in Town HallObama Addresses Health-Care Reform at Virtual Town Hall Meeting – washingtonpost.com

July 1, 2009

Trust for America’s Health releases “F as in Fat 2009” http://www.rwjf.org/files/research/20090701tfahfasinfat.pdf

June 30, 2009

Institute of Medicine Issues Report on Comparative Effectiveness Research

Initial National Priorities for Comparative Effectiveness Research – Institute of Medicine

Read Morgan Downey’s Testimony

http://www.iom.edu/Object.File/Master/64/740/Speaker%20Testimonies%203-4PM%20b

lock.pdf

June 30, 2009

Oregon enacts restaurant labeling bill AP Wire – Oregon | kgw.com | News for Portland Oregon and SW Washington

June 29, 2009

More Data on surgery for diabetes Weight-Loss Surgery May Be Beneficial for Diabetes – NYTimes.com

June 29, 2009

Kentucky phasing out sugar sweetened beverages Congress May Look to Ky. Schools’ Healthy Example in Creating Nutritional Policy – washingtonpost.com

June 25, 2009

IOM release workshop on Food Desserts The Public Health Effects of Food Deserts. Workshop Summary – Institute of Medicine

May 28, 2009

IOM Releases report on Weight Gain in Pregnancy Report Brief. Weight Gain During Pregnancy: Reexamining the Guidelines – Institute of Medicine

May 9, 2009

Do obesity related diseases predispose to swine flu severity? Other Illness May Precede Worst Cases of Swine Flu – NYTimes.com

Schools and Children

September 27th, 2009

As concern about childhood obesity has increased, the school environment has received increased attention.

Retooling school food offerings can help. The Somerville MA experiment Retooling food service for early elementary school…[Prev Chronic Dis. 2009] – PubMed Result

A very positive study on the value of nutrition education in the schools Effectiveness of school programs in preventing chi…[Am J Public Health. 2005] – PubMed Result

Effect of the school food environment Association between school food environment and pr…[J Am Diet Assoc. 2009] – PubMed Result

School food environments and practices affect diet…[J Am Diet Assoc. 2009] – PubMed Result

Schools are making progress in addressing obesity. Schools and obesity prevention: creating school en…[Milbank Q. 2009] – PubMed Result

International Journal of Obesity – Abstract of article: Childhood overweight and elementary school outcomes

Overweight affect school performance in girls but not boys. See: http://www.rand.org/pubs/reprints/2008/RAND_RP1315.pdf

Impact of removing low nutrition foods in schools. The Impact of Removing Snacks of Low Nutritional V…[Health Educ Behav. 2009] – PubMed Result

Food use in middle and high school fundraising: do…[J Am Diet Assoc. 2009] – PubMed Result

School Environment gets worse with higher grades. School food environments and policies in US public…[Pediatrics. 2008] – PubMed Result

BMI measurement in schools Body mass index measurement in schools. [J Sch Health. 2007] – PubMed Result

Journal of Public Health Policy – Disparities in Physical Activity and Sedentary Behaviors Among US Children and Adolescents: Prevalence, Correlates, and Intervention Implications

Journal of Public Health Policy – Arkansas Act 1220 of 2003 to Reduce Childhood Obesity: Its Implementation and Impact on Child and Adolescent Body Mass Index

Journal of Public Health Policy – Early Impact of the Federally Mandated Local Wellness Policy on Physical Activity in Rural, Low-Income Elementary Schools in Colorado

Journal of Public Health Policy – Preventing Childhood Obesity through State Policy: Qualitative Assessment of Enablers and Barriers

Journal of Public Health Policy – Correlates of Walking to School and Implications for Public Policies: Survey Results from Parents of Elementary School Children in Austin, Texas

Journal of Public Health Policy – Sociodemographic, Family, and Environmental Factors Associated with Active Commuting to School among US Adolescents

Journal of Public Health Policy – Implementation of Texas Senate Bill 19 to Increase Physical Activity in Elementary Schools

Inheritance Factors

September 26th, 2009

Genes are not the only way characteristics may be passed from generation to generation. Researchers are actively pursuing what is called epigenetics. Epigenetics refers to changes in appearance, or phenotype, which is not due to changes in the DNA, which regulates genes and their expression.

Intrauterine Environment

The intrauterine environment (the womb) has been shown to affect the child’s disposition to obesity. Fetal origins of obesity. [Obes Res. 2003] – PubMed Result and Programming of body composition by early growth an…[Proc Nutr Soc. 2007] – PubMed Result Maternal and child obesity: the causal link. [Obstet Gynecol Clin North Am. 2009] – PubMed Result Gestational weight gain may predispose offspring to obesity and high blood pressure Associations of gestational weight gain with offsp…[Circulation. 2009] – PubMed Result and Gestational weight gain and risk of overweight in …[Am J Clin Nutr. 2008] – PubMed Result

Multiple factors are probably at work leading to an increased risk of developing obesity. Developmental origins of childhood overweight: pot…[Obesity (Silver Spring). 2008] – PubMed Result and Early determinants of overweight at 4.5 years in a…[Int J Obes (Lond). 2006] – PubMed Result

The question is to what extent the genes or the intrauterine environment influence the progression to adult obesity. The influence of birthweight and intrauterine envi…[Int J Obes Relat Metab Disord. 2003] – PubMed Result

One way in which the fetus might be affected in his or her development is by enhanced nutrition in the womb

Intrauterine changes are thought by some to contribute to the increase in obesity in India. Obesity epidemic in India: intrauterine origins? [Proc Nutr Soc. 2004] – PubMed Result

Maternal weight gain during pregnancy may affect the baby’s birth weight and long term risks Gestational weight gain and child adiposity at age…[Am J Obstet Gynecol. 2007] – PubMed Result

Detrimental influences in the womb, such as smoking Maternal smoking during pregnancy and child overwe…[Int J Obes (Lond). 2008] – PubMed Result, Association of maternal lifestyles including smoki…[Obesity (Silver Spring). 2007] – PubMed Result, Associations of maternal prenatal smoking with chi…[Obes Res. 2005] – PubMed Result, and famine The Dutch Famine of 1944-1945: a pathophysiologica…[Curr Opin Clin Nutr Metab Care. 2006] – PubMed Result or harmful chemicals Developmental exposure to endocrine disruptors and…[Reprod Toxicol. 2007 Apr-May] – PubMed Result and Role of nutrition and environmental endocrine disr…[Mol Cell Endocrinol. 2009] – PubMed Result

An unique, new study found that maternal weight loss from bariatric surgery may improve cardiometabolic  risks in infants which is sustained into adulthood.Effects of Maternal Surgical Weight Loss in Mother…[J Clin Endocrinol Metab. 2009] – PubMed Result

 

Early infancy

Weight status in the first 6 months of life and ob…[Pediatrics. 2009] – PubMed Result

Predictors of body size in infancy Predictors of body size in the first 2 y of life: …[Int J Obes Relat Metab Disord. 2004] – PubMed Result

Parental feeding styles

Children from obese parents were more likely to have a preference for fatty foods, lower liking for vegetables and a more overeating type eating style than children with lean parents as well as a greater preference for sedentary activities. Food and activity preferences in children of lean …[Int J Obes Relat Metab Disord. 2001] – PubMed Result The picture of the obese mother using food for non-nutritive purposes may be a myth but there obese mothers may exercise less control. Parental feeding style and the inter-generational …[Obes Res. 2002] – PubMed Result Infants of overweight/obese mothers have higher energy intake Relationship between maternal obesity and infant f…[Nutr J. 2005] – PubMed Result Infants born to overweight/obese mothers have lower resting metabolic rate, higher BMI Lower energy expenditures in infants from obese bi…[Nutr J. 2008] – PubMed Result

Breastfeeding

Breastfeeding has long been considered protective against the development of obesity Association between infant breastfeeding and overw…[JAMA. 2001] – PubMed Result

But not everyone is convinced.Critical review of the World Health Organization’s…[Obes Rev. 2008] – PubMed Result and Breastfeeding and the risk of childhood obesity. [Coll Antropol. 2007] – PubMed Result

How breastfeeding might be protective has not yet been determined. Mechanisms underlying the association between brea…[Int J Pediatr Obes. 2009] – PubMed Result

Overweight/obese mothers may be less likely to breastfeed their children than normal weight mothers. A systematic review of maternal obesity and breast…[BMC Pregnancy Childbirth. 2007] – PubMed Result