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Essential Science: Obesity, coronavirus and overall health

mymedicplus — Wed, 11 Nov 2020 07:25:13 +0000

Source- http://www.digitaljournal.com/

A raft of new reports have been issued about obesity and ill-health effects. Included within these reports are on-going concerns about obese people and a greater chance of developing more severe COVID-19 symptoms.

Obesity continues to a major problem worldwide and it is associated with a range of metabolic disorders. Definitions of obesity vary, although it is generally accepted that obesity refers to the condition where excess body fat accumulates to an extent that it may have a negative effect on health.

There are different causes of obesity and the condition is not only linked to poor diet and insufficient exercise (such as eating excessive amounts of cheap high-calorie food and spending a lot of time sitting down at desk), for there are genetic issues to consider as well.

According to the University of Virginia there are differences in fat storage and formation between men and women, and this is influenced by different genes found in fat tissue. Furthermore, some of those genes identified are connected with conditions like type 2 diabetes and cardiovascular disease.

The reason for highlighting the genetic basis is to indicate that the causes of obesity and strategies of address obesity are more complicated than sometimes portrayed. This does not negate the danger surrounding obesity, as three new strands of research show, including one of topical interest in relation to the coronavirus pandemic.

Nutrition and childhood development

Part of the new sets of data relating to obesity and nutrition includes a study which looks at the impact upon children. Taking a longitudinal look, a new analysis considers height and weight of school-aged children and adolescents across the world.

That diet is important matches other research, albeit from a different perspective, such as one study that finds that a healthy quality Mediterranean-like diet partially modifies the association between obesity and cardiovascular mortality.

This study, which comes from Imperial College London, draws upon health information and other metrics relating to 65 million children. The children were aged between five to 19 years old, and the findings are collected from 193 countries.

This analysis shows that school-aged children’s’ height and weight, serving as indicators of their health and quality of their diet, vary enormously around the world. The analysis reveals a 20 centimeter difference between 19-year-olds in the tallest and shortest nations. The key variable is with childhood nutrition, including a lack of quality food. This important factor is associated with stunted growth and a rise in childhood obesity.

It also follows that the lifestyle of women with obesity during pregnancy can lead to long-term cardiovascular benefits for their children. If exercise is not regularly performed, the reverse can occur and children from obese mothers carry a risk of being less healthy and also becoming prone to developing obesity themselves.

Walter Siegmund (CC BY-SA 3.0)

The findings appear in the medical journal The Lancet, titled “Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants.”

At the other end of the age scale, severely overweight people are less likely to be able to re-wire their brains and find new neural pathways. This is something of importance in relation to stroke recovery. This finding appears in the journal Brain Science (“Obesity is Associated with Reduced Plasticity of the Human Motor Cortex”).

Too much sugar

A related area of research is linked to sugar in the diet. A study, looking at an animal model, has discovered that mice fed diets high in sugar developed worse forms of colitis than mice fed a standard diet.

Colitis is a form of inflammatory bowel disease. To explore the effects further, the researchers from UT Southwestern Medical Center examined the large intestines of the mice and discovered more of the bacteria that can damage the gut’s protective mucus layer to be present.

Importantly, the study pointed to sugar, such as the type of glucose found in high fructose corn syrup (used by parts of the food industry since the 1960s0 as the mist significant contributor to the effects.

The researchers have indicated that effect seen with mice can be extrapolated to humans, and this should act as some form of warning for a diet too rich in sugar.

The research is published in the journal Science Translational Medicine, titled “Dietary simple sugars alter microbial ecology in the gut and promote colitis in mice.”

Obesity and coronavirus risk

An individual’s health is important when considering coronavirus risk. A new study finds that factors inherent to obesity could increase vulnerability to COVID-19. Correlations in many countries exist between obesity and COVID-19 deaths.

In particular, inflammation in the lungs, when combined with high viral loads of the coronavirus, appears to create ‘a perfect storm’ for obese patients with COVID-19. Fat has high amounts of ACE2 receptors. These receptors serve as the entryways for the SARS-CoV-2 virus into the cells of the lungs.

Another concern is with the higher overall inflammatory state that accompanies obesity, and which primes many tissues to show a poor response to infection.

The outcome from the research is that medications used to lower inflammation in the lungs are beneficial to obese patients who have coronavirus. This may lead to a new medical intervention.

The research appears in eLife, titled “Obesity and diabetes as comorbidities for COVID-19: Underlying mechanisms and the role of viral–bacterial interactions.”

Essential Science

This article forms part of Digital Journal’s long-running Essential Science series, where new research relating to wider science stories of interest are presented on a weekly basis.

Last week we focused on coronavirus, considering why scientists are concenred over the issue of why some people become sicker than others when infected with the coronavirus. The answers may lie in with vitamin D levels.

The week before, our topic was global heating. We learned that as climate change continues to cause the average temperature around the planet to rise, staying cooler in what are increasingly set to be long, dry, and hot summers is a challenge that humanity needs to face. We examined three solutions for keeping cooler.

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Limited Eating Times Could Be a New Way to Fight Obesity and Diabetes

mymedicplus — Sat, 07 Dec 2019 05:47:00 +0000

Source: ecowatch.com

People with obesity, high blood sugar, high blood pressure or high cholesterol are often advised to eat less and move more, but our new research suggests there is now another simple tool to fight off these diseases: restricting your eating time to a daily 10-hour window.

Studies done in mice and fruit flies suggest that limiting when animals eat to a daily window of 10 hours can prevent, or even reverse, metabolic diseases that affect millions in the U.S.

We are scientists — a cell biologist and a cardiologist — and are exploring the effects of the timing of nutrition on health. Results from flies and mice led us and others to test the idea of time-restricted eating in healthy people. Studies lasting more than a year showed that TRE was safe among healthy individuals. Next, we tested time-restricted eating in patients with conditions known collectively as metabolic syndrome. We were curious to see if this approach, which had a profound impact on obese and diabetic lab rats, can help millions of patients who suffer from early signs of diabetes, high blood pressure and unhealthy blood cholesterol.

A Leap From Prevention to Treatment

It’s not easy to count calories or figure out how much fat, carbohydrates and protein are in every meal. That’s why using TRE provides a new strategy for fighting obesity and metabolic diseases that affect millions of people worldwide. Several studies had suggested that TRE is a lifestyle choice that healthy people can adopt and that can reduce their risk for future metabolic diseases.

However, TRE is rarely tested on people already diagnosed with metabolic diseases. Furthermore, the vast majority of patients with metabolic diseases are often on medication, and it was not clear whether it was safe for these patients to go through daily fasting of more than 12 hours – as many experiments require – or whether TRE will offer any benefits in addition to those from their medications.

In a unique collaboration between our basic science and clinical science laboratories, we tested whether restricting eating to a 10-hour window improved the health of people with metabolic syndrome who were also taking medications that lower blood pressure and cholesterol to manage their disease.

We recruited patients from UC San Diego clinics who met at least three out of five criteria for metabolic syndrome: obesity, high blood sugar, high blood pressure, high level of bad cholesterol and low level of good cholesterol. The patients used a research app called myCircadianClock, developed in our lab, to log every calorie they consumed for two weeks. This helped us to find patients who were more likely to spread their eating out over the span of 14 hours or more and might benefit from 10-hour TRE.

We monitored their physical activity and sleep using a watch worn on the wrist. As some patients with bad blood glucose control may experience low blood glucose at night, we also placed a continuous glucose monitor on their arm to measure blood glucose every few minutes for two weeks.

Nineteen patients qualified for the study. Most of them had already tried standard lifestyle interventions of reducing calories and doing more physical activity. As part of this study, the only change they had to follow was to self-select a window of 10 hours that best suited their work-family life to eat and drink all of their calories, say from 9 a.m. to 7 p.m. Drinking water and taking medications outside this window were allowed. For the next 12 weeks they used the myCircadianClock app, and for the last two weeks of the study they also had the continuous glucose monitor and activity monitor.

Timing Is the Medicine

After 12 weeks, the volunteers returned to the clinic for a thorough medical examination and blood tests. We compared their final results with those from their initial visit. The results, which we published in Cell Metabolism, were pleasantly surprising. We found most of them lost a modest amount of body weight, particularly fat from their abdominal region. Those who had high blood glucose levels when fasting also reduced these blood sugar levels. Similarly, most patients further reduced their blood pressure and LDL cholesterol. All of these benefits happened without any change in physical activity.

Reducing the time window of eating also had several inadvertent benefits. On average, patients reduced their daily caloric intake by a modest 8%. However, statistical analyses did not find strong association between calorie reduction and health improvement. Similar benefits of TRE on blood pressure and blood glucose control were also found among healthy adults who did not change caloric intake.

Nearly two-thirds of patients also reported restful sleep at night and less hunger at bedtime – similar to what was reported in other TRE studies on relatively healthier cohorts. While restricting all eating to just a six-hour window was hard for participants and caused several adverse effects, patients reported they could easily adapt to eating within a 10-hour span. Although it was not necessary after completion of the study, nearly 70% of our patients continued with the TRE for at least a year. As their health improved, many of them reported having reduced their medication or stopped some medication.

Despite the success of this study, time-restricted eating is not currently a standard recommendation from doctors to their patients who have metabolic syndrome. This study was a small feasibility study; more rigorous randomized control trials and multiple location trials are necessary next steps. Toward that goal, we have started a larger study on metabolic syndrome patients.

Although we did not see any of our patients go through dangerously low levels of glucose during overnight fasting, it is important that time-restricted eating be practiced under medical supervision. As TRE can improve metabolic regulation, it is also necessary that a physician pays close attention to the health of the patient and adjusts medications accordingly.

We are cautiously hopeful that time-restricted eating can be a simple, yet powerful approach to treating people with metabolic diseases.

Satchin Panda is a professor of regulatory biology at the Salk Institute for Biological Studies, and an adjunct professor of cell and developmental biology at UCSD, University of California San Diego.

Pam Taub is an associate professor of Medicine at the University of California San Diego

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Finding News Ways to Treat Childhood Obesity

mymedicplus — Wed, 20 Nov 2019 06:37:58 +0000

Source: usnews.com

IT’S A CRIPPLING, hereditary disease that afflicts 1 in 3 adolescents and teens in the U.S., exponentially outnumbering pediatric cancer cases. It’s the entry point for a range of related, potentially irreversible diseases that get worse over time, from depression to diabetes and kidney failure.

Yet when Dr. Claudia Fox, a pediatrician and specialist in the aliment, says she can help treat the disease — childhood obesity — with medication, people are stunned.

“Most people when they hear this are kind of confused. The most common reaction I get is, ‘Are you kidding me?'” They’re alarmed, she said, that a doctor would prescribe weight-control pills for a child, let alone an obese one, and aren’t shy about telling her what they think..

“They say, ‘Why do we even need medication for obesity? Wouldn’t it be better if the kid learned to stop eating Doritos, get off the couch and play?'” said Fox, who was part of a panel addressing childhood obesity at the U.S. News & World Report Healthcare of Tomorrow conference in Washington on Tuesday. “I wish it were that simple.”

Declared an epidemic in the U.S., epidemic, childhood obesity has become so prevalent and is spreading so quickly overseas the World Health Organization considers it among “the most serious public health challenges of the 21st century.”

Speaking at a breakout session on the topic (“A Population Health Imperative: Tackling Childhood Obesity”), Fox and the panelists of pediatricians who specialize in obesity — Dr. Evan Nadler, Dr. Fatima Cody Stanford, Dr. Ihuoma Eneli and moderator Dr. Sarah E. Barlow — agreed that obesity is prevalent in the U.S. and becoming more of a problem overseas. Yet as an illness, they concluded, it’s largely misunderstood and widely stigmatized, which only increases the problem.

Nadler, director of the Child and Adolescent Weight Loss Surgery Program at Children’s National Health System, called childhood obesity “the biggest problem in pediatric health care in America,” yet there isn’t a national drive or much urgency to solve it, even within the health care system.

“What can be more compelling than trying to tackle the most prevalent disease in children and the most expensive disease in children?” he asked. “It’s embarrassing, frankly, that our health care system hasn’t taken a more active interest.”

Kicking off the panel, Barlow, who is the director of the Children’s Health Integrated Program in Childhood Obesity at UT Southwestern Medical Center in Austin, laid out the sobering facts: Obesity in the U.S. ranges between 13% for adolescents up to just over 20% in teenagers 17 to 19 years old. Juvenile obesity hits hardest among African Americans (22%) and Latinos (25%) and the number of young people with a body mass index of 30 or higher has skyrocketed since the 1980s.

And the nation is paying a hidden price, she said, including $142 billion in medical costs and $66 billion in lost workplace productivity. Moreover, she said, obesity doesn’t go away with age: 1 of 3 young adults can’t serve in the U.S. military because they weigh too much.

“It’s not new,” she says. “We’ve been facing this problem for the last 15 to 20 years.”

Cody Stanford, a pediatrics professor at Harvard University and an obesity medicine physician scientist, said the problem has gone unchecked largely because of stigma associated with obesity. Contrary to what many assume — that children would lose weight if they ate properly and exercised — obesity is a “multifactorial” disease that involves genetic and environmental factors, including childhood trauma and psychological issues.

“What we do know is weight is more heritable than height,” she said. “The likelihood that parents with obesity will have a child who is lean is very low. That’s important for us to recognize. We don’t think about heritability when we think about treatment.”

Fox said it’s one reason why lay people are taken aback when she tells them medications can help control childhood obesity. While drugs alone aren’t the answer — some children need more drastic interventions, including combinations of bariatric surgery, psychological counseling and lifestyle changes — they could be an important tool in combating the issue, she said.

Yet there are aren’t many government-approved weight-loss drugs on the market for young patients, and drug companies aren’t competing to create new ones, says Fox, who teaches pediatric medicine at the University of Minnesota and is co-director of the university’s Center for Pediatric Obesity Medicine.

That “is a sad commentary,” she said. “If this were childhood cancer, parents and practitioners and the entire community would be up in arms.”

Nadler and Eneli, a pediatrics professor at Ohio State University and director of the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital, agreed that multi-faceted approaches are needed to tackle the disease. But both also said there are significant barriers to treatment, including medical insurers and longstanding stigma surrounding obesity and children.

Nadler said the prejudice and judgment against obese children even lives within the hospital walls; he’s overheard surgical colleagues bad-mouthing the concept of gastric-bypass surgery for pre-teens. The doctor also noted that only a handful of U.S. pediatric hospitals offer the procedure, and institutional support for it is hard to find.

Eneli said obesity “happens to be the last condition where people think it’s still OK to make fat jokes,” even among people whose loved ones have the disease. . Indeed, she said, “the worst kind of bias and stigma is what happens in the home, not at school.”

Then she suggested a PR campaign similar to those that raise awareness of breast cancer and support for research.

“Obesity needs a ribbon,” she said.

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