Melatonin offers new hope for obesity prevention according to recent studies
Recent collaborative research spearheaded by the University of Granada (UGR) has unveiled significant findings regarding the use of melatonin in the prevention of obesity. This research, conducted by a team comprising experts from UGR’s Department of Pharmacology, the Federico Olóriz Neurosciences Institute, the Biosanitary Institute of Granada, and the University of Qatar, has shown promising results in mitigating the risks associated with visceral obesity. This type of obesity is especially concerning as it involves fat accumulation deep within the abdomen, surrounding vital organs, thus posing heightened health risks.
The studies, which were led by Professor Ahmad Agil of UGR and published in the well-regarded journals Antioxidants and Biomedicine & Pharmacotherapy, employed a methodical approach to their experimentation. Using adult rats with obesity and diabetes of both sexes, the research demonstrated that chronic administration of melatonin at a dosage of 10 mg/kg of body weight per day over three months is significantly more effective in preventing obesity compared to short-term treatments. Notably, the treatment resulted in a reduction of visceral fat by approximately 3%. Moreover, the studies highlighted melatonin’s ability to alleviate muscle-fibre atrophy associated with obesity, transform muscle fibre types into a more oxidative and slower phenotype, and increase mitochondrial activity and content—factors which collectively contribute to the observed reduction in weight gain among the treated rats.
An intriguing aspect of the research involved combining melatonin treatment with exposure to slightly cold water, around 17°C, which simulates the average sea temperature. This combination was found to further enhance weight loss, suggesting a potential new approach to managing obesity in humans.
Professor Agil underscored the growing prevalence of obesity, overweight, and type 2 diabetes across both developed and developing nations. He attributed these conditions to poor adaptation of the human genome to current environmental factors that include sedentary lifestyles, consumption of hypercaloric diets, and exposure to persistent artificial light which disrupts natural circadian rhythms and reduces endogenous melatonin levels.
To counter these challenges, Professor Agil recommends several lifestyle adjustments based on individual circadian rhythms. During the day, he suggests exposure to natural light, engaging in physical activity, opting for low-calorie, unprocessed diets, and incorporating thermogenic spices in meals while avoiding snacks between meals and reducing the use of insulating clothing and heating in homes. At night, recommendations include sleeping in complete darkness, avoiding blue light-emitting devices before bedtime, and practising fasting to boost melatonin levels naturally. For older adults and those suffering from obesity, Professor Agil advises the administration of melatonin under medical supervision.
The overarching goal of these studies is to integrate strategies like melatonin administration and intermittent fasting into medical practices to address the complex challenges posed by ‘diabesity’—a confluence of diabetes and obesity—and its associated complications, such as hepatic steatosis, hypertension, and lipid disorders. The research builds on 13 years of prior studies which have consistently shown that pharmacological use of melatonin can serve as a viable strategy in treating central obesity and its related complications. Moreover, melatonin has been found to activate brown fat and enhance the conversion of subcutaneous fat to a more metabolically active form, thus promoting the formation of beige fat cells from mesenchymal stem cells in humans.
These findings not only reaffirm the potential of melatonin in treating visceral obesity but also highlight the necessity for further clinical trials to confirm its efficacy in human subjects. Encouraging results from existing human trials support the progression to more extensive studies focusing on melatonin’s role in maintaining mitochondrial homeostasis and potentially slowing or halting the progression of obesity and its complications through prolonged pharmacological use.
The research has received funding from the SAF2016-79794-R project of the Ministry of Science, Innovation and Universities and is also supported by the European Regional Development Fund (ERDF).
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Twenty years of research validates mediterranean diet’s role in lowering hypertension risk
A landmark study published in the European Journal of Clinical Nutrition has shed light on the enduring benefits of the Mediterranean diet in preventing hypertension (HTN) over an extensive 20-year period. Conducted among a group of initially non-hypertensive adults, this research marks a significant step in understanding long-term dietary impacts on health.
Hypertension remains a critical challenge globally, significantly influencing the onset of heart diseases and strokes, predominantly in low- and middle-income nations. Despite advancements in medication that stabilise blood pressure, approximately 30% of adults still suffer from HTN, which escalates both the healthcare costs and mortality associated with cardiovascular diseases (CVD). Lifestyle changes such as adopting balanced diets, regular physical activity, and smoking cessation are crucial for managing and preventing HTN. Official health guidelines recommend diets rich in plant-based foods, healthy fats, and lean proteins while being low in sodium and alcohol. The Mediterranean diet, celebrated since the 1960s for its role in preventing chronic conditions and reducing CVD mortality, has lacked long-term concrete evidence of its efficacy in managing blood pressure, prompting further investigation.
The study in question, known as the ATTICA study, complies with the Declaration of Helsinki and explores CVD incidence among Greek adults. Beginning in 2001-2002 with 4,056 individuals from the Attica region invited to participate, 3,042 agreed, embarking on a two-decade-long health journey. Initial assessments involved detailed face-to-face interviews at homes or workplaces by trained health professionals, who collected extensive socio-demographic, clinical, and biochemical data. Key health measures included fasting blood samples for glucose, insulin, total cholesterol, and high sensitivity C-reactive protein levels, among others. Participants also underwent physical examinations to ensure no pre-existing CVD and to measure blood pressure. Lifestyle factors including diet, exercise, and smoking habits were meticulously recorded, using a validated food frequency questionnaire to evaluate adherence to the Mediterranean diet through the MedDietScore.
Throughout the 20-year study period, participant engagement was maintained through regular follow-ups, with the latest in 2022 assessing 2,169 of the original cohort. This follow-up re-evaluated their health outcomes, including HTN, diabetes, and CVD development, corroborating data through family reports and medical records for deceased participants.
Statistical analyses utilised advanced software to contrast initial and 10-year dietary patterns, identifying four distinct adherence trajectories to the Mediterranean diet. Techniques such as correlation coefficients, chi-squared tests, and logistic regression models were employed to ascertain the connection between dietary adherence and HTN risk, accounting for variables like age, sex, body mass index, lifestyle habits, and initial health status.
Findings revealed that at the start, participants averaged 41 years of age with a near-equal gender distribution and showed moderate adherence to the Mediterranean diet, scoring an average MedDietScore of 27.1. Physically, 63.1% were minimally active, and about half were classified as having overweight or obesity. Early medical evaluations noted a 35.3% prevalence of hypercholesterolemia and a 3.9% incidence of diabetes.
Analysis of initial data highlighted a strong negative correlation between adherence to the Mediterranean diet and both systolic and diastolic blood pressures, indicating that higher dietary adherence correlated with lower blood pressure levels. Over the study’s duration, 314 individuals developed hypertension, representing a 22.2% incidence rate. Those who developed HTN typically were older, predominantly male, had higher obesity rates, poorer cardiometabolic profiles, and greater tobacco use compared to those who remained free from HTN.
In-depth analysis demonstrated that participants with low initial MedDietScore faced significantly higher HTN development rates than those with medium or high adherence levels. Statistical evaluation confirmed that each point increase in MedDietScore at baseline correlated with a 7% decrease in HTN risk over 20 years, a relationship that persisted even after adjusting for demographic and lifestyle factors.
The study also examined changes in diet adherence from the start to the 10-year point, revealing varied patterns. Notably, participants consistently adherent to the Mediterranean diet showed a remarkably lower incidence of HTN, with a 46.5% reduced risk in the fully adjusted model, underscoring the diet’s protective effect against HTN when sustained over time.
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Heightened risk of iron deficiency in children with overweight and obesity
A comprehensive study conducted by the University of Leeds’ nutritional scientists has revealed a significant correlation between overweight and obesity in children and young people and an increased risk of iron deficiency. The research, spearheaded by the School of Food Science and Nutrition, involved a meticulous analysis of numerous medical studies across 44 countries, focusing on individuals under 25 years old. These studies assessed levels of essential vitamins and minerals, including iron, in relation to body weight.
The findings indicated that iron deficiency is prevalent among both underweight and overweight youths. Professor Bernadette Moore of the School of Food Science and Nutrition highlighted the broader implications of these findings, suggesting that “Iron status may be the canary in the coalmine, signalling deeper health issues like prolonged inflammation, which is linked to serious conditions including heart disease, diabetes, and fatty liver.”
Unlike deficiencies in zinc and vitamin A, which were primarily found in undernourished children, iron deficiency in overweight children appears to stem from inflammation that disrupts iron absorption. This research, funded by the UK Biotechnology and Biological Sciences Research Council and published in the ‘BMJ Global Health’ journal on 10 May 2024, marks a significant advancement in understanding the nutritional challenges faced by children with obesity.
The impact of iron deficiency on cognitive functions such as attention, concentration, and memory is well-documented, with potential links to conditions like autism and ADHD. This study is pioneering in its focus on the association of iron deficiency with childhood obesity, an area previously unexplored.
Xiaomian Tan, a doctoral researcher at the University, emphasised the importance of this study, stating, “While the link between undernutrition and deficiency of crucial micronutrients in children’s growth is established, the risks posed by obesity—leading to what can be described as a hidden form of malnutrition—are less understood.”
The study also addresses the broader socio-economic implications. Historically, nutrient deficiencies have been associated with hunger, especially in lower- and middle-income countries where they contribute significantly to child mortality. However, the phenomenon of ‘hidden hunger’—nutrient deficiencies in the context of an energy-dense but nutrient-poor diet—is becoming more prevalent in both affluent and developing nations. This is often linked to diets dominated by ultra-processed foods in wealthier countries and limited dietary variety in poorer regions.
The dual burden of malnutrition and overnutrition is particularly pressing in regions like Africa and Asia, which are undergoing rapid economic changes and dietary shifts towards Western high-sugar, high-fat foods. Between 2000 and 2017, the number of overweight children under five years old rose significantly in these continents, alongside an increase in stunting.
Professor Moore also pointed out the alarming trend in the UK, where one in three children by age 11 have overweight or obesity, which compounds the risk of inflammation-driven iron deficiencies. She advocates for increased physical activity and dietary improvements to mitigate these risks.
The call for further research is clear, with an emphasis on the need for more comprehensive studies that address micronutrient deficiencies within the context of the growing global epidemic of obesity, particularly in regions currently lacking detailed data.
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New research debunks perceived benefits of overweight/obesity in lung cancer patients
In Buffalo, New York, the widely held belief that having overweight or obesity could have protective benefits for lung cancer patients has been critically re-examined by researchers at the Roswell Park Comprehensive Cancer Center. Despite obesity being linked to an increased risk and poorer prognosis in at least thirteen different cancer types, lung cancer has been noted as a striking exception. Previous studies suggested that patients with a higher Body Mass Index (BMI) faced a reduced risk of disease recurrence and enjoyed longer survival rates post-surgery, a phenomenon dubbed “the obesity paradox”. This has raised questions about the paradoxical role of obesity in lung cancer outcomes compared to its universally acknowledged negative impact on other cancer types.
Sai Yendamuri, MD, MBA, FACS, the Chair of Thoracic Surgery at Roswell Park, spearheaded a research initiative that has shed light on crucial “confounding factors” that distorted earlier conclusions, suggesting a beneficial link between overweight conditions and lung cancer patient prognoses. Dr. Yendamuri, along with a distinguished team including Santosh Patnaik, MD, PhD, Assistant Professor of Oncology in the Department of Thoracic Surgery, and Joseph Barbi, PhD, Assistant Professor of Oncology in the Department of Immunology, presented their groundbreaking findings at the annual American Association for Cancer Research (AACR) symposium held in San Diego, California, from April 5 to 10, 2024.
The research illuminated the inadequacy of BMI as a reliable measure of obesity, pinpointing it as one of the key factors leading to the misinterpretation of previous studies’ results. BMI, a simple calculation based on height and weight, fails to accurately represent the body’s fat percentage, its distribution, or differentiate between fat types. Through a meticulous case-control study utilising CT imaging, the team discovered that early-stage lung cancer patients exhibited a greater fat content without necessarily having a higher BMI, compared to high-risk individuals without lung cancer.
Moreover, the study revealed a heightened risk of disease recurrence in surgically treated lung cancer patients with substantial volumes of visceral fat—the dangerous type lodged between abdominal organs—regardless of their BMI status. Laboratory findings complemented these observations, suggesting that the rapid growth of lung tumours might be facilitated by an obesity-induced increase in suppressor leukocytes, which dampen the immune system’s ability to fight cancer.
Further investigations into patients categorised as having obesity through CT imaging rather than BMI calculations confirmed the suppression of the immune response within the lung microenvironment, allowing for unchecked cancer cell proliferation. These insights underscore the urgency for developing more precise obesity measurement methods to better understand its impact on lung cancer patients and tailor treatment approaches accordingly.
Dr. Yendamuri advocated for the exploration of blood-based testing as a future direction for accurately assessing obesity, circumventing the limitations of CT scans not typically conducted for all cancer patients. Identifying blood-based biomarkers correlating with imaging-derived fat measurements could revolutionise how obesity is gauged, facilitating more informed treatment decisions.
Another aspect of the study addressed the observed effects of certain medications, like metformin used for diabetes management, which appeared to offer additional anticancer benefits exclusively to patients with obesity. Laboratory and retrospective analyses supported the notion that in individuals with obesity, metformin could enhance the vulnerability of lung carcinoma tumours to immunotherapy, particularly immune checkpoint inhibitors (ICIs), promoting a more effective antitumor immune response.
Reflecting on the broader implications of their work, Dr. Yendamuri highlighted the necessity of re-evaluating the design of future studies to account for the limitations of BMI as an obesity measure and the distinct effects of medications in patients with obesity. Addressing the “obesity paradox” can pave the way for clearer, more beneficial patient recommendations, thereby potentially enhancing patient outcomes significantly. The team’s research, backed by both public and private funding, including support from the Roswell Park Alliance Foundation and National Institutes of Health agencies, marks a significant step forward in demystifying the complex interplay between obesity and lung cancer.
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Obesity and high-fat diets linked to swift vascular ageing in the brain
A new study conducted in mice traces how obesity and a high-fat diet may accelerate ageing in the blood vessels that supply blood to the brain. The work is being presented this week at the American Physiology Summit, the flagship annual meeting of the American Physiological Society (APS), in Long Beach, California.
The findings suggest that obesity and a poor diet can cause damage to accumulate in the blood vessels, reducing the supply of oxygen to parts of the brain and ultimately leading to cognitive decline. The study could help scientists find ways to intervene and preserve brain function in people with obesity, which is estimated to affect about 42% of U.S. adults.
“This project highlights the critical roles of vascular components and cellular ageing in cognitive deterioration, pinpointing novel potential therapeutic targets for dementia prevention and treatment,” said Sharon Negri, PhD, the study’s first author and a postdoctoral research fellow in the laboratory of Stefano Tarantini, PhD, in the Department of Neurosurgery at the University of Oklahoma Health Sciences Center.
Previous research has found strong links between mid-life obesity and an increased risk of cognitive decline and dementia later in life. The scientists sought to uncover the mechanisms behind this association, with a particular focus on the role of diet and vascular health.
To do this, the researchers studied the impact of a high-fat diet on blood flow to the brain and memory performance in aged mice with obesity. By using a special mouse model, they were also able to measure cellular senescence, a process when cells stop dividing and making new cells. Cellular senescence increases with ageing and contributes to a variety of ageing-associated diseases.
“Obesity may cause the cells in blood vessels in the brain to age faster and reach senescence. If a link between obesity and cellular senescence is established, it could open up new lines of investigation aimed at exploring therapeutic avenues to prevent or slow down the progression of senescence, with the potential to mitigate obesity-related health issues, including cognitive decline.” – Sharon Negri, PhD, study’s first author
The results showed that after three months, mice fed a high-fat diet had increased cellular senescence and reduced density of healthy blood vessels in the brain, as well as evidence of impaired learning in a maze test, compared with normal-weight mice fed a standard diet. In addition, the scientists found that removing the senescent cells using Navitoclax, an investigational cancer drug that selectively kills senescent cells, improved features of the brain vasculature.
If further experiments confirm that it is possible to reverse the detrimental effects of senescence, Negri and Tarantini next plan to evaluate whether various lifestyle interventions could help to prevent or reduce obesity-induced cognitive impairment.
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Revolutionising obesity treatment with new gender-specific microbiome findings
Recent investigations to be unveiled at the European Congress on Obesity (ECO) held in Venice, Italy, from the 12th to the 15th of May, 2024, have shed light on the pivotal role that variations in gut microbiota composition play in the genesis and evolution of obesity, revealing notable distinctions between genders. This differentiation may significantly influence the metabolism of various nutrients, thereby affecting the presence of bioactive molecules within the gut that are crucial in the progression of metabolic diseases.
The gut microbiota encompasses a complex consortium of microorganisms, including bacteria, viruses, fungi, and protozoa, that reside within the gastrointestinal tract. A state of imbalance within this microbial community, known as dysbiosis, has profound effects on metabolic health, altering the risk of developing diseases such as obesity. Yet, the specific microbial species that contribute to a higher or lower risk of obesity and their exact impact on metabolic health remain subjects of ongoing research.
In an effort to deepen understanding of the role these microorganisms play in obesity, researchers conducted an analysis of metagenomic and metabolomic data from a Spanish cohort. This analysis aimed to decipher the mechanisms through which gut microbes contribute to obesity’s development.
The study involved examining the faecal metabolome—the vast array of metabolites found in the gut and excreted in faeces, produced by gut bacteria as they metabolise food. These metabolites enter the bloodstream, where they can have significant health impacts.
A total of 361 adults (251 women and 110 men, with a median age of 44 years) from the Spanish Obekit study—a randomised trial exploring the relationship between genetic variants and responses to a hypocaloric diet—were included in the analysis. Participants were categorised based on their obesity (OB) index into LOW (BMI ≤ 30 kg/m²; fat mass percentage ≤ 25% for women or ≤ 32% for men; waist circumference ≤ 88 cm for women or ≤ 102 cm for men) or HIGH (BMI > 30 kg/m²; fat mass > 25% for women or > 32% for men; waist circumference > 88 cm for women or > 102 cm for men) obesity levels. This grouping ensured a balanced representation of sexes and ages within each category.
Microbiota profiling through genetic analysis was employed to ascertain the diversity, composition, and relative abundance of bacteria in participants’ stool samples.
Key findings indicated that individuals with a HIGH OB index displayed significantly reduced levels of Christensenella minuta—a bacterium associated with leanness and health. In men, an increased presence of Parabacteroides helcogenes and Campylobacter canadensis was strongly linked to elevated BMI, fat mass, and waist circumference. Conversely, in women, a higher abundance of Prevotella micans, Prevotella brevis, and Prevotella sacharolitica was strongly indicative of increased BMI, fat mass, and waist circumference, but these associations were not observed in men.
Further analyses, examining a broader spectrum of metabolic compounds in the blood, identified variations in certain metabolites, particularly elevated levels of bioactive lipids—phospholipids and sphingolipids—which are implicated in metabolic disease development and are key modulators of insulin sensitivity and contributors to diabetes and vascular complications in individuals with a HIGH OB index.
Dr. Paula Aranaz, the study’s lead author from the Centre for Nutrition Research at the University of Navarra in Spain, explained, “Our findings underscore the significant role of bacterial imbalance in the onset and progression of obesity, highlighting notable differences between genders. This imbalance affects the metabolism of bioactive molecules in the metabolome, which in turn influences metabolic disease development.”
Dr. Aranaz further elaborated on the protective role of the Christensenella minuta bacterium against obesity and noted that the microbial species influencing obesity risk differ by sex. This necessitates gender-specific interventions to prevent an obesity-promoting microbiome. She emphasised the need for additional research to pinpoint when the shift to an obesity-favourable gut microbiota occurs, to better time potential interventions.
She concluded with optimism, stating, “This study demonstrates the utility of combining metagenomics with metabolomics to unravel the mechanisms at play in metabolic disease development, such as obesity. This innovative, comprehensive approach has the potential to foster the creation of nutritionally precise strategies for weight management that alter specific bacterial strains or bioactive molecule levels.”
However, the authors acknowledged certain limitations of their study, including its relatively small sample size—particularly for men—and its geographical limitation to one region in Spain. Given that factors such as climate, geography, diet, and culture can influence the gut microbiome, the applicability of these findings to other populations may be limited.
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Healthcare professionals struggle to tackle childhood obesity due to insufficient training
In the face of the escalating childhood obesity crisis, healthcare professionals are encountering significant hurdles, primarily due to a glaring deficiency in training and operational bandwidth. This predicament was illuminated through a study published in the British Journal of General Practice, wherein researchers from the University of Birmingham conducted thorough interviews with healthcare professionals (HCPs) to delve into their experiences with aiding families in the battle against childhood obesity.
One revealing testimony from the study highlighted the practical challenges faced by HCPs: “I had one mum and her child was overweight, but she was a young parent and she actually didn’t know how to cook the dinners and, yeah… we spent a lot of time with her giving her worksheets, how to cook, make potato and beans rather than going to the fish and chip shop.” This account underscores the multifaceted nature of the obesity issue, which extends beyond medical intervention to encompass educational and lifestyle components.
The research unearthed several themes that have frustrated healthcare professionals in their efforts to support families. Among these was the constrained time and training available to HCPs, compounded by a scarcity of specialist services and limited access to routinely collected data on children’s weight. A poignant concern was the risk of eroding trust by broaching the sensitive subject of weight, alongside the need to navigate cultural sensitivities carefully.
Miranda Pallan, Professor of Child and Adolescent Public Health at the University of Birmingham and senior author of the paper, brought to light the pressures faced by healthcare professionals. “This study brings a fresh awareness about the pressures that healthcare professionals face, including the limitations that they face in trying to provide preventative care for young people,” she remarked, emphasising the barriers to offering effective guidance and support.
Echoing these concerns, Dr Ellen Fallows, a sessional GP with a keen interest in childhood obesity, noted a pervasive reluctance to address the root causes, primarily due to a lack of time, knowledge, and incentives among healthcare professionals. “Everyone thinks it is everyone else’s problem, no one is actually talking about the root causes with parents – which is predominantly food quality,” Dr Fallows observed. She advocated for the wider availability of quality training resources as a vital first step in equipping HCPs to tackle this issue.
The study also touched upon the contentious use of BMI centiles for assessing children’s weight issues, revealing a division among healthcare professionals. Some, including doctors and primary care nurses, admitted to being less familiar with BMI centiles and questioned its suitability for younger children. One participant noted, “We used to use the [height and weight] centile charts and actually the BMI will put a lot more children in an overweight category than the centile charts will.”
The collective insights from this study underscore a pressing need for a strategic overhaul in how childhood obesity is approached within the healthcare system. While the direct teaching of nutritious cooking to families might be beyond the scope of HCPs, the findings advocate for an enhanced support framework, enabling practical advice and referrals to specialist services. As childhood obesity continues to pose a serious, multifaceted challenge, the call for a comprehensive strategy that includes better training, resources, and a unified effort to address its root causes has never been more urgent.
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Study reveals sweeteners do not elevate hunger while aiding in blood sugar reduction
In a groundbreaking research endeavour, the substitution of sugar with both artificial and natural sweeteners has been shown to not increase hunger levels in individuals, whilst also facilitating a reduction in blood sugar levels. This discovery comes from a rigorous double-blind randomised controlled trial, which observed that foods containing sweeteners do not lead to heightened appetite sensations or alter appetite-related hormone reactions compared to their sugary counterparts. Notably, this substitution offers additional advantages, such as the lowering of blood sugar levels, a crucial factor for individuals at risk of developing type 2 diabetes.
The incorporation of sweeteners as a sugar substitute in food products has sparked considerable debate, with prior studies providing inconclusive evidence regarding their potential to stimulate appetite. However, this recent study, adhering to the highest standards of scientific proof, delivers compelling evidence that sweeteners and sweetness enhancers do not adversely affect appetite. Moreover, they play a significant role in reducing sugar intake.
Conducted under the auspices of the University of Leeds in collaboration with the Rhône-Alpes Research Center for Human Nutrition, this study forms part of the extensive research undertaken by the SWEET consortium. Comprising 29 European partners from research, consumer, and industry sectors, the consortium aims to investigate the long-term benefits and possible risks associated with the transition to sweeteners and sweetness enhancers, focusing on public health and safety, obesity, and sustainability. The research received funding from Horizon Europe.
Catherine Gibbons, the study’s lead author and an Associate Professor at the University of Leeds’ School of Psychology, stressed the importance of reducing sugar intake in combating the escalating prevalence of obesity-related metabolic diseases like type 2 diabetes. She noted that removing sugar from foods without offering a substitute could potentially compromise taste and heighten cravings for sweet foods, thus making adherence to a low-sugar diet challenging. The substitution of sugars with sweeteners and sweetness enhancers in food products represents a prevalent dietary and food manufacturing strategy to diminish sugar consumption and enhance the nutritional value of commercial foods and beverages.
Graham Finlayson, Principal Investigator and Professor of Psychobiology at the University of Leeds, highlighted the scrutiny that the use of sweeteners and sweetness enhancers has attracted, including claims linking their consumption to adverse health outcomes. These reports have muddled public perception, particularly among those at risk of metabolic diseases, about the safety of these substances.
“Our study provides essential evidence supporting the daily use of sweeteners and sweetness enhancers in managing body weight and blood sugar levels,” Finlayson stated.
This pioneering study, a first of its kind, examined the impact of consuming biscuits infused with either sugar, the natural sugar alternative Stevia, or the artificial sweetener Neotame on a group of 53 adult men and women with overweight or obesity issues. Prior research on sweeteners and sweetness enhancers predominantly utilised beverages as a medium and seldom included participants with overweight or obesity or both sexes. Moreover, these studies usually focused on a single sweetener, primarily aspartame, against a control, with very few examining the effects of repeated daily consumption of a known sweetener or sweetness enhancer as part of a regular diet.
The trial, executed at the University of Leeds and the Rhône-Alpes Research Center for Human Nutrition in France between 2021 and 2022, involved participants aged between 18 to 60, all with overweight or obesity. It comprised three two-week consumption phases, with participants consuming biscuits containing different fillings: sugar, Stevia, or Neotame, with intervals of 14-21 days between each phase.
The initial and final days of these phases were conducted in a laboratory setting. Participants, after an overnight fast, provided blood samples to establish baseline glucose, insulin, and appetite-related hormone levels. They were also asked to evaluate their hunger and food preferences. Following the biscuit consumption, participants rated their fullness over several hours, and measurements were taken for glucose and insulin levels, along with ghrelin, glucagon-like peptide 1, and pancreatic polypeptide – hormones linked to food consumption.
The findings indicated no significant differences in appetite or endocrine responses between the sweetener types and sugar. However, insulin levels, measured two hours post-consumption, along with blood sugar levels, were observed to decrease.
Professor Anne Raben, joint co-ordinator of the SWEET project from the University of Copenhagen, Denmark, remarked, “The findings affirm that sweeteners are a beneficial tool in reducing the consumption of added sugar without triggering a compensatory increase in hunger or energy intake. This supports the effectiveness of sweeteners in managing appetite, energy, and weight.”
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Obesity during youth could double the risk of multiple sclerosis in later life, research suggests
Children grappling with obesity might face a significantly higher likelihood of being diagnosed with multiple sclerosis (MS) in adulthood, according to recent research findings.
Multiple sclerosis is a condition that impacts the brain and spinal cord, leading to a wide array of potential symptoms, including challenges with vision, coordination in the arms or legs, sensation, or balance. As a lifelong affliction, MS can sometimes lead to severe disability.
These insights are set to be shared at the European Congress on Obesity, taking place in Venice this May, and stem from research conducted by the Karolinska Institute in Stockholm.
Prior studies have hinted at a connection between an elevated body mass index (BMI) during adolescence and a heightened risk of MS. However, the majority of these analyses relied on retrospective approaches and self-reported data, which could introduce biases.
The recent investigation aimed to prospectively assess the risk of MS development among a significant cohort of children with obesity in comparison to their counterparts in the broader population. To this end, the researchers turned to the Swedish Childhood Obesity Treatment Register, also known as Boris. This database stands as one of the globe’s most extensive records dedicated to the treatment of childhood obesity.
The team reviewed data pertaining to children between the ages of two and 19 who were enrolled in the registry from 1995 to 2020. This information was then juxtaposed with data from the general population of children.
In total, the study took into account data from over 21,600 children who commenced obesity treatment at an average age of 11, alongside more than 100,000 children without obesity.
Throughout an average tracking period of six years, MS was diagnosed in 28 children from the group with obesity (representing 0.13% of this cohort) and 58 children from the group without obesity (0.06%).
The average age at which MS was diagnosed remained similar across both groups, with diagnoses typically occurring around the age of 23.
While acknowledging certain limitations in their study, the researchers underscored: “Despite the limited follow-up time, our findings accentuate that childhood obesity amplifies the risk of developing early-onset MS by more than double.”
The study’s lead researchers, Associate Professor Emilia Hagman and Professor Claude Marcus, commented: “Obesity during childhood induces a low-grade, yet chronic inflammation, which likely elevates the risk of developing various conditions, including MS.”
They further elucidated that such chronic low-grade inflammation is believed to elevate the risk of other conditions, such as asthma, arthritis, type 1 diabetes, and certain cancers. Notably, they highlighted that weight loss can diminish inflammation, thereby potentially reducing the risk of developing these diseases.
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Very low calorie diets safe for teens with obesity when monitored by a dietitian, study finds
In recent findings set to be unveiled at the European Congress on Obesity (ECO) in 2024, researchers assert that stringent low-calorie diets, when under the vigilant oversight of seasoned dietitians, hold promise for adolescents grappling with moderate to severe obesity.
The study, originating from Australia, explored the viability and tolerance of very low energy diets (VLEDs) among teenagers, revealing an overall positive reception despite some experiencing adverse effects. VLEDs, characterised by a daily intake of 800 calories or less through specialised meal replacements like bars and shakes, aim to fulfil essential nutrient needs while offering an alternative path to weight loss. This approach is particularly geared towards young individuals who have found little success with traditional diet and exercise regimens, presenting a potential prelude to a more balanced diet without resorting to bariatric surgery.
Historically, the application of VLEDs in youth has been approached with caution due to scant data concerning potential side effects—ranging from headaches and fatigue to muscle cramps and digestive issues—and their impact on overall growth, cardiac health, and psychological well-being. This hesitancy underscores the significance of the study conducted by Dr. Megan Gow and her team at the Children’s Hospital Westmead Clinical School, affiliated with The University of Sydney, Westmead, Australia.
The research delves into the initial phase of the “Fast Track to Health” study, specifically the first four weeks during which participants engaged in a nutritionally balanced VLED to initiate weight loss. The cohort, comprising 141 adolescents aged 13 to 17 years with obesity and at least one obesity-related complication (e.g., hypertension, insulin resistance, or dyslipidemia), was divided to receive either four Optifast meal replacement products daily alongside low carbohydrate vegetables and a teaspoon of vegetable oil or a similar regimen with three meal replacements and one solid meal of lean meat and vegetables.
Support was provided through weekly consultations with a dietitian, with assessments at baseline, weekly intervals, and a comprehensive survey to gauge the diet’s acceptability, detailing aspects the participants found favourable or unfavourable.
Despite prevalent side effects, the adherence rate was notably high, with an average weight loss of 5.5kg observed across participants. The majority reported experiencing multiple side effects, including hunger, fatigue, headaches, and gastrointestinal disturbances, with the incidence peaking in the first week. Interestingly, a correlation was observed between the early onset of side effects and more substantial weight loss, hinting at higher compliance with the dietary restrictions.
Feedback on the VLED’s practicality and enjoyment yielded mixed reviews, with the structured nature and the tangible outcomes of weight loss cited as positives, whereas the restrictive diet and the palatability of meal replacements drew criticism.
The findings advocate for the short-term safety and potential acceptability of VLEDs under professional guidance for adolescents with significant obesity challenges. Dr. Gow emphasises the necessity for further research to pinpoint those who would benefit most from this approach. She advocates for the incorporation of VLEDs into clinical guidelines for managing severe obesity and related health issues in young people, positioning it as a preliminary step before considering medication or surgery.
Adolescents and their guardians are encouraged to consult healthcare professionals to explore suitable treatment avenues for obesity.
This study not only sheds light on the pragmatic aspects of implementing VLEDs among adolescents but also underscores the importance of professional oversight and the need for a broader discourse on obesity management in younger populations.
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BMI found outdated for childhood obesity measurement in Bristol study
A groundbreaking study hailing from Bristol has shed new light on the efficacy of current methods used to assess childhood obesity, proposing a shift towards a more precise alternative. This research scrutinises the longstanding reliance on Body Mass Index (BMI) for evaluating obesity in children, suggesting that the waist-to-height ratio (WHtR) could serve as a superior metric.
The comprehensive analysis spanned over 15 years and delved into the health metrics of 7,237 children, each nine years of age, revealing significant insights. These findings challenge the existing guidelines that favour BMI as the standard obesity measure, underlining the urgent need for more accurate obesity detection in paediatric health.
Published in the prestigious journal Paediatric Research, this study is a component of the expansive Children of the 90s project, drawing attention to the escalating obesity rates amongst 10 and 11-year-olds in England, a surge notably exacerbated by the Covid pandemic and yet to recede to pre-pandemic figures.
Professor Julian Hamilton-Shield, a consultant paediatrician at the Bristol Royal Hospital for Children and a leading figure in the study, voiced concerns over the increasing prevalence of severe obesity and its complications observed in his weight management clinic. “The uptick in severe obesity levels and its attendant severe complications underscores the necessity for reliable measures that offer a clearer insight into an individual’s health status,” stated Prof Hamilton-Shield.
The research team scrutinised BMI data sourced from the government’s National Child Measurement Programme, which annually assesses approximately a million Year 6 students across England. While BMI has been a cornerstone in determining healthy weight parameters, offering a simple and quick assessment method based on height and weight, its limitations are becoming increasingly apparent. Specifically, BMI fails to account for body frame variations or muscle mass, rendering it an incomplete measure of body fat.
This limitation is particularly poignant when considering that BMI might categorise individuals with significant muscle mass, such as rugby players, as having obesity, highlighting its outdated nature. In contrast, the study, conducted in collaboration with researchers from the University of Bristol, the University of Exeter, and the University of Eastern Finland, advocates for the WHtR as a viable replacement for BMI. This method promises a more accurate assessment of excess fat mass in children and adolescents.
Professor Andrew Agbaje, the lead author of the study, emphasised the practicality and effectiveness of the waist circumference-to-height ratio. “Utilising just a measuring tape, we can accurately identify eight out of ten children who genuinely have obesity. Furthermore, this method allows us to correctly recognise 93 out of 100 individuals who, despite being muscular, would be mistakenly classified as overweight or having obesity by BMI standards,” Prof Agbaje explained.
He further highlighted that unlike BMI, which fluctuates with age and sex, the waist-to-height ratio remains consistent, irrespective of these variables. This finding underscores the potential of WHtR to revolutionise how childhood obesity is measured, offering a more nuanced understanding of body composition and facilitating the identification of true obesity, thus enabling more targeted and effective interventions.
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Study highlights higher incidence of musculoskeletal issues in young girls with obesity
Recent research indicates a concerning trend among young girls aged 4 to 11 who are overweight or have obesity, showing they are more frequently visiting GPs for musculoskeletal problems compared to their counterparts of a healthy weight.
The study reveals that girls in their first year of school (reception year) with a Body Mass Index (BMI) classified as overweight have a 24% increased likelihood of attending a GP appointment for a musculoskeletal issue at least once. This probability soars to 67% for girls identified as living with obesity. Furthermore, by the time they reach year 6, girls with obesity are 20% more likely to consult a GP for similar problems. Conversely, boys in the same age bracket with a BMI categorised as underweight were found to be 61% less likely to seek such medical advice compared to their peers of a normal weight.
The most frequently reported problems were related to knee and back pain, as outlined in the results published in the “Archives of Disease in Childhood” journal, focusing on a specific London area.
Nicola Firman, the study’s lead author and a health data scientist at Queen Mary University of London, emphasised the scarcity of longitudinal studies examining the link between obesity and musculoskeletal health outcomes during childhood. Despite a systematic review revealing a general lack of substantial evidence, this study aims to bridge that gap by investigating these health outcomes in an ethnically diverse population within the UK, known for its high rates of childhood obesity and social deprivation.
Among the youngest participants, knee pain was reported by 46% of boys and 41.5% of girls, with these figures slightly decreasing among year 6 students to 40.4% for boys and 36% for girls. In terms of back pain, 22% of reception year boys and a higher 32% of girls experienced this issue, which increased to 30% for boys and an alarming 45% for girls by year 6.
Interestingly, the study noted that reception year girls with obesity were significantly more inclined to consult their GP over musculoskeletal issues than their healthy weight female peers, a trend not observed among boys.
Firman also referenced studies from Spain and the USA, noting an observed rise in back pain incidents among girls, not boys, highlighting the global need for more longitudinal research to fully understand the relationship between childhood obesity and musculoskeletal health.
The research sample included primary school children from four ethnically diverse local authorities in north-east London.
Katharine Jenner, Director of the Obesity Health Alliance, responded to these findings with concern, stressing that primary school-aged children should be enjoying their youth actively rather than facing the physical limitations and pains leading to GP consultations. She criticised the government’s lack of action on its obesity strategy, pointing out that the goal to halve childhood obesity by 2030 is becoming increasingly unattainable without significant policy changes and implementations.