Adolescent stress linked to adult obesity and hypertension
Recent research indicates a strong correlation between high stress levels experienced during adolescence and the subsequent development of cardiometabolic risk factors, such as obesity and hypertension, in adulthood.
Published in the Journal of the American Heart Association, this study underscores the necessity of implementing stress management techniques from an early age. These strategies are vital in reducing the likelihood of health issues later in life, including heart disease and Type 2 diabetes.
Dr. Fangqi Guo, the lead author of the study and a postdoctoral research fellow at the University of Southern California’s Keck School of Medicine, emphasises the significance of understanding how stress perceived from childhood impacts the escalation of cardiometabolic risk factors in young adults. Dr. Guo’s findings reveal that long-term stress perception significantly influences various cardiometabolic aspects such as fat distribution, vascular health, and obesity. He stresses the importance of adopting stress management practices during adolescence to safeguard health.
Cardiometabolic risk factors, encompassing obesity, Type 2 diabetes or prediabetes, high cholesterol, and hypertension, often co-occur and are major contributors to cardiovascular disease. In 2020, cardiometabolic diseases, including cardiovascular conditions and Type 2 diabetes, were leading chronic health issues in the U.S., accounting for approximately 25% of all deaths, as per the American Heart Association.
The American Heart Association’s 2017 report highlighted that childhood adversities have long-term effects on cardiometabolic health. In recent decades, perceived stress has also been increasingly recognised as a contributing factor to cardiometabolic health problems.
In this new investigation, researchers analysed data from 276 individuals participating in the Southern California Children’s Health Study. The participants, initially enrolled by their parents between 2003 and 2014 at an average age of six, underwent health assessments during adolescence and as young adults from 2018 to 2021. Their average ages during these assessments were 13 and 24 years, respectively.
Each assessment included responses to a four-item Perceived Stress Scale, a widely utilised method for assessing stress-related feelings and thoughts over the previous month. For the youngest participants, stress levels were reported by their parents. The participants were then categorised into four groups based on their stress patterns: consistently high, decreasing, increasing, and consistently low.
The study’s evaluation of cardiometabolic health involved various health measurements, such as blood pressure and weight. Researchers also examined neck artery thickness to assess blood flow, haemoglobin A1C levels to determine diabetes status, and body fat percentage, with a focus on abdominal fat, a known risk factor for cardiovascular disease and Type 2 diabetes.
Participants who reported higher stress levels from their teenage years into adulthood were more prone to high blood pressure, increased total body fat, more abdominal fat, poorer vascular health, and a higher risk of obesity than those who experienced lower stress levels.
Dr. Guo expressed surprise at the consistency of the association between perceived stress patterns and various risk factors. He advocates for healthcare professionals to incorporate the Perceived Stress Scale in clinical assessments, allowing for early identification and treatment of individuals with elevated stress levels.
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Losing weight through dance could beat conventional workouts
Traditional exercise routines, often recommended for shedding weight, can pose challenges in maintaining enthusiasm and commitment. Their repetitive and solitary nature, coupled with the physical exertion required, can make them less appealing over time.
Contrastingly, dancing emerges as a potent alternative for weight loss, according to recent research findings. Its inherent enjoyment and the opportunity for social engagement it provides set it apart from conventional exercise forms.
A meta-analysis examining 10 studies focusing on dance’s impact on individuals with overweight and obesity revealed significant health benefits. Regular dancers demonstrated marked improvements in body mass index (BMI), waist circumference, body fat percentage, and total fat loss, compared to non-dancers. These findings were published in the journal PLOS ONE.
The studies encompassed a variety of dance styles, including step-aerobic, cheerleading, creative, Zumba, bhangra, traditional, dance video games, square dance, simplified dance, and aerobic fitness dance. The frequency of dance sessions varied, with most participants dancing three times a week, except for square dancers (five times a week) and bhangra dancers (twice a week). Session durations ranged from 40 to 90 minutes, and the studies lasted from four weeks to one year.
Adherence to an exercise program is crucial for its success, and dancing’s entertainment value might significantly enhance this adherence. Dr. Jagdish Khubchandani, a public health professor at New Mexico State University not involved in the study, highlighted the motivational challenges of traditional exercises, often perceived as arduous and demanding in terms of time, physical effort, and financial resources.
Stephanie Escobedo, founder of Through the Body, a dance and fitness company, and not a participant in the research, echoed this sentiment. She emphasised the importance of finding an enjoyable exercise form for consistent engagement.
Dr. Menka Gupta, a functional medicine doctor at NutraNourish, remarked on the dance’s dual physical and mental health benefits. Beyond improving BMI, dance activities can elevate mood, reduce stress, and enhance sleep quality, thanks to the dopamine release associated with pleasure.
Dr. Khubchandani also referenced studies indicating dancing’s potential to enhance executive function, offering both physical and psychological advantages.
When it comes to choosing the most beneficial dance form, Dr. Gupta advises selecting one that resonates personally, ensuring long-term commitment and consistency. For older individuals or those preferring lower intensity, she recommends ballroom dancing for its social, balance, posture, and cardiovascular benefits.
Dr. Gupta particularly praises Zumba for its mental sharpness benefits, incorporating high-intensity interval training that fosters cognitive skills like decision-making and spatial recognition.
Escobedo supports the health benefits of various dance forms, highlighting ballet for muscle strength, balance, posture, and cardio endurance, and modern/contemporary dance for agility and core strength. She notes that popular cardio dance classes can contribute significantly to weight loss and overall fitness, offering a more enjoyable alternative to routine exercises.
Finally, Dr. Gupta stresses the emotional connection aspect of dance, sharing her personal preference for Zumba and Bollywood dancing, which evoke nostalgic childhood memories and connections.
In summary, dance not only serves as an effective exercise alternative for weight management but also offers diverse physical, mental, and emotional benefits, making it a comprehensive fitness choice.
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Curbing fruit juice intake in childhood may reduce obesity risk, research indicates
Recent research indicates that reducing the consumption of 100% fruit juice in children could be a key strategy in addressing the growing concern of childhood obesity, especially in younger age groups.
Published in the journal JAMA Pediatrics, this study sheds light on a significant issue: children who have overweight or obesity are more likely to maintain this status into adulthood. The researchers, therefore, advocate for limiting fruit juice intake to avoid excess calorie consumption and subsequent weight gain.
A team from the University of Toronto in Canada spearheaded the research, analysing data from 42 previous studies to explore the relationship between drinking 100% fruit juice and weight gain in both children and adults. While the link with adult weight gain requires further exploration, the team observed a definitive correlation between juice consumption and weight gain in children.
The study defined 100% fruit juice as a drink with no added sugar, with a standard serving being 8 ounces. The researchers evaluated data for approximately 46,000 children aged between 1 and 15 years. Their findings pointed to a clear association between each additional serving of 100% fruit juice and an increase in body mass index (BMI), a standard metric for determining overweight and obesity status. The team highlighted that, unlike whole fruits, juice lacks significant fibre, potentially leading to high calorie intake without a corresponding feeling of fullness.
The American Academy of Pediatrics has set guidelines advising against fruit juice for infants under one year and recommending a daily limit of 4 ounces as part of a meal for toddlers and young children. For children aged 1 to 6 years, the intake should not exceed 6 ounces per day.
On its website, the Academy emphasises, “Fruit juice offers no nutritional benefits over whole fruit,” pointing out that whole fruits also contain fibre and other essential nutrients. It advises against giving fruit juice at bedtime and cautions against its use in managing dehydration or diarrhoea.
The urgency of addressing childhood overweight and obesity is underscored by alarming statistics from the U.S., where 1 in 5 children aged 2 to 19 years have obesity. Obesity in childhood carries the risk of serious health issues such as high blood pressure, high cholesterol, type 2 diabetes, asthma, sleep apnea, and joint problems, according to the CDC.
The study observed that children consuming fruit juice gained more weight than those drinking zero-calorie beverages, like water. This weight gain was most pronounced in children aged 8 years and younger when compared to their peers consuming non-caloric drinks.
The types of juice consumed included pomegranate, berry, tart cherry, apple, citrus, and grape, with no noticeable differences in BMI impact based on juice type. The researchers suggested that weight gain could be attributed to the high liquid calorie content in fruit juice and the rapid absorption of fructose, which can affect liver function and cholesterol levels.
In conclusion, the study supports public health recommendations to limit the consumption of 100% fruit juice as a preventative measure against overweight and obesity in children.
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Excessive school holiday downtime linked to rising health concerns in children
The extended school holidays, a period of relaxation and rest for educators and students alike, may be inadvertently contributing to health issues in children. Recent research highlights a worrying trend of increased weight gain during these leisure times, particularly among children.
In Australia, the prevalence of children and teenagers with overweight or obesity stands at one in four, reflecting a global issue where over 124 million children and adolescents have obesity. These alarming figures have spurred governments, educational institutions, and communities to advocate for enhanced physical activity and healthier eating habits among the younger demographic.
The groundbreaking ‘Life on Holidays‘ study, spearheaded by the University of South Australia’s Alliance for Research in Exercise, Nutrition and Activity team, is the first to explore this phenomenon outside the United States. It specifically examined the impact of holiday periods on children’s fitness levels and body composition.
The study’s findings revealed a concerning pattern: children’s body fat accumulates more rapidly during school holidays than during academic terms. Notably, children in Years 4 and 5 exhibited a decrease in physical activity and an increase in sedentary behaviours during their holidays.
Key observations included children sleeping an average of 12 minutes less, engaging in 12 fewer minutes of physical activity daily, and spending an additional 70 minutes on screens each day during holiday periods. Consequently, there was a marked acceleration in body fat accumulation and a more pronounced decline in aerobic fitness compared to term time.
Professor Tim Olds, lead researcher from UniSA, suggests that promoting physical activities during school holidays could be crucial in combating these negative health trends. He notes that while children and their parents rightly deserve holiday downtime, the lifestyle shift during these periods often negatively impacts children’s health.
“On school holidays, kids are significantly less active than when they’re at school, leading to higher body fat percentages and lower levels of fitness,” Professor Olds remarked. He expressed concern over the rapid rate of weight gain and fitness loss during holidays, pointing out the potential long-term health risks such as cardiovascular disease and Type 2 diabetes.
The study, which spanned two years, focused on children aged 9-10 years and involved over 150 participants. Data were collected at the start and end of Terms 1 and 4 across Grades 4 and 5.
Co-researcher Dr Dot Dumuid highlighted that the unstructured nature of school holidays contributes significantly to these trends. She pointed out that children have unrestricted access to food and are prone to increased screen time due to the lack of structured activities.
Dr Dumuid contrasted this with the structured environment of school days, where meals are planned, and physical education lessons and playtimes are scheduled. She suggested that adopting American-style summer camps and holiday programs could be an effective way to address the issue in Australia. These programs, she noted, have been successful in providing children with physical activities in a more structured setting.
“Summer camps and holiday programs have shown positive results in America and could offer a valuable solution during Australian holidays,” Dr Dumuid said. She emphasised the need for a balance between leisure and physical activity, questioning the reliance on devices and TV for child care at the expense of children’s health.
The study underlines the importance of finding a healthy balance between relaxation and physical activity during school holidays. As societies grapple with increasing rates of childhood obesity and associated health problems, initiatives like summer camps and structured holiday programs could play a pivotal role in ensuring the health and well-being of the younger generation.
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Study highlights obesity’s role in blood condition leading to multiple myeloma blood cancer
The possible interplay between lifestyle factors such as smoking, insufficient sleep, and obesity, and their influence on a blood condition that can lead to a specific type of blood cancer, warrants further investigation, according to experts.
Recent findings published in “Blood Advances” suggest that certain modifiable risk factors, notably smoking and obesity, might elevate the risk of developing monoclonal gammopathy of undetermined significance (MGUS). This condition often precedes multiple myeloma, a form of blood cancer.
Dr. David Lee, an internal medicine resident at Massachusetts General Hospital and co-author of the study, emphasised the urgency of this research. He noted that despite significant advancements in multiple myeloma treatments, it remains incurable and is often diagnosed after considerable damage to the patient’s organs. He added, “Our research group is focused on investigating risk factors and aetiology of MGUS to better understand who may be at increased risk for developing MGUS and its progression to multiple myeloma.”
MGUS is characterised by abnormally high levels of a protein called M protein in the blood. While in most instances MGUS does not cause problems, there is an annual 1% risk of progression from MGUS to myeloma, a cancer affecting plasma cells.
Myeloma results in an accumulation of a type of white blood cell in the bone marrow, leading to tumour formation throughout the bones. The most significant risk factor for developing myeloma is age, particularly affecting those over 45. The disease is more prevalent in men and is twice as likely to occur in black individuals compared to white individuals. Furthermore, having overweight or obesity has been identified as a risk factor for myeloma.
Dr. Brian Durie, Chief Scientific Officer of the International Myeloma Foundation and a haematologist and oncologist at Cedars-Sinai Medical Center, who was not part of the study, highlighted a known correlation between MGUS, myeloma, and obesity. He explained, “There’s also a correlation between obesity and a lot of other things, other kinds of cancer, other kinds of issues with your immune system.”
The study indicated that obesity might be associated with a 73% higher likelihood of having MGUS compared to those without obesity. However, the researchers cautioned that while there is a notable connection, it does not definitively prove causation.
Dr. Gary Schiller, a clinical investigator in multiple myeloma and hematologic malignancies at the University of California Los Angeles, also not involved in the study, suggested alternative explanations for the presence of MGUS. He explained that MGUS is relatively common, especially in older populations, and its occurrence might coincide with other factors like increased body mass index and reduced sleep quality. Schiller cautioned against hastily interpreting these associations as causal relationships.
Schiller and others have investigated the influence of obesity on the progression of MGUS, exploring theories involving hormones with anti-inflammatory properties that might be deficient in individuals who have overweight. However, he asserts that the current evidence does not firmly support these hypotheses.
The authors of the study believe their findings could be instrumental in guiding future research into the role of modifiable risk factors in cancer risk. Lee stressed the importance of understanding the relationship between MGUS and these risk factors to develop effective preventative health strategies against diseases like multiple myeloma.
Durie pointed out the current lack of sufficient data to confirm that lifestyle modifications in response to these risk factors would significantly impact MGUS or myeloma outcomes. Nonetheless, he mentioned animal studies that suggest this area is worth future exploration.
The potential of modifiable risk factors in influencing health outcomes is significant, according to Durie. He suggested that efforts to reduce obesity could potentially improve outcomes for patients, emphasising the personal relevance and potential impact of such changes.
Both Durie and Schiller advise individuals with obesity and other risk factors not to be overly concerned about developing MGUS or myeloma. Durie noted, “The vast majority of patients with MGUS will never develop myeloma.” He stressed that for many, the risk of progression is low, and they are more likely to succumb to unrelated causes.
Schiller echoed these sentiments, highlighting the immediate and more pressing health risks associated with obesity, such as hypertension, diabetes, and cardiovascular diseases. He argued that these more immediate health concerns should take precedence over the potential risk of MGUS in the context of obesity.
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Study shows early breastfeeding mitigates child obesity, regardless of maternal weight
A recent study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health has revealed a significant correlation between early breastfeeding and reduced childhood obesity risks. This relationship holds true irrespective of the mother’s pre-pregnancy body mass index (BMI).
The ECHO Cohort study delved into the impact of breastfeeding practices in women who had overweight or obesity before pregnancy and its influence on their children’s BMIz scores. BMIz scores are used to compare a child’s height and weight against their peers, whereas BMI assesses body weight relative to height.
The research discovered that any consistent breastfeeding during the first three months of an infant’s life was linked with lower BMIz scores at ages 2 to 6, regardless of the mother’s pre-pregnancy BMI. This association was particularly pronounced in children whose mothers had obesity before pregnancy, compared to those whose mothers were merely overweight.
Dr. Gayle Shipp from Michigan State University, who led the study, emphasised the importance of each additional month of breastfeeding, whether exclusive or combined with other foods, in contributing to lower childhood weights. This effect was notably significant for mothers who had overweight or obesity before pregnancy.
The study analysed data from 8,134 mother-child pairs across 21 sites in 16 states and Puerto Rico. It examined BMI and BMIz scores obtained from study visits, medical records, or self-reported information. The research particularly focused on two aspects of breastfeeding: whether the mother ever breastfed and if she was exclusively breastfeeding at three months. The definition of continuous breastfeeding included any breastfeeding duration with the allowance of formula or other food, and the duration of exclusive breastfeeding without formula feeding or other food.
The study found that exclusive breastfeeding at three months was linked to a lower child BMIz score primarily among women with a normal pre-pregnancy BMI. Each additional month of either any or exclusive breastfeeding correlated with a significantly lower child BMIz score, especially for mothers who had overweight or obesity before pregnancy.
Dr. Shipp highlighted the significance of this research for health professionals, suggesting it as an opportunity to promote breastfeeding among all women, particularly those with obesity. The study’s findings have been published in the journal Pediatrics.
Fasting regimen proves effective against obesity-induced cognitive decline
Researchers have recently explored the beneficial effects of intermittent fasting (IF) on neuroinflammation and cognitive decline in a study published in Nutrients. They focused on mice subjected to a high-fat diet (HFD) and examined the impacts of IF on brain health, particularly in the context of diabetic encephalopathy.
Obesity and type 2 diabetes (T2D) are known for their adverse effects on cognitive functions, including memory impairment. These conditions often lead to increased permeability of the blood-brain barrier (BBB), worsening neuroinflammation and memory issues. The disruption in the hippocampal BBB is now seen as an early indicator of diabetes-related cognitive decline.
The study highlighted the role of two proteins, lipocalin-2 (LCN2) and galectin-3 (GAL3), in obesity and T2D-related chronic inflammation. These proteins are believed to be involved in activating harmful immune responses in the diabetic brain through BBB leakage.
The researchers used a mouse model to understand how chronic IF could counteract neuroinflammation caused by LCN2 and GAL3, as well as reduce adipose tissue inflammation. Mice were divided into three groups: normal diet, high-fat diet, and high-fat diet followed by intermittent fasting. The IF group first received an HFD for eight weeks, followed by a regimen of alternating fasting for 22 weeks.
Various tests were conducted, including EchoMRI for body fat measurement, insulin and glucose tolerance tests, and enzyme-linked immunosorbent assay (ELISA) for assessing serum protein levels. Additionally, apoptosis in white adipose tissues (WATs) was measured using the TUNEL assay, and the extent of BBB leakage in the hippocampus was also examined.
The study revealed that mice on a high-fat diet showed increased body weight, body fat, impaired glucose tolerance, and adipocyte death, alongside elevated levels of LCN2 and GAL3. However, intermittent fasting led to significant weight loss, improved insulin resistance, and reduced inflammation in the adipose tissue. This intervention also decreased serum levels of LCN2 and GAL3, reducing BBB leakage, neuroinflammation, and memory deficits.
In conclusion, the study posits that IF could be an effective alternative to continuous caloric restriction. It may improve insulin resistance, reduce adipose tissue inflammation, and mitigate metabolic dysfunctions in obesity and T2D, thereby protecting against cognitive impairment and memory deficits. The findings open new avenues for research into IF as a therapeutic strategy for managing obesity and T2D-related brain health issues.
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Study confirms light exercise effectively counters childhood obesity
Childhood obesity, a growing concern worldwide, might have a surprisingly straightforward solution: light exercise. Recent research led by an international team of scientists from the Universities of Exeter, Eastern Finland, Bristol, and Colorado, underscores the profound impact of light physical activity in combating the rise of obesity in children.
Drawing from the University of Bristol’s Children of the 90s study, the research tracked 6,059 children (53% female) from age 11 to 24. Amid global reports revealing a worrying trend of inactivity among adolescents — with over 80% failing to meet the World Health Organization’s guidelines for daily physical activity — the study presents an urgent narrative. The lack of exercise is anticipated to contribute to 500 million new cases of noncommunicable diseases by 2030, costing an estimated $23 million annually.
What’s striking about the study is the revelation that light physical activity, rather than moderate-to-vigorous exertion, plays a crucial role in reducing fat mass gain in youth. Dr. Andrew Agbaje of the University of Exeter, a key contributor to the study, emphasises the overlooked benefits of light physical activities like walking, household chores, and leisurely swimming. He suggests shifting public health messages from an emphasis on 60 minutes of moderate-to-vigorous activity to encouraging at least three hours of light activity daily.
Participants were observed over 13 years, with physical activity levels and health markers meticulously monitored using waist-worn accelerometers and dual-energy X-ray absorptiometry. The results were startling: each additional minute of sedentary behaviour correlated with a 1.3-gram increase in total body fat mass. In contrast, each minute of light physical activity corresponded to a 3.6-gram decrease in total body fat mass, amounting to a significant reduction of 950 grams to 1.5 kilograms over the study period.
In comparison, moderate-to-vigorous physical activity showed a minimal effect, reducing total body fat mass by only about 0.7 to 1.7 percent. This finding challenges the prevailing public health guidelines, which predominantly advocate for higher-intensity exercise.
The study, published in Nature Communications, calls for a reevaluation of health guidelines and policy statements, urging public health experts, policymakers, and parents alike to promote light physical activity as a key strategy in preventing childhood obesity. As Dr. Agbaje concludes, sustaining light physical activity can be the much-needed antidote to the detrimental effects of a sedentary lifestyle in young populations.
Rates of severe obesity in young American children are escalating, study reveals
A recent study published in the journal Pediatrics presents alarming evidence that severe obesity is on the rise among young children in the United States.
This concerning trend was initially hoped to be an exception for children participating in a government food programme, as earlier research indicated a slight decline in obesity rates about a decade ago among these children. However, the updated findings from 2020 show a rebound in the rate, countering the previous optimism.
National data align with these findings, suggesting that approximately 2.5% of preschool-aged children across the U.S. were classified as having severe obesity during the same period.
“We were doing well and now we see this upward trend,” stated Heidi Blanck of the U.S. Centers for Disease Control and Prevention, one of the authors of the study. “We are dismayed at seeing these findings.”
The study focused on children aged 2 to 4 who were enrolled in the Women, Infants and Children (WIC) programme, which offers healthy food and additional services to preschool-aged children from low-income families. Measurements and weights of the children were recorded for the study.
The researchers observed that 2.1% of children in the WIC programme had severe obesity in 2010. By 2016, this percentage had decreased slightly to 1.8%. However, by 2020, the rate had risen to 2%, equating to about 33,000 of the more than 1.6 million children in the WIC programme.
Twenty states recorded significant increases, with California exhibiting the highest rate at 2.8%. Notable rises were also seen in certain racial and ethnic groups, with the highest rate of approximately 2.8% found among Hispanic children.
Experts warn that severe obesity in early childhood is almost irreversible and is closely linked to chronic health issues and premature mortality.
The reasons for the increase in obesity rates remain unclear, according to Blanck. Some experts had previously attributed the decline in WIC obesity rates to policy changes in 2009, which included adjustments to food packages such as the removal of juice for infants, reduced saturated fat, and increased accessibility to fruits and vegetables.
Despite these policy changes remaining in effect, “the daily hardships that families living in poverty are facing may be harder today than they were 10 years ago, and the slight increases in the WIC package just weren’t enough,” suggested Dr. Sarah Armstrong, a Duke University childhood obesity researcher.
The study faced several challenges, including a decline in the number of children participating in the WIC programme over the past decade. Furthermore, the study period encompassed 2020, the year the COVID-19 pandemic began, leading to fewer parents taking their children for doctor visits and thus a reduction in the amount of complete data available.
Deanna Hoelscher, a childhood obesity researcher at the UTHealth Houston School of Public Health, commended the study despite its limitations, noting that “it gives you a hint of what’s going on.”
Post-2020 developments in childhood obesity rates are yet to be fully understood. Some smaller studies have indicated a significant increase in childhood obesity, particularly during the pandemic, when children were homebound from schools, experiencing disrupted eating and bedtime routines, and reduced physical activity.
“We are thinking it’s going to get worse,” Hoelscher added, highlighting concerns about the trajectory of childhood obesity in the wake of the pandemic.
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NHS reports over 3,000 daily admissions linked to obesity
NHS figures have alarmingly revealed that hospital admissions related to obesity in the UK have doubled in the past six years, now exceeding 3,000 cases daily. This alarming statistic underscores the growing weight problem in the UK, with obesity increasingly exacerbating illnesses and complicating treatments for a diverse group of patients, including expectant mothers, arthritis sufferers, and cancer patients. Notably, hospital admissions due to obesity now outnumber those linked to smoking by threefold. Furthermore, over 20 children are admitted each day due to obesity-related issues, a figure that has also seen a significant rise in recent years.
Government ministers are facing criticism for their perceived inaction on a problem that is not only detrimentally impacting public health but also stunting economic progress. This is after the government decided to postpone stringent anti-obesity measures. The impact of obesity is disproportionately felt in poorer areas, where hospital admissions are twice as likely compared to the wealthiest regions, thus impeding efforts to rejuvenate the labour market.
Luton, in particular, has emerged as the area in England most affected by health issues related to obesity, with one in every 20 residents admitted to hospital due to weight-related problems last year. This rate is more than tenfold higher than that in Bracknell Forest, which recorded the lowest rate.
Recent data estimates the annual cost of obesity to the UK economy at a staggering £98 billion, encompassing both NHS treatment costs of £19 billion and economic productivity losses amounting to £15 billion. NHS Digital’s latest figures for England reveal a record 1.2 million admissions where obesity was a factor in 2022-23, a significant increase from 617,000 in 2016-17. These admissions include cases where obesity was the primary reason for hospitalisation, often for bariatric surgery, as well as numerous instances where obesity was a secondary diagnosis, either contributing to hospital stays or complicating treatments.
Among those most affected are pregnant women, with 147,143 maternity admissions where obesity was a complicating factor for either the mother or child. Other conditions such as arthritis, gallstones, breast cancer, heart disease, and general pain also contributed to more than 10,000 admissions annually.
Daisy Cooper, Deputy Leader of the Liberal Democrats, criticised the government for missing multiple opportunities to foster a healthier living environment in the UK. She stressed that investing in public health would alleviate the burden on the NHS and bolster the economy by enabling more people to work.
The figures reveal a concerning trend among the younger population, with 8,261 admissions among under-16s, a significant increase from 4,062 in 2016-17. In the ten most deprived areas, there were 3,393 admissions per 100,000 people for obesity, more than double the rate in the wealthiest tenth.
Areas such as Gloucestershire, Southampton, Salford, Rotherham, Bradford, and much of east London have recorded rates above 4,000 per 100,000 people. In contrast, Bracknell Forest reported a rate of 420 per 100,000, with Windsor, Wokingham, Slough, Oxfordshire, Reading, and Brighton all reporting rates below 1,000.
In response to its high obesity rate, Luton has recently implemented a ban on advertising unhealthy food on council-owned properties. The rise in obesity-related admissions is partly attributed to increased medical awareness of the conditions excess weight can cause. However, local differences in how obesity is recorded also influence these statistics.
Victoria Atkins, the Health Secretary, has expressed a preference for focusing on healthy-living advice over measures she has termed “nanny-statish”, a stance that has disappointed health campaigners. Cooper has called for the revival of delayed plans for a 9pm watershed on junk food advertising and a ban on buy-one-get-one-free deals on unhealthy food. She also advocated for increased funding for public health initiatives at the council level.
Admissions for weight-loss surgery have not returned to pre-pandemic levels, with 5,099 admissions last year compared to over 6,000 five years ago. This decline in admissions where obesity is the primary reason is attributed to pressures on the NHS.
Despite this, 638 children under 16 were admitted primarily for obesity, nearly matching pre-pandemic figures. In response to these concerning trends, a government spokesman highlighted measures like compulsory calorie labelling and healthy food vouchers for low-income households. The spokesman emphasised the government’s commitment to tackling obesity across all socio-economic groups and in deprived areas, recognising it as a major cause of cancer.
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US panel of health experts advocate early interventions for childhood obesity from age 6
A panel of U.S. health experts has put forth a draft recommendation advocating for children with obesity to begin receiving comprehensive counselling aimed at fostering healthy eating and exercise habits, starting at the age of 6. This guidance, issued by the U.S. Preventive Services Task Force (USPSTF), builds upon their 2017 recommendation which suggested that obesity screening should commence from the same age.
Recent research underscores the value of intensive behavioural interventions, defined as a minimum of 26 hours of counselling with one or more health professionals, in aiding children and adolescents to achieve and maintain a healthy weight and enhance their overall quality of life. However, the recommendation does not set a specific timeframe for these interventions.
The USPSTF’s updated advice does not delve into the use of weight-loss medications like Novo Nordisk’s Wegovy, approved for use in children aged 12 and above, nor does it address surgical options. The Task Force reviewed evidence surrounding weight-loss medications but noted that further research is needed to fully grasp the long-term health impacts of such treatments.
According to Dr. Katrina Donahue from the University of North Carolina School of Medicine and a member of the Task Force, the proposed behavioural interventions encompass a combination of physical activity, behaviour change support, and education on healthy eating. Recognising that available resources vary by location, Donahue acknowledged that the implementation of these interventions might differ across cities.
The recommendation is backed by data from 58 randomised controlled trials involving over 10,000 children, which demonstrated the effectiveness of these interventions when a child engages in at least 26 hours of professional contact. The evidence for these intensive interventions received a “grade B” from the USPSTF, indicating high certainty of at least moderate benefit. The children in these trials lost an average of 4 to 6.5 pounds (approximately 2 to 3 kilograms), with the reductions being sustained for at least a year.
Childhood and adolescent obesity, through the age of 19, is defined as having a body mass index (BMI) – a weight-to-height ratio – higher than that of 95% of peers of the same age and gender. Nearly one in five U.S. children and teenagers are categorised as having obesity, based on data from the U.S. Centers for Disease Control and Prevention (CDC).
The American Academy of Pediatrics (AAP) guidelines also endorse lifestyle support, including over 26 hours of face-to-face, family-based, multicomponent treatment spanning 3 to 12 months. Additionally, the AAP recommends paediatricians consider weight-loss drugs for children with obesity aged 12 and over and to refer adolescents aged 13 and older with severe obesity for metabolic and bariatric surgery evaluation.
The USPSTF’s draft recommendation is open for public comment until the 16th of January 2023, inviting a wider discourse on the proposed approach to tackle childhood obesity.
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US study uncovers key gut metabolite’s role in combating obesity
Vanderbilt University researchers have made a groundbreaking discovery about the role of gut microbiota in obesity prevention. Published in the journal Cell Host & Microbe, their study reveals that bacteria in the small intestines produce a compound crucial for guarding against obesity. This finding sheds light on how disruptions in the microbiota, such as those caused by early-life antibiotic exposure, can increase childhood obesity risks.
One of the study’s key insights is the potential for probiotic bacteria, or the compounds they produce, to serve as preventive measures against antibiotic-associated childhood obesity. “Previous studies have indicated that either antibiotics or a high-fat diet can lead to obesity later in life by disturbing the microbiota,” explained Mariana Byndloss, DVM, PhD, assistant professor of Pathology, Microbiology and Immunology at Vanderbilt. “Our aim was to investigate the combined effect of these risk factors, which children often face simultaneously.”
Under the guidance of graduate student Catherine Shelton, who is the first author of the paper, the research team developed a model using young mice exposed both to antibiotics and a high-fat diet. This dual exposure led to increased weight gain, adiposity, and metabolic dysfunction in the mice.
The team’s investigation pinpointed a disruption in the small intestine microbiota caused by the combination of antibiotics and a high-fat diet. This disruption led to decreased levels of beneficial Lactobacillus bacteria and a corresponding reduction in a metabolite they produce, known as phenyllactic acid. The researchers identified phenyllactic acid as a regulator of a fat metabolism pathway in intestinal epithelial cells — the cells lining the intestines.
Byndloss noted, “The absence of this specific microbe and its metabolite changes how intestinal epithelial cells process fat, leading to increased fat in the bloodstream. Normally, phenyllactic acid instructs these cells to limit fat packaging and secretion. When this microbial signal is lost, the cells behave differently, resulting in increased obesity in mice.”
This discovery opens up the possibility of using phenyllactic acid or Lactobacillus bacteria as interventions for obesity, particularly in children undergoing antibiotic treatment. Lactobacillus is commonly found in probiotic supplements and in fermented foods like kombucha, kimchi, and probiotic milk products popular in Asia.
“Some cultures already have a practice of giving children fermented milk, which might be inadvertently providing this protective compound,” added Byndloss.
In the study’s mouse model, exposure to antibiotics alone did not lead to weight gain; it was the combination of antibiotics and a high-fat diet that heightened obesity risk. Byndloss suggests a healthy diet with limited excess dietary fats as a way to mitigate the negative impact of antibiotics on the microbiota.
Surprisingly, the researchers found that intestinal epithelial cells play a significant role in weight gain. “We usually associate obesity with adipose tissue and the liver, not intestinal cells. It was unexpected that a single metabolite acting on these cells could have such a profound effect in preventing weight gain,” Byndloss remarked.
Ongoing studies by Byndloss and her colleagues are exploring the role of Lactobacillus and phenyllactic acid in early life, particularly during breastfeeding. Given the high fat content in breast milk, the team is investigating whether this pathway offers protective benefits against obesity from a very early age.
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