Obesity Care

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.

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.

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.

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.

Pomegranate proves potent in metabolic health management

A comprehensive study featured in Nutrients journal has cast a spotlight on pomegranate (Punica granatum l., PG) and its polyphenolic compounds, scrutinising their potential to modulate metabolic irregularities. Historically embraced for its therapeutic properties against bacterial infections, diabetes, and various metabolic syndromes, pomegranate’s efficacy is being re-evaluated amidst concerns over the side effects of conventional pharmacological treatments.

The review delves into pomegranate’s pharmacokinetic profiles, safety, and bioavailability, particularly focusing on its capacity to combat metabolic disorders such as type 2 diabetes, obesity, dyslipidemia, and cardiovascular diseases. It outlines how PG’s consumption could attenuate insulin resistance, inflammatory cytokines, redox gene expression, blood pressure elevation, vascular damage, and lipoprotein oxidation.

In animal models, pomegranate seed oil has been found to reduce fat mass and enhance insulin sensitivity, corroborating previous research indicating significant reductions in lipid levels. The study further explains how enzymes and nuclear receptors involved in lipid metabolism are positively influenced by PG’s floral components.

Despite some contradictory findings regarding PG’s impact on food intake and weight gain, the review suggests genetic differences may account for varied physiological reactions to phytochemicals. PG polyphenols are also being explored for their anti-diabetic properties through diverse mechanisms, including modulation of PPAR-γ activity and adiponectin gene expression.

The review also evaluates the pharmacodynamics and safety of PG’s ellagitannin compounds, noting individual differences in urolithin production and absorption, which are influenced by factors such as gut microbiota composition and pH. Although high doses of PG have shown cellular and nuclear alterations in toxicological studies, conventional uses of PG and its compounds appear safe, with adverse effects only predicted at dosages exceeding those traditionally used in ethnomedicine.

In conclusion, the research indicates that PG could play a beneficial role in preventing metabolic disorders. However, the outcomes of clinical and pharmacokinetic studies remain variable, attributed to factors like plant part selection, cultivar differences, environmental conditions, bioavailability, organ accessibility, and individual genetic profiles. Despite these discrepancies, the therapeutic potential of PG in addressing components of metabolic syndrome highlights the need for integrated treatment strategies.

Obesity triggers neurodegeneration by inducing brain insulin resistance

In a pivotal study conducted by Mroj Alassaf and colleagues at the Fred Hutchinson Cancer Research Center in the United States, a novel connection between obesity and the onset of neurodegenerative diseases, such as Alzheimer’s, has been uncovered.

The research, employing the biological model of the common fruit fly, indicates that diets high in sugar, which are commonly associated with obesity, lead to insulin resistance within the brain. This resistance hampers the brain’s capacity to eliminate cellular waste, which in turn elevates the risk of neurodegenerative conditions.

The findings, released on November 7 in the open-access publication PLOS Biology, promise to be influential in the development of medical interventions aimed at mitigating the chances of neurodegenerative disease onset.

While the correlation between obesity and neurodegenerative diseases like Alzheimer’s and Parkinson’s has been acknowledged in scientific circles, the causal mechanisms at play have eluded researchers until now.

The team’s research delved into this conundrum by leveraging the genetic and physiological parallels between fruit flies and humans. Building on prior knowledge that a diet rich in sugar instigates insulin resistance in the peripheral tissues of fruit flies, the focus now shifted to their neural tissues. The study zoomed in on glial cells, as abnormalities in microglia are recognised contributors to neuronal decay.

The study measured the protein PI3k—a biomarker for insulin sensitivity in cells. The high-sugar diet was found to diminish PI3k levels in glial cells, suggesting a state of insulin resistance. The team also examined the fruit fly’s version of microglia, known as ensheathing glia, responsible for clearing out neuronal waste, including deteriorating axons.

These glial cells exhibited depleted levels of Draper, a protein integral to their waste-removal function, indicating a compromised ability. Subsequent experiments demonstrated that artificially reducing PI3k levels not only caused insulin resistance but also led to decreased Draper levels in the ensheathing glia. Moreover, when the team inflicted damage on olfactory neurons, the ensheathing glia of sugar-fed flies failed to clear the resulting neuronal debris due to their unresponsive Draper levels.

The researchers conclude by stating that their work with fruit flies has established that high-sugar diets induce insulin resistance in glial cells, which disrupts their neuronal cleanup role. This study sheds light on the potential pathways through which diets leading to obesity may elevate the risk of neurodegenerative diseases.

New study finds obesity in pregnancy raises risk of future heart disease

The link between maternal obesity and the long-term risk of cardiovascular disease has been further solidified by new research findings. A study led by Northwestern University in the United States has shone a light on the significant health risks faced by women who enter pregnancy with obesity.

The research team discovered that women with obesity before conception are more susceptible to complications during pregnancy than their counterparts with healthier pre-pregnancy weights. These complications include conditions like pre-eclampsia and gestational diabetes, which have previously been associated with an increased risk of heart disease later in life.

The study’s principal investigator, Dr. Sadiya Khan, emphasised that while these pregnancy-related issues can indeed signal future cardiovascular problems, they are not the underlying cause of heart disease. Instead, they merely highlight pre-existing risk factors that become apparent during the metabolic and physical demands of pregnancy.

To reach these conclusions, the researchers analysed health data from 4,216 women who were giving birth for the first time. They observed that those with higher body mass indices (BMIs) in the first trimester had an elevated risk of developing hypertensive disorders during pregnancy than those with BMIs within the normal range.

Dr. Khan explained that the study approached pregnancy as a ‘natural stress test’ for the heart, which could expose pre-existing health concerns. The implications of these findings underscore the importance of addressing pre-pregnancy obesity with proactive health interventions rather than waiting for cardiovascular events to occur.

The research team is advocating for healthcare providers to emphasise the importance of a nutritious diet and regular physical activity during prenatal visits. While weight loss is not recommended during pregnancy, guidance and support for maintaining an appropriate weight gain during this period are crucial.

The study also presented quantitative insights, revealing that among the participants, 4% had gestational diabetes and 15% encountered complications due to high blood pressure.

These findings, which align with prior research advocating for weight management during pregnancy through diet and exercise, have been published in the journal Circulation Research, providing valuable insights for expectant mothers and healthcare professionals alike.

Obesity’s role in severe flu outcomes unveiled by new study

Researchers in a pivotal study recently featured in Nature Communications have uncovered vital insights into why individuals with obesity are at an elevated risk for severe influenza. This comprehensive investigation combines both human clinical data and animal model analysis to unravel the complexities of immune response in obesity that heighten the vulnerability to influenza.

The global health landscape is facing a critical challenge with the rising prevalence of obesity, affecting over 13% of adults worldwide. The risks associated with obesity have been underscored during viral pandemics, such as the H1N1 outbreak and the recent COVID-19 pandemic, where obesity has been consistently linked with worse outcomes and heightened severity of respiratory infections.

This latest study seeks to bridge the knowledge gap in understanding how obesity mechanistically contributes to increased susceptibility to viral infections, beyond the recognised impacts of altered lung function, cardiovascular issues, and metabolic disturbances.

Researchers embarked on a meticulous study design, sampling blood and airway cells from individuals with obesity —those with a BMI over 35 kg/m^2—undergoing bariatric surgery. The study meticulously matched these participants with control subjects of normal weight, ensuring parity in age, gender, and ethnicity.

The investigative team conducted thorough clinical sampling using state-of-the-art techniques, including blood analysis, nasal synthetic absorptive matrix (SAM) sampling, and bronchoscopy.

A suite of laboratory experiments followed. These involved exposing various cell types, including bronchoalveolar lavage (BAL) cells and bronchial epithelial cells (BECs), to different strains of influenza viruses. The response of these cells was measured through advanced techniques like RNA extraction, protein quantification, and a range of assays including flow cytometry and metabolomics.

In vivo studies also played a role, with mice models used to examine the effects of administering recombinant mouse leptin followed by influenza virus infection. This holistic approach aimed to dissect the immune response in both the peripheral and airway-specific compartments.

The study’s findings are eye-opening. Contrary to initial assumptions, the researchers found no significant difference in the response of bronchial epithelial cells between individuals with obesity and individuals of a  normal-weight, suggesting that epithelial inflammation is not inherently altered in those with obesity during influenza infection.

However, the study did identify a significant compromise in the antiviral responses of BAL macrophages from patients with obesity. These cells displayed a reduced induction of critical interferons, such as IFN-α, IFN-β, and IFN-λ, which are vital components of the body’s antiviral defence system. Moreover, the production of key pro-inflammatory cytokines like IL-6, IL-8, and TNF was found to be less effective in individuals with obesity.

Metabolomic analysis of the BAL fluid identified significant changes in metabolite levels in patients with obesity, providing a clue to altered biochemical pathways in the lungs due to obesity.

The data from the MOSAIC cohort added a further layer of understanding, highlighting that immune dysregulation in patients with obesity was confined to the airway mucosa, with no significant systemic immune disturbances.

The study’s revelations pave the way for potential therapeutic strategies, including the manipulation of leptin pathways, which may be pivotal in mitigating the risk of severe influenza infections in populations with obesity.

By casting light on the molecular and immunological shifts that occur in the context of obesity, this research could form the foundation for developing tailored interventions that bolster the immune response in this high-risk group, enhancing their resilience to influenza and other viral respiratory infections.

Teachers could play a major role in combating childhood obesity

Recent scholarly insights have underlined a potentially transformative role that educators can play in combating the alarming rates of childhood obesity, particularly in the United States (US). As published in the reputable journal Nutrients, a meticulous study embarked on an exploratory journey to gauge the impact teachers could make in mitigating this health crisis among the younger generation.

The roots of childhood obesity have embedded themselves deep within the US, displaying a consistent upward trend, with a pronounced prevalence in disadvantaged regions. The escalating concern has drawn concerted interventions from health authorities at local, state, and federal levels, spotlighting schools as pivotal arenas for executing preventative measures.

At the heart of these initiatives lies an appreciable emphasis on the instrumental role of teachers. By being on the frontlines of programme delivery, they emerge as invaluable assets in recognising and diffusing obesity-curbing strategies among students. However, the pressing commitments inherent to the teaching profession pose a formidable challenge to prioritising their health – a dilemma exacerbated by the outbreak of the COVID-19 pandemic, which brought to light the imperative of maintaining teacher well-being.

In 2022, a seminal report from the RAND Corporation shed light on a concerning level of job-induced stress among teachers, pointing towards a positive correlation between employer-facilitated wellness programs and reduced stress levels. Multiple strands of research echo a similar sentiment: a robust student-teacher rapport is a cornerstone for fostering student engagement, regular attendance, enhanced emotional well-being, and an overall conducive academic atmosphere.

An investigative team from the American University, Washington, orchestrated an elaborate five-year intervention venture beginning in 2017. The primary objective was to immerse educators in a milieu of nutrition literacy, aimed at equipping them with the requisite skill set to impart obesity-preventive knowledge among elementary scholars in Washington, DC. The study encapsulated four schools, two of which were designated as control while the others were intervention cohorts. Teachers, pivotal to this initiative, furnished demographic details and partook in Teacher Health Surveys before and subsequent to the intervention period.

Survey feedback, encapsulated through a Likert scale, facilitated an overall health score, amalgamated from various metrics including chronic conditions, self-efficacy, health education ideologies, and general health standings. The project’s crux was to evaluate the influence of a professional development scheme on augmenting teachers’ capacity to infuse nutrition-centric discourse into their pedagogical regimen.

Each intervention session commenced with a wellness-centric activity, transitioning into a demonstration lesson from “Serving up MyPlate: A Yummy Curriculum.” Teachers at the intervention forefront were required to integrate a minimum of three nutrition-dedicated lessons throughout the academic year. To measure the pedagogical impact, a Student Nutrition Literacy Survey was administered at both the outset and the conclusion of the intervention.

The data depicted a collective participation of 92 educators from both the control and intervention factions. The demographic backdrop of these teachers showcased a reasonable level of uniformity across the schools. An age average of 36 years, a predominant female representation (84.8%), and a significant Black demographic (68.5%) constituted the participant profile.

A cadre of 55 teachers from the intervention spectrum attended the professional development suite, orchestrating 71 nutrition-oriented lessons. A meticulous Poisson regression analysis unearthed a predictive association among job stress, professional development attendance, and self-efficacy towards the incorporation of nutrition lessons. An incremental self-efficacy score and each additional session attendance manifested a 25% and 48% increased likelihood, respectively, of infusing nutrition lectures into the curriculum. Interestingly, a stark inverse relation was observed between stress levels and self-efficacy scores.

The investigative lens also focused on the ripple effect of health scores, lesson implementations, and aggregate health scores. A noticeable inverse relationship emerged between lesson execution and stress levels, indicating that session attendance contributed to lower stress levels among teachers. Moreover, a higher aggregate health score was recorded for teachers who integrated three or more nutrition lessons compared to their counterparts. The student demographic, comprising both intervention and control schools, showcased a balanced representation concerning age, gender, and grade level.

The baseline knowledge levels didn’t exhibit significant discrepancies between the students of intervention and control schools. However, a commendable uptick in scores was observed among students of the intervention cohort who were recipients of nutrition education from session-attending teachers. Notably, students exposed to three or more nutrition lessons reflected a 10% enhancement in their scores compared to those receiving two or fewer lessons.

The observations evinced the practicability and sustainability of a short-term professional development module aimed at fostering teacher health while concurrently advancing nutrition education. It’s imperative to highlight that although the rise in healthful eating awareness is promising, it doesn’t necessarily translate to a behavioural modification. A holistic approach to enhancing student health necessitates a foundational support structure for teacher health, underscoring the necessity of workplace professional development.

Empowering teachers with a robust knowledge repository, a wealth of resources, and adeptness in managing their health not only transforms them into educational conduits but also as potent change agents in the classroom. By co-opting teachers as collaborative partners in the quest to curb childhood obesity, a more structured pathway towards attaining health equity is envisioned. The study, in essence, reinforces the potential of a professional development framework as a viable stratagem in advancing teacher well-being and fortifying the bulwark against childhood obesity.

Rising obesity levels may intensify menopause symptoms and reduce hormone therapy efficiency, preliminary study indicates

The global surge in obesity, with an estimated 13% of adults now grappling with the condition, is a growing concern. A recent report suggests that obesity prevalence is higher among women than men (15% vs. 11%), with a more pronounced incidence in developed nations. Particularly in the United States, data from the Centers for Disease Control and Prevention (CDC) reveals that in 2020, 41.9% of individuals aged 20 and over were categorised as having obesity.

The far-reaching health implications of obesity are well-documented, encompassing a higher propensity for heart attacks, strokes, type 2 diabetes, respiratory ailments, and musculoskeletal issues.

A nascent study unveils a potential additional concern: obesity might amplify the severity of menopausal symptoms and compromise the effectiveness of hormone therapy aimed at alleviating these symptoms. The study’s lead author, Dr. Anita Pershad from the Eastern Virginia Medical School, shared her insights stating, “The core inference from our study is that obesity might exacerbate a woman’s menopausal symptoms while concurrently diminishing the relief provided by hormone therapy (HT).”

However, Dr. Kara McElligot, a NAMS-certified menopause practitioner and medical advisor at Mira, underscored the preliminary nature of this investigation, which encompassed a mere 119 participants and was executed retrospectively via chart review, thus inheriting a higher risk of bias.

The research, though yet to be peer-reviewed, was showcased at the 2023 Annual Meeting of The Menopause Society in Philadelphia, held between September 27 and 30. The study, spanning five years, meticulously reviewed the medical records of 119 women visiting a menopause clinic. These women were segregated into two cohorts based on their Body Mass Index (BMI)—those with a BMI above 30 were categorised as having obesity, while those below this threshold formed the other group.

The evaluation revealed no substantial disparity between the groups concerning age, the extent of menopause, hormone therapy utilisation, and acceptance. However, a significant finding emerged: women with obesity exhibited a higher propensity to report symptoms such as vasomotor symptoms (hot flashes), genitourinary/vulvovaginal symptoms, mood fluctuations, and diminished libido.

Dr. Sherry Ross, a seasoned OB/GYN at Providence Saint John’s Health Center in Santa Monica, elucidated a plausible cause, positing that women with obesity might experience intensified hot flashes and night sweats as fatty tissues could act as insulators, retaining heat within the body. Another theory proposes that obesity might trigger hormonal imbalances, thus engendering elevated oestrogen levels which, in turn, could exacerbate menopausal symptoms.

Dr. Ashley Parr, D.O., OB/GYN at The Women’s Hospital at MemorialCare Saddleback Medical Center, concurred with this notion, adding that the oestrogen-producing capability of fat cells could potentially alter the hormonal equilibrium of women with obesity during menopause, even post the cessation of ovarian function.

Moreover, the research identified a diminished likelihood of symptomatic relief post systemic and/or localised hormone therapy among women with obesity, compared to their counterparts without obesity. Dr. Pershad disclosed ongoing inquiries into the ambiguous efficacy of hormone therapy among women with obesity.

She further discussed exploring alternative designs and administration routes to potentially enhance hormone therapy effectiveness. Concurrently, Dr. Parr highlighted that obesity-associated risks for other health conditions like heart disease and breast cancer could deter the choice of hormone replacement, prompting considerations for non-hormonal treatment alternatives such as SSRIs, SNRIs, and vaginal oestrogen based on the specific symptoms sought to be addressed.

Dr. McElligot delineated the conceivable reasons behind the diminished effectiveness of hormone therapy in women with obesity, referring to various factors influencing the severity and experience of oestrogen deficiency, with obesity being a prime contender. She also brought attention to liver drug metabolism studies that reveal variations in circulating drug quantities based on BMI among adults, shedding light on the possible need for revising hormone therapy dosing recommendations to cater to the distinct metabolic dynamics presented by obesity.

Student’s bad eating habits could herald lifelong illness

Recent research emerging from UBC Okanagan delivers a stern warning: the unhealthy eating habits fostered during one’s university tenure could set the stage for a lifetime mired in significant health challenges, including obesity, respiratory ailments, and depression.

The caution comes from Dr. Joan Bottorff, a distinguished Professor affiliated with UBCO’s School of Nursing, who is part of a global team of investigators delving into the dietary habits of university attendees. The extensive study encapsulated the dietary patterns of nearly 12,000 medical scholars from a total of 31 universities located in China, striving to decipher the correlation between dietary behaviours, obesity, and a gamut of diseases.

Dr. Bottorff emphasised the crucial fact that the foundations for many unhealthy eating patterns are laid during the university phase and could persist for a substantial duration of an individual’s life.

“There’s a considerable amount of data that outlines how the consumption of high-calorie meals and sugar-laden foods and beverages by many students during this period can be a precursor to obesity,” Dr. Bottorff stated. While she acknowledged that these aren’t the sole contributing factors to obesity, they are significant and warrant attention.

The groundbreaking study, which recently graced the pages of Preventive Medicine Reports, was spearheaded by Dr. Shihui Peng from the School of Medicine at Jinan University in China. Although prior research robustly associates unhealthy diets with numerous chronic diseases, this particular inquiry aimed to unveil the link between poor dietary habits and infectious diseases, including common colds and diarrhoea.

Dr. Bottorff highlighted that while the structure of the study didn’t allow for a cause-effect demonstration, the association between unsound eating habits, obesity, and respiratory diseases was robustly substantiated.

She further brought to light the biomedical research backing the nexus between obesity and infectious diseases, a linkage further spotlighted amidst the COVID-19 pandemic. Dr. Bottorff explained, “Recent studies concerning COVID-19 reveal a tendency of individuals with obesity experiencing severe symptoms and outcomes, with explanations pointing towards compromised breathing due to excess weight and subpar inflammatory and immune responses.”

The quintessence of the problem, as per Dr. Bottorff, is rooted in the high-sugar, high-calorie dietary routine embraced by many students, which potentially morphs into a long-term plight, as these habits could segue into obesity. Moreover, she noted a vicious cycle where stress and anxiety could trigger overeating, which in turn could lead to further stress and depression.

She underscores the importance of not overlooking this perilous trend among university-goers, where a substantial fraction is known to indulge in unhealthy diets. “The nutritional quality of the food they consume is directly tied to obesity, which opens the gates to a host of other health issues extending beyond chronic diseases to infectious diseases,” she reiterated.

Dr. Bottorff recommends a university-wide initiative where students are educated on the principles of healthy eating. Additionally, she stresses the imperative for institutions to shoulder the responsibility of offering healthy and affordable food alternatives to the entire student body.

Reflecting on the matter, Dr. Bottorff advocated for a thorough examination of the food environment presented to students, ensuring that cafeterias and vending machines are stocked with healthy food choices. The collaborative effort between UBC Student Wellness and Food Services is a move in the right direction, addressing food security and literacy to mitigate the adverse impact of unaffordable food options and university-induced stress on students’ dietary choices.

Students facing food insecurity now have the recourse of a low-barrier food bank and a meal share program. Concurrently, the culinary team at UBCO Food Services, working in tandem with a registered dietitian, has been prioritising locally sourced, organic, and sustainably produced ingredients to diversify the food options available.

Encouraged by the progress, especially with healthier choices being more accessible in cafeterias and the reorganisation of vending machine items to place healthier options at eye level, Dr. Bottorff acknowledges the strides taken by many post-secondary institutions in addressing these issues. “The momentum gathered over the last four or five years is heartening,” she remarked, “It’s a positive deviation from the past, although there’s still a long journey ahead to fully tackle this issue.”

Unprecedented surge in applications for obesity medicine certification among U.S. physicians

The realm of obesity medicine is witnessing a remarkable influx of interest among U.S. physicians, showcased by a record-setting number of nearly 1,900 applicants aspiring to gain certification in this burgeoning field, as per recent figures released by the American Board of Obesity Medicine (ABOM). The forthcoming certification examination slated for October has garnered the participation of 1,889 physicians, portraying a significant ascent from the 1,001 candidates recorded in the previous year, a steep rise of 88.7%.

This amplified inclination towards obesity medicine certification among physicians parallels the soaring demand among patients for GLP-1 receptor agonist medications, namely Ozempic and Wegovy. The escalating appeal of these medications is underscored by the remarkable sales figure of Ozempic, which, as of August 2023, eclipsed $3 billion in the U.S. market.

Since its inception in 2012, the obesity medicine certification has been bestowed upon over 6,700 physicians. The profile of attendees for the upcoming October exam delineates a diverse representation, with 38% being internal medicine physicians and 30% specialising in family medicine. A prerequisite for appearing in the certification exam mandates physicians to accrue a minimum of 60 continuing medical education credits focusing on obesity.

The burgeoning interest in obesity medicine is also echoed in the sentiments shared by Dr. Judith Korner, MD, PhD, the board chair of ABOM, in a statement released on September 20. Dr. Korner emphasised that numerous diplomats have conveyed their pursuit of certification as a testament to their adeptness and knowledge in addressing obesity—a domain which often receives scant attention during their preceding medical instruction.

Dr. Korner further elucidated that the acknowledgment of obesity as a multifaceted chronic ailment, coupled with the progressive strides in devising efficacious treatment modalities, is fuelling the aspirations of physicians to render optimal care for individuals grappling with obesity. This, she believes, is the propelling force enticing a growing number of physicians towards this rapidly evolving medical frontier.
The establishment of ABOM in 2011 marked the genesis of a structured pathway for physicians to garner expertise in obesity medicine, and the current surge in applications embodies the expanding recognition and relevance of this medical specialty in contemporary healthcare paradigms.

The College of Contemporary Health, based in the United Kingdom, is also a pioneer in the field of education in obesity care and weight management, offering students from around the world certification in the field in the form of both postgraduate education and continuing professional development. Find our prospectus here to learn more.