Obesity Care

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.

Prolonged consumption of artificial sweeteners could elevate obesity risks, study finds

A recent study has established a concerning connection between long-term intake of artificial sweeteners such as aspartame and saccharin, as well as diet sodas, and an augmented risk of obesity. The findings were featured in the International Journal of Obesity, following an extensive examination of the relationships between the consumption of these substances and a variety of health parameters.

Undertaken as part of the Coronary Artery Risk Development in Young Adults (CARDIA) initiative, the research embraced a diverse participant group of 5,115 individuals, comprising both black and white men and women. The focal point of the study was to dissect the potential relationships between artificial sweetener and diet beverage consumption and the volumes of visceral adipose tissue (AT), intermuscular AT, and subcutaneous AT, while accounting for demographic factors and lifestyle elements such as total caloric intake and adherence to healthy eating guidelines.

Over a span of 25 years, 3,088 individuals — including 869 black women, 867 white women, 590 black men, and 762 white men aged between 18 and 30 at the onset — were rigorously examined, with their dietary intakes tracked at intervals of the inception, the 7th year, and the 20th year. This meticulous approach allowed for a nuanced breakdown of aspartame and saccharin consumption patterns across quintiles and tertiles, respectively.

Drawing a strong parallel between heightened artificial sweetener intake and expanded volumes of all three types of AT assessed — visceral, subcutaneous, and intermuscular — the study spotlighted worrying trends. Individuals in the uppermost quintile of aspartame consumption demonstrated greater AT volumes in comparison to those in the lowest quintile. Furthermore, higher aspartame intake was associated with pronounced increases in body mass index (BMI), weight, and waist circumference throughout the quarter-century follow-up period.

Similar trends were observed in saccharin consumption, with the highest tertile group reporting up to 14% higher subcutaneous AT alongside substantial augmentations in BMI, weight, and waist circumference. The consumption of diet beverages mirrored these patterns, revealing significant escalations in AT volumes and BMI in those indulging more frequently in these drinks.

Although sucralose intake depicted an upward trajectory in BMI and weight, it remained distinct by not showing a noticeable impact on AT volumes or anthropometric changes over the long-term period studied.

This seminal study foregrounded the alarming implications of prolonged artificial sweetener intake, connecting higher consumption levels with a substantial upswing in obesity risks — with the upper quintiles exhibiting up to a 78% greater propensity for obesity compared to their lower quintile counterparts.

Despite offering unprecedented insights, the research is cognisant of potential limitations including self-reporting biases and the possible influence of altered microbiomes on adipogenesis.

In light of these potent revelations, the researchers advocate a reevaluation of prevailing national advisories encouraging the substitution of added sugars with artificial sweeteners. Highlighting the potential adverse health repercussions of both options, the study calls for a more nuanced approach to fostering healthier dietary choices.

New research links early adolescent weight gain to higher depression risks in teen years

Recent studies indicate a strong correlation between elevated body mass index (BMI) in children and increased instances of depression during their teenage years. This correlation, as pinpointed in the comprehensive research conducted by King’s College London, has flagged early adolescence as a critical period wherein weight gain can significantly influence the onset of depressive symptoms later on in life.

The King’s College London team analysed data from over 10,000 twins born from 1994 to 1996, charting their height and weight at ages 12, 16, and 21 to determine their BMI. Additionally, the young participants filled out questionnaires that helped monitor depression symptoms such as feelings of loneliness, low moods, and exhaustion.

The insights derived from the research underscored a higher tendency among children with overweight to develop depression, a risk amplified the earlier in life they started to experience weight issues. Particularly, the span between 12 and 16 years was identified as a “sensitive point,” with weight gains during this period more strongly linked to later depression compared to gains between the ages of 16 and 21.

Senior co-author of the study, Thalia Eley, Professor of Developmental Behavioural Genetics, highlighted the significant role of early adolescence in the co-evolution of obesity and depressive tendencies. She further underscored the urgency of adopting a proactive approach to fostering positive body image and wellbeing, as opposed to merely focusing on weight, to thwart the onset of depression in later years.

Echoing these sentiments, the study’s principal author, Dr. Ellen Thompson emphasised the imperative need to unravel the intricacies of the mental health-weight nexus in adolescence to devise timely and effective support mechanisms. While the current study did not delve into the underlying causes of the observed relationship, earlier studies have pointed to factors like body dissatisfaction and external weight-related stigma as potent triggers.

In light of the increasing concerns around obesity and mental health disorders amongst the UK’s youth — a demographic where one-third have overweight or obesity by the time they finish primary school — the researchers propose that educational institutions integrate positive body image narratives in their curriculum.

These recommendations come against a backdrop of an alarming rise in child mental health crises, exacerbated by the COVID-19 pandemic, and sustained school closures which have put unprecedented demand on the NHS’s mental health services for young people. According to recent statistics, one in four older teenagers are grappling with “probable” mental health disorders, a spectrum that encompasses depression and anxiety symptoms.

Furthermore, the persistent pressures from social media and the bottleneck created by long waiting lists for accessing mental health services portray a grim landscape for the younger generation. The scholars behind the study press for urgent interventions to mitigate this rapidly spiralling crisis, urging for a renewed focus on promoting a healthy body image to stave off depression and foster mental wellbeing among youth.

Obesity-linked heart deaths triple in 20 years

Recent research disclosed a concerning surge in the number of US adults succumbing to heart disease where obesity was cited as a pivotal contributing factor, exhibiting a threefold rise between 1999 and 2020. This alarming revelation was documented in a study published in the Journal of the American Heart Association, leveraging data encapsulated in the comprehensive database curated by the Centers for Disease Control and Prevention (CDC).

Analysing death certificates facilitated a granular examination of the escalation in obesity-correlated cardiac deaths over the span of two decades. The researchers pinpointed a total of 281,135 heart disease fatalities attributed to obesity during the period under scrutiny. This translated to a tripling of the death rate, spiralling from a rate of 2.2 per 100,000 individuals to a significant 6.6 deaths per 100,000 populace, thereby showcasing a worrying trend in health outcomes related to obesity.

Ironically, this spike unfolded amidst a nearly 18 percent decrement in overall heart disease mortalities from 1999 to 2020, pointing towards a deep-seated issue relating specifically to obesity-linked cardiac ailments.

The racial and gender disparities were stark, with the black populace shouldering a higher mortality rate compared to other racial cohorts. Moreover, a gendered analysis revealed a preponderance of these deaths amongst males, albeit black females demonstrated a marginally elevated mortality rate relative to their male counterparts.

Obesity, delineated as a profound risk catalyst for heart disease, presently afflicts approximately 115 million individuals in the US, encompassing around 42% of the adult demographic and 20% of the juvenile population, as per CDC statistics. A decade-long observation underscores a rise by nearly 10% in adult obesity, illuminating the swelling magnitude of this health crisis.

Medical professionals accentuate the multifaceted pathways through which obesity can foster heart disease, encompassing the enhancement of blood pressure levels, fostering a surge in detrimental cholesterol whilst diminishing beneficial cholesterol levels, amplifying diabetes susceptibility, and facilitating the accrual of fatty substances within arterial structures.

The in-depth study unearthed that the primary culprits behind obesity-associated heart disease fatalities within the scrutinised period were ischemic heart disease — characterised by artery narrowing — accompanied by heightened blood pressure. This dual identification not only underscores the critical role of cardiovascular health monitoring in obesity management but also necessitates intensified focus on preventive measures to curb the steady increase in obesity-related cardiac deaths.

The findings evoke an urgent call for bolstered interventions targeting obesity prevention and management, steering individuals towards healthier lifestyles to avert the onset of associated cardiac complications. The study stands as a testament to the urgent necessity for a comprehensive approach in mitigating obesity-related health ramifications, fostering a society armed with the knowledge and resources to combat this escalating health concern effectively.

Exercise hormone irisin emerges as potential therapeutic agent in Alzheimer’s research

In the relentless pursuit to find effective treatments for Alzheimer’s disease, researchers have spotlighted a potential new ally: the hormone irisin, which is generated during physical exercise. This revelation brings a beacon of hope, suggesting a potential new frontier in Alzheimer’s therapy.

According to a recent study carried out by a team at the Massachusetts General Hospital in Boston, the elevation of irisin levels, encouraged through physical exercise, showcases promising results in reducing the plaque and tau tangles that are trademarks of Alzheimer’s disease. The role of irisin had been previously linked to the regulation of glucose and lipid metabolism in adipose tissue and the acceleration of the conversion of white fat tissue to brown, a process that augments energy expenditure.

Before delving deeper into irisin’s impact on Alzheimer’s, the team had pioneered the development of 3D human cell culture models of the disease. These models played a pivotal role in understanding how irisin interacts with amyloid-beta, a significant player in the Alzheimer’s landscape, present in the brain.

Previous studies on murine models had affirmed the beneficial effects of physical exercise in diminishing amyloid-beta accumulations, albeit without understanding the precise mechanism. The fresh insights gleaned from this study illuminated that irisin’s influence in this context is closely tied to the enhancement of an enzyme known as neprilysin, which is proficient in degrading amyloid-beta.

Se Hoon Choi, one of the study’s authors, illuminated that treating with irisin led to a “remarkable reduction of amyloid-beta pathology,” an effect steered by the bolstered activity of neprilysin, which is secreted in higher quantities by brain cells called astrocytes, in response to irisin.

Notably, the researchers managed to pinpoint the pathway that prompts cells to amplify neprilysin levels, opening avenues for further exploration and therapy development. The endeavour now stood grounded on a robust foundation of understanding how irisin, once introduced into the bloodstream, can navigate its way to the brain, showcasing its potential utility as a therapeutic agent.

Furthermore, senior author Rudolph Tanzi noted that irisin could be the principal orchestrator behind exercise-induced escalations in neprilysin levels that are instrumental in alleviating the amyloid-beta burden in the brain. Tanzi underscored the significant implications of these findings, propelling irisin to the centre stage as a promising target for preventive and therapeutic strategies against Alzheimer’s disease.
This groundbreaking study, published in the renowned journal Neuron on September 8 2023, brings to light irisin’s pivotal role as a mediator, leveraging the natural, exercise-induced hormone to forge a path towards revolutionary Alzheimer’s treatments. It brings us a step closer to harnessing the potential of physical exercise at a molecular level in battling the devastating impacts of Alzheimer’s, thus offering a new ray of hope in medical science’s quest to conquer this debilitating disease.

Child sleep apnea severity linked to obesity, finds new study

Researchers at UT Southwestern Medical Center and Children’s Health have discovered that obesity and older age are substantial predictors of the severity of obstructive sleep apnea (OSA) in children. The study, recently published in Laryngoscope Investigative Otolaryngology, underscores the essential role of obesity in paediatric OSA. This new finding contributes to the increasing recognition of the association between childhood obesity and various negative outcomes including cognitive deficits, impaired academic performance, behavioural issues, excessive daytime sleepiness, and potential long-term effects on cardiovascular health.

Obstructive sleep apnea is a sleep disorder characterised by repeated obstruction of the upper airway during sleep, leading to interruptions in both ventilation and sleep patterns. Diagnosis of OSA usually requires full-night polysomnography, an extensive sleep study that monitors brain waves, blood oxygen levels, and heart and breathing rates while the patient sleeps.

Traditionally, paediatric patients suffering from OSA have been treated with adenotonsillectomy, a surgical procedure involving the removal of the adenoids and tonsils. However, this surgery does not always resolve the problem, and some children continue to experience what is known as residual OSA after the procedure.

The study was led by Romaine F. Johnson, M.D., M.P.H., Professor of Otolaryngology – Head and Neck Surgery at UT Southwestern, who emphasised that “OSA is typically considered a condition that affects adults.” But Dr. Johnson pointed out that the growing epidemic of childhood obesity has led to an increase in the number of paediatric patients diagnosed with OSA. He explained that “higher levels of obesity and advancing age are key contributors to this issue,” and suggested that targeting childhood obesity could substantially enhance sleep quality and mitigate the detrimental consequences of both OSA and residual OSA.

Dr. Johnson and his research team initially embarked on the study to investigate the relationship between socioeconomic status (SES) and paediatric OSA. They examined the medical records of 249 children aged 18 or younger who underwent both polysomnogram and adenotonsillectomy at Children’s Health over a one-year span. To evaluate the influence of SES on paediatric OSA, the researchers utilised the area deprivation index (ADI), a metric defining neighbourhood-level disadvantages through various social determinants such as education, employment, and poverty.

Contrary to expectations, the study revealed that neighbourhood-level deprivation, as indicated by the ADI ranking, did not predict OSA severity or residual OSA after surgery. Instead, the team found that severe OSA was significantly associated with obesity, and residual OSA was more commonly linked with older age, particularly among adolescents.

While the research did not establish a direct link between SES and OSA severity, Dr. Johnson emphasised the need for further investigation into the relationship. He highlighted the critical nature of understanding how socioeconomic status intersects with paediatric OSA, stating that “social disadvantages can further affect the consequences of poor sleep quality.” He also noted that children who experience both OSA and social disadvantages might be at increased risk and may require specialised interventions.

The significance of this study lies in its identification of childhood obesity as a key factor in the severity of sleep apnea, thereby opening the door to potential interventions targeting weight management. Supported by the Beth and Marvin C. “Cub” Culbertson Professorship in Pediatric Otolaryngology, the research also emphasises the complex interplay between obesity, age, and sleep disorders in children, and calls attention to the need for a multifaceted approach to address these interconnected health challenges.

Luton Council takes action against childhood obesity by banning unhealthy food ads on municipal property

Luton Council has made a significant decision to combat the growing concern of childhood obesity in the town by implementing a ban on advertising for unhealthy food items on most of its council-owned property. As part of this determined initiative, advertisements featuring food products high in fat, salt, and sugar will no longer be permitted to be displayed on billboards, lampposts, screens, or roundabouts within the town’s jurisdiction.

This move, according to the council, aims to “protect children and adults” from the influence of marketing that promotes unhealthy eating habits. The situation has become particularly alarming in Luton, where childhood obesity rates have exceeded national levels. The latest figures from the National Child Measurement Programme (NCMP) revealed that 11.4% of reception age children in Luton (ages four to five) were classified as having obesity, compared to the national rate of 10.1%. Similarly, obesity among children aged 10 to 11 (Year 6) in Luton stood at 29.2%, noticeably higher than the national rate of 23.4%.

Labour councillor Khtija Malik, who holds the portfolio for public health, declared the ban as a “start” in the town’s efforts to decrease its “high rates of obesity among young children.” Ms. Malik stressed the importance of fostering healthy eating habits early in life, acknowledging the considerable impact advertising has on shaping people’s food choices.

This ban, although extensive, will not encompass all advertising locations within the town. Unhealthy food adverts may continue to be seen on bus shelters until at least 2027, as the council’s current advertising contract for these spaces extends to that year. However, Ms. Malik reassured that the council, having “control of our assets,” would exercise control over “what is advertised” in areas under its jurisdiction.

The move by Luton Council has not only demonstrated a proactive approach to a pressing public health issue but has also been met with support from advocacy groups. Fran Bernhardt, the children’s food campaign coordinator at Sustain, a group dedicated to better food and farming, lauded the council’s efforts, stating, “Luton Council has stood up to the food and drinks industry on behalf of all their residents.” She further emphasised the importance of the decision, pointing out that those residing in the most deprived areas are the ones most affected by unhealthy food advertising and are consequently most at risk from diet-related diseases.

The decision by Luton Council signifies an important step in recognising and addressing the complex factors that contribute to childhood obesity. By limiting the exposure to advertising that encourages unhealthy food choices, the council is actively working to create an environment that supports healthier lifestyle decisions. This ban is a notable example of local governance taking decisive action to influence public behaviour and health, reflecting a growing awareness of the pivotal role advertising plays in shaping dietary habits and preferences. It serves as a landmark measure that could potentially inspire similar initiatives in other towns and cities, contributing to a broader societal shift towards prioritising public health.

Hypothalamic differences discovered in people who are living with overweight or obesity

A groundbreaking study by researchers at the University of Cambridge has provided new insights into the role of the hypothalamus in controlling appetite. This small yet critical region of the brain, which is about the size of an almond, appears to have structural differences in those who are living with overweight or obesity compared to those of healthy weight.

Dr. Stephanie Brown from the Department of Psychiatry and Lucy Cavendish College, University of Cambridge, noted the importance of the hypothalamus in regulating appetite but also acknowledged the difficulty in studying it in living humans due to its small size.

The study team addressed this challenge by using a machine learning algorithm to analyse MRI scans of 1,351 young adults across different BMI categories. Published in Neuroimage: Clinical, their findings revealed that the hypothalamus’s overall volume was significantly larger in those who with overweight or obesity.

These findings offer further evidence to the connection between brain structure, weight, and food consumption, as obesity is a global concern affecting over 1.9 billion people worldwide. The condition increases risks for numerous health problems, including type 2 diabetes, heart disease, stroke, and mental health issues.

The team also explored the possibility that the changes in the hypothalamus might be related to inflammation. Previous animal studies have shown that a high-fat diet could cause inflammation in the hypothalamus, leading to insulin resistance and obesity. In some cases, just three days of a fat-rich diet was enough to trigger inflammation.

Dr. Brown emphasised that if similar processes occur in humans, a high-fat diet could impact our ability to sense when we’ve eaten enough, leading to weight gain. The researchers hypothesised that the brain might react to inflammation by enlarging specialised immune cells, known as glia, causing the hypothalamus to be larger.

Professor Paul Fletcher, the study’s senior author, expressed hope that this new approach to analysing brain scans would deepen our understanding of appetite control in obesity. While the exact implications of these findings are still unclear, more research is needed to confirm whether the increase in hypothalamic volume is a cause or result of being overweight, or if those with larger hypothalami are naturally inclined to eat more.

Supported by the Bernard Wolfe Health Neuroscience Fund, Wellcome, NIHR Cambridge Biomedical Research Centre, and additional funding from Alzheimer’s Research UK, the study presents a transformative view of obesity. It opens new avenues for exploring obesity from a neurological perspective, potentially revolutionising how obesity and overweight conditions are understood and treated. Future studies may provide essential insights into intervention strategies, reshaping the way we approach this global health challenge.

Obesity linked to impairment of immune cells protecting against psoriasis

Obesity is more than just a condition associated with excess weight; it can also influence the immune system in ways that make the body more susceptible to certain diseases. Recent research has shed light on how obesity may impair immune cells that protect against inflammation associated with psoriasis, a common skin disorder. This newfound understanding could pave the way for new treatments for psoriasis, particularly for those who suffer from obesity.

Psoriasis, marked by an accumulation of dry, scaly skin patches, is found to be twice as prevalent in individuals with obesity as compared to those without. This connection between obesity and psoriasis has long been observed, but the underlying mechanisms have remained elusive.

Researchers at Emory University in Atlanta, Georgia, led by Chaoran Li, took up the challenge to explore the intersection between obesity, inflammation, and psoriasis. They specifically investigated regulatory T-cells, which play a crucial role in controlling inflammation. These cells maintain a delicate balance in the skin, offsetting pro-inflammatory immune cells. While obesity is known to increase inflammatory cells, its influence on regulatory T-cells was not well understood.

Li’s team conducted a detailed genetic analysis of regulatory T-cells in various organs of mice, including the skin, spleen, lungs, and lymph nodes. They identified a unique subset of these cells that were prevalent in the skin of the rodents. Interestingly, this group was also found to be abundant in human skin samples.

The research took a significant turn when scientists genetically modified mice to lack these specific cells. When they applied a cream that induces psoriasis-like symptoms, such as skin thickening, the modified mice’s skin became nearly 50% thicker in a week compared to those with the anti-inflammatory cells. This observation strongly suggested that these particular cells have a role in preventing psoriasis symptoms.

To delve into the relationship with obesity, another group of mice were fed a high-fat diet for 16 weeks. The skin of these mice with obesity displayed fewer regulatory T-cells and was more reactive to the psoriasis-inducing cream than the skin samples from mice on regular diets. This correlation between obesity and a decrease in anti-inflammatory immune cells that prevent psoriasis was a pivotal discovery.

These findings not only highlight obesity’s impairment of crucial immune cells but also hint that a high-fat diet may be a key factor in psoriasis and other skin-related inflammations. This insight opens up the possibility that dietary interventions could be a viable treatment option for psoriasis.

Another promising avenue explored by the researchers involved the drug pioglitazone, known to boost the activity of regulatory T-cells. It was found to reduce skin inflammation in mice with obesity. Intriguingly, pioglitazone is also a type 2 diabetes medication. Some studies have indicated that individuals with diabetes on this drug have a lower risk of psoriasis, raising the potential of the medication as a dual-purpose treatment.

However, the applicability of these findings to humans still requires validation. Li’s team plans to examine how this specific subset of cells varies in humans with both psoriasis and obesity compared to those with one or neither condition.

This research represents a significant stride in understanding the intricate relationship between obesity, immune function, and psoriasis. By unearthing the cellular mechanisms behind this connection, it could potentially lead to more targeted and effective treatment options for those struggling with psoriasis, especially in the context of obesity. It also emphasises the importance of a healthy diet and its impact on overall skin health.