Exercise and weight loss combination amplifies battle against obesity and prediabetes
Groundbreaking research conducted at Washington University School of Medicine in St. Louis reveals the tremendous impact of combining regular exercise with a 10% body weight loss in combating obesity and prediabetes. The study found that this combination more than doubles insulin sensitivity compared to weight loss alone, reducing the risk of developing Type 2 diabetes and coronary heart disease.
The researchers initially knew that modest weight loss improves insulin sensitivity, and exercise alone has limited efficacy in aiding individuals with obesity and prediabetes in shedding pounds. However, they were astonished to discover the profound effect that combining a consistent exercise regimen with a 10% reduction in body weight can have on insulin sensitivity.
Published in the journal Nature Metabolism, the findings shed light on the crucial role of exercise in improving overall health outcomes for individuals struggling with obesity and prediabetes.
Dr. Samuel Klein, the senior investigator and director of the Center for Human Nutrition, explained the significance of the study’s results: “Insulin resistance is a major factor that causes Type 2 diabetes, nonalcoholic fatty liver disease, and abnormal blood lipids in people with obesity. We’ve shown that combining exercise with weight loss causes a marked improvement in whole-body insulin sensitivity, thereby lowering the risk of developing diabetes and treating obesity-related metabolic diseases to a much greater degree than is possible with weight loss alone.”
The study involved 16 participants with a body mass index (BMI) ranging from 30 to 49, indicating obesity. All participants had prediabetes and demonstrated medical evidence of insulin resistance.
Eight participants underwent a diet-only intervention, resulting in a 10% body weight loss. The other eight individuals followed the same dietary plan but also engaged in supervised exercise sessions multiple times per week.
Dr. Klein highlighted the significance of their findings: “The data from most studies show that exercise has very little effect on body weight in people with obesity… Our study involved detailed analyses of metabolic changes in muscle and body fat before and after a 10% weight loss in people who lost weight with diet therapy alone and in those who lost the same amount of weight with diet therapy plus supervised exercise training. The results demonstrate that the benefits of combining exercise with weight loss are considerable.”
With over 37 million Americans living with diabetes and more than 40% of the population grappling with obesity, which is a significant contributor to diabetes cases, the study’s findings have far-reaching implications. Approximately 96 million adults in the United States, or one in three, are estimated to have prediabetes.
Dr. Klein emphasised the crucial role of exercise in weight management therapy, stating, “The metabolic benefits we found in this study demonstrate the profound reasons why exercise should always be included in weight-management therapy.”
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Revitalising weight loss: The miraculous power of “beige fat” in reversing age-related weight gain
Discovering the ability to activate the body’s own fat-burning mechanisms and counteract age-related metabolic changes might seem like an unattainable dream, but researchers at Cornell University’s Division of Nutritional Sciences are working towards making it a reality. Their recent study explores the potential of a specific type of fat cells known as “beige fat” to reverse the effects of a slowing metabolism.
In mammals, including humans, two main types of fat exist: white adipose tissue (WAT), which stores excess calories, and brown adipose tissue (BAT), which burns calories to generate heat and regulate body temperature. The study sheds light on the therapeutic possibilities of a third type of fat called beige fat, a subtype of WAT. Beige fat shares characteristics with both white and brown fat, possessing thermogenic properties similar to brown fat and the ability to regulate blood sugar levels and reduce fatty acids associated with conditions like arterial hardening and heart disease.
The formation of beige fat occurs when adipose progenitor cells, a type of stem cell found within white fat, are stimulated by prolonged exposure to cold temperatures. However, as individuals age, their response to this stimulus weakens, leading to an imbalance favouring the production of white fat.
“Seasonal changes in beige fat occur in young humans, but an older person would have to stand outside in the snow in their underwear to achieve those same effects,” explains Dan Berry, an assistant professor in the Division of Nutritional Sciences at Cornell University.
Previous research by Berry revealed that the ageing process inhibits the formation of beige fat cells in response to cold temperatures.
The study’s lead author, Abigail Benvie, a doctoral student researcher in Berry’s lab, explains that the ultimate goal of their research is to find ways to stimulate metabolic pathways without subjecting individuals to prolonged cold exposure. Researchers successfully suppressed this pathway in ageing mice and stimulated the production of beige fat cells in areas where only white fat would typically form.
This research not only offers potential solutions for age-related weight gain and associated health conditions but also provides insights into the molecular mechanisms underlying beige fat formation. The study’s co-authors, including graduate students Derek Lee, Benjamin M. Steiner, and Siwen Xue, as well as Yuwei Jiang from the University of Illinois at Chicago, plan to further investigate the identified pathway and explore other molecular regulators of beige fat formation. With a $2.2 million, five-year grant from the National Institutes of Health, Berry’s lab aims to deepen our understanding of how these regulators change in levels and activity during the ageing process.
The study, published in the journal Nature Communications, represents a significant step forward in harnessing the potential of beige fat to combat age-related weight gain and improve metabolic health.
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Family-focused approach in paediatric primary care proves effective for child weight loss
A groundbreaking family-based treatment for childhood obesity, developed by researchers at the University at Buffalo (UB), has demonstrated significant success in a multicenter study conducted in paediatric primary care settings. Previously available only in specialised clinics, this evidence-based treatment has now been implemented for the first time in four U.S. cities, targeting children aged 6-12 and their parents.
Published in the Journal of the American Medical Association, the study reveals that family-based treatment conducted in paediatricians’ offices leads to improved weight-loss outcomes not only for the treated child and parent but also for untreated siblings. The research, supported by the National Heart, Lung and Blood Institute, emphasises that the healthy behaviours promoted during the treatment extend beyond the immediate family members, potentially improving the overall health of the entire family.
In the study, three times as many children in the treatment group (27%) experienced a clinically meaningful reduction in median body mass index (BMI) compared to the usual care group (9%). These improvements in weight correlated with enhanced cardiometabolic outcomes, such as blood pressure, lipids, and glucose regulation. The success of this novel family-focused treatment, pioneered by senior author Leonard H. Epstein, has significant implications for the long-term health and well-being of the treated children.
The family-based treatment program involves the implementation of eating and activity plans, education in parenting and behavioural techniques, and the facilitation of support for positive behaviour changes within both the family and peer environments. In individualised sessions, parents and children are seen together, reviewing self-monitored eating and activity levels, treatment manuals, handouts, and setting goals for weight and behaviour.
The randomised clinical trial enrolled 452 children aged 6 to 12, with one parent, in primary care practices across Buffalo, Rochester, Columbus, and St. Louis. Half of the children received family-based treatment, while the other half received usual care. Notably, the treatment demonstrated positive outcomes across racial and ethnic backgrounds.
Children receiving family-based treatment showed a significant difference in percent over median BMI compared to those receiving usual care, with a reduction of 6.48%. Furthermore, parents experienced a reduction of 3.97% in BMI, and untreated siblings who were overweight had a reduction of 5.38%. These changes in BMI among family members were interrelated, suggesting that the treatment fosters the modelling of healthy behaviours and facilitates real change in the shared family environment.
The success of this behavioural intervention underscores the growing need for similar treatments in paediatric primary care. The study authors emphasise the necessity for “coaches” in primary care settings who can provide support for obesity treatment and address various behavioural issues, including anxiety, depression, and eating disorders.
The implementation of this family-focused approach not only ensures the immediate health of children but also equips them with lifelong healthy practices. The study’s positive outcomes highlight the potential for transforming paediatric primary care into a hub for comprehensive behavioural interventions, addressing a wide range of health-related concerns.
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Study reveals obesity as a precursor to mental disorders across all ages
A recent study conducted by the Medical University of Vienna in collaboration with the Complexity Science Hub Vienna has uncovered that individuals suffering from obesity face an elevated risk of developing various mental disorders across all age groups. Interestingly, the study reveals that women are more susceptible than men to most of these disorders. The research findings were published in Translational Psychiatry, a renowned scientific journal.
The researchers meticulously analysed a comprehensive dataset, encompassing all inpatient hospitalisations in Austria between 1997 and 2014. The aim was to ascertain the relative risks of coexisting diseases in individuals with obesity and to pinpoint any statistically significant variations between genders. The data illustrated that an obesity diagnosis markedly heightens the likelihood of developing an array of mental disorders, including depression, nicotine addiction, psychosis, anxiety, eating disorders, and personality disorders.
Michael Leutner, who headed the study and is part of the Department of Internal Medicine II at MedUni Vienna, asserted, “The findings highlight the imperative need for increased vigilance toward psychiatric diagnoses in patients with obesity and engaging specialists early on if necessary.”
Elma Dervic, the co-first author of the study from the Complexity Science Hub, expounded on the innovative approach adopted to discern which illness typically manifested before or after an obesity diagnosis. “This novel method enabled us to identify trends and common patterns in the onset of diseases,” Dervic explained. The study revealed that, with the exception of disorders in the psychosis spectrum, obesity was likely to be diagnosed before the emergence of any psychiatric condition.
Contrary to a widely-held belief among physicians that psychopharmacological medications were responsible for the connection between mental disorders and obesity, the study suggests otherwise. “While this might hold true for schizophrenia, our data does not corroborate this for depression or other mental disorders,” elucidated Alexander Kautzky, the first author from the Department of Psychiatry and Psychotherapy at MedUni Vienna. However, it remains uncertain whether obesity directly impacts mental health or if early stages of psychiatric disorders are frequently overlooked.
Notably, the study found women to be more predisposed to nearly all mental disorders, except for schizophrenia and nicotine addiction. Approximately 16.66% of men with obesity were found to have nicotine addiction compared to just 8.58% of women with obesity. Conversely, the rate of diagnosed depression was nearly threefold higher in women with obesity (13.3% in women with obesity compared to 4.8% in women who did not have obesity) than in men with obesity (6.61% in men with obesity compared to 3.21% in men who did not have obesity).
With over 670 million individuals affected by obesity globally, it is well-established that obesity contributes to metabolic disorders and severe cardio-metabolic complications such as diabetes mellitus, arterial hypertension, and dyslipidemia. The revelation that obesity is frequently a precursor to serious mental disorders underscores its significance as a health risk factor, particularly for younger populations where the risk is most pronounced.
Consequently, the researchers stress the urgency for comprehensive mental health screening amongst patients with obesity to enable timely preventive measures or the provision of appropriate treatment.
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NHS England to open 10 more clinics for children with obesity
In response to the alarming rise in childhood obesity, NHS England has announced plans to launch 10 additional clinics specifically tailored to the needs of children with obesity. This expansion comes as part of a concerted effort to combat the escalating numbers of children and young people struggling with obesity and its associated health complications.
According to recent data released by NHS England, hospital admissions for children with obesity have soared in the past decade, with 9,431 admissions recorded in the year 2021/22, compared to just 3,370 in 2011/12.
Targeting children as young as two, the specialised clinics will offer intensive support to children with severe obesity and their families. It is estimated that around 3,000 children and teenagers, ranging from 2 to 18 years of age, will benefit from these services.
These clinics are designed to address not just the physical aspects of obesity, but also the underlying psychological and social factors. The support provided will encompass tailored care packages which are developed in collaboration with the child’s family. These packages may include diet and nutrition plans, mental health support, and personalised coaching, among other services.
This expansion, backed by an £18 million investment, will bring the total number of specialised obesity clinics for children in England to 30. The project is set to be rolled out over the next two years.
Amanda Pritchard, Chief Executive of NHS England, is slated to formally announce the opening of the new clinics at the NHS ConfedExpo conference in Manchester. In her address, she is expected to underscore the urgent need for such initiatives, stating, “Obesity can lead to a myriad of severe illnesses including cancer and diabetes, not only putting tremendous strain on the NHS but also exacting a devastating toll on individuals and their families. Inaction is not an option. These new clinics will offer a comprehensive, compassionate and tailored approach to support thousands of young individuals and their families.”
Professor Simon Kenny, NHS England’s National Clinical Director for Children and Young People, emphasised the holistic approach of these clinics. He noted that obesity can have far-reaching effects on every organ system, leading to long-term complications like premature mortality, type 2 diabetes, strokes, early joint replacements, and mental health issues. “By addressing obesity and its root causes in a manner that respects and accommodates the unique circumstances of each child and young person, these clinics will play a pivotal role in helping them lead healthier, more fulfilling lives. Our commitment to supporting the physical and mental health of as many children and young people as possible is unwavering,” he added.
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Prenatal exposure to durable ‘forever chemicals’ may contribute to childhood obesity, study finds
A recent study backed by federal funding suggests that exposure to per- and polyfluoroalkyl substances (PFAS), also known as ‘forever chemicals,’ during pregnancy is associated with higher body mass indices (BMIs) and increased risks of obesity in children.
The study, spearheaded by Brown University researchers, adds to the growing body of evidence that the consequences of exposure to PFAS begin even before birth, potentially predisposing children to health challenges later in life.
PFAS are a group of chemicals used in a variety of products such as water-repellent textiles, personal care items, firefighting foams, food packaging, and medical products, due to their oil and water-resistant properties. Their extremely stable structure means they can persist in the environment for thousands of years, earning them the nickname ‘forever chemicals’.
The research was carried out under the Environmental Influences on Child Health Outcomes (ECHO) program at the National Institutes of Health, employing a more extensive dataset compared to previous studies. Lead author Yun “Jamie” Liu, a postdoctoral research associate in epidemiology at the Brown University School of Public Health, stated that the study analysed eight research cohorts with varying demographics across the United States, making the findings more representative of the general population.
Using data collected over two decades involving 1,391 children aged between 2 and 5 years and their mothers, who were part of ECHO research sites in California, Illinois, Massachusetts, Colorado, New Hampshire, Georgia, and New York, the study examined blood samples taken from mothers during pregnancy. The levels of seven different PFAS were analysed, and children’s body mass indices were calculated.
The study revealed a correlation between higher levels of PFAS in the mothers’ blood during pregnancy and slightly elevated BMIs in children. This increased risk of obesity was consistent among both male and female children. Notably, these associations were evident even at relatively low levels of PFAS exposure.
Joseph Braun, the study’s senior author and a professor of epidemiology at Brown’s School of Public Health, highlighted the significance of these findings in contemporary contexts. He noted that despite the reduction in PFAS usage as manufacturers have phased them out due to health concerns, exposure during pregnancy could still pose risks. “This implies that children may continue to face risks of PFAS-related health issues,” Braun added.
Braun has been engaged in several studies examining the effects of PFAS on children’s health for over a decade. He believes that this kind of research can inform environmental policies and safety guidelines.
The research team aims to continue their investigations by exploring the relationships between maternal PFAS exposure and obesity-linked health outcomes in older children, eventually expanding to adolescents and adults.
The study received support from the ECHO program, the National Institute of Environmental Health Sciences, and the National Institute of General Medicine Sciences.
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Obesity alters brain function, hindering weight loss maintenance, study finds
Researchers from Amsterdam UMC and Yale University have recently unveiled a ground-breaking link between obesity and altered brain responses to nutrients. Their study indicates that obesity leads to reduced dopamine release and diminished nutrient-sensing activity in the brain. Worryingly, these changes persist even after weight loss, potentially explaining why maintaining weight loss is so challenging for many.
The research, published in Nature Metabolism, highlights that the brain’s responses to certain nutrients are impaired in individuals with obesity and don’t show improvement even after shedding weight.
Mireille Serlie, the lead researcher and Professor of Endocrinology at Amsterdam UMC, elaborates on the implications of the study, “Our results point toward enduring alterations in the brain among individuals with obesity, which could have a substantial impact on eating behaviour. We observed that, compared to individuals of normal weight, those with obesity exhibited lower dopamine release in a brain region that plays a pivotal role in the motivation associated with food consumption. Dopamine is crucial for the rewarding aspects of eating. Moreover, those with obesity demonstrated diminished brain activity in response to the infusion of nutrients into the stomach. Collectively, these results suggest that the brain’s ability to sense nutrients in the stomach and gut, or to process nutritional signals, is compromised in obesity, which may have significant repercussions on food intake.”
The regulation of food consumption is dependent on a complex interplay of metabolic and neural signals among the brain and various organs, such as the gut, as well as nutritional signals in the blood. This intricate network governs hunger and satiety sensations, regulates food intake, and controls the motivation to seek food. Though advances have been made in understanding these processes in animals, especially regarding metabolic diseases like obesity, less is known about the human mechanisms, mainly due to challenges in creating experimental setups within clinical settings that can elucidate these processes.
Addressing this knowledge gap, Serlie and her team, including colleagues from Yale, conducted a meticulously designed controlled trial. The study involved 30 participants with obesity and 30 of normal weight. It entailed infusing specific nutrients directly into the participants’ stomachs while simultaneously assessing their brain activity using MRI scans and monitoring dopamine release with SPECT scans.
The study discovered that while participants of normal weight showed distinct patterns of brain activity and dopamine release in response to nutrient infusion, these responses were significantly weakened in those with obesity. Furthermore, even after achieving a 10% body weight loss through a 12-week diet, the brain responses in individuals with obesity did not improve. This finding suggests that obesity induces long-term adaptations in the brain that persist even after weight loss.
“The enduring nature of these brain alterations, which do not reverse even after weight loss, might elucidate why so many individuals tend to regain weight following initial successful weight loss,” Serlie concludes.
This discovery brings to light the intricate challenges faced by those striving to lose weight and maintain the loss, suggesting that strategies need to address not only the physical aspects but also the neurological factors entangled with obesity.
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Elevated risk of stillbirth among pregnant women with obesity
Obesity before pregnancy appears to considerably increase the likelihood of perinatal mortality, suggests a mediation analysis study.
The study, involving 392,820 women, revealed that women with obesity before pregnancy had a 55% increased risk of perinatal mortality – defined as stillbirth or neonatal death prior to hospital discharge, as informed by Jeffrey Bone, a PhD candidate at the University of British Columbia, Vancouver, along with his team.
The study, published in PLoS One, also showed that even women who had overweight before pregnancy exhibited a 22% increased risk of perinatal mortality compared to women who had a normal BMI.
The largest mediator between obesity and perinatal death was the gestational age at delivery, which accounted for 63.1% of the association, according to the researchers. Adjustments were made for factors such as chronic hypertension, smoking, alcohol and substance use, previous stillbirths or preterm births, parity, maternal age, year of birth, chronic diseases, and asthma during the study.
Bone commented that women with obesity often face higher neonatal death rates and stillbirths, and the exact reasons for this remain to be fully deciphered. He said, “Our aim was to determine whether this could be partially attributed to their pregnancies ending earlier than those of women with normal weight.”
Even though these findings were anticipated, Bone believes there are still numerous questions that warrant further investigation. The team has recommended future studies to identify the specific factors contributing to higher pre-pregnancy BMI and their impact on perinatal mortality, such as inactive lifestyle, high calorie diet, and medical or genetic conditions.
The study emphasises the necessity for healthcare professionals to pay extra attention to pregnant women with obesity to prevent stillbirth and neonatal death, especially in the second trimester. Bone emphasised the complexity of the reasons for increased risks, which include maternal complications leading to preterm birth more frequently in obese women, as well as foetal and placental reasons. He stressed that more research is needed to better devise interventions for women with high pre-pregnancy BMI.
The research team evaluated data from 547,401 single live births and stillbirths in British Columbia between 2004 and 2017. The study excluded data from late terminations and women with births before 20 weeks of gestation.
Of the 392,820 women included in the study, 12.8% (50,352) were classified as having obesity, 20.6% (81,065) as having overweight, 60.6% (237,726) as normal weight, and 6.0% (23,677) as underweight. These pre-pregnancy weight categories were self-reported based on the following BMI ranges: underweight (<18.5), normal (18.5 to <25), overweight (25 to <30), and obese (BMI 30+).
The study found that, compared to women with normal BMI, those with obesity were more likely to have multiple births, smoke during pregnancy, suffer from chronic and gestational hypertension or diabetes, and have a history of caesarean delivery.
In terms of preterm birth rates, a pattern emerged correlating higher rates with an increased BMI: 7.3% among women with a normal BMI, 8.1% among overweight women, and 9.7% among women with obesity, according to the researchers.
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Increased risk of obesity and high blood sugar in children linked to prenatal cannabis exposure
A newly conducted study suggests that the use of cannabis during pregnancy may heighten the likelihood of children developing obesity or experiencing elevated blood sugar levels by the age of five.
Products containing non-psychoactive cannabidiol (CBD) or the psychoactive compound tetrahydrocannabinol (THC) are often employed by pregnant women to mitigate symptoms such as morning sickness, anxiety, post-traumatic stress disorder (PTSD), insomnia, and pain.
However, the study establishes a correlation between the exposure to such compounds during pregnancy and breastfeeding, and “increased percentages of fat mass and fasting glucose levels” in children upon their entry into school.
Brianna Moore, an assistant professor of epidemiology at the University of Colorado, who focuses her research on how early-life exposure to tobacco and cannabis impacts children’s growth and brain development, is the author of the study. Moore advises women to “avoid all forms of cannabis while pregnant or breastfeeding in order to minimise potential adverse health outcomes in their children.”
The research team analysed urine samples from 103 pregnant women, revealing that 15% of the women had detectable cannabinoid compounds in their bodies.
The findings show that the five-year-old children of these mothers had greater fat mass and fasting glucose levels compared to children whose mothers did not use cannabis during pregnancy.
Cannabis is known to contain over 100 cannabinoids, with CBD and THC being the most widely recognized. According to Dr. Moore, further studies are required to explore the effects of the other compounds on babies exposed to them during gestation and through breastfeeding.
In a separate 2016 study conducted in Colorado, it was discovered that up to 22% of pregnant women exhibited detectable cannabinoid levels in their bodies.
Earlier studies have also indicated that women who use CBD and THC during pregnancy not only increase the risk of their children having low birth weights and behavioural issues but are also doubling the likelihood of premature birth. Additionally, cannabis use during pregnancy has been associated with a higher prevalence of “psychotic-like” behaviours in nine-year-old children, as per other studies conducted in 2019 and 2020.
The research, titled ‘Fetal Exposure to Cannabis and Childhood Metabolic Outcomes: The Healthy Start Study’, is available in the Journal of Clinical Endocrinology and Metabolism published by the Endocrine Society.
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Obesity associated with diminished bone strength, particularly in men
Despite the protective implication often associated with high body weight in terms of fracture risk, recent studies suggest that obesity may in fact raise the risk of fractures, particularly in men with high body fat content.
A comprehensive examination of dual x-ray absorptiometry (DXA) data from a broad spectrum of over 10,000 U.S. individuals revealed an intricate connection between body weight and bone density. Dr. Rajesh Jain and Dr. Tamara Vokes, both from the University of Chicago, discussed these complex findings in the Journal of Clinical Endocrinology & Metabolism.
The duo discovered that each 1 kg/m2 increase in lean mass index correlated with a 0.19 higher T-score in people below 60 years of age. However, every corresponding increase in fat mass index was associated with a 0.10 decline in T-score, with a significant statistical difference (P<0.001).
Their research indicated that while lean mass positively impacted bone mineral density (BMD) equivalently in both genders, the deleterious effect of fat mass was more pronounced in men, leading to a 0.13 lower T-score per additional 1 kg/m2, compared to a 0.08 drop in women (P<0.001 for interaction).
“Our analysis of a large, heterogeneous population presenting a wide range of BMI indicated a clear negative correlation between bone density and fat mass, and a positive correlation with lean mass,” Jain and Vokes stated.
The researchers highlighted that despite lean mass exhibiting a stronger overall impact than fat mass, the detrimental effects of fat on BMD were significantly more evident in men and individuals with excessive fat content.
These insights hold critical clinical implications as they suggest obesity could contribute to declining BMD in patients traditionally not perceived as high fracture risk, and who therefore might not typically undergo DXA screening.
Contrasting previous studies constrained by small sample sizes or referral bias, Jain and Vokes’ findings reflect broader U.S. population data. They emphasise that obesity does not provide immunity against low BMD, advocating for clinicians to assess bone density, especially when other risk factors are present.
To reach their conclusions, the researchers assessed data from the National Health and Nutrition Examination Surveys conducted from 2011 to 2018. This dataset encompassed body composition and DXA measurements for 10,814 individuals aged 20 to 59.
Using linear regression models with total body BMD as the dependent variable, the researchers scrutinised the impact of lean and fat mass, accounting for age, gender, race/ethnicity, height, and smoking status. Notably, they highlighted the challenge of disentangling the interconnected influences of fat and lean mass on bone density.
Prior studies exploring the impact of fat mass on bone density reported varying results due to differing statistical methods and are somewhat outdated, the researchers pointed out. Moreover, the current study benefited from a densitometer with a higher weight limit, allowing for the examination of more severe obesity cases.
However, the study had limitations, including its focus on adults below 60 years, leaving room for potentially different body composition and bone mass relationships in older individuals. It also didn’t evaluate factors besides sex hormones that might elucidate the observed gender differences in the link between fat mass and bone density.
Despite women generally having a higher proportion of body fat, fat accumulation patterns differ by gender, with women typically storing fat in the hip and thigh areas, and men in the trunk and abdomen. Jain and Vokes acknowledged that differences in fat distribution might influence BMD, although their study could not conclusively prove this.
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Caesarean births linked to higher childhood obesity risk, Japanese study finds
A recent scientific study published in the journal Scientific Reports explores the potential impact of Caesarean section (CS) delivery on the incidence of obesity among three-year-old Japanese children.
Childhood obesity is a growing global health issue, as it can often persist into adulthood and raise the risk of various cardiometabolic disorders. Prior research has suggested that children born via CS may have a higher likelihood of obesity, potentially due to disturbances in their gut microbiomes. These children have been found to exhibit lower adiponectin levels and greater insulin resistance.
While ethnicity and race are also factors in the prevalence of paediatric obesity, with Asian children reportedly at a higher risk than their White and European counterparts, the correlation between CS birth and childhood obesity in the Japanese population remains relatively unexplored.
The objective of this study was to investigate this correlation, which could aid in the early identification of children at risk of adult obesity, thereby enabling early intervention through weight management programs.
For the study, the research team analysed data from 60,769 Japanese mother-child pairs participating in the national Japan Environment and Children’s Study (JECS). The mode of delivery was determined from health records, while anthropometric data was gathered through online questionnaires completed by the participants themselves.
The researchers identified obesity in children using the body mass index (BMI) cut-off values defined by the International Obesity Task Force guidelines, and only included children from singleton births in the analysis. The study excluded any multiple participations, multiple births, stillbirths or miscarriages, or any data with missing information related to height and/or weight, mode of delivery, and other covariates.
The researchers used logistic regression analysis and estimated adjusted risk ratios (aRR), taking into account various maternal and paediatric factors. They also conducted a sensitivity analysis using the obesity thresholds provided by the Japanese Association for Human Auxology guidelines.
The study found that 19% of the children were born via CS, with 8% classified as having obesity. The aRR for obesity in three-year-old Japanese children born through CS was 1.2 compared to those born via vaginal delivery. When the data was stratified by sex, the aRR values were 1.1 for boys and 1.2 for girls.
The sensitivity analysis corroborated these findings, with the risk of childhood obesity remaining statistically significant for Japanese girls. This aligns with previous studies that have reported an increased risk of certain cancers in females born through CS.
The data also revealed that children born via CS had lower birth weights and heights and were more likely to be born before 37 weeks of gestation. Mothers who had a CS were generally older, had higher pre-pregnancy BMIs, were less educated, and had a higher rate of pregnancy-related and obstetric complications. They were also more likely to smoke, suffer from physical illnesses, and use assisted reproductive technology.
In conclusion, the study suggests that CS births slightly heighten the risk of obesity at age three for both boys and girls in the Japanese population. This indicates that the mode of delivery may influence metabolic health, even among ethnic groups that are typically less prone to obesity. Factors such as maternal pre-pregnancy BMI, education level, and the child’s birth weight appeared to confound this relationship.
The study emphasises the need for further research to understand the mechanisms underlying the increased risk of paediatric obesity associated with CS delivery, including the possible association with gut microbiota. Moreover, the long-term cardiometabolic impacts of CS delivery should be further investigated.
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Study finds boys with obesity at higher risk of becoming infertile men
Italian researchers have discovered a potential link between obesity in boys and reduced testicle size, which may increase the risk of infertility in these young men later in life.
The study included boys aged 2 to 18 who were recommended to the Pediatric Endocrinology Unit at the University of Catania in Sicily for weight management. The researchers observed that boys with normal insulin levels displayed up to double the testicular volume in comparison to boys with high insulin levels.
Boys who had overweight or obesity and displayed hyperinsulinemia, or insulin resistance, generally had smaller testicles than other boys, according to the researchers. This condition, referred to as “testicular hypotrophy,” is known to elevate the risk of infertility in males.
Dr. Alex Robles, a fertility specialist at the Columbia University Fertility Center in New York, explained to Medical News Today that testicular volume is directly linked to semen profiles and is generally a reliable indicator of hormonal function. He added that infertile men typically have a smaller testicular volume compared to fertile men. This is also seen in men who consume exogenous anabolic steroids, leading to a reduction in the production of endogenous testosterone, testicular size, and sperm production.
Co-author of the study, Rossella Cannarella, a research assistant at the University of Catania in Italy, noted that the impact of obesity and related metabolic disorders on testicular growth is not thoroughly understood, despite the global rise in childhood obesity. The study, published in the European Journal of Endocrinology, found that having overweight or obesity was associated with a decrease in testicular volume during peri-puberty. Additionally, obesity-related conditions like hyperinsulinemia and insulin resistance were found to affect testicular volume both before and after puberty.
Cannarella suggests that more careful management of body weight during childhood could be a preventive strategy for preserving testicular function in adulthood.
Male infertility is believed to contribute to approximately half of all cases of couple infertility, but the causes often remain unknown. Research has shown a decrease in sperm concentration and count over the past four decades, while childhood obesity rates have increased dramatically. It is estimated that by age 35, 60% of children aged 2 to 19 will have obesity.
Dr. Robles also highlighted the significant connection between obesity and fertility issues, particularly in women. Obesity can disrupt the hormonal balance needed for egg growth, development, and ovulation. Similarly, in men, obesity can interfere with the hormones that assist in testosterone production by the testicles. Low testosterone is linked to reduced sperm production and quality.
However, Dr. Jagdish Khubchandani, a professor of public health at New Mexico State University, warned that while the study showed promise in highlighting the connection between obesity, metabolism, and testicular volume, it had limitations. The study was cross-sectional with a small population, so it could not establish a cause-and-effect relationship between testicular size, obesity, and risk of infertility.
Dr. Khubchandani emphasised that although there is a correlation between the global rise in obesity and the decline in sperm count, it doesn’t necessarily mean the two are directly linked. Factors such as diet and environment could independently influence obesity, metabolism, and reproductive health.
Dr. Robles agreed that while the findings of the retrospective review are plausible given the known impacts of obesity on hormonal regulation and testosterone levels, more research is necessary to determine if weight loss is an effective treatment for improving testicular volume. Previous research suggests that weight loss can improve hormonal health in men with obesity by restoring natural testosterone levels, which can subsequently increase testicular volume and sperm production.
Dr. Khubchandani highlighted the importance of early childhood interventions to address many health issues linked to obesity, including those discussed in this study. He added that obesity is a global pandemic and a leading cause of numerous health problems worldwide.
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