Obesity Care

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.

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.

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.

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.

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.

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.

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.

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.

Bariatric surgery associated with over 50% reduction in cancer risk for individuals with obesity

Bariatric surgery could considerably decrease the risk of cancers related to obesity, such as those of the breast, colon, liver, pancreas, ovaries, and thyroid, in patients with obesity.

“Bariatric surgery, which includes sleeve gastrectomy, gastric bypass, and gastric band procedures, is the principal method for significant weight loss in individuals with obesity,” stated Dr. Vibhu Chittajallu, a gastroenterology fellow at Case Western Reserve University and University Hospitals Cleveland Medical Center, during a Digestive Disease Week media briefing. He highlighted that these procedures offer benefits beyond weight loss, such as enhancements in patients’ mental and physical well-being.

Chittajallu further added, “Emerging evidence suggests that the substantial weight reduction linked with bariatric surgery may also provide a protective shield against the development of cancers associated with obesity. My team and I decided to delve deeper into this trend.”

Chittajallu and his team used TriNetX, a database involving 47 U.S. healthcare institutions and over 107 million patients, to conduct a retrospective study from 2002 to 2022. They singled out adults with a Body Mass Index (BMI) over 35 who underwent bariatric surgery, comparing them with patients with obesity who didn’t have the surgery. The study accounted for risk factors like smoking history, alcohol use, heart disease, hormone therapies, and cancer-screening tests, including 55,789 individuals in each group.

The researchers also used the International Agency for Research on Cancer to identify cancers with “sufficient” evidence of a connection to obesity. This included esophageal adenocarcinoma, multiple myeloma, and cancers of the kidney, colon, rectum, stomach, liver, gallbladder, pancreas, ovary, endometrium, breast, and thyroid.

The results revealed that after ten years, the cumulative occurrence of obesity-related cancer was 4% (n = 2,206) in the bariatric surgery group and 8.9% (n = 4,960) in the nonsurgical control group (HR = 0.482; 95% CI, 0.459-0.507).

Chittajallu pointed out that the bariatric surgery group consistently exhibited lower numbers of new cases for all types of obesity-related cancers, including those of the breast, colon, liver, pancreas, ovaries, and thyroid.

“Although more research is required to fully understand the impact of bariatric surgery on cancer risk,” Chittajallu concluded, “our findings indicate that bariatric surgery is a promising area to investigate.”

High obesity-related cancer mortality linked to easy access to fast food

Obesity has been a significant contributor to various health issues, including cancer. A recent cross-sectional study published in JAMA Oncology highlights the role of food environments in obesity-related cancer mortality. Communities with easy access to fast food were found to be 77% more likely to have high levels of obesity-related cancer mortality.

Researchers led by Dr. Malcolm Seth Bevel from the Medical College of Georgia analysed food access and cancer mortality data from over 3,000 counties in the United States. The study aimed to understand the association between food deserts (areas with limited access to grocery stores and healthy food options) and food swamps (areas with easy access to convenience stores and fast food) and obesity-related cancer mortality rates.

Using data from the U.S. Department of Agriculture Food Environment Atlas and the Centers for Disease Control and Prevention, the researchers calculated food desert and food swamp scores for each county. A higher score indicated fewer healthy food resources in the area.

The primary outcome of the study was obesity-related cancer mortality, defined as either high or low (71.8 or higher per 100,000 individuals and less than 71.8 per 100,000 individuals, respectively). The results showed that counties with high food swamp scores (easy access to fast food) were 77% more likely to have high rates of obesity-related cancer mortality.

Further analysis revealed a positive dose-response relationship between food desert scores, food swamp scores, and obesity-related cancer mortality rates. Counties with high rates of obesity-related cancer mortality also had a higher percentage of non-Hispanic Black residents, higher percentage of adults older than 65 years, higher rates of adult obesity, and higher rates of adult diabetes.

The study demonstrates the significant impact of food environments on obesity-related cancer mortality rates. Communities with easy access to fast food have a considerably higher risk of obesity-related cancer deaths. The findings emphasise the importance of promoting healthier food environments and improving access to nutritious food options in order to reduce obesity and its associated health risks, including cancer.

Chronic inflammation may explain why some mothers with obesity struggle with low milk production

A recent study published in The Journal of Nutrition has revealed that inflammation in lactating mothers who have obesity may interfere with the transfer of circulating fatty acids to the mammary gland, resulting in low milk production.

Obesity is associated with chronic inflammation and is a risk factor for insufficient milk production. Inflammation-mediated enzymes have been shown to suppress the uptake of fatty acids from the blood by body tissues, leading to high blood lipid concentrations. Fatty acids are critical for supporting milk production in the mammary gland, and therefore, inflammation could negatively impact milk production through this pathway. To test this hypothesis, a team of researchers led by Rachel Walker, a USDA-funded post-doctoral fellow, analysed blood, milk fatty acid profiles, and inflammatory markers from lactating women. The study included 23 women with very low milk production despite frequent breast emptying, 20 with moderate milk production, and 18 exclusively breastfeeding controls.

The researchers found that mothers with very low milk production had significantly higher obesity and inflammatory biomarkers, lower proportions of long chain fatty acids in milk, and a disrupted association between blood and milk fatty acids, compared to those with moderate milk production and exclusively breastfeeding controls. While milk and blood fatty acids were strongly correlated in controls, this was not the case in the very low or moderate milk production groups. These findings support the hypothesis that inflammation and obesity disrupt the transfer of fatty acids from circulation to the mammary gland, potentially contributing to insufficient milk production in women with obesity.

The study suggests the need for further investigation into the transfer of fatty acids to milk and its relationship with milk volume. The findings are of significant importance as it has been known for decades that mothers with obesity are at an increased risk of shortened breastfeeding duration. This study provides important new evidence that physiological differences, such as chronic inflammation, may contribute to some mothers’ struggles with milk production.

Men and women have different obesity drivers, pointing to the need for tailored interventions

A recent study conducted by researchers from UCLA has found sex-specific brain signals that may indicate why men and women develop obesity differently. Published in the journal Brain Communications, the study combined data from multiple modes of MRI imaging with clinical features and personal histories of patients to identify sex-specific mechanisms in the brain associated with obesity. The study aims to help tailor obesity interventions based on an individual’s sex.

The researchers analysed data from 183 participants aged between 18 and 55, which included 42 males with a non-obese BMI, 23 males with a high BMI, 63 females with a non-obese BMI, and 55 females with a high BMI. All participants completed a battery of self-report questionnaires that assessed various factors, including childhood trauma, anxiety and depression, visceral sensitivity, food addiction, bowel symptoms, and personality traits.

The researchers conducted three different brain MRIs to assess the structure, function, and connectivity of each participant’s brain. They then analysed the data sets from the three scans, along with clinical information, using an analytical tool to identify a limited number of variables from multiple data sets to predict an outcome.

The results of the study showed that specific network connectivity changes were associated with high BMI, regardless of sex. The researchers also found that in females, brain regions and networks had alterations associated with early life trauma, consistent with previous studies that showed that females with obesity may have greater anxiety, lower resilience, and difficulty integrating emotions with action-directed goal planning. The study also revealed that females may be more susceptible to the sight, smell, and taste of highly processed foods.

According to the researchers, the study’s results suggest that tailoring treatment plans for females with a high BMI should focus on emotional regulation techniques and vulnerability factors. However, they note that the study identified associations, not cause and effect. Future studies are needed to determine whether changes in the brain are a factor in the development of obesity or a result of the condition. The study builds on previous research that examined sex-related differences in the prominence and signalling of brain regions in obesity, which showed that women’s obesity was associated with emotion-related and compulsive eating, while men’s eating behaviour tended to be affected by a greater awareness of gut sensations and visceral responses.