Obesity Care

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.

Mediterranean diet linked to fewer signs of Alzheimer’s disease

According to a recent study, following a diet rich in leafy green vegetables, whole grains, nuts, and fish could result in fewer signs of Alzheimer’s disease. The study found that older adults who followed the MIND and Mediterranean diets had fewer amyloid plaques and tau tangles in their brains. While researchers are yet to establish a cause-and-effect relationship, the study showed that consuming specific foods can enhance brain health.

Individuals following the Mediterranean diet had levels of plaque and tangles in their brains similar to that of people 18 years younger than those who consumed the least brain-healthy foods. For those following the MIND diet, the figure was 12 years younger.

The Mediterranean diet contains food items from countries bordering the Mediterranean Sea, such as Italy, Greece, Cyprus, and Spain, including olive oil, dairy products, poultry, fish, fruits, vegetables, whole grains, legumes, nuts, and seeds.

The MIND diet, on the other hand, combines the DASH (Dietary Approaches to Stop Hypertension) and Mediterranean diets. It promotes eating leafy green vegetables, berries, nuts, and whole grains. It is also recommended to consume at least one serving of fish per week.

The study involved 581 older adults who agreed to donate their brains for research after death. Before dying, 39% were diagnosed with dementia, and after death, 66% met the criteria for Alzheimer’s disease. Participants completed yearly questionnaires about their eating habits, which were analysed and scored based on the type and quality of the food they consumed.

One of the most noteworthy findings of the study was that consuming green leafy vegetables corresponded to a lower amount of plaque in the brain, almost 19 years younger than those who ate less. However, researchers could not establish a direct relationship between a healthy diet and fewer brain deposits of amyloid plaques, known as an indicator of Alzheimer’s disease.

Dr. Puja Agarwal, a study author, said that improvement in people’s diets in one area, such as eating green leafy vegetables or not consuming fried foods, was associated with fewer amyloid plaques in the brain, similar to being around four years younger. The study provides evidence for a real food approach to eating, which focuses on natural, unprocessed or minimally processed foods while reducing processed or ultra-processed foods.

Obesity in childhood and puberty linked to higher risk of blood clots in later life

According to a new study by the University of Gothenburg, being overweight during childhood and early adulthood increases the risk of developing blood clots in later years. The study analysed the health data of 37,000 men and their early body mass index (BMI) and any blood clots that developed as they got older. The researchers found that both overweight in childhood and overweight in young adulthood increased the risk of venous blood clots later in life, with overweight in young adulthood proving to be a more influential factor than childhood overweight. While most blood clots occur in the legs and are not dangerous, they can become life-threatening if they travel to the lungs and cause a pulmonary embolism.

The link between obesity and blood clots is already well known, but the impact of a higher BMI in childhood on the risk was unclear. The researchers examined the data of a large group of men in Sweden who were born between 1945 and 1961, looking at school records at age 8 and Armed Forces medical examinations at age 20 to establish BMI data. They then looked at blood clot data on the men up to an average age of 62.

The study found that BMI at both age 8 and age 20 can be linked to blood clots independently of each other. As adults, the researchers found that two groups were more at risk – those who had been overweight both as a child and in early adulthood, and those with a normal weight in childhood but who became overweight in early adulthood. In addition, the study found that carrying excess weight in both childhood and early adulthood increased a person’s risk of arterial thrombi, which are clots that result from constricted blood vessels with fatty deposits. However, the researchers noted that more research is needed in this area as they only found a small number of cases.
The study’s senior authors emphasised that obesity and overweight during puberty seem to have a marked impact on a person’s future risks of venous thrombi. The study has been published in the Journal of Internal Medicine.

Common painkillers linked with heart failure in people with type 2 diabetes

A recent study published in the Journal of the American College of Cardiology suggests that the use of common pain medications such as Advil or Motrin (ibuprofen) may increase the risk of heart failure in people with type 2 diabetes. The study found that NSAIDs (nonsteroidal anti-inflammatory drugs) may lead to first-time hospitalisation for heart failure in patients with type 2 diabetes. This is noteworthy, as these individuals are already known to face an elevated risk of heart failure.

The Danish study included more than 330,000 individuals with type 2 diabetes, of whom 1 in 6 filled at least one NSAID prescription within a year. During a follow-up of almost six years, more than 23,000 subjects were hospitalised with heart failure for the first time, and NSAID use was associated with a 40 percent higher relative risk of first-time heart failure hospitalisation. Ibuprofen and diclofenac were found to increase the risk of heart failure hospitalisation, but not celecoxib and naproxen. There was no association of NSAID use and increased risk in people with well-controlled diabetes. Strong associations were found in people aged 65 and older, while no association was found in those younger than 65. The strongest association was found in very infrequent or new users of NSAIDs. The study highlights the need for education in patients with cardiac risk factors, such as diabetes, on the dangers of over-the-counter medications.

Obesity can lead to frailty in old age, study finds

A new study has found that adults with obesity are at greater risk of experiencing frailty in later life than adults with an average body mass index (BMI).

Researchers conducted a long-term study on adult men and women in Norway and discovered that obesity puts individuals at risk of becoming frail as they age. Frailty is characterised by physical deterioration and increased vulnerability, and while it has been associated with underweight older adults, the study reveals a positive association between obesity and the risk of frailty among older adults.

The study, published in the BMJ Open journal, analysed the body mass index and waist circumference of 2,340 women and 2,169 men over the age of 45 between 1994 and 1995. The participants were followed up for a period of 21 years to determine their risk of frailty. The researchers defined physical frailty as having three or more symptoms including poor grip strength, slow walking speed, exhaustion, unintentional weight loss, and low physical activity.

The findings show that participants with “baseline obesity” were more likely to be frail or pre-frail compared to those with an average BMI. Additionally, those with high waist circumference throughout follow-up were also more likely to be pre-frail or frail compared to participants with a stable normal waist circumference trajectory. Excess weight exacerbating the decline in muscle strength and physical capacity that occurs with age, along with metabolic disorders, inflammaging, and oxidative stress associated with obesity, could contribute to the risk of frailty.

The study’s lead author, Dr. Anju Jain, emphasised the importance of early intervention to prevent and treat obesity. She noted that while weight loss can be challenging, it is possible and can have significant health benefits. She also called for more public health efforts to promote healthy eating and physical activity throughout life.

The researchers caution against viewing frailty as solely a wasting disorder and highlight the importance of routinely assessing and maintaining optimal BMI and waist circumference throughout adulthood to reduce the risk of frailty in later life.

Excess weight, obesity more deadly than previously believed

A new study from the University of Colorado Boulder, and published in the journal Population Studies, has found that the risk of death from excess weight or obesity is much higher than previously believed, with mortality rates increased by between 22% to 91%. 

The research challenges the “obesity paradox,” which suggests that only extremely high levels of excess weight are associated with increased mortality risk. The study analysed data from nearly 18,000 people and found that using body mass index (BMI) to study health outcomes can bias findings, potentially leading to underestimates of the consequences of living in an environment where unhealthy food is cheap and sedentary lifestyles are the norm. The study estimates that about one in six U.S. deaths are related to excess weight or obesity.

The research found that a full 20% of people classified as having a “healthy” weight had previously been in the overweight or having obesity category, and that these individuals had a substantially worse health profile than those in the “healthy” category whose weight had been stable. The study also found that the health and mortality consequences of high BMI are duration-dependent, meaning that people who have spent most of their lives at a low BMI but have recently gained weight may have better health profiles than those who have had overweight or obesity for most of their lives.

The study’s author, Ryan Masters, hopes that the research will alert scientists to be “extremely cautious” when making conclusions based on BMI, and will draw attention to the public health crisis of an “obesogenic” environment in the U.S. Masters noted that the prospects of healthy ageing into older adulthood do not look good for groups born in the 1970s or 1980s who have lived their whole lives in this obesogenic environment. The study estimates that about 16% of U.S. deaths are related to excess weight or obesity, a figure that is eight times higher than previous research had suggested.

Scientists find link between obesity and dementia

According to a new study published in the journal Alzhiemers & Dementia journal , obesity could be a major factor in the development of dementia. Researchers found that having overweight or obesity in mid-life could increase the risk of developing Alzheimer’s disease and other forms of dementia later in life.

The study analysed data from over 1.3 million adults in the United States, Europe, and Asia. It found that people who had overweight or obesity in mid-life had a 31% higher risk of developing dementia than those who were of a normal weight. The risk increased to 82% for those who had severe obesity.

The researchers also found that having type 2 diabetes further increased the risk of developing dementia in individuals with overweight or obesity. This is because obesity and diabetes are both associated with inflammation, insulin resistance, and other metabolic abnormalities that can damage the brain and increase the risk of dementia.

The study’s lead author, Dr. Elina Hyppönen, emphasised that the findings highlight the importance of maintaining a healthy weight throughout life to reduce the risk of dementia. She suggested that lifestyle interventions, such as exercise and a healthy diet, could help prevent obesity and diabetes and lower the risk of dementia.

The study’s findings add to the growing body of evidence linking obesity and dementia. Previous research has suggested that obesity can increase the risk of cognitive decline and reduce brain volume, particularly in the hippocampus, which is critical for memory and learning.

The World Health Organization estimates that around 50 million people worldwide have dementia, and that number is expected to triple by 2050. The study’s authors suggest that preventing obesity and diabetes could be an important strategy for reducing the global burden of dementia.

A good night’s sleep may make it easier to stick to exercise and diet goals, study finds

Preliminary research presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023 suggests that people who get regular and uninterrupted sleep are more successful at sticking to their exercise and diet plans while trying to lose weight. 

The researchers found that good sleep health was associated with higher rates of attendance at group interval sessions, adherence to caloric intake goals and improvement in time spent performing moderate-vigorous physical activity. The researchers examined 125 adults with overweight or obesity over 12 months in a weight loss program that included measurements of sleep habits through patient questionnaires, sleep diaries and wrist-worn devices. 

They measured adherence to the program by percentage of group intervention sessions attended, percentage of days that participants ate between 85-115% of their recommended daily calories, and change in daily duration of moderate or vigorous physical activity. 

The study’s limitations include that it did not incorporate any intervention to help participants improve their sleep, that the study sample was not recruited based upon participants’ sleep health characteristics, and that the overall sample population had relatively good sleep health at baseline. Additionally, the sample was primarily white and female, so it is unclear whether these results are generalisable to different population groups.

Overall, the preliminary research suggests that sleep may play a key role in promoting self-control and making healthy choices, highlighting the need for public health efforts to promote healthy sleep habits and the importance of getting enough sleep for maintaining a healthy lifestyle.

Obesity in pregnancy increases the risk of cardiovascular disease in offspring, animal study shows

New research reveals that maternal obesity during pregnancy can have a negative impact on the lifelong health and function of a foetus’s heart. 

Researchers from the University of Colorado, US, have found a connection between maternal obesity and a higher risk of cardiac problems in offspring later in life due to the nutrients received while in the womb. The study involved feeding female mice a high-fat diet equivalent to a human eating a burger, chips, and a fizzy drink daily until they had obesity. Researchers then studied the foetuses of the mice while in the womb and up to 24 months after birth. They analysed their genes, proteins, and mitochondria and found that the heart is affected by the nutrients it receives while growing in the uterus. This leads to alterations in how the organ metabolises carbohydrates and fats. Due to the nutrients found in the high-fat diet, the hearts developed a preference for fats and moved away from sugar.

The study found that the hearts of both female and male offspring grew larger than average, impairing the organ’s ability to function normally due to an increase in weight. Male offspring showed signs of cardiovascular impairment from the start, while females’ health became worse over time. This may be due to increased oestrogen levels present in female mice that offer initial protection against cardiovascular dysfunction. However, this resistance weakens as oestrogen levels decline with age.

Having obesity during pregnancy can lead to the development of cardiovascular and metabolic conditions in humans, such as type 2 diabetes, heart disease, and cancer. The study’s lead author, Dr. Owen Vaughan, suggests that by improving our understanding of the mechanisms involved, this research can pave the way for treatments that could be used in early life to prevent later-life cardiometabolic illnesses. This could include offering more tailored advice on nutrition to mothers or children based on their body mass index or sex or developing new drugs that target metabolism in the heart of the foetus. Therefore, keeping active through regular exercise and maintaining a healthy diet during pregnancy are essential for reducing the risk of developing health complications.