Genetic link between body shape and heart disease
A study originating from Massachusetts General Hospital has found that a pattern of gene variants associated with certain body shapes increases the risk of T2DM as well as heart disease. This ‘apple-shape’ describes when weight is commonly deposited around the abdomen, rather than the hips and thighs. The researchers were aiming to discover whether a genetic predisposition to abdominal adiposity was associated with the risk of T2DM and coronary heart disease, they concluded that it certainly does.
Due to the many factors that contribute to the development of heart disease the researchers had to employ a method called Mendelian randomisation, which measures whether an inherited gene variant can cause the development of a disease. They used previous research which identified 48 different gene variants as responsible for abdominal adiposity and developed a genetic risk score. They combined this with data from the UK Biobank to determine any association. Whilst they found an association between genetic predisposition to abdominal adiposity and heart disease, they did not find any between lifestyle factors and genetic risk score. This therefore confirmed that the gene variants responsible for body shape were associated with cardiometabolic risk. The results may allow physicians to use body shape as a predictor for heart disease and T2DM in the future, however further research must be undertaken to identify any other gene variants that may be responsible.
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Childhood weight is 35-40% inherited
A new study from the University of Sussex has found that 35-40% of a child’s BMI is inherited from their parents. For obese children this proportion rises to approximately 55-60%. The research used data from 100,000 children and their parents across the globe and found that intergenerational transmission of BMI is around 0.2, or 20% each from the mother and father. Interestingly, the results were consistent across the different countries, with varying lifestyle factors coming into play, suggesting that this is not just an isolated phenomenon.
The study also found that the effect was more pronounced when a child was heavier. The ‘parental effect’ was higher in more obese children; for thin children, the association is likely to be 10% each from the mother and father, for the heavier child this could go up to 30%. The results highlight that obesity is not only due to lifestyle factors but also genetic and family factors, and therefore it may be wise to monitor the weight of children especially if their parents are overweight or obese.
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Body shaming linked to multiple health risks
People who suffer from obesity are often the subject of stereotyping from the people around them. A new study published in Obesity has described how this form of prejudice can actually increase the risk of cardiovascular and metabolic disease amongst people with obesity. Some schools of thought support the theory that stigma can help motivate the individuals to lose weight, however this study has found that it might in fact have the opposite effect. The research involved 159 adults with obesity who completed questionnaires measuring depression, body shaming and the internalisation of this stigma.
It was found that ‘weight bias internalisation’ (which occurs when people apply negative stereotypes to themselves – such as laziness) and diagnosis of metabolic syndrome correlated. Furthermore, those who had been subject to body shaming were more likely to internalise weight bias, and therefore this exacerbated their weight problem. Dr Tom Wadden, co-author of the study, wanted to highlight that health care providers and the media play an important role in promoting weight loss and should therefore be aware that shaming people will have a negative effect on their overall health; in summary, patients with obesity need to be treated with respect and supported in order to improve their health and bring them back to a healthy weight.
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New guidelines on paediatric obesity
The Endocrine Society has published a new set of guidelines to cover the prevention, treatment, and assessment for paediatric obesity. In the USA paediatric obesity costs an estimated £14.1 billion covering drugs prescriptions, emergency visits as well as outpatient appointments. Therefore there is a drive to identify those children at risk and the address these risks appropriately.
The clinical guidelines provide recommendations on how to evaluate children for medical and psychological complications. They also provide information on when to evaluate children for rare genetic causes of obesity, as well as when to consider medication and different surgical techniques for adolescents. The guidelines state that around 7% of children with severe obesity may suffer from a rare genetic mutation, and specific testing should be carried out if there is early onset obesity (before 5 years of age), an increased drive to eat food, or a family history of severe obesity.
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Impulsive personalities may lead to obesity
A new study conducted at the University of Texas at Dallas has found a link between impulsive personalities and the incidence of high body mass indices. The findings from this study have been published in Obesity. The study included 45 individuals and used different modalities to study their impulsivity such as self-reporting, neuropsychological testing and functional magnetic resonance imaging. By evaluating whether an individual’s decision making-style was more impulsive or cautious, using images on screens and measuring responses, the researchers were able to determine that participants with high BMI exhibited altered neural function compared to their normal weight counterparts.
The researchers originally thought that an inability to inhibit impulsive thoughts would be the driving factor behind the development of obesity, however it soon became clear that it was the inherent impulsive personality trait that is the mediating factor. Given these findings, the researchers hope that more will be done to develop treatments that provide coping skills or cognitive strategies for people to overcome impulsive behaviours. Further to this the increased self-awareness of impulsive behaviours may also help to control weight in certain individuals.
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Couples with obesity take longer to conceive
Couples with obesity could take from 55 to 59% longer to conceive than their normal weight counterparts. This is the outcome of a study performed at the National Institute of Health. Many studies up until now have focused on the weight status of the potential mother, but this study looked at the impact of the father’s body composition as well. The study itself included 501 couples from across the USA and the follow-up period ran for four years.
The BMI status was measured for each couple and the probability of conception was also measured using a statistical measurement called fecunadbility odds ratio. Factors such as age, smoking status, physical activity, and cholesterol levels were accounted for and it was found that obese couples take far longer to conceive on average. The authors explain that fertility experts may want to take into account the weight status and body composition of both the male and the female when counselling about pregnancy.
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Cancer mutation uses fat for fuel
New research published in Cell Metabolism has found that a certain melanoma mutation will cause the cancer to grow faster in a high-fat diet. The study was conducted on mice and found that cancers driven by a mutation in BRAF V600E (which is found in 60% of all melanomas) would thrive when the mice were given high-fat diets, alternatively, when they were fed lipid-lowering diets, the growth of the cancers slowed considerably. Most cancer cells display high glucose uptake, and recently low-carbohydrate diets have been tried as a therapeutic strategy against cancer. This research highlights that other factors could be at play, such as the BRAF V600E gene mutation; in this case a low-carbohydrate diet would not be helpful.
The research highlights the idea that diets can be specifically tailored to an individual’s needs, especially to prevent or delay tumour progression. Whilst human cancers can differ slightly in their metabolic properties, the researchers stress that this data could lead to more research into the designing of dietary regimens for cancer patients. At this point the researchers cannot be clear about which types of diets may trigger this, however they have managed to identify a compound known as acetoacetate as one of the triggers of this phenomenon, more research is being conducted.
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Blood tests can help predict surgery outcome
New research suggests that by calculating the ratio of circulating fatty acids, we may be able to predict the outcome of bariatric surgery. The study examined whether the ratios of serum stearic acid/palmitic acid (S/P) would be a reliable marker in predicting diabetes remission and assessing metabolic status. Two independent cohorts were assessed, totalling 413 participants. It was found that patients who had a higher level of S/P before surgery had a greater chance of diabetes remission.
By adding S/P ratio to HbA1c levels and fasting C-peptide the predictive potential of these tests has increased significantly. A similar measure was found in the second cohort of patients, highlighting the possible use of S/P ratio as a novel marker in preoperative assessment. The researchers are hoping that this study could help inform healthcare providers on who would benefit most from bariatric surgery.
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New detoxifying diet results in significant weight loss
Researchers from Skidmore College have developed a new ‘protein-paced’ diet (P-CR) that is based on consuming a low number of calories and intermittent fasting. They found that P-CR not only helps weight loss, but also enhances heart health, releases toxins from the body and reduces oxidative stress. P-CR itself involves consuming four to six meals a day, each with 20-25 grams of protein. The lead author, Paul Arciero, has also found that P-CR demonstrated sustained improvements in body weight, heart health and toxins when compared to traditional ‘heart-healthy’ diets.
Previous research has shown that weight loss can in fact release toxins into the blood, which is a natural reaction; P-CR is able to counter this by subsequently releasing those toxins from the body. Importantly, Arciero wanted to highlight that scientific evidence is now available that confirms that the quality of your diet matters, and through P-CR you can address a range of metabolic issues through diet alone.
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Does obesity affect your memory?
A new study from Indiana University has found that memory training has only a third of the benefit to older adults with obesity than it does to their normal weight counterparts. The researchers followed cognition over a period of 10 years and compared the trajectories of a sample of adults. They are unsure as to the specific mechanism of this, with one hypothesis being that obesity reduces the size of the hippocampus, so there is less capacity for new memories. Approximately 2,800 individuals with an average age of 74 took part in the study.
Whilst much research has been done to develop weight loss programs, this research highlights the importance of protecting memory function, especially with the growing age of the population and the ever increasing rate of obesity. Different types of memory training were used in the study, such as memory, reasoning and speed of processing, but the largest change was seen in the memory field.
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Teenage gastric bypass surgery and future complications
In a long term follow up study published in The Lancet Diabetes & Endocrinology it has been found that gastric bypass surgery helps severely obese teenagers keep weight off. The study aimed to assess the long-term effects of gastric bypass and any complications that were associated with this type of surgery. The study showed that whilst bypass surgery dramatically reduces teenagers’ weight, it could also lead to complications such as vitamin deficiencies. The researchers also found that, even though large weight loss had occurred, a third of the teenagers remained obese – meaning that earlier intervention may be needed along with lifestyle and dietary changes.
The lead author, Dr Thomas Inge, stressed that the study clearly showed the long-term benefits of bariatric surgery; however several nutritional risks have also been highlighted. The aim now is to focus on the health advantages whilst minimising these risks. It is clear that long-term follow up and care must be provided by centres that perform gastric bypass in teenagers, as the complications that follow could cause more problems in the future.
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Inactivity breeds inactivity
A new study published in Cell Metabolism has found that inactivity leads to further decreased motivation to move. The study was conducted in mice and aimed to shed light on why people, or animals, with obesity were less active. The findings suggest that there is more to it than extra body weight being disabling. The study’s senior author, Alexxai V Kravitz, has a background in Parkinson research, and he was struck by how much Parkinsonian mice behaved like obese mice; he therefore hypothesised that the dopamine systems were dysfunctional in both groups. In this study, mice were fed either a normal or a high-fat diet for 18 weeks. They found that the high-fat diet mice began to move less before they gained the majority of their weight, suggesting that it was not excess weight alone that is responsible for this behaviour.
Dopamine is critical for movement and the researchers found that the obese mice had deficits in the D2 dopamine receptor. They were keen to point out that there are likely to be many other factors at play, but the deficit in D2 goes a long way to explaining the lack of activity. The researchers also studied the connection between inactivity and weight gain, to see whether it was causative. Kravitz explained that ‘in many cases willpower is invoked as a way to modify behaviour, but if we don’t understand the underlying physical basis for that behaviour, it’s difficult to say that willpower alone can solve it.’ Further to this, if we can discover the physiological causes as to why many obese people are less active, it may help reduce stigma towards them and help with the development of future treatments for obesity.
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