How much sugar is too much sugar?
A new study published in the journal Obesity has shown that proposed changes in the ‘Nutrition Facts’ label on food will help people understand how much sugar they are consuming. The Canadian study aimed to test the efficacy of formats for labelling on food, showing the total and added sugar. The researchers conducted studies on 2,000 16-24 year olds and found that adding a percentage daily value for added sugar helped them identify foods with ‘too much’ sugar in.
At first these young people found it difficult to correctly identify foods high in sugar, but with added labels and percentage values they understood more and felt that they would be less inclined to consume those foods high in sugar. The study highlights the fact that whilst it is important to research the different types of treatment for obesity, we must not forget that prevention is better than a cure and that obesity can be stopped by even the simplest of measures.
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Mothers find it difficult to admit that their children are obese
Admitting that they themselves are obese is easier for a mother than admitting their child is. This comes after a study conducted in Ireland found that mothers were more honest and accurate about their own height and weight, but only 17% of mothers of obese children could admit that their child was overweight. This means that they are less likely to seek help and intervene due to their child’s weight, increasing the chances of the child gaining more weight, and eventually tracking this into adulthood.
The effect is more apparent in the cases of overweight daughters, where mothers are far less likely to admit that their daughters were obese than their sons. Identifying the problem is the first step to solving it, and by not recognising their children’s problems some mothers may be subconsciously putting their children at increased health risks. The researchers suggested that the problem may arise due to the fact that mothers are not objectively measuring their children, but could be comparing them to their peers. Furthermore, if a mother does identify her child as overweight, she may feel that she needs to intervene and upset the child, and therefore avoids this. In summary, the study called for more open and honest discussions between health professionals, parents and children in order to maintain healthy weight in the young.
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Focus on nutritional value, not calorific content
It’s time we stopped counting calories in food and started to pay more attention to its nutritional value if we are to cut illness from cardiovascular disease and curb obesity. This comes from an editorial published in the online journal Open Heart
Using published evidence, Drs Aseem Malhotra & James Di Nicolantonio, along with Professor Simon Capewell discuss that, much like stopping smoking, simple dietary changes can have a profound effect on health outcomes. They highlight the effects of increasing the amount of omega 3 fatty acid, olive oil and nuts in the reduction in deaths from cardiovascular disease.
They consider there is far too much focus on the calorific content of foods, whilst less attention is paid to the actual nutritional value of food. The overall cost of obesity related illness is in the region of £27 billion, a small mind-set change could therefore have a great effect on the economy. They also suggest that population-wide policies might achieve a more rapid reduction in disease, whilst also highlighting the need for change in focus, citing a potential government subsidy in fruit and vegetables as a possibility. In conclusion, they recommend that a Mediterranean type diet would be the best place to start as this will not only have health benefits, but will also highlight nutritional benefits of food to the general population. This would include emphasising the consumption of plant-based food such as fruit, vegetables and nuts, whilst also replacing butter with healthier fats such as olive oil, limitingred meat and eating more fish and poultry
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How obesity can affect stillbirth
Obese pregnant women are twice as likely to have stillbirths than their normal weight counterparts. Researchers at the University of Pittsburgh Graduate School of Public Health analysed data from 658 stillbirths (defined as reaching 16 weeks gestation and showing no evidence of life after delivery), mothers were described as lean, overweight, obese or severely obese. The rate of stillbirths per 1,000 was 7.7 for lean women, and 17.3 for severely obese women.
Lead author, Dr Lisa Bodnar, said, “We’ve known for some time that obese women are more likely to have stillbirths, but this is one of the first and most comprehensive efforts to figure out why”. Due to the study’s design it was difficult to prove cause and effect relationships, it was only possible to prove association. The most common causes of stillbirth amongst the obese population are placental diseases and hypertension. Foetal abnormalities, meaning the child would be unlikely to survive post-partum, and umbilical cord abnormalities were also highlighted as common causes. The results from this study show that obstetricians need to monitor the weight of pregnant and pre-pregnant women in order to avoid some, potentially tragic, complications.
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Good things come in Small Packages
A Cochrane review has shown that smaller portions, packages and tableware leads to the consumption of less food. The review analysed 72 studies over a span of 35 years, and concluded that ‘successfully reducing the size, availability and appeal of larger-sized portions, packages and tableware contributes to meaningful reductions in quantities of food people select and consume’.
For many years portion sizes have been increasing, and now a normal portion is much larger than it used to be This study aimed to prove that not only do portion sizes, but also package sizes and tableware, make a huge difference to consumption. The analysis suggested the potential of cutting 500 calories a day for US citizens, through the use of smaller portions. The study authors hope that the findings will provide fresh impetus for open discussion on how reducing the size, availability and appeal of large servings can be achieved in the public and commercial sectors.
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Fat responds to nerves activation
A breakthrough study has shown how fat is innervated and how direct stimulation can lead to fat breakdown. This comes after collaborative research from Instituto Gulbenkian de Ciência in Portugal and the Rockefeller University in the USA. Almost 20 years ago the same team, at the Rockefeller Univesity, discovered leptin, the hormone that is released by fat cells, that tell the brain how much fat is in the body. Low levels increase appetite, whilst high levels increase fat breakdown. However, it was not known how the lipolytic effect of leptin was mediated.
The researchers managed to dissect the nerve fibres from mice that innervated adipocytes and assess the functional relevance of these neurones. They observed obvious fat breakdown and fat mass reduction on activation of the sympathetic neurones. This study has not only clarified how leptin has its lipolytic effect but suggests new therapeutic strategies for overcoming the central leptin resistance seen in obesity.
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Can chemicals cause obesity?
The Endocrine Society have warned that exposure to certain chemicals can lead to obesity and diabetes. The new publication builds on the Society’s 2009 report which examined the role of Endocrine Disrupting Chemicals (EDCs) and human health. A study over 5 years was carried out in order to discover the potential role of EDCs in the development of obesity and diabetes. EDCs mimic, block and interfere with hormones within the body, this in turn alters the way cells within the body develop.
EDCs include dioxin chemicals produced during waste incineration, polychlorinated biphenyls, pesticides and bisphenol A (found in food can linings and receipts). Andrea Gore, Vacek Chair of Pharmacology at the University of Texas said ‘the evidence is more definitive than ever before – EDCs disrupt hormones in a manner that harms human health.’ The Society called for additional research to be carried out to discover more about the mechanisms involved; regulation to ensure that exposure to chemicals is minimised; creation of products that are safe; and education for the public and policy makers so that EDCs are kept out of food, water and the air.
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Children with severe obesity at high cardiometabolic risk
A new study carried out in North Carolina has found that children with severe obesity are at a much higher risk of developing heart disease and diabetes than those of a normal weight. Dr Ashley Cockrell Skinner, the lead researcher said that the ‘findings show a direct correlation between higher levels of obesity and adverse cardiometabolic risk factors that can lead to future disease’.
Researchers analysed data from 8,579 overweight or obese children from 3 to 19 years of age, using the Centers for Disease Control and Prevention growth charts. They found that the higher the severity of obesity, the higher the risks of a low HDL cholesterol level, high systolic and diastolic blood pressures, and high triglyceride and glycated haemoglobin levels. These are all well-known markers for cardiometabolic diseases. The researchers recommended that prevention and intervention strategies that look at reducing obesity in early life should receive much more attention, as it is too long to wait before the risk factors lead to disease. The paper highlights the need for increased attention to the issues that contribute to childhood obesity.
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A glass of water a day keeps obesity away?
Drinking 500ml of water half an hour before eating meals may help obese adults lose weight. A study conducted at the University of Birmingham on 84 obese adults showed that this simple intervention could be profoundly beneficial. The group was randomly split into two, and both were given a weight management consultation, to discuss how best to adapt lifestyle and behaviour, in order to promote weight loss. 41 were asked to “preload” with water before eating, whilst the others were told to imagine their stomach was full.
The participants were monitored over a 12 week period, and those that were asked to drink water before their main meal lost, on average, 1.3kg more than those in the control group. Those who preloaded 3 times a day lost 4.3kg! The intervention was simple and was shown to be effective at follow-up. We must bear in mind though that it was not only filling up on water before meals that resulted in weight loss, each participant was given lifestyle advice. The researchers hope to continue their research on a larger population in the future.
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Bad news for first born sisters…
Older sisters are more likely to be overweight and obese when compared to their younger siblings. According to a large study performed on 13, 406 Swedish sister pairs. The results corroborate with previous studies that found older brothers to be both, heavier, and taller, than their younger siblings. The study showed that at birth, firstborns weighed a little less than the second born sisters, however their BMI was around 2.4% higher during their first 3 months of pregnancy.
Overall it was found that firstborn women were 29% more likely to be overweight, and 40% more likely to be obese during their mid-20s, furthermore they were an average of 1.2mm taller. Sisters with a high number of siblings were also more likely to be shorter and the researchers hypothesised that this could be due to a phenomenon known as ‘resource dilution’ – the idea that parental resources are spread more thinly across a higher number of children.
It was unclear why older sisters seemed to be heavier, however the researchers hypothesised that changes in the womb after the first pregnancy could be a potential cause. It is possible that during the first pregnancy, blood vessels are narrower in the placenta, limiting flow. The body then adapts to this to store more fat and glucose. For subsequent pregnancies the blood flow is altered to stop this from happening. Although the findings confirm the results in other studies involving men, more research is needed to see whether there is an associated increase in metabolic risk in first born women.
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Does a feeling of reward cause obesity?
A French team have examined the role of pleasure when compared to that of energy needs in food intake. The study was performed on a group of mice and considered the activity of neurones that regulate feeding behaviours, known as NPY/AgRP. These are activated in periods of fasting and promote food intake. They found that these neurones become dispensable when a highly palatable diet is chosen; instead the hedonic circuitry in the brain drives the feeding behaviours. However when food is not palatable, it is the AgRP neurones that drive feeding in response to the body’s metabolic needs.
Using these findings it was shown that animals with compromised AgRP neurone activity could be more prone to comfort eating as they are more likely to consume palatable food due to stress. The mice with compromised AgRP neurones were also more sensitive to external factors, such as stress, they were therefore very good models for comfort eating.
A continued exposure to palatable foods, many of which are energy-rich could alter NPY/AgRP circuitry and cause them to become desensitised, leading to the reward circuit taking over. Overall, these results shed more light on the energy balance mechanisms controlled by NPY/AgRP and highlights how the reward circuitry interacts with it and may explain why people can’t seem to avoid eating the wrong foods!
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Is weight loss surgery altering gut bacteria?
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