Global Diabetes Rates Are Rising as Obesity Spreads – The New York Times

WASHINGTON — The global diabetes rate has risen by nearly half over the past two decades, according to a new study, as obesity and the health problems it spawns have taken hold across the developing world.

The prevalence of diabetes has been rising in rich countries for several decades, largely driven by increases in the rate of obesity. More recently, poorer countries have begun to follow the trend, with major increases in countries like China, Mexico and India.

The study, published Monday in the British medical journal The Lancet, reported a 45 percent rise in the prevalence of diabetes worldwide from 1990 to 2013. Nearly all the rise was in Type 2, which is usually related to obesity and is the most common form of the disease.

Continue reading the main story

RELATED COVERAGE

Global Health: Diabetes Epidemic Grows in ChinaSEPT. 9, 2013

The Quest for a Natural Sugar SubstituteJAN. 1, 2014

In Diabetes, a Complex of CausesOCT. 16, 2007

A major shift is underway in the developing world, in which deaths from communicable diseases like malaria and tuberculosis have declined sharply, and chronic diseases like cancer and diabetes are on the rise. The pattern is linked to economic improvement and more people living longer, but it has left governments in developing countries scrambling to deal with new and often more expensive ways to treat illnesses.

via Global Diabetes Rates Are Rising as Obesity Spreads – The New York Times.

Advertisements

Red Meat Is Not the Enemy – NYTimes.com

There are people in this country eating too much red meat. They should cut back. There are people eating too many carbs. They should cut back on those. There are also people eating too much fat, and the same advice applies to them, too.

What’s getting harder to justify, though, is a focus on any one nutrient as a culprit for everyone.

I’ve written Upshot articles on how the strong warnings against salt and cholesterol are not well supported by evidence. But it’s possible that no food has been attacked as widely or as loudly in the past few decades as red meat.

As with other bad guys in the food wars, the warnings against red meat are louder and more forceful than they need to be.

Americans are more overweight and obese than they pretty much have ever been. There’s also no question that we are eating more meat than in previous eras. But we’ve actually been reducing our red meat consumption for the last decade or so. This hasn’t led to a huge decrease in obesity rates or to arguments from experts that it is the reason for fewer deaths from cardiovascular disease.

Photo

It’s possible that no food has been attacked as widely or as loudly in the past few decades as red meat. Credit Justin Maxon/The New York TImes

The same reports also show that we eat significantly more fruits and vegetables today than we did decades ago. We also eat more grains and sweeteners.

This is the real problem: We eat more calories than we need. But in much of our discussion about diet, we seek a singular nutritional guilty party. We also tend to cast everyone in the same light as “eating too much.”

via Red Meat Is Not the Enemy – NYTimes.com.

Obese Children Show Early Signs of Heart Disease – NYTimes.com

Obese children and teenagers already show hints of future cardiovascular problems, new research has found.

German researchers studied 61 overweight and obese children 8-to 21-years-old, comparing them with 40 non-obese children of the same age. All were free of disease and not taking any medicines. The study is online in JACC: Cardiovascular Imaging.

Compared with children of normal weight, the obese group had significantly higher triglycerides, higher total cholesterol, lower HDL “good cholesterol” and higher LDL “bad” cholesterol. They also had higher blood pressure, higher fasting glucose and higher fasting insulin readings.

Using echocardiograms, the researchers found that in obese children part of the heart muscle — the left ventricle — was thicker on average, which in an adult would be a sign of impending cardiovascular problems.

“We do not know if these changes are reversible with weight loss or how they will impact future cardiovascular disease in these subjects,” said the lead author, Dr. Norman Mangner, a cardiologist at the University of Leipzig.

via Obese Children Show Early Signs of Heart Disease – NYTimes.com.

Obesity and cancer are linked, ASCO says – CNN.com

“It’s not enough to say there’s an association between obesity and cancer. We need to know why,” Hudis says. “With the why, we can do something about it.”

Scientists are exploring several hypotheses on how excess fat increases a person’s risk for cancer. The answer may be slightly different for each type of cancer, but the encompassing explanation seems to be that obesity triggers changes in how the body operates, which can cause harmful cell growth and cell division.

Many of these changes may be linked to inflammation. In general, inflammation occurs when your body is reacting to something out of the norm — say a virus or a splinter in your foot. Obesity seems to cause chronic inflammation, which in turn may promote cancer development.

Take for example, Hudis says, hormone-sensitive breast cancers. Chemicals in the body meant to regulate inflammation also increase production of the hormone estrogen. And studies have shown excess estrogen can cause breast cancer tumors.

via Obesity and cancer are linked, ASCO says – CNN.com.

Early, frequent antibiotic use linked to childhood obesity – LA Times

Early, frequent antibiotic use linked to childhood obesity - LA Times

Parents and pediatricians will often reach for antibiotics to treat middle ear infections, strep throat, fevers and other common ailments of childhood. But new research suggests that doing so, and prescribing broad-spectrum antibiotics in particular, increases those children’s risk of obesity, at least in early childhood.

A new study finds that babies who got broad-spectrum antibiotics in their first two years of life, or who were prescribed four or more courses of antibiotics in that period, were more likely to be obese at some point between their their second and fifth birthdays than were those who had taken no antibiotics, or who were treated with medications designed to target a narrow spectrum of disease-causing bacteria.

Broad-spectrum antibiotics — including amoxicillin, tetracycline, streptomycin, moxifloxacin and ciprofloxacin — are intended for treatment of major systemic infections, in cases where the bacteria causing the illness has not been identified, or where a patient is under attack by a strain of bacteria resistant to standard antibiotics. While they can be highly effective, their antibiotic action is indiscriminate, and beneficial bacteria in the body are often killed off as collateral damage.

The latest study tapped the medical records of 64,580 babies and children in and around Philadelphia. It was published Monday in the journal JAMA Pediatrics.

The heightened risk of obesity linked to antibiotic use was not huge: Babies who got wide-spectrum antibiotics in their first two years were about 11% more likely to be obese between 2 and 5 than were those who got no such drugs. Babies who had four or more courses of any antibiotics in the first two years were also 11% more likely to be obese in early childhood than those who’d had fewer exposures to antibiotics.

But among children who had four or more antibiotics prescriptions, including at least one wide-spectrum antibiotic, the risk of obesity rose to 17%. And the earlier a baby’s exposure to wide-spectrum antibiotic medications, the more likely he or she was, on average, to be obese between age 3 and 5.

via Early, frequent antibiotic use linked to childhood obesity – LA Times.

People eat more with overweight friends – UPI.com

People might not realize how setting affects eating decisions. According to a new study, eating with an overweight person makes people choose to eat more unhealthy foods.

Researchers from Cornell University’s Food and Brand Lab and the Mayo Medical Clinic invited 82 college students to eat a lunch consisting of spaghetti and salad, and they were divided into four groups.

One group was paired with an actress wearing a fat suit and making a healthy choice by eating more salad than spaghetti, another was paired with the actress wearing a fat suit and choosing more spaghetti than salad. The third group was paired with the actress choosing the more healthy meal without the fat suit and the last was paired with the actress choosing the less healthy meal without the fat suit.

Participants saw the actress serve herself before serving themselves, and the results show that no matter what the person wearing the fat suit picked for their meal, more salad or more spaghetti, 31.6 percent of the participants ate more pasta. Participants even ate 43.5 percent less salad when the person in the fat suit ate more salad.

This means many people could be making poor dietary choices based on the people surrounding them.

“Look up the menu beforehand and select a meal that suits your dietary goals,” recommends Brian Wansink, co-author of the study, published in the journal Appetite. “Or, if you’re going to a buffet, pre-commit to selecting modest portions of healthy foods and with that goal in mind, those around you will have less of a negative influence over what you eat.”

via People eat more with overweight friends – UPI.com.

Europeans Are Getting Fatter, Just Like Americans : Shots – Health News : NPR

Europeans Are Getting Fatter, Just Like Americans

by ROFF SMITH

Ireland is predicted to become the fattest country in Europe by 2030, according to a study released by the World Health Organization and the UK Health Forum.

As many as 90 percent of Irish men and 84 percent of Irish women are projected to be classified as overweight or obese by then. Blame goes to the usual culprits: unhealthy diets high in sugar and fats, and a lack of exercise.

The study defines overweight as a body mass index (BMI) of 25 (169 to 202 pounds for a 5′ 9″ adult, for example) and obese as a BMI of 30 (over 203 pounds for that height).

The picture isn’t a whole lot prettier for the rest of Europe. The study, which used a vast quantity of BMI measurements from around the Continent and computer modeling to predict trends, show rises in obesity rates across nearly all 53 Eurozone countries.

Even countries that aren’t at the top of the weight gain list will suffer. Forty four percent of Belgian men and 47 percent of Dutch men are projected to be classified as overweight or obese by 2030. (Note: In both countries, a popular snack is french fries with mayo.)

By contrast, three-quarters of men in England will be classed as either overweight or obese, and 8 out of 10 men in the Czech Republic, Spain and Poland.

“Our study presents a worrying picture of rising obesity across Europe. Policies to reverse this trend are urgently needed,” said the UK Health Forum’s Dr. Laura Webber, lead author of the study.

“There is no silver bullet for tackling this,” she told Shots. “We need a comprehensive package of approaches to support healthy eating and more physical activity in daily life.”

Even countries that seemed less at risk of obesity may have to worry. In Romania, the poorest country in Europe, only 10 percent of women are likely to be classified as obese by 2030, as opposed to Ireland where 47 percent of women will meet the criteria. But the variations, warns Webber, are likely caused by a scarcity of data from Romania.

A fried churro makes it way through the window of a shop in Madrid.

Jasper Juinen/Getty Images

Overall, she believes the figures are likely to be underestimated if anything, as the rising obesity levels in children have not been factored in.

Ireland’s overtaking England in the obesity stakes does not surprise Tam Fry, spokesman for UK-based National Obesity Forum. The country’s economic downturn means that people will have turned to cheaper, less healthy food. “People frequently think of Ireland as lush green, with fresh fruit and vegetables. But many areas of the countryside will have been deprived.”

It’s not clear if the study included Scotland, where the deep-fried Mars bar is a popular delicacy.

via Europeans Are Getting Fatter, Just Like Americans : Shots – Health News : NPR.

Study: Fructose intake linked to slightly higher risk of death | Fox News

Study: Fructose intake linked to slightly higher risk of death

By Laura TedescoPublished May 12, 2014Facebook197 Twitter124 Gplus8

It’s no secret that eating excessive amounts sugar puts you at risk for conditions like obesity and type 2 diabetes. Now, a new study in The American Journal of Clinical Nutrition suggests it may send you to an early grave, too: Women who eat the most sugar have a 10 percent higher risk of dying from any cause, compared to the average person, the researchers found

The scientists gathered dietary data from about 350,000 people, then tracked how many of them died from things like cancer and heart disease over a period of more than a decade. Interestingly, the women who consumed the greatest amount of added sugars (key word: added)—often from things like candy and cookies—didn’t have an elevated risk of keeling over.

However, those who consumed lots of liquid sugar—from sodas, sports drinks, juices, etc.—had higher odds of dying of any cause (from cardiovascular disease, in particular). Why? It could be because sugars from beverages are rapidly absorbed, resulting in significant blood-sugar spikes, the scientists say.

Here’s perhaps the most intriguing finding: The females who ate the most fructose, a type of sugar found in fruit, juice, soft drinks, and candies, faced an above-average chance of dying during the study period.

Why might consuming fructose have this effect? While this study just proved association, not causation, scientists do have a theory: Fructose produces “advanced glycation end-products,” or AGEs, which may damage the walls of your arteries, encourage bad cholesterol to hang around, and promote the progression of cancer. A high intake of the stuff may also lead to insulin resistance, a precursor to diabetes.

You don’t, of course, have to give up fruit, which is a staple of any well-balanced diet. But you may want to cut back on your intake of other sources of fructose: fruit juices, soft drinks, preserves, applesauce, dried fruit, and candies. Watch for “sucrose” on the labels of packaged food, too, since this type of sugar is 50 percent fructose.

via Study: Fructose intake linked to slightly higher risk of death | Fox News.

“Year of No Sugar” author explains health benefits of less sugar – The Denver Post

Tomato sauce can also be made sugar-free. (Cyrus McCrimmon, The Denver Post)

The next time you pick up a jar or can of tomato sauce at the grocery store, have a look at the ingredients. Almost always, you’ll find sugar listed on the label.

Which is sort of ridiculous. Why does tomato sauce need sugar? It’s used on spaghetti, lasagna and other savory foods.

But what’s this? Check out the nutrition facts label on the box of pasta. Sugar again! It’s even in single-serving cup-of-soup packages.

“Some of the top stealth sources of fructose are energy drinks, fruit yogurts, agave syrup and many foods labeled ‘low fat,'” said University of Colorado physician Richard J. Johnson, whose books “The Sugar Fix” and “The Fat Switch” discuss the problem in detail.

Sugar might be costumed as evaporated cane juice, table sugar, honey, fruit juice, powdered sugar, agave, crystalline fructose, brown sugar, molasses, maple syrup. It’s still sugar, and what is it doing in bacon? Or mayonnaise? Or ketchup?

That’s what blogger and author Eve O. Schaub wanted to know. Her epiphany began after she watched ” Sugar: The Bitter Truth.” That’s pediatric endocrinologist Robert Lustig’s documentary on his theory that fructose is more poison than sweetener, and that sugar is more fattening than fat.

These shortbread cookies, two with chocolate, are made without sugar. (Cyrus McCrimmon, The Denver Post)

“I was deeply alarmed,” Schaub said in a telephone interview from her home in Vermont.

“It made me think a lot about our palates, and the obesification of America. One hundred years ago, we didn’t have obesity or metabolic syndrome. What have we done that’s created those things?

“We had these studies in the 1960s and ’70s that said fat was bad. So we removed fat from everything. But then how do you make it taste good? Let’s put sugar in it. And it turns out that may have been the exact wrong thing to do.”

She began looking more closely at labels when she shopped for groceries. “There was sugar, in all its myriad guises,” Schaub writes in “Year of No Sugar,”the memoir inspired by Lustig’s video. Of course sugar is in sweet products, like cookies, cakes, candy and ice cream.

Fresh-baked sugarless bread is delicious. (Cyrus McCrimmon, The Denver Post)

But it’s also in peanut butter, sandwich bread, wine, milk, orange juice and dozens of other products that wouldn’t seem to need added sugar. Special K, promoted as a diet-friendly cereal, has three teaspoons of added sugar per 100 grams. Schaub found sugar in canned black beans and in a commercial Thai yellow curry sauce.

Those counterintuitive sugar-added products explain why a 2010 Robert Woods Johnson-funded study found that 33 percent of an American child’s diet consists of added sugar and solid fat.

“As a culture, are we normalizing this much sugar in what we eat?” Schaub said. “I don’t want to encourage anyone not to eat, but our consumption of sugar and fructose had quadrupled from what Americans were eating 100 years ago, and the number of obese Americans has septupled since then. All these issues are related. Fructose is the elephant in the room.”

Schaub, with Lustig, author David Gillespie, Michelle Obama, the Center for Science in the Public Interest and others, supports the proposed FDA nutrition-label modifications that specify the amount of added sugar and represent realistic serving sizes.

Dannon is among the companies getting ahead of the curve. It recently announced that by 2016, it will reduce sugar in yogurt products for children.

Some no-added-sugar advocates compare their campaign to the effort to print warning labels on cigarette packages.

“I think there are a lot of parallels between added sugar and tobacco,” Schaub said.

“Cigarettes do bad things to you, but the real harm is over a long period of time. It’s easy for people to dispute the harm. Fructose is the same way. The damage it does is over such a long period of time. It’s not as if a piano falls on your head and you die. It’s gradual and cumulative.”

via “Year of No Sugar” author explains health benefits of less sugar – The Denver Post.

A Number That May Not Add Up – NYTimes.com – NYTimes.com

A Number That May Not Add Up

By JANE E. BRODY APRIL 14, 2014, 12:01 AM 75 Comments

Yarek Waszul

In July 1998, the National Institutes of Health changed what it means to be overweight, defining it as a body mass index of 25 or greater for adults. The cutoff had been 28 for men and 27 for women, so suddenly about 29 million Americans who had been considered normal became overweight even though they hadn’t gained an ounce.

The change, based on a review of hundreds of studies that matched B.M.I. levels with health risks in large groups of people, brought the country in line with definitions used by the World Health Organization and other health agencies. But it also prompted many to question the real meaning of B.M.I. and to note its potential drawbacks: labeling some healthy people as overweight or obese who are not overly fat, and failing to distinguish between dangerous and innocuous distributions of body fat.

More recent studies have indicated that many people with B.M.I. levels at the low end of normal are less healthy than those now considered overweight. And some people who are overly fat according to their B.M.I. are just as healthy as those considered to be of normal weight, as discussed in a new book, “The Obesity Paradox,” by Dr. Carl J. Lavie, a cardiologist in New Orleans, and Kristin Loberg.

Unlike readings on a scale, B.M.I. is based on a person’s weight in relation to his height. It is calculated by dividing weight in kilograms by height in meters squared (or, for those not metric-savvy, weight in pounds divided by height in inches squared and the result multiplied by 703).

According to current criteria, those with a B.M.I. below 18.5 are underweight; those between 18.5 and 24.9 are normal; those between 25 to 29.9 are overweight; and those 30 and higher are obese. The obese are further divided into three grades: Grade 1, in which B.M.I. is 30 to 34.9; Grade 2, 35 to 39.9; Grade 3, 40 and higher.

Before you contemplate a crash diet because your B.M.I. classifies you as overweight, consider what the index really represents and what is now known about its relationship to health and longevity.

The index was devised in the 1830s from measurements in men by a Belgian statistician interested in human growth. More than a century later, it was adopted by insurers and some researchers studying the distribution of obesity in the general population. Though never meant to be an individual assessment, only a way to talk about weight in large populations, B.M.I. gradually was adopted as an easy and inexpensive way for doctors to assess weight in their patients.

At best, though, B.M.I. is a crude measure that “actually misses more than half of people with excess body fat,” Geoffrey Kabat, an epidemiologist at the Albert Einstein College of Medicine, has noted. Someone with a “normal” B.M.I. can still be overly fat internally and prone to obesity-related ills.

Calling B.M.I. an imperfect predictor of a person’s health risks, the Centers for Disease Control and Prevention cautions doctors against using it as a diagnostic tool.

For one thing, body weight is made up of muscle, bone and water, as well as body fat. B.M.I. alone is at best an imprecise measure of how fat a person may be. When Arnold Schwarzenegger was Mr. Universe, his B.M.I. was well in the obese range, yet he was hardly fat.

Another problem: the distribution of excess body fat makes a big difference to health. Those with lots of abdominal fat, which is metabolically active, are prone to developing insulin resistance, elevated blood lipids, high blood pressure, diabetes, premature cardiovascular disease, and an increased risk of erectile dysfunction and Alzheimer’s disease.

But fat carried in the hips, buttocks or thighs is relatively inert; while it may be cosmetically undesirable, it is not linked to chronic disease or early death.

Furthermore, a person’s age, gender and ethnicity influence the relationship between B.M.I., body fat and health risk. Among children, a high B.M.I. is a good indicator of excess fat and a propensity to remain overly fat into adulthood. But for an elderly person or someone with a chronic disease, a B.M.I. in the range of overweight or obesity may even be protective. Sometimes — after a heart attack or major surgery, for example — extra body fat can provide energy that helps the patient to survive. An added layer of fat can also protect against traumatic injuries in an accident.

On average, women have a higher percentage of body fat in relation to total weight than do men, but this does not necessarily raise their health risks. And African-Americans, who tend have heavier bones and weigh more than Caucasians, face a lower risk to health even with a B.M.I. in the overweight range.

Physical fitness, too, influences the effects of B.M.I. In an editorial in JAMA last year, Dr. Steven B. Heymsfield and Dr. William T. Cefalu of the Pennington Biomedical Research Center in Baton Rouge, La., noted that “cardiorespiratory fitness” is an independent predictor of mortality at any level of fatness.

While experts continue to debate whether a person can be “fit and fat,” Keri Gans, a dietitian in New York and former spokeswoman for the Academy of Nutrition and Dietetics, points out that physical activity and a healthy diet tend to offset the risks of being overweight.

“You don’t need to be thin to be fit,” she said. At any weight, fitness can reduce the risk of developing heart disease, lung disease, diabetes or high blood pressure.

via A Number That May Not Add Up – NYTimes.com – NYTimes.com.