Blogs / 80beats

In yet another warning signal of the toll that childhood obesity will take on health and health care budgets, a small study has shown that overweight kids as young as 10 years old have the thickened arteries of 45-year-olds. Researchers say the findings raise the possibility that these kids could develop serious heart disease in their 20s or 30s. “There’s a saying that ‘you’re as old as your arteries,’ meaning that the state of your arteries is more important than your actual age in the evolution of heart disease and stroke,” said [lead researcher] Dr Geetha Raghuveer [Telegraph].

The findings, while preliminary, should serve as a serious alarm bell in the United States, where about one-third of children are overweight and almost one-fifth are obese. Many parents think that “baby fat” will melt away as kids get older. But research increasingly shows that fat kids become fat adults, with higher risks for many health problems. “Obesity is not benign in children and adolescents,” said Dr. Robert Eckel, a former heart association president [AP].

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A drug that mimics the effects of a compound found in red wine has been shown to prevent obesity and diabetes in mice that were fed a high-calorie diet and prevented from exercising, taking another step towards the target of a anti-obesity pill. The natural compound found in grapes and red wine, called resveratrol, is believed to have numerous health benefits related to longevity, heart health, and metabolism. But tests in mice suggested gallons of wine would be necessary for humans to stand a chance of getting the same benefits. The scientists turned their attention to creating a more potent drug [BBC News].

The new experimental drug, called SRT1720, was developed by the pharmaceutical company GlaxoSmithKline. Researchers explain that mice fed a high-fat diet were tricked into switching their metabolisms to a fat-burning mode that normally takes over when energy levels are low…. “We are activating the same enzymes that are activated when people go to the gym,” said Peter Elliott, a vice president at Sirtris Pharmaceuticals, the Glaxo unit that developed the drug. “That is why we believe the profile for this drug is very safe” [Reuters].

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In a counterintuitive new study, researchers have found that obese women get less pleasure from drinking a chocolate milkshake than average-weight women, and suggest that obese women are therefore more likely to overeat in an attempt to get that high. Researchers used a fMRI brain scanner to record women’s levels of the pleasure-providing brain chemical dopamine while they were sipping milkshakes, and found that obese women had a muted pleasure response.

They also studied a dopamine-regulating gene variant that has previously been linked to obesity, and showed that women with this variant had the lowest dopamine levels and were also very likely to gain weight over the ensuing year. Dopamine expert Nora Volkow says this furthers the research on the genetic component of obesity: “It takes the gene associated with greater vulnerability for obesity and asks the question why. What is it doing to the way the brain is functioning that would make a person more vulnerable to compulsively eat food and become obese?” [AP]

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Researchers have developed two drugs that mimic some of the effects of exercise in mice, leading to rampant speculation that people may soon be able to take a dose of “exercise in a pill.” The dramatic study showed that the drugs built fat-burning muscles in mice and increased their endurance on an exercise wheel. Four years ago researchers bred genetically engineered mice that could run much further than normal, but this is the first test to prove that drugs can have the same effect [Telegraph].

“It’s tricking the muscle into ‘believing’ it’s been exercised daily,” said the study’s lead researcher, Ronald Evans…. “It’s basically the couch potato experiment, and it proves you can have a pharmacologic equivalent to exercise” [Wired News]. One drug proved effective for mice that were already exercising regularly, increasing their running time by 68 percent and distance by 70 percent. The other drug worked on mice that hadn’t been trained to exercise; that compound increased their running time by 23 percent and distance by 44 percent.

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California is striking a blow against obesity and heart disease: On Friday, Governor Arnold Schwarzenegger signed a bill outlawing the use of trans fats in all restaurants and bakeries. The bill creates the first state-wide ban of trans fats, but follows the path set out by cities like New York City and Philadelphia, which have already evicted the substance from restaurants within city limits.

Trans fats are created by pumping hydrogen into liquid oil at high temperature, a process called partial hydrogenation. The process results in an inexpensive fat that prolongs the shelf life and appearance of packaged foods and that, many fast-food restaurants say, helps make cooked food crisp and flavorful [The New York Times]. The artificial fats have been shown to increase levels of “bad” cholesterol and decrease levels of “good” cholesterol, and are therefore linked to heart disease.

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The results are out from a new study that compared the results of three different diets, and the researchers say that the famously low-carbohydrate, high-fat Atkins diet was the most effective. Lead researcher Meir Stampfer claims: “The low-carb diet was the clear winner in providing the most weight loss” [ABC News]. But many others are less convinced that the study gives the prize to the Atkins diet, and say that the study had some serious flaws.

The study, published in the New England Journal of Medicine, compared the Atkins diet to a low-fat diet that emphasized whole grains, fruits, and vegetables, and also to a “Mediterranean” diet that allows a modicum of fats in the form of olive oil, nuts, and fish. While obese people who stuck with the Atkins diet for two years lost an average of 12 pounds, compared to 10 pounds for the Mediterranean dieters and 7 pounds for the low-fat dieters, some say that focusing on those numbers misses the point. The study… was supposed to determine which of three types of diets works best. Instead, the results highlight the difficulty of weight loss and the fact that most diets do not work well [The New York Times].
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The day after the American Academy of Pediatrics recommended prescribing cholesterol-lowering drugs to some 8-year-olds, howls of protest arose from many doctors and parents. While the academy maintains that prescription drugs could help cope with the rising tide of childhood obesity and could prevent children from developing heart disease later in life, many observers say the guidelines send the wrong messages to families.

Some doctors said the recommendation would distract from common-sense changes in diet and exercise, which are also part of the new guidelines. “To be frank, I’m embarrassed for the A.A.P. today,” said Dr. Lawrence Rosen [The New York Times]. Childhood obesity expert David Ludwig adds: “My concern is what this is saying about society when we are so quick to prescribe drugs for these conditions before having systematically attacked the problem from the public health perspective” [The New York Times].

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The American Academy of Pediatrics has issued new guidelines that call for testing at-risk children’s cholesterol levels from the age of 2, and advise giving some children cholesterol-lowering drugs from the age of 8 in hopes of preventing heart disease later in life. Writing in the journal Pediatrics, doctors say that the recommendations have taken on “a new urgency, given the current epidemic of childhood obesity.”

The new guidelines are likely to stir the controversy over prescribing long-term medications to children, especially for treating symptoms related to obesity, which can also be treated with diet and exercise. But proponents say there is growing evidence that the first signs of heart disease show up in childhood, and with 30 percent of the nation’s children overweight or obese, many doctors fear that a rash of early heart attacks and diabetes is on the horizon as these children grow up [The New York Times].

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New York City made another attempt to improve the health of its citizens yesterday, as a ban on trans fats in the city’s restaurants, cafeterias, and even hot dog and pretzel stands took full effect. Trans fat, also known as partially hydrogenated vegetable oil, is linked to clogged arteries and heart disease. But restaurants have found many uses for the man-made vegetable shortenings and oils, which give pastry its flakiness and french fries their crispiness.

It’s the first such ban by a major U.S. city, and most give credit for the idea to New York Mayor Michael Bloomberg, who has been on a health crusade during his tenure in office. He banned smoking in bars and restaurants during his first term…. New York restaurant chains were recently ordered to start listing calorie information on their menus [Telegraph]. The first phase of the trans fat ban took effect last year, when restaurants were ordered to stop using them in cooking oils and spreads. Now, after a short grace period, any restaurant found using any trans fats will be fined up to $2,000.

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Gastric bypass surgery may seem a drastic option for someone battling obesity, but good results keep coming in: It works, and it appears to bring a host of health benefits. Last August, two studies showed that patients who tried the surgery had a reduced risk of dying from cancer; now a more specific study has demonstrated that the surgery cuts the risk of breast and colon cancer, the two most common forms.

Bariatric surgery is the only effective treatment for morbid obesity, according to the World Health Organization, and is usually performed using one of two different techniques. One focuses on reducing the size of the patient’s stomach alone, leading to decreased food intake. The second also reroutes food through the intestines, allowing fewer calories to be absorbed [Globe and Mail]. The surgery has already been shown to reduce risks of heart disease and diabetes, and the U.S. Medicare program is currently considering paying for the expensive surgery as a diabetes treatment.

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