Snacking clue to obesity epidemic

By Helen Briggs

Snacking and super sizing are two of the dieter's worst enemies, research suggests.

The average daily calorie intake in the US has increased by almost a third in 30 years, reaching 2,374 kilocalories.

The influence of bigger portion sizes and excessive snacking outweighs the shift towards high-calorie foods, say experts.

Focussing on reducing how much and how often people eat could help tackle obesity, they report in PLoS Medicine.

Obesity levels have risen sharply in many western countries since the 1970s. In the US, where the study was carried out, a third of all adults - more than 72 million people - are now categorised as obese.

A team from the University of North Carolina analysed data from food surveys carried out in the seventies, eighties, nineties and the last decade.

The surveys record all food and drink a person consumes over a 24-hour period.

The average daily energy intake of a US citizen increased from 1,803 kcal in 1977-78 to 2,374 kcal in 2003-06.

In the last decade of the study alone, the average daily calorie intake went up by 229 kcal.

Several factors are involved in energy intake - the number of calories (energy) in a specific amount of food (energy density), portion size and how many meals and snacks a day eaten.

The researchers say that while all of these have gone up, increases in the number of eating occasions and portion size seem to account for most of the change.

They suggest efforts to prevent obesity should focus on reducing the number of snacks and meals a day as well as portion size.

"These findings suggest a new focus for efforts to reduce energy imbalances in US adults," write Kiyah Duffey and Barry Popkin of the University of North Carolina in the journal PloS Medicine.

Commenting on the paper, Dr Áine O'Connor, a scientist at the British Nutrition Foundation said: "Many factors influence total energy intake that can lead to [being] overweight and obesity but it is possible that having more eating occasions through the day, for example by frequent snacking, would increase calorie consumption and so lead to weight gain.

"This study also looked at portion size and studies have shown that having larger portions of food leads to an increased intake.

"The researchers were based in the US, but many of the factors causing the obesity epidemic there are mirrored in the UK and, for those trying to control their weight, it is important to manage both how much and how often they eat."

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NZ's soaring diabetes rate puts us with world's worst

Rising levels of obesity blamed for disease that afflicts about 350 million people New Zealand has one of the developed world's worst diabetes problems - and the corresponding increase in obesity is part of the reason, according to an international study.

More than 350 million people in the world now have the disease, British researchers found.

The analysis, published online by the Lancet medical journal, adds several tens of millions to estimates of the number of diabetics and indicates that the disease has become a global health problem.

In wealthy nations, diabetes was highest in the United States, Malta, New Zealand and Spain, and lowest in the Netherlands, Austria and France.

Scientists blame the increase on the spread of a Western-style diet, leading to rising levels of obesity.

Other badly affected countries included many Pacific Island nations.

In the Marshall Islands one in three women and one in four men have diabetes.

Researchers also say that increased longevity is playing an important role.

Diabetes New Zealand president Chris Baty told Radio New Zealand that the results were not surprising, as the country also has one of the highest obesity rates.

The most common type of diabetes, Type 2, is strongly associated with obesity and a sedentary lifestyle.

University of Otago professor of nutrition and medicine Jim Mann also told the broadcaster that New Zealand had no concerted public health programme to tackle the obesity epidemic.

"Unless we do something about the obesity epidemic we're not going to do anything about the diabetes epidemic," he said.

One of the British study's main authors, Professor Majid Ezzati of Imperial College, London, said: "Diabetes is one of the biggest causes of mortality worldwide, and our study has shown that it is becoming more common almost everywhere. It is set to become the single largest burden on world health care systems.

"Many nations are going to find it very difficult to cope with the consequences."

The study - which was financed by the World Health Organisation and by the Bill and Melinda Gates Foundation - analysed blood from 2.7 million participants aged 25 and over from around the world over a three-year period.

To find out if they had diabetes, doctors measured the levels of glucose in their blood after they had fasted for 12 to 14 hours - blood sugar rises after a meal. If their glucose level fell below 5.6 millimoles a litre, they were considered healthy.

If their reading topped 7, they were diagnosed as having diabetes, while a result that ranged between 5.6 and 7 indicated that a person was in a pre-diabetic state.

From the results, it was estimated that the number of adults with diabetes was 347 million, more than double the 153 million estimated in 1980 and considerably higher even than a 2009 study that put the number at 285 million.

"We are not saying the previous study was a bad one," said Professor Ezzati. "It is just that we have refined our methods a little more."

DISEASE GROWS

* Worst: United States, Malta, New Zealand, Spain.

* Best: Netherlands, Austria, France.

- OBSERVER, NZ HERALD STAFF

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Obesity On The Rise In Canada

How to Fight Trend of Preschool Obesity

Institute of Medicine Calls for New Policies to Promote Exercise and Healthier Eating

By Salynn Boyles
WebMD Health News

June 23, 2011 -- A growing number of preschool-age children in the U.S. are overweight or obese and greater efforts are needed to address the problem, the health policy group Institute of Medicine (IOM) says.

In a new report, an IOM committee outlined policies designed to reduce obesity by promoting healthy eating, exercise, and sleep habits among infants, toddlers, and preschoolers.

But instead of focusing solely on what parents can do, the report highlighted ways federal and state regulators, doctors, and child-care workers can help prevent obesity in very young children.

One in 10 infants and toddlers in the U.S. and one in five children between the ages of 2 and 5 are overweight.

"Contrary to the notion that chubby babies are healthy babies and that young children grow out of their baby fat, it is looking like children who are overweight early may be more likely to be overweight and obese later on," committee chair Leann L. Birch, PhD, tells WebMD.

Limit TV Time

Birch, who directs the Pennsylvania State University Center for Childhood Obesity Research, says addressing the problem in very young children is critical because obesity-related conditions such as diabetes and high blood pressure are occurring with greater frequency among older children, teens, and young adults.

The IOM report included these recommendations for state and federal regulators:

• Requiring day care centers and preschools to provide the opportunity for at least 15 minutes of physical activity per hour to toddlers and older children, while allowing infants to move freely at times with appropriate supervision.
• Limit TV and other screen time to no more than 30 minutes for half-day day care programs and one hour for full-day programs.
• Day care centers and other child-care providers should be required to promote healthy sleep times during the day.

Kids Need More Sleep, Exercise

Birch says just like their parents, very young children appear to be sleeping less overall these days. Studies show that insufficient sleep time is a risk factor for obesity.

It is recommended that children age 2 and under get 12 hours or more of sleep each day and children between the ages of 2 and 5 get at least 11 hours of sleep.

Keeping TVs out of bedrooms, creating environments that promote naps and nighttime sleep, and establishing sleep routines are all important to promoting healthy sleep habits, IOM committee member Debra Haire-Joshu, PhD, MPH, of Washington University in St. Louis tells WebMD.

The report stressed the importance of giving young children plenty of opportunity to be active during the day.

"We know that children in many day care settings are not getting enough physical activity during the day," Birch says.

She says several states now require day care centers to provide the opportunity for at least two hours of physical activity during an eight-hour day.

"Children tend to be active in short bursts, so if they have the opportunity for activity throughout the day they are likely to expend more energy," she adds.

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Obesity rate is ballooning

By TYLER KULA, The Observer

Lambton County's obesity rate is slightly below the Canadian average, according to a new report.

Obesity in Canada, released by the Canadian Institute for Health Information (CIHI) and the Public Health Agency of Canada (PHAC), says 25% of adults are obese, based on height and weight data from 2007-2009.

In Lambton County the obesity rate for adults is 22%, up from 15% in 2003.

Canadian obesity rates have more than doubled for men and women since 1981, the 54-page report says.

"As our population gains weight and becomes obese, the incidence of type two diabetes, heart disease, stroke, some types of cancers are also increasing, therefore increasing the cost of the medical system to deal with those chronic illnesses," said Connie Mallette, a registered dietitian with Lambton County.

The CIHI-PHAC report says obesity cost the Canadian economy $4.6 billion to $7.1 billion in 2008, up from $3.9 billion in 2000.

Physical inactivity is the strongest indicator of obesity, the report says, but lifestyle factors don't account for everything.

Women in higher income brackets were significantly less likely to be obese than those with lower incomes — a difference not found for men.

There's no data to compare locally, said Lambton epidemiologist Crystal Palleschi. But studies from Statistics Canada have similar findings, she said.

The CIHI-PHAC study also points to higher obesity rates among aboriginal people. A 2002/03 study found 36% of on-reserve adults were obese.

A recently-released Health Sarnia-Lambton Community Picture report says 4.6% of Lambton County's population is aboriginal, compared to a provincial average of 2%.

Canadian obesity rates vary dramatically — from 5.3% in Richmond, B.C., to 35.9% in the Mamawetan/Keewatin/Athabasca region of Saskatchewan.

Addressing health services for individuals, implementing community-level strategies for individuals and groups, and developing public policies are aspects of developing a multifaceted, long-term approach for obesity prevention, the study says.

Locally, the Health Community Picture report recommends establishing transportation policies that increase access to healthy food — one of six recommendations addressing smoking, healthy eating, physical activity, mental health, alcohol and substance abuse, and injury prevention.

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Drug Maker Withdraws Bid for Obesity Drug Approval

Obesity on the rise in Canada, but Richmond has lowest rate in country

By Sean Sullivan, The Province

An abundance of fresh air, recreation facilities and level terrain may be some of the reasons why Richmond has the lowest obesity rate in Canada, residents say.

According to a joint report issued Monday from the Canadian Institute for Health Information and the Public Health Agency of Canada, one in four adults are now obese.

In Richmond, however, just five per cent of adults — one in 20 — are obese.

While the report doesn’t say why the community beats even fitness-crazy Vancouver, which stands at 6.2 per cent, jogger Shable Cheng-Yuan Hszgh said it’s all about the fresh air.

“We like to exercise: walking, jogging, or any exercise,” he said near the entrance to the city’s West Dike Trail.

Gesturing to the tall grass and cattails swaying alongside the Fraser River, he added, “It feels very isolated here. It’s easy to get outside.”

According to estimates by researchers, the equivalent of 405,000 cases of male obesity, and 646,000 cases of obesity in women could potentially be “altered or averted” if inactive Canadians did at least 15 minutes of low-impact activity a day, such as walking.And in Richmond, where the land is remarkably flat, walking is easy.

“You always see a lot of people out here,” Maureen Wielens said. “It’s flat, which makes it easier to bike across the dike.

“I wouldn’t be getting on a bike if I had to go up a hill,” she laughed.

The low rate of obesity in Richmond and neighbouring Vancouver stand in stark contrast to other regions of Canada, where rates shoot as high as 32 per cent in Kings County, P.E.I., and nearly 36 per cent in the northern Mamawetan/Keewatin/Athabasca region of Saskatchewan.

Between 1981 and 2009, obesity — based on actual measures of height and weight, and not people self-reporting their weight — roughly doubled across all age groups, and tripled for youth aged 12 to 17.

When figures for obesity are combined with those for being overweight, 62 per cent of Canadians overall weigh more than they should.

In addition to an increase in exercise, researchers if people improved “poor quality” diets by eating more fruits and vegetables, potentially 265,000 fewer men, and 97,000 fewer women would be obese.The report was quickly attacked by obesity experts as simplistic and misleading, arguing it risks leading to more discrimination against the overweight.

“The notion that 15 minutes of extra activity and eating more fruits and vegetables will have any noticeable impact on this epidemic is both simplistic and misleading,” said Dr. Arya Sharma, professor of medicine and chair in obesity research and management at the University of Alberta in Edmonton.

Many underlying drivers contribute to obesity, he said — including mental-health issues and the fact people are sleeping less and working longer hours. Researchers are exploring whether obesity starts in the womb.

“All of this is completely ignored when you bring it down to diet and exercise,” Sharma said.

Read more: http://www.theprovince.com/health/Obesity+rise+Canada+Richmond+lowest+rate+country/4977837/story.html#ixzz1PsYJosMv

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Is obesity a lifestyle or a disease?

By Kaitlin Prettyman, Deseret News

According to Medicare, obesity is a disease. But according to others, it's actually a lifestyle.

April Herndon, an associate professor of English at Winona State University in Minnesota, is one person who is tackling the issue.

Psychology Today writer Alice Dreger, a professor of clinical medical humanities and bioethics at Northwestern University's Feinberg School of Medicine in Chicago, asked Herndon to address some obesity questions. In regards to whether it's a disease or a lifestyle choice, Herndon said, "The truth is that obesity is so complicated that most doctors and scientists will admit that the answer may change for each person or (gasp!) that we just don't know."

A disease is defined by Merriam-Webster as "a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms."

So, is obesity a disease? The International Journal of Obesity doesn't think so. It says, "Obesity, defined as a body mass index (BMI, kg/m2) or percentage body fat in excess of some cut-off value, … lacks a universal concomitant group of symptoms or signs and the impairment of function which characterize disease according to traditional definitions."

Herndon seems to support this idea, too, when she says that obesity isn't really a disease but raises the risk of certain diseases or conditions. She gives the example that obesity may not be a health problem "in and of itself" when she says, "We know that women are more at risk for breast cancer, but we don't consider being female a disease. We know that having light-colored skin and light-colored eyes increases one's risk for skin cancer, but we don't consider lighter-skinned people diseased. Obesity is similar."

Focus Taiwan listed six obesity-related diseases that were ranked among the 10 leading causes of death. The six are cancer, heart disease, cerebrovascular disease, diabetes, hypertension and kidney disease.

Obesity rates increase with each year. The New York Times published an article in 2010 that said nearly 34 percent of adults are obese, which is more than double the percentage of 30 years ago.

Some people believe that the increase has come with changing times and things like television, video games and the Internet.

WebMD said, "Every hour children play video games or watch television may double their risk of obesity, a new study suggests."

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Drug Maker Withdraws Bid for Obesity Drug Approval

By REUTERS

Published: June 3, 2011

Orexigen Therapeutics, the maker of a weight-loss drug once seen as a potential blockbuster, said it was scrapping its bid for approval in the United States because of “unprecedented” demands by regulators on safety trials. Orexigen said that it would focus on developing the drug, Contrave, and another drug candidate, Empatic, in markets outside the United States until there was a clear pathway to approval in the United States. The Food and Drug Administration refused to approve Contrave in February because of concerns about its effects on the heart. Orexigen said the F.D.A. wanted it to conduct a study on Contrave’s heart side effects that is unprecedented and would generate much more information than necessary or feasible. As recently as 2010, Contrave was seen as a highly promising obesity drug. Stock in Orexigen, which is based in San Diego, fell $1.06, or 33 percent, to $2.12 a share.

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