Obesity a culprit as strokes rise in pregnant women

Written by Adam Tamburin | The Tennessean

The stroke rate for pregnant women and women who have recently given birth has increased by 54 percent since the mid-1990s, according to a new report that local physicians are greeting with alarm, if not surprise.

The report, released Thursday by the American Heart Association and the American Stroke Association, examined millions of patient discharge records in a national database culled from 1,000 hospitals. It found 4,085 hospitalizations because of pregnancy-related strokes from 1994-1995 and 6,293 of the same cases from 2006-2007.

These results come as no surprise to several local physicians, who say they have noticed an increase in risk factors for strokes, including obesity and high blood pressure, among their pregnant patients.

“It’s shocking, but it’s not surprising,” said Janice E. Whitty, director of maternal fetal medicine for Meharry Medical College.

“We’ve had a tremendous increase in obesity in pregnancy, and this, I think, is really driving this dreaded complication.”

Whitty said obesity among pregnant women often leads to high blood pressure and other complications that can increase the risk of a stroke.

Extra weight can add to risks

Cornelia Graves, medical director of the perinatal program at Baptist Hospital, said most of her hospital’s pregnant patients were obese before conceiving, a fact that is in keeping with Tennessee’s high obesity rate.

Graves said the added weight on most expectant mothers can exacerbate health risks pregnant women already face, as pregnancy often uncovers hereditary health issues that women have not yet encountered.

“Women come in with these histories of cardiovascular disease and diabetes and they come in 45 pounds heavier than their mothers were when they had children,” Graves said. “You already have genetic risk factors and then pregnancy unmasks these risk factors. And now you have this weight issue.”

Medications help

Whitty and Graves said this report’s findings are another indication of the nation’s struggle with obesity.

However, they said, they have not noticed a steep spike in pregnancy-related strokes.

Graves said this could be because of the aggressive treatment of high blood pressure in pregnant women in Middle Tennessee, and the TennCare program that offers health insurance to pregnant Tennesseans with low incomes.

About 60,000 women are enrolled in the program at a time, according to a TennCare spokeswoman.

Sometimes, Graves said, Baptist physicians put at-risk patients on several medications meant to combat high blood pressure.

“You’re not going to avoid every stroke, but those things can definitely help to turn the tide,” she said.

The key to avoiding strokes among at-risk women is the regular care of a physician, said Sanat Dixit, a neurosurgeon with Summit Medical Center and Cumberland Brain & Spine.

“Stroke in pregnancy could potentially be preventable if you can manage the risk factors properly,” he said. “Those risk factors can be mitigated with proper medical management.”

Whitty said obesity and added risk factors for stroke are especially prevalent among low-income patients, who might not have access to healthier food or might not view regular medical checkups as a necessity during pregnancy.

Preventive steps

Jessica Florida, vice president of physician recruitment for TriStar Health System, is due to give birth to her second child on Monday and is taking medication to fight her high blood pressure.

Although she doesn’t typically struggle with high blood pressure or obesity, Florida said, her blood pressure reached potential stroke levels in the days after the birth of her son in 2006.

“The blood pressure issue cropped up really quickly,” Florida said. “It was scary once I realized that my blood pressure was as high as it was.”

Florida credited her doctors and a more strenuous exercise regimen with defusing what could have been a deadly health hazard.

Whitty, Graves and Dixit all said that women should regularly monitor obesity, high blood pressure and other stroke risks — even if they aren’t pregnant.

“Many of those patients never see a physician until they get pregnant,” Graves said. “We need to close in that window and care for women … during those child-bearing years.”

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UNC Obesity Epidemic Study: People eating bigger portions, more often
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Restaurant scheme to tackle obesity in children with smaller portions

CONOR POPE, Consumer Affairs Correspondent

THE CHICKEN nuggets and chips combination so beloved of Irish children may become a thing of the past if a restaurant initiative aimed at tackling childhood obesity takes off.

Thousands of restaurants are to begin offering child-friendly portions of their adult menus alongside their children’s menus as part of a joint campaign announced yesterday by the Nutrition and Health Foundation and the Restaurants Association of Ireland.

The “Kids Size Me” scheme being rolled out by the group’s 6,000 members is looking to provide healthier options for children.

President of the association Brian Fallon said it would also give members who took part “huge marketing material” at a time when many were struggling to keep their doors open.

Participating restaurants will offer children access to healthier food options by making smaller portions of adult meals available as an alternative to the standard children’s menus. They will carry the new “Kids Size Me” symbol.

Over the coming weeks, consumers will be able to check which restaurants are participating on the wheretoeat.ie website.

Dietician and foundation manager Dr Muireann Cullen said Ireland had one of the highest rates of childhood obesity in the world and one in four Irish children was overweight or obese.

She said it was “essential to ensure children have access to healthier food options in the appropriate serving size and that this is actively promoted by restaurants”.

Research commissioned by the foundation found there was an overwhelming demand for child-size portions of adult meals, with 98 per cent of parents wanting the option of ordering smaller portions off adult menus for their children.

It found that while 80 per cent of restaurants allowed diners to do this, nearly two-thirds did not publicise the fact.

The survey found 78 per cent of children chose their meal themselves with 53 per cent ordering of the adult menu.

“It is clear that the demand is out there and it is now time for restaurants to act on that demand,” said Mr Fallon, one of the owners of Fallon Byrne on Dublin’s Exchequer Street.

“It is about a mindset and about changing attitudes.”

He said his restaurant would be changing its menus to reflect it was part of the new campaign.

He did not believe restaurants would replace their children’s menus entirely but would use the new portion options as “a bolt-on to what already exists, which will start a process of getting people to think about the healthier options”.

He stressed that while the campaign would not cost restaurants money, it would still offer parents better value for money.

The foundation survey found 55 per cent of parents thought a children’s meal costing between €5 and €7.50 was value for money, while a third thought the price ceiling could reach €10 and still represent good value.

52% of children eat out once a month

98% of parents want their children to have child-sized portions of adult meals

73% of children chose their own meals

56% would pay €7.51-€10 for a portion for a 10-12-year-old.

Based on an NHF survey of 500 parents.

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Snacking Clue To Obesity Epidemic

Dwyane Wade Undergoes Lasik Eye Surgery
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Can Michigan win the battle against obesity?

Written by Louise Knott Ahern

The numbers are staggering.

They get quoted all the time, dire estimates about how much it costs Michigan to be the 10th fattest state in the nation.

They show up in expert testimony before the Legislature. They appear in press releases by advocacy groups trying to influence state law. Gov. Rick Snyder himself reportedly relied on one estimate — $9 billion — as the basis for listing obesity reduction as a priority in his administration.

But is it really $9 billion? Or is it more like $42 billion, as one study suggests? Or maybe only $52 million, cited by yet another?

The wide-ranging disparities raise more questions than they answer about what Michigan’s rising obesity epidemic means for the businesses, taxpayers and individuals of the Great Lakes state.

Where do the estimates come from? What do they include? And, most importantly, who ultimately pays the bill?

Chart: Healthcare costs and obesity
Data:Michigan county-by-county obesity rates
Tips: Do just one thing toward better health

“The costs of obesity are enormous,” said Dr. Lee Kaplan, chairman of the national Campaign to End Obesity, a consortium of roughly 50 businesses, nonprofits, government agencies and other groups. “You have medical costs, you have disease, you have death and quality of life, military preparedness, and of course, lastly, you have lost productivity in the economy. What part of modern society have we not touched on as being adversely affected by obesity? None. So who pays the bill? We all do.”

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

UNC Obesity Epidemic Study: People eating bigger portions, more often

Post on July 1, 2011 by Adam Searing

UNC-Chapel Hill researchers have a pretty comprehensive study out today that looks at how – and not just what – people eat over the last thirty years. The results point to what they think is a major cause of people getting much, much heavier: people are eating significantly more in bigger portions at each meal and they are eating more often between meals.

This research goes way beyond the “supersize me” fast food debacle, because it looks at what people are eating in a wide variety of situations over a long period of time. I’ve read the full article and I think the authors are pretty persuasive that, at least based on this study, a primary problem causing our obesity epidemic is simply that people are eating way too much.

Just like anything in public health, it’s always hard to separate out the causes with obesity. With cities and towns set up for cars and not pedestrians or bicycles, with huge increases in soda consumption coupled with corresponding large drops in average price for sugary drinks, with the elimination of gym and recess as part of the school day in many areas, there are plenty of potential causes.

However, this UNC study on portion size is persuasive in its arguments mainly because it looked at so many people over such a long period of time for some pretty specific behavior. It’s worth a look.

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How To Fight Trend in Preschool Obesity