Social epidemic of "diabesity" and community-driven solutions - Mark Hyman at TEDMED 2012

Unhealthy lifestyles have brought on a social epidemic of "diabesity," says author Mark Hyman, and community-driven solutions may be the only way out.

Best ways to achieve weight loss - DW interview

Dr. Carsten Lekutat presents the DW health program and although not as famous as Dr. Oz he does a better job selecting experts for interview and sharing evidence-based information. In this video, the director of the German Institute for Human Nutrition, Dr. Hans-Georg Joost, speaks about being overweight, the risks of dieting, and what you should know about belly fat.



Deutsche Welle (DW) is Germany's international broadcaster. The service is aimed at the overseas market. It broadcasts news and information on shortwave, Internet and satellite radio in 30 languages.

References:

In Good Shape program - DW http://buff.ly/1igxuzV

Comments from Twitter:

Heidi Allen @dreamingspires: Great interview

Sugar is hiding in plain sight - TED-Ed video by UCSF endocrinologist

When you eat something loaded with sugar, your taste buds, your gut and your brain all take notice. This activation of your reward system is not unlike how bodies process addictive substances such as alcohol or nicotine -- an overload of sugar spikes dopamine levels and leaves you craving more

While sugar is easy to spot in candy, soft drinks and ice cream, it also hides out in foods you might not expect -- including peanut butter, pasta sauce and even bologna! Robert Lustig, a pediatric endocrinologist at the University of California, San Francisco, decodes confusing labels and sugar's many aliases to help determine just how much of that sweet carbohydrate makes its way into our diets.



Lesson by Robert Lustig, animation by The Tremendousness Collective.

More info: Sugar: Hiding in plain sight - Robert Lustig | TED-Ed http://buff.ly/1iY0PTc

Video Pre-Op Guide to Bariatric Surgery from Cleveland Clinic

A 13-minute video from the official Cleveland Clinic channel on YouTube:

Promise of Prevention: Effects of 4 Risk Factors on U.S. Life Expectancy and Disparities

This analysis included 4 preventable risk factors:

- smoking

- high blood pressure

- elevated blood glucose

- adiposity

The researchers estimated the effects of these 4 preventable risk factors on national life expectancy and on disparities in life expectancy and disease-specific mortality among 8 subgroups of the US population (the “Eight Americas”). The groups were defined on the basis of race, location and socioeconomic characteristics of county of residence, in 2005.

Who has the lowest number of risk factors?

Asians had the lowest mean body mass index, fasting plasma glucose, and smoking; whites had the lowest systolic blood pressure (SBP).

Who has the highest number of risk factors?

Systolic blood pressure (SBP) was highest in blacks, especially in the rural South - 5-7 mmHg higher than whites. The other three risk factors were highest in Western Native Americans, Southern low-income rural blacks, and/or low-income whites in Appalachia and the Mississippi Valley.

How much shorter is life expectancy if you have the risk factors?

These 4 risk factors reduced life expectancy at birth by 5 years in men and 4 years in women.

Life expectancy effects were smallest in Asians (M, 4.1 y; F, 3.6 y) and largest in Southern rural blacks (M, 6.7 y; F, 5.7 y).

Smoking and high blood pressure had the largest effect on life expectancy disparities.

Disparities in the 4 risk factors (smoking, blood pressure, blood glucose, and adiposity) explain a significant proportion of disparities in mortality from cardiovascular diseases and cancers. They also explain some of the life expectancy disparities in the US.

New Cardiovascular Prevention Guidelines, 2013. Cleveland Clinic physicians, Dr. Rocco and Dr. Nissen answer questions about AHA/ACC Heart and Stroke Risk Factor Guidelines & what they mean for you on this spreecast video chat. (12/2013)

References:

Danaei G, Rimm EB, Oza S, Kulkarni SC, Murray CJL, et al. (2010). The Promise of Prevention: The Effects of Four Preventable Risk Factors on National Life Expectancy and Life Expectancy Disparities by Race and County in the United States. PLoS Med 7(3): e1000248. doi:10.1371/journal.pmed.1000248

Image source: Wikipedia, public domain.

Innovative Weight Loss Surgery at Cleveland Clinic

Innovative Weight Loss Surgery at Cleveland Clinic: The new method reduces stomach volume by 2/3 without removing any part of the stomach. A major difference between this procedure and others is that it may potentially be reversible.

Laughter May Increase Appetite

A hearty laugh and a moderate workout may have more in common than anyone thought.

Both affect the appetite hormones in much the same way:

- When leptin goes down, it increases appetite
- When ghrelin goes up, it increases appetite

That is what typically happens after moderate exercise.

Leptin (from Greek, leptos, meaning thin) is a protein hormone that plays a key role in regulating energy intake and expenditure, including appetite and metabolism. Leptin acts on receptors in the hypothalamus of the brain where it inhibits appetite.

Ghrelin is a hormone that stimulates hunger. The name is based on its role as a growth hormone-releasing peptide, with reference to the root "ghre", meaning to grow. It is produced by the cells lining the fundus of the stomach and epsilon cells of the pancreas. It is considered the counterpart of the hormone leptin, produced by adipose tissue.

Twitter comments:

@LJaneTn Fat and Funny?

@doctorwhitecoat This explains why I'm always so hungry.

@scanman That explains why I eat too much when I party with friends.

References:
Laughter Affects Appetite Much Like a Workout Does. WebMD.

Image source: Wikipedia, public domain.

Following DASH Diet Improves Brain Activity in Overweight Adults

A new study suggest that the DASH diet in combination with regular exercise improves mental activity by 30% in overweight adults compared with those who didn’t diet or exercise. The DASH diet was developed for the Dietary Approaches to Stop Hypertension (DASH) study and emphasizes low-fat dairy products and low-cholesterol foods as well as carbohydrates and fruits and vegetables.

Researchers say high blood pressure affects about 50% of adults aged 60 and older and increases the risk of Alzheimer’s disease and other forms of mental decline like dementia.

These are 5 healthy lifestyle factors associated with a lower risk of developing high blood pressure:

1. Healthy weight: body mass index (BMI) of less than 25.
2. Daily exercise: average of 30 minutes of vigorous exercise per day.
3. Heart-healthy diet (DASH).
4. Moderate alcohol use.
5. Use non-narcotic pain relievers less than once per week.

References:

DASH Diet Fuels the Brain - WebMD.
Top diets of 2012 - from Cleveland Clinic health blog http://buff.ly/X2I4BJ
6 healthy lifestyle factors associated with a lower risk of developing high blood pressure
A table to show the impact of lifestyle interventions on blood pressure http://bit.ly/johjzs - Great for patient education.

Related:

What is the best diet in the world? DASH Diet, according to the latest review. TIME, 2011.
The long history of dieting fads: "soap should be eaten for its diuretic properties", wrote a prominent surgeon in 1810. Lancet, 2012. 

What the Average American Consumes in a Year

Average size

The average American is 36.6 years old and eats 1,996.3 lbs. of food per year. The average man is 5’9” and weighs 190 lbs. The average woman is 5’4” and weighs 164 lbs.

Meat consumption

Each year, Americans eat 85.5 lbs. of fats and oils. They eat 110 lbs. of red meat, including 62.4 lbs. of beef and 46.5 lbs. of pork. They eat 16.1 lbs. of fish and shellfish and 32.7 lbs. of eggs.

Americans eat 31.4 lbs. of cheese each year and 600.5 lbs. of non-cheese dairy products. They drink 181 lbs. of beverage milks. They eat 141.6 lbs. of caloric sweeteners, including 42 lbs. of corn syrup.

Fruit and vegetables

Americans consume 56 lbs. of corn each year and eat 415.4 lbs. of vegetables. Americans eat 273.2 lbs. of fruit each year.

Coffee

Every year, Americans consume 24 lbs. of coffee, cocoa and nuts. Americans consume 0.2 lbs. of caffeine each year, about 90,700 mg.

Fast food

The foods include 29 lbs. of French fries, 23 lbs. of pizza and 24 lbs. of ice cream. Americans drink 53 gallons of soda each year, averaging about one gallon each week.

They eat an average of 2,700 calories each day.

Salt

Americans consume 2.736 lbs. of sodium, which is 47 percent more than recommended. Some pizzas are 'saltier than the sea' (NHS blog).

References:
Food Consumption in America - VisualEconomics.com.

Preventing diabetes, biological passport for athletes and more from the Lancet

Low-dose combination therapy with rosiglitazone and metformin was highly effective in prevention of type 2 diabetes in patients with impaired glucose tolerance, with little effect on the clinically relevant adverse events of these two drugs.

Preventing type 2 diabetes with low-dose combinations: Lifestyle interventions aimed at reducing bodyweight, and use of metformin, thiazolidinediones, acarbose, and orlistat, reduce the risk of diabetes by 25—60% over 3—6 years

The biological passport and doping in athletics: A biological passport monitors an athlete's blood and body chemistry values over time to assess whether there has been a deviation from an established baseline, thus indirectly detecting illegal manipulation.

A long look at obesity: Even with their primitive understanding of nutrition, our neolithic forebears somehow made the “right choices”, thriving on a wholesome diet of nuts, seeds, and fruits with the occasional piece of meat. And what is more, their rare intake of animal protein could only have been obtained through vigorous exercise, which they would, of course, indulge in every day.

Former FDA commissioner on the killer combination of salt, fat and sugar - our food

David A Kessler, former commissioner of the FDA (the US Food and Drug Administration):

"Our favourite foods are making us fat, yet we can't resist, because eating them is changing our minds as well as bodies

For example, KFC's approach to battering its food results in "an optimised fat pick-up system". With its flour, salt, MSG, maltodextrin, sugar, corn syrup and spice, the fried coating imparts flavour that touches on all three points of the compass while giving the consumer the perception of a bargain – a big plate of food at a good price."

The ranks of overweight adults and children continue to increase. For the first time in history, overweight persons actually outnumber those who are malnourished. Obesity now kills more men and women in developed nations than war, terrorist attacks, or climate changes. On average, obese individuals forfeit about 9 years of life.

More on the same topic in the video below:



"Fake foods are more affordable. It's enticing people to eat more because they think they're saving money when they're really just buying heart disease." 10 Questions for Jillian Michaels. TIME, 2010.

References:

Obesity: The killer combination of salt, fat and sugar | David A Kessler. Guardian.

JAMA - Fat, Gluttony and Sloth: Obesity in Literature, Art and Medicine, July 7, 2010, Miksanek 304 (1): 101 http://goo.gl/eEos
Sweat Bees prefer sweaty people because the human diet is so salty that their perspiration is saturated with that essential nutrient. WSJ, 2012.

Alcohol consumption and raised body mass index (BMI) act together to increase risk of liver disease

Drinkers of 15 or more units per week in any BMI category and obese drinkers had raised relative rates for all definitions of liver disease, compared with underweight/normal weight non-drinkers.

The relative excess risk due to interaction between BMI and alcohol consumption was 5.58.

Raised BMI and alcohol consumption are both related to liver disease, with evidence of a supra-additive interaction between the two.

The occurrence of both factors in the same populations should inform health promotion and public health policies.

References:

Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies. BMJ 2010;340:c1240.
Alcohol literally kills: Gary Moore had 380mg/dL in his blood, Winehouse 416mg/dL when she died surrounded by 3 empty vodka bottles. Telegraph UK, 2012. 

Image source: Wikipedia, public domain.

18% tax on pizza and soda can decrease U.S. adults' weight by 5 pounds (2 kg) per year

Nearly a third of American children are overweight or obese. In our inner cities a prevalence of obesity of more than 50% is not uncommon. Too many calories in, too little energy out.

With two-thirds of Americans either overweight or obese, policymakers are increasingly looking at taxing as a way to address obesity on a population level.

The tobacco experience showed that education is not enough: regulation, litigation, and legislation are needed too. Increasing taxes on cigarettes has been the single most effective strategy in reducing smoking.

An important part of the obesity story is clearly the huge increase in consumption of sugar sweetened beverages (SSBs): carbonated sodas, sweet teas, energy drinks, flavoured water, and sports drinks. Their use has more than doubled in recent years.

"Sadly, we are currently subsidizing the wrong things including the product of corn, which makes the corn syrup in sweetened beverages so inexpensive."

Instead, the agricultural subsidies should be used to make healthful foods such as locally grown vegetables, fruits and whole grains less expensive.

Danish government imposed 25% tax on ice cream, chocolate, sweets, and will increase taxes on soft drinks, tobacco, alcohols to combat obesity, heart disease, and other illnesses. BMJ. http://goo.gl/ixc0

 Some pizzas are 'saltier than the sea' (NHS blog).

References:
Tax soda, pizza to cut obesity, researchers say | Reuters.

The case of the sugar sweetened beverage tax. BMJ 2010;341:c3719.

'To Burn Off Calories in This Soda, Walk 5 Miles' - new label http://buff.ly/1vzbCKH

Image source: Soft drinks, Wikipedia, public domain.

Cheap fast food "enticing people to eat more because they think they're saving money when they're really buying heart disease"

"Fake foods are more affordable. It's enticing people to eat more because they think they're saving money when they're really just buying heart disease."

References:
10 Questions for Jillian Michaels. TIME, 2010.

Being obese at age 40 reduces life expectancy by 7 years for women and 6 years for men

In Scotland 68.5% of men, 61.8% of women, 36.1% of boys, and 26.9% of girls are classified as overweight or obese.

Being obese at age 40 reduces life expectancy by 7.1 years for women and 5.8 years for men.

The article summarises the most recent recommendations from the Scottish Intercollegiate Guidelines Network (SIGN) on the management of obesity.

References:
Management of obesity: summary of SIGN guideline. Logue et al. 340: c154. BMJ, 2010.

Comments from Google Buzz:

Luke Rosenberger - thanks! looks like original source of the life expectancy data (according to footnote) is actually a 2003 article from annals of internal medicine - http://www.ncbi.nlm.nih.gov/pubmed/12513041

Ves Dimov, M.D. - Looks correct. That's why I always say that we need a medical librarian on board... :)

For Google Buzz and Twitter, I typically link to the source where the text appeared when I first saw it. It's very nice to trace it back to the original source however. Thank you so much.

Luke Rosenberger - makes sense to me. you know us librarians, always reading the footnotes first ;-)

Image source: Wikipedia, public domain.

Childhood diabetes associated with increasing birth weight - 7% increase in risk for every 1000 g in weight

Childhood onset diabetes is associated with increasing birth weight, equivalent to a 7% increase in risk for every 1000 g in weight.

Caesarean section increases the risk by around 20%.

The risk of childhood onset diabetes increases with maternal age: 5% for each five years of age.

References:
Maternal age and diabetes in childhood. BMJ 2010;340:c623.

Image source: Wikipedia, GNU Free Documentation License.

Nonsurgical Weight Loss with a Liquid Meal Program - Mayo Clinic Video

"Surgery may be an option for some people, but for those who don't want surgery or can't have it for medical reasons, there is another option. Doctors at Mayo Clinic developed a liquid meal program geared toward people who need to lose a lot of weight."

Study: Protective role of lower body fat is striking, or how pear is better than apple

From Reuters:

People who accumulate fat around the abdomen and stomach are more likely to die of heart disease and other causes than bottom-heavy people.

People with fat in their thighs and backsides may live longer because the fat traps harmful fatty particles and actively secretes helpful compounds.

Fat on the bottom and thighs appears to store excess fatty acids. Pear-shaped people also appear to have lower levels of compounds called inflammatory cytokines.

Leg fat may also be better at producing hormones such as leptin, which are made by fat and affect appetite and metabolism.

References:
Why those fat thighs may help you live longer. Reuters, 2010.
Image source: Williams pear, 1822 printing from the Horticultural Society of London. Wikipedia, public domain.

Presentation: Fructose drives hyperuricemia and uric acid then causes hypertension

The following presentation is by the nephrologist Joel Topf who writes the blog PBFluids.com. The subject is how fructose drives hyperuricemia and how uric acid then causes hypertension.

He used the slidecast feature on slideshare (http://www.slideshare.net/faqs/slidecast), so the slides have a full audio track.

Uric Acid, Fructose and Hypertension

View more presentations from Joel Topf.