Expert: Childhood Obesity Must Be Treated as Disease, Not Moral Failing

Six years after the U.S. Preventive Services Task Force recommended that children as young as 6 be screened and treated for obesity, a report published Wednesday (Dec. 7) indicated doctors aren’t screening children and insurance policies aren’t covering treatment more significantly today. The report, which includes input from 43 multidisciplinary stakeholders, was published in Obesity, The Obesity Society’s (TOS) journal and was the product of a conference sponsored by TOS, the Agency for Healthcare Research and Quality and the American Academy of Pediatrics Institute for Healthy Childhood Weight.

The report lists recommended changes, including family-based behavioral therapy, integrated chronic care and a multi-disciplinary team approach. For more on the study, go to Obesity.

Dr. Nikhil Dhurandhar, a past president of The Obesity Society and chairman of the Department of Nutritional Sciences at Texas Tech University, is available to discuss this report and the need for increased attention to childhood obesity. Dhurandhar began his career as a physician treating people with obesity, then turned to research, focusing on a human adenovirus that has been shown to cause obesity. He is a pioneer in the movement within the medical community to see obesity as a complex disease instead of the calories in vs. calories out model society accepted for decades.

Expert
Dr. Nikhil Dhurandhar, chairman, Department of Nutritional Sciences, (806) 834-6446 or nikhil.dhurandhar@ttu.edu

Talking points and quotes
• Childhood obesity is a serious disease and not easy to manage. A week ago, a teenage girl in Texas City (outside of Houston), shot herself, citing bullying about her weight.
• For many, obesity still is seen as a product of poor behavior and choices that can be legislated away. Two years ago, Puerto Rico tried to fine parents of children with obesity.
• Another form of well-meaning but insensitive (and ultimately ineffective) discrimination used against children with obesity is to weigh them in school and send home letters about their weight – so-called “fat letters.” The relationship between the school system and students’ weight is addressed in the documentary “The Student Body,” in which Dhurandhar is interviewed.
• In reality, penalizing parents of children with obesity is similar to penalizing parents of children with cancer or other diseases.
• “Obesity in general is considered a personal failure and treated as an issue of greediness and laziness that can be fixed by simple behavioral measures. In children, these sentiments are even more amplified. These children should simply be ‘disciplined’ and parents be penalized, according to one view.”
• “We absolutely need to address childhood obesity. But it should be addressed as the disease that it is, not with a casual approach to address a moral failure.”

Posted in Obesity | Leave a comment

The Rhythm of Your Breathing Affects Memory and Fear

Newswise — CHICAGO — Northwestern Medicine scientists have discovered for the first time that the rhythm of breathing creates electrical activity in the human brain that enhances emotional judgments and memory recall.

These effects on behavior depend critically on whether you inhale or exhale and whether you breathe through the nose or mouth.

In the study, individuals were able to identify a fearful face more quickly if they encountered the face when breathing in compared to breathing out. Individuals also were more likely to remember an object if they encountered it on the inhaled breath than the exhaled one. The effect disappeared if breathing was through the mouth.

“One of the major findings in this study is that there is a dramatic difference in brain activity in the amygdala and hippocampus during inhalation compared with exhalation,” said lead author Christina Zelano, assistant professor of neurology at Northwestern University Feinberg School of Medicine. “When you breathe in, we discovered you are stimulating neurons in the olfactory cortex, amygdala and hippocampus, all across the limbic system.”

The study was published Dec. 6 in the Journal of Neuroscience.

The senior author is Jay Gottfried, professor of neurology at Feinberg.

Northwestern scientists first discovered these differences in brain activity while studying seven patients with epilepsy who were scheduled for brain surgery. A week prior to surgery, a surgeon implanted electrodes into the patients’ brains in order to identify the origin of their seizures. This allowed scientists to acquire electro-physiological data directly from their brains. The recorded electrical signals showed brain activity fluctuated with breathing. The activity occurs in brain areas where emotions, memory and smells are processed.

This discovery led scientists to ask whether cognitive functions typically associated with these brain areas — in particular fear processing and memory — could also be affected by breathing.

The amygdala is strongly linked to emotional processing, in particular fear-related emotions. So scientists asked about 60 subjects to make rapid decisions on emotional expressions in the lab environment while recording their breathing. Presented with pictures of faces showing expressions of either fear or surprise, the subjects had to indicate, as quickly as they could, which emotion each face was expressing.

When faces were encountered during inhalation, subjects recognized them as fearful more quickly than when faces were encountered during exhalation. This was not true for faces expressing surprise. These effects diminished when subjects performed the same task while breathing through their mouths. Thus the effect was specific to fearful stimuli during nasal breathing only.

In an experiment aimed at assessing memory function — tied to the hippocampus — the same subjects were shown pictures of objects on a computer screen and told to remember them. Later, they were asked to recall those objects. Researchers found that recall was better if the images were encountered during inhalation.

The findings imply that rapid breathing may confer an advantage when someone is in a dangerous situation, Zelano said.

“If you are in a panic state, your breathing rhythm becomes faster,” Zelano said. “As a result you’ll spend proportionally more time inhaling than when in a calm state. Thus, our body’s innate response to fear with faster breathing could have a positive impact on brain function and result in faster response times to dangerous stimuli in the environment.”

Another potential insight of the research is on the basic mechanisms of meditation or focused breathing. “When you inhale, you are in a sense synchronizing brain oscillations across the limbic network,” Zelano noted.

Other Northwestern authors include Heidi Jiang, Guangyu Zhou, Nikita Arora, Dr. Stephan Schuele and Dr. Joshua Rosenow.

The study was supported by grants R00DC012803, R21DC012014 and R01DC013243 from the National Institute on Deafness and Communication Disorders of the National Institutes of Health.

Posted in Breathing, Human Behavior: Fear, Human Behavior: Memory, Zen | Leave a comment

Wedding-dress shopping should be a fairy tale, but it’s usually a scam.

You pay $5,000 for a dress that costs $200 to make. Bridal boutiques hide the brands on their dresses so you can’t comparison shop, and inflate lead times so you’re pressured to buy on the spot for fear the dress won’t be ready in time. And in the end, you get an overpriced cookie-cutter dress, all because the industry exploits sentimentality and tradition.

Anomalie does it differently. The startup founded by a former Apple supply chain sorceress officially launched this week to bring a transparent, tech-inspired approach to what brides wear on their special day. For a wedding dress made with the same fabrics by the same manufacturers as the boutiques, it only charges around $1,200, and you get to customize how it looks.

First, you submit any photos, Pinterest boards or ideas for what you want and do a phone consultation with one of Anomalie’s designers. Forty-eight hours later you get sketches of how your dress could look, with a chance to give feedback. You’re referred to a local tailor to get all your measurements, and they can also do any necessary alterations just before the wedding. Anomalie dresses typically cost between $800 and $1,500 depending on materials, paid up front.

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Posted in Disruption, Environmental Health: Design, Marriage | Leave a comment

Ability to bear children at an older age linked to longevity

CLEVELAND, Ohio (December 7, 2016)–Death and taxes have long been said to be the only two things guaranteed in life. Exactly when someone will die, in most instances, remains a mystery. A new study, however, identifies one possible predictor–specifically, telomere length. This has been linked to longevity, as well as the ability to bear children at an older age. The study is being published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Several studies have already shown that late maternal age at last childbirth is positively associated with maternal longevity. The Long Life Family Study (LLFS) reported that the odds of living up to the top fifth percentile were two times higher for women who had their last child past the age of 33 years than for those who had their last child before the age of 29. The study “Telomere length is longer in women with late maternal age,” used data from LLFS to show that certain factors associated with the rate of aging and longevity, such as telomere length, are also associated with later maternal age at the birth of the last child.

Telomeres are essential parts of human cells that affect how our cells age. They are caps at the end of each strand of DNA that protect the chromosomes, like the plastic tips at the end of shoelaces. Telomeres provide protection to chromosomes during the replication process to prevent the loss of DNA strands. As people age, the length of telomeres decreases. Longer lengths are typically associated with better health.

In this study, the proportion of women in the longest telomere tertile was higher for women in the fourth quartile of maternal age at the birth of their last child than in the first quartile (35.7% vs 20.2%). Compared with women who had their last child at 29, women with a later age at birth of their last child were found to have increased odds of being in the longest tertile of telomere length.

“With longevity and the ability to bear children at an older age associated with longer telomere length, this study suggests that a higher maternal age of successful child bearing may be a marker of healthy aging,” says Dr. JoAnn Pinkerton, NAMS executive director. “However, it’s important to remember that personal and social factors often influence childbearing age, and these factors may not have any relation to either a woman’s ability to bear children at later ages, longevity, or telomere length.”

Posted in Telomeres | Leave a comment

Open-access journal pulls latest flawed study linking vaccines to autism

Vaccines are causing more autism cases among kids? Frontiers in Public Health recently accepted a survey-based research effort—decidedly unscientific in design—suggesting it’s so. Now, after receiving heavy criticism, the publisher has retracted the abstract.

The retracted study used anonymous online surveys forwarded by homeschool organizations in four states to their members. Its abstract, accepted by the Frontiers in Public Health journal on November 21, reported that children who were vaccinated were three times more likely to be diagnosed with neurodevelopmental disorders, such as autism and attention deficit hyperactivity disorder. Survey results were collected on 666 children aged 6 to 12 years old in 415 families.

The journal quickly pulled the article after being bombarded by criticism of its motives and credibility, later releasing a short statement on Twitter. Frontiers said the article was “provisionally accepted but not published,” and that it has reopened its review.

The paper, first authored by Anthony Mawson, a visiting professor of epidemiology at Jackson State University, was reportedly peer reviewed by Linda Mullin, a chiropractor at Life University, and Kueifang Hsieh, a research associate professor for disability and human development at University of Illinois at Chicago.

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Target Reannounces Recall of Menorahs Due to Fire Hazard

The menorahs can melt when the candles are burning, posing a fire hazard.

Remedy:
Consumer Contact:

Target at 800-440-0680 from 7 a.m. to 6 p.m. CT daily, online at www.target.com and click on “School/Stationery/Seasonal” on the product recalls page or the “Product Recalls” tab on Target’s Facebook page for more information.

Units:

About 2,600 (previously recalled in May 2016)

Description:

This recall involves clear acrylic Hanukkah menorahs in a pyramid design that are 10.5 inches long, 1.2 inches wide and 2.3 inches high. Model number 240-14-0169 and bar code can be found on a round white label on the side of the menorah.

Incidents/Injuries:

The firm has received eight reports of the product melting, including three reports of fire. No property damage or injuries have been reported.

Remedy:

Consumers should immediately stop using the recalled menorahs and return them to Target for a full refund.

Sold Exclusively At:

Target stores nationwide from October 2015 through December 2015 for about $20.
Importer(s):

Target Corp., of Minneapolis
Manufactured In:
China

Posted in Pediatric Health: Injuries, Uncategorized | Leave a comment

Polypharmacy in psychiatric practice, etiology and potential consequences

Psychiatric polypharmacy is defined as the use of two or more drugs in the treatment of a psychiatric condition. Although, a lack of consensus has been reported among researchers globally about the number of medications that would quantify polypharmacy, nevertheless, it is widely prevalent in clinical practice. The rationale for polypharmacy is not clear. Etiologic factors are patient demographics (age, gender, race, low socio-economic status), personality disorder (obsessive-compulsive, borderline), psychiatric conditions (psychosis, schizophrenia, affective or mood disorders), comorbidities, severity of disease, treatment- refractoriness, prescribing practice, inpatient or outpatient setting, concern for reduction of extra-pyramidal and other side effects. Psychiatric polypharmacy is seen not only in adults but also in youths. Among children and adolescents’ the polypharmacy correlates are age (13 -15 years), male gender, caucasian race, low socio-economic status, medicaid or public insurance, disability, and foster care or child custody outside of biological family. Pediatric polypharmacy is also associated with a diagnosis of behavioral disorder, autism spectrum disorder, ADHD, conduct disorder/oppositional defiant disorder, personality disorder, violence, tics, psychosis, affective and mood disorder.

The concurrent administration of multiple drugs increases the risk of drug interactions and adverse effect including morbidity and mortality. Psychiatric polypharmacy is also associated with cumulative toxicity, poor medication adherence and treatment non-compliance. Thus, psychiatric polypharmacy poses a significant public health problem. However, not all polypharmacy is harmful. Polypharmacy is proven to be beneficial in patients with psychotic, mood or affective disorder having dual diagnosis with substance abuse, personality disorder (obsessive compulsive) and comorbid conditions including thyroid, pain or seizure disorder. Combination therapy with different class of drugs antidepressants or antipsychotics with different mechanism of action have beneficial therapeutic consequences. Therefore, a better understanding of physicians’ rationale for polypharmacy, patient tolerability and effectiveness of prescribing strategy is needed to guide practitioners and to inform the development of evidence based treatment guidelines.

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For more information about the article, please visit http://benthamscience.com/journals/current-psychopharmacology/article/145585/

Reference: Sarkar, S.; et al (2016). Polypharmacy in Psychiatric Practice, Etiology and Potential Consequences. Curr Psychopharmacol., DOI: 10.2174/2211556005666160916124719

Source

Posted in Health Care: Ethics, Health Care: Medical Errors, Polypharmacy | Leave a comment

Bariatric Surgery Mitigates Afib Risk

Bariatric surgery was associated with a reduced risk of developing atrial fibrillation (AF) among obese individuals, researchers reported.

In a substudy of the multicenter, ongoing Swedish Obese Subjects (SOS), bariatric surgery patients had a 29% lower rate of developing atrial fibrillation compared to the non-surgery group, during nearly 20 years of follow-up (HR 0.71; 95% CI 0.60-0.83; P<0.001), according to lead author Shabbar Jamaly, MD, of the University of Gothenburg in Sweden, and colleagues.

In addition, younger patients who underwent bariatric surgery had an even lower risk reduction for the development of atrial fibrillation (P=0.001 for interaction), as well as patients with initially higher diastolic blood pressure (P=0.028).

The study, and an accompanying editorial that cast some doubt on the study findings, were published in the Journal of the American College of Cardiology.

In an interview with MedPage Today, co-author Kristjan Karason, MD, PhD, also of the University of Gothenburg, said, “To our knowledge, this is the first time weight-loss has been reported as reducing the risk of new-onset atrial fibrillation… .”

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Posted in Heart Health: Atrial Fibrillation, Obesity: Bariatric Surgery | Leave a comment

Body composition may affect older women’s risk of urinary incontinence

In a study of older women, the prevalence of stress- and urgency urinary incontinence (SUI and UUI) was at least two-fold higher among women in the highest category of body mass index (BMI) or fat mass compared with women in the lowest category.

Also, women who lost at least 5% of their BMI or fat mass were less likely to experience new or persistent SUI over 3 years than women with less weight loss.

The findings suggest that higher BMI and fat mass are important markers of risk for SUI and UII in older women, and that their risk of SUI may be partially reversible through weight loss.

“Interestingly, changes in body composition and grip strength were associated with changes in SUI, but not in UUI, frequency over time. These findings suggest that optimization of body composition may help to modify the risk of SUI, but not necessarily UUI,” said Dr. Anne Suskind, lead author of the Journal of the American Geriatrics Society study.

Source

Posted in Incontinence | Leave a comment

The Myth of the Strong Leader: Political Leadership in the Modern Age

All too frequently, leadership is reduced to a simple dichotomy: the strong versus the weak. Yet, there are myriad ways to exercise effective political leadership—as well as different ways to fail. We blame our leaders for economic downfalls and praise them for vital social reforms, but rarely do we question what makes some leaders successful while others falter. In this magisterial and wide-ranging survey of political leadership over the past hundred years, renowned Oxford politics professor Archie Brown challenges the widespread belief that strong leaders – meaning those who dominate their colleagues and the policy-making process – are the most successful and admirable.

In reality, only a minority of political leaders will truly make a lasting difference. Though we tend to dismiss more collegial styles of leadership as weak, it is often the most cooperative leaders who have the greatest impact. Drawing on extensive research and decades of political analysis and experience, Brown illuminates the achievements, failures and foibles of a broad array of twentieth century politicians. Whether speaking of redefining leaders like Franklin Delano Roosevelt, Lyndon Johnson, and Margaret Thatcher, who expanded the limits of what was politically possible during their time in power, or the even rarer transformational leaders who played a decisive role in bringing about systemic change – Charles de Gaulle, Mikhail Gorbachev and Nelson Mandela, among them – Brown challenges our commonly held beliefs about political efficacy and strength.

Overturning many of our assumptions about the twentieth century’s most important figures, Brown’s conclusions are both original and enlightening. The Myth of the Strong Leader compels us to reassess the leaders who have shaped our world – and to reconsider how we should choose and evaluate those who will lead us into the future.

Posted in Human Behavior: Leadership | Leave a comment

Vitamin-Fortified Snack Food May Lead Consumers to Make Poor Dietary Decisions

J Acad Nutr Diet. 2016 Nov 30. pii: S2212-2672(16)31215-1. doi:10.1016/j.jand.2016.10.008. [Epub ahead of print]

Vitamin-Fortified Snack Food May Lead Consumers to Make Poor Dietary Decisions.

Verrill L, Wood D, Cates S, Lando A, Zhang Y.

Abstract

BACKGROUND:

The US Food and Drug Administration’s (FDA’s) fortification policy discourages the fortification of certain foods, including sugars and snack foods such as cookies, candies, cakes, chips, and carbonated beverages, yet manufacturers sometimes add vitamins and minerals to snack foods.

OBJECTIVE:

To assess whether vitamin-fortified snack foods affect consumers’ information-seeking, purchase decisions, and product-related health perceptions.

DESIGN:

For this experimental study, participants were randomly assigned to study conditions to compare products that varied in product type, nutrition profile, and fortification and nutrient claim status. Data were collected via an online consumer panel.

PARTICIPANTS/SETTING:

US adults aged 18 years and older were randomly selected from Research Now’s e-panel online household panel. Data were collected during fall 2014 (N=5,076).

INTERVENTION:

Participants were randomly assigned to one of 24 conditions: two products (vegetable chip/potato chip), two nutrition profiles (healthier/less healthy), two fortification scenarios (not fortified/fortified), and three nutrient claim conditions (two no claim/one with claim). The design was not balanced; claims were not shown on products that were not vitamin fortified.

MAIN OUTCOME MEASURES:

Outcome measures were information-seeking (viewed the Nutrition Facts label), purchase decisions, perception of product healthfulness, and correct selection of product with the healthier nutrient profile.

STATISTICAL ANALYSIS PERFORMED:

Logistic regression was used to test all models. Analyses was adjusted for general label use, consumes product, health status, age, sex, level of education, presence of children in the household, and race/ethnicity.

RESULTS:

When the snack food carried a nutrient claim for vitamin fortification, participants were 1) less likely to look for nutrition information on the Nutrition Facts label, 2) more likely to select the product for purchase, 3) more likely to perceive the product as healthier, and 4) less likely to correctly choose the healthier product.

CONCLUSIONS:

Snack foods that have been vitamin-fortified may cause consumers to make poor dietary decisions.

Source

Posted in Nutrition: Additives, Nutrition: Appetite, Nutrition: Bars, Nutrition: Functional Foods, Nutrition: Habits, Nutrition: Hydration, Nutrition: Information, Nutrition: Junk Food, Nutrition: Labeling, Nutrition: Marketing, Nutrition: Polyphenols, Nutrition: Resveratrol, Nutrition: Supplements | Leave a comment

Tufts researchers uncover possible source of genetic error causing multiple diseases

MEDFORD/SOMERVILLE, Mass. (December 5, 2016)–Tufts University researchers have discovered a possible explanation for the occurrence of a genetic error that causes over a dozen neuromuscular and neurodegenerative disorders, including Huntington’s disease, myotonic dystrophy and forms of spinocerebellar ataxia.

The error occurs as copies of three-letter sequences of DNA–known as CAG and CTG triplets–expand and repeat themselves hundreds or even thousands of times, disrupting normal gene sequences.

Genetic analyses in baker’s yeast now reveal that these large-scale expansions are sqazcontrolled by genes that have been implicated in a process for repairing DNA breaks, leading the researchers to surmise that the expansions occur while breaks are being healed. Baker’s yeast, known as Saccharomyces cerevisiae, is frequently used in scientific research.

The findings are published in Nature Structural & Molecular Biology.

“We think these large-scale repeat expansions could occur in a single step,” said Sergei Mirkin, Ph.D., White Family Chair in Biology at Tufts School of Arts and Sciences and corresponding author on the paper. “The DNA replication machinery stalls within those repeats, which ultimately results in the formation of DNA breaks. To heal those breaks, cells seem to involve a special path of repair, called break-induced replication, which sacrifices the fidelity of DNA synthesis for the sake of a quick fix. As a result, large numbers of extra repeats can be added while the break is healed.”

Previous studies have identified certain mutations in DNA replication machinery that account for small-scale repeat expansions in which only a few extra repeats are added, but the cause of rapid accumulation of hundreds of repeats has remained unclear until now.

To detect and analyze large-scale expansions of CAG and CTG repeats, Mirkin and his colleagues developed an experimental system in yeast that observed simultaneous additions of more than 100 triplets, a first for such systems. This observation is similar to what happens in human disease.

Jane Kim, Ph.D., who was a research assistant professor in Mirkin’s lab when the research was conducted and who is the paper’s first author, said the model suggests answers to two questions that have puzzled researchers.

“Not only does this model explain how additions of hundreds of repeats can occur in human diseases, but it can also account for a bias towards expansions observed in human pedigrees,” said Kim, now an assistant professor at California State University San Marcos.

The authors note that the timing of expansion in human cases is still unclear and presents an important area of future investigation.

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The study was performed in Mirkin’s lab by Kim with the help of two former undergraduate students, Samantha Harris, currently a student at Harvard Medical School, Teresa Dinter, currently a technical research assistant at Brigham & Women’s Hospital and graduate student Kartik Shah, currently a scientist at Amgen.

Research in Mirkin’s lab is supported by the National Institute of General Medical Sciences (NIGMS) of the National Institutes of Health (awards R01GM60987 and P01GM105473) and by a generous contribution from the White family. Kim was supported by the NIH Training in Education and Critical Research Skills postdoctoral program (K12GM074869) and by Tufts University. Harris received support from REU award NSF DBI 1263030. Dinter received support from Tufts Summer Scholars.

Kim, J. C., Harris, S., Dinter, T., Shah, K., Mirkin, S. “The role of break-induced replication in large-scale expansions of (CAG)n/(CTG)n repeats.” Nature Structural & Molecular Biology (2016) DOI: 10.1038/nsmb.3334

Posted in Epigenetics, Genetics, Huntington's | Leave a comment