Obesity in Teens Seems to Raise Risk for Illness, Death in Middle Age

By Amy Norton
HealthDay Reporter

WEDNESDAY, April 13, 2016 (HealthDay News) — Overweight teenagers may face an increased risk of dying from heart disease or stroke by the time they reach middle age, a large new study suggests.

The study of more than 2 million Israelis found that those who were overweight or obese as teenagers were two to three times more likely to die prematurely of cardiovascular causes, compared to those who’d been thin as teens.

Experts called the findings, published online April 13 in the New England Journal of Medicine, worrisome, if not all that surprising.

The concern is largely related to the fact that teen obesity has become so prevalent. In the United States, about one-fifth of 12- to 19-year-olds are obese, according to the U.S. Centers for Disease Control and Prevention.

“This is an important study,” said Dr. Carl “Chip” Lavie, medical director of cardiac rehabilitation and prevention at Ochsner Medical Center, in New Orleans.

According to Lavie, who was not involved in the research, the findings are concerning for a number of reasons. For one, he pointed out, many people in the study were teenagers at a time when severe obesity was uncommon — and when teenagers, regardless of weight, were more physically active than they are now.

“The situation has now drastically changed, with kids only getting physical activity if they participate in organized sports,” Lavie said.

On top of that, he added, many teens spend a “substantial” amount of time being completely sedentary — in front of the TV or on their phones and computers — while eating more junk food compared with past generations.

“I am very concerned that overweight and obese teenagers will be in serious trouble 30 years down the road,” Lavie said. “Many will no longer be just overweight or mildly obese, but will likely have much more severe obesity.”

The findings are based on records from close to 2.3 million Israeli teenagers who underwent physical exams ahead of their mandatory military service between 1967 and 2010.

By 2011, just over 36,000 had died — at which point the oldest members of the group had been followed for about 40 years.

Since the study group was still fairly young, death rates from heart trouble and stroke were low across the board. But men and women who’d been obese as teens showed higher risks, especially when it came to heart disease — where fatty plaques build up in the arteries and can eventually cause a heart attack.

Obese teenagers were five times more likely to die of heart disease by middle age, versus those who were thin but not considered underweight. Their risk of death from any cardiovascular cause — including stroke and cardiac arrest — was more than tripled.

Similarly, overweight teenagers had a threefold higher risk of dying from coronary heart disease later in life, and a twofold higher risk of death from any cardiovascular cause, the findings showed.

The study does not, however, answer the question of why.

It’s not clear whether it’s the extra pounds early in life or other factors — such as a poor diet or lack of exercise — that raised people’s cardiovascular risks, according to Dr. Steven Heymsfield, a spokesperson for the Obesity Society. He is also a professor at Pennington Biomedical Research Center, in Baton Rouge, La.

Still, Heymsfield said the study is impressive in its size and careful measurements of teenagers’ body mass index (a measure of weight in relation to height).

“This gives us confirmation of something I think we knew,” Heymsfield said. “Being obese as a teenager is bad for you.”

It’s not certain whether childhood obesity carries a special health hazard, or whether heavy kids are at risk simply because they often become even heavier adults.

The study lacked information on adulthood weight, said lead researcher Dr. Gilad Twig, of Sheba Medical Center, in Tel Hashomer, Israel.

Regardless, he said, teen obesity is a “strong predictor” of premature death from cardiovascular disease — even if it is through effects on adulthood weight.

“This study stresses the importance of maintaining a healthy weight [during] childhood and adolescence,” Twig said.

Lavie and Heymsfield agreed, and emphasized that a healthy diet and regular exercise — which can boost cardiovascular fitness — are key.

Childhood is the “best time” to ward off obesity, Heymsfield said. But, he added, it’s never too late to adopt healthier habits, even if you’ve been overweight most of your life.

“The important things,” Heymsfield said, “are to not smoke, get your blood pressure down to normal levels, watch your lipid [cholesterol] levels, and be physically active.”

He noted that other studies have shown it’s possible to be “fat but fit,” with the help of regular exercise.

More information

The U.S. Centers for Disease Control and Prevention has tips on helping kids maintain a healthy weight.

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'Paleo' Diet May Help Older Women's Hearts, Waistlines

By Dennis Thompson
HealthDay Reporter

SUNDAY, April 3, 2016 (HealthDay News) — The so-called Paleo diet may help older women lose weight, improve their cholesterol profile and lower future risk of diabetes and heart disease, a new study has found.

Women experienced these benefits by sticking to the guidelines of the Paleo diet, even though they were not required to restrict their calorie intake, the researchers said.

The study results indicate that the Paleo diet could prove an effective means of battling the obesity epidemic, said lead study author Caroline Blomquist, a doctoral student at Umea University in Sweden.

The findings are scheduled for presentation Sunday at the annual meeting of the Endocrine Society, in Boston. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

“Obesity-related disorders have reached pandemic proportions with significant economic burden on a global scale,” Blomquist said in a prepared statement. “It is of vital interest to find effective methods to improve metabolic balance.”

A Paleo diet requires people to eat foods similar to those available to humans during the Paleolithic period, which dates from 10,000 to 2.5 million years ago, according to the Mayo Clinic. The diet typically includes foods that could be obtained by hunting and gathering — lean meats, fish, fruits, vegetables, nuts and seeds — and limits foods that became common with the advent of farming, such as dairy products, grains and legumes.

In this study, Blomquist and her colleagues had 35 postmenopausal women who were obese but had normal blood sugar levels follow a Paleo diet for two years.

The group aimed to consume 30 percent of their daily energy intake from protein, 30 percent from carbohydrates, and 40 percent from fats mainly made up of “good” unsaturated fats.

The diet used in the study included lean meat, fish, eggs, vegetables, fruits, nuts and berries, with rapeseed, olive oils and avocado as additional fat sources. It excluded dairy products, cereals, added salt and refined fats and sugar.

An outside expert noted that the study diet was a modified one that veers slightly from a strict Paleo diet.

“I’m not sure I would say this is a Paleo diet,” said Dr. Caroline Apovian, director of the Nutrition and Weight Management Center at Boston Medical Center. “This is more of a cross between a Paleo diet and a Mediterranean diet.”

A “control group” of 35 postmenopausal women were asked to follow a low-fat diet consisting of 15 percent protein, 30 percent fat and 55 percent carbohydrates.

After two years, the women eating the Paleo diet reported they had decreased their intake of “bad” saturated fats by 19 percent, while increasing by their intake of monounsaturated fats by 47 percent and their intake of polyunsaturated fats by 71 percent. In comparison, the women on the low-fat diet reported no significant changes in their intake of fats.

Specific fatty acids associated with insulin resistance were significantly lower in the women eating Paleo-type foods compared with those on the prudent control diet.

Both diets, however, resulted in similar — and significant — weight loss, the researchers said.

Apovian said it makes sense that the Paleo diet could provide some health benefits.

“You’re basically eliminating all processed and simple carbohydrates, which we know is one of the exacerbations or causes of overweight, obesity and insulin resistance,” Apovian said.

But the diet could cause some deficiencies in crucial nutrients, said nutritionist Connie Diekman. She is director of university nutrition for Washington University in St. Louis and a former president of the Academy of Nutrition and Dietetics.

Eliminating all dairy could put calcium, vitamin D and potassium intakes at risk, while cutting back on legumes and whole grains could cause deficiencies in fiber, manganese, magnesium and selenium, said Diekman.

“Avoiding beans and grain foods also makes meeting nutrient needs harder,” she said. “The beauty of including all food groups is that, when consumed in proper portions, we can more easily meet nutrient needs. When a food group is skipped, nutrient balance can be impacted.”

It also can be difficult for a person to follow a lifestyle diet like Paleo, Diekman added.

“The best advice I would give is to find an eating plan that does two things — includes the foods that you enjoy and meets your nutrient needs — and then learn about proper portions,” she said.

Apovian also noted another downside to a Paleo diet is that it focuses on foods that are not available to the Americans who need the diet most.

“To the average American and to the lower socioeconomic classes that suffer the most from disease and obesity, they can’t do this. It’s financially impossible,” Apovian said. “Low-income people who need to eat like this, can’t. That’s the problem in this country.”

More information

For more on the Paleo diet, visit the Academy of Nutrition and Dietetics.

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New Guidelines Recommend Inpatient Rehab After Stroke

WEDNESDAY, May 4, 2016 (HealthDay News) — If possible, people who’ve had a stroke should be sent directly to inpatient rehabilitation after their hospital discharge. This would be instead of a skilled nursing facility or nursing home, according to new guidelines by the American Heart Association/American Stroke Association (AHA/ASA).

Inpatient rehabilitation may be part of the hospital. Or, it may be a freestanding facility.

Ideally, stroke patients should begin their rehabilitation before they even leave the hospital. For example, they should start to learn how to prevent falls while still in the hospital, the groups recommend. This includes tips on how to make their home safer such as by removing throw rugs and improving lighting.

Patients should also learn about the side effects of their medication and how to use devices such as wheelchairs, walkers and canes before they leave the hospital, the AHA/ASA advises.

“This recommendation will probably change medical practice. Even the top stroke centers may not have a formal falls-prevention program, but it is very important because a high percentage of patients end up falling after a stroke,” the lead author of the new guidelines, Carolee Winstein, said in an AHA/ASA news release.

Once discharged from the hospital, stroke patients should be sent to an inpatient rehab facility where they can continue their recover and receive more intensive therapy, the guidelines say.

“Previous guidelines have focused on the medical issues involved in the initial management of stroke, but many people survive a stroke with some level of disability. There is increasing evidence that rehabilitation can have a big impact on the survivors’ quality of life, so the time is right to review the evidence in this complex field and highlight effective and important aspects of rehabilitation,” said Winstein.

Winstein is a professor of biokinesiology and physical therapy at the University of Southern California in Los Angeles.

Unlike a nursing home, an inpatient rehabilitation facility provides patients with at least three hours of rehab on daily basis. Patients work with a range of health care providers. They may include physical therapists, occupational therapists and speech therapists, the AHA/ASA explained.

“If the hospital suggests sending your loved one to a skilled nursing facility after a stroke, advocate for the patient to go to an inpatient rehabilitation facility instead — unless there is a good reason not to, such as being medically unable to participate in rehab,” said Winstein.

“There is considerable evidence that patients benefit from the team approach in a facility that understands the importance of rehabilitation during the early period after a stroke,” she said.

Other recommendations issued by the AHA/ASA include:

  • Stroke patients who have trouble walking should undergo intense mobility-task training to help relearn how to perform daily activities, such as climbing stairs.
  • The use of a computer, books, music and virtual reality games could help enhance rehabilitation for stroke patients, making it more engaging and mentally stimulating.
  • Stroke patients who have trouble speaking should undergo speech therapy.
  • Patients who have vision problems and have trouble focusing should perform eye exercises.
  • Balance training should be offered to stroke survivors at risk for falls.
  • Exercise regimens tailored to individual stroke patients can help them continue to improve their fitness level once their rehabilitation is complete.

“For a person to fulfill their full potential after stroke, there needs to be a coordinated effort and ongoing communication between a team of professionals as well as the patient, family and caregivers,” said Winstein.

The new guidelines were published May 4 in the journal Stroke.

More information

The U.S. National Institutes of Health provides more information on rehabilitation after stroke.

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Mild Appendicitis Complication Rates Similar for Surgery, Antibiotics

FRIDAY, March 25, 2016 (HealthDay News) — Antibiotics can be used to treat mild appendicitis, but the condition returns in some patients who receive the drugs, researchers report.

Surgical removal of the appendix (appendectomy) has long been the standard treatment for appendicitis, which is when the appendix becomes inflamed and infected.

Millions of appendectomies are performed worldwide each year, including more than 300,000 in the United States, according to the new analysis.

The international team of researchers reviewed five studies that included a total of 1,116 patients with mild appendicitis. They found that rates of complications were similar for those who received antibiotics (5 percent) and those who had an appendectomy (8 percent).

Of the patients who initially received antibiotics, 8 percent had an appendectomy within a month and 23 percent had a recurrence of appendicitis within 12 months.

According to the best evidence available, “using antibiotics as the primary treatment for mild appendicitis does not lead to more complications in the first twelve months of follow-up,” study co-author Dr. Ville Sallinen, a gastrointestinal surgeon at Helsinki University Hospital in Finland, said in a university news release.

“Used as the primary treatment, antibiotics reduced the number of surgeries by 92 percent within the first month of diagnosis,” study co-author Kari Tikkinen, an adjunct professor, said in the news release.

“However, this choice of treatment meant that appendicitis recurred in 23 out of 100 patients within one year. Moreover, no long-term follow-up exists for now,” Tikkinen added.

The researchers also wondered if increased use of antibiotics to treat mild appendicitis would contribute to the growing problem of antibiotic resistance.

But with no clear-cut evidence for or against antibiotic treatment, they said the decision might come down to personal preference.

“In medicine and surgery, treatment choices are increasingly based on shared decision-making, where patients and care providers make decisions together. I expect that this will also increasing apply to treatment of mild appendicitis,” said Tikkinen.

The study findings were published recently in the British Journal of Surgery.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about appendicitis.

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Life-Saving Health Care in Poor Nations Would Cost $5 Per Person: Study

SUNDAY, April 10, 2016 (HealthDay News) — The cost of health care that could save the lives of millions of children and their mothers every year would be less than $5 per person, researchers report.

The money would expand basic health services — such as birth control, nutritional supplements and medication to treat serious illnesses such as pneumonia and malaria — in 74 low- and middle-income countries. Those countries account for more than 95 percent of mother and child deaths each year, according to the study published April 9 in The Lancet.

The researchers reported that, worldwide, in 2015 nearly 6 million children under age 5 died, as did more than 300,000 women from pregnancy-related causes.

“Many of these deaths could be prevented if high-impact and affordable solutions reached the populations that needed them most,” study leader Dr. Robert Black said in a John Hopkins University news release. Black is a professor of international health in the university’s Bloomberg School of Public Health.

“Our analysis shows that expanding access to care to keep more mothers and children alive and healthy is feasible, and a highly cost-effective investment,” he added.

The researchers said expanding basic health services could prevent the deaths of 1.5 million newborns, 1.5 million children and 149,000 mothers. That would reduce overall deaths in the three groups by half.

The researchers concluded that making family planning services more widely available could prevent nearly 28 million pregnancies and save 1.5 million lives a year. The study findings indicate that increased access to birth control could prevent the deaths of 67,000 mothers, 440,000 newborns and 473,000 children. It could also prevent an estimated 564,000 stillbirths a year, the researchers said.

It would cost an estimated $4.70 per person annually to improve basic health services in poorer regions of the world, the study found.

“For less than $5 per person, essential health services could reach the people who are most in need of them. Community health workers or primary health centers can deliver the majority of these services, which reduces the cost of expanding coverage,” Black said.

More information

GlobalHealth.gov has more on maternal and child health.

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May 23 Webinar on Hearing Aids: The Basic Information You Need to Know

For Consumers

May 23 Webinar on Hearing Aids: The Basic Information You Need to Know - (JPG)

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Did you know that May is Better Hearing and Speech Month?  Do you have questions about hearing loss and hearing aids?

Learn more Wednesday, May 23, 2012 at 2:00 p.m. ET, when FDA’s Center for Devices and Radiological Health (CDRH) will host a webinar to discuss basic information on hearing aids.

The featured speaker, audiologist Shu-Chen Peng, Ph.D., CCC-A, in CDRH’s Office of Device Evaluation, will discuss what consumers need to know about hearing loss, hearing aids, the different types and styles of hearings aids available, and how to get the most out of them.

An opportunity to ask questions will follow the presentation.

When: Wednesday, May 23, 2:00 p.m. ET

Length: 30 minutes

Where: To join the Webinar, see the instructions at http://www.fda.gov/AboutFDA/Transparency/Basics/ucm304193.htm.

Host: FDA’s Center for Devices and Radiological Health

Featured speaker: Audiologist Shu-Chen Peng, Ph.D., CCC-A, Office of Device Evaluation

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

May 21, 2012

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