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Archive for May, 2010

Temple to study how to help students lose weight

Wednesday, May 19th, 2010

It is not news that students live busy and sometimes unhealthy lifestyles. Having an irregular pattern of eating, drinking, sleeping, stress, and studying can make it difficult to stay healthy in college. Nicole Patience, a clinical dietitian at Temple Student Health Services, believes that there are not many weight loss plans designed for college students in particular, as the campus setting can be challenging. Melissa Napolitano of Temple’s Center for Obesity Research and Education says that a third of college students are overweight. Patience created a program called Onward to Weight Loss Success (OWLS) years ago and it teaches students about emotional eating, alcohol and weight gain, dining out, healthful cooking, and “mindful eating.”

Philadelphia Inquirer

February 22, 2010

Early in her college career, Kimberly Davidson fell into the typical campus lifestyle, a tailor-made prescription for weight gain: Study hard. Party. Watch TV. Eat junk food.

Davidson, 21, a junior at Temple University, had put on the so-called Freshman 15. Now she would like to lose about 30 pounds, which would place the 5-foot-9 social-work major at 140, well within the healthy weight range for her height.

She will join more than 20 other female Temple students in an 11-week weight-loss program that will aim to break ground and fine-tune methods that work best with the college crowd.

“There are very few weight-loss programs designed specifically for college students, and there isn’t a lot of data about the efficacy of the programs,” said Nicole Patience, a clinical dietitian at Temple Student Health Services.

The campus setting can be particularly challenging – with irregular sleep patterns, budget constraints, the stress of being away from home for the first time, and the prevalence of parties.

In addition, many Temple students work at least 20 hours a week, another stressor that could lead to poor eating habits.

“It’s a unique set of challenges,” Patience said, “compared to someone in the work world.”

Obesity is a problem of particular relevance because about a third of college students are overweight, said Melissa Napolitano of Temple’s Center for Obesity Research and Education, which will evaluate and monitor the program run by Patience.

Michelle Obama came to Philadelphia on Friday to promote her “Let’s Move” national campaign to lower childhood obesity.

Patience began her program – Onward to Weight Loss Success (OWLS) – 21/2 years ago after hearing from students how much they wished they could lose weight in a healthy way. This semester will be different in that the program will be monitored and evaluated by the obesity center.

In the program, students learn about such topics as emotional eating, alcohol and weight gain, dining out, healthful cooking, and “mindful eating” – being in the moment, so to speak, rather than being distracted in front of a TV. All the discussions are geared toward college students, their lifestyles, and their budgets.

Participants set goals and keep “food records” as part of the weekly one-hour meetings, Patience said.

The students will receive physicals before and after the program. Their weight loss, attitudes, moods, and body images also will be assessed.

Twenty-six students have signed up. Half will get the program immediately; the rest become a control group, then will get help in the next cycle.

To be eligible, students must exceed weight limits for their body mass index. A 5-foot-5 woman, for example, would have to weigh 150 pounds or more to be eligible.

Just how much weight they can expect to lose is uncertain. In the past, those in Patience’s program still living the college life have lost about a half-pound a week, compared with working-adult programs in which people shed one to two pounds a week, said Napolitano, an associate professor of kinesiology and public health at the obesity center.

Napolitano hopes the study will yield best weight-loss practices for students that can be rolled out to other campuses nationally.

“We want to get to people earlier,” she said, “before poor habits are established.”

Students will receive a $20 gift card for participating in the study, but Patience expects “internal motivation” – not the gift card – will keep them involved.

“One of my big motivations was just going there every week and seeing the other girls. We were each other’s motivations,” said Shuntelle Stephen, 23, who was in the program a year ago.

Stephen, who gained weight after taking steroids for asthma, lost 25 pounds in the program and has since lost 15 more by continuing to follow what she learned.

A public-health major, Stephen began going to the gym daily with her new friends. Information presented in the sessions also helped, she said. She learned, for example, that a margarita has about as many calories as 90 Gummy Bears.

Stephen, who has transferred to a New York state university, said she had entered the group a “very bad eater,” relying on frozen and fried foods. She exited eating more healthfully, enjoying fruits and vegetables, controlling portions, and having small meals or snacks regularly during the day rather than loading up once or twice.

Temple junior Kimberly Davidson has struggled with her weight since her senior year in high school. Lately, she has been biking more and buying fresh foods at the grocery store that recently opened near campus.

“I cook every day for myself. I’ve been doing a lot better,” she said.

She looked forward to beginning the group this week and getting a boost.

“I just kind of want to feel better and be in better shape,” said Davidson. “It’s something I’ve wanted to do for a long time. It will be good to have someone helping.”

Fat Behaves Differently in Patients With Polycistic Ovary Syndrome

Wednesday, May 19th, 2010

Ricardo Azziz, M.D.,M.P.H., director of the Center for Androgen-Related Research and Discovery at the Cedars-Sinai Medical Center, and principal investigator on a recent study, found that fat tissue acts very differently in women with PCOS than in other women. He argued that discoveries as such might help to better understand the causes underlying the disorder, and may be helpful in developing treatments that will protect patients against developing heart disease and other potential health issues. The research was published in the February issue of Journal of Clinical Endocrinology and Metabolism.

ScienceDaily (Feb. 17, 2010) — Fat tissue in women with polycystic ovary syndrome produces an inadequate amount of the hormone that regulates how fats and glucose are processed, promoting increased insulin resistance and inflammation, glucose intolerance, and greater risk of diabetes and heart disease, according to a study conducted at the Center for Androgen-Related Research and Discovery at Cedars-Sinai Medical Center.
Polycystic ovary syndrome, or PCOS, is the most common hormonal disorder of women of childbearing age, affecting approximately 10 percent of women. It is the most common cause of infertility, and an important risk factor for early diabetes in women.
“We’re beginning to find that fat tissue behaves very differently in patients with PCOS than in other women,” said Ricardo Azziz, M.D.,M.P.H., director of the Center for Androgen-Related Research and Discovery, and principal investigator on the study. “Identifying the unusual behavior of this fat-produced hormone is an important step to better understanding the causes underlying the disorder, and may be helpful in developing treatments that will protect patients against developing heart disease and insulin resistance.”
Fat tissue is the body’s largest hormone-producing organ, secreting a large number of hormones that affect appetite, bowel function, brain function, and fat and sugar metabolism. One of these hormones is adiponectin, which in sufficient quantities encourages the proper action of insulin on fats and sugars and reduces inflammation. Women with PCOS produce a smaller amount of adiponectin than women who do not have the disease, in response to other fat-produced hormones, according to the research to be published in the February issue of Journal of Clinical Endocrinology and Metabolism.
While Polycystic Ovary Syndrome is often associated with obesity, women with the disorder are not necessarily more likely to be overweight. In fact, in the study, adiponectin was lacking in PCOS patients whose weight was considered to be in a healthy range, as well as in those patients who were overweight.
PCOS also can cause symptoms such as irregular ovulation and menstruation, infertility, excess male hormones, excess male-like hair growth (hirsutism), and polycystic ovaries. About two-thirds of women with PCOS have insulin resistance, an impairment in the effectiveness of the hormone insulin, which regulates the body’s utilization of fats and sugars, and which results in a higher risk for diabetes, metabolic syndrome, and cardiovascular disease. The causes of insulin resistance in PCOS patients remain unknown.

Obesity — Mild or Severe — Raises Kidney Stone Risk

Wednesday, May 19th, 2010

Dr. Brian R. Matlaga, assistant professor of urology at the Johns Hopkins University School of Medicine and director of stone diseases and ambulatory care at Hopkins’ James Buchanan Brady Urological Institute, was the lead author of a study that explored the effects of excess weight in relation to kidney stone development, and was published in the February issue of the Journal of Urology. Many studies in the past have shown a strong correlation between obesity and kidney stone disease. As obesity is a growing problem throughout the world, researchers such as Dr. Matlaga are interested in the risks presented with varying ranges of obesity.

ScienceDaily (Feb. 18, 2010) — Obesity in general nearly doubles the risk of developing kidney stones, but the degree of obesity doesn’t appear to increase or decrease the risk one way or the other, a new study from Johns Hopkins shows.

“The common thinking was that as weight rises, kidney stone risk rises as well, but our study refutes that,” says study leader Brian R. Matlaga, assistant professor of urology at the Johns Hopkins University School of Medicine and director of stone diseases and ambulatory care at Hopkins’ James Buchanan Brady Urological Institute. “Whether someone is mildly obese or morbidly obese, the risk for getting kidney stones is the same.”

The findings are published in the February Journal of Urology.

Over the last decade, several epidemiological studies have shown a strong connection between obesity and kidney stone disease. However, as obesity continues to rise worldwide, Matlaga and his colleagues wondered whether different subcategories of obesity, ranging from mildly to morbidly obese, presented different risks.

To answer the question, the researchers used a national insurance claims database to identify 95,598 people who had completed a “health risk assessment” form with information about their body mass index (BMI), a measure of body fat calculated by dividing weight by height, and a general indicator of underweight, healthy weight, or overweight. The database, which spanned over a five-year period from 2002 to 2006, also had encoded information indicating whether these individuals had been diagnosed with kidney stone disease.

Using a definition of obesity as having a BMI greater than 30 kg/m2 (which, in English measurements, corresponds to a 5 foot tall person who weighs 153 pounds, or a 6 foot tall person who weighs 221 pounds), the researchers calculated the incidence of kidney stones in people who were non-obese and in those who were obese. Among the non-obese individuals, 2.6 percent were diagnosed during the study period with kidney stones, compared to 4.9 percent of the obese individuals. When the investigators arranged those in the obese group by their BMIs, ranging from above 30 kg/m2 to more than 50 kg/m2, they found that the increased risk remained constant, regardless of how heavy the individuals were.

Matlaga says that he and his colleagues aren’t sure why obese people are more at risk for kidney stones, though metabolic or endocrine factors unique to obesity are likely reasons, along with dietary factors such as a high-salt diet. The researchers plan to study these potential risk factors in subsequent studies.

 

Overweight Middle-Aged Adults at Greater Risk for Cognitive Decline in Later Life

Wednesday, May 19th, 2010

The Journal of Gerontology: Medical Sciences Editor Luigi Ferrucci, MD, PhD, of the National Institute on Aging, published a set of ten articles examining the consequences and causes of obesity in older populations. He argued that the risk of obesity is not only limited to physical detriments but also can impair neurological functioning too. A study led by Anna Dahl, MS, of Sweden’s Jönköping University, studied individuals with higher body mass index scores in relation to general cognitive ability. Also, a team of researchers led by Alice M. Arnold, PhD, of the University of Washington, Seattle, studied changes in weight in relation to future physical limitations and mortality in the elderly.

ScienceDaily (Feb. 24, 2010) — The adverse affects of being overweight are not limited to physical function but also extend to neurological function, according to research in the latest issue of The Journals of Gerontology Series A: Biological and Medical Sciences.

The publication presents a collection of ten articles highlighting new findings related to obesity in older persons.

“One of the unanticipated consequences of improved medical management of cardiovascular disease is that many obese individuals reach old age,” saidJournal of Gerontology: Medical Sciences Editor Luigi Ferrucci, MD, PhD, of the National Institute on Aging. “We need a better understanding of the causes and consequences of obesity in older individuals — especially when obesity is associated with sarcopenia.”

A study headed by Anna Dahl, MS, of Sweden’s Jönköping University, found that individuals with higher midlife body mass index (BMI) scores had significantly lower general cognitive ability and significantly steeper decline than their thinner counterparts over time. These statistics were compiled from a study of Swedish twins that took place over the course of nearly 40 years, from 1963 to 2002; the results were the same for both men and women.

Other studies reported in the journal show that obesity appears particularly threatening in the presence of other health problems, such as poor muscle strength and depression.

Similarly, changes in weight also signify declines in overall health. A team of researchers led by Alice M. Arnold, PhD, of the University of Washington, Seattle, found that such fluctuations are significant indicators of future physical limitations and mortality in the elderly. Arnold and her colleagues used data from the Cardiovacscular Health Study, which included information from over 3,000 individuals aged 65 and older from 1992 to 1999. They discovered that a history of cyclically losing and gaining weight increased a person’s chance of having difficulty with activities of daily living — bathing, dressing, eating, etc. — by 28 percent.

Airlines grapple with overweight passengers

Wednesday, May 19th, 2010

The weight issue has been a delicate one for airlines trying to respond to concerns from both large passengers and those feeling crushed while sitting next to them. Film director Kevin Smith was recently kicked off a flight because of his size. He focused his anger on Southwest, but the incident put the spotlight on all airlines and their heavy passenger policies. Rick Seaney, CEO of Farecompare.com, an airfare comparison shopping site says that airlines do not want to get involved with this, and will avoid it at all costs. A third of the population is now obese, more than double the % obese of just 20 years ago, yet the size of an airplane seat has not changed very much. Brandon Macsata, executive director of the Association for Airline Passenger Rights, says that it is up to each airline to decide on policies for overweight passengers. Spokeswoman for JetBlue, Alison Croyle says that they address this problem as needed on a case by case basis.

2-17-2010

(CNN) — When film director Kevin Smith was recently kicked off a flight because of his size, he focused his anger on Southwest, but the incident put the spotlight on all airlines and their heavy passenger policies.

Smith said that he had no trouble buckling his seat belt and lowering his armrests on the flight Saturday and that his neighbors didn’t complain about him invading their space.

He said he suspected he may have been bumped by an airline employee who did not like his films.

Southwest has apologized to Smith — twice — but said he was not singled out to be removed.

“Our employees made the decision to remove Kevin after a quick judgment call that he might have needed more than one seat for his comfort and those seated next to him,” wrote Linda Rutherford, Southwest’s vice president of communications and strategic outreach, on the airline’s blog.

On his blog, Smith countered that all he wanted Southwest to do was admit that he wasn’t “too fat to fly” and that the incident “was all an unfortunate error” on the airline’s part. He expressed frustration that Southwest had not done so.

A related CNN.com story has generated thousands of comments from readers passionate about both sides of the issue.

“This whole thing has gotten so ridiculous. Southwest and all of the other airlines need to make bigger seats. Kevin Smith and the rest of America has become bigger and bigger, the airlines need to accommodate that, plain and simple,” wrote one poster.

But another summed up the frustration of otherair travelers.

“I did the fly-up-on-Monday-fly-home-on Friday thing for three years straight and nothing struck fear into the hearts of my fellow fliers more than seeing a ridiculously large person lumbering down the aisle as we were all boarding. Kudos to the airline for standing up for its passengers,” the poster wrote.

Who makes the decision?

The weight issue has been a delicate one for airlines trying to respond to concerns from both large passengers and those feeling crushed while sitting next to them.

“It’s embarrassing — airlines don’t want to touch this with a 20-foot pole,” said Rick Seaney, CEO of Farecompare.com, an airfare comparison shopping site. “[But] this is only going to get worse.”

A third of Americans are now classified as obese, according to the Journal of the American Medical Association, but the width of a coach airplane seat has changed little, remaining between 17 and 18 inches in most commercial planes.

The Federal Aviation Administration does not regulate seat width, but it does require passengers be able to sit belted and with both armrests down to comply with safety standards.

Ultimately, it is up to each airline to decide which passengers are too big to safely fly in one seat, said Brandon Macsata, executive director of the Association for Airline Passenger Rights. That means a gate agent, flight attendant or pilot can make that determination.

Macsata called the current guidelines arbitrary and said they are often unfair to women because they are typically larger in the hips, while men are often larger in the belly or in the chest.

He also urged people frustrated with fat passengers — the term preferred by his organization — to direct their anger at the airlines instead.

“It should not be about the size of the person’s butt sitting next to you, but rather the size of the seat that both of you are sitting in,” Macsata said.

“We’re crammed in like sardines, you don’t have to be a fat person to be uncomfortable sitting in those seats.”

A simple remedy would be for airlines to retrofit the first row of each plane with seats that are a bit roomier and reserve them for large fliers, who would pay more for booking them, Macsata said.

Addressing a ‘sensitive issue’

Airlines have adopted various policies to cope with the issue. Some are easier to find than others.

Southwest Airlines, for example, refunds the cost of an additional seat to “customers of size” after travel is completed if the flight doesn’t oversell. Southwest did not return phone calls asking for the number of people who have taken advantage of the refund policy.

Farecompare.com’s Seaney said there is little incentive for people to buy two seats. Many would rather pay for one ticket and take their chances that vacant seats will be available on their flight, rather than spend double and wait for a refund, he added.

United Airlines last year implemented a policy that requires obese passengers to buy a second seat, unless vacant seats are available on their flight — in which case they would be seated next to one for free.

American Airlines has a similar policy and encourages customers to address their seating needs when booking their flight.

JetBlue does not have a policy in place for customers who require an additional seat, but the airline addresses their needs on a case-by-case basis, spokeswoman Alison Croyle said in a statement.

“We understand this is a sensitive issue,” Croyle said. “If we can accommodate larger customers on the plane, we will do so at no additional charge.”

Delta did not return phone calls asking for details on its policy.

A few weeks ago, Air France announced that starting this month, it would refund the cost of a second coach seat purchased by heavier passengers if the economy cabin was not fully booked.

Still, industry observers said formal guidelines should be adopted to avoid incidents like the one involving Kevin Smith. Flight attendants, gate agents and pilots shouldn’t be made to act as “judges and juries” on weight issues, Seaney said.

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