Lack of Exercise is twice as deadly as obesity

crabsallover highlights, key points, comments / links.

How many deaths can theoretically be avoided if inactive people became more active, compared to how many could be avoided if obese people lost weight?

If activity levels were increased so that no-one was classed as inactive, then this could reduce early deaths by more than 7%. This compares to avoiding obesity, which could reduce deaths by nearly 4%.

In 2008, 676,000 deaths were attributable to physical inactivity, compared with 337,000 deaths attributable to obesity. This large study also found that among inactive individuals, even small increases in activity may be of benefit, whatever their weight or waist size.

So should we concentrate purely on physical activity and stop worrying about losing weight?

More.... http://www.nhs.uk/news/2015/01January/Pages/Inactivity-twice-as-deadly-as-obesity.aspx

Link to science (Open Access): http://ajcn.nutrition.org/content/early/2015/01/14/ajcn.114.100065.abstract?sid=6be3c78d-3af7-4b26-83b1-45e5da06d5c1

Free pdf: http://ajcn.nutrition.org/content/early/2015/01/14/ajcn.114.100065.full.pdf+html

How to turn fat-storing cells into energy burning cells?

Inhibitors of Janus Kinase convert fat-storing cells (white fat cells) into energy-burning cells (brown fat cells).

reposted from: http://www.nhs.uk/news/2014/12December/Pages/Hopes-for-chemicals-that-turn-bad-fat-good.aspx

Obesity could 'rob you' of 20 years of health

reposted from: http://www.nhs.uk/news/2014/12December/Pages/Obesity-could-rob-you-of-20-years-of-health.aspx

Is obesity jab 'two years away'?

reposted from: http://www.nhs.uk/news/2014/06June/Pages/Claim-that-obesity-jab-is-two-years-away-premature.aspx

crabsallover highlights, key points, comments / links.

“New obesity jab could be available within two years,” the Mail Online reports. The headline comes following news that scientists have identified a protein that may help stimulate the production of brown fat.

Brown fat helps keep mammals warm. In humans, it is mostly found in newborn babies, who are particularly vulnerable to cold. As we age, we do not need brown fat as much, and in adulthood we have mostly white fat. Excess white fat (obesity) can damage your health, whereas brown fat has been linked to protection against obesity and type II diabetes; as such, it has attracted increasing interest and research.

Brown fat also helps to burn calories when the body is exercising (or, less pleasantly, when you are cold enough to shiver). Unlike white fat, it acts like muscle, keeping the body firm and toned.

The study, which involved mice rather than people, found that the new protein helped stimulate the production of brown fat. 

The optimism surrounding these findings is based on the hope that researchers could potentially harness the effects of this molecule to develop an obesity treatment in the future.

However, claims that an “obesity jab could be available within two years” seem overly optimistic.

Studies on people are needed before any claims of this kind can be made.

Where did the story come from?

The study was carried out by researchers from Harvard Medical School and the Dana-Farber Cancer Institute, in the U.S., and was funded by grants from the US National Institutes of Health and JPB Foundation.

The study was published in the peer-reviewed science journal Cell.

The Mail Online’s headline that “a new obesity job could be available within two years” is not supported by the publication, although the authors did state that the “therapeutic potential in metabolic diseases is obvious”. 

There was a related study, performed by the same research team, in which the effects of the hormone irisin were studied, also in mice. Evidence suggests that irisin can also help stimulate production, by turning white fat into brown fat.

Somewhat confusingly, the Mail Online and the Daily Express seem to have reported on the findings of both studies as if they were a single piece of research.

What kind of research was this?

This was a laboratory study that used mice to identify and investigate the function of hormones released in muscles in response to exercise and cold.

Obesity levels in middle- and high-income countries is high and continuing to rise, with associated diseases including type 2 diabetes, cardiovascular disease and cancer.

As a result, the authors state there is increasing interest in brown fat – which uses energy to create heat and stops mammals becoming overly cold. In humans, brown fat is mostly found in newborn babies, who are particularly vulnerable to cold (as they have a large surface area to body volume ratio and are unable to shiver). As we age, we do not need as much brown fat to keep us warm, and have mostly white fat. However, brown fat has also been linked to protection against obesity and type II diabetes. Some hope that finding a way to make the body produce more brown fat, or convert white fat into brown fat, may help prevent obesity.

Exercising is a simple way to increase energy expenditure, and helps prevent obesity and associated metabolic disorders. It also increases the circulating levels of certain hormones released from muscle, which are known to mediate some of the beneficial effects of exercise.

The researchers wanted to see if there was the potential to harness some of these hormones to artificially mimic the beneficial effects of exercise, and investigated the role of brown fat in this process.

What did the research involve?

The research involved numerous genetic and protein studies involving mice. They were looking for molecules that were released during exercise and in response to cold, which would give them clues as to how exercise and brown fat activity were generating health benefits. By screening numerous molecules, they sought to identify those that were having the most important effects. 

What were the basic results?

• The experiments identified a molecule called meteorin-like (Metrnl) (Genecards), which was present in muscle and fat.
• Circulating levels of Metrnl rose after mice exercised and when they were exposed to the cold. 
• Metrnl was found to stimulate energy expenditure and converted regular fat into heat-producing brown fat. Metrnl also improved glucose tolerance – a sign of metabolic health – in mice fed a high-fat diet. It was doing this by interacting with many aspects of the body’s immune system and its temperature regulation systems.
• Blocking Metrnl action stopped these beneficial effects – confirmation that it was heavily involved in this process.  
• Metrnl levels increased as a result of repeated bouts of prolonged exercise, but not during short-term muscle activity.

How did the researchers interpret the results?

The researchers concluded that Metrnl’s “therapeutic potential in metabolic diseases is obvious. The recombinant Metrnl protein used here hints at that potential, but other proteins with better pharmacological properties will be required”.

Conclusion

This study identified a molecule that is induced by exercise and exposure to cold. It has been implicated in stimulating brown fat development and improving glucose tolerance – both of which have been linked to a lower risk of obesity and type II diabetes, giving hope that harnessing the effects of this molecule could create obesity treatments.

However, this optimism appears premature, as the research was conducted solely in mice. It will need to be reproduced and validated in humans to see if it is safe and effective at stimulating weight loss or other benefits. These remain unproven at this stage.

Other promised potential “anti-obesity jabs” include leptin and irisin, neither of which have delivered convincing results in human trials. This serves to highlight that when a new compound shows promise in mice, these don’t necessarily translate into effective medicines for humans.

On this basis, the Mail’s headline that a “new obesity jab could be available within two years” appears unjustified.

Rather than holding out hope of some magic medical bullet to beat or treat obesity, it’s best to try and lose weight through healthy eating and exercise. Our free 12-week NHS Weight Loss plan can help you achieve sustainable weight loss. 

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.

Links to the headlines

New obesity jab could be available within two years after scientists discover hormone that helps the body burn fat. Mail Online, June 6 2014

New drug boosting immune system could beat obesity and diabetes. Daily Express, June 6 2014

Links to the science

Rao RR, Long JZ, White JP, et al. Meteorin-like Is a Hormone that Regulates Immune-Adipose Interactions to Increase Beige Fat Thermogenesis. Cell. Published online June 5 2014

'Fizzy drink tax' to stop UK being 'fat man of Europe' - Health News - NHS Choices

'Fizzy drink tax' to stop UK being 'fat man of Europe' - Health News - NHS Choices

reposted from:

crabsallover highlights, key points, comments / links.


What were the main findings of the report?

The report has 10 key recommendations which include actions that would need to be taken by health professionals and ways to make healthier choices easier. The key recommendations are as follows:

• Education and training programmes for healthcare professionals: 

The report says that Royal Colleges, Faculties and other professional clinical bodies should promote targeted education and training programmes within the next two years. These should help to train healthcare professionals working in both general practice and hospital care to ensure that they ‘make every contact count’. This means sensitive recognition and appropriate referral and management for overweight and obese patients.

• Weight management services: 

It is recommended that the departments of health in the four UK nations should together invest at least £100 million in each of the next three financial years to increase provision of weight management services across the country, to mirror the provision of smoking cessation services (£88.2 million was spent on smoking services in 2011/12). This is recommended to include both early intervention programmes and greater provision for management of severe obesity, including bariatric (weight loss) surgery. The report says that adjustments could then be made to the Quality and Outcomes Framework, providing incentives for GPs to refer patients to such services.

• Nutritional standards for food in hospitals: 

Within the next 18 months food-based standards should be introduced in all UK hospitals in line with those put in place for schools in England in 2006. Commissioners should work with a delivery agent similar to the Children’s Food Trust to put these measures into place.

• Increasing support for new parents: 

The health visitor service in England should be extended to include delivering basic food preparation skills to new mothers and fathers, and to guide appropriate food choices which will ensure nutritionally balanced meals, encourage breastfeeding and using existing guidance in the Personal Child Health Record as a tool to support this.

• Nutritional standards in schools: 

The existing mandatory food- and nutrient-based standards in England should be applied to all schools including free schools and academies. From the 2014/15 academic year, this should be accompanied by a new requirement on all schools to provide food skills, including cooking and growing – alongside a sound theoretical understanding of the long-term effects of food on health and the environment.

• Fast food outlets near schools: 

In its first 18 months of operation, Public Health England should undertake an audit of local authority licensing and catering arrangements with the intention of developing formal recommendations on reducing the proximity of fast food outlets to schools, colleges, leisure centres and other places where children gather.

• Junk food advertising:

A ban on advertising of foods high in saturated fats, sugar and salt before the television watershed of 9pm, and an agreement from commercial broadcasters that they will not allow these foods to be advertised via internet ‘on-demand’ services, such as ‘catch-up’ internet streamed TV services.

• Sugary drinks tax:

A duty should be piloted on all sugary soft drinks, initially for one year, increasing the price by at least 20%. The authors say that estimates suggest a duty of just 20p per litre could generate revenue of approximately £1 billion per year, which could theoretically be used to provide weight management programmes across the country. It is suggested the tax would be an experimental measure for one year, looking at the effects and then seeing what impact it has upon consumption patterns and producer/retailer responses.

• Food labelling: 

In the next year, major food manufacturers and supermarkets should agree a unified system of traffic light food labelling (to be based on percentage of calories for men, women, children and adolescents) and visible calorie indicators for restaurants, especially fast food outlets.

• Travel and green spaces: 

Public Health England should guide Directors of Public Health in working with Local Authorities to encourage active travel and protect or increase green spaces to make the healthy option the easy option. In all four nations, local authority planning decisions should be subject to a mandatory health impact assessment to evaluate their potential impact upon the populations’ health.

Obesity levels range 20-30% for men, 15%-35% for women - Prevalence by Class

reposted from: https://twitter.com/PaulNuki/status/294592158508412931/photo/1

Data from National Obesity Observatory (NOO). Slide set (with above slide) available to download.

Shows Obesity by class, county. More than 6 out of 10 men are obese or overweight whilst more than 5 out of 10 women are obese or overweight. Obesity has increased from 15% in 1993-5 to 25% in 2009-11.

Increases in Obesity and Overweight and associated health risks

reposted from: Scientific American Digital - October 2010
Risks-Overweight-Obese-SCIAM-1010104.pdf

In 2008 compared to 1980 USA had many more adults and children who were obese and overweight with corresponding increases in Coronery Heart Disease, type 2 Diabetes (for overweight males double the risk), colon cancer and an x2-3 increase in risk of death if you are obese at 50.

Middle age fat and life-span in women

Middle age fat and life-span

NHS ChoicesSep 30, 2009 18:31:00 GMT Share

“Middle-age spread can knock years off your life,” the Daily Mail has warned, saying that piling on weight in middle age can cut your chances of living to an old age by 80%.

This news is based on a well conducted study that had followed 121,700 nurses since 1976, carrying out regular and comprehensive assessments of them. It does suggest, as may be expected, that reduced weight and body fat is associated with good health and survival. The research team also adjusted to account for various social, demographic and lifestyle factors that may influence the association.

It should be noted that the study did not assess the chance of survival, but of ‘healthy survival’ at age 70 or over (the researchers’ own measure of disease-free living), which was seen in only 9.9% of participants. 

While there are some limitations to the study, its conclusions agree with traditional advice that the best way to aim for a healthy life is to eat a balanced diet, exercise regularly and avoid health risk behaviours such as smoking and excess alcohol.

Where did the story come from?

The story was published in the British Medical Journal and authored by Qi Sun and colleagues of Harvard School of Public Health and the University of Warwick. The study was funded by the National Institutes of Health in the US, and the Pilot and Feasibility Program sponsored by the Boston Obesity Nutrition Research Center.

What kind of scientific study was this?

This was a cohort study designed to examine the theory that mid-life “adiposity” (build up of fat) is linked to a reduced chance of maintaining optimal health in older age.

The study involved participants of the Nurses’ Health Study, which started in 1976 and enrolled 121,700 healthy women aged between 30 and 55. Questionnaires were sent to the participants upon entry into the study (baseline) and at various points during the follow-up period, asking questions on disease, lifestyle and medical risk factors. Food frequency questionnaires were used in 1980 and repeated every two to four years.

A 36-item health status survey was included on the 1992, 1996, and 2000 questionnaires, and included questions on physical activity and perception of health. Major chronic diseases (including coronary disease, cancer and diabetes) were self-reported and then confirmed through medical records. From 1995 onwards, 93% of nurses aged 70 or older had their cognitive function assessed.

Weight and height were collected during the baseline questionnaire, with further weight assessments every two years thereafter. Although weight was self-reported, a validity study was carried out in 184 women and showed a strong correlation between self-reported and measured weights.

In a 1986 assessment of central obesity, the participant’s BMI was calculated and measures of waist circumference, hip circumference, and waist-to-hip ratio were taken. The study population for this analysis was, however, only a subset of the primary study population (9512 for waist circumference; 9450 for hip circumference; 9438 for waist-hip ratio). When conducting analyses between these measures and survival, researchers adjusted for various social and demographic factors that might affect the relationship.

The final follow-up for the purposes of this study was in 2000, when 95% of the cohort could be contacted. Deaths were identified by reports from next of kin, postal authorities, or through the national death index and almost all of those who had died could be identified. The researchers defined healthy survivors as women who survived to age 70 or older and were at that point free from 11 major chronic diseases, had no major limitations of physical function, had intact cognitive function and were in good mental health.

What were the results of the study?

Only 1686 (9.9%) of the surviving cohort met the criteria for a “healthy survivor”. A total of 15,379 (90.1%) were “usual survivors”, who had various impairments of either chronic disease, cognitive function or mental health, physical health, or a combination of these. In comparison, healthy survivors were typically healthier at baseline, and were more likely to have better diet and greater education. They were also less likely to have overall or central obesity in 1986, to have gained less weight since age 18, and to smoke.

After adjusting for various lifestyle and dietary variables, there was a significant trend of a reduced chance of healthy survival in those women with a higher BMI at baseline or greater waist circumference, hip circumference or hip-to-waist ratio in 1986. Compared with women of BMI 18.5 to 22.9, obese women (BMI ≥30) had a 79% decreased risk of healthy survival (odds ratio 0.21, 95% confidence interval 0.15 to 0.29).

The chance of healthy survival after age 70 was also decreased with weight gained from age 18 until middle age. For women who were both overweight (BMI ≥25) and had gained at least 10kg since age 18, there was an 82% decreased risk of being a healthy survivor compared to women of lean BMI and who had remained at a relatively stable weight.

What interpretations did the researchers draw from these results?

The researchers say that their findings give evidence that adiposity in middle-aged women is strongly related to a reduced risk of healthy survival into older age.

What does the NHS Knowledge Service make of this study?

This is a very well conducted study that has followed a large group of women over a considerable period of time using regular and comprehensive assessments. It does suggest, as one might expect, that reduced weight and adiposity is associated with healthy survival. In their analyses they also adjusted for various social, demographic and lifestyle factors that may affect the association. However, there are still related issues to consider:

• 
  

  Although the news highlights that “middle-age spread” reduces your chance of surviving by 80%, it is not survival that is being assessed, it is healthy survival. 
  

  
  
• This measure was designed by the study authors to mean absence of any of 11 major chronic diseases, physical limitations, cognitive impairment or mental health issues at age 70. Very few people in this cohort met these full criteria, and it may be expected that a comparatively low proportion of the general population aged 70 or over would be able to meet all of them. Outside of this study context, there is no validated definition of a healthy survivor in general use.
• Most women were under 75 at the study’s end-point, and so survival rates into older ages cannot be accurately determined.
• The adiposity measures were conducted at one time point in 1986, and the women may have changed over time.
• Weight and measurements were self-reported, which may introduce inaccuracies, although the researchers did make efforts to account for this through their validation assessment.
• 
  

  Although some news reports feature photographs of men, this was a study of women only. Results from this study may not be generalised as applying to men. 
  

  
  
• Additionally, all participants were nurses, a specific social group that may not be comparable to all other populations. The women were also primarily of white ethnicity.

The researchers say that their study “emphasises the importance of maintaining a healthy weight from early adulthood”. Despite the limitations, their conclusions agree with traditional advice that, although all genetic and medical predispositions to disease may not be controllable, the best way to aim for a healthy life is to eat a balanced diet, exercise regularly and to avoid health risk behaviours as much as possible such as smoking and excess alcohol.

Links To The Headlines

How middle-age spread can knock years off your life. Daily Mail, September 30 2009

Gaining weight in middle age cuts chances of healthy long life. The Daily Telegraph, September 30 2009

Links To Science

Sun Q, Townsend MK, Okereke IO et al. Adiposity and weight change in mid-life in relation to healthy survival after age 70 in women: prospective cohort study. BMJ 2009;339:b3796

Obesity & the Regulation of Body Mass, part 1 (draft), source: Lehninger - Principles of Biochemistry

source: Lehninger Principles of Biochemistry (5th Ed, 2008), Chapter 23.4, pg 930-932

I've recently bought the latest edition of Lehninger Principles of Biochemistry ( 5th Edition, 2008). Chapter 23.4 & 23.5 summarises Obesity & the Regulation of Body Mass. Also see my summary of September 2007 Scientific American article.

To a first approximation, obesity is the result of taking in more calories in the diet than are expended by the body's energy consuming activities. The body can deal with an excess of calories in 3 ways:

1. convert excess fuel to fat and store it in adipose tissue.
2. burn excess fuel by extra exercise.
3. "waste" fuel by diverting it to heat production (thermogenesis) by uncoupled mitochondria.
   

In mamamals a complex set of hormonal and neuronal signals acts to keep fuel intake and energy expenditure in balance, so as to hold the amount of adipose tissue at a suitable level. Dealing effectively with obesity requires understanding these checks and balances under normal conditions, and how these homeostatic conditions can fail.

Adipose tissue has important endocrine functions

FIGURE 23-33 Set-point model for maintaining constant mass. When the mass of adipose tissue increases (dashed outline), released leptin inhibits feeding and fat synthesis and stimulates oxidation of fatty acids. When the mass of adipose tissue decreases (solid outline), a lowered leptin production favors a greater food intake and less fatty acid oxidation.

FIGURE 23-34 Obesity caused by defective leptin production. Both of these mice, which are the same age, have defects in the OB gene. The mouse on the right was injected daily with purified leptin and weighs 35 g. The mouse on the left got no leptin, and consequently ate more food and was less active; it weighs 67 g.

FIGURE 23-35 Hypothalamic regulation of food intake and energy expenditure. (a) Anatomy of the hypothalamus and its interaction with adipose tissue. (b) Details of the interaction between the hypothalamus and an adipocyte, described later in the text.

FIGURE 23-36 Hormones that control eating. In the arcuate nucleus, two sets of neurosecretory cells receive hormonal input and relay neuronal signals to the cells of muscle, adipose tissue, and liver. Leptin and insulin are released from adipose tissue and pancreas, respectively, in proportion to the mass of body fat. The two hormones act on anorexigenic neurosecretory cells to trigger release of α-MSH (melanocortin); this produces neuronal signals to eat less and metabolize more fuel. Leptin and insulin also act on orexigenic neurosecretory cells to inhibit the release of NPY, reducing the "eat" signal sent to the tissues. As described later in the text, the gastric hormone ghrelin stimulates appetite by activating the NPY-expressing cells; PYY3-36, released from the colon, inhibits these neurons and thereby decreases appetite. Each of the two types of neurosecretory cells inhibits hormone production by the other, so any stimulus that activates orexigenic cells inactivates anorexigenic cells, and vice versa. This strengthens the effect of stimulatory inputs.

Mild obesity takes years off your life

reposted from: http://www.newscientist.com/article/dn16790-mild-obesity-takes-years-off-your-life.html?DCMP=OTC-rss&nsref=health

If you are moderately obese (30-35 kg/m2) you are likely to be shortening your life by 2-4 years. You increase you risk of mortality by 30% & increase Systolic Blood Pressure by 5mm Hg for every 5 kg/m2 increase.

• 00:01 18 March 2009 by Michael Marshall

If you are moderately overweight (BMI between 30 and 35 kg/m²), you will probably live two to four years less than if you stick to your ideal weight, according to a major new study of obesity and mortality.

The research may help to resolve a long-standing controversy about whether mild obesity is actually a health risk. While it is accepted that being severely overweight reduces life expectancy, the effects of being slightly overweight have been hotly debated.

A team led by Richard Peto and Gary Whitlock of the Clinical Trial Service Unit at the University of Oxford, pulled together data from 57 studies, as part of a major study called the Prospective Studies Collaboration.
They looked at almost 900,000 people, mostly from Europe and North America, to see whether those with a higher body mass index (BMI) were more likely to die early.
BMI is a measure of how obese a person is, based on their weight and height (calculate yours here). The ideal range is 22.5 to 25 kilograms per square metre.

People whose BMI was higher than 25 kg/m² had shorter lifespans on average.

Middle-aged spread

Those who were moderately overweight, with a BMI between 30 and 35 kg/m², lived two to four years less.

This level of mild obesity is now common, particularly among middle-aged people.

People who were severely obese, with a BMI between 40 and 45 kg/m², lived eight to ten years less on average – a reduction comparable to that caused by smoking.

This level of morbid obesity is still rare.
The increase in early mortality was caused by a range of diseases, including heart disease, stroke, diabetes, liver disease, kidney disease, some forms of cancer and lung disease.
Whitlock says, "Excess weight shortens human lifespan. If you are becoming overweight or obese, avoiding further weight gain could well add years to your life."
Journal reference: The Lancet, DOI: 10.1016/S0140-6736(09)60318-4

Discussion

In this collaborative analysis of data from almost 900 000 adults in 57 prospective studies,

overall mortality was lowest at about 22·5–25 kg/m² in both sexes and at all ages, after exclusion of early follow-up and adjustment for smoking status.

Above this range, each 5 kg/m² higher BMI was associated with about 30% higher all-cause mortality (40% for vascular; 60–120% for diabetic, renal, and hepatic; 10% for neoplastic; and 20% for respiratory and for all other mortality) and no specific cause of death was inversely associated with BMI.

Eating & exercise

Eating & exercise 1 in 6 children were obese in 2002

Obesity prevalence among adults: by sex, England

The prevalence of obesity in England has increased markedly among both adults and children since the mid 1990s. In 2002 it was similar for both sexes; the rate for boys and girls was 17 per cent and for adults was 23 per cent. In 1995 the equivalent figures were 10 per cent for boys and 12 per cent for girls, 15 per cent for men and 18 per cent for women.

There is no evidence that the average calorific intake or consumption of foods rich in fat and added sugar has increased in the UK since the mid 1980s. Men aged 19 to 64 in 2000/01 reported a daily energy intake of approximately 2,323 kcal (a reduction of 6 per cent since 1986/87). Women in the same age groups reported 1,642 kcal, a reduction of 3 per cent.

Reductions over the same period were also observed in the contribution of total fat to total energy intake (from 38 to 34 per cent in men and from 39 to 34 per cent in women) and saturated fat (from 15 to 13 per cent in men and from 17 to 13 per cent in women).

Percentage of adults who meet the physical activity recommendations: by sex and age, 2003, England

In 2003 the percentage of adults meeting the recommendations for physical activity in England declined with age for both sexes. Men were more active than women in every age group and their activity levels declined steadily with age. For women, activity levels remained the same until the 45 to 54 age group, and then declined.

Since the early 1990s there has been a steady increase in the use of cars and a decrease in walking and cycling to school or to work in GB. Among children aged five to ten, the proportion who walked to school fell from 61 per cent in 1992–94 to 52 per cent in 2002–03, mirroring the equivalent 10 percentage point rise in the proportion of school journeys by car, from 30 per cent to 40 per cent.

Among adolescents aged 11 to 16, the proportion of journeys to school by car increased from 16 to 23 per cent over the same period, reflecting the combined decrease in journeys on foot or by bicycle.

For adults aged 17 and over, the proportion of journeys to work where the main mode of travel was by car rose from 66 per cent in 1989–91 to 71 per cent in 2002–03. During the same interval journeys that were mainly on foot fell from 13 to 10 per cent.

Sources: Health Survey for England 1994–2003, Department of Health
Welsh Health Survey 2003/04, National Assembly for Wales

Notes:
View the latest HSE data on obesity.

Notes & definitions

Published on 17 January 2006 at 9:30 am

Being overweight can reduce Life Expectancy by 3 years - Framlingham study

reposted from: Annals of Internal Medicine. via Wikipedia Overweight.

A 2003 Framingham Heart Study found that being overweight at age 40 years reduced your life expectancy by three years. For the obese, life expectancy loss was reduced by six years.

Results: Large decreases in life expectancy were associated with overweight and obesity. Forty-year-old female nonsmokers lost 3.3 years and 40-year-old male nonsmokers lost 3.1 years of life expectancy because of overweight. Forty-year-old female nonsmokers lost 7.1 years and 40-year-old male nonsmokers lost 5.8 years because of obesity. Obese female smokers lost 7.2 years and obese male smokers lost 6.7 years of life expectancy compared with normal-weight smokers. Obese female smokers lost 13.3 years and obese male smokers lost 13.7 years compared with normal-weight nonsmokers. Body mass index at ages 30 to 49 years predicted mortality after ages 50 to 69 years, even after adjustment for body mass index at age 50 to 69 years.

Conclusions: Obesity and overweight in adulthood are associated with large decreases in life expectancy and increases in early mortality. These decreases are similar to those seen with smoking. Obesity in adulthood is a powerful predictor of death at older ages.

Obesity - Wikipedia

From left to right, the "healthy" man has a 33 inch (84 cm) waist, the "overweight" man a 45 inch (114 cm) waist, and the "obese" man a 60 inch (152cm) waist.

Being too fat 'can damage sperm'

By Caroline Parkinson Health reporter, BBC News, Barcelona

The world's obese population is rising

Obese men have poorer quality sperm, perhaps because too much fat around their testicles causes them to heat up, scientists have suggested.

University of Aberdeen researchers looked at the sperm of over 2,000 men in couples having problems conceiving.

The heaviest men had a higher proportion of abnormal sperm, as well as other problems.

The scientists told a European fertility conference losing weight probably boosted fertility.

We are pleased to be able to add improved semen quality to the long list of benefits that we know are the result of an optimal body weight Dr Ghiyath Shayeb University of Aberdeen

Being obese is already known to affect women's chances of getting pregnant.

The men were divided into four groups, according to their BMI (body mass index).

Other factors which could affect fertility, such as smoking, high alcohol use and age, were taken into account by the researchers.

Men who had a healthy BMI of 20 to 25 were had higher levels of normal sperm than those who were heavier.

They also had higher semen volume, the European Society for Human Reproduction and Embryology meeting in Barcelona was told.

But those with a higher BMI had lower volumes of seminal fluid, and a higher proportion of abnormal sperm.

There was no significant difference between the four groups in sperm concentration or activity.

Other studies have also linked obesity to DNA damage in the sperm.

Semen quality

Dr Ghiyath Shayeb, who led the research, said: "Our findings were quite independent of any other factors and seem to suggest that men who are trying for a baby with their partners, should first try to achieve an ideal body weight.

"This is in addition to the benefit of a healthy BMI for their general well being.

"Adopting a healthy lifestyle, a balanced diet, and regular exercise will, in the vast majority of cases, lead to a normal BMI.

"We are pleased to be able to add improved semen quality to the long list of benefits that we know are the result of an optimal body weight."

The researchers will now look at male BMI in fertile and infertile couples to see if the poorer semen quality is directly linked to poor fertility, and examine further how obesity can damage sperm.

Dr Shayeb said there were a number of possible explanations, including different hormone levels in obese men, overheating of the testicles caused by excessive fat in the area, or simply the lifestyle and diet that leads to obesity also causing poorer semen quality.

Dr Ian Campbell, chair of the charity Weight Concern, said

it was known that overweight people had a tendency to have fewer children.

He said there had been a suspicion that was mainly due to lack of opportunity.

"But if weight actually has a detrimental effect on sperm quality, that's really interesting," he said

"It's one more reason for men to lose weight."

WHO - Establishing true costs of health and obesity

WHO - Preventing the global obesity epidemic - 2000

Total report size: 253 pages
Summary 16 pages - click on Parts 1..2 etc, for additional pdf

Part 1: The problem of Overweight and Obesity

Part 2: Establishing the true costs of the problem of overweight and obesity

reposted from: http://commentisfree.guardian.co.uk/abby_oreilly/2007/11/fat_for_purpose.html

The comments are better than this article.

Fat for purpose

Even though they're ridiculed and discriminated against, not all overweight people want to conform to the notion that thin is beautiful

Abby O'Reilly

November 20, 2007 9:00 AM

Fatness has become synonymous with unhappiness. If you are overweight you are not allowed to feel confident: it's against the rules. You're not even supposed to step outside without strapping down your effervescing gut with an elasticated waistband, because fatties don't look or feel attractive. They dress badly. They have greasy hair. They smell like stale chicken wings, body odour and warm fats, and they are lazy. There are no studies to corroborate this, of course. This is the archetypal fat person, the one that would exist should the world spontaneously combust and a superior life force begin to piece together society using the remnants of Gillian McKeith's brain with cuttings from tabloids and women's weeklies.

The front-page report that

almost two thousand people are too fat to work,

according to documents released by the Department for Work and Pensions for 2006-2007, will further fuel the belief that fat people are the scourge of society, addicted to daytime TV and flaky pastry. Despite this being a relatively small percentage of the fat population in the UK, anyone with a spare tyre, whether working or not, will be considered one of the wobbly masses "working the system" and claiming the £4.4bn that rightly belongs to the thin people who earned it.

There were individuals receiving incapacity benefit for a number of reasons, including migraines and acne, but it is the overweight who are considered morally repugnant: fatties have no integrity, their "condition," if it can be called that, is something to be highlighted and shamed rather than sensibly addressed. The article is illustrated with a photograph of the hanging belly of an obese woman, tightly covered in grey sweat pants and a white shirt, inciting the physical revulsion that we are conditioned to feel by the rotund. A lot of fat people work, and work well. What the departmental figures fail to recognise is the number of people actively discriminated against in the job market owing to the fact that they are porkers, and the media prefers to perpetuate the concept that fatties don't work because they don't want to rather than because they can't get employed. It should also be pointed out that to claim incapacity benefit you have to be assessed, and fatness is one thing that you just can't fake.

I am a fat woman and have never resisted that definition. I feel that to do so would endorse the idea that there is something inherently wrong with me, rather than society. I wouldn't say I am particularly insecure about my weight; no more so than someone with a big nose, or oddly shaped head. The greatest problem has always been impolite comments from those who believe that as a fatty I am public property, and owed a verbal pummeling. I refuse to let this influence me, especially since I have no problem with the way I am. This is my biggest crime.

We live in a culture where our ability to adhere to the rules of self-perfection is considered directly proportionate to our success, especially for women. Glossy magazines daily boast images of the emaciated size zero beauties littering celebsville, and while we can't emulate their lifestyles, their look has become achievable, and costs nothing at all (just your health). So being overweight indicates a lack of self-control, something that can only be remedied by substituting your penchant for doughnuts with delicious mung beans.

If you are clinically overweight and not stringing up the noose, you must not admit it. This must be hidden under the bed like a shameful secret, shrouded in years' worth of chocolate wrappers and crisp packets. To raise your bingo wings in the air as a bleary eyed request for help is considered responsible: you exist on the fringes, yes, but at least you realise that you are "aesthetically displeasing" and want to change. However, refusing to allow your weight to impinge on your life means that you will be subject to unyielding pressure from the dieting industry and a media machine intent on making you recognise the error of your ways. To be content when you are different forces society to question its rules of acceptability, and as the anomaly you have to be obliterated before anyone else realises that it's possible to think outside the box. You are depressed being overweight because thin people say so. And if this is not true, then tough luck because everyone still thinks so.

A report last week claimed that those taking the weight-loss drug rimonabant, sold in the UK under the name Acomplia, have an increased chance of developing psychiatric problems. In the study, carried out at the University of Copenhagen, more than 4,000 patients took part in four medical trials. Those taking the drug were 40% more likely to suffer from anxiety and depression. The drug was not licensed in the US over fears suicide rates would increase but in the EU has been approved as a prescription only medicine. Although you may end up eating your own hair, and carving your weight loss along your arms with a butter knife, it is an effective method of shedding those unwanted pounds. People are opting to take this medication because the prospect of becoming mentally deranged is considered far more appealing that living as a "wide load," and so what does this say about the status quo? If a woman has starved herself to the point of death owing to the pressures to be skinny then she is referred to a cognitive behavioural therapist, with the psychological aspects of her condition validated. If someone is very fat, however, the possibility they may have underlying issues that have precipitated their weight problem is ignored simply because, unlike anorexia, the results of obesity are less glamorous. Fatness is considered nothing more than the ugly result of gluttony, and so nobody cares that a weight loss drug could seriously damage a fatty's mental health because they will look better. In many respects it's considered a public service.

Overweight people are not acceptable, an attitude which has permeated the national consciousness. The word "fat" is invested with negativity, considered a derogatory term used as an insult, as opposed to the word "thin" which invokes images of beauty and perfection. Some people are genetically predisposed to be overweight. Others may be miserable, prone to comfort eating. Either way, the claim put forward by Weight Watchers and endorsed by celebrity culture - loose weight and feel great - not only creates, but also enhances existing insecurities, in addition to placing unrealistic expectations on the power of weight control. Yes, many women who loose weight are much happier, but many who choose not to lead perfectly normal and fulfilled lives. You don't have to be thin to be happy, and you don't have to be fat to be unhappy. It is time emphasis shifted from pressurising people to loose weight through public humiliation, to supporting the idea that it is possible to be successful and cheerful even if you are the wrong side of 15 on the scales.

There are health implications to being overweight, and of course, support should be accessible to those who want and need it. We shouldn't encourage people to be fat, but it is counterproductive to claim that the only way you can be happy and get the promotion you want is by banishing your muffin top, because some of us just cannot do it. Considering that many people are overweight, shouldn't we foster an all-inclusive society, rather than making every fat person feel like a grotesque beast of burden and assuming they are trapped in a neverending cycle of binge eating and depression? What will this do other than foster generations of teenagers and adults who lack the confidence to even step outside without being shrouded in a black cagoule?

Obesity 'fuels cancer in women'

reposted from:

Obesity 'fuels cancer in women'

Being overweight is a risk factor for cancer

About 6,000 middle-aged or older women in the UK develop cancer each year because they are obese or overweight, a Cancer Research UK-funded study says.

The study, which looked at 45,000 cases of cancer in 1m women over seven years, says this is about 5% of such cases.

It is published online by the British Medical Journal and blames excess fat for 50% of cases of womb cancer and a type of oesophageal cancer.

Last week an international study warned of the link between cancer and weight.

'Bigger impact'

The World Cancer Research Fund warned that carrying excess weight significantly increased the risk of cancer.

CANCERS LINKED TO OBESITY Womb Oesophagus Bowel Kidney Leukaemia Breast Multiple myeloma (bone marrow) Pancreatic Non-Hodgkin's lymphoma Ovarian

Figures indicate that about 23% of all women in England are obese and 34% are overweight.

The latest study looked at how often cancers occurred in 1.2m UK women aged 50 to 64 over a seven year period. More than 45,000 cases of cancer and 17,000 cancer deaths occurred during that time.

Lead researcher Dr Gillian Reeves, from Oxford University, said:

"We estimate that being overweight or obese accounts for around 6,000 out of a total 120,000 new cases of cancer each year among middle-aged and older women in the UK.

"Our research also shows that being overweight has a much bigger impact on the risk of some cancers than others.

"Two thirds of the additional 6,000 cancers each year due to overweight or obesity would be cancers of the womb or breast."

Age difference

The research found that the link between weight and risk of cancer depended on a woman's stage of life.

Invest in a healthier lifestyle today and we can reap the benefits of reduced disease risk and longer life tomorrow Dr Ian Campbell Weight Concern

For example, being overweight increases the risk of breast cancer only after the menopause and the risk of bowel cancer only before the menopause.

Sara Hiom, from Cancer Research UK, said: "This research adds to the evidence regarding the impact of being overweight or obese on developing cancer and dying from the disease.

"While most people readily associate carrying extra weight with being a general health risk, many do not make a specific link with cancer."

Dr Ian Campbell, medical director of the charity Weight Concern, said: "Whereas it was once thought there was little one could do to prevent cancer, it's now clear that lifestyle impacts greatly on overall cancer risk.

"The message is clear. Invest in a healthier lifestyle today and we can reap the benefits of reduced disease risk and longer life tomorrow."