Sleep apnea requires monitoring after bariatric surgeryTue. Aug 19, 2008 
Although weight loss resulting from bariatric surgery improves obstructive sleep apnea (OSA), the degree of improvement is more closely related to the severity of the condition before surgery than an individual's initial weight and subsequent weight loss. OSA is common among obese individuals and its severity usually increases with the individual's weight. However, losing weight does not automatically resolve OSA, especially in severe cases, say researchers at Walter Reed Army Medical Center. In post surgical follow up studies of a small group of bariatric patients, many still had moderate to severe OSA one year after surgery. Surprisingly, even though their condition remained severe, most people thought they had improved to the point that they could discontinue treatment. According to Christopher J. Lettieri, MD, Chief of Sleep Medicine at Walter Reed Army Medical Center, people should not assume that their OSA will automatically resolve after weight loss. The baseline apnea-hypopnea index (AHI), a measure used to identify the presence of OSA and define its severity, is the most important determinant of whether or not an individual will be cured of the disease. Individuals with a lower AHI may experience complete resolution of their OSA. While many individuals can expect to experience improvement in symptoms of OSA, assessment of the severity of OSA should continue after surgery so that adjustments in treatment match more precise medical measurement of the condition instead of subjective improvements in symptoms such as snoring or daytime sleepiness. SOURCE: Journal of Clinical Sleep Medicine Neighborhood environment associated with weightWed. Aug 13, 2008 
Living in a community with a high density of fast food outlets, few parks and recreational areas, and few sidewalks increases the likelihood of residents being overweight and obese say researchers at the Oregon Research Institute. Researchers surveyed health information from 1200 residents between the ages of 50 and 75, in 120 Portland neighborhoods. They associated the reported health and lifestyle habits of respondents with the characteristics of their communities which included land use, fast food outlet density, public transportation, and the presence of recreational space. The study confirmed that a significant association exists between environmental factors and the rates of overweight and obesity in those areas. Areas that reduced barriers to healthy eating and exercise had lower rates of obesity while those that increased accessibility to unhealthy foods and lacked recreational areas were associated with higher obesity rates among residents. According to researcher Fuzhong Li, Ph.D., "34% of U.S. adults aged 20 and over are obese. Part of the rise in this disease may be attributed to our surroundings; for example, increased accessibility to unhealthy foods. The built environment is also creating barriers for our ability to exercise. Many neighborhood areas lack parks and other recreational facilities and suburbs are often designed to discourage neighborhood walking. Simply focusing on encouraging people to change their lifestyles, to eat better and to get more exercise, is insufficient. Measures are also needed to improve features of the built environment, which are often modifiable (e.g., via changes in city zoning, development policies), to support people in making such changes." SOURCE: American Journal of Preventive Medicine Less activity and more television problematic for immigrant Hispanic childrenFri. Aug 08, 2008 
Immigrant children are less active than their US-born counterparts say researchers who suggest the need for lifestyle interventions targeting ethnic minority groups. With childhood obesity continuing to rank as a major health risk in the United States, researchers from the U.S. Department of Health and Human Services were prompted to analyze national child health survey data for greater insight into the issue. They found that more than 11 percent of U.S children were physically inactive, but this figure doubled when restricted to immigrant Hispanic children. Similarly, 67 percent of immigrant Hispanic children did not participate in sport compared to 42 percent of children in the general population. When compared with native white children, the odds of physical inactivity and lack of sports participation were both 2 times higher for immigrant Hispanic children with foreign-born parents, and the odds of television watching over 3 hours per day were 1.5 times higher. K. Singh, Ph.D., of the Health Resources and Services Administration and author of the study says, "Given the health benefits of physical activity, continued higher physical inactivity and lower activity levels in immigrant children are likely to reduce their overall health advantage over U.S.-born populations during adulthood." He continues with the recommendation, "To reduce disparities in childhood physical activity, health education programs designed to promote physical activity should target not only children from socially disadvantaged households and neighborhoods but also children in immigrant families." SOURCE: Archives of Pediatrics & Adolescent Medicine Close contact and more activity avoids weight regainThu. Aug 07, 2008 
Effective maintenance of weight loss may require more than the recommended 30 minutes of moderate exercise on at least 5 days a week suggest researchers from the University of Pittsburgh. Dieters may need to exercise 55 minutes a day on at least five days a week as well as limit calories to sustain long-term weight loss. Observing 201 overweight and obese women over a two year period, the researchers tracked progress during the initial six month weight loss phase of restricted calorie diets, physical activity, and group education meetings, and continued monitoring the women for eighteen months into the maintenance period. They found that the women had an 8 to 10% initial weight loss in six months but had difficulty maintaining it. Weight loss was reduced to an average 5% of initial weight at the end of two years.
About 25% of the women were able to maintain the 10% weight loss for two years. These women were more active; exercising five times a week for about 55 minutes, maintained contact with the intervention team by telephone, adopted healthier eating behaviors, and ate less fat than those who regained weight. SOURCE: Archives of Internal Medicine The more you watch – the more you snackTue. Aug 05, 2008 
If you are watching your weight, you may find reducing the time you spend watching television helps. Food advertising on television exerts a powerful influence on a viewer's desire to eat high density snack foods. While observing the television behaviors of university students, researchers found that participants who watched over four hours or more of TV per day snacked more frequently while watching TV, recognized more TV advertisements and consumed more energy-dense snacks than students who viewed less than one hour of TV per day. Specifically, male students and medium-to-high television viewers had higher odds of being overweight or obese. "The link between how much a person snacks while watching TV was directly related to viewing food advertisements, specifically when choosing to eat an energy-dense snack," said John Spence, a professor in the University of Alberta's Physical Education and Recreation Department. "The exposure to the advertising seems to stimulate a desire to eat that particular food product. Also, sitting watching TV provides a prime opportunity to snack." SOURCE: American Journal of Health Promotion New guidelines for endoscopy in bariatric patientsMon. Jul 28, 2008 
With the number of bariatric surgeries now exceeding 100,000 each year, the American Society for Gastrointestinal Endoscopy (ASGE) has issued guidelines on the role of endoscopy in the bariatric surgery patient. "Obesity in this country is a major health problem that contributes to increased morbidity, mortality and a host of diseases. Bariatric surgery results in durable and significant weight loss," said Jason A. Dominitz, MD, MHS, chair of ASGE's Standards of Practice Committee. "Endoscopy plays an important role in the preoperative bariatric patient to detect and/or treat lesions in the gastrointestinal tract that might potentially affect the type of surgery performed. In addition, endoscopy is used to diagnose and treat many of the postoperative symptoms or conditions the patient may develop." The new guidelines recommend:
SOURCE: Gastrointestinal Endoscopy Keeping up with the weight of the JonesesSun. Jul 27, 2008 
Your weight, and how you feel about it, appears to be powerfully and subconsciously affected by the weight of people around you. This means that your perception of whether you need to diet is influenced by how your weight compares to people around you of the same age and sex. The consequences could be a spiral of imitative obesity according to a group of European economists studying the phenomena. Professor Andrew Oswald at the University of Warwick, one of the researchers, said "Consumption of calories has gone up but that does not tell us why people are eating more. Some have argued that obesity has been produced by cheaper food, but if fatness is a response to greater purchasing power, why do we routinely observe that rich people are thinner than poor people?" He said: "A lot of research into obesity, which has emphasized sedentary lifestyles or human biology or fast-food, has missed the key point. Rising obesity needs to be thought of as a sociological phenomenon not a physiological one. People are influenced by relative comparisons, and norms have changed and are still changing." SOURCE: University of Warwick Think less – exercise moreThu. Jul 24, 2008 
Attempting to motivate people to exercise using cognitive strategies such as explaining the benefits of exercise is not working says Vicki Conn, professor and associate dean of research in the MU Sinclair School of Nursing. Instead, people need to be given practical behavioral strategies to get them motivated for exercise. Focusing their attention on people with chronic illness, researchers from University of Missouri looked at 163 research studies to find out which strategies worked best to help people stay motivated for exercising. They found that significant increases in activity resulted from strategies such as feedback, goal setting, self-monitoring, and stimulus or cues. Any method where participants record and track their activity over time increased awareness and provided motivation for improvement. Common cognitive strategies used by healthcare providers which attempt to change knowledge, beliefs and attitudes, did not improve physical activity. "It is important for care providers to set very specific, manageable goals with patients," Conn said. "For example, ask them to exercise for 20 minutes, three times a week and track their progress by writing it down. Have them schedule exercise on their calendars, or prompt them by setting their walking shoes by their doors. Ask how they can reward themselves if they accomplish the goal. This will help incorporate activity into their daily routines and provide them with a sense of accomplishment." "Behavior interventions increased participants' activity by an average of 48 minutes per week, which is enough to provide them with health benefits," Conn said. "People may feel overwhelmed by the thought of exercise, or think they have to work out 60 minutes, five days a week, but doing just 12 minutes per day may get them started toward better health." SOURCE: Patient Education and Counseling Childhood obesity now greater concern than smoking or drug abuseTue. Jul 15, 2008 
Parents in America are now more concerned about childhood obesity than smoking or drug abuse according to a national poll on children's health released by the University of Michigan C.S. Mott Children's Hospital. The poll asked adults to prioritize a list of 20 health concerns for children. Obesity was ranked highest by 35 percent of the adults. Hispanic adults ranked obesity lower than other groups despite higher rates of childhood obesity in the Hispanic population. The top 10 health concerns for US children in 2008 are:
The poll director, Matthew M. Davis, MD, MAPP notes, "We found multiple difference in the priority of health problems for kids in the minds of adults by race, ethnicity, income or some other characteristic. What this tells us is that there is no 'one-size-fits-all' public health approach to these issues, so as doctors, nurses and public health officials work to find ways to help their community deal with health issues, it's important that they remember to tailor their approach to the priorities of the community." SOURCE: University of Michigan Recipe for weight gain in teenage girlsSat. Jul 12, 2008 
Gradual weight gain in teenage girls may result from Internet time, alcohol consumption, and lack of sleep according to Dr. Catherine Berkey and colleagues from Harvard Medical School. After surveying over 5000 girls between 14 and 21, the researchers found that girls 18 and older who had more than 2 alcoholic drinks a week or slept less than 6 hours gained the most weight. When Internet use was factored in, it was found that this group had the potential to gain about 4 pounds a year. This slow gain would be difficult to detect and over 3 to 5 years contibute to significant weight issues. Dr. Berkey comments "these behaviors may promote gradual gains in body weight, but the girls and their parents may not understand why." To help maintain a healthy body weight, she encourages adolescent girls to replace recreational Internet time with more sleep, and avoid alcoholic beverage consumption. SOURCE: Journal of Pediatrics |
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