Both household food insecurity (HFInsec) and childhood overweight are significant problems in the United States. Paradoxically, being foodinsecure may be an underlying contributor to being overweight. A study of almost 8,500 lowincome children ages 1 month to 5 years, published in the October 2009 issue of the Journal of the American Dietetic Association, suggests an association between household food insecurity and overweight prevalence in this lowincome population. However, sex and age appear to modify both the magnitude and direction of the association.

Food insecurity is defined as the lack of access to enough food for an active, healthy life, which results from limited or uncertain access to nutritionally adequate and safe foods in socially acceptable ways. In 2004, 11% of households in the United States reported household food insecurity, and households with children younger than 6 years old and black and Hispanic households experienced higher rates of household food insecurity and hunger. Prevalence of household food insecurity and overweight has increased over time and are more prevalent in lowincome families.

This crosssectional study is based on demographic, anthropometric, food security and other healthrelated data collected from November 1998 through December 1999, on a sample of children and mothers from low income families participating in the Massachusetts Department of Public Healths WIC (Special Supplemental Nutrition Program for the Women, Infants, and Children) Program. Data on the childrens age, sex, parental/caretaker report of child race/ethnicity and maternal education were also collected.

Of the 8,493 children with complete data, 31% of the children were from foodinsecure households (8.3% with hunger), and 18.4% of the sample was overweight. Prevalence of HFInsec did not differ significantly by age, sex or maternal education.

Because significant interactions were found between HFInsec and agegroup and sex, the researchers separated the subjects into four groups, boys < 2 years old, girls < 2 years old, boys 25 years old and girls 25 years old. In girls < 2 years old, HFInsec was associated with a lower likelihood of being overweight. No correlation was found for boys < 2 years. In contrast, 2 to 5year old girls from households reporting HFInsec with hunger had a 47% higher odds of overweight than those from food secure households. No association was found for HFInsec without hunger among 25 year old girls, and again, no association was found among 25 year old boys.

Writing in the article, Elizabeth MetallinosKatsaras, Associate Professor, Department of Nutrition, School for Health Sciences, Simmons College, Boston, states, “The findings of this study suggest that HFInsec is associated with overweight prevalence in low income ethnically and racially diverse girls. Age and sex, however, appear to modify both the magnitude and the directionality of the association. Future research should examine these associations using a longitudinal research design. Moreover, qualitative research is needed to establish the underlying behaviors that may affect the development of childhood overweight among families with uncertain and limited food availability and how these behaviors may vary by sex.”

The article is “Food Insecurity Is Associated with Overweight in Children < 5 Years" by Elizabeth MetallinosKatsaras, PhD, RD, Bettylou Sherry, PhD, RD, Jan Kallio, MS, RD, LDN. It appears in the Journal of the American Dietetic Association, Volume 109 Issue 10 (October 2009), published by Elsevier.

Source
Lynelle Korte

According to Vivus Inc, their experimental drug Qnexa for treating obesity showed positive results in late stage trials, where patients who took the new diet pill, a combination of phentermine (a stimulant) and topiramate (an anticonvulsant), shed an average of nearly 15 per cent of their body weight over a year and also showed significant improvements in cardiovascular and other obesityrelated risk factors.

Vivus Inc announced results of the EQUIP and CONQUER Phase 3 trials in a public statement on Wednesday, 9 September. The 56week pivotal studies evaluated the safety and efficacy of Qnexa in more than 3,750 patients in 93 centres.

According to the drug company, the studies

“Met all primary endpoints by demonstrating statistically significant weight loss with all three doses of Qnexa, as compared to placebo.”

“Patients taking Qnexa also achieved significant improvements in cardiovascular and metabolic risk factors including blood pressure, lipid levels, and type 2 diabetes,” said the statement.

The key results showed thatOn average, in the EQUIP study, patients treated with Qnexa lost 14.7 per cent of their body weight (an average of 37 lbs or 16.8 kg) over the 56 weeks of the study.
Patients treated with Qnexa showed significant improvements in cardiovascular, metabolic and inflammatory risk factors.
The drug exceeded FDA efficacy benchmarks for weight loss agents at all three doses tested in the trials.
Completion rates were significantly higher than placebo at all three doses (up to 69 per cent), indicating the drug was well tolerated.
The drug showed a favourable safety profile (the balance between benefits and risk).EQUIP Study

For the randomized, doubleblind, placebocontrolled EQUIP study, the investigators recruited 1,267 obese patients from 93 centers across the US (1,050 women and 217 men) with a starting average BMI of 42.1 kg/m2 and weight of 256 lbs (116 kg). The trial lasted 56 weeks, comprising four weeks of dose titration and then 52 weeks of treatment.

The study had 3 arms low dose Qnexa, full dose Qnexa, and placebo, and patients were asked to follow a low calorie diet that left them short of around 500 calories a day. They were also required to make some simple changes to their lifestyle.

The EQUIP study results showed thatThe average weight loss for patients taking Qnexa who completed the study was 37 pounds (16.8 kg) for the full dose group and 18 pounds (8.2 kg) for the low dose group, compared to 6 pounds (2.7 kg) in the placebo group.
60 per cent of the patients on the full dose who completed the study lost at least 10 per cent of their starting body weight, while 43 per cent lost at least 15 per cent.
Completion rates were 47, 57 and 59 per cent for the placebo, low dose and full dose groups.
Full dose patients showed significant improvements in blood pressure, triglycerides and cholesterol.CONQUER Study

The CONQUER study was a randomized, doubleblind, placebocontrolled, prospective trial, that like the EQUIP study had 3 arms, except that the patients took either a once a day middose of Qnexa (as oppoosed to a low dose), a full dose or placebo.

From across 93 centers in the US, the trial investigators recruited 2,487 overweight and obese patients (1,737 women and 750 men) who had high blood pressure, high cholesterol or type 2 diabetes and whose average starting BMI was 36.6 kg/m2 and weight was 227 lbs (103.0 kg).

As in EQUIP, the patients underwent 4 weeks of dose titration period followed by 52 weeks of treatment, were asked to follow a low calorie diet with a daily deficit of 500 calories a day and were required to make some simple changes to their lifestyle.

The CONQUER study results showed thatThe average weight of those who completed the study was 30 pounds (13.6 kg) in the full dose group, 24 pounds (10.9 kg) in the middose group, and 6 pounds (2.7 kg) in the placebo group.
64 per cent of the full dose patients who completed the study lost at least 10 per cent of their starting weight, while 39 per cent lost at least 15 per cent.
Completion rates were 57, 69 and 64 per cent for the placebo, mid dose and full dose groupsThe CONQUER study results also showed a number of risk factor reductions in patients taking Qnexa compared to those taking placebo. The following results were reported for reductions among patients showing the highest levels at baseline for each risk factor (top 25th percentile) and who completed the 56 weeks of the studyThe patients with highest blood pressure experienced a significant systolic blood pressure reduction of 20 mmHg from 147 mmHg, compared to 14 mmHg in the placebo group.
There was also a significant reduction in blood pressure medication among the Qnexa patients compared to the placebo group.
The patients with the highest triglyceride levels experienced a significant reduction of 98 mg/dL from 268 mg/dL, compared to 42 mg/dL from 262 mg/dL in the placebo group.
The patients with the highest hemoglobin A1c levels (a measure of blood sugar for diabetes patients) experienced a significant reduction of 0.6 from 7.3 per cent compared to only 0.1 from 7.4 per cent for the placebo group.
There was also a significant reduction in diabetes medication among the Qnexa patients compared to the placebo group (all patients were treated to standard of care for type 2 diabetes).Adverse Events

Across both studies the most commonly reported side effects were dry mouth, tingling, constipation, altered taste and insomnia. Using tests that followed FDA guidelines, the investigators found no signals for suicide risk. There were no suicide attempts or behaviours, and there was no sign that people were thinking of suicide across all treatment groups, said the company statement.

Overall scores for depression and quality of life, including self esteem and general health showed significant improvement among patients who took Qnexa.

Scores for depression or depressed mood adverse events were similar in Qnexa and placebo groups and under 2 per cent for moderate to severe events.

Leland Wilson, president and chief executive officer of VIVUS said

“The outstanding results from the EQUIP and CONQUER studies, in addition to the results from EQUATE that were reported late last year, confirm the positive effect of Qnexa and underscore the important role this therapy may play in the lives of patients battling obesity and related comorbidities, if approved by the FDA.”

He said the company plans to file for federal approval by the end of this year and also submit the study reports for peerreviewed journal publication.

“We believe these results may provide a compelling opportunity for global pharmaceutical companies, and we intend to initiate partnering discussions now that we have the full data set in hand,” said Wilson.

However while these results are impressive, according to various reactions in the media this week, there remains the question of what might happen in the longer term, both for patients who continue to use the drug and those who come off it.

In the 1990s the “fenphen” combination of fenfluramine and phentermine also achieved impressive results with weight loss, but it was eventually withdrawn after reported links with pulmonary hypertension and serious heart valve problems, followed by lawsuits that are still being pursued against the drug maker.

For Qnexa Vivus have combined phentermine with topiramate which is better known as an antiepilepsy drug although several studies have recently reported it has shown positive results in controlling weight loss and binge eating, according to a comment by Dr Mitchell Roslin, of Lenox Hill Hospital in New York City, reported by MedPage Today.

Source Vivus Inc, MedPage Today.

Written by Catharine Paddock, PhD

US authorities are investigating concerns that antiobesity drug Orlistat may cause liver damage.

Orlistat went on sale under the brand name Alli without the need for a prescription in the UK in April.

The US Food and Drug Administration (FDA) has received more than 30 reports linking the drug to serious liver injury.

The pill, which works by blocking the absorption of fat in the body, is considered an option for people with diabetes who have a Body Mass Index (BMI) of 28 or more. It is also available on prescription as Xenical. Clinical trials suggest adding Orlistat to a reducedcalorie, lowerfat diet, can help people lose 50 per cent more weight than dieting alone.

Conducting a new review

The FDA said it was now conducting a review of the safety of the drug, but stressed no definite association with liver damage had been established at this stage. The European Medicines Agency said there was no plan to change the product information at present but the situation was under review. The manufacturer GlaxoSmithKline said there was no evidence the drug caused liver damage.

Antiobesity drugs a last resort

Zoe Harrison, Care Advisor at Diabetes UK, said “If people taking Orlistat are concerned about their health, Diabetes UK would advise them to contact their healthcare team, particularly if they experience possible symptoms of liver injury such as jaundice (yellowing of skin or eyes), loss of appetite or nausea.

The U.S. Food and Drug Administration announced that it is reviewing adverse event reports of liver injury in patients taking the weight loss drug orlistat, marketed as the prescription drug Xenical and the overthecounter medication Alli.

Between 1999 and 2008, the FDA received 32 reports of serious liver injury in patients taking orlistat. Of those cases, 27 reported hospitalization and six resulted in liver failure. Thirty of the adverse events occurred outside the United States. The most commonly reported adverse events included yellowing of the skin or whites of the eyes (jaundice), weakness, and stomach pain.

The FDA is reviewing additional data submitted by orlistat manufacturers on suspected cases of liver injury, and the issue has been discussed at the FDAs Center for Drug Evaluation and Research Drug Safety Oversight Board.

“The issues here are complex, but FDA has benefited from the input of the Board, including comments from representatives from three FDA Centers and several other Agencies in the Department of Health and Human Services,” said Steven Osborne, M.D., executive director of the Board.

The FDAs analysis of these data is ongoing, and no definite association between liver injury and orlistat has been established at this time. Consumers taking Xenical should continue to take it as prescribed, and those using overthecounter Alli should continue to use the product as directed.

Full text of the Early Communication about an Ongoing Safety Review can be found here.The Early Communication is a risk communication tool used by the FDA to inform the public about its ongoing safety reviews of drugs. The FDA will release its findings on orlistat as soon as the review is completed.

Consumers who have used orlistat should consult a health care professional if they experience symptoms possibly associated with development of liver injury, particularly weakness or fatigue, fever, jaundice, or brown urine. Other symptoms may include abdominal pain, nausea, vomiting, lightcolored stools, itching, or loss of appetite.

The FDA urges both health care professionals and consumers to report suspected side effects from the use of orlistat to FDAs MedWatch Adverse Event Reporting program either online, or by regular mail, fax, or phone.

Online
Regular Mail use postagepaid FDA form 3500 and mail to MedWatch, 5600 Fishers Lane, Rockville, MD 208529787
Fax 800FDA0178

A study, “Prenatal Origins of Poor Sleep in Children,” in the Aug.1 issue of the journal SLEEP found that alcohol consumption during pregnancy and small body size at birth predict poorer sleep and higher risk of sleep disturbances in 8yearold children born at term. Findings are clinically significant, as poor sleep and sleep disturbances in children are associated with obesity, depressive symptoms, attention deficit hyperactivity disorder, and poor neurobehavioral functioning.

Results indicate that children exposed prenatally to alcohol were 2.5 times more likely to have a short sleep duration of 7.7 hours or less and 3.6 times more likely to have a low sleep efficiency of 77.2 percent or less across all nights, independent of body size at birth and current maternal alcohol use. Smaller body size at birth also was associated with poorer sleep and with a higher risk for clinically significant sleep disturbances among children born at term. More specifically, lower weight and shorter length at birth were associated with lower sleep efficiency, and a lower ponderal index (an indicator of fetal growth status) was associated with the presence of sleep disturbances. In addition, children with short sleep duration were more likely to have been born via Caesarean section than were children sleeping longer (23.1 percent versus 8.4 percent respectively).

According to principal investigator Katri Räikkönen, PhD, in the department of psychology at the University of Helsinki, Finland, even low levels of weekly prenatal exposure to alcohol have adverse effects on sleep quantity and quality during childhood.

“The results were in accordance with the fetal origins of health and disease hypothesis and the many studies that have shown that adverse fetal environment may have lifelong influences on health and behavior,” said Räikkönen. “However, this is among the few studies that have reported associations between birth variables and sleep quality and quantity among an otherwise healthy population of children.”

The epidemiologic cohort study obtained data from 289 children born at term (from 37 to 42 weeks of gestation) between March and November 1998. Sleep duration and sleep efficiency (actual sleep time divided by the time in bed) were measured objectively by actigraphy at 8 years of age for an average of 7.1 days. Parents completed the Sleep Disturbance Scale for Children to report sleep problems and sleep disorder symptoms such as bedtime resistance and sleep disordered breathing.

Results show that the odds for low sleep efficiency increased by 70 percent for every standard deviation decrease in weight at birth and by more than 200 percent for every decrease in length. For every standard deviation decrease in ponderal index at birth, the risk of parentreported sleep disorders increased by 40 percent. Associations were not confounded by sex, gestational length, prenatal and perinatal complications, body mass index (BMI) at eight years of age, asthma, allergies or parental socioeconomic status.

The authors report that small body size at birth may function as a crude marker of disturbances in the fetal environment, and it is associated with prematurity, intrauterine growth retardation, prenatal alcohol exposure and poorer sleep quality in children and young adults. Results demonstrate that among children born healthy and at fullterm, a linear relationship exists between smaller body size at birth and poorer sleep quality eight years from birth.

Source
Kelly Wagner

Obesity, among other factors, is strongly associated with an increased risk of rapid cartilage loss, according to a study published in the August issue of Radiology.

“We have isolated demographic and MRIbased risk factors for progressive cartilage loss,” said the studys lead author, Frank W. Roemer, M.D., adjunct associate professor at Boston University and codirector of the Quantitative Imaging Center at the Department of Radiology at Boston University School of Medicine. “Increased baseline body mass index (BMI) was the only nonMRIbased predictor identified.”

Tibiofemoral cartilage is a flexible connective tissue that covers and protects the bones of the knee. Cartilage damage can occur due to excessive wear and tear, injury, misalignment of the joint or other factors, including osteoarthritis.

Osteoarthritis is the most common form of arthritis, affecting 27 million Americans, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. In osteoarthritis, the cartilage breaks down and, in severe cases, can completely wear away, leaving the joint without a cushion. The bones rub together, causing further damage, significant pain and loss of mobility.

The best way to prevent or slow cartilage loss and subsequent disability is to identify risk factors early.

“Osteoarthritis is a slowly progressive disorder, but a minority of patients with hardly any osteoarthritis at first diagnosis exhibit fast disease progression,” Dr. Roemer said. “So we set out to identify baseline risk factors that might predict rapid cartilage loss in patients with early knee osteoarthritis or at high risk for the disease.”

The researchers recruited patients from the Multicenter Osteoarthritis (MOST) Study, a prospective study of 3,026 people, age 50 79, at risk for osteoarthritis or with early xray evidence of the disease. The study is funded by the National Institute on Aging.

Dr. Roemers study consisted of 347 knees in 336 patients. The patient group was comprised of 65.2 percent women, mean age 61.2, with a mean BMI of 29.5, which is classified as overweight. Recommended BMI typically ranges from 18.5 to 25. Only knees with minimal or no baseline cartilage damage were included. Of 347 knees selected for the study, 20.2 percent exhibited slow cartilage loss over the 30month followup period and 5.8 percent showed rapid cartilage loss. Rapid cartilage loss was defined by a whole organ magnetic imaging score of at least 5, indicating a large full thickness loss of 75 percent in any subregion of the knee during the followup period.

The results showed that the top risk factors contributing to rapid cartilage loss were baseline cartilage damage, high BMI, tears or other injury to the meniscus (the cartilage cushion at the knee joint) and severe lesions seen on MRI at the initial exam. Other predictors were synovitis (inflammation of the membrane that lines the joints) and effusion (abnormal buildup of joint fluid).

Excess weight was significantly associated with an increased risk of rapid cartilage loss. For a oneunit increase in BMI, the odds of rapid cartilage loss increased by 11 percent. No other demographic factorsincluding age, sex and ethnicitywere associated with rapid cartilage loss.

“As obesity is one of the few established risk factors for osteoarthritis, it is not surprising that obesity may also precede and predict rapid cartilage loss,” Dr. Roemer said. “Weight loss is probably the most important factor to slow disease progression.”

“Risk Factors for MRIdetected Rapid Cartilage Loss of the Tibiofemoral Joint over a 30month Period the MOST Study.” Collaborating with Dr. Roemer were Yuqing Zhang, D.Sc., Jingbo Niu, M.D., John A. Lynch, Ph.D., Michel D. Crema, M.D., Monica D. Marra, M.D., Michael C. Nevitt, Ph.D., David T. Felson, M.D., M.P.H., Laura Hughes, Georges ElKhoury, M.D., Martin Englund, M.D., Ph.D., and Ali Guermazi, M.D., for MOST study investigators.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (radiology.rsnajnls.org)

Nearly 90 percent of morbidly obese patients with Type 2 diabetes experienced diabetes resolution within the first year of gastric bypass surgery and about 60 percent remained diabetesfree five to 16 years later, according to a new study presented today at the 26th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).

Those most likely to experience a recurrence of diabetes regained the most weight or had a more severe insulindependent form of diabetes prior to surgery. More than 75 percent of patients who were controlling their diabetes with dietary and lifestyle management and more than 65 percent who were using oral medications before surgery continue to be diabetesfree after gastric bypass surgery. About 70 percent of insulindependent patients had a recurrence of diabetes independent of weight loss or gain, and 40 percent of those who regained about 20 percent of the weight also experienced a return of the disease.

“The severity of the diabetes at the time of surgery and the regain of excess weight loss longterm seem to be the primary determinants of longterm diabetes resolution after gastric bypass surgery,” said James W. Maher, MD, professor of Surgery at Virginia Commonwealth University and coauthor of the study. “This study suggests that people with Type 2 diabetes and morbid obesity who get surgery before becoming insulindependent have the greatest chance for complete resolution and avoiding the progression of diabetes.”

In a retrospective analysis, researchers at Virginia Commonwealth University studied 177 people with morbid obesity and Type 2 diabetes who had gastric bypass surgery between 1993 and 2003. Researchers divided patients into three categories based on their diabetes treatment prior to surgery insulin dependent (59); oral medications (83); diet and lifestyle changes only (35). Patients were followed from five to 16 years.

Patients who had a recurrence of diabetes regained about 10 percent more of their excess weight than those with no recurrence. On average, patients who remain free of diabetes had excess weight loss of about 73 percent while diabetes returned in those that had 66 percent excess weight loss.

“Our study suggests that the shortterm resolution of diabetes that is independent of weight loss may be different than the mechanism that is responsible for longterm resolution,” added Dr. Maher. “In any case, bariatric surgery remains one of the most effective treatments for diabetes and morbid obesity.”

Nearly 24 million Americans are affected by diabetes1 and the total estimated cost of diabetes in 2007 was $174 billion, including $116 billion in excess medical expenditures and $58 billion in reduced national productivity.2 About 50 percent of men and 70 percent of women who have the disease are obese.3

People who are morbidly obese are generally 100 or more pounds overweight, have a BMI of 40 or more, or a BMI of 35 or more with an obesityrelated disease, such as Type 2 diabetes, heart disease or sleep apnea. According to the ASMBS, more than 15 million Americans are considered morbidly obese and in 2008 an estimated 220,000 people had some form of bariatric surgery. The most common methods of bariatric surgery are laparoscopic gastric bypass and laparoscopic adjustable gastric banding (LAGB).
vThe American Diabetes Association (ADA) recently recommended bariatric surgery be considered for adults with BMI > 35 and Type 2 diabetes, especially if diabetes is difficult to control under current therapy.5

Two landmark studies, published in the New England Journal of Medicine in August 2007, showed patients with morbid obesity who have bariatric surgery (including gastric banding, gastric bypass, and vertical banded gastroplasty) lost significant weight over the longterm and are significantly less likely to die from heart disease, diabetes and cancer seven to 10 years following the procedure than those who did not have surgery.6, 7

A 2004 study in the Journal of the American Medical Association showed that bariatric surgery resolved or improved Type 2 diabetes in 86 percent of patients and resolved sleep apnea in more than 85 percent of patients.8

References

1. Centers for Disease Control and Prevention. National diabetes fact sheet general information and national estimates of diabetes in the United States, 2007. Atlanta, GA U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008.

2. American Diabetes Association. “Economic Costs of Diabetes in the U.S. in 2007.” Diabetes Care. Volume 31. Number 3. March 2008.

3. American Heart Association. Type 2 Diabetes. Updated 18 February 2009. [Cited 27 April 2009] Available from americanheart.org/presenter.jhtml?identifier=3044759

4. Dixon JB. Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes. JAMA. 2008; 299(3)316323

5. American Diabetes Association. Standards of Medical Care in Diabetes 2009. Diabetes Care, Volume 32, Supplement 1. January 2009. [Cited 2009 April 27].

6. Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 35774152.

7. Adams TD, Gress RE, Smith SC, et al. Longterm mortality after gastric bypass surgery. N Engl J Med 200735775361.

8. Buchwald H. Bariatric Surgery A Systematic Review and Metaanalysis. JAMA. 2004; 29217241737.

Source

South Dakota State University research shows that a child with leaner body mass, or muscle, builds bigger bones than a child who weighs the same but has a greater percentage of fat.

“We were interested in the relative influence of lean mass, which is muscle, versus fat mass on how bone grows as kids grow,” said Howard Wey, an associate professor in SDSUs College of Nursing.

Wey and professor Bonny Specker, director and chair of the Ethel Austin Martin Program in Human Nutrition at SDSU, are continuing to study the issue. They have analyzed data Specker and her team have assembled by taking bone and body composition measurements of rural Hutterite children in South Dakota.

“Theres a little bit of controversy because weight itself has a positive influence on bone,” said Wey. “Heavier individuals tend to have more bone just to support their weight.”

The SDSU study was designed to look deeper at that issue to see whether there are differences in how lean mass and fat mass correlate with bone development. Wey presented the findings at the annual meeting of the Pediatric Academic Societies in Baltimore in early May.

“A larger child is going to have larger bones just because hes heavier,” Wey said. “But if you have two kids at the same weight, the one whose weight is dominated by fat mass is more likely to have smaller bones than the one whose weight is dominated by lean mass. Smaller bones are weaker than larger bones.”

The study is an offshoot of SDSUs ongoing South Dakota Rural Bone Health Study, directed by Specker. To date the project has tracked more than 1,700 individuals over a threeyear period to evaluate how lifestyle affects bone density in three groups of people Hutterites, rural nonHutterites and nonrural nonHutterites.

The National Institutes of Health funds that research. The Ethel Austin Martin Endowed Program in Human Nutrition also supports SDSUs ongoing bone research.

To study fat mass versus lean mass as a factor in bone development, the SDSU researchers gathered two to three measurements over a 36month period on about 150 male and about 200 female Hutterite children ages 8 to 18.

Because they are growing children, all the children in the study showed increases in bone mass, area and density, Wey noted. But there were clear differences in rates of change.

“We looked at multiple measurements over time. We found that lean mass had a positive effect on rates of change,” Wey said. “Kids with higher lean mass, or muscle, tended to have greater rates of change, and kids with higher fat mass tended to have lower rates of change.”

Wey said the results are preliminary but are fairly consistent. They also confirm what Speckers research team has learned in a crosssectional study of Hutterite children. That study essentially a look at an entire group of children at one point in time suggests that lean mass has a positive effect on bone.

The ongoing SDSU research will add to what scientists know about bone development. The new knowledge is one factor that can help the medical community in forming guidelines about diet and exercise to deal with health issues such as childhood obesity and the subsequent influence on adult disorders such as osteoporosis.

Healthy eating means consuming the right quantities of foods from all food groups in order to lead a healthy life. Diet is often referred to as some dietary regimen for losing weight. However, diet simply means what food we eat in the course of a 24hour, one week, or one month, etc. period. A good diet is a nutritional lifestyle that promotes good health. A good diet must include several food groups because one single group cannot provide everything a human needs for good health.How do you define healthy eating? The crucial part of healthy eating is a balanced diet. A balanced diet or a good diet means consuming from all the different good groups in the right quantities. Nutritionists say there are five main food groups whole grains, fruit and vegetables, protein, diary, and fat & sugar.

Whole grains

According to the USDA (United States Dept. of Agriculture) we should consume at least 3 ounces of whole grains per day. A whole grain, unlike refined grains, still has the bran and the germ attached. Whole grains are rich in fiber, minerals and vitamins. When grains are refined the bran and germ are removed.

It is not possible to know whether food is made from whole grain just by looking at it. To be really sure you have to read the label. In the list of ingredients, the word whole or wholegrain needs to appear before the name of the grain.

Whole grain products include breads, pastas and cereals they need to be made with 100% whole grain. Whole grain foods and flours include 100% whole wheat, brown rice, bulger, corn, buckwheat, oatmeal (oats), spelt and wild rice.

Interesting related article

What is fiber? What is dietary fiber? Fiber rich foodsFruit and vegetables

Fruit and vegetables have a high vitamin, mineral and fiber content these nutrients are vital for your body to function well. Several studies have proven that a good intake of fruit and vegetables may protect from developing heart disease, diabetes type 2, and cancer.

Most health departments throughout the world recommend that we consume five portions of fruit and vegetables each day. This could include either fresh, frozen or canned, or dried fruit and veggies. A portion means either one large fruit, such as an apple, mango, or a banana, or three heaped tablespoons of vegetables. It could also include one glass of 100% fruit or vegetable juice. A fruit/vegetable drink is one portion, no matter how big it is. Beans and pulses can also count as one portion.

Protein

We need protein for the building and repairing of tissue in our body. Proteinrich foods also include essential minerals, such as iron, magnesium, zinc, as well as B vitamins. The NHS (National Health Service) of the UK says that proteins should make up about 20% of our nutritional intake. The following foods are good sources of proteinMeatPoultryFishEggsBeansNutsQuornSoya (includes tofu)Nutritionists advise that the fat in meat should be trimmed and drained away after cooking. The skin should be removed from poultry. For people who are not vegetarians, nutritionist advise we consume fish at least twice a week, preferably fish rich in omega oils, such as trout, fresh tuna, sardines, mackerel and salmon. The canning process of tuna removes the essential oils, hence only fresh tuna is considered as an oily fish.

It is better for your health to grill, roast or microwave meats and fish, rather than frying them.

Vegans, who do not eat any foods from animal sources, may get their protein from nuts, seeds, soya, beans and quorn. Vegans may have to supplement their zinc and B12 vitamin intake as these foods are not rich in them.

Dairy

Although butter, cream and even sometimes eggs are often classed as dairy products, in nutrition they are more frequently placed in the protein (eggs) or fat & sugar category. Dairy products are a good source of calcium which is important for healthy bones and teeth. Dairy products include milk, yoghurts, cheese, and some soya dairy products. Nutritionists say we should aim for low fat dairy products.

People who do not consume animal sourced foods can get their calcium intake from other products, such as broccoli, cabbage and soya milk and yoghurts with added calcium.

Interesting related article

What is Fat? How much fat should I eat?Fats and sugars

These include sugar, chocolate, cakes, biscuits, jam, butter, margarine, mayonnaise, nondiet sodas, etc. all products with a very high fat or sugar content.

There are two basic types of fats saturated and unsaturated. Cream, margarine and fried foods are high in saturated fats, while vegetable oils and oily fish are rich in unsaturated fats. Saturated fat consumption should be kept to a minimum because excess consumption significantly increases the risk of developing such diseases as heart disease.

Even sugary foods and drinks, like some sodas and sweets should be kept to a minimum because they are high in calories and bad for your teeth.

Interesting related articles

What are the eight most popular diets today?

What is The Atkins Diet?

What is The Zone Diet?

What is the Vegetarian Diet?

What is a Vegan Diet?

What is Weight Watchers?

What is the South Beach Diet?

What is The Raw Food Diet?

What is the Mediterranean Diet?Healthy eating and the World Health Organization (WHO) The WHO makes the following 5 recommendations they apply both to populations and individualsWe should aim for an energy balance and a healthy bodyweight.
We should limit our energy consumption from total fats. We should also aim for more unsaturated fats and less saturated fats.
We should up our consumption of fruits, vegetables, legumes, whole grains and nuts.
We should consume as little simple sugars are possible.
As well as making sure our salt is iodized, we should also limit our consumption of salt/sodium.
WHO also recommends that we Consume enough vital amino acids to provide “cellular replenishment and transport proteins”. These can be found in animal sourced proteins and some selected plant sourced proteins. A combination of other plants, with the exception of rice and beans, may also provide essential amino acids.
Consume essential quantities of vitamins and certain minerals.
Should avoid directly poisonous and carcinogenic substances.
Avoid consuming foods that may are contaminated with human pathogens, such as E. coli and tapeworm eggs.Interesting related article

What is salt? How much salt should I eat?The Healthy Eating Index (HEI) issued by the USDA (United States Department of Agriculture) The HEI is a measure of diet quality that reviews how people are conforming to Federal dietary guidance. The HEI was first formulated by the USDA in 1995 and was renewed in 2005. The standards were created using a density approach they are expressed as a percentage of calories per 1,000 calories. The components of the 2005HEI can be seen below

Healthy Eating Index 2005 components and standards for scoring1Total Fruit (includes 100% juice)
Maximum points 5
Standard for maximum score ≥0.8 cup equiv. per 1,000 kcal
Standard for minimum score zero No Fruit
Whole Fruit (not juice)
Maximum points 5
Standard for maximum score ≥0.4 cup equiv. per 1,000 kcal
Standard for minimum score zero No Whole Fruit
Total Vegetables
Maximum points 5
Standard for maximum score ≥1.1 cup equiv. per 1,000 kcal
Standard for minimum score zero No Vegetables
Dark Green and Orange No Dark Green or Orange Vegetables and Legumes2
Maximum points 5
Standard for maximum score ≥0.4 cup equiv. per 1,000 kcal
Standard for minimum score zero No dark green or orange Vegetables or Legumes
Total Grains
Maximum points 5
Standard for maximum score ≥3.0 oz equiv. per 1,000 kcal
Standard for minimum score zero No Grains
Whole Grains
Maximum points 5
Standard for maximum score ≥1.5 oz equiv. per 1,000 kcal
Standard for minimum score zero No Whole Grains
Milk3
Maximum points 10
Standard for maximum score ≥1.3 cup equiv. per 1,000 kcal
Standard for minimum score zero No Milk
Meat and Beans
Maximum points 10
Standard for maximum score ≥2.5 oz equiv. per 1,000 kcal
Standard for minimum score zero No Meat or Beans
Oils4
Maximum points 10
Standard for maximum score ≥12 grams per 1,000 kcal
Standard for minimum score zero No Oil
Saturated Fat
Maximum points 10
Standard for maximum score ≤7% of energy5
Standard for minimum score zero ≥15% of energy
Sodium
Maximum points 10
Standard for maximum score ≤0.7 gram per 1,000 kcal5
Standard for minimum score zero ≥2.0 grams per 1,000 kcal
Calories from Solid Fats, Alcoholic beverages, and Added Sugars (SoFAAS)
Maximum points 20
Standard for maximum score ≤20% of energy
Standard for minimum score zero ≥50% of energy
1 Intakes between the minimum and maximum levels are scored proportionately, except for Saturated Fat and Sodium (see note 5).
2 Legumes counted as vegetables only after Meat and Beans standard is met.
3 Includes all milk products, such as fluid milk, yogurt, and cheese, and soy beverages.
4 Includes nonhydrogenated vegetable oils and oils in fish, nuts, and seeds.
5 Saturated Fat and Sodium get a score of 8 for the intake levels that reflect the 2005 Dietary Guidelines,

According to a research abstract presented at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies, a link exists between the severity of obstructive sleep apnea (OSA) and weight gain.

Results indicate that people with an apneahypopnea index (AHI), the average of the combined episodes of apnea and hypopnea that occur per hour of sleep, of over 15 had an increase in body mass index (BMI) of 0.52 kg/m2 compared to those with an AHI between 5 and 15, who saw an increase of 0.22 kg/m2.

According to lead author Mark Brown, MD, Department of Psychiatry at the University of Arizona College of Medicine in Tucson, people suffering from more severe OSA may be more likely to gain more weight than those with less severe OSA over time.

“OSA is a disorder characterized by decreases or cessation of breathing during sleep. Obesity is a known risk factor for the disorder; however, it is hypothesized that the effects of OSA itself may predispose patients to weight gain,” said Brown.

The study included data from 3,001 men and women from the Sleep Heart Health Study (SHHS) with an average age of 62.19. Of the sample, 55.2 percent of participants were female and 76.1 percent were Caucasian. Participants were classified as having no (AHI of less than 5), moderate (AHI between 5 and 15), and severe OSA (AHI of over 15). Weight and polysomnograph information were collected. Linear regression was used to examine the association between AHI groups and the change in BMI over approximately five years. The final model was adjusted for age, gender, race, initial BMI and change in AHI over 5 years.

Abstract Title SleepDisorded Breathing and Weight Gain The Sleep Heart Health Study.Presentation Date Thursday, June 11
Category Sleep Disorders Breathing
Abstract ID 0515

Source
Kelly Wagner