Tag: obesity

Categories : Cancer Surgeries & ProceduresTags :

Bariatric Surgery Reduces Cancer Risks with Obesity

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Obesity
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A study published in JAMA shows that weight loss through bariatric surgery for adults with obesity was associated with a 32% lower risk of developing cancer and a 48% lower risk of cancer-related death compared with those who did not have the surgery.

Rising obesity numbers are being seen all over the world. The International Agency for Research on Cancer describes 13 types of cancer as obesity-associated cancers such as endometrial cancer, postmenopausal breast cancer, and cancers of the colon, liver, pancreas, ovary and thyroid.

Lead author of the study, Ali Aminian, MD, at Cleveland Clinic, said that bariatric surgery is currently the most effective treatment for obesity. “Patients can lose 20 to 40% of their body weight after surgery, and weight loss can be sustained over decades. The striking findings of this study indicate that the greater the weight loss, the lower the risk of cancer,” said Dr Aminian.

From 2004 and 2017, the SPLENDID (Surgical Procedures and Long-term Effectiveness in Neoplastic Disease Incidence and Death) study matched a group of 5053 adult patients with obesity who had bariatric surgery 1:5 to a control group of 25 265 patients with obesity who did not undergo the surgery.

After 10 years, 2.9% of patients in the bariatric surgery group and 4.9% of patients in the non-surgical group developed an obesity-associated cancer.

After 10 years, 0.8% of patients in the surgery group and 1.4% of patients in the non-surgical group died from cancer, indicating that bariatric surgery is associated with a 48% lower cancer mortality risk.

Researchers noted that the benefits of bariatric surgery were seen in a wide range of study participants in terms of age, sex and race. In addition, benefits were similarly observed after both gastric bypass and gastric sleeve operations.

“According to the American Cancer Society, obesity is second only to tobacco as a preventable cause of cancer in the United States,” said the study’s senior author, Steven Nissen, MD, Chief Academic Officer of the Heart, Vascular and Thoracic Institute. “This study provides the best possible evidence on the value of intentional weight loss to reduce cancer risk and mortality.”

Numerous studies have shown the health benefits of bariatric or weight-loss surgery in patients with obesity. The Cleveland Clinic-led STAMPEDE study showed that following bariatric surgery, significant weight loss and control of type 2 diabetes last over time. The SPLENDOR study showed that in patients with fatty liver, bariatric surgery decreases the risk of the progression of liver disease and serious heart complications.

The SPLENDID study adds important findings to the literature focused on the link between obesity and cancer. Given the growing epidemic of obesity worldwide, these findings have considerable public health implications.

“Based on the magnitude of benefit shown in our study, weight loss surgery can be considered in addition to other interventions that can help prevent cancer and reduce mortality,” said Jame Abraham, M.D., chairman of the Hematology and Medical Oncology Department at Cleveland Clinic. “Further research needs to be done to understand the underlying mechanisms responsible for reduced cancer risk following bariatric surgery.”

Source: Cleveland Clinic

Categories : Injury & Trauma Metabolic DisordersTags :

Obesity in Women Linked to Increased Fracture Risk

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Obesity
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Women with obesity and overweight, particularly women with high waist circumference, are more susceptible to fractures than those with normal weight, according to new research presented at the European Congress on Obesity (ECO). In men, however, underweight, not overweight, is associated with a greater risk of broken bones.

Obesity has long been thought to help protect against fractures. This is because mechanical loading on bones, which increases with body weight, helps increase bone mineral density, an important determinant of bone strength.

However, recent studies have suggested that the relationship between obesity and fracture risk varies depending on sex, the skeletal site studied and definition of obesity used (body mass index [BMI] vs waist circumference).

To find out more, Dr Anne-Frederique Turcotte, Endocrinology and Nephrology Unit, CHU de Quebec Research Centre, Quebec City, Canada, and colleagues, analysed data from CARTaGENE, a prospective population-based cohort of almost 20 000 individuals aged 40-70 years from Quebec, Canada.

In women, greater waist circumference (WC) was linearly associated with an increased risk of fracture. For each 5cm (two inch) increase in WC, the risk of fracture at any site was 3% higher and the risk of a distal lower limb fracture was 7% higher.  The association between WC and ankle fractures was particularly strong.

In women, greater BMI was associated with a greater risk of distal lower limb fractures. Compared with women with a BMI of 25 kg/m², those with a BMI of 27.5-40 kg/m² showed a greater risk of distal lower limb fractures.  The increase in risk rose linearly from 5% in those with a BMI of 27.5 kg/m², to 40% in those with a BMI of 40 kg/m².

Women with a BMI of 22.5 kg/m² had a 5% lower risk of distal lower limb fractures than those with a BMI of 25 kg/m².

It isn’t known why obesity is associated with a higher risk of fractures in women.  However, most fractures are a result of a fall and falls are more common in people with obesity.  The ankle, unlike the hip and thighbone, is not protected by soft tissue, which could make it more prone to breaking during a fall.

Dr Turcotte added: “Waist circumference was more strongly associated with fractures in women than BMI.  This may be due to visceral fat – fat that is very metabolically active and stored deep within the abdomen, wrapped around the organs – secreting compounds that adversely affect bone strength.

“We also know that people with obesity take longer to stabilise their body, when they trip, for example.  This is particularly pronounced when weight is concentrated at the front of the body, suggesting that individuals with distribution of body fat in the abdominal area may be at higher risk of falling.” 

In men, increases in BMI and WC were not significantly associated with fractures.  However, men with underweight were at higher risk of distal upper limb fractures than those with normal weight.  Men with a BMI ≤17.5 kg/m² were twice as likely to have distal upper limb fracture as men with a BMI of 25 kg/m².

The researchers say a larger number of fractures in men is needed to determine whether this is a true result or whether the pattern for men follows that for women.

The analyses were adjusted for a number of potential confounders: age, menopausal status, ethnicity, marital status, education, income, area of residence, smoking status, alcohol consumption, physical activity level, supplemental calcium and vitamin D intake, history of fracture and comorbidities and medications known to influence fracture risk.

The study authors said: : “Our findings show that the relationship between obesity and fractures is complex and varies by sex. In women, there was a linear relationship between waist circumference and the incidence of fracture at any site and at the distal lower limb, particularly at the ankle.

“Similar results were observed for women with a BMI between 27 and 40 kg/m². In men however, there was no relationship between obesity and the risk of fracture, although a BMI in the underweight range was associated with a higher risk of some fractures.”

Source: EurekAlert!

Categories : Diseases, Syndromes and ConditionsTags :

Obesity in Mice Causes AD Treatments to Backfire

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In a new study published in Nature, researchers found that treatments that were effective for atopic dermatitis (AD) in lean mice actually worsened the condition in obese mice.

Tracking the development of AD in obese and lean mice, the researchers found that obese mice developed more inflammation and more severe AD. This increased inflammation was present even after obese mice lost weight. There were similar results in an experimental model of asthma, with obese mice developing more inflammation.

The researchers next looked in detail at immune cells called T cells in lean and obese mice with AD. Lean mice had more TH2 cells, a class of T cells known to play a role in the development of AD. Obese mice had more of a class of T cells called TH17. These cells trigger a different type of inflammation.

Similar trends were seen in blood samples taken from people. Markers of TH17 cell activity increased along with body mass index (BMI) in a database of serum collected from people with AD. Conversely, in samples from patients with severe asthma, TH2 cell activity decreased as BMI increased.

Drugs that block TH2 cell activity are used in the treatment of severe AD as well as asthma and other inflammatory conditions. The researchers tested antibodies to block TH2 cell activity in lean and obese mice with severe AD. While the antibodies reduced skin inflammation in lean mice as expected, they made the condition worse in obese mice. Analysis of immune cells suggested that blocking TH2 cell activity in the obese mice worsened other forms of inflammation.

Obese mice were also found to have less activity of peroxisome proliferator-activated receptor-γ (PPARɣ) in their TH2 cells. When lean mice were engineered to lack PPARɣ, their inflammatory response resembled that of obese mice.

Drugs that increase PPARɣ activity increase insulin sensitivity and are approved for the treatment of type 2 diabetes. The researchers found that giving one of these drugs to obese mice changed their inflammatory response to resemble that of lean mice. It also restored their sensitivity to the antibodies that block TH2 cell activity.

“Our findings demonstrate how differences in our individual metabolic states can have a major impact on inflammation, and how available drugs might be able to improve health outcomes,” said Dr Ronald Evans from the Salk Institute, who helped lead the work.

Source: National Institutes of Health

Categories : Metabolic DisordersTags :

Weekly Prednisone Could Reduce Obesity and Help in Muscular Dystrophy

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In a study on obese mice fed a high-fat diet, receiving prednisone once weekly improved their exercise endurance and strength, and their reduced weight. The study was published in the Journal of Experimental Medicine. A previous study had found that weekly prednisone was helpful in muscular dystrophy.

“These studies were done in mice. However, if these same pathways hold true in humans, then once-weekly prednisone could benefit obesity,” explained senior author Dr Elizabeth McNally.

“Daily prednisone is known to promote obesity and even metabolic syndrome – a disorder with elevated blood lipids and blood sugar and weight gain,” Dr McNally said. “So, these results, in which we intermittently ‘pulse’ the animals with once-weekly prednisone, are strikingly different. Obesity is a major problem, and the idea that once-weekly prednisone could promote nutrient uptake into muscle might be an approach to treating obesity.”

The once-weekly prednisone, a glucocorticoid steroid, promoted nutrient uptake into the muscles. The researchers also found these mice had increased adiponectin levels, an adipocyte-secreted hormone involved in protecting against diabetes and insulin resistance. Mice that were already obese from eating a high-fat diet were also found to benefit after once-weekly prednisone, experiencing increased strength, running capacity and lower blood glucose.

Most knowledge on steroids like prednisone is derived from studies of daily doses of prednisone

“We see a very different outcome when it is taken once a week,” Dr McNally said. “We need to fine tune dosing to figure out the right amount to make this work in humans, but knowing adiponectin might be one marker could provide a hint at determining what the right human dose is.”

Dr McNally described the weekly dose as “a bolus, or spike, of nutrients going into your muscle.”

“We think there is something special about promoting this spike of nutrients into muscle intermittently, and that it may be an efficient way to improve lean body mass,” she added.

“What is exciting to me about this work is the finding that a simple change in the dosing frequency can transform glucocorticoid drugs from inducers to preventers of obesity,” said corresponding author Mattia Quattrocelli. “Chronic once-daily intake of these drugs is known to promote obesity. Here we show that dosing the same type of drug intermittently – in this case, once weekly – reverses this effect, promotes muscle metabolism and energy expenditure, and curtails the metabolic stress induced by a fat-rich diet.”

Many patients take prednisone daily for different immune conditions, which has side effects including weight gain and even muscle atrophy with weakness. Investigators want to determine whether patients can get the same immune benefit with intermittent prednisone dosing, which could be much more beneficial to the muscle.

Dr McNally’s team previously found that intermittent prednisone administration was helpful for muscular dystrophy, showing once weekly prednisone improved strength, recently reporting that a pilot trial in humans with muscular dystrophy in which one weekly dose of prednisone improved lean mass.

McNally wants to identify biomarkers most critical to measure a beneficial response to prednisone.

“If we can determine how to choose the right dose of prednisone that minimises atrophy factors and maximises positive markers like adiponectin, then we can really personalise the dosing of prednisone,” she said.

The group also recently showed that weekly prednisone uses strikingly different molecular pathways to strengthening the muscle in male versus female mice, based on a new study just published in the Journal of Clinical Investigation by Isabella Salamone, a graduate student in Dr McNally’s lab.

The benefits of weekly prednisone are linked to circadian rhythms, according to another new study published in Science Advances. Human cortisol and steroid levels spike early in the morning before awakening.

“If you don’t give the drug at the right time of day, you don’t get the response,” Quattrocelli said. “In mice, we obtained good effects with intermittent prednisone in muscle mass and function when we dose them at the beginning of their daytime. Mice have a circadian rhythm inverted to us, as they generally sleep during the daytime and are active at night. This could mean that the optimal dosing time for humans during the day could be in the late afternoon/early evening, but this needs to be appropriately tested.”

Conducting these studies in mice is a major limitation, Dr McNally said.

“While we are encouraged by the pilot study in humans with muscular dystrophy, mouse muscles have more fast-twitch fibres than humans, and slow-twitch muscle could be different,” Dr McNally said. “More studies are needed to try to better understand whether these same mechanisms work in human muscles.”

Source: Northwestern University

Categories : Metabolic DisordersTags :

High Lipid Levels Even More Damaging than Previously Believed

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Blood sample being drawn
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High lipid levels in people with type 2 diabetes and obesity are more harmful than previously thought, according to findings from a new study which found that stressed cells can damage nearby cells.

In patients with metabolic diseases, elevated lipid levels in the blood create stress in muscle cells – a reaction to changes outside the cell which damage their structure and function.

The study, published in Nature Communications, shows that these stressed-out cells give off a signal which can be passed on to other cells.

The signals, known as ceramides, may confer a short-term protective benefit, because they are part of a mechanism designed to reduce stress in the cell. But in long term conditions such as metabolic diseases, the signals can actually kill the cells and worsen symptoms and the illness.

High lipid levels have long been known to damage tissues and organs, contributing to the development of cardiovascular and metabolic diseases including type 2 diabetes, a condition which can be caused by obesity.

Professor Lee Roberts, who supervised the research, said: “Although this research is at an early stage, our discovery may form the basis of new therapies or therapeutic approaches to prevent the development of cardiovascular and metabolic diseases such as diabetes in people with elevated blood fats in obesity.”

In the lab, the team replicated the blood lipid levels observed in humans with metabolic disease by exposing skeletal muscle cells to palmitate, a fatty acid. The cells began to transmit the ceramide signal.

When these cells were mixed with others which had not been previously exposed to lipids, the researchers found that they communicated with each other, transporting the signal in packages called extracellular vesicles.

The experiment was reproduced in human volunteers with metabolic diseases and gave comparable results. The findings provide a completely new angle on how cells respond to stress, with important consequences for our understanding of certain metabolic diseases including obesity.

Professor Roberts said: “This research gives us a novel perspective on how stress develops in the cells of individuals with obesity, and provides new pathways to consider when looking to develop new treatments for metabolic diseases.

“With obesity an ever-increasing epidemic, the burden of associated chronic disease such as type 2 diabetes necessitates new treatments. We hope the results of our research here open a new avenue for research to help address this growing concern.”

Source: University of Leeds

Categories : Metabolic DisordersTags :

Getting Adequate Sleep Results in Reduced Calorie Intake

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Getting adequate sleep could be key to fighting growing rates of obesity around the world, according to a study published in JAMA Internal Medicine, which focused solely on improving sleep duration in overweight individuals.

Understanding the underlying causes of obesity and how to prevent it is the best way to fight obesity, according to first author Dr Esra Tasali. “The current obesity epidemic, according to experts, is mostly explained by an increase in caloric intake, rather than lack of exercise,” she said.

In a randomised clinical trial with 80 adults, published in JAMA Internal Medicine, researchers found that young, overweight adults who habitually slept fewer than 6.5 hours a night were able to sleep for 1.2 hours longer after a personalised sleep hygiene counselling session. The sleep intervention was intended to extend time in bed duration to 8.5 hours and, compared to controls, the increased sleep duration also reduced participants’ overall caloric intake by an average of 270 kcal (calories) per day.

“Over the years, we and others have shown that sleep restriction has an effect on appetite regulation that leads to increased food intake, and thus puts you at risk for weight gain over time,” said Tasali. “More recently, the question that everyone was asking was, ‘Well, if this is what happens with sleep loss, can we extend sleep and reverse some of these adverse outcomes?”

The study examines the effects of sleep extension on caloric intake but also does so in a real-world setting, with no influence on participants’ diets. Participants slept in their own beds, tracked their sleep with wearable devices, and otherwise followed their normal lifestyle without any instructions on diet or exercise.

“Most other studies on this topic in labs are short-lived, for a couple of days, and food intake is measured by how much participants consume from an offered diet,” said Tasali. “In our study, we only manipulated sleep, and had the participants eat whatever they wanted, with no food logging or anything else to track their nutrition by themselves.”

Instead, to objectively track participants’ caloric intake, investigators relied on the “doubly labelled water” method to track change in energy stores, which uses isotopes of hydrogen and oxygen in drinking water. “This is considered the gold standard for objectively measuring daily energy expenditure in a non-laboratory, real-world setting and it has changed the way human obesity is studied,” said Professor Dale A. Schoeller, senior study author and pioneer of the method.

Overall, individuals who increased their sleep duration were able to reduce their caloric intake by an average of 270 kcal per day – which would translate to roughly 12 kg of weight loss over three years if the effects were maintained over a long term.

Perhaps the most surprising aspect of the study was the intervention’s simplicity. “We saw that after just a single sleep counselling session, participants could change their bedtime habits enough to lead to an increase in sleep duration,” said Dr Tasali. “We simply coached each individual on good sleep hygiene, and discussed their own personal sleep environments, providing tailored advice on changes they could make to improve their sleep duration. Importantly, to blind participants to sleep intervention, recruitment materials did not mention sleep intervention, allowing us to capture true habitual sleep patterns at baseline.”

Even though the study did not systematically assess factors that may have influenced sleep behaviour, “limiting the use of electronic devices before bedtime appeared as a key intervention,” said Dr Tasali.

Following just a single counselling session, participants increased their average sleep duration by over an hour a night. Despite prescribing no other lifestyle changes, most participants had a large decrease in how much they ate, with some participants’ intake reduced by 500kcal per day.

The subjects were only involved in the study for a total of four weeks, with two weeks for gathering baseline information about sleep and caloric intake, followed by two weeks to monitor the effects of the sleep intervention.

“This was not a weight-loss study,” said Dr Tasali. “But even within just two weeks, we have quantified evidence showing a decrease in caloric intake and a negative energy balance – caloric intake is less than calories burned. If healthy sleep habits are maintained over longer duration, this would lead to clinically important weight loss over time. Many people are working hard to find ways to decrease their caloric intake to lose weight – well, just by sleeping more, you may be able to reduce it substantially.”

Source: University of Chicago Medicine

Categories : NeurologyTags :

Body Fat Linked to Risk of Reduced Cognitive Function

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A new study published in JAMA Network Open has found that greater body fat is a risk factor for reduced cognitive function, such as processing speed, in adults.

Even when accounting for cardiovascular risk factors or vascular brain injury, the association between body fat and lower cognitive scores persisted. This suggests other, currently unknown, mechanisms linking excess body fat to reduced cognitive function.

For the study, 9166 participants were measured by bioelectrical impedance analysis to assess their total body fat. In addition, 6733 underwent magnetic resonance imaging (MRI) to measure abdominal fat packed around the organs known as visceral fat, and the MRI measured vascular brain injury, including silent brain infarctions and high white matter hyperintensities. Cardiovascular risk factors were measured using health and lifestyle questions and physical measures, and cognitive assessment was measured by the Digital Symbol Substitution Test and the Montreal Cognitive Assessment.

Lead author Sonia Anand, lead author, professor of medicine of McMaster University said: “Our results suggest that strategies to prevent or reduce having too much body fat may preserve cognitive function.”

She added that “the effect of increased body fat persisted even after adjusting for its effect on increasing cardiovascular risk factors like diabetes and high blood pressure, as well as vascular brain injury, which should prompt researchers to investigate which other pathways may link excess fat to reduced cognitive function.”

Co-author Eric Smith, associate professor of clinical neurosciences at the University of Calgary, said that “preserving cognitive function is one of the best ways to prevent dementia in old age. This study suggests that one of the ways that good nutrition and physical activity prevent dementia may be by maintaining a healthy weight and body fat percentage.”

Participants had no existing cardiovascular diseases, and ranged in age from 30 to 75, with an average age of about 58 and 56% were women. Most were White European origin, with about 16% other ethnic backgrounds. 

Source: McMaster University

Categories : Diet and NutritionTags :

Chewing Food Thoroughly Helps in Weight Management

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Previous research has shown that the age-old advice of chewing food thoroughly helps protect against weight again obesity, and now a study has revealed why this is so.

Typically, the chewing process reportedly enhances the energy expenditure associated with the metabolism of food and increases intestinal motility all add up to an increased heat generation in the body, known as diet-induced thermogenesis (DIT). However, how prolonged chewing induces DIT in the body remains unclear. A study published in the journal Scientific Reports answers these questions.

DIT increases energy expenditure above the basal fasting level – a factor known to prevent weight gain. The team previously found that slow eating and thorough chewing not only increased DIT but also enhanced blood circulation in the splanchnic region of the abdomen. Although these studies linked chewing-induced-DIT with increased digestion and absorption-related activity in the abdomen, they left scopes for further exploring a few crucial points.

Senior author Prof Hayashi Naoyuki Hayashi from Waseda University explained: “We were unsure whether the size of the food bolus that entered the digestive tract contributed to the increase in DIT observed after slow eating. Also, do oral stimuli generated during prolonged chewing of food play any role in increasing DIT? To define slow chewing as an effective and scientific weight management strategy, we needed to look deeper into these aspects.”

To find the answers, the researchers designed their new study to exclude the effect of the food bolus by involving liquid food. The entire study included three trials conducted on different days. Volunteers swallow 20mL liquid test food normally every 30 seconds as a control trial. In the second trial, the volunteers kept the same test food in their mouth for 30 seconds without chewing, allowing longer tasting before swallowing. In the third trial they studied the effect of both chewing and tasting; the volunteers chewed the 20mL test food for 30 seconds at a frequency of once per second and then swallowed it. The variables such as hunger and fullness, gas-exchange variables, DIT, and splanchnic circulation were duly measured before and after the test-drink consumption.

While there was no difference in hunger and fullness scores among the trials, as Prof Hayashi describes: “We found DIT or energy production increased after consuming a meal, and it increased with the duration of each taste stimulation and the duration of chewing. This means irrespective of the influence of the food bolus, oral stimuli, corresponding to the duration of tasting food in the mouth and the duration of chewing, increased DIT.” Gas exchange and protein oxidation too increased with the duration of taste stimulation and chewing, and so did blood flow in the splanchnic celiac artery. Since this artery supplies blood to the digestive organs, upper gastrointestinal tract motility also increased in responsivense to chewing.

The study demonstrated that energy expenditure through thorough chewing, though small, could help reduce obesity and metabolic syndrome.

With robust evidence behind it, slow eating and thorough chewing could be the latest recommendations for managing weight.

Source: Waseda University

Categories : DentistryTags :

Obesity Found to Fuel Periodontal Disease

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Chronic inflammation resulting from obesity may trigger osteoclast production and bone tissue breakdown, including the alveolar bone that holds teeth in place, according to a new animal model study.

The study, reported in the Journal of Dental Research, found that excessive inflammation caused by obesity raises the number of myeloid-derived suppressor cells (MDSC), a group of immune cells that increase during illness to regulate immune function. MDSCs, which originate in the bone marrow, develop into a range of different cell types, including osteoclasts.

Bone loss is a major symptom of periodontal disease which may ultimately lead to tooth loss. Periodontal disease affects more than 47% of adults 30 years and older, according to the Centers for Disease Control and Prevention.

“Although there is a clear relationship between the degree of obesity and periodontal disease, the mechanisms that underpin the links between these conditions were not completely understood,” said Keith Kirkwood, DDS, PhD, professor of oral biology in the UB School of Dental Medicine.

“This research promotes the concept that MDSC expansion during obesity to become osteoclasts during periodontitis is tied to increased alveolar bone destruction. Taken together, this data supports the view that obesity raises the risk of periodontal bone loss,” said Kyuhwan Kwack, PhD, postdoctoral associate in the UB Department of Oral Biology.

In the study, two groups of mice were fed different diets over the course of 16 weeks: one group a low-fat diet that derived 10% of energy from fat, the other group a high-fat diet getting 45% of energy from fat.

The high-fat diet group developed obesity, had more inflammation and a greater increase of MDSCs in the bone marrow and spleen compared to the low-fat diet group. The high-fat diet group also developed a significantly larger number of osteoclasts and lost more alveolar bone, which holds teeth in place.

Additionally, in the group fed a high-fat diet, the expression was significantly elevated for 27 genes tied to osteoclast formation.
The findings may help reveal the mechanisms behind other chronic inflammatory, bone-related diseases that develop concurrently with obesity, such as arthritis and osteoporosis, Prof Kirkwood said.

Source: University at Buffalo

Categories : COVIDTags :

Nearly 4 in 10 Swedish COVID Patients in ICUs had Obesity

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People with obesity were overrepresented among adults in Sweden in intensive care for COVID during the first wave of the pandemic, with over twice the proportion as compared to the general population. 

The study, appearing in PLOS One, used  the Swedish Intensive Care Registry (SIR) tp the researchers identified all patients with COVID who were admitted to ICUs in Sweden during the initial wave of the pandemic, in spring and summer 2020. Where height and weight data were missing from SIR, this was supplemented directly from the ICUs and also through the Nationwide Passport Register.

Though people with obesity were identified early on as a risk group that was affected especially severely by COVID, this study contributes to a new, more detailed picture.

A total of 1649 individuals with COVID from ICUs around Sweden were included. All the participants were aged 18 and over; three-quarters were men; and pregnant women were excluded.

The results show that patients with obesity (BMI of 30 kg/m2 or more) were overrepresented among those with COVID receiving intensive care in Sweden, which was 39.4 %, compared to 16% in the general population .

A high BMI increased the risk of both serious illness with long stays in intensive care and of death. A link was found between BMI over 30 and a 50% increase in mortality risk, compared with the normal-weight group. Among those who survived, a BMI over 35 was associated with a more than doubled risk of intensive care for over 14 days. These analyses have been adjusted for age, gender, comorbidity, and state of health at ICU arrival.

“For individuals with COVID who are in intensive care, obesity means an increased risk of death, and among those who survive, obesity boosts the risk of intensive care lasting more than 14 days,” explained first author Lovisa Sjögren, researcher at Sahlgrenska Academy, University of Gothenburg. “Based on our results, obesity should be included as an important risk factor in COVID. Patients with obesity who suffer from COVID should be monitored closely.”

The study is based on the Swedish Intensive Care Register, and Dr Sjögren points out that high-quality registers are a basic precondition for studies of this type to be feasible.

Senior author Jenny M Kindblom, Associate Professor at University of Gothenburg added: “Some international studies have shown a connection between high BMI and the risk of becoming severely ill with COVID. We can now show this in a Swedish context, and with the advantage of having a fully up-to-date BMI value for every patient,” said.

At an early stage during the pandemic, the researchers who conducted the study were in touch with HOBS, a Swedish patient organisation for people living with overweight and obesity. Many members were concerned that a high BMI would elevate the risk of serious illness in COVID.

“At the time, there were no publications in the field, and the study was initiated to enable us to answer patients’ questions. We now hope as many people as possible will take the opportunity to get vaccinated, and that health services include BMI – as a risk factor and perhaps choose to exercise special vigilance in monitoring patients with obesity who are suffering from COVID,” said Prof Kindblom.

Source: University of Gothenburg