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Long-term losing of weight does not have a significant effect to the body composition and overall sports performance of elite athletes trying to achieve a gradual weight reduction, says a new study conducted at Norwegian School of Sport Sciences, Oslo, Norway and published in the August 2011 issue of the International Journal of Sport Nutrition and Exercise Metabolism.

There are times when athletes are recommended to undergo some gradual weight reduction to achieve an ideal cut-off weight for a particular event. To achieve this, a weight loss of 0.5 to 1 kilo per week is carried out through moderate restriction of energy intake. However, the long-term effect of these weight loss procedures has not yet been observed in previous studies. Thus, in this particular study, the researchers recruited and observed twenty-three elite athletes for a period of six to twelve months. They have tried comparing the body mass index, the fat mass, and the lean body mass of these athletes who underwent 0.7 percent weight loss and those who had 1.4 percent weight loss per week. And what did the researchers discovered? They have noted that body composition and performance of elite athletes do not suffer with gradual weight reduction. Therefore, losing weight can be executed without any danger to an elite athlete that needs to lose weight gradually.

Reference:

International Journal of Sport Nutrition and Exercise Metabolism; Long-term effect of weight loss on body composition and performance in elite athletes; Garthe, I. et al.; August 2011

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Significant weight reduction and not the type of weight loss diet has a great influence to the levels of adipokine released by fat cells in obese patients trying to lose weight, says a new study conducted at Robert Gordon University, Scotland, United Kingdom and published in the 2011 issue of Diabetes, Metabolic Syndrome and Obesity.

The fat tissue, medically known as the adipose tissue, does not only store fats. It also serves as an endocrine organ that releases hormones to influence other organ functions.  One of the most important hormones released by adipose tissues is the adipokine, a special chemical, which is important for the regulation of inflammation and insulin sensitivity within the body.  In a study published in the February 2007 issue of Diabetes, it was shown that fat particularly visceral fat is associated with the noninfectious inflammation seen in patients with obesity problems, making visceral fat distribution as one of the major causes of metabolic diseases in the human population. Adipokines from fat tissues also regulate the appetite and the metabolism of glucose, making this hormone a very important determinant to the amount of calories taken into the body and used for the production of energy. Adipokines comes in different forms. The most common of which are leptin, adiponectin, tumor necrosis factor-alpha, plasminogen activator inhibitor, resistin, and interleukin 6. Most of these adipokines cause pro-inflammatory reactions within the body. However, resistin, tumor necrosis factor and leptin are the most notorious in producing atherosclerosis or hardening within the blood vessel walls. Adipokine levels usually increase with increased fat tissue bulk. Therefore, the presence of these adipokines is detrimental to one’s health.

The only exception to proinflammatory action of adipokines is adinopectin. Unlike other adipokines, adinopectin has antiatherosclerosis properties. Furthermore, it is also observed to decrease in level with increased fat formation within the body.

Repeatedly, it was proven by several studies that losing weight has a negative effect to the levels of circulating adipokines within the body. Nevertheless, no researcher has yet proven whether the type of weight loss diet has a significant effect to extent of adipokine level decrease.

In this particular study, the researchers were able to demonstrate that weight loss itself and not the macronutrient intake or the type of diet used is important to have an effective decrease in the amount of adipokines within the body. In fact, with a minimum weight loss of 23.8 percent from the baseline weight level, significantly improved the levels of adipokines to a healthier range.

Thus, the researchers of this study concluded the type of weight loss diet does not matter in the normalization of adipokine levels. Actual weight reduction is the only thing that counts.

Reference:

Diabetes, Metabolic Syndrome and Obesity; Effect of weight loss on adipokine levels in obese patients; Rolland, C., et al.; 2011

Diabetes; Visceral Fat Adipokine Secretion Is Associated With Systemic Inflammation in Obese Humans; Fontana, L. et al.; February 2007

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Unhealthy lifestyle after weight loss surgery can lead to weight regain within five years after successful weight loss surgery operation, says a study conducted by a group of Brazilian researchers and published in the August 2011 issue of the journal entitled Nutrition.

Roux-en-Y gastric surgery is one of the most common weight loss surgery procedure that often provides an almost 100 percent success rate in severely obese patients who want to get rid of pounds and pounds of fat within their body. According to MedlinePlus, weight loss surgery is meant for severely obese patients who want to lose 80 to 100 pounds to achieve a healthier weight. Overweight patients may also opt to have this procedure if they have other problems such as diabetes and sleep apnea.

However, according to the said study published by Nutrition, patients who fail to have a healthier lifestyle modification after the surgical procedure may return to their old obese selves if no proper diet, regular exercise and nutritional follow-up is incorporated into their lifestyle. The prove their point, the researchers of this study followed up 100 obese patients who had roux-en-Y procedure from 1998 to 2008. They assessed their dietary habits using a 24 hour dietary recall and Food Frequency Questionnaire. Their intensity of physical activity were also recorded and analyzed accordingly. They have noted that 56 percent experienced weight regain within two to five years after the surgical procedure. The most common culprit to their weight regain includes excessive caloric intake and sedentary lifestyle.

Because of these results, the researchers recommended nutritional counseling and follow-up in patients who had undergo weight loss surgery to ensure that they will be able to maintain their weight loss after the procedure.

Reference:

Nutrition; Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass; Friere, R.H. et al.; August 2011

MedlinePlus: Weight Loss Surgery

Most health experts believe that there is one standard cut-off for high-risk BMI values and this standard covers all sexes and nationalities. However, newer studies reveal that the high-risk BMI value that may be true to one race may be too high for another race. Because of this issue, the World Health Organization addressed this problem, investigated, and reconciled the real discrepancies in the high-risk BMI values that are true for Europeans and Asians.

According to the study published by Lancet in January 2004, Asians who are at risk for type 2 diabetes and heart problems have lower BMI values compared to their European and American counterparts. In fact, their BMI values are substantially lower than the usual cut-off BMI value recommended by the World Health Organization. The World Health Organization’s cut-off for overweight is 25 kg/m². However, available clinical data reveal that Asians with a mean BMI value of 22 to 25 kg/m² can already have a risk, which is the same as that of an American who has a BMI value of more than 25 kg/m².

The body mass index cut-off point has many uses for the management of overweight and obesity and their corresponding chronic health complications. With the help of these cut-off points, policies and facilitation of preventive measures can be put into play. The timing for appropriate intervention can be planned depending on the need that is dependent on the existing BMI cut-off point. In the epidemiological point of view, BMI values exist to determine the relationship between the existing health problems and the probable triggering factors that may result into such disease. Clinically, BMI value cut-offs exist to determine which patient is at risk. It can also determine the magnitude of the existing problem by comparing it with the existing normal BMI values. From there, it will be easier for any practitioner to decide for his course of action and treatment management depending on the values presented to him by his patient.

Co-morbidities do exists in the ever-increasing values of the body mass index. In addition, in the Asian population, these co-morbidities may manifest themselves even in a much lower value that is considered normal for Europeans and Americans alike.

There also exists a problem in the presence of inter-racial subgroups. Variations in the country of origin and migration status may also affect the possible obesity outcomes even in the same population. In the United States, a place where racial intermarriages are common, overweight Asian Americans have a very low incidence rate as expected using the current BMI classifications. However, this incidence rate will increase as more and more Asian Americans are born in the United States and more and more decided to stay in this country.

The body mass index in actuality is the correlation of the body fat percentage and the height. It serves as an unbiased comparison even when tall and short population groups exist. Nevertheless, since body fat cannot be measured directly using the body mass index values, there is still a possibility that it is actually measuring the amount of muscles built in patients who work out instead of the actual body fat mass.

In general, as analyzed by the World Health Organization, Asian women, except of Chinese, and Asian men have lower normal body mass index values for age compared to the whites. Compared to the European population, the Asians have a BMI value that is 1.3 kg/m² lesser than the European population.

Indeed, in the Asian race, health problems and other complications can start to exist even in BMI values that are considered normal for the white population. However, further researches are necessary to establish the overweight and obesity values in the Asian population once and for all.

Reference:

The Lancet; Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies; World Health Organization Expert Consultation; January 2004

Obesity is a body condition wherein the body mass index becomes more than 30 kg/m². It is caused by excessive fat accumulation resulting in the development of chronic health problems. In the United States alone, studies have shown that 33 percent of American men and 35 percent of American women are considered obese. As a result, chronic health conditions such as dyslipidemia, type 2 diabetes mellitus, hypertension, heart problems, and cancers are on the rise. In fact, the United States government spends approximately $100 billion per year just to pay medical costs associated with obesity.

Bone mass and strength usually deteriorates after a person reaches adulthood. In women, this bone deterioration becomes more pronounced after the menopausal state. According to the October 2001 issue of the journal entitled Calcified Tissue International, about 10 million American adults belonging to the age range bracket of 50 years old and above are having problems with osteoporosis and another 34 million patients are at risk for this bone problem. This resulted in the $17 billion budget expenditure of the American healthcare system in 2001.

Some recent clinical studies suggest that obesity and bone metabolism may be strongly associated.  However, the old school of medical sciences believes that obesity has positive benefits to bone health. Many experts think that mechanical loading in the form of body weight has a beneficial effect to bone formation despite its risk for the development of other health problems.

In a recent study conducted at Grand Forks Human Nutrition Research Center, North Dakota and published in the June 2011 issue of the Journal of the Orthopedic Surgery and Research, the researcher discovered that excessive fat accumulation, a phenomenon seen in obesity, might have detrimental consequences for the bone mass. In fact, it can even affect the metabolism of bones using several mechanisms.

Obesity can decrease the production of bone cells. You see, adipocytes, the fat cells, and osteoblasts, the bone cells, are both derived from a common stem cell. Obesity increases the number of fat cell production and, therefore, this can decrease the production of osteoblasts resulting in decreased bone formation.

Obesity also causes the development of chronic inflammation within the body. This leads to the increased activity of osteoclasts, the bone cells responsible for the resorption of bones and therefore, decreased bone mass.

Leptin and adinopectin may affect bone formation and affect bone resorption. Leptin is a hormone that takes the center stage in fat metabolism. It is implicated as one of the most responsible hormones in the development of obesity. Adinopectin, on the other hand, is a hormone released by fat cells. According to the said study published by the Journal of Orthopedic Surgery and Research, the increased production of and secretion of leptin and adinopectin in obese individuals may directly or indirectly affect the formation of bone and bone resorption thereby altering the health of individual bones.

Decreased intestinal calcium absorption. Obese individuals who have high intake of fat in their diet tend to have less intestinal calcium absorption resulting in the decreased level and availability of calcium within the body. With decreased levels of calcium, bones become fragile leading to pathologic fractures and probably osteoporosis.

In our present generation, the true relationship between obesity and bone mass formation is still not fully understood. Further investigation is necessary to establish this fact.

References:

Calcified Tissue International; The prevalence of osteoporosis: gender and racial comparison; Melton, L.J. 3^rd; October 2001

Journal of Orthopedic Surgery and Research; Effects of obesity on bone metabolism; Cao, J.J.; June 2011

Exercise in obese patients may not just cause weight loss but may also improve their risk for many chronic problems, says a new study conducted by two researchers from the Department of Internal Medicine, Cardiovascular and Nephrological Diseases, University of Palermo, Palermo, Italy and published in the June 2011 issue of the Journal of Sports Medicine and Physical Fitness.

It is now known that obesity is a global problem not only in developed countries but also in the developing countries as well. It increases the risk for many health problems such as diabetes, cardiovascular disease, cancer and other chronic conditions. The presence of excess adipose tissues is implicated as one of the major causes of metabolic complications resulting in increased insulin resistance and alteration in lipid and glucose metabolism. The production of unwanted chemicals within the body’s adipose tissues also increases resulting in the development of oxidative stress.

Obesity management that includes regular exercise and physical activity is now known to improve the lipid levels within the body and increase the insulin sensitivity while increasing the lean muscle mass content and basal metabolism. It is now also known that regular physical activity can improve sugar tolerance and bone mineral density preventing the occurrence of osteoporosis and other bone problems.

Experts are now recommending an exercise program of about thirty to forty-five minutes per day physical activity three to five times per week to achieve improvement in body function and condition. With healthy weight loss, significant reduction in the blood pressure level and increased protection against oxidative stress can be achieved. Truly, an inverse association between systemic inflammation and physical activity exists reducing one’s risk for cardiovascular problem and blood vessel damage.

Reference:

The Journal of Sports Medicine and Physical Fitness; Exercise in Obesity Management; Hopps, E. and Caimi, G.; June 2011

Many patients with type 2 diabetes are either overweight or obese. In fact, the November 2004 issue of Morbidity and Mortality Week Report of the Centers of Disease Control and Prevention states that the prevalence of overweight or obesity among diabetic patients is 85.2 percent and while 54.8 percent of these patients were diagnosed of having obesity only.

Obese patients with concomitant type 2 diabetes have a hard time controlling their blood sugar, blood cholesterol levels, and blood pressure. As a result, they are in a greater risk for the development of other chronic problems such as hypertension, atherosclerosis, hypercholesterolemia, cardiac disease and cancer compared to their normal-weighing diabetic counterparts.

Metformin is considered a first-line treatment for the type 2 diabetes. It can be used alone or in combination with other oral hypoglycemic agents or injectable insulin for better control of the blood sugar level. Metformin improves your blood sugar level by decreasing the amount of glucose absorbed from the food you eat and controls the amount of glucose produced by your liver. Furthermore, it can also help in improving your body’s response to the stimulation of insulin. Metformin cannot be used in patients with type 1 diabetes since these patients do not produce insulin, therefore, it can never help in controlling the blood sugar level in this situation.

Recent studies suggest that metformin can also be an effective weight loss option for patients suffering from metabolic syndrome, a group of conditions which includes increased insulin resistance or increased blood sugar level, abnormality in lipid profile, hypertension, and too much fat around the waist line.

In a study conducted by a group of researchers from Family Care, PC, Dyersburg, Tennessee and published in the July 2007 issue of the Journal of the American Academy of Nurse Practitioners it was noted that metformin causes a significant weight loss outcome most especially when combined with healthy lifestyle interventions such as a healthy diet and regular physical activity. In fact, in this particular study, all study subjects who had metformin plus lifestyle intervention had better BMI values, smaller waist circumference, more controlled blood pressure values, better blood glucose levels and more body response to insulin stimulation compared to those who did not use metformin at all.

In another study published in the April 2005 issue of the Annals of Internal Medicine, the researchers noted that patients who had a healthier lifestyle intervention and metformin use at the same time are almost 50 percent more likely to recover from metabolic syndrome compared to those who did not take any effort at all to lose weight.

Does metformin have a role in weight control in patients without diabetes?

According to one study conducted by a group of scientists from Massachusetts College of Pharmacy and Health Sciences-Worcester/Manchester, Manchester and published in the Annals of Pharmacotherapy June 2008, the weight loss effect of metformin in nondiabetic patients appears promising. Metformin seem to normalize the weight circumference, the blood cholesterol level, and the blood sugar level, thus protecting these patients from future development of diabetes and metabolic syndrome. However, since most of the previous studies have a small study population, the researchers of this particular study suggest a larger clinical investigation to establish the role of metformin in losing weight in patients without diabetes. Thus, until that moment comes, metformin is not recommended for nondiabetic patients who want to lose some weight.

Reference:

1. Centers for Disease Control and Prevention: Prevalence of Overweight and Obesity Among Adults with Diagnosed Diabetes — United States, 1988–1994 and 1999–2002
2. MedlinePlus: Metformin
3. Journal of the American Academy of Nurse Practitioners; Effects of lifestyle intervention and metformin on weight management and markers of metabolic syndrome in obese adolescents; Harden, K.A. et al.; July 2007
4. Annals of Internal Medicine; The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial; Orchard, T.J. et al.; April 2005
5. Annals of Pharmacotherapy; Role of metformin for weight management in patients without type 2 diabetes; Desilets, A. R. et al.; June 2008

Women, despite being pregnant, should carefully monitor their weight. According to a study conducted in Indiana University School of Medicine, Indianapolis and published in the June 2011 issue of the American Journal of Obstetrics and Gynecology, labor patterns usually become longer in women in increased body mass index values compared to those with normal weights.

The researchers of this said study aimed to know different labor patterns associated with different BMI values. They have gathered more than 100,000 records of pregnant women with single term pregnancy. They analyzed the pattern in the recorded labor curves and recorded the BMI values for each of those women who successfully reached 10 cm cervical dilatation. They have noted that women who have a BMI value of more than 40 reached the active phase of labor within 3.4 hours. On the other hand, women with normal BMI values reached the active phase of labor only within 2.4 hours.

Using their analysis, the researchers concluded that as the BMI values increase, the length of labor time also increases, suggesting that the management of labor patterns could be altered by the body mass index value of the patient. However, further studies are still needed to establish this fact.

Reference:

American Journal of Obstetrics and Gynecology; Contemporary labor patterns: the impact of maternal body mass index; Kominiarek, M.A. et al.; June 2011

Overweight and obesity can result in poorer results of in vitro fertilization, says a new study conducted by a group of researchers from Department of Obstetrics and Gynecology, AIIMS, New Delhi, India and published in the July 2011 issue of the Archives of Gynecology and Obstetrics.

In the said study, the researchers aimed to demonstrate the influence of the women’s body mass index to the response of the ovary to stimulation and the outcome of in vitro fertilization. They gathered more than three hundred records of patients who underwent in vitro fertilization from January 2008 to October 2010. They tried to determine the body mass index of each of the patients as well as the results of their in vitro fertilization. They have noted that there was no significant difference in the number of egg cells retrieved from women with normal BMI values and overweight and obese women. However, they have noted that egg cells from overweight and obese women have poorer quality compared to those in normal BMI values.

Thus, the researchers concluded that female obesity has a great influence to the in vitro fertilization outcome. However, ovarian response to hormonal stimulation was not affected with increased BMI values.

Reference:

Archives in Gynecology and Obstetrics; Correlation of body mass index with outcome of in vitro fertilization in a developing country; Singh, N. et al.; July 2011

Approximately 44 percent of the American adults report symptoms of gastroesophageal reflux disease or GERD each and every month, says John Hopkins Medicine Health Alerts and there appears to be a strong association between increasing body mass index values and gastroesophageal reflux. According to the same source, people who are overweight have a 50 percent increased risk of having heart burn compared to people with normal BMI values.

What on earth is gastroesophageal reflux and how does it happen?

Gastroesophageal reflux disease is a condition in which the contents of the stomach, which may be in the form of solid foods or liquids, leak back toward the esophagus from the stomach. The acid that leaks back with the stomach contents irritates the lining of the esophagus resulting in the symptoms of heartburn.

In normal circumstances, the ring-like muscle fibers encircling the junction between the esophagus and the stomach, the lower gastroesophageal sphincter, prevents the food that passed from the esophagus to stomach to regurgitate back to the esophagus. However, if the sphincter does not close well, any stomach content can possibly leak back into the esophagus – and this results in the symptoms of gastroesophageal reflux. Unfortunately, gastroesophageal reflux does not only cause troublesome symptoms, it can actually damage the lining of the esophagus.

What are the most common risk factors for the development of gastroesophageal reflux?

Anything that increases the pressure within the abdomen can cause the lower esophageal sphincter to relax, allowing the stomach contents to leak back into the esophagus. In obese and overweight patients, extra fats within the abdominal increase the pressure within the stomach resulting in the symptoms of gastroesophageal reflux disease.  In addition to this, the fat cells within the body may also release some chemicals that can relax the esophageal sphincter resulting to GERD.

Estrogen levels may also have a role in the development of gastroesophageal reflux disease in women. As mentioned by John Hopkins Medicine Health Alerts, obese women are at a greater risk for the development of this problem compared to obese men. Furthermore, some studies also noted that the incidence of GERD is highest in women in their premenopausal stage and in postmenopausal women who are taking estrogen replacements.

What are the most common symptoms of gastroesophageal reflux disease?

1. Burning pain within the chest right behind the breastbone that increases when lying down, bending, and eating
2. Sensation of food entrapment behind the breastbone
3. Relief of discomfort with the use of antacids
4. Feeling of nausea a few minutes after eating

Other less common symptoms of gastroesophageal reflux include:

1. Frequent occurrence of cough without any clear cause
2. Difficulty in swallowing
3. Frequent hiccups
4. Change in voice or hoarseness
5. Frequent unexplained sore throat
6. Food regurgitation

What are the possible complications of GERD?

Erosive esophagitis. Erosive esophagitits is the term used to describe the inflammation and swelling of the esophageal lining resulting from esophageal irritation.

Barrett esophagus. Medline Plus defines Barrett esophagus as the disorder of the esophageal lining caused by the exposure of the esophagus to stomach acids. Barrett esophagus results in dysplasia, the morphological changes in the cells lining the esophagus. Dysplasia in turn can lead to the development of esophageal cancer.

Now that we know the symptoms, the causes and the possible complications of gastroesophageal reflux, let’s go back to the main question: Can losing weight improve symptoms of heart burn? The answer is “yes.” Losing weight definitely decreases the fat distribution around the abdominal area leading to lesser pressure to the stomach. Decreased pressure within the stomach keeps the lower esophageal sphincter contracted and this decreases the risk for stomach content leakage to the esophagus. Thus, to prevent the development of symptoms associated with gastroesophageal reflux disease, one must achieve a normal BMI value.

Reference:

John Hopkins Medicine Health Alerts: How Does Losing Weight Improve GERD?

Medline Plus: Barrett’s esophagus

Annals of Internal Medicine;  Meta-Analysis: Obesity and the Risk for Gastroesophageal Reflux Disease and Its Complications; Hampel, H. et al.; August 2005