As Years Spent Obese Rise, So Do Heart Risks

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Study strengthens link between excess pounds and cardiovascular troubles

By Steven Reinberg

HealthDay Reporter

TUESDAY, July 16 (HealthDay News) -- There's more bad news for overweight Americans: A 30-year study finds the risk for heart disease rises the longer someone is obese.

"Each year of obesity was associated with about a 2 to 4 percent higher risk of subclinical coronary heart disease," said study lead author Jared Reis, an epidemiologist with the U.S. National Heart, Lung, and Blood Institute.

"Subclinical" heart disease means damage to arteries that shows up in markers such as calcium buildup on arterial walls, but has not yet developed into symptomatic illness.

"Those with longest duration of both overall obesity and abdominal obesity tended to have the highest risk" for subclinical disease, Reis said.

The report was published in the July 17 issue of the Journal of the American Medical Association.

In the new study, Reis' team used scans to track calcium buildup in the heart arteries in almost 3,300 adults 18 to 30 years old. When the study began in the mid-1980s, none of the participants were obese.

During the course of the study, however, more than 40 percent became obese and 41 percent developed abdominal obesity (excess belly fat). Those who became obese tended to stay obese for years, the researchers noted.

The investigators found that 27.5 percent of these long-term obese participants showed signs of heart disease, and the problem got worse the longer the individual had been obese.

More than 38 percent of those with more than 20 years spent obese had calcified arteries compared with only about a quarter of those who never put on that level of excess weight, the findings showed.

Among those with overall obesity, 6.5 percent had more dangerous "extensive" arterial calcification, as did 9 percent of those with obesity centered around the belly area. In contrast, only about 5 percent of those who were not obese had this extensive calcification, the researchers found.

Reis said the findings could have dire implications as Americans age.

"With the increased prevalence of obesity over the last 30 years, younger individuals are becoming more obese at a younger age than in previous generations," he noted. "This longer duration of obesity may have important implications on the future burden of subclinical heart disease and potentially rates of clinical heart disease in the United States."

Another heart expert agreed.

"Obesity rates in adults and children have increased markedly in the United States over the last 25 years," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles. "This is particularly concerning as obesity is associated with an increased risk of diabetes, premature cardiovascular disease, and mortality."

Dr. David Katz, director of Yale University's Prevention Research Center, said he also worries about rising obesity rates among the young.

"I have long feared that in an age of increasingly prevalent type 2 diabetes among children, the day may dawn when angina is an adolescent rite of passage alongside acne," Katz said.

This new study compounds that worry, he said. "It demonstrates just what common sense would suggest: That the longer the exposure to the adverse effects of obesity, the greater the harm to the coronary arteries."

According to Katz, "this study is yet another reason -- as if we needed one -- to devote all possible effort to the prevention, control and reversal of rampant obesity in childhood."

Obese Applicants More Often Denied Entry to Graduate Schools: Study

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Applicants of any size fared equally in phone interviews, but bias crept in at face-to-face meetings

By Robert Preidt

HealthDay Reporter

WEDNESDAY, July 24 (HealthDay News) -- Add higher education to the list of things obese people might lose out on due to discrimination. A new study finds that being overweight may lower your odds of getting into graduate school.

"The success rate for people who had had no interview or a phone interview was pretty much equal," study author Jacob Burmeister, himself a Ph.D. candidate at Bowling Green State University, said in a university news release.

"But when in-person interviews were involved, there was quite a bit of difference, even when applicants started out on equal footing with their grades, test scores and letters of recommendation," he added.

Researchers looked at 97 applicants to psychology graduate programs at U.S. universities. The students in the study told the researchers about their application experiences and whether or not they received an offer of admission. The students included details such as whether they had been interviewed in person or over the telephone.

According to Burmeister's team, students who were relatively overweight or obese were less likely to be offered admission after an in-person interview.

This weight bias was stronger for female applicants, according to the study, which was published recently in the journal Obesity.

"When we looked at that we could see a clear relation between their weight and offers of admission for those applicants who had had an in-person interview," Burmeister said.

The researchers weren't surprised by their findings, according to Burmeister.

"We know that these kinds of biases are pretty common and even [perceived to be] somewhat acceptable compared to other biases, and there's not much legally forbidding it," he said.

"We might expect psychology faculty to be more aware of these types of biases. Thus, the level of bias found in this study could be a conservative estimate of the level of bias in the graduate admissions process in other fields," Burmeister added.

Q&A: Were You Born to Be Obese?

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Aug. 1, 2013 -- For people who often feel hungry right after eating, a recent finding about genetics and obesity was, if not welcome news, at least thought-provoking.

People who have two copies of a modified form (or variant) of a certain gene are much more likely to feel hungry after eating a meal, says researcher Rachel Batterham, MD, PhD, of the University College London.

One in six people has two copies of the modified "fat mass and obesity associated" (FTO) gene. That could help explain some obesity. People with this gene have high levels of the hormone ghrelin, which increases hunger.

Batterham and a U.S. expert in genetics and obesity talked about the finding and what it might mean.

Batterham is head of the University College London Centre for Obesity Research and head of Obesity and Bariatric Services at the UCL Hospital. Her study, published July 15 in the Journal of Clinical Investigation, was funded by the Rosetrees Trust and others.

Lu Qi, MD, PhD, is an assistant professor of nutrition at the Harvard School of Public Health.

Q: Can you put this new discovery in perspective with other obesity and genetics findings, since many genes have been linked with body mass index and obesity?

The effect of FTO on obesity, so far, is that it's the most common “genetic contributor to overweight and obesity, and is estimated to affect 1 billion people worldwide," Batterham says.

This is one piece of the puzzle, she says, but possibly a key piece.

Qi agrees. But he cautions that scientists must test many more people to confirm Batterham’s results.

Q: At this point, how big of a role might genes play in obesity?

"From previous studies, it is estimated that 40% to 70% of a person's BMI is inherited," Batterham says, but it's complex and not as simple as just giving a percent.

Overall, the role of any single gene [in obesity] is not big, Qi says. However, if all the obesity-related genes are considered, “the effect would be sizable."

Q: Is it possible to be tested for the FTO variant?

Several companies already offer direct-to-customer testing for variants, including FTO, Batterham says. But she wants to study whether knowing that you have the FTO variant would help people make better lifestyle choices.

Q: If you have two copies of the FTO variant, what can you do to avoid obesity?

More research is needed, Batterham says, but she cited studies showing that aerobic exercise and a high-protein diet may help such people. Results of the research have been mixed, she says.

Behavioral therapy might help people who have the double FTO variant avoid temptation, she says.

Q: Could the new findings, as well as other findings, lead to a treatment?