"Healthy obesity" is a myth, says report

Scientists weigh the results of eight studies, find excess pounds raise death risk over time

By Steven Reinberg

HealthDay Reporter

MONDAY, december 2, 2013 HealthDay News)-the idea that some people may be overweight or obese and still be healthy is a myth, according to a new Canadian study.

Even without high blood pressure, diabetes or other metabolic problems overweight and obese people have higher rates of death, heart attacks and strokes after 10 years compared with their thinner counterparts, the researchers found.

"These data suggest that increased body weight is not a benign condition, even in the absence of metabolic abnormalities, and argue against the concept of healthy obesity or benign obesity," says researcher Dr. Ravi Retnakaran, Associate Professor of medicine at the University of Toronto.

Conditions healthy obesity and benign obesity has been used to describe people who are obese but did not have the aberrations that usually accompanies obesity, high blood pressure, high blood sugar and high cholesterol, Retnakaran explained.

"We found that metabolically healthy obese individuals are at increased risk of death and cardiovascular events in the long term compared to metabolically healthy normal-weight individuals," he added.

It is possible that obese people are metabolically healthy have shown low levels of certain risk factors that worsen over time, researchers suggest in the report, published online dec 3 in the Annals of Internal Medicine.

Dr. David Katz, Director of Yale University's Prevention Research Center, welcomed the report. "Attention to the recent" obesity paradox "in the professional literature and popular culture alike, this is a very timely and important papers," said Katz. (Obesity paradox is that some people benefit from chronic obesity.)

Some obese people seem healthy because not all weight gain is harmful, Katz said. "It is partly due to genes, in part on the source of calories, partly at the task level, partly on hormone levels. Weight gain in the lower limbs among younger women tend to be metabolically harmless. weight gain as fat in the liver may be harmful at very low levels, "said Katz.

A number of things, however, work to increase the risk of heart attack, stroke and death over time, "he added.

"Above all the fat in the liver interfere with its function and insulin sensitivity," Katz said. This will start a domino effect, he explained. "Insensitivity to insulin causes the pancreas to compensate by increasing insulin production. Higher insulin levels affect other hormones in a cascade that causes inflammation. Fight-or-flight hormones are affected, raising blood pressure. Liver dysfunction also reduces blood cholesterol levels, "said Katz.

In General, they added things that people do to make themselves fitter and healthier tends to make them less fat, he said.

"Lifestyle practices promote weight control in the long run, generally contributes to better health as well. I am in favour of a focus on finding health over focus on losing weight, "noted Katz.

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?

Nutritionists: FDA Trans Fat Ban Good for America's Heart Health

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They urge greater use of healthier oils, like canola oil or other vegetable oils, in food-making process

By Dennis Thompson

HealthDay Reporter

FRIDAY, Nov. 8 (HealthDay News) -- The U.S. Food and Drug Administration's proposal to ban trans fats from the food supply will trigger some scrambling by manufacturers and restaurant chains, but ultimately it will be a boon to the nation's health, dietitians say.

In fact, food manufacturers had been pivoting away from trans fats before the FDA announced its proposal Thursday, searching for useful substitutes.

"The lion's share of the added trans fats have been removed from our food supply. But this is a good step toward eliminating the remaining amount that continues to pose heart disease risk for many people," said Kim Larson, a registered dietitian nutritionist and spokeswoman for the Academy of Nutrition & Dietetics.

Even so, the FDA estimates that totally eliminating trans fats could prevent 20,000 heart attacks and 7,000 deaths due to heart disease each year.

Food makers first adopted partially hydrogenated vegetable oils -- the source of trans fats -- as a substitute for butter, due to health concerns over the saturated fats contained in butter, explained Cleveland Clinic dietitian Kristin Kirkpatrick.

Using trans fats to make a cracker gives it flakiness and "adds a buttery taste without putting butter in it," Kirkpatrick said. Trans fats also can be used to add a creamy taste, she said, noting that non-dairy creamers are loaded with the artificial fats.

Other foods that contain trans fats include margarine, prepared desserts, canned cake frosting, microwave popcorn, frozen pizzas and boxed cookies, nutritionists noted.

But the food industry has progressed to the point where trans fats can be replaced with healthier options, with no effect on food's taste or texture, Kirkpatrick said.

"I think this is an opportunity to look at some of those healthier oils, like canola oil or other vegetable oils, and how they can be incorporated into foods that traditionally used trans fats," Kirkpatrick said. "I think we can do that without affecting taste."

Trans fats are created in an industrial process that adds hydrogen to liquid vegetable oils. These partially hydrogenated vegetable oils are solid at room temperature.

Trans fats became popular because of their versatility in food production. They make processed foods "shelf-stable," able to stay on supermarket shelves for months without going bad. Fast food restaurants loved trans fats because they could be used repeatedly in commercial deep fryers without having to be replaced, according to the American Heart Association.

But, trans fats gained a notorious reputation because they literally do everything wrong in the human body when it comes to cholesterol.

Trans fats simultaneously increase LDL (bad) cholesterol levels and lower HDL (good) cholesterol levels, nutritionists explained.

They also cause inflammation, said Penny Kris-Etherton, a registered dietitian and professor of nutrition at Penn State University. "Inflammation is not only a root cause of heart disease, but other chronic diseases as well," she said.

Expert Q&A: Losing the Baby Weight

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An interview with Elizabeth Ward, MS, RD.

Gaining weight is essential during pregnancy, but once the baby arrives, most moms can’t wait to lose the extra weight. But losing weight after giving birth is different from losing weight at other times, especially if you are breastfeeding your baby. 

To get professional advice on how to lose baby weight the healthy way, WebMD turned to Elizabeth Ward, MS, RD, an expert in pregnancy, lactation, and kids' nutrition, and author of Expect the Best. Here’s what she had to say.

It takes lots of calories and good nutrition to support the growth and development of a new life, so it is very important that you eat a healthy diet. But you also need to be careful not to gain too much or too little weight. 

Most doctors base their recommendation of weight gain on the weight of the mom before pregnancy.  Women with a normal BMI (body mass index) should gain anywhere between 25 and 35 pounds, and up to 45 for twins.  Overweight women may be able to safely gain between 15 and 25 pounds, but should not use pregnancy as a time to diet or lose weight.

Check with your doctor to determine if it is safe for you to gain less or more than the recommended range.  Pregnancy is a very personal journey, and what is most important is to take care of yourself, eat a healthy diet, and make sure you take your prenatal vitamins to ensure you get all the nutrients you need for you and the baby.

There will be more to lose after the baby is born, and studies show that if you don’t get it off within a year, the extra weight is more likely to become permanent. And if you are thinking about getting pregnant again, it is best to return to your healthy weight before conception.

That is a myth. Gaining too much weight will not necessarily cause the baby to be larger. Just because you are "eating for two" doesn’t mean you should eat twice as much. Gaining beyond 25-35 pounds for a single birth just makes it harder to lose after the baby is born.

Forget about dieting for at least six weeks postpartum and focus on eating a healthy diet.  Most women are sleep-deprived, tired, and lack the energy to exercise, prepare healthy meals, and do what it takes to lose weight.  

Losing the baby weight can take upwards of a year. Ideally, you should take the weight off gradually, aiming for 1-2 pounds per week.

Gut Bugs May Hold Key to Weight Control, Mouse Study Suggests

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Findings hint that obese people might benefit from transfer of stomach bacteria of thinner people

By Randy Dotinga

HealthDay Reporter

THURSDAY, Sept. 5 (HealthDay News) -- The bacteria living in your digestive system may be the last thing on your mind, but a new study in mice raises the prospect that obese people might get benefits through the transfer of a thinner person's gut germs.

The research is preliminary, and there are a variety of obstacles, including as-yet-unknown side effects in people, cost and the "ick" factor. "Fecal transplants" are now used to treat people with an intestinal disorder, and they're not for the faint of heart (or stomach).

Still, the findings from researchers at the University of Colorado reveal the potential promise of the approach.

In the future, there may be "a way to swap bacteria that's not gross," said Justin Sonnenburg, an assistant professor at the Stanford University School of Medicine. "There may even someday be a pill you could take."

At issue are the germs that live within your body and help you digest food, among other things. The bacteria live in communities, and "there's a huge, increasing interest in understanding these communities at a fundamental level," Sonnenburg said. "That way, we can prevent diseases they're associated with."

The new study looked at what might happen if germs from a thinner person were transferred into an obese person.

They took fecal bacteria from four sets of adult, female, human twins in which one sister was obese (a step above simply being overweight), and then transplanted the germs into mice. They then fed the mice various diets, including some meant to represent the typical unhealthy American diet.

"[The results] show that mice that get microbes from obese individuals gain more weight than those that get microbes from lean individuals," said study co-author Rob Knight, an associate professor at the University of Colorado at Boulder. "In other words, the weight gain can be transmitted from humans to mice by transferring their microbes."

There's another twist: Mice like to eat each other's feces, so they naturally transferred fecal bacteria to each other. The mice with germs from the obese twins appeared to be affected by their counterparts with germs from thinner twins and actually gained less weight.

But the opposite wasn't the case. And, the researchers found, a typical high-fat, American-style diet seemed to eliminate the benefits for the obese-twin mice of eating the feces of their thinner twin counterparts.

What does this all mean? It's possible to disrupt weight gain by transferring gut bacteria and to use mice to understand more about the germs inside humans, Knight said. Results of animal studies, however, often don't translate to humans.

The study, which appears in the Sept. 6 issue of the journal Science, was funded in part by the food company Kraft, the U.S. National Institutes of Health and the Crohn's and Colitis Foundation of America.

The Shift: Tory Johnson’s Weight Loss Journey

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Good Morning America frequent contributor Tory Johnson opens up in her new book The Shift about the key changes she made for a happier, healthier life.

Courtesy of Tory Johnson

Being fat dominates so many areas of your life—far beyond the obvious of how you look.

I know because until recently I was always fat. OK, obese. I’m 42.

I began to suffer little indignities starting as a child in Miami Beach. I was always last to be picked for a team in phys ed because no one wanted the fat girl on their team. They still don’t.

As a teenager, my concern about the way I looked took over my social schedule. I turned down invitations to pool parties because there was no way I’d wear a bathing suit in front of other kids.

As an adult, my negative body image meant I routinely steered clear of dinner parties and professional events—traditional ways people meet and develop friendships. No way I’d be the only woman in pants while others strutted in tight dresses. I can’t help but think of all the potential connections I missed. All because of my weight.

I got married in a blue suit because I would have looked absurd in a white gown. No one asked why I wasn’t wearing a wedding dress. They knew.

But it wasn’t always about petty vanity. I stayed away from doctors and didn’t have a single medical checkup for more than a decade after I gave birth to twins. I cringed at the thought of getting the inevitable lecture about my weight. Had something been wrong with me physically, I wouldn’t have known. For years, I never had a regular period. This all stemmed from my inability—my refusal—to do anything about my weight.

The Chat changed everything.

Tory’s top 10 weight loss secrets »

It happened 18 months ago when a woman named Barbara Fedida told me my clothes didn’t do me justice and that she wanted to send me to a stylist.

Barbara is the highest-ranking woman executive at ABC News and I am an on-air contributor for Good Morning America.

She never used the words “fat, diet or obesity” but her message was clear: I needed to lose weight. Let’s face it: on TV looks matter.

In my own way, I took her words to mean “lose weight or lose your job,” even though she didn’t come close to making that threat and has assured me to this day that my role was never in jeopardy.

Barbara changed my life. I think she may have actually saved my life. I know she rescued me from continuing on an unhealthy path both mentally and physically and for that I will be forever grateful to her.

That’s why I dedicated The Shift, my new book about how I lost 62 pounds in one year, to Barbara. She told me what I needed to hear and I was ready to listen. In a nutshell, what I came to learn was that what I put in my head is much more powerful than what I put in my mouth.

I’m on a mission to share that message and more with others who have battled weight for years and are finally ready to make The Shift and do something about it once and for all. If I can do it, anyone can.

I’ve always thought that companies should treat employees as people, to view them far more than worker bees. To care about their families and their lives. To invest in their health. In this tough, fast-paced economy, that personal concern has fallen by the wayside in many respects. We’re too busy to care—and that’s a problem.

From the White House to the boardroom, there’s obvious concern about obesity and its links to rising health costs, shorter life spans, lost productivity and absenteeism. Yet simply urging everyone to exercise more, eat right and smoke and drink less isn’t cutting it because Americans are fatter than ever.

It’s time for employers and colleagues to talk frankly about health and weight to peers to figure out a solution—together.

Thanks to that difficult chat, I’ll never again neglect my health.

I appreciate that Barbara cared enough about me, my appearance and my health to engage me with dignity and respect, not shame and embarrassment. All of us can be that person to someone else—and hopefully the recipient of that message will be as open to shifting as I was.

More weight-loss advice from Tory »

Courtesy of Tory Johnson

Tory Johnson is the author of The Shift: How I Finally Lost Weight and Discovered a Happier Life. Connect with her at www.shiftwithtory.com or on Twitter @ToryJohnson.com.

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