Obesity

In Bariatric Surgery, Sleeve Gastrectomy Now More Common than Bypass — Physician’s First Watch

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In Bariatric Surgery, Sleeve Gastrectomy Now More Common than Bypass — Physician’s First Watch.

The authors examined data on some 44,000 patients undergoing surgery in a 39-hospital Michigan collaborative. From 2008 to 2013, the prevalence of sleeve gastrectomy rose from about 6% to 67% of bariatric procedures. The Roux-en-Y approach dropped from 58% to 27%; adjustable banding fell from 35% to 5%. – See more at: http://www.jwatch.org//fw109242/2014/09/03/bariatric-surgery-sleeve-gastrectomy-now-more-common#sthash.4m9BIpud.dpuf

Stupidity is Worse for us than Either Sugar or Saturated Fat

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Stupidity is worse for us than either sugar or saturated fat.

Read this article and you’ll encounter a well reasoned rant with lots of links for further reading enjoyment.  My personal journey includes a significant weight loss experience in my early 20’s.  Over the years I’ve gained back some of the 200 plus pounds lost.  Over the years I’ve also gotten lazy with my dietary habits.  Too many calories and an aging metabolism is not a combination for staying trim.  So I got serious (again) and have dropped 12 pounds the past three months.  I’ve always known what to do but failed to do what needed to be done.

And so it goes.  Change. Adapt. Repeat.

Dietary Determinants of Hepatic Steatosis and Visceral Adiposity in Overweight and Obese Youth at Risk of type 2 Diabetes

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Conclusion: Hepatic steatosis is associated with a greater intake of fat and fried foods, whereas visceral obesity is associated with increased consumption of sugar and reduced consumption of fiber in overweight and obese adolescents at risk of type 2 diabetes. This study was registered at clinicaltrials.gov as NCT00755547.

via Dietary determinants of hepatic steatosis and visceral adiposity in overweight and obese youth at risk of type 2 diabetes.

Higher BMI May Be Better for Older Adults

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The association between all-cause mortality and BMI created a U-shaped curve with a broad base (P-nonlinearity <0.001). The “nadir of the curve for BMI and mortality was between 24.0 and 30.9, with the lowest risk being between 27.0 and 27.9 (HR 0.90, 95% CI 0.88-0.92),” wrote Caryl A. Nowson, PhD, of Deakin University in Melbourne, Australia, and her co-authors, in the American Journal of Clinical Nutrition.

They said that mortality risk did not increase with excess weight in this population until BMI was ≥33 (HR 1.08 for BMI of 33.0-33.9, 95% CI 1.00-1.15).

Risk of mortality was highest at a BMI lower than 23, the authors said. Using a BMI of 23.0 to 23.9 as the reference, there was a 12% greater risk of mortality for those with a BMI in the range of 21.0-21.9 (HR 1.12, 95% CI 1.10-1.13) and a 19% greater risk for those with a BMI in the range of 20.0-20.9 (HR 1.19, 95% CI 1.17-1.22), the authors said.

via Higher BMI May Be Better for Older Adults.

BMI and all-cause mortality in older adults: a meta-analysis.

Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes — NEJM

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Conclusions

We observed a J-shaped association between BMI and mortality among all participants and among those who had ever smoked and a direct linear relationship among those who had never smoked. We found no evidence of lower mortality among patients with diabetes who were overweight or obese at diagnosis, as compared with their normal-weight counterparts, or of an obesity paradox.

via Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes — NEJM.

Obesity Week!

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The New DIETs (New Dietary Interventions to Enhance the Treatments for Weight Loss) Study is the first randomized trial that will compare how these four diets — none of which restrict calories — can influence body weight.

 

Obesity experts are anticipating answers on whether a vegan or vegetarian diet will offer better weight loss than a pescatarian or omnivorous one, experts told MedPage Today in the run-up to Obesity Week here.

via Obesity Week Parses Dietary Lifestyle and Weight Loss.

Diabetes Prevention: Lifestyle Change – amednews.com

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The national YMCA of the USA was awarded a three-year, $12 million grant from the federal Center for Medicare and Medicaid Innovation to make its diabetes-prevention program available to about 10,000 Medicare patients in 17 communities. Medicare fee-for-service patients pay no additional out-of-pocket cost for the YMCA class and 27 private health plans cover it. For other patients, the fee is charged on an income-based sliding scale that varies by facility and can reach $400, says Matt Longjohn, MD, MPH, the national health officer at YMCA of the USA.

26 million Americans have diabetes, more than 8% of the U.S. population. Researchers estimate that one in three U.S. patients — about 80 million — can be classified as prediabetic either because of their scores on diagnostic blood tests or a combination of age, family history of diabetes and other factors. Patients with prediabetes are two to five times likelier than patients with normal blood glucose to develop type 2 diabetes. Ten percent of prediabetics will become diabetics within seven years, says Ronald T. Ackermann, MD, MPH, associate professor of medicine at Northwestern University Feinberg School of Medicine in Chicago.

A randomized controlled trial of more than 3,000 patients with prediabetes found that patients exposed to an intensive lifestyle-modification program that aimed for 7% weight loss and 150 minutes in weekly physical activity were 58% less likely to develop diabetes than those who received standard lifestyle recommendations and took a placebo pill. During the study’s three-year period, the patients who got the comprehensive lifestyle support in the form of 16 lessons covering diet, exercise and behavior modification avoided diabetes at a rate nearly double that of patients who got the standard advice and took the diabetes drug metformin.

For every seven prediabetics who participated in the lifestyle-modification program, one case of diabetes was avoided, said the study in the Feb. 7, 2002 issue of The New England Journal of Medicine.

via Diabetes prevention: Set on a course for lifestyle change – amednews.com.