Meal timing strategies appear to lower appetite, improve fat burning

July 24, 2019

Science Daily/The Obesity Society

Researchers have discovered that meal timing strategies such as intermittent fasting or eating earlier in the daytime appear to help people lose weight by lowering appetite rather than burning more calories, according to a report published online today in the journal Obesity, the flagship journal of The Obesity Society. The study is the first to show how meal timing affects 24-hour energy metabolism when food intake and meal frequency are matched.

"Coordinating meals with circadian rhythms, or your body's internal clock, may be a powerful strategy for reducing appetite and improving metabolic health," said Eric Ravussin, PhD, one of the study's authors and associate executive director for clinical science at Louisiana State University's Pennington Biomedical Research Center in Baton Rouge.

"We suspect that a majority of people may find meal timing strategies helpful for losing weight or to maintain their weight since these strategies naturally appear to curb appetite, which may help people eat less," said Courtney M. Peterson, PhD, lead author of the study and an assistant professor in the Department of Nutrition Sciences at the University of Alabama at Birmingham.

Peterson and her colleagues also report that meal timing strategies may help people burn more fat on average during a 24-hour period. Early Time-Restricted Feeding (eTRF) -- a form of daily intermittent fasting where dinner is eaten in the afternoon -- helped to improve people's ability to switch between burning carbohydrates for energy to burning fat for energy, an aspect of metabolism known as metabolic flexibility. The study's authors said, however, that the results on fat-burning are preliminary. "Whether these strategies help people lose body fat need to be tested and confirmed in a much longer study," said Peterson.

For the study, researchers enrolled 11 adult men and women who had excess weight. Participants were recruited between November 2014 and August 2016. Adults, in general good health, aged 20-to-45-years old were eligible to participate if they had a body mass index between 25 and 35 kg/m2 (inclusive), body weight between 68 and 100 kg, a regular bedtime between 9:30 p.m. and 12 a.m., and for women, a regular menstrual cycle.

Participants tried two different meal timing strategies in random order: a control schedule where participants ate three meals during a 12-hour period with breakfast at 8:00 a.m. and dinner at 8:00 p.m. and an eTRF schedule where participants ate three meals over a six-hour period with breakfast at 8:00 a.m. and dinner at 2:00 p.m. The same amounts and types of foods were consumed on both schedules. Fasting periods for the control schedule included 12 hours per day, while the eTRF schedule involved fasting for 18 hours per day.

Study participants followed the different schedules for four days in a row. On the fourth day, researchers measured the metabolism of participants by placing them in a respiratory chamber -- a room-like device -- where researchers measured how many calories, carbohydrates, fat and protein were burned. Researchers also measured the appetite levels of participants every three hours while they were awake, as well as hunger hormones in the morning and evening.

Although eTRF did not significantly affect how many calories participants burned, the researchers found that eTRF did lower levels of the hunger hormone ghrelin and improved some aspects of appetite. It also increased fat-burning over the 24-hour day.

"By testing eTRF, we were able to kill two birds with one stone," said Peterson, adding that the researchers were able to gain some insight into daily intermittent fasting (time restricted-feeding), as well as meal timing strategies that involve eating earlier in the daytime to be in sync with circadian rhythms. The researchers believe that these two broader classes of meal timing strategies may have similar benefits to eTRF.

Hollie Raynor, PhD, RD, LDN, who was not associated with the research, said "this study helps provide more information about how patterns of eating, and not just what you eat, may be important for achieving a healthy weight." Raynor is a professor and interim dean of research in the Department of Nutrition, College of Education, Health, and Human Sciences at The University of Tennessee, Knoxville.

Peterson and colleagues said prior research was conflicted on whether meal timing strategies help with weight loss by helping people burn more calories or by lowering appetite. Studies in rodents suggest such strategies burn more calories, but data from human studies were conflicting -- some studies suggested meal timing strategies increase calories burned, but other reports showed no difference. The study's authors said, however, that previous studies did not directly measure how many calories people burned or were imperfect in other ways.

https://www.sciencedaily.com/releases/2019/07/190724103702.htm

Offering children a wide variety and large quantities of snack food encourages them to eat more

Less focus on plate size and more on reducing quantity and variety of food key to getting children to snack less

July 19, 2019

Science Daily/Murdoch Childrens Research Institute

Offering children a wide variety and large quantities of snack food encourages them to eat more - and may contribute to weight problems, a new study has found. The research also found that how snacks are presented (in a large or small container) has little influence on how much children snack.

A new study has found that offering children a wide variety and large quantities of snack food encourages them to eat more -- and this practice may be contributing to Australia's weight problem.

The research*, led by the Murdoch Children's Research Institute and published in the latest International Journal of Obesity, also found that how snacks are presented (in a large or small container) has little influence on how much children snack.

Lead researcher Dr Jessica Kerr said their study found children weren't greatly affected by container size, with food consumption mainly driven by the quantity/variety of snacks on offer.

"There has been a popular push by nutritionists and public health officials towards replacing large dishware with smaller versions to nudge people towards healthier decisions," she said. "But we have found dishware size has very little effect on the amount of food consumed."

Dr Kerr said while the overconsumption of snack foods is an important contributor to obesity, most people do not recognise the impact it has on their calorie intake.

"Children and adults should only consume energy-dense snacks occasionally -- they do not need to be part of daily energy intake," she said. "But the reality is that Australians typically get around 30-40 per cent of their energy intake from snack foods."

Dr Kerr said three times as many children in Australia are now overweight or obese compared to 30 years ago.

"About 20 per cent (1 in 5) of children are overweight or obese," she said. "There are many complications of children being overweight such as type 2 diabetes, orthopaedic and respiratory disorders, liver problems and sleep apnoea."

Dr Kerr said until now studies into snacking behavior were limited by self-reported data or small sample sizes.

"Past dietary studies have mostly focused on main meals," Dr Kerr said. "It is important to determine on a larger scale how dishware size and the quantity, variety, and energy density of snacks affect both child and adult snacking behavior when apart from each other outside of the family environment," she said.

For the study, participants ate during a 15-minute snack break between 20 other health assessments at the Child Health CheckPoint, which looked at the health of 1800 children, aged 11-12 years, and their parents across a variety of factors from physical activity to sleep.

The children and parents were given a snack box containing non-perishable items such as crackers, cheese, a muesli bar, biscuits, a tub of peaches and chocolate.

The quantity/number and variety of snack food items and the container sizes that the food was presented in varied. Children and parents ate separately and at different times.

Researchers recorded how much food each child and parent left in the box uneaten, and calculated the total grams and kilojoules consumed.

"Children who were offered more snack items consumed considerably more energy and a slightly higher food mass. Manipulating box/container size had little effect on consumption," she said.

The impact on adults was little, however Dr Kerr said adults were more aware that they were being observed and this may have impacted their eating behaviour.

Dr Kerr said further research should be done with parents and community leaders to better understand the use and purpose of snack food items in the face of time pressures, marketing, and child preferences.

"Although there is sometimes a place for snack items to bridge the gap between main meals, our results reinforce calls to educate parents and schools about appropriate snack items and amounts of food to offer children," she said.

"Our research indicates that more attention and resources should be directed to toward offering children smaller amounts of food and, specifically, fewer and less variety of energy-dense foods and pre-packaged items. Interventions should not solely invest in reducing dishware size in the expectation that this will lead to reduced intake of snack foods."

https://www.sciencedaily.com/releases/2019/07/190719105511.htm

Should obesity be recognized as a disease?

July 17, 2019

Science Daily/BMJ

With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognise it as a disease? Experts debate the issue in The BMJ today.

Obesity, in which excess body fat has accumulated to such an extent that health may be adversely affected, meets the dictionary definition of disease, argue Professor John Wilding at the University of Liverpool and Vicky Mooney, representing the European Coalition for People living with Obesity (ECPO).

They point out that more than 200 genes influence weight, and most of these are expressed in the brain or in adipose tissue. "Thus body weight, fat distribution, and risk of complications are strongly influenced by biology -- it is not an individual's fault if they develop obesity."

They argue that the recent rapid increase in obesity is not due to genetics but to an altered environment (food availability and cost, physical environment, and social factors).

Yet the widespread view is that obesity is self inflicted and that it is entirely the individual's responsibility to do something about it, while healthcare professionals seem ill informed on the complexity of obesity and what patients with obesity want.

Recognising obesity as a chronic disease with severe complications rather than a lifestyle choice "should help reduce the stigma and discrimination experienced by many people with obesity," they add.

They disagree that labelling a high proportion of the population as having a disease removes personal responsibility or may overwhelm health services, pointing out that other common diseases, such as high blood pressure and diabetes, require people to take action to manage their condition.

They suggest that most people with obesity will eventually develop complications, and those who do not could be considered as not having disease. "But unless we accept that obesity is a disease, we are not going to be able to curb the epidemic," they conclude.

But Dr Richard Pile, a GP with a special interest in cardiology and Clinical Lead for Prevention for Herts Valleys Clinical Commissioning Group, argues that adopting this approach "could actually result in worse outcomes for individuals and society."

He believes that the dictionary definition of disease "is so vague that we can classify almost anything as a disease" and says the question is not whether we can, but whether we should, and to what end.

If labelling obesity as a disease was harmless then it wouldn't really matter, he writes. But labelling obesity as a disease "risks reducing autonomy, disempowering and robbing people of the intrinsic motivation that is such an important enabler of change."

There is an important difference psychologically between having a risk factor that you have some responsibility for and control over and having a disease that someone else is responsible for treating, he says.

What's more, making obesity a disease "may not benefit patients, but it will benefit healthcare providers and the pharmaceutical industry when health insurance and clinical guidelines promote treatment with drugs and surgery," he warns.

While self determination is key in enabling change, "we should acknowledge that the origins of obesity for most people are social, and so too is the solution," he adds. "If people meet, shop, cook, eat, and engage in activities together the end result will be improved wellbeing and reducing obesity will be a consequential beneficial side effect."

Classifying obesity as a disease is neither essential nor beneficial. It's much more complicated than that, he concludes.

https://www.sciencedaily.com/releases/2019/07/190717195401.htm

Early and ongoing experiences of weight stigma linked to self-directed weight shaming

New study identifies key characteristics of people who internalize weight bias

July 15, 2019

Science Daily/University of Pennsylvania School of Medicine

Weight bias is a common form of prejudice against people who are viewed as having excess weight. Some individuals who struggle with weight may internalize the stigma directed toward them, blaming and devaluing themselves because of their weight. While it's known that weight "self-stigma" is associated with poor mental and physical health, it isn't clear who is most prone to this internalization. In a new study published today in Obesity Science and Practice, researchers at Penn Medicine and the University of Connecticut Rudd Center for Food Policy and Obesity surveyed more than 18,000 adults enrolled in the commercial weight management program WW International (formerly Weight Watchers Inc.), and found that participants who internalized weight bias the most tended to be younger, female, have a higher body mass index (BMI), and have an earlier onset of their weight struggle. Participants who were black or had a romantic partner had lower levels of internalization.

"We don't yet know why some people who struggle with their weight internalize society's stigma and others do not," said the study's lead author Rebecca Pearl, PhD, an assistant professor of Psychology in Psychiatry in the Perelman School of Medicine at the University of Pennsylvania. "These findings represent a first step toward helping us identify, among people trying to manage their weight, who may be most likely to self-stigmatize. People who are trying to lose weight may be among the most vulnerable to weight self-stigma, but this issue is rarely discussed in treatment settings."

Research has found that, beyond the effects of BMI and depression, self-directed weight stigma is associated with increased risk for cardiovascular and metabolic disease. In this study -- the largest investigation of weight self-stigma in the world -- researchers surveyed adults to identify key characteristics and experiences of people who internalize weight bias.

Participants recalled when in their life they experienced weight stigma from other people, how frequent and how upsetting the experiences were, and who it was that called them names, rejected them, or denied them an opportunity simply because of their weight. Results showed that almost two-thirds of the participants reported experiencing weight stigma at least once in their life, and almost half reported experiencing these events when they were children or teens. The researchers examined the relationships between these experiences and levels of self-directed stigma.

Participants who reported experiencing weight stigma from others had higher levels of internalized weight bias than those who reported no experiences of weight stigma. Researchers say this was particularly true for participants who had weight-stigmatizing experiences early in life and continued to have these upsetting experiences as adults. People who experienced weight stigma from family members or friends, or from those in their workplace, community, or health care setting, also had greater evidence of weight self-stigma compared to participants who did not encounter weight stigma from those sources.

"Our findings can inform ways to support people who are experiencing or internalizing weight stigma, including opportunities to address weight stigma as part of weight management and healthy lifestyle programs," said the study's principal investigator Rebecca Puhl, PhD, a professor of Human Development and Family Sciences at the University of Connecticut.

The study sample, although the largest to date, represented only a small percentage of WW members, so the findings may not generalize to all members or to adults trying to lose weight in other ways. Some prior research has suggested that people who internalize weight bias may have worse long-term weight loss outcomes, but more research on this topic is needed.

In addition, Pearl's team is developing a psychological intervention for weight self-stigma that can be incorporated into weight management.

https://www.sciencedaily.com/releases/2019/07/190715075424.htm

Seeing greenery linked to less intense and frequent unhealthy cravings

July 12, 2019

Science Daily/University of Plymouth

New research shows that being able to see green spaces from your home is associated with reduced cravings for alcohol, cigarettes and harmful foods.

Being able to see green spaces from your home is associated with reduced cravings for alcohol, cigarettes and harmful foods, new research has shown.

The study, led by the University of Plymouth, is the first to demonstrate that passive exposure to nearby greenspace is linked to both lower frequencies and strengths of craving.

It builds on previous research suggesting exercising in nature can reduce cravings, by demonstrating the same may be true irrespective of physical activity.

Researchers say the findings add to evidence that points to the need to protect and invest in green spaces within towns and cities, in order to maximise the public health benefits they may afford. They also suggest the causality of this link needs to be investigated further.

The study, published in the journal Health & Place, is the first to investigate the relationship between exposure to natural environments, craving for a range of appetitive substances and the experiencing of negative emotions or feelings.

It involved academics from the University's School of Psychology, with support from the European Centre for Environment and Human Health at the University of Exeter.

Leanne Martin, who led the research as part of her Master's degree in Plymouth, said: "It has been known for some time that being outdoors in nature is linked to a person's wellbeing. But for there to be a similar association with cravings from simply being able to see green spaces adds a new dimension to previous research. This is the first study to explore this idea, and it could have a range of implications for both public health and environmental protection programmes in the future."

For the research, participants completed an online survey that explored the relationships between various aspects of nature exposure, cravings.

Among other things, it measured the proportion of greenspace in an individual's residential neighbourhood, the presence of green views from their home, their access to a garden or allotment; and their frequency of use of public greenspaces.

The results showed that having access to a garden or allotment was associated with both lower craving strength and frequency, while residential views incorporating more than 25% greenspace evoked similar responses.

The study also measured physical activity undertaken within the same time frame that cravings were assessed, showing the reduced craving occurred irrespective of physical activity level.

Dr Sabine Pahl, Associate Professor (Reader) in Psychology, added: "Craving contributes to a variety of health-damaging behaviours such as smoking, excessive drinking and unhealthy eating. In turn, these can contribute to some of the greatest global health challenges of our time, including cancer, obesity and diabetes. Showing that lower craving is linked to more exposure to green spaces is a promising first step. Future research should investigate if and how green spaces can be used to help people withstand problematic cravings, enabling them to better manage cessation attempts in the future."

https://www.sciencedaily.com/releases/2019/07/190712120211.htm

Exercise improves brain function in overweight and obese individuals

July 9, 2019

Science Daily/Society for the Study of Ingestive Behavior

New findings out of the University of Tübingen show that, on top of its benefits for metabolism, mood, and general health, exercise also improves brain function. In recent studies, researchers learned that obese and overweight individuals are prone to insulin resistance in the brain, where it provides information about current nutritional status, as well as the rest of the body. So researchers wanted to know whether exercise can improve insulin sensitivity in the brain and improve cognition in overweight individuals.

In the current study, led by Dr. Stephanie Kullmann, 22 sedentary adults with overweight or obesity (an average BMI of 31) underwent two brain scans before and after an 8-week exercise intervention, including cycling and walking. Brain function was measured before and after using an insulin nasal spray to investigate insulin sensitivity of the brain. Participants were also assessed for cognition, mood, and peripheral metabolism.

Even though the exercise intervention only resulted in a marginal weight loss, brain functions important for metabolism "normalized" only after 8-weeks. Exercise increased regional blood flow in areas of the brain important for motor control and reward processes, both of which depend on the neurotransmitter dopamine. Dopamine is an important neurotransmitter for learning new motor skills and in reward-related learning and this research shows that exercise significantly improves dopamine-related brain function. One area in particular, the striatum, had enhanced sensitivity to insulin after the 8-weeks of exercise such that the brain response of a person with obesity after exercise training resembled the response of a person with normal-weight. Interestingly, the greater the improvement in brain function, the more belly fat a person lost during the course of the exercise intervention. Behaviorally, participants reported an improvement in mood and task switching, which is an indicator for improved executive function.

"The bottom line is that exercise improves brain function," said Kullmann. "And increasing insulin sensitivity in dopamine-related brain regions through exercise may help decrease the risk of a person to develop type 2 diabetes, along with the benefits for mood and cognition."

https://www.sciencedaily.com/releases/2019/07/190709171815.htm

'Lentils will help you run faster:' Communicating food benefits gets kids to eat healthier

May 8, 2019

Science Daily/Washington State University

Communicating food benefits to children that they can relate to may get them to eat healthier.

That's according to a study published today in the Journal of Nutrition Education and Behavior by Washington State University and Florida State University scientists.

The researchers found affirming statements like 'eat your lentils if you want to grow bigger and run faster' were more effective at getting kids to make healthy food choices than presenting the food repeatedly without conversation.

In fact, kids ate twice as much healthy food when they were told how it would benefit them in terms they could understand as opposed to when they were given the food with no contextual information.

"Every child wants to be bigger, faster, able to jump higher," said Jane Lanigan, associate professor in the WSU Department of Human Development and lead author of the study. "Using these types of examples made the food more attractive to eat."

Previous research shows that offering foods repeatedly increases the likelihood that kids will try something new. But that research didn't look at the context of those offerings, Lanigan said.

In their study, Lanigan and her colleagues wanted to see if child-centered nutrition phrases (CCNPs), affirmative statements that simply convey the benefits of healthy food, influenced young children to make healthier food choices. The phrases focus on goals children have and are based on accurate nutrition information.

The WSU and FSU research team ran an experiment where they offered healthy foods to a group of three-to-five-year old children for six weeks.

Before beginning, the 87 children in the experiment ranked how much they liked four foods chosen from different food groups including, green peppers (vegetable), tomatoes (vegetables), quinoa (grain), and lentils (protein).

The kids were then offered two of the foods they liked the least twice a week. Over the six-week experiment, the researchers presented the children one of their low-rated foods with pre-selected age-appropriate facts about the benefits of the food. The other food was merely given to them to taste. A coin flip determined which food would be paired with the CCNP. The experiment was built into the kids' normal class routine, Lanigan said.

The researchers then measured how much the kids ate at three times: pre-test, post-test, and one month after the study ended. The immediate post-test showed no result, likely because the kids "got sick of eating the same foods," Lanigan said.

Results and impact

The month-after measurement told a different story.

"We found that a month later, the kids ate twice as much of their CCNP food with the repeated exposure compared to the food without the positive words," Lanigan said. "For example, when we presented lentils we would say, 'This will help you grow bigger and run faster."

Over time, Lanigan and colleagues' study shows that using CCNPs is likely to increase the amount of healthy food that children eat.

"I have two kids and I probably could have done things differently when trying to get them to eat healthier," Lanigan said. "We wanted to fill a gap, where parents are often told what their kids should be eating but not how to get them to eat it. And that's really important."

https://www.sciencedaily.com/releases/2019/05/190508093734.htm

Fat fruit flies: High-sugar diet deadens sweet tooth; promotes overeating, obesity in flies

May 7, 2019

Science Daily/University of Michigan

Some research suggests that one reason people with obesity overeat is because they don't enjoy food -- especially sweets -- as much as lean people.

But it's not understood if obesity itself or eating certain foods causes taste changes, or how those changes impact appetite and obesity.

For clues, University of Michigan researchers turned to Drosophila melanogaster -- fruit flies -- in a study appearing May 7 in Cell Reports.

They discovered that after feeding fruit flies a high-sugar diet, the flies' taste neurons triggered a molecular chain-reaction that hampered their ability to taste sweets, which in turn fueled overeating and obesity. Further, eating sugar caused the taste changes, not the metabolic consequences of obesity or the sweet taste of food.

The fly findings are significant because if people respond similarly to sugar, researchers are closer to understanding how too much sugar contributes to overeating and obesity. And, because these are molecular changes, it supports the idea that overeating is at least partly beyond our control.

While it's impossible to measure fruit flies' "enjoyment" of food, they certainly ate more on the high-sugar diet, said principal investigator Monica Dus, U-M associate professor of molecular, cellular, and developmental biology.

And yes -- fruit flies do become obese, said Christina May, first author of the study and a doctoral student in Dus' lab. Flies and humans share other surprising similarities: Both love sugar and fat and produce dopamine upon eating it, and their brain cells use many of the same proteins and molecules humans do, for the same things.

The researchers tested their findings in several ways. First, they fed flies that were genetically obese but never exposed to high dietary sugar, and their taste didn't change. However, when they fed sugar equivalent to a cookie to flies unable to store fat, they stayed thin but still lost the ability to taste sweets.

"That's really amazing because it tells you their ability to taste sweets changed because of what they're eating, not because they're becoming obese," May said.

To find out if the sugar or the sweet taste of food caused taste changes, the researchers fed flies a diet similar to artificially sweetened diet soda. Only the files eating real sugar lost their sweet-tasting ability.

"We know it's something specific about the sugar in the diet that's making them lose their taste," Dus said.

The researchers identified the molecule O-GlcNAc transferase, a sugar sensor located in the flies' taste buds that keeps track of how much sugar is in the cells. OGT has previously been implicated in obesity-related conditions like diabetes and heart disease in humans.

They also manipulated flies' taste cells so that even on a high-sugar diet they wouldn't lose taste, and those flies didn't overeat despite loads of sugar.

"This means the changes in taste, at least in flies, are pretty important to drive overconsumption and weight gain," Dus said. "Do changes in taste also play a role in the overconsumption that we see when humans and other animals find themselves in food environments high in sugar?"

Study co-author Anoumid Vaziri, a doctoral student in Dus' lab, said the findings "not only shed light on sugar-diet-dependent neural mechanisms of overeating and obesity, but provide a platform to study the underlying molecular mechanisms that drive changes in neural activity."

So what's this mean for people who are overweight, dieting or feel addicted to sugar? It's possible that in the long-term, a drug or other intervention that corrects dietary sweetness and preserves the sweet taste sensation could someday help curb obesity and the associated chronic diseases. But that is years away, May said.

More importantly, if humans respond the same way as the flies, the research suggests that changing the amount of sugar in the diet can help regulate our food intake, Dus said. Much of the sugar we eat is hidden in processed food, and it's important to keep it to a minimum, she added.

"I think if you try to keep added sugars out of your diet, you'll probably be totally fine, you won't have problems with changing taste and overeating," May said. "All of us try to avoid the added sugars. That's important."

Dus said that future research will examine sugar's impact on the brain's reward circuits to learn what causes overeating, and how sugar changes the brain on a molecular level.

https://www.sciencedaily.com/releases/2019/05/190507121423.htm

Being a car commuter with obesity linked to a 32% increased early death risk

April 27, 2019

Science Daily/European Association for the Study of Obesity

New research presented at this year's European Congress on Obesity in Glasgow, Scotland (28 April -- 1 May) shows that individuals with obesity who commute by car have a 32% higher risk of death, from any cause, compared with those individuals with a normal weight and commute via cycling and walking. The study is by Edward Toke-Bjolgerud, University of Glasgow, UK, and colleagues.

Previous work, using UK Biobank data, has shown that active commuting, mainly cycling, was associated with a 50% lower risk of death, from any cause, and heart disease compared to car commuting. Since 57% of men and 66% of women in the UK are overweight or obese -- a condition linked with a range of poor health outcomes -- the authors of this new research aimed to investigate how different modes of active commuting (car, cycling, walking, mixed-mode) might alter the association between obesity and adverse health outcomes.

Their analysis includes 163,149 UK Biobank participants who have been followed up for a mean of 5 years. The age range was 37 to 73 years and 50.8% were women. Obesity was defined as a body mass index (BMI) (kg/m2) of greater than 30. Active commuting to and from work was self-reported and people classified in one of the following groups: car commuters, walking and cycling (active-mixed), cycling-only and walking-only. The health outcomes of interest were death from any cause, death due to heart disease and hospital admission due to non-fatal heart disease.

Dr Carlos Celis, from the British Heart Foundation Glasgow Cardiovascular Research Centre at the University of Glasgow and lead investigator of this work, reported that during the follow-up a total of 2,425 participants died and 7,973 developed heart disease. Compared with having a healthy body weight and reported mixed active commuting (walking and cycling to and from work; reference group), being obese combined with car commuting was associated with a 32% higher risk for premature death, a doubling of risk of heart disease mortality and a 59% increase in risk non-fatal heart diseases.

In contrast, those people with obesity who reported being active commuters had a risk of death from any cause that was similar to normal weight active commuters, suggesting that cycling or walking to and from work could reduce the detrimental effect of obesity. However, the risk of heart disease was still increased by 82% in active commuters with obesity compared with normal weight active commuters.

The authors conclude: "Our findings, if causal, suggest that people with overweight or obesity could potentially decrease the risk of premature mortality if they engage in active commuting."

They add: "Regardless of your body weight, being physically active could partly reduce the excess risk associated with obesity. However, compared to other forms of physical activity -- such as gyms and exercises classes -- active commuting can be implemented and fitted within our daily routines, often with no additional cost, but at the same time could increase our overall physical activity levels and therefore help to meet the current physical activity recommendations for health."

https://www.sciencedaily.com/releases/2019/04/190427201946.htm

Obesity and emotional problems appear to develop together from age 7

April 27, 2019

Science Daily/European Association for the Study of Obesity

Obesity and emotional problems, such as feelings of low mood and anxiety, tend to develop hand-in-hand from as young as age 7 years, according to new research being presented at this year's European Congress on Obesity (ECO) in Glasgow, UK (28 April-1 May).

The analysis of a large nationally representative sample of over 17,000 children in the UK finds that regardless of their socioeconomic status, girls and boys with obesity at age 7 were at greater risk of emotional problems at age 11, which in turn, predicted high body mass index (BMI) at 14 years of age.

While the study did not investigate the reasons why obesity and emotional problems develop together during childhood, the researchers say that a range of factors are likely to be involved.

"Children with higher BMI may experience weight-related discrimination and poor self-esteem, which could contribute to increased depressive symptoms over time (as has been shown in adults), while depression may lead to obesity through increased emotional eating of high-calorie comfort foods, poor sleep patterns, and lethargy," explains Dr Charlotte Hardman from the University of Liverpool, UK, who co-led the study. "Our findings highlight the importance of early interventions that target both weight and mental health and minimise negative outcomes later in childhood."

Adolescence is a key developmental period for both obesity and emotional problems. But how they relate to each other over time is unclear, and little research has focused on the onset and co-occurrence of these disorders through childhood and adolescence.

Lower socioeconomic status is strongly associated with both obesity and poor mental health, but it is unknown whether the association between these two health outcomes is merely a function of shared socioeconomic disadvantage.

In this study, researchers used statistical modelling to assess associations between obesity and emotional problems in 17,215 children born in the UK between 2000 and 2002, who are taking part in the Millennium Cohort Study -- a nationally representative, UK birth cohort study of over 19,000 individuals born at the start of the millennium.

Information on children's height and weight (BMI) were collected at ages 3, 5, 7, 11 and 14 years, and parents filled in a questionnaire on their children's emotional problems such as feelings of low mood and anxiety. The researchers adjusted for a range of factors known to affect both obesity and mental health including gender, ethnicity, socioeconomic status, and behavioural problems, as well as parents' mental health.

Rates of obesity and emotional problems increased gradually throughout childhood and adolescence. Almost 8% (814/10,767 children with available data) of young people were obese by the age of 14, and around twice that number were reported to have had feelings of low mood and anxiety (1369/10,123).

By adolescence, around a fifth (137/693) of those with obesity also had high levels of emotional distress.

The analysis found that obesity and emotional problems tended to occur together in mid-childhood and adolescence between the 7 and 14 years of age, but not in early childhood (3 to 5 years of age).

On average, girls had higher BMIs and emotional symptoms than boys from 7 to 14 years of age, but co-occurrence and development of obesity and emotional problems were similar in both girls and boys.

After taking socioeconomic status into account, the association between BMI and emotional problems was reduced slightly, suggesting that socioeconomic disadvantage may partly explain the link between children's obesity and poor mental health.

"The shared socioeconomic risk in the development of obesity and poor mental ill-health could be explained by numerous factors. For instance, socioeconomically deprived areas tend to have poorer access to healthy food and green spaces, which may contribute to increased obesity and emotional problems, and compound the effects of family-level socioeconomic disadvantage," says Dr Praveetha Patalay from University College London, UK who co-led the research.

"As both rates of obesity and emotional problems in childhood are increasing, understanding their co-occurrence is an important public health concern, as both are linked with poor health in adulthood. The next steps are to understand the implications of their co-occurrence and how to best intervene to promote good health."

The authors acknowledge that their findings show observational associations, so conclusions about cause and effect cannot be drawn. They point to several limitations, including unmeasured confounding, parent report, and the attrition rate that may have influenced the results.

https://www.sciencedaily.com/releases/2019/04/190427201943.htm