Obese People Might Be More Sensitive to Pain

Physical factors may combine to increase sensitivity, researchers say

By Steven Reinberg
HealthDay Reporter

Obese people may be more sensitive to pain than people who aren't overweight, a new study suggests.

Researchers gauged reaction to pain among 62 older adults who had osteoarthritis of the knee, a disease that affects more than 20 million people in the United States. The study participants -- one-third of whom were obese -- were given a mild electrical shock on the left ankle that caused sensations of tingling and mild pain in the lower leg. This was done before and after the participants took a 45-minute, coping-skills session that included progressive muscle-relaxation exercises.

The researchers wanted to see if coping-skills training would help people with osteoarthritis to better cope with the pain caused by the disease.

But the scientists were especially interested in determining how the obese group responded to pain. A small number of studies have looked at pain sensitivity among obese people, but they have produced conflicting results.

The researchers found that obese individuals had a greater physical response to the electrical stimulation than non-obese people. They based their findings by measuring the reflex of the lower leg muscles; this indicated that the obese individuals had a lower tolerance for pain, even though they said that they felt no more pain than non-obese people.

The findings are to be presented Saturday at the American Psychosomatic Society annual meeting, in Denver.

"For subjective indicators of pain, obese people indicated similar levels of pain to non-obese people," said study author Charles Emery, a professor of psychology at Ohio State University. "But when we looked at objective indicators, we found that the obese group had a lower threshold for pain."

Emery believes that obese people may have more experience with pain because of their weight. "They may be used to some degree of pain," he said.

But obese people appear to experience greater pain than non-obese people, Emery added. "It is important to look at both objective indicators of pain, as well as subjective indicators," he said. "We need to keep in mind that the subjective rating may not be reflective of physiological processes that are going on."

One expert found the study results compatible with what is known about how people experience pain.

"These results do not surprise me at all," said Dr. Doris K. Cope, director of the Pain Medicine Division at the University of Pittsburgh.

Pain is not only a physiological stimulus-response, but the psychological interpretation of that stimulus providing a total experience of pain, Cope said. "Psychological studies of the obese demonstrate personality differences between obese and non-obese subjects, so it would not surprise me if these patients also experience pain differently as well," she said.

Source: Healthcenter.com

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Obesity May Up Physical Pain Reaction

Study Shows Stronger Pain Reaction in Obese People

Obesity may heighten physical reaction to pain, according to a new study.

The study shows a greater physical pain reaction in obese people, compared with people who aren't obese, even after brushing up on their coping skills.

However, subjective pain perception -- how people consciously perceive pain -- wasn't tied to obesity in the study.

"I think the most important point of this preliminary study is that obese individuals may have a lower threshold for pain [possibly due to chronic inflammation associated with obesity], which is not evident if we rely solely on self-report of pain," researcher Charles Emery, PhD, tells WebMD in an email.

Emery, a psychology professor at Ohio State University, worked with colleagues on the study. Their findings will be presented in Denver at the American Psychosomatic Society's annual meeting.

Physical Reaction to Pain

Emery's team studied 62 people with osteoarthritis, the most common form of arthritis. Participants were 50 to 76 years old. About a third of them were obese.

First, participants got a mild electrical shock to their left ankle to measure their pain reflex. The body automatically pulls away from pain; that automatic physical reaction is the pain reflex.

Obese participants had a stronger pain reflex than those who weren't obese, the study shows.

Next, participants got a 45-minute lesson in coping skills to help them learn to better handle pain. The lesson included instruction in progressive muscle relaxation.

Then, they took the pain test again. This time, all participants had a milder pain reflex than in the first test. But obese participants still had a stronger physical reaction to pain than those who weren't obese.

"The relaxation procedure helped both groups cope with pain," Emery says, in a news release. "Additionally, our tests showed both groups had higher physical pain thresholds after the relaxation session. But the obese participants still had a lower threshold for tolerating the pain."

Feeling the Pain

After both tests, participants completed questionnaires about pain and anxiety. All had similar perceptions of pain, regardless of obesity.

In other words, obese people had a stronger physical reaction to pain, but their subjective pain perception was the same as people who were not obese.

"This is important because if an obese person begins an exercise program, he may not cognitively experience pain when in fact it is hurting the body on some level," Emery says, in the news release. "That could lead to severe pain down the road."

Past studies on obesity have had mixed results. "Some studies say that obese people are more tolerant of pain, while other studies say they are less tolerant," Emery says.

"Our findings show the importance of looking at objective as well as subjective measurements of how the body responds to pain stimuli," he adds.

Source: Medicinenet.com

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Obesity Increases The Risk Of Contracting Cancer

"Obesity increases the risk of contracting cancer", states Dr. Javier Salvador, Director of the Department of Endocrinology and Nutrition at the University Hospital of the University of Navarra.

Overweight has become a worldwide epidemic, not only in industrialised countries, but also in developing ones where problems of malnutrition go hand in glove with high percentages of obesity. The rates are currently rising at an alarming pace. In Spain some 15% of the population suffer from obesity and 54% from an excess of weight. Rates are going up because of the imbalance between ingestion and calorie consumption - due both to the growth and proliferation of unhealthy eating habits and an increase in sedentary life habits and styles.

One of the main problems in Western society is the rise in infant obesity the incidence of which has now reached that of obesity amongst adults. It is known that a very high proportion of these children will be obese when they become adults. Treatment is complicated and so we have to take action on prevention and on encouraging healthy lifestyles and habits in the home, at school and so on.

Clinical repercussion

Overweight produces significant changes in health, particularly those of a cardiovascular nature such as high arterial (blood) pressure, cardiopathy and ischemia; but also problems of a metabolic nature such as diabetes type 2 and changes in blood fat, apnea during sleep, alterations in the joints, and so on. Obesity is also involved in changes in hepatic function – as a consequence of the infiltration of fat, the liver deteriorates and may end up with hepatic cirrhosis.

Society at large is aware that obesity is damaging in these ways to our health. What has not been known to date is that it is associated with certain cancers. This is important, for example, for women with a family history of breast cancer – obese members of these families are more likely to contract the disease.

Apart from clinical pathologies overweight causes psychological problems of self-esteem, symptoms of depression, anxiety, and so on. Thus, dealing with and treating all these means high health costs.

Source: Medicalnewstoday

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Noni Juice Might Lower Smokers' Cholesterol

Claims that it can ward off any number of ailments have helped boost annual sales of Tahitian noni juice into the billions, and now a new study suggests the drink may, in fact, help lower cholesterol.

But skeptics note that the small study -- like most others looking at the product -- was funded by the maker of the juice, and they are calling for a larger, independent clinical trial.


The findings were to be presented Thursday at the American Heart Association (AHA) annual conference on Cardiovascular Disease Epidemiology and Prevention, in Phoenix.


"Are the findings a reason for people to drink noni juice? I don't think that there is an answer to that," said Dr. Stephen Barrett, a retired psychiatrist and founder of Quackwatch, which has investigated the unfounded claims of noni juice distributors in the past.


While not dismissing the idea that the juice, made from the bumpy fruit of the Polynesian noni plant, might have some heart-healthy effects, Barrett added, "You'd want to have someone who's independent, at some point, do the study."


The study's lead researcher, Dr. Mian-Ying Wang of the University of Illinois College of Medicine, defended her team's work. She pointed out that the study was a double-blinded, placebo-controlled effort that met the standards of the college's Institutional Review Board.


Wang drinks noni juice daily. She claims it helps her feel more energized and concentrate better, and has even thickened her hair. "I do recommend it," she said, "and several of my coworkers drink noni juice for their cholesterol -- it controls it very well."


Noni juice does have an ancient history among the peoples of the South Pacific, where Wang said, "it has been used for over 2,000 years as a traditional medicine." She said her previous research has found the juice does contain a very high level of disease-fighting antioxidants.


However, the bitter-tasting beverage has had a more checkered history in the United States, with some distributors having claimed it cured everything from arthritis to cancer to AIDS. In 1998, unsubstantiated claims led attorney generals in Arizona, California, New Jersey and Texas to levy a $100,000 fine against one major noni juice maker, Utah-based Morinda Inc., ordering it to cease making such claims.


Morinda owns Tahitian Noni International (TNI), which funded Wang's study. However, according to the company's Web site, the company now claims only that the juice is "rich in antioxidants that promote wellness." They go on to say that "TNI and its distributors do not claim that noni cures cancer or any other ailments." In a statement, TNI said its global sales had reached $3 billion by 2005.


In the Illinois study, Wang's team compared blood levels of total cholesterol and triglycerides (fats) in 132 smokers. Twenty-six of the participants drank a harmless placebo mixture while 106 drank one ounce to four ounces daily of TNI's brand of noni juice (mixed with grape and blueberry juice for palatability).


Wang said the study focused on smokers because their cholesterol levels tend to be higher than those of nonsmokers, and they are at higher risk for heart disease.


At the end of the month-long study, noni drinkers saw their total cholesterol drop from an average of 235.2 mg/dL to 190.2 mg/dL, while their triglycerides declined from 242.5 mg/dL to 193.5 mg/dL.


Although the data was not included in the heart association meeting data, Wang said levels of LDL "bad" cholesterol showed a "trend toward decreasing" in noni drinkers, while levels of HDL "good" cholesterol rose 17 percent to 20 percent.


However, not everyone was impressed with the findings. Dr. Jeffrey Galpin is an assistant clinical professor of medicine at the University of Southern California in Los Angeles who has investigated claims made by noni juice distributors in the past.


Like Barrett, he said that the remedy "may well have benefits, but somebody -- and not the company -- is going to have to do studies that are well-controlled with no conflict of interest."


He also pointed to one small, independent study that found that overindulgence in the juice could actually be dangerous. "A couple of people used this juice for a few months and drank a ton of it -- one of them ended up needing a liver transplant and the other had some kind of related hepatitis," he said.


He and Barrett also noted that the four-week study says little about the juice's ability to benefit users over the long term.

Then there's the juice's expense.

"If there are antioxidants in noni juice, prove to me that it's worth $35 for 24 ounces -- instead of just eating some [antioxidant-rich] blueberries," Galpin said.

Barrett agreed, noting that drinking three to four ounces of noni juice a day would cost consumers the same as taking a prescription statin medication, "which we know works." Beyond that, Barrett said, "we know that if you simply eat a healthy low-fat diet, your cholesterol level drops really fast."

Galpin also questioned the AHA's decision to promote the small, company-funded study in its press kit for this week's meeting. "That shocked me," he said.

But Dr. Barbara Howard, vice chairwoman of the AHA's Nutrition, Physical Activity and Metabolism Council, defended the association's choice. "There's a huge focus on these kinds of supplements nowadays, and the AHA has made it clear that these are all basically unproven and need a lot more research," she said. "This [choice] doesn't in any way reflect our judgment of the quality of the study."

According to Wang, skeptics may soon get what they wish for, anyway.

"Based on this data," she said, "I'm going to submit a [proposal for a] bigger clinical trial to the AHA, to try and get funding." At the same time, the U.S. National Center for Complementary and Alternative Medicine is currently recruiting participants for its own federally funded, phase 1 clinical trial focused on the juice's effectiveness against cancer.

Source: YahooNews

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Noni Juice: Can It Lower Cholesterol?

Early research suggests that a commercially available juice made from a plant used for centuries in Polynesian folk medicine may have heart-healthy benefits, but all agree that larger studies are needed to confirm the finding.

Researchers report that significant reductions in total cholesterol and triglycerides were seen in smokers who drank a product containing juice from the fruit of the noni tree every day for a month. The study was funded by the manufacturer of the product, sold as Tahitian Noni Juice.

The study was presented Thursday at the 46th Annual Epidemiology Conference of the American Heart Association.

American Heart Association spokeswoman Barbara Howard, PhD, called the findings intriguing and said the study is a rare example of good research on a dietary supplement or food that makes health claims.

"Supplement stores are full of products that make health claims that aren't backed up by science," she tells WebMD. "This study was only a first step, but it is a step in the right direction."

Reductions Substantial

Researcher Mian-Ying Wang, MD, says she first became interested in studying noni juice in 1999 after becoming convinced that it helped reduce her pain from a wrist fracture.

She has received more than $800,000 in grants from Utah-based Morinda Corp., which sells the juice via the Internet and through independent distributors. The cholesterol/triglyceride research came from a larger cancer prevention study involving adult smokers.

A total of 106 smokers drank 1 to 4 ounces of the product, made from the juices of the noni plant, blueberries, and grapes, every day for a month. Twenty-six additional smokers drank a similar-tasting juice drink that did not contain noni juice. None of the participants were on cholesterol-lowering medications.

Total cholesterol levels in the noni juice drinkers dropped from 235.2 mg/dL to 190.2 mg/dL after a month; average triglyceride (blood fat) levels dropped from 242.5 mg/dL to 193.5 mg/dL. Cholesterol and triglycerides did not have any significant change during the period in the group that got the drink without noni juice.

Source: WebMD.com

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Warning over child obesity push

The bid to halt rising child obesity by 2010 will fail unless the government shows more leadership, a study says.

Public sector watchdogs the National Audit Office, Healthcare Commission and Audit Commission said there was good work going on at a local level.

But they said government departments needed to offer more guidance as there was confusion about the push.

Public Health Minister Caroline Flint said "huge steps" had been made, but added more had still to be done.

The number of obese children has increased from 9.6% in 1995 to 13.7% in 2003.

The overall cost of obesity to the NHS is currently around £1bn, with a further £2.3bn to £2.6bn for the economy as a whole.

The target was set in July 2004 in a bid to unite the various partnerships between councils, the NHS, voluntary sector and schools into tackling childhood obesity.

But despite being 18 months into the campaign key parts of the delivery plan have still not being published.

And guidance to primary care trusts on measuring children was only published in January.

This means youngsters will not start to be measured until the summer and initial results probably not available until next year - just three years before the target is supposed to be met.

The target is the joint responsibility of the Department of Health, Department for Education and Skills and the Department for Culture, Media and Sport, and states that rising rates of obesity in those under the age of 11 must halt by 2010.

Guidance

The report warned that a "lack of timely guidance" had meant that organisations supposed to be working together to stop rising childhood obesity had been unclear about their roles.

Schools, in particular, needed better guidance to increase the use and accessibility of sports facilities.

Steve Bundred, chief executive of the Audit Commission, said the target to halt rising obesity in under-11s was "very complex and ambitious".

"The causes of obesity are very varied.

"Tackling it requires tackling a whole range of lifestyle and behavioural issues."

Anna Walker, chief executive of the Healthcare Commission, said childhood obesity was a major issue for the nation's health and the provision of healthcare.

"Children who are overweight tend to grow into adults who have a range of health problems as well."

Paul Sacher, founder of the Institute of Child Health's Mend Programme, which works with families on adopting healthier lifestyles, accused the government of lacking ambition.

"We should be trying to reverse the trend, not just halt it. We have shown that if you address diet, exercise and behaviour you can make a difference.

"But to date we have had little lead by the government, it has been too slow."

Ms Flint said "huge steps" have already been made.

"Our public health agenda is the first concerted attempt to seriously tackle rising levels of obesity."

But she added: "We know that leadership and co-ordination are going to be crucial as is giving people information and support in making a difference to their own lives. We recognise we need to do more."

Source: BBCNews.com

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UK Government Response To Report On Tackling Childhood Obesity

Ministers from across government responded today to a report by the National Audit Office, Audit Commission and Healthcare Commission on progress towards meeting the government's public service agreement to halt the year on year increase in obesity in children under 11 by 2010.

Public Health Minister Caroline Flint said:

"Tackling childhood obesity is a government wide priority. We have made huge steps forward already in starting to change attitudes through the 5 A Day campaign, the school fruit scheme and more investment in school food. Our public health agenda is the first concerted attempt to seriously tackle rising levels of obesity. We know that leadership and co-ordination are going to be crucial as is giving people information and support in making a difference to their own lives.

"We recognise we need to do more. We will continue to develop our work across government and the public sector to ensure that we stay on track to meet our target to halt the year on year increase of childhood obesity by 2010."

Jacqui Smith, Minister for Schools, said:

"We are working effectively with Government colleagues, agencies, schools and local authorities to effect no less than a transformation in the health content of school meals and undo decades of neglect.

"We have already made the first payments from the £220 million available to help schools and local education authorities implement local strategies to transform their school lunches. The School Food Trust is now established and will be working intensively with schools and local authorities to support them in implementing the new minimum standards for school meals and increasing demand for healthier food."

Richard Caborn, Minister for Sport, said:

"We know that participating in sport and physical activity is crucial in tackling obesity. From parents, to teachers to Government, we all have a role to play in encouraging young people to get out from behind their computer games, and out playing sport and getting active. Sport and physical activity should be a natural part of every kids daily life. We are making a major contribution towards children's health through our investment of over £1.5 billion in creating a sustainable structure for school sport. We want young people to have every opportunity to play sport both within and outside the curriculum - our long-term ambition is to offer all children at least four hours of sport, two hours of PE within the curriculum and at least 2 to 3 additional hours of sport outside of school by 2010. It's also why we are investing record amounts of money in sporting provision across the country."

The PSA target is jointly owned by the Department of Health, Department of Culture Media & Sport and the Department for Education and Skills.

Source: Medicalnewstoday

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Watchdogs warn on child obesity target

Ministers have defended their plans for tackling childhood obesity after influential watchdogs warned that targets could be missed.

A joint report from the National Audit Office, the Healthcare Commission and the Audit Commission expressed concern about the slow progress being made.

They said that the ambition to halt rising childhood obesity rates by 2010 was being undermined by confusion about how progress should be measured.

Guidance to primary care on measuring children was


only published in January, and initial results are not expected to be available until next year - leaving just three years to meet a target originally set in 2004.

Steve Bundred, chief executive of the Audit Commission, said that rising obesity rates could cost the economy £3.6bn by 2010, plus a further £1bn in healthcare costs.

"If the trend continues, this generation of children will be the first for many decades that doesn't live for as long as their parents," he said.

Anna Walker, chief executive of the Healthcare Commission, said: "If we are serious about tackling childhood obesity then all government agencies must work together more effectively.

"Those of us involved in inspection and assessment must ensure that this partnership working really takes place nationally and locally."

The target is the joint responsibility of the Department of Health, the Department for Education and Skills and the Department for Culture, Media and Sport.

Sir John Bourn, head of the NAO, said: "Central government must set a clear direction if we are to tackle obesity in children.

"Given that the target was established in 2004, the three government departments could have been quicker in co-ordinating their own actions and making sure that those in the frontline were fully informed and supported in their efforts.

"There is now a need for the three departments to work closely together to provide the leadership and direction that the whole delivery chain requires."

Responding to the criticism, public health minister Caroline Flint said that "huge steps forward" had already been taken.

"Our public health agenda is the first concerted attempt to seriously tackle rising levels of obesity," she added.

"We know that leadership and co-ordination are going to be crucial as is giving people information and support in making a difference to their own lives.

"We recognise we need to do more. We will continue to develop our work across government and the public sector to ensure that we stay on track to meet our target to halt the year-on-year increase of childhood obesity by 2010."

Schools minister Jacqui Smith said that £220m was being made available to help schools and local education authorities improve school lunches.

And sports minister Richard Caborn said: "We are making a major contribution towards children's health through our investment of over £1.5bn in creating a sustainable structure for school sport."

Source: YahooNews

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UK to miss obesity targets, warns new report

Halting the deadly rise in childhood obesity will not be achieved without stronger leadership from the top, warns a stark new report from three UK watchdogs.

An investigation published today by the Audit Commission, the Healthcare Commission and the National Audit Office warns that a lack of guidance and coordination means that the government's vaunted aim of halting the rise in obesity in children under 11 is unlikely to materialise.

"Without greater clarity, those further down the delivery chain may be wasting resources on ineffective or inappropriate interventions that fail to target those children most at risk," says the report.

This is the third in a series of studies examining the effectiveness of the mechanisms to deliver government Public Service Agreement (PSA) targets.

This particular report investigated the strength and efficiency of that part of the delivery chain that aims to reduce obesity in children between the ages of 5 and 10.

The child obesity PSA target was set in July 2004, but the key ingredients of the delivery plan will not be published until May 2006. The target 'to halt the increase in obesity among children under the age of 11 by 2010' was set in response to a jump in the growth of childhood obesity.

The incidence of childhood obesity grew from 9.6 per cent in 1995 to 13.7 per cent in 2003.

The target is jointly owned by Department of Health, Department for Culture, Media and Sport, and Department for Education and Skills.

Obesity now costs the NHS around £ 1.6 billion a year and the UK economy a further £ 2.3 billion of indirect costs. If this trend continues, the annual cost to the economy could be £ 3.6 billion a year by 2010.

"Tackling childhood obesity is a government wide priority," said public health minister Caroline Flint.

"Our public health agenda is the first concerted attempt to seriously tackle rising levels of obesity. We know that leadership and co-ordination are going to be crucial as is giving people information and support in making a difference to their own lives."

But the report emphasises that these words must be turned into action if targets are to be met.

"Central Government must set a clear direction if we are to tackle obesity in children," said Sir John Bourn, head of the National Audit Office.

"There is now a need for the three departments to work closely together to provide the leadership and direction that the whole delivery chain requires."

The report recommends greater clarity and direction from central government. It says that it is essential that the three departments work closely together to provide strong leadership.

In addition, a better definition of regional roles and responsibilities is needed. Government offices for the regions could play a greater role in bringing together the various elements of the delivery chain.

"We recognise we need to do more," said Flint. "We will continue to develop our work across government and the public sector to ensure that we stay on track to meet our target to halt the year on year increase of childhood obesity by 2010."

The Audit Commission is an independent body responsible for ensuring that public money is spent economically, efficiently and effectively, to achieve high quality local services for the public. The Healthcare Commission exists to promote improvements in the quality of healthcare and public health in England and Wales.



Source: Foodnavigator

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Assault of the Biopirates

John Mbaria, Special Correspondent
Nairobi

THEY COME AS TOURISTS AND WE URGE them to feel at home in our land and to travel as far and wide in it as they can. Others come as associates of a clique of "conservationists" who have maintained a traditional hold on Africa's conservation policy and practice.

Some come openly as researchers or students eager to dig as much information out of the countryside as possible. Yet others live with us, either as "visiting scientists" working in our national research institutions and universities or as "expert" expatriates.

And we are always eager to extend our generosity. Our governments are equally eager to license them. In Kenya, such licensing carries a caveat, in writing, that the researchers must share with the country the proceeds of their research and must not take away any specimen from any corner of the republic. We also impose other rules and guidelines and ask the National Council for Science and Technology (NCST) and the Ministry of Education to enforce them.

Then we sit back. The government forgets to give the NCST teeth and rarely asks its intelligence arm to monitor the visitors' activities. And so, for the time they are in Kenya, they have our entire wilderness to themselves. Sometimes they come into contact with our "men in green," the Kenya Wildlife Service (KWS) rangers on the beat. But in many cases, they are all alone or are accompanied by a few guides who act more like David Livingstone's porters, Suma and Suzi, often providing intimate services to spice up the research expeditions.

Inevitably, many specimens are spirited away from Kenya and the rest of Africa. For instance, The EastAfrican last year ran a story on how the Mount Kenya Bush Viper - a species of snake discovered whose venom is believed to contain chemicals that can prevent breast cancer - is shipped out of Kenya. All the smugglers need to do is to place it in a deep freezer shortly before they ship it out. This knocks the reptile out for 7-9 hours, which enables the thieves to carry the snake on their person and fly out to Europe and the US.

IN MANY CASES, RESEARCHERS dig up things that look unimportant to us. But almost always, Africans - through ordinary conversations - unwittingly give them vital leads. We even encourage them, wondering at the same time why these queer fellows are so interested in chameleons, beetles, slugs or giraffes' dung.

Years later, we may read a newspaper article about how a biotechnology company has come up with a wonder drug - without making the connection.

For instance, a colleague says that, in the 1970s, there were claims that a muddy substance found in Lang'o District in Uganda had the power to heal a number of different ailments. However, he says, these claims were dismissed as unsubstantiated rumours put about by witchdoctors.

But as detailed in a new report published by a US think-tank, Out of Africa: Mysteries of Access and Benefit Sharing, a British company, SR Pharma (formerly Stanford Rook Ltd), took the "rumours" seriously. After intensive research, the company ended up isolating a unique bacterium, Microbacterium vaccae, that is now used effectively against chronic viral infections, including HIV. Needless to say, SR Pharma made millions of dollars in annual sales and, according to the report, never saw any reason for sharing a single shilling with those who came up with the "rumour."

The British firm is in good company. Dozens of multinationals have been looting biological resources and traditional African knowledge with impunity. "It's a free-for-all out there," says the report, "and until the Convention on Biodiversity (CBD) solves the problems of access and benefit-sharing, the robbery will continue."

That seeds, plants, bacteria, algae, viruses, not to speak of larger animals have and continue to be stolen from Africa is no longer a secret. The robbery is open, widespread and ugly. There are those who say such robbery is part of the official policy of governments in the West, pointing to the fact that in almost all cases, the relevant multinationals end up getting patents for what they have stolen. For instance, the report says that 12 different medically valuable natural products have been stolen from different African countries to make antibiotics, antifungal drugs, appetite depressants and drugs that are effective against diabetes and other diseases.

In addition, six different sources of cosmetics have been illegally acquired from Africa, ending up as vital formulae for the manufacture of whiteners and skin and hair products. Further, agricultural and horticultural products acquired illegally from Algeria, Morocco, Tunisia, Burkina Faso, Tanzania, Somalia, Sudan, Nigeria, Ethiopia and elsewhere in Africa are now generating huge profits for those who hold equity in various multinationals.

But even after such public exposure, the culprits remain unremorseful, often voicing the opinion that there is no such thing as biopiracy. In most cases, the media and the Internet are used to whitewash these corrupt acts while arguments on who, in Africa, is the true owner of such biological resources as bacteria and viruses are advanced to confuse the issue.

Even in cases where African communities have clearly isolated certain plants or organisms and used them to treat different ailments for hundreds of years, someone still disputes their ownership of such knowledge.

But African countries have wittingly or unwittingly abetted the robbery. First, few of these countries have got round to enacting rules to govern access to and sharing of benefits accruing from their natural wealth and the traditional knowledge of their peoples. Meanwhile, African nationals - sometimes even government representatives - play an active role in the robbery.

For instance, The EastAfrican last year exposed how the stealing of industrial enzymes from two of Kenya's Rift Valley Lakes, Bogoria and Nakuru, in 1992 was aided by senior wildlife officials, while researchers working at one of Kenya's public universities collaborated with British nationals in the research.

Moreover, governments in the West routinely disregard the African input in the development of medical, cosmetics and other products during the patenting process. In essence, what patents do is to give the thieving multinationals the exclusive right to earn millions or even billions of dollars from a product identified and sometimes partially developed by Africans. The latter are locked out from sharing any of the profits and if they dared produce similar products for commercial purposes, the World Trade Organisation and other trade watchdogs are at hand to prevent this, while the West is itself ready to defend such patents with its superior economic and military power.

There are reports that thousands of patents on African plants have been filed. These include brazzeine, a protein that is 500 times sweeter than sugar and is obtained from a plant in Gabon; teff, used to make Ethiopia's flat injera bread; thaumatin, a plant sweetener from West Africa; the African soap berry and the Zulu cowpea; and genetic material from the West African cocoa plant, to name but a few.

The case of Bayer is significant. The German drug-making giant got a patent for a diabetes drug whose ingredients were drawn from the water masses of Ruiru in central Kenya and had, by 2004, raked in a profit of $379 million. On its part, the California-based biotech company, Genencor, which is associated with the stealing of industrial enzymes in Kenya, reportedly has annual sales of $3-4 billion.

Africans, intellectuals have been complaining, Africans are reduced to begging for crumbs from the robbers' tables. "They are stealing the loaf and sharing the crumbs," Dr Tewolde Berhan Egziabher, a leading expert on the topic at the Institute for Sustainable Development in Ethiopia, was quoted as saying during the World Summit on Sustainable Development (WSSD) in Johannesburg, South Africa, in 2002. Attempts to force the companies to share their wealth with the true owners of the knowledge or biological resource have been made at the South-South Biopiracy Summits.

Such conferences have raised awareness about the ongoing robbery and how biologically rich Africa is. They have also shown how Africans had isolated and developed, centuries before Europeans scramble for the continent, useful products based on the properties of plants, seeds, algae and other biological resources. But passing on this message seems to be the only success achieved so far by the anti-biopiracy activists.

In some cases, experts have called for the enactment of legislation and pleaded with the West to respect the seemingly toothless Convention on Biodiversity (CBD). In principle, CBD - which came into force in 1993 - asks signatories to respect sovereignty over biological resources. In 1999, efforts were made to give it some teeth, with further negotiations being carried out during the WSSD in 2002. But even after lengthy negotiations and renegotiations (the latest round was held recently in Spain), nothing tangible or binding has so far been achieved.

One campaign for justice has paid off. The most unique case is that of Hoodia, a cactus that the San people of the Kalahari desert have used for centuries to ward off hunger, the Kalahari being a harsh environment. But elsewhere in the world, food - and particularly fatty and sugary food - is available in such quantities that while the San used Hoodia to suppress hunger, Westerners began to use it to suppress their appetites.

In came the South African Council for Scientific and Industrial Research (SCIR) which, in 1997, realised that the lead compound of hoodia was an active appetite suppressant. SCIR then got patents for extracts from several species of the hoodia and traded these to a British drug company, PhytoPharm.

In turn, the latter sold the patent to the giant Pfizer company. Of these deals, the US report says, "All this wheeling and dealing took place without anyone bothering to contact the San."

Interestingly, when the story hit the headlines, PhytoPharm defended its action by claiming that the 100,000-strong population of the San were all dead. But following international pressure, SCIR agreed to give the San an estimated 0.003 per cent of the royalties it receives from PhytoPharm. In addition, media attention forced Pfizer to terminate its hoodia research and to return the rights to PhytoPharm. Apparently, though, PhytoPharm was not deterred. A year later, it licensed the hoodia to Unilever, which curiously claimed that it would not be making any drug from Hoodia but would be selling "functional food" products from the species after three years.

Unilever is reported to have paid PhytoPharm $12.5 million and pledged a further $27.5 million and undisclosed royalties once its products were in the market.

WHAT NEEDS TO BE done to stem such robbery or, at least, to ensure that Africans benefit from their resources and from what they have all along known? There are those who call for speedy legislation for purposes of guaranteeing a reasonable system of benefit sharing. "Legislation is required and it is required yesterday," Nolwazi Gcaba, a South African patent and copyright attorney, was once quoted as saying.

Others place their hopes on the CBD. Ratified by 183 countries and in force since 1993, CBD recognises the sovereignty of states and communities over their genetic resources. However, the treaty has been opposed by some Western governments, including the US, whose Congress refused to ratify it in 1994. In addition, its provisions are contradicted by the Trade Related Intellectual Property Rights (Trips) agreement of the World Trade Organisation (WTO). The WTO has required member countries to recognise Trips since 1995.

It will be difficult for African communities wishing to be paid the true worth of their traditional knowledge to do so, because the entire system of global trade, intellectual property rights and patents does not recognise that they too are thinking beings who possess knowledge and practices that are different from what emanates from the West.

When the ongoing robbery is finally taken seriously by Africans (and peoples in the rest of the developing world) they will find that they may need to fight for an alternative intellectual property rights system that will accord what emanates from Africa due recognition. A starting point, as some have demanded, would be for developing countries to freeze each and every patent on living things. They ought to take the cue from the agitation made by representatives of African countries who, during a WTO meeting in Seattle, US, demanded the cessation of the patenting of life and the protection of community knowledge and heritage.

Source: Allafrica.com

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Obesity's Home: City or Suburbs?

Urban sprawl may not deserve blame for obesity, researchers report.

Siim Soot, PhD, and colleagues analyzed the height, weight, and home addresses on the drivers' licenses of about 7 million Chicago-area residents. The researchers calculated each person's BMI (body mass index, which is based from one's height and weight). Body mass index is used as an estimate of body fat.

Suburbs close to Chicago had residents with the lowest BMIs. The most distant suburban areas were similar, in terms of BMI, to most city neighborhoods.

When it comes to obesity, a person's income and education probably trumps location, the researchers note.

Soot's team works at the Urban Transportation Center of the University of Illinois at Chicago (UIC). They presented their findings to the Transportation Research Board of the National Research Council, states a UIC news release.

Sleek Suburbs?

If Soot's study is right, it dents the theory that city dwellers are leaner because they walk everywhere, while suburbanites bulk up behind the driving wheel.

"There is scant evidence that obesity is directly associated with urban sprawl," write Soot and colleagues. Not all studies come to their conclusion, but those studies often didn't compare specific neighborhoods, Soot's team notes.

In their study, people with high incomes, college educations, and high home values tended to be leaner -- and many of those people lived in suburbs near Chicago. The opposite was also true, the study shows.

Fudge Factor

Many people fudge in reporting their weight for their driver's license. That little lie doesn't bother the researchers too much because they figure that just about everyone does it, regardless of where they live.

"It is very likely that the majority of individuals weigh more than the reported figure on their driver's license," the researchers write. "If everyone or most individuals weigh a fixed percentage more, then we do not have a problem" with the data.

Source: Webmd.com

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Effect of artificial sweeteners in weight control and energy intake

It is widely believed by the public that replacing sugars with artificial sweeteners will help reduce calorie (energy) intake and aid weight loss. As a result sales of foods and drinks sweetened with artificially sweeteners are at an all time high, as are rates of overweight and obesity.

However, while appropriate use of artificial sweeteners may help control energy intake and bodyweight in the short-term, little is known about the long-term impact of artificial sweetener consumption on energy intake and body weight.

A lower intake of energy relative to energy expenditure promotes weight loss. Therefore, it would make sense that substituting foods and drinks containing artificial sweeteners for those with sugar, weight loss would follow. However, the science is not as straight forward as it may seem: the body is capable of sensing and adapting to a reduced energy intake, and as a result people may compensate for this by eating more later.

Professor David Benton, of the University of Wales, Swansea, conducted a review of the scientific evidence looking at the effect of artificial sweeteners in weight control and energy intake. Publishing his findings in Nutrition Research Reviews, Professor Benton concluded that at present the scientific evidence suggests there is a lack of convincing evidence to draw firm conclusions on the role of artificial sweeteners on long-term energy intake and bodyweight regulation. Current evidence suggests that, although artificial sweeteners may be helpful in the short-term, there is little long-term benefit of in people of normal, body weight.

Professor Benton suggests this is because "consumption of artificial sweeteners or low-energy foods tends to be followed by an increase in energy intake to make up for the lost energy in people of a normal bodyweight". The evidence as its stands, suggests that men, rather than women, and children rather, than adults, are better at compensating. However, people who exercise dietary restraint (i.e. watch what they eat carefully)may benefit from artificial sweeteners as they tend not to compensate for energy intake.

Professor Benton suggests that following a low-fat diet is best for weight loss. "Energy-dense diets tend to be associated with obesity, and energy-dense foods tend to be high in fat and have a low water content". High-carbohydrate diets, however, tend to be low in fat. He adds "a number of studies suggest that the use of artificial sweeteners leads to increased consumption of fat, which in theory could lead to weight gain in unrestrained eaters" as gram for gram fat provides more than twice the calories of sugar. There are a number of reasons why this may be, including that fact that carbohydrates, when consumed as solids, promote satiety (feelings of fullness) more than fat. Therefore, people who eat high fat meals may end up eating more energy than people who eat high carbohydrate meals.

It is clear that artificial sweeteners are not a magic solution to all bodyweight problems but may be helpful to some people as part of an overall diet and lifestyle conducive to slimming or weight control.

Source: News-medical.net

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Getting fit: Weight loss not so simple

By CINDY PRYOR

According to the weight loss industry it's simple to lose weight — just take a pill or follow a certain diet. If only it were that simple! We spend over 30 billion dollars each year on weight loss products and yet we are more overweight than ever.

There are a number of factors which contribute to our weight gain and our inability to permanently maintain weight loss. One thing you must do is to make a real commitment to exercise and make healthy eating decisions on a regular and consistent basis.

One tool to help you stay motivated to exercise is to try to remember all the health benefits you're getting from working out. Looking better is only one benefit to exercise. If that's your only reason to exercise it may be hard to stay motivated when the weight doesn't come off as fast as you expected.

Changing the way you eat is the other key factor to long term weight loss. You'll need to make healthy food choices every day. Keeping a food journal may help you to see when you are over-eating, be honest, write down everything you eat, even if it's a bite of something.

A food journal also may help you to see if you are an emotional eater, are you eating for comfort or because you are really hungry. Try to keep in mind the size of your food portions. Our sense of portion size has been altered with the super-sizing of our meals. Remember that eating healthy never stops, unlike a diet you only do for a little while.

Source: Publicopiniononline

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A Look at Food Industry Responses to the Rising Prevalence of Overweight

By Grotz, V Lee

The role of the food industry in the response to the epidemic of obesity is guided by many factors, including the current state of knowledge of the problem. There have been efforts among food and beverage companies to help increase our knowledge about the factors contributing to overweight and to investigate product and marketing changes that may help reduce the risk of weight gain. The value of their future contributions is dependent on corporate resolve, but also on interactive guidance from government and health institutions on the best strategies to take and the best research to support. This is especially clear given the complex nature of the causes of obesity and approaches for treatment.

Key words: food industry, obesity, overweight



INTRODUCTION

With the current epidemic presence of overweight,1-3 its related health risks,4-6 and staggering costs,7 it is not surprising that there has been an intense interest in the actions of US food industries in response. It may be useful to consider the kinds of actions taken to date by the food industry, as well as the causative factors involved. This paper, while not meant to be an all- encompassing report on food industry activities, may shed light on some that are perhaps not so widely known to the public, and may help us all to know how best to work with a potentially valuable resource in addressing the public health problem of overweight.

HISTORICAL PERSPECTIVE

The food industry has been faced with a changing climate, with research at varying stages of depth along the way and with ever- increasing media attention (International Food Information Council Foundation 1990-1999 data, personal communication).8 An assessment of steps that the food industry has taken in response must take into account this climate and these changes.

For example, in the not-too-distant past, obesity was not considered to be a widespread public health threat. Rather, it was mainly perceived as a cosmetic issue related to individual choice.9 Therefore, the serious health risks associated with obesity were less clearly appreciated, as was the value of modest weight loss and/ or prevention of excess weight gain. In such a climate of thinking, the responsibility of the food industry in helping to prevent a rising prevalence in obesity was not considered as critical as it seems to be today, by either food companies or by outside experts.

In contrast, obesity has been recently perceived as a multifactorial issue affecting all segments of the population.1- 3,10,11 Portion control, the readier availability of prepared foods over fresh foods, poorer eating behaviors, and food advertising practices, among other factors, have been linked to the epidemic of overweight.12-19 Weight loss as modest as 5% is now accepted as a reasonable goal that can improve existing comorbid conditions and prevent the development of new adverse health conditions. In short, new research has altered the perception of how foods may affect the prevalence of overweight and how even small dietary changes may be key to successful weight management,11,20,21 which provides a direct path for the food industry to follow to help provide support.

THE INITIAL RESPONSE: RESEARCH

The first response of food industry to the growing problem of obesity was to conduct research, either initiated on its own or through support of others' efforts. This included marketing and academic research. Marketing research has helped the food industry to understand whether its consumers have an interest in new food choices, presentations, marketing strategies, etc. Most food companies, however, typically do not have significant experience in the business of conducting scientific research into the causes, treatment, or prevention of obesity. Further, clinical research is quite cost-intensive. Many companies have found that a collaborative approach helps to pool funds that separately might either be deployed with less impact or be insufficient to significantly support an academic study or series of studies. While there may be several approaches to this, one approach has been for companies to support the International Life Sciences Institute (ILSI).

ILSI is a non-profit, worldwide foundation that seeks to positively impact public health through increased understanding of scientific issues related to nutrition and food safety.22 To provide sound scientific and policy guidance, ILSI has respected academic leaders on its advisory board and has sought input on various projects from high-level governmental organizations. The ILSI North America branch is supported by about 50 companies, the majority of whom are major food, or food ingredient, companies. ILSI has also identified overweight/obesity as a key issue for its efforts in helping to achieve scientific solutions to help improve public health.

Through activities at ILSI, the food industry has helped to make possible research that touches upon many aspects of overweight and its related health risks. For example, ILSI, through its Research Foundation, has sponsored scientific research on the role of physical activity,23 as well as on the early feeding practices of mothers and how these practices can impact children's weight.24 ILSI has also sponsored an expert review of the effects of sugars and carbohydrates in nutrition,25 and through its Research Foundation, research on the needs of health care professionals in pediatric weight management and what is indicated for effective weight management practices.26-31

While there are many, many other important sources of obesity- related research to consider in the evaluation of the right and best approaches to understanding, treating, and preventing obesity, ILSI- sponsored research, funded by grants from companies related to the food business, as well as independent foundations, has helped to improve our collective understanding of the problem and what our next steps should be.

SECONDARY STEPS

Support of Intervention Programs

Following the early investigations and thoughts and beliefs about the causes and treatments of overweight, some food companies have also lent support to certain intervention programs.

One such intervention program is TAKE 10!, a school-based program for children in kindergarten through grade 5.32 This program was created by teachers and students and was initiated by the ILSI Research Foundation. By linking 10-minute age-appropriate activities to learning objectives, this program incorporates physical activity into lessons. Children participating in this program have demonstrated not only increased physical activity but also increased attention in class.33 Research has also shown the program to be sustainable: teachers are overall positive towards the program and are willing to continue to use it.

Another example is a Web-based program, Kidnetic. com, which was designed to promote active living and healthy eating among children ages 9 through 12.34 For example, children can enter games that challenge them to do a series of physical activities while racing against a clock. Other links contain activities that promote learning about better nutrition. The Kidnetic.com website is an initiative funded by the International Food Information Council (IFIC) Foundation. The website lists 13 major food organizations as the sole sources of unrestricted grants that provided funding.

America on the Move(TM) is also a Web-based, not-for-profit program. In contrast to the other examples, this program is not solely focused on children. Instead, it is a program that attempts to prevent weight gain by encouraging modest changes in lifestyle, such as decreasing energy intake by 100 calories a day and increasing activity by 2000 extra steps a day.35 Participants can register online to receive a free regular newsletter and track their progress. Such novel approaches to lifestyle intervention can potentially provide a widespread, low-cost strategy for weight management. The Web program lists numerous food/beverage-related companies as sources of funding.

New Products and Marketing Strategies

In some ways, new products and marketing strategies represent a more aggressive response of the food industry to the problem of overweight, insofar as these steps are self-initiated and self- sustained, and may not equate to short-term business "wins." Thus, their existence comes with the acceptance of certain risks, which may not be inconsequential.

One example of new products are those recently offered by Kraft Foods following a 1993 public commitment by Kraft to reduce the fat and calorie content of a wide range of its products and the portion sizes of its single-serve packages.36 These feature low-calorie snacks, called "100 Calorie Packs," that are single-serve portions of products under well-known brands, such as Oreo, Kraft Cheese Nips, and Wheat Thins, that are intentionally marketed as sensible snacks. Similarly, the McDonald's Corporation has made less calorie- and fat-dense items, such as salads and water, available in its restaurants.

Some major juice manufacturers, such as Tropicana and Ocean Spray, have introduced lower-calorie versions of juice products, and some major carbonated soft drink manufacturers have expanded their redu\ced calorie product line to include products such as Coca- Cola's C2 and PepsiCo's Pepsi Edge. All of these drinks have significantly fewer calories than do the full-calorie/sugar versions. In the case of the soft drinks, they are not as low in calories as soft drinks that qualify for a "diet" or "no calorie" claim according to FDA standards, but each of these products still has some sugar/high-fructose corn syrup and so may still possess some of the hedonic properties associated with these ingredients. Such products may represent an attractive first step into lower- calorie beverages for consumers who might otherwise purchase only full-calorie soft drinks. For consumers who have a significant calorie intake from soft drinks, these changes may be helpful in the overall management of calories.

There have also been changes in food industry marketing strategies. McDonald's Corporation has phased out its supersize portions of fries and drinks.37 Additionally, while more attention may be warranted here, some vending contracts between soft drink companies and elementary and middle schools have been changed to help reduce the visibility and temporal availability of full-sugar soft drinks to younger children. Similarly, with increased research showing the relationships of television food advertising and overweight in children26 and potential risks of poorer eating habits into older years,25 some companies have increased the target age of their television advertising of certain foods and beverages away from younger children and towards an older audience. This could translate into reducing the risk of poorer food selection among growing children and increasing parental influence over food choices.

In addition, many food companies with websites now post responsible nutrition information on their sites. Beyond nutrition information about a company's products, this can include information on healthy weight and active lifestyle programs. One company, Subway, an international sandwich corporation, which has had a successful advertising campaign focused on the potential utility of its products in weight management, has also sponsored talks to children about the health risks of overweight, given by "Jared," someone who has been made widely known as a Subway success story.38

New Collaborations

The food industry has also responded to the problem of overweight with new collaborations. Shaping America's Youth, for example, is a program developed in cooperation with the Office of the Surgeon General and is sponsored by several major food companies.39 One of the first goals of Shaping America's Youth was to create an online database of programs for managing or preventing overweight in children. With the creation of this database within the past year, its next goal is to assess what kinds of programs are best suited to meeting specific needs for the prevention and treatment of childhood overweight. Another example is Salsa Sabor y Salud, a program sponsored by Kraft Foods, which is implemented in conjunction with the National Latino Children's Institute. This program was designed to bring healthier eating and living practices to Latino children in the United States, and emphasizes making appropriate food choices and increasing physical activity.

In addition to work within organizations such as ILSI and IFIC, some food industries have initiated their own conferences and symposia to discuss the issues and potential solutions possible within/by the food industry. These include conferences such as the Fifth Nestl Nutrition Conference, at which approaches to the prevention and treatment of obesity was the focus. Similarly, a recent symposium held by McNeil Nutritionals, LLC, a Johnson & Johnson company, attended by senior executives representing over 20 major food companies, included world-recognized medical experts and opinion leaders in consumer insights and innovations and focused on candidly discussing how the food industry can best respond to the obesity epidemic.

Unrestricted Grants

Many food companies have also made unrestricted grants to relevant health care professional organizations in an effort to help them determine the best ways to combat obesity, including continued research. High on the list for these companies are organizations such as the American Heart Association, the American Diabetes Association, the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Dietetic Association.

Continued Research

Food companies continue to support academic research efforts aimed at improving our ability to respond to the obesity epidemic through ILSI. ILSI North America recently held a conference on "Portion Size, Weight Gain and Children" to identify scientific issues that should be addressed, and continues to support research on eating patterns and effective intervention strategies. Support of other academic research efforts is also likely taking place, and marketing research is continually adding to the picture shaping the actions of food companies.

CONCLUSIONS, COMMENTS, AND FUTURE DIRECTIONS

Obesity is the result of a complex mix of factors10,11,40,41 that are not just related to the intake of prepared foods and beverages. In the face of this knowledge, and given its varied responsibilities, including to its customers, stockholders, employees, and supporting and surrounding communities, food companies have to consider to what extent, and how, they should be involved. In general, the food industry has helped to increase our understanding of the epidemic of obesity and has been part of initiatives aimed at improving the situation. It goes without saying that more can be done. However, to gain the best support from food and beverage companies in the fight against obesity, it may be critical for government and major health and research organizations to work more closely with them.

Food companies do respond to research and, as seen in the examples given in this paper, can help support it. They should be encouraged to continue that support. Food companies also may need assistance in finding the right place to target research support. For example, a review of the Shaping America's Youth database of weight management strategies revealed that, although over seven million dollars have been invested in these programs by academic and other organizations, only 4% of the programs have reported outcomes.42 Without effective outcome measurements, the utility of such programs is difficult to understand. Similarly, food companies may need guidance on what are the best strategic initiatives for helping to combat the problem of overweight. Given the historical difficulty of treating obesity,11 support of programs designed to help prevent excess weight gain, especially in children and higher- risk populations, may be of the highest priority.

Wherever possible, however, food companies should also take additional, reasonable initiatives without prompting. The epidemic of overweight is a global health threat. With increased awareness of the role of portion size in overweight, the restaurant industry needs to focus on supporting portion control. Similarly, food and beverage companies, with their significant marketing expertise, may want to consider ways to help disseminate information wanted and needed by both consumers and practicing physicians. They may also want to introduce programs to help their own employees and their families to have healthier weights, which might also lower overall company health care costs.

Changing our nation's general approach to eating and physical activity will not be accomplished overnight. Therefore, it is that much more important to engage the food industry, and all other major industries, in efforts to help reduce the prevalence of overweight. Many food companies have a serious commitment to optimum public health, and we should all make efforts to embrace and capitalize on that commitment.

Source: Redorbit.com

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Treatment and Prevention of Obesity: What is the Role of Exercise?

By Jakicic

The increasing prevalence of overweight and obesity highlight the need for improved intervention strategies to counteract this significant public health problem. To this end, it appears that increases in energy expenditure through exercise and other forms of physical activity may be an important component of effective interventions to enhance initial weight loss and the prevention of weight regain. However, to achieve these outcomes, adequate levels of exercise and physical activity appear to be necessary, with 60 to 90 min/d currently being recommended. While this appears to be a significant amount of activity, overweight and obese adults should be counseled to progressively increase to these levels of exercise and physical activity. Moreover, there is significant evidence that even if an overweight or obese adult is unable to achieve this level of activity, that significant health benefits can be realized by participating in at least 30 minutes of daily activity that is at least moderate in intensity. Therefore, it is important to have interventions that target these levels of physical activity to improve health-related outcomes and to facilitate long-term weight control.

Key words: energy expenditure, fitness, overweight, physical activity

2006 International Life Sciences Institute


INTRODUCTION

Prevalence of overweight (body mass index ≥ 25.0 kg/m^sup 2^) and obesity (body mass index ≥ 30.0 kg/m^sup 2^) have been increasing over the past few decades.1 Current estimates in the United States indicate that in excess of 65% of adults are overweight, with over 30% classified as obese.1 These increasing rates of obesity are of concern because of their link to numerous chronic health-related conditions such as heart disease, diabetes, and various forms of cancer.2 Thus, it is important to understand factors that impact body weight control and to develop effective interventions to both treat and prevent the onset of obesity and its associated health-related conditions.

The causes of overweight and obesity can be linked to behavioral, metabolic, and genetic factors. However, ultimately, weight gain occurs due to positive energy balance, in which energy intake exceeds energy expenditure. Therefore, manipulation of either of these parameters of energy balance could influence body weight control and potentially minimize the health risks associated with excess body weight. Of particular interest is the role of exercise in improving energy expenditure and this potential impact on body weight. The purpose of this review is to summarize the effect of exercise on body weight control in adults.

THE ROLE OF EXERCISE ON HEALTH-RELATED OUTCOMES

Exercise and increased energy expenditure have been shown to be important for numerous health-related outcomes, including both morbidity and mortality.3 For example, classic studies conducted by Paffenbarger et al.4,5 have repeatedly demonstrated an inverse association between leisure-time physical activity and all-cause mortality in their Harvard Alumni Study. While that study involved only men, numerous studies have demonstrated that the positive influence of increased energy expenditure from physical activity on health-related outcomes is also present in women.6,7 Moreover, the positive influence of increased energy expenditure resulting from physical activity and exercise has been consistently shown across various chronic disease states, including heart disease, cancer, and diabetes.3 Thus, it is widely accepted that increased energy expenditure through exercise and physical activity can positively influence health, which favors interventions to increase energy expenditure in previously sedentary individuals.

The impact of exercise and physical activity on improving health- related outcomes and reducing both morbidity and mortality may operate through improvements in cardiorespiratory fitness. Blair et al.8,9 have found an inverse relationship between the level of cardiorespiratory fitness and mortality. Moreover, it has been shown that an increase in cardiorespiratory fitness results in a reduction in the risk of death, whereas a decrease in cardiorespiratory fitness is associated with an increase in the risk of death.9 These data, in combination with data demonstrating an inverse association between energy expenditure and health risk, may indicate that the greatest reduction in health risk may result from an increase in energy expenditure, which stimulates significant improvements in cardiorespiratory fitness.

The implications of these findings may have particular importance for the overweight and obese adult. While excess body weight is associated with increased health risk from numerous chronic health conditions,2 a number of studies have demonstrated that the health improvements associated with higher levels of cardiorespiratory fitness and energy expenditure appear to be present even in adults classified as overweight or class I or II obese.10-12 Thus, increased energy expenditure through exercise and other forms of physical activity should be recommended for overweight and obese adults even in the absence of weight reduction, and this may be associated with improved health outcomes in these individuals.

THE EFFECT OF EXERCISE ON WEIGHT LOSS

Excess body weight is a result of energy imbalance, where energy intake exceeds energy expenditure, which results in positive energy balance. Thus, weight loss can be achieved through eliciting an energy deficit in which energy intake is less than energy expenditure. The role of exercise in this process is to enhance energy expenditure, which will result in weight loss if there is not a concurrent and equal increase in energy intake.

It has been proposed that there are three components of energy expenditure: resting energy expenditure (REE), thermic effect of meals/food (TEM), and energy expenditure resulting from physical activity (EEPA). Tataranni, et al.13 have suggested that in sedentary adults, REE and TEM are relatively constant and typically account for 60% to 70% and 10% of total daily energy expenditure, respectively. However, EEPA is highly variable between individuals and therefore may provide the most meaningful opportunity to increase energy expenditure, which may ultimately impact body weight control. Thus, because exercise and other leisure-time activities contribute to EEPA, targeting interventions at this component of energy expenditure may have a meaningful impact on weight loss by contributing to an energy deficit.

While exercise and physical activity can increase energy expenditure and contribute to weight loss, it is important to understand the impact that this increase in energy expenditure will have on weight loss. Results from short-term interventions, which are typically 6 months or less in duration, have shown the magnitude of weight loss that is achievable with exercise alone compare with diet alone or the combination of diet plus exercise. The results of these studies have been remarkably consistent. For example, an early study conducted by Hagan et al.14 reported reductions in body weight of 11.4%, 8.4%, and 0.3% in males participating in 12 weeks of diet plus exercise, diet alone, or exercise alone, respectively. The pattern of weight loss for women was similar, with weight losses of 7.5%, 5.5%, and 0.6% in the same three interventions, respectively. Wing et al.15 reported similar results across the initial 6 months of a behavioral intervention, with weight losses of 2.1, 9.1, and 10.3 kg in the exercise, diet, and diet plus exercise groups, respectively.15 These results reflect the data provided in the clinical guidelines developed by the National Heart, Lung and Blood Institute, which indicate that exercise may enhance weight loss achieved through diet alone. However, in clinical interventions, weight loss from exercise is typically less than what can be achieved through dietary modification resulting in significant reductions in energy intake.2

While there is research demonstrating that a similar energy deficit achieved through either a reduction in energy intake or increase in energy expenditure will result in a similar change in body weight,16 the amount of exercise necessary may be difficult to achieve by most individuals. For example, it is recommended that energy intake be reduced by 500 to 1000 kcal/d to elicit weight loss,17 which theoretically would result in 1 to 2 pounds of weight loss per week if energy expenditure were to remain constant. However, it should be noted that a 90.7-kg (200-lb) individual would need to engage in approximately 82.7 min/d (1 hr 23 min/d) to 165.4 min/d (2 hr 45 min/d) of brisk walking (4 METS) to expend 500 to 1000 kcal/d, which theoretically would result in 1 to 2 pounds of weight loss per week if energy intake were to remain constant. It may not be practical for most individuals to accumulate this level of physical activity each day, which may suggest that combining modest reductions in energy intake with modest increases in energy expenditure to elicit a 500 to 1000 kcal/d energy deficit may be the most practical approach to achieving this magnitude of weight loss.

Despite the modest impact of exercise on weight loss during the initial phase of treatme\nt (typically 6 months), exercise may be important for continued weight loss or maintenance of weight loss beyond this period. For example, Jakicic et al.18,19 demonstrated that exercise was associated with higher levels of long-term weight loss achieved at 12 and 18 months within a behavioral intervention. However, it is important to note that exercise is not the only behavior that is important for enhancing long-term weight loss. Jakicic et al.20 also demonstrated that the greatest magnitude of weight loss was achieved through a combination of increased energy expenditure through exercise and a reduction in energy intake. Data from the National Weight Control Registry demonstrate that individuals who successfully maintain significant weight loss in the long term report engaging in both high levels of leisure-time physical activity and consuming a moderate energy intake.21 Moreover, McGuire et al.22 have reported that increasing energy intake or decreasing energy expenditure from exercise or other forms of physical activity results in weight regain. Thus, these data suggest that while exercise is an important behavior for enhancing long-term weight loss and preventing weight regain, other behaviors affecting energy balance are also critical to this process and should be included in a comprehensive intervention weight control program.

EXERCISE DOSE CONSIDERATIONS FOR LONG-TERM WEIGHT CONTROL

Recent dietary guidelines in the United States have highlighted the importance of exercise and physical activity in the management of body weight and risk associated with chronic diseases.23 However, the level of exercise that is recommended may vary depending on the health-related outcome desired. It has been found that 30 min/d of moderate-intensity activity reduces the risk of chronic diseases. This level of activity is similar to what has been recommended by the Centers for Disease Control and Prevention and the American College of Sports Medicine24 and the Surgeon General's Report on Physical Activity and Health.3 Therefore, regardless of the level of body weight and desire for weight control, this level of activity should be recommended to all individuals as a method of improving health and reducing chronic disease risk.

Current guidelines also recommend levels of activity that may be necessary for the prevention of weight gain and regain. For example, it is recommended that 60 min/d of moderate-intensity activity be the target level for preventing weight gain, whereas 60 to 90 min/d may be the target level for preventing weight regain following significant weight loss.23 Thus, it appears that the recommended level of activity for weight control may be at least twice the level that is necessary to reduce risk from chronic diseases. These higher levels of activity for weight control were initially recommended by the American College of Sports Medicine,17 and have since been endorsed by other organizations.25,26 Moreover, these recommendations are based on a growing body of literature suggesting that 60 to 90 min/d of at least moderate-intensity activity may be necessary to enhance long-term weight control outcomes.18,19,21,27 Therefore, individuals at risk for weight gain or individuals seeking to maintain recent weight loss may need to progressively increase to these levels of activity to achieve the desired outcome.

Pedometers and step counters have become popular recently in an effort to promote adequate levels of physical activity that may impact health outcomes. Currently, 10,000 steps per day is recommended, and there is evidence that this level of activity is consistent with the recommendation to participate in at least 30 minutes of moderate-intensity activity per day to improve health- related outcomes.28 However, the achievement of higher levels of activity that may be necessary to enhance weight control outcomes may require individuals to significantly increase the number of steps they accumulate through the day, which is consistent with the current physical activity guidelines for weight control.23 These factors should be considered when pedometers and step counters are integrated into weight loss interventions, with individuals progressively increased to higher levels of activity to enhance long- term weight control.

Also very important in weight control is the intensity of physical activity. As indicated above, current recommendations are that activity be at moderate intensity, which for most individuals is a brisk walking pace. However, research has examined whether higher-intensity activity improves weight control outcomes and, based on currently available data, it appears that energy expenditure rather than exercise intensity is important for enhancing weight loss outcomes. For example, Duncan et al.29 examined a spectrum of exercise intensities and demonstrated similar changes in body weight and body composition across these intensities when total energy expenditure was held constant. More recently, Jakicic et al.19 reported a similar result in a 12-month intervention, again showing no difference in weight loss between moderate- and vigorous-intensity exercise when total energy expenditure did not differ between these conditions. These data suggest that weight loss interventions should initially target adequate levels of energy expenditure, with the intensity of the activity adjusted to the individual based on fitness level and preference.

THE ROLE OF RESISTANCE EXERCISE IN THE TREATMENT OF OBESITY

Resistance exercise has also been examined as a potential intervention strategy for weight control. A review of the literature in this area conducted by Donnelly et al.30 did not show any advantages for weight loss compared with other forms of exercise. Unfortunately, few of these studies have examined the long-term impact of resistance exercise on weight loss, which indicates that there is a need for research in this area. However, in the few long- term studies examining the impact of resistance exercise on weight loss, there appears to be no clear advantage compared with other forms of exercise. For example, in one of the few long-term studies examining the effect of resistance exercise on weight loss, Wadden et al.31 reported no improvement in weight loss across a 40-week intervention period with the inclusion of resistance exercise. Thus, in the absence of energy restriction, it appears that resistance exercise has a minimal impact on changes in body weight. However, resistance exercise may be important for overweight and obese adults because of the potential improvements in strength, which may have a positive impact on physical function in these individuals.28


Source: Redorbit.com

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Red Alert on Food Labelling

By STEPHEN HAYWARD Consumer Correspondent

SUPERMARKET pizzas and ready meals are to get "traffic light" labels to warn how healthy food is - amid growing fears of an obesity epidemic.

Waitrose is the first major chain to adopt the system - green for good, amber for OK and red for the least healthy. The labels will also show the nutritional content of processed foods.

It comes as the Government's food watchdog launches its own warning system next month.

A decision has yet to be made on whether the Food Standards Agency scheme should be compulsory.

But the FSA believes the coding will make it easier for shoppers to understand labels and hopes the food industry will adopt it as the norm.

Waitrose will use the special labels from March 13. Spokesman Christian Cull said: "Shoppers want to make informed choices. We believe all retailers should adopt the FSA guidelines."

Source: Redorbit

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Governors Urge Change in Eating Culture

By ROBERT TANNER

WASHINGTON - Greasy food. Sugary drinks. And exercise? The tolls from today's temptations, from sweet soft drinks popular with school kids to drive-through lunches eaten behind the wheel, are well-known: obesity, diabetes, heart attacks. Governors say states can guide people to healthier choices — and that they must to cut rising health care costs.

Mike Huckabee of Arkansas is leading the way among the dozens of governors gathered here Saturday for their annual meeting, with a zeal that comes from knowing the costs up close, both personal and financial. Four years ago, his doctor diagnosed him with type 2 diabetes and said he was sure to die an early death. The then 290-pound Huckabee said: "Can we rewrite the last chapter of this book?"

He went on to do just that, changing his eating habits — "anything fried" — starting an exercise regimen, and dropping 110 pounds. Next week, the Republican who jokes about running for the presidency runs another marathon, his third, back in Little Rock.

On a personal level, it means he's rewritten his future. But for Huckabee, along with many governors who've joined with his initiative, the aim is much broader — to change the nation's focus from treating disease to preventing it, and so doing to save lives and get control of soaring health care costs. That in turn would free state governments, workers and private business to spend their money on other demands.

"Every single one of our states is being confronted with an extraordinary crisis, as well as an epidemic ... of overeating, underexercising and smoking," Huckabee told a crowd of governors, health officials and experts, and lobbyists. "The fact is 2,000 Americans will die today, and tomorrow, and the day after that. They'll die not because of some calamity. They'll die because of cultural and lifestyle choices that we can really work on."

The toll is 700,000 a year from chronic diseases. And the cost is $117 billion a year to the economy.

It's time to change the nation's culture, Huckabee said, in the same way that the nation changed its thinking on littering, drinking and driving, smoking and driving without a seatbelt.

States can be key movers, governors said. Among some of the programs already operating:

• Enroll overweight recipients of Medicaid, the government health care program for the poor, into Weight Watchers at a discounted rate, as Tennessee has done.

• Provide fresh, local produce at discounted costs to thousands of rural residents, as a Hawaiian health clinic in Oahu has done with federal and state support.

• Boost physical education programs at public schools with specific guidelines and policy changes, as encouraged by a Michigan program.

Source: YahooNews

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Childhood obesity time bomb explodes

By Beezy Marsh and David Harrison

Soaring levels of obesity have sparked a crisis of "adult" diabetes in children, a new study has revealed.

The number developing Type 2 diabetes - which normally affects overweight people in middle age - has risen 10-fold in the past five years.

The increase, from 10 to 100 new cases every year, emerges in the first nationwide study into the explosion of Type 2 diabetes in the under-16s. It had been thought that the total number of children suffering from the condition, which leads to heart disease, blindness, kidney failure and strokes, was just 100.

The head of the research team from the Royal College of Paediatrics and Child Health described the figure as "shocking".

The findings come at a critical time for the health of the nation, including young people. Prof Sir Liam Donaldson, the chief medical officer, has warned that obesity will result in some children dying before their parents. The new research is revealed as the Sunday Telegraph today unveils Jamie Oliver as a new food columnist.

The chef and campaigner will write every month about British food in Stella magazine. The newspaper has also brought together a panel of experts to discuss the current state of British food in a debate chaired by the broadcaster and writer John Humphrys.

Poor nutrition has fuelled increased obesity and diabetes. Doctors blame diets rich in junk food and a "couch potato" lifestyle - with children, for example, watching television and playing computer games for hours on end.

The Department of Health plans the first anti-obesity public health campaign later this year, but doctors fear it will not be enough.

Researchers from the Royal College carried out a national audit of all NHS diagnoses of Type 2 diabetes in under-16s in 2004-5. But experts say the 100-a-year figure is likely to be the tip of the iceberg because many parents may not realise that their seriously overweight children are showing the early signs of diabetes.

A further 60,000 children are thought to be suffering weight-related metabolic syndrome - a combination of conditions including high blood pressure, raised cholesterol and increased fats in the blood - which is though to precede Type 2 diabetes.

Alarmingly, Type 2 diabetes in children appears to lead to more aggressive complications than Type 1, which is caused by the body's failure to produce enough insulin to regulate blood sugar.

Type 2 diabetes usually occurs later in life and is sometimes known as late-onset diabetes or non-insulin-dependent diabetes mellitus because insulin treatment is not always needed.

Julian Shield, a paediatrician and endocrinologist at Bristol University and Bristol Royal Hospital, who carried out the research, said: "Until now we had no idea how many children were being diagnosed with Type 2 diabetes. It is a shocking figure."

Currently, the National Health Service runs just two specialist child obesity clinics at Bristol Royal Hospital for Sick Children and at Great Ormond St Hospital in London.

But the obesity crisis is not confined to children. A quarter of Britons have a body mass index higher than 30 and are therefore clinically obese - a 75 per cent increase on 10 years ago.

Neville Rigby, a spokesman for the International Task Force on Obesity, a research-led think tank, said: "The childhood obesity time bomb has already exploded. The issue now is facing up to a rapidly worsening scale of problems."

Sam Etherington, the deputy chairman of the British Medical Association, called for action to stop companies advertising junk food to children.

A spokesman for the charity Diabetes UK said: "Overweight people are 80 times more likely to develop Type 2 diabetes than those who maintain a healthy weight.

"It is important that we act now to reduce the rates of obesity. Individuals and families must take responsibility for their own health."

A Department of Health spokesman said: "Our aim is to tackle poor diet and reduce obesity in the population as a whole."


Source: Thelegraph

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OBESITY FACTS

• About 65 percent of U.S. adults older than 20 are either overweight or obese, with 30 percent obese, as shown by data collected between 1999 and 2000.

• In South Carolina, more than three in five adults are either overweight or obese; one in four is obese.

• The prevalence of overweight and obese U.S. adults increased 16 percent between the national health survey conducted from 1988 to 1994 and the one done in 1999-2000.

• The percentage of U.S. children ages six to 19 who are overweight has more than tripled since 1980.

• The U.S. Department of Health and Human Services Healthy People 2010’s goal is to reduce the prevalence of obesity among U.S. adults to below 15 percent.

Source: Thestate.com

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Time is here for a reality check

MUCH has been made in recent times of the so-called obesity epidemic facing young people.

Lack of exercise, and unhealthy eating have been blamed for our children getting fatter.

But while attention has been on children it seems the rest of us are also piling on the weight.

According to the latest research 62 per cent of men and 45 per cent of women are overweight or obese.

The really worrying thing is that many of us are in denial about our weight.

The latest figures show that only 32 per cent of men and 37 per cent of women see themselves that way.

It seems it is time for a reality check.

Maybe we should all have a good look in the mirror and if we are not absolutely happy with what we see make the effort to do something about us.

Losing weight is not that hard — and making the effort is surely better than living with the problems obesity can bring.

Source: Bordermail.com

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HHS and VA to Target Diabetes, Obesity Among American Veterans

With obesity and deadly diabetes at higher levels among America's veterans, the Department of Health and Human Services (HHS) and Department of Veterans Affairs (VA) have announced a coordinated campaign to educate veterans and their families about ways to combat these health issues.

"Central to our goal of controlling the cost of heath care is the promotion of wellness, fitness and the prevention of chronic disease," HHS Secretary Mike Leavitt said. "We are working to encourage Americans to adopt healthy lifestyles and to take the responsibility for making wise choices to improve their fitness and health."

Veterans are nearly three times as likely as the general population to have diabetes, one of the major complications associated with being overweight. According to the National Institute of Diabetes and Digestive and Kidney Disease (part of the National Institutes of Health), 7 percent of the U.S. population has diabetes. Among veterans receiving VA health care, the rate is 20 percent.

"Inactive lifestyles and unhealthy eating habits can cause needless suffering for America's veterans," VA Secretary R. James Nicholson said. "Obesity and diabetes are major threats to the health and lifestyles of our veterans, who are deserving of a robust campaign to educate them on healthy habits."

In a news conference here today, Secretary Leavitt, VA Secretary Nicholson, VA Under Secretary for Health Dr. Jonathan B. Perlin and Surgeon General Richard H. Carmona announced the start of a campaign called "HealthierUS Veterans" -- a multi-pronged educational effort to encourage healthy eating and physical activity among veterans, their families and members of their communities. VA medical centers will be the hubs of the program where they will promote nutrition and exercise with participating "Steps to a Healthier US" grantee organizations, throughout the country.

"Our service men and women are known for their extraordinarily high levels of fitness," Dr. Perlin said. "We want our veterans to be identified the same way."

Overweight patients receiving VA health care may participate in weight loss programs tailored to their needs. They may also receive pedometers, diet advisories and "prescriptions" suggesting how much to walk -- or, in the case of wheelchair users, how much to roll.

The two secretaries also plan to kick off regional educational campaigns this spring in four cities where VA medical centers and HHS Steps programs collaborate. Local celebrities and members of veterans' service organizations will be invited to participate.

In May, the "HealthierUS Veterans" program will participate with the President's Council on Physical Fitness during the council's annual rally in Washington.

Source: Redorbit

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Should obesity be regulated?

Surgeon general to tackle the issue at USC forumBy CZERNE M. REIDStaff WriterShould government put America on a diet to solve the obesity crisis? Or would that be a form of force-feeding?

Two out of three U.S. adults — and 16 percent of children 6 to 19 — are overweight or obese.
The numbers aren’t much better in South Carolina, where more than three in five adults are overweight or obese.

Surgeon General Richard Carmona says regulation isn’t the answer to stemming that epidemic.
“It has to start with the individual,” said Dr. Carmona, who will speak Wednesday at a forum on obesity and public policy, hosted by the USC School of Law. “Do you really want the government to tell you what to eat?”

Government regulation should be the last resort except in cases where people promote their business dishonestly or in ways that could harm the public, Carmona said. Even then, regulation might not be necessary if the public is well-informed and asks the right questions.
Appropriate state and local government roles include raising health literacy, providing technical and funding assistance for various programs, and providing role models and mentors, Carmona said.

“I would hope that the average person, armed with the right information, would make the right decision for their health, for their safety,” Carmona said.

While in South Carolina for USC’s annual Johnson & Johnson Healthcare Lecture, Carmona plans to visit an elementary school as part of his 50 Schools in 50 States initiative through which he talks with students nationwide about risky behaviors and healthy choices. He already has visited 26 schools.

Hopes for a lifestyle revolution rest in educating today’s children, Carmona said. “It’s not going to be done in one generation. It will be an inter-generational transfer of culture.”
Carmona’s message on obesity is part of a bigger debate on how much of the responsibility of addressing the epidemic rests on individuals, and how much the government should intervene.

For example, classifying obesity as a disease could clear the way for insurance companies to pay for preventive measures, said Dr. Phyllis Speiser, a member of the Obesity Consensus Working Group, an international consortium of 65 physicians and other health professionals.
Under today’s health system, few preventive services — such as counseling — are paid for by insurers, said Speiser, who also is a pediatric endocrinologist at Schneider Children’s Hospital in New York.

“There certainly has to be personal responsibility, but people have to be educated,” she said. “Part of that education process is the provision of preventative health services.”
Carmona sees obesity as part of a larger group of preventable, behavior-related problems such as smoking and wearing a seat belt. Despite prevention efforts, many people continue to choose to put themselves at risk.

Other experts say those behaviors might not be entirely under the person’s control.
“Some people might classify obesity as a voluntary health risk, but it’s part of a much larger group of behaviors that may or may not be voluntary,” said Robert Veatch, professor of medical ethics and former director of the Kennedy Institute of Ethics at Georgetown University.
Nonvoluntary factors include genetics, psychological and other conditions that affect behavior, and decisions made for children by adults.

If, in fact, obesity is mainly a result of voluntary actions, deciding how obese you want to be is a value judgment, Veatch said, and the government should not be involved in that directly — except when personal choices saddle the public with additional expenses.

“The government has a legitimate role in letting people know the cost to themselves and to others,” Veatch said. “I don’t know what else they ought to be doing.”

The Centers for Disease Control and Prevention reports that in 1998, overweight- and obesity-related medical expenses accounted for 9.1 percent of U.S. medical expenditures, then costing as much as $78.5 billion.

South Carolina ranks among the top 10 states in terms of obesity-related medical expenses. From 1998 to 2000, annual obesity-related costs in South Carolina were an estimated $1.1 billion — more than 6 percent of adult medical expenses.

“Even if you’re willing to sacrifice your own life, society pays for your indiscretion,” Carmona said. “We pay in the loss of a life and the value of a person, but we also pay economically at a time when we really can’t afford that.”

Source: Thestate.com

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The truth about skin products

Should you just stick to the moisturiser or pick up a face wash, a scrub -- the whole gamut, as well?

We launch a new series on beauty/ grooming products to help you get consumer-savvy.

First let's look at the most common skin products in the market and find out whether you really need them.

Do you have a skin query for Dr Parul Kolhe?

Moisturiser

Your daily moisturiser prevents water loss from your skin cells, keeps them hydrated and nourished and provides a protective barrier from the elements.

For this reason, it must contain a sunscreen of at least an SPF 10 (Garnier's Sun Control Moisturiser costs Rs 115 for 100). For indoor use, a moisturiser without sunscreen will do as well.

Aloe vera, sunflower oil, glycerine are all good moisturisers and should be present in the ingredients list of your product.

Face lotions, body lotions and foot/ hand creams all moisturise your skin. But, though the ingredients in a body lotion are similar to a face lotion, the formulations are slightly different; the former needs to be oilier to give more protection to parts exposed to trauma (injury due to wear and tear) like hands and feet.

Also, hand and foot creams may contain salicylates or urea to dissolve thick calluses; if used on the face, it could burn or damage your delicate facial skin. So, use products only for the body part it is meant for.

A word of caution: no lotion, medicated or otherwise, can cure cellulite (dimpling of skin on thighs and buttocks due to fat deposits) or dissolve body fat, so don't waste your money on such empty promises.

The verdict: A good moisturiser is an absolute must for any person, man, woman and child alike. If I had to recommend only one skin product that can't be done without, this would be it.

Night cream

Any cream gets an undisturbed eight hours to work on your skin if applied before you sleep. Night creams hydrate the upper layer of skin cells, making them plumper; therefore, your skin look smoother, shinier and tighter.

~ Creams with ceremides or alfa-hydroxy acids smoothen fine lines and wrinkles and act as anti-ageing products (Garnier's Wrinkle Lift A at Rs 172 for 50 ml).

~ Creams with hydroquinone or retinoids remove pigment from the cells of the skin's upper layers and act as whitening agents (L'Oreal's White Perfect Night Cream at Rs 600 for 50 ml).

~ Creams with aloe vera, jojoba extracts or glycerine help new cells grow faster and act as repairing agents (Alonurish Alnite cream at Rs 95 for 50 ml).

Never use night creams in the daytime as they may contain ingredients that sensitise your skin to sunlight.

The verdict: Night creams are luxury products. A young person with normal to oily skin can actually do without them but some sort of night application, even if it is just a plain moisturiser, is an absolute must for dry skin.

Face wash

This is perhaps the most commonly used product and yet the most carelessly chosen. A face wash should remove dirt, grime and excess oil from your face without stripping it of all moisture.

Your facial skin has a certain natural pH, which is acidic (pH is the measure of acidity or alkalinity -- the lower it is, the more acidic the substance).

Using a harsh soap can change the pH to alkaline, which would be favourable to bacterial infections that cause acne. Even the mildest of soaps (with the exception of Dove) are alkaline

You should be careful, therefore, to use a pH balanced face wash (it keeps your skin at the correct level of natural acidity) such as Neutrogena (Rs 285 for 200 ml) or Johnson & Johnson's pH balanced face washes (Rs 225 for 150 ml). Another option would be to use a pH restoring toner after washing.

Specially formulated soap free cleansers are available for dry skin; these contain stearyl alcohol or isopropyl alcohol and glycerides that hydrate and moisturise the skin as they clean and leave a film of moisturiser on your face, like the Cetaphil Cleanser (Rs 185 for 100 ml).

Oily-skinned people, however, should opt for mattifying washes that do not add moisture and degrease the skin (Lakme Matteffect at Rs 85 for 100 ml).

Face washes that contain salicylic acid are especially good for acne prone people as they reach into your pores and unplug blackheads that are the forerunners of acne.

The verdict: I personally feel that face washes are an essential in your daily skin care kit, so it is definitely worth spending on.
Face scrub

These products, which contain granular residues that may comprise ground apricot kernels, walnut shells or synthetic granules in a cream base, do the following to your skin:

~ Remove the deposits of grime and dead skin cells.

~ Your pores are unclogged.

~ Blackheads removed and a fresh inner layer of skin is revealed.

~ It makes your skin look smoother and can get rid of pigmentation when used regularly.

Homemade scrubs with sugar granules or 'besan' are economical, but may have uneven rough edged particles causing scratches. Marketed scrubs have uniform rounded granules with lesser chances of damage.

Scrubs also incorporate other ingredients like alfa hydroxy acids which dissolve the upper dead layer of skin making it easier to remove (St Ives Apricot AHA Scrub is Rs 155 for 175ml and Lakme's Apricot Scrub at Rs 55 for 50 ml are effective and pocket friendly).

Elderflower, Vitamin E and ginseng are anti-ageing and whitening ingredients present in some scrubs. To allow your skin to regenerate between exfoliation, use scrubs only two to three times per week.

The verdict: Though not an absolute necessity for all of us, this product can be used with discretion only before 'Have to look good' occasions.

Face pack

Face packs are usually used after a facial, but can be applied by themselves, once or twice a week.

It is applied as the last step of a facial after cleansing, massaging and steaming that are the initial steps of a facial.

They consist of a paste like base that should be applied as a thick layer and left to dry (about 15 minutes). During this time, the added active ingredients can improve your skin quality.

Here are some of the ingredients present in the face packs along with their benefits:

~ Liquorice, bear berry or tomato extracts for whitening ie removing isolated dark marks or blotches.

~ Lactic acid (milk packs) for softening and fairness (improving the overall colour of your skin).

~ Honey for hydrating the upper layer of skin.

The verdict: A face pack is a 'feel good' product, which is pampering but not necessary. You don't need to splurge on them routinely. Use once in a while, for that extra confidence.

So here's hoping you no longer have to stand in front of the cosmetics counter at the supermarket, scratching your head in confusion.

Just reach out for what your skin needs.

Source: Rediff.com

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Food companies are hunting for next big diet fad

BY SARAH ELLISON

In the five years she worked at a call center for SlimFast, Maria Viega became used to women calling in tears, desperate for advice on how to stop cheating on their diets.

"Their main complaint," Viega says, "is that they were hungry."
Now, the food industry has a novel solution: products that will make people feel full, even when they aren't.

Big food companies often are late-comers to diet fads, which tend to bubble up through popular books and personal recommendations. Food makers are, by their nature, predisposed to want people to eat more, as embodied by the classic Lay's potato-chip slogan: "Bet you can't eat just one!"

But given Americans' obsessions with their waistlines, diet foods are one of the faster growing areas of the otherwise slack food business.

As a result, companies from Nestle SA to Unilever and Kraft Foods are trying to get ahead of the game by creating their own food fad. They have experimented with special starches, new types of fiber and a process that occurs in the small intestine called the "ileal brake mechanism."

The goal: Create products that dieters will buy more of in order to eat less.

FULFILLING FOODS

Food sales have been increasing about 2 percent a year, according to market-research firm ACNielsen. By contrast, sales relating to particular diet fads can be spectacular, if erratic.

In 2004, for example, com-panies sold $2.6 billion in low-carbohydrate products, almost eight times as much as they sold in 2002. Then, last year, sales fell 10 percent.

The concept of controlling one's appetite isn't new. Getting the science right and incorporating it into everyday products is a complicated process. Food makers call it "satiety," the science of what keeps people feeling satisfied or sated.

Early explorers of the idea were makers of caffeine supplements and pharmaceuticals, such as diet pills Dexatrim and the Fenfluramine-phentermine combination. Some of these products work by agitating the nervous system and diverting the body's attention from digesting food.
Since the late 1970s, dieters have torn through dozens of different weight-loss concepts, including the Pritikin and Scarsdale diets.

In the 1980s, they avoided salt and started jogging.

In the 1990s, dieters gravitated to low-fat regimes.

Then, in 1997, the reissue of the Dr. Atkins diet book, which originally was published in the 1970s, popularized a low-carbohydrate, high-protein diet that captivated dieters.

It also caused major problems for food-industry players who had poured resources into low-fat products. Many companies thought Atkins-style, low-carb dieting would be a fleeting phenomenon and were caught flat-footed when it became a multibillion-dollar opportunity.
"When we launched (Lean Cuisine), it was all about low calories, leg warmers and Jane Fonda," says Brett White, head of marketing for Nestle's Lean Cuisine. "Then, it was about low cholesterol and low fat — the cycles are happening faster and faster." Nestle is based in Vevey, Switzerland.

The low-carb diet changed dieters' approach to weight-loss. Notably, it suggested they could lose weight without having to feel hungry, because protein is metabolized slowly.

The popularity of the Atkins diet has waned recently, as some adherents found their cholesterol levels rising sharply. Still, consumers haven't forgotten its fundamental lesson and are reluctant to return to their hunger pangs.

The "glycemic index," currently a hot diet concept, is a natural successor to this idea. It ranks carbohydrates depending on how they raise the body's blood-sugar levels. A constant sugar level prevents big surges in insulin production and staves off the feeling of hunger. Normally, the body uses insulin to break down sugar.

Foods with a low glycemic index are digested more slowly. That is the concept the big food marketers are trying to mimic in their laboratories.

PUTTING ON THE BRAKES

Scientists at Unilever, based in London and Rotterdam, are betting on a technology four years in development that focuses on something called the "ileal brake mechanism."

The ileum is the lower part of the small intestine, an area that fat penetrates only when there is too much for the body to process. When it does, the ileum sends a message to the brain that the body is full.

Unilever found a way to alter the structure and the coating of fat molecules so they remain intact as they pass through the digestive system and trigger a sated response when they hit the ileum.

Terry Olson, general manager of marketing for SlimFast, says the technique can convince the body it has consumed 500 calories — the equivalent of a ham and cheese sandwich — when it really had consumed only 190, the amount contained in a SlimFast shake.

The low-carb fad cut SlimFast's $1 billion sales by more than a half in three years, and Unilever is hoping this discovery will help revive one of the industry's best-known and most-battered diet brands.

Unilever has put some of those special satiety-inducing fat molecules in SlimFast. The product now promises to keep dieters full for four hours, up from the 2½ hours of a regular SlimFast shake.

The new product, an upgraded version of Unilever's SlimFast Optima shakes, started arriving on store shelves in late January, one of the first of such products from a big food company.
Rival food makers are looking to exploit different hunger-related mechanisms. Danone SA, based in Paris, is selling nutrition bars called Lu, which use a special type of starch that is released slowly to keep the body's blood-sugar level constant.

Last year, Danone re-searchers also applied for patents on special types of fiber that slow the rate at which food travels through the digestive system. The fiber delays "gastric emptying," which is food's voyage from the stomach to the intestine, and encourages "gastric distention" or the stretching of the stomach. Combined, that makes people feel full longer. The tricky part is not to block their systems entirely.

Kraft Foods, Northfield, Ill., maker of Chips Ahoy cookies and Ritz crackers, is experimenting with a proprietary technology based around starches that are resistant to being broken down by the body.

Regular starch, a basic ingredient of baked goods, typically acts like sugar. This new kind behaves like fiber, which is digested slowly and keeps blood-sugar levels on an even keel. But it still performs the basic function of starch, such as keeping cookies from crumbling.

The starch is being produced now but won't show up in Kraft products for some time, says Todd Abraham, Kraft's vice president of global research and technology strategy.

WHOLE-BODY APPROACH

Little about the science employed by these food giants is simple.
Most weight-loss efforts fail because they work on only one hunger stimulant, says Richard Mattes, a food and nutrition professor at Purdue University.

He organized a symposium for Unilever, for which he consults, in West Palm Beach, Fla., featuring specialists who had each worked on a different satiety mechanism. There was an expert on the brain, one on the upper intestine, another on the lower intestine and another on the endocrine system.

Their goal was to look at "the multiple redundant mechanisms our body uses to make sure we get enough energy," he says. In plain language, that means even if a person's stomach is full, his eyes can look at chocolate cake and want to eat it.

At Lean Cuisine's testing centers, focus-group participants used to pass the time with their own magazines. After eating a Lean Cuisine meal, they were required to stay for several hours and tell the panel leaders how hungry they were every 30 minutes.

But even looking at a picture of tempting food, the testers discovered, could make people feel hungry again. Last year, Lean Cuisine banned testers from bringing their own magazines and instead gave them issues with the food ads taken out. They supplied videos to watch but chose ones that didn't have images of food.

"If the only way we judged hunger was how full the stomach is, no one would ever have dessert," says Mark Friedman, associate director at the Monell Chemical Senses Center in Philadelphia, a group funded by industry and the government that studies human perception.
Friedman is skeptical of the food companies' research, which he says won't be able to address the myriad body functions governing hunger.

FOOD AND DRUGS

The move to put appetite suppressants in food could place big food makers in some awkward company. Fen phen, a combination of two diet drugs, ran into trouble when Fenfluramine — the "fen" half of the combination — was withdrawn from the market in 1997 after it was found to cause heart damage.

In 2004, Unilever bought the rights to market a Hoodia gordonii extract as a diet aid. Hoodia gordonii is a compound based on a bitter-tasting plant that grows only in southern Africa's Kalahari Desert. Legend has it that Kalahari bushmen chewed on the plant during long hunting trips to stave off hunger.

Herbal supplements don't have to be approved by the U.S. Food and Drug Administration for sale, but they do require FDA approval to make certain claims. Unilever is conducting clinical trials with its British partner to develop Hoodia gordonii products, which could hit shelves in 2008.

Perhaps the best-known representative of Hoodia gordonii in the U.S. is former Playboy model Anna Nicole Smith, who appears in ads promoting TrimSpa's Hoodia gordonii weight-loss products.

David Mela, the Unilever project leader for the new SlimFast technology, says his com-pany's formulation has nothing to do with weight-loss supplements found on most drugstore shelves.
"A lot of these products have blackened the reputation of the weight-control area," Mela says. "If there were a supplement out there that worked fantastically, there wouldn't be an obesity problem."

Source: Twincities.com

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Obesity Is A Significant Predictor Of Periodontal Disease

People have a new reason to stick to their New Year's resolution to lose excess weight besides fitting into the latest fashion trends. Researchers from University at Buffalo found that obesity is a significant predictor for periodontal disease, independent of age, gender, race, ethnicity, and smoking. This study printed in a recent supplement to the Journal of Periodontology (JOP).

Furthermore, analysis of this national sample suggests that insulin resistance mediates the relationship between obesity and periodontal disease. It was found that the severity of periodontal attachment loss increased proportionally with increasing insulin resistance. In addition, the number of teeth lost increased significantly with increasing levels of insulin resistance. Individuals in the highest insulin resistance category lost 1.1 more teeth compared to individuals in the lowest category.

"People who have a higher body mass index produce cytokines (hormone-like proteins), that lead to systemic inflammation and insulin resistance," said Robert J. Genco, vice provost at the University at Buffalo and editor of the JOP. We propose that chronic stimulation and secretion of proinflammatory cytokines associated with periodontal infection also occurs, contributing to insulin resistance, which may further predispose to diabetes mellitus."

Genco and his research team recently showed that diabetics with periodontal disease may have greater mortality from diabetic complications such as cardiovascular disease and kidney complications than diabetics with little or no periodontal disease.

"The presence of periodontal infection combined with obesity may contribute to type 2 diabetes and its complications, such as coronary heart disease," said Kenneth A. Krebs, DMD and AAP president. "Although further studies are needed, people should remember that living a healthy lifestyle along with daily brushing and flossing and visiting your oral health care provider is always in fashion."


BACKGROUND INFORMATION

A total of 12,367 non-diabetic individuals 20 to 90 years old participated in the dental section of the NHANES III study. Of these 53 percent were men and 47 percent were women and 43 percent of all the individuals were overweight.


Source: Medicalnewstoday

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Obesity linked to breast cancer

New York - Among women not using hormone therapy, obesity and the byproducts of oestrogen breakdown appear to raise the risk of breast cancer, according to findings published in the International Journal of Cancer.

"Hormone therapy and body mass index (BMI) have been associated with postmenopausal breast cancer," Dr Francesmary Modugno, of the University of Pittsburgh, and colleagues write. "Because estrogen metabolism may affect breast cancer risk and can be altered by weight and hormone therapy, it might play a role in the hormone therapy-BMI-breast cancer associations."

BMI is the ratio of body weight and height, and a score of 30 or higher is considered obese.

The researchers analysed data from subjects enrolled in the Observational Study of the Women's Health Initiative to examine relationships among obesity, hormone therapy, oestrogen metabolism and breast cancer. They compared levels of two oestrogen metabolic chemicals, 2-OHE1 and 16-alpha-OHE1, in 200 women who developed breast cancer and in 200 who did not.

In women who used hormone therapy, there was a modest but significant increase in 16-alpha-OHE1 and significantly higher 2-OHE1 levels in both groups. For these subjects, there was no association among BMI, estrogen metabolism and breast cancer risk.

For women who did not use hormone therapy, however, "greater BMI and higher 16-alpha-OHE1 were individually and jointly associated with increased cancer risk", the investigators found. Compared with women with low BMI and low estrogen metabolite levels, those with a high BMI and high 16-alpha-OHE1 were 3.5-times more likely to develop breast cancer.

Oestrogen metabolism is affected by both BMI and hormone therapy, the team concludes, "potentially explaining the interaction between BMI and hormone therapy in relation to breast cancer risk".

Source: News24.com

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Preventing Child Obesity

by Dennis Watson

"Obesity" is a condition of excess body fat, which puts a child at increased risk for developing heart disease, Type II diabetes, osteoarthritis, high blood pressure and asthma.

Facts:


Did you know that more than 60% of American youth eat too many fatty foods, and less than 20% eat the recommended five or more servings of fruits and vegetables per day.

From 25-40 percent of children inherit the tendency towards overweight.

While children's fat consumption has decreased over the past several decades from 40 percent to 34 percent, their rate of obesity has risen from 12 percent in 1991 to as much as 30.5 percent today. One reason: children have increased the amount of calories they eat each day by as many as 300.

Causes:


Family genetics and history plays a significant part in whether your child will develop a serious weight problem.

If you come from a family of heavy people, and high-calorie food is readily available yet exercise is not, your children are likely to become overweight.

Highly processed, high-calorie meals and fast foods have become staples of the typical Western diet. Poor nutrition spells weight gain.

Eating habits have also changed drastically: family meals have often been replaced by munching continuously throughout the day. Cookies, chips and other high-calorie snack foods are readily available for children to fill up on.

As a result of Obesity:


Many obese children have behavior and learning problems.

Overweight children tend to have more anxiety and poorer social skills than normal weight children. At one extreme, these problems may lead to acting out and disrupting the classroom. At the other, they may cause social withdrawal.

Stress and anxiety also interfere with learning. School-related anxiety can create a vicious cycle in which ever-growing worry fuels ever-declining academic performance.

Obesity is associated with increased risk for a number of dangerous medical conditions, including heart disease, cancer, gallstones, high blood pressure, diabetes, and musculoskeletal disorders.

What to do?


- Exercises like brisk walking, jogging, and playing out door games help to reduce weight.


- Focusing on good health and nutrition, not a certain weight goal.

- Teach and model healthy and positive attitudes toward food and physical activity without emphasizing body weight.

- Take a good look at what is consumed in your children's day and see how you can encourage healthier eating.

- Discourage eating meals or snacks while watching TV because eating in front of the TV may make it difficult to pay attention to feelings of fullness and may lead to overeating.

- Provide opportunities to help children develop positive attitudes about healthy foods and learn appropriate eating patterns, mealtime behavior, and communication skills.

- Encourage children to eat slowly.

- Do not use food as punishment or reward.

- Be a role model by setting a good example for children to follow by demonstrating healthy eating behaviors and an active lifestyle.

- Determine the type of physical activity that suits your child's life style and continuously encourage physical activity.


- Limit high sugar and fat foods without being overly

restrictive. Fat should not be restricted in the diets of children younger than 2 years of age. Children between 2 and 5 should consume gradually diminishing amounts of fat so that by the age of 5 their diet contains no more than 30 percent of calories from fat.

In conclusion:

If you have a child that is considered obese or is getting there please take steps now to reverse or stop it. Getting involved early will have a lasting impression on your child's well being. Also, this will give you a good opportunity to examine your own health condition.

Source: Dailyindia.com

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Statistics Behind Governors' Health Push

Some of the statistics driving action on preventive health programs among governors and health experts:

Percent of adults 20 and over who are overweight or obese: 65 percent.

Percent of adults 20 and over who are obese: 30 percent.

Percent of children ages 6 to 19 who are overweight: 16 percent.

From 1977 to 1995, Americans decreased walking trips by 40 percent, while increasing car trips by 90 percent.

Disease:

Heart disease: 70 million Americans have cardiovascular disease.

Diabetes: Seven percent of Americans have diabetes; experts predict that 30 percent to 40 percent of all children born in the U.S. in 2000 will be diagnosed with diabetes during their lifetime.

Arthritis: Arthritis cases linked to obesity rose from 3 percent in 1971 to 18 percent in 2002.

Source: Washingtonpost.com

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Succulent fans share love of plants

By Pat Sherman

ESCONDIDO – Most people think of aloe when they have a scraped knee or sunburn. Aloe vera gel is used in cosmetics and pharmaceuticals for its soothing properties.

However, said Escondido resident Ronald Chisum, few people realize that there are more than 300 varieties in the aloe family, including one indigenous to Kenya that can grow to 50 feet tall, the aloe bainesii.

Chisum has more than 60 varieties of the succulent in his Escondido garden. His aloe bainesii is 20 feet tall.

“We call them tree aloes,” he said. “It looks like a tree, except it happens to be an aloe vera plant.

“There's this huge diversity of aloes. Some have orange and reddish colored hues to the sap, so if you got it on your skin, it would turn bright yellow or orange.”

For 25 years, Chisum has shared his love of thorny and water-storing plants through the Palomar Cactus and Succulent Society.

The group meets at noon on the fourth Saturday of each month at the Joslyn Senior Center in Escondido. Membership is $15 annually.

Club President Richard Henderson has been a member for nine years. The San Marcos resident spends several hours a day tending a cactus garden that occupies about 700 feet of frontage space along Mission Avenue at Palomar College.

“I have about 3,000 plants in the ground and another 1,000 in pots over there,” said Henderson, 68. “I move them back and forth from the house.”

Art and photography students at the college regularly come to sketch or take pictures in the garden.

Henderson has divided the garden into sections containing varieties of succulents, including cacti.

“One of them is a sansevieria garden,” Henderson said. “Some people refer to it as mother-in-law's tongue. It has a thorn at the very tip of the lip.

“I guess it reminded somebody of their mother-in-law,” he said with a laugh.

Another area contains gasteria, or ox tongue, a succulent in the aloe family.

“If you remember your Latin, gasto is your stomach,” Henderson said. “These plants have a little flower that comes out once a year or so, and it looks like a stomach, just hanging on the end of a plant.”

Each month, the club invites a speaker to address the group. Today's speaker will discuss bonsai trees.

Members often bring cuttings of cactus or succulents from their garden to enter in a raffle, Henderson said. The money is used to buy books for the club's botanical library, housed at the senior center. Meetings also include a plant show.

“People bring stuff in, and we give them a little prize for the best plants,” Henderson said.

Chisum said he likes the diversity of the succulent family.

“You can get all colors, sizes and shapes,” he said. “There are literally thousands of plants to choose from.”

Many members of the group tend to gravitate toward specific varieties, Chisum said, and visit places where they flourish. A couple of members went to Madagascar and later gave a slide presentation on the giant baobab tree, one of the largest succulents in the world.

Also known as the “tree of life” for its ability to provide shelter, food and water for animals and humans, the baobab was central to the story in Disney's “The Lion King.”

Source: Signonsandiego

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