Study shows strong link between obesity and depression

There is a strong link between obesity and mood and anxiety disorders, especially among Caucasian Americans and those with more education and higher income, according to an analysis conducted by researchers from Group Health Center for Health Studies.

The study, published in the July issue of the Archives of General Psychiatry, found that an obese person is about 25 percent more likely than a non-obese person to have a mood or anxiety disorder, such as depression. It also indicated that among Caucasian Americans and more educated people who are obese, that likelihood may be as high as 44 percent.

While the study did not show whether obesity leads to depression or vice versa, "it's almost certain that the association works in both directions," said Greg Simon, MD, MPH, a Group Health psychiatrist and the lead author of the study.

The researchers also found a negative association between obesity and substance abuse. That is, an obese person is 25 percent less likely than a non-obese person to have had a substance abuse disorder sometime in their lives.

"Understanding the connection between obesity and depression is an important public health issue because both of these conditions are so common and have a significant impact on our health care systems," Dr. Simon explained.

He pointed to the evidence that an average American has a 30 percent chance of being obese. This study shows that when a person is depressed, the odds of also becoming obese are as high as 40 percent.

About 20 percent of Americans are diagnosed sometime in their lives with depression. "Among those who are obese, that likelihood of depression jumps to 28 percent," said Dr. Simon.

The study is based on an in-person survey that the researchers from Harvard Medical School conducted among a nationally representative sample of 9,125 adult men and women. Obesity is defined in the study as having a body mass index (BMI) of 30 or more.

While previous studies have shown a connection between obesity and depression, this is the largest and most representative study of the two problems in U.S. population. Also, this study included a much more careful assessment of mental health problems than earlier research, according to Dr. Simon.

Unlike many previous studies that show a link between obesity and depression among women only, this study revealed a strong link in both genders. There were significant differences among social and cultural groups. In groups where obesity is more common--that is, among non-white and less educated groups--there is less depression among the people who are obese. But in groups where there is less obesity, it is accompanied by more depression.

This may indicate that stigma accounts for some of the relationship between obesity and depression, said Dr. Simon. "Perhaps in groups where obesity is less socially normative, it's less acceptable and that's why there's a greater association with depression," he suggested. "But in groups where it is less stigmatized, obesity doesn't seem to be as depressing."

Research currently underway Group Health may lead to a better understanding of the link between body weight and mental health, and how these problems might be moderated.

Dr. Simon and his team are now conducting studies to address questions such as: Do depressed people have more difficulty increasing physically activity? Are their diets different than the diets of non-depressed people? Are depressed people less likely to be successful with structured weight-loss programs? Can weight-loss programs designed specifically for depressed people make a difference?

Simon's article was co-authored by Michael Von Korff, ScD, Kathleen Saunders, JD, and Diana Miglioretti, PhD, of Group Health Center for Health Studies; Paul K. Crane, MD, and Gerald van Belle, PhD, of the University of Washington; and Ronald C. Kessler, PhD, of Harvard Medical School.

The research was supported by grants from the National Institute of Mental Health, with additional support from the National Institute of Drug Abuse, the Substance Abuse and Mental Health Services Administration, the Robert Wood Johnson Foundation, the John W. Alden Trust, the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the U.S. Public Health Service, the Pan American Health Organization, Eli Lilly and Company, and GlaxoSmithKline.

About Group Health and its Center for Health Studies About Founded in 1947, Group Health is a consumer-governed, nonprofit health care system that coordinates care and coverage. Based in Seattle, Group Health and its subsidiary health carriers, Group Health Options, Inc. and KPS Health Plans, serve more than 574,000 members in Washington and Idaho. Group Health Center for Health Studies conducts research related to prevention, diagnosis, and treatment of major health problems. It is funded primarily through government and private research grants. Please visit the virtual newsroom on our Web site, www.ghc.org under "Newsroom."

Source: News Target

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American diets lack fruit, veg, says USDA

Most Americans are not consuming enough of the daily recommended amounts of fruits and vegetables, according to research by the US Department of Agriculture (USDA) and the National Cancer Institute.

Published in this month's Journal of the American Dietetic Association, the latest findings reveal that only 40 percent of Americans have been consuming at least five servings of fruits and vegetables per day.

And dark green and orange vegetables and legumes were the most lacking from people's diets, with current intake of these being less than a third of the recommended amounts.

The researchers said they used the “most accurate and reliable data available and appropriate statistical methods” to estimate the nation's fruit and vegetable consumption, and to determine whether this meets the combined recommendations found in the USDA Food Guide Pyramid, and in the more recent MyPyramid guide.

Fruit and vegetable consumption has been linked to a reduced risk of cancer and cardiovascular disease, and is also said to play a role in weight management by helping to promote satiety and decrease energy intakes. Such science is partly what prompted the USDA to increase its recommendations for fruit and vegetable consumption in its new 2005 MyPyramid guidelines.

As well as recommending greater amounts of fruits and vegetables, MyPyramid differs from the Food Guide Pyramid also includes more specific recommendations about types of vegetables.

MyPyramid recommends 1-2.5 cups of fruit and 1-4 cups of vegetables per day, depending on age, sex and activity level, for a total of 2-6.5 cups. In both the 1992 Food Guide Pyramid and the 5 A Day Program, a ‘serving' of most fruits and vegetables is half a cup. So when the new recommendations are combined, they are equivalent to about 4 to 13 servings.

But this is not nearly the amounts actually being consumed by Americans, with the latest research revealing that average intake currently stands at 4.7 servings per day.

Mean intakes by all age and sex groups are below the recommended amounts for fruits, total vegetables, and all subgroups of vegetables with one exception: 12-15 year-olds are currently consuming more than the recommended levels of starchy vegetables, mainly white potatoes, corn and peas.

Based on single food intake data for 8,070 people participating in a 1999-2000 National Health and Nutrition Examination Survey, the research indicated that adequate intake of fruits and vegetables ranged from a low of 0.7 percent of boys aged 14-18, whose combined recommendation is five cups, to a high of 48 percent of children aged 2-3, whose combined recommendation is one cup.

Among women aged 51-70, only 17 percent met their combined recommendation. Among all other sex-age groups, fewer than 11 percent met their goals.

“A large proportion of the US population needs to increase their fruit and vegetable intake if recommendations are to be met,” wrote the researchers.

“Barriers to increasing consumption (…) should be investigated, and strategies for appropriate programs and interventions should be developed,” they added.

Source: Food Navigator

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'Proof' behind high protein diets

Scientists say a gut hormone could explain why high protein diets can aid weight loss.

PYY is released when a person eats protein-rich foods and sends signals to the brain indicating fullness.

The Medical Research Council team at University College London believe their findings could help tackle obesity.

But dieticians said much more work was needed before people could be advised to make long-term changes to their eating habits.

Many popular diets, including the Atkins, employ high protein foods.

Although there has been evidence to suggest high protein diets are effective in achieving and maintaining weight loss, the reasons for this have been unclear.

Although PYY was discovered more than 20 years ago, its role is still debated.

Dr Rachel Batterham and colleagues have shown that low levels of PYY can result in obesity.

Dietary control

High protein diets lead to highest PYY levels in the body and the greatest curb in hunger in both obese and normal weight people.

Overall, however, the PYY levels were lower in the obese individuals than in the normal weight individuals. The associated reduction in appetite was also smaller when the person was obese.

The researchers decided to engineer mice that were genetically unable to produce PYY in order to study the long-term effects of a high protein diet.

The engineered mice ate more than normal mice and became obese, even when they were offered protein-rich foods.

When the researchers gave the mice PYY to treat their deficiency, their food consumption went down to normal levels, as did their weight.

When they withdrew the PYY treatment, the mice ate more and became obese again.

Long-term commitment

The researchers said small tweaks to meals - a couple of spoonfuls less of potato and an extra slice of meat - could make a difference.

Dr Batterham said: "We have proved that if you do not have PYY you become obese, and if you give it back then you lose the weight again."

She said the next step was to do longer studies in humans.

"It's not a diet that you would go on for a few months. You would go on it for life.

"We need to check that it would be compatible with lifestyle and look at the safety aspect."

Dr Batterham said the changes required to the average person's diet would be small - 2-3% increases in protein intake and small reductions in carbohydrate intake.

"It's not drastic. It's subtle changes. Less potato and slightly more meat with your main meal, for example."

She suspects that there is an evolutionary explanation for why protein is most satiating, with protein making up a substantial part of hunter-gatherer diets.

Rachel Cooke from the British Dietetics Association said: "More research is certainly needed on this type of dietary regimen before firm recommendations can be made about its long-term safety and efficacy."

Source: BBC News

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Overweight Tots Apt to Stay Fat

Don't Count on Overweight Children Outgrowing Extra Weight, Researchers Say

Americans' weight problems may start as early as toddlerhood, and don't always fade with maturity, a new study shows.

The study looked at more than 1,000 American children and appears in the September issue of Pediatrics, the official journal of the American Academy of Pediatrics. Its take-home message: Don't assume kids will outgrow their childhood chubbiness.

"Sixty percent of children who were overweight at any time in the preschool period, and 80% of the children who were overweight at any time during the elementary period were overweight at age 12 years," write Philip Nader, MD, of the University of California, San Diego, and colleagues in the study.

Results were similar for boys and girls.

It may be better to address plumpness early on, "rather than delaying in hopes that overweight and the patterns that support it will resolve themselves in due course," write the researchers.

Nader's team studied children in 10 U.S. cities from age 2 to 12. The children were born in 1991, when America's waistline had already started to expand.

The researchers tracked the kids' BMI (body mass index, a measure based on height and weight). Overweight was defined as having a BMI in the top 15% for their age group.

The study found that those overweight at any time before age 12 -- even at the tender age of 2 -- were more likely to be overweight at 12.

About the Study

The kids' height and weight were measured seven times -- at ages 2, 3, 4 1/2, 7, 9, 11, and 12.

Using the measurements, the researchers calculated the children's BMI.

"The more times a child was overweight, the greater the odds of being overweight at age 12 years relative to a child who was never overweight," Nader's team writes.

The reverse was also true. Kids at the lower end of the BMI range for their age tended not to be overweight at age 12.

Other studies have shown similar results, though they may not have tracked kids' BMI as closely, Nader's team notes.

Time to Step In?

"Any time a child reaches the 85th percentile for BMI may be an appropriate time for intervention," Nader says, in a UC San Diego news release.

He offers some specific advice for parents.

"Parents should demand that the environment that their child is exposed to include healthy foods, less exposure to TV and sedentary activities, and safe, active places for physical activity, including neighborhood parks and quality physical education in schools," Nader says.

Kids are growing and need good nutritionnutrition, so grown-up diets may not be appropriate. Concerned parents should consult the child's doctor for guidance.

Findings in Focus

The study has some limitations. It doesn't show what the kids ate, how active they were, whether they tried to lose weight, or whether their parents were overweight.

The findings don't mean all overweight toddlers will become overweight tweens, or that lean children will stay slender.

In fact, the study shows that 40% of the kids ever overweight in preschool, and 20% of those ever overweight in elementary school, were not overweight at age 12.

Still, not being overweight "is a positive health goal for most individuals," and, "efforts to reduce overweight need to begin in childhood," write Nader and colleagues.

Source: WebMD.com

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Protein Triggers Weight Loss Hormone

Eating protein triggers a natural weight-loss hormone, British researchers say.

When released in the gut, the hormone known as PYY reduces hunger. And high-protein foods set off PYY better than other foods, according to Rachel L. Batterham, M.D., of University College London, and colleagues.

Recent studies suggest PYY is part of the solution to obesity. Compared with a normal-weight person, for example, an obese person has to eat twice as many calories to trigger PYY.

"We've now found that increasing the protein content of the diet augments the body's own PYY, helping to reduce hunger and aid weight loss," Batterham says, in a news release.

If this sounds like the Atkins Diet, Batterham and colleagues say it's not. They note that many people on the Atkins Diet eat a lot of saturated fat as well as a lot of protein.

Obesity, Men, And Mice

Is PYY really the key to obesity? Batterham's team first looked at what kind of food best satisfies hunger. They studied nine obese men and 10 normal-weight men. After brief fasts, the men ate different meals. Each of the meals — a high-protein meal, a high-fat meal, and a high-carbohydrate meal — had the same number of calories.

All the men said the high-protein meal best satisfied their hunger. Interestingly, the normal-weight men found the high-fat meal more satisfying than the high-carb meal, while the obese men did not.

Measurements showed the high-protein meal triggered the most PYY in all of the men. In the normal-weight men — but not the obese men — the high-fat meal triggered more PYY than the high-carb meal.

Batterham's team genetically engineered a mouse strain that did not have the PYY gene. These mice ate huge amounts of food, and quickly became obese.

Normally, obese mice fed a high-protein diet will eat less and lose weight. But a high-protein diet didn't help the PYY-defective mice lose weight — unless they also got PYY treatments.

Hunters Vs. Farmers

Why does protein trigger PYY and satisfy hunger so well? It's not entirely clear. But Batterham and colleagues suggest we blame our ancestors.

The prehistoric humans whose genes we inherit had a different diet than we do. They got 19 percent to 35 percent of their energy from protein and 22 percent to 40 percent from carbs. Our modern diet gets 49 percent of its energy from carbs and only 16 percent protein.

"One potential weight loss strategy is therefore to increase the satiating power of the diet and promote weight loss through the addition of dietary protein — harnessing our own satiety system," Batterham says. "Such a diet is perhaps more typical to that of our hunter-gatherer ancestors."

The findings appear in the September issue of the journal Cell Metabolism.

Source: CBS News

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EFSA Reconfirms Safety of Noni Juice

EFSA was asked for scientific advice to assess whether case reports of acute hepatitis had an impact on the safety of noni juice a fruit juice made from the fruit of “noni”. Noni juice was authorised in 2003 as a novel food ingredient.

The European Food Safety Authority’s (EFSA) Panel on dietetic products, nutrition and allergies (NDA) has come to the conclusion that there is no convincing evidence for a causal relationship between the acute hepatitis observed in case reports and the consumption of noni juice.

EFSA was asked for scientific advice by the European Commission to assess whether case reports of acute hepatitis had an impact on the safety of noni juice a fruit juice made from the fruit of “noni”.

Noni juice was authorised in 2003 to be put on the market as a novel food ingredient. The NDA Panel On the basis of the available information, it is unlikely that consumption of noni juice at the observed levels of intake induces adverse human liver effects. It should be emphasized that EFSA did not investigate or evaluate possible health benefits associated with noni juice nor the scientific validity of any related health claims.

Noni juice is made from the fruit of the Morinda citrifolia L. plant, sometimes known as the Indian Mulberry. It was authorised in the European Union in 2003 for use as a novel food ingredient in pasteurised fruit drinks, under the Novel Foods Regulation, after its safety was assessed in a risk assessment carried out by the EU’s former Scientific Committee on Food (SCF).

Following information from the Austrian authorities, the European Commission asked EFSA to re-assess the safety of noni juice by reviewing recent case reports of severe hepatitis in people consuming noni juice. In addition, EFSA’s NDA Panel considered various data including studies conducted with humans and laboratory animals to test potential toxicity, as well as data on noni juice consumption in Europe.

In conclusion, the Panel confirmed the findings of the SCF regarding the studies on toxicity as well as genotoxicity and allergenicity. From a toxicological point of view, noni juice has been adequately tested. On the basis of the available information, it is unlikely that consumption of noni juice at the observed levels of intake induces adverse human liver effects. The Panel concluded that there is no convincing evidence for a causal relationship between the acute hepatitis observed in the case studies reported and the consumption of noni juice.

EFSA said that it should be underlined that EFSA focussed on the safety assessment and the Panel did not evaluate health claims related to the consumption of noni juice.

Source: Nutrition Horizon

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