Chocolate May Lower Risk of Heart Failure
Posted by on August 20, 2010 - 10:04am

Benefits shown in middle-aged and elderly women

Middle-aged and elderly Swedish women who regularly ate a small amount of chocolate had lower risks of heart failure risks, in a study reported in Circulation: Heart Failure, a journal of the American Heart Association.  The nine-year study, conducted among 31,823 middle-aged and elderly Swedish women, looked at the relationship of the amount of high-quality chocolate the women ate, compared to their risk for heart failure. The quality of chocolate consumed by the women had a higher density cocoa content somewhat like dark chocolate by American standards. In this study, researchers found:

  • Women who ate an average of one to two servings of the high-quality chocolate per week had a 32 percent lower risk of developing heart failure.
  • Those who had one to three servings per month had a 26 percent lower risk.
  • Those who consumed at least one serving daily or more didn’t appear to benefit from a protective effect against heart failure.

The lack of a protective effect among women eating chocolate every day is probably due to the additional calories gained from eating chocolate instead of more nutritious foods, said Murrray Mittleman, M.D., Dr.P.H., lead researcher of the study.  “You can’t ignore that chocolate is a relatively calorie-dense food and large amounts of habitual consumption is going to raise your risks for weight gain,” said Mittleman, director of the Cardiovascular Epidemiology Research Unit at Harvard Medical School’s Beth Israel Deaconess Medical Center in Boston. “But if you’re going to have a treat, dark chocolate is probably a good choice, as long as it’s in moderation.”

High concentration of compounds called “flavonoids” in chocolate may lower blood pressure, among other benefits, according to mostly short-term studies. However, this is the first study to show long-term outcomes related specifically to heart failure, which can result from ongoing untreated high blood pressure.   In the observational study, researchers analyzed self-reported food-frequency questionnaire responses from participants 48-to-83-years-old in the Swedish Mammography Cohort. Combining the results with data from national Swedish hospitalization and death registries between 1998 through 2006, the researchers used multiple forms of statistical modeling to reach their conclusions on heart failure and chocolate consumption.

Mittleman said differences in chocolate quality affect the study’s implications for Americans. Higher cocoa content is associated with greater heart benefits. In Sweden, even milk chocolate has a higher cocoa concentration than dark chocolate sold in the United States.    Although 90 percent of all chocolate eaten across Sweden during the study period was milk chocolate, it contained about 30 percent cocoa solids. U.S. standards only require 15 percent cocoa solids to qualify as dark chocolate. So, by comparison, American chocolate may have fewer heart benefits and more calories and fat per equivalent amounts of cocoa content compared to the chocolate eaten by the Swedish women in the study.   Also, the average serving size for Swedish women in the study ranged from 19 grams among those 62 and older, to 30 grams among those 61 and younger. In contrast, the standard American portion size is 20 grams.

“Those tempted to use these data as their rationale for eating large amounts of chocolate or engaging in more frequent chocolate consumption are not interpreting this study appropriately,” said Linda Van Horn, Ph.D., R.D., immediate past chair of the American Heart Association Nutrition Committee and professor in the Department of Preventive Medicine at Northwestern University’s Feinberg School of Medicine in Chicago. “This is not an ‘eat all you want’ take-home message, rather it’s that eating a little dark chocolate can be healthful, as long as other adverse behaviors do not occur, such as weight gain or excessive intake of non-nutrient dense ‘empty’ calories.”

Heart failure occurs among about 1 percent of Americans over age 65. A condition in which the heart can’t pump enough blood to the rest of the body, heart failure rates are increasing as our aging population grows.“Anything that helps to decrease heart failure is an important issue worth examining,” Mittleman said.

Co-authors are Elizabeth Mostofsky, M.P.H.; Emily Levitan, Sc.D.; and Alicja Wolk, Dr.Med.Sci. Author disclosures and funding support are on the manuscript.

Source: Press release prepared by the American Heart Association

Tobacco Smoke Exposure Increases Chronic Disease in Children
Posted by on August 10, 2010 - 2:45pm

In July, a commentary in the journal Pediatrics discussed several new studies that have increased our knowledge of the  association between tobacco smoke exposure and childhood morbidity and mortality.  Collectively, these new reports demonstrate that in several categories of chronic childhood illness (asthma, obesity, and mental health disorders) there are small-to-moderate independent associations with tobacco smoke exposure either during pregnancy or in the postnatal period.   A moderate association with tobacco smoke and dental caries (cavities) in children was also reported.   One study found an association between smoke exposure of pregnant women and subsequent childhood overweight in offspring.   What was especially significant about the latter study was the fact that it was conducted in pregnant women who did NOT smoke but were exposed to smoke from the father.  Studies looking at mothers who smoke continue to show an association to their children's mental health status that affects their children's  ability to participate in social activities and make friends.

Colorless Diet for Weight Loss?
Posted by on July 28, 2010 - 4:00pm

I just received a FDA email about the safety of color additives in food.   What caught my eye was the subheading:  "Without color additives, colas wouldn't be brown, margarine wouldn't be yellow and mint ice cream wouldn't be green."   I  wonder if colorless food could help reduce the obesity epidemic!!!   Seriously, to read the article, click here.

Obesity and Body Shape Linked to Poorer Brain Function in Women
Posted by on July 14, 2010 - 12:05pm

CHICAGO --- The more an older woman weighs, the worse her memory, according to new research from Northwestern Medicine. The effect is more pronounced in women who carry excess weight around their hips, known as pear shapes, than women who carry it around their waists, called apple shapes.  The study of 8,745 cognitively normal, post-menopausal women ages 65 to 79 from the Women's Health Initiative hormone trials is the first in the United States to link obesity to poorer memory and brain function in women and to identify the body-shape connection.

"The message is obesity and a higher Body Mass Index (BMI) are not good for your cognition and your memory," said lead author Diana Kerwin M.D., an assistant professor of medicine and a physician at Northwestern Medicine. "While the women's scores were still in the normal range, the added weight definitely had a detrimental effect."

For every one-point increase in a woman's BMI, her memory score dropped by one point. The women were scored on a 100-point memory test, called the Modified Mini-Mental Status Examination. The study controlled for such variables as diabetes, heart disease and stroke.   The study will be published July 14 in the Journal of the American Geriatric Society.

The reason pear-shaped women experienced more memory and brain function deterioration than apple-shaped women is likely related to the type of fat deposited around the hips versus the waist. "Obesity is bad, but its effects are worse depending on where the fat is located," Kerwin said.

Cytokines, hormones released by the predominant kind of fat in the body that can cause inflammation, likely affect cognition, Kerwin said. Scientists already know different kinds of fat release different cytokines and have different effects on insulin resistance, lipids and blood pressure.

"We need to find out if one kind of fat is more detrimental than the other, and how it affects brain function," she said. "The fat may contribute to the formation of plaques associated with Alzheimer's disease or a restricted blood flow to the brain."    In the meantime, the new findings provide guidance to physicians with overweight, older female patients.

"The study tells us if we have a woman in our office, and we know from her waist-to-hip ratio that she's carrying excess fat on her hips, we might be more aggressive with weight loss," Kerwin said. "We can't change where your fat is located, but having less of it is better."

Kerwin's research is funded by the T. Franklin Williams Award from Atlantic Philanthropies and Association of Specialty Professors and the Wisconsin Women's Health Foundation Faculty Scholar Award. The Women's Health Initiative was funded by a grant from the National Heart, Lung and Blood Institute.

Marla Paul is the health sciences editor. Contact her at marla-paul@northwestern.edu

Will Better Health Insurance Coverage Reduce Obesity?
Posted by on April 14, 2010 - 9:31am

The Agency for Healthcare Research and Quality issued its 2009 National Healthcare Quality Report and National Healthcare Disparities Report on April 13.  The 2009 reports include a new section on lifestyle modifications because preventing or reducing obesity is a crucial national goal. The reports found:

  • One-third of obese adults have NEVER received advice from their doctor about exercise.
  • Obese adults who are black, Hispanic, poor or have less than a high school education are LESS likely to receive diet advice from their doctors.
  • Most overweight children and one-third of obese adults report that they have NOT been told by their doctor that they are overweight.
  • Most American children have NEVER received counseling from their health care provider about exercise, and almost half have NEVER received counseling about healthy eating.

The reports indicate that the lack of health insurance slows improvement in health care quality and reduction of disparities.  For many services, not having insurance is the single strongest predictor of poor quality care, exceeding the effects of race,  ethnicity, income or education.

So, the BIG question....will expanding health insurance to more people change some of these statistics????   Let's hope so.

Twice as Many Women to be Diagnosed with Gestational Diabetes
Posted by on February 26, 2010 - 5:13pm

According to a study that was coordinated by investigators at Northwestern University's Feinberg School of Medicine, two to three times more pregnant women may soon be diagnosed and treated for gestational diabetes, based on new measurements for determining risky blood sugar levels for the mother and her unborn baby.

“As result of this study, more than 16 percent of the entire population of pregnant women qualified as having gestational diabetes,” said lead author Boyd Metzger, MD.  “Before, between 5 to 8 percent of pregnant women were diagnosed with this.”

Blood sugar levels that were once considered in the normal range are now seen as causing a sharp increase in the occurrence of overweight babies with high insulin levels, early deliveries, cesarean section deliveries and potentially life-threatening preeclampsia, a condition in which the mother has high blood pressure that affects her and the baby. Large babies, the result of fat accumulation, are defined as weighing in the upper 10 percent of babies in a particular ethnic group. Because large babies increase the risk of injury during vaginal delivery, many of the women in the study were more likely to have a cesarean section.  To view entire news report written by science writer, Marla Paul click here.

November is American Diabetes Month!
Posted by on November 2, 2009 - 10:42am

Diabetes mellitus is an endocrine disease affecting approximately 7% of the US population.  Diabetes is categorized into two classes: Type 1, or insulin dependent diabetes, and Type 2, or adult onset diabetes.

Type 1 Diabetes is a condition in which the pancreas produces little or no insulin, a hormone necessary for the metabolism of glucose.  Type 1 Diabetes is generally diagnosed in childhood or early adolescence and is considered to be primarily genetic in origin.  Symptoms include extreme hunger, fatigue, rapid weight loss and blurry vision.  There is no cure for Diabetes, but successful treatment includes insulin injections, blood sugar monitoring, a healthy diet, and regular exercise.

Type 2 Diabetes accounts for 90-95% of all Diabetes cases in the United States.  In Type 2 Diabetes, the body is either insulin resistant or the pancreas does not produce enough insulin.  This type is often preventable and is strongly linked to obesity.  Symptoms are similar to Type 1 Diabetes but, depending on the severity, treatment may only include blood sugar monitoring, a healthy diet, and regular exercise.  Severe or advanced cases may require medication and/or insulin injections.

Resources at Northwestern for Diabetes:

The Division of Endocrinology at Northwestern Memorial Hospital provides comprehensive diagnosis and treatment for a variety of endocrine related disorders.  Physicians in the department specialize in endocrine tumors, endocrine disease genetics, gestational diabetes, and offer specialized services in diagnosis and treatment of Type 1 and Type 2 Diabetes.  The department participates in a variety of NIH-sponsored research trials.  Results from NMH’s participation in the National Institute’s of Health 10-year study on prevention of type 2 diabetes can be found at http://www.feinberg.northwestern.edu/news/2009C-October/Diabetes.html.

Click to see physician finder:

http://nmhphysicians.photobooks.com/

Northwestern Physicians/ Researchers specializing in Diabetes treatment:

The Division of Endocrinology, Metabolism, and Molecular Medicine at Northwestern University features a diverse faculty, many of whom are leaders in their field.  The department, headed by Dr. Andrea Dunaif, is committed to clinical and basic science research development and training.  The research interests of the department are diverse and extend to multiple subfields of endocrinology.  Researchers studying diabetes include Dr. Franck Mauvais-Jarvis, who studies the role of estrogen receptors in pancreatic cells, Dr. M. Geoffrey Hayes, PhD, who studies the genetic components of diabetes, and Dr. Boyd E. Metzger, MD, whose research on gestational diabetes has been widely published.

IWHR Highlighted Researcher

Dr. Robert F Kushner, MD, MS is the Clinical Director of the Northwestern Comprehensive Center on Obesity and a Professor of Medicine at the Feinberg School of Medicine.  Dr. Kushner has published various books, book chapters, and articles and serves on the editorial board of various prestigious journals including Obesity, Obesity Management, and the Journal of the American Dietetic Association.  Popular publications include Dr. Kushner’s Personality Type Diet, Treatment of the Obese Patient and Fitness Unleashed: A Dog and Owner’s Guide to Losing Weight and Gaining Health Together.  Although Dr. Kushner’s research interests are in obesity and nutrition, his research and publications have implications for a diabetic population.  Recently he published a study in Obesity examining various lifestyle interventions for prevention of weight gain in type II diabetic patients taking the common diabetes medication pioglitazone (Actos®).  The study showed that the weight gain side effects commonly associated with this medication can be diminished or alleviated by lifestyle interventions such as medical nutrition therapy (MNT).  The greatest success was seen in patients who received intensive follow up MNT, which included lessons in meal planning, food preparation, goal-setting and exercise recommendations.

For information on Dr. Kushner or to purchase his books:

http://www.counselingoverweightadults.com/

Other Useful Links and Resources:

http://www.nlm.nih.gov/medlineplus/diabetes.html
http://www.cdc.gov/diabetes/
http://www.diabetes.org
http://www.dlife.com/

Eat Less, Move More
Posted by on August 31, 2009 - 8:57am

Research has shown that portion control may be the most  effective form of dieting when you take into account longevity and sustained weight loss and management.  The reason, according to Dr. Everett Logue et al. in Obesity (http://www.nature.com/oby/journal/v12/n9/full/oby2004187a.html) may be that portion control is an easier behavioral target than planned exercise.  Although increasing consumption of fruits and vegetables may be the easiest way to change behaviorally, it does not appear to be as effective in long term weight reduction.

Okay, so all I have to do is eat a little less, and move a little more.  Well, it’s not that simple.  If you’ve tried portion control in the past like I have, you might be rolling your eyes.  Actually, 36% of women in the Illinois Women’s Health Registry are currently using portion control to lose weight, while only 20% are trying exercise.   So how can we make portion control work for us?  The important thing to understand is that portion sizes are often FAR LESS than we think they are.  In fact, research has shown that Americans typically underestimate their caloric intake by as much as 25%.  So if I think I’m only eating 1600 Calories (a typical weight loss goal), I might actually be eating 2,000.  It’s also important to know that women and men of similar height and weight do NOT have the same caloric needs.   Metabolism in women works differently; men generally have a higher Basal Metabolic Rate (BMR), which is the rate at which our bodies break down calories.  In other words, we don’t need to eat as much as our male counterparts…sorry ladies, but try leaving that second helping to him.

So what is the correct portion size?  Well we are probably all familiar with the serving size values:

1 cup green and leafy vegetables or ½ cup mashed potatoes for the veggies
½ - 1 cup of fruit or 1 oz dried fruit
½ cup rice, 1 cup (cooked) pasta, or a bagel for the grains
3 oz chicken, beef or fish for protein
1 cookie or a ½ cup ice cream for the sweets

But what do these sizes actually look like?  Well, sadly, a lot less than we’d like to think.  Here’s the run down:

Portions Table

For more portion size tips, see this cool tool at http://www.webmd.com/diet/healthtool-portion-size-plate

Even though portion control can be an effective weight loss method, it is still important to keep an active lifestyle and exercise regularly for a healthy weight AND a healthy heart!  Happy and Mindful Eating!

Watch your weight - for your brain's sake
Posted by on August 26, 2009 - 11:07am

News related to obesity has recently been splattered all over the news, even more than usual in my opinion.  The latest headline is that obese or overweight patients had significantly less brain matter than those whose weights were considered normal.  The research article, "Brain Structure and Obesity," resulted from a collaboration between the University of Pittsburgh and the University of California, Los Angeles (UCLA) and was published online this month in the scientific journal Human Brain Mapping.  The senior author on the publication was quoted in the U. S. News & World Report as saying, "The brains of obese people looked 16 years older than their healthy counterparts while [those of] overweight people looked 8 years older."

An important thing to note about the research article is that their test subjects were an average age of 77 years old; therefore, these specific results are only applicable to the elderly population.  I looked through the research article itself and was happy to see that the genders were fairly represented in the test groups, with women comprising approximately 50% of the patients tested in normal, overweight, and obese groups.  As presented in the paper, authors did not find any striking differences correlated to gender; their results were equally applicable to both men and women.  It was acknowledged that there is some controversy among scientists regarding the association between brain volume and gender, and the authors cited additional published studies from other laboratories.  It was noted in their conclusion that gender effects are an important variable to pay attention to in future studies.  You can access a summary of the research article here.

Obesity is a sensitive issue for everyone, but a 2006 study suggested that it may affect the quality of life of women more than men.  A team led by Dr. Peter Muennig of Columbia University looked at existing data from a 2000 survey on health and quality of life.  More than 13,000 adults participated in this survey administered by the U. S. Department of Health and Human Services.  Dr. Muennig and colleagues also incorporated data from 1990-1995 on death rates in the U. S. into their study.  They concluded that health-related drops in quality of life scores were four times higher for overweight women than overweight men, and more than two times higher for obese women than obese men.  More strikingly, the authors found that there were about twice as many deaths among overweight and obese women than for men (when compared to their normal-weight counterparts) for the time represented in their study.  WebMD has a nice summary of the article here (including its caveats), or you can access the full article for free through PubMed Central.

You can help further these studies by participating in ventures such as the Illinois Women's Health Registry, or similar surveys administered in your state (or country, etc.)!  What do you think about these studies and their results?   Has obesity affected you or your loved ones in any way?

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