Obesity

Posted on Cognitive dysfunction, Dementia, Diabetes, Diet, Obesity

Restricting sugar consumption in utero and in early childhood significantly reduces risk of midlife chronic disease

New research shows combined use of sodium glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) is likely to offer additional protection against heart and kidney disease in patients with diabetes

A new study has found that a low-sugar diet in utero and in the first two years of life can meaningfully reduce the risk of chronic diseases in adulthood. This provides compelling new evidence of the lifelong health effects of early-life sugar consumption.

A study published in the journal Science reveals that children who had sugar restrictions during their first 1,000 days after conception faced up to a 35% lower risk of developing Type 2 diabetes and a 20% reduced risk of hypertension in adulthood. The research indicates that low sugar intake by mothers during pregnancy was sufficient to lower these health risks, and maintaining sugar restrictions after birth further enhanced the benefits.

Using an unintended “natural experiment” from World War II, researchers at the USC Dornsife College of Letters, Arts and Sciences, McGill University in Montreal, and the University of California, Berkeley, examined how sugar rationing during the war influenced long-term health outcomes.

The United Kingdom introduced limits on sugar distribution in 1942 as part of its wartime food rationing program. Rationing ended in September 1953.

The researchers used contemporary data from the U.K. Biobank, a database of medical histories and genetic, lifestyle and other disease risk factors, to study the effect of those early-life sugar restrictions on health outcomes of adults conceived in the U.K. just before and after the end of wartime sugar rationing.

“Studying the long-term effects of added sugar on health presents challenges,” explains Tadeja Gracner, a senior economist at the USC Dornsife Center for Economic and Social Research and the study’s corresponding author. “It is difficult to identify situations where individuals are randomly exposed to different nutritional environments early in life and tracked over a span of 50 to 60 years. The end of rationing provided us with a unique natural experiment that helped us overcome these obstacles.”

On average, during rationing, sugar intake was about 8 teaspoons (40 grams) per day. When rationing ended, sugar and sweets consumption skyrocketed to about 16 teaspoons (80 grams) per day. 

Notably, rationing did not involve extreme food deprivation overall. Diets generally appeared to have been within today’s guidelines set by the U.S. Department of Agriculture and the World Health Organization, which recommend no added sugars for children under two and no more than 12 teaspoons (50g) of added sugar daily for adults. 

The immediate and large increase in sugar consumption but no other foods after rationing ended created an interesting natural experiment: Individuals were exposed to varying levels of sugar intake early in life, depending on whether they were conceived or born before or after September 1953. Those conceived or born just before the end of rationing experienced sugar-scarce conditions compared to those born just after who were born into a more sugar-rich environment.

The researchers then identified those born in the U.K. Biobank data collected over 50 years later. Using a very tight birth window around the end of sugar rationing allowed the authors to compare midlife health outcomes of otherwise similar birth cohorts.  

While living through the period of sugar restriction during the first 1,000 days of life substantially lowered the risk of developing diabetes and hypertension, for those later diagnosed with either of those conditions, the onset of disease was delayed by four years and two years, respectively. 

Notably, exposure to sugar restrictions in utero alone was enough to lower risks, but disease protection increased postnatally once solids were likely introduced. 

The researchers say the magnitude of this effect is meaningful as it can save costs, extend life expectancy, and, perhaps more importantly, improve quality of life.

In the United States, individuals with diabetes face average annual medical expenses of approximately $12,000. Additionally, an earlier diagnosis of diabetes is associated with a significantly reduced life expectancy; specifically, for each decade that diagnosis occurs earlier, life expectancy decreases by three to four years.

The researchers note that these numbers underscore the value of early interventions that could delay or prevent this disease.

Experts continue to raise concerns about children’s long-term health as they consume excessive amounts of added sugars during their early life, a critical period of development. Adjusting child sugar consumption, however, is not easy—added sugar is everywhere, even in baby and toddler foods, and children are bombarded with TV ads for sugary snacks, say the researchers.

“Parents need information about what works, and this study provides some of the first causal evidence that reducing added sugar early in life is a powerful step towards improving children’s health over their lifetimes,” says study co-author Claire Boone of McGill University and University of Chicago.  

Co-author Paul Gertler of UC Berkeley and the National Bureau of Economics Research adds: “Sugar early in life is the new tobacco, and we should treat it as such by holding food companies accountable to reformulate baby foods with healthier options and regulate the marketing and tax sugary foods targeted at kids.” 

This study is the first of a larger research effort exploring how early-life sugar restrictions affected a broader set of economic and health outcomes in later adulthood, including education, wealth, and chronic inflammation, cognitive function and dementia. 

Posted on A to Z of Medical Conditions, Diabetes, Obesity

Brighter nights and darker days could lead to an early grave

Are you protecting your children’s eyes from the sun this summer?

A study of more than 13 million hours of data collected from light sensors worn by 89,000 people has found exposure to bright nights and dark days is associated with an increased risk of death.

Researchers investigated whether personal day and night light and lighting patterns that disrupt our circadian rhythms predicted mortality risk.

Published in the journal Proceedings of the National Academy of Sciences, the findings indicate that individuals exposed to high levels of light at night faced a 21% to 34% increased risk of death. In contrast, those exposed to high levels of daylight experienced a 17% to 34% decrease in their risk of death.

“Exposure to brighter nights and darker days can disrupt our circadian rhythms. This disruption can lead to various health issues, including diabetes, obesity, cardiovascular disease, mental health problems, and an increased risk of death,” explains Professor Sean Cain, a senior author and sleep expert from Flinders University.

“These new insights into the potential adverse impact of light have shown us just how important personal light exposure patterns are for your health.”

Associate Professor Andrew Phillips, co-senior author, states that nighttime light exposure disrupts circadian rhythms by shifting their timing (phase-shift) and weakening the signal (amplitude suppression) of the central circadian ‘pacemaker,’ which regulates circadian rhythms throughout the body.

“Disruption to the body’s circadian rhythms is linked to the development of metabolic syndrome, diabetes, and obesity and is also strongly implicated in the development of cardiometabolic diseases, including myocardial infarction, stroke and hypertension,” says Associate Professor Phillips.

“The observed relationships of night light exposure with mortality risk may be explained by night light disrupting circadian rhythms, leading to adverse cardiometabolic outcomes.

“Our findings clearly show that avoiding night light and seeking daylight may promote optimal health and longevity, and this recommendation is easy, accessible and cost-effective,” adds Associate Professor Phillips.

The study authors from FHMRI Sleep Health investigated the relationship between personal light exposure and the risk of all-cause and cardiometabolic mortality in 89,000 participants from the UK Biobank, aged between 40 and 69. Metrics were recorded using wrist-worn sensors, and the National Health Service collected the participants’ mortality data over an approximate follow-up period of eight years.

Sleep duration, sleep efficiency, and midsleep were estimated from motion data. At the same time, cardiometabolic mortality was defined as any cause of death corresponding to diseases of the circulatory system or endocrine and metabolic diseases.

The research also showed a disrupted circadian rhythm predicted higher mortality risk, which the authors were able to determine using computer modelling. Findings accounted for age, sex, ethnicity, photoperiod, and sociodemographic and lifestyle factors.

Lead author Dr Daniel Windred says that the findings demonstrate the importance of maintaining a dark environment during the late night and early morning hours, when the central circadian ‘pacemaker’ is most sensitive to light, and seeking bright light during the day to enhance circadian rhythms.

“Protection of lighting environments may be significant in those at risk for circadian disruption and mortality, such as in intensive care or aged-care settings,” says Dr Windred.

“Across the general population, avoiding night light and seeking daylight may lead to a reduction in disease burden, especially cardiometabolic diseases, and may increase longevity.”

Posted on Diabetes, Obesity

Sustained remission of diabetes and other obesity-related conditions found a decade after weight loss surgery

Study finds that type 2 diabetes patients treated with GLP-1RAs who lowered their BMI also reduced their cardiovascular risk

A study published in the New England Journal of Medicine found that ten years after undergoing bariatric surgery during their teenage years, more than half of the participants maintained significant weight loss. Additionally, many of these individuals showed improvements in obesity-related conditions, including type 2 diabetes, high blood pressure, and high cholesterol.

“Our study demonstrates remarkable results from the longest follow-up of weight loss surgery during adolescence, confirming that bariatric surgery is a safe and effective long-term strategy for managing obesity,” stated lead author Justin Ryder, PhD. He is the Vice Chair of Research in the Department of Surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and an Associate Professor of Surgery and Pediatrics at Northwestern University Feinberg School of Medicine.

Bariatric surgery is significantly under-utilized in the U.S., with only one out of every 2,500 teens with severe obesity undergoing the procedure. Based on existing recommendations, nearly five million adolescents qualify for effective weight loss interventions, such as bariatric surgery.

Hillary Fisher, now 31 years old, is glad she decided to undergo surgery at the age of 16. She was one of 260 adolescents who participated in the long-term Teen-LABS study.

“I felt overwhelmed by the daily struggles I faced due to my weight, health issues, and bullying in high school,” Ms. Fisher said. “After several unsuccessful attempts to lose weight, I weighed 260 pounds, and we decided that bariatric surgery was the solution. It changed my life; the improved health and self-esteem that came with losing 100 pounds were significant for me, and I would absolutely do it again.”

Notably, the study found that 55 per cent of the participants who had type 2 diabetes as teenagers and underwent surgery were still in remission of their diabetes at 10 years. 

“This is considerably better than the outcomes reported in people who underwent bariatric surgery as adults, a major reason why treating obesity seriously in adolescents is so important,” added Dr. Ryder. 

Indeed, a recent multi-centre randomized controlled trial found diabetes type 2 remission in adults to be 12-18 per cent at seven to 12 years after bariatric surgery.

Posted on Exercise, Obesity, Weight Loss

Study finds intense exercise may suppress appetite in healthy humans

What is moderate and vigorous exercise?

A rigorous workout suppresses hunger more than moderate exercise in healthy adults, with females potentially more affected, according to a small study published in the Journal of the Endocrine Society.

The study investigates how exercise intensity affects ghrelin levels and appetite in men and women. Ghrelin, known as the “hunger hormone,” is linked to feelings of hunger.

“We discovered that high-intensity exercise reduces ghrelin levels more effectively than moderate-intensity exercise,” said lead author Kara Anderson, Ph.D., from the University of Virginia and the University of Virginia Health System in Charlottesville, Virginia. “Additionally, we found that individuals felt ‘less hungry’ after high-intensity exercise compared to when they engaged in moderate-intensity exercise.”

Ghrelin circulates in acylated (AG) and deacylated (DAG) forms, which are known to affect appetite. The study noted that data on the impact of exercise intensity on AG and DAG levels and their effects on appetite is sparse and primarily limited to males.

To address this shortfall, the study examined eight males and six females. Participants fasted overnight and then completed exercises of varying intensity levels, determined by blood lactate measurements, followed by self-reported measurements of appetite.

The study noted that females had higher levels of total ghrelin at baseline compared with males. However, only females demonstrated “significantly reduced AG” following the intense exercise.

“We found that moderate intensity either did not change ghrelin levels or led to a net increase,” the study noted. These findings suggest that exercise above the lactate threshold “may be necessary to elicit a suppression in ghrelin.”

Researchers also acknowledged that more work is needed to determine the extent to which exercise’s effects differ by sex.

Ghrelin has been shown to have wide-ranging biological effects in areas including energy balance, appetite, glucose homeostasis, immune function, sleep, and memory.

“Exercise should be thought of as a ‘drug,’ where the ‘dose’ should be customized based on an individual’s personal goals,” Anderson said. “Our research suggests that high-intensity exercise may be important for appetite suppression, which can be particularly useful as part of a weight loss program.”

Posted on Obesity

Innovative nanoparticle therapy targets fat absorption to combat obesity

Researchers have unveiled a novel approach to tackle obesity by targeting fat absorption in the small intestine.
Researchers have unveiled a novel approach to tackle obesity by targeting fat absorption in the small intestine.

Researchers have introduced a new method to address obesity by targeting fat absorption in the small intestine. The advanced nanoparticle system, designed to transport therapeutic molecules directly to the digestive tract, has displayed significant potential in preventing diet-induced obesity.

Presented today at UEG Week 2024, the study focuses on an enzyme called Sterol O-acyltransferase 2 (SOAT2), which plays a critical role in fat absorption in the small intestine.3,4 By inhibiting this enzyme, the study offers a promising therapeutic approach to reducing fat absorption and potentially preventing obesity.

Despite extensive research into fat metabolism, effective inhibitors of intestinal fatty acid uptake have remained elusive until now. Lead researcher Dr. Wentao Shao explained, “For years, researchers have studied fat metabolism, but finding an effective way to block fat absorption has been difficult. While most strategies focus on reducing dietary fat intake, our approach targets the body’s fat absorption process directly.”

The research team has developed an innovative delivery system using nanoparticles. These are tiny capsules made from a polymer core and coated in a protective shell. The system is designed to efficiently carry small interfering RNAs (siRNAs) to the small intestine. Once there, the siRNAs can reduce SOAT2 expression, which in turn inhibits fat absorption. In mouse models, the animals treated with nanoparticle therapy absorbed less fat and avoided obesity, even when on a high-fat diet.

“This oral treatment offers several advantages”, said Dr Shao. “It’s non-invasive, has low toxicity, and it has high potential for better patient compliance compared to current obesity treatments, which are often invasive or difficult to maintain. This makes it a promising alternative.”

The study also uncovered the underlying mechanism by which SOAT2 regulates fat absorption. Inhibition of SOAT2 in the small intestine triggers the degradation of CD36, a protein responsible for transporting fat. This process involves both cellular stress and the recruitment of E3 ligase RNF5, an enzyme that enhances CD36 degradation.

Previous studies have shown that blocking hepatic SOAT2 leads to fat accumulation in the liver, 5,6  whereas this intestine-specific approach circumvents that risk, offering a safer and more focused treatment for obesity.