Posted on Patient Talk

Weight loss beneficial for individuals with obesity, but not for the lean

Researchers find weight loss may be beneficial for individuals with obesity, but not for the lean


Researchers find weight loss may be beneficial for individuals with obesity, but not for the clean credit Kenny Eliason, Unsplash (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

Intentionally losing weight can bring long-term health benefits for individuals with obesity, regardless of the method or strategy they use, according to a study of almost 200,000 people. Those who lost more than 4.5kg had less weight gain and a lower risk of type 2 diabetes than those who did not lose weight, but lean individuals did not benefit, with weight loss attempts associated with longer-term weight gain and higher risks of type 2 diabetes. The research is publishing September 27thin the open-access journal PLOS Medicine.

Obesity can lead to higher risks of diseases including type 2 diabetes. Controlling weight can be an effective strategy for preventing and managing obesity and related diseases, though long-term weight change and risk of developing type 2 diabetes are not well studied.

Qi Sun and colleagues from the TH Chan Harvard School of Public Health, U.S., included healthy participants from three prospective cohort studies from 1988 – 2017. Individuals were aged between 24-78 and predominantly female — 11.6% male and 14.2% male in the cohorts. They grouped methods that led to weight loss of more than 4.5kg into seven categories: low-calorie diet, exercise, low-calorie diet plus exercise, fasting, commercial weight loss program, diet pills and a combination of fasting, commercial and diet pills (FCP).

Exercise was most effective for long-term weight control and prevention in individuals with obesity and associated with least weight gain after four years — 4.2% overall average less weight than at the start in individuals with obesity, 2.5% weight loss in overweight, and 0.4% in lean people. This was inverted for FCP, which saw individuals with obesity sustaining 0.3% weight loss, overweight people sustaining 2% more weight gain, and lean individuals 3.7% more weight gain.

24 years later, risk of diabetes was reduced for individuals with obesity irrespective of weight loss strategy – ranging from a 21% reduction for exercise to a 13% reduction for diet pills. For overweight individuals, the researchers saw a range of 9% reduction in type 2 diabetes risk for exercise to an increase of 42% risk for those who took pills, and in lean individuals, all weight loss was associated with an increased risk of type 2 diabetes — ranging from a 9% increase for exercise and a 54% increase for pills or FCP.

The authors conclude that while weight loss can be beneficial for those who are overweight and obese, weight loss strategies do not bring the same gains for lean individuals and weight loss strategies should be used only by those who medically need them.

“We were a bit surprised when we first saw the positive associations of weight loss attempts with faster weight gain and higher type 2 diabetes risk among lean individuals,” Sun adds. “However, we now know that such observations are supported by biology that unfortunately entails adverse health outcomes when lean individuals try to lose weight intentionally. Good news is that individuals with obesity will clearly benefit from losing a few pounds and the health benefits last even when the weight loss is temporary.”

Posted on Multiple Sclerosis

Diet high in guar gum fibre limits inflammation, MS symptoms in mice

What To Do With Guar Gum - YouTube

Diets high in guar gum, a common food additive and dietary fibre, limited inflammation and delayed the onset of multiple sclerosis (MS) symptoms in mice, according to new research by members of the University of British Columbia (UBC) Microbiology and Immunology department.

“The rapid increase of autoimmune and inflammatory disorders in industrialized countries in the last few decades indicates dietary choices are one environmental factor contributing to incidence,” said Dr. Lisa Osborne, senior researcher on the study and an assistant professor with UBC Microbiology and Immunology.

“Dietary fibres are potent modulators of immune responses and can control inflammation in multiple diseases, but they’re a very biochemically diverse family. Our study gives us a clearer window into the potential of several sources of fibre in maintaining immune health.”

Dr. Osborne and colleagues exposed groups of mice to a variety of diets—a control five percent cellulose fibre diet, a diet entirely lacking in dietary fibre, or diets enriched (30%) with fibre in either resistant starch, inulin, pectin, or guar gum. Quar gum was the only fibre type that significantly limited the MS-like symptoms. 

Guar gum—guaran—is extracted from guar beans, and is often used as an additive to thicken and stabilize food and animal feed, and in industrial applications. India and Pakistan are major growers of the bean.

“Guar beans aren’t that common in western diets, and the gum isn’t used at these high levels as an additive in the west,” says Naomi Fettig, first author on the study and a PhD student with the Department of Microbiology and Immunology at UBC.

“Experts have consistently been saying fibre is good for you—and a variety of fibre sources is important to immune health—but there hasn’t been very much critical work into identifying how the body responds to different fibre types. It’s fascinating that this particular source has such an impact.”

In the US and Canada, the average daily intake of fibre is 15 grams—current recommendations are double that at 30 grams. The recommended values don’t take into account any specific fibre type. “Incorporating guar beans might be challenging to achieve at the doses we gave to mice,” says Dr. Osborne. “But a guar gum derivative, partially hydrolyzed guar gum, is commercially available as a prebiotic.”

After the gum is broken down by the microbiota of mice, the resulting molecules appeared to reduce the activity and proliferation of a type of CD4+ T cells, Th1 cells, that play a key part in activating the autoimmune response. It’s that response that leads to MS-like symptoms in mice. The effects of fibre on Th1 cells remained largely unknown prior to this study, and these findings suggest that the biochemical differences in fibre structures can influence diverse immune pathways.   

Dr. Osborne and her lab now want to explore the potential benefits in humans—including developing a more detailed understanding of the molecular picture, which might help design therapeutics that offer the benefits of such high guar gum diets in a more practical form. 

Posted on Diet

Coffee drinking is associated with increased longevity

Coffee drinking is associated with increased longevity
Coffee drinking is associated with increased longevity

 

Drinking two to three cups of coffee a day is linked with a longer lifespan and lower risk of cardiovascular disease compared with avoiding coffee, according to research published today in the European Journal of Preventive Cardiology, a journal of the ESC.1 The findings applied to ground, instant and decaffeinated varieties.

“In this large, observational study, ground, instant and decaffeinated coffee were associated with equivalent reductions in the incidence of cardiovascular disease and death from cardiovascular disease or any cause,” said study author Professor Peter Kistler of the Baker Heart and Diabetes Research Institute, Melbourne, Australia. “The results suggest that mild to moderate intake of ground, instant and decaffeinated coffee should be considered part of a healthy lifestyle.”

There is little information on the impact of different coffee preparations on heart health and survival. This study examined the associations between types of coffee and incident arrhythmias, cardiovascular disease and death using data from the UK Biobank, which recruited adults between 40 and 69 years of age. Cardiovascular disease was comprised of coronary heart disease, congestive heart failure and ischaemic stroke.

The study included 449,563 participants free of arrhythmias or other cardiovascular disease at baseline. The median age was 58 years and 55.3% were women. Participants completed a questionnaire asking how many cups of coffee they drank each day and whether they usually drank instant, ground (such as cappuccino or filtered coffee), or decaffeinated coffee. They were then grouped into six daily intake categories, consisting of none, less than one, one, two to three, four to five, and more than five cups per day. The usual coffee type was instant in 198,062 (44.1%) participants, ground in 82,575 (18.4%), and decaffeinated in 68,416 (15.2%). There were 100,510 (22.4%) non-coffee drinkers who served as the comparator group.

Coffee drinkers were compared to non-drinkers for the incidence of arrhythmias, cardiovascular disease and death, after adjusting for age, sex, ethnicity, obesity, high blood pressure, diabetes, obstructive sleep apnoea, smoking status, and tea and alcohol consumption. Outcome information was obtained from medical records and death records. The median follow up was 12.5 years.

A total of 27,809 (6.2%) participants died during follow up. All types of coffee were linked with a reduction in death from any cause. The greatest risk reduction seen with two to three cups per day, which compared to no coffee drinking was associated with a 14%, 27% and 11% lower likelihood of death for decaffeinated, ground, and instant preparations, respectively.

Cardiovascular disease was diagnosed in 43,173 (9.6%) participants during follow up. All coffee subtypes were associated with a reduction in incident cardiovascular disease. Again, the lowest risk was observed with two to three cups a day, which compared to abstinence from coffee was associated with a 6%, 20%, and 9% reduced likelihood of cardiovascular disease for decaffeinated, ground, instant coffee, respectively.

An arrhythmia was diagnosed in 30,100 (6.7%) participants during follow up. Ground and instant coffee, but not decaffeinated, was associated with a reduction in arrhythmias including atrial fibrillation. Compared with non-drinkers, the lowest risks were observed with four to five cups a day for ground coffee and two to three cups a day for instant coffee, with 17% and 12% reduced risks, respectively.

Professor Kistler said: “Caffeine is the most well-known constituent in coffee, but the beverage contains more than 100 biologically active components. It is likely that the non-caffeinated compounds were responsible for the positive relationships observed between coffee drinking, cardiovascular disease and survival. Our findings indicate that drinking modest amounts of coffee of all types should not be discouraged but can be enjoyed as a heart healthy behaviour.”

Posted on Patient Talk

Are You Ready for Your First Pool?

Installing a pool on your property is a huge commitment of both time and money. However, having somewhere to relax with friends and family on a hot summer afternoon is priceless. But, before you go all in, you should familiarize yourself with the process. Today’s post is just one of many great pool owner resources brought to you by Patient Talk.

Above Or Below Ground?

For most people, there are two choices: an above ground pool or an inground pool. Above ground swimming pools have the financial advantage, as they are often a fraction of the cost of inground. Many people choose an above ground pool to avoid the exponential cost of excavation. An inground pool, however, can be easier to maintain since, depending on how it’s built, you likely won’t have to worry about ripping the liner. Others choose an inground pool because they blend with the landscape better. Another option is a semi-inground pool, which is a hybrid of both.

Finding the Right Installation Company

Something else to consider before you make a decision is the rules and regulations in your area. In most places, you’ll have to have a licensed contractor to install your pool and a licensed electrician to run electricity to the pump and filter. It’s important that you hire the right people for this job, especially with all you are investing in the project. Once you have decided the type of pool you want and where you want it located, look online for well-rated pool installation companies. Call a few different companies and provide a clear description of what you want done. Enquire about their experience, their pricing, and their timelines. Once you have heard from your best options, make a decision quickly to move the project forward.

If you live in a cooler area, you might want to look into having solar panels installed to heat your pool. Look for a search engine that lets you input specifics about your project, and investigate pricing for solar paneling specifically for pools. This is a less common application for solar these days, so it might be a little harder to find contractors who handle it, but once you can relax in your warm pool on a brisk fall evening, it will all be worth it.

Rules and Regulations

It’s important that your installer is familiar with the pool rules and regulations for your area. Often, you’ll be required to build your pool a certain number of feet from utility and other easements. To find out if and where these exist, visit your local City Hall or property assessor’s office.

Aside from the cost of the pool, you will also be required to ensure that it is inaccessible to the general population and safe for those that do use it. For this, you will almost certainly have to have a fence around your pool. Keep in mind that this can add an extra $4,500 to your overall cost, but this might be much more if you choose to add a wooden privacy fence instead of a chain-link fence. You’ll have to have a separate contractor for this as well, and you want to read reviews and go over all of your needs with each service provider before you move forward. All of your contractors will need to be aware of easements and utility lines, such as gas, underground electric, and sewer. You will also likely be required to have a pool alarm.

Benefits to Health and Well-Being

Yes, having a pool is a big commitment, but it can also be a great opportunity to help your body and mind. Swimming is great aerobic exercise, but it is also low impact, which is great if you suffer from joint pain. In fact, swimming can be great for pain relief. According to Southside Pain Specialists, swimming can provide relief while also helping you build your stamina, muscle strength, and flexibility. You may find yourself heading to the pool for the fun, but benefiting from the health benefits, too.

Ongoing Financial Commitment

Having a home swimming pool might let you skip a few vacations, which is important if you’re on a tight budget. It can cost up to $500 each season simply by opening and closing your pool. This doesn’t even include the cost of repairing malfunctioning equipment, replacing the liner, or making other repairs. You will also be on the hook for the extra electricity it takes to run the pool pump during the summer (or all year, depending on where you live). In The Swim acknowledges that a variable or two-speed pump can help reduce these costs.

You must also factor in whether adding a swimming pool to your property will make your home more sellable or if it will be a liability. Regardless of the type of features you add, you might want to take before and after pics and hold onto any receipts and information showing improvements you’ve made to the property. Finally, don’t forget about the added cost you’ll incur to keep your pool beautiful. In addition to chemicals and maintenance equipment, you may also have to pay for landscaping, a deck, or a patio.

Enjoy the Benefits

Deciding to install a pool is a big decision that shouldn’t be taken lightly. There are many factors to consider, such as the cost of installation and maintenance, the size and shape of your yard, and how much use you think the pool will get. If you decide a pool is right for you, make sure to hire qualified contractors who can help you navigate all the permitting and construction process. Pools add value to your home and can provide hours of fun for friends and family members during the summer months- making the decision even easier!

Pools can be great low-impact exercise and even help to ease the pain that accompanies chronic conditions. If you are interested in more information about what it’s like to live with particular conditions from the patients themselves, visit Patient Talk.

Posted on Diabetes, Infectious Diseases

COVID-19 infection may increase risk of type 1 diabetes, suggests nationwide study of 1.2 million children

Nationwide study spanning first 2 years of the pandemic finds 0.13% of children and adolescents who contracted COVID-19 were diagnosed with type 1 diabetes a month or more after infection compared to 0.08% in children without a registered infection

Testing positive for SARS-CoV-2, the virus that causes COVID-19, is associated with an increased risk of new-onset type 1 diabetes in children and adolescents, according to a new research at this year’s European Association for the Study of Diabetes (EASD) Annual Meeting in Stockholm, Sweden (19-23 Sept).   The study is by Hanne Løvdal Gulseth and Dr  German Tapia, Norwegian Institute of Public Health, Oslo, Norway, and colleagues.

The study used national health registers to examine new onset type 1 diabetes diagnoses made in all youngsters aged under 18 in Norway (over 1.2 million individuals) over the course of 2 years, starting on March 1, 2020, comparing those who contracted COVID-19 with those who did not.

“Our nationwide study suggests a possible association between COVID-19 and new-onset type 1 diabetes”, says Dr Hanne Løvdal Gulseth, lead author and Research Director at the Norwegian Institute of Public Health. “However, the absolute risk of developing type 1 diabetes increased from 0.08% to 0.13%, and is still low. The vast majority of young people who get COVID-19 will not go on to develop type 1 diabetes but it is important that clinicians and parents are aware of the signs and symptoms of type 1 diabetes. Constant thirst, frequent urination, extreme fatigue and unexpected weight loss are tell-tale symptoms.”

It has long been suspected that type 1 diabetes, which is usually diagnosed in younger people and is associated with the failure of the pancreas to produce insulin, is a result of an over-responsive immune reaction, possible due to a viral infection, including respiratory viruses.

Several recent case reports have suggested a link between new onset type 1 diabetes and SARS-CoV-2 infection in adults. But evidence is more limited in children. A recent CDC report found that US children were 2.5 times more likely to be diagnosed with diabetes following a SARS-CoV-2 infection, but it pooled all types of diabetes together and did not account for other health conditions, medications that can increase blood sugar levels, race or ethnicity, obesity, and other social determinants of health that might influence a child’s risk of acquiring COVID-19 or diabetes [1].

In this nationwide study, Gulseth and colleagues linked individual-level data from national health registries for all children and adolescences in Norway (1,202,174 individuals). Data were obtained from the Norwegian preparedness register that is updated daily with individual-level data on PCR-confirmed SARS-CoV-2 infections, COVID-19 vaccinations and disease diagnoses from the primary and secondary health care service.

Children were followed from March 1st 2020 (the start of the pandemic) until diagnosis of type 1 diabetes, they turned 18 years old, death, or the end of the study (March 1st 2022), whichever occurred first.

The researchers examined the risk of young people developing new-onset type 1 diabetes within or after 30 days after PCR-confirmed SARS-CoV2 infection. They compared this group with children and adolescents in the general population who did not have a registered infection, as well as to a group of children who were tested but found to negative for the virus.

Over the 2 year study period, a total of 424,354 children tested positive for SARS-CoV-2 infection and 990 new-onset cases of type 1 diabetes were diagnosed among the 1.2 million  children and adolescents included in the study.

After adjusting for age, sex, country of origin, geographical area and socio-economic factors, the analyses found that young people who contracted COVID-19 were around 60% more likely to develop type 1 diabetes 30 days or more after infection compared to those without a registered infection or who tested negative for the virus (see figure in full abstract).

“The exact reason for the increased risk of type 1 diabetes in young people after COVID-19 is not yet fully understood and requires longer-term follow-up and further research into whether the risk could be different in children who are infected with different variants”, says Gulseth.

She adds, “It’s possible that delays in seeking care because of the pandemic might explain some of the increases in new cases. However, several studies have shown that SARS-CoV-2 can attack the beta cells in the pancreas that produce insulin, which could lead to development of type 1 diabetes. It’s also possible that inflammation caused by the virus may lead to exacerbation of already existing autoimmunity.”

The authors acknowledge that the study was observational and does not prove cause and effect, and they cannot rule out the possibility that other unmeasured factors (e.g., underlying conditions) or missing data may have affected the results. They also note that they only included children who took a PCR test, not a lateral flow test or asymptomatic infections, in the analyses which may limit the conclusions that may be drawn.