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Limiting TV ads for foods high in sugar, salt, fat may reduce child obesity

Limiting TV ads for sugary, salty and high-fat foods and drinks might help reduce childhood obesity, British researchers suggest.

They looked at advertising of these products between 5:30 a.m. and 9 p.m. If all such ads were withdrawn during those hours, the number of obese kids in Britain between the ages of 5 and 17 would drop by 5% and the number of overweight kids would fall 4%, the study found.

That’s equivalent to 40,000 fewer kids in Britain who would be obese and 120,000 fewer who would be overweight, the researchers said.

The findings were published online this week in the journal PLOS Medicine.

Oliver Mytton, an academic clinical lecturer at the Center for Diet and Activity Research at the University of Cambridge, led the study.

“Measures which have the potential to reduce exposure to less-healthy food advertising on television could make a meaningful contribution to reducing childhood obesity,” the authors said in a journal news release.

But they also pointed out that they could not fully account for all factors that would affect the impact of the policy, if implemented.

They added: “Children now consume media from a range of sources, and increasingly from online and on-demand services, so in order to give all children the opportunity to grow up healthy it is important to ensure that this advertising doesn’t just move to the 9-10 pm slot and to online services.”

More information

For more on childhood obesity, visit the U.S. Centers for Disease Control and Prevention.

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Doctors urged to tackle malnutrition in obesity

A recent editorial calls on doctors to address the underrecognized problem of malnutrition among individuals with obesity to help prevent early death from cardiovascular events.

A study has found that malnutrition is common among people with acute coronary syndrome, which is the sudden reduction of blood flow to the heart that causes angina or a heart attack.

The researchers — at the University Hospital Álvaro Cunqueiro in Vigo, Spain — found that malnutrition in these individuals was an independent risk factor for all-cause mortality and major cardiovascular events, such as stroke or another heart attack.

Surprisingly, they found that malnutrition was common even among those with overweight or obesity.

The results appear in the Journal of the American College of Cardiology.

In an accompanying editorial, two cardiologists write that physicians commonly perceive malnutrition to be a problem that only affects people who are “undernourished” — in other words, underweight.

In fact, individuals with overweight or obesity are often malnourished as a result of their low intake of micronutrients and the poor quality of the foods that they eat.

“Malnutrition is a largely underrecognized and undertreated condition in patients with increased body mass index, as increased abdominal girth is too often mistaken for overnutrition rather than undernutrition,” says Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, CO.

Dr. Freeman co-authored the editorial with Dr. Monica Aggarwal, who is an associate professor of medicine at the University of Florida in Gainesville.

“It’s important to dispel the thought that weight is correlated with food quality and that [patients with obesity] are not at risk of malnutrition,” says Dr. Freeman.

The World Health Organization (WHO) estimate that 462 million adults have underweight worldwide, whereas 1.9 billion have overweight or obesity. However, they note that the term malnutrition can apply to both of these groups.

The researchers in Spain conducted a retrospective analysis of 5,062 people admitted to the University Hospital of Vigo with acute coronary syndrome.

They calculated the body mass index (BMI) of each person and scored their nutritional status using three standard measures: the Controlling Nutritional Status score, the Nutritional Risk Index, and the Prognostic Nutritional Index.

These measures use different combinations of values, such as BMI and blood levels of albumin, white blood cells, and cholesterol, to estimate the quality of the nutrition that a person is receiving.

According to these three measures, between 8.9% and 39.5% of all of the participants — depending on the specific measure — were moderately or severely malnourished.

Although those whose BMI labeled them as having underweight were the most likely to be moderately or severely malnourished, between 8.4% and 36.7% of those whose BMI suggested they had overweight or obesity fell into these categories.

Moreover, up to 57.8% of those with overweight or obesity had some degree of malnutrition, again depending on the index used.

During the median follow-up period of 3.6 years, 20.7% of the participants had a major cardiovascular event, and 16.4% of them

Study finds obesity medicine specialists are using evidence-based care

Study finds obesity medicine specialists are using evidence-based care
Obesity and weight-management care supported by scientific research and clinical trials is best for patients, says a survey by Johns Hopkins Medicine researchers. They urge physicians to offer services to their patients with obesity such as nutritional counseling. Credit: Public domain image courtesy of Carlos Silva

The United States obesity rate is now more than 40%, and physicians are looking for new and more effective ways to treat the problem. In 2013, the American Medical Association recognized obesity as a complex, chronic disease that requires medical attention. However, past research studies showed that the percentage of physicians providing adequate counseling and treatment to patients with obesity remains low.

Additionally, patients with obesity are often unaware that such services even exist.

To better understand the state of obesity medicine in the United States, Johns Hopkins Medicine researchers surveyed physicians certified in the discipline by the American Board of Obesity Medicine (ABOM) found that these practitioners, whose numbers are low, commonly offer key services supported by scientific research and clinical trials.

This suggests that primary care clinicians can be increasingly confident that their patients will receive this “evidence-based care” when referred to an obesity specialist. Overall, most of the respondents endorsed the use of nutrition, behavioral services, weight-loss surgical care and anti-obesity medications approved by the U.S. Food and Drug Administration (FDA).

The findings were published online on Sept. 10, 2020, in the journal Clinical Obesity.

“Modifications are key to losing weight,” says study lead author Kimberly Gudzune, M.D., M.P.H., associate professor of medicine at the Johns Hopkins University School of Medicine, and director of both the Johns Hopkins Healthful Eating, Activity and Weight Program and the Johns Hopkins Obesity Medicine Fellowship. “A lot of physician training doesn’t include obesity treatments such as lifestyle counseling and medication management, and without it, you’re unlikely to help patients lose weight. We want to ensure that obesity medicine providers are providing great care to help patients achieve long-term success.”

Through ABOM, Gudzune surveyed over 490-obesity medicine certified physicians. The physicians were asked about their current clinical practices in the hope of learning if the services they offer are in line with currently accepted science.

Gudzune and her colleagues found that the majority of ABOM physicians responding to their survey offered nutritional (90%), exercise (68%) and mental health (77%) counseling to their patients. Only a few offered minimally invasive procedures (24%), but most provided care before and after surgery (63%). Most (83%) prescribed FDA‐approved medications—both short‐ and long‐term agents (71%).

Gudzune’s team concluded that most of the survey participants’ obesity medicine services are evidenced based.

Gudzune plans to use the study’s findings to raise patient awareness that there are health care providers specifically trained to help with obesity and its consequences, such as a greater risk of cardiovascular disease, diabetes, certain cancers and premature death. She also hopes the study results can be used to identify where gaps may exist in obesity care and to support development of more comprehensive treatments.

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