One in eight adults obese - global survey

PARIS -- Over one in eight adults are now obese -- a ratio that has more than doubled since 1975 and will swell to one in five by 2025, a major survey reported Friday.

Of about five billion adults alive in 2014, 641 million were obese, the data showed -- and projected the number will balloon past 1.1 billion in just nine years.

The research warned of a looming crisis of "severe obesity" and disease brought on by high-fat, high-sugar diets causing blood pressure and cholesterol to rise.

"There will be health consequences of magnitudes that we do not know," author Majid Ezzati of Imperial College London told AFP.

The survey, published in The Lancet medical journal, claimed to be the most comprehensive of its kind conducted to date.

People are divided into healthy or unhealthy weight categories based on a universally-adopted measure dubbed Body Mass Index -- a ratio of weight-to-height squared.

A healthy BMI ranges from 18.5 to 24.9.

One is considered underweight below 18.5, overweight from 25 up, and obese from 30 -- when the risk of diabetes, stroke, heart disease and some cancers escalates massively.

With a BMI of 35, one is categorized as severely obese, and from 40 upward as morbidly so.

Among men globally, obesity tripled from 3.2 percent of the population in 1975 to 10.8 percent in 2014 (some 266 million), and among women from 6.4 percent to 14.9 percent (375 million), said the survey -- 12.9 percent combined.

This was equivalent to the average adult, 18 and older, being 1.5 kilos (3.3 pounds) heavier every decade.

"If the rate of obesity continues at this pace, by 2025 roughly a fifth of men (18 percent) and women (21 percent) will be obese," according to a statement by The Lancet.

More than six percent of men and nine percent of women will be severely obese.

Weighty flip-flop

The ratio of underweight people in the world declined at a slower rate than obesity grew, said the authors -- from about 13.8 percent in 1975 to 8.8 percent for men, and 14.6 percent to 9.7 percent for women.

"Over the past 40 years, we have changed from a world in which underweight prevalence was more than double that of obesity, to one in which more people are obese than underweight," said Ezzati.

At current rates, more women will be severely obese (a BMI of 35 or more) than underweight by 2025, and the world will miss its stated target of halting obesity at 2010 levels.

In 2014, the world's fattest people lived in the island nations of Polynesia and Micronesia, where 38 percent of men and more than half of women were obese, said the study.

Nearly a fifth of the world's obese adults (118 million) lived in six high-income countries -- the United States, Britain, Ireland, Australia, Canada and New Zealand.

The US was home to one in four severely obese men and almost one in five severely obese women in the world.

Surgery as a solution? 

At the other extreme, the paper said, Timor-Leste, Ethiopia and Eritrea had the lowest BMI numbers in the world, with averages as low as 20.1

More than a fifth of men in India, Bangladesh, Timor-Leste, Afghanistan, Eritrea and Ethiopia, and a quarter of women in Bangladesh and India, were underweight.

"The global focus on the obesity epidemic has largely overshadowed the persistence of underweight in some countries," the research paper said.

"To address this problem will require social and food policies that enhance food security in poor households, but also avoid overconsumption of processed carbohydrates and other unhealthy foods."

Like being underweight, severe and morbid obesity has many health risks.

"We can deal with some of these, like higher cholesterol or blood pressure, through medicines," said Ezzati.

"But for many others, including diabetes, we don't have effective treatment."

The paper says stomach-shrinking bariatric surgery may become the "most effective intervention for weight loss and disease prevention" as waistlines continue expanding.

The data was compiled from 1,698 studies involving 19.2 million adults from 186 countries which are home to 99 percent of the world's population.

Unlike earlier research, studies were only included if the participants' height and weight had been measured -- not self-reported.

The data did not include statistics on children and teenagers.

source: interaksyon.com

The unflattering side effect of a low-carb diet

You’ve been wanting to lose weight so you can fit into that lovely red dress you’re eyeing to wear on your special date. So, you’ve decided to eliminate carbohydrates in your meal believing you will not gain extra pounds before the date. Yes, low-carb diets may be good for your waistline, but it may not be the same for your breath.

Bad breath from low or no-carb diets is often caused by chemicals called ketones that are released in the breath as the body burns fat. An example of this effect occurs especially in the popular Atkins diet. Carbohydrates aren’t readily available, so the body starts consuming other fats and proteins as its source of energy. As a result, one gets a breath problem.

It’s not an oral hygiene problem. Brushing, flossing, and scraping the tongue may not be able to hide the bad breath. Instead, reconsider your diet and modify it to avoid this embarrassing condition. There may be some ways to mask bad breath by (using mouthwash, for instance), but the basic problem still exists—so, better introduce complex carbohydrates (found in whole grains and vegetables like broccoli and spinach) in your diet instead.

What to do

Though this is not an oral hygiene problem, certain remedies can help banish the bad breath or at least mask the odor.

• Drink more water. Drinking water and swishing it around your mouth after your mouth after you eat helps moisten the mouth and gets the food particles that may contribute to odor, out. Chewing fresh parsley can also help.

• Chew sugarless gum or suck on sugarless mints. In particular, those that contain Xylitol also kill bacteria and can prevent cavities.

Optimum nutrition means having a well balanced meal—the greatest percentage for energy source should come from carbohydrates. The key is on the amount and kinds of foods that we eat. Complex carbohydrates may be good for dieters and with people who have diabetes because they are rich in fibers and makes one feel full at once. So, before you blame carbohydrates for any added inches in your waistline and decide to eliminate them altogether, think again. The downside could be unattractive, too.

• Want to know more? Manila Doctors Hospital’s resident nutritionists and dieticians at the PROHEALTH Center offer diet counseling services that are tailor-fit to your lifestyle. They also offer nutrition and disease education on common medical conditions such as diabetes, hypertension, and obesity.

PROHEALTH is open from Mondays through Saturdays from 8:00am to 5:00 pm and is located at the ground floor of Manila Doctors Hospital, No. 667 United Nations Ave., Ermita, Manila. You may reach them at these numbers (02) 524-3011 local 4718. For more information, visit the Manila Doctors website here.

source: interaksyon.com

Obese cancer patients often shorted on chemo doses

Obese people are less likely to survive cancer, and one reason may be a surprising inequality: The overweight are undertreated.

Doctors often short them on chemotherapy by not basing the dose on size, as they should. They use ideal weight or cap the dose out of fear about how much treatment an obese patient can bear. Yet research shows that bigger people handle chemo better than smaller people do.

Even a little less chemo can mean worse odds of survival, and studies suggest that as many as 40 percent of obese cancer patients have been getting less than 85 percent of the right dose for their size.

Now, the largest organization of doctors who treat cancer, the American Society of Clinical Oncology, aims to change that. The group has adopted guidelines urging full, weight-based doses for the obese.

Don't call it supersizing; it's right-sizing cancer care, said Dr. Gary Lyman, a Duke University oncologist who led the panel that wrote the advice.

"There's little doubt that some degree of undertreatment is contributing to the higher mortality and recurrence rates in obese patients," he said.



The Food and Drug Administration's cancer drug chief, Dr. Richard Pazdur, agrees.

"By minimizing the dose, or capping the dose, we have been undertreating patients," he said.

The dosing issue applies to all types of cancer treated with chemo — breast, colon, lung, ovarian and even blood diseases such as leukemia.

It affects a lot of people. Big isn't healthy but it's the new "normal" — 60 percent of Americans are overweight and more than one-third of them are obese.

Giving too little chemo "could make it as if they didn't even get treated at all ... so they go through the whole ordeal with no benefit, in the extreme case ," said Dr. Jennifer Griggs, a University of Michigan breast cancer specialist who also worked on the guidelines.

So why do doctors limit dose?

Sometimes it's for good reason — the patient has diabetes, heart problems or other illnesses that interfere with how much chemo they can stand. Usually, though, it's because doctors are afraid to follow a standard weight-based formula because the dose seems so huge and they're afraid of harming the heart and blood system, Lyman said.

"You're three times the size of the average person, but it doesn't mean your heart is," Griggs explained.

Yet studies show that heavier patients are less likely to develop dangerous, low blood counts from cancer treatment, and that they clear chemo drugs more quickly from the body than thinner people do.

A paper Lyman published in the journal Nature in August said that a 20 percent reduction in chemo doses lowered remission and cure rates by half in animal experiments and helped the tumors develop resistance to the drugs. Other research in people found lower survival among those getting less chemo as well.

Even if a patient develops a problem from a chemo treatment and doctors have to dial it back, it's important to try a full dose the next time around so the patient gets all the treatment intended, Lyman said.

That happened to Tracy Smith, a 46-year-old Durham, N.C., woman treated at Duke in 2011 for breast cancer that had spread to more than a dozen lymph nodes. Doctors gave her full chemo doses based on her weight, which at 285 pounds classified her as obese.

Three times, high fevers put her in the hospital, and one treatment was cut short because doctors thought it was causing wheezing and possible lung damage. But she resumed and finished the intended treatment and has been cancer-free since then.

After hearing you have cancer, "you're just kind of in a fog" and don't think to ask about doses of the drugs you need, she said. "I trusted my doctor. Doctors should be well aware of what you can tolerate. You should do whatever you can to fight this beast."

Smith's tumor was fueled by estrogen — a hormone made in abundance by fat tissue. Robin McRath, a floral designer who helps run a women's shelter in Ludington, Mich., had the same type.

"It's like a playground, an amusement park, for cancer cells when you're fat," she said. She was only was 41 when her cancer was diagnosed five years ago, and her oncologist, Dr. Carol Peterson, treated her with full doses based on her weight — about 240 pounds, which put her in the obese category.

"We didn't discuss dosage. That didn't matter to me — I just wanted to get it out of my system," she said of the cancer, and praised the treatments to prevent one of chemo's most feared side effects. "There are fantastic anti-nausea medicines. I was never sick one day."

McRath is active in the Obesity Action Coalition, an education and advocacy group. A spokesman said the group was unaware of the dosing issue for obese patients.

Not all doctors are aware either. Luckily for McRath, hers was. Peterson said she uses full doses unless a patient has other health issues.

"If that's their only problem — if they're just overweight or obese — they can do quite well" with full weight-based doses, she said.

Duke's Lyman agreed, and offered this advice to patients: "Ask your doctor how they plan to treat you and whether you're going to get the full dosing. The doctor may have a good reason not to, but you should have that discussion."

source: philstar.com

The good and evil truths about your food addictions

It’s hard to resist the simple addiction of sipping a hot cup of coffee or frappe, or perhaps the tingling sensation that sweet foods could give, or munching on those bags of chips while watching sappy movies late in the afternoon. But does your body appreciate them the way your taste buds do?

Dieticians and nutritionists from Manila Doctors Hospital’s (MDH) PROHEALTH Research and Education Center give you the truth about your addictions.







Coffee
• It’s known as a mental stimulant, which keeps us alert after some time.
• It boosts energy levels and prevents sleepiness, as the body releases adrenaline when we take it in.
• It may also help burn calories as it increases the body’s metabolism.

BUT: If you drink more than two cups a day, you may face the following:

PMS. While caffeine can decrease discomfort and that bloated feeling, it can cause a drop in blood sugar, which in effect aggravates PMS.

Cancer. Though there is no concrete evidence that caffeine alone may cause cancer, but if you love to drink coffee and smoke at the same time, then beware. Studies show that doing so may lead to cancer, particularly breast cancer.

Too much caffeine may lead to headaches, sleep problems and anxiety attack and bladder conditions as it acts as a diuretic to the body.

How to deal: If you can’t get rid of your frappes and espressos right away, try lessening your intake each day until you’re used to drinking small amounts or none at all. Substitute coffee for something healthier —nothing could be better than water.

Sugar
Sugar is a carbohydrate. It boosts your energy, helps sharpen memory, as glucose is the main sugar that feeds our brain cells. If taken moderately, it will help you gain weight.
BUT: This wickedly yummy treat may bring about these negative effects:
Hyperglycemia. A blood-sugar problem caused by too much sugar and improper diet.
Tooth decay. The bacteria in plaque depend on sugars to produce acids, which break down the enamel and start tooth decay.

Headaches and dizziness. Low glucose levels resulting from the severe dip after a high sugar intake tax the brain and cause headaches.

Other symptoms of too much sugar intake are great stress and fatigue, depression, anxiety, lack of mental alertness, and rapid mood swings. It may also delay wound healing, particularly for people with cancer or other disease conditions, as bacteria thrives on sugar as their immediate food source.

How to deal: Always eat your meals on time to prevent craving for sweets. Satisfy your sweet tooth by eating fruits instead.



Junk Food
Chips, packs of salted goodies, are the most convenient food-on-the-go. It is handy to eat or take anywhere, but junk food is precisely that—junk! It’s tasty (especially when it’s in your favorite flavor) but gives us nothing but empty calories (meaning we gain weight but we don’t get any nutrients from it).

BUT Junk food will never give us nutrition that our body needs. Some of its harmful effects are:
• Lack of energy
• Poor concentration
• Heart diseases
• High cholesterol

How to deal: Self-discipline is what you need to be able to swerve away from your junkie-addiction. If you’re really craving for something to munch on, the least you can do is substitute the flavored varieties with the plain-flavored ones, or better yet opt for a bag of popcorn (but not the microwaveable kind). A healthier option? Try crunching on dried or roasted unsalted nuts instead. It gives you the same comfort of chips without causing harm to your body.

Want to know more? Manila Doctors Hospital’s resident nutritionists and dieticians at the PROHEALTH Center offer diet counseling services that are tailor-fit to your lifestyle. They also offer nutrition and disease education on common medical conditions such as diabetes, hypertension, and obesity.

• PROHEALTH is open from Mondays through Saturdays from 8 am to 5 pm and is located at the ground floor of Manila Doctors Hospital, 667 United Nations Ave., Ermita, Manila. You may reach them at these numbers (02) 524-3011 local 4718. For more information, you may visit http://www.maniladoctors.com.ph.

source: interaksyon.com

Why your smile prefers water over soft drinks

HERE are some interesting stats about soft drinks:

• The average soft drink serving size has tripled since the 1950s.

• The average person drinks about 45 gallons of soda per year.

• Seven percent of adults drink four servings or more per day.

• At least 20 percent of children drink four servings or more per day.

Soft drinks are loaded with sugar and empty calories. Consumption has been linked to obesity, diabetes, and heart problems.

But of major concern to us, as your lifelong oral health partner, is that sugary, carbonated drinks really bully your teeth!






1. The acids eat away at your tooth enamel

Your tooth enamel is strong—the hardest substance in your body, in fact. But the phosphoric acid and citric acid in soft drinks (ironic name for sodas, isn’t it?) is stronger.

2. Carbonated sugar is replacing calcium-rich milk

In 1966, Americans drank more milk (33 gallons/year) than soft drinks (20 gallons/year). Contrast that with 2010, when the average American drank 45 gallons of soft drinks and only 20 gallons of milk.

3. Diet isn’t really better

You can remove sugar from the equation, but the acid is still there! In fact, many sugar-free soft drinks are more acidic than high-sugar ones.

Root beer may be the safest soft drink for your teeth, even though it’s loaded with sugar. Why? Because it’s comparatively low in acid.

4. Constant sipping creates a constant war zone

Every time you take a sip of a Coke, your mouth becomes an acid-attack zone. It takes your mouth up to 30 minutes to rebalance and create a safe zone for your teeth again. Until then, your teeth ARE losing protective substance, leaving them more vulnerable to cavities, and sensitivity.

5. It’s a dessert disguised as a beverage

Don’t believe us? Here’s the math:

One 12 oz can of Coke (the smallest serving available) has 39 grams of sugar, which is more than:

• 3 snack packs of Chips Ahoy

• 2 servings of frozen yogurt

• A whole slice of apple pie WITH ice cream on top.

So, minimize the damage by:

1. Drinking less! Replace soft drinks with milk, water, even juice.

2. Drinking it all at once, instead of sipping all day.

3. Swishing it down with water to clear away the sugar and acidity.

source: asianjournal.com

Bridging the nutritional gap

MANILA, Philippines - Diabetes, hypertension, obesity — more and more people are getting afflicted with these so-called “lifestyle diseases.”

As a result, their performance at work or at play is impaired. What is causing the increasing number of cases of lifestyle diseases? According to the Food and Nutrition Research Institute (FNRI), an unhealthy diet is a key factor in the prevalence of these conditions.

Vitamins and minerals are necessary for proper food metabolism. When people do not get the right amount of vitamins and minerals into their body, they are unable to efficiently turn the proteins and carbohydrates that they eat into energy. This is why even though they eat so much, they still feel weak and get tired quickly.

Vitamins and minerals are also needed to strengthen the immune system. When people have a shortage of important vitamins and minerals in our body, their immune system is less than optimal and they become vulnerable to illness.

This unhealthy diet creates a vicious cycle: when people feel sick or weak or tired, they lose their drive to engage in healthy physical activities such as sports or exercise. Even simple things such as walking or climbing stairs become tiresome. This leads to a sedentary lifestyle, where they feel that changing their diet and physical routine is too great an effort, so, it’s not surprising that their health and our quality of life suffer.

Lack of nutrients

 Based on the 2008 FNRI National Nutrition Survey, more than 70 percent of Filipinos across populations groups lack vitamins A and C, calcium, and iron in their daily diet.

For example, the FNRI’s Recommended Nutrient Intake (RENI) on a daily basis for vitamin A is 550 micrograms for male adults (aged 19 to 65 and above), and 500 micrograms for female adults (aged 19 to 65 and above).

However, the 2008 survey shows that actual average vitamin A intake among Filipino adults is just 499.6 micrograms, while the elderly only take in 379.9 micrograms daily.

In the case of vitamin C, the RENI for male adults (aged 19 to 65+) is 75 milligrams while the RENI for female adults (aged 19 to 65+) is 70 milligrams.

The 2008 survey, however, shows that on the average, Filipino adults only consume 44.7 milligrams of vitamin C daily, while the elderly consume 44.5 milligrams daily.

As for calcium, the RENI for male adults is 750 milligrams for those aged 19 to 64, and 800 milligrams for those aged 65 and above. The RENI for female adults is 750 grams for those aged 19 to 49, and 800 grams for those aged 50 and above.

According to the 2008 FNRI survey, the actual average daily calcium consumption among adults is only 370 milligrams, while the elderly only consume 330 milligrams of calcium every day.

Iron consumption among Filipino adults is also below the RENI. The RENI for iron among male adults aged 19 to 65 and above is 12 milligrams. The RENI for iron among non-pregnant female adults aged 19 to 64 is 27 milligrams, and for those aged 65 and above, 10 milligrams.

Actual average iron consumption among Filipino adults, however, was found to be only at 9.4 milligrams daily, while the average consumption among the elderly was even lower at 7.5 milligrams a day.

The 2008 FNRI survey also found that 65 percent of Filipinos across population groups are not taking enough calories to meet their daily energy requirement.

The RENI pegs the energy requirements for Filipino male adults as follows: 19 to 29 years old, 2,490 kilocalories (kcal); 30 to 49 years old, 2,420 kcal; 50 to 64 years old, 2,170 kcal; and 65 years old and above, 1,890 kcal.

For female adults, the energy requirements are: 19 to 29 years old, 1,860 kcal; 30 to 49 years old, 1,810 kcal; 50 to 64 years old, 1,820 kcal; and 65 years old and above, 1,410 kcal.

On the average, however, Filipino adults only consume 1,915 kcal daily while the elderly consume even less, with only 1,436 kcal daily.

According to FNRI’s computation, these figures mean that 65 percent of Filipinos are not getting enough energy for their everyday activities.

So how do people change to a healthy lifestyle and be at their best? Obviously, they need to commit themselves first to a healthy diet. The FNRI website (www.fnri.dost.gov.ph) provides an illustrated, dietary guide called the Filipino Food Pyramid to help people make the right food choices for optimum health and nutrition.

 Besides switching to a healthy diet, Filipinos also need to take health supplements to fill in the nutrition gaps on days when, for one reason or another, one’s food choices are less than ideal.

There are encouraging signs that more and more Filipinos are becoming educated about the value of nutritional supplements and they are taking more of these. FNRI surveys show in 2003, only 22.9 percent of Filipinos said they took health supplements. In 2008, that figure had risen to 46.8 percent.

The top two reasons these people gave for taking supplements were health and extra energy. Other reasons were “doctor-recommended,” “perform better in school/work,” and “not getting enough vitamins from the diet.”

To get the maximum benefits from a vitamin and mineral supplement, make sure to choose one that has complete nutritional content.  Centrum is complete and specially balanced with 30 vitamins and minerals the body needs, from vitamin A to zinc. For adults aged 50 and above, on the other hand, Centrum Silver’s age-adjusted formula is perfect for the changing needs in their golden years.

source: philstar.com

Saturated fat tied to sinking sperm counts in Danes

(Reuters Health) – Saturated fats, like those found in rich cheeses and meats, may do more than weigh men down after a meal – a new study also links them to dwindling sperm counts.

Researchers found that young Danish men who ate the most saturated fats had a 38 percent lower concentration of sperm and 41 percent lower sperm counts in their semen than those who ate the least fat.

“We cannot say that it has a causal effect, but I think other studies have shown that saturated fat intake has shown a connection to other problems and now also for sperm count,” said Tina Jensen, the study’s lead author from Rigshospitalet in Copenhagen.

The new research is not the first to connect diet and other lifestyle factors to sperm production and quality.

In 2011, Brazilian researchers found eating more grains - such as wheat, oats or barley – was associated with improved sperm concentration and motility, and fruit was also linked to a speed and agility boost in sperm (see Reuters Health story of November 18, 2011 here: reut.rs/TBfCrA).

But that study and most others looked at these associations using data on men seeking fertility treatments, which may not be representative of all men.

For the new study, Jensen and her colleagues surveyed and examined 701 young Danish men who were about 20 years old and getting checkups for the military between 2008 and 2010.

They were asked about the food they ate over the prior three months, and then asked for a semen sample.
Jensen told Reuters Health the young men’s main motivation to participate in the study was the $85 it paid – not to see if they were fertile.

The researchers then broke the results into four groups, depending on how much of the men’s energy intake came from saturated fats, and compared how much sperm the men in each group produced.

The men who got less than 11.2 percent of their energy from saturated fats had an average sperm concentration of 50 million per milliliter of semen and a total sperm count of about 163 million.

That compared to 45 million sperm per milliliter of semen and a 128 million count in men who got more than 15 percent of their energy from saturated fats, the researchers report in The American Journal of Clinical Nutrition.

The World Health Organization defines anything over 15 million sperm per milliliter of semen as normal. In the study, 13 percent of men in the lowest-fat group and 18 percent of men in the highest-fat group fell below that level.

Although the study cannot determine whether other lifestyle factors might account for the link, Jensen said her team’s findings may partially explain studies that have found sperm counts decreasing around the world.

Last year, French researchers reported that the number of sperm in one milliliter of the average 35-year-old Frenchman’s semen fell from about 74 million in 1989 to about 50 million in 2005 (see Reuters Health story of Dec 4, 2012 here: reut.rs/Vzg2NU).

“I think obesity is another cause, but (saturated fats) could also be a possible explanation,” she said.

Jensen said that the next step is to find the mechanism by which saturated fat could influence sperm count, and then to see whether sperm counts improve when men cut down on saturated fat in their diets.

Until then, she said it’s still too early to tell men with low sperm counts to cut back on saturated fat, but added it’s still probably a good idea since it’s also linked to other problems, such as heart disease and cancer.

SOURCE: bit.ly/UL3VhP The American Journal of Clinical Nutrition, online December 26, 2012.

US approves first obesity drug in 13 years

WASHINGTON DC - US regulators on Wednesday approved the first drug to treat obesity in 13 years, a drug called lorcaserin, marketed as Belviq and made by Arena Pharmaceuticals.

The drug works to control the appetite through receptors in the brain and was approved as additional therapy for certain overweight and obese patients, combined with diet and exercise.

Trials showed the drug helped people lose an average of three to 3.7 percent of their body weight after a year when compared to a placebo, the US Food and Drug Administration said.

It is approved for use in obese adults with a body mass index of 30 or greater, or overweight adults with a BMI of 27 or greater who have at least one other condition such as high blood pressure, type 2 diabetes, or high cholesterol.

Arena's stock opened the day at $9 per share and jumped as high as 47 percent on news of the US approval. The company said it is also seeking approval on the European market, but has no timeline yet for a decision.

Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, described obesity as "a major public health concern," and said the new drug offers a treatment option when used "responsibly in combination with a healthy diet and lifestyle."

However, the FDA warned that Belviq is not for women who are pregnant or nursing, and called for further long-term postmarketing studies on the drug's potential risks.

The label will also recommend that Belviq be discontinued in patients who fail to lose five percent of their body weight after 12 weeks of treatment.

"These patients are unlikely to achieve clinically meaningful weight loss with continued treatment," said the FDA statement.

Belviq activates the serotonin 2C receptor in the brain, and may cause serious side effects if taken in combination with certain medications for depression and migraine that increase serotonin levels or activate serotonin receptors.

"Belviq may also cause disturbances in attention or memory," said the FDA.

Common side-effects in patients without diabetes include headache, dizziness, fatigue, nausea, dry mouth, and constipation.

In diabetic patients, side effects may include low blood sugar, headache, back pain, cough, and fatigue.

Lorcaserin was rejected in 2010 by the Endocrinologic and Metabolic Drugs Advisory Committee, which advises the FDA, over concerns that it formed breast tumors in rats.

But those effects did not appear in trials on overweight and obese humans.

An independent advisory committee to the FDA recommended the drug be approved in May after three randomized, placebo-controlled trials of nearly 8,000 patients spanning one to two years.

"All participants received lifestyle modification that consisted of a reduced calorie diet and exercise counseling," the FDA said.

"Compared with placebo, treatment with Belviq for up to one year was associated with average weight loss ranging from three percent to 3.7 percent."

Some patients with type 2 diabetes experienced higher levels of weight loss, with 38 percent of these patients achieving at least five percent loss of their body weight compared to 16 percent who did the same on a placebo.

The pills will be manufactured at Arena's facility in Zofingen, Switzerland, and will be distributed in the US by Eisai Pharmaceuticals.

Arena is headquartered in San Diego, California.

According to Michael Aziz, internist at Lenox Hill Hospital in New York City, the biggest apparent drawback to the drug is the tiny amount of weight loss that patients experience while taking it.

"The only problem with this drug is the weight loss is so, so very low," Aziz told AFP, remarking that a 200 pound (91 kilogram) person might lose just six pounds (2.7 kg) in a year, based on the study data.

"That is so insignificant," he said. "I think people should also implement lifestyle changes because the fact is, people can lose one pound a week and that is perfectly healthy."

The last anti-obesity drug approved in the United States was Xenical (Orlistat) by Roche in 1999.

Sold over the counter as Alli by GlaxoSmithKline, it works by preventing the body from absorbing fat, though its tendency to cause gastrointestinal side effects such as oily, loose stools have curbed its popularity among patients.

article source: interaksyon.com

UK study: Obesity not always tied to higher heart risk

NEW YORK — An obese person isn't inevitably at increased risk of cardiovascular disease and death, a new U.K. study finds.

"The people really at risk are the ones who have obesity in combination with other metabolic health risk factors," said Mark Hamer, a principal research associate at University College London who worked on the study.

The results are in line with most previous research that defined metabolic health as having normal levels of markers like blood pressure, blood sugar, HDL, or "good" cholesterol, and C-reactive protein, which is a measure of inflammation in the body.

"People with good metabolic health are not at risk of future heart disease -- even if they are obese," Hamer told Reuters Health.

On the flip side, the non-obese in poor metabolic shape face as much risk as the unhealthy obese, the researchers concluded.

The findings, published in the Journal of Clinical Endocrinology & Metabolism, are based on more than 22,000 middle-aged participants in national health studies conducted in England and Scotland.

According to the researchers, the results suggest that metabolic factors may be more important in predicting a person's risk of cardiovascular disease than excess body weight in itself.

From a clinical perspective, stratifying individuals based upon their metabolic profile may help to identify those -- both obese and non-obese -- who should be treated with drugs or changes in diet and exercise, the study authors noted.

"We encourage obese people to lose weight for their health, but (some) provision should be made in how we screen people for metabolic risk," Hamer told Reuters Health.

An adult who has a body mass index -- a height-to-weight ratio -- of 30 or higher is considered obese. A normal BMI is between 18.5 and 24.9, and a BMI between 25 and 29.9 is considered overweight.

During the past 20 years, obesity has increased significantly in the United States. More than a third of American adults are obese, according to the Centers for Disease Control and Prevention.

Poor metabolic health?

For the new report, Hamer and a colleague collected data on participants' BMI and metabolic profiles and followed individuals, on average, for seven years. Then they looked at how many participants had died during the study period, and from what causes.

None of the participants had heart disease at the start of the study.

Almost a quarter were obese, and just under a quarter of those were considered "metabolically healthy obese" -- meaning they had no abnormal blood pressure, cholesterol, blood sugar or inflammation readings.

During the study period, more than 600 participants died from heart-related causes and 1,800 from other causes.

The obese individuals in good metabolic health were not at greater risk of dying from cardiovascular disease than the metabolically healthy non-obese, the researchers found.

But both non-obese and obese participants in poor metabolic health had a 59 percent and 64 percent increased risk of dying from heart disease, respectively, compared to the healthy non-obese.

Among the metabolically unhealthy participants, the non-obese had high levels of hypertension and inflammation -- comparable to those in the unhealthy obese group.

The metabolically unhealthy obese also had a 72 percent higher risk of dying from non-heart-related causes than those in good health.

That was after taking into account study participants' age, sex, smoking, physical activity and socioeconomic status.

Researchers found the results to be largely unchanged when they used waist circumference to define obesity instead of BMI.

‘Think more broadly'

Hamer and his colleague note in their report that a strength of their study was having a large study population. But because the researchers only measured participants' metabolic risk factors at the beginning of the study, it's possible that some of the metabolically healthy obese went on to develop unhealthy readings.

The study shows the need "to think more broadly about obesity" rather than to focus on body weight alone, said Dr. Cora Lewis, a professor of preventive medicine and an epidemiologist at the University of Alabama, Birmingham, who was not involved in the research.

"If you are obese and you struggle with weight, but your (metabolic) risk factors are fine, that may not be such a bad place to be," Lewis told Reuters Health -- adding that only "a minority of people" fit the description of "metabolically-healthy obese."

Equally important, the study shows that people may be at increased metabolic risk no matter what they weigh, she noted.

Excess body fat may be carried not only under the skin, but also inside the abdomen, heart, liver and muscles -- making it hard to tell -- she added.

"BMI doesn't always tell you everything. If you are non-obese, but you have high cholesterol or hypertension, you have some work to do," Lewis said. — Reuters

source: gmanetwork.com