A new study published online in JAMA Pediatrics finds that a combination of aerobic workouts plus resistance training offers the best hope for teenagers battling obesity.
From the abstract:
Aerobic, resistance, and combined training reduced total body fat and waist circumference in obese adolescents. In more adherent participants, combined training may cause greater decreases than aerobic or resistance training alone.
Here’s more from The New York Times coverage of the study, which found that “diet without exercise accomplishes little:”
Canadian researchers put 304 obese teenagers on a diet with a daily energy deficit of 250 calories (measured from their resting energy expenditure). Then they assigned them randomly to one of four groups for 22 weeks: aerobic training on exercise machines like treadmills, resistance exercise using weight machines and free weights, combined aerobic and resistance training, and a diet-only group with no exercise… Continue reading →
There was no comfortable place for 17-year-old Alexus Burkett in her school’s typical sports program of soccer and lacrosse and basketball.
“They don’t let heavyset girls in,” she says.
Alexus was “bullied so bad about her weight,” says her mother, Angelica Dyer, “and there was no gym that would take her when she was 14, 15 years old. There was no outlet.”
But Alexus has found a sports home that is helping her bloom as an athlete: an innovative program called “OWL On The Water” that offers rowing on the Charles River specifically for kids with weight issues.
She has lost more than 50 pounds over half a year, but more importantly, says her mother, “They’ve given me my daughter’s smile back.”
Alexus Burkett stretches during warm-ups before “OWL On The Water” instruction time. (Jesse Costa/WBUR)
“It’s given me a lot of good strength and it’s making me more outgoing,” Alexus says. “We’re all best friends and we’re all suffering with the same problem — weight loss — so we’re more inspiring each other than we are competing against each other.”
OWL On The Water offers a small solution to a major national problem: According to the latest numbers, 23 million American kids are overweight or obese, and only about one quarter of 12-to-15-year-olds get the recommended one hour a day of moderate to vigorous physical activity. Heavier kids are even less likely to be active, and only about one-fifth of obese teens get the exercise they need, the CDC finds.
“I know I need to be active, but please don’t make me play school sports!” That’s what exercise physiologist Sarah Picard often hears from her young clients at the OWL — Optimal Weight for Life — program at Boston Children’s Hospital that sponsors OWL On The Water.
Many gym classes still involve picking teams, “and my patients are the ones that are always picked last,” she says. “You’re the biggest one, you’re the last one, you’re picked last, and you’re uncomfortable.”
They are strong, powerful people.
– Sarah Picard
School fitness testing is important, Picard says, but it, too, can be an ordeal: “I have kids who sit in my office and tell me that they didn’t go to school for a week because they wanted to miss the fitness testing,” she says.
While many a coach might see bigger bodies as poorly suited to typical team sports, Picard sees them as having different strengths. Particularly muscular strength.
“What I’ve observed is that these kids are much better at strength and power-based activities,” she says. And rowing is particularly good for them, she says, because though it is strenuous, it is not weight-bearing, and thus more comfortable for heavier bodies — yet a heavier, strong body can pull an oar much harder than a smaller person’s body. The program begins by building on that muscular strength, she says, and then works on aerobic fitness. Continue reading →
My adolescence was a blur of rushing from school to dance classes with my older sister. After hours of practice, we couldn’t wait to get home and make berry smoothies that we’d slurp from the blender. My sister and I did almost everything together.
A new study suggests this relationship may have played a key role in keeping me healthy and fit.
The study, released online by the Journal of Preventive Medicine, found that siblings may have a greater influence on a child’s risk of obesity than parents do. Specifically, having an obese older sibling is associated with more than double the risk of being obese compared to having an obese parent. The association is even greater among siblings of the same gender.
It may seem obvious that family members influence a child’s chances of being obese, but the importance of the type of family relationship has been less clear. This new study, led by Dr. Mark Pachucki at the Mongan Institute for Health Policy at Massachusetts General Hospital, is the first to compare the influence of sibling obesity and parent obesity on a child’s obesity risk.
Dr. Pachucki and his team surveyed almost 2,000 only-child and two-child families from the larger Family Health Habits Survey. One parent from each family reported on the food environment, physical activity, weight and height for themselves and their children. The researchers also considered and analyzed the parents’ socioeconomic status, demographic background and overall health. Continue reading →
Years ago, on my daughter’s first birthday, my mother-law, an avid cook, baked her a cake. I don’t remember if it was chocolate or layered. What I do remember is forbidding my baby from eating it — not even a nibble. Why, I thought, would I introduce processed sugar into a one-year-old’s diet when she’d been perfectly content with avocados and bananas? “Don’t you want to see pure joy on her face?” asked one friend. Yeah, sure, but not from frosting.
Needless to say, the birthday cake prohibition triggered a bit of a backlash among some family members, and earned me labels like “rigid” and “crazy.”
But these days, with the huge national backlash against sugar — from the new film “Fed Up” and Eve Schaub’s popular family memoir, “Year Of No Sugar,” to Mark Bittman’s regular columns hammering on the message of sugar’s toxicity — I feel somewhat vindicated.
The experts carry the ball. The journalist Gary Taubes calls the “energy balance” theory — the notion that all calories are the same, and that as long as you exercise enough, you’ll avoid gaining or even lose weight no matter what you eat — “nonsense.” One Coke, we learn, will take more than an hour to burn off. The pediatrician Rob Lustig, a leading anti-sugar campaigner, notes that “we have obese 6-month-olds. You wanna tell me that they’re supposed to diet and exercise?” David Ludwig, another M.D., notes that there is no difference between many processed foods and sugar itself, saying you can eat a bowl of cornflakes with no added sugar or a bowl of sugar with no added cornflakes and “below the neck they’re the same thing.” Lustig reminds us that anyone can develop metabolic syndrome: “You can be sick without being fat; this is not just a problem of the obese.”
And so on. Senator Tom Harkin says, “I don’t know how they (the food industry) live with themselves,” comparing them to the tobacco industry. Bill Clinton says, effectively, “We blew it,” when it came to this struggle.
The movie has some splendid moments: A mother cries at the difficulty of the choice she must make between giving her child what she wants and giving her what’s best. Her struggle is common, and she’s fighting against an almost overwhelming tide of marketing and, yes, even addiction. A school lunch worker, speaking of the fact that few kids choose the healthy option at lunch, says, “You can’t choose for them.” But they are children; we must choose for them. Not only are their parents not present, but their parents often don’t know what’s best.
The journal Nature reports that some lab mice have lived out my food fantasy: Even though they ate a heavy, high-fat diet — my particular dream is unlimited Ben & Jerry’s — they did not become obese, because researchers found a novel way to tweak their metabolism.
Sigh. The caveats first: What works in mice might not in humans. It might not be safe. Clinical trials are not on the immediate horizon. This is no reason to stop eating healthy food and exercising.
But we can dream, right? And we can savor the explanations from Dr. Barbara Kahn of Beth Israel Deaconess Medical Center and Harvard Medical School, senior author on the Nature paper. She sums up: “We found an enzyme in fat that appears to be elevated in people with obesity and diabetes. And if we inhibit it in mice, we can increase the amount of energy that the animal burns, and thereby decrease the amount of calories that are stored as fat.”
It’s something like the extra energy you burn when you exercise, she said — except without the exercise.
Dr. Kahn’s team found a gene that, when suppressed, makes metabolism less efficient — which is actually a good thing if you’re trying to avoid obesity.
“Generally, in our lives, we think it’s good to be efficient — and it certainly is good to be efficient in time management,” she said. “But if your metabolism is efficient, it means you need fewer calories to generate the energy that cells need for their basic metabolism, and therefore, if you eat too many calories, you will put on weight. But if the cells are inefficient, they’ll burn up those extra calories and you won’t put on weight.”
So do these findings — centering on an enzyme known as nicotinamide N-methyltransferase or NNMT — indeed hold the promise of some sort of drug to prevent or treat obesity?
“The approach we used in the mice was mainly prevention,” Dr. Kahn said, “but the same idea should work for treatment of obesity. I have to caution, of course: one has to look into all the safety aspects if one considers such a treatment in humans. But all the cellular machinery is there, so it should work.” Continue reading →
(Photo: Yale Rudd Center for Food Policy and Obesity)
By Melinda J. Watman Guest contributor
When the American Medical Association declared obesity a disease last year, most of us — advocates who work to help those with obesity — were thrilled.
We saw the new definition’s potential to change how medical professionals regard people with obesity, increase society’s focus on obesity, push insurance companies to cover obesity treatments, reduce social stigma and moderate the anxiety and depression often afflicting those with obesity.
Already, we see some of those hopes being realized. Just last week, the federal government’s Office of Personnel Management issued a ruling that health insurers who cover federal employees may no longer exclude coverage of weight loss drugs on the basis that obesity is a “lifestyle” condition or that obesity treatment is “cosmetic.” This is one more significant step in the recognition and treatment of obesity as a disease.
The three authors concluded that labeling obesity a disease led their subjects to want to eat more, eat worse and care less about their weight. They suggested that labeling obesity a disease leads to the belief that it is futile to try to manage one’s weight.
Whether one agrees with the study’s findings and conclusions or not, the underlying question of whether obesity should be accepted as a disease is the critical point. The authors certainly question its validity based on the findings that their subjects suffered an “undermining of beneficial self-regulatory processes.”
What is interesting is that if it were any other chronic illness with comparable results, we would not be questioning whether the illness should be classified as a disease. Rather, we would be trying to find better ways to engage, educate, support and treat those patients as we continued to work on new therapeutics to manage the disease.
As is often the case with obesity, it would appear this line of thinking and research has the potential to further marginalize the problem and those affected by it. This is completely counter to what the AMA policy strives for – the same medically accepted framework to diagnose, treat and support patients as exists with any other chronic illness. Continue reading →
This morning’s On Point with Tom Ashbrook raised a critical question: might antibiotics be “a scale-tipping X-factor” driving the American obesity epidemic?
Featuring reporter Pagan Kennedy, who just wrote apiece on this topic, “The Fat Drug,” for the New York Times Magazine, and researcher, Dr. Illseung Cho, with the New York University School of Medicine, author of a recent Nature article on antibiotics’ impact on the microbiome, the radio segment explored the possibility that missing microbes in our gut might be party responsible for our growing weight.
Who knew, for instance, that a single course of antibiotics can potentially alter your gut bacteria forever?
Here’s more from Kennedy’s report:
American kids are prescribed on average about one course of antibiotics every year, often for ear and chest infections. Could these intermittent high doses affect our metabolism?
To find out, Dr. Blaser and his colleagues have spent years studying the effects of antibiotics on the growth of baby mice. In one experiment, his lab raised mice on both high-calorie food and antibiotics. “As we all know, our children’s diets have gotten a lot richer in recent decades,” he writes in a book, “Missing Microbes,” due out in April. At the same time, American children often are prescribed antibiotics. What happens when chocolate doughnuts mix with penicillin?
The results of the study were dramatic, particularly in female mice: They gained about twice as much body fat as the control-group mice who ate the same food. “For the female mice, the antibiotic exposure was the switch that converted more of those extra calories in the diet to fat, while the males grew more in terms of both muscle and fat,” Dr. Blaser writes. “The observations are consistent with the idea that the modern high-calorie diet alone is insufficient to explain the obesity epidemic and that antibiotics could be contributing.”
A new study finds that the luxuries of modern life come at an extremely high cost: a greater chance of becoming obese or developing diabetes.
Researchers report that in lower-income countries, ownership of a household device — including a car, computer or TV — significantly “increased the likelihood of obesity and diabetes.” Specifically, owning these items was “associated with decreased physical activity and increased sitting, dietary energy intake, body mass index and waist circumference.” Of the three “devices,” owning a TV had the strongest association with the bad health outcomes.
In poorer countries, such big-ticket items are clearly less prevalent than in rich countries, however they are fast becoming more ubiquitous. And so, apparently, are the ills associated with sitting around watching TV, typing on a computer and driving.
Here’s more from the news release:
The spread of obesity and type-2 diabetes could become epidemic in low-income countries, as more individuals are able to own higher priced items such as TVs, computers and cars. The findings of an international study, led by Simon Fraser University health sciences professor Scott Lear, are published today in the Canadian Medical Association Journal.
Lear headed an international research team that analyzed data on more than 150,000 adults from 17 countries, ranging from high and middle income to low-income nations.
Researchers, who questioned participants about ownership as well as physical activity and diet, found a 400 per cent increase in obesity and a 250 per cent increase in diabetes among owners of these items in low-income countries.
The study also showed that owning all three devices was associated with a 31 per cent decrease in physical activity, 21 per cent increase in sitting and a 9 cm increase in waist size compared with those who owned no devices. Continue reading →
This just in from Boston Children’s Hospital: The immune system may play a key role in the asthma that can develop along with obesity — and that new understanding may point to possible ways to stop or treat obesity-related asthma.
A growing body of literature links asthma with obesity, but the reason for the link has been unknown. Both conditions have become more common over the last several decades. The new study, led by Dale Umetsu, MD, PhD, and Hye Young Kim, PhD, of the Division of Allergy and Immunology at Boston Children’s, explored obesity’s effects on the immune system.
The researchers studied mice that were fed a high-fat diet causing them to become obese. Unlike mice fed normal diets, the obese mice developed airway hyper-reactivity or constricted and twitchy airways, the predominant feature of asthma.
In the study, obesity appeared to alter the innate immune system—the body’s first responder to infection—in several ways to cause lung inflammation.
In addition, when IL-1β [a protein linked to inflammation] production was blocked with the drug anakinra (Kineret, Swedish Orphan Biovitrum), used to treat rheumatoid arthritis, the obese mice did not develop asthma.
We already know that fast food restaurants are among the culprits in America’s obesity epidemic, but it’s not just where you eat, it’s what. In particular, Boston University has just sent over word of a study that linked specifically fast-food burgers and sodas to obesity in young African-American women. From the press release:
A research team from Boston University’s Slone Epidemiology Center examined the association between consumption of foods from restaurants and risk of becoming obese in a large cohort of young African American women. Their results, published online today in Ethnicity & Disease, provide evidence that frequently eating hamburgers from restaurants is associated with higher risk of obesity. Higher intake of sugar-sweetened soft drinks, which are commonly consumed together with restaurant foods, was also independently associated with obesity risk.
This study was conducted using data from the Black Women’s Health Study, an ongoing investigation of the health of 59,000 African American women that began in 1995. The analysis included younger women, aged 21 to 39 years, because most weight gain occurs before middle age. The women studied were not obese and had no history of cancer or cardiovascular disease at the start of follow-up. Diet was assessed twice (in 1995 and 2001) using validated questionnaires, and information on the participants’ weights was collected every two years from the study’s start until 2011…
The researchers found that women who ate burgers from restaurants at least twice a week were 26 percent more likely to become obese by the end of the study than those who rarely ate burgers, after controlling for many factors including overall diet quality and sugar-sweetened soft drink consumption. In addition, women who drank at least two sugar-sweetened soft drinks per day were 10 percent more likely to become obese than those who drank none, after controlling for overall diet quality and restaurant burger consumption.