Productivity Takes a Hit From Obesity, Diabetes

(HealthDay News) -- Obese workers with diabetes are less productive than their normal-weight co-workers, says a U.S. study.

Researchers surveyed 7,338 working adults about missed work time, reduced work effectiveness and impairment of daily activities. The results showed that people who were obese and had type 2 diabetes lost 11 percent to 15 percent of work time (about 5.9 hours a week) because of health problems, compared with 9 percent of work time (about 3.6 hours a week) lost by normal-weight people.

The survey also found that obese people with type 2 diabetes reported impairment during 20 percent to 34 percent of their daily activities, such as taking care of children, shopping and exercising.

The findings are in the May/June issue of the American Journal of Health Promotion. Read more...

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Diabetes, Obesity After 60 May Drive Up Breast Cancer Risk

(HealthDay News) -- A woman's risk of developing breast cancer appears to rise if she has diabetes or is obese after age 60, a new study indicates.

Previous research has linked obesity and increased breast cancer risk, but "the diabetes link had not been clearly shown," said researcher Dr. Hakan Olsson, a professor of oncology at Lund University in Lund, Sweden.

He is scheduled to present his findings this week at the 2011 San Antonio Breast Cancer Symposium.

The diabetes link held even after he accounted for obesity and levels of blood lipids, such as cholesterol. It is an association, however, not proven cause and effect.

A strength of the study, Olsson said, is that it looked at the population as a whole, not only women with breast cancer. He studied the medical records of more than 2,700 patients for up to 10 years before they developed breast cancer and also records for about 20,500 patients who never developed cancer. Read more...

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Neck Fat a Measure of Heart Risk

(HealthDay News) -- A too-tight shirt collar might be an indicator of future heart trouble, Framingham Heart Study researchers report.

Doctors have long measured fat in the gut -- visceral adipose tissue, to use the formal name -- to help assess the risk of cardiovascular disease. But fat in the neck is closely associated with the known factors for heart trouble, such as cholesterol levels and diabetes, said a report using data on 3,320 offspring of the study's original participants.

"Neck circumference was associated with cardiometabolic risk factors, even after adjustment for visceral adipose tissue," the researchers wrote in the report, which was to be presented Wednesday at the American Heart Association's Cardiovascular Disease Epidemiology and Prevention annual conference in Palm Harbor, Fla.

The standard ways to assess obesity is to measure the waistline and determine body-mass index. But neck fatness could add to the risk assessment a physician makes by measuring the waistline, the researchers said.

"Upper-body subcutaneous adipose tissue and visceral adipose tissue independently contribute to cardiometabolic risk," they reported.

Dr. Gregg C. Fonarow, a professor of medicine at the University of California, Los Angeles, said the researchers had "done a really good job of looking past the conventional measurements of risk."

"This is another way by which clinicians can assess the degree of adiposity of patients as a measure of cardiovascular risk and make recommendations about reducing risk," he said.

But the basic message, Fonarow said, is that carrying too much fat is not good for the heart, no matter where in the body the fat happens to be.

"It is just another insight into how much adipose tissue there is," he said. "When you measure waist circumference, you look at visceral fat in the abdomen. Here you're looking at visceral fat in another area of the body."

"The study makes good sense to me," said Dr. Kirk Garratt, director of interventional cardiovascular research at Lenox Hill Hospital in New York City. "They are putting a quantifiable measurement on something we've known for some time -- that people with upper-body obesity are at heightened risk of cardiovascular disease."

The obese body comes in two forms, Garratt said: pear-shaped, with most of the excess weight around the hips; and apple-shaped, with most of the weight in the upper part of the body.

"People with most of the weight in the upper part of the body have more cardiovascular disease," Garratt said. "It appears to be that certain kinds of metabolic abnormalities contribute to the atherothrombotic risk."

But no matter where the excess fat is located, it's best to lose it, he said.

"Everybody who has a body-mass index over 25 increases the risk of coronary events, regardless of where they are carrying their weight," Garratt said.

More information
The American Heart Association has more on the risks of obesity.

'Fasting Signal' Offers Clues to Insulin Resistance in the Obese

HealthDay News) -- A signal known to play a role during fasting also becomes active in the fat tissue of obese mice in the early stages of progression toward type 2 diabetes, say researchers. They also found that blocking this signal in fat tissue prevents insulin resistance in obese mice.

Previous research found that the CREB pathway keeps blood sugar in balance during fasting by triggering glucose production in the liver. It's also been found that excessive CREB activity in diabetes contributes to high blood sugar and insulin resistance.

In this new study, researchers at the Salk Institute for Biological Studies investigated whether CREB was important in mature fat tissues as well. They found that CREB activity in fat cells in obese mice encourages insulin resistance by lowering the production of a hormone called adiponectin and the insulin-sensitive glucose transporter 4 (GLUT4).

Obese mice genetically altered to lack CREB in fat cells became more sensitive to insulin and were also protected from the development of fatty liver and inflammation in fat tissue. CREB seemed relatively unimportant in healthy mice, but in obese mice, the signal appears to be "doing something more pathological."

The findings suggest the "stress of obesity activates CREB genes and contributes to insulin resistance," noted Marc Montminy and colleagues.

"Taken together, these results show that targeting therapies to adipose tissue and, in particular, to the CREB signaling system could have important therapeutic benefits in a variety of insulin-resistant states," the researchers concluded.

The study was published in the March issue of Cell Metabolism.

More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about insulin resistance and pre-diabetes.

Health Tip: Your Diabetes Health-Care Team

(HealthDay News) -- If you have diabetes, you need more than just a primary care doctor to help manage your health.

The American Diabetes Association says other specialists also should be considered as part of a diabetic's medical team. They include:

• An endocrinologist, or a primary care physician with significant experience in treating diabetes.
• A registered nurse trained in diabetes care, who can help with day-to-day diabetes management concerns.
• A registered dietitian, who can help you decide your daily diet and help you learn how food affects your blood sugar.
• An eye doctor, who can check your eyes regularly for diabetes-related complications.
  A podiatrist, who regularly examines your feet.
• A dentist, who checks regularly for gum disease and other oral problems.
• An exercise physiologist, who teaches you how exercise can help control diabetes and prevent complications.
• A therapist or social worker, who can help you deal with the emotional aspects of having diabetes.

Rising Blood Sugar May Harm the Aging Brain

(HealthDay News) — Scientists have unmasked what appears to be a major mechanism contributing to normal, age-related cognitive decline.
Happily, it’s a mechanism that is amenable to change: rising blood glucose levels, which means that exercise might be the antidote.

Researchers reporting in the December issue of Annals of Neurology showed that rising blood sugar levels, a normal part of aging, affect a part of the hippocampus, a part of the brain critical to learning and memory. Read More

Excess Weight Ups Risk of Death, No Matter Where It Collects

(HealthDay News) -- Whether you're shaped like an apple or a pear, if you're overweight, you have a higher risk of dying than someone of normal weight, a new European study says.

But, those who tend to collect their weight around the middle -- apple-shaped -- face an even higher risk of death than those whose excess weight tends to settle in their hips and thighs -- pear-shaped.

"We found that a large waist circumference is related to a higher risk of death even for individuals who have the same BMI [body mass index, a ratio of weight to height]," said the study's lead author, Dr. Tobias Pischon, of the German Institute of Human Nutrition. "Therefore, you could say that adipose [fat] accumulation in the abdominal region is even more detrimental than just having an elevated BMI level," he added.

Previous research had linked abdominal fat with a higher risk of chronic diseases. But past research generally hadn't assessed the risk of death in those who were overweight and those who were overweight with more abdominal fat, according to background information in the study.

The new research, published in the Nov. 13 issue of the New England Journal of Medicine, included almost 360,000 people from nine European countries who were part of the European Prospective Investigation into Cancer and Nutrition (EPIC).

In addition to weight information and whether or not the study participants had died, the researchers also adjusted the data for education level, smoking status, alcohol consumption, physical activity and height.

During a follow-up period of almost 10 years, slightly less than 15,000 people enrolled in the study had died.

Those with the lowest risk of death were men with a BMI of 25.3 and women with a BMI of 24.3. A body mass index between 25 and 29.9 is considered overweight, and a BMI over 30 is considered obese, according to the U.S. National Heart, Lung, and Blood Institute.

Men with a BMI between 30 and 35 had a 24 percent increased risk of death compared to normal weight men. And women with a BMI between 30 and 35 had a 17 percent increased risk of death compared to their slimmer counterparts, Pischon said.

When the researchers factored in abdominal fat, they found that men with the largest waist circumference had more than double the risk of death, and women with the largest waist circumference increased their risk of death by 78 percent.

"Having a large waist circumference is related to a higher risk of death. This is even true for people who -- in terms of BMI -- would be considered as being normal weight," Pischon said.

Dr. Marc Siegel, an internist at New York University Langone Medical Center in New York City, said, "Fat is a problem. Obesity of all kinds correlates with heart disease, stroke, diabetes, and more. But, abdominal fat is a more rudimentary indicator of risk.

"The bottom line is, if you want to live a long and healthy life, eat right, exercise and reduce stress. Fat is bad for you, period," Siegel added.

More information
To learn more about the health risks of too much weight, visit the Weight-control Information Network.

High Sodium Levels Don't Raise Blood Pressure

(HealthDay News) -- Elevated sodium levels in the blood aren't related to the future risk of high blood pressure, say U.S. researchers who looked at almost 2,200 people.

At the start of the four-year study, the participants' blood pressure levels were defined as optimal, normal or high-normal. None of them had high blood pressure. Sodium levels increased with age, and those with higher sodium levels had a higher rate of diabetes and higher creatine levels, which suggests decreased kidney function.

However, study leader Dr. Rodrigo M. Lago and colleagues found no association between blood sodium levels and blood pressure, and no link between sodium and gender or body weight.

During the study, blood pressure increased by at least one stage (for example, from normal to high-normal) in 37 percent of the participants, including 15 percent who developed high blood pressure. But the risk of increasing blood pressure was unrelated to blood sodium levels. In fact, the study found that those with the highest sodium levels had a lower risk of developing high blood pressure.

The findings, which were published in the November issue of the Journal of Hypertension, suggest that many different factors contribute to differences in blood pressure between individuals, the study authors said.

But they added that people still need to watch the amount of salt in their diet.

More information
The American Academy of Family Physicians offers tips on how to lower high blood pressure.

Every Diabetic Is Ultimately a Diabetes Educator

By Sean Kelley

Americans apparently know a lot about diabetes. A recent Gallup survey found that:
• 81% of respondents had been tested for diabetes

• 25% had been told by a health-care professional that they were at high risk for the disease

• 56% believed the disease to be as serious as heart disease, the No. 1 killer in America.

Even more interesting, most respondents were keenly aware of major risk factors for the disease and preventive measures that diabetics could take to avoid complications—although conclusions from focus groups recently held by the American Diabetes Association seem to contradict the Gallup findings. Read More

All This Talk of Diabetes Mortality Is a Downer

By Sean Kelley

Last week I went to San Francisco for the American Diabetes Association’s Scientific Sessions, a huge annual gathering of endocrinologists, scientists, nurse educators, and pharmaceutical companies. The latest research on type 1 and type 2 diabetes was delivered, theories discussed, and news announced.

There was much discussion of uncomfortable subjects: neuropathy, nephropathy, cardiovascular disease, hypoglycemia, death. While not fatal itself, diabetes has lots of excellent ways to kill you through related conditions: stroke, heart disease, and kidney failure spring immediately to mind. Read More

Healthy Raw Food Recipes Class: "Green Up Your Diet"

Join Chef Dina Knight of elivinghealth.com and greenivore.net as she speaks with guest chef Alicia Ojeda on the importance of greening up your diet. Reversing diabetes, weight-loss, emotional eating..join us at the upcoming class "Green Up Your Diet" live!