How Americas Diet Culture Hinders Those With Eating Disorders

The inevitable January advertising of New Year, New You has arrived, and with it, the societal pressure to drop weight.

For some, this can be motivating, even goodafter all, Americas obesity rate is at a record high, according to research from the Centers for Disease Control and Prevention. But for many, the pressure to lose weight can be quite triggering, especially for those predisposed to developing eating disorders.

Longstanding research has shown that eating disorders can be hereditary, meaning some people are simply more likely to develop them than others. But new research from the Eating Recovery Center shows there might be a more specific genetic link than previously thought.

The risk of developing an eating disorder is largely inherited, meaning that people with a family history of eating disorders are more likely to have one, but the identity of which genetic variation increases that risk is unknown, Michael Lutter, who works as an attending psychiatrist for the Eating Recovery Center, told The Daily Beast.

Lutter researches the genetic and neurobiologic basis of eating disorders; his goal is to find a very specific genomic mutation that could cause eating disorders. While the genomic mutation hes looking for most likely affects a very small amount of people, it could be a game changer for treating eating disorders.

Lutter compared his search for this gene to that of breast cancers BRCA1 and 2 mutations.

Individuals with those mutations have a much higher risk of breast cancer, but only three percent of breast cancers are caused by these mutations, according to the CDC.

Similarly, we are trying to find something similar in the eating disorder population. If we can find the rare mutation, then it gives a better understanding of the underlying neurobiology of eating disorders, he said.

Lutters latest research sequenced the genes of 93 unrelated people with eating disorders, some who restrict their food and some who binge eat. Its pretty uncommon for an eating disorder patient to struggle exclusively with anorexia, bulimia or binge eating disorder, as people will cross over disordered eating behaviors in their lifetime, Lutter said, so the two groups of patients that were tested was a fair sample for this study.

He found specific links in two different genetic variations. For restrictive eaters, the variant is called neurotensin, which works in the brain to regulate appetite and tells your body it needs more food. For binge eaters, its called glucagon-like peptide 1, a hormone released by the gastrointestinal system after meals to tell you when youre full.

These results dont surprise Lutterhe says the fact that people with eating disorders would have genetic mutations for genes involved in appetite and fullness makes sensebut they had never been seen before. Still, the findings are in their preliminary stages; they cant be applied in a clinical setting yet.

Right now theres no way to use genetics to guide treatment but it does offer a better understanding of the pathophysiology of the illness that we can do these studies and measure levels of these hormones, Lutter said. He thinks that were close to developing treatment for eating disorders based on genetics in the next 10 or 20 years.

Lutter said that whats exciting is that there are drugs on the market that could target the hormones in the genetic variations his research found. For example, some diabetes medications might be able to restrict ones urge to binge eat. There are good drug targets so there are a lot of new potential leads for researchers to develop new treatments, he noted.

Until then, however, the New Years resolution madness can be quite challenging.

Lauren Muhlheim, Psy.D., a clinical psychologist for Eating Disorder Therapy LA, says that while this genetic research is important, its also relevant to know that there is no one single cause of someones eating disorder.

They are very complicated illnesses that dont stem from a single cause but from a complex interaction of biological, psychological and environmental factors. And I dont think you can ever tease it apart, she said.

Those environmental factors? The huge focus around losing weight or becoming a better version of yourself for the New Year.

Even though research shows that 80 percent of New Years resolutions (the top two being exercising more and eating healthier) fail, its easy to buy in to the idea that you need to lose weight, specifically at a time when were bombarded with messages that target body insecurities.

I cant remember who said it, but someone once said that the diet industry is brilliant because its the one product that repeatedly fails and makes you believe that its your fault, Muhlheim said. People are very susceptible to the newest fad diet, so I think its a very challenging time of year to people who are susceptible to eating disorders, especially with social media. Were getting more bombarded than we have in the past.

How do you know if youre susceptible to eating disorders? As its a very complex disease, its impossible to pinpoint this, but Tom Hildebrandt, Chief of the Division of Eating & Weight Disorders at Mount Sinai Health System, told The Daily Beast that some things to take note of are whether or not youre in an environment where restriction and dieting is valued in a critical way, are extremely stressed or are going through a big transition in your lifewhether thats high school to college, college to adulthood, becoming a parent, or even going through menopause.

The thing about this time of year is really not to get caught up in the swarm of information that comes from peers, social media and advertisers trying to sell you fixes to it, Hildebrandt said. Try to insulate yourself against that stuff.

This, of course, is easier said than done. Muhlheim suggested curating a healthy, body-positive feed on your social media channels and consuming culture that steers away from harmful messaging. Muhlheim recommended following the hashtag #haes, or healthy at every size, and #intuitiveeatinga quick search yields registered dietitians like Claudia T. Felty and Alissa Rumsey, whose feeds are all about having a healthy relationship foodor downloading podcasts like Love, Food.

That said, eating disorders are dangerous. If you or someone you know is struggling, its important to get an evaluation by a physician or a therapist, Muhlheim said, referring those who may be binging or purging, is preoccupied by obsessive thoughts about food, is having trouble functioning normally, or is skipping social events to contact the National Eating Disorders Association Helpline or the Eating Recovery Center.

Read more: https://www.thedailybeast.com/how-americas-diet-culture-hinders-those-with-eating-disorders

I just want to cut it off: the weight-loss patients who no longer fit their skin

Bariatric surgery is a highly cost-effective way to lose life-changing amounts of weight but the NHS rarely removes the excess skin that is left behind. Desperate patients are now crowdfunding their operations while struggling with anxiety, depression and identity issues

When Haze Atkin passed the 32kg (5st) mark on her weight-loss programme, something strange began happening to her skin. First it grew softer. Then it grew emptier. By the time she had shed her 64th kilo, her body had shrunk so much that her loose skin needed to be folded into her clothes. Now, when Haze sits, a hovercraft of skin skirts her seat. When she takes a bath, her spare skin floats. In bed, her husband Chris accidentally rests an elbow on it; he cant always be sure where Haze ends. The edges of her have become mistakable.

To her childrens delight, Haze can wobble her skin and make it talk like a puppet. Sometimes her daughter holds out her hands like a set of scales and Haze places her stomach skin on them. She thinks it weighs a stone. It has become oddly plastic, so that Haze can gather it in her hands and stretch and shake it, fold and mould it. But the one thing she can never do with her skin is forget it.

Like many people with excess skin, Haze lost a lot of weight after bariatric surgery. In the 10 months after her gastric bypass an operation the NHS has come to see as highly cost-effective she shrank from 149kg (23.5st) to 70kg (11st). She met all her targets. Her surgeons called her a model patient. And yet, just when Haze should have felt she had achieved her goal, her skin held her back. The scales said she had reached the end of her journey, but the mirror told a different story.

Haze is one of the 9,325 UK patients who in 2013 underwent bariatric surgery on the NHS, according to statistics held by NHS Digital. The same year, NHS England reported that the price of keyhole bariatric surgery for diabetes patients with a BMI of 35, for instance, is recoverable in just 26 months. According to projections from the Department of Health, the cost to society and the economy of people being overweight and obese could increase to almost 50bn in 2050, so it is easy to see why bariatric procedures make financial sense. But is the surgery causing a different kind of health crisis? Is such massive weight loss MWL, as healthcare professionals call it solving one problem only to create a new one, a generation of weight-loss survivors tormented by anxiety and depression because they no longer fit their skin?

Haze has a simple message to the NHS. You dont just leave people half-done. Finish it.

The NHS does perform some skin removal operations. But the only mention of skin removal in all Nices recommendations is that a multidisciplinary bariatric team provide information on, or access to, plastic surgery (such as apronectomy) when appropriate (an apronectomy is a mini tummy tuck to remove the apron of skin that hangs over the pubic area). This provision varies hugely by region. In theory, a patient needs to show that skin removal surgery is a health rather than a cosmetic intervention.

In practice, the local clinical commissioning groups, which commission NHS healthcare, rarely approve such applications which is why crowdfunding websites are full of people who have lost massive amounts of weight and are desperate to remove their skin, even if it means posting explicit, naked or near-naked photographs that play to a sort of pornography of excess skin. Hazes page has raised 332 of the 6,600 she needs for surgery. She applied to the NHS she suffers from skin infections, anxiety and depression, and believes the extra weight exacerbates her fibromyalgia (she is registered disabled). But she was rejected.

Lisa
Lisa Riley, who had skin surgery. Photograph: Ken McKay/ITV/Rex/Shutterstock

So each week for the past four years she and Chris have laid aside 20 every spare penny towards the cost of the fleur de lis abdominoplasty on which Haze has set her heart. This double incision runs vertically and horizontally, and was part of the suite of operations carried out on the actor and TV presenter Lisa Riley in her documentary Lisa Rileys Baggy Body Club. The fleur de lis leaves a wound so severe that Rob Winterton, the cosmetic surgeon who performed it on Riley, says it is comparable to a 20 or 30% burn.

But for Haze, the surgery is the only way out of an unbearable predicament. At 30, she finds her skin so invasive, so mentally hard to deal with, every day I just want to cut it off myself. It invades my thoughts, my feelings, all the time. Every time I get dressed.

If you catch yourself in the mirror, Chris interjects. If I touch you wrong. If I roll on you. If I see you getting dressed.

Hazes skin is always on her mind which is not, of course, where skin is meant to be. Her daily life has evolved to make dozens of minute accommodations. She must wash carefully, lying down and stretching her skin out in order to clean and dry it thoroughly. Where the skin is folded, bacteria grows, she says. Dressing is a military operation. Everything is tucked away. And her relationship, the way she and Chris interact, has changed too.

Haze has gone from one kind of person to another, and the speed of her transformation has caught both her and Chris by surprise. You went from having a plus-size, curvy, full wife which you never had a problem with to suddenly this petite woman with hanging sacks of skin, Haze says to Chris, who is seated at her side. And it really threw you.

It was trying to remember who she is, Chris replies. Not mentally but physically. Its like, are you sure its you?

The pair have been married for 13 years. But the surgery, so hyper-efficient and cost-effective, has not given their emotions, their instincts, their bodies, time to adjust. Ill get there in the end, Chris says. Its because the process is so quick. Very shocking.

They had a small amount of savings, which Haze spent on a breast augmentation to save my sanity because she was so depressed by her new paper bag breasts. Even so, in their most intimate moments, Hazes skin still comes between them. If Im on top and I lean forward, she says, my stomach gets there first. She turns to Chris. You literally hold it back, she says, putting her hands at her narrow waist to demonstrate. To try and make you feel better, he nods, and they reach for each others hands.

Two further years of saving lie between Haze and Chris Atkin and the promised land of an operation so extensive that Winterton says it puts two and a half feet of scar on a patient. Providing, of course, that inflation does not outstrip them. But Paul Watling, 34, from Manchester, has barely a week to wait. Like Haze, he was rejected for the operation on the NHS after months of psycho-evaluation. He was trying to get along with his skin, to live with it, until last summer when he picked up a friend from hospital after body lift surgery.

The sight of his friend in his new skin made Paul see himself with unexpected clarity. At lunch with his mother and his girlfriend, Charlotte, I turned around and said: I need it. I just felt the time had come to put this part of my life to bed.

We are talking in a breakout area of Manchester Metropolitan University where Paul works as a night-time duty manager for halls of residence. While students amble down the corridor, Pauls voice quickens. This is it! Something that has been a negative aspect of my life for all my life is banished for ever.

Paul
Paul Watling: I feel great. But I dont look it. I look awful. Photograph: Christopher Thomond for the Guardian

The negative aspect of Pauls life began as a child with a tendency to overeat. At 22, he weighed 191kg (30st). He was offered a gastric bypass after doctors discovered a lung tumour (he was too fat to operate on) and this was in 2005 was promised that his excess skin would be removed on the NHS. However, by the time his weight had stabilised, he was turned down for the skin surgery. Depressed by what he saw in the mirror, the nipples that sagged far below his chest, the reams of spare stomach and undereye sacks that made him look permanently tired, Paul began to eat and drink heavily.

I thought: If Im going to look this bad, I may as well fill it out and just be the fat guy again, he says.

Over the next 10 years his weight rose as he ate to fill up his skin; a gastric bypass is only a tool to help with weight loss, and depends on adjustments to diet and exercise to work. While his stomach expanded, Paul kept telling himself: Im nowhere near as bad as I was. Then, last Christmas, he woke up after a binge and needed the bathroom. Looking down at the toilet bowl, he realised he couldnt see what he was doing; his stomach was too large. I thought, thats not normal. I dont remember that.

He was staying at a friends house, and his friends bathroom contained a set of scales, something Paul hadnt seen in a long time. He stepped on. I was like: Wow! This is insane! The scales said he weighed 162kg (25.5st). He found his friend in the kitchen. I took my shirt off and said: Take a photo. And I could see, in that photo, the 21-year-old me. I said: This has to stop.

He researched nutrition and exercise plans and began to adjust his diet and lift weights. After 11 months, in an entirely self-directed effort, he had lost 64kg (10st).

I feel better than I have ever felt in my life, Paul says. I feel great. But I dont look it. I look awful. While we talk, Pauls right arm disappears beneath the table to shield his stomach from passersby.

Im happier now with the way people treat me and it is a world of difference. But when I was bigger, I was happier with the way I looked. I was just a fat guy. Thats all I was. Yeah, people take the piss and are cruel but its there for everyone to see. This, he says, looking down to where he can feel his skin pulling over his belt line, is a hidden shame. Even the fat guys in the gym hang around in the dressing room. But Im ashamed. I sneak into the family room and lock the door.

Paul is troubled not only by his skin but also by the fact that it troubles him. Its a constant internal struggle for me. Why are you spending 10 grand on this? Its just appearance. Come on! You can rise above this. Of course, how you look shouldnt matter, he says, but it does matter, because of the experiences you had when you were younger, the years of verbal and physical abuse. He is a heavy metal fanand has always identified as an outsider, found comfort in it. But his skin has made him feel more privately misplaced, estranged in a way that is unfamiliar he has become an outsider in his own body.

I know I should be proud of my excess skin. It should be a battle scar But the flip side, which is the stronger side that always wins, is: Look at the state of you, youre gross, youre disgusting, you cant let anyone see you I dont want to fit in with society, I want to fit in with myself.

Paul is right that not everyone with excess skin feels as he does. Krystina Wright, 31, from Grendon in Warwickshire, lost 44kg (7st) with the help of Slimming World, and has a pouch at her stomach.

She knows she has undergone a transformation, and that her skin tells the story of it. Last year she was shortlisted for Slimming Worlds woman of the year. Out dress shopping, she stood in the fitting room in her underwear, and her mum remarked, You can see youve lost weight. But I never see that in the mirror, Krystina says. When Im walking, [the skin] around my legs is obviously looser than somebody who hasnt lost weight but I just ignore it. Im so happy with my journey that everything negative about my old self doesnt seem to matter.

Even in her contentment, however, Krystina still associates the experience of being fat with an old self, and it is this sense of disjuncture between an old self and a new self, a fat self and a thin self, that challenges people who have lost a transformative amount of weight.

Skin is a boundary between ourselves and the outside world. But for Haze Atkin, her skin, in its looseness, provides an untrue border; her skin seems to stop beyond her true edges. Instead, she strongly demarcates the line between old and new selves. When she was fat, she was Hayley. Two years ago, after weight loss, she changed her name legally. Its weird to see pictures of me before, she says. You cant I cant tie those two people together.

Im very proud of Hayley. But thats not me. Theres a real separation. She picks up her stomach. The thing thats hanging on is this. Hayleys skin.

Elna Baker can relate to Hazes divided self. The American writer and performer, 35, has documented her weight loss and skin removal surgery in blogs and podcasts such as This American Life. Between losing weight (nearly 50kg/8st) and losing the skin, she lived in the same sort of limbo as Haze she thinks of it now as a transitional place between fat and this idea of thin.

Elna
Elna Baker: I feel like Im wearing a disguise. Photograph: PR

But Baker also says she has travelled further along the timeline I dont know how to explain it. But theres, like, a core thing that youre still running from, she says, speaking on the phone from New York. And not to sound ungrateful for the means and the experience of getting to transform, but I also feel its more complicated than I expected, because its about identity and gender and worth. The thing that still saddens me is that I lived too long in the world as a fat woman to forget the way the world exists when youre fat. So now I feel like Im wearing a disguise, which allows me not to have to experience on a daily basis judgment, shame and hatred. But I also have all this muscle memory of that. So I sometimes feel confused like Im still experiencing a side-effect of a thing I no longer am.

Baker had implants to return her breasts to their former size, a body lift, a thigh lift and a circumferential body lift a cut around the circumference of the body. The scar draws a line between her top half and bottom half and has left her feeling, literally, a little divided.

Despite complications afterwards that meant that she had to pack her wounds with gauze, pushing wads into the holes left by burst stitches as if she were stuffing a soft toy, Baker is glad that she had the operations. But she has spent the past year using therapy, meditation and self-help to address the boundary between old Elna and new Elna. She hopes the division is an illusion and it is possible to reach into the depths of me and meet the person [I was] and integrate it.

Haze, meanwhile, hopes for the opposite, that surgery will not only make her proud of her body but sever her from the past. And Paul, only a week away from his operation, sometimes has to quiet the small voice that asks: What if I go through this and Im still not happy? He reminds himself: Ive set this up in my mind. This is closure of a lifetime of not being happy in my body.

All he, and Haze and anyone, really want is to be comfortable in their own skin.

Read more: https://www.theguardian.com/lifeandstyle/2018/jan/02/i-want-to-cut-it-off-weight-loss-patients-excess-skin

Poor diet is a factor in one in five deaths, global disease study reveals

Study compiling data from every country finds people are living longer but millions are eating wrong foods for their health

Poor diet is a factor in one in five deaths around the world, according to the most comprehensive study ever carried out on the subject.

Millions of people are eating the wrong sorts of food for good health. Eating a diet that is low in whole grains, fruit, nuts and seeds and fish oils and high in salt raises the risk of an early death, according to the huge and ongoing study Global Burden of Disease.

The study, based at the Institute of Health Metrics and Evaluation at the University of Washington, compiles data from every country in the world and makes informed estimates where there are gaps. Five papers on life expectancy and the causes and risk factors of death and ill health have been published by the Lancet medical journal.

It finds that people are living longer. Life expectancy in 2016 worldwide was 75.3 years for women and 69.8 for men. Japan has the highest life expectancy at 84 years and the Central African Republic has the lowest at just over 50. In the UK, life expectancy for a man born in 2016 is 79, and for a woman 82.9.

Diet is the second highest risk factor for early death after smoking. Other high risks are high blood glucose which can lead to diabetes, high blood pressure, high body mass index (BMI) which is a measure of obesity, and high total cholesterol. All of these can be related to eating the wrong foods, although there are also other causes.

causes of death graphic

This is really large, Dr Christopher Murray, IHMEs director, told the Guardian. It is amongst the really big problems in the world. It is a cluster that is getting worse. While obesity gets attention, he was not sure policymakers were as focused on the area of diet and health as they needed to be. That constellation is a really, really big challenge for health and health systems, he said.

The problem is often seen as the spread of western diets, taking over from traditional foods in the developing world. But it is not that simple, says Murray. Take fruit. It has lots of health benefits but only very wealthy people eat a lot of fruit, with some exceptions.

Sugary drinks are harmful to health but eating a lot of red meat, the study finds, is not as big a risk to health as failing to eat whole grains. We need to look really carefully at what are the healthy compounds in diets that provide protection, he said.

undernourishment graphic

Prof John Newton, director of health improvement at Public Health England, said the studies show how quickly diet and obesity-related disease is spreading around the world. I dont think people realise how quickly the focus is shifting towards non-communicable disease [such as cancer, heart disease and stroke] and diseases that come with development, in particular related to poor diet. The numbers are quite shocking in my view, he said.

The UK tracks childhood obesity through the school measurement programme and has brought in measures to try to tackle it. But no country in the world has been able to solve the problem and it is a concern that we really need to think about tackling globally, he said.

Today, 72% of deaths are from non-communicable diseases for which obesity and diet are among the risk factors, with ischaemic heart disease as the leading cause worldwide of early deaths, including in the UK. Lung cancer, stroke, lung disease (chronic obstructive pulmonary disorder) and Alzheimers are the other main causes in the UK.

The success story is children under five. In 2016, for the first time in modern history, fewer than 5 million children under five died in one year a significant fall compared with 1990, when 11 million died. Increased education for women, less poverty, having fewer children, vaccinations, anti-malaria bed-nets, improved water and sanitation are among the changes in low-income countries that have brought the death rate down, thanks to development aid.

People are living longer but spending more years in ill health. Obesity is one of the major reasons. More than a billion people worldwide are living with mental health and substance misuse disorders. Depression features in the top 10 causes of ill health in all but four countries.

Our findings indicate people are living longer and, over the past decade, we identified substantial progress in driving down death rates from some of the worlds most pernicious diseases and conditions, such as under age-five mortality and malaria, said Murray Yet, despite this progress, we are facing a triad of trouble holding back many nations and communities obesity, conflict, and mental illness, including substance use disorders.

In the UK, the concern is particularly about the increase in ill-health that prevents people from working or having a fulfilling life, said Newton. A man in the UK born in 2016 can expect only 69 years in good health and a woman 71 years.

This is yet another reminder that while were living longer, much of that extra time is spent in ill-health. It underlines the importance of preventing the conditions that keep people out of work and put their long term health in jeopardy, like musculoskeletal problems, poor hearing and mental ill health. Our priority is to help people, including during the crucial early years of life and in middle age, to give them the best chance of a long and healthy later life, he said.

Read more: https://www.theguardian.com/society/2017/sep/14/poor-diet-is-a-factor-in-one-in-five-deaths-global-disease-study-reveals

Billionaire Bloomberg to fund $5m public health projects in 40 cities worldwide

Exclusive: Melbourne, Accra and Ulaanbaatar among cities to benefit from funding pledged by former New York mayor to tackle issues from air pollution to obesity

Michael Bloomberg, the billionaire bte noire of both the sugar industry and the tobacco industry, famously fought for a ban on the sale of large-sized colas and other sweet drinks when he was mayor of New York and lost. Although that is not how he sees it.

We actually won that battle, he says. I have always thought if we had not been stopped by the court, it would have died as an issue. Nobody would have known about it. But the fact that it kept coming back to the newspapers was a gift in disguise because people started to think, Holy God, maybe full-sugar drinks are bad for me.

So what happened was consumption of full-sugar drinks around the world has gone down dramatically. If we had won the thing, I think it would have been less.

Bloomberg did plenty more for public health while mayor of New York, including imposing one of the first bans on smoking in bars and restaurants in 2003. Since then he has widened his sphere of influence, funding successful campaigns through his philanthropic foundation for sugar taxes in Mexico and Philadelphia and for curbs on smoking all over the world.

Now, appointed last year as the World Health Organisations global ambassador for non-communicable diseases meaning anything that can harm or kill you that is not infectious the eighth richest person in the world, worth an estimated $47.5bn, is taking his philosophy and his cash to 40 cities around the globe.

His offer, taken up by about 40 cities so far and officially launched on Tuesday, is $5m in assistance from Bloomberg Philanthropies as well as technical support for cities that choose to focus on one of 10 healthy lifestyle issues, including curbing sugary drink consumption, air pollution, promoting exercise and and bans on smoking. They range from affluent Melbourne in Australia to Cali and Medellin in Colombia, Accra in Ghana, Ulaanbaatar in Mongolia, Khatmandu in Nepal and Kampala in Uganda.

National and state governments collect taxes, but it is city governments that make things happen. 50% of people currently live in cities and that is projected to rise to 70% in the next decade or so. Cities are where the rubber meets the road, Bloomberg told the Guardian. The problems are in the cities and the solutions are in the cities.

Bloomberg is upbeat, indomitable and an independent thinker. He made his money in global financial services and has been a Democrat, a Republican and an independent at various times. He says he believes the war on sugar and tobacco, of which his foundation must be seen as the main global financial backer, is being won.

In parts of the world, clearly yes, and particularly on smoking, he said. In Europe nobody would have thought people wouldnt insist on smoking in an Irish bar or pub or an Italian restaurant, but the smoking campaign has really worked, reducing consumption in all of western Europe, north and south America and even in China.

But there are places where poor people live and they are still smoking and really damaging their lungs and they are going to die young. It is up to us to keep the battle going. Sugar is a little bit less developed but still working.

His attention is on non-communicable diseases more broadly now that includes air pollution and road traffic accidents as well as cigarettes, alcohol and bad food. Cities in poor countries may argue that they have too many other problems to spend time on sugary drinks, but, says Bloomberg, poverty, ill-health and poor education are all interlinked.

It will be harder to get the public behind you because they less understand the damage being done to their own health. But thats the challenge. The cities where its easy have probably already addressed the issue, he said.

Michael
Michael Bloomberg and WHO director-general Dr Margaret Chan Photograph: Bloomberg Phlilantropies

Bloomberg would not suggest it is easy to make the sort of changes he has pushed for in all these years.

I dont remember anybody objecting to the smoking ban when we put it in, although a lot of people wanted to take my picture and a lot of people gave me one finger waves, he said. If there was an easy solution to a complex problem, we wouldnt have the problem. If you want to make things better, youre going to be doing things that are tough.

The cities that commit to the Partnership for Healthy Cities can choose between curbing sugary drink consumption, passing laws to make public places smoke-free or banning cigarette advertising, cutting salt in food, using cleaner fuels, encouraging cycling and walking, reducing speeding, increasing seatbelt and helmet use, curbing drink driving or carrying out a survey to collect data on the lifestyle risks the city population runs.

Cape Town in South Africa was one of the earliest cities to commit and will focus on reducing the intake of sugary drinks. Its mayor, Patricia de Lille, says they are facing an epidemic of type 2 diabetes, caused by obesity. Diabetes is a silent killer, she said. We dont have the luxury to work by trial and error. Unfortunately we have to get it right first time.

London has also said it wants to be involved, although which issue will be the focus has not yet been revealed. It is a city with which Bloomberg says he has a complex relationship his former wife is British and his daughters hold dual nationality. He has an honorary knighthood from the Queen. He also has an honour from the City of London that he intends one day to cash in.

I do have the right to drive sheep across London Bridge and before I die, I want to do it one day at rush hour, just to see what happens, he said.

Read more: https://www.theguardian.com/society/2017/may/16/billionaire-bloomberg-to-fund-5m-public-health-projects-in-40-cities-worldwide

Newly Discovered Enzyme Prevents Sugar Being Stored As Fat

Its January, and many of you are likely scrambling to pick a diet in an attempt to lose some of the post-Christmas weight gain. Your body’s conversion of all the excess sugar consumed into fat certainly didn’t help, but a team of researchers from the University of Montreal may have found a way to regulate this. As reported in Proceedings of the National Academy of Sciences, a new enzyme has been discovered that can directly control how your body converts sugar and fats.

Mammalian cells use both sugar (glucose) and fatty acids as their main sources of energy. Much of this glucose is stored in the liver as glycogen, a dense compound that can be mobilized whenever the body requires it for energy production. Those in developed countries tend to have diets that are too sugar-rich, giving themselves far more glucose than their body needs at the time. An excess of carbohydrates will also produce too much sugar for the body to be able to immediately use. Any large glucose excess is converted and stored as fat, and a major build up can lead to obesity.

Insulin, a hormone produced by the pancreatic beta cells, causes the liver to convert glucose into glycogen. Those with type 2 diabetes do not produce enough insulin when required, or they produce ineffective insulin that isnt able to interact with the glucose in the blood, meaning glucose remains in the bloodstream.

Excess glucose in the blood also leads to the over-generation of a glycerol 3-phosphate (Gro3P) within cells. Normally, Gro3P participates in many cellular processes, including the formation of fats (lipids) andthe conversion of glucose into other useful compounds (glycolysis).

However, too much Gro3P is toxic to cells; tissues can be damaged, and the metabolic, glucose, and fat conversion processes are unable to operate properly. The derangement of these can lead to type 2 diabetes and even cardiovascular (heart) disease. Thus, excess glucose in the body is essentially toxic for a variety of reasons.

Cupcakes, of course, will input a fairly high amount of sugar into your bloodstream. Ruth Black/Shutterstock

As this new study details, an enzyme called Gro3P phosphatase, or G3PP, has been discovered, hiding within all types of body tissue. This enzyme appears to be able to regulate both the conversion of glucose and fats into other compounds, and the production of adenosine triphosphate (ATP), the cell’s “energy currency.” This means that G3PP has direct influence over how glucose and fats are used within the body.

Using laboratory rats, the researchers showed that increasing the activity of G3PP within their livers ultimately lowers their weight gain and ability to produce glucose from the liver. Murthy Madiraju, a researcherat the University of Montreal Hospital Research Centre (CRCHUM), noted in a statement that G3PP prevents excessive formation and storage of fat and it also lowers excessive production of glucose in liver, a major problem in diabetes.

This offers a stepping stone for researchers hoping to manipulate this enzyme within humans. By using G3PP to alter how glucose and fats are absorbed and produced, those unable to control this themselves such as those suffering from type 2 diabetes could potentially be treated.

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Read more: http://www.iflscience.com/health-and-medicine/newly-discovered-enzyme-prevents-sugar-being-stored-fat

Why a Cure to Obesity Could Be in Your Poop

Discussions about weight loss may soon take a dramatic turn. At issue will be the microbiome, a collection of bacteria that lines the intestine, nose, throat, skin, and genital tract.

Although people are blissfully unaware of its existence, humans have about 10 times more bacteria lining the surface of their bodies (about 100 trillion) than they have cells in their bodies (about 10 trillion). In many ways, we live in peace with our microbiome, which helps to digest food and balance glucose levels. But the microbiome has also been associated with various problems, including asthma, allergies, eczema, and diabetes. The microbiome also helps to store fat, which can lead to obesity.

Obesity isnt a trivial problemit affects life-expectancy, quality of life, and health-care costs. The problem is far more common than most people realize. More than 44 percent of the worlds population is obese; 300 million people are morbidly obese. In the United States, about 35 percent of the population battles obesity.

So how can you know whether you have a good microbiome or a bad microbiome?

Microbiomes are acquired when babies leave the womb (which is sterile) and enter the birth canal (which isnt). This is the moment when people inherit a set of bacteria that will later determine whether they are more likely to be thin or obese. So what do we do? We fight back with diet and exercise. As a consequence, many people successfully lose weight. Unfortunately, about 80 percent of those who lose weight will regain it within 12 months. The yo-yo effect occasionally exceeds the original weight. Researchers have now shown that both the propensity for obesity and the demoralizing weight rebound can be predicted by the type of bacteria that comprise the intestinal microbiome.

Can the microbiome be manipulated away from the obese phenotype and toward the thin phenotype? Recently, scientists have performed a series of studies that offer a ray of hope.

In 2013, Jeffrey Gordon and coworkers at the University of Washington studied three sets of female fraternal twins and one set of identical twins. In each case, one twin was obese and the other thin. The researchers then took fecal samples from an obese twin or a thin twin and transferred them into the intestines of mice that were sterile (so-called germ-free mice). Although all of the mice ate the same amounts of food, those that had received intestinal bacteria from obese women stored more fat and grew heavier than those that had received microbiomes from thin women.

When Gordon and his colleagues put the thin mice and obese mice into the same cage, they found something that surprised them. The obese mice became thin. The reason was that mice are coprophagic, meaning that they eat feces from other mice. In this case, the obese mice ate the feces from the thin mice. (Its unclear whether it is more disgusting that mice eat the feces of other mice or that there is actually a word for it.)

In 2016, Eran Elinav and coworkers at the Weizmann Institute of Science in Rehovat, Israel, advanced Gordons studies by determining exactly what was happening in the intestines of thin mice that allowed them to remain thin.

First, they repeated Gordons studies, finding that germ-free mice that received the feces from obese mice became obese and those that received the feces from thin mice remained thin. Then they studied the yo-yo effect. They found that when obese mice lost weight, they were much more likely to regain the weight and regain it quickly if they retained the microbiomes of obese mice. On the other hand, if obese mice received fecal transplants from thin mice, they would not only lose weight, they wouldnt regain it. The researchers had eliminated the yo-yo effect.

Then the Israeli researchers compared the metabolites produced by the bacteria in obese mice with those produced in the intestines of the thin mice. One thing jumped out: Mice that were obese no longer produced certain flavinoids, specifically apigenin and narigenin. (Flavinoids are a byproduct of certain plants and fungi.) Then they found out why. The bacteria from obese mice made enzymes that destroyed apigenin and narigenin, so less of these flavinoids were available. They also found that high-fat diets promoted the growth of bacteria that destroyed the flavinoids.

Why was this important? Flavinoids are critical to the storage of fats. Also, apigenin and narigenin increase energy expenditure. Because they had lost apigenin and narigenin, obese mice expended less energy and stored more fats.

The next experiment was encouraging. Researchers found that administering apigenin and narigenin to obese mice not only caused them to lose weight; it also eliminated the yo-yo effect.

What does this mean for people? Hard to know. Mice arent people. But studies are underway to determine whether obesity can be treated with fecal transplants from thin people or by administering flavinoids like apigenin and narigenin. Time will tell. But discussions about losing weight might soon shift from miracle diets to something entirely different.

Paul A. Offit is the director of the Vaccine Education Center at the Childrens Hospital of Philadelphia and the author of Pandoras Lab: Seven Stories of Science Gone Wrong (National Geographic Press, 2017).

Read more: http://www.thedailybeast.com/why-a-cure-to-obesity-could-be-in-your-poop

Gluten-free diet carries increased obesity risk, warn experts

Food adapted for those with coeliac disease often has more fat and less protein, and no benefits to non-sufferers, finds research

Substituting everyday staples with gluten-free foods could increase the risk of obesity, experts have warned, after finding that such products often contain higher levels of fats than the food they aim to replace.

A gluten-free diet is essential to those with coeliac disease an auto-immune condition that is thought to affect 1% of Europeans while the regime is also proving increasingly popular among those without the disease. But while a host of gluten-free products are on the market, researchers have said they have a very different nutritional make-up to conventional staples.

There is very little [consumers] can do about it, said Joaquim Calvo Lerma of the Instituto de Investigacin Sanitaria La Fe in Spain and co-author of the research. Unfortunately consumers can [only] eat what is available on the market.

Calvo Lermas warning comes after he and his and colleagues compared 655 conventional food products to 654 gluten-free alternatives across 14 food groups including breads, pasta, breakfast cereals, biscuits and even ready meals, covering a range of brands.

The results presented at the annual meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition reveal that, overall, gluten-free products were more energy-dense than their conventional counterparts.

The team found that, on average, gluten-free bread loaves had more than twice the fat of conventional loaves, while gluten-free breads in general had two to three times less protein than conventional products. Gluten-free biscuits were also found to be lower in protein but higher in fat, while gluten-free pasta had lower levels of sugar and just half of the protein of standard pasta.

Calvo Lerma warned that gluten-free foods could be contributing to an increased risk of obesity, particularly among children who are more likely to eat products like biscuits and breakfast cereals. He urged consumers to compare gluten-free products across brands to find those with the lowest fat content.

Calvo Lerma also called on manufacturers to innovate. It is the responsibility of the food industry to produce these type of gluten-free products from other materials that are much healthier or have a [more] enhanced nutritional profile than the current raw materials being used, like cornflour or potato starch, he said, pointing out that healthier products could be made, for example, using grains such as buckwheat or amaranth.

He added that manufacturers should also add more complete and clearer labels to products to highlight their nutritional content, including levels of vitamins and minerals.

Benjamin Lebwohl, from the coeliac disease centre at Columbia University, who was not involved in the research, said that the study backs up previous evidence that gluten-free foods are nutritionally suboptimal. But while a gluten-free diet is essential for coeliacs, it is not intrinsically healthy or unhealthy, he added. It depends on the choices you make as part of the gluten-free diet, he said.

Sarah Sleet, chief executive of Coeliac UK, said the latest findings tie in with the charitys own research, adding that further development of lower-fat, gluten-free products would be welcomed.

David Sanders, professor of gastroenterology at the University of Sheffield, noted that other studies have found gluten-free and conventional foods to have similar nutritional value. The jury is out, he said.

But Sanders cautioned that there is no evidence a gluten-free diet has benefits for those without gluten sensitivity or coeliac disease. Once you go into the territory of dietary restrictions without medical symptoms then you are running the gauntlet of missing out on various vitamins or minerals without realising it, he said.

Read more: https://www.theguardian.com/lifeandstyle/2017/may/11/gluten-free-diet-carries-increased-obesity-risk-warn-experts

Two-thirds of people in Mexico, Chile and Ecuador are obese, UN finds

Study calls epidemic frightening and finds that overnutrition and sedentary lifestyles are costing countries tens of billions of dollars every year

More than two-thirds of people living in Mexico, Chile and Ecuador are overweight or obese, costing their economies tens of billions of dollars every year, driving rates of disease and straining health services, according to a new UN report.

While the number of hungry people in Latin America and the Caribbean has halved in the past 25 years, the region is now struggling to combat an obesity epidemic.

Changing diets, including more processed food that are high in salt, sugar and fat, along with more sedentary lifestyles have triggered a rising tide of obesity, experts say.

The implications for the future of countries are frightening … undernutrition is declining, but overnutrition is expected to become the largest social and economic burden in the region, the UN World Food Programme (WFP) said in a statement.

The report by the WFP and the UNs Economic Commission for Latin America and the Caribbean (ECLAC), said over the next six decades people being overweight and obese would cost Mexico an estimated $13bn a year, Ecuador $3bn and Chile $1bn.

Undernutrition, when people do not get enough food, and obesity itself a form of malnutrition are two sides of the same coin, and together they inflict a so-called double burden of disease on people and economies, the report said.

Undernutrition impairs child growth and brain development, while obesity can led to type 2 diabetes, cancer and heart disease.

We now witness a worrying trend among vulnerable communities with cases of undernourishment and overweight simultaneously within the same families, said Miguel Barreto, WFPs regional director said in a statement.

Both undernourishment and overweight represent a serious burden for the health of those families, that eventually translates into losses in productivity, and in pressure on the health and education systems in the country where they live.

According to the World Health Organisation, obesity is an epidemic worldwide, killing 2.8 million adults every year, and obesity-related conditions now cause more deaths than hunger.

In Latin America, obesity is increasingly affecting the regions poor, particularly women.

In Mexico, a country that faces one of the worlds most acute obesity crisis, 74% of women are obese or overweight compared with 70% of men, the report said.

The report urged food companies to play a greater role in combating obesity.

The food industry has the opportunity to ensure the production, availability and accessibility of healthier food products, it said.

Governments should also do more to promote exercise and health eating and place greater controls on food labelling.

The report noted Chiles efforts to combat obesity, including an 18% tax on sugary drinks introduced in 2014 one of the worlds highest along with laws that restrict the advertising of unhealthy foods targeting children.

In 2014, Mexico also introduced a 10% tax on fizzy drinks, and 2016 research by the British Medical Journal found that the sugar tax led to as much as a 12% reduction in sales during the first year it was implemented.

Read more: https://www.theguardian.com/society/2017/apr/25/obesity-epidemic-latin-america-mexico-chile-ecuador-un-report

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Are you tired of being fat? Are you tired of trying all these different diets which simply don't work for you? Are you tired of being affraid to go to the beach because you have the feeling that everyone will be starring at your big big butt? Are you tired of being short of breath when you try to run? Are you tired of avoiding to look at yourself in the mirror? Are you tired? Because I was tired! Two years ago I was fat, I was sick and I had absolutely no self esteem. Now I am another person – fresh, lean, vibrant and healthy thanks to the high carb raw vegan lifestyle.