Diet

The Deadly Link Between High Dietary Salt Intake and Obesity

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New research indicates abnormal activation of a protein may explain the deadly combination of salt intake and obesity.

Dietary salt intake and obesity are two important risk factors in the development of high blood pressure. Each packs its own punch, but when combined, they deliver more damage to the heart and kidneys than the sum of their individual contributions. Discovering the molecular mechanisms behind this lethal synergy has presented a challenge to scientists, but research led by Toshiro Fujita, MD, professor and chairman of the Department of Internal Medicine and chief of the Department of Nephrology and Endocrinology at the University of Tokyo, suggests that high dietary salt intake and obesity work together to trigger an abnormal activation of a cellular protein called Rac1.

According to Dr. Fujita, the team’s findings carry important implications for the treatment of hypertension. “Our data indicate that the Rac1-mediated pathway in the kidneys can be an alternative therapeutic target for salt-sensitive hypertension and salt-mediated kidney injury,” he said. “Based upon our results, we can speculate that Rac1 in the kidneys regulates salt susceptibility of blood pressure, and that Rac1 inhibitors, as well as MR antagonists, may be effective in the treatment of salt-sensitive hypertension.”

In the meantime though, if you are obese lose the weight and ingest ONLY the appropriate amount of dietary salt.

But, this is good news for patients with persistent high blood pressure and may offer a pathway to mediate the combination effects of dietary salt and obesity.

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Obesity

America’s Anti-Cigarette Campaign is Massively Failing

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Failing by a mile, according to a new study.

CDC incidence data released yesterday showed a big whiff in the government’s anti-tobacco campaign.

Although the number of daily smokers declined to 19.3 percent from 21 percent in 2005, this represented the slowest decline in 40 years. Going forward the CDC predicts a disappointing 200 basis point decline over the next ten years.

A rate near 18% will miss the Healthy 2020 target of 12% by a longshot.

Citi issued a report this morning calling the new data bullish for the industry, in which the bank prefers Lorillard and Reynolds American. Analyst Vivien Azer said the anti-tobacco campaign is running out of steam:

“The lack of progress we have seen in  educing smoking in the U.S. is nothing new, and is something the government saw coming. Recall, graphic warnings are set to be introduced in the U.S. in September 2012, and despite these efforts, the impact on smoking is expected to be minimal. While further tax hikes or increased restrictions should be expected, these take time to implement, such that we believe there is little near-term risk of accelerating cigarette industry volumes declines in the U.S.”

Yuk!

There needs to be a better education program, involving social media, rather than trying to scare smokers straight.

Obesity and smoking are two preventable downers for American’s heath.

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Diet

Weight Loss From Reducing Calories Can Lead to Unrealistic Expectations

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This post of a paper caught my eye this morning, since I am dieting and trying to reduce my body weight. I am using My Fitness Pal online and count calories in and exercise calories expended. So far I have lost about 9 pounds.

Common rules of thumb exaggerate how much weight people will lose from a given dietary calorie reduction, leading to unrealistic expectations and disappointment, researchers said.

Whereas patients are often told that cutting 500 calories a day will let them lose a pound a week, a more realistic formula is that such a caloric reduction would lead to a 50-pound loss over three or more years, according to Kevin D. Hall, PhD, of the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Md., and colleagues.

Even then, they explained in the Aug. 27 issue of The Lancet — a special edition devoted to obesity — such weight loss is possible only if the calorie reduction is actually maintained over that time.

The standard rules — endorsed by the National Institutes of Health and the American Dietetic Association, among others — fail to consider that human metabolism responds dynamically to changes in diet and body composition, Hall and colleagues asserted.

If a 300-pound dieter could really lose a pound a week by cutting his regular diet by 500 calories, he would vanish entirely in six years.

“This ubiquitous weight-loss rule (also known as the 3,500 [calorie]-per-pound rule) was derived by estimation of the energy content of weight lost, but it ignores dynamic physiological adaptations to altered body weight that lead to changes of both the resting metabolic rate as well as the energy cost of physical activity,” the researchers wrote.

When people gain weight, their baseline energy needs increase, to keep the extra tissue alive and to move it around. Likewise, when weight is lost, their baseline needs decrease.

So when people cut calories below the baseline requirement — thereby triggering weight loss — the gap between their intake and their baseline energy needs begins to shrink. At some point, it may disappear altogether, at which point weight loss stops.

Hall and colleagues put together what they said was a better model of caloric intake and resultant weight loss, incorporating feedback mechanisms to reflect metabolic changes over time in response to diet and body weight.

It indicated that weight change in response to caloric restriction occurs over a relatively long period of time.

Each reduction of 100 kilojoules daily — 24 calories — in intake eventually leads to a loss of 1 kg (2.2 lbs) in body weight, the researchers determined. But only half that loss occurs in the first year. In three years, 95% of the ultimate loss will be realized.

On the flip side, using data from previous studies, Hall and colleagues said their calculations suggest that the U.S. population has a persistent excess energy intake of 30 kilojoules (7.2 calories) per day, explaining the increasing prevalence of overweight and obesity.

For the population to return to body mass index values that prevailed in the 1970s, average diets would need to shrink by about 220 calories per day.

The researchers pointed out that these figures are averages for the adult population. Individuals’ metabolic requirements for sustaining a given body mass vary substantially.

Consequently, “a given diet results in an uncertain degree of energy deficit,” Hall and colleagues wrote.

I suppose I will just have to be patient and wait the three to five years to reach my weight goal. But, then again, I have been packing on the extra weight for decades now and I cannot expect a quick fix.

I can do it.

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Dentistry

American Obesity Rates Remain Higher Than 20% in ALL States

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According to the latest Gallup Poll.

Colorado continues to be the state with the lowest obesity rate in the country, at 20.1% in the first half of 2011. Fewer than one in four residents are obese in the 10 states with the lowest obesity rates. In the 10 states with the highest levels of obesity, rates are 29% or higher. West Virginia has the highest obesity rate in January through June 2011, at 34.3%, which is also the highest Gallup has measured for any state since it began tracking obesity rates in 2008.

These results are based on 177,237 interviews conducted daily from January through June 2011. Gallup tracks U.S. obesity levels as part of the Gallup-Healthways Well-Being Index, using Americans’ self-reported height and weight to calculate Body Mass Index (BMI) scores. BMI scores of 30 or higher are considered obese.

The 26.3% obesity rate for the nation overall in January through June of this year is essentially unchanged from 26.6% in 2010. However, this 2011 rate is higher than the 25.5% in 2008. So far in 2011, obesity rates are generally more likely to be rising in the states where they are already the highest and declining in the places where they are lowest.

These obesity rates are way too high and I am doing my best to lose weight.

Diet plus exercise should do the trick but it is a slow – very slow – process.

While obesity in the United States as a whole remains unchanged so far in 2011 compared with last year, many of the country’s most obese states continue to see the trend go in the wrong direction. At the same time, many states are registering improvements this year. Still, in no state are obesity rates lower than 20%, revealing residents throughout the entire country have much work to do to begin to tackle the nation’s obesity problem.

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Health

Americans Do Not Support Bias in Hiring Smokers or the Obese

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According to the latest Gallup Poll.

More than 8 in 10 Americans think it is not right for companies to refuse to hire people just because they are significantly overweight or smoke. Fourteen percent say the practice should be allowed for each.

The views Americans express in the July 7-10 poll are essentially unchanged from prior Gallup readings on the same questions since 2005. In 2003, Gallup also found most Americans saying that if they were in a position to hire someone, it would make no difference to them if that person were overweight (79%) or smoked (74%).

While the new poll found that for the first time a majority of Americans want smoking to be banned in all public places, far fewer people support making it completely illegal in the United States. Taking all these findings about smoking together shows that Americans — while generally in favor of not having others smoke around them — appear mostly supportive of an individual’s freedom of choice to use tobacco.

But, they do favor higher health insurance rates or smokers but not for the very obese.

In contrast to the lack of support for hiring discrimination against smokers, the majority of Americans (60%) say it is justified to set higher health insurance rates for smokers. Thirty-eight percent say it is unjustified.

Similarly, Americans are more supportive of setting higher health insurance rates for people who are significantly overweight than they are of allowing companies not to hire such people (42% vs. 14%). However, the majority — 57% — say it is unjustified to set higher rates just because someone is very overweight.

Here is the chart:

So, what are the implications?

Most Americans say live and let live. As long as YOUR behavior does not affect me, then go for it.

However, a majority does now favor a ban in smoking in public places (as second hand smoke does affect others). But, if you want to eat yourself to poor health and literally to an early death, then it is your business.

As companies across the United States face the challenge of maintaining a healthy, productive workforce and grapple with rising health insurance costs, corporate hiring policies and insurance rates for smokers and very overweight people are becoming prominent issues.

Americans are clear on one point, though — they do not support allowing companies to discriminate against smokers or significantly overweight people when making hiring decisions. Whether a national consensus or corporate policy, however, has any impact on a specific hiring situation is a separate issue. The data confirm that if a man is making the hiring decision, he may be more likely than a woman to discriminate against a very overweight person — similar to what Gallup has found in the past.

Americans are more divided when it comes to how to set health insurance rates for smokers and the very overweight. While a majority say it is justified to set higher rates for smokers, a similar majority says it is unjustified to do the same for significantly overweight people.

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