Obesity can cause cardiovascular ill-health, even in the young

Higher than normal body mass index (BMI) is known to lead to cardiovascular ill-health in mid-to-late life, but there has been limited investigation of its effect in young, apparently healthy, adults. Researchers have now shown that having a higher BMI can cause worse cardiovascular health in those aged as young as 17, according to a study presented to the annual conference of the European Society of Human Genetics.

Dr Kaitlin Wade, a Research Associate at the Medical Research Council Integrative Epidemiology Unit (MRC-IEU) at the University of Bristol, Bristol, UK, and colleagues used data from The Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate the potential link between increased BMI and cardiovascular health. "ALSPAC is a world-leading birth cohort study, started in the early 1990s with the inclusion of more than 14,000 pregnant mothers and their partners and children, and provides an excellent opportunity to study environmental and genetic contributions to a person's health and development. It was therefore ideal for this purpose," Dr Wade will say.

The researchers hypothesised that cardiovascular risk due to increased BMI was likely to emerge in earlier life. The design of existing observational studies (those just looking for associations in the population) have meant that they are unable to make a distinction between correlation and causation. The MRC-IEU specialises in the use of genetics to help these difficult analytical situations and in this case researchers were able to use genomic data from ALSPAC to detect the likely causal relationship between higher BMI and higher blood pressure and left ventricular mass index (LVMI) in those aged 17 and 21. A thickening of the left ventricle in the heart (hypertrophy) means that it has to work harder to pump blood and is a common marker for heart disease.

Higher BMI did not appear to have an effect on heart rate in these young adults, although previous studies have shown an association - most likely due to bias caused by the mixing of effects of an additional factor resulting in a distortion of the true relationship (confounding). "Our results showed that the causal impact of higher BMI on cardiac output was solely driven by the volume of blood pumped by the left ventricle (stroke volume). This, at least in part, can explain the causal effect of higher BMI on cardiac hypertrophy and higher blood pressure that we observed in all our analyses," says Dr Wade.

The results support efforts to tackle the obesity epidemic from an early age in order to prevent the development of cardiovascular changes known to be precursors of cardiovascular ill-health and disease. "It is the first time that the nature of this relationship has been shown in group of young adults where it has been possible to draw improved conclusions about its causation," says Dr Wade.

The researchers are now trying to untangle the relationship between higher BMI and disease mechanisms including metabolomics (the study of the chemical processes involved in the functioning of cells and the abundance and diversity of microbes living in the gut - the gut microbiome). "We have also begun an analysis of the causal role of higher BMI on detailed measures of cardiac structure and function within the ALSPAC data. We hope to further explore these associations within an older population - the UK 1946 birth cohort.

"Whilst randomised controlled trials are important for disentangling cause and effect in disease, they are expensive, time-consuming and labour-intensive. Modern genomics allows us to detect causality more quickly and cheaply, and the availability of large quantities of genetic data means that we can overcome the limitations of observational epidemiological studies. We believe that there are clear messages for cardiovascular health in our findings and we hope that they may lead to increased efforts to tackle obesity from early life," Dr Wade will conclude.

Chair of the ESHG conference, Professor Joris Veltman, Director of the Institute of Genetic Medicine at Newcastle University¸ Newcastle, United Kingdom, said: "Distinguishing between correlation and causation is tremendously difficult in medical sciences, especially for complex interactions like those between obesity and cardiovascular disease. In this study, statistical genetics approaches were applied to longitudinal cohorts from the UK to improve this. The scientists could demonstrate that obesity also causes poorer cardiovascular health in young adults. In contrast, higher BMI did not seem affect heart rate in this group.''

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Weekly Coffee Date

Hi Friends! We finally moved in to the new house! We spent our first night yesterday and although most of our rooms are still empty and we have a lot of painting ahead of us, we’re so excited just to be here. When I get things up to picture quality shape I will absolutely share more. I hope everyone has a good Memorial Day weekend and takes some time to remember those who died while serving their country. I’d love to hear about some of your Memorial Day plans or traditions!

Here is a brief history on Memorial Day. Its traditions date back to the Civil War but it wasn’t declared a national holiday until 1971.

Sleep has always been difficult for me and now I can add this to the long list of things I think about as I lay awake at night. Lack of sleep may cause your brain to “eat itself.”

I’ve been known to buy a pair or two of jeans with some fashionable rips but I’m not sure I could shell out 400 bucks for these jeans covered in fake mud at Nordstrom.

A fascinating story about doing eye surgery on a 600-pound tiger at a wildlife retreat in Australia.

If you are a Bachelor/Bachelorette fan like me you might enjoy this in depth mathematical analysis of Bachelorette contestants.

photo by dorothee brand for belathee photography

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Dorothy lost 148 pounds

Transformation of the Day: Dorothy lost 148 pounds. Over the course of 15 years, she experienced significant weight gain. When her weight reached over 350 pounds, she put her faith in action. Prayer, surgery, healthy food and regular exercise was the perfect combination. What was your motivation? I wasn’t always overweight. Over the past 15 […]

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Medical research: Antibody reduces body fat in a mouse model of menopause

A newly discovered antibody, trialled in a mouse model of menopause, may help to boost bone mass and reduce body fat, a paper published online in Nature suggests. Further research is needed to determine whether these findings will translate to humans, but the study could aid the development of a single drug to help treat both post-menopausal osteoporosis and weight gain, and obesity in general.

Loss of bone mass and increased levels of visceral body fat are common features of menopause. Here, Mone Zaidi and colleagues show how treatment with an antibody against part of the pituitary hormone follicle-stimulating hormone increases bone mass and reduces adiposity in mice that have had their ovaries removed. The antibody treatment also reduced adiposity in regular mice fed a high-fat diet. Mice treated in this way showed increases in oxygen consumption, physical activity and thermogenesis (heat production) in brown and beige fat.

Current anti-obesity treatments, which tend to work by reducing appetite or blocking nutrient absorption, have limited efficacy and can cause side effects. The authors suggest that a humanized version of the newly reported antibody might also be of potential use in other conditions involving visceral adiposity, such as metabolic syndrome, cardiovascular disease, cancer, diabetes and polycystic ovary disease.

Article: Blocking FSH induces thermogenic adipose tissue and reduces body fat, Mone Zaidi et al., Nature, doi: 10.1038/nature22342, published online 24 May 2017.

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Angela lost 20 pounds and lots of body fat

Transformation of the Day: Angela lost 20 pounds. Her body fat percentage went from 38% to 24% and she no longer has to take blood pressure or diabetes medication. She has taken control of her life and her health. Check out how she did it. After many years of uncontrolled hypertension and countless hospitalizations, Coach Anthony Elfonzia […]

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Why does dieting not work? Study sheds light

Many of us know from experience that losing weight is a feat of endurance. Some diets will work, others won't, and despite our best efforts, it might seem at times as though a diet makes us put on even more weight. So why does dieting not work? A new study finds a mechanism that may explain how our body limits weight loss, working against us when we are trying to lose weight.

New research helps to explain why sometimes, diets simply do not allow us to lose weight.

New research published in the journal eLife has uncovered a mechanism in mice that may be responsible for those frustrating moments in a dieter's life when nothing seems to work.

Mice, our fellow mammals, share enough similarities with the human body to provide a good model for understanding how our body responds to weight loss efforts.

The team of researchers - led by Dr. Clemence Blouet from the Metabolic Research Laboratories at the University of Cambridge in the United Kingdom - examined a group of neurons in the brain's hypothalamus and their role in regulating appetite.

The hypothalamus is a brain area responsible for producing hormones that regulate a series of bodily functions, ranging from body temperature and hunger, to mood, libido, and sleep.

This brain region contains a group of neurons called "agouti-related neuropeptides" (AGRP), which play a key role in regulating appetite. When AGRP neurons are "on," we want to eat, but when these neurons are deactivated, they can make us stop eating almost completely. AGRP neurons have the same effect in animals.

Testing the effect of AGRP neurons in mice

Dr. Blouet and team used genetics to switch these neurons "on" and "off" in mice. They used transgenic mice that had been modified to have the hM3Dq designer receptor, which can only be activated by designer drugs.

This genetic "shortcut" was tested in previous studies, which used evolved G protein-coupled receptors to control the neural activity in mice remotely.

The mice were examined in special "metabolic chambers" that can measure energy expenditure. They were also fitted with probes that measured their body temperature - which is also an indicator of how much energy the body is expending.

Dr. Blouet and colleagues took energy expenditure measurements in different situations - namely, in situations where food was either more or less available.

The experiments revealed that "artificially activating the neurons in mice that don't have access to food increases the animals' activity levels but reduces the rate at which they burn calories."

This helps the mice to maintain the same weight. However, when the small rodents were allowed to eat - or even just smell or see the food - their energy expenditure levels went back to normal.

"Finally, exposing mice to a high-fat diet for several days inhibits their AGRP neurons, and causes the animals to burn calories at a faster rate," report the authors.

In other words, AGRP neurons regulate our appetite depending on the amount of food that is available.

The study's lead investigator explains further:

"Weight loss strategies are often inefficient because the body works like a thermostat and couples the amount of calories we burn to the amount of calories we eat. When we eat less, our body compensates and burns fewer calories, which makes losing weight harder.

Our findings suggest that a group of neurons in the brain coordinate appetite and energy expenditure, and can turn a switch on and off to burn or spare calories depending on what's available in the environment. If food is available, they make us eat, and if food is scarce, they turn our body into saving mode and stop us from burning fat."

Dr. Blouet goes on to speculate that from an evolutionary perspective, such a mechanism may have evolved in order to help animals cope with famine. Evidently, in the case of dieting, the brain cannot tell that the person is intentionally trying to lose weight.

The study's first author, Dr. Luke Burke, also explains what these findings mean to the person who is trying to lose weight:

"This study could help in the design of new or improved therapies in future to help reduce overeating and obesity. Until then, [the] best solution for people to lose weight - at least for those who are only moderately overweight - is a combination of exercise and a moderate reduction in caloric intake."

Learn how mindful eating may help people to lose weight.

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Weight loss after gallbladder removal: Causes and how to manage it

Gallbladder removal surgery is also called a cholecystectomy. It is a very common procedure. The gallbladder is a small organ that is part of the digestive system and is not essential for survival.

The gallbladder stores bile, which is a substance that is produced by the liver. Bile is necessary to break down and digest fats.

A person usually has a cholecystectomy if they get gallstones, which are collections of hardened substances that form within the gallbladder. These stones can cause ongoing episodes of abdominal pain, inflammation, or infection of the gallbladder.

Gallstones can also cause blockages in the duct of the gallbladder and the duct between the liver and pancreas. This can lead to further complications, such as pancreatitis or inflammation of the pancreas.

Fast facts on weight loss after gallbladder removal:

• A person can live without their gallbladder.
• When gallstones become a problem, surgery is usually required to remove the gallbladder.
• It is not uncommon for people to lose a little weight after having a cholecystectomy.
• There are several strategies, including exercise and diet, that can be used to make this short-term weight loss a more permanent change.

What causes weight changes after surgery?

Weight loss after gallbladder surgery may be caused by pain medication, surgical side effects, or a bland diet.

There are several reasons for weight loss after gallbladder removal. These include:

Following a low-fat diet

Following a low-fat diet for a few weeks before surgery reduces the number of calories taken in. It is not uncommon for people to experience some weight loss as a result of these dietary changes.

Surgical side effects

Some of the side effects of surgery, such as diarrhea, nausea, or vomiting can also cause weight loss.

Some people experience prolonged diarrhea after a cholecystectomy. Doctors are not sure why this happens, but it may be the result of excess bile being present in the digestive system.

Some people also experience a decreased appetite for several weeks following surgery.

Pain medication

Pain medication administered after the surgery can cause constipation. Pain and constipation can also reduce the desire to eat, which could reduce caloric intake and cause weight loss.

Bland diet

While recovering from surgery, most people will be unlikely to tolerate anything too spicy or rich. Temporarily following a bland diet, which is also likely to be lower in calories can cause mild weight loss.

Surgical recovery

Recovering from surgery can be tough. How the surgery was performed can impact the recovery process.

Traditional surgery tends to come with a more difficult recovery and more pain. Additional pain medication may be required, which can lead to a diminished appetite.

In most cases, weight loss after gallbladder surgery is just a temporary issue. Once the body has adjusted, usually within a few weeks, weight loss will slow down or stop.

Weight management after surgery

After gallbladder removal, it is essential to eat a healthful diet and be more active.

People must understand that fad diets and "quick fixes" aren't just ineffective; they can be dangerous. The safest ways to lose weight are:

• following a healthful diet
• being more active
• eating a well-balanced diet that is rich in fruits, vegetables, low-fat dairy, lean protein, and fiber
• eliminating empty calories from sugars and fats, such as those in sweetened drinks and candy, can help both with weight loss and long-term health concerns

Living an active lifestyle is essential for weight loss after gallbladder removal. It is important to speak with a doctor about when it is appropriate to return to or begin an exercise routine after surgery.

Someone with a significant amount of weight to lose should speak with their doctor for advice and support.

The doctor will likely recommend taking a little time off after surgery before working out. Once cleared to return to activity, walking, biking, yoga, or swimming are excellent choices.

Diet after surgery

A high-fat diet can cause gallstones. As a result, people are frequently advised to follow a low-fat diet for a few weeks before the surgery. Once the surgery is over, most people can slowly return to a regular diet.

Though a doctor may not prescribe a special diet, a bland diet can minimize abdominal or digestive discomfort after surgery.

The diet may include:

• avoiding fried, fatty, or greasy foods
• not eating spicy foods
• avoiding foods that cause gas
• reducing caffeine intake
• eating smaller meals
• increasing fiber intake slowly

In order to minimize the risk of side effects after gallbladder surgery, it may be preferable to start with small meals.

Common side effects after surgery

After surgery, there may be some side effects, including indigestion and gas.

Side effects from the surgery should only last a few weeks after the procedure. If they last longer than a few weeks, report it to the surgeon.

Common side effects of gallbladder removal include:

Someone experiencing these side effects should check in with their doctor about medication or lifestyle changes that can relieve their symptoms. It can also be helpful to track what aggravates or triggers the side effects and avoid them if possible.

Report any other abnormal symptoms to a doctor. These include:

• fevers
• worsening stomach pain
• nausea and vomiting that does not go away
• jaundice - yellowing of eyes and skin
• skin wounds that are warm, red, draining, or painful

Who is affected by weight loss after gallbladder removal?

People with gallstones are the most likely to have their gallbladder removed, and so are more likely to be affected by weight loss after surgery.

In some cases, gallstones don't cause any symptoms. In other cases, they can be very painful, and irritate the gallbladder or pancreas. A cholecystectomy is the most effective treatment for frequent bouts of pain, inflammation, or infection due to gallstones.

Written by Nicole Galan

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