Body Mass Index Archives - InnoHEALTH magazine

Non-Obese and Lean Indians also Prone to Type 2 Diabetes

InnoHEALTH Magazine — Mon, 03 Jun 2019 09:01:35 +0000

Contrary to popular belief, not only obese and overweight but also nonobese and lean persons may be prone to type 2 diabetes. A recent study has found that while most diabetics in the West are also overweight and obese, in India nearly 20 to 30 percent suffering from diabetes are non-obese and even some are lean.

The incidence of type 2 diabetes has been showing an upward trend in India and elsewhere in the world. This basically arises due to insulin resistance. Increasing obesity and sedentary lifestyle are considered to be the main pivotal factors for insulin resistance and consequent diabetes. However, the new study has busted the myth that increasing obesity alone is the main causative factor.

Insulin resistance occurs when the cells in muscles, body fat and liver start resisting the signal that the insulin hormone is trying to send out to get glucose (also known as body sugar, which is the main source of body’s fuel) out of the bloodstream and put it into the cells. Insulin resistance leads to diabetes, which in medical parlance is known as type 2 diabetes mellitus or T2DM.

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Rotating night shifts may trigger Type 2 diabetes
Stressful events can increase women’s obesity

Researchers measured insulin and C-peptide levels of 87 diabetics(67 men and 20 women). Actually, beta cells in the pancreas that make insulin also release the C-peptide-a polypeptide composing of 31 amino acids. Although C-peptide does not actually affect the blood sugar of a person, the doctors can measure its level to figure out how much insulin the person’s body is making.

What made researchers measure the C-peptide levels along with insulin levels in the diabetics under study? This is because C-peptide gets secreted at a more constant rate across time durations as compared to the insulin secretion. Also, C-peptide levels are more stable compared to the insulin levels (its half-life is nearly six times that of insulin)which facilitates testing of beta cells’ response, the study has pointed out. The results revealed that the persons included in the study had largely the features of adiposity characterised by high body fat, abdominal fat and fatty liver condition, which may not be visible from outside.

The study has concluded that nonobese (BMI below 25) and even lean (BMI below 19) Indians have high body fat, excess fat in the liver and skeletal muscles and lesser skeletal muscle mass. In particular, they have ectopic fat in the liver (non-alcoholic fatty liver disease) and pancreas (nonalcoholic pancreas disease), which may contribute to insulin resistance leading to diabetes even in young age.

Along with high body fat and visceral fat, researchers also found elevated levels of insulin and C-peptide in the 87 diabetic patients studied by them. Such patients would benefit better from pharmacotherapy using insulin sensitizers or weight loss therapy, the study noted.

Summarising the outcome of the study, Dr. Anoop Misra, chairman Fortis C-DOC who led the study, told India Science Wire: “Indians have normal weight-high body fat and low muscle mass. They are not overtly obese but have not only high body fat but fat which is located in the crucial organs of metabolism, i.e., liver and pancreas. Once this occurs, the action of the insulin hormone becomes jeopardized, and blood sugar startsincreasing.”

“Indian physicians should urge patients to lose weight even when they are in normal body mass index (BMI) category to maintain body habitus at leaner side. This could prevent diabetes in those who do not have it yet, and blood sugar levels are better managed in patients with diabetes.” he added.

Credits: India Science Wire

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Lonely People Run the Risk of Dying Early

InnoHEALTH Magazine — Thu, 11 Oct 2018 09:35:01 +0000

Before we meaningfully or unwittingly leave our parents or acquaintances alone, we must be aware that the latest study has found that Loneliness is bad for the heart and a strong predictor of premature death.

Recently, at a scientific congress in Dublin, Ireland, a paper was presented which minced no words to assert that feeling lonely was a stronger predictor of poor outcomes than living alone, in both men and women. The study found “Loneliness is more common today than ever before, and more people live alone,” said Anne Vinggaard Christensen, study author and Ph.D. student, The Heart Centre, Copenhagen University Hospital, Denmark. The soul-searching paper was presented at EuroHeartCare 2018, the European Society of Cardiology’s annual nursing congress.

“Previous research has shown that loneliness and social isolation are linked with coronary heart disease and stroke, but this has not been investigated in patients with different types of cardiovascular diseases.”

The study investigated whether the poor social network was associated with worse outcomes in 13,463 patients with ischaemic heart disease, arrhythmia (abnormal heart rhythm), heart failure, or heart valve disease.

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Data from national registers were linked with the DenHeart survey, which asked all patients discharged from April 2013 to April 2014 from five heart centers in Denmark to answer a questionnaire about their physical and mental health, lifestyle factors such as smoking and social support.

Social support was measured using registry data on living alone or not, and survey questions about feeling lonely – Do you have someone to talk to when you need it? Do you feel alone sometimes even though you want to be with someone? “It was important to collect information on both, since people may live alone but not feel lonely while others cohabit but do feel lonely,” explained Ms. Vinggaard Christensen. Feeling lonely was associated with poor outcomes in all patients regardless of their type of heart disease, and even after adjusting for age, level of education, other diseases, body mass index, smoking and alcohol intake.

Loneliness was associated with a doubled mortality risk in women and nearly doubled risk in men. Both men and women who felt lonely were three times more likely to report symptoms of anxiety and depression and had a significantly lower quality of life than those who did not feel lonely.

Ms. Vinggaard Christensen noted that people with poor social support may have worse health outcomes because they have unhealthier lifestyles, are less compliant with treatment, and are more affected by stressful events. But she said: “We adjusted for lifestyle behaviors and many other factors in our analysis, and still found that loneliness is bad for health.”

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She concluded: “We live in a time when loneliness is more present and health providers should take this into account when assessing risk. Our study shows that asking two questions about social support provides a lot of information about the likelihood of having poor health outcomes.”

European guidelines on cardiovascular prevention state that people who are isolated or disconnected from others are at increased risk of developing and dying prematurely from coronary artery disease. The guidelines recommend an assessment of psychosocial risk factors in patients with established cardiovascular disease and those at high risk of developing cardiovascular disease.

The study has highlighted growing concerns about the issue and assumes great significance at places where loneliness is turning into a bane for victims due to lack of support system.

The study assumes significance and greater attention as the world marks the International Day of Older Persons on October 1, each year.

On December 14, 1990, the United Nations General Assembly voted to establish October 1 as the International Day of Older Persons as recorded in Resolution 45/106.

The holiday was observed for the first time on October 1, 1991. The holiday is celebrated by raising awareness about issues affecting the elderly, such as senescence and elder abuse. It is also a day to appreciate the contributions that older people make to society. This holiday is similar to National Grandparents Day in the United States and Canada as well as Double Ninth Festival in China and Respect for the Aged Day in Japan.

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Socioeconomic Inequalities in the UK

InnoHEALTH Magazine — Thu, 09 Aug 2018 10:45:12 +0000

Since the post-war period, socioeconomic inequalities in children’s weight have reversed in the UK – with disadvantaged children originally being more likely to be thinner than more advantaged children, but now typically being more likely to be overweight or obese, according to an observational study.

Previously, studies of this kind have analyzed trends in body mass index (BMI), but not height and weight separately; this study is the first to disentangle the changes behind increasing BMI inequalities over time.

Between 1953 to 2015, the difference in children’s BMI levels between the most and the least disadvantaged children has expanded, however, the difference in children’s height has narrowed, and fewer disadvantaged children are now of short stature.

Authors of the study, published in the Lancet Public Health Journal, say that these trends highlight the powerful influence that the obesogenic environment has had on socioeconomically disadvantaged children, with and the failure of decades of previous policies to prevent obesity and related socioeconomic inequalities.

“Our findings illustrate a need for new effective policies to reduce obesity and its socioeconomic inequality in children in the UK – previous policies have not been adequate, and existing policies are unlikely to be either. Without effective interventions, childhood BMI inequalities are likely to widen further throughout adulthood, leading to decades of adverse health and economic consequences,” says the lead author Dr. David Bann, UCL, UK.

“Our results illustrate a need for strong additional legislative changes that focus on societal factors and the food industry, rather than individuals or families. Bold action is needed, such as creating further incentives for food manufacturers to reduce sugar and fat content in food and drinks, reduce the advertising of unhealthy foods to children and families, and incentivize the sale of healthier alternatives. The Soft Drinks Industrial Levy is a positive but likely very limited step in the right direction”

The study included data for children born in England, Scotland and Wales from four longitudinal birth cohort studies beginning in 1946, 1958, 1970 and 2001. In the paper, 22,500 children were assessed at the age of 7 years, 34,873 were assessed at the age of 11, and 26,128 were assessed at the age of 15.

Between the ages of 7, 11 and 15 years, the children’s height and weight were measured, and BMI was calculated. The child’s father’s occupation was used as a marker of their socioeconomic position, and the association between socioeconomic position and weight was also analyzed from childhood and adolescence.

On average, the 2001 cohort was taller, heavier and had a higher BMI than the earlier born cohorts.

In all cohorts, the most disadvantaged children tended to be shorter than the least disadvantaged children. However, the difference narrowed over time – with the most disadvantaged 7-year olds being 3.9cm shorter than the least disadvantaged children in the 1946 cohort, whereas the difference in children in the 2001 cohort was 1.2cm.

At the same time, differences in weight reversed, with the lower socioeconomic position being associated with lower childhood and adolescent weight in the 1946, 1958 and 1970 cohorts, but with higher weight in the 2001 cohort. For example, the most disadvantaged 11-year olds weighed 2kg less than the least disadvantaged children in the 1946 cohort, however in the 2001 cohort, the most disadvantaged 11-year olds weighed 2.1kg more than the least disadvantaged children.

As a result of the weight and height changes, BMI inequalities were larger and appeared earlier in childhood in the 2001 cohort than in the earlier-born cohorts. In the 2001 cohort, the most disadvantaged 7-year olds had a BMI that was 0.5 kg/m2 greater than the least disadvantaged children.

Inequalities generally widened with age. By the age of 15 years, BMI inequalities were present across all cohorts except the 1946 cohort and were largest in the 2001 cohort (1.4 kg/m2 difference between the most and least disadvantaged teenagers, compared with a difference of 0.4kg/ m2 and 0.6 kg/m2 for the 1958 and 1970 cohorts, respectively).

Explaining the differences in childhood height, weight and BMI since the post-war period, the authors point to the considerable changes to diets and physical activity levels in Britain.

These include the end of wartime rationing in 1954 when diets typically included higher consumption of vegetables, and lower consumption of sugar and soft drinks. Since that time, the food environment has become increasingly obesogenic, and society has become more unequal, which may have particularly impacted on the access to healthy foods among socially disadvantaged families, resulting in increased childhood BMI among these groups. In addition, inequalities in adult BMI emerged in the 1980s and may have contributed to childhood BMI changes, as parents’ and children’s BMI are associated.

The authors note some limitations, including that most children enrolled were white, so the findings cannot be generalized to all ethnic groups in Britain. They also note that dropout rates were higher in more disadvantaged children, which could result in BMI inequalities being under or overestimated.

As BMI does not account for the level of fat, it may be an inexact measure of obesity and could have led to healthy children being miscategorized as overweight or obese. Lastly, the father’s occupation is only one aspect of the socioeconomic position, although the results remained the same when repeated using the mother’s education level.

Informatively, this study was funded by Cohorts and Longitudinal Studies Enhancement Resources’ (CLOSER), a collaborative research programme funded by the UK Economic and Social Research Council, Medical Research Council and based at the UCL Institute of Education and was additionally supported by the Academy of Medical Sciences/the Wellcome Trust. It was conducted by researchers from UCL and Loughborough University.

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Over stitch – weight lose device

InnoHEALTH Magazine — Fri, 04 May 2018 09:23:09 +0000

Obesity continues to be a challenge in all parts of the world, an epidemic which is spreading with an immense pace. Many procedures have been in vogue to tackle this issue in the past decade. Lately Global Hospitals, a multi super specialty tertiary care hospital has successfully performed first of its kind, procedure on a 45 year old who was almost 30 kilos overweight as per the body mass index count. This pro- cess involves reduction in the size of stomach using an endoscopic suturing device.

The Food and Drug Administration (FDA) has approved the use of a device commonly termed as ‘over stitch’ which is meant for suture perforation. This procedure is intended to facilitate weight loss in obese and adult patients. The outpatient procedure usually takes less time, also the recovery time is less since there’s no incision involved, in most of the cases the patients are discharged on the same day. The device does not alter the stomach’s natural anatomy in any way, however; patients are advised to follow medically supervised diet and exercises in future. While this procedure does not guarantee to replace the conventional method, however; it can be treated as an option while discussing to perform it on the patient. Since bariatric surgery is expensive and needs post surgery maintenance, this new procedurecan be a good option. The benefit being that this procedure is primarily performed through an oral cavity rather than through the abdomen like in the case of bariatric surgeries. It’s absolutely safe and effective to the patients in order to lead a healthier life.

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Global nutrition needs swift efforts

InnoHEALTH Magazine — Mon, 30 Apr 2018 11:05:15 +0000

Global nutrition crisis threatens human development, demands ‘critical step change’ in response – Report

Women’s health in India has emerged as a major nutritional challenge with the country wrestling largest number of anemic women in the world and the other having to tackle diseases related with obesity –that is on the rise, warns the latest Global Nutrition Report, 2017. It says there is malnutrition among adults globally.A total of 614 million women aged between 15–49 years were affected by anemia. India had the largest number of women impacted, followed by China, Pakistan, Nigeria and Indonesia.In India and Pakistan, more than half of all women of reproductive age have anemia.

It is a global issue that many women in high-income countries also suffer from; prevalence rates may be as high as 18% in countries such as France and Switzerland. Obesity (body mass index (BMI) ≥30) is most common among North American men (33%) and women (34%), and lowest among Asian and African men (6%) and Asian women (9%).

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Overweight and obesity are increasing in almost every country and are a real concern for many low and middle income countries, not just high-income ones.The problem affects more women than men in all the world’s regions, reflecting a wider global gender disparity.

Hypertension is most common (28%) among African women and European men, and lowest (11%) among North American women. A quarter of Asian and Latin American men suffered from raised blood pressure in 2015. While more women worldwide are affected by obesity, the case for diabetes and hypertension is mixed. There is more diabetes among men than women in Asia, Europe, Northern America and Oceania, and more hypertension among men than women in all regions except Africa.

The world now faces a serious nutrition- related challenge, whether stemming from under nutrition or obesity, states Global Nutrition Report 2017.

The report found the vast majority (88%) of countries studied face a serious burden of two or three of these forms of malnutrition. It highlights the damaging impact this burden is having on broader global development efforts.

“The world can’t afford not to act on nutrition or we risk putting the brakes on human development as a whole,” said Corinna Hawkes, Co-Chair of the Global Nutrition Report’s Independent Expert Group and Director of the Centre for Food Policy at City, University London. “We will not achieve any of the Global Goals for Sustainable Development (SDGs) by the 2030 deadline unless there is a critical step change in our response to malnutrition in all its forms. Equally, we need action throughout the goals to tackle the many causes of malnutrition.”

The Report calls for nutrition to be placed at the heart of efforts to end poverty, fight disease, raise educational standards and tackle climate change.

“We know that a well-nourished child is one-third more likely to escape poverty,” said Jessica Fanzo, Bloomberg Distinguished Professor of Global Food and Agriculture Policy Ethics at Johns Hopkins University and Global Nutrition Report CoChair.

At least 41 million children under five are overweight, with the problem affecting high and lower income countries alike
At least 10 million children in Africa are now classified as overweight
One-third of North American men (33%) and women (34%) are obese
155 million under-fives are stunted; Africa is the only region where absolute numbers are rising, due to population growth
52 million children worldwide are defined as wasted, meaning they do not weigh enough for their height

In all 140 countries studied, the report found ‘significant burdens’ of three important forms of malnutrition used as an indicator of broader trends:
1) childhood stunting-children too short for their age due to lack of nutrients, suffering irreversible damage to brain capacity,
2) anemia in women of reproductive age-a serious condition that can have long term health impacts for mother and child, and
3) overweight adult women-a rising concern as women are disproportionately affected by the global obesity epidemic.

“They will learn better in school, be healthier and grow into productive contributors to their economies. Good nutrition provides the brainpower, the ‘grey matter infrastructure’ to build the economies of the future.”

Rates of undernutrition in children are decreasing, the report said, with recent gains in some countries. But global progress is not fast enough to meet internationally agreed nutrition goals, including the Sustainable Development Goals (SDG) target 2.2 to end all forms of malnutrition by 2030.

EmornUdomkesmalee, Co-Chair of the Global Nutrition Report’s Independent Expert Group and Senior Advisor, Institute of Nutrition, Mahidol University, Thailand, said, “It’s not just about more money – although that is important – it’s also about breaking down silos and addressing malnutrition in a more joined-up way alongside all the other drivers of development. There’s a powerful multiplier effect here that we have to harness.”

The report found that overweight and obesity are on the rise in almost every country.With 2 billion of the world’s 7 billion people are now overweight or obese and a less than 1 per cent chance of meeting the global target of halting the rise in obesity and diabetes by 2025.

Rising rates of anemiaamong women of reproductive age are also cited as a concern with almost one in three women affected worldwide and no country on track to meet global targets. “Historically, maternal anemia and child undernutrition have been separate problems to obesity and noncommunicable diseases,” said MsFanzo. “The reality is they are intimately connected and driven by inequalities everywhere in the world. That’s why governments and their partners need to tackle them holistically, not as distinct problems.” Donor funding for nutrition rose by just two per cent in 2015, to US$867 million, representing a slight fall in the overall percentage of global aid. The report says funding needs to be ‘turbo charged’ and calls for a tripling of global investments in nutrition, to $70bn for over next 10 years to tackle childhood stunting, wasting and anemia and to increase breastfeeding rates. Crucially, donors are only spending 0.01 per cent of official development assistance on diet related Non-Communicable Diseases, a ‘disturbingly low’ level.

Pledges to invest in nutrition must be ‘concrete’ and ‘acted upon’, not ‘empty rhetoric’, the report said. Of the 203 commitments made at the Nutrition for Growth Summit in 2013 those most likely to be classified as ‘on course’ are the UN agencies’ at 86 per cent, followed by ‘other organisations’ at 75 per cent and NGO policy commitments at 73 per cent.

The report found there is a critical need for better data on nutrition – many countries don’t have enough data to track the nutrition targets they signed up to and to identify who is being left behind.

Report says the world consumes too much salt. Intake varies by region, but no region had intakes within the WHO-recommended limits of 2 g/day of sodium. Asia has the highest intake (4.3 g/day of sodium), followed by Europe (4.0 g/day of sodium). At national level, only seven countries (Burundi, Comoros, Gabon, Jamaica, Kenya, Malawi and Rwanda) have sodium intakes within desirable limit).

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Stressful events can increase women's obesity

InnoHEALTH Magazine — Tue, 03 Apr 2018 08:33:59 +0000

Women who experienced one or more traumatic lifetime events or several negative events in recent years had higher odds of being obese than women who didn’t report such stress, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2017, a premier global exchange of the latest advances in cardiovascular science for researchers and clinicians.

“Little is known about how negative and traumatic life events affect obesity in women. We know that stress affects behaviour, including whether people under- or overeat, as well as neuro-hormonal activity by in part increasing cortisol production, which is related to weight gain,” said study senior author Michelle A. Albert, M.D., M.P.H., professor of medicine, cardiology, and founding director of the Center for the Study of Adversity and Cardiovascular Disease, at University of California, San Francisco.

Obesity, a preventable risk factor for cardiovascular and other diseases, impacts more than one-third of U.S. adults. According to the American Heart Association, nearly 70 percent of American adults are either overweight or obese. Women tend to live longer than men, putting especially obese, aging women at greater risk for disease, said study author Eva M. Durazo, Ph.D., a post-doctoral scholar at the NURTURE Center, Division of Cardiology, and UCSF said.

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The researchers studied the relationship between major life events and obesity in a group of 21,904 middle-aged and older women, focusing on women with the highest obesity prevalence. They defined obesity as having a body mass index (BMI) of 30 kg/m2 or higher. And, they measured the impacts of two types of stress: traumatic events, which could occur anytime in a woman’s life and includes events as death of a child or being a victim of a serious physical attack, as well as negative life events that had occurred in the previous five years of a woman’s life. Negative events included wanting employment but being unemployed for longer than three months or being burglarized.

Sleep deprivation may increase risk of cardiovascular disease in older women Older women who don’t get enough sleep were more likely to have poor cardiovascular health, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2017. In the new study researchers considered sleeping at least two hours more during the weekend than on the weekday as a sign of being in state debt. Among the roughly 21,500 female health professionals between ages of 60 and 84 the research team followed, women who were in sleep debt were more likely to be obese and have hypertension. When taking into account socioeconomic status and sources of stress, such as negative life events and work-related stress that could also influence cardiovascular health, quality of sleep was still an important factor for good overall cardiovascular health. The results suggest that not getting enough sleep during the week might throw the body off and may increase risk of cardiovascular disease in older women.

NEARLY A QUARTER (23 PERCENT) OF THE WOMEN STUDIED WERE OBESE

Women who reported greater than one traumatic life event versus no traumatic life events had 11 percent increased odds of obesity;

The higher the number of negative life events reported by women in the last five years, the higher the tendency for increased odds of obesity. Specifically, women who reported four or more negative life events had a 36 percent higher risk of obesity, compared to women who reported no such events;

Among women who had higher levels of physical activity, there was a stronger association between increasing cumulative/chronic stress and obesity, though the reason for this finding remains uncertain.

“Our findings suggest that psychological stress in the form of negative and traumatic life events might represent an important risk factor for weight changes and, therefore, we should consider including assessment and treatment of psychosocial stress in approaches to weight management,” Albert said.

Because the study looks at the association between stressful events and obesity in a snapshot of time, future studies should look at the relationship longitudinally, following people for weight gain over time after life events have occurred, according to Albert.

“This is important work because women are living longer and are more at risk for chronic illnesses, such as cardiovascular disease. The potential public health impact is large, as obesity is related to increased risks of heart attack, stroke, diabetes and cancer, and contributes to spiraling healthcare costs,” Albert said.

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SMART MIRROR AND KIONATIK

InnoHEALTH Magazine — Thu, 10 Aug 2017 09:28:19 +0000

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Smart Mirror And Kionatik
Dr. Avantika Batish is working as Director Strategy and Healthcare at International Health Emergency Learning and Preparedness. Also, guest faculty for MBA (HR) and MBA Healthcare Management at various B-Schools and is a soft skills trainer.

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The Ministry of Health and Prevention (MOHAP) has announced the launch of a new set of innovative health services featuring futuristic technology solutions – particularly artificial intelligence (AI) during its participation at Arab Health 2017.

His Excellency Al Ketbi, has announced the launch of the Smart Mirror which is the first of its kind globally to allows patients to analyze their body’s temperature, pulse, weight, height, and their body mass index. It also features a weather forecast component that can be utilized by looking through the mirror.

The Smart Mirror is an active tool for patients suffering from diabetes, cardiovascular diseases, as well as blood pressure problems, as it monitors their weight, height, blood pressure and body temperature. The Chatbot service is driven by basic artificial intelligence software and facilitates ‘smart’ online chats that help reduce healthcare cost as well as improve the flow of health services.

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The interactive AI facility can assist the Ministry by mimicking human conversations to answer questions which can also be integrated with other software platforms to allow other communication activities such as sending messages and holding telemedicine conferences via Skype with a physician.

Another smart technology, ‘Kiomatik’, will welcome patients and guests and perform other reception duties via an innovative system, motion tracking, a high-definition camera, and three-dimensional display devices embedded in a robot.

It will also provide necessary information about the health facilities, set appointments, and answer basic questions from patients.

The Kiomatik Beacon technology also operates as a wireless device with face-recognition capability. The patient is immediately recognized upon arrival at the health facility and informed about his or her schedule which will appear at the reception platform without the assistance of any hospital employee.

Kiomatik reduces the need for computers and other announcement systems as medical staff can use the apps installed on smart watches and smartphones to communicate with patients and inform them whenever they need to visit a health facility for examination.

An advanced self-registration service ‘Kiosk’ can recognize patients’ faces using a 17-inch screen that registers them upon arrival at the hospital or medical center. This pioneering technology is still currently under research and development.

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