Outlook: Obesity Epidemic

Ms. Farley is a freelance medicalwriter based in Wakefield, RI.

Just the Facts: Breaking Down theObesity?Incontinence Link

• Women with body mass index (BMI) &#8805;35 were 2 times as likely to develop urinary incontinence as women with BMI <23
• A weight gain of 11.2 to 22 lb after age 18 makes a woman 44% more likely to be incontinent
• A weight gain of 66 lb increases a woman's likelihood of incontinence by 4 times
• Up to 40% of women under age 60 may have a urinary incontinence problem
• Losing weight has been shown to improve urinary control

Glycemic Index Diets Successful inShort Term

An Australian review of 6 clinical trialsfound that diets relying on the GlycemicIndex (GI) effectively achieved weightloss among overweight and obese adultsin the short term.

The GI relies on the effects that certainfoods have on blood sugar levels. Foodsthat are high on the GI include whitebread, potatoes, and rice. Foods low onthe GI include beans, yogurt, and highfibergrains.

Dieters are recommended to eat foodslower on the index.

While there was not a huge difference inweight loss with low&#8212;GI diets&#8212;2 lb moreweight loss, on average&#8212;the diet appearsto be effective in the short term. Dietersshould be aware, however, that the questionof the long-term effectiveness of thisapproach has yet to be determined.

Is WHR More Significant Than BMI?

Which is the better predictor of heartdisease: waist-to-hip ratio (WHR) or BMI?A new study suggests that WHR canmore accurately predict one's propensityto developing heart disease. According toresearchers, even a small potbelly isassociated with a higher risk of developingarterial plaque.

A thicker waist will have a greaterimpact on the risk of cardiovascular disease,even if BMI is normal. As peopleage, they need to be more aware ofweight gain in the midsection.

Researchers studied BMI, WHR, andWC (waist circumference). Results showthe following:

• Those in the top 5th for their WHR were nearly twice as likely to have calcium deposits as those in the bottom 5th for WHR
• WHR had a stronger link to coronary artery calcium prevalence than BMI and WC in men and women
• People in the top 5th for WHR were 3 times more likely to have aortic plaque than those in the bottom 5th for WHR

Link Between Obesity and Migraine Questioned

Another study has emerged refutingclaims that there is a link between obesityand migraine headaches. The Swedishstudy looked at women aged 40 to 74 tofind an association between high BMIand incidence of migraines. Results didnot detect any link, showing that 32% ofobese women and 38% of nonobesewomen had active migraines&#8212;not a significantdifference. Investigator Dr. PeterMattsson of the University Hospital inSweden noted, "If there are true associationsbetween obesity and features ofmigraines such as frequency, these arelikely to be small and cannot be reliablystudied in small or moderately sizedcommunity samples."

Vertigo Drug Doubles as Weight-loss Drug

Researchers at the Tel Aviv UniversitySackler School of Medicine along withthe drug company Obecure have developedHistalean, a weight-loss drug basedon the vertigo drug betahistine. Availablefor more than 30 years, betahistineblocks the histamine₁ and histamine₃receptors in the brain, which are connectedto the sense of feeling full andone's desire to eat fatty food. Results ofHistalean use were more significant inwomen. Women under the age of 50who took the drug for 12 weeks lost 7times more weight than those who tookthe placebo. According to 1 study participant,taking the pill "wasn't hard."

The Latest on Good Fat/Bad Fat

Harvard researchers reviewed datafrom 2 large-scale epidemiologic studies&#8212;the Nurses' Health Study and theHealth Professionals Follow-up Study&#8212;and came to some updated conclusionson the state of fat in one's diet:

• Switching over some of one's dailyintake of carbohydrates to unsaturatedfat (vegetable oils) will result inlower low-density lipoprotein (LDL;"bad") cholesterol levels and higherhigh-density lipoprotein (HDL; "good")cholesterol levels.
• 1 g fat = 9 calories; 1 g carbs = 4calories
• Saturated fat&#8212;found in meat anddairy products&#8212;causes increases inLDL cholesterol as well as increasesin HDL cholesterol. The increase inHDL levels, however, is not enough tocounter the effects of the increasedLDL levels.
• Replacing 5% of total calorie intakewith polyunsaturated fat wouldlower the risk of heart disease by30% to 40%
• Trans fat raises LDL cholesterol, lowersHDL cholesterol, and makesblood platelets "stickier," therebypromoting LDL particles that damagearteries and raising the risk of bloodclots, diabetes, gallstones, dementia,heart disease, and infertility
• Trans fat (also known as "metabolicpoison") is created by adding hydrogenatoms to vegetable oils
• Federal guidelines state that up to 35%of total calories can come from fat. Dr.Walter Willett of Harvard's School ofPublic Health says that up to 40% isokay.
• Saturated fats should be limited toabout 17 g per day. As a frame of reference,a 7-oz cheeseburger has 12g and a scoop of ice cream hasabout 10 g.