Outlook: Obesity Epidemic

Ms. Farley is a freelance medical writerbased in Wakefield, Rhode Island.

Fatty Liver on the Rise

A new study has shown that dietsloaded with foods high on the glycemicindex (GI) may be causing fatty liver inmice. These findings may be linked tothe increase in the number of cases offatty liver disease in Americans—another by-product of obesity.

These high-GI foods include whitebread, white rice, and most preparedbreakfast cereals, which rapidly raiseone's blood sugar level. Low-GI foodsinclude vegetables, fruits, beans, andunprocessed grains that raise theblood sugar level slowly.

As fatty liver was becoming morecommon in Americans, many physiciansattributed it to alcoholism—butthat would not explain the increase inpediatric cases. Previously a rarelyreported condition in children, today itis estimated that between 25% and50% of overweight kids will have it. Asthese kids grow into adults, the fattyliver condition will become full-blownliver disease. The study authors arelikening the rise of this condition to theincrease in type 2 diabetes seen in the1990s. The study results appear in theSeptember 2007 issue of Obesity.

Heart Suffers When Overweight

A data review indicated that evenwhen blood pressure (BP) and cholesterolare lowered, the heart is still at riskif an individual is overweight or obese.The study data included >300,000 individuals,18,000 of whom had heartattacks or died during the study.

Once the researchers accounted forage, sex, physical activity, and smoking,they determined that overweight individualshad a 32% greater risk of heart diseaseand obese individuals had an 81%greater risk. After adjusting for healthyBP and cholesterol in the study group,they found that overweight individualsstill had a 17% increased risk and obeseindividuals had a 49% increased risk. Thestudy appears in the September 2007issue of Annals of Internal Medicine.

Lose Weight Before Getting Pregnant

Obese women are 40% more likelythan normal-weight and overweightwomen to have stillborn infants—fetaldeath in the 20th week or later. Blackwomen have an even greater risk—90% higher, compared with their whitecounterparts.

The reasons include the fact thatobese women are more likely to havediabetes and high blood pressure duringpregnancy. Another factor may bethe increased lipid levels among obesewomen, which narrow blood vesselsand promote blood clotting in thefetus' blood supply. Physicians adviselosing weight before becoming pregnant.In fact, the larger the woman, thegreater her risk of stillbirth—extremelyobese women are twice as likely to havea stillborn infant as normal-weight oroverweight women.

In a related study, the researchersfound that the endometrium has a partin the fertility of overweight and obesewomen. It is possible that excessweight affects the endometrium wherethe fertilized egg implants. Amongwomen undergoing fertility treatment,45.5% of normal-weight or underweightwomen had pregnancies lastingbeyond 20 weeks per cycle of treatment,and 38.8% of women who wereoverweight or obese went beyond 20weeks of pregnancy.

Within the study group of 2656women, the rates of miscarriage andectopic pregnancy increased as bodymass index increased. According to thestudy authors, the extra weight createsan "extraovarian detrimental effect andits correction could improve the reproductiveoutcomes in overweight andobese patients."

Several Risk Factors for Childhood Obesity

One of the biggest factors in a child'srisk of becoming obese is the mother'sweight. Other factors include theamount of television watching andwhether there is a rapid weight gainduring early childhood. According to aNew Zealand study, the 3 most significantfactors are:

• Having an overweight or obesemother
• Being a girl
• Watching too much television (>3hours is associated with 5% morebody fat than in those who werelimited to 1 hour)

The researchers warn that childrenbegin to show signs of being overweight/obese early in life; therefore,strategies to combat weight gainshould begin early as well.