DIET Thin people may be fat inside
Thu, 10 May 2007 19:05:10 GMTBy MARIA CHENG, AP Medical Writer
LONDON - If it really is what's on the inside that counts, then a lot of thin people might be in trouble.
Some doctors now think that the internal fat surrounding vital organs like the heart, liver or pancreas — invisible to the naked eye — could be as dangerous as the more obvious external fat that bulges underneath the skin.
"Being thin doesn't automatically mean you're not fat," said Dr. Jimmy Bell, a professor of molecular imaging at Imperial College, London. Since 1994, Bell and his team have scanned nearly 800 people with MRI machines to create "fat maps" showing where people store fat.
According to the data, people who maintain their weight through diet rather than exercise are likely to have major deposits of internal fat, even if they are otherwise slim. "The whole concept of being fat needs to be redefined," said Bell, whose research is funded by Britain's Medical Research Council.
Without a clear warning signal — like a rounder middle — doctors worry that thin people may be lulled into falsely assuming that because they're not overweight, they're healthy.
"Just because someone is lean doesn't make them immune to diabetes or other risk factors for heart disease," said Dr. Louis Teichholz, chief of cardiology at Hackensack University Medical Center in New Jersey, who was not involved in Bell's research.
Even people with normal Body Mass Index scores — a standard obesity measure that divides your weight by the square of your height — can have surprising levels of fat deposits inside.
Of the women scanned by Bell and his colleagues, as many as 45 percent of those with normal BMI scores actually had excessive levels of internal fat. Among men, the percentage was nearly 60 percent.
Relating the news to what Bell calls "TOFIs" — people who are "thin outside, fat inside" — is rarely uneventful. "The thinner people are, the bigger the surprise," he said, adding the researchers even found TOFIs among people who are professional models.
According to Bell, people who are fat on the inside are essentially on the threshold of being obese. They eat too many fatty, sugary foods — and exercise too little to work it off — but they are not eating enough to actually be fat. Scientists believe we naturally accumulate fat around the belly first, but at some point, the body may start storing it elsewhere.
Still, most experts believe that being of normal weight is an indicator of good health, and that BMI is a reliable measurement.
"BMI won't give you the exact indication of where fat is, but it's a useful clinical tool," said Dr. Toni Steer, a nutritionist at Britain's Medical Research Council.
Doctors are unsure about the exact dangers of internal fat, but some suspect it contributes to the risk of heart disease and diabetes. They theorize that internal fat disrupts the body's communication systems. The fat enveloping internal organs might be sending the body mistaken chemical signals to store fat inside organs like the liver or pancreas. This could ultimately lead to insulin resistance, type 2 diabetes, or heart disease.
Experts have long known that fat, active people can be healthier than their skinny, inactive counterparts. "Normal-weight persons who are sedentary and unfit are at much higher risk for mortality than obese persons who are active and fit," said Dr. Steven Blair, an obesity expert at the University of South Carolina.
For example, despite their ripples of fat, super-sized Sumo wrestlers probably have a better metabolic profile than some of their slim, sedentary spectators, Bell said. That's because the wrestlers' fat is primarily stored under the skin, not streaking throughout their vital organs and muscles.
The good news is that internal fat can be easily burned off through exercise or even by improving your diet. "Even if you don't see it on your bathroom scale, caloric restriction and physical exercise have an aggressive effect on visceral fat," said Dr. Bob Ross, an obesity expert at Queen's University in Canada.
Because many factors contribute to heart disease, Teichholz says it's difficult to determine the precise danger of internal fat — though it certainly doesn't help.
"Obesity is a risk factor, but it's lower down on the totem pole of risk factors," he said, explaining that whether or not people smoke, their family histories and blood pressure and cholesterol rates are more important determinants than both external and internal fat.
When it comes to being fit, experts say there is no short-cut. "If you just want to look thin, then maybe dieting is enough," Bell said. "But if you want to actually be healthy, then exercise has to be an important component of your lifestyle."
Study Young girls more likely to be fat
Thu, 10 May 2007 02:59:37 GMTBy MATTIAS KAREN, Associated Press Writer
STOCKHOLM, Sweden - As every Western nation struggles with child obesity, the Swedes are puzzled by an unusual blip in the data: Why are little girls more likely to be fat than little boys? A recent study by researchers at Sweden's Uppsala University showed that today's 4-year-old girls were six times as likely to be obese compared to 20 years ago — a bigger jump than among boys.
"This indicates that there is a relatively recent change in our lifestyles that is behind this," said Ulf Holmback, the lead researcher for the study published in the April issue of Acta Paediatrica. "But it's difficult to say what that is."
The weight increase itself was expected — Swedes, along with most other Europeans, have been getting heavier.
But obesity experts are scratching their heads over the gender difference that emerges in obesity rates. In 1982, just 1 percent of all 4-year-olds were deemed obese. By 2002, 2 percent of the boys that age were obese, but 6 percent of the girls were. The discrepancy was similar for 10-year-olds.
An analysis of children who are overweight — not obese — the percentage of overweight 4-year-olds has roughly doubled to 20 percent for girls and 18 percent for boys during the same 20-year period.
"It's hard to come up with a smart explanation for this," said Carl-Erik Flodmark, head of the child obesity center at Malmo University Hospital. "One biological explanation could be that boys are more active, and when the calorie load increases, maybe girls are more affected."
Flodmark, considered one of Europe's experts on childhood obesity, said the research could be skewed because it studied children from just one part of Sweden. But, he said, other studies also reveal the gender difference in obesity rates for that age group.
According to data compiled by the International Association for the Study of Obesity, IASO, the situation seems unique to Sweden.
The IASO has compiled surveys from all European Union countries, and typically the differences in the obesity rates for boys and girls are very small. In countries that have large gender discrepancies among children — such as Greece and Estonia — it is the boys who have higher rates of being overweight.
And among adults across Europe, women generally are fitter than men.
Since 1980, when Swedes were among of the slimmest of Western nationalities, obesity among adults has doubled from 5 percent to 10 percent by 2005 in both sexes, according to Sweden's national statistics agency. However, roughly half the men are overweight compared to 36 percent of the women.
That is still far lower than the United States, where recent government figures show 71 percent of men are overweight, and two-thirds of women are. About one-third of the U.S. adult population is obese.
Among EU nations, Sweden is in the middle, with Germany, Greece and the Czech Republic the most overweight, according to the IASO.
The IASO's Neville Rigby said Sweden is hardly alone in having heavier children.
"Worldwide, in every country, we're beginning to see changes taking place, sometimes quite rapidly," Rigby said.
Holmback and other researchers hope to eventually sort out why Swedish girls are getting heavier than boys. Both he and Flodmark said it is crucial to help girls who are obese because they suffer more under the pressure of modern beauty ideals.
"It doesn't matter as much for boys if they are obese," Flodmark said.
FDA OKs drug patch to treat Parkinsons
Wed, 09 May 2007 22:42:15 GMTWASHINGTON - The treatment options for patients with early Parkinson's expanded Wednesday with the approval of a new drug in patch form — a first for medicines to treat symptoms of the disease.
The once-daily Neupro patch contains a drug called rotigotine, which has not been sold before in the United States, the Food and Drug Administration said. The drug patch, made by Schwarz Pharma AG, is the first for the treatment of symptoms of Parkinson's disease.
Parkinson's disease results from the loss of dopamine-producing brain cells. Dopamine is crucial for the communication between cells that control muscle movement, which explains the trembling commonly seen in Parkinson's patients.
Rotigotine works by activating dopamine receptors in the brain, mimicking the neurotransmitter's effect.
The most common side effects for Neupro include skin reactions at the patch site, dizziness, nausea, vomiting, drowsiness and insomnia, the FDA said. Most are typical with this class of drugs.
Other potential safety concerns include sudden onset of sleep while engaged in activities such as driving or operating machinery, hallucinations and decreased blood pressure when standing up, the agency said.
An estimated 1 million people in the U.S. have Parkinson's, with an additional 60,000 cases diagnosed each year.
Belgium's UCB bought Germany-based Schwarz Pharma last year.
Study Estrogen may help fight disease
Wed, 09 May 2007 20:22:43 GMTBy TOM BREEN, Associated Press Writer
CHARLESTON, W.Va. - Estrogen may give women an edge in resisting heart disease that can be caused in part by air pollution, a new West Virginia University study found.
Researchers determined that males and post-menopausal females are more likely to suffer damaged arteries linked to diesel exhaust than women of childbearing age. That coincides with a major national study released earlier this year showing older women are at significantly higher risk for heart problems caused by air pollution than other people.
The research also found that when the estrogen-producing ovaries of the female lab animals were removed, their risk for damaged arteries increased.
The findings are especially significant for West Virginia, which grapples with the highest rate of heart disease in the country, and which has three metropolitan areas among the 25 worst for air pollution in the country, according to the American Lung Association.
"We are burdened tremendously with epidemics of obesity and cardiovascular disease in West Virginia," said researcher Timothy Nurkiewicz, who was among those from WVU's Center for Interdisciplinary Research in Cardiovascular Sciences who presented their findings earlier this month at a conference in Washington, D.C.
In January, a federally funded study of 65,893 women found that the fine grit in polluted air boosts the risk of heart disease in women who have gone through menopause.
Nurkiewicz said the WVU study suggests estrogen could play a factor in giving blood vessels greater ability to dilate, but that more research is needed.
"It shouldn't be taken out of context," he said. "It's still an animal study."
Nurkiewicz, who studied the effects of a type of particle found in diesel exhaust, used rats in the research. In the future, he wants to increase the types of air pollution particles he studies, and to include humans in the study.
Dr. David Meyerson, a cardiologist at Johns Hopkins University and a spokesman for the American Heart Association, said the study's findings are also important for showing that even the smallest particles in air pollution can be harmful.
"This study and others like it may signal a new and important phase in our understanding of cardiovascular disease and air pollution," he said.
Earlier this year, the American Lung Association ranked the metropolitan areas of Weirton-Steubenville, Charleston, and Huntington-Ashland as among the 25 worst in the nation for air pollution. West Virginia also has the country's highest rate of heart disease among adults, according to the federal Centers for Disease Control and Prevention.
Dr. Kerry Gateley, executive director of the Kanawha County Health Department in Charleston, said polluted air can be especially dangerous for people with other conditions such as asthma or lung disease brought on by smoking.
"You put those individuals in a heavily polluted situation and they will tend to have adverse events quicker than the general population," he said.
