Weighing obesity surgery risks for teens
Fri, 27 Apr 2007 04:09:16 GMT
By LISA CORNWELL, Associated Press Writer
CINCINNATI - Seventeen-year-old Amanda Munson gained confidence and energy as she lost 40 of her 296 pounds after weight-loss surgery and her diabetes went into remission.
"People have told me I not only look thinner, but I seem to glow — maybe because I'm so much happier," she said. The 5-foot-5 high school senior from nearby Burlington, Ky., hopes to lose 75 to 100 more pounds.
Munson is the first of 200 teenagers who will be enrolled in a five-year, federally funded study on the benefits and risks of bariatric surgery on adolescents.
Surgery has been effective in treating extreme obesity in adults. Researchers want to find out if adults and adolescents who have the surgery have significantly different health problems and whether there is any benefit to having the operation earlier in life.
The researchers are responding to the growing problem of extreme obesity among the young.
"We know bariatric surgery is effective for weight-loss. We just need to carefully document how teenagers respond," said Dr. Thomas Inge, associate professor of pediatrics and surgery at Cincinnati Children's Hospital Medical Center, which is leading the study.
Recent data from the Centers for Disease Control and Prevention suggest that about 2 million U.S. adolescents may be severely obese and have complications of obesity previously seen only in adults.
While adult weight-loss surgery still is more common, an estimated 2,744 youngsters nationwide had the operations from 1996 through 2003, with the pace tripling between 2000 and 2003, according to an earlier study co-written by Inge.
The doctors expect their research will show that severe obesity in teens is associated with medical and psychosocial problems which may be more effectively treated during adolescence than waiting until adulthood.
"What's fascinating is that teenagers already can have a half-dozen complications of obesity that the surgery within months — if not weeks — can remedy," he said Inge, who has been performing the surgery on adolescents for five years.
The National Institute of Diabetes, Digestive and Kidney Disorders provided more than $5 million last year for the study. Texas Children's Hospital in Houston, Children's Hospital of Alabama in Birmingham and the University of Pittsburgh also are collecting data.
Researchers will compare data before and after surgery on health factors that include cholesterol levels, liver function, cardiosvascular risk and markers for diabetes. Those findings will be compared with data from a similar study on adults who have been obese since adolescence but are only now having the surgery.
Participants must already have been scheduled for the surgery and must have compelling obesity-related complications such as Type 2 diabetes, sleep apnea, high blood pressure or other cardiovascular risk factors.
Information also will be collected on psychological and social effects of the surgery on the teenagers. Severe obesity can lead to low self-esteem, less social interaction with peers and depression.
Kerri Green, director of education for the Weller Health Education Center in Easton, Pa., believes studies are needed to find out if young people can understand the physical, psychological and emotional consequences of bariatric surgery, which she said should be done only for compelling medical reasons.
"We see a lot of what we call the 'Extreme Makeover' phenomenon, where kids see surgery as a quick fix that will make up for poor eating habits and a lack of exercise," she said.
Munson's mother, Barbara Farnsworth, said they exhausted all other options before resorting to surgery.
"It breaks your heart to see your child struggling and becoming so depressed and to hear doctors say she won't see 30 if she doesn't lose weight," Farnsworth said. "This is only a tool, but I now see a future for Amanda that just wasn't there before."
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On the Net:
http://www.cchmc.org/teen-LABS
New diabetes genetic risk factors found
Fri, 27 Apr 2007 06:25:37 GMT
By LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Scientists have found clusters of new gene variants that raise the risk of Type 2 diabetes — and how the researchers did it is as important as what they found.
In one of the largest studies yet of human genetic variability, the scientists tested the DNA of more than 32,000 people in five countries to pin down spots that harbor genetic risk factors for this complicated killer.
This type of research — called a "genome-wide association" study — promises to usher in a new era of genetics. Most breakthroughs so far have come from finding a mutation in a single gene that causes illness. But some of the world's most common killers, such as heart disease and diabetes, are caused by complex interactions among numerous genes and modern lifestyles — and teasing out the genetic culprits until now has been almost impossible.
"We have been for all of the last decade or more looking under the lamppost to try to find those genes ... and lots of times the lamplight was not actually where we wanted it," said Dr. Francis Collins, genetics chief at the
National Institutes of Health, a co-author of the research unveiled Thursday.
This new approach "allows us to light up the whole street, and look what we find."
What? Four previously unknown gene variants that can increase people's risk of Type 2 diabetes, and confirmation that six other genes play a role, too.
The work, by three international research teams that shared their findings, was published online Thursday by the journal Science.
Also Thursday in the journal Nature Genetics, another team led by Iceland researchers reported separately finding one of those same new genes — and that, interestingly, it seems to increase the diabetes risk most in people who aren't obese.
Next, the researchers will have to figure out just what those genes do, in hopes they'll point toward new ways to treat or prevent a disease that affects more than 170 million people worldwide, and rising.
With Type 2 diabetes, the body gradually loses its ability to use insulin, a hormone key for turning blood sugar into insulin. It is a major cause of heart disease, as high blood sugar damages blood vessels, and leads to kidney failure, blindness and amputations.
Obesity and lack of exercise are chief risk factors. But heredity is involved, too: People with an affected parent or sibling are at 3.5 times greater risk of developing diabetes than people from diabetes-free families.
The new work scanned DNA to find patterns of small gene variations known as SNPs more common in diabetics. SNPs can serve as signposts for tracing disease-promoting genes. To be certain the implicated SNPs were involved, the researchers then checked for them in still more volunteers, ultimately testing DNA from 32,500 people in Britain, Finland, Poland, Sweden and the U.S.
The highest-risk variants can increase by 20 percent someone's odds of developing Type 2 diabetes, the teams reported.
Among the genes implicated:
_One that helps pump zinc into insulin-producing pancreatic cells, raising questions about the metal's role in insulin secretion.
_A pair previously linked only to certain cancers, another brand new area for diabetes researchers to probe.
_A region of chromosome 11 where genes of any sort had never been described.
Report Tainted hogs enter food supply
Thu, 26 Apr 2007 22:45:59 GMT
By ANDREW BRIDGES, Associated Press Writer
WASHINGTON - Several hundred of the 6,000 hogs that may have eaten contaminated pet food are believed to have entered the food supply for humans, the government said Thursday. The potential risk to human health was said to be very low.
The government told the three states involved it would not allow meat from any of the hogs that ate the feed to enter the food supply.
No more than 345 hogs from farms in California, New York and South Carolina are involved, according to the Agriculture Department. It appears the large majority of the hogs that may have been exposed are still on the farms where they are being raised, spokeswoman Nicol Andrews said.
Salvaged pet food from companies known or suspected of using a tainted ingredient was shipped to hog farms in seven states for use as feed.
The government will compensate farmers if they kill those hogs, said Kenneth Peterson of department's Food Safety and Inspection Service. The department knew of no countries moving to suspend imports of U.S. pork products.
Also, a poultry feed mill in an eighth state, Missouri, also received possibly contaminated pet food scraps left over from production. The fate of the feed made from that waste was under investigation.
The pet food sent to the farms later was discovered to have an ingredient, rice protein concentrate, imported from China that was tainted by an industrial chemical, melamine. Testing also revealed other related and similarly banned compounds, including cyanuric acid.
Food and Drug Administration inspectors were preparing to visit China as part of the agency's investigation.
Melamine is not considered a human health concern. But there is no scientific data on the health effects of melamine combined with the other compounds, said David Elder, director of enforcement for the FDA.
Still, the FDA and Agriculture Department believe the likelihood of someone becoming ill after eating pork from hogs fed contaminated feed is very low. Meanwhile, the University of California, Davis, is developing a test to measure melamine levels in tissue, Andrews said.
Since mid-March, pet food companies have recalled more than 100 brands of dog and cat food and treats; more recalls were announced Thursday. An unknown number of cats and dogs have fallen ill or died after eating products made with contaminated rice protein concentrate or a second tainted ingredient, wheat gluten.
Some pet food, while unsuitable for sale for that purpose, was still considered safe for animals to eat as it had not been recalled at the time it was forwarded to hog farms. Its use at hog farms raised the possibility that melamine entered the human food supply.
The department on Thursday released the following state-by-state breakdown of its investigation into farms thought to have received the contaminated pet food for use as hog feed. The farms were not identified.
_CALIFORNIA: State officials are working to contact the purchasers of 50 whole hogs raised on a single farm.
_NEW YORK: A breeder farm's 125 to 140 swine are under quarantine pending the results of urine and manure tests. None of the hogs went to slaughter.
_SOUTH CAROLINA: Urine tests done on some of the 800 hogs now quarantined at a farm have tested positive for low levels of melamine. None went to slaughter. According to the state veterinarian, none of the suspect feed was fed to the hogs. Federal tests on the feed have come up negative. The positive urine tests could not be immediately explained, although contaminated feed could have escaped detection during tests, the FDA said.
_NORTH CAROLINA: A farm with 1,400 hogs is under quarantine. It shipped 54 animals to a slaughterhouse, where they are on voluntary hold.
_UTAH: Eight hogs sent to slaughter by one farm remain on hold. Also on hold are 3,300 hogs at a second farm, as well as 40 to 50 carcasses at a slaughterhouse supplied by that producer. Meat from no more than 100 other hogs from the producer, all processed earlier by that same plant, may have entered the food supply, Andrews said.
_KANSAS: Meat from 195 hogs from a single producer may have entered the food supply via a Nebraska slaughterhouse. The farm is holding another 150 hogs.
_OKLAHOMA: A show hog operation purchased contaminated feed but no hogs have gone to slaughter.
In addition, an Ohio hog farm has been cleared.
Each year, about 105 million hogs are slaughtered and processed in the United States.