Dr Brett’s Blog

From BBC News

Mothers-to-be who are obese increase their odds of having a baby with abnormalities including spina bifida, researchers say.

Their analysis of data from 39 studies found obese women were more than twice as likely to have a baby with spina bifida or another neural tube defect.

The risk of heart defects and cleft lip was also raised, the Journal of the American Medical Association says.

Up to a fifth of pregnant mothers in the UK are classed as obese.

Leading clinicians said the government should be focussing anti-obesity campaigns on women of child-bearing age.

It is well known that women who are obese are more likely to have difficulty conceiving and once they are pregnant, overweight and obese women and their babies are at a greater risk of a range of health problems.

However, this is the first time that so many studies have been combined to build a more accurate picture of the risks to the unborn child, according to lead researcher Dr Judith Rankin of Newcastle University.

“Given that we are seeing an increase in the number of people who are overweight or obese, then we may see an increase in the number of babies born with abnormalities,” she said.

However, she stressed these abnormalities were uncommon.

“Spina bifida only occurs in approximately one in every 2,000 births, so the risk, even among obese women, remains very low.

“Women who are thinking about trying for a baby need to check their own weight first and then think about seeking help if they are overweight.

“While you are pregnant it’s not the time to start a weight loss diet but it is more important to eat sensibly and healthily,” she said.

The Royal College of Midwives echoed this advice.

Dr Rankin’s team will now continue the work to examine why there is a link between a mother’s weight and abnormalities in the baby. They say it could be related to nutritional deficiencies or undetected diabetes in the mother.

Both maternal diabetes and a lack of folic acid are established risk factors for birth abnormalities, particularly neural tube defects which affect the brain and spinal cord.

Prevention

Andrew Russell, chief executive of the Association for Spinal Bifida and Hydrocephalus, said: “Folic acid does seem to be involved. It is very important for women planning a pregnancy or likely to fall pregnant to take a folic acid supplement.”

Experts from the Royal Society of Medicine believe the government should be funding campaigns to target women of child-bearing age.

The RSM’s president of the Obstetrics & Gynaecology section, Professor Philip Steer, said: “We’ve had warnings on cigarette packets telling us that smoking can harm the unborn baby as well as the mother. But there seems to be little effort made to warn mothers about the risk obesity poses to mother and child.”

A Department of Health spokeswoman said: “Our advice is that all women should aim to embark on pregnancy as fit and as healthy as possible. To this end, we have introduced a range of initiatives to help people stop smoking, including free NHS services, and eat healthy.”

By 2015, it is expected there will be 2.3 billion overweight and more than 700 million obese adults worldwide.

Obese is considered as a Body Mass Index (BMI) over 30, while overweight is classed as a BMI over 25. BMI is calculated by dividing your weight in kilograms by your height in metres squared.

Dr Brett Says: Most mums are now aware that their lifestyle can have an effect on their unborn child. What is concerning is the amount of mums that are ignoring the evidence, especially when it comes to drinking and smoking. Unfortunately many mums also aren’t aware that there are many more things that effect your baby other than just smoking and drinking. The way you eat, the way you exercise and even the way you think can have a big impact on your childs future health.

Dr Brett says: I just wanted to share with you some cool quotes that were passed on to me by a colleague of mine.

Referring to Lance’s Team US Postal Service, Dr. Jeff Spencer (Team Chiropractor) in his book Lance acknowledged Dr. Spencer by saying “Part doctor, Part guru, Part medicine man”…”who we believed could fix any and all of our problems”. “While he fixed us physically, he also fixed us mentally” and “if you judged the most important man on the Postal team by the foot traffic in and out of his door, then it was Jeff (Dr. Spencer).  Without him, we knew we’d never make it to Paris.”

As the Tour Down Under approaches these cyclists give us a really good reminder of what chiropractic care is really about. It is not just about healing from injuries, nor is it just about preventing injuries. At its best chiropractic is a lifestyle, a way of helping your body perform at its absolute best whatever the challenges it confronts. Be it a common cold, an injury, a child falling over or just the daily grind chiropractic can help you get and stay well and perform at your best.

From The Washingtom Post

MONDAY, Dec. 22 (HealthDay News) — Even a few extra pounds and just a little inactivity increased the risk of heart failure in a major study of American doctors.

“What this study shows is that even overweight men who are not obese have an increase in heart failure risk,” said Dr. Satish Kenchaiah, lead author of a report on the finding in the Dec. 23 issue of Circulation.

As for exercise, “even a little amount of physical activity appears to decrease the risk of heart failure,” said Kenchaiah, who did the research as a epidemiologist at Brigham and Women’s Hospital in Boston and is now at the U.S. National Heart, Lung, and Blood Institute.

The study has followed more than 21,000 doctors for two decades, measuring among other factors the influence of overweight and physical activity on development of heart failure, the progressive loss of ability to pump blood, which is often a prelude to major coronary events.

Outright obesity, defined as a body-mass index of 30 or over, has long been known as a risk factor for heart failure. The new report concentrated on men who were borderline overweight, with a body-mass index of 25 to 29.9.

About 5 percent of the doctors were obese, and 40 percent were overweight, when the study began. Adjusting for other risk factors such as high blood pressure and high cholesterol, the study found a 49 percent increased incidence of heart failure in overweight men compared to those with a body-mass index of 25 or less. Incidence of heart failure was 180 percent for the obese men compared to the leaner ones.

It was the same story for physical activity. “Men who engaged in physical activity anywhere from one to three times a month had an 18 percent reduction in heart failure risk,” Kenchaiah said. “For those who were active five to seven times a week, the reduction was 36 percent. The more you exercise, the more reduction you achieve.”

The association of even minimal physical activity with reduced risk could be explained as an indicator of good habits in general, he said. “It is possible that they have a healthier lifestyle in general,” Kenchaiah said.

The study found that doctors who rarely or never exercised were older, smoked cigarettes more often, and were more likely to have high blood pressure or diabetes.

“This new report reinforces what we’ve said in the past,” said Dr. Gerald Fletcher, a preventive cardiologist at the Mayo Clinic in Jacksonville, Fla. “Not being obese but being overweight is definitely a risk factor for heart failure.”

While Fletcher said he would have liked a more definitive indicator of physical activity — the report described it as simply breaking a sweat — he said the study showed again that “vigorous exercise makes the difference. The more you do, the better it is for you.”

Two-thirds of Americans have excess body weight, and only about 30 percent exercise regularly, Kenchaiah said. About 660,000 new cases of heart failure are diagnosed each year in the United States, he said, and 80 percent of the men and 75 percent of the women aged 65 and older who are diagnosed with heart failure die within eight years.

Dr Brett Says: This just goes to show why it is dangerous to focus purely on one measurement like weight or cholesterol. Even people with a “normal” weight can suffer from heart disease if they are no eating, thinking and moving in a healthy way.

Dr Brett Says: What? Why would Dr Brett be commenting on elephants in a zoo? Well it turns out that we have a lot in common with those elephants. Like them we have been placed in an artificial environment. Like them we no longer get as much exercise a we used to. Like them we no longer eat as much variety or as fresh as we used to and like them we no longer have the same quality social interactions that we used to. And guess what.. just like them we are also getting more chronic diseases, more infections, more fertility issues and more behavioral problems than we used to.

We really are like animals living on captivity and the more we can get back to eating, thinking and moving like we used to the better off we will be.

from eFlux Media

Regular exercise can help sufferers in the fight against cancer, according to new research.

Researchers believe that exercise equivalent to a 30-minute walk five times a week can help prevent cancer, slow the disease’s progress, enhance recovery and prevent its recurrence.   

Exercise cuts the levels of insulin, a hormone that causes most of the body’s cells to take up glucose from the blood and triggers faster cell growth, boosting women’s risk of breast cancer and recurrence of the disease.

“This is one of the first studies out that has shown that in women who do not have a history of breast cancer, that they can actually reduce their risk by exercising,” said Dr. Susan K. Boolbol, a breast surgeon at Beth Israel Medical Center.

Besides, exercise also cuts blood levels of estrogen and testosterone, two sex hormones produced in both men and women that have been associated with uterine lining, prostate and breast cancers. On top of that, exercise burns fat, which can hoard additional amounts of estrogen. Thus, by decreasing obesity, it diminishes the risk of a series of cancers.

Scientists also found that, when people sleep less than seven hours a night, the benefits of regular exercise may disappear. In some cases, the risk of developing cancer may actually double. “We think it’s quite interesting and intriguing. It’s kind of a first look into this. It isn’t something that has been widely studied,” said James McClain of the National Cancer Institute, part of the U.S. government’s National Institutes of Health.

Another benefit of exercise is linked to cancer, many doctors recommending it to their patients, as a part of the therapy.

Dr Brett Says: If any other cancer drugs and treatments got the same results for as many forms of cancers as exercise, healthy foods and reducing stress in even just one study then it would be plastered all over the news. Time and again these lifestyle interventions are shown to help reduce the risk of cancer, so why aren’t we doing them? Is it that people are demanding instant (quick fix) answers or is it that our society/health care system is teaching people to look for instant (quick fix) answers, I think it is a little of both.

Saturday November 1, 2008 (foodconsumer.org) — The Centers for Disease Control and Prevention issued a report Thursday saying that the rate of new cases of diagnosed diabetes in the United States has nearly doubled in the past ten years.

The data published in the CDC’s Morbidity and Mortality Weekly Report show that in the past decade, incidence (new cases) of diagnosed diabetes has increase from 0.48 percent during 1995-1997 to 0.91 percent in 2005-2007 in 33 states surveyed.

 “This dramatic increase in the number of people with diabetes highlights the increasing burden of diabetes across the country,” says lead author Karen Kirtland, Ph.D., a data analyst with CDC’s Division of Diabetes Translation.

“This study demonstrates that we must continue to promote effective diabetes prevention efforts that include lifestyle interventions for people at risk for diabetes. Changes such as weight loss combined with moderate physical activity are important steps that individuals can take to reduce their risk for developing diabetes.”

The data came from CDC’s Behavioral Risk Factor Surveillance System, which provides incidence rates of diabetes for 43 states and two U.S. territories, but only 33 states had data for both time periods.

The incidence of newly diagnosed diabetes varied from state to state. West Virginia was hit hardest where 1.27 percent of residents were newly diagnosed with the condition while Minnesota is the healthiest state where 0.50 percent was newly diagnosed with the disease.

Puerto Rico had 1.28 percent newly diagnosed during the 2005-2007 period. The worst states in addition to West Virginia included Alabama, Florida, Georgia, Kentucky, Louisiana, South Carolina, Tennessee, and Texas.

“This report documents the geographic distribution of new cases of diabetes and is consistent with previous studies showing an increase in new diabetes cases,” said Kirtland.

“We must step up efforts to prevent and control diabetes, particularly in the Southern U.S. region where we see higher rates of diabetes, obesity and physical inactivity.”

Diabetes that affects about 30 million of Americans may be caused by a variety of risk factors including older age, lower educational attainment, low physical activity, obesity, weight gain, according to the report.

Editorialists for the report say that obesity has been identified as a major risk factor in the increasing incidence of diabetes. Like the increased incidence of diabetes, obesity has also been on the rise.

It has been found early already that the rate of diabetes in the South was the highest. In the South, the prevalence of obesity and physical inactivity were also highest (27.3 %) with the highest prevalence (30%) found in three southern states: Alabama, Mississippi, and Tennessee, the editorialists said citing another CDC report.

The CDC report says that efforts to prevent diabetes should focus on people with high risk for type 2 diabetes, which account for 90 to 95 percent of all diabetes cases in the U.S.   The authors of the report say “a 5%–10% reduction in body weight coupled with 30 minutes of moderate physical activity 5 days a week resulted in a 58% reduction in diabetes over a 3-year period.”

A health observer cautioned that obesity may be just a scapegoat for the increased prevalence of diagnosed diabetes.   Although obesity by itself may have a direct impact on the condition, what behind the obesity epidemic - diet and physical activity- may be more important.  

Arsenic in drinking water, persistent organic pollutants (most pesticides), drinking fruit juice, diet soda, soft drinks sweetened with high fructose corn syrup (HFCS), exposure to bisphenol A, PCBs, overeating, eating fatty foods, red meat and high sugar diet are some of risk factors that have been associated with increased risk of diabetes. 

Type 2 diabetes - a condition in which cells do not use insulin properly to convert sugar to energy leading to buildup of sugar in the blood can cause complications such as heart disease, blindness, kidney failure and poor circulation in the feet.

Foods that help prevent diabetes or may help treat the condition include turmeric, vitamin K1, vitamin D, chamomile tea, Mediterranean diet, green leafy vegetables, legumes, soy food, red wine compound resveratrol, and tart cherries among others.

Dr Brett Says: I really liked this article because it focused on the lifestyle aspects of diabetes. When the rates of diabetes have doubled in the last ten years it is impossible to blame it on anything other than our lifestyle choices. I also agree that diet and exercise are more important than weight. Obesity (as well as diabetes) are merely some of the side effects of poor lifestyle choices rather than the cause of any disease. In other words if you aren’t eating, thinking and moving in a healthy way it is very possible to be skinny and unhealthy.

From usnews.com

Vigorous Exercise Aids Those With Obesity-Related Gene

Effect of mutation blunted in people with above-average activity scores, study finds

Posted September 8, 2008     

MONDAY, Sept. 8 (HealthDay News) — Physical activity may reduce the risk of obesity in people with a genetic mutation that predisposes them to high body-mass index (BMI), says a U.S. study.

Recent research has shown a link between BMI and variants of the fat mass and obesity associated with the (FTO) gene. The mutations connected with obesity occur in about 30 percent of European populations and are associated with a 1.75-kilogram (3.9-lb.) increase in body weight, according to background information in the study.

While lifestyle factors such as diet and exercise are important factors in weight control, it’s not exactly clear how they interact with genetics.

In this study, researchers analyzed DNA samples from 704 healthy Amish adults, average age 43.6, and also conducted a series of physiological tests on the participants, including recording their physical activity over a seven-day period.

Among the participants, 54 percent of men and 63.7 percent of women were overweight, and 10.1 percent of men and 30.5 percent of women were obese. The genetic analysis showed that 26 single-nucleotide polymorphisms (SNPs — changes in a single base letter of DNA) in the FTO gene were associated with BMI.

Further investigation found that the two strongest SNPs were associated with BMI only in people with low physical activity scores. The SNPs had no effect on people with above-average physical activity scores.

The study was published in the Sept. 8 issue of the Archives of Internal Medicine.

“Activity levels in the ‘high-activity’ stratum were approximately 900 calories [860 calories for women and 980 calories for men] higher than in the ‘low-activity’ stratum, which, depending on body size, corresponds to about three to four hours of moderately intensive physical activity, such as brisk walking, housecleaning or gardening,” the researchers wrote.

“In conclusion, we have replicated the associations of common SNPs in the FTO gene with increased BMI and risk to obesity in the Old Order Amish. Furthermore, we provide quantitative data to show that the weight increase resulting from the presence of these SNPs is much smaller and not statistically significant in subjects who are very physically active. This finding offers some clues to the mechanism by which FTO influences changes in BMI and may have important implications in targeting personalized lifestyle recommendations to prevent obesity in genetically susceptible individuals.”

Dr Brett Says: For those of you who are up to date with what is happening in the world of epigenetics this will come as no big surprise, for others this may be quite revolutionary. Studies like these are now confirming that we are no longer just dealt a genes card that we have to live with. What is often more important than the genes we are dealt is which genes we actually use. As it turns out which genes we use is determined by our lifestyle (in this case exercising).