Obesity and diabetes by middle age tied to heart failure later on

admin   •   December 5, 2016   •   4732

FILE PHOTO: Women sit on a bench in New York's Times Square May 31, 2012. REUTERS/Brendan McDermid

FILE PHOTO: Women sit on a bench in New York’s Times Square May 31, 2012. REUTERS/Brendan McDermid

(Reuters Health) – People who reach middle age without developing high blood pressure, diabetes or obesity may have a lower risk of heart failure later in life, a recent study suggests.

Obesity, diabetes and hypertension can lead to structural changes in the heart that increase the stiffness of the muscle and reduce its ability to contract forcefully. These structural and functional changes in the muscle reduce the ability to circulate blood, which can lead to heart failure.

Compared to people with all three risk factors – high blood pressure, diabetes and obesity – adults who had none of these health problems by age 45 were 73 percent less likely to develop heart failure over the rest of their lifetime, the study found.

And when people reached 55 without any of these three risk factors, they were 83 percent less likely to develop heart failure than adults who did have these problems.

“Preventing the onset of obesity, hypertension and diabetes will substantially lower a person’s risk for heart failure and substantially increase the average number of years they will live healthy,” said senior study author Dr. John Wilkins of Northwestern University Feinberg School of Medicine in Chicago.

“The benefits of preventing the onset of the risk factors themselves often far exceeds the benefits experienced through treatment of the risk factors after they’ve developed,” Wilkins added by email.

Approximately 5.7 million adults in the United States currently suffer from heart failure, researchers note in the Journal of the American College of Cardiology: Heart Failure.

This population faces a significantly reduced quality of life and higher mortality rates. Hypertension, obesity and diabetes are highly prevalent and preventable risk factors for heart failure, the authors write.

In an analysis of data on tens of thousands of U.S. men and women, researchers found 53 percent of them did not have diabetes, high blood pressure or obesity at age 45. Less than 1 percent did have all three risk factors at that age.

By age 55, about 44 percent of adults still didn’t have any of the three risk factors for heart failure, and 2.6 percent had all three.

Researchers identified 1,677 cases of heart failure after age 45, and another 2,976 cases after age 55. They followed people through age 95 or death.

People who didn’t have any of the three risk factors at 45 or 55 were significantly less likely to develop heart failure as they aged – this was true of men, women, white and black participants.

Men at age 45 years without any of the three risk factors lived an average of 10.6 years longer free of heart failure than those with all three, while women at age 45 without any of the three risk factors lived an average of 14.9 years longer without heart failure.

Of the three risk factors, diabetes had a particularly strong association with spending a shorter period free of heart failure. People without diabetes in middle age lived an average of 8.6 to 10.6 years longer without heart failure than those with the disease.

One limitation of the study is that people who joined at different points in time might have different generational risks of developing diabetes, obesity, high blood pressure or heart failure, the authors note. Researchers also lacked data on risk factors for heart failure earlier in life, or information on any lifestyle changes some participants might have made to improve their health before middle age.

Still, the study adds to a large body of evidence linking diabetes, high blood pressure and to a lesser extent obesity, to a higher risk of developing heart failure, said Dr. Mary Norine Walsh, medical director of heart failure and cardiac transplantation at St. Vincent Heart Center in Indianapolis, Indiana.

“All three of these conditions are risk factors for coronary heart disease, and people with coronary heart disease are prone to developing heart failure,” Walsh, also president-elect of the American College of Cardiology, said by email.

“Keeping your weight under control pays off later in life, and monitoring your blood pressure and blood sugar with your physician is crucial,” added Walsh, who wasn’t involved in the study. “Avoiding all three of these conditions can add years to your life.”

SOURCE: bit.ly/2gLtRZY Journal of the American College of Cardiology: Heart Failure, online November 28, 2016.

Increased stress at work linked to higher risk of diabetes

UNTV News   •   January 16, 2018

A paramedic (R) checks the blood sugar level of a patient at SS Diabetes Care clinic in Jakarta, Indonesia, April 22, 2016. REUTERS/Beawiharta

(Reuters Health) — Workers who experience an increase in stress on the job over time may be more likely to develop diabetes than their coworkers who don’t, a recent study suggests.

Researchers examined data on 3,730 petroleum industry workers in China. At the start of the study, none of the workers had diabetes.

After 12 years of follow-up, workers who experienced increasing stressful tasks on the job were 57 percent more likely to develop diabetes, the study team reports in Diabetes Care.

At the same time, workers who experienced a decline in coping resources like social support from friends and family or time for recreational activities were 68 percent more likely to develop diabetes.

“Major changes in work may affect our risk of developing diabetes,” said Mika Kivimaki, a researcher at University College London in the UK who wasn’t involved in the study.

“It is therefore important to maintain a healthy lifestyle and a healthy weight, even during turbulent periods at work,” Kivimaki said by email.

In the study, Yulong Lian of Xinjiang Medical University and colleagues didn’t report exactly how many workers developed diabetes. Lian didn’t respond to requests for comment.

Worldwide, nearly one in 10 adults had diabetes in 2014, and the disease will be the seventh leading cause of death by 2030, according to the World Health Organization.

Most of these people have type 2 diabetes, which is associated with obesity and aging and happens when the body can’t properly use or make enough of the hormone insulin to convert blood sugar into energy. Left untreated, diabetes can lead to nerve damage, amputations, blindness, heart disease and strokes.

Physicians have long recommended exercise, weight loss and a healthy diet to control blood pressure and minimize complications of the disease. Stress reduction is also advised because, whether it’s caused on the job or not, stress may also make diabetes worse by directly contributing to a spike in blood sugar or by leading to unhealthy lifestyle habits that can cause complications.

The study looked at several forms of job-related stress and found that what researchers described as “task stressors” – such as feeling overloaded with work or unclear about expectations or responsibilities of the job, and the strains of physical labor – were the biggest contributors to the risk of developing diabetes.

So-called organizational stressors like interruptions, closures or poor communication didn’t appear to influence the odds of diabetes. Job control, or how much ability workers had to influence their day-to-day work activities, also didn’t appear to impact diabetes risk.

Among coping resources that influenced the risk of diabetes, declines in self-care and decreases in rational coping skills appeared to make the most difference, the study also found.

The study wasn’t a controlled experiment designed to prove whether or how changes in work stress or coping resources might influence the odds of developing diabetes.

Other limitations include its focus workers in a single, predominantly male industry and its reliance on stress and diabetes assessments at just two points in time.

Still, the findings add to evidence that stress can play a role in the development of diabetes and suggest that it’s worth paying closer attention to the specific role played by stress on the job, said Dr. Pouran Faghri, director of the Center for Environmental Health and Health Promotion at the University of Connecticut in Storrs.

“Stress has been associated with behavioral problems such as comfort or binge eating, consumption of high fat, energy-dense foods, poor dietary choices, physical inactivity and sedentary behavior,” Faghri, who wasn’t involved in the study, said by email.

“There is also an association with reduced sleep quality and negative psychological health such as depression, anxiety, insecurity, powerlessness and low self-esteem,” Faghri added. “These behavioral changes will lead to obesity and the development of type 2 diabetes.”

SOURCE: bit.ly/2EzORyq Diabetes Care, online December 18, 2017.

Prenatal and early childhood fructose tied to asthma in kids

UNTV News   •   December 20, 2017

A bronchodilator is placed atop of a prescription treatment paper that belongs to Shahrour’s son who is suffering from asthma, inside their home in the besieged town of Arbeen, in Damascus suburbs, Syria February 6, 2016. REUTERS/Bassam Khabieh

(Reuters Health) – – Grade school kids may be more likely to develop asthma if they consumed lots of drinks sweetened with sugar and high fructose corn syrup or if their mothers drank these beverages often during pregnancy, a recent study suggests.

To assess the connection between childhood asthma, sodas and other sugar-sweetened beverages, researchers examined data about eating habits from about 1,000 mother-child pairs as well as information on kids’ health, including whether they had an asthma diagnosis by ages 7 to 9.

After accounting for maternal obesity and other factors that can also influence kids’ odds of developing asthma, researchers found that women who consumed the most soda and sugary beverages during pregnancy were 70 percent more likely to have a child diagnosed with asthma by mid-childhood than mothers who never or rarely had sodas during pregnancy.

Women who had the most total fructose during pregnancy were 58 percent more likely to have kids with asthma than women who had little to no fructose.

“Previous studies have linked intake of sugary beverages with obesity, and obesity with asthma,” said study co-author Sheryl Rifas-Shiman, a researcher at Harvard Medical School and Harvard Pilgrim Health Care Institute in Boston.

“In addition to influencing asthma through increasing the risk of obesity, we found that sugary beverages and high fructose may influence the risk of asthma not entirely through obesity,” Rifas-Shiman said by email. “This finding suggests that there are additional mechanisms by which sugary beverages and fructose influence asthma risk beyond their effects on obesity.”

What kids ate and drank also mattered. Even after accounting for prenatal exposure to sodas, kids who had the most total fructose in their diets earlier in childhood were 79 percent more likely to develop asthma than children who rarely or never had fructose.

Once researchers also factored in whether children were overweight or obese, kids with the highest fructose consumption were still 77 percent more likely to have asthma.

Mothers who consumed more sugary beverages tended to be heavier and have less income and education than women who generally avoided sodas and sweet drinks. But the connection between sodas, sugary drinks and childhood asthma persisted even after accounting for these factors.

“We don’t know for certain the exact pathways by which sugary beverages and fructose lead to asthma,” Rifas-Shiman said. “We believe at least in part they act by increasing inflammation, which may influence the child’s lung development.”

The study wasn’t a controlled experiment designed to prove whether or how sodas or sugary drinks might cause asthma.

Another limitation is that researchers relied on women to accurately recall and report on soda consumption for themselves and their young children, which may not always be accurate, researchers note in the Annals of the American Thoracic Society.

Even so, the findings add to the evidence that women should avoid sodas and sugary foods and drinks during pregnancy and also limit these things for their young kids, said Dr. Leda Chatzi, a researcher at the Keck School of Medicine at the University of Southern California in Los Angeles who wasn’t involved in the study.

“Pregnant women should stay away from sugar sweetened drinks and foods with added sugars,” Chatzi said by email.

“Healthy eating during pregnancy is critical to their baby’s growth and development of chronic diseases such as asthma later in life,” Chatzi added. “A healthy dietary pattern during pregnancy contains a variety of food groups, including fruits and vegetables, breads and grains, protein sources and dairy products.”

SOURCE: bit.ly/2BaEVOI Annals of the American Thoracic Society, online December 8, 2017.

Diabetes and obesity both tied to higher risk of cancer

UNTV News   •   December 14, 2017

FILE PHOTO: Women sit on a bench in New York’s Times Square May 31, 2012. REUTERS/Brendan McDermid

(Reuters Health) – Many cancer cases worldwide may happen at least in part because people are overweight or have diabetes, a new report suggests.

Diabetes and being overweight or obese were a factor in 5.6 percent of new cancer cases worldwide in 2012, or about 792,600 cases, the authors say.

Researchers examined rates of 12 types of cancer from 175 countries in 2012. Then, because cancer can take a long time to develop, they looked back at 2002 data on rates of overweight or obesity and type 2 diabetes, which is caused in part by obesity.

Overall, about 544,000 cancer cases, or about 3.9 percent of the total, were linked with a high body-mass index (BMI, a ratio of weight to height), and 280,000, or 2 percent, were linked with diabetes.

A BMI of 25 or higher indicates overweight, and a BMI of 30 or higher indicates obesity. (A BMI calculator is available online here: bit.ly/2tXeEf4.)

“Increases in diabetes and high BMI worldwide could lead to a substantial increase in the proportion of cancers attributable to these risk factors, if nothing is done to reduce them,” said lead study author Dr. Jonathan Pearson-Stuttard of Imperial College London in the UK.

“These projections are particularly alarming when considering the high and increasing cost of cancer and metabolic diseases, and highlight the need to improve control measures, and increase awareness of the link between cancer, diabetes, and high BMI,” Pearson-Stuttard said in a statement.

Worldwide, an estimated 422 million adults have diabetes and more than 2 billion adults are overweight or obese, researchers report in the Lancet Diabetes and Endocrinology.

Both high BMI and diabetes are risk factors for various types of cancer, potentially due to biological changes caused by these conditions – such as high insulin, high blood sugar levels, chronic inflammation, and dysregulated sex hormones such as estrogen.

The biggest proportion of cancer cases related to diabetes and high BMI – about 38 percent – occurred in high-income western countries, followed by east and southeast Asian countries at about 24 percent.

Although cancers are still less common in some low and middle-income countries than in high-income nations, these countries had particularly large impacts from diabetes and high BMI.

For example, between 9 percent and 14 percent of all cancer cases in Mongolia, Egypt, Kuwait, and Vanuatu were tied to high BMI and diabetes.

Globally, liver cancer and endometrial cancer contributed the highest number of cancer cases related to diabetes and high BMI, at 25 percent and 38 percent, respectively.

By 2025, growing rates of diabetes and obesity could contribute to a 30 percent increase in the number of cancers related to these conditions in women, and a 20 percent increase in related cancers in men, researchers estimated.

The study wasn’t a controlled experiment designed to prove whether or how diabetes or obesity directly cause cancer. Another limitation is that because many cancers can take years to develop, a decade-long study might underestimate the connection between cancer and these other health problems.

“Perhaps most surprising is that the already striking findings of the study are likely to be underestimates of the true impact of obesity and diabetes on cancer rates,” said Dr. Graham Colditz, author of an accompanying editorial and a researcher at Washington University School of Medicine in St. Louis, Missouri.

The biggest increases in weight and diabetes-related cancers were seen in low and middle-income countries, where rates of overweight and obesity have been rising dramatically in recent years, Colditz noted.

“It is hard to overstate the importance of working to maintain a healthy weight,” Colditz said by email. “It lowers the risk of multiple cancers – as well as diabetes, heart disease, liver disease, and arthritis.”

SOURCE: bit.ly/2ymIURZ Lancet Diabetes and Endocrinology, online November 28, 2017.


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