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Archive - 05 - 2012
Researchers Call for Obesity Prevention Efforts to Focus on Community-Wide Systems that Influence Early Life
May 31, 2012 (Penn Medicine) New Community Approach is Necessary to Lower Increasing Rates of Childhood Obesity.National data show that currently more than 10 percent of preschoolers in the United States are obese, and an additional 10 percent are overweight. In a recently published article, a researcher from the Perelman School of Medicine at the University of Pennsylvania, in collaboration with peers and colleagues from across the nation, says that effective strategies to target pregnancy, infancy, and toddlers are urgently needed to stop the progression of childhood obesity. The call to action comes just weeks after the release of a recent report from the Institute of Medicine (IOM) and an HBO documentary, "The Weight of the Nation," both of which focused on the nation's growing obesity epidemic. The full text of the article is available in the June issue of Childhood Obesity.The authors point to evidence which shows that over the past several generations behavioral and societal changes have led to the obesity epidemic, with attendant health and economic consequences demanding new scientific approaches, policy, and actions. Obesity, they say, is a complex problem involving multiple factors including the family, community structures and services, and broad societal forces. That these contributors are interrelated only adds complexity to the issue, which ultimately results in a growing epidemic."A systems approach would link interventions in a variety of settings and take into account both behavioral and environmental factors. The importance of taking a broader look at these factors is further evidenced by the recent IOM report which provides a road map for how we can continue to make progress in preventing obesity," said Shiriki Kumanyika, PhD, MPH, professor of Epidemiology at Penn Medicine. "In this article, we propose an ambitious but achievable approach that focuses on tackling obesity at the earliest stages of life, and within the larger community, not just at the individual level."Evidence increasingly suggests that the risk for childhood obesity begins even before and during pregnancy via maternal obesity and excessive gestational weight gain. Studies show it is likely that obese preschoolers will continue to be obese later in childhood and they may begin to exhibit adverse effects of obesity as early as three years of age.Additional research shows that progress toward implementing effective and sustainable child obesity prevention strategies requires strengthening current approaches to add a component that addresses pregnancy onward. A review of evidence from basic science, prevention, and systems research supports an approach that begins at the earliest stages of development, and uses a broader community approach to focus on implementing improved healthy behaviors and environmental changes in communities, including food industry and transportation policy.Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.The Perelman School of Medicine is currently ranked #2 in U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $479.3 million awarded in the 2011 fiscal year.The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top 10 hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; and Pennsylvania Hospital the nation's first hospital, founded in 1751. Penn Medicine also includes additional patient care facilities and services throughout the Philadelphia region.Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2011, Penn Medicine provided $854 million to benefit our community.
May 22, 2012 (Digestive Disease Weekly) A new study from the Washington University School of Medicine, St. Louis, MO, suggests that patients with diabetes mellitus type II (DM) should be screened for colorectal cancer (CRC) at younger ages than is usually recommended. While DM, which occurs when there are excess levels of insulin in the blood, is associated with increased risk of colorectal neoplasia (new tissue that results in the formation and growth of a tumor), there are currently no modifications in current screening guidelines for individuals with DM.Investigators led by Hongha T. Vu, MD, clinical gastroenterology fellow, Washington University, sought to determine if patients with DM should be screened earlier than patients at average risk for CRC. They found that the presence of adenomas among those screened between the ages of 40 and 49 with DM was about the same as those screened between the ages of 50 and 59 without DM. While many studies show an association between diabetes and CRC and polyps, this is the first study to show adverse risk in younger patients demonstrating that they should undergo screening earlier.We concluded that those with diabetes may require early screening because they have a similar risk of colon cancer and precursor adenomas as older non-diabetics who are currently recommended to start screening at age 50, said Dr. Vu.Researchers performed a retrospective cohort study of patients undergoing colonoscopy over a six-year period and compared three age groups matched for date of exam and gender: ages 40 to 49 with DM, ages 40 to 49 without DM, and ages 50 to 59 without DM.Dr. Vu cautioned that because the study was not prospective, investigators cannot say with certainty that diabetes is by itself a risk factor. Other risk factors overlap, such as obesity, diet and smoking. She added that the public health implications are significant since approximately 23 million Americans have diabetes, and that number is expected to double in the next 25 years.No pharmaceutical funding was provided for this study.Dr. Vu will present these data on Tuesday, May 22 at noon PT in Halls C-G of the San Diego Convention Center.
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