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Archive - 10 - 2012
Overweight, Obesity in Adolescents Appears Associated with Increased Risk for End-Stage Renal Disease Over Time
October 29, 2012 (JAMA) Being overweight and obese during adolescence appears related to an increased risk of all-cause treated end-stage renal disease (ESRD) during a 25-year period, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.Children and adolescents with high body mass index (BMI) often become obese adults, and obese adults are at risk for chronic conditions such as diabetes, which can mean future risk of chronic kidney disease and ESRD, according to the study background.Asaf Vivante, M.D., of the Israeli Defense Forces Medical Corps and the Edmond and Lily Safra Childrens Hospital, Sheba Medical Center, Tel Hashomer, Israel, and colleagues examined the association between BMI in adolescence and the risk for all-cause, diabetic and nondiabetic ESRD.Medical data for almost 1.2 million adolescents (17 years old) who were examined for fitness for Israeli military service between January 1967 and December 1997 were linked to the Israeli ESRD registry in a nationwide population-based retrospective study.In this long-term nationwide population-based study, overweight and obesity at age 17 years were strongly and positively associated with the incidence of future treated ESRD, although the absolute risk for ESRD remains low, the authors comment.The study results indicate that 874 participants (713 men, 161 women) developed treated ESRD for an overall incidence rate of 2.87 cases per 100,000 person-years during more than 30 million follow-up person-years. Compared to normal-weight adolescents, those adolescents who were overweight and obese had an increased future risk for treated ESRD, with incidence rates of 6.08 and 13.40 cases per 100,000 person-years, respectively, the results show.Researchers also estimated the association between BMI and treated diabetic ESRD and suggest that compared with normal weight adolescents, overweight adolescents at 17 years old had six times the risk for diabetic ESRD and obese adolescents at 17 years old had 19 times the risk for diabetic ESRD, according to the results.Although the results for diabetic ESRD were remarkable, with risks increasing six-fold and 19-fold among overweight and obese adolescents, respectively, our results also indicate a substantial association between elevated BMI and nondiabetic ESRD, the authors note.(Arch Intern Med. Published online October 29, 2012. doi:10.1001/2013.jamainternmed.85. Available pre-embargo to the media at http://media.jamanetwork.com.)Editors Note: Access to anonymized databases was provided by the Israeli Defense Forces Medical Corps and the Israeli Ministry of Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.Commentary: The Skinny on Obesity, End-Stage Renal DiseaseIn an invited commentary, Kirsten L. Johansen, M.D., of the San Francisco Veterans Affairs Medical Center, writes: A study by Vivante et al in this issue of the Archives adds the development of end-stage renal disease (ESRD) to the list of adverse outcomes associated with adolescent overweight and obesity.The association of obesity with ESRD is good news and bad news. The good news is that obesity represents a potentially modifiable risk factor, and control of weight and the hypertension and inactivity that often accompany excess adiposity could prevent or slow the development of some cases of ESRD and may potentially reduce the morbidity and mortality associated with CKD [chronic kidney disease]. The bad news is that it is not easy to address obesity, Johansen continues.Although there is no evidence that it is ever too late to improve outcomes by increasing physical activity or shedding excess weight, the results reported by Vivante et al in this issue of the Archives highlight the potential advantages of starting early before chronic disease has developed and unhealthy lifestyles have become lifelong habits, Johansen concludes.(Arch Intern Med. Published online October 29, 2012. doi:10.1001/2013.jamainternmed.917. Available pre-embargo to the media at http://media.jamanetwork.com.)Editors Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
October 30, 2012 (Northwestern University) Study finds regular exercise doesnt impact amount of time women spend sitting.Women who exercise regularly spend as much time sitting as women who dont, according to a new Northwestern Medicine study.Emerging research shows that prolonged sitting has significant health consequences and the new Northwestern study suggests that being a dedicated exerciser doesn't prevent women from spending too much of their day sitting.This research is the latest indication that public health recommendations should be established to encourage Americans to limit the amount of time they spend sitting every day, said Lynette L. Craft, first author of the study and an adjunct assistant professor in preventive medicine at Northwestern University Feinberg School of Medicine.We all know someone who gets a good workout in every day, but then spends a large portion of their day sitting in front of a computer with few breaks, Craft said. If these people could replace some of the sitting with light activity---just getting up, moving around, maybe standing up when talking on the phone, walking down the hall instead of sending an email---we do think they could gain health benefits.The Northwestern research was done in collaboration with Ted Zderic, of the Pennington Biomedical Research Center and was published in the International Journal of Behavioral Nutrition and Physical Activity.Past studies have shown that people who sit for extended periods of time---even those meeting exercise recommendations---are more likely to develop chronic conditions such as diabetes, obesity, cardiovascular disease and some cancers.This was the first study to use an objective measuring device to examine the relationship between the type of exercise recommended in the governments Physical Activity Guidelines for Americans and sitting. The guidelines recommend adults engage in a minimum of 150 minutes of moderate intensity aerobic activity every week. Previous studies on physical activity and sitting have primarily relied on self-reported data.While many of the women in the study met or exceeded 150 minutes of physical activity per week, in reality only a fraction of the womens days were spent being physically active. The women in the study spent an average of nine hours a day sitting. That number is consistent with previous results from much larger studies that examined the number of hours Americans spend sitting every day.I think some people assume, If Im getting my 30 to 40 minutes of physical activity a day, Im doing what I need to do for my health, Craft said. Of course, exercise is very important and is associated with many positive health benefits, but negative health consequences are associated with prolonged sitting, and this study shows that just because youre physically active doesnt mean youre sitting less.For the study, 91 healthy women ranging in age from age 40 to 75 wore an activPAL activity monitor device during waking hours for one week. The device, which was worn on the thigh, recorded time spent sitting, standing and stepping, and engaging in sustained 10-minute bouts of moderate-to-vigorous physical activity.Trying to replace some sitting time with more light activity throughout the day---along with the recommended bouts of moderate and vigorous exercise---is an approach more Americans should try to take, Craft said.Future studies are needed to further examine the relationship between the type of exercise recommended in the Physical Activity Guidelines for Americans and sitting. For example, various subgroups such as men, children and the elderly should also be studied, Craft said.The Lynn Sage Breast Cancer Foundation, the Avon Foundation and the Edward G. Schlieder Educational Foundation supported the study.
One in Ten AMI Patients Have Unrecognized Incident Diabetes
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COBA Conference Steers Forward in the Fight Against Childhood Obesity
Google Secures Patent for Glucose-Sensing Contact Lens
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