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Staying Slim After Weight-Loss Surgery Could Cut Cancer Risk in Half

WEDNESDAY, Nov. 6, 2019 — The drastic weight loss that occurs with successful bariatric surgery could have an extra benefit — it may slash your risk of cancer.

People with severe obesity who dropped more than 20% of their total body weight following surgery wound up cutting their risk of cancer by more than half, compared with those who didn’t lose as much weight after the procedure, a new study reports.

“Those who lost more weight had a significantly reduced risk of cancer,” said lead researcher Dr. Angela Stroud, an assistant professor with the Oregon Health & Science University School of Medicine’s division of bariatric surgery.

Previous studies have linked obesity to cancer, so these researchers set out to see exactly how much weight loss might protect a person.

Stroud and her colleagues turned to a long-term study of bariatric surgery, gathering data on more than 2,100 people treated at 10 medical centers across the United States. The type of surgery could either be gastric bypass or gastric banding.

People who underwent the surgery and didn’t lose weight had an overall higher risk of cancer during seven years of follow-up. Those whose body mass index (BMI) dropped under 30, the threshold for obesity, had a 40% reduced risk of cancer compared with those who remained obese.

Further, researchers found that the more weight a person lost, the less likely they were to develop cancer.

About 6.2% of those who lost less than 20% of their body weight received a cancer diagnosis within seven years of their surgery, compared with 3.6% of patients who lost 20% or more, researchers reported.

Those who lost between 20% and 35% of their total weight following bariatric surgery had a 56% reduction in their overall cancer risk, compared with those who lost less than 20% of their initial weight.

The results indicate that people who want to lower their cancer risk should opt for gastric bypass surgery, since the average person who underwent gastric banding did not lose anywhere near as much weight, Stroud said.

This also shows that obese people who are worried about cancer likely need weight-loss surgery to reduce their risk, said Dr. Eric DeMaria, president of the American Society for Metabolic and Bariatric Surgery. Diet and exercise likely can’t lead to the sort of dramatic weight loss that’s required.

“Here we have a study that says you’ve got to be more aggressive with the weight loss to really see the impact, and that really puts it in the terrain of bariatric surgery,” said DeMaria, chief of general and bariatric surgery at the East Carolina University Brody School of Medicine in Greenville, N.C. He wasn’t involved with the study.

Breast cancer was the most common among the patients, followed by thyroid, melanoma, colon, kidney, uterine and lung.

Dramatic weight loss might be reducing cancer risk by lowering rates of type 2 diabetes, Stroud said.

“There’s definitely an association between type 2 diabetes and cancer, so if we’re making diabetes better that might be one of the bigger players in all of this,” she said.

People who lose more weight also might be benefitting from much lower levels of inflammation, as well as healthier gut bacteria, Stroud said.

But researchers also found that metabolic changes directly linked to weight and appetite were associated with lower cancer risk.

For example, for each 20% reduction in leptin — a hormone that decreases hunger — there was a 20% reduction in cancer, researchers said.

Decreases in diabetes-related fasting glucose and insulin also were associated with reduced cancer risk, as were increases in ghrelin, the “hunger hormone.”

Studies like this shine a light on an underappreciated risk associated with obesity, compared with the risk of heart disease or diabetes, DeMaria said.

The link between obesity and cancer “is not widely appreciated among the public, I think,” DeMaria said. “People don’t intuitively say you’re at high risk for cancer if you’re obese. They don’t think that way. It’s not as known. “

The new study was presented Tuesday at the American Society for Metabolic and Bariatric Surgery’s annual meeting, in Las Vegas. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed journal.

More information

The U.S. National Cancer Institute has more about obesity and cancer.

© 2019 HealthDay. All rights reserved.

Posted: November 2019

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Staying Optimistic Might Lengthen Your Life

By Alan Mozes
HealthDay Reporter

MONDAY, Aug. 26, 2019 (HealthDay News) — An upbeat view of life may increase your odds for living to a ripe old age, new research suggests.

The finding stems from a look at optimism and longevity among nearly 70,000 women and 1,400 men. It builds on earlier research linking higher levels of optimism to lower risks of chronic illness and premature death.

“This study took us further by suggesting that optimistic people are more likely to achieve ‘exceptional longevity,’ which we defined as living to age 85 or older,” said study lead author Lewina Lee, a clinical research psychologist with the U.S. National Center for Posttraumatic Stress Disorder at the Veterans Affairs Boston Healthcare System.

Compared to their least optimistic counterparts, the most optimistic men and women studied were 50% to 70% more likely to reach that advanced milestone, Lee said.

They were also 11% to 15% more likely to live longer overall, the study found.

The findings held up even after accounting for other influences, such as educational background, marital status, friendships, chronic health problems, and depression, Lee said.

Optimism was also powerful predictor of longevity regardless of a person’s habits when it came to tobacco and alcohol use, exercise, eating well or getting routine medical care.

“Most studies have focused on deficits or problems that increase the risk of dying,” Lee noted. “Our study is novel is that we considered the benefits of a psychological asset — optimism — in promoting longevity.”

The study team suggested that the findings could point the way towards new interventions that might foster optimism and thereby extend life, such as meditation and certain psychotherapy programs.

Lee and her colleagues discuss their findings in the Aug. 26 issue of Proceedings of the National Academy of Sciences.

They concluded that optimism matters after analyzing data from the Nurses’ Health Study, which focused on women, and the Veterans Affairs Normative Aging Study, which focused on men.

The women were 58 to 86 years old (average age: 70) when their health habits, overall health and optimistic outlook were first assessed. They were followed for 10 years.

Continued

The men were 41 to 90 years old (average age: 62) when they had a similar assessment and a physical exam in 1986. They were followed for 30 years.

At the end of the tracking periods, researchers found that results for women and men were roughly the same: The more optimistic the individual, the greater the chances for living longer — and the greater the chances for reaching an “exceptional” age.

But that doesn’t necessarily mean that Debbie Downers are doomed to shorter lives, Lee said. Her team only found an association and not a cause-and-effect link.

“The association between optimism and exceptional longevity was independent of depression,” Lee said. “This suggests that the presence of optimism is more than just the absence of depression,” so that even among those who struggle with depression a little optimism might still work longevity wonders.

Kit Yarrow, a consumer psychologist at Golden Gate University in San Francisco, said there are many reasons why optimism breeds longevity.

“Optimists experience less stress, because they don’t tend to dwell on negatives and feel more empowered to overcome hurdles,” said Yarrow, who wasn’t involved with the study. “They are less likely to give up, and they bounce back more quickly from problems and setbacks. Stress is a killer and wreaks havoc on our bodies.”

Optimists also are less likely to experience depression, feelings of hopelessness and negativity — factors often linked to poorer health and higher rates of disease, she added.

On top of that, Yarrow said, optimists tend to take better care of themselves and have an easier time making and keeping friends, “a well-documented source of health and longevity.”

She acknowledged that access to money, good food and education and, of course, genetics can also have a big impact on longevity.

But unlike good genes, Yarrow said, “optimism and her powerful sister, gratitude, can be learned.”

WebMD News from HealthDay

Sources

SOURCES: Lewina Lee, Ph.D., clinical research psychologist, U.S. National Center for Posttraumatic Stress Disorder, Veterans Affairs Boston Healthcare System, and assistant professor, psychiatry, Boston University School of Medicine; Kit Yarrow, Ph.D., professor emerita, Golden Gate University, San Francisco;Proceedings of the National Academy of Sciences, Aug. 26, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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Evolution Could Explain Why Staying Slim Is So Tough

TUESDAY, July 16, 2019 — It’s not easy maintaining a healthy weight. Even when you manage to drop a few pounds, they often return.

Why would the body seem to encourage obesity?

New research suggests the answer lies far back in human evolution, with an anti-starvation mechanism that primes the body to store fat.

The key to this mechanism is a protein dubbed “RAGE,” according to New York University (NYU) scientists working with mice. They believe RAGE evolved to help keep ancient humans from starving when food was scarce.

But today, in times of plenty, there’s a glitch at work: RAGE is produced to combat the cellular stress caused by overeating.

The protein seems to mistake this stress as similar to starvation, and so it switches off the body’s ability to burn fat. The result: fat becomes easy to accumulate, but tough to shed.

Still, there’s a silver lining to all of this, the NYU team said, because the research might lead to anti-obesity drugs.

“Our thinking is that RAGE is targetable. When we put mice with no RAGE expression at all on a high-fat diet, they ate the food but were not becoming obese,” explained study author Dr. Ann Marie Schmidt, from the NYU School of Medicine.

And a lack of RAGE appeared to be safe, at least for mice. “When you totally delete RAGE in mice, they have normal reproduction and no problems with cognition,” she said.

The researchers hope that because RAGE seems to be active just during times of metabolic stress instead of during everyday functions, taking it away won’t create problems.

But don’t pin your hopes on a RAGE-deleting drug just yet.

Schmidt was quick to note that any such drug is a long way off yet because the research is currently in mice. Findings from animal studies don’t always translate to humans.

Still, Schmidt said the potential is exciting.

In addition to limiting the body’s ability to burn fat, RAGE also may contribute to inflammation throughout the body. So, along with taming obesity, it’s possible that removing the RAGE protein might help with some of the inflammatory consequences of obesity, such as diabetes, cancer, hardening of the arteries and Alzheimer’s disease, according to the researchers.

Dr. Michael Wood, medical director for bariatric (weight-loss) surgery at the Detroit Medical Center’s Harper University Hospital, said the study was interesting, although very early.

And, Wood said, “obesity is a very complicated problem, and I think these findings are an oversimplification.”

But Wood noted that it’s possible the RAGE protein plays a role in excess weight. It’s just not likely the only factor in the development of obesity.

“I don’t think there’s one switch or any one thing that can solve this complicated issue. There’s no magic bullet for obesity,” he said.

Right now, if someone wants to lose weight, they have to commit to lifestyle changes, Wood said. And, that’s true even if someone has weight-loss surgery. He added that the most significant change comes from eating fewer calories. Exercise is a healthy habit, but only a small component of weight loss.

The study was published online July 16 in the journal Cell Reports. Funding was provided by the American Heart Association, the U.S. Public Health Service and the American Diabetes Association.

More information

Learn more about how to lose weight from the U.S. National Heart, Lung, and Blood Institute.

© 2019 HealthDay. All rights reserved.

Posted: July 2019

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Staying Healthy With Type 2 Diabetes

By Barbara Brody

overweight woman riding bicycle

You might have heard that type 2 diabetes is the “better” form of diabetes to have (compared with type 1), but that’s not exactly right. While some people with type 2 can control the condition with oral medication and simple lifestyle tweaks, others need stronger treatment. What’s more, the long-term consequences of having type 2 can be very serious. The upshot: You have a lot of power to determine what your future with type 2 looks like.

“Keeping good control of your blood sugar really helps reduce your risk of complications,” says Meg Crook, MD, an endocrinologist at the University of Virginia Health System. That means making the changes to your medication plan and lifestyle habits you need to keep your A1c down. You’ll be much less likely to have serious problems if you keep your A1c below 7%, but if you can get it below 6%, that’s even better, she says.

You should also be sure you understand what the possible complications of the disease are, so you can catch them right away if they do crop up. To do that, ask your doctor these questions:

How can I make sure my feet stay healthy?

Having high blood sugar for a long time can cause nerve damage, often in the feet. That means you might not feel calluses and sores, which can become infected. Crook says you should check your feet regularly (perhaps before you put on your socks) and see your doctor once a year for a monofilament test to check your sensation.

How will I know if I am getting kidney disease?

You might not know, because it rarely has noticeable symptoms in the beginning, says Crook. Your doctor should order a microalbumin test each year to check for protein in the urine that might indicate early kidney damage.

Is it true that I have a higher-than-average risk of heart disease?

Absolutely, says Crook. “Someone who has diabetes has an equivalent risk of having a heart attack as someone who’s already had a heart attack,” she says. Diabetes and heart disease are
closely linked.

Continued

How often should I get my eyes checked?

See an ophthalmologist at least once a year for a complete exam so that you can be monitored for conditions including glaucoma, cataracts, and retinopathy (damage to blood vessels in the retina). “If you have branching blood vessels that are likely to bleed, [the doctor] can laser them to prevent that,” says Crook.

What other complications should be on my radar?

People with diabetes also face a higher risk of gum disease, sexual problems, bladder issues, sleep apnea, dementia, and depression. They’re more apt to get certain types of cancer, too. But seeing your doctor regularly, taking your medication as prescribed, and keeping your lifestyle healthy can make all the difference.

“Drink lots of water, no soda, eat plenty of vegetables, and stay as active as you can. Your goal should be about 150 minutes of moderate activity a week,” says Crook. “I like to tell patients that what you do with your lifestyle has two to three times the impact of what a drug can do.”

Find more articles, browse back issues, and read the current issue of WebMD Magazine.

Sources

SOURCES:

Meg Crook, MD, endocrinologist, University of Virginia Health System.

National Institute of Diabetes, Digestive, and Kidney Diseases: “The A1C Test and Diabetes;” “Preventing Diabetes Problems.”

© 2019 WebMD, LLC. All rights reserved.

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Exercise Key to Staying Slim After Weight Loss: Study

THURSDAY, April 4, 2019 — If you’ve lost a bunch of weight and want to keep those pounds from piling back on, you’ll need to make regular physical activity a part of your life.

New research looking at people who lost 30 pounds or more and kept it off for a year or longer found that regular exercise was key.

“These people rely on physical activity to maintain their weight rather than restricting calorie intake. This shows how critical physical activity is for maintaining weight,” said lead author Danielle Ostendorf. She’s a postdoctoral fellow at the University of Colorado Anschutz Health and Wellness Center.

But Ostendorf was quick to point out these findings don’t mean that people shouldn’t pay attention to their diet. “Diet is very important, especially for weight loss,” she said.

To lose weight, you need to eat fewer calories than you use during the day, according to the U.S. Centers for Disease Control and Prevention. The number of calories someone needs depends on several factors, including age and activity level.

Generally, a 40-year-old woman needs between 1,800 and 2,200 calories a day, the U.S. government’s dietary guidelines recommend. A man the same age usually needs about 2,400 to 3,000 calories daily. The more you move, the more calories you can eat.

The current study looked at three groups of people.

The weight maintainer group included 25 adults who had lost about 30 pounds or more and kept it off for more than a year. Another group included 27 adults at a normal weight. The final group had 28 adults who were either overweight or obese.

All three groups were monitored over a week while they were living as normal. No one gained or lost weight.

The volunteers weren’t given any specific instructions on diet or exercise. They gave urine samples at the beginning and end of the study to measure how many calories they used (energy expenditure).

Each participant also wore a fitness device to measure their activity. It could differentiate whether people were standing or stepping and determine intensity level, Ostendorf said.

The study found that people who maintained their weight loss burned about 180 more calories a day during physical activity than other participants.

People who are overweight and obese use more calories normally, just to move a larger body throughout the day, the researchers explained. So, the fact that the maintainers used more calories than people who were still overweight or obese suggests they were more physically active.

Data from the fitness devices suggested the same. Maintainers clocked about 12,000 steps per day. Normal-weight adults had about 9,000 steps daily, and those who were overweight or obese had 6,500.

The maintainers spent about 95 minutes a day doing moderate to vigorous activity, Ostendorf said. Moderate activity might be walking up a hill; you can still talk but you might be a little out of breath. Running is an example of vigorous activity, she said.

Compared to the normal-weight group, both the maintainers and the overweight and obese group ate and used 300 calories more a day. But the maintainers appeared to compensate with more activity, researchers said.

The takeaway: You have to be active to stay at a healthy weight.

“People can lose weight and maintain the weight loss. There are people who have done this successfully. And it doesn’t have to be an extreme workout,” Ostendorf said.

Current U.S. physical activity guidelines call for at least 150 to 300 minutes weekly of moderate-intensity activity. Any physical activity counts toward that goal.

Dana Angelo White, a registered dietitian and clinical assistant professor of athletic training and sports medicine at Quinnipiac University in Hamden, Conn., agreed with the study’s conclusion.

“If you manage to successfully lose weight, there’s a certain level of maintenance required. And, you can’t just rely on diet or exercise by themselves,” said White, who wasn’t involved with the study.

She emphasized that everyone — regardless of weight status — needs to be physically active for good health.

“Commit to moving more. That doesn’t mean you need to go from zero to a hundred overnight. But find some sort of enjoyable exercise routine, and increase your activity outside of exercise as well. Make extra steps wherever you can. Walk around on your lunch break, or if you can, walk your kids to school. Anything to keep moving,” White suggested.

The study was published in the March issue of Obesity.

More information

Learn more about the importance of exercise from the American Heart Association.

© 2019 HealthDay. All rights reserved.

Posted: April 2019

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New Leash on Life? Staying Slim Keeps Pooches Happy, Healthy