Keith Vaz: Diabetes was a real wake-up call

Keith, who is chairman of the Home Affairs Select Committee, is making sure his teenage children Luke and Anjali are aware of the condition and are tested regularly.

“Diabetes does run in families and if people are aware of that they can make changes to their life and delay the onset,” he says.

It’s not known for sure why people from Asian and African backgrounds are more prone to the condition but it may be due to the different way in which their muscles burn fat. One study concluded the rate among these communities in the UK was “astonishingly high”.

Keith adds: “Awareness is so critical. Our job is to harvest people and send them to their GPs.”

Medication and improvements in his diet mean that although there is no cure, Keith’s diabetes is under control.

“I’ve had to increase my tablets,” he says. “Diabetes will affect my health as I get older. If I don’t look after myself then blindness, liver failure and amputations are all concerns.

“I’m never going to go to a gym but I intend to get an exercise bike for my home.”

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Local Researchers Make Link Between Night Shift Work & Diabetes

PITTSBURGH (KDKA) — If you regularly worked the night shift, even if you’re retired now and keep a normal daytime schedule, you’re at higher risk of a common disease: diabetes.

Researchers at the University of Pittsburgh interviewed 1,000 retired night shift workers, classified them into 0 to 7 years, 8 to 14 years, 15 to 20 years, and more than 20 years.

“Our definition was any non-overtime work that fell within the midnight to 6 a.m. window,” says University of Pittsburgh’s Dr. Timothy Monk.

Both body mass index, or BMI, and diabetes rates were higher for night shift retirees compared to day workers.

Even when BMI was taken into account, the risk of diabetes was 1.4 to 2 times greater and there was no difference among the groups, suggesting that any time on night shift might be associated with a higher risk.

The way the body processes energy and uses the hormone insulin can be affected by sleep deprivation and disrupted circadian rhythms, which is your internal clock.

Just about everyone works the night shift at some point in their career, and many jobs are crucial in the overnight hours.

So eliminating night shift is impractical. But it could be made more sensible.

“In many cases, there are situations where it is not always vital that people work through the night. There are ways of having them, for example, work in the evening, or share the work, rather than have them do an overnight. Because there is a cost,” Monk says.

And just because you’ve worked a night shift doesn’t mean diabetes is a done deal.

“Even with this increased likelihood of getting diabetes, 75 percent of the retired shift workers did not get diabetes. So that gives us hope.” Monk said.

If you work night shift, you might want to pay attention to this risk.

Watch your diet, get regular exercise, and ask your doctor about testing your blood sugar at check-ups.

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Life changes 'can save millions from diabetes'

A major review of scientific evidence concluded that diet and exercise are vital for staving off the illness, which affects 3.8 million people in Britain.

Combined with stopping smoking and regular checks on blood pressure and glucose levels, Type 2 diabetes can be prevented altogether, the team from the University of Alberta, Canada, said.

Last month, Diabetes UK said losing weight, eating more fruit and vegetables and taking regular exercise is all people need to do to significantly slash their chance of developing Type 2.

Hunt for perfect mix of diet and exercise to beat diabetes

The largest study of its kind is to be carried out to find the right lifestyle to prevent Type 2 diabetes, which is threatening to become a medical “disaster” in Britain.

Experts aim to work out not only the best way to eat, drink and exercise but even how to sleep.

It could lead to people at risk of developing the condition being given a detailed diet and exercise regime, much like a prescription, to help protect themselves.

Professor Anne Raben, the project’s chief coordinator at the University of Copenhagen, said: “We would like to find out if our current dietary and exercise recommendations are optimal or whether another lifestyle and regimen is more effective.

“It could save billions in health care costs for society if we are able to find a formula for how to best prevent Type 2 diabetes.”

The three-year study will start at the end of the year and involve 2,300 adult volunteers and 200 children aged from 12 to 18.

Eight countries will be involved including the UK, where the trial will be run by the University of Nottingham and Swansea University.

Professor Raben said: “We already know that a diet which follows current dietary guidelines can prevent diabetes. What’s unique about this project is that we are testing two diets against one another to find out if there might be a more effective alternative.

“We will include two types of exercise to determine if there is one that is more suitable. Finally we will also study the importance of stress and sleeping patterns.”

Exercise As Effective As Drugs For Treating Heart Disease, Diabetes

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Zia Soleil

Forget the pills — there’s new evidence that exercise may be as effective as medications in treating heart disease and diabetes.

Doctors now advise everyone, from young children to older adults, to become more physically active. It’s the best way to maintain a healthy weight, keep the heart muscle strong, and improve your mental outlook. But can exercise be as good as drugs in actually preventing disease and treating serious chronic illnesses?

That’s what researchers from the London School of Economics, Harvard Medical School and Stanford University School of Medicine wanted to find out. They compared the effect of exercise to that of drug therapy on four different health outcomes: heart disease, recovery from stroke, heart failure treatment and preventing diabetes.

The scientists pooled the results of 305 trials involving 339,274 people who were randomly assigned to either an exercise program or a drug-based therapy and found that there were no detectable differences between the two groups when it came to preventing diabetes and keeping additional events at bay for heart patients. And the physical activity was most powerful for participants who experienced a stroke. The only group that didn’t benefit from the exercise over drugs were patients with heart failure, likely because the strain of the physical activity wasn’t recommended for their condition.

(MORE: Exercise Alone Can Melt Away Dangerous Belly Fat in Diabetics)

The findings involving diabetes patients confirmed previous trials that documented how effective physical activity can be in bringing blood sugar levels down.

So why do most doctors prescribe drugs over exercise? There are more rigorous studies testing the effectiveness of drug therapies to treat common diseases, say the study authors, than there are studies that test the power of exercise. With these results, however, the researchers hope to see more work on how exercise can be a significant part of a treatment program for diseases ranging from heart problems to diabetes.

Those studies will need to analyze physical activity in the same way that drugs are studied, to determine how much exercise is needed to trigger beneficial changes in the body that can treat or prevent disease.

Currently, to maintain optimum health, federal experts recommend that people exercise at a moderate intensity for about 2.5 hours a week. But fewer than half of Americans meet that recommendation, and a third of Americans don’t get any exercise at all. The latest findings should encourage even those who aren’t active, however, since research shows even just talking a brisk walk can help lower the risk for high blood pressure, high cholesterol and diabetes, and be as powerful as medications in keeping the body healthy.

Doctors sound alarm on child fitness and health | Society | The …

They risk being the couch potatoes of the future – the children who prefer playing computer games, watching TV or just lounging around to visiting their nearest skatepark or taking inspiration from Andy Murray and picking up a tennis racket.

They are not the majority, but they may be – and soon.

New research published on Thursday shows that almost half of all the country’s seven-year-olds lead such sedentary lives that they do not even take the one hour of exercise a day which the UK’s chief medical officers recommend as the bare minimum to boost their health and stop them becoming overweight or developing heart problems. While 50.8% of children of that age do have one hour of exercise, the other 49.2% do not meet the official recommendation.

The findings, published in the medical journal BMJ Open, have prompted renewed concerns about children’s lifestyles and soaring childhood obesity, and whether the key pledge of last year’s London Olympics – to “inspire a generation” to take part in sport – will ever be realised. It is already known from the government’s National Child Measurement Programme in England that by the final year of primary school 33.9% of pupils are either overweight (14.7%) or obese (19.2%).

The four home nations’ medical advisers believe all children and young people should do at least an hour’s moderate to vigorous physical activity every day. But results from using accelerometers to measure the activity levels of 6,497 seven-year-olds over the course of a week show that in 2008-09, when the research was undertaken, exactly half (50%) of the pupils were sedentary for at least 6.4 hours a day.

Girls were particularly inactive: just 38% did the recommended hour of exercise, compared with 63% of boys. Children of Indian origin were the least active of seven ethnic groups, while just 43% of seven-year-olds in Northern Ireland managed the hour, compared with 52.5% in Scotland, the most active home nation.

Interestingly, children whose mothers had never worked or who were long-term unemployed were the most likely to do at least an hour’s physical activity and were the least sedentary, while children from two-parent families were less active than those being brought up by just their mother.

The Royal College of Paediatrics and Child Health, which represents the UK’s 11,000 specialist children’s doctors, said it was worried about the trend towards so many children entertaining themselves indoors in front of devices rather than outdoors as previous generations did.

Prof Mitch Blair, the college’s officer for health promotion, said: “It concerns me that half of all UK seven-year-olds are sedentary for six to seven hours every day and are failing to undertake the recommended daily minimum level of physical activity; at an age at which children should be moving around a lot more and enjoying active play instead of being glued to screens.”

He called for limits on the number of fast-food premises allowed to open near schools, a complete ban on the advertising of junk food before the 9pm television watershed to reduce children’s exposure to itand for all children to be taught how to cook nutritious meals at an early age, not just moves to boost exercise among young people. “We know obesity isn’t going to go away overnight, but there are vital steps we need to be taking now to instil positive attitudes and behaviours so future generations lead healthier lifestyles, and as a result, lower the risk of developing serious obesity-related health conditions,” Blair added.

Some schools have sought to encourage students to take part in activities that increase their heart rate by building climbing walls and offering more modern pursuits such as dance alongside traditional team games, which research shows turns some pupils off, especially girls. Thembi Nkala, a senior cardiac nurse with the British Heart Foundation, said: “This study shows us that far too many children are not nearly as active as they should be. If we want the next generation to grow up fit and healthy, we all need to do more to encourage children to be more active by providing a variety of fun and enjoyable activities that appeal to all groups.”

The education secretary, Michael Gove, sparked huge controversy in 2010 by axing the £162m-a-year dedicated school sport grant, introduced by Labour, which schools had used to expand the range, quality and regularity of active pursuits they offered. As a result, much of the England-wide network of school sport partnerships disappeared and most of the school sports co-ordinators who had overseen a rise in participation lost their jobs. Sports stars joined furious headteachers, parents and pupils in protest, forcing Gove into a partial U-turn.

The Department of Health said the government was building on the Olympic and Paralympic legacy by investing £1bn in community sport. “We have committed to giving primary schools £300m of ring-fenced funding to improve PE and sport, and help all pupils to develop healthy, active lifestyles, and have invested a further £3m to extend Change4Life School Sports Clubs to areas with the highest childhood obesity,” said a health department spokesman.

Diabetes now afflicts those in their 20s

BANGALORE: Type 2 diabetes, believed to afflict the 40-plus age group, is growing younger. Patients are now increasingly in the 20-29 age group.

Of the 12,782 persons who underwent diabetes screening in the past year for a study conducted by a diagnostic lab, 2,713 (21%) suffering from high sugar levels were aged 20-29 years. It’s a clear indicator that Type 2 diabetes — attributed to genetic causes and lifestyle — is affecting the youth.

A recent case which made doctors sit up was a 17-year-old CET aspirant, who was first diagnosed as a case of Type 1 diabetes. The diagnosis was later changed to Type 2 diabetes. Type 1 diabetes is seen in children and adolescents where the body’s malfunctioning affects insulin production. “Because he was so young, he was first treated by a general physician for Type 1 diabetes. More tests proved his was a case of Type 2 diabetes. The causes were increased stress levels due to exam pressure, improper dietary habits, obesity and other lifestyle changes,” said Dr Praveen Ramachandra, adult and paediatric endocrinologist from Columbia Asia hospital.

The study revealed that lifestyle issues are making youngsters more prone to diabetes.

“We were surprised to see many youngsters having high sugar levels, with borderline diabetes. In the initial stages, there may not be any symptoms. When screened, we figured out the need for exercise and healthy dietary habits for such persons, many of who are men. The age group of 20-29 years was so far a grey area, and there was no preventive medication so far. There is need for further research in this area,” said Dr HN Ravi Kumar, managing director of RV Metropolis.

The survey drew material from diabetes screening camps conducted across Bangalore from April 2012 to June 2013. “Such patients need proper counselling,” Dr Ravi added.

Two employees of the Karnataka Rural Infrastructure Development were found to be suffering from Maturity Onset Diabetes of Young (MODY). “The employees, aged 28 and 29, were suffering from MODY caused due to genetic abnormality, and are on treatment now,” said Dr Ravi.

The study was conducted by RV Metropolis Diagnostic and Healthcare Centre.

‘Am I diabetic?’

When youngsters are told they are diabetic, they receive the news with disbelief. This young techie was no exception.

“I started losing weight drastically. I’d feel tired all the time, and this affected my work. When I visited the doctor and gave several tests, I was told my blood had high sugar levels. I’m suffering from Type 2 diabetes,” said a 28-year-old software architect.

“The first line of treatment is diet and regular exercise. I’m on that,” he said.

Scary stats

12,782 persons underwent diabetes screening

13.61% (1,739) persons had very high sugar levels (160-500 mg%).

5.92% were women

7.63% were men

3% were in 0-9 age group (juvenile diabetes)

5% were 10-19 years old

21% (2,713) with symptoms of diabetes are in 20-29 age group

(Source: RV Metropolis study)

Exercise Up in U.S., But So Is Obesity: Report – WebMD

Exercise Up in U.S., but So Is Obesity: Report

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, July 10 (HealthDay News) — Although Americans are exercising more, the obesity epidemic continues to expand, University of Washington researchers report.

Their nine-year study of data from two U.S. health surveys suggests that physical activity alone is not enough to combat the problem.

“While physical activity has improved noticeably in most counties, obesity has also continued to rise in nearly all counties,” said lead researcher Laura Dwyer-Lindgren, from the university’s Institute for Health Metrics and Evaluation.

The obesity problem is directly related to how much Americans eat, said senior author Ali Mokdad, a professor of global health at the Institute for Health Metrics and Evaluation.

“Americans are not doing enough to control what they eat,” he said. They still consume more energy than they burn off through exercise, he said.

According to the U.S. Centers for Disease Control and Prevention, more than one-third of U.S. adults are obese, and obesity contributes to serious chronic illnesses, high medical costs and premature death.

“We have to face the reality that obesity is affecting our health,” Mokdad said. “We need to take care of ourselves by watching what we eat and how much we exercise.”

From 2001 to 2009, the percentage of adults meeting recommendations for physical activity — 150 minutes of moderate activity or 75 minutes of vigorous activity a week — increased in most counties in the United States, the researchers report July 10 in Population Health Metrics.

But the percentage of adults considered obese also increased significantly. “In some counties, this increase was greater than 15 percentage points,” Dwyer-Lindgren said.

There was very little correlation between change in obesity and change in physical activity, the researchers noted.

Large disparities existed in 2011 between the best- and worst-performing counties. Less than 20 percent of men were obese in some counties, while nearly half were obese elsewhere, the report shows. For women, the gap was even larger — from less than 20 percent in some places to almost 60 percent in another.

Physical activity also bounced around, ranging from roughly one-third to about three-quarters, depending on county, for both men and women.

Big gains in physical activity were seen in counties in Kentucky, Georgia and Florida, but Kentucky’s Lewis County also had the biggest increase in male obesity — from about 29 percent in 2001 to about 45 percent in 2009. Western states claimed some of the most active counties, with residents of Wyoming’s Teton County the most active of all — with about 78 percent meeting recommended exercise guidelines.

Six of the eight least active counties were in Mississippi.

Increases in physical activity suggest that many communities have successfully adopted healthier lifestyles, likely through policies that promote physical activity, Dwyer-Lindgren said.

Obesity is Now a Disease | Care2 Healthy Living

We, as Americans, are fat. That doesn’t mean that we are all fat; it just means that nearly 1/3 of Americans are obese and for this we pay out $147 billion annually in medical expenditures related to obesity. If this strikes you as shocking, well, this is not something that has happened overnight. Some say we have been moving toward this cataclysm of an epidemic for decades now. Some blame the fast food industry. Some blame the pervasive culture of desire and greed. Some blame the individual for just eating way too much. Blame aside, obesity is, and remains, a huge problem in this country and seems to be doing anything but going away.

As of last week, the American Medical Association (AMA) officially recognized obesity as a disease, which is a term that is made in effort to change the way the medical establishment wrestles with issues related to obesity. The labeling of obesity as a “disease” might not immediately change how doctors treat patients directly, but it will most certainly change the way obesity-related conditions are covered by insurance.

As it stands now, doctors are not readily encouraged to have the, sometimes, difficult conversations with patients about things like diet, exercise, and lifestyle decisions, not because they are awkward and difficult, but because such conversations are not reimbursed. So if the doctors don’t get paid, there is no incentive to alert a patient to their declining health. Instead doctors are driven toward conversations about procedures, rather than prevention. In the case of obesity, which is connected to everything from heart disease to diabetes, this is tragic.

Now that obesity is labeled as a disease, the hope is that there will be more of these diet and exercise conversations taking place (and paid for by insurance companies). But beyond the economics of the disease, it is hard to know how much this label will actually change. Could there be repercussions, such as more drugs created and unnecessarily prescribed? Will this label lead to more stigma? Also, by labeling obesity as a disease, will this take the focus off the food system, which markets cheap, substandard, nutritionally vacant foodstuffs to the masses at the expense of nearly everyone? Time will tell.

What do you think of this decision? Weigh in below.

Related:
Obesity Causes and Solutions

Is Obesity a Disease? | BU Today | Boston University

The nation’s top doc group has voted to classify obesity as a disease.

An overdue bow to science or a clever dodge of the real problem? The American Medical Association’s decision Tuesday to classify obesity as a disease left the weight of expert opinion, so to speak, unsettled.

“Long time coming—I have been fighting for this for over 20 years,” says Caroline Apovian, a School of Medicine professor of medicine and pediatrics and director of the Nutrition and Weight Management Center at Boston Medical Center. Obesity researcher Daniel Miller is more circumspect. The School of Social Work assistant professor fears that the decision “will prompt people to further identify obesity as a purely medical problem, and one that is best treated by pharmaceuticals or surgery,” leaving what he calls the root causes—social and environmental influences—in the dust. Miller agrees, however, that if the decision “means access to treatment for some who otherwise might not be able to get it, that is obviously a good thing.”

Then there’s the wait-and-see school. Whether the AMA made the right call depends on whether it “will reduce the number of obese Americans and the gravity of their obesity,” says Alan Sager, a School of Public Health professor of health policy and management. And take-two-pills-and-call-me-in-the-morning hasn’t worked to date to stem the wave of weight, he says: “Doctors have never been the most powerful actors in combating obesity,” which has mushroomed because of such things as the cost and distribution of good foods and changes in exercise patterns.

Apovian says the disease designation is justified by research showing that weight gain in animals correlates to damage in the gut-to-brain signaling system. “The body does not recognize how much fat is being stored,” she says. “Therefore, you do not feel full, and keep eating.”

The vote by the AMA, the country’s premier doctor group, fired up numerous questions, ranging from the best way to treat this newly defined disease to the implications for insurance and social attitudes toward the overweight. The newest disease affects more than one-third of Americans and costs $147 billion a year in medical bills. The AMA’s verdict—which contravened the recommendation of its own study committee—cited a need to destigmatize obesity, which some doctors say is not subject solely to people’s control, and the fact that obesity has some effects of disease, such as interfering with the body’s function.

Professors Daniel Miller (from left), Caroline Apovian, and Alan Sager. Miller photo by Michael Malyszko. Apovian photo courtesy of Apovian. Sager photo by Kalman Zabarsky

Opponents counter that a disease must be diagnosable, and the diagnostic tool for identifying obesity, body mass index, is unrealistic and unreliable. Professional athletes have clocked in as overweight under versions of the BMI, because muscle weighs more than fat.

Critics contend also that obesity is a risk factor for diseases like diabetes or heart ailments, rather than a disease itself. They predict more runaway medical costs if overweight people now turn to surgery and drugs rather than to diet and exercise.

If carrying excess pounds is a disease, should eating better and physical activity be considered best-practice treatment? Apovian says no, because our body chemistry often renders those tactics alone futile: “The body thinks it is starving and is going to get you back to that set point by making you very, very hungry. This is the essence for why it is a disease.”

On this point, Miller agrees with Apovian, saying individual responsibility is one strand in a complex causation web that can include environmental factors well beyond a person’s control. Poor neighborhoods, for example, are often nutrition “deserts,” with few stores that sell healthful food. For that reason, Apovian argues, the government should classify such neighborhoods as medically underserved, a designation now given to areas with a shortage of health care providers. “Bad food, hopefully, in the next few years will be seen as poison,” she says. “Just like we did with tobacco.”

Sager doubts that such a designation will be made. He points out that free-market advocates have blocked government action on helping underserved populations, and their philosophy is sure to extend to government promotion of stores carrying healthful foods. Also, he says, legally speaking, “no one is obliged to do anything different because the AMA has voted to rename obesity a disease.”

Apovian believes the decision actually will aid President Obama’s goal of “bending the cost curve” in medicine. In some cases, she says, insurance companies already cover bariatric (stomach-reducing) surgery; if the AMA’s vote pushes them to pay for diet and exercise programs to prevent obesity, diabetes, and heart disease, it will save money in the future treating those problems. Sager predicts “a modest effect” in expanded insurance coverage from the AMA decision.

Should the new definition of obesity influence attitudes toward the obese? For example, nonobese travelers applauded a requirement by some airlines that obese passengers purchase two seats instead of squeezing into one seat and overwhelming the person next to them. If obesity is a disease, doesn’t that policy become discrimination?

“Yes, absolutely. Make the seats bigger, for God’s sake,” says Apovian.

Air Canada has an intriguing third way. It gives a free second seat to obese fliers who present a doctor’s note to the airline.


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