More Evidence Ties Obesity to Disability in Older Women – WebMD

Evidence Ties Obesity to Disability in Older Women

By Dennis Thompson

HealthDay Reporter

MONDAY, Nov. 11 (HealthDay News) — Women who are obese as they near retirement age have a higher risk of early death and may find their remaining years blighted by disability, researchers say.

Obese women are three to six times more likely to suffer a disability late in life that will make it difficult for them to get around, with the risk rising with their level of obesity, according to a new study published online Nov. 11 in JAMA Internal Medicine.

A second study in the same journal issue found that being overweight or obese raises your risk of heart attack and heart disease even if you are otherwise healthy.

The number of women aged 85 years and older in the United States is increasing, according to study background information, with 11.6 million women expected to reach 85 by 2050.

Obesity rates also continue to increase, and nearly one-third of U.S. women 75 years and older are obese. This extra weight not only reduces life span, but also can severely harm an older woman’s quality of life.

“For dying and losing the ability to walk, the risks were alarmingly high — over threefold to upwards of over sixfold,” said study co-author Eileen Rillamas-Sun, a staff scientist at the Fred Hutchinson Cancer Research Center, in Seattle. “I believe that remaining mobile is very important to most older people, especially since it is useful for retaining one’s independence.”

The new findings aren’t that surprising, but they’re important, one expert noted.

Together, the two studies “verify something that we knew, but give us some more ammunition to craft more programs and pay more attention to women’s body weight and obesity overall,” said Dr. Georges Benjamin, executive director of the American Public Health Association (APHA).

“The obesity epidemic isn’t just our kids, and if you are thinking forward we are having this enormous growth as the baby boomers age through society,” he said. “We’re going to have to spend a lot of time encouraging women to achieve a sensible body weight.”

Rillamas-Sun’s study examined the health records of nearly 37,000 older women participating in the Women’s Health Initiative, a long-term study sponsored by the U.S. National Institutes of Health.

The researchers found that about 12 percent of healthy-weight women had become disabled by age 85, requiring a walker or some other assistance for getting around.

By comparison, between 25 percent and 34 percent of obese women were disabled, with incidence rising with the patient’s body mass index (BMI), a measurement of body fat that takes height and weight into account.

Overall, a waist circumference greater than 35 inches was associated with a higher risk of early death, along with new diseases developing during the study period and mobility disability, the researchers said.

Yoga can cure early stage heart disease, diabetes: Study

NEW DELHI: Can yoga be a cure for early stage diabetes and heart disease? The results of a year-long study, published in the latest issue of the Journal of Yoga and Physical Therapy suggests so.

In this study, conducted at Sir Ganga Ram Hospital, 100 patients at risk for coronary heart disease and type-II diabetes were divided into two groups – one of them was prescribed conventional lifestyle modification such as exercise, diet and smoking cessation while the other was prescribed yogic exercises in addition.

“There was a significant reduction in body mass index (BMI), blood pressure and total cholesterol among others in both the groups. But when compared with the conventional lifestyle group, the yoga group had a significantly greater decrease in BMI, low density lipoprotein cholestrol (LDL) and increase in high density lipoprotein cholesterol (HDL),” said D S C Manchanda, the lead author of the study, and head of the cardiology department at Sir Ganga Ram Hospital.

Manchanda said that mechanisms underlying regression of early arthrosclerosis – thickening of the artery wall – in metabolic syndrome was not clear though. “Control of several risk factors like hypertension, type-II diabetes mellitus lipids, reversal or preventive effects of both psychological and oxidative stress and reducing inflammation may be contributing factors,” he added.

On the basis of the study results, cardiologists say, yoga may be a cost effective technique to target multiple risk factors for heart disease and type-II diabetes prevention. “Though larger trials are required, it is suggested that yoga may be incorporated in the therapeutic lifestyle modifications for metabolic syndrome as well as coronary heart disease and type-II diabetes,” Dr Manchanda said.

Yogic exercises that have been shown to have positive impact include breathing exercises such as pranayamas and anulom-vilom – alternate nose breathing. Asanas like surya namaskar, tadasna and vajrasana have also been shown to have positive impact on patients.

Non-communicable diseases, chiefly cardiovascular diseases , diabetes, cancer and chronic respiratory diseases, are the major cause of adult mortality and morbidity worldwide. “Most of the non-communicable diseases, for example diabetes or heart disease, affect the person in the productive years. It causes reduced productivity and early retirement. Also, it puts immense pressure on the public health expenditure as in most cases the treatment costs are higher compared to the communicable diseases. Preventive strategies such as yoga must be propagated for better health,” said a senior doctor.

Indigenous diabetes testing kit to cost 90% less

NEW DELHI: India is set to introduce indigenous testing products for diabetes by the year-end, bringing down costs by 90 per cent. The Indian Council for Medical Research (ICMR) is in the final stages of testing products including strips and readers for diabetes.

Speaking on the need for India to have affordable indigenous technologies, health minister Ghulam Nabi Azad said on Friday, “I have given ICMR a deadline of the end of the year to bring indigenously developed testing strips for diabetes.”

ICMR director general Dr VM Katoch said the cost of a diabetes testing strip was between Rs 15-30 since the products were all patented. ICMR aims to bring down the cost to Rs 3-5.

Dr Katoch added, “A dozen projects have been initiated while four are in a very advanced stage. We are hopeful that we will be able to come out with some products by December.”

India is home to 62 million diabetics, second only to China which has 92.3 million diabetics. By 2030, India’s diabetes numbers are expected to cross the 100 million mark according to a 2012 report by International Diabetes Federation. More worryingly, WHO projects that in the next 10 years, deaths by diabetes will increase by 35%.

The economic burden due to diabetes in India is among the highest in the world. As per WHO estimates, mortality from diabetes, heart disease and stroke cost about $210 billion in India in 2005. Much of the heart disease and stroke in these estimates were linked to diabetes. Diabetes, heart disease and stroke together will cost about $333.6 billion over the next 10 years in India alone, estimates WHO.

Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. The disease exposes a person to heart attack, stroke, amputations, nerve damage, blindness and kidney disease.

Work on diagnostic tests for TB, dengue, kalazar, leptospirosis and other infections that are indigenously produced is also underway.

A diabetes drug which does not hurt your heart

BARCELONA: Mankind’s fight with diabetes and its associated medical complications goes back over 3,500 years ago. In fact, the earliest record of diabetes, written on a third dynasty Egyptian papyrus by physician Hesy-Ra , describes it as a “great emptying of the urine” .

Medical advances since then have progressed from treating diabetes with “wheat grains, fruit and sweet bee” to a host of integrated drugs, apart from a regimen of diet and exercise.

Currently, diabetes (both Type 1 and 2) affects an estimated 371 million people and kills over 4 million annually worldwide. Worryingly, over 63 million of these patients are found to be in India alone. Even more alarming is the correlation between diabetes and cardiovascular (CV) disease. Studies have shown that approximately 50% of diabetics die of a cardiovascular event.

As Dr Mark Kearney, professor of cardiovascular and diabetes research at the British Heart Foundation, University of Leeds, said: “If you are a South Asian, you are not only more susceptible to Type 2 diabetes but also to cardiac failure.” In fact, the cardiovascular age of a diabetic is pegged at 15 years more than the patient’s biological age. In simple terms, people with diabetes are four times more likely to die of a heart attack or stroke as compared to those who don’t have diabetes.

The main outlook in treatment of such patients is not to increase the risk of CV events even further. This is where data from Phase 3 trials in linagliptin, a DPP-4 inhibitor, holds out some sweet news. Boehringer Ingelheim and Eli Lilly and Company recently announced at the annual European Association for the Study of Diabetes meeting that treatment with linagliptin is not associated with increased risk of CV events in the treatment of T2D. Linagliptin (a 5mg tablet, once daily), is the only DPP-4 inhibitor that does not require dose adjustments in adults with T2D.

It is marketed as Trajenta in Europe and Tradjenta in the US. The results from the Phase 3 clinical trials of linagliptin, that covered 6,000 people with T2D in various countries, are even more heartwarming when its efficacy, safety and tolerability levels, especially among elderly patients, are considered.

(This correspondent was in Barcelona at the invitation of Boehringer-Ingelheim )

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.

India has too few cardiac, diabetes specialists

BANGALORE: In the world’s second most populous country, diseases of the heart are the biggest killers. The bigger tragedy is that the number of cardiac specialists graduating every year in India is a meagre 250.

The concern among medicos today is not just the limited number of postgraduate seats available in the country’s 381 medical colleges, it’s also the skewed distribution of seats between subjects. The number of seats in clinical subjects that deal with patients directly is low, though they attract the most number of students. In the end, those who don’t make it to these seats make do with para-clinical seats.

It’s worse for diabetics. Even when the country is heading towards becoming the diabetes capital of the world, we have only 50 PG seats in endocrinology. Not to forget that uncontrolled diabetes leads to kidney failure, heart failure and stroke. The US, on the other hand, has 250 PG seats in this subject.

While the World Health Organization puts tuberculosis as the sixth highest contributor to the number of deaths in India, we have only 307 specialized doctors graduating in pulmonary medicine every year. If cancer is the most feared disease in recent times, India has set apart 48 seats for specialization. In contrast, the US has 508 seats.

While a mother dies every 10 minutes in India, we have only around 1,400 obstetrics and gynaecology seats. There are about 93 seats in gastroenterology, as against 433 in the US, even when diarrhoeal diseases are the second highest contributor to deaths in India.

On the other hand, there are 5,833 para-clinical PG seats in the country. Pathology tops with 1,201 MD seats, microbiology has 724 and community medicine 736, biochemistry has been allotted 481 seats and physiology 672.

“Non-clinical subjects don’t deal with patients directly,” says Dr Devi Shetty, former member, board of governors, Medical Council of India. “The younger generation is not attracted to these subjects unless they have a scientific bent of mind. Most doctors who graduate would want to treat patients. Thus, the market value of these non-clinical degrees remains very low. They are the least preferred and taken up only if students don’t have a choice. Sometimes, they remain vacant.”

Experts in the field also point out that when there’s an increase in the number of PG seats, it happens in the non-clinical subjects. The increase, thus, becomes pointless.

Doctors say every unit in a medical college in the country can accommodate up to five PG students, according to MCI norms. If that’s the case, the number of PG seats can go up to 38,390 in the current scenario.

Speciality seats

Discipline——————- India————Us

Cardiology——————- 250————- 781

Diabetology/Endocrinology—50————251

Gastroenterology————— 93————-433

Haematology——————– 13————– 523

Nephrology———————-84————– 416

Neurology———————–159———- 592

Oncology———————— 48————- 508

(Source: MCI India, National Resident Matching Program)

Low diversity of gut bacteria linked to heart disease, obesity


By Staff Writer
NYR Natural News

Natural Health News — New research shows that there is a link between number and diversity of bacterial species in the gut and the risk of chronic disease.

An international consortium of researchers report that overweight people with fewer bacterial species in their intestines are more likely to develop complications, such as cardiovascular diseases and diabetes. In addition, a gut with decreased bacterial richness appears to function entirely differently to the healthy variety with greater diversity.

Says lead researcher Jeroen Raes from the University of Brussels: “This is an amazing result with possibly enormous implications for the treatment and even prevention of the greatest public health issue of our time.”

Diversity is the key

Gut bacteria strengthens our immune system, produces vital vitamins and communicates with the nerve cells and hormone-producing cells within the intestinal system. The researchers add that gut bacteria also produces a variety of “bioactive substances” which enter the bloodstream, affecting our biology.

The gut needs a wide diversity of intestinal bacteria in order to maintain all these processes. In the current study people who were overweight were more likely to have low diversity in their gut flora.

The bacterial link

In this current study researchers took a closer look at the intestinal flora of 169 obese Danes and 123 non-obese Danes. The results were published in the journal Nature.

According to Raes “We were able to distinguish between two groups based on their intestinal flora: people with a large richness of bacterial species in their intestines and people with a fewer bacterial species. A species-rich bacterial flora appeared to function differently compared to the poorer variety. It was surprising to see that obese and non-obese people were found in both groups.”

The scientists found that the group with lower species richness in their intestinal flora was more susceptible to developing obesity-related conditions and chronic inflammation.

In addition, the obese people in this group were more at risk of cardiovascular conditions than the obese people in the other group. These are important results that suggest that it is not only weight gain and dietary habits that play a role in the development of medical complications in obese people.

Chicken and egg?

Metabolic conditions have become an epidemic partly due to the modern sedentary lifestyle and the and easy access to large amounts of energy-dense food. It is expected that obesity will increase tremendously all over the world; from 400 million obese people in 2005, to more than 700 million in 2015.

Some people appear to be more vulnerable to putting on eight than others and many studies over the years have examined the possible cause of this.

The researchers say they do not know whether lack of intestinal bacteria is the cause of obesity, or whether obesity causes a decrease in intestinal bacteria.

However, previous research has also suggested a link between gut bacteria and obesity. A study from the Cedars-Sinai Medical Center in Los Angeles, for example, found that certain types of bacteria in the gut cause it to take more calories from food, therefore leading to weight gain.

Dietary measures

Another finding of the international study was that a quarter of the participants had 40% fewer gut bacteria genes and correspondingly fewer bacteria than average.

Extrapolated to the entire population this suggests that a low number and diversity of gut bacteria could play a major role in health problems.

They say they cannot yet explain fully why some people have fewer intestinal bacteria compared with others, but they believe our diet may be a contributing factor.

They point to a 2012 study from a French research team, which revealed that a group of overweight participants who followed a low-fat diet for 6 weeks and who had fewer intestinal bacteria at the beginning of the diet, showed an increase in gut bacteria in both variety and amount.

“Our intestinal bacteria are actually to be considered an organ just like our heart and brain, and the presence of health-promoting bacteria must therefore be cared for in the best way possible. Over the next years, we will be gathering more knowledge of how best to do this.”

Good gut bacteria could protect obese people from heart disease and diabetes …

  • Scientists have discovered a link between obesity-related diseases and levels of bacteria found in the intestines
  • They also found that gut flora with low levels of bacterial diversity functions differently to those with a variety of microorganisms
  • Results
    suggest it is not only weight gain and dietary habits that play a role
    in the development of medical conditions in obese people

By
Emma Innes

13:18 EST, 28 August 2013


|

13:18 EST, 28 August 2013

Good bacteria in the gut protect obese people from heart attacks and strokes, according to scientists.

A study has found a link between the medical problems caused by being overweight, and the bacterial species in the intestines.

People with less of these bugs are more likely to develop metabolic disorders such as cardiovascular diseases and diabetes.

Good bacteria in the gut protect obese people from heart attacks and strokes, according to scientists

Good bacteria in the gut protect obese people from heart attacks and strokes, according to scientists. People with more good bacteria are less likely to develop heart disease and diabetes

A flora with decreased bacterial richness seems to function entirely differently to the healthy variety with greater diversity.

Professor Jeroen Raes, of Vrije University in Belgium, said: ‘This is an amazing result with possibly enormous implications for the treatment and even prevention of the greatest public health issue of our time.

‘But we are not there yet. Now we need studies in which we can monitor people for a longer period.’

Metabolic conditions are becoming endemic because of people failing to exercise and eating foods that are high in sugar and fat.

It is expected obesity levels will nearly double from 400 million in 2005, to more than 700 million in 2015 – and the trend is expected to persist at least until 2030.

Professor Raes and his colleagues examined the intestinal flora of 169 obese and 123 non-obese Danes and found those with low species diversity had more metabolic abnormalities, such as increased body fat and insulin resistance.

A flora with decreased bacterial richness seems to function entirely differently to the healthy variety with greater diversity

A flora with decreased bacterial richness seems to function entirely differently to the healthy variety with greater diversity

Professor Raes said: ‘We were able to distinguish between two groups based on their intestinal flora: people with a large richness of bacterial species in their intestines, and people with less bacterial species.

‘A species-rich bacterial flora appeared to function differently compared to the poorer variety. It was surprising to see obese and non-obese people were found in both groups.’

The scientists found the group with lower species richness in the intestinal flora were more susceptible to developing obesity-related conditions and chronic inflammation.

The obese people in this group were more at risk of cardiovascular conditions than the obese people in the other group.

The results are important because they suggest it is not only weight gain and dietary habits that play a role in the development of medical complications in obese people.

In a second study published in the same journal, Professor Stanislav Ehrlich of the National Institute of Agronomic Research in Jouy-en-Josas, France, showed eating plenty of fruit and vegetables can boost gut microbes.

He looked at 49 obese or overweight individuals and found increasing consumption of high-fibre foods led to more bacterial richness and improved some clinical symptoms associated with obesity.

The finding supports previous research linking diet composition to the structure of gut microbe populations – and suggests a permanent change may be achieved through adopting an appropriate diet.

A QUARTER OF PEOPLE LACK HEALTHY LEVELS OF GUT BACTERIA

Humans have about 3.5lbs of bacteria living in their intestines, according to a new study.

However, a quarter of people have guts which house fewer bacteria than they should do to ensure we stay healthy.

One in four people are lacking the healthy bacteria which help break down our food and maintain a healthy digestive system, scientists have discovered.

Experts looking at intestinal bacteria from 292 people in Denmark found that about a quarter of people have up to 40 per cent less gut bacteria than average.

These people are more likely to be obese and suffer from mild inflammation in the digestive tract and in the entire body.

This is known to affect metabolism and increase the risk of type 2 diabetes and cardiovascular diseases.

Author of the study Oluf Pedersen, professor and scientific director at the Faculty of Health and Medical Sciences, University of Copenhagen, says we need plenty of bacteria in our guts in order to improve our health.

He compares the human gut and its bacteria with a tropical rainforest and explains that we need as much diversity as possible, and – as is the case with the natural tropical rainforests – decreasing diversity is a cause for concern.

In the study, which is published in the scientific journal Nature, Professor Pederson said: ‘It appears that the richer and more diverse the composition of our intestinal bacteria, the stronger our health.

‘The bacteria produce vital vitamins, mature and strengthen our immune system, and communicate with the many nerve cells and hormone-producing cells in the intestinal system.

‘And, not least, the bacteria produce a wealth of bioactive substances which penetrate into the bloodstream and affect our biology in countless ways.’

The comments below have not been moderated.

I’ve just finished a course of antibiotics and am having some natural yoghurt with breakfast each day to try to restore my good bacteria – still don’t feel so good – so I’m wondering whether to lash out the $30 or so for some refrigerated probiotics – I had once before and felt great soon after – hmm – maybe …

Frankly
,

Sydney, Australia,
29/8/2013 02:22

Kefir is one of the options. Lactofermentation is another one. people have been doing it for centuries. It is easy, it is cheap, you can do it. The only thing, you have to get over your fear of bacteria instilled in you by the advertising of antibacterial products.

Margareth
,

LV,
28/8/2013 22:54

In response to ‘Thomas. Hexham, UK’ there’s much research (finally!) into the importance of the human microbiome (our unique mix of gut/ intestinal bacteria) in relation to our health. The best ways – in my opinion – to increase the ‘good’ bacteria is to eat a balanced diet,* very* much limiting processed foods and sugars especially. Also, avoid broad spectrum antibiotics (which wipe out good bacteria and allow bad bacteria to flourish) unless absolutely necessary. Finally, find a really good broad probiotic – a good one will help to repopulate your gut with a diverse range of the ‘good’ bacteria.

Rachel_NZ
,

Auckland,
28/8/2013 22:48

Does a lack of the ‘right’ bacteria cause obesity, or does obesity cause a lack of the ‘right’ bacteria?

Norfolk Dumpling
,

Great Yarmouth,
28/8/2013 22:37

I’d be more interested in the different enzymes present and variations in their expression over time and on specific diets. There is great difficulty isolating all the bacteria present in the gut flora whereas the enzymes they produce can be easily measured. Also, it would be necessary to know which enzymes- even different types of the same enzyme so methods of identifying these would be required.

It seems odd if they haven’t used this approach which is called metabolomics/proteomics because it is agreed for many areas of microbial ecology to be the best. It will lead to more very interesting information about the role of gut flora particularly any links to cancers in the gut and diet and other gastoenteric diseases as well as modulation of the immune response.

ken mist
,

paris,
28/8/2013 22:37

I got my water Kefir off ebay for 3 quid, been using it for over a year now and never looked back, cleared up my acne too

Mark
,

Sheffield,
28/8/2013 22:27

The generational legacy of taking antibiotics for everything, including things they don’t help/cure.

MyOpinionIsDifferent
,

GrowUp, United Kingdom,
28/8/2013 22:18

Non of it will replace a good diet and exercise. It’s not rocket science and it takes effort.

worried for the future
,

Leeds England,
28/8/2013 22:08

As someone else said – kefir. Google it. I make my own.

Brighton Boy
,

Brighton sometimes,
28/8/2013 22:07

Good bacteria is really relating to taking a good probiotic supplement daily and eating lots of live yogurt .

petra
,

Sandon,
28/8/2013 22:05

The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.

A Label Calls Attention to Obesity

James Steinberg

Personal Health

Personal Health

Jane Brody on health and aging.

Most people know that obesity can result in serious health problems, yet many of us continue to focus on its cosmetic consequences rather than its risks to health.

This distorted view may change now that the American Medical Association has finally labeled obesity a disease, not just a risk factor for other disorders. Last month, the organization recognized that obesity is a verifiable illness that warrants far more attention than physicians, patients and insurers currently give it.

The designation may change how aggressively doctors treat obesity, foster the development of new therapies, and lead to better coverage byinsurers. After all, the price of not treating obesity is now in the stratosphere. Obesity-related health conditions cost the nation more than $150 billion and result in an estimated 300,000 premature deaths each year.

If the population’s weight gain is not soon capped (or better yet, reversed), experts predict that half of adults in America will be obese by 2040. The A.M.A. has said in effect that it is medicine’s responsibility to provide the knowledge and tools needed to curb this runaway epidemic.

On June 19, James Gandolfini, the hefty award-winning actor who portrayed Tony Soprano in “The Sopranos,” died at 51, apparently of a heart attack, while on vacation in Italy. Even if genetics played a role, Mr. Gandolfini’s weight contributed significantly to his risk of sudden cardiac death.

Not a week earlier, a 46-year-old member of my family who weighed over 300 pounds died suddenly of what might have been a heart attack while dozing in front of the television. He had long suffered from sleep apnea (a risk factor for sudden death), high blood pressure and severe gout, all results of his extreme weight.

Fran Saunders, a 62-year-old Brooklynite, is determined to avoid a similar fate. At 4 feet 11 inches tall and 157 pounds, she was clinically obese. She was sent for blood tests when she complained of a vision problem that could have been related to her weight. All her lab readings — total cholesterol, triglycerides, blood sugar — were seriously abnormal. Her doctor said she was a heart attack waiting to happen. But “the bad news was a blessing in disguise,” she told me.

Though she had long been a regular at the gym, she knew it was time to get her diet on a healthier track to lower her cholesterol, her risk of developing diabetes and her chances of dying prematurely.

She now monitors what she eats and how much she exercises with a free cellphone app, My Fitness Pal. Gradual weight loss started almost overnight at a pound or two a week. Although her goal weight is 110 to 115 pounds, her blood test results improved significantly after she lost just seven pounds.

“My doctor told me that every pound I lose lowers my risk,” said Ms. Saunders. “I know it’s possible for some people to be fit and fat, but that wasn’t the case for me, and it was time to stop kidding myself.”

The list of problems obesity can cause should be a call to action for the one-third of American adults who are obese. Heart Disease and Stroke Obesity can raise levels of artery-damaging triglycerides and LDL cholesterol, and lower levels of protective HDL cholesterol. This raises the risk of atherosclerosis tenfold by fostering a buildup of plaque in arteries that feed the heart and brain. The chest pains of angina occur when the heart cannot get enough oxygen-rich blood through plaque-clogged arteries. A piece of plaque can break off at any time and block a narrowed artery, causing a heart attack or stroke.

Obesity also strains the heart and can lead to heart failure — a heart unable to pump the blood necessary to supply the body with adequate oxygen and nutrients.

High Blood Pressure Excess body fat increases the volume of blood the heart must pump to supply all tissues with nutrients and oxygen. This increases the pressure on artery walls, which contributes to heart disease, stroke and kidney failure.

Type 2 Diabetes Obesity impairs the body’s ability to use insulin to maintain normal blood sugar levels. Diabetes, in turn, is a leading cause of heart disease, stroke, kidney disease and blindness. Once a late-in-life disease, Type 2 diabetes now is often seen in overweight children. Even being moderately overweight can lead to insulin resistance, in which the body becomes insensitive to the hormone. The condition can be reversed by weight loss.

Joint Disease The more weight a person carries, the greater the stress on joints and the risk of developing painful, incapacitating osteoarthritis in the knees, hips and lower back. Obesity is a major reason for the sharp rise in costly joint replacements. Excess weight can also cause premature failure of an artificial joint.

Breathing Problems In addition to causing shortness of breath during physical exertion, obesity is the leading cause of obstructive sleep apnea — breathing stops periodically during sleep, followed by an abrupt intake of air and loud snoring. Apnea disrupts sleep and results in daytime drowsiness that can cause accidents.

Cancer People who are obese are at increased risk of developing cancers of the colon, breast, endometrium, esophagus, pancreas, kidney, thyroid and gallbladder. One possible reason: increased amounts of growth factor in obese people may promote tumor development. Metabolic Syndrome One-third of overweight and obese people have a constellation of six factors that seriously raise the risk of cardiovascular disease: abdominal obesity, high blood pressure, high cholesterol, insulin resistance, excessive clotting factors and inflammatory compounds in the bloodstream. Abdominal fat is especially hazardous because it is metabolically active, unlike relatively inert fat on the hips and thighs.

The list of obesity’s hazards goes on: infertility in women, pregnancy problems, gallstones and gout, not to mention emotional disorders, social ostracism and employment discrimination.

The first step toward avoiding all of these is a simple calculation to determine whether you are at risk. The most frequently used measure is body mass index, calculated by dividing weight in kilograms by height in meters squared. The National Heart, Lung and Blood Institute, among others, offers a free calculator online. In general, a B.M.I. of 30 or more indicates obesity, but B.M.I. can be misleading if heavy bones and big muscles account for a large portion of someone’s weight.

A simpler measure is a waistline as large as or larger than a person’s hips. Overweight typically starts at a waist of 40 inches for men and 35 inches for women.

The easiest assessment of all? Stand naked in front of a mirror and honestly assess the contribution that fat is making to your body’s composition. It’s not hard to see.


This post has been revised to reflect the following correction:

Correction: July 1, 2013

An earlier version of this article misstated the formula for calculating body mass index. The measurement is reached by dividing weight in kilograms by height in meters — not centimeters — squared.

A version of this article appeared in print on 07/02/2013, on page D7 of the NewYork edition with the headline: A Label Calls Attention to Obesity .

Disappointing Results for Weight Loss and Diabetes

In a frustrating outcome, a long-term weight-loss program aimed at overweight adults with diabetes didn’t cut the rate of heart attacks and strokes, a major study showed.

But losing weight did provide at least one major benefit by cutting the development of chronic kidney disease, a leading cause of premature death in people with Type 2 diabetes. It also showed some ancillary benefits like cutting medicine use, depression and hospitalizations. Doctors said the finding shouldn’t discourage people—particularly those with diabetes—from exercising and eating a healthy diet. Several other studies have shown that exercise and a healthy diet can prevent people at risk for Type 2 diabetes, the most common form of the disease, from getting the disease.

New results from the study were presented Monday at the American Diabetes Association’s annual meeting and published in the New England Journal of Medicine.

Diabetes affects about 26 million Americans and is characterized by high blood-glucose levels caused by the body’s inability to either make or properly use insulin. Type 2 diabetes is associated with weight gain and older age. The disease raises the risk of heart attacks and strokes, kidney disease, blindness, amputations and nerve damage.

The study—called Look Ahead—was stopped early by the National Institutes of Health partly because it was clear a goal of showing a reduction in cardiovascular events wouldn’t be reached. The study was supposed to last for about 13 years but was stopped after patients had been followed for about a decade. Patients in the study were diagnosed with Type 2 diabetes, were overweight or obese, and were between age 45 and 75 when the study started in 2001. Although the lifestyle interventions in the study were stopped early, researchers said they continue to track the patients in the study.

Researchers wanted to know if a long-term study looking at weight loss would show a reduction in actual events like heart attacks and strokes. The study was able to successfully show that a middle-age and elderly group of patients could lose weight and keep it off for nearly a decade. Several short-term studies looking at overweight people considered to be at risk for developing diabetes and heart disease have shown benefits of losing weight, such as improved blood sugar levels, lower blood pressure and cholesterol.

The study assigned about 2,600 people to an intensive intervention group that emphasized exercise and cutting calories. About 2,600 were in a less intensive group that received counseling sessions on nutrition and physical activity. People in the intensive group initially met with a counselor weekly for the first six months of the study; those in the less intensive group started out with three counseling sessions annually. For both groups, the frequency of the counseling sessions was reduced later in the study. Patients in the more intensive group were instructed to exercise for 175 minutes a week and to consume a diet of about 1,200 to 1,800 calories a day. Those in the less intensive group—which was the study’s control group—weren’t given specific exercise or calorie targets.

During the first year of the study, patients in the intensive group lost 8.6% of their total body weight, while those in the control group lost just 0.7%. When the study stopped, people in the intensive group had lost a total of 6% of their body weight while those in control group lost 3.5%. Doctors said the 2.5% between study groups simply might not be large enough to show a reduction in cardiovascular events. Patients in the intensive group lost about 14 pounds.

Rena Wing, the study chairwoman and a professor at Alpert Medical School of Brown University in Providence, R.I., said another possibility for the study failing to meet its main goal was that patients in the control group were more likely to be on cholesterol-lowering medicines which lower the risk of heart attacks and strokes.

Exercising such as walking for just 75 minutes a week provides some health benefits, studies show, although 150 minutes is best. “It’s really better than not doing anything,” said Ronald Sigal, a professor of medicine at the University of Calgary in Alberta, Canada, during a separate presentation on exercise and diabetes. Dr. Sigal said people could consider as little as walking for 15 minutes three times a week and some sort of resistance training twice a week.

Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@dowjones.com

A version of this article appeared June 24, 2013, on page D1 in the U.S. edition of The Wall Street Journal, with the headline: Disappointing Results for Weight Loss And Diabetes.