Excess weight and cancer risk

New figures from Cancer Research UK show that people who are obese now outnumber people who smoke two to one in the UK, and excess weight causes more cases of certain cancers than smoking.

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Almost a third of UK adults are obese and, while smoking is still the nation’s biggest preventable cause of cancer and carries a much higher risk of the disease than obesity, Cancer Research UK’s analysis revealed that being overweight or obese trumps smoking as the leading cause of four different types of cancer.

Excess weight causes around 1,900 more cases of bowel cancer than smoking in the UK each year. The same worrying pattern is true of cancer in the kidneys (1,400 more cases caused by excess weight than by smoking each year in the UK), ovaries (460) and liver (180).

The charity wants the Government to act on its ambition to halve childhood obesity rates by 2030 and introduce a 9pm watershed for junk food adverts on TV and online, alongside other measures such as restricting promotional offers on unhealthy food and drinks.

Full story: Obese people outnumber smokers two to one| Cancer Research UK

See also: Obesity ’causes more cases of some cancers than smoking’ | BBC News

Children of obese mums at higher diabetes risk

University of Edinburgh | June 2019 |Children of obese mums at higher diabetes risk

New research indicates that babies who are born to mothers with obesity have a higher risk factor for developing type 2 diabetes in later life. The study also reports that being overweight in pregnancy also increases the child’s diabetes risk by a half. 

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The experts behind the research analysed data from the birth records of 100000 children born in Aberdeen during 1950 and 2011 and linked them with the national register for diagnosed diabetes in Scotland. Figures revealed around one quarter of women were overweight during pregnancy over the 60-year period. One in ten were obese, with a body mass index (BMI) greater than 40.

Offspring whom mums were overweight or obese during pregnancy had an associated risk factor of between 1.4 and 3.5-fold increased incidence.

The study indicates that the proportion of obese mothers increased five-fold from around one in 30 during the 1950s to almost one in six between 2000 and 201 (Source: University of Edinburgh)

Read press release in full from University of Edinburgh

Journal article Consequences of being overweight or obese during pregnancy on diabetes in the offspring: a record linkage study in Aberdeen, Scotland

Full reference: Lahti-Pulkkinen, et al. | 2019| Consequences of being overweight or obese during pregnancy on diabetes in the offspring: a record linkage study in Aberdeen, Scotland| Diabetologia| 1-8.

Abstract

Aims/hypothesis

Maternal obesity in pregnancy is associated with cardiovascular disease and mortality rate in the offspring. We aimed to determine whether maternal obesity is also associated with increased incidence of type 2 and type 1 diabetes in the offspring, independently of maternal diabetes as a candidate mechanistic pathway.

 

Methods

Birth records of 118,201 children from 1950 to 2011 in the Aberdeen Maternity and Neonatal Databank were linked to Scottish Care Information–Diabetes, the national register for diagnosed diabetes in Scotland, to identify incident and prevalent type 1 and type 2 diabetes up to 1 January 2012. Maternal BMI was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on offspring outcomes was tested using time-to-event analysis with Cox proportional hazards regression to compare outcomes in offspring of mothers in underweight, overweight or obese categories of BMI, compared with offspring of women with normal BMI.

 

Results

Offspring of obese (BMI more than or equal to 30 kg/m2) and overweight (BMI 25–29.9 kg/m2) mothers had an increased hazard of type 2 diabetes compared with mothers with normal BMI, after adjustment for gestation when weight was measured, maternal history of diabetes before pregnancy, maternal history of hypertension, age at delivery, parity, socioeconomic status, and sex of the offspring: HR 3.48 (95% CI 2.33, 5.06) and HR 1.39 (1.06, 1.83), respectively.

 

Conclusions/interpretation

Maternal obesity is associated with increased incidence of type 2 diabetes in the offspring. Evidence-based strategies that reduce obesity among women of reproductive age and that might reduce the incidence of diabetes in their offspring are urgently required.

Is video gaming positively associated with higher body mass?

Are children, teenagers and adults who spend a lot of time playing video games more obese? This meta-analysis study looked into this question, and found that the cliché to be true – but only for adults | Social Science & Medicine | published online 9 June 2019 | story via ScienceDaily

A new study comprising a total of 20 relevant studies with more than 38,000 participants has revealed a small correlation between video game playing and excess weight or body mass. However, the link was only established for adults but not for children and teenagers. This authors identified a significant indirect effect which shows that people who spend more time playing video games also spend less time exercising and therefore weigh more or have more body mass which helps explain this correlation.

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Abstract

Rationale.

High body mass and obesity are frequently linked to the use of sedentary media, like television (TV) or non-active video games. Empirical evidence regarding video gaming, however, has been mixed, and theoretical considerations explaining a relationship between general screen time and body mass may not generalize to non-active video gaming.

Objective

The current meta-analysis had two main goals. First, we wanted to provide an estimate of the average effect size of the relationship between sedentary video gaming and body mass. In doing so we acknowledged several context variables to gauge the stability of the average effect. Second, to provide additional evidence on processes, we tested the displacement effect of physical activity by video gaming time with the help of a meta-analytic structural equation model (MASEM).

Method

Published and unpublished studies were identified through keyword searches in different databases and references in relevant reports were inspected for further studies. We present a random-effects, three-level meta-analysis based on 20 studies (total N = 38,097) with 32 effect sizes.

Results

The analyses revealed a small positive relationship between non-active video game use and body mass, indicating that they shared less than 1% in variance. The studies showed significant heterogeneity,  Moderator analyses revealed that the relationship was more pronounced for adults,  as compared to adolescents, or children,  MASEM found little evidence for a displacement of physical activity through time spent on video gaming.

Caroline Marker, Timo Gnambs & Markus Appel | Exploring the myth of the chubby gamer: A meta-analysis of studies on sedentary video gaming and body mass  | Social Science & Medicine | published online 9 June 2019

See also: Do video games drive obesity? | ScienceDaily

 

Cochrane: Different ways to reduce consumption of sugary drinks

Cochrane | June 2019 |Different ways to reduce consumption of sugary drinks

The latest Cochrane review looks at how the consumption of sugary drinks might be reduced at population level. The review summarises evidence from 58 studies from 19 different countries, in North and South America, Australasia and Europe and South East Asia, all of which tested ways of reducing consumption of drinks containing sugar.

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The review summarizes evidence of testing different ways of reducing consumption of sugary drinks, such  labelling and pricing of sugar sweetened drinks and healthy alternatives. The review also looked at broader policy initiatives such as community-based campaigns to encourage healthier choices

All of the studies included in the review were from a number of settings such as schools, homes, cafes and shops. The reviewers found some evidence that some of the measures implemented have been successful, and from this they identify a number of ways that consumption of sugar may be reduced:

These measures included:

  • Labels that are easy to understand, such as ‘traffic-light’ labels, and labels that rate the healthiness of beverages with stars or numbers.
  • Limits to the availability of sugary drinks in schools.
  • Price increases on sugary drinks in restaurants, stores and leisure centres.
  • Children’s menus in chain restaurants which include healthier beverages instead of sugary drinks as the default.
  • Promotion and better placement of healthier beverages in supermarkets.
  • Government food benefits (e.g. food stamps) which cannot be used to purchase sugary drinks.
  • Community campaigns focused on supporting healthy beverage choices.
  • Measures that improve the availability of low-calorie beverages at home, e.g. through home deliveries of bottled water and diet beverages.

Plain language summary Cutting back on sugar-sweetened beverages: what works?

Full Cochrane Review 

Further details are available from Cochrane 

 

 

Obesity rates are increasing more rapidly in rural areas than in cities

Mahase, E. | 2019| Obesity rates are increasing more rapidly in rural areas than in cities

A global study which looked at  over 2000 population based studies, analysed global trends in body mass index (BMI) using height and weight data for more than 112 million adults across 200 countries between 1985 and 2017. The researchers report that obesity rates have increased more rapidly in rural areas than in cities (Source: BMJ).

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One of the study’s authors, Majid Ezzati, from Imperial College London’s School of Public Health, said: “The results of this massive global study overturn commonly held perceptions that more people living in cities is the main cause of the global rise in obesity. This means that we need to rethink how we tackle this health problem.

As countries increase in wealth, the challenge for rural populations changes.”

The study has now been published in the journal Nature where it can be read in full

Nature Obesity rates are increasing more rapidly in rural areas than in cities

BMJ Rising rural body-mass index is the main driver of the global obesity epidemic in adults

 

Obesity a factor in over 700 000 hospital admissions in 2017/18

NHS Digital | May 2019 | 711,000 hospital admissions where obesity was a factor in 2017/18

NHS Digital figures on obesity released 8 May show the number of  hospital admissions, prescription items, prevalence among adults and children as well as physical activity and diet.

Hospital admissions

New figures in the report show that:

  • Around two thirds of the admissions where obesity was recorded as either a primary or secondary diagnosis in 2017/18 were for women (66%)
  • Of the 6,627 Finished Consultant Episodes (FCEs) for bariatric surgery in 2017/18, 79% of the patients were female.

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Prescriptions

The number of items prescribed by primary care for obesity treatment decreased by 8% from 401,000 items in 2017 to 371,000 items in 2018, and continues a downward trend since a peak of 1.45 million items in 2009. The Net Ingredient Cost (NIC) saw an increase for the first time in five years, rising from £6.9m in 2017 to £8.1m in 2018.

Obesity Prevalence

  • Adult obesity prevalence stood at 29% in 2017, an increase from 26% in 2016
  • Prevalence of child obesity in both Reception and Year 6 was over twice as high in the most deprived areas than in the least deprived areas; 13% compared to 6% in reception year, and 27% compared to 12% in Year 6.

Physical activity and diet

  • 68% of men and 64% of women aged 19 and over met the government’s physical activity guidelines for adults in 2017/18
  • 21% of men and 23% of women were classed as inactive in 2017/18
  • 20% of boys and 14% of girls were meeting the government’s physical activity guidelines for children
  • Women (32%) were more likely to consume the recommended five portions of fruit and vegetables a day, than men (26%)
  • 18% of children consumed the recommended five portions of fruit and vegetables a day in 2017.

The full report, Statistics on Obesity, Physical Activity and Diet, England, 2019, is available from NHS Digital 

Leeds becomes first UK city to lower its childhood obesity rate

Rudolf, M., Perera, R., Swanston, D., Burberry, J., Roberts, K., & Jebb, S.| 2019|Observational analysis of disparities in obesity in children in the UK: Has Leeds bucked the trend? | Pediatric Obesity| https://doi.org/10.1111/ijpo.12529

Leeds has credited its lowered childhood obesity rate, data from the National Child Measurement Programme (NCMP) inidcates the biggest decline in obesity in Leeds is 6.4% in the reception class, at about the age of four. From 2016 to 2017, 625 fewer reception class children were obese.

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Leeds has shown an impressive decline in childhood obesity when compared with the rest of England and its closest sociodemographic neighbours.

From their findings- reported in the Pediatric Obesity- the researchers conclude the obesity strategy in Leeds merits further exploration to understand the factors that may have led to its success in reducing the prevalence of obesity and narrowing social inequalities, and to compare this with approaches taken in other cities (Source: Rudolf et al, 2019).

Summary

Background

The prevalence of obesity in childhood is of high concern, especially in deprived populations. We explored trends in obesity following the introduction of a citywide strategy focused on preschool children.

Methods

Analysis of obesity prevalence using the National Child Measurement Programme 2009 to 2017 for primary‐school children in Leeds using 5‐year aggregated data for Leeds, comparable cities, and England as a whole.

Results

Prevalence of obesity in Leeds for school entry children fell significantly, whilst comparable cities (CC) and England as a whole showed no change. The reduction in Leeds was primarily in the most deprived, but also amongst the affluent.

Prevalence in older children in Leeds was unchanged whilst it increased for comparable cities and England. In the deprived, obesity increased: Leeds by 1.4%; CC 1.3%, England 1%. In the affluent, obesity prevalence reduced more in Leeds than elsewhere: 2% in Leeds, 0.8% in CC, and 0.7% in England.

Conclusions

There has been a notable decrease in the prevalence of obesity especially amongst the most disadvantaged children at entry to primary school in Leeds. How this was achieved merits in‐depth consideration.

Full article available from Pediatric Obesity 

In the news:

The Guardian Leeds becomes first UK city to lower its childhood obesity rate