Brunei - Brunei's obesity prevalence close to 30 pct: health ministre

BANDAR SERI BEGAWAN, May 25 (Xinhua) -- Obesity prevalence is close to 30 percent while the diabetes rate is over 12 percent in Brunei, Brunei's minister of health told the World Health Organization Assembly in Geneva, Switzerland, local news daily Brunei Times reported Wednesday.

Brunei's health minister, Dr Hj Zulkarnain said days ago in Geneva that tackling non-communicable diseases (NCDs) in Brunei poses challenges that cannot be met by Brunei's Ministry of Health (MoH) alone.

In a statement issued by MoH, the minister said success demands intersectoral collaboration and significant behavioral change among the population.

"We want to empower communities and individuals to take responsibility for their own health. This will not be straightforward," he said.

The minister said to tackle the threat of NCDs, "we must face up to its key determinant -- societal behavior and lifestyles."

He said Brunei adopted a two-pronged approach to the issue of behavior change.

"At the individual level, we engage our clients using brief interventions at all points of contact. At the population level, we are actively developing choice architecture that provides a clear nudge towards healthier decisions."

There is also a need to address the commercial interests that stand to gain from the marketing of sugary drinks and unhealthy foods, Zulkarnain said.

The minister said Brunei will engage with the WHO and international partners to determine and test a comprehensive approach to address "profit-driven diseases."

Zulkarnain headed Brunei's delegation to the 69th WHO Assembly, which saw the attendance of 194 WHO members. The theme for this year's World Health Assembly is "Transforming the World: The 2030 Agenda for Sustainable Development."

Xinhua

Cambodia - Kingdom’s scales tip: study

There are now more overweight than underweight women in Cambodia, according to a study published this month in the science journal Nutrients, a fact health experts say increases women’s risk of non-communicable diseases.

The study gathered data from Cambodian demographic surveys from 2000 and 2014, looking at women between 15 and 49 years old. The results showed malnutrition shrinking and obesity growing until obesity surpassed malnutrition for the first time in 2014. Both populations face health risks.

“Cambodia is thus now facing a double burden of malnutrition in women and has to define and implement appropriate strategies to improve the nutritional status of women,” the study states.

The researchers define underweight as having a body mass index of less than 18.5kg per square metre of height and overweight as over 25kg per square metre.

Anemia and difficulties in childbirth are major problems for underweight women, who tend to be from poorer, more remotely located households, researchers found.

Overweight women on the other hand face a growing risk from non-communicable diseases (NCDs) like diabetes. Wealth is positively correlated with being overweight, but education level is negatively correlated. Nonetheless, obesity is rising much more quickly among the poor.

Iman Morooka, the spokeswoman for UNICEF Cambodia, confirmed the data, saying that 18 per cent of adult women in the Kingdom were overweight, compared to 14 per cent of women who were underweight.

World Health Organization spokeswoman Vicky Houssiere said the burden of NCDs in Cambodia was growing. Collectively, diabetes, cardiovascular disease, cancer and chronic respiratory disease caused 43 per cent of deaths in Cambodia in 2014, up from 35 per cent in 2011.

Igor Kossov

phnompenhpost

Australia - Do Female Hormones Contribute To Obesity?

Scientists suggest that exposure to estrogen from soy products or PVC plastics could explain the higher rates of obesity in males of developed countries.

AsianScientist (Jun 16, 2014) – An imbalance of female sex hormones among men in Western nations may be contributing to high levels of male obesity, according to new research from the University of Adelaide.

In a paper published in the journal PLOS ONE, researchers from the University’s School of Medical Sciences suggest that obesity among Western men could be linked with exposure to substances containing the female sex hormone estrogen – substances that are more often found in affluent societies, such as soy products and plastics.

Mr. James Grantham, medical student at the university, compared obesity rates among men and women from around the world with measures such as gross domestic product to determine the impact of affluence on obesity. He found that while it was normal for women in the developing world to have significantly greater levels of obesity than men, the developed world offers quite a different picture.

“Hormonally driven weight gain occurs more significantly in females than in males, and this is very clear when we look at the rates of obesity in the developing world,” Grantham said.

“However, in the Western world, such as in the United States, Europe and Australia, the rates of obesity between men and women are much closer. In some Western nations, male obesity is greater than female obesity.

While poor diet is no doubt to blame, this research strongly suggests that there might be more to the obesity epidemic than just high caloric intake.

Professor Maciej Henneberg, co-author of the study, said, “Exposure to estrogen is known to cause weight gain, primarily through thyroid inhibition and modulation of the hypothalamus. Soy products contain xenoestrogens, and we are concerned that in societies with a high dietary saturation of soy, such as the United States, this could be working to ‘feminise’ the males. This would allow men in those communities to artificially imitate the female pattern of weight gain.

“Another well-established source of xenoestrogen is polyvinyl chloride, known as PVC. This product is in prominent use in most wealthy countries, from plastic medical devices to piping for our water supplies.”

Micro-evolutionary changes may be occurring within Western societies that could also be leading to changes in testosterone and estrogen in men.

“This would certainly explain the various concerns about sperm count reductions among men in developed nations,” Henneberg said.

The authors said further research is needed to better understand whether or not environmental factors are leading to a “feminisation” of men in the Western world.

Health & Medicine

The article can be found at: Grantham and Henneberg. (2014) The Estrogen Hypothesis of Obesity.

Source: University of Adelaide; Photo: Tony Alter/Flickr/CC.

Asia - Top Concerns For Asia: Mental Health, Obesity, NCDs

Mental health, obesity and non-communicable diseases are top-priority goals for the region between 2015 and 2030, according to experts from nine Asian countries and Australia.

Mental health, obesity and non-communicable diseases are growing threats and should be among development targets being negotiated at the United Nations between 2015 and 2030, according to a statement issued by experts representing nine Asian countries and Australia at a meeting in Kuala Lumpur, Malaysia.

The Regional Workshop on Sustainable Development Goals: Priorities and Solutionsconvened representatives from Malaysia, Thailand, Indonesia, the Philippines, Vietnam, Singapore, Myanmar, Cambodia and Australia.

Another essential target: universal health coverage, says Dr. Zakri Abdul Hamid, who chairs the Malaysian Industry-Government Group for High Technology.

“We are moving towards a universal meeting of minds on what our world development agenda will be in the medium term through 2030. This is a key exercise in priority setting and Asia needs both a common vision and a common message in order to have real impact on this important global process,” Dr. Zakri said.

The workshop agreed that there is a lot that can be done to further sustainable development in Asia through co-operation and collaboration, citing the availability of exemplary practice and policies.

And the regional centers of the UN’s Sustainable Development Solutions Network (SDSN, a brainchild of Secretary-General Ban ki-Moon and headed by Jeffrey Sachs of Columbia University), such as one recently opened in Malaysia, can play a role in the region in identifying good practices as well.

Stressed for their critical importance to sustainable development were the roles of science, technology and innovation, of investment in R&D, of media, youth and women, and of the recently-created, multi-disciplinary science organization called Future Earth.

The experts agreed that the Sustainable Development Goals (SDGs), which will replace the largely successful Millennium Development Goals, should give greater importance to integrating economic prosperity, social inclusion and environmental sustainability, and promote good governance. Further, there should be a SDG on cities, they said.

Next, the classic measure of economic growth (Gross National Product, or GNP) needs to be complemented by one that includes and reflects five forms of capital: natural, built, social, human as well as financial.

Other key challenges to be addressed include financing, debt relief, subsidies, technology transfer, intellectual property rights, trade reform and capacity building. The MDG education goal was set too low, the experts agreed — quality and lifelong learning to address future challenges must be included in the coming set of development goals.

Finally, an agreed measure of poverty that goes beyond income is needed, such as the Multi-dimensional Poverty Index and “a systems approach to providing food security.”

Source: IPBES.

Singapore - Obesity: How inflammation influences appetite

Managing weight gain could become easier thanks to new insights that explain how acute inflammation, such as that caused by influenza, suppresses appetite but chronic inflammation increases it.

Insensitivity to a hormone that balances food intake with energy expenditure explains the contradictory effects of different inflammatory conditions on appetite

Sustained low-grade inflammation and an above-average appetite are commonly found in obese individuals. Therefore, it seems counterintuitive that the acute inflammation associated with many illnesses normally suppresses appetite. A team led by Weiping Han of the Singapore Bioimaging Consortium at A*STAR has used mice to elucidate the molecular mechanisms that explain the different effects of chronic and acute inflammation on appetite1. The study also helps to explain why obesity compromises appetite-suppression mechanisms.

The team’s insights center around the different effects of acute inflammation and chronic obesity-related inflammation on the transcription of a gene expressed in neurons of the hypothalamus of the brain. A neurohormone called leptin controls transcription of the pro-opiomelanocortin (Pomc) gene, which suppresses appetite. Leptin is normally produced by fat cells at levels that ensure food intake matches energy expenditure. However, obese individuals often become insensitive to leptin, leading to a larger-than-normal appetite.

Previous studies by other groups and Han showed that in well-fed animals of normal body weight, leptin inhibited appetite by causing a protein called STAT3 to migrate to the nucleus of POMC neurons. The nuclear STAT3 suppressed appetite by sustaining normal levels of the Pomc gene's transcription.

In their recent study, again in well-fed animals of normal body weight, Han and co-workers found that acute inflammation — such as that caused by a viral infection — suppressed this translocation of STAT3, but more than compensated for the slight reduction in Pomc transcription by causing a protein called RELA to migrate to the nucleus. The nuclear RELA elevated the rate of Pomc transcription to above the normal level. This is consistent with the loss of appetite associated with most illnesses.

The researchers also found that in obese mice, methylation — a DNA modification that usually silences gene expression — prevented the nuclear RELA from binding to the Pomc promoter. RELA also blocked STAT3 from entering the nucleus.

“We believe that the lower than normal rates of Pomc transcription caused by the combination of both of these effects accounts — at least, in part — for why obese individuals have a larger-than-normal appetite despite chronic inflammation,” explains Han. He also notes that the role of RELA in sequestering STAT3 from Pomc promoter sequences provides a much-needed explanation of how chronic inflammation contributes to leptin resistance.

“We’re hopeful that these insights into how different causes of inflammation interfere with leptin signaling might help to identify more effective and safer drugs to curb the appetite of obese individuals or better still, prevent leptin resistance,” says Han.

The A*STAR-affiliated researchers contributing to this research are from the Singapore Bioimaging Consortium and the Institute of Molecular and Cell Biology

References

1. Shi, X., Wang, X., Li, Q., Su, M., Chew, E. et al. Nuclear factor κB (NF-κB) suppresses food intake and energy expenditure in mice by directly activating the Pomc promoter. Diabetologia 56, 925–936 (2013). | article

Australia - Babies Born To Overweight Mothers Have Thicker Arteries, Study

The walls of the body’s major artery – the aorta – are already thickened in babies born to mothers who are overweight or obese, according to a new study.

The walls of the body’s major artery – the aorta – are already thickened in babies born to mothers who are overweight or obese, according to a new University of Sydney study.

More importantly, the Archives of Disease of Childhood study found that this arterial thickening is independent of the child’s weight at birth – a known risk factor for later heart disease and stroke.

Twenty-three women, whose average age was 35, were included in the study when they were 16 weeks pregnant. A body mass index (BMI) of more than 25 kg/m2 was defined as overweight or obese, and BMI ranged from 17 to 42 among the women.

The abdominal aorta, the section of the artery extending down to the belly, was scanned in each newborn within seven days of birth to find out the thickness of the internal walls – the intima and media.

Intima-media thickness ranged from 0.65 to 0.97 mm, and was associated with the mother’s weight. The difference in intima-media thickness between babies of overweight and normal weight mums was 0.06 mm.

According to study co-author, Dr. Michael Skilton from the University’s Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, thickening of the abdominal aorta is an indication of early atherosclerosis, the disease that leads to the majority of heart attacks and strokes.

“We already know that the children of overweight or obese mothers are more likely to become overweight and obese themselves, which will potentially increase their risk of heart attack and stroke in adulthood,” he said. “By studying newborn babies, we can potentially avoid the impact of whether or not the child becomes obese in later life.

Skilton said that this is the first study demonstrating that being an overweight or obese mother can itself potentially lead to poor health of the blood vessels, which is consistent with higher risk of heart disease and stroke in later life.

“Our findings suggest that overweight/obesity may have an ‘intergenerational’ effect. That is, that the children of overweight or obese mums may themselves be at higher risk in adulthood of having heart attacks and strokes, irrespective of whether or not they themselves are obese,” he said.

The researchers are currently looking to replicate their findings with a much larger group of women and babies.

The article can be found at: Begg LM et al. (2013) Maternal adiposity and newborn vascular health.

Source: University of Sydney;

Health & Medicine

http://www.asianscientist.com

Thailand - Experts Discuss Rising Obesity In Asia Pacific

Experts discussed the rising epidemic of obesity at the 19th Asian Pacific Congress of Cardiology in Pattaya, Thailand.

Over eating, sedentary lifestyles, cultural attitudes, and lack of prevention programs are to blame for the rising epidemic of obesity in the Asia Pacific region, say cardiovascular experts at the 19th Asian Pacific Congress of Cardiology held from February 21-24 in Pattaya, Thailand.

Overweight and obesity has quadrupled in China and societies still label people of healthy weight as poor, they said.

“In many of the countries in Asia Pacific the malnutrition problem nowadays is not undernutrition it is overnutrition, which has resulted in overweight and obesity,” said Professor Kui-Hian Sim, President Elect of the Asian Pacific Society of Cardiology.

The Asia Pacific Cohort Studies Collaboration (APCSC) found that the prevalence of overweight and obesity among 14 countries in the Asia Pacific region varied considerably by country.

The prevalence of obesity (BMI>30) in men ranged from 0.3 percent in India and 1.3 percent in Indonesia to 13.8 percent in Mongolia and 19.3 percent in Australia. In women the lowest rates were found in India (0.6 percent), China and Japan (both 3.4 percent) and the highest rates in Australia (22.2 percent) and Mongolia (24.6 percent).

“Asia Pacific has developed rapidly and technological advances mean that children now spend too much time on the internet and mobile devices so they don’t take up much physical activity,” said Sim.

“The Asian culture revolves around food as a way of showing hospitality because in the past there was a lot of famine. As a result there is a cultural perception that if you’re not fat or obese then you are not well off,” he said.

Dr. Rachel Huxley, an APCSC co-investigator, said that although the absolute prevalence of obesity in Australia was considerably higher than that of China and Japan, the relative increases in the prevalence over the last 20 years has been much greater in these two Asian countries than in Australia.

The combined prevalence of overweight and obesity increased by 46 percent in Japan from 16.7 percent in 1976-1980 to 24 percent in 2000 and by 414 percent in China from 3.7 percent in 1982 to 19 percent in 2002.

The APCSC researchers also calculated the population attributable fraction for cardiovascular disease due to overweight and obesity in these 14 countries.

Taking China as an example, despite the relatively low prevalence of overweight and obesity, it accounted for just over 3 percent of fatal coronary heart disease and 3.5 percent fatal ischemic stroke.

At the other end of the scale, overweight and obesity accounted for nearly 8 percent of coronary heart disease in Mongolia and over 9 percent in Australia. It also accounted for nearly 9 percent of ischemic stroke in Mongolia and more than 10 percent in Australia.

“Increasing ‘westernization’ of lower- and middle-income countries in the Asia Pacific region is associated with increasing gross domestic product (GDP) and the adoption of more westernized patterns of physical inactivity and diets richer in calories and fat. The influx of fast food, confectionery and soft drink companies into the region is likely to further exacerbate the obesity problem,” said Huxley.

Huxley recommended policy changes that could influence the food environment such as mandatory use of food labeling, higher taxes on high fat/energy foods, restricted advertising on fast food (especially to children), and food subsidies for fruits and vegetables.

There also needed to be a concerted effort by medical experts in tackling the obesity epidemic, said Prof. Sim.

“Very little has been done about overweight and obesity in the Asia Pacific region because it doesn’t belong to any specialty. Cardiologists focus on smoking and risk stratification while diabetologists look at blood sugar. Cardiologists need to take up the challenge of obesity in order to curb the cardiovascular epidemic,” said Sim.

Source: European Society of Cardiology;

Health & Medicine

http://www.asianscientist.com

Australia - Brain Circuit Makes It Harder For Obese People To Lose Weight

Researchers in Australia explain why when obese people diet, they end up losing less weight.

Imagine you are driving a car, and the harder you press on the accelerator, the harder an invisible foot presses on the brake. That’s what happens when obese people diet – the less food they eat, the less energy they burn, and the less weight they lose.

While this is a known phenomenon, scientists at Sydney’s Garvan Institute of Medical Research and the University of New South Wales (UNSW) have pinpointed the exact brain circuitry behind it using various mouse models.

In the journal Cell Metabolism, Dr. Shu Lin, Dr. Yanchuan Shi, and Professor Herbert Herzog and his team show that the neurotransmitter Neuropeptide Y (NPY), known for stimulating appetite, also plays a major role in controlling whether the body burns or conserves energy.

“This study is the first to identify the neurotransmitters and neural pathways that carry signals generated by NPY in the brain to brown fat cells in the body. It is also the first to show a direct connection between Arc NPY, the sympathetic nervous system and the control of energy expenditure,” said Herzog.

The researchers found that NPY – produced in a particular region of the brain called the arcuate nucleus (Arc) of the hypothalamus – inhibits the activation of ‘brown fat,’ one of the primary tissues where the body generates heat.

While NPY also influences other aspects of the sympathetic nervous system such as heart rate and gut function, its control of heat generation through brown fat seems to be the most critical factor in the control of energy expenditure.

“When you don’t eat, or dramatically curtail your calorie intake, levels of NPY rise sharply. High levels of NPY signal to the body that it is in ‘starvation mode’ and should try to replenish and conserve as much energy as possible. As a result, the body reduces processes that are not absolutely necessary for survival,” he said.

Until the twentieth century, people did not have ready access to foods high in fat and sugar, said Herzog. So in evolutionary terms, the body had mechanisms in place only to prevent weight loss, he said.

“Obesity is a modern epidemic, and the challenge will be to find ways of tricking the body into losing weight – and that will mean somehow circumventing or manipulating this NPY circuit, probably with drugs,” he said.

The article can be found at: Shi YC et al. (2013) Arcuate NPY Controls Sympathetic Output and BAT Function via a Relay of Tyrosine Hydroxylase Neurons in the PVN.

Source: Garvan Institute of Medical Research;

Health & Medicine

http://www.asianscientist.com

Brunei - 'Fight obesity to cut risk of breast cancer'

IF OBESITY among children is not tackled, they may be at risk of developing breast cancer in the future, said a consultant oncologist at the Ministry of Health yesterday.

In an interview with The Brunei Times, Associate Professor Dr Hj Muhammad Syafiq said breast cancer is associated with obesity and the risk of developing the cancer increases with age.

"We do not want to wait for it (breast cancer) to happen. We must try to reduce it."

Associate Professor Dr Hj Muhammad Syafiq also said that breast cancer affects both men and women. However the percentage affecting men is small.

There is only one per cent of breast cancer cases in Brunei that involve men, he added.

"Over the period of 10 years, there were only four cases (of men with breast cancer)," he added.

He further explained that most of the men who were diagnosed with breast cancer were the elderly folk.

"What can now be said is that breast cancer is found to be related with obesity," said the associate professor.

"In theory, breast cancer could affect anyone who is obese regardless of gender."

Associate Professor Dr Hj Muhammad Syafiq spoke to The Brunei Times on the sidelines of the Breast Cancer Awareness Month 2012 celebration at the Tutong Community Hall held in November 2012.

At the event, he delivered a presentation titled, "Breast Cancer in Brunei Darussalam".

During his presentation, he adviced ways to lower the risk of acquiring the non-communicable disease such as losing weight for those who are obese as well as being rigorous about examining one's breasts, regular clinical exams and mammograms.

In an article published by The Brunei Times, November 21, 2012, the Minister of Health, Yang Berhormat Pehin Orang Kaya Johan Pahlawan Dato Seri Setia Hj Adanan Begawan Pehin Siraja Khatib Dato Seri Setia Hj Mohd Yusof cited preliminary results of Phase Two of the Brunei Darussalam Second National Health and Nutritional Status Survey 2009-2011 said that 8.8 per cent of Bruneian children under the age of five are overweight and 3.3 per cent of them are obese.

NURHAMIZA HJ ROSLAN

The Brunei Times

Canada - Could high insulin make you fat? Mouse study says yes

When we eat too much, obesity may develop as a result of chronically high insulin levels, not the other way around. That's according to new evidence in mice reported in the December 4th Cell Metabolism, a Cell Press publication, which challenges the widespread view that rising insulin is a secondary consequence of obesity and insulin resistance.

The new study helps to solve this chicken-or-the-egg dilemma by showing that animals with persistently lower insulin stay trim even as they indulge themselves on a high-fat, all-you-can-eat buffet. The findings come as some of the first direct evidence in mammals that circulating insulin itself drives obesity, the researchers say.

The results are also consistent with clinical studies showing that long-term insulin use by people with diabetes tends to come with weight gain, says James Johnson of the University of British Columbia.

"We are very inclined to think of insulin as either good or bad, but it's neither," Johnson said. "This doesn't mean anyone should stop taking insulin; there are nuances and ranges at which insulin levels are optimal."

Johnson and his colleagues took advantage of a genetic quirk in mice: that they have two insulin genes. Insulin1 shows up primarily in the pancreas and insulin2 in the brain, in addition to the pancreas. By eliminating insulin2 altogether and varying the number of good copies of insulin1, the researchers produced mice that varied only in their fasting blood insulin levels. When presented with high-fat food, those with one copy and lower fasting insulin were completely protected from obesity even without any loss of appetite. They also enjoyed lower levels of inflammation and less fat in their livers, too.

Those differences traced to a "reprogramming" of the animals' fat tissue to burn and waste more energy in the form of heat. In other words, the mice had white fat that looked and acted more like the coveted, calorie-burning brown fat most familiar for keeping babies warm.

Johnson says it isn't clear what the findings might mean in the clinic just yet, noting that drugs designed to block insulin have been shown to come with unwanted side effects. But, he added, "there are ways to eat and diets that keep insulin levels lower or that allow insulin levels to return to a healthy baseline each day."

Unfortunately, constant snacking is probably not the answer.

More information: Mehran et al.: "Hyperinsulinemia drives diet-induced obesity independently of brain insulin production." Cell Metabolism, DOI: 10.1016/j.cmet.2012.10.019

Journal reference: Current Biology and Cell Metabolism

Provided by Cell Press

http://medicalxpress.com

Malaysia - Malaysia weighed down by obesity problem

Numbers are worrying - almost half of all adults there are obese or overweight

When William Tan was still in his 20s, playing basketball and hitting the gym were part of his exercise regimen. But since switching jobs, the marketing executive, now 33 and bogged down by a more hectic work schedule, has seen the kilos pile onto his 1.76-metre frame. "I got busy. Then I got lazy. I wanted to enjoy my free time, eating and drinking," Tan said.

In just six years, his weight climbed from 76 kilograms to 84 kilograms, moving him from the "acceptable" to the "overweight" range. "At my age now, it's harder to lose weight than it was in my 20s," said Tan, who is also busy preparing for his wedding next year.

Not just Tan but thousands of other Malaysians like him are also weighed down by excess fat. In fact, their expanding waistlines have Malaysian authorities worried about their health and the strain this would put on the public health-care system.

The numbers are worrying. In 1996, only 5 per cent were obese, which means their body mass index was above 25. A decade later, this figure had almost tripled to 14 per cent. Last year, it rose to 15 per cent, in a country of more than 28 million people. These days, almost half of all adult Malaysians are overweight or obese - a level some doctors have described as "alarming".

About 20 per cent of Malaysians over the age of 30 have diabetes, dubbed a silent killer disease, up from 14 per cent in 2006. Another 33 per cent who are above the age of 30 have high blood pressure, or hypertension, another silent killer.

Deputy Health Minister Rosnah Shirlin told Parliament last year that Malaysia's obesity rate was the highest in South-east Asia and ranked sixth among Asia-Pacific countries. Recently, she had more bad news: Three in four Malaysians do little or no exercise.

The Health Ministry has run numerous campaigns and advertisements on how to stay healthy, but Tan can attest to the challenges of losing weight.

Like many people living in Kuala Lumpur, he spends one to two hours stuck in the capital's rush-hour traffic every day, guaranteed to exhaust anyone remotely thinking of going to the gym.

Furthermore, Malaysians love to celebrate every festive occasion with lots of good food, which is often high in fat, sugar and salt, said Malaysian Medical Association president S.R. Manalan.

"High crime rates have also encouraged Malaysians to drive everywhere and park as close as possible to the nearest exit, which cuts down on their walking," he noted.

Health care is heavily subsidised in Malaysia and the country's health-care bill has skyrocketed from 12.6 billion ringgit (US$4.1 billion) in 2001 to 33.7 billion ringgit in 2010.

Teo Cheng Wee

The Straits Times

Vietnam - Obesity on the rise in children, adults in Vietnam

VietNamNet Bridge – Dr Do Thi Ngoc Diep, director of the City Nutrition Center, warned about obesity in children in the country at a seminar on "nutrition and physical exercise therapy in the treatment of obesity," held recently in Ho Chi Minh City.

She quoted from a recent survey done by the City Nutrition Center on 2,500 pupils of two elementary schools in District 10 in HCMC, which showed that obesity affected nearly 30 percent children in age groups from 6-15 years.

This figure has shocked many parents. In particular, overweight accounts for 20.8 percent and obesity 6.8 percent.

Dr Diep said the center's latest survey showed that in addition to providing nutrients(too much flour, sugar, fat), the reason why children in the city suffer from overweight and obesity is due to lack of physical movement. "They only play electronic games and use most of their time to watch TV, which is passive. Thus children cannot find ways to use their energy and excess fat accumulates day by day.”

The City Nutrition Center survey shows the status of overweight and obesity in children had increased significantly at ages below 15 years, mostly children from 2 to 10 years of age.

In 1999 only 2.2 percent children under 5 were overweight or obese, while in 2010 this proportion was 11 percent, 6 times more.

That means in the future, the number of obese people in Vietnam will be high, and it is forecast there will be an increase of related diseases such as high blood pressure, heart diseases, and sexual disorders.

But the situation is worth considering as revealed at the 13th national cardiac and vascular conference that is taking place in the northern province of Quang Ninh from October 8.

Based on  a survey conducted on 17,000 adults living in eight different areas of the country by the Vietnam Nutrition Institute, experts concluded that 16.3 percent of respondents are obese and 40 percent have fat stomachs, meaning the measurement of their second and third rounds (waist and bottom) are larger than average.

As a result, the number of people with high blood pressure, heart diseases and sexual disorders has increased in Vietnam.

25.1 percent of the population over the age of 25 is hyper tense. That means one in every four adults in the nation suffers from high blood pressure. The rate was 1.5 percent in 1960, 10.1 percent in 1970, and more than 16 percent in 2000.

Unhealthy habits such as sitting for long hours in an office, consuming a salty diet that is rich in protein and fat but lacking in fiber, drinking beer, smoking and stress have resulted in the increase of these diseases.

Obesity and high blood pressure not only badly affects sexual competence, they make the situation worse due to the side effects of medicines taken for hypertension treatment, said the report.

Before, most patients facing sexual disorders in Vietnam were over 50, but now it has appeared among males as young as 18-20 years.

VietNamNet/SGGP

USA - Is there an "obesity paradox" in diabetes?

NEW YORK - Obesity and diabetes might not be the double whammy you'd expect, according to a fresh look at older studies.

Surprisingly, researchers found that overweight and obese people who get diagnosed with the blood sugar disorder tend to live longer than their leaner peers.

This so-called "obesity paradox" has been observed before in chronic diseases like heart and kidney failure, said Mercedes R. Carnethon of the Feinberg School of Medicine at Northwestern University in Chicago.

But that doesn't mean you should start downing ice cream and other high-calorie foods if you just found out you have diabetes, Carnethon told Reuters Health. Nor does it mean that padding your waist is a good way to improve your prognosis before you get the disease.

In fact, it's probably not that excessive pounds are protective, said Carnethon, but rather that lean people who get diabetes are somehow predisposed to worse health.

"Perhaps those individuals are somehow genetically loaded to develop diabetes and have higher mortality," she said. "A normal-weight person who has diabetes has an extremely high mortality rate."

The new findings are based on data from five earlier studies that tracked people over time to identify risk factors for heart disease. More than 2,600 participants developed type 2 diabetes during the studies, and 12 per cent of them had a normal weight when they got the diagnosis.

The death rate was 1.5 per cent per year among overweight and obese people, compared to 2.8 per cent per year among their trimmer peers.

After accounting for several risk factors for heart disease - including age, blood pressure, high cholesterol and smoking - lean people were more than twice as likely to die at any given point as heavier people. The same held true for deaths caused by heart disease, which is linked to obesity.

"It was a little bit unexpected to see that," said Carnethon.

One potential limitation of the study is that the researchers couldn't always account for how much people smoked, which might explain part of the results.

It's also possible that a few people might have been diagnosed with diabetes outside of the studies and been told to slim down by their own doctor before they were seen by the study researchers. That could also have contributed to the findings, although Carnethon said the effect would be small.

She added that it's not clear how to best treat normal-weight people with type 2 diabetes, although weight training seems preferable over cardio exercise.

Older people and people of Asian descent are more likely to be normal-weight when diagnosed with diabetes, and Carnethon stressed that doctors need to take the disorder extra seriously when it's not accompanied by obesity.

"These findings do apply to a growing segment of the population," she said.

SOURCE: bit.ly/O0uT3Q Journal of the American Medical Association, online August 7, 2012.

Reuters

UK - Breast-Feeding May Help Women Fight Obesity Decades Later

Breast-feeding may help mothers reduce the risk of obesity later in life, according to a study of 740,000 post-menopausal women in the U.K.

For every six months women breast-fed, their body mass index was 0.22, or 1 percent, lower, even decades after giving birth, according to the research, which was published today in the International Journal of Obesity. The observation was made across socioeconomic groups and regardless of the number of children the women had.

While the body-fat measure, known as BMI, was higher in women who gave birth to more children, it was lower in mothers who breast-fed than in those who hadn’t. Breast-feeding has also been found to reduce the risk of childhood obesity. More than 1.4 billion adults globally are overweight and at least 500 million of them are obese, with a BMI of 30 or more, according to the World Health Organization.

“A 1 percent reduction in BMI may seem small, but spread across the population of the U.K., that could mean about 10,000 fewer premature deaths per decade from obesity-related conditions, such as diabetes, heart disease and some cancers,” Valerie Beral, co-author of the study and director of the Cancer Epidemiology Unit at the University of Oxford, said in a statement.

The study, funded by Cancer Research UK and the Medical Research Council, used data from the Million Women Study, which investigates how reproductive and lifestyle choices affect women’s health. Of the 740,000 participants in today’s study, 88 percent had had at least one child and 70 percent of those women had breast-fed for an average of 7.7 months.

The average age of the women in the study was 57.5 and the mean BMI was 26.2. BMI is a measure of body fat calculated using a person’s height and weight. A person whose BMI is between 25 and 30 is considered overweight, while one whose BMI is 30 or greater is obese.

While the exact reason for the lower BMI years after giving birth wasn’t studied, breast-feeding may set mothers on a healthier trajectory that is long-lasting, Beral said. It seems to be “a very simple way of having a persistent slight reduction,” she said.

Makiko Kitamura

http://www.bloomberg.com/

Singapore - Singapore scientists discover control mechanism for obesity, cancer

SINGAPORE: A*STAR scientists in Singapore have made what is believed to be groundbreaking discovery of the mechanism that controls obesity, atherosclerosis and, potentially, cancer.

Scientists from the Institute of Molecular and Cell Biology (IMCB) and the Singapore Bioimaging Consortium (SBIC) said they have found a new signalling pathway that regulates both obesity and atherosclerosis.

The team showed, for the first time, that mice deficient in the Wip1 gene were resistant to weight gain and atherosclerosis via regulation of the Ataxia telangiectasia mutated gene (ATM) and its downstream signalling molecule mTor.

A*STAR says these groundbreaking findings were published in the journal Cell Metabolism on 3 July and may provide significant new avenues for therapeutic interventions for obesity and atherosclerosis.

Obesity and atherosclerosis-related diseases account for over one-third of deaths in the Western world. In Singapore, 10.8 per cent of its population is obese, and cardiovascular disease accounted for 31.9 per cent of all deaths in 2010.

Atherosclerosis, a progressive disease of the large arteries, is an underlying cause of many cardiovascular diseases.

Controlling these conditions remains a major challenge due to an incomplete understanding of the molecular pathways involved.

Obesity and atherosclerosis are accompanied by the accumulation of lipid droplets in fat cells and in foam cells respectively.

Foam cells can subsequently rupture, damaging blood vessels, and contributing to further progression of atherosclerosis.

The scientists discovered that Wip1 deficient mice, even when fed a high-fat diet, were resistant to obesity and atherosclerosis by preventing the accumulation of lipid droplets.

This appeared to be through increased autophagy, the normal process by which the body degrades its own cellular components.

The scientists showed that the Wip1 deficient mice exhibited increased activity of ATM which decreased mTor signalling, resulting in increased autophagy.

This degraded the lipid droplets and suppressed obesity and atherosclerosis.

"This is the first time that Wip1-dependent regulation of ATM-mTor pathway has been linked to authophagy and cholesterol efflux, thus providing an entirely new avenue for treatment of obesity and atherosclerosis," Dr Dmitry Bulavin, senior principal investigator at IMCB and lead author of the paper, said.

The scientists are hopeful that the ATM-mTor pathway could similarly map onto cancer to suppress tumour progression.

Similar to suppression of obesity and atherosclerosis, activation of autophagy in cancer cells could result in degradation of cellular content that is essential for cancer cells to sustain rapid proliferation. This, in turn, will result in suppression of cancer growth.

Dr Dmitry Bulavin said: "We are building on this research to investigate if the same mechanism could also control tumour progression and hence potentially unlock new therapeutic treatments targeting Wip1, ATM and mTor in cancer as well and the preliminary results are promising."

This discovery also adds to the growing significance of ATM as an important gene with a key role in protecting us from major pathological conditions. Previous work has established Wip1-dependent regulation of ATM as a potent regulator of tumorigenesis via activation of tumour-suppressor p53.

Together, these three pathological conditions -- obesity, atherosclerosis and cancer -- account for more than 70 per cent of mortality worldwide, making ATM-related pathways very attractive therapeutic targets.

Professor Hong Wanjin, executive director of IMCB, said, "This is the first time that these important molecules have been integrated into a linear pathway that plays a prominent role in controlling obesity and atherosclerosis. It is a fine example of how fundamental research can shed light on biological and medical questions to potentially open new avenues of formulating therapeutic strategies for the benefit of patients."

- CNA/wm