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This week: Sustainable fat loss key to cardiometabolic benefits • Maternal obesity accelerates ageing in offspring, but exercise helps • Breast surgeon calls for higher focus on breast health from a younger age

Sustainable fat loss key to cardiometabolic benefits

People who lose weight and keep it off can stabilise or even improve their cardiometabolic risk factors compared to people who regain weight, according to a new study led by researchers from the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in the US.

The study was published in the Journal of the American Heart Association. After a successful one-year intensive lifestyle weight-loss intervention, maintaining the weight loss (as opposed to regaining it) was better for all cardiometabolic risk factors assessed three years later, including HDL cholesterol, triglyceride, fasting glucose and glycated hemoglobin concentrations, blood pressure, and waist circumference.

‘Regaining weight was associated with a reversal of the benefits seen from losing weight’ said senior and corresponding author Alice Lichtenstein, a nutrition scientist and director of the Cardiovascular Nutrition Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts; ‘If you lose weight and maintain the weight loss for a long period of time, do the benefits continue? The answer is yes and sometimes the benefits get even stronger. If you lose weight and don’t maintain it, the benefits are diminished or disappear. These findings emphasise the dual importance of not only achieving a healthy body weight but maintaining a healthy body weight.’

‘What we need to focus on now is how we can support not only healthy approaches to losing weight, but healthy approaches to helping those who are successful in losing weight maintain the weight loss. The latter may be the most challenging’ Lichtenstein continued.

The team also sought to identify the point distinguishing ‘maintaining’ from ‘regaining’ and at what percentage the cardiometabolic risk benefits of weight loss were diminished, but found no clear point of demarcation. Few studies have directly compared successful weight loss maintenance with weight regain, in part because no standardised definition for successful weight-loss maintenance exists.

Source: Tufts University


Maternal obesity accelerates ageing in offspring, but exercise helps

It has long been known that obesity impairs metabolism and predisposes to diabetes and heart disease. New research shows that the effects of maternal obesity even pass across generations to offspring, accelerating the rate of ageing of metabolic problems that occur in normal life.

Researchers with the University of Wyoming and the Salvador Zubiran National Institute of Medical Sciences and Nutrition, in Mexico City, studied offspring of obese rat mothers. They observed the offspring throughout their lives – puberty, early adult life, late adult life and early ageing – to determine the rate at which they aged. Offspring of obese mothers had more body fat and showed early prediabetic signs such as an early rise in insulin resistance, increasing susceptibility to diabetes.

Offspring of the obese mothers showed impaired function of their mitochondria, the power stations of cells that generate the energy cells need to function properly. These changes make it more likely that organisms will develop heart disease.

The research – which was led in part by Peter Nathanielsz of UW’s Wyoming Pregnancy and Life Course Health Center – appears in the Journal of Physiology.

Interestingly, some of the unwanted outcomes resulting from maternal obesity were different in male and female offspring. The reason for this is not clear, but it is thought to be hormonal in nature. Encouragingly, exercise by the offspring improves many of the poor offspring outcomes that result from maternal obesity.

‘These new findings add to the accumulating evidence for the influence of conditions in the womb and early life on the offspring’s health and susceptibility to diseases throughout life’ Nathanielsz said.

For example, earlier research by Nathanielsz and colleagues indicated that an obese pregnant mother and exposure to a high-fat, high-sugar diet during pregnancy produces a fatty liver in the foetus, potentially predisposing children to obesity, metabolic and cardiovascular disorders later in life. Another study found that the child of a slightly undernourished mother is more likely to suffer early ageing of the heart.

Source: University of Wyoming


Breast surgeon calls for higher focus on breast health from a younger age

The question of when women should start thinking about breast cancer prevention and receiving regular breast check-ups can be a difficult issue to deal with, however Associate Professor Sanjay Warrier, a breast oncology and oncoplastic surgeon and President of Breast Surgeons of Australia & New Zealand, believes breast health should sit next to skin health in terms of everyday importance.

‘SLIP, SLOP, SLAP is widely known as the successful tag line for healthy skincare practices. Kids learn it from a young age and it reminds you of what to do when going outside’ Warrier said; ‘I would like to see LOOK, LIFT, FEEL as the tag line for women when it comes to breast care. Breast self-examinations involve looking at the breasts in the mirror, lifting the arm up over the shoulder, feeling the breast and armpit in circular motions with the pads of the fingers and then finally feeling the nipple.’

‘This is a process which I would like to see become ingrained into the lives of women all over the world from an early age. By doing this, undertaking self-examinations will become second nature and women will be more aware of any changes in their breasts. The earlier the detection, the better.’

Warrier, an Associate Professor at the University of Sydney, is passionate about helping to reduce the incidence of breast cancer and helping both women and men to overcome breast cancer and believes education and prevention needs to start from a young age.

‘I believe teenagers and women in their twenties need to be more aware of their breast health, and more active in consulting their GP about how to prevent breast cancer early’ he said.

According to the National Breast Cancer Foundation, two women under the age of 40 will be diagnosed with breast cancer every day in Australia.

‘In addition to undertaking self-examinations, young women need to consider getting regular breast checks. Breast cancer prevention should be a life-long effort for women, young and old. Even teenagers need to start thinking about the long-lasting effects their health choices will have down the track’ Warrier said; ‘Breast cancer isn’t usually on the radar of young women. Most Australians assume that breast cancer is a problem that only older women face, but that assumption is incorrect and extremely dangerous.’

Research by the Cancer Institute NSW found that between 2013 and 2015, 80 women between the ages of 25 and 29 were diagnosed with breast cancer in NSW alone. The figure rose to 233 for women between the ages 30 and 34. The Cancer Council states that 5% of the women diagnosed with breast cancer every year are under the age of 40.

Breast cancer in young women can be more dangerous than breast cancer in older women. This is because young women’s breast tissue is usually denser than the breast tissue of older women, meaning that lumps are harder to notice. Mammograms can be less effective for women under the age of 40 for this reason.

‘Ideally, we need to be encouraging young women to learn how to undertake breast self-examinations so they know what they are doing and to see their GP to get regular check-ups. If young women are shown how to LOOK, LIFT, FEEL, they are more likely to know what to do at home’ Warrier explained.

‘Time is of the essence with breast cancer. Unfortunately, social norms make young women less likely to check for breast cancer and more likely to ignore the typical warning signs. Young people can often fall into the trap of thinking that they’re invincible. To be fair, I think we all believe this until something goes wrong. Young women should be careful to not assume that lumps are cysts or just regular forms of growth.  If you feel something abnormal, consult your doctor.’

Women with breast cancer in their family may be more likely to be diagnosed with breast cancer themselves. However, Warrier believes that this is another trap that young people can fall for; ‘The things you do when you’re young have a massive impact on your risk of breast cancer. You can reduce your chances by eating a healthy diet, drinking less alcohol and stopping smoking. A lot of young people don’t actually know this. They assume it’s all down to genes and age.’

‘My advice to all women, including younger women, is even if you think your risk of breast cancer is relatively low, it’s still worth routinely monitoring your breast health and even visiting your GP for a more thorough check-up from time to time. Take good care of your health, eat well, rest and avoid putting toxins into your body. Prevention and early detection are important when it comes to cancer.’

Source: Dr Sanjay Warrier

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