Link between obesity, kidney cancer identified

Receptors for leptin, a protein hormone, may be associated with tumor recurrence in patients with renal cell carcinoma (RCC), providing further understanding about molecular links between obesity and RCC tumor formation and prognosis, according to a study at The University of Texas MD Anderson Cancer Center.

The findings are being presented April 18 at the annual meeting of the American Association of Cancer Research (AACR) in New Orleans.

The leptin receptors, called LEPR, were found to be hypermethylated in tumors in a study involving 240 newly diagnosed and previously untreated Caucasian RCC patients. Methylation is a mechanism by which cells control gene expression and both hypomethylation and hypermethylation are known to play roles in silencing of tumor suppressor genes or over-expression of oncogenes in cancer cells. LEPR was one of 20 obesity-related genes that the research team examined.

"Obesity is an established risk factor for RCC with more than 40 percent of these cases attributed to excessive body weight," said Xifeng Wu, M.D., Ph.D., professor of Epidemiology and principal investigator for the study. "Growing evidence suggests that obesity also may be associated with the prognosis of RCC. The molecular mechanism LEPR and two other genes, NPY and LEP, are involved in RCC tumorigenesis. LEPR methylation in tumors is associated with recurrence in RCC patients and thus, LEPR may provide a functional link between obesity and RCC."

The study evaluated the association between methylation of 20 obesity-related genes and RCC. For the discovery portion of the study, 63 tissue pairs of RCC tumors and normal adjacent tissues from the surrounding kidney were used. An additional 177 pairs were included for the validation component of the study.

The patients were mostly males with an average age of 59 years who had never smoked. Most of the patients had clear cell RCC and were at the earliest stage of disease.

"Patients were classified into high- and low-LEPR methylation groups," said Julia Mendoza-Perez, Ph.D., a visiting scientist of Epidemiology at MD Anderson who presented the findings at AACR. "We found that high LEPR methylation was associated with a significantly higher risk of tumor recurrence."

The results were adjusted by age, gender, pathologic stage of disease, grade, smoking status, body mass index, hypertension and histology.

"In addition, high LEPR methylation in tumors was associated with more advanced tumor features, such as high pathologic stage, high grade, and clear cell RCC histology," said Wu.

The researchers add that future studies are needed to further understand the biology underlying the ties between LEPR methylation and RCC recurrence.

Soaring obesity in women causes womb cancer cases to DOUBLE in just 20 years

Obesity is fuelling a massive jump in the number of women suffering womb cancer.
The number of patients diagnosed with the disease has almost doubled in 20 years, correlating alongside a spike in womb cancer rates, Cancer Research UK warned.
From 1993 to 1995, around 19 women in every 100,000 developed womb cancer in the UK, rising to 29 women in every 100,000 by 2011-13 (the most recent figures available).
Around 9,000 women are now diagnosed with womb cancer every year in the UK - up from around 4,800 new cases a year 20 years ago.
It kills around 2,000 women every year.
Professor Jonathan Ledermann, director of the Cancer Research UK and UCL Cancer Trials Centre, said: 'It's worrying that womb cancer cases are going up so sharply.
'We don't know all the reasons why. But we do know that about a third of cases are linked to being overweight so it's no surprise to see the increases in womb cancer cases echo rising obesity levels.
'The good news is that thanks to research and improved treatments, survival has improved.
'In the 1970s, almost six in 10 women diagnosed with the disease survived for at least 10 years. Now almost eight in 10 women survive.
'But we need more research to understand the biology of the disease better and to know more about how it is caused so that we can improve the treatment of these women as well as preventing more cases.'
In January, Cancer Research UK warned that almost 700,000 more people could develop cancer in the next 20 years due to being overweight or obese.

We are NOT to blame for being OBESE, claims health expert

I DON'T know exactly what qualifies as a "superhuman effort" but when I hear that phrase I tend to picture someone who has dived into a freezing lake to save a child or lifted a heavy car off a crushed cyclist. I don't think of someone who refuses an extra helping of pudding.

In the mind of the Government's health tsar Susan Jebb, however, that mere act is sufficient to elevate someone to the status of Batman, Spiderman or some other fantasy hero. "Obesity has increased greatly over the last few decades," she said last week.

"That is not a national collapse of willpower. It's something about our environment that has changed. You need in some cases a superhuman effort to reduce your food intake."

It is not our fault if we get fat, she asserts. We should blame those dastardly food companies and retailers who line the high streets with burger shops and put sweets next to the tills.

How can we be expected to walk past such temptation without succumbing? I don't doubt that some people find it harder than others to know when to stop eating. However there is ultimately only one cause of obesity: not slow metabolism, not faulty genes but eating too much.

Unless you are being force-fed like a goose bred for paté de foie gras it is entirely within your control to monitor what you eat. Virtually all packaged food now comes with details of calorific content so it is not too hard to work out if you are exceeding a sensible daily intake of food.

If Jebb, who also serves as professor of diet and population health at the University of Oxford, thinks we can't be expected to have the willpower to turn down sugary snacks, from what else does she think we should be absolved: drinking too much, taking drugs, shoplifting, groping women on the Tube, hitting people we don't like? Civilised life becomes utterly impossible if we are not expected to exercise willpower and control our behaviour. Exercising selfrestraint is not superhuman, it is just human.

THE trouble is, it isn't only Jebb who seems to have this view of humans as pathetic creatures who bear no responsibility for their own actions. It has now become the ruling philosophy of many policy-makers and do-gooders.

In 2013 the American Medical Association voted to classify obesity as a disease against the advice of an expert panel that had warned of the consequences.

Activity equivalent calorie labelling to fight obesity

If pictorial warnings on tobacco products help in effectively conveying the harsh reality of the effects of tobacco and increase the awareness among users and potential users, there is a strong case to change the way food items are labelled, too. Instead of merely stating that a particular food item has a certain amount of calories, there is a greater possibility that people would change their eating habits if the labels contained information on equivalent exercise required to burn the calories contained in the food item, the Royal Society of Public Health, U.K., says.

“Giving consumers an immediate link between foods’ energy content and physical activity might help to reduce obesity,” Shirley Cramer, Chief Executive at the Royal Society of Public Health writes in The BMJ.

There is little information that current information found on food and drink packaging, including “traffic light” labelling, has any effect on consumption behaviour. “Packaging should not only provide nutritional information but should also help people to change behaviour,” she notes.

The Royal Society for Public Health has called for the introduction of “activity equivalent” calorie labelling. The prominent pictorial icons placed alongside existing front-of-pack information would contain symbols that show the minutes of several different physical activities that would be required to burn off the calories individuals consume in the product. “The aim is to prompt people to be more mindful of the energy they consume and how these calories relate to various activities in their everyday lives, to encourage them to be more physically active,” she writes. “Those from lower socioeconomic societal groups often have lower nutritional knowledge, and health literacy. Information on food must be presented in a medium that can be understood by all sections of society, regardless of social class or economic situation. It is known that consumers understand symbols more easily than numeric information which suggests activity equivalent calorie labels may provide an easier reference for people less able to decipher current front-of-pack labels,” the RSPH position paper notes.

For example, instead of merely stating that a can of carbonated drinks contains 138 calories, mentioning that it would take a person of average age and weight about 26 minutes of walk to burn 138 calories contained in the can of drink will be direct and more effective. “Given its simplicity, activity equivalent calorie labelling offers a recognisable reference that is accessible to everyone,” Cramer writes.

“Initial studies show that this approach can change behaviour by reducing intake or modifying choice” she notes. The Royal Society of Public Health got important and positive feedback from people on activity equivalent labelling. For instance, public polling by the society has shown that almost half (44 per cent) of people find current front of pack information confusing. And almost two-third (63 per cent) of people said they would support the introduction of activity equivalent labelling. After viewing activity equivalent calorie labels compared with current traffic light front-of-pack information, people were over three times more likely to indicate that they would undertake physical activity. A body of evidence indicates that even a modest increase in physical activity can have significant health benefits. For instance, a brisk 20 minute walk each day has the potential to lower a person’s risk of premature death by between 16-30 per cent.

Centre planning sugar tax to fight obesity, diabetes

NEW DELHI: Junk food and sugar-sweetened beverages will soon be taxed higher and subjected to tougher advertising norms. The government plans these measures to control the growing incidence of diabetes in the country.
The health ministry and the central food safety regulator are working on a proposal to cut consumption of unhealthy food and beverages, mainly among children. For, these are known to be responsible for the burden of diabetes cases and obesity. An inter-ministerial consultation on the matter took place in February .
"There is a serious effort to control non-communicable diseases, mainly diabetes and cancer. We have a multisectoral action plan and consultations are on with different ministries," a senior health ministry official said. The ministry is compiling feedback from ministries and will refer the proposal to the finance ministry and the PMO, he added.
There is consensus among ministries and departments on the need for stringent measures to contain the rising disease burden right from childhood, the official said.
Diabetes Foundation and Centre of Nutrition and Metabolic Research estimates show the annual per capita consumption of sugar-sweetened beverages in the country rose from around 2 litres per head in 1998 to 11 litres per head in 2014.

More Evidence That Obesity Is A Global Catastrophe In Slow Motion

Sometimes it is harder to see things that move in slow motion. Perhaps if the global obesity epidemic moved any faster, it would garner an emergency response similar to Ebola, Zika, and other infectious disease epidemics that have gripped the world in recent years. As two recent studies published in The Lancet and authored by the Non-Communicable Disease (NCD) Risk Factor Collaboration have re-emphasized, the sheer magnitude of the global obesity epidemic dwarfs those of most other epidemics. The impact may be much greater as well, accounting for many more deaths  (over 3.4 million a year) and more costs (over $2 trillion a year). My colleague Larry Cheskin, MD, Associate Director of our Global Obesity Prevention Center (GOPC) at Johns Hopkins University and Associate Professor at the Johns Hopkins Bloomberg School of Public Health, describes the global obesity epidemic as “a catastrophe happening in slow motion.” But has everyone around the world responded as if the obesity epidemic were indeed a catastrophe ?

One of the Lancet studies confirmed that obesity and overweight is a growing problem worldwide, even in countries that in the past have had problems with lack of food. The study analyzed the change in body mass index (BMI) from 1698 studies among 19.2 million adults in 200 countries from 1975 to 2014. The researchers found that during this time period the average BMI increased from 21·7 to 24·2 kg/m2 among men and from 22·1 to 24·4 kg/m2 among women. Average BMIs among men were lowest (21·4 kg/m2) in central Africa and south Asia and highest in 29·2 kg/m2 in Polynesia and Micronesia. Among women, average BMIs were lowest (21·8 kg/m2) in south Asia to and also highest (32·2 kg/m2) in Polynesia and Micronesia. During the same time period, obesity prevalence more than tripled from 3·2% to 10·8% among men and more than doubled (6·4% to 14·9%) among women. By comparison, the prevalence of people are underweight, presumably from lack of enough food, decreased from 13·8% to 8·8% among men and 14·6% to 9·7% among women.

The other Lancet study showed a substantial worldwide increase in diabetes since 1980 by analyzing 751 studies that included nearly 4·4 million people. As the study’s senior author Professor Majid Ezzati form Imperial College  explained,“obesity is the most important risk factor for type 2 diabetes and our attempts to control rising rates of obesity have so far not proved successful. Identifying people who are at high risk of diabetes should be a particular priority since the onset can be prevented or delayed through lifestyle changes, diet or medication.” The study found that between 1980 and 2014, diabetes prevalence more than doubled from 4·3% to 9·0% among men and climbed by over 50% from 5·0% to 7·9% among women. This corresponded to the number of adults with diabetes worldwide nearly quadrupling from 108 million to 422 million. In 2014, northwestern Europe has the lowest diabetes rates. Polynesia and Micronesia has the highest (affecting nearly a quarter of adults), followed by Melanesia and the Middle East and north Africa. While not all diabetes cases are related to obesity, obesity is a major risk factor for the more common type of diabetes, Type II or adult-onset diabetes. And diabetes can have devastating health consequences such as heart problems, kidney disease, and stroke. (Of course, obesity can result in many other health problems besides diabetes.)

Obesity surgery linked to reduced pain, improved mobility

Many severely obese patients have less pain and better mobility in the first few years after weight loss surgery, a U.S. study suggests.

Researchers followed more than 2,200 obese patients who had weight loss surgery. After one year, 58 percent of them reported less pain and 77 percent said they had better physical function.

By three years, the proportion of patients still reporting improvements in pain and physical function dropped significantly to 49 percent and 70 percent, respectively.

Patients did, however, report consistent improvements in walking ability at one and three years, and those who started with knee and hip problems also reported lasting pain reductions and mobility increases around these joints.

While surgery remains more effective for lasting weight loss than alternatives such as dieting and exercising, the findings suggest that not all surgical patients will get the same results, said lead study author Wendy King, a public health researcher at the University of Pittsburgh.

The amount of weight lost after the surgery, rather than the type of surgery, was "consistently related to improvements in pain and function," King said by email.

Globally, 1.9 billion adults are overweight or obese, according to the World Health Organization. Obesity increases the risk of heart disease, diabetes, joint disorders and certain cancers.