High School Students Graduating To Be Tomorrow's Cancer And Cardiovascular Patients, Australia

Results of a national diet and physical activity survey of high school students, released today (9 Feb), will ring alarm bells among educators, health professionals and parents.

The research, by Cancer Council and the Heart Foundation, reveals excessive prevalence of overweight and obesity among students (highest in low SES areas), inadequate rates of physical activity, insufficient fruit and vegetable intake and a high proportion of students making food choices based on advertising.

The participation of 12,000 students in years eight to 11 across 237 schools provides the first truly national sample for a physical activity survey of young Australians since 1985.

Key findings:

- One in four students are overweight or obese, with a significantly higher rate in low SES areas.

- Eighty-five per cent of students don't engage in sufficient activity to provide a health benefit.

- Low fruit and vegetable intake, with 76% not meeting the daily recommended intake of four vegetable servings daily and 59% not meeting the daily recommended intake of three servings of fruit daily.

- One third drink four or more cups of soft drink, cordial or sports drink a week

- More than half (51%) tried a new food or drink product in the past month they had seen advertised.

Cancer Council Australia CEO, Professor Ian Olver, said the findings confirmed what health experts had been saying for years, that poor nutrition and inadequate exercise were contributing to an unprecedented number of overweight and obese adolescents and a "chronic disease time bomb".

"If ever there was a wake-up call for Australians, this is it," Professor Olver said. "As obese kids move into adulthood the heightened risk of chronic diseases like cancer means previous gains in life expectancy may be reversed. We may see today's teenagers die at a younger age than their parents' generation for the first time in history"

National Heart Foundation of Australia CEO, Dr Lyn Roberts, said that all policy makers should be deeply disturbed by the findings.

"This piece of research confirms what we've feared for some time - that the high school students of today will grow up to be the heart attack victims of tomorrow," Dr Roberts said.

Chair of Cancer Council Australia's Nutrition and Physical Activity Committee, Kathy Chapman, said the report provided compelling evidence for the Australian Government to implement a comprehensive obesity strategy, as recommended by the National Preventative Health Taskforce.

"Overweight and obesity significantly increase cancer risk and unless we address the problem, common cancers such as bowel and breast cancer will surge," Ms Chapman said.

Source:
Cancer Council Australia

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Our Lady Of Lourdes Medical Center Among First To Offer Single Port Surgery For Weight Loss Surgery Patients

Our Lady of Lourdes Medical Center and renowned weight loss surgeon Dr. Alex Gandsas have announced the successful completion of a single port sleeve gastrectomy procedure that has resulted in a "scarless" surgery. Lourdes is thought to be the only hospital in New Jersey that has performed the sleeve gastrectomy procedure though the patient's belly button.

"This is a remarkable step toward significantly improving the cosmetic results for patients," says Gandsas, who was assisted during the surgery by Dr. Adeshola Fakulujo. "The belly button is the body's natural scar. By reducing the operative site to one single incision in the belly button, the scar is practically invisible."

A laparoscopic sleeve gastrectomy, which removes 75 percent of the stomach so that it looks like a sleeve, is traditionally performed through six incisions that range from .5 to 1.5 centimeters in diameter. These incisions allow the necessary surgical instruments to be inserted, as well as a special camera to view structures inside the abdomen. But with the single-port surgery, the same equipment is guided through just one incision in the belly button. Minimally invasive procedures are associated with shorter length of stay, less pain and quicker return to normal activity.

"The single-port technique is more technically challenging because of ergonomics," explains Gandsas, who is also the chair of the Department of Surgery at UMDNJ - School of Osteopathic Medicine. "Your instruments are working in one line. But with appropriate patient selection, and an experienced surgeon, outcomes are excellent. What's more, patients appreciate the cosmetic benefit of a virtually scarless procedure. In my experience, patients want fewer incisions with any surgery."

Candidates for the single-port sleeve gastrectomy procedure are those with a body mass index (BMI) of 40 to 45, and those who have an abdominal wall that has less thickness to it so that inserted instruments can move freely.

While the approach to the surgery differs from the traditional laparoscopic method, the sleeve gastrectomy procedure itself is still the same. Because of this, it still has the same benefits and risks for patients.

According to Gandsas, the benefits include the fact that sleeve gastrectomy is relatively successful, with patients losing about 40 to 50 percent of excess weight after three years. It's also a good alternative to standard gastric bypass, which may be too risky for some patients. Sleeve gastrectomy also does not affect the absorption of food, so nutritional deficiencies are not a problem. The drawbacks - sleeve gastrectomy is irreversible, and while rare, there is risk for infection, leaking of the sleeve and blood clots.

"Single port surgery itself is gaining popularity and many see a natural progression," adds Gandsas. "We are moving toward fewer incisions to reduce surgical impact. However, we still need randomized prospective studies looking at comparable outcomes between single-port sleeve gastrectomy and standard laparoscopy. These minimally invasive techniques are as a bridge as we push the envelope and refine our techniques to improve the patient experience."

Lourdes Medical Center of Burlington County and Our Lady of Lourdes Medical Center are designated Blue Distinction Centers® for Bariatric Surgery by Horizon Blue Cross Blue Shield of New Jersey. HealthGrades, the nation's leading independent healthcare ratings organization, has given Our Lady of Lourdes Medical Center a five-star rating for overall bariatric surgery two years in a row, ranked it number three in New Jersey for two consecutive years and awarded it the Bariatric Surgery Excellence Award™ in 2009.

Source:
Our Lady of Lourdes Medical Center

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Race Plays Role In Weight-Related Counseling Among Obese Patients

When it comes to advising obese patients, blacks receive less weight reduction and exercise counseling from physicians than their white counterparts. This is according to a recent study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health who examined the impact of patient and doctor race concordance on weight-related counseling. The results are featured in the January 2011 online issue of Obesity.

"Contrary to our expectations, we did not observe a positive association between patient-physician race concordance and weight-related counseling," said Sara Bleich, PhD, lead author of the study and an assistant professor with the Bloomberg School's Department of Health Policy and Management. "Rather, black obese patients seeing white doctors were less likely to receive exercise counseling than white obese patients seeing white doctors. We also found that black obese patients seeing black doctors were less likely to receive weight reduction counseling than white obese patients seeing black doctors. This suggests that regardless of the physician's race, black obese patients receive less weight-related counseling than white obese patients. Our findings could be due to a number of factors such as negative physician perspectives towards black patients or a lack of sensitivity to the underlying levels of obesity risk for black patients as compared to white patients."

Obesity is defined as having a body mass index (BMI) greater than or equal to 30 kg/m2 and is an important risk factor for mortality and morbidity. In the U.S., blacks are disproportionately affected by obesity and are at an increased risk for a number of chronic diseases associated with obesity, such as cardiovascular disease, hypertension and diabetes.

Researchers analyzed National Ambulatory Medical Care Surveys (NAMCS) from 2005-2007, a nationally representative cross-sectional survey of physician office visits, among individuals ages 20 years and older. Using a sample size of 2,231 visits of black and white obese patients to their black and white physicians from the specialties of general/family practice and general internal medicine, Bleich and colleagues examined the relationship between doctor-patient race concordance and weight-related counseling (measured as weight reduction, diet/nutrition and exercise counseling). Logistic regression was used to model the outcome variables of interest. In addition, tests were used to statistically compare whether physicians of each race provided counseling at different rates for obese patients of different races.

"Previous studies have shown disparities in the proportion of black obese adults informed by physicians that they were overweight compared to white obese adults," said Lisa Cooper, MD, MPH, senior author of the study and a professor in the Bloomberg School's Department's of Epidemiology and Health, Policy and Management. "We now also see that black patients are receiving different medical counseling as well. Further research is needed to understand how to improve obese patient counseling, particularly among the black population." "Impact of Patient-Doctor Race Concordance on Rates of Weight-Related Counseling in Visits by Black and White Obese Individuals" was written by Sara N. Bleich, Alan E. Simon and Lisa A. Cooper.

Source:
Johns Hopkins Bloomberg School of Public Health

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Extreme Obesity Associated With Higher Risk Of Death For 2009 H1N1 Patients

For those infected with the 2009 pandemic influenza A (H1N1) virus, extreme obesity was a powerful risk factor for death, according to an analysis of a public health surveillance database. In a study to be published in the February 1, 2011, issue of Clinical Infectious Diseases, researchers associated extreme obesity with a nearly three-fold increased odds of death from 2009 H1N1 influenza. Half of Californians greater than 20 years of age hospitalized with 2009 H1N1 were obese.

Data from 500 adults hospitalized with H1N1 in the first four months of 2009 in California were analyzed to test the hypothesis of obesity as a risk factor for increased fatality. Extreme obesity is defined as having a body mass index (BMI) equal to or over 40. The data was collected April 20 - Aug. 11, 2009, by health providers and reported to local health departments, which subsequently provided the data to the California Department of Public Health. During this period, H1N1 accounted for 50 percent of influenza-like illnesses. Patients under 20 years of age and pregnant patients were excluded from the study.

"Extremely obese persons with a body mass index equal to or over 40 should get vaccinated annually for influenza," according to study author Janice K. Louie, MD, MPH, of the California Department of Public Health. "They should also see their health provider early if symptoms of influenza develop, so that they can get diagnosed and treated as quickly as possible. This is especially important if the influenza virus is known to be circulating in the community and causing illness." Dr. Louie stressed that more research is needed to understand why extremely obese people are more likely to die from the 2009 H1N1 influenza infection.

"A Novel Risk Factor for a Novel Virus: Obesity and 2009 Pandemic Influenza A (H1N1)" pdf.

Source:
John Heys
Infectious Diseases Society of America

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