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Obese adolescents at greatest risk of becoming severely obese adults

Obese adolescents are 16 times more likely to become severely obese by age 30 than their healthy weight or even overweight peers, according to a new study led by Penny Gordon-Larsen, PhD, associate professor of nutrition in the UNC Gillings School of Global Public Health.   Public health researchers found that nearly 40 percent of obese adolescents are expected to become severely obese by age 30, compared to only 2.5 percent of healthy weight and overweight teenagers. The study was published in the Nov. 10, 2010, issue of the Journal of the American Medical Association. It is believed to be the first longitudinal study to examine the persistence and development of severe obesity over the transition from the teenage to adult years. The link found between adolescent obesity and adult severe obesity suggests intervention programs might be most effective during childhood or adolescence, before the worst weight gain occurs, said senior study author Gordon-Larsen, who is a fellow at UNC’s Carolina Population Center. “Severe obesity can lead to life-threatening complications, including diabetes, hypertension, hyperlipidemia, asthma and arthritis, as well as substantial reductions in life expectancy,” she said. “It’s critical that we identify who is most at risk for this condition, and when they are most vulnerable to it. Then we’ll have better evidence for when and how to effectively intervene.” Dr. TheCurrent weight loss drugs are either minimally effective or come with a high risk of side effects, while people who have bariatric surgery, or “stomach stapling” operations, can suffer major potential complications, said Natalie The, PhD, postdoctoral research associate and lead author of the study. Therefore, preventing severe obesity may be the most effective strategy to avoid obesity-related health risks, she said. Researchers defined adult severe obesity as a body mass index (BMI) of greater than or equal to 40, and being overweight and obese as a BMI greater than 25. The study found that while 1.2 percent of males and 2.4 percent of females who were normal weight as adolescents became severely obese as adults, 37 percent of males and 51 percent of females who were obese as adolescents became severely obese as adults. The risk of becoming severely obese was highest in black females. “While we know that the transition from the teenage years to the adult years is one of high risk for weight gain, few studies have tracked individuals over time to understand the risk of developing severe obesity,” The said. To measure the association between obesity in adolescence and severe obesity in adulthood, researchers studied data from the U.S. National Longitudinal Study of Adolescent Health. More than 8,800 people who were 12- to 21-year-olds in 1996 were followed into adulthood (ages 24-33 in 2007-2009). Results showed that across all weight, sex and racial and ethnic groups, 7.9 percent of these teenagers who were not severely obese as adolescents became severely obese as young adults 13 years later. On the other hand, 70 percent of the teens who were severely obese remained so as they aged. On average, over the period of the study, a teenage female who was 5 feet 4 inches tall, weighed 130 pounds and never developed severe obesity gained about 30 pounds; however a female of the same height who did become severely obese gained about 80 pounds. “Obese adolescents are at considerably high risk for becoming adults with severe obesity,” Gordon-Larsen said. “Given the rapid rise in severe obesity and its associated health risks, early prevention efforts are critically needed.” Dr. SuchindranDr. PopkinDr. NorthAlong with Gordon-Larsen and The, the study co-authors were Chirayath Suchindran, PhD, professor of biostatistics, Kari North, PhD, associate professor of epidemiology, and Barry Popkin, PhD, Carla Smith Chamblee Distinguished Professor of Global Nutrition, all in UNC Gillings School of Global Public Health. The study’s title is “Association of Adolescent Obesity with Risk of Severe Obesity in Adulthood.”

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Brain autopsies of 4 former football players reveal not all get chronic traumatic encephalopathy

Preliminary results from the first four brains donated to the Canadian Sports Concussion Project at the Krembil Neuroscience Centre, TorontoWesternHospital, reveal that two of the four former Canadian Football League (CFL) players suffered from a brain disease known as Chronic Traumatic Encephalopathy (CTE), while two did not show signs of CTE. Bobby Kuntz, a former Toronto Argonaut and Hamilton Tiger-Cat and Jay Roberts, an Ottawa Roughrider both had a history of repeated concussions during their careers and showed the characteristic signs of CTE, an abnormal build-up of a protein called Tau in the brain, and other degenerative changes.

CTE can result in memory impairment, emotional instability, erratic behavior, depression, and problems with impulse control. CTE may eventually progress to full-blown dementia. Dr. Hazrati is very clear, however, to emphasize that the precise relationship between concussions and neurodegeneration remains to be demonstrated by future research.

Peter Ribbins, a former Winnipeg Blue Bomber, passed away in December 2010, at age 63 of Parkinson’s disease. Autopsy results show he did not have signs of CTE. Tony Proudfoot, anall-star defensive back for the Montreal Alouettes, died at age 61 in 2011 of Lou Gehrig’s disease (a neurodegenerative condition also known as ALS). Although a connection between ALS and repeated head trauma is being researched, Proudfoot did not have signs of CTE. Both of these players were in the league at a time when it was common to spear tackle with the crown of the head. According to the Canadian Football League Alumni Association (CFLAA), Proudfoot experienced repeated head trauma as a hard-hitting defensive back throughout his 12 seasons in the league.

Kuntz passed away in February 2011 at age 79 after a long battle with Parkinson’s Disease and diffuse Lewy body disease, a condition that overlaps with Parkinson’s and Alzheimer’s. Roberts, 67, who died in October 2010, suffered from dementia and lung cancer. The autopsies were performed by Dr. Lili-Naz Hazrati, a neuropathologist in the Laboratory Medicine Program at the University Health Network.

“While both of these men appeared to have pathological signs of CTE, they also suffered from other serious neurological and vascular related diseases,” said Dr. Hazrati. “Right now we have more questions than answers about the relationship between repeated concussions and late brain degeneration. For example, we are still trying to understand why these two players acquired CTE and the other two did not.”

Mary Kuntz, wife of the late Bobby Kuntz, donated his brain to the Canadian Sports Concussion Project at the Krembil Neuroscience Centre and believes the more players who donate their brains, the better the chances of helping future athletes.

“We’ve always had questions about Bob’s health, because there were so many conflicting medical opinions,” said Mary Kuntz. “We knew there must have been some effect from all of the concussions over the years, and this was an affirmation that concussions did have a part in his health problems.

“Young players should know the risks of concussions. When you are young, you can’t believe what can happen to you when you are older, but we have lived though it. What is good about this study is that there will be more evidence and information for players.”

“We were very happy to be involved in this and it has brought us a sense of closure.”

The Canadian Sports Concussion Project at the Krembil Neuroscience Centre is organized by a team of concussion experts including Dr. Charles Tator and Dr. Richard Wennberg and scientists from several other Canadian institutions. The focus of the project is to further our understanding of how concussions affect the brain.

“There are still so many unanswered questions surrounding concussion and the long-term consequences of repeated head injuries,” said Dr. Tator. “We are trying to determine why some athletes in contact sports develop CTE and others don’t, as well as how many concussions lead to the onset of this degenerative brain disease. Also, we need to develop tests to detect this condition at an early stage and to discover treatments.”

According to Jed Roberts, son of Jay Roberts, he and his sisters began noticing early signs of their father’s memory decline when he starting repeating stories, but insisting he had never told them. “My dad had numerous concussions, although they were undocumented, and I think he knew there was something was wrong, which is why he wanted to help find answers that would hopefully protect future football players,” said Jed, a former CFL player with the Edmonton Eskimos. “I think it is really important that we create awareness around this issue, so that players can live healthy, productive lives beyond the game.”

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