From Bloomberg.com

People in 45 U.S. states lost ground in an ongoing push to reduce obesity to 15 percent of the population by 2010, according to the Centers for Disease Control and Prevention.

Kentucky, Louisiana, South Carolina, Virginia and West Virginia were the only states where obesity was less prevalent last year than in 2005, the Atlanta-based CDC said in a report today. The agency cited estimates derived from individuals’ self-reported data. While Colorado had the lowest prevalence of obesity, at 18.7 percent, its rate climbed from 17.4 percent two years earlier, researchers said.

The proportion of U.S. adults who reported being obese in 2007 rose to a record 25.6 percent, which would include about 54 million people. That’s 1.7 percent higher than two years earlier, the researchers said. CDC officials said the survey shows the 2010 target, set in 2000 by public and private health groups, may be elusive, leaving millions at risk for heart disease and diabetes.

“It’s going to certainly be a struggle to get down to 15 percent, particularly for the country as a whole,” said Deborah Galuska, associate director for science at the CDC’s Division of Nutrition, Physical Activity and Obesity, in a telephone interview today.

The agency estimates actual obesity at 34 percent of the population, rather than the lower figure based on the survey, Galuska said. The CDC figure takes into account that people can sometimes be less than truthful about their height and weight, she said.

Healthy People 2010

Healthy People 2010, a set of health goals established by federal scientists in January 2000, calls for obesity to be reduced to 15 percent of U.S. adults by 2010, according to program’s Web site.

The prevalence of obesity among adults age 18 years or older was 25 percent to 29 percent in 28 states, including New York, Texas, and Illinois, according the 2007 telephone survey of 350,000 people conducted by Atlanta-based CDC. In three states, Alabama, Mississippi and Tennessee, more than 30 percent of people were obese.

About 72 million Americans age 20 and older are considered obese under current U.S. guidelines, the CDC said in a December report based on interviews, physical examinations and laboratory tests. That report put the obesity rate at 34 percent.

From Overweight teens up disease risk as adults

People already overweight in adolescence have an increased mortality rate from a range of chronic diseases, Norwegian researchers said.Researchers at the Norwegian Institute of Public Health said the incidence of obesity among children and adolescents has increased worldwide, but the long-term effects, both with regard to ill-health and mortality rate, have been insufficiently documented.“We found that increasing degrees of obesity among adolescents lead to an unfavorable development in the mortality rate from a range of significant causes of deaths,” Tone Bjorge of the University of Bergen and researcher with the Medical Birth Registry at the Norwegian Institute of Public Health.

The study, published in the American Journal of Epidemiology, said those overweight in adolescence — both men and women — had an increased mortality rate from endocrine and nutritional/metabolic diseases, cardiovascular diseases, colon cancer and respiratory diseases. There were also many cases of sudden death in this group.

From 1963 to 1975, the Norwegian Institute of Public Health studied 227,000 Norwegian adolescents ages 14 to 19 years and tracked them for on average of 35 years.

Nearly 10, 000 deaths were registered in this group. Cause-specific mortality rate among people who had low and high body mass index were compared with the mortality rate among people who had normal BMI at the start of the follow-up.

Up to half of cancer deaths could be avoided with lifestyle changes, experts say

From HealthDay

Imagine therapies that could cut cancer deaths in half.

Well, these “breakthrough” treatments are here, according to a recent American Cancer Society report that said as many as 50 percent of cancer deaths could be prevented with lifestyle changes, such as quitting smoking, maintaining a healthy weight, and getting screened for certain malignancies.

“Nearly half of all cancer is related to two things — tobacco and obesity,” said Dr. Jay Brooks, chief of hematology/oncology at Ochsner Health System in Baton Rouge, La. “That’s something I don’t think people truly grasp.”

Dr. Neil Hayes, a medical oncologist specializing in lung and head and neck cancers at the University of North Carolina School of Medicine, concurred. “Most of my patients are smokers, so it’s rare I see someone truly surprised by the diagnosis. But I don’t think they fully think through the risk associated with smoking,” he said.

Evaluating your risk of cancer, and taking steps to modify those risk factors within your control, could save your life.

Smoking is far and away the leading cause of preventable cancer deaths. In the United States, nearly one-third of all cancer deaths — more than 170,000 Americans — each year are related to tobacco use, according to the American Cancer Society (ACS). Yet, almost one in four American adults still uses tobacco. And, about 22 percent of teens are still lighting up.

“Not smoking is the single most important thing you can do to lower your risk of cancer,” Brooks said.

Another important risk factor cited by the cancer society is the increasing girth of the average American. Poor nutrition, lack of exercise, and excess weight are likely at the root of as many as 188,277 cancer deaths annually, according to the ACS.

A recent New England Journal of Medicine study that included more than 900,000 U.S. adults found that the heaviest people had the highest risk of death — 52 percent higher for men and 62 percent for women — compared to people of normal weight.

However, what isn’t yet known, Hayes said, is if proper nutrition can prevent that increased risk. “We have an incomplete understanding of diet’s impact on cancer. But a healthy lifestyle is associated with all kinds of good things,” he said.

The ACS recommends eating at least five servings of fruits and vegetables a day, and getting at least 30 to 60 minutes of moderate to vigorous activity at least five days a week. Walking, biking and skating are examples of moderate activity, while jogging, fast bicycling, weight training, aerobics and swimming are considered vigorous activity.

Hayes said too much alcohol is also associated with some cancers, particularly tumors of the esophagus, pharynx, and mouth. The ACS recommends that women drink no more than one alcoholic beverage a day and men no more than two alcoholic drinks a day.

Then there’s the lifesaving issue of screenings. Some cancer screenings, such as those for skin, breast, cervical and colon cancers, can actually detect precancerous changes that may eventually lead to malignancies.

For instance, with a colonoscopy a doctor can find and remove polyps before they turn into cancer. The ACS report estimated that as many as half of the 55,000 colon cancer deaths that occur each year could be prevented with proper screening.

“Aside from avoiding tobacco and maintaining a healthy body weight, cancer screening is the most important thing people can do to reduce their chances of dying from cancer,” the ACS report stated.

From New York Times

Being obese or even overweight may increase a person’s risk of developing up to a dozen different types of cancer, European researchers report in a new study.

Doctors have long suspected a link between weight gain and certain cancers, including colon and breast cancers. But the new study, published Friday in the journal Lancet, suggests it could also increase chances for cancer of the esophagus, thyroid, kidney, uterus and gall bladder, among others.

While the study suggests a link, there is no definitive proof that being fat in itself causes cancer.

“To make the link between cause and effect, we need to tick several boxes,” said Dr. Andrew Renehan, the study’s lead author and senior lecturer at the School of Cancer Studies at the University of Manchester. “This study begins to tick the first two or three boxes, but more research is needed to confirm it.”

The researchers compiled data from 141 studies and considered more types of cancers and more diverse populations than had been done previously. The research covered more than 280,000 cases from North America, Europe, Australia and Asia.

The subjects, both overweight and normal weight, were followed for about nine to 15 years, with researchers tracking their body mass index, or BMI — a calculation based on weight and height — and correlating it with incidents of cancer.

In men, an average weight gain of 33 pounds increased the risk of esophageal cancer by 52 percent, thyroid cancer by 33 percent, and colon and kidney cancers each by 24 percent, the research found.

In women, a weight gain of 29 pounds increased the risk of cancer in the uterus and gall bladder by nearly 60 percent, esophagus by 51 percent and kidney by 34 percent, the study said.

The link was weaker for bone and blood cancers, for both men and women.

In Asian populations, there appeared to be a stronger link between increased BMI and breast cancer, the study said.

“This study provides a lot of circumstantial evidence about the dangers of obesity,” said Dr. David Robbins, a gastroenterologist at Beth Israel Medical Center in New York, who was not involved in the study. “It also highlights the cancer crisis we face as obesity rates increase worldwide.”

Scientists are unsure how being overweight could make people more susceptible to cancer.

“One of the hypotheses is that the presence of excess fat cells could affect the levels of hormones in your body,” Renehan said. “At a cellular level, that may favor the development of tumors in humans.”

Because many studies have found that fatter people are more likely to get cancer, experts often recommend losing weight to reduce cancer risk.

“The simple message is that, if you manage to keep a healthy body weight, you will have a lower risk of developing cancer,” said Ed Yong, of Cancer Research United Kingdom.

The Lancet study was paid for by British Medical Association, the University of Manchester and the University of Bern, Switzerland. Renehan has consulted for several pharmaceutical companies that make hormone replacements

From USATODAY.com

Higher blood volumes probably cause lower concentrations of prostate-specific antigen, or PSA, in obese prostate cancer patients, reports a study today, leading the authors to speculate that screening with PSA tests might miss some cancers in obese men.

Most U.S. prostate cancers are diagnosed by a biopsy prompted by a high PSA, the researchers write in The Journal of the American Medical Association.

“The ability to accurately detect prostate cancer can be compromised by any factor that decreases PSA concentrations,” they write.

The study of more than 13,000 men who had undergone prostate cancer surgery found that patients with a body mass index, or BMI, of 35 or greater had PSA concentrations that were 11% to 21% lower than normal-weight patients. A 5-foot-8 man who weighs 230 pounds has a BMI of 35, which is considered moderately obese. A BMI of less than 25 is considered normal.

An alternative explanation for obese men’s lower PSA concentrations is their lower testosterone levels. If this were true, the researchers write, obese men would be expected to have lower total amounts of PSA, which is excreted by prostate tumors. However, obese patients in the study had similar or higher total amounts of PSA than normal-weight patients.

Obese prostate cancer patients have a higher risk of dying than normal-weight patients, says senior author Stephen Freedland, an assistant professor of urology and pathology at Duke University. One reason could be that screening is missing some of their early cancers, he says.

Although the link between obesity and lower PSA concentrations remains unproven in men who have not been diagnosed with prostate cancer, Freedland says, he has begun to use a lower PSA cutoff when screening obese patients. While the test’s manufacturer recommends a cutoff of 4, Freedland says he is lowering it by 20%

roughly the difference found in his study

in men whose BMI is 35 or higher. So instead of 4, he’s using 3.2 or 3.3.

Freedland’s study “just drives one more nail in the coffin of the concept that one size fits all for PSA,” says Bruce Roth, a professor of medicine and urology at the Vanderbilt-Ingram Cancer Center in Nashville.

“There wasn’t anything overly scientific about choosing 4.0″ as a PSA screening cutoff, says Roth, a board member of the American Society of Clinical Oncology. PSA levels increase as prostates enlarge with age, Roth says, and “there are likely racial differences.”

Still, Roth says, it’s too soon to start using a lower PSA cutoff when screening obese men. “It’s hard to say what you should do in a screening population based on data only in diagnosed patients,” he says. If an obese man has no symptoms and a normal-sized prostate, lowering the PSA threshold for performing a biopsy “is stretching it a little bit.”