Obesity+and+weight+management

Summary of Topic Here
In the past 20 years, a dramatic increase in obesity rates has occurred in the United States (CDC, 2010). A change in lifestyle, such as inactivity and overconsumption of calories, is strongly correlated with this epidemic. The Centers for Disease Control has shown the upward trends of obesity from 1985 to 2009.  Obesity is related to chronic diseases such as hypertension, type 2 diabetes, cancer, and heart disease. Americans are recognizing the benefits of maintaining a healthy weight, but are bombarded with media sources which may or may not contain accurate information. Below, are headlines related to obesity and weight management that the average American consumer may find confusing due to hidden messages the author portrays to catch the readers eye.

Important Definitions Here

 * Antigen: a substance or molecule that when introduced triggers an immune response
 * B Lymphocyte: A lymphocyte derived from bone marrow that provides humoral immunity; it recognizes free antigen molecules in solution and matures into plasma cells that secrete immunoglobulin (antibodies) that inactivate the antigens
 * Bariatric Surgery: Surgery on the stomach and/or intestines to help the patient with extreme obesity lose weight. Bariatric surgery is a weight-loss method used for people who have a body mass index (BMI) above 40. Surgery may also be an option for people with a BMI between 35 and 40 who have health problems like heart disease or type 2 diabetes.
 * Body Mass Index (BMI): a measure of an adult's weight in relation to his or her height, specifically the adult's weight in kilgrams divided by the square of his or her height in meters.
 * Gastric Bypass Surgery: A weight-loss surgery in which the stomach is made smaller and part of the small intestine is bypassed, reducing the amount of food a person can eat as well as the amount of calories that can be absorbed.
 * Mediterranean Diet: diet high in fish, olive oil, and fruits and vegetables
 * Obesity: BMI of 30 or higher.
 * Phagocytosis: the process in which a cell engulfs particles, in this case, a dying cell
 * Prediabetes: A condition in which a fasting plasma glucose test and/or an oral glucose tolerance test provide readings that are elevated, but not quite diabetic; raises the risk of diabetes.
 * Pro-inflammatory: promotes inflammation
 * T Lymphocyte: A type of white blood cell derived from the thymus (hence T cells) involved in controlling immune reactions.
 * <span style="font-family: Arial,Helvetica,sans-serif;">Waist Circumference: Measurement of the size of an individuals waist.

<span style="font-family: Arial,Helvetica,sans-serif;">[|Decker: Losing 10 pounds could boost your immunity: Health on MSNBC]
<span style="font-family: Arial,Helvetica,sans-serif;">The article Losing 10 Pounds Could Boost Your Immunity discusses data found in the study The Effects of Weight Loss and Gastric Banding on the Innate and Adaptive Immune System in Type 2 and Prediabetes (Viardot, 2010). It defines the immune system and correctly states information about the “pro-inflammatory” immune cells that are the central cells focused on in this article. As the article continues, it informs the reader of the exact parameters of the study. The article informed the readers that the study was conducted on obese people with Type 2 Diabetes or Prediabetes that underwent a gastric banding procedure and were put on extreme calorie restricted diets. The article has quotes from one of the researchers, Samaras. Results are all stated correctly and they are in the right context. The misleading part of the article is the headline. It implies that anyone who loses 10 pounds can boost their immunity. In reality, a loss of 13 pounds in the subjects was required to bring down levels of pro-inflammatory cells associated with decreased immunity. Only those who were overweight with Type 2 Diabetes or Prediabetes and underwent the specific parameters of the study increased their immunity. It cannot be applied to the general public.

<span style="font-family: Arial,Helvetica,sans-serif;">Losing weight with the assistance of gastric bypass surgery has shown in studies to have positive effects on the immune system. Chronic inflammation increased the expression of CD95 antigen that is associated with increased cell death. When bariatric surgery was performed, the correction of these elevated levels occurred (Cottam, 2003). A correlational study on the influence of obesity on immune function was performed and found that T and B lymphocyte counts were decreased by 19-32% in obese subjects. Monocyte and granulocyte phagocytosis and oxidative burst activity were 13-16% higher in obese subjects (Nieman, 1999).

<span style="font-family: Arial,Helvetica,sans-serif;">The scientific studies above indicate that obesity negatively affects the immune system of the body. The results of these studies support the idea that loss of weight in obese persons has significant effects on their immune systems. Comparing this information to the data given in the article, one could state that the media adequately informs the public with acceptable and accurate information.

==<span style="font-family: Arial,Helvetica,sans-serif;">[|Schroeder; Link Between Everyday Stress and Obesity Strengthened With Study Using an Animal Model;ScienceDaily] ==

<span style="font-family: Arial,Helvetica,sans-serif;">The news article Link Between Everyday Stress and Obesity Strengthened with Study Using an Animal Model used rats to try and find the association between stress and weight gain. In this study the rats were on a Visible Burrow System, an animal model of chronic social stress (Melhorn, 2009). The rats were put into groups of four males and two females and a hierarchy of dominance in the males developed. At the beginning all of the rats had a decrease in food intake and body weight, but after the hierarchy was formed only the dominant rat returned to a normal food intake—the other males continued to eat less and usually ate during the day when they normally ate at night. After two weeks the males were separated and allowed to eat what they desired, each of them overeating. This study seems to show that in a social stress situation and during recovery, rats tend to change eating habits and patterns. The study suggests at the beginning that they are comparing this social stress in rats to social stresses in humans pertaining to public speaking, tests, and job and relationship pressures.

<span style="font-family: Arial,Helvetica,sans-serif;">A pattern has been seen in many studies on weight loss and management in obese children. A multidisciplinary program was conducted among obese Filipino children for body weight loss (Tan-Ting, 2010). In the study the children underwent dietary, exercise, and behavioral changes to see the affects over a fifteen month trial period. From this study, the mean weight loss was 4.2 kg with an average of 5.3% body weight loss. BMI declined by 1.5 units. There was also a decrease in body fat and waist circumference. In a study based in Germany, children were enrolled in a multidisciplinary study for long-term weight loss treatment (Weigel, 2008). This study had many of the same conclusions as the previous study including a drop in BMI. Based on the research, it is best to have a multifaceted program for weight loss in the obese.

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<span style="font-family: Arial,Helvetica,sans-serif;">The article titled Link Between Everyday Stress and Obesity Strengthened with Study Using an Animal Model is in my opinion more “news” than “noise”. The stress they speak of is not actually everyday stresses, but more intense social pressures. As shown in the Filipino children study, the best way to combat obesity is through a multi-professional and support system. Children need help from many professionals and support from family and friends to lose weight and prevent obesity in adulthood. Although the article talks about the link between stress and obesity and the studies are about weight loss, there is still information that leads me to believe that they are connected. The more support and counseling each child got took part in the weight loss and decrease of BMI. The more support decreases social pressures and helps with the stresses involved in social settings. =====

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<span style="font-family: Arial,Helvetica,sans-serif;">One headline entitled Calcium’s Weight Loss Potential Gets RTC Support leads people to believe there may be a "magic pill" as an answer to our nation’s weight problems. A closer look reveals a less promising outcome. Several studies have been done in order to find an answer to the obesity problem including the effects of dietary calcium on weight loss. Calcium supplement with vitamin D was the subject of a study to determine the effect of calcium on weight loss (Zhou, 2010). This study was a population–based, placebo-controlled, randomized, double blind trial that took place over a four year period. The percentage of body fat were significantly different between the calcium intervention group and the placebo group (P<0.05). This study supports the hypotheses that high calcium intake can have beneficial effects on body fat/lean composition, but the absolute amounts of change were small ( change in % trunk fat: mean 1.8%, 2.0 % vs 4.9% at year 4, P=0.003). =====

<span style="font-family: Arial,Helvetica,sans-serif;">Another randomized, double-blind, placebo-controlled human trial that took place over the course of two years measured the effect of 1500 mg calcium carbonate supplements on weight loss (Yanovski, 2009). Subjects were randomized in a 1:1 ratio to receive either the supplement or placebo. The measured change in body weight among all participants after 2 years was +1.3±6.5 kg, but no statistically or clinically significant differences in change in body weight was found between groups. The study concluded no significant alteration of weight loss or gain over the two year period indicating calcium supplementation was not effective as a weight loss tool.

<span style="font-family: Arial,Helvetica,sans-serif;">A lab based study on the subject of calcium and weight loss explored the effect of dairy sources of calcium (Eller, 2010). Rats were used in this carefully controlled experiment and were given diets of a calcium supplement along with various milks including skim milk powder, casein, whey and soy protein isolate. The aim of this study was to determine the effect of calcium in conjunction with milk proteins. This time, the rats who got the skim milk powder with the calcium supplement had a lower percentage of body fat. These results might lead us to believe in calcium as a weight loss aid, but the variables were carefully controlled for the rats. Humans have too many variables that are difficult if not impossible to control. <span style="font-family: Arial,Helvetica,sans-serif;">These studies didn’t set out to find an answer to the obesity problem but to examine the effect of calcium on weight loss. Some results were positive and statistically significant in favor of calcium supplementation use as a weight loss tool but the amounts of change were small. A conservative daily calorie deficit in conjunction with a modest exercise routine over the course of two or four years will have the dramatic effects we wish for in the easy answer we want in a pill.

==<span style="font-family: Arial,Helvetica,sans-serif;">[|Lofley; More Calcium and vitamin D may aid in weight management; Nutra ingredients-usa.com] == <span style="font-family: Arial,Helvetica,sans-serif;">The news article More Calcium and Vitamin D May Aid Weight Management written by Stephen Daniells is a review of the study published in the Am J Clin Nutrition 2010; 1-5. According to this article, an increase in calcium by “580 milligrams per day and blood levels of vitamin D of 30.2 nanograms per milliliter were associated with 5.3 kg weight loss over the two year intervention." The article states that this is a controversial subject because the relationship has not been consistent between different studies. Different groups and organizations have different stances depending on the person interviewed. A secondary analysis done through Nutrition & Metabolism showing calcium intake of 1,400-1,500 showed lower fat gain in the trunk area and a higher lean mass. Other studies have also shown a correlation.

<span style="font-family: Arial,Helvetica,sans-serif;">In the original research article, it did indeed show a correlation with weight loss and serum vitamin D levels and calcium as the article stated. The research used different diets to compare how the different levels of vitamin D and calcium affect weight loss. It was not just an increase in calcium and serum vitamin D but also an increase through a low fat diet, Mediterranean diet, and low carbohydrate diet that had the same amount of calories. In the article, it did talk about how more research is needed to confirm this correlation is in fact correct ([|Shahar, 2010.pdf]).

<span style="font-family: Arial,Helvetica,sans-serif;">Although, two other studies findings did not coincide with the results found in the study above or the news article. An article titled Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents, showed that children who consume more milk tended to gain more weight and larger weight gains were seen in children that drank more 1% milk and skim than those who consumed smaller amounts, and the dietary calcium had more of an effect on weight gain than did the dietary fat. Boys who consumed more than 3 servings of milk per day had a larger BMI than boys who ate more than 1 serving but less than or equal to 2 servings. Also, girls who consumed more than 3 servings of milk a day had larger BMI’s than those that consumed half a glass or less each day ([|Berkey, 2005.pdf]). The second study article found Calcium and dairy intakes in relation to long-term weight gain in US men showed that there was an increased weight. Different male health professionals sent in diet information for twelve years. The outcome of the study showed weight gain of about 3 kg with an increase of calcium intake of 108mg/day over 12 years ([|Rajpathak, 2006.pdf]). The news article was overall a good headline when only looking at the studies shown in article. When compared to other research it is more controversial and isn't this cut and dry.

==<span style="font-family: Arial,Helvetica,sans-serif;">[|﻿﻿Holmgren; Commercials Are the Culprit in TV-Obesity; The New York Times] == <span style="font-family: Arial,Helvetica,sans-serif;">[|Source; 2.bp.blogspot.com] <span style="font-family: Arial,Helvetica,sans-serif;">﻿The news article Commercials are the Culprit in TV-Obesity Link summarizes findings from a human based experimental trial that seems to imply childhood obesity is single-handedly associated with the effect television commercials have on children. Researchers from the University of California, Los Angeles compared the time the kids spent viewing television and videos. They asked caregivers to track children’s media use during one weekday and one weekend day during 1997, then again in 2002. The effect was more prevalent in children under the age of seven. The more television commercials a child is exposed to, the more likely he or she will be to try those foods and want to continue eating them, which then increases risk for weight gain (Zimmerman, 2009). The study wasn’t able to document how much food advertising children were exposed to. Research shows that young children are exposed to about 30 hours of food-related advertising annually. Authors of this study fail to disclose that there are many other factors linked to obesity. The study did not compare the activity of children to the television shows or commercials they watched. Television commercials are not the only predictor in childhood obesity, because they failed to mention many other factors.

<span style="font-family: Arial,Helvetica,sans-serif;">Commercials may alter what children think about food intake, the television programs and commercials also decrease the inactivity rates in children increasing sedentary inactivity and obesity rates. There are many factors which increase the rate of obesity in young children, some of which are viewing television commercials, but also viewing television. One article states that the more hours children view television and/or videos, the more likely they were likely to consume fast foods (Taveras, 2006). Television viewing increases the amount of unconscious eating in young children. Another article states that obese children are more suseptable to food related cues. Moreover, exposure to such cues induce increased food intake in all children (Halford, 2004). The article also described different factors in the relationship between television viewing and childhood obesity, one of which being inactivity. These just being a few factors and all must be taken into consideration when dealing with childhood obesity.

<span style="font-family: Arial,Helvetica,sans-serif;">The article titled Commercials are the Culprit in TV-Obesity Link is in my opinion more “noise” than “news” and unduly confuses parents of the factors related to childhood obesity. The author, Fred Zimmerman, wrote several articles one of which stated that watching greater than 2 hours per day of TV and or videos in U.S. preschool-age children was associated with a higher risk of being overweight or at risk for overweight and higher adiposity-findings in support of national guidelines to limit preschool children's media use. Computer use was also related to higher adiposity in preschool children (Zimmerman, 2009). Embedded commercials may alter a child’s food preference, but there are too many other factors to consider when dealing with childhood obesity.

<span style="font-family: Arial,Helvetica,sans-serif;">Conclusion
<span style="font-family: Arial,Helvetica,sans-serif;">The media is presenting the obesity epidemic through headlines that focus on one cause and one hopeful solution. This makes the general public believe in a quick fix approach to weight loss. The headlines take truths from credible research and attempt to simplify data for the common consumer. Headlines confuse consumers in different ways including overgeneralizing, and misinterpreting. <span style="font-family: Arial,Helvetica,sans-serif;">In the case of the Losing10 Pounds Boosts your Immunity it gives the impression that if anyone loses 10 pounds it will increase their immunity. When in actuality it can only be applied to an obese population with specific comorbidities. This is an example of overgeneralization. <span style="font-family: Arial,Helvetica,sans-serif;">Glancing through an article can cause misinterpretations because the information isn’t read in depth. The media often uses sensationalism to pull readers in, but often readers do not get past the headline to understand the article and may alter habits or lifestyles off a small bit of information. <span style="font-family: Arial,Helvetica,sans-serif;">Obesity is a growing problem that will require multiple interventions to reverse. Changes in lifestyle such as energy balance, healthy diet, and physical activity levels all need to be included in the efforts to maintain a healthy weight and decrease obesity rates. <span style="font-family: Arial,Helvetica,sans-serif;">References

<span style="font-family: Arial,Helvetica,sans-serif;">Berkey CS, Rockett HRH, Willett WC, Colditz GA. Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents. Arch Pediat Adol Med. 2005; 159(6): 543-50.

<span style="font-family: Arial,Helvetica,sans-serif;">Borzekowski DLG, Robinson TN. The 30-second effect: An experiment revealing the impact of television commercials on food preferences of preschoolers. [Journal of the American Dietetic Association.] 2001;101:42-46.

<span style="font-family: Arial,Helvetica,sans-serif;">Cottam DR, Schaefer PA, Shaftan GW, et al. Dysfunctional Immune-Privilege In Morbid Obesity: Implications and Effect of Gastric Bypass Surgery. Obesity Surgery. 2003;13:49-57.

<span style="font-family: Arial,Helvetica,sans-serif;">Eller LK, Reimer RA. A high calcium, skim milk powder diet results in a lower fat mass in male, energy- restricted, obese rats more than a low calcium, casein, or soy protein diet. The Journal of Nutrition. July 2010; 140(7):1234-41.

<span style="font-family: Arial,Helvetica,sans-serif;">Halford JCG, Gillespie J, Brown V, Eleanor EP, Terence MD. Effect of Television Advertisements for Foods on Food Consumption in Children. J.C.G Halford et al. / Appetite. 2004;221-225.

<span style="font-family: Arial,Helvetica,sans-serif;">Melhorn SJ, Krause EG, Scott KA, Mooney M, Johnson JD, Woods SC, Sakai RR. Meal Patterns and Hypothalamic NPY Expression During Chronic Social Stress and Recovery. American Journal of Physiology - Regulatory, Integrative and Comparative Physiology. 2009.

<span style="font-family: Arial,Helvetica,sans-serif;">Nieman DC, Henson DRUA, Nehlsen-Cannarella SL, et al. Influence of obesity on immune function.Journal of the American Dietetic Association.1999;99(3):294-299.

<span style="font-family: Arial,Helvetica,sans-serif;">Rajpathak SN, Rimm EB, Rosner B, Willett WC, Hu FB. Calcium and dairy intakes in relation to long-term weight gain in US men. Am J Clin Nutr. 2006; 83(3): 559-66.

<span style="font-family: Arial,Helvetica,sans-serif;">Reish LA, Gwozdz W. Chubby Cheeks and Climate Change: Childhood Obesity as a Sustainable Development Issue. International Journal of Consumer Studies. 2010; 1-7.

<span style="font-family: Arial,Helvetica,sans-serif;">Shahar DR, Schwarzfuchs D, Fraser D, Vardi H, Thiery J, Fielder GM, Bluher M, Stumvoll M, Stampfer MJ, Shai I. Dairy calcium intake, serum vitaminD, and successful weight loss. Am J Clin Nutr. 2010; 1-5.

<span style="font-family: Arial,Helvetica,sans-serif;">Tan-Ting AM, Llido L. Outcome of a hospital based multidisciplinary weight loss program in obese Filipino children. Nutrition. 2010;1-5.

<span style="font-family: Arial,Helvetica,sans-serif;">Taveras EM, Sandora JT, Shih M-C, DD, Goldmann DA, Gillman MW. The Association of Television and Video Viewing with Fast Food Intake by Preschool-Age Children. Obesity Research Journal. 2006;14:2034-2041.

<span style="font-family: Arial,Helvetica,sans-serif;">U.S. Obesity Trends. Centers for Diesease Control. Available at: []. Accessed November 9, 2010.

<span style="font-family: Arial,Helvetica,sans-serif;">Viardot A, Lord RV, Samaras K. The effects of weight loss and gastric banding on the innate and adaptive immune system in type 2 diabetes and prediabetes. J ClinEndocinolMetab. 2010;95(6):2845-50.

<span style="font-family: Arial,Helvetica,sans-serif;">Weigel C, Kokocinski K, Lederer P, Dotsch J, Rascher W, Knerr I. Childhood obesity: concept, feasibility, and interim resurlts of a local group-based, long-term treatment program. J Nutr Educ Behav. 2008;40(6): 369-73.

<span style="font-family: Arial,Helvetica,sans-serif;">Yanovski JA, Parikh J, Yanoff LB, et al. Effects of calcium supplementation on body weight and adiposity in overweight and obese adults: a randomized clinical trial. Ann Intern Med. 2009; 150(12): 821-W146.

<span style="font-family: Arial,Helvetica,sans-serif;">Zhou J, Zhao LJ, Watson P, et al. The effect of calcium and vitamin E supplementation on obesity in postmenopausal women: secondary analysis for a large-scale, placebo controlled, double-blind, 4-year longitudinal clinical trial. Nutrition & Metabolism. 23 July 2010; 7:62

<span style="font-family: Arial,Helvetica,sans-serif;">Zimmerman FJ,Bell JF. Associations of Television Content Type and Obesity in Children. American Journal of Public Health 2010;100(2):334-340