Booster Shots

Oddities, musings and news from the health world

Category: obesity

Harvard researchers conduct a real-world test of soda taxes

June 17, 2010 |  4:00 pm

Another day, another study on soda taxes.

Soda But this one isn’t based on mathematical models or unreliable food frequency questionnaires. This time, researchers at Harvard implemented a temporary soda tax in the cafeteria of the school's Brigham and Women’s Hospital in Boston. Then they waited to see whether actual people changed their drinking habits.

It turns out that they did. During a four-week period when the price of a 20-ounce bottle of soda went up by 45 cents – which amounted to a 35% price increase – sales fell by 26%. Meanwhile, sales of bottled diet soda rose by 20%. (The researchers said they were unable to change the prices of fountain drinks, so those soft drinks were not subject to the tax.)

Prices for full-calorie soda went back to normal after the test period, but sales ticked back up only slightly. Then researchers posted fliers around the cafeteria that said:

"Lose up to 15-25 pounds in one year and decrease your risk of diabetes by 1/2. Just skip one regular soda per day. For zero calories, try diet soda or water."

Those fliers remained up for four weeks, but sales of bottled soda didn’t fall during that period – in fact, they rose slightly.

Finally, the researchers reinstated the 45-cent soda tax while keeping the fliers up for another four weeks. That cut into sales of bottled soda, prompting a 36% decline compared with the weeks before the prices first changed.

The researchers concluded that taxes can work – only the price increase had a statistically significant effect on sales of sugared soda. When the tax was in place, diners switched to diet soda and coffee; sales of water and fountain drinks stayed the same throughout the study.

The researchers also wondered whether people who skipped their usual sodas would reward themselves by buying more snacks and desserts, but sales of those treats didn’t change either.

Of course, there was no way to tell whether anyone actually lost weight – or reduced their risk of health problems like obesity and diabetes – as a result of the tax.

The results were published online Thursday by the American Journal of Public Health.

-- Karen Kaplan

Photo: Higher prices encouraged consumers to switch from regular soda to diet soda or coffee. Credit: Justin Sullivan / Getty Images

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Obesity takes a toll on sexual health

June 15, 2010 |  6:29 pm

It is well known that obesity raises one’s risk of developing type 2 diabetes, heart disease, stroke, high blood pressure and certain types of cancer, among other health problems. But how does it affect one’s sex life? Leave it to the French to provide the answer.

Sex In a study to be published online Wednesday in the British Medical Journal, researchers from the National Institute of Health and Medical Research in Paris and the London School of Hygiene and Tropical Medicine report that obese men and women have more health issues related to sex than people of normal weight. Using data collected during lengthy phone interviews with more than 10,000 French adults, they found that:

  • Compared with women of normal weight, obese women were 30% less likely to have had a sexual partner in the previous year.
  • Obese women in their late teens and 20s were three times as likely to have met a sexual partner online and twice as likely to have watched a pornographic movie.
  • Among women in their late teens and 20s, obese women were four times more likely than normal-weight women to report an unintended pregnancy or an abortion.
  • Perhaps this was because they were 70% less likely to use birth control pills and eight times more likely to rely on “less effective methods, such as withdrawal.”

As for the guys:

  • Compared with men of normal weight, obese men were 70% less likely to have had more than one sexual partner in the previous year (but equally likely to have had at least one).
  • Obese men were more than twice as likely than normal-weight men to have experienced erectile dysfunction in the previous year.
  • Among men in their late teens and 20s, the odds of contracting a sexually transmitted disease in the previous five years were more than 10 times greater for obese men than for men of normal weight.

“The study lends a new slant to a familiar message: that obesity can harm not only health and longevity, but your sex life,” concludes an editorial that accompanies the study.

-- Karen Kaplan

Photo: Carrying around extra pounds can put a damper on your sex life, researchers say. Credit: iStockphoto

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Which comes first: Obesity or depression?

June 10, 2010 |  1:01 pm

Obesity2 Obesity and depression are often linked, but it's not clear whether one condition tends to precede the other. One new study suggests depression may help cause obesity, but obesity doesn't necessarily cause depression.

Researchers at the University of Alabama, Birmingham, looked at data from a longitudinal study of more than 5,000 men and women ages 18 to 30. Over the 20-year study, participants' waist circumference and body mass index was measured and they were asked about symptoms of depression.

The study found that the waist circumference among the people who started the study with depression was about 1 inch larger than those who started the study reporting lower levels of depression. This was true regardless of race, gender, ethnicity and education level. In contrast, those who started the study with higher body-mass index and waist circumference did not show a change in depression symptoms over time.

"If you are interested in controlling obesity, and ultimately eliminating the risk of obesity-related diseases, then it makes sense to treat people's depression," the lead author of the study, Belinda Needham, said in a news release.

There is a possible physiological explanation why the two conditions occur together. Both conditions are linked to higher levels of the stress hormone cortisol.

The study is published in the June issue of the American Journal of Public Health.

-- Shari Roan

Photo: Tim Sloan  /  AFP/Getty Images

A psychologist explains our hatred of the soda tax

June 7, 2010 |  2:38 pm

Among the myriad topics we tackle here at Booster Shots, none seem to invoke more outrage than the so-called soda tax. Now Sheena Iyengar, a social psychology professor at Columbia Business School, tells us why: People simply hate being told what not to do.

Soda tax Psychologists have a name for this -- reactance. The power of this emotion was captured in a 1976 study comparing the efficacy of two signs meant to curb vandalism in a public restroom. One politely asked users to refrain from writing on the stalls. The other said: "Do NOT write on the walls!" Guess which sign was surrounded by more graffiti?

The same instinct is responsible for the outpouring of hate against the proposed tax on sodas and sugar-sweetened beverages, Iyengar writes in Slate. She should know -- she recently published a 352-page book called "The Art of Choosing."

And if any further confirmation is necessary, check out some of the 100+ comments her essay has prompted so far. Among them, "Poet Doc" writes that:

We're all forgetting one important point here: America is supposedly a free country, therefore I have a right to be as unhealthy as I choose to be.

And "Robert" chimes in that:

As free people we are not subject to what the government decides is behavior that should be favored. Should we tax people who don't graduate from school? Should we tax beef? Fast Food? Motorcycles? Cars that go over 35 miles per hour? All of these are bad for the individuals, and cost the government money to care for us.

Reactions like these underscores why a soda tax -- if it ever came to pass -- might backfire. "In the real world," Iyengar writes, "people's desire to assert their freedom to drink soda may very well trump the disincentive of higher cost."

-- Karen Kaplan

Photo: Consumers see freedom in these bottles of sugary drinks. Credit: David McNew / Getty Images

Attention to beverage calories grows, but has yet to catch up with waistlines

May 27, 2010 | 10:50 am

Drink Calories count, even if they're not chewed. Consumers know this, and yet still they splurge. (Often daily. At every meal. And in between meals.) But, finally, it seems, they're starting to do the math, even as researchers are analyzing the finer effects of what we drink.

The journal Physiology & Behavior recently devoted an entire issue to beverages and health.

Among the featured papers:

-- Patterns of beverage use across the lifecycle. The upshot: Kids are lapping up increasing amounts of  treacly drinks; so are adults. Adults over 60, however, seem to cut back on beverages in general.

From the abstract: "The consumer shift toward increased levels of [sugar-sweetened beverages] and alcohol, limited amounts of reduced fat milk along with a continued consumption of whole milk, and increased juice intake represent issues to address from a public health perspective."

-- Dairy beverages and energy balance. The upshot: Calcium is good for you; don't skimp on it.

From the abstract: "A new line of evidence suggests that an inadequate calcium intake during an energy restricted weight loss program may trigger hunger and impair compliance to the diet."

-- Alcohol, appetite and energy balance: Is alcohol intake a risk factor for obesity? The upshot: Some alcohol seems to be good; more is probably bad.

Water From the abstract: "Epidemiological data suggests that moderate alcohol intake may protect against obesity, particularly in women. In contrast, higher intakes of alcohol in the absence of alcohol dependence may increase the risk of obesity, as may binge-drinking, however these effects may be secondary to personality and habitual beverage preferences."

And now we have the just-released Drink This, Not That!, both for consumers who prefer the simplicity of being told what to do and for those who enjoy marveling at the shocking number of calories available for a relative pittance. (Perhaps you've perused Eat This, Not That! Same  approach.)

The new offering gives this example, among  others: A Gotta Have It (i.e. large) sized PB&C shake from Cold Stone Creamery: 2,010 calories.

It's unclear just how popular such an offering is -- or whether an almost-500 calorie alternative is truly the best way to go.

But attention to such details is good. And overdue.

Here's CalorieCount's offering of calories in beverages -- many, many beverages to be exact.

And here's some free advice on choosing beverages from the Centers for Disease Control and Prevention. Among the tips: Skip whipped cream at the coffee shop. Ask that smoothies be prepared without added sugar. And then there's this: Drink water with meals.

It's crazy enough, it just might work.

-- Tami Dennis

Photos: Don't kid yourself. Credits: Los Angeles Times

The FDA cites rare risk of liver damage with weight-loss drugs Xenical and Alli

May 26, 2010 | 11:02 am

The Food and Drug Administration said Wednesday that it is ordering a revision of the labels of the weight-loss drugs Xenical and Alli to warn of the risk of very rare cases of severe liver damage associated with their use. The active ingredient in both drugs is orlistat, which blocks the absorption of fats in the intestines. Xenical is a prescription form of the drug. Alli is an-over-the-counter version which contains lower doses.

The agency said it had identified 13 cases of severe liver damage associated with the drugs, one in the United States and 12 abroad. Two of the patients died from liver failure and three others required liver transplants. The FDA said it could not positively say that the drug caused the damage because there is insufficient data in most of the cases. Some of the patients, for example, might have been taking other drugs or had other medical conditions that could have caused the injury. Worldwide, more than 40 million people have taken either Xenical or Alli, so the cases are very rare.

Patients taking the drugs should contact their physicians if they develop itching, yellow eyes or skin, dark urine, loss of appetite, or light-colored stools, all of which are signs of liver damage.

-- Thomas H. Maugh II

And the Xtreme Eating awards go to ... really fattening restaurant food

May 25, 2010 |  2:59 pm

Hold on to your stomachs -- the Center for Science in the Public Interest has come out with its Xtreme Eating awards, giving dubious honors to restaurant fare that maxes out on fat and calories.

Ky0nyencAmong the winners (or should that be losers?) is the pasta carbonara at Cheesecake Factory; when served with chicken this dish comes in at 2,500 calories and 85 grams of saturated fat. Also on the list is the New Zealand rack of lamb at Outback Steakhouse. The lamb alone (no sides) is 1,300 calories and 60 grams of saturated fat, plus 1,340 milligrams of sodium (recommended daily allowance of sodium is from 2,400 milligrams for a healthy adult, although some health experts think it should be far lower).

Cinnamon cream stacked and stuffed hotcakes at Bob Evans will set you back 1,380 calories, 27 grams of saturated fat, and 7 grams of trans fat. That's about the same calories and fat, said CSPI, as two country-fried steaks and four eggs. California Pizza Kitchen has a tostada pizza on its menu that, when served with steak as a topping, has 1,680 calories, 32 grams of saturated fat and -- you'd better sit down for this -- 3,300 milligrams of sodium.

"One might think that chains like Outback Steakhouse and the Cheesecake Factory might want to lighten up their meals now that calories will be required on their menus, courtesy of the health care reform law signed in March," said Michael Jacobson, CSPI's executive director, in a news release. The Washington D.C.-based organization is known for bringing the public's attention to examples of outrageously fattening restaurant foods. "But these chains don't promote moderation. They practice caloric extremism, and they're helping make modern-day Americans become the most obese people ever to walk the Earth."

Restaurant menu labeling is already in effect in several areas around the country, including California. Although Jacobson is understandably pessimistic about the effect the law will have, some restaurants have started to clean up their act or at least devise marketing campaigns to draw customers' attention to more healthful fare. Romano's Macaroni Grill has tweaked some of its tried-and-true recipes as well as put new, lighter dishes on the menu. And Applebee's and Corner Bakery have highlighted lower-calorie menu choices, making it a no-brainer for people to choose less fattening meals.

Of course, if you're in the mood for a splurge, you can indulge in Cheesecake Factory's chocolate tower truffle cake, with 1,670 calories and 48 grams of saturated fat per slice. We loved this description from CSPI: "Even half a tower leaves each person with a load of calories to store somewhere. 'Layers and Layers of Fudge Cake with Chocolate Truffle Cream and Chocolate Mousse,' says the menu. Say hello to layers and layers of you."

We'll have ours with a small Diet Coke.

-- Jeannine Stein

Photo: Cheesecake Factory got dinged by the Center for Science in the Public Interest for its high-calorie offerings. Photo credit: Ken Kwok / Los Angeles Times

Rodent of the Week: Male fat is different from female fat

May 21, 2010 |  1:01 pm

Men often carry extra weight on their stomachs while women tend to accumulate fat on the butt, hips and thighs. A new mouse study suggests why: It seems that female fat tissue and male fat tissue behave very differently.

Researchers at UT Southwestern Medical Center in Dallas examined mouse genes (fat distribution in mice is similar to humans) and found only 138 genes that were common to both male and female fat cells. That means that fat on men is governed by a largely different gene expression profile than fat on women.

After menopause, women's fat distribution often changes and women become more susceptible to belly fat. A woman's risk of heart disease also rises. The discovery of distinct male and female fat genes might yield clues to understanding what happens after menopause, said the lead author of the study, Dr. Deborah Clegg.

The study also showed that male mice consuming a high-fat diet for 12 weeks gained more weight than female mice on the same diet. The male's fat tissue also became more inflamed than the females' fat. But when the female mice had their ovaries removed to induce menopause, their fat began looking much more like male fat.

"However, estrogen replacement therapy in the mice reduced the inflammation and returned their fat distribution to that of mice with their ovaries intact," Clegg said in a news release.

The study raises the possibility that hormones produced by the ovaries determine where fat is deposited in women. Clegg's future research will focus on whether a type of hormone replacement therapy can be developed for postmenopausal women to protect them from belly fat accumulation and heart disease.

The study was published this week in the International Journal of Obesity.

-- Shari Roan

Book Review: 'The Stress-Eating Cure' by Rachael F. Heller and Richard F. Heller

May 15, 2010 |  1:57 pm


Many dieters will see themselves in the portraits of overeaters presented in “The Stress-Eating Cure,” by Rachael F. Heller and Richard F. Heller, authors of the popular “Carbohydrate Addict” books. 

The Hellers write in their new book about the anxiety-induced stress eater, the task-avoiding stress eater, the person who eats on the sly. They describe people whose overeating is triggered by social situations, those who eat to reward themselves for self-sacrifice and others who eat on the run, barely tasting their food.

The 11 types of stress eaters they identify have something in common, they say: Their overeating, cravings and weight gain are caused not by a lack of discipline and willpower but by a hormonal imbalance.

Unlike those whose bodies produce the right amount of hormones in the face of unpleasant circumstances, stress eaters -- who often are more sensitive to their environments -- respond to stress with “trigger-quick” hormonal reactions, the Hellers say. The hormones at play are ghrelin, serotonin, oxytocin and leptin as well as insulin, cortisol and adrenaline. 

Each type of stress eater is prone to surges and deficiencies in these hormones in different combinations, the authors say. The Hellers offer a diet they say will help bring these hormones back into balance and relieve stress, plus behavioral modification programs that are tailored to each type.

Continue reading »

Some clergy may have higher obesity and chronic disease rates than their congregations

May 14, 2010 | 11:46 am

Being a member of the clergy has its responsibilities, but the demands of the job may take a bigger toll than most people think. A new study found that some clergy members had higher rates of obesity and chronic diseases than their non-clergy counterparts.

L1bx87nc The study, published online recently in the journal Obesity, surveyed 1,726 male and female members of the United Methodist clergy in North Carolina, asking their height and weight and if they'd ever been diagnosed with conditions such as high blood pressure, diabetes, coronary heart disease and asthma. The clergy members were predominately male (75%), white (91%), married (87%), older (average age 52) and highly educated.

Researchers from the Duke University Center for Health Policy found that obesity rates among all clergy ages 35 to 64 was 39.7%, about 10% higher than the general population of North Carolina. Obesity rates among male clergy ages 45 to 54 was 14.2% higher than North Carolinian men. However, fewer clergy were overweight compared to the general population -- 34.9% compared to 40.3%.

Clergy members also had significantly higher incidences of being diagnosed with certain chronic diseases, including diabetes, arthritis, high blood pressure and asthma.

In the paper, the authors wrote: "Unfortunately, clergy face numerous challenges to exercise and healthy eating habits. These challenges include a vocation that is sedentary, with an average of four evenings per week away from home, and frequent work weeks of [more than 50 hours] with little schedule predictability." They added, "We can only speculate as to why self-reported disease rates were higher for clergy. Obesity is likely one contributing factor. Another reason may be a tendency among clergy to put the needs of others before their own, in their work to serve God."

-- Jeannine Stein

Photo credit: Markus Schreiber / Associated Press


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