Give slim kids higher marks, says French diet guru

PARIS (Reuters) - Pierre Dukan, the nutritionist behind the popular but controversial Dukan diet, has suggested that France tackle child obesity by giving extra exam marks for slimness.

Dukan, who has sold 8 million copies of his diet book worldwide, made the proposal in a 250-page book called 'An Open Letter to the Future President', which he sent out on Tuesday to 16 candidates for France's presidential election.

The plan calls for high school students to be allowed to take a so-called "ideal weight" option in their final year exams, the "baccalaureat," under which they would earn extra points if they kept a body mass index (BMI) of between 18 and 25.

Those already overweight at the start of the two-year course would score double points if they managed to slim down over a period of two years.

"It's a fantastic motivator," Dukan told Reuters.

"The baccalaureat is really important in France. Kids want to get it, their parents want them to even more, so why not get them to work together on nutrition?"

Weight gain is becoming an increasing problem in France and experts say sedentary lifestyles and poor nutrition are to blame.World Health Organisation (WHO) figures show 50.7 percent of the population were overweight in 2010, including 18.2 percent classed as obese.

"There's a real problem. Since the 1960s the number of overweight people in France has risen from 500,000 to 22 million and it's going up every year," Dukan said.

"When you reach those levels, it's no longer a health problem, it becomes a political problem, and the leaders of the nation need to worry about it."

As well as the suggestion for students, Dukan's book, which will hit French bookshops on Thursday, contains a further 119 suggestions for the future president on ways to fight obesity.

One idea is the creation of a French fast-food restaurant serving more nutritional versions of the ubiquitous burgers and fries.

Dukan has earned an international reputation as diet guru to the stars, although his methods have drawn criticism from some health experts and weightwatchers who say his high-protein meal plan causes fatigue, bad breath and dizziness. But he is also a committed campaigner for the promotion of healthier lifestyles.

He recently met executives from McDonald's France with a suggestion for a healthy "McDukan" burger, made with low-fat meat and with oatmeal bread instead of the usual white bun. Unfortunately, the giant food chain turned him down.

"They were interested, but they said the public wasn't quite ready for it yet," he said.

The BMI, obtained by dividing a person's weight by the square of their height, is used as an indicator of the proportion of body fat. The WHO defines a BMI of 18.5 to 25 as normal, 25 to 30 as overweight, and over 30 as obese.

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Modest exercise cuts obese women's blood pressure

NEW YORK (Reuters Health) - Even fairly modest amounts of exercise can help older obese women lower their blood pressure numbers, a new clinical trial suggests.

In a study that randomly assigned 404 women to exercise or not, researchers found that lower-intensity activity -- walking on a treadmill or pedaling an exercise bike -- curbed what's known as exercise blood pressure.

That refers to blood pressure levels during physical activity, including daily routines like walking around a store or climbing stairs.

While it's normal for blood pressure to rise when we're active, steeper increases have been linked to a heightened risk of heart disease -- independent of a person's usual blood pressure at rest.

So the new findings, the researchers say, reinforce the importance of staying physically active.

"Try to keep finding ways to fit more physical activity into your life," said lead researcher Damon L. Swift, of the Pennington Biomedical Research Center in Baton Rouge, Louisiana.

It's familiar advice. But the findings, reported in the journal Menopause, strengthen the case for exercise, say the authors, because they come from a well-designed study in which sedentary women were randomly assigned to exercise or stay inactive.

The fact that exercisers showed a blood pressure benefit suggests that the exercise, itself, deserves the credit.

For the study, Swift and his colleagues recruited 404 women ages 45 to 75 who were overweight or obese, sedentary and had higher-than-normal blood pressure.

They randomly assigned the women to one of four groups: three that exercised at different levels for six months and one that stuck with their usual lifestyle.

In one exercise group, the women got the equivalent of what experts generally recommend for most adults: about 2.5 hours of moderate activity per week.

A second group got only about half that amount of exercise, while the third worked harder -- equivalent to almost 4 hours of moderate activity per week.

In the end, all three exercise groups showed improvements in their exercise blood pressure. In the most-active group, systolic blood pressure (the "top" number) dropped by an average of about 14 points.

But the least active group was close behind, shaving 11 points off their systolic blood pressure.

Exercise did not change the women's blood pressure at rest, however.

But since high exercise blood pressure may put a strain on the heart, lowering it -- even without effects on resting blood pressure -- might do the heart good, according to Swift.

And even people who do not have full-blown chronic high blood pressure may have abnormal exercise readings.

"One of the things we saw was that even among women with pre-hypertension, a good portion had abnormally elevated exercise blood pressure," Swift said.

'IT DOESN'T TAKE A LOT OF EXERCISE'

At the study's start, 204 women had pre-hypertension -- higher than 120/80 millimeters of mercury (mm Hg), but lower than the threshold for high blood pressure, which is 140/90 mm Hg. Of those women, about 40 percent had abnormally high exercise blood pressure.

According to Swift, the bottom line for current couch potatoes -- men and women of all ages -- is that it doesn't take a lot of exercise to see potential health benefits.

"A lot of people think of exercise as this big thing that will take up a lot of their time," Swift said. But simple things like a walk around your neighborhood can fit the bill, he noted. "You don't have to go to the gym."

And don't get discouraged if you fail to shed pounds, Swift said. In this study, women who exercised did not lose weight, but they did lower their exercise blood pressure and boost their overall cardiovascular fitness levels.

It is always wise, however, for sedentary overweight people to have a check-up with the doctor before becoming active.

"It's good to know if you have a condition that could be aggravated by exercise," Swift noted.

SOURCE: http://bit.ly/xpRSqs Menopause, online December 12, 2011.

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Study shows memory loss can start as early as 45

LONDON (Reuters) - Loss of memory and other brain function can start as early as age 45, posing a big challenge to scientists looking for new ways to stave off dementia, researchers said Thursday.

The finding from a 10-year study of more than 7,000 British government workers contradicts previous notions that cognitive decline does not begin before 60 years of age, and it could have far-reaching implications for dementia research.

Pinpointing the age at which memory, reasoning and comprehension skills start to deteriorate is important because drugs are most likely to work if given when people first start to experience mental impairment.

A handful of novel medicines for Alzheimer's disease, the most common form of dementia, are currently in clinical trials, but expectations are low and some experts fear the new drugs are being tested in patients who may be too old to show a benefit.

The research team led by Archana Singh-Manoux from the Center for Research in Epidemiology and Population Health in France and University College London found a modest decline in mental reasoning in men and women aged 45-49 years.

"We were expecting to see no decline, based on past research," Singh-Manoux said in a telephone interview.

Among older subjects in the study, the average decline in cognitive function was greater, but there was a wide variation at all ages, with a third of individuals aged 45-70 showing no deterioration over the period.

"It doesn't suddenly happen when you get old. That variability exists much earlier on," Singh-Manoux said. "The next step is going to be to tease that apart and look for links to risk factors."

HEALTHY LIFESTYLE

Participants were assessed three times during the study, using tests for memory, vocabulary, and aural and visual comprehension skills.

Over the 10-year period, there was a 3.6 percent decline in mental reasoning in both men and women aged 45-49 at the start of the study, while the decline for men aged 65-70 was 9.6 percent and 7.4 percent for women.

Since the youngest individuals at the start of the study were 45, it is possible that the decline in cognition might have commenced even earlier.

Singh-Manoux said the results may also have underestimated the cognitive decline in the broader population, since the office workers in the study enjoyed a relatively privileged and healthy lifestyle.

Factors affecting cardiovascular function -- such as obesity, high blood pressure, high cholesterol and smoking -- are believed to impact the development of Alzheimer's and vascular dementia through effects on brain blood vessels and brain cells.

The research findings were published in the British Medical Journal, alongside an editorial by Francine Grodstein of the Brigham and Women's Hospital in Boston, who described the results as convincing.

Most research into dementia has focused on people aged 65 and over. In future, scientists will need to devise long-term clinical studies that include much younger age groups and may have to enroll tens of thousands of participants, she said.

One way to deal with this "major challenge" might be to use computerised cognitive assessment tests, rather than face-to-face interviews, although more research is still needed on this approach, she added.

SOURCE: http://bit.ly/xmiz8B BMJ, January 5, 2012.

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Diabetes in pregnancy, poverty linked to ADHD

NEW YORK (Reuters Health) - Babies born to poor mothers with pregnancy-related diabetes have an extra-high risk of developing attention-deficit/hyperactivity disorder, a new study suggests.

So-called gestational diabetes typically develops during the second or third trimester of pregnancy, especially in women who are overweight before getting pregnant, eat an unhealthy diet and don't exercise. It affects between two and 10 percent of pregnant women, according to national data, and rates are rising alongside type II diabetes in the general public.

While the new study doesn't prove that moms' gestational diabetes leads to ADHD in kids, it's likely that diabetes-related changes in the blood shared by mother and fetus could affect how babies' brains develop, researchers said.

"There seems to be more research going in the direction that... the brains of children with ADHD are different," said Ginette Dionne, who has studied gestational diabetes and language development at Laval University in Quebec but wasn't involved in the new study.

"Gestational diabetes may not be a specific cause (of ADHD), but may be one of the factors that affects brain development," she added.

Researchers from the Mount Sinai School of Medicine in New York led by Dr. Yoko Nomura recruited 212 preschoolers for their study, two-thirds of whom were at risk for ADHD, based on teacher and parent reports.

According to interviews with their moms, 21 had been diagnosed with gestational diabetes while pregnant.

The researchers found that at ages three to four, kids whose mothers had had gestational diabetes scored worse on tests of language, memory and IQ than those with diabetes-free moms. And at age six, they had more communication and attention problems.

The effect seemed to be most pronounced in kids born to moms with gestational diabetes who were also poor. Those kids were 14 times more likely to meet the criteria for an ADHD diagnosis at age six, compared to kids of moms who were middle class or well-off and hadn't had gestational diabetes.

Babies of women who'd had gestational diabetes but weren't poor, or were poor but diabetes-free, were not at increased risk of ADHD, the researchers report in the Archives of Pediatrics & Adolescent Medicine.

In cases of gestational diabetes, babies get exposed to extra glucose in the blood that passes through the placenta, researchers said. Diabetes could also affect the amount of oxygen or iron in that blood.

Something about the altered blood, or the way the baby's body responds to it, may interfere with brain development.

"Really right now we have no idea what the specific culprit is," Dionne told Reuters Health.

"What the cumulative data is showing is there is something happening to the brain development of babies of these mothers that have gestational diabetes, and it doesn't seem to affect all babies equally."

Environment after birth also appears to play a role -- kids who grow up in disadvantaged families might not be able to bounce back from early developmental issues, according to experts.

"If you have a subtle problem, if you have better medical care, better food, better intellectual stimuli, you might be able to fix it," Nomura told Reuters Health.

"But if you're born into a harsher, more adverse environment, maybe that tiny little problem acts as a bigger hindrance developmentally."

Researchers agreed that the findings reinforce the importance for women who are planning to become pregnant of getting their weight under control and improving their diet to lower their chances of developing gestational diabetes.

"It is equally important not to frighten pregnant women because (gestational diabetes) is relatively common," said Asher Ornoy, who studies the effects of gestational diabetes at the Hebrew University of Jerusalem, Israel, in an email to Reuters Health.

"Hence preventive measures -- early diagnosis, good nutrition in pregnancy, avoiding overweight... are very important."

SOURCE: http://bit.ly/yxbpbf Archives of Pediatrics & Adolescent Medicine, online January 2, 2012.

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