In Memorium: Albert (Mickey) J Stunkard

In Memorium: Albert (Mickey) J Stunkard


In Memorium: Albert (Mickey) J Stunkard

Posted: 23 Jul 2014 05:00 AM PDT

Stunkard twinsAs I spend my days at the 9th Canadian Obesity Network’s Summer Bootcamp for young trainees from Canada and around the world, I was saddened to learn of the passing of Mickey Stunkard, clearly one of the biggest names in obesity research – at a healthy age of 92.

With well over 500 publications to his name, Mickey is perhaps best known for his twin studies showing that the body weight of adopted identical twins reared apart resembles each other and that of their biological parents rather than the weight of their adoptive parents.

This work helped establish the basis for much of the genetic work on obesity that followed, clearly showing that differences in body weight between two individuals are much more accounted for by their difference in genetics than by differences in their “lifestyles”.

These findings were often misused in “nature vs. nurture” debates, an issue that serious scientists have long laid to rest in light of our current understanding that the two cannot be discussed separately, simply because genes and lifestyle interact on virtually every level – from molecules, to cells, to behaviours.

Here is what one obituary had to say about Mickey:

“He surveyed obesity treatment studies in the late ’50s and found that the nation’s diet programs could claim only a 2 percent success rate. He was an early advocate for the use of bariatric surgery to induce weight loss. He also published the first modern account of binge eating in obese individuals.”

I have had to pleasure to often hear him speak at conferences.

He will be dearly remembered.

@DrSharma
Kananaskis, AB

 

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9th Annual Canadian Obesity Network Obesity Research Bootcamp

9th Annual Canadian Obesity Network Obesity Research Bootcamp


9th Annual Canadian Obesity Network Obesity Research Bootcamp

Posted: 22 Jul 2014 05:00 AM PDT

CON Bootcamp 2014As regular readers will be well aware, each year I attend the Canadian Obesity Network’s Obesity Research Bootcamp, an intense 10-day course for hand-picked young obesity researchers from Canada and around the world.

This year the trainees from Canada (13), Germany (8), Argentina (3), Chile (1), Malaysia (2), Peru (1), Spain (1), USA (1) come from a wide range of research areas – from molecular genetics to health psychology.

Following the opening address by Philip Sherman, Director of the Canadian Institutes of Heath Institute for Nutrition, Metabolism and Diabetes (CIHR-INMD), the course began yesterday with small-group learning sessions on defining and measuring obesity (Ian Jannsen, Queen’s University), weight bias and discrimination (Mary Forhan, University of Alberta), mental health issues (Valerie Taylor, University of Toronto), and energy balance (Eric Ducet, University of Ottawa).

These were complemented by presentations from the trainees on their own work and journal-club style discussion of key papers on relevant issues.

Not least, the camp also encourages networking and discussions that push the trainees to remarkably broaden their perspective on obesity.

I certainly look forward to an intense week at bootcamp.

@DrSharma
Kananaskis, AB

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Obesity Weekend Roundup, July 18, 2014

Obesity Weekend Roundup, July 18, 2014


Obesity Weekend Roundup, July 18, 2014

Posted: 20 Jul 2014 05:00 AM PDT

As not everyone may have a chance during the week to read every post, here’s a roundup of last week’s posts:

Have a great Sunday! (or what is left of it)

@DrSharma
Kanaskis, AB

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Birth Control And Obesity

Birth Control And Obesity


Birth Control And Obesity

Posted: 18 Jul 2014 05:00 AM PDT

sharma-obesity-birth-control-pillAlthough obesity is a well-recognised factor for female infertility, the vast majority of women with excess weight are probably more interested in effective birth control.

That this is not as simple as it seems is evident from an article by Sheila Mody and Michelle Han from the University of California, San Diego, published in Clinical Obstetrics and Gynecaology.

The paper succinctly reviews a wide range of issues related to birth control and obesity.

To begin with, the authors points out that unintended pregnancies in obese women are often a problem simply because obese women are far less likely to use effective contraception than non-obese women. This non-use may in part be attributable to fear of weight gain, when most studies show that modern hormonal contraception is associated with almost no weight gain. The exception appears to be depot-medroxyprogesterone (DMPA), which may cause about 5 lb weight gain in the first year of use.

As for efficacy, the data show that unintended pregnancy rates among overweight women using oral contraceptives are similar or slightly higher than that among nonoverweight women. The reasons for these higher rates are not exactly clear.

Fortunately, the efficacy of intrauterine devices (IUD) appear no different between obese and non-obese women although the insertion of an IUD maybe more difficult in obese women because of poor visualization of the cervix and limited assessment of uterine position (a problem that can often be solved with the help of an ultrasound).

The paper also discusses the suitability of the vaginal vaginal contraceptive ring, which has been hypothesized to offer higher hormone levels for obese women than oral contraceptives because the hormones are absorbed directly into the vaginal mucosa and do not go through the first- pass liver metabolism.

Finally, the paper discusses issues around contraception for women who have undergone bariatric surgery (who have a particularly high rate of unintended pregnancies) as well as best practices for emergency contraception.

This is clearly information that all clinicians who counsel obese women should be aware of.

@DrSharma
Edmonton, AB

ResearchBlogging.orgMody SK, & Han M (2014). Obesity and Contraception. Clinical obstetrics and gynecology PMID: 25029338

 

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Infant Antibiotic Exposure and Obesity Risk

Infant Antibiotic Exposure and Obesity Risk


Infant Antibiotic Exposure and Obesity Risk

Posted: 17 Jul 2014 05:00 AM PDT

sharma-obesity-gut-buts1With all the interest in the role of the gut bacteriome in the development of obesity, it was only a matter of time before someone examined the relationship between antibiotic use and obesity risk.

This is exactly what Anita Kozyrskyj and colleagues from the University of Alberta, Edmonton, Canada, explored in a paper now published in the International Journal of Obesity.

For their study they linked rovincial healthcare records to clinical and survey data from a Canadian longitudinal birth cohort study, whereby antibiotic exposure during the first year of life was documented from prescription records.

Overweight and central adiposity were determined from anthropometric measurements at ages 9 (n=616) and 12 (n=431) years.

According to this analysis, infants receiving antibiotics in the first year of life were about twice as likely to be overweight later in childhood compared to those who were unexposed.

However, after adjustment for birth weight, breastfeeding, maternal overweight and other potential confounders, this association persisted in boys but not in girls. The reason for this discrepancy is not clear.

Although these findings are in line with the notion that early use of antibiotics may predispose to obesity, it is important to not that these type of studies cannot prove causality.

It may well be that other non-measured factors could explain this association (e.g. overprotective or lower SES parents may be more likely to use antibiotics in their infants – both factors are independently associated with higher rates of obesity).

Nevertheless, given the rather high rates of antibiotic exposure in infants it appears that this may well be a promising area for further research not just in the context of obesity but also for many of the other conditions that are now believed to be influenced by intestinal flora.

@DrSharma
Edmonton, AB

ResearchBlogging.orgAzad MB, Bridgman SL, Becker AB, & Kozyrskyj AL (2014). Infant antibiotic exposure and the development of childhood overweight and central adiposity. International journal of obesity (2005) PMID: 25012772

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