Test points to 'hidden' fat risk

Women with fat around organs in the abdomen were at highest risk

A test has been designed which can show if people of normal weight are at an increased risk of heart disease because they are carrying "hidden" fat.

Developed by South Korean researchers, it checks blood-flow via a cuff on the ankle or arm.

Writing in Clinical Endocrinology, the team say those with the poorest blood flow had more fat around their organs, and so were most at risk.

UK experts said the study reinforced the dangers of abdominal fat.

Good heart health seems to depend more on our shape than our weight. Professor Peter Weissberg, British Heart Foundation

The test measures the flexibility of someone's artery walls. The more elastic they are, the better a person's circulation will be.

The researchers from the University of South Korea tested 150 women aged 22 to 67, who all had healthy lifestyles.

The women's weight was checked.

The researchers then also checked for visceral fat, which lies around the organs and which differs from the ordinary fat which lies underneath the skin, using both the cuff test and body scans - to double-check the results.

People can have too much visceral fat but still be a normal body weight.

Approximately 40% of people are thought to have too much visceral fat stored round their abdominal organs - the key area of concern.

Early detection

The team found normal weight women who had high visceral fat levels scored 11% higher on the test than women who were overweight with normal visceral fat levels.

This suggests the normal weight women had a higher risk of heart disease.

The researchers say other methods of measuring visceral fat levels and the risk of heart disease have been expensive and time-consuming, and that the cuff test could offer a way of diagnosing those at risk early.

And they say identifying those at risk early means they could be encouraged to change their lifestyles to improve their health.

Professor Duk-Chul Lee, who led the research, said: "While having lots of fat around your organs is bad for your health, people can easily reduce their visceral fat levels by taking regular exercise.

"It is essential that people realise the importance of maintaining a healthy lifestyle as well as a healthy body weight."

'Middle-aged spread'

Professor Paul Stewart, an obesity specialist at the Queen Elizabeth Hospital in Birmingham, said: "The take-home message of this study is that having more fat around your the belly area puts you at increased risk of heart disease.

"it's not so much about general obesity; it's about middle-aged spread and where fat lies that's the problem.

"This is one more test that can indicate risk."

Professor Peter Weissberg, medical director of the British Heart Foundation (BHF), said: "This study confirms what we have known for some time; good heart health seems to depend more on our shape than our weight. "

''Visceral' fat inside our abdominal cavity - surrounding our intestines - increases our heart disease risk more than fatness in other parts of our body. "It's possible in future that measures of waist circumference will be included to refine the heart disease risk assessment.

"But factors such as blood pressure, cholesterol and smoking - which are routinely taken into account - are more important."

Google 15 - Motivation to lose weight - 4

Day before holiday to Turkey.

Foresight - in last 25 years - overweight or obese - has tripled. By 2025, 40% in England may be obese

The World Health Organisation claims over a billion people worldwide are overweight, and at least 300 million obese (WHO 2003). The UK population has grown steadily fatter: twenty-three percent of the UK population is now obese, a threefold increase since 1980 (Lister 2005). Obesity is both a major cause of chronic ill health and “considered a disease in its own right” (WHO 2003).

If current trends continue, by 2025, 40% of people in England will be obese. Obesity in Brazil currently 10%, in 2025 could be 15%.

Scoping the Foresight Project on Tackling Obesities: Future Choices

1 Why a Foresight project?

Foresight is uniquely placed to build a broad vision of obesity futures, able to bring together disciplines as diverse as nutrition and the built environment or food technology and sports science, whilst also encompassing medicine, pharmacology, economics and the social and behavioural sciences. Foresight's ability to envision future trends, inject new thinking and to identify those health impacts fundamental to policy making will provide fresh insight to this challenging area, identifying the interventions most likely to make a difference to obesity.

Over the last 25 years, the number of people classed as either overweight or obese in England has tripled. The year on year rise in obesity is not confined to adults. In England in 1995, 10% of boys under 16 were classed as obese. Now the proportion exceeds 16% and is forecast to reach 24% by 2025. As weight increases, so does the likelihood of a range of chronic, life limiting conditions including diabetes, cardiovascular disease, cancer and arthritis leading the Chief Medical Officer to describe obesity as a 'health time bomb'.

In 1998 the National Audit Office estimated that obesity cost the NHS £480 million. By 2002, the Health Select Committee considered the costs to the NHS to be between £990 - £1,125 million. Indirect costs to the economy are thought to be £2 billion a year, rising to £3.6 billion by 2010.

The health and economic costs to the nation alone are compelling reasons for the need to seriously address obesity. However, obesity is set within a complex cultural, social and behavioural framework, with a dynamic landscape of contributing factors. Such complexity suggests that solutions will not come from a single source but will involve multiple scientific disciplines and evidence sources.

2 Work to date

Foresight has already conducted scoping activity for a project on obesity by consulting widely with stakeholders, which include those from the public and private sector, together with NGOs and researchers from a diverse range of disciplines. Foresight has also conducted a series of in depth interviews with key stakeholders and obesity experts and has run two multidisciplinary workshops. This paper presents key conclusions from the work undertaken to date and illustrates where Foresight could add value to this complex field.

3 Key findings

Complex and not as well understood as represented

Obesity is often represented as a well understood condition, at the heart of which is a simple energy equation; too much in, not enough out. Foresight's scoping work has already established that the causes of obesity are neither simple nor well understood. It was significant that every discipline consulted suggested a different driver to be of primary importance.

For nutritionists it is too much energy dense food whereas exercise physiologists assert that calorie intake has not changed significantly over time, reduced levels of exercise are the dominant factor. Meanwhile economists explain obesity in terms of falling food basket prices and economic development, social scientists point to the negative correlation between obesity and socio-economic status, architects highlight changes in the built environment while physiologists pinpoint the falling number of hours slept, saying that causes an increase in the level of appetite driving hormones.

One area of agreement on cause is that whilst genetic variants are known to be associated with extreme forms of obesity, changes in genes cannot be responsible for such a rapid rise in obesity at a population level. Modulation of gene expression over the entire lifecourse is a more likely cause with the impact of environment at critical stages of human development such as fetal life and early childhood, having a lifetime programming effect, determining not only body weight but also the risk of chronic disease in later life.

Obesity is a complex and dynamic mix of the social, behavioural and biological, with significant granularity not only at a population level between different age, gender, ethnic and socio-economic groups but even within households, with for instance, obese and normal weight children frequently being raised together. Such a wide range of opinion and of presentation of obesity, has led to polarised views on cause, making it difficult for policy makers to pick myth from reality. It also points to the likelihood of multiple and complex points of intervention.

A very active area for research with little collaboration

Obesity is already a dominant research theme across many different disciplines. However a major concern is the silo nature of this research, which means that few, if any, have an overview or understanding of the whole system. This became apparent during Foresight's obesity scoping workshops, which brought together a very wide range of individuals. Many confessed to rarely speaking to researchers from other fields.

The 'silo mentality' is exacerbated by the current science career and research structure which is not currently configured to reward the large scale co-operation required for multi or transdisciplinary research with funding, RAE points or publications. There is also no doubt that the integration of data across a broad range of disciplines is technically difficult, meaning that it is rarely attempted. An additional problem here is the sheer breadth of determinants, making it a challenge to identify those which are key and understand how they interact.

The link between obesity and broader social determinants

Obesity is widely seen not merely as a marker for an increased risk of health problems, but also one of broader social and economic impacts, such as poverty, fractured families and lack of education. Many pointed to the social stigma of obesity and the risks of intervention creating an outcast obese underclass, perceived as lazy and worthless.

Agreement on the issue of responsibility

All consulted have highlighted the issue of responsibility; whether it should lie solely with the individual and, especially in the light of the above, if individuals are not sufficiently empowered to make change, who has the power to help them and how.

Key brakes to understanding

Foresight has also identified several key brakes to understanding, some of which Foresight may not be able to change directly, but which it can have a key role in highlighting for those able to influence them.

One is the need to understand the motivations behind lifestyle choice, especially given their importance in determining effective interventions. Why people make the choices they do is in fact well researched by the food, diet and exercise industries but it appears that this information is not shared widely enough with the science and health community.

A further concern is the current reliance on linear projections of obesity, with no alternative scenarios currently under consideration. Another is the tools for human studies, including the need for long term studies of population groups, together with the means for accurate assessment of food intake which are currently unwieldy, expensive and only suitable for small scale studies. Finally the need for a forum for inter-disciplinary debate is clear.

Despite the gaps and uncertainties identified by many in the evidence base, there is a need to act on the best available evidence whilst instigating an action research mechanism to ensure that activity is responsive to the appearance of new data.

4 WHERE FORESIGHT CAN ADD VALUE

The key challenge is to develop a shared understanding of what is likely to work and how to create change.

Foresight has the credibility, knowledge and impartiality needed to widen the breadth of understanding of obesity, joining up many silo activities and, enabling a better understanding of the wider causes and impacts of obesity.

Foresight is also uniquely placed to be able to demonstrate 'the big picture' on obesity, in a way which would be impossible for virtually any other organisation or research group.

This broad vision is necessary in order to build on existing work and enable more effective co-ordination of activity together with a joined up strategic approach on an issue which currently causes the premature death of 30,000 Britons a year.

In addition Foresight could add value in terms of pointing to the need for co-ordination of data gathering on a large scale (beyond the scope and capability of normal scientific collaboration), suggesting to the most appropriate bodies, that a framework be developed for combining surveillance activities (as carried out within the NHS) with academic evidence. This increasing need will converge with future advances in sensor technology and automated surveillance throughout the environment creating fascinating possibilities for a new approach to the study of human behaviour and activity. Such interventions would need to be rigorously evaluated to maximise value from datasets.

A particular advantage of an overview which covers many technologies is that Foresight can act as a 'broker', between disciplines as well as introducing new technologies with potential obesity applications, to researchers who would otherwise never have been exposed to them. Foresight can also provide the forum in which debate can be created.

Collaboration between industry knowledge and databases and science brokered by Foresight may lead to more innovative experimental approaches to studies of human populations, including long term longitudinal studies.

A better understanding of behaviour will lead to interventions that are more likely to succeed.

5 CONCLUSION

There is undoubtedly a great deal of activity in this area but it is apparent from the scoping activity that it has reached a point where a step change is required in both approach and thinking if a sustainable response to obesity is to be delivered.

By taking a look at the whole system - how the various elements mesh together and interact and what they might look like in the future, Foresight could deliver this step change as well as create an exemplar which will help understand how to effect change in other intractable public health issues.

Academic Poster (pdf)

Trends and drivers of obesity: A literature review for the Foresight project on obesity

reposted from: Foresight
my: highlights / emphasis / key points / comments

Food labelling campaign launched - The GDA v Traffic Light Wars

Rival supermarkets are using different labelling methods

Some of the UK's biggest food manufacturers are launching a £4m campaign to promote nutritional labels.

The labels show percentages of guideline daily amounts (GDA) of sugar, salt, fat and calories in each serving.

Other firms use red, amber and green labels - where green is good and red warns not to consume too much - approved by the Food Standards Agency.

But the 21 firms and retailers using the GDA system say people will not buy products with red labels on them.

reposted from: BBC.co.uk
my highlights / emphasis / comments

See the figures behind GDAs and traffic light labels

The GDA campaign - supported by a coalition of the UK's biggest food and drink manufacturers as well as supermarkets Tesco, Somerfield and Morrison - begins on Monday with TV and print adverts.

Members of the GDA group say consumers will find the percentages of GDAs easier to understand than the FSA's "traffic light" system.

GDA labelling shows percentages of guideline daily amounts per serving

GDA campaign director Jane Holdsworth said the new labelling system was about "lifestyle" choices.

"We have made it simple to compare what's inside thousands of everyday foods so you can choose what best suits your diet," she said.

And Tesco said its GDA labelling had already changed the buying behaviour of its shoppers.

Tesco spokesman Jonathan Church told BBC Radio 4's Today programme: "Our sales data shows customers are using it to make changes towards healthier foods.

"We have seen it in ready meals, sandwiches and other product categories."

More than 5,000 products already carried GDA labelling and this would be extended to every Tesco-owned food item within the next few months, he said.

There are claims that the traffic light system is easier to use

Mr Church denied the supermarket was trying to safeguard sales at the expense of customers' health, saying fat and salt content in some products had been lowered as a result of GDA labelling.

But supporters of the FSA's traffic light system - used by firms including Sainsbury's, Waitrose , the Co-Op, Marks and Spencer and Asda - say the GDA system is flawed because many adults do not understand percentages.

The FSA says its research shows traffic light labels are easier to understand.

"Some consumers do like the extra information that GDAs provide," it said in a statement.

HAVE YOUR SAY Why not simply have the supermarkets sell only healthy food? Marc Woodhall, Burton on Trent Send us your comments

"However, without a traffic light colour code our research showed that shoppers can't always interpret the information quickly and often find percentages difficult to understand and use."

If traffic light colours were added to products with GDA labels this would "reduce the confusion in the marketplace", it added.

Diabetes UK also gave their backing to the traffic light system, saying it was the "quickest and easiest" way for consumers to know what their food contained.

"If manufacturers choose to produce their own labelling guidance, it will only serve to confuse shoppers," said chief executive Douglas Smallwood.

"Voluntary food labelling will only work if manufacturers look at it from the view of the consumer, rather than suiting themselves."

---

GUIDELINE DAILY AMOUNTS
	Women	Men
Energy (Calories)	2,000	2,500
Protein	45g	55g
Carbohydrate	230g	300g
of which sugars	90g	120g
Fat	70g	95g
of which saturates	20g	30g
Fibre	24g	24g
Sodium	2.4g	2.4g
Equivalent as salt	6g	6g
Source: Institute of Grocery Distribution

---

TRAFFIC LIGHT LABELLING
	Low Per 100g	Medium Per 100g	High Per 100g
Fat	0-3g	Between 3g and 20g	20g and over
Saturated fat	0-1.5g	Between 1.5g and 5g	5g and over
Total sugars	0-5g	Between 5g and 15g	15g and over
Salt	0-0.3g	Between 0.3g and 1.5g	1.5g and over
Source: Food Standards Agency

Differentiating Food Fats - The good, the bad, and the ugly (or the unsaturated, the saturated, and the trans)

DOC News November 1, 2006
Volume 3 Number 11 p. 10
© 2006 American Diabetes Association

Joene Hendry

Explaining different types of food fats and how to replace the bad with the good, the saturated and trans with the unsaturated, can be confusing. Healthy eating requires some fats, but the permeation of unhealthy fats in so many readily available foods makes overconsumption easy.

reposted from: http://docnews.diabetesjournals.org/cgi/content/full/3/11/10
my highlights / emphasis / edits

Yet it is imperative that clinicians emphasize the important role food and nutrition play in their patients' health, says American Dietetic Association (ADietA) spokesperson Bethany Thayer, MS, RD.

"All patients should receive dietary advice on healthy eating habits from their physicians, and all patients at risk for obesity, cardiovascular disease, or diabetes (the great majority of adults in the U.S.) should see a registered dietitian at least once," concurs Dariush Mozaffarian, MD, MPH, of Harvard School of Public Health in Boston.

To help limit unhealthy fats in patients' diets, Thayer and Mozaffarian stress two main messages: The body does not need saturated or trans fats—both are unhealthy—and patients should avoid all foods containing partially hydrogenated vegetable oils, in which trans fats are found.

The 2005 Dietary Guidelines from the U.S. Department of Agriculture (USDA) suggest a total fat intake of 20–35% of daily calories, with the majority coming from unsaturated fats, <10%> saturated fats, and minimal amounts from trans fatty acids.¹ Dietary guidelines for disease prevention from the American Diabetes Association and the American Heart Association suggest a total fat intake that does not exceed 35% of total daily calories consisting primarily of unsaturated fats, <7%> and minimal or <1%>trans fats.^2,3

UNSATURATED: THE HEALTHIER FATS

The healthier food fats are unsaturated, found in foods such as monounsaturated and polyunsaturated vegetable oils, oily coldwater fish, nuts and seeds, and avocados.

Studies suggest that substituting unsaturated for saturated and trans fats and increasing consumption of omega-3 fatty acids from fish and plant sources are effective nutrition strategies for prevention of cardiovascular disease.⁴ Research also shows that replacing some carbohydrates with unsaturated fat lowers blood pressure and triglyceride levels and increases HDL cholesterol levels.⁵ Additionally, polyphenols in olive oil, especially higher phenolic content virgin olive oil, may reduce cardiovascular risk factors.⁶

TOM MARESCHAL/GETTY IMAGES

Unsaturated fats contain omega-3 fatty acids, which inhibit blood clotting and inflammation and relax arteries, as well as omega-6 fatty acids, which promote blood clotting and inflammation and constrict arteries, Thayer explains. Since these fatty acids tend to counteract each other, it is best to balance their intake, keeping in mind that corn oils used in processed foods, restaurant foods, and home cooking are higher in omega-6, while canola and olive oils and oily coldwater fish contain higher levels of omega-3.

SATURATED AND TRANS: THE UNHEALTHY FATS

Saturated fats come primarily from animal products—the meats and cheeses most people eat, notes ADietA spokesperson Cynthia Sass, MPH, MA, RD, LD/N. Saturated fats also are found in tropical oils (such as palm, palm kernal, and coconut oils), cocoa butter, and coconut.

"Trans and saturated fats hold products together and increase shelf-life and are therefore common in processed foods," Sass says.

Trans fats or trans fatty acids form during the partial hydrogenation of vegetable oils, which increases shelf-life and stability during deep-frying and creates solid fats for commercial cooking and food manufacturing.⁷ While they occur naturally in meat from cows, sheep, and other ruminants, dietary trans fats are found primarily in margarines, vegetable shortening, prepared and packaged baked goods, chips and crackers, commercially prepared fried foods, and fast food and restaurant foods.

"Gram for gram and calorie for calorie, trans fatty acids are the most harmful nutrient in the food supply for risk of coronary heart disease," Mozaffarian says, adding that analysis of research shows "adverse effects from trans fat intake at 1–3% of total energy, or 2–7 grams in a 2,000-calorie-per-day diet."

Avoidance is the best tactic, but since this is difficult for many Americans, the next best step is to read labels, ask questions, and monitor fat intake to minimize saturated and trans fats.

MONITORING FAT INTAKE

Food label nutrition boxes list fat content in grams and percentages. Both Thayer and Sass suggest ignoring the percentages: They are confusing and often misunderstood. Rather, the grams of fat per serving should be tallied to determine daily intake.

With so many Americans at risk for diabetes, obesity, and cardiovascular disease, a dietary fat intake goal for disease prevention seems reasonable. To maintain a total fat intake of <30%> intake of <7%,> eaten daily <33> be consumed. That would mean 1,500 kcal would consist of <50 g total fat and >2,000 kcal, <65> fat and <15>; and 2,500 kcal, <83> fat and <19>

Other tips for helping patients limit unhealthy dietary fats:

• Read labels to determine saturated and trans fat contents.
  
• Choose foods containing <1>
  
• Choose foods listing 0 g trans fats per serving. Caution: Foods labeled as such legally may contain <500> eating multiple servings of a single food or a combination of foods labeled as having zero trans fat, but which actually may contain 200–400 mg trans fats per serving (i.e., 4–5 crackers, 1–2 cookies, 1 tablespoon margarine), consumption may quickly reach 1–2% of trans fats per total calories.
  
• Choose foods labeled low fat, which must contain 3 g fat per serving.
  
• Choose deli meats and cheeses with the lowest possible fat content according to nutrient content brochures located at deli counters.
  
• Watch serving sizes. One serving of cheese is about one slice or 1/4 cup and may contain 3–6 g fat per serving.
  
• Avoid foods tasting smooth or creamy and those feeling greasy or leaving a greasy stain on a napkin. They are probably high in unhealthy fats.
  
• Use cooking oils, such as canola, with little saturated and no trans fat.
  

Most important, read ingredient lists and ask questions. "For now, consumers can only definitively determine that a product contains zero trans fats if there are no partially hydrogenated vegetable oils in the ingredient list," Mozaffarian says. And unless restaurants, fast-food outlets, and supermarkets voluntarily state their use of partially hydrogenated oils, consumers must inquire whether these oils containing trans fat are used.

NYC Bans Trans Fat

BY NICK KOLAKOWSKI

For some time, health professionals have drawn attention to the dangers of trans fat, suggesting that Americans—particularly those with diabetes—slash their intake as close to zero as possible. Now, the New York City Board of Health has taken things one giant step farther by voting for a near-total ban of the substance in the city's restaurants. A public hearing on the issue was scheduled for late October, followed by a final vote at the end of the year.

Trans fat, created by adding hydrogen to vegetable oil in order to improve the shelf life and stability of foods, raises LDL cholesterol levels and individual risk of coronary heart disease. It is found in vegetable shortenings and some types of margarine, as well as a variety of snacks and fried foods. New York City's plan, approved unanimously by the board of health on September 26, would limit its more than 20,000 restaurants to 0.5 g of artifi cial trans fat per serving of any menu item.

"Human life is much more important than shelf life," Lynne D. Richardson, a board of health member and professor of emergency medicine at Mount Sinai School of Medicine in New York, told The New York Times.¹ "I would expect to see fewer people showing up in the emergency room with heart attacks if this policy is enacted."

If the measure is approved, restaurants have until July 2007 to switch to oils, margarines and shortening with less trans fat and until July 2008 to eliminate menu items, including cakes or chips, that exceed the limit. The exceptions would be naturally occurring trans fat and packaged food items that remain in the packaging while served.

The typical American currently consumes some 5.8 g trans fat per day, according to the U.S. Food and Drug Administration (FDA). While this raises the risk of heart disease in all individuals, the problem is particularly acute for those with diabetes, whose heart disease death rate is two to four times higher than that of those without the condition. More than 700,000 adults in New York City have been diagnosed with diabetes. Other cities, such as Chicago, are considering similar measures, but recent news reports suggest that restaurants and food companies will fight New York's ban in the courts.

"The commissioner [Health Commissioner Thomas R. Frieden, MD] in New York should be commended for his efforts to remove them [trans fats] from restaurant diets," says John Buse, director of the Diabetes Care Center at the University of North Carolina–Chapel Hill and vice president, medicine and science, of the American Diabetes Association. "They're a clear and present danger for cardiovascular disease, for people who have diabetes as well as those who don't."

Nationwide, the FDA now requires that trans fat be listed on nutrition labels, joining the saturated fat and dietary cholesterol listings that have been there since 1993.

Footnotes

FYI

Resources for monitoring daily nutrient intakes:

• ADA's Web site, www.diabetes.org/nutrition-and-recipes/nutrition/overview.jsp

• USDA's www.MyPyramid.gov

• A free diet and exercise journal Web site, www.my-calorie-counter.com

• www.nutrition.gov, for consumer information on food and nutrition

• Diabetes Carbohydrate and Fat Gram Guide, 3rd Edition, a book by Lea Ann Holzmeister, RD, CDE, available at the ADA's online bookstore, http://store.diabetes.org.

References

1. Department of Health and Human Services and the U.S. Department of Agriculture: Dietary Guidelines for Americans 2005. Available online at www.healthierus.gov/dietaryguidelines. Accessed September 25, 2006.

2. American Diabetes Association: Nutrition recommendations and interventions for diabetes–2006 (Position Statement). Diabetes Care 29:2140–2157, 2006.[Free Full Text]

3. Lichtenstein AH, Appel LJ, Brands M, et al.: Diet and lifestyle recommendations revision 2006: A scientific statement from the American Heart Association Nutrition Committee. Circulation 114: 82–96, 2006.[Abstract/Free Full Text]

4. Hu FB, Willett WC: Optimal diets for prevention of coronary heart disease. JAMA 288:2569–2578, 2002.[Abstract/Free Full Text]

5. Appel LJ, Sacks FM, Carey VJ, et al.: Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: Results of the OmniHeart randomized trial. JAMA 294:2455–2464, 2005.[Abstract/Free Full Text]

6. Covas MI, Nyyssonen K, Poulsen HE, et al.: The effect of polyphenols in olive oil on heart disease risk factors: A randomized trial. Ann Intern Med 145:333–341, 2006.[Abstract/Free Full Text]

7. Mozaffarian D, Katan MB, Ascherio A, et al.: Trans fatty acids and cardiovascular disease. N Engl J Med 354: 1601–1613, 2006.[Free Full Text]

1. Lueck, Thomas J: New York City plans limits on restaurants' use of trans fats, The New York Times,September 27, 2006,B4 .

Public want food 'traffic lights' labelling of foods

By Adam Brimelow BBC News, Health correspondent

There are claims that the traffic light system is easier to use

The public overwhelmingly support 'traffic light' food-labelling rather than the system adopted by much of the food industry, a survey suggests.

The Netmums website surveyed more than 17,000 parents, and found 80% backed 'traffic lights'.

This offers a simple red, amber and green guide to nutrition.

But many in the food industry prefer giving percentage figures of guideline daily amounts (GDA) for things like calories, sugars and fat.

The findings come as the British Medical Association announced its backing for the traffic light idea.

The National Heart Forum also says that GDA markings are complex and misleading.

GDA labelling supporters say their system provides people with more detailed information.

To be able to look at the box straight away, know that it's all green and just grab it, is really good for young mums with very young children who want to run away Claire Perera

They argue that the traffic lights are too crude and simplistic. Both sides reckon their schemes encourage healthy eating.

Cathy Court, a director of Netmums, said the strength of the traffic lights scheme was its simplicity.

Child friendly

She said some of the parents who responded to the survey stressed that the easy-to-use nature of the scheme made it ideal to use with their children.

She said: "An important thing nowadays is to get your children to understand what healthy food is.

"People could actually use it to teach their children about healthy food, and work out healthy options together."

Claire Perera, a mother of two, is convinced that traffic light labelling is best.

She said: "My priority isn't whether I can get a good cereal or a bad cereal. It's making sure I don't lose Luis.

"So to be able to look at the box straight away, know that it's all green and just grab it, is really good for young mums with very young children who want to run away!"

Dr Vivienne Nathanson, BMA head of science and ethics, said: "It is absolutely essential that it is simple, that you don't need to sit down and start trying to work out what that percentage means.

"And the traffic lights system is something you can even see from a distance, so you can start to hone in on the foods that are predominantly green or green and amber, and just cut down on the foods that are marked red."

Not scared of red marks

The independent watchdog the Food Standards Agency also wants the wider industry to adopt traffic light labelling.

Rosemary Hignett, FSA head of nutrition, said the evidence so far was that consumers are not running scared of red markers - as feared by critics of the traffic light scheme.

"They are using the information to balance their shop. They are not interpreting the red as "don't buy".

"They are interpreting it as "high in fat, salt or sugar - therefore don't eat too much of this product.

"So they are using it in a very sensible way, in fact."

Tesco insist they are not seeking any competitive advantage by sticking with GDAs.

The company said it was convinced its approach was better for working out a balanced diet through the day.

It also said traffic light labelling might appear simpler at first, but the GDA approach was more likely to change customer behaviour, and encourage a switch to healthy products.

reposted from: BBC.co.uk
my highlights / emphasis / comments

Retailers to stop trans-fat use

Some margarines contain trans-fats

Major UK retailers plan to stop adding harmful trans-fats to their own-brand products by the end of the year. Trans fats at Wikipedia.

The move was announced by British Retail Consortium members Asda, Boots, Co-op, Iceland, Marks and Spencer, Sainsbury's, Tesco and Waitrose.

It is hoped the move could help cut rates of heart disease and obesity.

reposted from: http://news.bbc.co.uk/1/hi/health/6314753.stm
my highlights / edits

Cholesterol-raising trans-fats, in the form of hydrogenated oils, are often added to bakery and dairy products to extend shelf-life and improve texture.

TRANS-FATS They are partially hydrogenated vegetable oils, turning oily foods into semi-solid foods Used to extend shelf life of products Put into pastries, cakes, margarine and some fast foods Can raise levels of "bad" cholesterol Even a small reduction in consumption can cut heart disease They have no nutritional benefit

They are also used by the fast-food industry.

But they have no nutritional value, and like saturated fats, they raise blood cholesterol levels which increase the risk of coronary heart disease.

Health authorities around the world have recommended their consumption be slashed.

A BRC spokesman said about 5,000 own-brand products would be affected by the decision.

'Major change'

He said it took time to remove the fats, as retailers had to ensure their products remained appealing to consumers in their re-formulated form.

Several leading retailers have already committed to reducing trans-fat levels, but the latest announcement represents a marked acceleration of the process.

Andrew Opie, BRC food policy director, said the decision by its leading members showed that they were prepared to act to achieve major change must faster than any legislation could do.

He said: "This is the latest in a string of healthy food initiatives and shows that BRC members, responding to customer concerns, are willingly delivering a scale and pace of change way beyond anything retailers or manufacturers are doing anywhere else in Europe."

Alex Callaghan, of the British Heart Foundation, said: "It's good to see companies making moves towards reducing and removing trans-fats from their own-brand products.

"Currently, it isn't easy for shoppers to know how much trans-fats are in the food they eat, and it can be confusing.

"The BHF calls for manufacturers and retailers to work towards elimination of trans-fats from products.

"In the meantime, trans-fats should be clearly labelled food packaging so that people can make informed decisions about their diet."

In Denmark, trans-fats in the form of partially hydrogenated oils were effectively banned four years ago.

The European Union is encouraging retailers to reduce or stop adding trans-fats.

However, it is also taking action against the Danish authorities, on the grounds that their ban is a block on free trade with other member states.

Chemically, trans fats are made of the same building blocks as non-trans fats, but have a different shape. In trans fat molecules, the double bonds between carbon atoms (characteristic of all unsaturated fats) are in the trans rather than the cis configuration, resulting in a straighter, rather than a kinked shape. As a result, trans fats are less fluid and have a higher melting point than the corresponding cis fats. (source: Wikipedia)

Firmicute Gut Bacteria make you fatter - Nature magazine

reposted from: Nature Podcast: 21 December 2006
from Nature Podcast / Original audio source
Nature Video: http://www.nature.com/nature/videoarchive/gutmicrobes/index.html
my highlights / edits

In "Conclusion" (3rd video) Jeff Gordan says: "The study of the coevolution of microbes with human cells may help to treat obesity. Which human genes are manipulated by microbes? The number of calories in food is determined in the lab but the total caloric yield may differ between individuals depending on the ratio of Bacteroidetes and Firmicutes.

This is a transcript of the 21 December edition of the weekly Nature Podcast. Audio files for the current show and archive episodes can be accessed from the Nature Podcast index page (http://www.nature.com/nature/podcast), which also contains details on how to subscribe to the Nature Podcast for FREE, and has troubleshooting top-tips. Send us your feedback to mailto:podcast@nature.com

Transcript reposted: http://www.nature.com/nature/podcast/v444/n7122/nature-2006-12-21.html

Chris Smith: This week, should we think of ourselves as passengers in our own bodies? Well, Jeff Gordon says we should.

Jeff Gordon: A human being is not composed only of human cells. In fact, as adults we contain ten times more microbial cells on our body surfaces than human cells.

Chris Smith: And those very same bugs make a huge difference to whether we're fat or thin;

Hello, Merry Christmas, I'm Chris Smith, welcome to this week's show. First up, who would have thought that bacteria living in your gut could make a big difference to your body weight? Here's Jeff Gordon and his team, Peter Turnbaugh and Ruth Ley who've found that a bulging waistline in mice and humans is associated with a big change in intestinal flora. Nature 444, 1009–1010 (21 December 2006) ; Nature 444, 1022–1023 (28 December 2006) ; Nature 444, 1027–131 (21 December 2006)

Jeff Gordon: We're very interested in the alliances between microbes in humans. A human being is not composed only of human cells. In fact, as adults we contain ten times more microbial cells on our body surfaces than human cells. These partnerships are mutually beneficial. We're very interested in the role of microbes in our gut and one of the attributes that they provide is the capacity to digest otherwise indigestible components of our diet. So the question we had here was do the microbes in our gut influence our energy balance?

Chris Smith: So how did you try and explore that?

Jeff Gordon: We started out with mice and looked at the microbial communities of obese mice. They're obese because they had a genetic mutation that caused them to reliably develop obesity while they were young adults, and compared their community structure to their litter mates who didn't have this mutation and therefore were lean.

Chris Smith: So, Peter Turnbaugh, you're the lead author on this paper, when you actually did this, what did you find?

Peter Turnbaugh: We were able to take advantage of really the revolution that's going on in sequencing technology and so here at Wash U we have the genome sequencing centre, we were able to directly isolate DNA from the mouse gut and take that DNA and use them high throughput shotgun sequencing techniques to try to look at what genes were present in the bacterial community of obese mice and what we found was that there seemed to be more genes in the obese community for harvesting energy from the diet, so breaking down complex sugars that we might eat that the human or the mouse can't normally digest.

Chris Smith: So these guys have got a richer microbial flora effectively?

Peter Turnbaugh: First, originally, when we looked at who's there, we saw that there's two major groups of bacteria, the Firmicutes and the Bacteroidetes, and we saw them in the obese mouse, there was a shift in the relative abundance of these two groups so there were more Firmicutes and less Bacteroidetes.

(From Wikipedia: Researcher Jeffery Gordon and his colleagues found that obese humans and mice had a lower percentage of a family of bacteria called Bacteroidetes and more Firmicutes. But they are not sure if Firmicutes cause obesity or if people who are obese grow more of that type of bacteria.)

Chris Smith: Is the trait transmissible, in other words, can you take that different spectrum and confer it upon another animal and make that animal gain weight because that surely is the way to prove wholeheartedly that this is underlining why they're so fat?

Peter Turnbaugh: Right, exactly, so what we were able to do is harvest the microbial community from an obese mouse, or a lean mouse, and then directly colonize germ-free mice with either the obese flora or the lean flora and what we saw was the mice that were exposed to the microbes from an obese mouse actually gained more fat over the course of the experiment than the mice that were given lean microbial community.

Chris Smith: So that's mice, but actually happens if you look in humans who are too fat, are they, too, carrying an abnormal spectrum of bacteria in their intestines? Ruth Ley is the first author on a second paper which sits next to this one in this week's Nature. Ruth, what did you find in humans?

Ruth Ley: We found that the obese humans did actually have exactly the same shift in their ratio of Firmicutes to Bacteroidetes that we'd seen in the mice.

Chris Smith: How did you actually do the study? Can you tell us a bit about that?

Ruth Ley: We had 12 subjects that were randomly assigned to two different diets, one was a fat restricted diet and the other one was a low calorie diet and these people were on a diet for a year and we collected a stool sample from them before they started the diet and then three times over the course of the year, and just using the same techniques we used for the mice, we extracted DNA from their stool and we sequenced the 16 S genes for the bacteria, which was the one that tells you what kinds of bacteria are present. So we generated a very large amount of sequence for this kind of study and from that we were able to see that first of all before the diet the obese people had a skewed ratio of Firmicutes to Bacteroidetes compared to lean people so we also had some lean controls and then as they lost weight, the amount of Bacteroidetes increased and began to resemble what you would see in a normal lean person, and the amount of the increase was proportional to the amount of fat that they actually lost over time.

Chris Smith: So what do you think is going on? Why should just losing weight change the bugs that you have growing in your intestine?

Ruth Ley: Well, that's a mystery at the moment. We know that there's some kind of link, some sort of dynamic linkage between the fat that's carried on the body, we know that fat cells produce hormones and there could be some signaling between the adipose tissue in the body and the kinds of bugs that are in the intestine but at this point we don't understand the mechanism.

Chris Smith: Ruth, thanks, very much. Back to Jeffrey Gordon, Jeffrey, what are the implications of what you found?

Jeffrey Gordon: Well, surely a key element that determines the amount of fat that we store in our bodies is the amount of energy that we consume and the amount of energy that we expend through exercise and work. What this study shows is that there's also a microbial component to determining how much adipose tissue you might have and that they microbes in the gut are part of the equation that affects predisposition to, or the patho-physiology of obesity.

Chris Smith: So now you can blame your gut bacteria as well as a slow metabolism for the extra stone or two that you're carrying around your middle. That was Jeff Gordon, Peter Turnbaugh and Ruth Ley. They're all from Washington University in St Louis and they found that being overweight is associated with a big shift in the types of bacteria found living in our intestines.