65 million more obese adults in the US and 11 million more in the UK expected by 2030!

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The rising prevalence of obesity around the globe places an increasing burden on the health of populations, on healthcare systems and on overall economies. A major challenge for researchers is to quantify the effect of these burdens to inform public policies. Using a simulation model to project the probable health and economic consequences from rising obesity rates in the United States and the United Kingdom, researchers at Columbia University's Mailman School of Public Health and Oxford University forecast 65 million more obese adults in the U. S. and 11 million more in the U.K. by 2030, leading to millions of additional cases of diabetes, heart disease, stroke, and cancer. The findings suggest that medical costs associated with treatment of these preventable diseases in the U.S. alone will increase by $48-66 billion per year.
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The paper, "Health and Economic Burden of the Projected Obesity Trends in the USA and the UK," is part of a series of articles on obesity published in the August 27 issue of Lancet. The research was led by Y. Claire Wang, MD, ScD, Mailman School assistant professor of Health Policy and Management, with colleagues from Oxford University.



To construct historic trends in BMI the researchers analyzed data from two nationally representative surveys: the U.S. National Health and Nutrition Examination Survey (NHANES) from 1988 to 2008, and the Healthy Survey for England (HSE) from 1993 to 2008. The U.S. and U.K. have the highest obesity rates among the countries belonging to the Organization for Economic Cooperation and Development.
Projecting from these data sets: the researchers predicted the following impacts for the U.S. by 2030:

• Obesity prevalence among men would rise from 32% in 2008 to approximately 50% and from 35% to between 45% and 52% among women.
• 7.8 million extra cases of diabetes
• 6.8 million more cases of coronary heart disease and stroke
• 539,000 additional cases of cancer
• Annual spending on obesity-related diseases would rise by 13-16%, leading to 2.6% increase in national health spending.
• Total medical costs associated with treatment of these preventable diseases are estimated to increase by $48-66 billion/year.

For the U.K., researchers predicted the following developments by 2030:

• Prevalence of obesity among men would increase from 26% to between 41—48%, and among women from 26% to 35-43%.
• 668 000 more cases of diabetes
• 461,000 more cases of heart disease and stroke
• 139,000 additional cases of cancer.
• In the U.K., annual spending on obesity-related health would increase even more rapidly than in the U.S. due to its older population, rising 25%.

"Many chronic and acute health disorders associated with excess bodyweight burden society—not only by negatively affecting the health-related quality of life but also by incurring significant costs," says Dr. Wang. These stem not only from increased healthcare expenditures but also from worker absenteeism, disability pensions, less productivity at work due to poor health, and earlier retirement."

The new study shows that even a small drop in average body mass index (BMI) would have a major health and economic impacts. They therefore recommend action to promote healthier body weights.

"Taking no action would have the catastrophic consequences described in our study, but a population level decrease in BMI by 1% would avoid as many as 2.4 million cases of diabetes, 1.7 million cases of heart disease and stroke, and up to 127 000 cases of cancer in the U.S.alone."

There are currently 99 million obese individuals in the U.S and 15 million in the U.K. The distribution of obesity is somewhat different in the two nations. In the U.S. about one-quarter of all men are obese regardless of ethnicity. Almost half of black American women (46%) are obese, compared with a third of Hispanic women and 30% of white women. In the U.K., the proportion of obese white men (19%) is slightly higher than black men (17%) and much higher than Asian men (11%). One-third of black women in the U.K. are obese, compared with 1 in 5 white women and 1 in 6 Asian women.

While there is some evidence that the rise in obesity is levelling off in some nations and possibly in the U.S., the jury is still out, says Dr. Wang. "Population weight changes are slow to manifest. Whether or not the U.S. and UK have turned a corner or plateaued will not be clear until survey results over the next few years provide additional data points."

The suggestion that obese people die earlier, thus saving the likely expected social and healthcare costs if that person survives to old age, is also discussed in the paper. However the authors conclude, "Without a doubt, healthcare expenditure is high for elderly people, but these costs should not be used to justify the cost-savings of dying younger, or to suggest that obesity prevention has no benefit."

Provided by Columbia University

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Prostate Cancer Patients' Weight Linked to Tumor Size, Study Finds

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ScienceDaily (June 2, 2010) — The size of tumors in prostate cancer patients is directly linked to their weight, according to a new six-year study conducted by researchers at Henry Ford Hospital in Detroit.

The research team, led by Nilesh Patil, M.D., of Henry Ford's Vattikuti Urology Institute and Department of Radiology, found heavier patients, or those with the highest body mass index (BMI), also had the largest tumors. They discovered the connection after studying 3,327 patients who had undergone robotic removal of their cancerous prostate glands and surrounding tissue.

"As the patients body mass index increased, the tumor volume increased synchronously," says Dr. Patil. "Based on our results, we believe having a larger percentage of tumor volume may be contributing to the aggressive nature of the disease in men with a higher BMI."



The study will be presented June 2 at the 2010 American Urology Association's annual meeting in San Francisco.

Working from a well-established link between aggressive prostate cancer and higher BMI, the team set out to find if overweight and obesity specifically affects the tumor volume in cancerous prostates.

The BMI measures body fat based on combined height and weight in adult men and women, and sets a number that defines underweight, normal weight, overweight, and obesity -- from 18.5 or less for underweight to 30 or higher for obesity. Tumor volume is the size of a malignant tumor as a percentage of the space it takes up in the affected tissue, in this case the prostate gland.

Patients were studied from October 2001 to October 2007. They were divided into six categories based on their BMI -- 24.9 or less (normal or underweight), 25 to 29.9 (overweight), 30 to 34.9 (obese), and 40 or higher (morbidly obese). In each category, the mean age was about 60.

After their tumors were removed, each was weighed and compared to a categorized database of prostate weight. In each BMI category, they found the weight of the patient to be directly correlated to the size of the tumor (i.e. the smaller the patient, the smaller the tumor, and the heavier the patient, the larger the tumor).

In addition to Dr. Patil, study co-authors at Henry Ford Hospital included Sanjeev Kaul, M.D.; Akshay Bhandari, M.D.; James Peabody, M.D.; and Mani Menon, M.D.

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