Obesity surgery?s benefits extend to next generation

[MsJacquiiC]

Pregnancies after the operation yield healthier children.

Children born to women who have achieved drastic weight loss through stomach surgery are healthier than children born to severely obese moms, a new study shows.

This is the first proof that exposure to obesity in utero is associated with long-term effects...

The findings suggest that obesity creates an unhealthy environment for a fetus that has ramifications later on, scientists report in the November Journal of Clinical Endocrinology & Metabolism.

?This is very important work,? says Dana Dabelea, a physician and epidemiologist at the University of Colorado?Denver and the Colorado School of Public Health in Aurora. ?This is the first proof that exposure to obesity in utero is associated with long-term effects,? she says.

Severely obese women should be encouraged to lose weight before becoming pregnant, asserts study coauthor John Kral, a surgeon at the State University of New York Downstate Medical Center in Brooklyn. Obese women who are interested in having kids and getting weight-loss surgery at some point in their lives should get the surgery first, he says.

Kral collaborated with researchers at University of Laval in Quebec City in contacting 49 women who had given birth and had also undergone a specific type of obesity surgery. About half of the women had one child before surgery and another child after.

All the women had undergone biliopancreatic diversion bariatric surgery, in which a portion of the stomach is removed and food and digestive enzymes are shunted past part of the small intestine, limiting the amount of nutrients absorbed. On average, the women lost more than one-third of their body weight after surgery, and they kept it off. Thus, the women went from being severely obese to slightly overweight.

The surgeries took place between 1984 and 2005. During that time, these women had a combined total of 111 children?54 born before obesity surgery and 57 afterward. When the children were examined in 2007 and 2008, they ranged in age from 2 to 25 years.

The researchers found that 19 children born before their moms underwent surgery were severely obese, compared with six children born after surgery.

As a group, the children born after surgery scored better on a host of medical tests. Blood tests revealed that those born after surgery had healthier levels of leptin and ghrelin, hormones that regulate appetite. These children also used insulin more efficiently. This hormone regulates how cells process sugars, and children born to women after weight-loss surgery had less evidence of insulin resistance, which can a precursor to diabetes.

Measurements of overall HDL cholesterol, the good kind, were higher in children born after surgery, and their total-cholesterol-to-HDL ratio was lower.

Children born after mom had obesity surgery also had lower blood levels of C-reactive protein, a marker of low-grade, chronic inflammation.

These scores reveal a person?s risk of cardiovascular disease, stroke and other health risks, Kral says.

The new data suggest that a fetus can undergo epigenetic changes in the womb brought on by maternal obesity, Kral says. ?Any number of genes are potentially modifiable in the intra-uterine environment,? he says, including genes that guide metabolism.

Meanwhile, the cause of obesity itself is unclear. Obesity probably has a genetic component, Dabelea notes, and is easily influenced by overeating and a sedentary lifestyle. But she adds that programming caused by maternal obesity during fetal development is another important mechanism. ?How this programming operates?what exactly happens in these exposed offspring?we don?t know.?

What?s more, earlier animal experiments suggest that ?maternal obesity actually resets the satiety balance point? in the fetus, Dabelea says, so that offspring need to eat more to feel full.

In a departure from past generations? medical dogma, she adds, doctors are starting to counsel women to maintain only modest weight gain during pregnancy and should ask obese women to lose weight while pregnant.


By Nathan Seppa
September 26th, 2009; Vol.176 #7 (p. 9 - Science News)


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Bariatrics The branch of medicine that deals with the causes, prevention, and treatment of obesity. The term bariatrics was created around 1965, from the Greek root baro ("weight," as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery.

Obesity Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Obesity has been defined as a weight more than 20% above what is considered normal according to standard age, height, and weight tables, or by a complex formula known as the body mass index. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk. CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Cholesterol A fat-like substance that is made by the body and is found naturally in animal foods such as meat, fish, poultry, eggs, and dairy products. Foods high in cholesterol include organ meats, egg yolks, and dairy fats. Cholesterol is needed to carry out functions such as hormone and vitamin production. When cholesterol levels are too high, some of the cholesterol is deposited on the walls of the blood vessels. Over time, the deposits can build up and cause the blood vessels to narrow and blood flow to decrease. Total blood cholesterol levels above 240 mg/dl are considered high. Levels between 200 and 239 mg/dl are considered borderline high. Levels under 200 mg/dl are considered desirable.

Diabetes Mellitus A disease that occurs when the body is not able to use blood glucose (sugar). Blood sugar levels are controlled by insulin, a hormone in the body that helps move glucose from the blood to muscles and other tissues. Diabetes occurs when the pancreas does not make enough insulin or the body does not respond to the insulin that is made. There are two main types of diabetes mellitus: Type 1 Diabetes and Type 2 Diabetes. All forms of diabetes have been treatable since insulin became medically available in 1921, but there is no cure.

High-density Lipoprotein A unit made up of proteins and fats that carry cholesterol to the liver. The liver removes cholesterol from the body. HDL is commonly called "good" cholesterol. High levels of HDL cholesterol lower the risk of heart disease. An HDL level of 60 mg/dl or greater is considered high and is protective against heart disease. An HDL level less than 40 mg/dl is considered low and increases the risk for developing heart disease. Certain changes in lifestyle can have a positive impact on raising HDL levels: Aerobic exercise Weight loss Smoking cessation Removing trans fatty acids from the diet One drink of alcohol a day or less yields higher HDL-C levels, more so in women than men. Adding soluble fiber to diet Using supplements such as omega 3 fish oil Limiting intake of dietary fat to 30–35% of total calories

Metabolism All of the processes that occur in the body that turn the food you eat into energy your body can use. Exercise, food, and environmental temperature influence metabolism.

Overweight It is defined as a Body Mass Index (BMI) of 25 to 29.9. Body weight comes from fat, muscle, bone, and body water. It is important to remember that although BMI correlates with the amount of body fat, BMI does not directly measure body fat. As a result, some people, such as athletes, may have a BMI that identifies them as over their ideal body weight even though they do not have excess body fat. CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Protein One of the three nutrients that provides calories to the body. Protein is an essential nutrient that helps build many parts of the body, including muscle, bone, skin, and blood. Protein provides 4 calories per gram and is found in foods like meat, fish, poultry, eggs, dairy products, beans, nuts, and tofu. Proteins are an essential human nutrient, obtained from both plant and animal foods. Though their greatest commercial use is in food products, they are also employed in adhesives, plastics, and fibres.

Satiety The feeling of satisfaction or fullness with the intake of food.