Certain types of antipsychotic medication can cause children to put on weight—as much as 18 pounds—according to research appearing in the Journal of the American Medical Association.

Dr. Chrostoph Correll, MD, and associates observed 272 children aged 4 to 19 taking atypical antipsychotic medication for the first time. Drugs/Medications included olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperadol) and aripiprazole (Abilify)—drugs sometimes used to treat children with autism, schizophrenia or bipolar disorder.

Children’s weights were monitored over a 12-week period. During the last two weeks of the study, nearly all experienced significant weight gain. Average gain was as follows: 18.7 pounds with onanzapine, 13.7 pounds with quetiapine, 11.7 pounds with risperidone, and 9.7 pounds with aripiprazole. Children in the control group gained less than half a pound (.44 pounds) on average.

“(E)ffects such as age-inappropriate weight gain, obesity, hypertension, and lipid and glucose abnormalities are particularly problematic during development because they predict adult obesity, metabolic syndrome, cardiovascular morbidity, and malignancy,” authors of the study write.

Doctors were so concerned over weight gain in children taking onanzapine that they stopped treatment before the study was completed. “Each antipsychotic was associated with significantly increased fat mass and waist circumference,” authors write. “Altogether, 10 percent to 36 percent of patients transitioned to overweight or obese status within 11 weeks.”

As more children—some younger than 5-years-old—are diagnosed with bipolar and “disruptive behavior” disorders (such as ADHD), there is also a rise in atypical antipsychotic prescriptions. These medications are generally effective for children with autism and schizophrenia, but they may not be the best treatment for other conditions.

The authors suggest seeking alternative treatments. They write that, in view of the negative health outcomes, the benefits of using these medications “must be balanced against their cardiometabolic risks”, and say the results suggest including in prescription guidelines closer monitoring during the early months of treatment.

They also plan on researching whether or not diet restrictions and additional medications for weight and glucose control will help balance the potential negative effects of the drugs.

Early obesity in women may be linked with difficulty in becoming pregnant. Women who became obese by age 18 and participated in a weight-loss surgery study showed higher rates of infertility and polycystic ovarian syndrome (PCOS).

Forty-two percent of the women in the study trying to conceive experienced infertility, but pregnancy was more likely for women who became obese after age 18. The good news is, surgical weight loss may increase fertility.

The study, the Longitudinal Assessment of Bariatric Surgery (LABS), provided information on the fertility of obese women considering surgical weight loss procedures.

Obesity can interfere with a woman’s hormone levels, making it difficult to become pregnant. This also makes vitro procedures less likely to work. Even in the event of conception, there are major health risks to both mother and child. Not only are miscarriage rates higher, but there are also a higher rates of premature and still-births.

Weight loss surgery, also known as bariatric or metabolic surgery, which includes gastric bypass surgery and lap banding, may help obese women trying to conceive. Many women don't know that having such a procedure is an option.

Research shows that bariatric surgery can reduce pregnancy complications for obese women, and LABS participants were no exception. Roughly 62 percent of LABS participants who underwent surgery who hoped to conceive experienced at least one live birth after infertility.

After weight loss surgery, doctors advise women to wait at least 18 months after surgery (6 months after banding) before trying to become pregnant. They also suggest using contraceptives while waiting for the body to become more stable.

“As the incidence of obesity increases in the United States, women’s health care practitioners are likely to care for a substantial number of patients who will undergo bariatric surgery,” says Dr. William Gibbons of the American Society for Reproductive Medicine. “Studies like this one are extremely useful to help us determine how to advise these patients and best meet their needs.”

Find more information about pregnancy after bariatric surgery, or test your knowledge with Healia’s Pregnancy Quiz.

Legislators are considering the option of food taxes on sweetened beverages, including soda pop, and snack foods in an effort to battle obesity. Forty states are in support of a small tax on soda, while New York and Maine believe a higher tax may be necessary.

 
According to a report in The New England Journal of Medicine, sugar consumption has risen 30 percent over the last decade. For teens and children, soda accounts for 10-15 percent of total calories consumed. By removing just ¼ of the sugar in sweetened beverages, consumers can reduce annual caloric intake by 8,000 calories. This figure equates to roughly two pounds of weight in a year.

“Americans consume about 250 to 300 more calories daily today than they did several decades ago,” according to authors Kelly D. Brownell, Ph.D., and Thomas R. Frieden, M.D., M.P.H. “Though no single intervention will solve the obesity problem, that is hardly a reason to take no action.”

Such a high rate of sugar intake can do more than expand the waistline. It can also increase the risk of type 2 diabetes, heart disease, and other problems as a result of poor nutrition and weight gain. The objectives of those in support of a tax are twofold—to lower consumption, and to encourage soft drink producers to decrease the amount of caloric sweeteners in their products.

There are strong arguments on both sides. People arguing against the tax point out that food is necessary to survive. They believe raising prices will make it more difficult for low-income families to eat. Others argue that the poor would benefit the most. As the price of fresh produce and other healthier options goes up, soda and junk food prices are going down. People with tighter budgets consume more of the cheap but less nutritious foods and beverages.

“As Coca-Cola prices increased by 12 percent, sales dropped by 14.6 percent,” Frieden and Brownell wrote. Analysts believe that a 1 cent-per-ounce price increase could reduce consumption by as much as 10 percent. Justin Wilson, senior research analyst for the Center for Consumer Freedom, argues that such a tax is manipulation against the consumer. “The tax code should not be used as a method for social engineering, and that’s what this is,” he said.  Legislators see the issue a little differently.

Higher prices have been used effectively in the past to reduce tobacco sales, and any revenue from a tax on soda could raise up to $14.9 billion per year. This money could be used to support health reforms or other programs. New Yorkers’ support rose by 20 percent when lawmakers suggested using these funds for obesity prevention programs.

Obese women should limit weight gain to between 11 and 20 pounds during gestation, according to an updated set of pregnancy weight gain guidelines released Thursday by the Institute of Medicine. Previously, the Institute did not recommend a specific gestational weight gain range for obese women, but the section was added in response to increasing obesity rates and high weight gain trends in pregnant women. This is the first time the Institute has issued new pregnancy weight gain guidelines in nearly 20 years.

The Institute of Medicine also reevaluated the weight gain recommendations for overweight, normal weight, and underweight women, though the alterations in these weight groups were minute. The Institute now suggests overweight women gain between 15 and 25 pounds, normal weight women gain 25 to 35 pounds, and underweight women gain 28 to 40 pounds during gestation.

These guidelines are based on multiple factors affecting the health of the mother and embryo. Most central to the Institute’s recommendations is the body mass index (BMI) of the expectant mother, a measurement based on acceptable weight to height ratios. Women with a BMI of 30 or greater are considered obese, while a BMI of 25 to 29.9 is considered overweight. Normal weight women have BMIs between 18.5 and 24.9 and a BMI below 18.5 falls in the underweight range.

To measure your BMI, visit the National Institute of Health’s body mass index calculator.

Test your pregnancy knowledge on the Healia Pregnancy Quiz and challenge yourself on the Weight Management Quiz. After taking the quizzes, visit the Healia Pregnancy Health Guide for more pregnancy information and check out the Healia Obesity and Overweight Health Guide to learn more about weight gain.

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In an effort to educate the American public about healthy eating, First Lady Michelle Obama broke ground today on a new organic garden on the South lawn of the White House.  Along with local elementary school students, she prepared the soil for the first working kitchen garden at the White House since Eleanor Roosevelt’s "victory garden” during World War II.

Michelle Obama hopes that the garden can help people better understand where their food comes from and how to make healthier food choices to combat obesity in the United States. She also mentioned how getting her children, Sasha and Malia, involved in growing a vegetable garden makes them more curious about fresh fruits and vegetables and encourages them to try eating them.

Advocates for organic and locally grown food have long promoted the idea of kitchen gardens as a way for people to eat healthfully and cost-effectively in tough economic times.

If you are interested in starting an organic garden, call your local agricultural extension service or the USDA for resources. Share your ideas for healthy eating on Healia Communities or learn more about weight management.

_{Photo: Mr. Marshall, Flickr, Creative Commons}

A study appearing today in the New England Journal of Medicine provides evidence that low-fat, low-carb, and high-protein diets all can lead to successful long-term weight loss, as long as they reduce a person’s calorie intake. While previous research has suggested that one type of diet may be better than another, the present study followed people for two years and found that lasting weight loss was similar among participants who followed diets that were similar to popular specialty weight-loss programs.

Researchers from the Harvard School of Public Health followed more than 800 overweight adults on one of four diets, each with a different distribution of nutrients: low-fat, high carb; low-fat, high-protein; high-fat, low-carb; and high-fat, high-protein. Though the diets were similar to commercial plans, the study did not directly compare popular diets. All four diets contained healthy fats, were high in whole grains, and were low in cholesterol.

Each dieter was encouraged to cut 750 calories a day from their diet, exercise 90 minutes a week, keep an online food diary, and meet regularly with diet counselors to chart their progress. After two years, the results showed that all four groups had the same average weight loss of 9 pounds and all lost an average of 2 inches off of their waistline. Most risk factors for cardiovascular disease improved for dieters as well including increases in HDL ("good") cholesterol and decreases in LDL ("bad") cholesterol, triglycerides, blood pressure, and insulin resistance.

The study also found that people who made good use of diet counseling saw better results. Those who attended the most meetings lost an average of 22 pounds, far more than the overall average of 9 pounds.

The researchers conclude that it does not matter what the nutrient composition of a diet is, as long as a diet reduces calorie-intake and remains heart healthy (high in fiber and low in saturated fats). They stress that following a restricted-calorie diet that is good for the heart allows dieters to eat a variety of foods and reduces monotony, which makes it easier for people stick with their diets. Instead of eliminating several foods from your diet, dieters just need to be reasonable about portion control. The key to successful weight loss is simply: eat less.

One researcher not involved in the study provided a different take on the results. In an accompanying editorial, she notes that after two years of very focused effort on the part of motivated participants who had access to several weight-loss resources, the average weight loss achieved was very modest. This leads her to conclude that the key to reversing the obesity epidemic may not lie in the hands of individuals. Instead, community-based programs that start in childhood and help encourage schoolchildren to eat better and move around more may be the best way to combat obesity.

Want to learn more about how to cut calories and maintain weight loss? See How can I control my weight? in the Healia Health Guide to Weight Management, or join the Healia Health Community for Weight Management.

_{Photo: davitydave, Flickr, Creative Commons}

You may have heard that portion sizes served up by restaurants have gone up dramatically over the last several generations. Now, a new report shows that such "portion inflation" is not just confined to restaurants. A study published this week in the Annals of Internal Medicine shows that the average portion sizes in today’s cookbooks have increased by nearly 40 percent in calories per serving in the past 70 years for nearly every recipe reviewed, accounting for an extra 77 calories per serving.

In addition to surveying several cookbooks the study looked more in depth at one particular book that has been a mainstay of American kitchens since the 1930s. Of the 18 recipes that appear in all seven versions of the cookbook (including the most recent 2006 edition), 17 of them have increased in calories per serving. The increases are partly attributable to an increase in the total calories in each recipe (now an average of 567 calories) and to larger portion sizes. One chili recipe demonstrates both such increases: in 1936, the recipe made 14 servings at 228 calories each, while the "same" recipe in the 2006 edition makes 10 servings at 576 calories each.

Several recipes did not change ingredients at all, but portion sizes as much as doubled from the original 1930s recipe. For example, some brownie and cookie recipes that used to make 30 servings now make only 15 from the same amount of batter.

The increases in calorie content and portion size are likely related to the growing affluence of the United States since the 1930s. Recipes that formerly included cheaper, less calorie-dense ingredients like beans and rice now call for meats and fats. Portion sizes may have gotten larger as people became able to afford larger servings.

People who are trying to manage their weight are often told by doctors and nutritionists to eat out less and cook at home more often. The current study suggests that people who are cooking at home using modern recipes may not be cutting their calories as much as they think. However, most excess calories in the American diet still come from food eaten outside the home, according to nutrition experts.

If you are trying to manage your weight, the researchers suggest that you halve the portion size as soon as you cook something from a modern cookbook. Just put the other half away before it even makes it to your plate, where you could end up eating it without even thinking about it. According to the study authors, such "mindless eating" is a large part of the reason why increasing portion sizes – both at restaurants and in the home – are dangerous.

Want to learn more about how to manage your weight sustainably? Read the Healia Health Guide on Weight Management for tips on portion control and ways to avoid mindless eating. To share your story with a community of people who are also trying to manage their weight, join the Healia Health Community for Weight Management. For more on nutrition, join the Healia Health Community on Diet and Nutrition.

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Being obese may be more than just a metaphorical headache – according to a study released this week, obesity may actually increase the risk of getting migraine headaches. The study finds that both men and women with excessive belly fat are more likely to suffer from migraines or other types of severe headaches.

The study examined data from a U.S. Government heath survey of more than 22,000 people and found that people between the ages of 20 and 55 who were considered obese based on their waist circumference were more likely to report suffering from migraines. Nearly 37 percent of obese women in this age group said they had migraines, compared to 29 percent of women who did have excess body fat. About 20 percent of obese men aged 20 to 55 reported migraines, while only 16 percent of non-obese men did.

Complete results of the study will be presented at the upcoming annual meeting of the American Academy of Neurology in Seattle.

Migraines are severe headaches that are sometimes accompanied by visual disturbances, nausea, and sensitivity to light and sound. They are more common in women, tend to run in families, and are most prevalent between the ages of 20 and 45. Migraines affect an estimated 10 percent of the U.S. population, but the percentage is much higher among young and middle-aged adults.

According to the study authors, their findings suggest that losing weight in the stomach area may help young and middle-aged people with migraines, especially women. The next step in this line of research is to demonstrate that losing weight from around the belly actually reduces migraines in this age group.

While there are already several very compelling health reasons to lose weight if you are obese – reductions in the risk of heart attack, stroke, osteoarthritis, certain forms of cancer, and dementia, to name a few – all of them are "future" risks. Someone who has excruciating migraines may be more motivated to lose weight if he or she knew it might help rid them of the headaches they already have.

For more information on migraines, read the Healia Health Guide on Migraine, or share your experiences in the Healia Health Community for Migraine Headache.

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Super Bowl Sunday is the ultimate occasion for a house party. But what kind of food do you serve your hungry football-fan guests? Greasy chips and bean dip? No thanks. The Centers for Disease Control and Prevention (CDC) has compiled a list of healthy, low-fat recipes that contain fruits and vegetables. Fruits and vegetables are low in fat and contain essential vitamins, fiber, and other nutrients that may reduce your risk for many chronic diseases, including heart disease and certain cancers.

Try some of these healthy and delicious recipes for appetizers and dips that will impress even your most demanding and hungry football fans. This way, your guests can sit around all day watching football and eating without being penalized for excessive calorie consumption.

Tortilla Pizzas

Recipe Summary:
Preparation Time: 20 minutes
Number of Servings: 6
Cups of Fruits and Vegetables Per Person: 1.00

Ingredients:

• 12 small corn or flour tortillas
• Vegetable oil or margarine
• 1 (16oz) can refried beans
• 1/4 cup chopped onion
• 2 ounces fresh or canned green chili peppers, diced
• 6 Tbsp red taco sauce
• 3 cups chopped vegetables, such as broccoli, mushrooms, spinach, and bell peppers
• 1/2 cup (2oz) shredded part-skim mozzarella cheese
• 1/2 cup chopped cilantro (optional)

Directions:
Brush one side of each of two tortillas with water. Press the wet sides of the tortillas together to form a thick crust for the pizza. Brush the outside of the tortillas with a small amount of oil or margarine. Evenly brown both sides in a heated frying pan. Repeat with the rest of the tortillas. Set aside. Heat refried beans, chopped onion, and half of the diced chili peppers together in a medium saucepan, stirring occasionally. Remove from heat. Spread about 1/3 cup of the bean mixture on each tortilla pizza. Sprinkle with 1 tablespoon of taco sauce, then top with 1/2 cup of the chopped vegetables, 1 teaspoon of diced chili peppers, and 1 tablespoon of shredded cheese for each pizza. Return to frying pan and heat until cheese melts. Top with cilantro, if desired. Serve immediately.

Cranberry Salsa

Recipe Summary:
Preparation Time: 10 minutes
Number of Servings: 8
Cups of Fruits and Vegetables Per Person: 0.50

Ingredients:

• 4 oz 100% cranberry juice blend
• 1-1/2 cups diced tomatoes
• 1 cup fresh cranberries, sliced thin
• 1/4 cup ripe medium avocado, diced
• 1/2 cup diced pineapple
• 1/2 cup thinly sliced scallions (including green tops)
• 2 Tbsp lemon juice
• 1/4 cup finely chopped jalapeno peppers
• 2 cloves crushed garlic (about 1 tsp)
• fresh ground pepper, as desired

Directions:
Place juice into a saucepan. Boil for about 5 minutes until reduced to about 1 Tbsp of syrup. Place the reduced juice and all remaining ingredients into a medium bowl and stir until incorporated. Chill and serve immediately with favorite chips and vegetables. * Fresh cranberries may be stored in your freezer for up to 1 year.

Cucumber Yogurt Dip

Recipe Summary:
Preparation Time: 15 minutes
Number of Servings: 6
Cups of Fruits and Vegetables Per Person: 0.50

Ingredients:

• 2 cups plain low-fat yogurt
• 2 large cucumbers, peeled, seeded, and grated
• 1/2 cup nonfat sour cream
• 1 Tbsp lemon juice
• 1 Tbsp fresh dill
• 1 garlic clove, chopped
• 1 cup cherry tomatoes
• 1 cup broccoli florets
• 1 cup baby carrots

Directions:
Peel, seed, and grate one cucumber. Slice other cucumber and set aside. Mix yogurt, grated cucumber, sour cream, lemon juice, dill, and garlic in a serving bowl. Chill for 1 hour. Arrange tomatoes, cucumbers, broccoli, and carrots on a colorful platter. Serve with cucumber dip.

Bruschetta with Plums and Fresh Basil

Recipe Summary:
Preparation Time: 30 minutes
Number of Servings: 6
Cups of Fruits and Vegetables Per Person: 1.00

Ingredients:

• 1 sourdough baguette (24 inch)
• 4 oz fat-free cream cheese, whipped
• 6 cups sliced fresh California plums
• 1 cup fresh basil

Directions:
Slice baguette into 24 inch-thick pieces. Toast in a 350°F oven until golden brown. Spread each slice of bread with fat-free cream cheese. Slice plums into thin slices. Place several slices of plum on each piece of bruschetta. Garnish with fresh basil leaf

Avocado Green Onion Party Dip

Recipe Summary
Preparation Time: 30 minutes
Number of Servings: 7
Cups of Fruits and Vegetables Per Person: 0.50

Ingredients:

• 1/2 medium avocado, seeded and peeled
• 1 cup low fat cottage cheese
• 3/4 cup plain, non-fat yogurt
• 1/2 cup sliced green onions
• 1/4 cup shredded carrots
• 1 Tbsp fresh lemon juice
• 1/4 cup non-fat mayonnaise
• 2 cups broccoli florets
• 1 cup cucumber slices
• 28 melba toast rounds

Directions:
Dice avocado into small pieces, toss with lemon juice and set aside. In food processor or blender, blend cottage cheese, yogurt and mayonnaise until smooth. Add cottage cheese mixture to avocado, gently stirring in onions and carrots. Cover and chill. Serve with vegetable crudités and melba toast rounds, allowing ½ cup vegetables, 4 melba toast rounds and 8 Tbsp dip per serving.

_{Source: Centers for Disease Control and Prevention, www.fruitsandveggiesmatter.gov
Photo: David Hudson Floyd, Flickr, Creative Commons}

A small-scale study published in today’s Proceedings of the National Academy of Sciences suggests that women may have a harder time resisting foods that they find tempting than men do. If true, the results may explain why women have higher rates of obesity and why they tend to have a harder time losing weight.

In the study, 13 women and 10 men were initially asked to identify their favorite foods from a list that included such things as fried chicken, chocolate cake, lasagna, barbecued ribs, ice cream, and pizza. After fasting for at least 17 hours, the participants had their brains scanned with a PET scanner while they were being shown pictures of their favorite food. At the same time, the researchers piped in the smell of the food from the next room and even teased the hungry subjects with a taste of the food on a cotton swab placed on their tongue.

The participants previously had been instructed in how to use a technique called cognitive inhibition to suppress thoughts of hunger and eating. After the scans, participants of both sexes reported that the inhibition technique had decreased their hunger, but the brain scans tell a different tale. In men, there was a decrease in activity in areas of the brain that are involved in "emotional regulation, conditioning, and the motivation to eat,” specifically the amygdala, hippocampus, insula, orbitofrontal cortex and striatum. In women, these brain regions remained active, suggesting that despite their attempts to control their hunger, the craving was still there.

The researchers say their finding is consistent with behavioral studies that show women have a greater tendency to overeat when they are presented with foods they like and also during times of emotional stress. It is unclear why this happens, but the researchers suggest that differences between the sexes in levels of sex hormones such as estrogen may be to blame, as such hormones are known to influence food intake, body weight, and fat distribution.

Critics of the study note that it is hard to draw general conclusions from such a small study. They also note that the women in the study were not asked about the status of their menstrual cycle, a factor that could have skewed the results.

Even so, if you are a woman trying to lose weight, or simply trying to maintain your current weight, it may be a good idea to avoid situations in which you will be exposed to tempting foods. If you love donuts, don’t go into a donut shop to get coffee; the sights and smells may be enough to tempt you into buying a pastry you don’t really want. Similarly, going to all-you-can-eat buffets, even if you are planning to “just have a salad,” may not be a good idea. You may also want to convince your spouse or significant other to stop eating tempting foods around you, because beyond just being unfair, this practice could actually sabotage your attempts at trying to stay healthy. Finally, don’t go to the grocery store hungry, especially on “free sample day.”

For more information on healthy eating, join the Healia Health Community on Diet and Nutrition. For specific techniques to help you achieve and maintain a healthy weight, read the Healia Health Guide on Weight Management.


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