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Study finds Gastric Banding can be used to prevent diabetes

13 February 2014

Study finds Gastric Banding can be used to prevent diabetes

Weight loss could be crucial in preventing patients with impaired fasting glucose (IGF) developing diabetes, according to a study published in Diabetologia. The authors from the Centre for Obesity Research and Education (CORE), Monash University,the Walter and Eliza Hall Institute, University of Melbourne, and the Baker IDI Heart and Diabetes Institute, Australia, report that patients who received a laparoscopic adjustable gastric band (LAGB) had a reduced risk of progressing from IFG to diabetes.

“We show that the rate of progression from IFG to diabetes is substantially reduced in obese people who undergo LAGB surgery…these findings strengthen the case for a randomised trial to determine whether LAGB surgery is a safe and cost-effective approach to preventing type 2 diabetes in this population.”

Study

The investigators note that patients with IFG are at high risk of developing type 2 diabetes and obesity is a major risk factor. Therefore, they assessed whether LAGB in obese patients with IFG reduced the risk of developing type 2 diabetes.

This retrospective cohort study looked at the outcomes of obese people with IFG who underwent LAGB and compared them with those of Australian adults with IFG from a population-based study (AusDiab).

A total of 3,174 patients underwent LAGB between October 1995 and August 2007, 333 (248 women and 85 men) had IFG (5.6–6.9mmol/l) and no history of diabetes or of glucose-lowering drug use. Of the 333 patients, 281 (84%; 210 women and 71 men) had follow-up weight and FPG data.

At five years, the LAGB patients lost an average of 25kg. After a minimum follow-up period of four years, 14 patients developed diabetes (12 women) and 169 did not. There was a strong relationship between the weight change and the occurrence of diabetes.

When they compared these results with those of 1,043 AusDiab patients who had IFG and were followed for five years, 65 AusDiab participants developed diabetes. Importantly, when they examined obese AusDiab patients, the incidence of diabetes increased significantly (p<0.001) and was greater than the LAGB group (p<0.02).

GASTRIC BANDING WAS ASSOCIATED WITH A REDUCED RISK OF DIABETES OF MORE THAN 75%

To assess whether banding was independently associated with diabetes, they combined the data from both groups, replacing percentage weight change with the presence or absence of LAGB surgery. They found that from 1,324 patients, LAGB was associated with a reduced risk of diabetes of more than 75% (OR 0.239 [95% CI 0.095, 0.571], p =0.004), with female sex and baseline FPG also significantly associated with progression to diabetes.

Conclusion

“Taken together with the findings of the multivariable analysis, we conclude that weight loss in obesity complicated by IFG prevents progression to diabetes,” the authors write. “This accords with the recent Swedish Obese Subjects findings, trials of weight loss drugs and other reports of remission of diabetes after medical or surgically induced weight loss.”

World study highlights NZ obesity rate

7 February 2014

World study highlights NZ obesity rate

A World Health Organisation study of fast food purchases per capita has found that New Zealand is one of the worst, with a sharp increase in both fast food consumption and obesity rates.

In a ranking of 25 countries, New Zealand had the fourth highest increase in terms of fast food purchases.

The authors behind the study suggest that better regulation of food products is the answer to cutting back on unhealthy eating.

Rather than looking at the density of fast food outlets or self-reported fast food consumption as researchers have done in the past, the authors took the novel approach of taking data on the number of fast food transactions per capita from 1999 to 2008 in 25 high-income countries and compared them with figures on body mass index (BMI) in the same countries over the same time period as an indication of fast food consumption.

A person with BMI of 25 or more is considered overweight, while one with a BMI of 30 or more is considered obese.

The authors of the study found that while the average number of annual fast food transactions per capita increased from 26.61 to 32.76, average BMI increased from 25.8 to 26.4. Thus, each 1-unit increase in the average number of annual fast food transactions per capita was associated with an increase of 0.0329 in BMI over the study period.

Auckland University's Professor of Population Nutrition and Global Health, Boyd Swinburn, says New Zealand should be taking notice of the study.

"New Zealand, the US, UK and Australia tend to be quite de-regulated, but northern european countries in particular tend to be more regulated, so what they found was that the higher the level of regulation, the less the fast food purchases and the less the obesity," Mr Swinburn said.

So we're starting to dig into some of the underlying causes if you like of the environment that's creating the obesity."

Mr Swinburn says we need to stop marketing fast food to children.

"Many countries have regulations against that and in New Zealand we say it's ok, we'll leave it up to the industry."

He also says we should look at introducing a calorie count on menu boards to see how many calories are in the item we're buying.

"I don't think we're doing things right in New Zealand and there's quite a few countries now that are getting the picture and are starting to put some regulations in place to make the environment less creating of obesity."

One in three kiwi children are said to be overweight or obese.

NZ Obesity Statistics - Ministry of Health 2012/13

7 February 2014

NZ Obesity Statistics - Ministry of Health 2012/13

Obesity key facts and statistics

This page provides introductory statistics about obesity in New Zealand as it affects adults and children.

Adult obesity statistics

The 2012/13 New Zealand Health Survey found that:

  • almost one in three adults (aged 15 years and over) were obese (31%), a further 34% were overweight
  • 48% of Māori adults were obese
  • 68% of Pacific adults were obese
  • there has been an increase in obesity in males from 17% in 1997 to 30% in 2012/13
  • there has been an increase in obesity in females from 21% in 1997 to 32% in 2012/13.

Child obesity statistics

The 2012/13 New Zealand Health Survey found that:

  • one in nine children (aged 2 to 14 years) were obese (11%)
  • a further one in five children were overweight (22%)
  • 19% of Māori children were obese
  • 27% of Pacific children were obese
  • children living in the most deprived areas were three times as likely to be obese as children living in the least deprived areas. This finding is not explained by differences in the sex, age or ethnic composition of the child population across areas of high and low deprivation
  • the childhood obesity rate has increased from 8% in 2006/07 to 11% in 2012/13.

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