Study says obesity may soon be top cancer cause

If its rates keep climbing, obesity could rise from causing 8 percent of all cancers in Europe, to becoming the top cause in women, according to an Associated Press article published by the Washington Post yesterday.

lipocytes-fat-cells-picture

From How Stuff Works: When more calories are consumed than used, extra fat accumulates in the lipocytes

“Obesity is catching up at a rate that makes it possible it could become the biggest attributable cause of cancer in women within the next decade,” said Andrew Renehan, a cancer expert at the University of Manchester. Renehan presented his findings to a joint meeting of the European Cancer Organisation and the European Society for Medical Oncology in Berlin on Thursday.

Renehan and colleagues designed a model to estimate the number of cancers that could be blamed on being fat in 30 European countries. In 2002, they calculated that 70,000 cases of cancer out of about 2 million cancer cases were attributable to being overweight or obese. By 2008, the number had jumped to at least 124,000.

Colorectal cancer, breast cancer in menopausal women and endometrial cancer accounted for 65 percent of all cancers linked to being fat. Renehan said that in the U.S., some studies found obesity was responsible for up to 20 percent of cancers.

Sad kids more likely to be obese adults

Here’s an interesting study that seems to bear witness to the findings in the ACE Study that link child abuse — physical, sexual and emotional — to adult obesity:

From MedPage Today, a review of a study from the journal, BMC Medicine, in which Andrew Picture 6Ternouth, PhD, of the Institute of Psychiatry at King’s College in London, with co-authors David Collier and Barbara Maughan found that:

Sad youngsters are more likely to grow up to be fat adults, particularly if the unhappy child is a girl, according to a British study of more than 6,500 adults who were born in 1970.

The study’s part of the 1970 Birth Cohort Study of 16,496 people who were born in England and Wales. More details:

  • The strongest predictors of adult BMI were BMI at age 10 and parental BMI.
  • Self-esteem, self-reported worrying, self-reported nervousness, and locus of control all significantly predicted weight gain.
  • There was significant interaction between emotionality and locus of control and gender — the impact of these factors was greater in women than in men.
  • Childhood emotional problems predicted weight gain in women only. Childhood self-esteem predicted weight gain in both men and women, although the effect was stronger in women. An external locus of control predicted weight gain in both men and women.

Did obesity conference leave something out?

The CDC held its first “Weight of the Nation” conference in July. It issued the report “Recommended Community Strategies and Measurements weightofnationto Prevent Obesity in the United States,” along with a companion implementation guide. The report recommends 24 environmental and policy strategies to prevent obesity. They include affordable health food and beverages and promoting physical activity. Preventing child trauma wasn’t on the list, even though child trauma and obesity are linked.

Research by David Williamson, a CDC researcher who used data from the Adverse Childhood Experience Study to look at the connection between child trauma and obesity, shows a link between child abuse — physical, sexual and emotional — and obesity in at least 8 percent of the obese population. With 70 million obese and morbidly obese Americans, that’s five million people.

Researchers know that obesity is complex issue: there’s no one answer to solve it. The CDC has a great Web site about obesity. But nowhere does it mention the link between childhood trauma and obesity. And nowhere in the “Recommended Strategies” does it say that one of the many approaches communities can take to prevent obesity is to prevent child abuse. As a journalist, I’m curious about this and want to find out why.

And during this time of grappling with rising health-care costs, obesity is a matter of economics, too. A study also issued at the conference showed that the health cost of obesity in the United States is as high as $147 billion annually. Dr. William Dietz, director of CDC’s Division of Nutrition, Physical Activity and Obesity, noted that obesity can lead to diabetes, heart disease and some cancers. That’s why people who are obese spend nearly $1,500 more each year on health care than those who aren’t obese. And the number is in an upward trend: the study noted that the proportion of all annual medical costs that are due to obesity increased from 6.5 percent in 1998 to 9.1 percent in 2006.

Update: I asked Dr. David Brown, an epidemiologist at the Centers for Disease Control and Prevention and lead author on recent ACE Study research that links child trauma with premature mortality, why it’s taking so long for the CDC to integrate the ACE Study research with its other programs. He gave the following answer:

The classic CDC model is that a program develops, and eventually, there’s enough interest to include it in the states’ BRFSS (Behavioral Risk Factor Surveillance System) to gather some population-based data. This is used as evidence to educate policy makers. “It’s a step-wise process,” says Brown, “building evidence that motivates people to do something with the research.”

In the late 1980s, the CDC started gathering national data on the prevalence of high blood cholesterol and high blood pressure. “Once we began getting data on a national level, and started some clinical trials, then things started to move,” says Brown. In the mid- to late 1990s, state-based programs in heart disease and stroke emerged. In 2000 – 2005, all the states founded programs. But one of the huge studies that led to the current awareness and prevention programs of heart disease started 60 years ago, with the Framingham Heart Study — in 1948.

“That’s a long process,” says Brown. “That’s kind of where this [link between child trauma and adult chronic disease] is at as well.”

The report, “Recommended Community Strategies and Measurements to Prevent Obesity in the United States,” along with a companion implementation guide, appears in CDC’s MMWR Recommendations and Reports. A companion implementation guide is also available on the CDC Web site.
“It is critical that we take effective steps to contain and reduce the enormous burden of obesity on our nation”, said CDC Director Thomas Frieden, M.D., M.P.H. “These new recommendations and their proposed measurements are a powerful and practical tool to help state and local governments, school districts, and local partners take necessary action.”
The Common Community Measures for Obesity Prevention Project was guided by a systematic process that included expert opinion and a review of the published scientific literature, resulting in the adoption of 24 recommended environmental and policy level strategies to prevent obesity.
The strategies promote the availability of affordable healthy food and beverages, support healthy food and beverage choices, encourage breastfeeding, encourage physical activity or limit sedentary activity, support safe communities that support physical activity, and encourage communities to organize for change.

ACEs Too High launches!

Labor Day weekend, 2009. Eleven years after the first research paper about the Adverse Childhood Experiences Study came out in the American Journal of Preventive Medicine. Its co-founders thought that the results rang so clear and true that the medical, public health and social services communities would embrace its findings immediately. So far, it’s been a relative handful of very observant social service experts who work in cultures that embrace change. The medical and public health communities are moving more slowly.

Doesn’t it seem as if the most revolutionary ideas take a very long time to wend their way through our society to

ACE pyramid is study's conceptual framework

Pyramid represents ACE Study concept

adoption and integration? Perhaps it takes so long, because the truly revolutionary ideas ping so many different institutions and cultures.

It’s also four years after I wrote my first article about the ACE Study. “Targeting obesity at its roots: Childhood trauma may be at the core of the epidemic of overweight adults” appeared in the Sacramento Bee’s Sunday Forum section. There’s no link, because only staff-written articles remain in their archives. So, I’ve appended the article to the end of this post.

Thanks to Connie Valentine, founder of the Incest Survivors Speakers Bureau in Davis, CA, for introducing me to Dr. Vincent Felitti, retired chief of Kaiser Permanente’s Department of Preventive Medicine in San Diego and Continue reading

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