Obesity May Shorten Lives By Almost 4 Years: Study

And obese middle-aged people die an average of more than 7 years sooner, U.S. statistics show

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

THURSDAY, Jan. 16, 2014 (HealthDay News) -- Obese American adults die an average of almost four years earlier than those with normal weight, and middle-aged obese adults face the highest risk of an early death, a new study suggests.

One expert wasn't surprised by the findings.

"As we are watching the epidemic of obesity grow, we need to understand the huge implications -- not just on chronic illness, but also the effect on life expectancy," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City.

"It is time that we treat obesity as a medical illness, because, as with other chronic diseases, it causes premature death," said Steinbaum, who was not involved in the study.

In the study, researchers Dr. Luisa Borrell and Lalitha Samuel of the City University of New York reviewed data collected by the U.S. National Health and Nutrition Examination survey between 1988 and 1994, as well as national death statistics through the year 2006.

They found that obesity was associated with at least a 20 percent increased risk of death from all causes or from heart disease. Overall, obese adults died 3.7 years earlier from all causes and 1.7 years earlier from heart disease, compared with normal-weight adults.

The study found the risk to be highest among obese adults aged 45 to 64, who died 7.1 years earlier from all causes and up to 12.8 years earlier from heart disease.

Kelly Hogan is a clinical dietitian at Mount Sinai Hospital in New York City. She said the health impact of the obesity epidemic in the United States might be even greater in the future.

"Given the prevalence of obesity among children and young adults, early intervention is absolutely essential in order to prevent this trend from increasing exponentially as these populations continue to age," Hogan said. More resources spent on educating Americans about healthy eating could go a long way toward saving lives, she added.

Steinbaum agreed that more must be done. "As time goes on and obesity increases, life expectancy is going to decrease," she said. "The drain on the health care system will rise."

The study was published online Jan. 16 in the American Journal of Public Health.

source : Obesity May Shorten Lives By Almost 4 Years: Study

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Hormone Therapy May Cut Risk of Repeat Joint Replacement Surgery in Women

Those who took it after hip, knee replacement saw risk of second procedure drop by about 40 percent

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By Steven Reinberg

HealthDay Reporter

THURSDAY, Jan. 23, 2014 (HealthDay News) -- Women who start hormone replacement therapy after having had hip or knee replacement surgery may cut their risk of needing another procedure in the same joint by nearly 40 percent, a new study suggests.

About 2 percent of those who have a hip or knee replacement need another surgery within three years. Most of these additional procedures are needed because of a complication known as osteolysis, which happens when tiny pieces of the implant seep into the tissue around the implant, causing inflammation that destroys the bone around the implant, the British researchers explained.

"There is evidence that drugs like hormone replacement therapy, used usually to prevent osteoporosis and fractures, might have a beneficial effect on implant survival in patients undergoing knee or hip replacement," said lead researcher Dr. Nigel Arden, director of musculoskeletal epidemiology at the University of Oxford in England.

"These findings must be confirmed in further studies, but they are consistent with previous reports by our group showing an association between use of other drugs that have similar effects on bone and the risk of implant revision [surgery]," he said.

However, many women are nervous about taking hormone replacement therapy because of previously reported increased risks for heart disease and cancer. Since the risk of a second surgery is small, the question remains whether or not it's worth starting hormone replacement therapy at all.

"Indeed, this is only a small added benefit of hormone replacement therapy. However, it is a relevant piece of information for women who have received a total knee or hip replacement and are considering hormone replacement therapy for menopausal symptoms," Arden said.

The report was published online Jan. 22 in the Annals of the Rheumatic Diseases.

For the study, Arden and his colleagues collected data on more than 21,000 women who had not used hormone replacement therapy after a hip or knee replacement. The investigators compared these women with more than 3,500 women who had taken hormone replacement therapy for at least six months after surgery.

The researchers found that women who had taken hormone replacement therapy for six months after surgery were 38 percent less likely to need another surgery than those who had not.

Moreover, women who took hormone replacement therapy for a year or more after surgery were more than 50 percent less likely to need another surgery over three years of follow-up.

Taking hormone replacement therapy before joint replacement, however, didn't make a difference in the risk for a repeat procedure, the researchers noted.

Dr. Neil Roth, an orthopedic surgeon at Lenox Hill Hospital in New York City, thinks there may be a role for drugs that help build and strengthen bone after knee and hip replacement surgeries. Based on this study, hormone replacement therapy might also be helpful, he added.

Roth noted, however, that this study only showed an association, and not a cause-and-effect link, between hormone replacement therapy and a lowered risk for another surgery.

"Right now, I wouldn't make any changes in the way I clinically treat things based on this study, but I think it deserves further investigation," he added.

source : Hormone Therapy May Cut Risk of Repeat Joint Replacement Surgery in Women

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First-Time Cesarean Rates Dipped in 2012: CDC

But doctor says the surgical births are still too commonplace

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

THURSDAY, Jan. 23, 2014 (HealthDay News) -- Efforts to curb cesarean birth rates in the United States might be working, with health officials reporting a 2 percent decline in the number of first-time surgical deliveries between 2009 and 2012.

Cesarean delivery rates in 19 states reporting to the U.S. Centers for Disease Control and Prevention averaged 21.9 percent in 2012, the CDC said in a report released Thursday. This represented a return to the rate last recorded for those states in 2006.

Report co-author Michelle Osterman, a statistician at the CDC's National Center for Health Statistics, said the turnaround was significant. "The rates had been going up every year, but in 2009 they either stabilized or started to come down," she said.

The real impact might be felt in the overall cesarean rate, Osterman said.

"Because primary cesareans are starting to decline, the overall cesarean rate will be impacted because there is only a 10 percent chance that a woman who has had a cesarean is going to have a vaginal birth afterward," she said. The overall rate has stabilized at about 33 percent of all births in the United States, Osterman said.

One expert said the report indicates slight progress.

"At least the rate stopped going up," said Dr. Mitchell Maiman, chairman of obstetrics and gynecology at Staten Island University Hospital in New York City. "After decades of climbing, there seems to be a hold to it. But we could do a lot better."

The risks to the mother and baby are much higher in a cesarean birth than in a vaginal birth, Maiman said.

"Once you have the first cesarean, you're overwhelmingly likely to have repeat cesareans," he said, noting the odds for complications and death rise dramatically with each additional C-section. "It's also worse for the baby as multiple studies have proven."

Risks to the mother include infection, excessive bleeding and blood clots traveling to the legs or lungs. Risks to the baby include injury during delivery, breathing problems and the potential need for intensive care.

"Vaginal delivery is the preferred method for having a baby," Maiman said. "Cesarean should only be resorted to when it's absolutely necessary."

Maiman said the cesarean rate is so high because doctors fear malpractice lawsuits.

"The pressure is on physician practices because it takes so much time and energy to stay with a patient for hours for a vaginal delivery, compared to the quickness of a cesarean," he said. "Most of the lawsuits are for the failure to do a cesarean in a timely fashion."

In a separate reporting region, the researchers found that in 28 states and New York City, the first-time cesarean rate dropped from 22.1 percent in 2009 to 21.5 percent in 2012.

source : First-Time Cesarean Rates Dipped in 2012: CDC

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