High BMI Causes Depression – and Both Physical and Social Factors Play a Role

A largescale new study provides further evidence that being overweight causes depression and lowers wellbeing and indicates both social and physical factors may play a role in the effect.

With one in four adults estimated to be obese in the UK, and growing numbers of children affected, obesity is a global health challenge. While the dangers of being obese on physical health is well known, researchers are now discovering that being overweight can also have a significant impact on mental health.

The new study, published in Human Molecular Genetics, sought to investigate why a body of evidence now indicates that higher BMI causes depression. The team used genetic analysis, known as Mendelian Randomisation, to examine whether the causal link is the result of psychosocial pathways, such as societal influences and social stigma, or physical pathways, such as metabolic conditions linked to higher BMI. Such conditions include high blood pressure, type 2 diabetes and cardiovascular disease.

In research led by the University of Exeter and funded by the Academy of Medical Sciences, the team examined genetic data from more than 145,000 participants from the UK Biobank with detailed mental health data available. In a multifaceted study, the researchers analysed genetic variants linked to higher BMI, as well as outcomes from a clinically-relevant mental health questionnaire designed to assess levels of depression, anxiety and wellbeing.

To examine which pathways may be active in causing depression in people with higher BMI, the team also interrogated two sets of previously discovered genetic variants. One set of genes makes people fatter, yet metabolically healthier, meaning they were less likely to develop conditions linked to higher BMI, such as high blood pressure and type 2 diabetes. The second set of genes analysed make people fatter and metabolically unhealthy, or more prone to such conditions. The team found little difference between the two sets of genetic variants, indicating that both physical and social factors play a role in higher rates of depression and poorer wellbeing.

Lead author Jess O’Loughlin, at the University of Exeter Medical School, said: “Obesity and depression are both major global health challenges, and our study provides the most robust evidence to date that higher BMI causes depression. Understanding whether physical or social factors are responsible for this relationship can help inform effective strategies to improve mental health and wellbeing. Our research suggests that being fatter leads to a higher risk of depression, regardless of the role of metabolic health. This suggests that both physical health and social factors, such as social stigma, both play a role in the relationship between obesity and depression.”

Source: University of Exrter

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Incomplete Polyp Removal During Colonoscopy Can Bring Cancer Danger

Amy Norton wrote . . . . . . . . .

Colonoscopy screening can help prevent colon cancer by allowing doctors to find and remove potentially pre-cancerous growths called polyps. But if they fail to get the whole growth, the odds of a recurrence are high, a new study shows.

The likelihood that it will occur within the next few years more than doubled.

Repeat exams found a new growth in the same colon segment 52% of the time compared to 23% in colon segments where polyps had been completely removed, the findings showed.

And the prevalence of advanced polyps — ones with a greater cancer potential — was six times higher in colon segments where there’d been an incomplete removal: 18% versus 3%.

Experts said the findings point to the importance of doctors’ technical skills, not only in finding polyps, but in removing them.

Polyps are growths in the lining of the colon that are most often benign, but in some cases develop into cancer. For that reason, doctors usually remove any polyps they spot during routine colonoscopy screening.

Doctors’ polyp detection rate has long been seen as a measure of their skill. In fact, patients are encouraged to ask their doctor what her or his polyp detection rate is before having a colonoscopy, said Dr. Douglas Rex, president of the American Society for Gastrointestinal Endoscopy, in Downers Grove, Ill.

“Some [doctors] are very good at it, and others aren’t good,” Rex said.

But it’s only more recently that doctors’ variance in removing polyps has come under scrutiny. The new findings add to evidence that competence in polyp removal “clearly needs to be addressed,” said Rex, who was not involved in the research.

At the same time, he stressed that no one should be deterred from getting a colonoscopy. “It detects a lot of colon cancers, and can prevent colon cancer,” Rex said. “Overall, it’s a very powerful tool.”

Plus, he noted, the large majority of polyps in this study were completely removed.

The findings were published online in the Annals of Internal Medicine.

Past studies have estimated that incomplete polyp removal contributes to anywhere from 10% to 30% of colon cancers that develop after colonoscopy screening.

But it has not been clear the incomplete removal, per se, is to blame.

It’s a tricky matter to parse out, explained Dr. Heiko Pohl, lead researcher on the new study. Even when a polyp is incompletely removed, a new one detected at a follow-up exam may or may not be a regrowth.

It could be a polyp that was missed before, said Pohl, a gastroenterologist at the VA Medical Center in White River Junction, Vt.

For their study, his team looked at data on 166 patients who’d taken part in an earlier research project. There, the researchers had found that of 346 polyps removed by 11 gastroenterologists, 10% were incompletely removed.

The researchers verified that by analyzing biopsied tissue from the margins of the removed polyp: If polyp tissue was present, that meant removal was incomplete. Those patients were advised to return for a repeat exam within a year.

Of the 166 patients in the current study, 32 had at least one polyp that was incompletely removed. Pohl’s team found that in colon segments where there had been an incomplete removal, the odds of new growth were significantly higher.

The researchers estimated that incomplete polyp removal accounted for 28% of all new growths detected in the study group.

But while some patients did have advanced polyps, none had cancer, Pohl said. The growths were considered advanced based on their size.

According to Dr. Reid Ness, an associate professor of medicine at Vanderbilt University Medical Center in Nashville, Tenn., “These results emphasize the necessity for endoscopists to perform [polyp removal] using instruments and techniques shown to reliably result in complete polyp resection.”

For patients who have had polyps removed, Ness said, the important thing is to return for follow-up exams.

The recommended interval varies patient to patient, based on factors like the polyp size, Rex noted. (With larger growths, follow-up is generally shorter.)

The findings are not a cause for alarm, the experts said.

Perspective is important, Pohl explained. Polyps are very common, whereas the average person has about a 5% lifetime risk of developing colon cancer, he said.

At this point, Pohl noted, patients cannot ask their doctor about his or her rate of incomplete polyp removal: There is no way for doctors to track that performance as they do with their polyp detection rate.

Source: HealthDay

Spicy Pork Risotto

Ingredients

I thick slice white bread
water or milk, for soaking
1 lb fresh ground pork
2 garlic cloves, minced
1 tbsp finely chopped onion
1 tsp black peppercorns, lightly crushed
pinch of salt
1 egg
corn oil, for pan-frying
14 oz canned chopped tomatoes
1 tbsp tomato paste
1 tsp dried oregano
1 tsp fennel seeds
pinch of sugar
4 cups beef stock
1 tbsp olive oil
3 tbsp butter
1 small onion, finely chopped
generous 1-3/8 cups risotto rice
2/3 cup red wine
salt and pepper
fresh basil leaves, to garnish

Method

  1. Cut off and discard the crust from the bread, then soak in the water or milk for 5 minutes to soften. Drain and squeeze well to remove all the liquid.
  2. Mix the bread, pork, garlic, onion, crushed peppercorns, and salt together in a bowl. Add the egg and mix well.
  3. Heat the corn oil in a skillet over medium heat. Form the meat mixture into balls and brown a few at a time in the oil. Remove from the skillet, drain, and set aside until all the meatballs are cooked.
  4. Combine the tomatoes, tomato paste, oregano, fennel seeds, and sugar in a heavy-bottom pan. Add the meatballs. Bring the sauce to a boil over medium heat, then reduce the heat and let simmer for 30 minutes, or until the meat is thoroughly cooked.
  5. Make the risotto. Bring the stock to a boil in a pan, then reduce the heat and keep simmering gently over low heat while you are cooking the risotto.
  6. Heat the olive oil with 2 tablespoons of the butter in a deep pan over medium heat until the butter has melted. Stir in the onion and cook, stirring occasionally, for 5 minutes, or until soft and starting to turn golden. Do not brown.
    Reduce the heat, add the rice, and mix to coat in oil and butter. Cook, stirring constantly, for 2-3 minutes, or until the grains are translucent.

  7. Add the wine and cook, stirring constantly, for 1 minute until reduced. Gradually add the hot stock, a ladleful at a time. Stir constantly and add more liquid as the rice absorbs each addition. Increase the heat to medium so that the liquid bubbles. Cook for 20 minutes, or until all the liquid is absorbed. Season to taste.
  8. Lift out the cooked meatballs and add to the risotto. Remove the risotto from the heat and add the remaining butter. Mix well. Arrange the risotto and a few meatballs on plates. Drizzle with tomato sauce, garnish with basil, and serve.

Makes 4 servings.

Source: Risotto


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