Traveling and Smoking during Pregnancy leads to Obesity

The next two weeks I'll be busy traveling for different meetings, so my posting will be extra light. However, before I embark on my travels, I want to leave you with this headline from Yahoo! news: Smoking Mothers Lead to Fat Children.

Apparently, Japanese researchers have found that children of women who smoked at any time during pregnancy are three times as likely to be obese. This does not bode well for my state - which has the 5th highest obesity rate in the nation, and where nearly 30% of women smoke during pregnancy. It seems beyond low birth weight and prematurity, later obsesity is yet another reason to quit smoking if you become pregnant. Not to mention, you will reduce your risk for heart disease, cancer, and stroke.

Quitting smoking is difficult, but help is available.

Facebook breastfeeding debate driving you to drink? Not so fast...

If you've been keeping up with the discussions about Facebook letting pro-anorexia members freely mingle (despite research that says "pro-ana" websites are bad for women) while they ban breastfeeding moms for posting pictures of their children eating (despite research that shows breastfeeding is good for women AND their children), you'll know it's enough to drive anyone to drink.

Not so fast. While research does suggest women may receive some benefits from alcohol consumption, new research published yesterday in the online version of the International Journal of Cancer shows caution is in order.

Researchers followed over 41,000 postmenopausal women of diverse ethnic backgrounds, including African-American, Japanese-American, Latina, Native-Hawaiian and White women. They tracked the women for an average of 8 years and recorded their dietary intake (including alcohol consumption), lifestyle decisions, genetic risk factors, and health outcomes. The investigators found women who drank 2 or more alcoholic beverages of any kind (wine, liquor, or beer) daily had twice the risk of contracting endometrial cancer (cancer of the lining of the uterus) as women who did not drink. They did not find an increased risk for endometrial cancer among women who consumed less than 2 alcoholic drinks daily.

When they separated women according to their preferred/most often consumed beverage, there were differences in rates of endometrial cancer. Women who drank 2 or more servings of wine daily were 3 times as likely to develop endometrial cancer as non-drinkers. Women who drank just 1 or more servings of hard liquor were on average twice as likely to develop endometrial cancer as those who abstained. The investigators did not find any differences among women who preferred beer, mostly because few women identified beer as their primary drink of choice.

The investigators also studied alcohol consumption in relation to other risk factors for endometrial cancer, such as body mass index, history of pregnancy, use of hormone replacement therapy, and smoking. They found lean women (women with a BMI less than 25) who consumed at least two drinks daily had greater risk for endometrial cancer than overweight and obese women. Women who never gave birth also were at greater risk for endometrial cancer if they consumed 2 or more drinks daily. Smokers and women who used hormone replacement therapy did not show increased risk for endometrial cancer based on their alcohol consumption.

So while you may derive some health benefits from enjoying your favorite libation, there also are some risks if you get too carried away too often. In addition to "how many" drinks you have, be mindful of how much you pour into a glass. (Do you ever notice a bottle of wine lasts longer in a restaurant - when someone else is pouring - than it does at home?). Here's a guide to standard serving sizes (yes, that reads 5 ounces for a glass of wine). Bottom line: moderation is key.

Metabolic Syndrome: you can decrease your risk

Most people have heard about common diseases like high blood pressure, diabetes, and arthritis. However, few people know about the metabolic syndrome, which is a disorder that affects an estimated 25% of Americans (and growing), and is associated with serious disease.

The metabolic syndrome is a group of conditions related to your metabolism that occur at the same time. These conditions include: (a) obesity, especially around your belly/mid-section; (b) high blood pressure; (c) abnormal cholesterol levels, including low levels of the "good cholesterol" (HDL) and high levels of triglycerides, or fat in your blood; and (d) insulin resistance, where the normal process your body uses to get sugar (glucose) into your cells does not work, resulting in increased levels of both insulin and glucose in your blood. Having any one of these conditions increases your likelihood of heart disease, heart attack, type 2 diabetes, and stroke. However, having them in combination can double and even triple your risk.

The good news is that lifestyle changes are key to preventing and treating the metabolic syndrome. In a study published in this month's International Journal of Obesity, researchers followed 224 people (80% of whom were women) for one year after assigning them to one of four groups: (1) use of an appetite suppressant alone, (2) a lifestyle modification program to lose weight, (3) the appetite suppressant plus the group lifestyle modification, and (4) the appetite suppressant plus brief meetings with their primary care physicians on weight loss, food diaries, healthy food choices, etc.

All weight loss treatments were successful in helping participants lose weight. Further, they found that weight loss decreased risk for metabolic syndrome: for every 2.2 pounds lost, there was an 8% reduction in the risk for the disorder. Additionally, participants who lost at least 5% of their starting body weight were 59.2% less likely to have the metabolic syndrome, and those who lost at least 10% of their starting body weight were 83.2% less likely to have the metabolic syndrome. Essentially, lose weight - even just a couple of pounds - and you can reduce your risk for the metabolic syndrome and related diseases.

Other ways to prevent and treat the metabolic syndrome? Stop smoking, exercise most days, and eat fiber-rich foods. Sounds like just healthy living to me. Couldn't we all use a little more of that?

Maybe breastfeeding isn't better

After all my ranting about breastfeeding yesterday, I see an article in Pediatrics today that caused me pause. Apparently, women who smoke and breastfeed are lacing their milk with nicotine, and it's having a negative effect.

Researchers in Pennsylvania studied 15 mother-infant pairs to better understand how nicotine affects infants in the short-term. Moms were asked to breastfeed their babies on two separate occasions. On one occasion, the moms dressed in disposable lab coats and gloves and entered a 700 square foot stainless steel chamber to smoke without their babies present. Then they removed their protective garb, washed their hands, provided a sample of breast milk, and breastfed their babies upon demand. The babies were then placed in a crib or on a carpeted floor to sleep. On the second occasion, the moms did not smoke before breastfeeding their babies and putting them down for a nap. On both occasions, researchers monitored the babies' sleep patterns and movement.

The first relevant finding in this study was that both nicotine and cotinine (a metabolite of nicotine) were present in the mothers' breast milk. The researchers estimated the infants received 4.3 times the amount of nicotine when moms smoked before breastfeeding, compared to when they did not.

The second relevant finding is that infants who fed after their mothers' smoked slept 36.7% less than when their mothers did not smoke beforehand. Further, there was a direct and negative relationship between nicotine exposure and sleep: the more nicotine the infants were exposed to, the less they slept. This is not wholly surprising - after all, nicotine is a stimulant.

The researchers suggest that although nicotine has been removed from the list of drugs contraindicated during lactation, nursing mothers who smoke still should consider the negative effects of nicotine on their infants. Since nicotine is not stored in breast milk, they suggest these mothers time their breastfeeding and avoid nursing 30 to 60 minutes after smoking, when nicotine levels peak. They also caution there may be other chemicals transferred in breast milk that we don't know about, and these unknown compounds may have negative health consequences.

What's the moral of this story? Quit if you smoke - it's better for you and your baby. If you don't quit, at least avoid nursing when nicotine levels are highest. You'll transfer less nicotine to your baby, and you both may get more sleep. And that's something everyone in the household can benefit from.

Eat Better, Breathe Easier

Most everyone knows that eating a diet high in fruits, vegetables, whole grains, and lean meats reduces the risk of a number of diseases, including cancer and obesity. A study published this month shows that a healthy diet also reduces the risk of chronic obstructive pulmonary disease, or COPD. COPD occurs when the tubes that carry air in and out of the lungs are partially blocked, making it difficult to breathe. This finding is especially significant for women, because the COPD death rate for women nearly tripled between 1980 and 2000.

Smoking and second-hand smoke exposure are the main culprits of COPD, but not all smokers contract COPD. Additionally, this new study shows that even exsmokers had a lower risk of contracting COPD if they primarily consumed healthy foods. Also interesting: lean women (those with a body mass index less than 21) who consumed a higher fat diet with more refined sugars were more likely to contract COPD whether or not they exercised regularly.

Often smoking and poor eating habits go hand-in-hand, so it's clear that women who smoke are at an even greater risk for developing COPD than previously thought. However, these new findings also suggest that even women who used to smoke can help reduce their future risk for COPD by improving their diets. There are a number of resources available to improve eating habits. Here's a sample. Also visit with your doctor, who may be able to tell you about local resources in your community.

As for smoking...let's all breathe easier.

Stop Smoking, Start Gaining?

Many women who smoke say they are afraid to stop smoking for fear of gaining weight. However, new research suggests that reductions in smoking rates had less than a 1% effect on increased rates of obesity nationwide. Further, a forthcoming study shows that among weight-concerned smokers trying to quit, nicotine has only a small and temporary effect on weight maintenance.

What does contribute to weight gain? A social network analysis of over 12,000 people between 1971 and 2003 showed that friends and family are key. Individuals were 57% more likely to become obese if a friend became obese, 40% more likely if a sibling became obese, and 37% more likely if a spouse became obese. Further, same sex friends and family members had more influence on weight gain than opposite sex friends and family members.

So if you're worried about how quitting smoking might affect your waistline, fret no more. And whether you smoke or not, do take a look around your inner circle. If you see women friends and family members packing on the pounds, you may want to suggest a walk as opposed to a meal when spending time together.