Tag Archives: obesity

Introduction Recent updates to guidelines for the management of type 2 diabetes (T2DM) have emphasised the importance of addressing cardiorenal risk and weight control, in conjunction with blood glucose regulation.1–4 All guidelines remain committed to lifestyle interventions (diet, physical activity and behavioural changes) as foundational therapy to be introduced at diagnosis, optimised and continued life-long. However, the progressive nature of T2DM typically requires the addition and dose-escalation of one or more blood glucose-lowering agents to achieve and maintain adequate glycaemic control.5 Several of the newer glucose-lowering ag

Introduction Atrial fibrillation (AF) is a common arrhythmia responsible for significant patient morbidity, including stroke, heart failure and intrusive palpitations.1 Obesity is well recognised as a contributor to AF incidence and symptom burden.2 Weight loss has been shown to reduce occurrence of AF and increase the likelihood of maintaining sinus rhythm after cardioversion or catheter ablation for AF.3–5 Although it has been demonstrated that weight loss can reduce AF burden in a trial setting, it is well recognised that motivation for sustained weight loss is low in a real-world population, and often any weight loss achieved is tempora

Introduction The World Health Organisation (WHO) defines obesity as “abnormal or excessive fat accumulation that may impair health” and classifies obesity based on body mass index (BMI), with those with a BMI of 25–30 kg/m2 termed as overweight and those with BMI over 30 kg/m2 defined as obese.1,2 Obesity has reached pandemic levels in the last 50 years.3 One and a half billion people over the age of 20 in the world are thought to be overweight or obese.4 Obesity is associated with low-grade chronic inflammation leading to insulin resistance, which may progress to diabetes mellitus.5 Moreover, fatty liver disease, systemic hypertension

25in25 The meeting began with an update on the 25in25 initiative from BSH Chair-Elect Dr Lisa Anderson (St George’s University Hospital, London). This national quality improvement initiative, led by the BSH in collaboration with over 54 national and international healthcare organisations, has the goal of reducing heart failure deaths by 25% over the next 25 years. With already over one million people in the UK living with heart failure, a number which is expected to double by 2040, the ambitious initiative is eagerly awaited. In the UK alone this could translate to over 10,000 lives saved per year. A population health approach underpins th

Introduction Overweight and obesity are a global pandemic.1 These evermore frequent conditions are associated with serious chronic diseases (e.g. diabetes mellitus, hyperlipidaemia, cancer), and incremented risk for cardiovascular events.2,3 Metabolic syndrome (MS), a constellation of anthropometric and metabolic anomalies, is frequently associated with an increased body mass index (BMI) and related to an adverse cardiovascular prognosis.4 Despite the well-established association between BMI and cardiovascular prognosis, the concept of healthy obesity has emerged in more recent years, resembling a phenotype of obesity without metabolic distur

Introduction Triglycerides (TG) and cholesterol are water-insoluble molecules that are transported through the aqueous medium of plasma in large quantities from sites of absorption, synthesis or storage to tissues that require them for cell functions such as energy production. To enable transport to occur, these lipids are solubilised into plasma lipoproteins which have the general structure of a lipid-filled core and a surface of phospholipid and specific proteins. It is the proteins that direct the fate of the contained lipid by interacting with key lipolytic enzymes and cell membrane receptors. Figure 1 depicts the general structure of lip

What’s new in transplantation Are kidney donors worse off? The meeting was opened by Dr Anna Price (Queen Elizabeth University Hospital, Birmingham) who addressed the long-term cardiovascular effects of unilateral nephrectomy in living kidney donors.1 Previous studies have shown a significant prevalence of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD),2,3 but the effects of reduced renal function in living kidney donors has been unexplored until now. A recent study by Price et al. demonstrated that living kidney donors had a reduction in estimated glomerular filtration rate (eGFR) from 95 to 67 ml/min

So what should the government be doing to tackle obesity? A new podcast, from the Health Foundation discusses this question and more with: Dame Sally Davies, Master of Trinity College Cambridge, and former Chief Medical Officer for England and Chief Medical Adviser to the UK government Harry Rutter, Professor of Global Public Health at the University of Bath James Forsyth, Political Editor at The Spectator and regular columnist for The Times. The podcast can be viewed at: https://www.health.org.uk/news-and-comment/podcast/episode-02-the-government-and-obesity

Introduction It is time to adopt recent (and even some 20th century) evidence for obesity and weight management. Some aspects of current practice, both clinical and epidemiological, are still largely lodged in the mid-19th century. The body mass index (BMI) was first proposed in 1835 by Adolphe Quetelet, a Belgian mathematician, as a way to standardise body composition assessment for people of different heights. His work was published in the English language a few years later.1 At that time, few people, mostly affluent, had a BMI above 30 kg/m2, and far fewer had type 2 diabetes. The main public health concern was malnutrition, and BMI <18

Acute heart failure is a common cause of admission to hospital with over 67,000 admissions in England and Wales a year, and is the leading cause of hospital admission in people 65 years or older in the UK. NICE expects the six quality statements will help improve outcomes from this condition. The six quality statements are: Adults presenting to hospital with new suspected acute heart failure have a single measurement of natriuretic peptide. Adults admitted to hospital with new suspected acute heart failure and raised natriuretic peptide levels have a transthoracic doppler 2D echocardiogram within 48 hours of admission. Adults admitted to hos