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Dropping Preschool Obesity Rates an Encouraging Sign

Thursday, April 3rd, 2014

The news is mixed when it comes to obesity rates in the United States. The good news is that the obesity rates in preschool-age children appears to be dropping. The latest data shows a decline in preschool obesity, from 14% to 8% since 2003. However, at the same time, obesity rates in women over 60 seems to be going in the opposite direction. The overall obesity rate hasn’t changed in the last ten years.

By analyzing data from the CDC’s National Health and Nutrition Examination Survey (NHANES), researchers determined that there has been a significant drop in obesity rates in two- to four-year-old children, particularly those from low income families who participate in federal nutrition programs. The news is encouraging because it means that there is hope for affording even more widespread and long-term changes.

One piece of information the new data does not provide is the precise reasons for the changes. However, in recent years, there has been an increasing initiative at both local and regional levels to provide enhanced opportunities for increased physical activity and improved nutrition in child care centers and schools, probably playing a role in the positive changes that are occurring. For example, consumption of sodas and other sugary drinks has declined, which is most likely one major factor.

The CDC also reported last year that only one in five adults gets enough exercise, something that could certainly contribute to the rising obesity rates in older women. Healthy adults over 65 should strive for the equivalent of 30 minutes of brisk walking five days a week plus strength exercises twice a week. Children need much more; those under 18 should be getting around an hour a day of aerobic exercise, plus muscle and bone strengthening activities.

However, it’s important to recognize that adding more exercise into your daily routine alone will most likely not be enough to achieve significant weight loss. If you have extra weight to lose, and you are ready to get started, realize that while exercise plays an important role, nutrition plays a much more important one. This is partly because many people overestimate the number of calories they burn exercising, or they are hungrier after they exercise and eat more to compensate.

Sometimes creating small changes in your diet may be all you need; others will need to make more dramatic changes. Either way, making the changes gradually will probably help you develop more lasting habits and ultimately see better results. Focus on natural, healthy foods, and try some helpful tricks such as eating more slowly, planning meals ahead of time, and getting more sleep, if you don’t tend to get enough. Lots of helpful information can be found here.

The bottom line is that the unchanging overall obesity rate means that there is an ongoing need for education and initiative. However, the decline in preschool obesity is an encouraging sign that the scales may be starting to tip in the right direction.

– Yvonne S. Thornton, M. D., M. P. H.

Teen Pregnancy May Be Associated With Obesity Risk in Later Life

Thursday, August 1st, 2013

Concern about the increased prevalence in teen pregnancies has raised a lot of questions societally as well as within the medical community. It is no secret that an event such as childbirth can play a large role in a woman’s health, and the potential changes that may take place are increased in a teenager, whose body is still growing and changing throughout adolescence. From very real concerns such as the potential for premature delivery to the psychological effects of becoming a mother at a very young age or giving a child up for adoption, there is much fodder for examination and research.

One study has even suggested that there is a potential association between adolescent pregnancy and obesity later in life. However, it is important to note that this association is still vague at best, and researchers have yet to uncover a cause for this heightened obesity risk.   While it is possible that the associations between adolescent pregnancy and obesity is caused by the physiological changes that take place in the female body (and in particular the adolescent female body) during pregnancy, there are also many factors –primarily psychological and sociological—to take into consideration in order to determine the underlying cause of this association.  I believe that these young women, obese or not obese, gain so much weight when they are pregnant that obesity is the result of the pregnancy and they cannot lose the weight postpartum, given the additional responsibilities of raising a child.

Demographically speaking, adolescent mothers are more likely to be from a racial minority, to have lived in poverty, or to have attained a lower educational level than many of their peers. Four out of five black women are either overweight or obese.  It is highly likely that at least part of the association between adolescent pregnancy and weight gain is due to this “crossover”, as women of these demographics are also those most likely to be classed as overweight or obese. This is part of the difficulty in determining whether or not there are other physiological factors to take into account.

My take on the conclusions of this study and the entire situation of pregnant adolescents  and future obesity is that these young women are looking for acceptance and have very low self-esteem.  Their feelings are exploited by their male counterparts, who have a biological imperative to be intimate and not be rebuffed. Consequently, sexual intercourse is a form of being “accepted” and “loved”, only to find out later that the girl is pregnant, has gained excessive weight during the pregnancy and is now alone being responsible for a new life.  Her old habits (no exercise and cheap fast food) with a low or nonexistent income lead to her obesity and that of her child.  Then, it becomes a vicious cycle.

Regardless of the reasons for the prevalence of overweight and obese women among those who were pregnant as teenagers, studies like these highlight the importance of increased contraceptive aid and sexual education among female adolescents. At present, it seems that the primary association between these two groups of women, i.e.,  those who become pregnant as teenagers and those who are classed as overweight or obese in adulthood,  is a lack of education or awareness about their bodies.

– Yvonne S. Thornton, M. D., M. P. H.


Further Proof that What You Drink Can Affect Your Urinary Health

Thursday, July 11th, 2013

Urinary health is a bit of a tricky subject for some women to discuss, but it can be one of the biggest issues that many women face throughout their lives. Most women will endure issues such as Urinary Tract Infections (UTIs) or urinary incontinence at some point during their lives, and it is important for women to have a healthy dialogue with their doctor about the ways that they can prevent and treat problems such as UTIs when they occur.

There has long been a consensus among doctors that the amount of fluid intake that a woman has day-to-day, can affect the healthy of her bladder, kidneys, and urinary tract. One of the most important things that a woman can do to maintain her health is to be certain that she is drinking the recommended amount of water throughout the day. However, a new study is showing that the types of fluids a woman takes into her body plays as important of a role in preventing and treating UTIs as the amount of fluid that she drinks.

Caffeine and drinks high in sugar such as sodas are one of the biggest risk factors for both men and women for experiencing urgency symptoms and UTI symptoms. This is in addition to the elevated risks of obesity and diabetes that come with drinking sugary sodas. On the other hand, certain types of fruit juices such as orange and grapefruit may reduce the symptoms of UTIs.   In this observational study, the ingestion of citrus juices had a weak link for significance regarding an actual improvement in lower urinary tract infections or the prevention of a urinary tract infections. Citrus juice ingestion showed more promise in men compared to women.  Recent studies have also debunked the idea of drinking cranberry juice to prevent urinary tract infections.  The best way to reduce the risk of urinary tract infections is to drink more water and refrain from sexual intercourse.  Simple advice, but difficult to follow.

None of this is surprising news for doctors, many of whom have been recommending that women with a history of UTIs avoid caffeinated drinks and sodas, while increasing their water intake, for years. What is probably more surprising is the number of women who still do not know about the effects that caffeine and sugar consumption can have not just on their weight, but on other aspects of their health. This is a clear indicator that more women need to be open about any UTI problems that they may be experiencing so that they can have an open and honest discussion with their doctor about their urinary health. There is nothing to be shy about in this case, especially when such simple measures can be taken to ensure your health.

– Yvonne S. Thornton, M. D., M. P. H.


Not Even Your Feet are Spared from the Changes of Pregnancy

Monday, February 25th, 2013

And you thought puberty was bad! When you become pregnant, your body will go through so many changes you’ll be left feeling like you were transported into a different body. Some of the strange bodily changes you’ll experience will go away. The extra curves, the thicker hair, and the pregnancy glow are a result of temporary hormonal changes. However, some changes will last forever. Unfortunately, your stretch marks are in that category, but we’ll save that painful discussion for another time. One surprising change you might notice is a bigger shoe size.

During pregnancy, your body produces large amounts of hormones that are meant to make the pregnancy and birthing process easier. One such hormone is known as relaxin. This hormone loosens the muscles and ligaments, which make your stomach’s expansion easier and will eventually make it easier for your baby to pass through your birth canal. Unfortunately, it doesn’t distinguish which muscles need to be loosened, so it affects all of them at once.

Now that you know what relaxin does, you’ll be able to imagine how it affects your feet during pregnancy. Since the arches of your feet are mainly made up of ligaments, the relaxin hormone will cause them to stretch out as you put weight on them. The bones in your foot will also adjust based on this expansion. After you’ve given birth, the relaxin will leave your body, but your feet will stay at their new, longer length.

Studies show that obese women will experience more of a stretch, so it is more likely your shoe size will change after pregnancy if you’re overweight. Similarly, women who spend a lot of time on their feet will suffer from a more increased shoe size.

Unfortunately, there is no telling how much the relaxin in your body during pregnancy will affect the size of your feet. However, you might be able to minimize it by achieving a healthy weight before pregnancy and spending as little time as possible standing. If your shoe size does go up, just think of it as the perfect excuse to buy more shoes.

 – Yvonne S. Thornton, M. D., M. P. H.


Obesity Impairs Fertility More in Black Women

Monday, November 5th, 2012

Infertility can be heartbreaking to women trying to conceive. Dreams of holding a newborn baby in the delivery room are often put on hold as women who have been diagnosed as infertile seek alternative methods of conception. Infertility is technically defined as a woman’s inability to get pregnant after a year of trying with no contraceptive methods. There are numerous causes of infertility, but sometimes doctors are unable to determine the cause on a case-by-case basis. Often, infertility is a result of obesity. A recent study showed that obese black women are often more infertile than white women.


Healthy black women do not necessarily have a harder time getting pregnant than healthy white women. However, black women who are obese will have a harder time than white women in the same situation. Specifically, a larger hip-to-waist ratio was associated with infertility. The study could not confirm why women heavier in the lower body and hips area had a harder time getting pregnant, but it could be a result of inhibited estrogen metabolism caused by a large amount of fat. An increase in the resistance to insulin might also be to blame.


The results of the study should be an incentive for obese black women looking to conceive to lose weight. In addition to increasing fertility, a healthy weight prior to conception will make for an easier pregnancy and a healthier baby. However, the results should also be taken with a grain of salt. The results failed to study the health of the potential fathers, who might also have been obese. Obesity in men could lower their sperm count, which would make it even harder for obese couples to conceive.


Obese women, whether black or white, will have a harder time getting pregnant. Though these results suggest that infertility is more common in black women who are obese, women of either race should attempt to reach a healthy weight before trying to have a baby. Fertility will be increased, and you’ll have a happier and healthier pregnancy. If you’re having trouble conceiving, you should talk to your physician about ovulation treatments and the potential for an IVF.


– Yvonne S. Thornton, M. D., M. P. H.

Yet Another Risky Pill for Weight Loss

Monday, July 23rd, 2012

Are you ready for a miraculous weight loss pill?  Aren’t we all?  As much as we’d all love to believe that they finally came up with a pill that will melt away the pounds, most of us are also worrying about the side effects, and rightly so.  The FDA just approved yet another wonder drug, but it will still be up to the public to find out just how safe it is.

On Tuesday, the US Food and Drug Administration allowed another weight loss pill to be put on the market.  It’s called Qsymia, and though it does have risky side effects, they believe the benefits outweigh the dangers.  Dr. Janet Woodcock, Director of FDA’s research department said that “Obesity threatens the overall wellbeing of patients and is a major public health concern.”  Because obesity impacts two-thirds of Americans, it does indeed seem like a major issue, but taking care of that problem with a pill is quite another matter.  Some past weight loss drugs approved by the FDA were found to have very dangerous side effects that cost people their lives.  You might remember the rise and fall of the popular diet pill Fen-Phen for example.  Even after years of testing in the lab, some drugs can prove to have side effects that either weren’t observed in the controlled tests or were ignored as minor drawbacks.

Qysymia is a combination for stimulants and anti-seizure drugs and is one of the first new diet pills to become FDA approved in 13 years.  Its side effects and risks include a fast heart rate, metabolic acidosis, birth defects, and heart damage.  It is only approved for those considered obese, which is a BMI of 30 or more, and those with a BMI of 27 or more and who have a weight-related medical condition.  The two experts on the FDA panel who voted against the approval of Qsymia worry that it will have “severe, even fatal, consequences.”  Dr. Woodcock, however, believes that if it’s used properly and in combination with a healthy diet and regular exercise, it could be just the thing we need to halt the obesity epidemic.

I don’t know about other physicians, but I plan to stick to the less-miraculous prescription for a health weight- eating right and staying active.  There just can’t be a pill for everything!


– Yvonne S. Thornton, M. D., M. P. H.



Is Your Brain Influencing Your Weight

Thursday, June 14th, 2012

Losing weight when you are obese is a serious challenge, likewise gaining weight when you are anorexic.  This difficulty stems from the habits we create for ourselves and consequently, the conditioning our brains receive.  When you need to overcome an eating disorder, it’s not just a matter of willpower, but studies suggest it’s also a matter of remapping brain circuitry, and that’s no easy task.

As of 2008, one in every 200 US women suffered from Anorexia and more than two out of every three were overweight or obese.  That means millions of American women are struggling with their weight every day.  For this reason, scientists in the Developmental Brain Research Program at the University of Colorado School of Medicine wanted to find out how eating behavior was related to dopamine pathways, similar to those found in drug addictions.  They compared the brain activity of 63 women who were either anorexic or obese to those of normal weight and found that “reward circuits in the brain are sensitized in anorexic women and desensitized in obese women.”  Basically, this means that anorexic women get much more pleasure and satisfaction out of a sweet treat than someone who is obese.  As with drug tolerances, it takes much more of those foods we love to satisfy the cravings of someone who is overweight.  Anorexic women on the other hand, might feel like they’ve had too much, a sugar overdose so to speak, after partaking in a single serving.  More research needs to be done to determine the precise role of the brain’s reward system when it comes to eating disorders, but so far, it seems that it definitely has some part in regulating food intake.

Although the involvement of your brain circuitry might make your battle with weight loss or weight gain more intimidating, all is not lost.  Recent brain research shows that with gradual habit changes and regular conditioning, we can change the neural pathways in our brains.  As with any addiction, kicking the habit isn’t easy, but once you train your brain, your new, healthier habits should help keep you on track.


– Yvonne S. Thornton, M. D., M. P. H.


Sleep Yourself Thin

Thursday, May 31st, 2012

When you are a parent, you do not always get a lot of opportunity for sleeping.  You do not get a lot of time for yourself in general really.  You have work to take care of, children to manage, and somewhere in there, a body to consider.  The fact is though, with our busy American lifestyles, the health of our bodies simply seems to take a back seat.  Unfortunately, this has caused many of us to become overweight, or even worse, obese and diabetic.  A recent study shows though, that if we could all just find enough regular time to sleep, we might be able to stay slimmer and healthier in general.

Right now, nearly two-thirds of Americans are overweight or obese.  Even more concerning is how many of these people are progressing into diabetes.  The CDC cites diabetes as a health issue for 8.3% of Americans and a whopping 79 million show signs of prediabetes.  While poor diet and little to no exercise are obvious causes for such an epidemic, stress and sleep schedules also play a role.   A recent study by researchers at the Brigham and Women’s Hospital and the Harvard Medical School in Boston found that “lack of sleep or disrupted sleep patterns…may lead to an increased risk of diabetes and obesity.”  The study involved tracking the effects of disrupted sleep routines in participants by shifting their sleeping time from 10 hours a night, to just 5.6 hours per 24 hour period.  This sleep restriction and pattern disruption caused 32% of participants to have decreased insulin secretion when they ate and lower metabolic rates, which led to high blood sugar levels bordering on pre-diabetic.  If they had continued the study for a year, they estimated that these levels could have caused them to gain about 12.5 additional pounds of body weight in one year.  When you add these conclusions to the hectic lifestyle of working American parents, it is no wonder so many are struggling with their weight.

When we are young, we spend a lot of time fighting our parents over daily naps and early bed times, but once we grow up, we find it even harder to put ourselves to bed.  Perhaps this study will help us hardworking adults realize that it is no use staying up all night stressing about our busy lives, if it only gives us fewer nights to live.


– Yvonne S. Thornton, M. D., M. P. H.

Dance Your Way to Fitness?

Thursday, July 22nd, 2010

I read a press release the other day from the University of Illinois at Chicago where researcher David Marquez is conducting a study. He plans to get older Latinos out on the dance floor to determine whether doing the mambo, merengue and cha-cha-cha will help them stay fit, and perhaps avoid obesity, diabetes and other ills of a sedentary lifestyle.

While the results won’t yet be in for a while, I whole-heartedly endorse the premise. A number of years ago, I had gained a lot of weight, was overworked and was getting little exercise. Then I signed up for ballroom dancing classes. Not only did I have a blast (winning a dance contest along the way), but I whittled down my waistline while doing it.  Other studies have shown that ballroom dancing can also benefit your mental fitness and decrease your risk of developing Alzheimer’s disease.

So, if you’re bored with exercise machines, and if jogging just isn’t your thing, put on your dancing shoes and go. Unless your doctor advises against physically challenging activity, I can’t think of a better, more fun-filled fitness routine.

See you on the dance floor.

– Yvonne S. Thornton, MD, MPH

More media attention for the study

Friday, June 5th, 2009

Forbes reports on my study, showing that obese pregnant women should limit weight gain as does Medline.

Other media outlets giving the study prominent coverage are United Press International, Yahoo News, The Baltimore Sun, US News and World Report, and even the Times of India.

– Yvonne S. Thornton