Obesity in Asia!!!

Body Mass Index and Diabetes in Asia: A Cross-Sectional Pooled Analysis of 900,000 Individuals in the Asia Cohort Consortium

Background
The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia. 

Methods and Findings
A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m) and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR) of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5–24.9 Kg/m2 as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76) for BMI lower than 15.0 kg/m2 to 2.23 (95% CI 1.86, 2.67) for BMI higher than 34.9 kg/m2. The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001), in cohorts from India and Bangladesh (p<0.001), in individuals with low education (p-value 0.02), and in smokers (p-value 0.03); no differences were observed by gender, urban residence, or alcohol drinking. 

Conclusions
This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk factors for diabetes.

PLoS ONE 6(6): e19930. doi:10.1371/journal.pone.0019930

Why is this cool?

 The researchers recorded the body mass index of 900,000 people across Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. They found that there was a positive correlation between high body mass index and presence of diabetes. This correlation extends across gender, location, and alcohol consumption.
 You may ask "We already knew that, so what is the big deal?"

 Well, it is an interesting thing, but most studies on diabetes on on people of European descent and it is entirely possible that the Asian peoples are sufficiently different, due to their particular evolutionary history, such that diabetes does not result from being fat. Well, that was not the case. Another idea, and I don't know if they checked it, is that the Asian diet may make a huge difference and as such it could disconnect diabetes from weight. Again, their data suggests that no matter how you get fat, you are racing towards diabetes.

 Why is this interesting to me? Well, I live in the States and here we worry about China dominating everything because of their invincible economy. An economy which is not as burdened as the American one is with old people and overweight people. Can China's economy grow as quickly as it has been when it becomes saddled with the long lived and obese? I suspect not. I wonder what cultural initiatives will be cooked up to deal with their obesity. What has been done for the obesity problem of the U.S. of A.?
 I also see this issue as another aspect of global warfare! Imagine that the USA projected unparalleled spending power on the part of China and was running out of options on how to contain or otherwise mitigate that growth, what choices would it have?

The US would institute a system of actively prompting massive food consumption! The people would be obese. The economy burdened with health costs. This is the future!

Binge drinking cure....possibly!!!!

Binge alcohol drinking is associated with GABAA {alpha}2-regulated Toll-like receptor 4 (TLR4) expression in the central amygdala.

Liu J, Yang AR, Kelly T, Puche A, Esoga C, June HL Jr, Elnabawi A, Merchenthaler I, Sieghart W, June HL Sr, Aurelian L.

Abstract

Binge drinking (blood-alcohol levels ≥ 0.08 g% in a 2-h period), is a significant public health burden in need of improved treatment. Gene therapy may offer beneficial alternatives to current psychosocial and pharmacotherapeutic interventions, but identification of the target genes is a clinical challenge. We report that a GABA(A) α2 siRNA vector (pHSVsiLA2) infused into the central nucleus of the amygdala (CeA) of alcohol-preferring (P) rats caused profound and selective reduction of binge drinking associated with inhibition of α2 expression, decreased GABA(A) receptor density, and inhibition of Toll-like receptor 4 (TLR4). CeA infusion of a TLR4 siRNA vector (pHSVsiLTLR4a) also inhibited binge drinking, but neither vector functioned when infused into the ventral pallidum. Binge drinking was inhibited by a GABA(A) α1 siRNA vector (pHSVsiLA1) infused into the ventral pallidum, unrelated to TLR4. The vectors did not alter sucrose intake and a scrambled siRNA vector was negative. The data indicate that GABA(A) α2-regulated TLR4 expression in the CeA contributes to binge drinking and may be a key early neuroadaptation in excessive drinking.


Proc Natl Acad Sci U S A. 2011 Mar 15;108(11):4465-70. Epub 2011 Feb 28.

Why is this cool?

 Like many of you, I drink and sometimes, not often, I drink too much. As a younger lad, I drank profusely and constantly. People suggested that I lay off the sauce, but what did they know?

 

 Well, it turns out that those people told some people and those people outsourced the research to this group. Most alcohol drinkers are calm and relaxed, but there are those (mostly under 25 years old) that just can't stop themselves. It is some sort of mental disorder (total guess on my part) that prevents someone from enjoying drinks in moderation. How do you treat a mental disorder (again, total guess) with such a physical manifestation? These researchers did it by pumping special RNA straight into a rat brain. This may seem trivial, but this is really astounding! The RNA was targeted towards transcription of specific receptors in a specific region of the brain.
 What is RNA? Well, everyone knows that DNA is where our genetic heritage lies, but how does that create us? The DNA is transcribed to RNA, which is essentially a messenger system, and that RNA is translated into protein. Well, it turns out that RNA can do a great many things in the cell, such as inhibit the translation of other RNAs, this RNA is called "short inhibitory RNA" (siRNA). This paper uses specially designed siRNAs  to inhibit receptors associated with binge drinking.
 If you think about far flung future applications, we have ripe story telling potential! Let us say that the treatment here gets translated into pill form or patch or oral liquid form. Sneaky parents would use this treatment on their children to prevent them from binge drinking at bonfires.

Caring bartenders might use the treatment to prevent problem drinkers from getting completely hammered.
 Now, let's consider different problems that may be explained by similar compulsions as found in binge drinking, specifically: binge eating. What if the obesity epidemic that is strangling the highly developed countries could be cured with an orally administered pill?
What if the government mandated that everyone took the pill as a means of ensuring food security? What if controlling the amount of food we eat is the next civil liberty to be taken from us? I think that the government should stop telling me to be skinny and healthy, because my fatness is an expression of FREEDOM!!!