TIME European Union

European Court Rules That Obesity Could Be a Disability

The case was brought by a Danish man who weighs more than 350 pounds (160kg)

In a ruling delivered Thursday morning, the European Court of Justice (ECJ) said “obesity can constitute a disability” for the purposes of equality at work legislation, the BBC reports.

The ECJ, Europe’s highest court, was asked earlier this year to consider the case of Karsten Kaltoft, a Danish childminder, who claimed he was fired by his local authority for being too overweight.

Judges said that if obesity could hinder “full and effective participation” at work then it could count as a disability. This means that if a person has a long-term impairment because of their obesity then they would be protected by disability legislation.

The ruling is binding across the E.U. but it is left up to the national courts to decide if someone’s obesity is severe enough to be classed as a disability. This is something the Danish court will now have to assess in Kaltoft’s case.

Important to the ruling is the European Court’s judgement that the origin of the disability did not matter, meaning that it is irrelevant if the person is obese because of overeating.

The judgement may mean that employers will have to start providing larger seats, special parking spaces and other facilities for obese workers.

[BBC]

TIME Obesity

Law Enforcement Is the Fattest Profession, Study Finds

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Along with firefighters and security guards

Police officers, firefighters and security guards have the highest rates of obesity of all professions, according to a Wall Street Journal analysis of data from the American Journal of Preventive Medicine.

According to the Journal, 40.7% of police, firefighters and security guards are obese. Other jobs with high obesity rates include clergy, engineers and truckers.

On the other side of the obesity scale is a grouping of economists, scientists and psychologists, with an obesity rate of 14.2%. Other professions with low obesity rates are athletes, actors and reporters.

Read more at The Wall Street Journal

TIME Diet/Nutrition

Most Kids Don’t Eat Three Meals A Day, Study Says

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Kids get 42% of their calories from snacks

Eating three square meals a day is the oldest nutrition advice in the book, and some of the most important for staying healthy. But new research shows that children are snacking instead of eating three meals a day on a regular basis, a habit that could be contributing to overweight and obesity and putting them at risk of heart disease later in life.

In a series of reports published in the European Journal of Clinical Nutrition, the International Journal of Obesity and the European Journal of Nutrition, Aino-Maija Eloranta, a PhD candidate at the Institute of Biomedicine and Physiology at the University of Eastern Finland, and her colleagues followed a group of 512 boys and girls enrolled in the Physical Activity and Nutrition in Children (PANIC) Study. The children, ages 6-8, and their parents reported what the kids ate and drank for four days. The researchers also measured their body mass index, waist circumference, blood pressure, cholesterol, blood glucose and insulin levels.

MORE: 7 Eating Habits You Should Drop Now

About 45% of the boys and 34% of girls in the study ate all three meals, meaning a majority of them did not. The most-skipped meal was dinner. “That was a surprise,” says Eloranta. “Among older children, adolescents and even adults, breakfast is the one that is skipped.”

Skipping dinner can have major implications for children’s health, she says, since it’s traditionally the most calorie- and nutrient-rich meal, giving growing children the energy they need to develop. In fact, the children who ate three meals a day had smaller waist circumferences and a 63% lower risk of being overweight or obese than those who skipped some of the major meals.

MORE: 5 Things Everyone Gets Wrong About Breakfast

The scientists also found that among all kids, snacks provided as much as 42% of the children’s daily calories. That’s not necessarily a bad thing, says Eloranta, except that most snacks are high in sugar and low in healthy nutrients like fiber. On average, the children consumed more saturated fat (which has been linked to a higher risk of heart disease) and salt and ate less vitamin D, iron and fiber than guidelines recommend.

MORE: Alice Waters: The Fate of Our Nation Rests on School Lunches

Eloranta did find one positive trend: lunch. Because lunch was provided at school, it was lower in sugar and higher in nutrients and healthier fats than the kids’ other meals on average. This suggests that one of the best ways to help children maintain healthy weights and avoid heart problems later might be to give them three meals a day. “Maybe we don’t have to worry about single nutrients or single foods [like sugar or fat] that much,” she says. “When you eat meals, you automatically receive the good nutrients.”

TIME health

Why Fat-Shaming by Doctors Really, Really Matters

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Between 210,000 and 440,000 people die every year as a result of preventable hospital mistakes. How many of those are casualties of weight bias?

xojane

This story originally appeared on xoJane.com.

Recently I ran across an article in the Boston Globe detailing a new survey on medical errors in Massachusetts. The findings were stunning: Nearly 25% of Massachusetts residents reported a medical mistake had occurred either to them or to someone they know, and of those, half said the oversight had serious repercussions to their health.

The study, along with other new research into medical mistakes and patient safety, was commissioned by the Betsy Lehman Center, an organization named for a Globe health reporter who died in 1994 when she was given an overdose of chemotherapy for her breast cancer — an overdose that was four times the correct amount.

Medical errors are no small matter in the US. A 2013 report shocked everyone when it revealed that between 210,000 and 440,000 people die every year as a result of preventable hospital mistakes. To put that in context, heart disease, the number one cause of death in the US, killed just shy of 600,000 people in 2010. Cancer, death-causer number two, killed 577,000 people the same year. Horrifically, the 2013 report places preventable medical mistakes as the third-biggest cause of death in the US.

It’s enough to make you not to want to go to a hospital, ever.

I talk a lot about fat-shaming in medical contexts. I’ve done so for years, and the single most common misapprehension I get from people is that fat-shaming by a doctor is merely a matter of personal discomfort. People assume that complaints about bad treatment by weight-biased doctors — doctors who often ignore symptoms or fail to run tests, or run tests that are unnecessary, or who knee-jerkily prescribe weight loss for everything from allergies to acne — are simply a matter of fat patients wanting their doctors to be nicer to them. “Doctors need to be able to tell you when you’re morbidly obese!” critics assert, as though that is even approaching the point.

In the first place, fat patients — or ANY patients — wanting their doctors to be nicer to them is entirely warranted. Doctors are not gods, and patients do not need to accept condescension, rudeness, or cruelty simply because the person dispensing it wears a white coat. I realize virtually every GP in the world is overworked and overstressed and trying to do way more than is reasonable for one person, and I have no doubt that eventually patients start to all run together, an endless parade of meatpuzzles with varying sets of symptoms, but that’s not an excuse. Doctors should consider how they communicate with their patients, and should make efforts to do so in ways that are at the very least respectful of basic human dignity. Even noncompliant patients — which I suspect is how many doctors see fat people — deserve to be treated with respect.

But besides all that, fat-shaming is not just an issue of feeling comfy and safe in the exam room. Fat-shaming can have life-threatening consequences when a doctor is making assumptions about a patient’s health and needs based exclusively on a visual appraisal and personal assumptions. This is not to say that a visual assessment isn’t useful as a part of an exam, but it’s just that — a PART of an exam, and insufficient for an accurate picture of an individual’s whole health.

While limited research has been done on this angle specifically, I think it’s reasonable to suggest that a doctor with unexamined weight bias is going to be at a far greater risk of making mistakes when diagnosing and treating fat patients.

And when people argue that doctors are entitled to weight bias, they are overlooking the very real danger that weight bias can and does lead to serious consequences for fat patients, when doctors assume that an ovarian tumor is just weight gain caused by overeating, or that asthma is just a patient being “out of shape,” or that fibromyalgia is just laziness.

If you don’t believe me, then check out the #DiagnosisFat hashtag on Twitter, which I inadvertently started when I had a little ramble on the subject and solicited people’s stories of medical misdiagnosis or delayed diagnosis owing to weight bias.

Even I’m a little stunned by the number of people responding, and the fact that so many of the stories have similar themes. The experiences being shared are by turns frustrating, enraging, and in some cases, downright brutal. While culturally we’re very eager to blame fat people for rising healthcare costs, we seem unwilling to consider that assigning that blame creates an environment in which many fat people are not being treated with the same level of care as thinner patients.

And I shouldn’t need to explain that when quality of care goes down, so does a patient’s health and prognosis. A fat patient whose cancer goes undetected for far longer as she struggles to follow her doctor’s advice to lose weight is going to require far more dramatic efforts than a patient who receives the correct diagnosis and treatment in the earlier stages of the disease. A fat patient whose doctor is praising sudden weight loss caused by a gastrointestinal disorder will suffer debilitating symptoms longer than a patient whose doctor doesn’t assume unexplained weight loss is always a positive thing. A fat patient whose Lupus is ignored for a decade because her doctor assumes her symptoms are weight-related will have permanent damage — damage that a patient whose doctor identifies the condition sooner will not.

Weight bias in medicine has dire repercussions for many, and so when a doctor makes a fat-shaming comment during an exam, while it may be a momentary source of distress, it’s also much larger than that — it’s a red flag. And in a medical environment where literal hundreds of thousands of people die every year as a result of preventable medical errors, it’s a red flag worth heeding. Your survival may depend on it.

Lesley Kinzel is Deputy Editor at xoJane.com.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Obesity

The 10 Healthiest and 10 Least-Healthy States

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Here are the states that are doing it right—and those in real need of a checkup

In some ways, Americans today are healthier than they were in 1990, when the United Health Foundation first published America’s Health Rankings, an annual state-by-state assessment of our nation’s health. Cardiovascular and cancer deaths are down, and the smoking rate has decreased 36%. Plus, life expectancy is at an all-time high—78.7 years. “But although we’re living longer, we’re also living sicker, with preventable illness at an alarming level,” says Reed Tuckson, MD, external senior medical advisor to United Health Foundation. The number-one reason: Obesity. “Since 1990, the obesity rate went from 11.6% to 29.4%, a 153% increase,” Dr. Tuckson says. In the last year alone, it rose 7%. Physical inactivity is also at a new high: 23.5% of Americans do not exercise at all.

Read on for the states that are doing it right—and the 10 that have a lot more work to do to improve their health.

The 10 Most Healthy States

10. Nebraska

2013 Rank: 11
Change: +1

Nebraska is among the healthiest states in America in 2014, coming in at number 10 (a slight increase over last year). Nebraska has a low rate of drug deaths, high rate of high school graduation, and high immunization coverage among children.

Challenges:
High prevalence of binge drinking
High incidence of Salmonella
Large disparity in health status by education level

HEALTH.COM: 12 Vaccines Your Child Needs

9. North Dakota

2013 Rank: 9
Change: None

North Dakota is the ninth most-healthy state in the U.S. this year, thanks to its low rate of drug deaths, high immunization coverage among teens, and low prevalence of low birth weight. North Dakota also came in ninth in 2013.

Challenges:
High prevalence of binge drinking
High prevalence of obesity
High occupational fatalities rate

8. Colorado

2013 Rank: 8
Change: None

Colorado is known for its outdoor activities—hiking, skiing, biking—so it should come as no surprise that the state has the lowest rates for obesity and diabetes in the United States. It ranks eighth for the second year in a row.

Challenges:
High prevalence of binge drinking
High prevalence of low birth weight
Large disparity in health status by education level

7. New Hampshire

2013 Rank: 5
Change: -2

New Hampshire comes in at number seven, and is just one of several New England states to rank in the top 10 for 2014. New Hampshire residents are more active than most Americans, enjoy a low rate of infectious disease, and have a low infant mortality rate. There is also high immunization coverage among teens.

Challenges:
High prevalence of binge drinking
High rate of drug deaths
Low per capita public health funding

6. Minnesota

2013 Rank: 3
Change: -3

Minnesota is known for its bitterly cold winters, but that doesn’t stop residents of this snowy state from keeping active, which also helps the state have one of the lowest obesity and diabetes rates in the nation. Minnesota also has a low rate of drug deaths.

Challenges:
High prevalence of binge drinking
High incidence of pertussis
Low per capita health funding

HEALTH.COM: 14 Fad Diets You Shouldn’t Try

5. Utah

2013 Rank: 6
Change: +1

Fewer people smoke in Utah than in any other state. Utah also has the second-lowest diabetes rate, the fourth-lowest obesity rate, a low percentage of children in poverty, and a low rate of preventable hospitalizations.

Challenges:
High rate of drug deaths
Low immunization coverage among teens
Limited availability of primary care physicians

4. Connecticut

2013 Rank: 7
Change: +3

Connecticut, the 4th-healthiest state in the U.S. this year, has a low prevalence of smoking, high immunization coverage among children, and a low occupational fatalities rate.

Challenges:
High prevalence of binge drinking
High rate of preventable hospitalizations
Large disparity in health status by education level

HEALTH.COM: 15 Ways Smoking Ruins Your Looks

3. Massachusetts

2013 Rank: 4
Change: +1

Massachusetts is the third-healthiest state in the nation in 2014. In the past two years, drug deaths have decreased by 9% and the rate of physical inactivity has decreased 11%. Massachusetts also has more residents with health insurance than any other state.

Challenges:
High prevalence of binge drinking
High rate of preventable hospitalizations
Large disparity in health status by education level

2. Vermont

2013 Rank: 2
Change: None

The runner-up—and the healthiest state in the continental U.S.—is Vermont. Vermont has the highest high school graduation rate in the country, a low percentage of children in poverty, and a low violent crime rate. In the last year, binge drinking has decreased 11% (though it’s still a challenge), and in the last two years, smoking has declined by 13%.

Challenges:
High prevalence of binge drinking
Low immunization coverage among children
Large disparity in health status by education level

1. Hawaii

2013 Rank: 1
Change: None

For the second year in a row, Hawaii earns the honor of healthiest state in America. Relatively few people in the Aloha State are obese, the cancer rate is low, and the state has the lowest rate of preventable hospitalizations in the country. Smoking has decreased by 21% in the last two years, and binge drinking has declined by 15%.

Challenges:
High prevalence of binge drinking
High incidence of infectious disease
Low immunization coverage among children

HEALTH.COM: 27 Mistakes Healthy People Make

The 10 Least Healthy States

41. Indiana

2013 Rank: 41
Change: None

With 31.8% of adults obese, 28.3% of adults never exercising, and a huge air pollution problem, Indiana comes in at number 41.

Strengths:
Low incidence of infectious disease
Low percentage of children in poverty
High immunization coverage among teens

42. South Carolina

2013 Rank: 43
Change: +1

Coming in at 42, South Carolina is struggling to keep its children healthy: it has a low rate of high school graduation, high prevalence of low birth weight, and ranks in the bottom half of the states for the immunization of children. It also has high rates of obesity, diabetes, and physical inactivity.

Strengths:
Low prevalence of binge drinking
Low incidence of pertussis
Low rate of preventable hospitalizations

HEALTH.COM: Could You Have Type 2? 10 Diabetes Symptoms

The 10 Least Healthy States

43. Alabama

2013 Rank: 47
Change: +4

Ranking 43rd overall, Alabama has the highest diabetes rate in the nation, at 13.8% of adults—a 17% increase over the last two years. The state also has a high prevalence of low birth weight and a limited availability of dentists.

Strengths:
Low prevalence of binge drinking
High immunization coverage among children
Small disparity in health status by education level

44. West Virginia

2013 Rank: 46
Change: +2

With 27.3% of the adult population lighting up, West Virginia has the highest prevalence of smoking in America. It also has more drug deaths than any other state, as well as the second-highest obesity rate.

Strengths:
Low prevalence of binge drinking
Low incidence of infectious disease
High per capita health funding

45. Tennessee

2013 Rank: 42
Change: -3

Tennessee ranks 50th for violent crime, 49th for physical inactivity, 47th for obesity, and 45th overall.

Strengths:
Low prevalence of binge drinking
Low incidence of pertussis
Ready availability of primary care physicians

46. Oklahoma

2013 Rank: 44
Change: -2

Ranking 46th, the Sooner State has a high prevalence of physical inactivity, low immunization coverage among children, and a limited availability of primary care physicians. Since 1990, violent crime has increased 12%, while the nationwide rate dropped 37% during the same time period.

Strengths:
Low prevalence of binge drinking
Low incidence of pertussis
Low prevalence of low birth weight

47. Kentucky

2013 Rank: 45
Change: -2

While lots of people in Kentucky smoke, very few of them exercise, a combination that lands the Bluegrass State at number 47. Kentucky also suffers from a high percentage of children in poverty and a high rate of preventable hospitalizations.

Strengths:
Low prevalence of binge drinking
Low violent crime rate
High immunization coverage among children

HEALTH.COM: 20 Filling Foods That Help You Lose Weight

48. Louisiana

2013 Rank: 48
Change: None

Louisiana ranks 48th in 2014 thanks to its high incidence of infectious disease, high prevalence of low birth weight, and high rate of preventable hospitalizations.

Strengths:
Low incidence of pertussis
High immunization coverage among teens
Small disparity in health status by education level

49. Arkansas

2013 Rank: 49
Change: None

Coming in second to last—same as in 2013—Arkansas has a high incidence of infectious disease, a limited availability of dentists, and low immunization coverage among children. Additionally, obesity has increased 12% over the last two years.

Strengths:
Low prevalence of binge drinking
High per capita public health funding
Small disparity in health status by education level

50. Mississippi

2013 Rank: 50
Change: None

For the third year in a row, the least-healthy state in the U.S. is Mississippi. Mississippi ranks last on six measures: physical inactivity, rate of infectious disease, low birthweight, infant mortality, cardiovascular deaths, and premature deaths.

Strengths:
Low prevalence of binge drinking
High immunization coverage among children
Small disparity in health status by education level

This article originally appeared on Health.com

TIME Obesity

Study: Obesity May Shorten Life Expectancy by Up to 8 Years

Young obese people are at most risk

A new study has found that obesity can shorten one’s life by almost a decade.

Researchers at McGill University linked obesity with an increased risk of developing heart disease and type 2 diabetes — ailments that dramatically reduce both life expectancy and the number of years spent free of chronic illnesses.

Obesity and extreme obesity can reduce life expectancy by up to eight years and deprive people of as many as 19 years of healthy living, the study published Thursday in The Lancet Diabetes & Endocrinology concludes.

Researchers used data from the U.S. National Health and Nutrition Examination Survey to create a model to estimate the risk of disease based on body weight and then examined how excess weight contributed to years of life lost. The model found that the younger someone becomes obese, the more years he or she ultimately loses.

“The pattern is clear,” Dr. Steven Grover, lead author and Professor of Medicine at McGill University, said in the published study. “The more an individual weighs and the younger their age, the greater the effect on their health, as they have many years ahead of them during which the increased health risks associated with obesity can negatively impact their lives.”

TIME politics

Can My Clinic Fix Childhood Obesity?

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To determine if a child’s weight is a problem, a key measure is body mass index

Of the 10 children in my family, I was the only one who was obese. I didn’t know it at the time, but my family mirrored obesity trends in Holtville, the small town in California where I grew up. In Imperial County, which borders Arizona and Mexico, 1 in 10 people were considered obese in the 1970s and ’80s. I hated being obese and fantasized about a magical solution that could transform me overnight.

Fast forward to the present: My weight is under control and I’m the director of programs at Clinicas de Salud del Pueblo, a non-profit community clinic in Imperial County.

Unfortunately, obesity is more common here than when I was a kid. Today, 4 in 10 children in Imperial County are considered obese or overweight. Couple this with a poverty rate of 22 percent, and you have a recipe for an unhealthy community.

To determine if a child’s weight is a problem, a key measure is body mass index—measuring the child’s weight against a national standard for their height, age, and gender. A child in the 85th percentile or more is considered overweight; at the 95th percentile and above, a child is obese.

One major problem is that many parents see obesity as something their children will outgrow—not a major health concern that requires treatment. The clinic used to tell families to eat healthy and exercise, and to come back next year for a physical exam. This method didn’t work. Most kids don’t grow out of being overweight or obese and many parents don’t know how to help them make healthy choices around food and exercise.

In 2011, my clinic saw an opportunity to join forces with other agencies—including San Diego State University’s Institute for Behavioral and Community Health and the Imperial County Public Health Department—to come up with a new strategy for controlling obesity. One focus is identifying problems much earlier, and monitoring them more closely over time.

In order to get real money, we applied for a 4-year research grant from the Childhood Obesity Research Demonstration (or CORD) study of the Centers for Disease Control and Prevention. The grant program is part of the Affordable Care Act and aims to tackle childhood obesity in impoverished communities. We were fortunate to be one of three sites funded—the others are in Massachusetts and Texas.

Last year, we invited 600 children to participate—and we allow any family to access the services. Three to four times a year, the child sees a clinician for a weight management and wellness exam. A patient care coordinator also works with the family. Finally, community health workers (or promotoras) lead a series of workshops on parenting skills, setting goals, and incorporating fun games into physical activities.

One of the first families to participate in Clinicas’ family wellness program was the Padillas, whose 11-year-old daughter had been struggling with her weight. It was difficult for them at first. The family doesn’t have a car and needed to find a ride or take the bus, which can be tricky. And, like many families, they felt reluctant to visit the clinic when they lapsed.

The Padillas eventually figured out how to manage the plan. They went on walks, watched less TV, gave up drinking sweet tea, and ate less fattening foods. Today, they eat more fruits and vegetables, drink more water, go to sleep earlier, and include more physical activities in their daily routine.

But it’s not just families that need to commit to change. As part of Our Choice/Nuestra Opción, experts conducted training with the staff of clinics, childcare facilities, schools, recreation agencies, and restaurants. There’s work to do in improving our own health.

The magical solution to childhood obesity that I wished as a kid doesn’t exist. Tackling this problem means making a long-term commitment—and understanding that change won’t happen overnight.

Leticia Ibarra is director of programs at Clinicas de Salud del Pueblo, Inc. She has 16 years of professional experience in research, project management, working with clinics, and consulting in community-based, collaborative health communication and promotora interventions to improve the health and well-being of Latino and immigrant communities. She wrote this for Zocalo Public Square.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Research

6 Breath Tests That Can Diagnose Disease

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A new study uses breath to diagnoses diabetes, but other diseases like cancer and obesity may be breath-detectable too

A new study shows that it may be possible to diagnose type 1 diabetes in kids even before the onset of severe illness.

Currently, about one in four kids with type 1 diabetes don’t know they have it until they start having life-threatening symptoms. However, a new study published in the Journal of Breath Research shows researchers might be able to diagnose the disease by detecting a chemical marker (acetone) in the breath that makes it smell sweet, but indicates a build-up of chemicals in the blood (ketones) that occurs when a person’s insulin levels are low. High levels of acetone in the breath can indicate high levels of ketones in the blood. The hope is that if proven effective, this breath test will help physicians make a diagnosis earlier.

Growing research suggests breath tests can be used to detect a variety of diseases, from diabetes to various cancers. Research is still early in some areas—and there are other factors beyond disease that can result in chemical markers in the blood and breath—but some medical institutions are already using the tests of a variety of diagnosis.

Type 1 Diabetes
In the new study, researchers collected compounds in the breath from 113 children and adolescents between the ages 7 and 18. They also measured the kids’ blood-sugar and ketone levels. They found a link between higher levels of acetone in the breath and ketones in the blood. “Our results have shown that it is realistically possible to use measurements of breath acetone to estimate blood ketones,” said study author Gus Hancock, a professor at Oxford in a statement. “We are working on the development of a small hand-held device that would … help to identify children with new diabetes.”

Colorectal Cancer
In a small study published in 2012 in the British Journal of Surgery, researchers from the the University Aldo Moro of Bari in Italy collected the breath of 37 patients with colorectal cancer and 41 healthy control participants. The researchers were measuring the amount of volatile organic compounds (VOCs) in the participants’ breath, with the thought being that cancer tissues and cells may release distinct chemicals. The researchers were able to identify 15 of 58 specific compounds that were correlated with colorectal cancer. Based on this, the were also able to distinguish between cancer patients and healthy patients with 75% accuracy.

Lung Cancer
In 2013, researchers from the University of Latvia used an electronic nose-like device to identify a unique chemical signature in lung cancer patients. As TIME has previously reported, there are several groups who think this process can be standardized for cancer with further research. In June, scientists at the American Society of Clinical Oncology meeting in Chicago presented a device they think has real promise.

Obesity
There are obviously a number of ways that obesity can be diagnosed without a breath test, but a 2013 study published in the Journal of Clinical Endocrinology & Metabolism found that obese people had unique markers in their breath, too. Researchers at Cedars-Sinai Medical Center studied the breath of 792 men and women trying to detect methane. Those with higher levels of methane and hydrogen gases in their breath also tended to be heavier with a BMI around 2.4 points greater than those with normal gas levels. The hope, the researchers say, is that a test could be developed that could detect a type of bacteria that may be involved in both weight and levels of gas in the breath. There may be ways to clinically curb that bacteria growth.

Lactose Intolerance
Johns Hopkins Medicine uses breath testing to help diagnose lactose intolerance. Patients drink a lactose-heavy drink and clinicians will analyzed the breath for hydrogen, which is produced when lactose isn’t digested and is fermented by bacteria.

Fructose Intolerance
Johns Hopkins also uses breath tests to assess whether an individual is allergic or intolerant to fructose, a sugar used to sweeten some beverage and found naturally in foods like onions, artichokes, and wheat. The test is similar to a breath test for lactose intolerance. Patients will drink a cup of water with dissolved fructose and over a three hour period, clinicians will test their breath. Once again, a high presence of hydrogen can indicate that the patient is not properly digesting it.

TIME Obesity

Obesity Now Costs the World $2 Trillion a Year

Half the world's population could be obese by 2030, warns a McKinsey Global Institute report

The global cost of obesity has risen to $2 trillion annually, according to a new report, more than the combined costs of armed violence, war and terrorism.

The McKinsey Global Institute report says currently almost 30% of the world’s population is obese, and that if present trends continue, that almost half the population will be clinically overweight or obese by 2030.

The report cautioned that no single solution would reverse the problem, instead calling for a “systemic, sustained portfolio of initiatives” to tackle the crisis, such as better nutritional label, healthier food at schools, advertising restrictions on fatty foods and beverages, and public health campaigns.

TIME Obesity

You Exercise Less When You Think Life Isn’t Fair

The 'why try' effect gets in the way of weight loss

People who have been the target of weight discrimination—and who believe the practice is widespread—are more likely to give up on exercise than to try to lose weight, according to a new study published in Health Psychology.

The online study of more than 800 Americans specifically looked at whether participants believed in “a just world,” or in this case, the belief that their positive actions will lead to good results. People who experienced weight bias in the past and didn’t believe in a just world were more likely to say they didn’t plan to exercise than those who did believe the world is just. In a separate part of the study, participants primed with anecdotes designed to suggest that the world is unjust were more likely to say they didn’t plan to exercise.

Experiencing discrimination leads some people to adopt a pessimistic view of the world, and they accept negative stereotypes about themselves, including the belief that they’re lazy, said study author Rebecca Pearl. “When someone feels bad about themselves and is applying negative stereotypes to themselves, they give up on their goals,” said Pearl, a researcher at Yale University, referring to a phenomenon known as the “why try” effect.

It’s an area of conflicting research. Some previous studies found that weight discrimination leads to weight loss, while others concluded that weight discrimination discourages exercise. Belief in a just world may be the factor that distinguishes between the two, Pearl said. People who think their exercise will pay off are more likely to try.

Because believing in a just world is key to losing weight, Pearl said that legislation and other public policy efforts could act as a “buffer against loss of sense of fairness.”

“It’s important for doctors to be aware of what people are experiencing, to know that these experiences might have real effects on people’s confidence,” Pearl said.

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