Exercise during pregnancy may help obese women avoid dangerous complications

Exercise may be an efficient way for obese pregnant women to lower their risk of diabetes, dangerously high blood pressure and other complications, research suggests.

"The study suggests that a prenatal exercise-based intervention leads to both decreased costs and improved outcomes in obese women," said Leah Savitsky, a medical student at Oregon Health and Science University in Portland who led the study.

As reported at the 37th annual meeting of the Society for Maternal-Fetal Medicine in San Diego, California, Savitsky and her team analyzed previously published research on the effect of exercise on pregnant women with a body mass index (BMI) of at least 30.

The normal range for BMI - a ratio of weight to height - is 18.5 to 24.9; a BMI of 30 or more indicates obesity. (A BMI calculator is here, on the website of the U.S. Centers for Disease Control and Prevention

Based on their analyses of those earlier studies, the researchers estimated the benefit of exercise for women who are obese at the start of their pregnancy.
They calculated that for every one million such women, there would be 38,176 cases of a dangerous pregnancy-related blood pressure problem known as preeclampsia among those who exercised, compared to 113,000 cases among those who didn't exercise.

Exercise would also be linked to a decrease in so-called gestational diabetes, with a rate of 195,520 per million among exercisers compared to 305,500 among non-exercisers, according to their calculations.

Likewise, they estimated, for every million obese pregnant women the preterm birth rate would drop from 105,059 to 90,923 with exercise, the maternal death rate would fall from 90 to 70 and the neonatal death rate would drop from 1,932 to 1,795.

Based on a cost-effectiveness threshold of $100,000 per quality-adjusted life year, an exercise intervention could save money as long as expenses are held to just under $3,000.

The effects of exercise may be even more beneficial than the study suggests, Savitsky said.

"This study did not consider additional downstream benefits on control of weight beyond pregnancy as well as the downstream potential benefits on hypertension and diabetes," she told Reuters Health by email.

Women who are not obese may benefit as well. The researchers applied their model to women with a normal BMI of 18.5 - 24.9 and found similar improvements in outcomes among those who exercise, although the cost-effectiveness thresholds were lower.

One trial that the study drew from looked at 765 women randomized to an exercise group or a control group  "We showed that women who do not exercise are three times more likely to develop (high blood pressure), 1.5 times more likely to gain excessive weight and 2.5 times more likely to give birth to a large infant," said Michelle Mottola of Western University in London, Ontario, Canada, who was involved in the randomized trial.

"With the obesity epidemic looming in our society, perhaps we should be turning our attention to prevention of disease. It does not seem to be too late even for obese pregnant women to engage in lifestyle change that may substantially reduce health care costs," Mottola told Reuters Health by email.

The current study was not designed to develop specific exercise guidelines for obese pregnant women; these women should consult their obstetricians for guidance. In the meantime, the American College of Obstetricians and Gynecologists advises obese pregnant women to "start with low-intensity, short periods of exercise and gradually increase as able."

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How your body shape may influence your disease risk

Could the shape of your body influence your risk of disease? Many doctors think so, and a recent study published in the Journal of the American Medical Association found that those with a genetic predisposition toward one particular body type actually had a higher risk of conditions like Type 2 diabetes and heart disease.

That body type is what physicians call “apple-shaped”— when the circumference of your belly is larger than the circumference of your hips. In other words, those who are apple-shaped tend to carry most of their weight in their middle.

Other body shapes include pear (where most weight is carried in the hips and thighs, but not the middle), hourglass (where weight is carried both up top and in the hips and thighs, with a smaller waist), and tube (where little excess weight is carried, and a person is long and lean).

Of all of these shapes, apple is the most dangerous, according to many doctors and nutritionists, including Dr. Christine Jellis, a cardiologist at Cleveland Clinic, and Lauren Blake, a registered dietician at The Ohio State University Wexner Medical Center. That’s because, Blake told Fox News, apple-shaped people carry more visceral fat — which surrounds the organs — as opposed to subcutaneous fat —which lies beneath the skin.

“Excess visceral fat causes excess fatty acids to drain into the liver and into the muscles, which then triggers changes in the body,” Blake said. Those changes include an increased risk of diabetes, heart attack, stroke and other ailments, she added.

The good news is that those who would fit into the apple-shaped category can take some steps to mitigate their disease risk. Fox News talked to Dr. Jellis and Blake about some crucial tips:

1. Focus on eating whole foods
“My message is always go back to the simple things,” Dr. Jellis said, noting that people should maintain a healthy diet and focus on consuming lean meat, and plenty of fruits and vegetables.

2. Stay active
Exercise is another key component in a healthy lifestyle. “Part of the reason why people accumulate abdominal fat, especially as they get older, is related to the fact that they aren’t as active as they once were,” Blake said. She recommended choosing an exercise that you enjoy, whether that’s swimming, biking, or even walking, to ensure that you stick with the plan.

3. Don’t try to spot-treat
Focus on overall health, and don’t just try to lose weight in one part of the body, Blake said, as that is often a futile task. Instead, focus on shedding excess pounds overall.

4. Know your risk
“Unfortunately, we can’t change our genetics, so we have to work with what we’ve got,” Dr. Jellis said. Those who are overweight and carrying weight around their middle should be vigilant about diet and exercise, especially if they have a family history of these disease risks.

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Support programs help moms extend breast-feeding time

Support programs for new mothers help them to breast-feed their babies for longer periods and to keep breast milk as the baby's only source of nutrition, according to a new review of existing evidence.

The researchers concluded that breast-feeding support - whether educational or just encouraging - by trained professionals or lay people generally benefited women and their babies.

"Breast-feeding is really important," said lead author Alison McFadden, who directs the Mother and Infant Research Unit at the University of Dundee in the UK. "Good support will help mothers to breastfeed longer and breastfeed exclusively, which of course is good for mothers and babies."

McFadden and her colleagues are part of the international Cochrane network of researchers who analyze evidence on health topics. Their new review was published in the Cochrane Library.

The World Health Organization recommends that babies be breast-fed exclusively for the first six months of life and then given breast milk along with other food until they're two years old.
Babies who are breast-fed are less likely to develop infections, become overweight and develop diabetes, the researchers write.

"For women, it reduces the incidence of breast and ovarian cancer and diabetes," McFadden told Reuters Health.

For the review, the researchers analyzed 73 studies that compared women who received breast-feeding support to women who received no support or a different kind of intervention. Overall, 75,000 women and their babies were included in the analysis. Most were from high- to middle-income countries.

Support can come in many forms, the authors say - including reassurance, praise, information and the opportunities to discuss problems and ask questions.

Women who received support were about 8 percent less likely to stop breast-feeding before six months, compared to women who didn't get the added help.

For every 1,000 women who received the added help, 304 stopped breast-feeding by four to six weeks and 510 stopped breastfeeding by six months, whereas for every 1,000 women who didn't receive support, 353 stopped within four to six weeks and 573 stopped by six months.

Also, 732 of every 1,000 women who received supported were no longer exclusively breast-feeding at six months, while the same was true for 823 of every 1,000 "unsupported" women.

Certain factors may make the support more valuable for mothers and babies, the researchers found.

For example, it didn't matter whether a health care professional or a trained lay person delivered the support. But, McFadden said, "it needs to be offered, proactive and scheduled so mothers know when to expect support."

Additionally, face-to-face contact and support appeared to be better than help delivered over the phone.

"The people we're hoping will take note of this are those providing the breast-feeding support - the health professional and the people making health policy," said McFadden.

The next step for this type of research would be to make these support services available to a large number of women.

For new parents and parents-to-be, McFadden said, it's important to ask their health care providers about breastfeeding support programs.

"If that support is not available, seek it out," she said.

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Walking linked to improved brain function

A moderate-intensity walking regimen may reduce symptoms of mild cognitive impairment that are linked to poor blood vessel health in the brain, a small study suggests.

Participants with vascular cognitive impairment, sometimes called vascular dementia, who walked three hours per week for six months had improved reaction times and other signs of improved brain function, the Canadian team reports in British Journal of Sports Medicine.

Vascular cognitive impairment, or VCI, refers to mildly impaired thinking or more advanced dementia that's due to the same kinds of blood vessel damage seen with heart disease elsewhere in the body. It is the second most common cause of dementia after Alzheimer's disease.
"It is well established that regular aerobic exercise improves cardiovascular health and cerebrovascular health," the study's senior author Teresa Liu-Ambrose told Reuters Health in an email.

"More specifically, it reduces one's risk of developing chronic conditions such as high blood pressure, diabetes (type II), and high cholesterol. These chronic conditions have a negative impact on the brain - likely through compromised blood flow to the brain," said Liu-Ambrose, a researcher with the Aging, Mobility, and Cognitive Neuroscience Lab at the University of British Columbia in Vancouver.

The brain is a highly metabolic organ and to keep it healthy, it requires good blood flow to deliver the necessary nutrients and oxygen to its tissues, she added.

"It is worth noting that in our study, reduced blood pressure (secondary to exercise) was associated with improved cognitive function," Liu-Ambrose said.

Aerobic exercise may also benefit the brain by increasing growth factors, which are substances made by the body that promote cell growth, differentiation and survival, she said.

Liu-Ambrose and colleagues randomly assigned 38 older adults with mild VCI to one of two groups. One group followed an aerobic training program consisting of three one-hour walking classes each week for six months, while the other group continued with their usual care. In addition, both groups were given information about vascular cognitive impairment and tips for eating a healthier diet.

Before the exercise program began and at the end of six months, all the participants also had functional MRI brain scans and other tests that measured neural activity and cognitive ability.
People in the aerobic training group had significant improvements in their reaction times on the cognitive tests, and showed changes in their brain activity that made them resemble healthy brains more. The comparison group showed no changes.

Overall, exercise appears to be a promising strategy for promoting cognitive health in older adults, Liu-Ambrose said.

"While more research is needed to better understand how it brings about its benefits and what factors may impact the degree of benefit observed, there is minimal negative consequence of exercising," she said.

Liu-Ambrose said she doesn't know if exercise can actually prevent VCI because there have been no studies to determine that. "However, population based studies do suggest that physical activity does reduce the risk of developing VCI. Moreover, as mentioned earlier, aerobic exercise is very effective in reducing vascular risk factors associated with VCI, such as high blood pressure."

The study was small, and because participants had to be able to walk for up to an hour, it's possible they were physically healthier than average, the authors note. The socializing involved in the walking classes might have also had some effect, they add.

"Given the small sample size, one needs to be cautious about interpreting the results of this pilot study. However, it is encouraging to see that the six-month aerobic exercise program improved certain aspects of cognition and showed changes on functional brain imaging," said Dr. Joe Verghese, director of the Montefiore Einstein Center for the Aging Brain at Montefiore Medical Center in New York.

"The effect of exercise in this, and other studies seems to be on improving executive functions, which are required for planning, thinking and judgment," Verghese, who wasn't involved in the study, said by email.

"The findings, if confirmed in larger studies, may have implications in advising exercise in older patients with vascular risk factors for brain protection," Verghese said.

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Broccoli compound could help treat type 2 diabetes

Broccoli could hold the key to slowing, and potentially reversing, the disease, according to a new study.

Some people don't like to eat their vegetables , but for obese people with type 2 diabetes , broccoli could hold the key to slowing, and potentially reversing, the disease, according to a new study.

Scientists used both computational and experimental research to zero in on a network of 50 genes that cause symptoms associated with type 2 diabetes. They also located a compound called sulforaphane — which is found naturally in cruciferous vegetables such as broccoli , Brussels sprouts and cabbages — that could turn down the expression of those genes, according to the findings, published today (June 14) in the journal Science Translational Medicine.

In the study, the scientists gave sulforaphane to obese patients , in the form of a concentrated broccoli sprout extract. They found that it improved the patients' systems' ability to control their glucose levels and reduced their glucose production — two symptoms of diabetes that can lead to other health problems, including coronary artery disease , nerve damage and blindness, according to the Centers for Disease Control and Prevention .

"It's very exciting and opens up new possibilities for the treatment of type 2 diabetes ," Anders Rosengren, an assistant professor at the University of Gothenburg in Sweden, told Live Science.
Type 2 diabetes, the most common form of diabetes, affects more than 300 million people globally. For those with the disease who are obese, the excess fat in the liver makes the body less sensitive to the hormone insulin, which can make it difficult for the organ to help regulate blood sugar levels. Normally, insulin, which is produced by the pancreas , stimulates the liver to pull glucose out of the bloodstream and store it for later use.

People with type 2 diabetes are usually advised to change their diet to help control their blood sugar levels. " Lifestyle changes are at the core of type 2 diabetes treatment but often need to be complemented with drugs," Rosengren said.

Currently the main treatment option is the drug metformin . But not every person who needs it can take it. About 15 percent of type 2 diabetes patients have reduced kidney function and taking metformin can increase their risk for lactic acidosis, an unhealthy build-up of lactic acid, which can cause abdominal discomfort, shallow breathing, muscle pain or cramping, and tiredness.

About 30 percent of patients who take metformin develop nausea, bloating and abdominal pain.

Finding an alternative to metformin was one of the team's objectives. But there was also general frustration in the clinical community that research labs were having a difficult time developing new anti-diabetic compounds , Rosengren said.

One challenge is that researcherslooking to develop new drugs have traditionally studied single genes or individual proteins . But diabetes is much more complicated than that. It involves a large network of genes, so the scientists had to find a new, systematic approach that took a holistic view of the disease.

Study leader Annika Axelsson, a doctoral student at Gothenburg, and her colleagues began by analyzing liver tissue from diabetic mice who were raised on a "Western diet" containing 42 percent fat and 0.15 percent cholesterol. After several tests, the scientists identified 1,720 genes associated with hyperglycemia, a condition in which an excessive amount of glucose circulates in the blood.

After further analysis, the researchers narrowed the 1,720 genes to a network of 50 linked genes that together result in high bloodglucose levels . This network became the so-called disease signature for type 2 diabetes.

Next, the researchers used a database of existing drug compounds and employed a mathematical modeling program to rank those compounds for their potential ability to reverse the disease signature — in other words, to turn down those overexpressed genes.

Sulforaphane had the highest ranking. The team ran several experiments to see if it could actually lower glucose levels in living systems. First, they tested the compound in cells growing in lab dishes, and found that it inhibited glucose production. Next, they tested it in rodents, and found that it improved glucose tolerance in animals on a high-fat or high-fructose diet.

Finally, the researchers tested sulforaphane in people. Over the course of 12 weeks, 97 patients with type 2 diabetes took a daily dose of concentrated broccoli sprout extract in powdered form. The dose was about 100 times the amount found naturally in broccoli . For those who were not obese, the sulforaphane did not have any affect.

But for those who were obese, the results were significant, the researchers reported. Typically, for people with type 2 diabetes, glucose levels in the blood stay high, even when they are fasting. But sulforaphane reduced fasting blood glucose in these patients by 10 percent compared to the participants in the study who took a placebo, according to the study. That amount is enough to lower a person's risk of developing health complications. And the compound did not cause gastrointestinal problems that metformin can cause, nor other side effects.

For the next phase of this study, Rosengren said the team would like to investigate the effects of sulforaphane on people with prediabetes to see whether it could improve their glucose control before type 2 diabetes develops.

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Bangladesh: 3 Jamaat-ul-Mujahideen Bangladesh members arrested

Rapid Action Battalion (RAB) of Bangladesh arrested three members of  the Jamaat-ul-Mujahideen Bangladesh's 'Sarwar-Tamim Group' after conducting raids at the Bakhtabali area in Narayanganj district. RAB claims that they are the members of the JMB's suicide squad.
Kamrul Hasan, RAB-11 Commander Lieutenant Colonel, said that they were nabbed from Lal Miar Char of Boyrakandi area.
The arrested terrorists are Mohammad Waliullah Chishti alias Johnny (27) of Muradnagar area of Comilla, Mohammad Kamrul Hasan alias Hridoy (35) of Debidwar area of the same district and Mohammad Al Amin Sheikh alias Rajib (25) of Mollarhat area of Bagerhat.
Kamrul told, a foreign pistol, revolver, five bullets, 'militancy books', and leaflets were recovered from the spot. "A group of 20-25 people led by a top leader were held in a secret meeting. They were planning an attack'.
They tried to flee on getting the news of RAB's raid. However, three of them were caught. We are on the lookout of the rest.
The arrested Omar and Rajib Sheikh are booked under anti-terrorism law, said an RAB official.

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We believe the foiled plane attack plot was Islamic-inspired terrorism: Australian Federal Police

"Exactly what is behind this is something that we will need to investigate fully," Australian Federal Police commissioner Andrew Colvin said.
Security has been increased at Australian airports after police foiled "Islamic-inspired" plans for a bomb attack on an aircraft during counter-terrorism raids in which four men were arrested on Saturday, the Australian Federal Police (AFP) have confirmed.
"In recent days, law enforcement has become aware of information that suggested some people in Sydney were planning to commit a terrorist act using an improvised device," AFP commissioner Andrew Colvin said during a press conference with Prime Minister Malcolm Turnbull on Sunday, adding:
"We do believe it is Islamic-inspired terrorism. Exactly what is behind this is something that we will need to investigate fully."
"At this time we don't have a great deal of information on the specific attack, the location, date or time. However, we are investigating information indicating that the aviation industry was potentially a target..."
Five properties were searched on Saturday across the Sydney suburbs of Surry Hills, Lakemba, Punchbowl and Wiley Park. The commissioner said four of those searches may continue for days.

ARRESTED MEN NOT YET CHARGED
An AFP spokesman told Reuters the men had not been charged as of Sunday morning.
Turnbull said advice from Australian security and intelligence agencies had led to increased security measures at Sydney airport on Thursday, while the country's other domestic and international airports were affected from Saturday.
"Some of the measures will be obvious to the public, some will not be," Turnbull said.
Colvin said travellers could expect an increased police and security agency presence at airports.
"You can expect longer delays to make sure that more screening is being done on baggage, both hold luggage as well as hand luggage," adding that travelers should allow more time to get through security.
Australia, a close ally of the United States, has been on heightened alert for attacks by home-grown militants returning from fighting in the Middle East, or their supporters, since 2014.
Authorities say they have thwarted a number of potential attacks since then but there have been several "lone wolf" assaults, including a cafe siege in Sydney that left two hostages and the gunman dead.
About 100 people have left Australia for Syria to fight alongside organizations such as Islamic State, Australia's immigration minister said last month.

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