How Weight Loss Helps the Heart http://www.usnews.com/health/family-health/heart/articles/20 09/08/11/how-weight-loss-helps-the-heart.html
By Ed Edelson

(Thanks to Kevin for sharing this information with us!)

HealthDay Reporter TUESDAY, Aug. 11 (HealthDay News) -- Losing a lot of weight rejuvenates the physical structure of the heart, and it makes no difference whether the weight is lost by surgery or by dieting, a new British study shows. The heart muscles of people who started with a body mass index (BMI) averaging 40 -- a BMI of 30 is the usual marker of obesity -- became noticeably thinner and more efficient when they brought their BMI down to 32.2 in a single year, according to a report in the Aug. 18 issue of the Journal of the American College of Cardiology. "Both diet and bariatric surgery led to comparable, significant decreases" in heart structure abnormalities and malfunction, the University of Oxford researchers reported. Bariatric surgery is designed to induce weight loss by reducing the amount of food people can eat, the amount of food they can metabolize or both. Weight loss averaging 21 kilograms (about 45 pounds), achieved by the 37 obese people in the study, "is typically what is seen after bariatric surgery," said Dr. Philip R. Schauer, director of the Cleveland Clinic Bariatric and Metabolic Institute. Noting that many of the obese people lost those kilograms by eating less, Schauer called it "quite unusual for someone to diet with that effect. These were a very special subset." And the problem with weight loss by diet is that "weight regain is the norm, whereas with bariatric surgery there is ample evidence that the weight loss is maintained," Schauer said. The Oxford researchers used cardiac MRI, a special X-ray technique, to obtain detailed information on the structure of the hearts not only of the 37 obese participants but also of 20 normal-weight volunteers, whose average BMI was 21. They found that the walls of the left and right ventricles, the blood-pumping chambers of the heart, were significantly thicker in the obese people. They also found impaired ability of the heart to hold blood at diastole, the resting point of the heartbeat, in the obese. A year later, after weight loss, the heart muscles of the obese people were less overgrown and the hearts could also hold more blood. Thickening of the aorta, the main heart artery, was also greatly reduced after weight loss. "These findings provide a potential mechanism for the reduction in mortality seen with weight loss," the researchers wrote. And it thus helps explain something of a medical mystery -- why people who are grossly overweight are more at risk of heart attack and sudden death than their numbers show, said Dr. Christine Ren, a bariatric surgeon who is an associate professor of surgery at New York University Langone Medical Center. "Most of them say they are pretty healthy, maybe with a slight elevation of blood pressure, but when you really drill down to it you can show an abnormal cardiac function," Ren said. "The point is that their heart is not normal and that already is having a negative effect on their health." Losing weight by dieting is desirable, "but the problem with diets is that statistics show maintenance of weight loss by diet is extremely difficult and quite rare," Ren said. Bariatric surgery is expensive, costing anywhere from $15,000 to $25,000, she said, and it is not perfect. "There is always going to be 5 percent of these people who gain most of their weight back, but it still is the best chance of having significant weight loss," Ren said. However, health insurance coverage of bariatric surgery is uncertain, varying from company to company and state to state, she said, and many plans are starting to put more limits on coverage. More information Bariatric surgery is described by the U.S. National Library of Medicine.  

Thank you to Guayas for this article.

Probiotics Help Gastric-Bypass Patients Lose Weight More Quickly

ScienceDaily (July 13, 2009) — New research from the Stanford University School of Medicine and Stanford Hospital & Clinics suggests that the use of a dietary supplement after Roux-en-Y gastric bypass surgery can help obese patients to more quickly lose weight and to avoid deficiency of a critical B vitamin.

In a study published in the July issue of the Journal of Gastrointestinal Surgery, John Morton, MD, associate professor of surgery at the medical school, showed that patients who take probiotics after the gastric-bypass procedure tend to shed more pounds than those who don't take the supplements. Probiotics are the so-called "good" bacteria found in yogurt as well as in over-the-counter dietary supplements that help in the digestion of food.

 

"Surprisingly, the probiotic group attained a significantly greater percent of excess weight loss than that of control group," said Morton, who wrote the paper with lead author Gavitt Woodard, a third-year medical student, and five other medical students at the Surgery Center for Outcomes Research and Evaluation in Stanford's Department of Surgery. Morton has performed more than 1,000 of these bypasses at Stanford Hospital & Clinics.

The researchers followed 44 patients on whom Morton had performed the procedure from 2006 to 2007. Patients were randomized into either a probiotic or a control group. Both groups received the same bariatric medical care and nutritional counseling, as well as the support of weight-loss study groups. Both groups also were allowed to consume yogurt, a natural source of probiotics. In addition, the probiotic group consumed one pill per day of Puritan's Pride, a probiotic supplement that is available online and in many stores. Morton has no financial ties to the company that makes the supplement.

The study showed that at three months, the probiotics group registered a 47.6 percent weight loss, compared with a 38.5 percent for the control group.

The study also found that levels of vitamin B-12 were higher in the patients taking probiotics — a significant finding because patients often are deficient in B-12 after gastric-bypass surgery. The probiotics group had B-12 levels of 1,214 picograms per milliliter at three months, compared with the control group's levels of 811 pg/mL.

Morton said he now recommends probiotic supplements to his patients, and he plans to continue to look for ways to enhance the outcomes from the procedure.

Roughly 15 million Americans are morbidly obese, and bypass surgery is becoming an increasingly common treatment for the problem. Some 150,000 Americans who have a body mass index of more than 40 — who are typically at least 100 pounds overweight — have the procedure each year.

Morton said the study was prompted by the fact that some patients have problems eating after gastric-bypass surgery. "For some reason, the food doesn't go down right," he said. When no anatomical reasons could be found for blockages, he hypothesized that a build-up of bacteria in the intestine — bacterial overgrowth — might be the culprit.

"Bacterial overgrowth can be bad in that it changes your motility, how you empty," Morton said. "A lot of people aren't aware that we all carry about a lot of bacteria in our intestines and that they're extremely helpful in aiding digestion. And I thought, 'Well, if we give these patients probiotics, then maybe we can improve these symptoms.'

"Part of the obesity puzzle may be due to the kind of bacteria you have in your intestine," he said.

There was no outside funding for the study.