“Healthy Foods” Differ By Individual

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Ever wonder why that diet didn’t work? An Israeli study tracking the blood sugar levels of 800 people over a week suggests that even if we all ate the same meal, how it’s metabolized would differ from one person to another. The findings, published November 19 in Cell, demonstrate the power of personalized nutrition in helping people identify which foods can help or hinder their health goals.

Blood sugar has a close association with health problems such as diabetes and obesity, and it’s easy to measure using a continuous glucose monitor. A standard developed decades ago, called the glycemic index (GI), is used to rank foods based on how they affect blood sugar level and is a factor used by doctors and nutritionists to develop healthy diets. However, this system was based on studies that average how small groups of people responded to various foods.

The new study, led by Eran Segal and Eran Elinav of the Weizmann Institute of Science in Israel, found that the GI of any given food is not a set value, but depends on the individual. For all participants, they collected data through health questionnaires, body measurements, blood tests, glucose monitoring, stool samples, and a mobile-app used to report lifestyle and food intake (a total of 46,898 meals were measured). In addition, the volunteers received a few standardized/identical meals for their breakfasts.

As expected, age and body mass index (BMI) were found to be associated with blood glucose levels after meals. However, the data also revealed that different people show vastly different responses to the same food, even though their individual responses did not change from one day to another.

“Most dietary recommendations that one can think of are based on one of these grading systems; however, what people didn’t highlight, or maybe they didn’t fully appreciate, is that there are profound differences between individuals—in some cases, individuals have opposite response to one another, and this is really a big hole in the literature,” says Segal, of Weizmann’s Department of Computer Science and Applied Math. “Measuring such a large cohort without any prejudice really enlightened us on how inaccurate we all were about one of the most basic concepts of our existence, which is what we eat and how we integrate nutrition into our daily life”, says Elinav, of Weizmann’s Department of Immunology. “In contrast to our current practices, tailoring diets to the individual may allow us to utilize nutrition as means of controlling elevated blood sugar levels and its associated medical conditions.”

Moving Toward Personalized Nutrition

Compliance can be the bane of nutrition studies. Their outcomes rely on participants, away from the laboratory, rigidly following a diet and honestly recording their food intake. In the Weizmann study, the participants (representing a cross-section of Israel’s population and all unpaid) were asked to disrupt their weekly routine in two ways: They were to eat a standardized breakfast such as bread or glucose each morning and also enter all of their meals into a mobile app food diary. In return, the researchers would provide an analysis of the participants’ personalized responses to food, which relied on strict adherence to the protocol. Elinav and Segal say this proved to be a strong motivator, and participant meal reporting closely matched the biometric data obtained from their glucose monitors.

The individualized feedback yielded many surprises. In one case, a middle-aged woman with obesity and pre-diabetes, who had tried and failed to see results with a range of diets over her life, learned that her “healthy” eating habits may have actually been contributing to the problem. Her blood sugar levels spiked after eating tomatoes, which she ate multiple times over the course of the week of the study.

“For this person, an individualized tailored diet would not have included tomatoes but may have included other ingredients that many of us would not consider healthy, but are in fact healthy for her,” Elinav says. “Before this study was conducted, there is no way that anyone could have provided her with such personalized recommendations, which may substantially impact the progression of her pre-diabetes.”

To understand why such vast differences exist between people, the researchers conducted microbiome analyses on stool samples collected from each study participant. Growing evidence suggests gut bacteria are linked to obesity, glucose intolerance, and diabetes, and the study demonstrates that specific microbes indeed correlate with how much blood sugar rises post-meal. By conducting personalized dietary interventions among 26 additional study participants, the researchers were able to reduce post-meal blood sugar levels and alter gut microbiota. Interestingly, although the diets were personalized and thus greatly different across participants, several of the gut microbiota alterations were consistent across participants.

“After seeing this data, I think about the possibility that maybe we’re really conceptually wrong in our thinking about the obesity and diabetes epidemic,” says Segal. “The intuition of people is that we know how to treat these conditions, and it’s just that people are not listening and are eating out of control—but maybe people are actually compliant but in many cases we were giving them wrong advice.”

“It’s common knowledge among dieticians and doctors that their patients respond very differently to assigned diets,” he adds. “We can see in the data that the same general recommendations are not always helping people, and my biggest hope is that we can move this boat and steer it in a different direction.”

The researchers hope to translate what was learned in this basic research project so that it can be applied to a broader audience through further algorithmic developments that would reduce the number of inputs that are needed in order to provide people with personalized nutritional reports.

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The report, “Personalized Nutrition by Prediction of Glycemic Responses,” was published online in Cell.

Processed Meat Is Carcinogenic – World Health Organization

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Salami, sausage, ham and bacon — the latest study by the International Agency for Research on Cancer (IARC) has found a strong link between processed meat and bowel cancer, as well as evidence for probability of such a link also between red meat and bowel cancer.

IARC, which is the World Health Organisation’s cancer research body, classifies compounds’ carcinogenic properties on a scale of decreasing certainty. In group 1 are agents that are definitely carcinogenic to humans; in 2A those that are probably carcinogenic to humans; 2B includes those that are possibly carcinogenic to humans; 3, includes not classifiable agents; and in group 4, those that are probably not carcinogenic to humans.

Processed meat “refers to meat that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavour or improve preservation”, includes things like salami, sausage, ham and bacon, and has been ranked in group 1 by IARC, in the same category as tobacco and alcohol.

According to the study, for every 50 grams of processed meat consumed daily, the risk of colorectal cancer increases by 18 per cent.

In their press release Dr Kurt Straif, Head of the IARC Monographs Programme, said: “For an individual, the risk of developing colorectal cancer because of their consumption of processed meat remains small, but this risk increases with the amount of meat consumed. In view of the large number of people who consume processed meat, the global impact on cancer incidence is of public health importance.”

Although the study scores red meat better than processed meat, its 2A classification means it is now on par with glyphosate, a herbicide contained in products such as Monsanto’s Round-Up, the probably carcinogenic properties of which made headlines earlier in the year. However according to IARC, eating red meat is not just linked to bowel but to pancreatic and prostate cancer too.

Meat industry groups and the research institutes they fund reject that eating meat is on par with smoking or other lifestyle causes to cancer, such as alcohol consumption, obesity and lack of exercise. Nutritionists also argue that the benefits of eating red meat regularly, in combination with plenty of fruit, fibre and exercise, counteract the risk to colorectal cancer.

Yet the debate on the health effects of processed and red meat is nothing new, and neither are the recommendations by health practitioners to limit the amounts consumed to reduce the risk of obesity, diabetes, and heart disease – although the IARC study falls short of setting a safe recommended amount for red meat.

Environmentalists  have too been highlighting for sometime how an increasingly intensive meat industry – responsible for much deforestation, carbon emissions, reliant on fossil fuels and addicted to antibiotics,  is not a sustainable source of food for people and planet.

Even if one doesn’t accept the latest findings by IARC, it seems there are many reasons to limit our processed and red meat intake. Whether a healthy heart or a healthy planet is your thing, good old moderation may well just do the trick.

By Annalisa Dorigo

Plant-Based Diet For First Time Ever Recommended In US Federal Guidelines

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Nutritional experts of the 2015 Dietary Guidelines Advisory Committee recommend a predominantly plant-based diet for health and environmental reasons.

As was recently shared in the article, “8 Nations Going Vegetarian, Proving To The World Less Is More,” a massive shift in health mentality is inspiring people everywhere to invest in their health. In 2010, the UN released a report urging citizens to adopt a plant-based diet for health and environmental reasons. Who knew that earlier this year, the 2015 Dietary Guidelines Advisory Committee would outline similar recommendations for American citizens?

The report, released earlier this year, includes recommendations by the 2015 Dietary Guidelines Advisory Committee on what Americans should be eating. This is the first time the committee has concluded a diet higher in plant-based foods and low in animal-based foods to not only be both healthier for the body, but better for the environment.

The report details their official recommendations for a “healthy dietary pattern,” which has vegetables, fruits, and whole grains at the very top of the list and red meat and processed meats at the very bottom.

“The overall body of evidence examined by the 2015 DGAC identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meats; and low in sugar-sweetened foods and drinks and refined grains.”

The 571-page report gives an in-depth look at what Americans are presently eating. “The quality of the diets currently consumed by the U.S. population is suboptimal overall and has major adverse health consequences,” it states.

Most notable is the large gap between a healthy diet and the standard American diet: “On average, the U.S. diet is low in vegetables, fruit, and whole grains, and high in sodium, calories, saturated fat, refined grains, and added sugars.”

Earlier this year it was reported that only 9% of American adults manage to consume the recommended amount of daily fruits and vegetables. Despite the bounty of healthy living resources and information available, America’s greatest challenge may be overcoming the idea of ‘quick fixes’ and short-term solutions.

The committee’s findings on the Standard American Diet include:

  • Roughly half of American adults have one or more chronic diseases related to poor diet and inactivity
  • Preventable diseases include cardiovascular disease, hypertension, type 2 diabetes, and some cancers
  • More than two-thirds of American adults are overweight or obese
  • Nearly one-third of children are overweight or obese
  • Chronic diseases disproportionately affect low-income communities
  • Focus on disease treatment rather than prevention increases and strains health care costs and reduces overall health

Amazingly, this is also the first time the committee has included environmental sustainability in its recommendations. It is mentioned that a diet lower in animal foods is not only healthier for the body, it’s better for the environment:

“Quantitative modeling research showed how healthy dietary patterns relate to positive environmental outcomes that improve population food security. Moderate to strong evidence demonstrates that healthy dietary patterns that are higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in calories and animal-based foods are associated with more favorable environmental outcomes (lower greenhouse gas emissions and more favorable land, water, and energy use) than are current U.S. dietary patterns.”

The federally appointed panel is comprised of nutritional experts, and their recommendations help to put policies in place to ensure American eat healthier. Their task is to help set standards for school lunches, food stamp programs, and other programs for children and pregnant women.

By at Amanda Froelich at True Activist 

Non-Egg “Mayo” May Need New Name After FDA Warning Letter

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The U.S. Food and Drug Administration has issued a warning to the makers an eggless mayonnaise-like spread called Just Mayo, telling the food company that they cannot call eggless mayo mayo.

The FDA noted that mayonnaise must contain eggs according to its food standard of identity.

Although the food company, Hampton Creek, uses the word “mayo” rather than “mayonnaise,” the FDA wrote in its warning that, “The term ‘mayo’ has long been used and understood as shorthand or slang for mayonnaise.”

Hampton Creek was also sued last year over a similar issue. The maker of popular mayonnaise brand Hellmann’s sued Hampton Creek because its spread did not contain eggs, but the plaintiff dropped the lawsuit after a strong response from Just Mayo supporters.

By Cheryl Bretton

“Female Viagra” Flibanserin Is Completely Different From Male Viagra

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Flibanserin requires a whole new understanding of “Viagra” for those who are familiar with the male Viagra sildenafil. While sildenafil acts specifically on the penis, and only acts when a man is aroused — it does nothing to arouse the man itself — flibanserin is completely different.

The “pink pill” does not work on the groin. Although not completely understood, it is thought to work on the brain, increasing desire rather than allowing body parts to function optimally.

Some scientists believe that some individuals who have little or no feelings of sexual desire may have an imbalance of excitatory and inhibitory neurotransmitters, and so neural activity is not controlled in ways that promote sexual arousal.

Flibanserin increases certain chemicals in the brain while blocking others. This effects an increase in mood chemicals that are considered to be associated with sexual desire.

Another difference between the two drugs is that sildenafil can be taken when needed and lasts 2-4 hours. Flibanserin needs to be taken every day to work.

A third difference is efficacy: men with erectile dysfunction achieve erections 67 – 89 percent of the time with Viagra compared to 27 – 35 percent when taking placebos, and the chance of a man who has taken sildenafil achieving successful sexual intercourse roughly doubles from 35 percent to 69 percent.

The efficacy of flibanserin is only known from tests in which women were found to have an average of one extra sexually satisfying experience every 28 to 56 days (yes, one extra every month or two).

Both drugs have undesirable side effects.

The side-effects of sildenifil can include dizziness, headache, flushing and upset stomach. Also, some men experience increased sensitivity to light, blurred vision, and color blindness to blue and green.

Flibanserin also has several undesirable side-effects: marked sedation, sleepiness and fatigue, which side-effects are made worse if a woman drinks alcohol or takes medication that alters the metabolism of the drug.

By Cheryl Bretton

Herpes Test For $9 Approved By FDA

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The FDA has fast-tracked a new inexpensive finger-stick test for herpes, as well as a processing system for the test.

The FDA cleared the test under its expedited 510(s) regulatory pathway for low- to moderate-risk devices that are similar to products already on the market.

The $9 test was developed by Theranos, a Palo Alto, California company that has a history of making tests at prices lower that Medicare and Medicaid reimbursement rates, but the herpes test is Theranos’ first FDA cleared device.

Tests of this kind do not generally require FDA approval before being sold, but Theranos submitted its test for premarket review because it “wanted to remain deeply committed to ensuring that [its] systems and … laboratory-developed tests are of the highest quality …” according to Theranos’ CEO Elizabeth Holmes.

Theranos was criticized earlier this year for carrying out “stealth research” — keeping its data under wraps and unavailable for peer-review by journals.

The device, which tests for herpes simplex virus 1, works like most finger-stick tests. The user pricks their finger with a pin attached to a processor which provides a positive or negative reading. The main health benefit of Theranos’ test is one of accessibility: low cost.

Herpes simplex virus 1 is carried by 40 – 60 percent of high socioeconomic populations and 70 – 80 percent of low socioeconomic populations. The most common symptom is blisters that develop on or around the mouth or, less commonly, other areas of the body, which form ulcers when they rupture, during which time the “cold sore” is contagious.

By Cheryl Bretton

Seniors Get A Free Checkup Every Year Under Obamacare, And It Includes Tests For Several Conditions

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Obamacare has several provisions that effect seniors specifically, including free annual visits and lower prescription costs, as well as special services to keep seniors from being cheated in fraudulent health care scams. What seniors need to know about their free yearly checkup and the free tests that come with it was recently explained by AARP.

The area of health care reform that covers seniors is Medicare, and it provides for Americans aged 65 and older.

Under Medicare, seniors are entitled to a yearly wellness visit free. This free visit is intended so that older Americans can consult their doctor and develop and maintain a plan just for them to stay healthy.

To use this service, seniors are advised to call their doctor’s office and say, “I would like to schedule my free annual wellness benefit,” according to the American Association of Retired Persons’s (AARP) vice president for health, education and outreach Nicole Duritz.

The yearly visit includes free screenings for cholesterol and diabetes, as well as consultation about the patient’s diet.

During this visit, seniors can expect to have their blood pressure checked and be asked questions about their medications, as well as how they have been feeling. Doctors may recommend changes to dosages, flu or tetanus shots, a mammography or colonoscopy (both of which are free under Obamacare), or another procedure.

Seniors are still advised to ask and make sure about who is covering the costs for anything done at the clinic or hospital, according to Duritz, who warned that it may make a difference if the tests are conducted during the free yearly visit or are scheduled for a later visit. The receptionist who handles the scheduling can also answer these types of questions, Duritz noted.

There are other considerations about medical costs as well, Duritz said. For example, if something is discovered during a colonoscopy, during which procedure the patient is sedated, how will the doctor proceed? If the doctor will remove the polyp during that procedure, there will be bill for that removal. These are things seniors are advised to consider and ask their doctors about before anything is undertaken.

Blog by Cheryl Bretton

25 US States Have Lice Resistant To Over-The-Counter Treatments

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According to researchers who tested 30 US states, head lice populations in the majority are now resistant to over-the-counter pesticides commonly recommended by doctors and schools.

“If you use a chemical over and over, these little creatures will eventually develop resistance,” said Dr. Kyong Yoon, a lead researcher on the study. “So we have to think before we use a treatment.”

Wide use of the main ingredient in many head lice treatments, pyrethoids, has caused a genetic change in many US lice populations, the researchers found.

“We are the first group to collect lice samples from a large number of populations across the U.S.,” Yoon said.

“What we found was that 104 out of the 109 lice populations we tested had high levels of gene mutations, which have been linked to resistance to pyrethroids.”

The mutations took place in a trio of genes linked together under the term “knock-down resistence,” or kdr, which have been known to scientists for decades from crop insecticide research. When kdr mutations take place, the nervous system, which is targeted by insecticides, is desensitized.

“The good news is head lice don’t carry disease. They’re more a nuisance than anything else.”

California, Texas, Maine, and Florida head lice have the highest degree of pyrethroid-resistence — they had all three genetic mutations. There was only one state of the 30 tested where pyrethoid-based treatments would still be highly effective: Michigan.

Why Michigan’s head lice had not developed resistance will be the matter of future research.

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Kdr resistant lice were found in the states colored pink

In light of the discovery, Yoon and his colleagues recommend using other treatment options for dealing with head lice. Currently though, many of those options are only available by prescription.

The research will be presented along with 9,000 other developments at the upcoming American Chemical Society meeting in Boston.

By Cheryl Bretton

Know Your Fats: Trans Linked To Death And Heart Disease, Saturated Not

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Not all fats are equal, according to research by a McMaster University team. Some fats are linked to death, heart disease, stroke, and Type 2 diabetes, while other fats are not associated with these health conditions at all. The issue is not as simple as a line between healthy and unhealthy fats, however, as lead author Dr. Russel de Souza explained.

“Fats should not be considered as one entire group of food,” de Souza told The Speaker.

“We have known for many years that different types of fat have different health effects. Fats that are liquid at room temperature, like olive oil, or canola oil, or those hidden away in nuts — contain essential fats that the body needs for growth and development. Saturated fat, which is solid at room temperature, like butter, behaves differently. Trans fat, which is a liquid fat that has been made solid in a food lab, behaves differently still.

De Souza and his fellow researchers at McMaster University, where de Souza is an assistant professor in the Department of Clinical Epidemiology and Biostatistics, analysed 50 studies, seeking for correlations between trans and saturated fats and health outcomes.

The team’s findings, which were published in the British Medical Journal, pointed to the danger of consuming trans fat. Trans fat, de Souza explained, has no health benefits but poses real heart health risks.

Trans fats is associated with a 34 percent increase in death overall, and more specifically a 28 percent increased risk of death from heart disease and a 21 percent increase heart disease risk.

The evidence for saturated fat is so far not conclusive enough for medical professionals to give a certain recommendation. A tentative one, though, was provided by de Souza, who advised that even though saturated fats were not associated with coronary heart disease, diabetes or stroke, many foods high is saturated fat, such as hamburgers, hot dogs, and higher-fat milks, have been shown by research to increase cancer risk.

Health guidelines for dangerous trans fat limit consumption to less than one percent of energy. For saturated fats, the current recommended limit is less than 10 percent.

De Souza pointed out that there were very healthy options to the unhealthy fats — as well as the white flour and sugar commonly used as fat substitutes — in the foods people buy. In particular, de Souza suggested nuts, seeds and olive oils as healthier choices when it came to fats. Some diets, he said, already comply with these recommendations.

Cardiovascular disease
Dr. Russel de Souza

“The whole diet matters. Dietary patterns consistently associated with good health, such as Mediterranean diets, plant-based diets, or the DASH diet, tend to be low in saturated fat, but their healthfulness is not due solely to the fact that they are low in saturated fat — it’s likely because they combine a number of foods that are highly nutritious, such as whole grains, fruits, legumes, vegetable, and nuts; and avoid foods that contain refined starch and sugar and processed trans fats.”

The importance of the study, which confirmed five previous coronary heart disease studies, lies largely in the evidence that, contrary to what is commonly advised in popular dietary information, saturated fats are not the cause of increased death and heart disease, but trans fats definitely are.

“It’s important to remember that not all fats are equal,” stated de Souza. “And there may be important differences in the health effects of saturated fats from different foods.”

By Cheryl Bretton

First Online Autism Test Developed – The RBQ-2A

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The RBQ-2A Online test, the first self-assessment test for autism spectrum disorder, has been developed by psychologists from the University of Cardiff. The test can also be used to help in diagnosing other diseases that involve behaviors similar to those associated with autism, such as Obsessive-Compulsive Disorder, Parkinson’s disease, and Tourette syndrome.

The test measures adults’ response to one of the primary criteria used in the diagnosis of autism — repetitive behaviors.

The psychologists behind the test say that it is a reliable method for measuring whether a person has frequent or severe autism-related behaviors. However, a diagnosis of autism requires more than just one test. The researchers believe the RBQ-2A can be combined with other tests to fully diagnose autism.

The RBQ-2A was tested out on 311 British and Australian adults — some of which had been diagnosed with autism, some of which had not. The researchers found that those with autism scored higher on the test for repetitive behaviors.

“Many measures used for research and diagnoses of autism rely on parents, teachers or caregivers to report the behaviours of individuals with the condition,” said Professor Sue Leekam, Cardiff University’s Chair of Autism and Director of the Wales Autism Research Centre.

“What our research has done is develop a test where individuals can report on their own behaviours, for both research and clinical purposes, ensuring we get a fuller picture of the way that these behaviours affect people,” she added.

The next step for the researchers is to expand the test to apply to all people, not just adults, and from there, they hope the test will be implemented in clinics across the UK.

By Cheryl Bretton

Gender pay differences for doctors: Why women make less

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Setting out to access why men physicians make more than women, according to statistics, a joint-research team has published Thursday the results of their study, based on an analysis of data for 776 male and female physicians.

“In addition to implicit bias and differences in negotiations and social networks, women’s tendency to prioritize substantial pay less than men may account for some of the gender pay inequities that exist in our society. However, substantial pay is different from equal pay. I bet most women still want fair pay,” said Dr. A. Charlotta Weaver, lead author of the Journal of Hospital Medicine study.

Recent studies have determined that American female physicians make $50,000 less per year than male physicians — an average $165,278 compared with $221,297.

The new research, however, found that after accounting for age, geography, specialty, amount and type of work, women made around $15,000 less than men in the field.

The breakdown of the reasons women make less than men goes like this, according to the study: working women are younger, less likely to be leaders, and more often work part-time.

Women physicians more frequently prioritize other work interests over financial compensation, the researchers found. Women considered pay the fourth most important priority, while men ranked it the second. Both ranked optimal work load first.

Women more frequently were employed as pediatricians and staff in university settings.

It was also found that women work more nights, report fewer daily billable encounters than their male peers, and are more often divorced than male physicians.

“The gender earnings gap persists among hospitalists,” concluded the researchers. “A portion of the disparity is explained by the fewer women hospitalists compared to men who prioritize pay.”

By Cheryl Bretton

Stomach balloon approved by FDA for weight loss

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Dieting leaving you with that empty feeling? The FDA Tuesday approved a new device to fill in for food in the stomachs of weight loss practitioners with a device that requires no surgery: a dual balloon system.

Although medical professionals do not fully understand how filling the stomach triggers feelings of fullness — even in the absence of actual food — they understand that it works.

The ReShape Dual Balloon device is placed in the stomach through the mouth. The typical procedure is a 30 minute minimally invasive endoscopic one, according the the FDA.

Unlike some surgical measures undertaken to lose weight, the balloon does not alter the stomach’s anatomy.

The balloon is meant to be used for around six months while the person also exercises and follows a medically supervised diet.

“For those with obesity, significant weight loss and maintenance of that weight loss often requires a combination of solutions including efforts to improve diet and exercise habits,” said William Maisel, M.D., M.P.H., acting director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health. “This new balloon device provides doctors and patients with a new non-surgical option that can be quickly implanted, is non-permanent, and can be easily removed.”

The balloon is not meant for all dieters. Only obese adults with a body mass index of 30 to 40 kg/m and who have one or more obesity-related conditions, such as diabetes, high cholesterol and high blood pressure, are recommended to try it.

The FDA made their decision on the balloon after the successful results of a clinical trial in which 187 obese participants ranging in age from 22 to 60 lost an average of 14.3 pounds (or 6.8 percent of total body weight) in six months, and who kept off around 10 pounds after six more months. This was contrasted against a control group of roughly the same size who lost only 7.2 pounds in the first six months.

The device is not recommended for those who have had previous gastrointestinal or bariatric surgery or who have been diagnosed with inflammatory intestinal or bowel disease, large hiatal hernia, symptoms of delayed gastric emptying or active H. Pylori infection, nor is it for those who use aspirin daily or who are pregnant.

Potential side effects for the procedure, the FDA warned, include headache, muscle pain, and nausea from the sedation and procedure; in rare cases, severe allergic reaction, heart attack, esophageal tear, infection, and breathing difficulties can occur. Once the device is placed in the stomach, patients may experience vomiting, nausea, abdominal pain, gastric ulcers, and feelings of indigestion.

By Cheryl Bretton