Fattest US Cities: Did Your Hometown Make New Ranking?

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Diets, Fitness

Seattle, take a bow. Jackson, hit the gym. A new study ranking the nation�s 100 fattest cities has found residents of the Mississippi city topped the scales nationally, while Jimi Hendrix�s hometown has the smallest proportion of overweight residents.

The analysis, by Wallethub.com, found that 70 percent of Americans aged 15 and older are overweight or obese � in line with statistics compiled by the Centers for Disease Control and Prevention. But some cities are more likely to have more residents who hit those thresholds than others.

On balance, the south tended to rank higher in the new study, which has historically been the case, while residents of colder, northern states and the Pacific Northwest fared better.

Dr. Charles Platkin, director of the New York City Food Policy Center and Distinguished Lecturer at Hunter College, City University of New York, tells Newsmax Health the new rankings aren�t entirely surprising but bring attention to regional factors that may play a role in U.S. obesity trends.

“There isn’t any major new information here,” Platkin explains. “There are a lot of variables that go into diet and obesity, including poverty levels, and diet and culture of southern states, for instance.”

The 10 fattest cities on the new list tended to be southern:

• Jackson
• Memphis, Tenn.
• Little Rock, Ark.
• McAllen, Texas
• Shreveport, La.
• Chattanooga, Tenn.
• Mobile, Ala.
• Lafayette La.
• Winston-Salem, N.C.
• Knoxville, Tenn.

At the other end of the spectrum, researchers found the following 10 cities to be on the lowest end of the �obesity� scale:

• Seattle-Tacoma-Bellevue, Wash.
• Portland, Ore.
• Minneapolis-St. Paul, Minn.
• Denver and Colorado Springs, Colo.
• Boston-Cambridge, Mass.

The researchers, as well as the U.S. Department of Agriculture, suggested a variety of factors play a role in U.S. obesity trends. Among them:

Regional variations in diet. The south is famous for barbecue, fried foods, and sweet tea; northern and coastal cities may offer a wider range of healthy options of vegetables, whole grains, and fruits. These differences in dietary patterns are influenced by social, demographic, cultural, historical, and economic factors

Poverty. Economic factors play a role in food choices and activity levels. According to the USDA, 42.2 million people live in households where access to healthy foods is limited, often because of poverty-related issues. In such households, families may not be able to afford to eat regular, balanced, healthy meals, or may turn to less-healthy alternatives to save money. Such households are more prominent in the south than the northeast, the west, and the Midwest.

Education. Schooling and personal achievement, uncertainty about jobs, and even access to good grocery stores also factor into food choices linked to obesity rates.

Activity, exercise trends. Northern metropolitan cities and other areas, such as the Denver area, that are popular places for healthy physical activities � such as hiking, skiing, and other outdoor sports � tend to rank lower in obesity scores.

Shopping habits. The shopping and dietary habits of people who participate in the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, are other factors. Most households receiving SNAP benefits, according to the USDA, don�t consume the same quantities of fruit, whole grains, and other healthy foods as people who aren�t on receiving food assistance.

USDA research has shown that 11 states � located along the western and southern borders of the country plus the District of Columbia � have higher-than-average levels of poverty and more people receiving SNAP benefits. These factors explain, at least in part, the prevalence of obesity across southern states. There is a higher level of food insecurity and greater use of SNAP benefits.

Platkin notes the survey rankings don�t aim to solve the nation�s obesity crisis, but they could inform aggressive promotions and education � similar to what Americans have done with in past public health campaigns, such as those aimed at tobacco use.

“Look at things we have done successfully, like smoking cessation and recycling,” he says.

Culturally significant programs like food access and cooking classes might make a difference in regions of the country where obesity rates are especially high, he adds.

Combatting poverty could also lead to improvements in diet and activity levels in some cities.

“Culturally, what are the diets, how much outdoor appeal is there, physical activity, and what about binge drinking in these areas?� he says.

To check out the complete list of the nation�s 100 fattest cities, check out Wallethub.com.

Common Nutrient in Food Tied to Risky Blood Clotting

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Diets, Fitness

A nutrient in meat and eggs may conspire with gut bacteria to make the blood more prone to clotting, a small study suggests.

The nutrient is called choline. Researchers found that when they gave 18 healthy volunteers choline supplements, it boosted their production of a chemical called TMAO.

That, in turn, increased their blood cells’ tendency to clot. But the researchers also found that aspirin might reduce that risk.

TMAO is short for trimethylamine N-oxide. It’s produced when gut bacteria digest choline and certain other substances.

Past studies have linked higher TMAO levels in the blood to heightened risks of blood clots, heart attack and stroke, said Dr. Stanley Hazen, the senior researcher on the new study.

These findings, he said, give the first direct evidence that choline revs up TMAO production in the human gut, which then makes platelets (a type of blood cell) more prone to sticking together.

Choline is found in a range of foods, but it’s most concentrated in animal products such as egg yolks, beef and chicken.

Hazen said he and his colleagues at the Cleveland Clinic wanted to isolate the effects of choline on people’s levels of TMAO and their platelet function. So they studied supplements.

The researchers had 18 healthy adults –10 meat-eaters and eight vegetarians/vegans — take choline supplements for two months.

The supplements provided around 450 milligrams of choline daily — roughly the amount in two or three eggs, Hazen said.

One month in, the study found, the supplements had raised participants’ TMAO levels 10-fold, on average. And tests of their blood samples showed that their platelets had become more prone to clotting.

“This study gives us one of the mechanisms by which TMAO may contribute to cardiovascular disease,” said Dr. J. David Spence.

Spence, who was not involved in the study, directs the Stroke Prevention & Atherosclerosis Research Centre at Western University in London, Ontario, Canada.

For the healthy people in this study, Spence said, the TMAO rise from choline might not be worrisome. But, he added, it might be a concern for people at increased risk of heart disease or stroke.

Spence suggested those individuals limit egg yolks, beef and other foods high in choline.

Hazen had similar advice. “You don’t have to become a vegetarian,” he said. “But you could try eating more plant-based foods, and more vegetarian meals.”

He also pointed to the Mediterranean diet — rich in olive oil, vegetables and fish. In an earlier study, Hazen said, his team found that a compound in olive oil seems to inhibit TMAO formation.

The new study uncovered yet another compound that may counter TMAO: low-dose aspirin.

In a separate experiment, the researchers had some participants take 85 milligrams of aspirin (a baby aspirin) a day, in addition to choline supplements. That, it turned out, lessened the rise in TMAO and the change in platelet activity.

Doctors already prescribe low-dose aspirin to certain people at risk of heart disease and stroke.

It’s possible, Hazen said, that aspirin’s effects on TMAO are one reason it helps ward off cardiovascular trouble.

The current study is small and preliminary. But it’s the latest to suggest that the gut “microbiome” plays a key role in cardiovascular disease, Spence said.

The “microbiome” refers to the trillions of bacteria that dwell in the gut. Spence said researchers are just beginning to understand how gut bacteria and their byproducts affect the cardiovascular system.

But one hope, he said, is to figure out what balance of gut bacteria supports cardiovascular health — and possibly use probiotic (“good” bacteria) supplements to help treat people at high risk of heart disease or stroke.

Spence said his own lab is working on just that.

There are, of course, many factors in heart disease risk — from age to high blood pressure to diabetes to smoking, Hazen pointed out.

“We’re saying a portion of the risk is related to the gut microbiome,” he said.

Hazen and a colleague report potential royalty payments from several companies related to “cardiovascular diagnostics and therapeutics.” One company, Cleveland HeartLab, recently launched a test for measuring TMAO levels.

The findings appear in the April 25 online issue of Circulation.