Having a gym nearby does help us to lose weight, suggests new research.

The new study was led by Kate Mason, from the London School of Hygiene & Tropical Medicine in the United Kingdom, and the findings were published in The Lancet Public Health.

Mason and her colleagues started out from the observation that the built environment can have serious public health consequences. So, they wondered whether living next to an exercise facility — and implicitly, building more of them — might help in the fight against obesity.

To find out the answer, the researchers examined data from a large cohort study called the U.K. Biobank study — which ran from 2006 to 2010 — and looked at whether residential proximity to fast food outlets and physical exercise centers had any bearing on weight measurements.

The study included the waist and body mass index (BMI) measurements as well as body fat percentages of approximately 400,000 people.

The findings may inform existing urbanization practices and have a bearing on public policy.

Living near exercise facilities lowers BMI

The research included data on adults between 40 and 70 years old who attended a total of 21 assessment centers between 2006 and 2010.

Using multilevel linear regression models and sensitivity analyses, the team accounted for potential confounders. These included individual demographic and socioeconomic characteristics. They also examined whether the findings would depend on sex or household income.

The indoor and outdoor exercise facilities considered included gyms, swimming pools, and sports playing fields, but they did not include public parks or cycling paths.

Almost a third (31.2 percent) of the participants did not have any exercise facilities within 1 kilometer of their home. However, on average, there was one such facility within this distance.

The distance to the first fast food outlet was 1.1 kilometers, on average, and around 18.5 percent of the study participants lived within half a kilometer of fast food.

Overall, the analysis revealed that living close to an exercise facility did, as expected, lower obesity risk.

Individuals living in close proximity to at least six exercise facilities had a waistline that was 1.22 centimeters smaller, a BMI that was 0.57 points lower, and a body fat percentage that was 0.81 percent lower, on average.

This link was stronger for women and higher-income groups of people, note the researchers.

Additionally, the study found that the farther people lived from a fast food outlet, the smaller were their BMI, waistline, and body fat percentage. This association was the strongest among women.

Governments should 'design in' health

Mason comments on the findings, saying, "The results of our study suggest that increasing access to local physical activity facilities and, possibly, reducing access to fast food close to residential areas could reduce overweight and obesity at the population level."

"Designing and planning cities in a way that better facilitates healthy lifestyles may be beneficial," she adds, "and should be considered as part of wider obesity prevention programmes."

"This could be improved by restricting the number of new fast food outlets in a neighborhood and how close they can be to people's homes, incentivizing operators of physical activity facilities to open in residential areas with few facilities, or funding local authorities to provide such facilities."

Co-senior study author Prof. Steven Cummins, from the London School of Hygiene & Tropical Medicine, echoes similar thoughts:

"National and local governments need to think seriously about 'designing in' health as cities grow in order to improve health and reduce health inequalities."

"It would also be important to make sure new physical activity facilities are affordable, especially when they are located in lower-income areas," Prof. Cummins adds.

"The associations we observed were weaker for people from low-income households," he continues, "and this might be because they can't afford to use many of these facilities."

But they also highlight some limitations to their study, particularly regarding the effects of fast food outlet proximity on weight. They note that not all fast food outlets were considered, some were mistakenly classified as restaurants, and healthful fast foods were not accounted for.

The observational nature of the study, however, means that the team were unable to establish a causal relationship, nor can we know whether fast food outlets and gyms were set up in areas where people are known to have unhealthy or healthy lifestyles, respectively, or whether the reverse is true.

Using a desk fitted with a movable footrest raises metabolic rate more than sitting or standing at a desk.

Lead study author Craig A. Horswill, a clinical associate professor in the Department of Kinesiology and Nutrition at the University of Illinois at Chicago, and colleagues conducted the study. Horswill is an expert in metabolism and exercise.

Their findings were published in the journal WORK.

Physical activity and healthful eating habits are crucial to maintaining good health. Each year in the United States, an estimated 300,000 deaths are likely caused by physical inactivity and consuming an unhealthful diet. These deaths occur across numerous conditions, including stroke, heart disease, diabetes, and colon cancer.

A significant part of the problem is working in an office and sitting at a desk for 8 hours per day.

Previous research has shown that individuals who work at a desk have larger waists and a greater risk of heart disease. One study reported that although participants spent around 73 percent of their working day sitting down, many of them wanted to sit down less and spend more time exercising as part of their working day.

Strategies to beat damage of sedentarism

Some companies have employed strategies to help their workers be less desk-bound, such as incorporating yoga into their day, organizing lunchtime activities, and providing treadmill desks, standing desks, and regular walking breaks.

A study that compared sitting and sit-stand desks revealed that employees with sit-stand desks not only stood for 60 more minutes than people who remained seated, but they also burned 87 more calories per day.

Although it is best to avoid being sedentary for long periods, fidgeting has been demonstrated to help counteract the adverse effects of sitting — findings that have been further emphasized by the new study.

According to Horswill, "Sitting is bad for our health, but it is a big part of daily life for many people. Exercise is a good way to counteract the negative effects of sitting, but just incorporating physical activity into one part of our day may not be enough to overcome the damage caused by prolonged sitting and an otherwise sedentary lifestyle."

The researchers compared the effect of sitting at a desk, sitting at a desk fitted with a movable footrest that allows the feet to swing, teeter, or twist, and standing at a desk on metabolic rate.

Metabolic rate and heart data were collected during each stage. Participants moved through each 15-minute stage of sitting, sitting with the device, and standing.

Metabolic rates elevated with device

Using a desk fitted with the moving device raised metabolic rate 7 percent more than standing and 17 percent more than just sitting. Movement while sitting had no impact on the cognitive function of participants.

"These results suggest that non-exercise active thermogenesis, which we call NEAT, can increase movement and calorie burning, and may have the potential to impact health," reports Horswill.

"We expected to see the metabolic rate increase with each progressive stage, but instead found that metabolic rates from movement while seated were either equal to or higher than rates while standing."

Craig A. Horswill

Horswill notes that NEAT is something that everyone can do and may help toward improving health and even reduce the rates of early death.

Although further research needs to be completed to confirm the findings, there is a lot of evidence to suggest that NEAT could be a viable solution for those who are unable to use standing desks due to injury or disability.

Knee osteoarthritis can sometimes lead to knee replacement surgery, as cartilage damage cannot be reversed.

Osteoarthritis is the commonest form of arthritis and the most common joint disorder in the United States.

Specifically, osteoarthritis of the knees affects 10 percent of men and 13 percent of women aged 60 and above in the U.S.

It is widely accepted that obesity is a risk factor for arthritis. In fact, according to the Centers for Disease Control and Prevention (CDC), almost a third (31 percent) of obese U.S. adults have now been diagnosed with arthritis by their physician.

But how can these individuals slow down the progressive degeneration of the joints that occurs in osteoarthritis?

Studies have revealed that for obese and overweight people, weight loss can make a difference. Losing weight reduces the activity of inflammatory immune cells that are thought to be key in the osteoarthritis-related degradation of the cartilages.

But until now, it was not clear whether some weight loss regimens were more effective than others. So, researchers led by Dr. Alexandra Gersing, from the Department of Radiology and Biomedical Imaging at the University of California, San Francisco, set out to investigate the impact of dieting alone, dieting and exercise, or exercise alone on the progression of knee osteoarthritis.

"Once cartilage is lost in osteoarthritis, the disease cannot be reversed," explains Dr. Gersing. So, finding the best plan for reducing knee cartilage damage is crucial.

The new findings were presented at this year's annual meeting of the Radiological Society of North America, held in Chicago, IL.

Exercise alone does not work

Dr. Gersing and colleagues investigated the progression of knee osteoarthritis in 760 people with a body mass index (BMI) higher than 25 kilograms per square meter. The participants were 62 years old, on average, and they were enlisted in the Osteoarthritis Initiative national research project.

The participants had either risk factors for osteoarthritis or a mild to moderate form of the disease.

Of the 760 participants, 380 lost weight and 380 did not. Those who lost weight were broken down into three subgroups, by weight loss method. One group followed a diet and engaged in exercise, another group did only exercise, and a third group lost weight through diet alone.

Dr. Gersing and team assessed the progression of osteoarthritis using MRI at baseline, 48 months later, and 96 months later (the end of the study). Over the 96-month period, the degeneration of the cartilage was drastically lower in the weight loss group compared with the no-weight loss group.

Importantly, however, these promising results were found only among those who lost weight through a combination of diet and exercise, or just diet.

Interestingly, this was true despite the fact that those in the exercise-only group lost just as much weight as those in the diet only and diet plus exercise group.

Compared with those who did not lose any weight, exercise-alone weight loss had no influence on cartilage degeneration.

The study authors conclude, "Results suggest that cartilage degeneration is slowed through weight loss in obese and overweight subjects over 96 months. This protective effect was, however, only found in subjects losing weight through diet and combined exercise and diet programs."

"These results add to the hypothesis that solely exercise as a regimen in order to lose weight in overweight and obese adults may not be as beneficial to the knee joint as weight loss regimens involving diet."

Dr. Alexandra Gersing

A person with morbid obesity may have difficulty performing daily functions, such as walking and breathing, and is at increased risk for many serious health problems.

In theory, anyone can become morbidly obese. For someone to gain weight and become morbidly obese, they must consume more calories than their body can burn and use. The body stores the unnecessary calories as fat.

As more and more calories are consumed, the fat stores grow larger, leading to obesity or, as a worst case, morbid obesity.

What is morbid obesity?

Those who are morbidly obese are at an increased risk of developing serious health problems.

Morbid obesity is when a person has extreme amounts of excess body fat and a body mass index or BMI greater than 35.

BMI is a scale that helps doctors and other medical professionals determine if a person is within a healthy weight range.

Some doctors also consider a person to be morbidly obese if their BMI is not over 35, but they are more than 100 pounds overweight.

BMI is broken down as follows:

• Normal: 19.0–24.9
• Overweight: 25.0–29.9
• Obese stage 1: 30.0–34.9
• Obese stage 2: 35.0–39.9
• Morbidly obese stage 3: 40.0 or greater

When a person is morbidly obese, they are at greater risk of heart disease, certain illnesses, and conditions that directly affect their quality of life.

How does morbid obesity differ from obesity?

A person can be obese without being considered morbidly obese. A person who is obese has a BMI of 30 or above. An obese person has a greater chance of developing:

Morbid obesity occurs when a person reaches a level of obesity that greatly increases the chances of developing one of these conditions.

These conditions are often referred to as comorbidities and are responsible for causing disabilities or even death.

Risk factors

While almost anyone can become morbidly obese, certain factors put a person more at risk than others. These include the following:

• Genetic factors: Some research indicates that people with a family history of obesity or morbid obesity are more likely to become morbidly obese themselves.
• Personal habits: The food a person chooses to eat and a person's activity level affect whether or not they become overweight or obese.
• Mental factors: Stress and anxiety can both cause someone to put on weight, as they can lead the body to produce more of the stress hormone cortisol. Cortisol leads to fat storage and weight gain.
• Sleep habits: Lack of sleep can be another contributor to weight gain.
• Being female: Many women have trouble losing pregnancy weight and are prone to gaining weight during menopause.
• Certain medical problems: Some medical issues can cause obesity, including Cushing's syndrome or Prader-Willi syndrome.
• Some medications: Antidepressants and beta-blockers are just a few of the drugs that may cause weight gain.
• Aging: As adults age, slowing metabolism and sedentary but busy lifestyles may make people more likely to gain weight.

Symptoms

The main symptom of morbid obesity is having a BMI of 35 or higher and obesity-related health problems, such as diabetes or hypertension. Other symptoms may include:

• excess fat buildup around the body
• being easily winded
• difficulty walking
• trouble breathing

Diagnosis

Many Americans are obese. According to the Centers for Disease Control and Prevention (CDC), over one-third of the United States adult population is obese. Furthermore, the CDC identifies about 17 percent of all children in the U.S. as obese.

A doctor may want to know about the history of a person's weight level, any weight loss efforts, and their eating and exercise habits. From there, a doctor will likely perform one or more tests.

To start, a doctor may measure someone's BMI to determine if they are obese or morbidly obese.

Is BMI accurate?

BMI is not without its drawbacks. In fact, BMI is an estimate and not an exact measure of body fat.

People, particularly athletes, can throw off a BMI scale and fall into or out of the unhealthy ranges, depending on their sport. For example, bodybuilders may have very high body mass indexes while having low body fat.

Body fat percentage

A doctor may evaluate a person's body fat percentage, as well as their BMI. This can be done with either a skin fold test, which uses bioelectrical impedance, or a water or air displacement device. All these tools are used to try to calculate the percentage of someone's body that is fat.

Blood work

Finally, a doctor may want to order blood work to help rule out potentially fixable causes of excessive weight, such as side effects of medication. The blood work also checks for related health concerns that many people with morbid obesity can have.

Complications

Osteoarthritis can be a complication of morbid obesity.

When a person is morbidly obese, they have an increased risk of developing additional diseases and conditions. These related conditions can be debilitating or even deadly and include:

• heart disease
• abnormal blood lipid counts
• type 2 diabetes
• reproductive issues
• osteoarthritis
• obesity hypoventilation syndrome
• stroke
• sleep apnea
• gallstones
• certain cancers
• metabolic syndrome

Treatment options

Fortunately, there are several treatment options for a person with morbid obesity to choose from to lose weight. Some of these options include:

• diet and exercise
• medication
• surgery

Diet and exercise

It is not always easy for a person to lose weight from diet and exercise, and no single plan or program works for all people.

A person should discuss diet and exercise plans with their doctor or dietitian. Medical professionals can help set reasonable starting points and achievable goals. Also, being under a doctor's care can help avoid problems from overexercising.

People who have morbid obesity may have difficulty exercising due to limited mobility. A doctor or physical therapist can suggest exercises that they can do safely.

Weight loss medication

Medications offer a less reliable means of losing weight than changes in diet. Once a person stops taking a medication, they will likely regain the weight unless significant changes to diet and exercise have been made.

There are several over-the-counter medications and supplements available. Often, doctors do not recommend these because their claims are not supported by research.

Surgery

Surgery may be a final option for some people who have not had success with diet and exercise. A doctor will need to discuss what surgery option is best for an individual. Any surgery comes with risks, which should be factored into the decision to undergo a procedure.

There are two surgical options typically used. These are:

• Gastric banding: This is where a ring is placed around the stomach, limiting the amount of food that can enter.
• Gastric bypass: Where portions of the stomach are bypassed, giving a feeling of fullness.

If a person is successful at losing a significant amount of weight, they may also choose to have skin removal surgery, where surgeons remove excess skin from the body.

Prevention

A healthful diet that includes non-processed fruit and vegetables will help prevent obesity.

The best way to prevent obesity is through diet and exercise. A healthful diet combined with regular, moderately intense exercise is ideal.

A person should look to eat:

• fresh, non-processed fruits
• green, leafy vegetables
• limited amounts of sugar
• reduced number of calories
• smaller, more frequent meals

A person may want to consider regularly doing some of the following exercises for 30 minutes, up to five times a week:

• walking
• running
• jogging
• jumping rope
• riding a bike
• swimming
• rowing
• yoga or other fitness classes

Takeaway

Left untreated, a person with morbid obesity can develop any number of more serious health conditions. These conditions can be limiting and potentially fatal.

When treated, morbid obesity can be reversed, and the chances of developing other medical conditions are greatly reduced. Diet and exercise are the most effective, long-term solutions to reversing morbid obesity.

A hyperextended knee often occurs after high-impact events, such as landing hard after a jump or stopping short when running. Due to the nature of this injury, athletes are most at risk, particularly those involved in contact or extreme sports.

When this injury occurs, it is not uncommon for a person to notice swelling, be in moderate to extreme pain, and have soft tissue damage in or around the knee.

In this article, we take a close look at the symptoms of a hyperextended knee, how to treat one, and how long it takes for a hyperextended knee to heal.

Symptoms

A hyperextended knee may occur after high-impact events. Symptoms can include swelling, severe knee pain, and visible bruising.

A hyperextended knee is often easy to spot when it happens. A person can often feel the knee bend backward out of line with the leg.

When a hyperextended knee occurs, it is very likely the person will experience the following symptoms:

• moderate to severe knee pain
• swelling
• instability in the knee
• feeling of weakness in the knee as if it is giving out
• visible bruising

People will often experience reduced mobility following a hyperextended knee. It is usually difficult to straighten or bend the injured knee. Reduced mobility may be due to one of the following:

• damaged ligaments
• swelling
• weakness in knee

The symptoms will range from mild to severe depending on how far back the knee was bent. The severity of the injury and damage to the surrounding tissues and ligaments affects how much pain and swelling a person will experience.

Treatment

Using a brace when resting a hyperextended knee injury is recommended.

Treatment for a hyperextended knee depends on how severe the injury is. Often, treatment begins with RICE.

R — rest

Following a hyperextended knee injury, it is a good idea to stop the activity that caused the damage in the first place.

For an athlete, this may mean sitting out a few games. For the average person, rest may mean not walking on the injured leg or using a brace.

During rest, a person may also:

• receive physical therapy to restore range of motion
• use pain medication
• use anti-inflammatory medication

I — ice

Ice is a popular treatment for injuries such as a hyperextended knee, as it helps reduce swelling and relieve some pain.

A person should apply ice to the hyperextended knee for about 15 minutes at a time, multiple times a day. Ice should always be used with a barrier, such as a towel, to prevent damage to the skin.

C — compression

Compression involves wrapping the injured knee with some pressure. Elastic support bands or compression wraps are available for this purpose. Some knee compression wraps can be viewed here.

Compression, in the same way as ice, can help reduce pain and swelling from the injury. It can also provide a little support to the weakened knee.

E — elevation

The injured knee should be elevated whenever possible. The knee should be held above the heart, which is often accomplished by laying down and raising the leg on a pillow or other comfortable platform.

Treatment for severe cases

In more extreme cases, a hyperextended knee will require surgery to fix the ligaments or alignment of the knee.

A torn anterior cruciate ligament (ACL) is the most common complication, but other tendons and structural supports can be damaged. The ACL is a pair of ligaments in the knee.

It is possible that multiple areas of the knee will require surgery to repair.

Recovery

Recovery time from a knee injury varies. In less severe cases, a person may recover within 2 to 4 weeks from the time of the injury.

During recovery, a person needs to avoid any activity that can make the injury worse. Also, a person should use the RICE method.

If surgery is required, recovery is likely to take much longer. It can take 6 months or more to recover from surgery fully. Though it will take a long time, most people will see a full recovery.

As part of the recovery process, a doctor will likely recommend physical therapy. Even if a person has had surgery, physical recovery is still required to restore muscle strength and range of motion.

Exercises

Swimming may be recommended to increase strength following a hyperextended knee injury.

There are many exercises that a person can do following a hyperextended knee injury. The goal of the exercises is to improve range of motion and increase strength.

A person should discuss exercise options with their doctor or physical therapist.

Some potential exercises that a person may do include:

• swimming
• gentle hamstring stretches
• stationary bike
• straight leg raises
• wall sits
• lateral step-up
• quad sets — strengthening the quads (thigh muscles) by contracting, holding and releasing the muscles, placing a rolled towel under the knee for support if lying down

The exercises that a person does while recovering from a hyperextended knee should be gentle to start with and get progressively more challenging as a person's knee recovers and gets stronger.

Outlook

People who experience a hyperextended knee injury may see full recovery following their injury.

A person must seek medical attention as soon as possible following the injury and follow all recommended treatment advice for the best chance of full recovery.

It can be difficult for athletes and active people to rest, but it is necessary for the best recovery from a hyperextended knee.

A person can reduce their risk of getting a hyperextended knee through exercise and stretching. It is essential that the muscles surrounding the knees are strong. Also, stretching both before and after exercise, when the muscles are warm, is crucial as well.

But more focused research indicates that high blood levels of cholesterol are less influenced by cholesterol-containing foods, such as eggs, than individual factors, such as ethnicity, gender, hormonal functioning, and overall nutrition.

Like egg whites, egg yolks have a high protein content and contain many essential vitamins, minerals, fats, and healthy calories.

What are the benefits

Studies suggest that eggs may play a role in healthy eating patterns.

Eggs are a low-cost, nutrient-filled, easy to access and prepare food, making them an excellent dietary staple for many people worldwide. Eggs are also a very versatile food. And the consumption of eggs does not usually conflict with most religious or moral guidelines.

Eating egg whites and yolks together in a whole egg also contains the right balance of protein, fat, and calories that allows most people to feel fuller and more satisfied at meals.

A 2015 study found that obese Mexican-American women who ate eggs regularly after pregnancy got higher overall scores on the Healthy Eating Index than those who did not, suggesting eggs might play a role in healthy eating patterns.

Possible further health benefits associated with egg yolks include:

• increasing immune function, including antioxidant, antimicrobial, and anti-cancer action
• increasing eye health, including lowering the risk of macular degeneration, and age-related cataracts
• improving bone density and resilience
• maintaining a healthy blood production and composition, especially iron content and clotting factors
• maintaining a healthy, regulated metabolism
• improving fat and protein metabolism
• improving cellular growth and repair
• improving cardiovascular health
• maintaining a healthy blood pressure
• increasing skin and hair health
• improving bowel and bladder health
• increasing nutritional absorption during digestion
• production and health of neurotransmitters
• improved brain development and health
• reducing the risk of bowel obstruction and kidney stones
• reducing overall body inflammation

More recently researchers have begun to explore the potential of various immune-stimulating compounds found in egg yolks called immunoglobulins.

A 2017 study found that female mice that consumed the egg yolk nutrient anti-VacA IgY were less likely to get become infected by Helicobacter pylori, a bacteria that commonly causes intestinal infection.

Nutrition

The amount of nutrition in each egg yolk depends on the size of the egg, how it was raised and processed, and what species it is. And the final dietary value of egg yolks varies greatly depending on how they are prepared. For example, cooking whole eggs in oil may double, even triple, the fat and cholesterol content of an egg dish.

According to the United States Department of Agriculture (USDA), a raw egg yolk from one standard, large (17 gram) egg in the United States has:

• 55 calories
• 2.7 grams(g) protein
• 4.51 g fat: 1.624 g saturated fat, 1.995 g monounsaturated fat, and 0.715 g of polyunsaturated fat
• 184 milligrams (mg) of cholesterol
• 0.61 g of carbohydrate
• 0.10 g of sugar
• 0 g dietary fiber

Egg yolks contain at least seven essential minerals, including:

Egg yolks are high in many vitamins, especially fat and water-soluble vitamins.

The table below outlines the vitamin content of one large (17 g) egg yolk.

Egg yolks are also high in many compounds, vitamins, and other nutrients known to have health benefits, including the prevention of several long-term and infectious diseases.

Per unit size, duck, quail, and free-range heritage hen eggs are considered to contain higher amounts of most of the important nutrients than conventional chicken eggs.

Yolk vs. egg white

Contact with raw egg means hands and surfaces should be washed.

Egg yolks contain an average of 43 percent of the total protein content of the egg.

And nearly all the water-soluble and fat-soluble vitamins and minerals in eggs are found in the yolk. Several studies have concluded that consuming whole eggs has far more significant benefits than eating egg whites alone.

For example, a 2017 study found that young men who ate whole eggs immediately after resistance exercises had higher rates of muscular metabolism than those who only consumed egg whites.

The fact that most of an egg's nutrition is found in its yolk should not be surprising. Biologically, egg yolks are designed to be the primary source of nutrients for a growing embryo.

Eating egg yolks safely

The most common health concern associated with eggs is food poisoning from the bacteria Salmonella. Poultry naturally carry Salmonella and can contaminate their eggs with the bacteria.

Salmonella infections can be very serious, especially for young children, people with immune conditions, and those over the age of 65. But following a few basic safety precautions when purchasing, storing, handling, and cooking eggs significantly reduces the risk of Salmonella poisoning.

Tips for safely dealing with eggs include:

• purchasing eggs from a reputable, licensed source or a trusted local farmer
• making sure eggs are not cracked, have holes, or are dirty before purchasing
• always storing eggs in the refrigerator at 40°F (4°C) and making sure they are refrigerated before purchase
• washing hands and all exposed surfaces with soap and water immediately after coming into contact with raw eggs
• eating or refrigerate eggs shortly after cooking them, no more than 2 hours
• cooking eggs until at least the whites are firm — for high-risk individuals, cook eggs until both the whites and yolk are firm
• cooking egg dishes, such as casseroles or quiches, to an internal temperature of at least 160°F (71°C) — if unsure about egg temperatures while cooking, use a cooking thermometer
• cooking scrambled eggs until firm
• throwing away broken, dirty, or cracked eggs
• throwing away expired eggs and egg products
• avoiding eggs that have an odd consistency, appearance, or smell
• keeping raw eggs away from other foods, especially those consumed raw
• using pasteurized eggs for dressings and condiments that require soft-boiled eggs, such as Hollandaise sauce, mayonnaise, and Cesar salad dressing

In general, the link between egg yolks and chronic conditions, such as cardiovascular disease, high-cholesterol, high-blood pressure, and disorders that influence circulation, such as diabetes, remains unclear.

A new smartphone app could be the answer to preventing overeating and obesity.

Obesity is one of the most significant health concerns in the United States, and it affects more than one third of adults.

Many conditions that are related to obesity are preventable, including high blood pressure, heart disease, diabetes, and some cancers.

Progress has been made to address the obesity epidemic. After decades of increases in obesity, rates have started to level off among children and adolescents and slowed down over time among adults. Obesity remains a threat to health, and while rates vary between states, overall, they remain high nationwide.

Making lifestyle changes, such as altering nutrition, increasing physical activity, and participating in talking therapies, have been shown to be effective in helping with weight loss, and, as a result, preventing chronic diseases.

However, these interventions can prove expensive and require several visits over the course of many months with trained professionals.

Delivering low-cost weight loss interventions

The rise of smartphones over the past decade has provided a new way to deliver low-cost obesity interventions.

The current weight loss app market has been shown to include 28,905 apps across all platforms. Most of these focus on exercise, diet, and monitoring calorie intake and body weight. However, only 0.05 percent of the apps were developed with professional input.

Other research has demonstrated that behavioral strategies often found in evidence-based weight loss interventions are only observed in a minority of weight loss apps.

"Mobile technology, which is ubiquitous today," notes Carolina Ruiz, an associate professor of computer science at Worcester Polytechnic Institute (WPI) in Massachusetts, "has the capacity to deliver evidence-based weight loss interventions with lower cost and user burden than traditional intervention models."

Although mobile apps hold a strong position in the obesity battle, many of them require users to list every food they have eaten in a day and log all physical activity, which is a labor-intensive task that often causes users to give up tracking their data altogether.

Moving beyond the realms of tracking to include more personalized interventions, evidence-based theories, and advanced technologies could improve the impact of mobile apps on the obesity epidemic.

A three-pronged approach to overeating

Ruiz conducted the new research — to try to tackle some of the drawbacks of weight loss apps — together with Bengisu Tulu, an associate professor in WPI's Foisie Business School, and Sherry Pagoto, a professor of allied health sciences at the University of Connecticut in Mansfield.

Their new findings were presented at the Annual Symposium for the American Medical Informatics Association, held in Washington, D.C.

The paper reported on a study of 16 participants over the age of 18 years who were overweight and had been recruited to test the app. At the end of the 1-month study, nine of the subjects had lost an average of 5 pounds, three had maintained the same weight, and four had gained 2 pounds, on average.

SlipBuddy offers a unique three-pronged approach to overeating, and, ultimately, aims to alter the user's behavior — instead of just tracking metrics. The app integrates behavioral strategies and technologies such as machine learning, text mining, and mobile devices.

"I'm very hopeful that what we're doing will make a big difference," notes Tulu. "Most weight loss apps," she adds, "are all about tracking something — tracking your calories, tracking your blood glucose, tracking your steps. This goes beyond that. We're using machine learning to make this about intervention."

First, rather than the user recording everything they eat — which is often underreported — they are only required to log times when they think they overindulged.

Next, the app collects information to identify triggers for the unhealthful behavior, such as watching TV, socializing, or commuting, and uses machine learning to forecast when the user has a higher chance of overeating.

Finally, at times when the likelihood of overeating is high, SlipBuddy will suggest some healthful activities that prevent overindulging. For example, going out for a walk could help to sever the connection between watching TV and eating.

Pushing the boundaries in obesity research

Users are required to check in three times each day, at 9 a.m., 2 p.m., and 8 p.m., to enter data about stress, hunger levels, fatigue, weight, and overeating episodes.

Technologists design many weight loss apps without enough input from clinical psychiatrists and psychologists, explains Tulu. However, the work carried out by this team differs by aiming to incorporate clinical tools.

"This is truly an interdisciplinary project that pushes the boundaries in obesity research."

Carolina Ruiz

"The use of machine learning algorithms to uncover accurate predictive patterns of behavior," adds Ruiz, "allows our app to deliver user-centric, evidence-based, personalized approaches to prevent overeating, which will have a positive impact on combating obesity.

Ruiz and colleagues are expected to conduct a more extensive study in 2018 and report that the app could be available for release for Android and iOS in 2019.

Childhood weight and well-being appear to be linked.

Childhood overweight and obesity is a growing problem in the United States and elsewhere.

Around 1 in 3 U.S. children and teenagers are overweight or obese. Levels have, worryingly, tripled since the 1970s.

Being overweight often goes with a number of health problems, but it also has psychological effects. Children who are overweight are more prone to low self-esteem, negative body image, and depression.

Due to the size of this issue, much research is focused on trying to understand the psychology behind becoming overweight, as well as on the impact of being overweight on children's psychological well-being.

One such study is the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants Study. This prospective cohort study was set up with the aim of preventing obesity in children and understanding the factors that contribute to it.

Investigating children's diets and well-being

Recently, a team from the Sahlgrenska Academy of the University of Gothenburg in Sweden used data from this study to look at the links between psychological well-being and weight in children.

The study included 7,675 children aged 2–9 from eight European countries. These were Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain, and Sweden.

At the start of the study, parents completed a questionnaire that detailed how often specific foods were eaten each week. There were 43 food items to choose from in total.

From all of this information, every child was assigned a Healthy Dietary Adherence Score (HDAS). The HDAS score captures information about the child's adherence to a healthful diet. It takes into account behaviors such as avoiding sugary and fatty foods and eating fresh vegetables and fruit.

Also, the children's well-being was assessed at the start and end of the 2-year trial period. This included information regarding self-esteem, emotional problems, and relationships with parents and peers. Height and weight were also captured at the start and end of the study.

Once the data had been analyzed, a clear pattern emerged, linking diet to psychological well-being. The findings were recently published in the journal BMC Public Health.

"We found that in young children aged 2–9 years, there is an association between adherence to healthy dietary guidelines and better psychological well-being, which includes fewer emotional problems, better relationships with other children, and higher self-esteem, 2 years later," says corresponding study author Dr. Louise Arvidsson.

"Our findings suggest that a healthy diet can improve well-being in children."

Dr. Louise Arvidsson

The authors report that higher levels of self-esteem at the start of the study were associated with a higher HDAS after 2 years, and that the associations between HDAS and well-being were not affected by the child's weight, which was unexpected.

Dr. Arvidsson says, "It was somewhat surprising to find that the association between baseline diet and better well-being 2 years later was independent of children's socioeconomic position and their body weight."

The current study is the first to have examined links between HDAS scores and well-being.

Other findings and next steps

They also found that eating 2–3 portions of fish per week was associated with better self-esteem, as well as no emotional problems or issues with peers. Consuming wholemeal products was also linked with an absence of peer problems.

Interestingly, the associations went in both directions. For instance, children with a better sense of well-being ate fruits, fats, and sugars in line with recommendations, and those with better self-esteem had lower sugar intakes.

As other researchers have suggested, emotions can regulate eating and eating can regulate emotions.

The findings are interesting, but, as ever, the researchers mention some limitations. The study was observational and relied on self-reported data, for example, meaning that cause and effect cannot be ascertained.

Also, the children with poorer diets and lower self-esteem were more likely to drop out of the study, making conclusions a little less easy to draw.

More work needs to be done. As Dr. Arvidsson says, "The associations we identified here need to be confirmed in experimental studies including children with clinical diagnosis of depression, anxiety, or other behavioral disorders rather than well-being as reported by parents."

Because obesity in children is such an urgent issue, no doubt further studies will be waiting in the wings.