Roundup: High or Low BMIs are Unhealthy, One Year Between Pregnancies Reduces Risks, and FDA's Pending Crackdown on e-Cigs

Both Too High or Too Low BMI Levels Linked to Early Death From Range of Diseases, New Research Finds

A higher risk of heart disease and some cancers has already been linked to obesity. Now, researchers have linked BMI levels that are either too low or too high to a greater risk of early death from a range of major diseases.

The study, published this week in The Lancet Diabetes and Endocrinology and conducted by scientists at London School of Hygiene and Tropical Medicine, focuses on BMI, or body mass index. A BMI is determined by dividing a person’s weight in kilograms by the square of their height in meters. The study’s authors say they found that keeping a BMI in the range of 21 to 25 kg/m2 is linked to the lowest level of morbidity.

For an adult, a BMI of between 18.5 and 24.9 is considered a normal weight. Between 25 and 29.9 is considered overweight. A BMI of 30 or higher is considered obese.

Researchers reviewed data on 3.6 million people and 367,512 deaths. They found that obesity, or BMI of 30 or more, was linked to an increased prevalence of heart disease and cancer. Obesity can also contribute to other chronic conditions, such as respiratory disease, liver disease and diabetes. The study also revealed that being underweight is linked to a “surprising wide range of deaths,” including dementia, Alzheimer’s, cardiovascular disease and suicide.

The difference in life expectancy was as much as 4.2 years for obese men and 3.5 years shorter for obese women. And 4.3 years shorter for underweight men and 4.5 for underweight women.

“We have filled this knowledge gap to help researchers, patients and doctors better understand how underweight and excess weight might be associated with diseases such as cancer, respiratory disease and liver disease,” said Krishnan Bhaskaran, lead author of the study and associate professor of statistical epidemiology at London School of Hygiene and Tropical Medicine.

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Women Should Wait a Year Between Pregnancies, New Study Says

Women should wait at least a year between giving birth and getting pregnant again to reduce health risks to mother and baby, a new study says.

While World Health Organization (WHO) guidelines recommend mothers wait between 18 and 24 months between pregnancies, the new study published in JAMA Internal Medicine suggests the one-year interval is enough. Less time between pregnancies increases chances of premature births, smaller babies and infant and mother mortality.

The study of 150,000 births in Canada, conducted by the University of British Columbia (UBC) and the Harvard TH Chan School of Public Health, found that getting pregnant less than 12 months after giving birth was associated with risks for women for all ages. Women older than 35 who became pregnant six months after giving birth had a 1.2 percent risk of maternal mortality or harm, while waiting 18 months between pregnancies decreased the risk to 0.5 percent, the researchers found. Younger women, between 20 and 34 years of age, who conceived six months after having a baby, had an 8.5 percent risk of giving birth prematurely, with the risk decreasing to 3.7 percent if they waited 18 months.

The study’s findings are particularly encouraging for older women who often feel the burden of their “biological clock.”

“Older mothers for the first time have excellent evidence to guide the spacing of their children,” said Wendy Norman, M.D., senior study author. “Achieving that optimal one-year interval should be doable for many women and is clearly worthwhile to reduce complication risks.”

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FDA to Take Tougher Actions Against e-Cig Products to Protect Youth

The U.S. Food and Drug Administration (FDA) said it will reveal “forceful” steps in mid-November to reduce use of e-cigarettes among young people. The pending actions could involve increased enforcement of identification and age-verification requirements.

The agency announced in September that something had to be done to address the “alarming increase in youth use of e-cigarettes.”

The agency has threatened to ban all flavored e-cigarettes because of their popularity among school-age teens. The Juul “vaping” product has become particularly popular with teens and adolescents. It’s concerning to the FDA and public health officials because it’s discreet and looks and charges like a USB flash drive.

“We’re committed to announcing a new action plan by mid-November that will set forth a series of new, forceful steps to firmly confront and reverse the youth addiction trends that are at epidemic levels,” said FDA Commissioner Scott Gottlieb, M.D., in a statement.

The 10 million adults and teenagers who vape regularly in the U.S. are exposing themselves to various levels of toxic chemicals, according to research released earlier this year. Vaping products contain nicotine, the addictive chemical common in traditional cigarettes.

Over the past several weeks, FDA leadership has met with the five companies – Altria Group Inc., JUUL Labs Inc., Reynolds American Inc., Fontem Ventures, and Japan Tobacco International USA Inc. – that represent the current market for e-cigarettes.

“These have been constructive meetings,” said Dr. Gottlieb. “The companies acknowledged the serious public health consequences associated with youth use of tobacco products.”

The companies acknowledged the role that flavored e-cigarette products play in making the products appealing to kids. Some proposals discussed included restricting “distribution of certain flavored products to channels with enhanced age verification processes,” the FDA said. Or that the agency require certain products that are more appealing to kids come off the market until these products receive pre-market authorization from the agency,” the FDA said.

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