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Some good news in the war on weight: Obesity in the United States may finally be stabilizing instead of increasing, two new studies show.

But the rates of obesity remain high, with about one-third of Americans still falling into that weight category. And, rates of obesity among already heavy 6- to 19-year-old boys appear to be increasing.

“Obesity still remains a significant problem that we need to deal with, but recent data suggests the increasing trend of obesity may be slowing down,” said the lead author of one of the studies, Cynthia Ogden, an epidemiologist at the National Center for Health Statistics in Hyattsville, Md.

Results of the studies were being published online Jan. 13 in advance of print publication Jan. 20 in the Journal of the American Medical Association.

In an accompanying editorial, Dr. J. Michael Gaziano, from the Massachusetts Veterans Epidemiology Research and Information Center, wrote that these studies “offer a glimmer of hope that in the United States at least, the steady, decades-long increases in overweight and obesity may have slowed or perhaps reached a plateau. But even if these trends can be maintained, 68 percent of U.S. adults are overweight or obese, and almost 32 percent of school-aged children and adolescents are at or above the 85th percentile of body-mass index (BMI) for age.”

The consequences of obesity are far-reaching. Excess weight is linked to type 2 diabetes, heart disease, stroke, high blood pressure, high cholesterol, cancer, joint disease, sleep apnea, asthma and other chronic conditions, Gaziano said.

After remaining relatively stable between 1960 and 1980, obesity rates steadily increased, according to government statistics gathered from 1988 to 1994 and again from 1999 to 2000.

The current studies included data from the National Health and Nutrition Examination Survey (NHANES) gathered from 2007 to 2008, which were compared with statistics from 1999 through 2006. One study focused on adults, while the other looked at children from infancy through the teen years.

The adult study found the prevalence of overall obesity was 33.8 percent — 32.2 percent in men and 35.5 percent in women. The rates of obesity for women remained relatively stable during the study period. In men, however, the rates went up during the first five years and then leveled off.

“The increases in the prevalence of obesity previously observed do not appear to be continuing at the same rate over the past 10 years, particularly for women and possibly for men,” wrote the researchers.

The risk of being obese increased with age, according to the study. The biggest increases came after age 40. Blacks — both male and female — and female Mexican-Americans were significantly more likely to be obese than non-Hispanic whites.

For the study on children, the researchers sorted the data into three different cut-off points, according to Ogden — a BMI over the 85th percentile for age and gender, over the 95th percentile or the 97th. In general, over the 85th percentile is considered overweight in children, while over the 95th percentile is considered obese, according to the U.S. Centers for Disease Control and Prevention.

Overall, 9.5 percent of children under 2 had a BMI over the 95th percentile, and 16.9 percent of children between 2 and 19 had a BMI above the 95th percentile, according to the study.

It appears that the rate of obesity leveled off in 1999 in children and has remained steady since, with one exception. The researchers found an increase in the number of white boys between 6 and 19 years old whose BMIs were over the 97th percentile.

The researchers don’t know why the rates of obesity might be increasing in this one group, because the study wasn’t designed to find out the cause of such trends, only to spot them, Ogden said.

Anirban Basu, a health economist at the University of Chicago, said that many factors may contribute to the overall stabilization of obesity rates. “It is possible that the rise in calorie intake that we saw during the late 90s and early 2000s has flattened out,” he said. “Better awareness does play a role, given the billions of dollars spent on obesity and diabetes awareness and also diet regimens.”

“There are a lot of transitions happening at the individual level across all BMI categories. It’s important to understand those transitions and, even if overall obesity proportions have stabilized, to think about targeted intervention,” Basu added.

SOURCES: Cynthia Ogden, Ph.D., epidemiologist, National Center for Health Statistics, Hyattsville, Md.; Anirban Basu, Ph.D., health economist and assistant professor, medicine, Center for Health and the Social Sciences, University of Chicago;

Belgian transplant surgeons are reporting a medical first: They coaxed a donor trachea to grow its own network of blood vessels before transplantation by first embedding it for months in the recipient’s arm.

The innovative approach not only brought the patient a healthy, functional trachea (windpipe), but it did so without the need for taking lifelong immunosuppressive drugs, as is common with most transplant operations.

“This is very new,” said study author Dr. Pierre Delaere, a professor of otolaryngology at University Hospital Leuven. “People with airway problems can stay alive with tracheal cannula [tubing]. However, a tracheal cannula can give serious breathing and speech difficulties. This new technique may lead to improved quality of life for this group of patients.”

Delaere and his colleagues describe the new procedure in the Jan. 14 issue of the New England Journal of Medicine.

Though many body parts, including kidneys, lungs and other organs, are relatively amenable to transplant, a complex structure like the trachea is not.

“You can’t just transplant the trachea because it doesn’t have a distinct blood vessel supplying it,” explained Dr. Megan Sykes, a transplant immunologist at Harvard Medical School and the author of an accompanying commentary. “You can’t just hook it up to the recipient’s blood vessels.”

But life for people with severely damaged trachea can be very difficult. The patient described in the study was a 55-year-old woman whose windpipe was seriously injured during an emergency tracheotomy after a car accident 25 years earlier. The woman could breathe only with the aid of implanted tracheal stents that caused her to cough continuously and left her vulnerable to a series of infections, including bronchitis and pneumonia.

The Belgian team tried an experimental form of transplant to help the woman. They first found a donor trachea from a deceased man with the same blood type, but the problem of maintaining a blood supply remained.

To get around that problem, the team opened up the woman’s lower left arm and created a kind of pocket for the 3.5-inch-long donor trachea beneath the skin. The trachea “lived” within the woman’s arm forearm for four months. During much of this time, she received standard anti-rejection drugs.

Placing the trachea within the blood- and nutrient-risk environment of the forearm “allowed a process called neovascularization to take place,” wherein the donor windpipe grew a vital network of blood vessels, Sykes explained.

But something else happened, too. The surgeons knew that once anti-rejection drugs were discontinued, the woman’s immune system would attack and destroy the soft mucosal (inner) tissue of the donor trachea. So, a month into the process they opened up the forearm and grafted a piece of soft mucosal lining from the recipient’s mouth onto the donor trachea.

Once immunosuppressive drugs were stopped, the mucosal tissue from the donor was gradually destroyed — as expected — but the transplanted mouth tissue from the patient grew to replace it. In the meantime, the hard cartilage rings of the donor trachea — which give the windpipe its structure — were not rejected, Sykes said, because cartilage is a special kind of tissue that seems to be protected from the immune system.

“So, what was left from the donor — the cartilage in the tracheal rings — is still donor-derived,” said Sykes, who is also associate director of the Transplantation Biology Research Center at Massachusetts General Hospital.

After four months of being embedded in the woman’s forearm, the trachea — now made up of cells from both the recipient and donor — was carefully removed, along with its new blood vessels, and transplanted into her neck.

CT images taken after the operation “showed that the airway had been restored by the tracheal transplant,” the researchers said, and “since the removal of the airway stents, the patient has had no further episodes of bronchitis or pneumonia.”

One year later, the woman remains “satisfied with the outcome” and has no need for anti-rejection drugs, the team said.

According to Delaere, it’s tough to say just how many patients could benefit from this type of procedure in the future. However, because of its high level of safety and the lack of need for immunosuppressive therapy, “this procedure may become the standard of care,” he said.

Sykes noted that transplant specialists have toyed in the past with the notion of boosting the vasculature of transplanted tissue beforehand, “but the idea of doing that in one place [on the body] and then implanting it in another — that’s really new.”

The procedure is “a breakthrough in the context of tracheal reconstruction,” Sykes said. “It’s a way of repairing large tracheal defects that couldn’t be repaired before.”

SOURCES: Megan Sykes, M.D.,, professor, surgery and medicine, Harvard Medical School, and associate director, Transplantation Biology Research Center, Massachusetts General Hospital, Boston; Pierre Delaere, M.D., Ph.D., professor, otolaryngology, University Hospital Leuven, Leuven, Belgium;

Daily supplements of calcium and vitamin D reduce the risk of fractures in women and men of all ages, even if they’ve suffered previous fractures, but vitamin D supplements alone don’t offer significant protection, a new study has found.

Researchers analyzed data from 68,517 people, average age 70, who took part in seven studies that looked at the effect vitamin D or vitamin D plus calcium had on reducing fractures.

The analysis revealed that vitamin D given alone in doses of 10 micrograms to 20 micrograms per day doesn’t prevent fractures. However, calcium and vitamin D given together reduce the risk of hip fractures, total fractures and possibly vertebral fractures.

The study, published online Jan. 12 in BMJ, called for additional studies of vitamin D, especially vitamin D given at higher doses without calcium.

There’s a growing consensus that a combination of calcium and vitamin D is more effective than vitamin D alone in preventing nonvertebral fractures, Opinder Sahota, of Queen’s Medical Center in Nottingham, England, wrote in an accompanying editorial.

Further research is need to determine the most effective dose, treatment duration and method of taking the calcium/vitamin D combination, Sahota said.