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While it’s long been understood that being overweight or obese raises the odds of stroke, new research indicates those carrying extra weight are far less likely to die after having such a “brain attack”.

For the study, scientists analysed more than 1 000 people who had a so-called ischaemic stroke, in which a clot blocks blood flow to the brain. The researchers found that severely obese patients were 62% less likely to die afterward than patients of normal weight.

Best not to have a stroke

Also, stroke patients who were underweight were 67% more likely to die than those of normal weight.

This doesn’t mean it’s safe to bulk up, though, the study authors said.

“We still want to make sure the public is aware that the number one thing is, it’s best not to have a stroke to start with,” said study author Dr Zuolu Liu. She’s a neurologist and stroke fellow at the University of California, Los Angeles Medical Center.

“Controlling obesity is still very important to controlling [the risk of] stroke,” Liu added.

More than 795 000 people in the United States suffer a stroke every year, according to the US Centers for Disease Control and Prevention. Of those, about 140 000 die. The vast majority of strokes occur when a clot blocks blood flow to the brain, but strokes can also occur due to bleeding inside the brain.

‘Nutritional reserve’

The so-called “obesity paradox”, which suggests obesity may act as protection for certain people, had previously been shown in heart disease and kidney disease patients, Liu noted.

In stroke patients, extra weight may serve as a “nutritional reserve” that helps them withstand the rigours of recovery, she said. Recovery can involve aggressive physical and occupational therapy, and potential problems swallowing.

Liu and her colleagues assessed more than 1 000 people (average age 71) who suffered a clotting stroke. Participants were split into five categories based on body mass index (BMI): underweight, normal weight, overweight, obese, and severely obese.

BMI is a measurement based on height and weight. People are considered overweight if their BMI is 25 to 29, and obese with a BMI above 29. Study participants’ average BMI was 27.5.

Additional findings indicated that stroke patients who were classified as obese were 46% less likely to die after the stroke than those of normal weight, while those who were overweight were 15% less likely to die.

Results were calculated after adjusting for other factors that could influence survival rates, such as high blood pressure, high cholesterol levels or smoking.

Prevention best policy

The study also looked at the odds that patients would experience disabilities after their stroke. But these findings conflicted with the obesity paradox found for survival.

“Someone with severe obesity is still more likely to be left with [disabilities] than otherwise,” Liu said.

Dr Jonathan Raser-Schramm is medical director of the stroke programme at Christiana Care Health System in Wilmington, Delaware. He noted that the obesity paradox remains an area of active research.

“Many previous studies have demonstrated that increasing body mass index is associated with increasing risk of stroke and death, and have emphasised the role that healthy diet and frequent exercise play in preventing stroke,” Raser-Schramm said. He wasn’t involved in the new study.

“I wouldn’t want the focus on the obesity paradox after stroke to cloud the most important message for all of us, which is that preventing stroke in the first place through healthy living should be the priority,” he added.

The study is scheduled to be presented at the American Academy of Neurology’s annual meeting, in Philadelphia, May 4–10. Research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

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When a social media “influencer” hawks junk food, young kids may be easily won over, a new study suggests.

British researchers found that when children saw images of two famous YouTube “vloggers” simply holding junk food, they immediately showed a craving for cookies and candy.

Insidious form of marketing

Unfortunately, they were not similarly swayed by images of those online stars with healthy foods.

Experts said the findings point to the power of an insidious form of junk food marketing, in which companies pay social media influencers to feature their products.

“Most parents are surprised this exists,” said Jennifer Harris, of the University of Connecticut’s Rudd Center for Food Policy and Obesity. “They often have no idea how targeted their kids are when they’re online.”

Harris, who was not involved in the study, conducts research on food marketing to kids.

She said that in comparison to traditional advertising, it’s difficult to study the influence of social media on kids’ food preferences.

“There isn’t a lot known about it, because it’s hard to track what kids are seeing on social media,” Harris explained.

So she said she was “excited” to see the new findings, published online in the journal Pediatrics. They show, through an experimental design, how social media images can immediately influence kids’ food choices, Harris said.

A selection of snacks

For the study, researchers from the University of Liverpool created phony Instagram accounts that appeared to belong to two popular YouTube video bloggers.

Both vloggers – unidentified by the researchers – are young adults who are popular with British children and have four to 12 million subscribers to their YouTube channels and their real Instagram accounts.

Researchers then recruited 176 girls and boys aged nine to 11 and randomly assigned them to one of three groups.

All of the kids viewed a handful of images from the mock Instagrams: One group saw images in which the vloggers were holding healthy food, like fresh fruit; a second group saw them holding chocolate cookies or other junk food; the third group saw them holding non-food items, such as sneakers.

Afterward, children were offered a selection of snacks and told they could eat as much as they wanted. The snacks included candy, chocolate, carrot sticks and grapes.

Overall, the study found, kids who viewed the junk food images were more likely to munch on candy and chocolate: They ate 32% more calories from those foods than their peers who’d viewed non-food images – and 20% more than kids who’d seen pictures of healthy food.

Innate preferences

In contrast, kids in the healthy-snack group were unimpressed by the images: They ate no more carrots and grapes than their peers did.

That may be because children simply have an “innate preference” for sugary, fatty, salty treats, according to lead researcher Anna Coates, a doctoral student in psychological sciences.

“Unlike adults,” she said, “children are less motivated to resist food marketing, as they’re not driven by long-term health goals.”

Coates said it’s important for parents to know this type of marketing exists.

“Food marketing embedded within a YouTube video is more discreet and targeted than other forms, and therefore, potentially more powerful,” she said. “Parents could talk to their children about why they think social media influencers are paid to show these products in their vlogs.”

Harris agreed that parents should talk about the cosiness between marketers and social media stars. But she also doubted how much good it would do.

Children lie about their age

“Research suggests that even when kids know, they don’t really care,” Harris said. “What’s most important to them is what their friends are doing.”

Plus, she said, “When you’re 13, you’re not thinking about getting heart disease 30 years from now.”

What about regulation? It’s tricky, Coates said. YouTube, Instagram and other social media have minimum age requirements for account holders – so junk food marketers can deny that their social media efforts target kids.

The reality is that children lie about their ages and create accounts anyway, Coates said. Or they simply view public content on the sites.

Surveys of UK children show that half of eight- to 11-year-olds use Instagram, while more than 80% of 5- to 15-year-olds use YouTube, according to Coates’ team.

In the United States, Harris said, companies self-regulate, and they refrain from advertising on children’s TV networks, for example. But kids are still awash in ads directed at a broad audience.

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