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Researchers Identify Role For Protein Linked To Obesity, Type 2 Diabetes

2013-01-06T06:28:00.000-08:00

Main Category: Diabetes
Also Included In: Obesity / Weight Loss / Fitness; Biology / Biochemistry
Article Date: 21 Dec 2012 - 0:00 PST Current ratings for:
Researchers Identify Role For Protein Linked To Obesity, Type 2 Diabetes

Researchers at UT Southwestern Medical Center have taken another step toward better understanding the metabolic functions of obesity and its connection to type 2 diabetes.

Dr. Philipp Scherer, Director of the Touchstone Center for Diabetes Research at UT Southwestern, led a group of researchers in a recent multicenter study published in Nature Medicine that successfully identified ways to manipulate the protein mitoNEET. This is the first time the protein has been effectively altered to expand fat tissue in a way that allows subjects - in this case, mice - to remain metabolically healthy.

MitoNEET is a key component of a cell's mitochondrion, which serves as the cell's energy powerhouse. When the levels of MitoNEET protein were elevated inside the fat cells of rodents, more fat was stored in the adipose tissue, thereby keeping toxic lipids away from other types of cells. This sequestration resulted in extremely obese yet metabolically healthy mice that displayed no signs of type 2 diabetes. In contrast, when MitoNEET levels were decreased, the mice became lean but unhealthy, and developed pre-diabetic conditions such as failure to metabolize glucose properly.

"The manipulation of mitochondrial activity in fat tissue is a very powerful approach to control how much excess energy we store in our bodies and where we store it. We have heretofore underestimated the importance of mitochondrial pathways in our fat cells and their influence on how we manage our weight," said Dr. Scherer, senior author of the three-year study and Professor of Internal Medicine and Cell Biology at UTSW.

The body stores fat in the white adipose tissue, and, ideally, individuals burn any excess calories through exercise and a healthy diet. The current research findings suggest that manipulating components of mitochondria in fat cells can be an effective way to funnel excess calories into "good" locations. This storage then thwarts their negative effect on other internal organs like the liver in which excess fat accumulation is toxic.

The obese mice in this study weighed 120 to 130 grams (4.23 to 4.58 ounces), whereas a normal adult mouse weighs 25 to 30 grams (.88 to 1.06 ounces). This difference is the equivalent of a 150-pound person increasing his or her weight to 700 pounds.

The researchers were careful to clarify that the findings were not meant to encourage obesity, even though the obese mice were considered metabolically healthy. The study instead provides a clearer understanding of the mitochondrion's importance to the metabolic dysfunction - that is characteristic of obese patients and those with type 2 diabetes.

"These results taught us a great deal about how fat cells sense, store, and burn energy," said Dr. Christine Kusminski, a postdoctoral researcher in Internal Medicine who served as the study's first author. "By learning more about the underlying mechanisms, we hope to develop ways to target these pathways for future drug development."

The researchers now hope to translate these findings into a clinical setting. The staff of the Touchstone Center is devoted to the study of cells and tissues that either contribute to or are affected by diabetes and related diseases, including the physiology of adipose tissue.

Other UT Southwestern researchers involved in the study were Dr. William L. Holland, Instructor in Internal Medicine; Dr. Kai Sun, Assistant Instructor in Internal Medicine; Dr. Jiyoung Park, Assistant Instructor in Internal Medicine; and Stephen B. Spurgin, a medical student. Scientists from the Albert Einstein College of Medicine, the University of Utah School of Medicine, and Merck Research Laboratories also contributed.

The investigation was funded by support from the National Institutes of Health, the American Heart Association, and fellowships from the Juvenile Diabetes Research Foundation and the Department of Defense.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Small Changes In Eating Prompts Weight Loss

2013-01-06T03:28:00.000-08:00

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Nutrition / Diet
Article Date: 31 Dec 2012 - 0:00 PST Current ratings for:
Small Changes In Eating Prompts Weight Loss

Making small easy changes to our eating habits on a consistent basis - 25 days or more per month - can lead to sustainable weight loss, according to research by Professor Brian Wansink in Cornell University's Food and Brand Lab. The challenge is to figure out which changes work for specific individuals and how to stick with changes long enough to make them second nature.

To explore this issue, Cornell researchers launched the National Mindless Eating Challenge (NMEC), an online healthy eating and weight loss program that focused on simple eating behavior changes, instead of dieting.

NMEC participants, after answering questions about their eating goals, background and well-being, were sent three customized tips to follow for a month. All tips were founded on research and based on Wansink's book "Mindless Eating: Why We Eat More than We Think" (Bantam, 2006). Participants could download a checklist to track their adherence to tips and receive email reminders to keep them on track. At the end of each month they were expected to send in a follow-up survey. Of the 504 participants who completed at least one follow-up survey, more than two thirds (42 percent) either lost weight or maintained their weight (27 percent).

Weight loss was highest among people who made changes consistently.

Those whose adherence was 25 or more days per month reported an average monthly weight loss of 2 pounds, and those who stayed in the program at least three months and completed at least two follow-up surveys lost on average 1 percent of their initial weight.

According to the study, which is published in the peer-reviewed Journal of Medical Internet Research (Nov-Dec., Vol. 14:6), common barriers that prevented people from making changes included personally unsuitable tips, forgetting, being too busy, unusual circumstances such as vacations and emotional eating.

"These results confirm that small, consistent changes in our daily eating behavior can result in gradual weight loss and in developing healthier eating habits," said Wansink, a marketing professor in Cornell's Dyson School of Applied Economics and Management. Results of the study also show that it is a challenge for many people to stick to a program for a long period of time. For those who want to lose weight or eat more healthfully, the researchers conclude that finding an initial set of tips that are relevant and doable for an individual can be enough to learn the general principle.

"Later come up with your own changes and succeed at reaching your goal," Wansink said.

The NMEC participants said that the most effective tips they received were:

Keep counters clear of all foods but the healthy ones.
Never eat directly from a package - always portion food out onto a dish.
Eat something hot for breakfast within the first hour of waking up.
Avoid going more than thee or four hours without having something small to eat.
Put down your utensils between bites to slow down your eating.

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Healthy Lifestyle During Menopause May Decrease Breast Cancer Risk Later On

2013-01-06T00:16:00.000-08:00

Main Category: Menopause
Also Included In: Breast Cancer; Obesity / Weight Loss / Fitness
Article Date: 30 Dec 2012 - 0:00 PST Current ratings for:
Healthy Lifestyle During Menopause May Decrease Breast Cancer Risk Later On

Obese, postmenopausal women are at greater risk for developing breast cancer and their cancers tend to be more aggressive than those in lean counterparts. A University of Colorado Cancer Center study published in the December issue of the journal Cancer Research shows how this risk might be prevented.

"By using nutrient tracers for fat and sugar, we tracked where the body stored excess calories. In lean models, excess fat and glucose were taken up by the liver, mammary and skeletal tissues. In obese models, excess fat and glucose were taken up by tumors, fueling their growth," says Erin Giles, PhD, postdoctoral researcher at the CU Cancer Center and the paper's lead author.

In short, if you are lean, excess calories go to healthy tissue. If you are obese, excess calories feed the tumor.

"This implies that the menopausal window may be an opportunity for women to control their breast cancer risk through weight management," Giles says.

In this study, Giles worked with a team of scientists including postdoctoral fellows Elizabeth Wellberg and Sonali Jindal, as well as faculty members Steve Anderson, Pepper Schedin, Ann Thor and Paul Maclean. Their study also showed that tumors from obese animals had increased levels of the progesterone receptor, and this receptor appears to give tumors a metabolic advantage for growth. To extend their findings to humans, they recruited gene analysis experts David Astling and Aik-Choon Tan who analyzed 585 human breast cancers and found that human tumors expressing the progesterone receptor had the same metabolic advantage.

"Basically, we saw an abnormal metabolic response to fat and sugar in the obese that, in many ways, mirrors the response to fat and sugar in Type II diabetes," Giles says. Noticing this similarity, the group tested the use of the common Type II diabetes drug, Metformin, in their model of postmenopausal breast cancer.

"With treatment, tumor size was dramatically decreased in the obese, and tumors showed reduced expression of the progesterone receptor," Giles says.

Using a pre-clinical model, the investigators found that weight gain during menopause is particularly bad for those who are obese when entering menopause. Together, the results of this study suggest that the combination of obesity and weight gain during menopause can impact breast cancer in two ways. First, tumors that arise in obese women appear to have a metabolic advantage, and second, the inability to store excess calories in healthy tissues may further fuel tumor growth.

"While drugs may be useful in controlling breast cancer risk in obese, postmenopausal women, our results imply that a combination of diet and exercise may be equally if not more beneficial," Giles says.

The group's ongoing studies are testing whether interventions such as diet and exercise, during the period of menopausal weight gain, can improve tumor outcomes.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our menopause section for the latest news on this subject. This work was primarily supported by the Komen Foundation (KG081323), Cancer League of Colorado, American Institute for Cancer Research, and Colorado Nutrition Obesity Research Center (NORC) pilot award (NIH DK048520).

University of Colorado Denver

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Consuming Whole Eggs May Improve Blood Lipids According To New Research

2013-01-05T21:14:00.000-08:00

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Cholesterol; Hypertension
Article Date: 20 Dec 2012 - 0:00 PST Current ratings for:
Consuming Whole Eggs May Improve Blood Lipids According To New Research

It is estimated that 34% of Americans are affected by an increasingly prevalent condition known as metabolic syndrome which is a combination of at least three of the following risk factors: large waistline, high triglycerides, low HDL cholesterol, high blood pressure and elevated blood sugar.(i) These individuals have a variety of risk factors that increase the likelihood of developing diabetes and cardiovascular disease. Decades of mixed messaging regarding dietary cholesterol have led to avoidance of certain foods, such as eggs, particularly among individuals who are faced with health conditions. However, a recent study published in Metabolism suggests that including whole eggs as part of a weight loss diet may have positive effects on lipoprotein profiles for individuals with metabolic syndrome.(ii)

In this study, middle-aged men and women with metabolic syndrome consumed either three whole eggs or an equivalent amount of egg substitute daily as part of a carbohydrate-restricted, weight loss diet.(ii) Although participants eating the whole eggs were consuming twice as much cholesterol as they had at the beginning of the study, the researchers observed no effects on total blood cholesterol or LDL cholesterol levels after 12 weeks on the diet. All participants, including those consuming whole eggs, had improved lipid profiles with decreases in plasma triglycerides and increases in HDL cholesterol.(ii)

"Eating egg yolks was actually associated with enhanced health benefits in these high-risk individuals," explains Dr. Maria Luz Fernandez, lead study author and Professor at the University of Connecticut, "Subjects consuming whole eggs had greater increases in HDL cholesterol and more significant reductions in the LDL/HDL cholesterol ratio than those who ate the cholesterol-free egg substitute."

A Closer Look at the Incredible Egg

The United States Department of Agriculture's Agricultural Research Service has reported that eggs now have 14 percent less cholesterol (down from 215 mg to 185 mg) and 64 percent more vitamin D than previously thought.(iii) Naturally nutrient-rich, one large egg provides varying amounts of 13 essential vitamins and minerals, including nutrients that aren't found abundantly in other foods, including vitamin D and choline. Many of these nutrients reside in the yolk, such as lutein and zeaxanthin, which are antioxidants that may prevent macular degeneration and consequent age-related blindness. While eggs contain only small amounts of these nutrients, research shows that lutein and zeaxanthin from eggs may be more bioavailable, or better used by the body, than from more concentrated sources like supplements.(iv) A recent study published in Food and Function found that daily consumption of egg yolks was associated with increases in plasma lutein, zeaxanthin and ß-carotene in people with metabolic syndrome, which is typically associated with low levels of these important nutrients.(v)

High-Quality Egg Protein and Weight Management

Weight management is a crucial aspect of preventing and managing chronic disease such as metabolic syndrome. All-natural, high-quality protein helps build muscle and allows people to feel fuller longer and stay energized, which can assist with weight management.(vi, vii) In fact, an egg breakfast, compared with a bagel breakfast of similar calories, has been shown to lead to greater feelings of fullness and reduced food intake at later meals, resulting in a significant reduction in BMI and waist circumference.(viii)

Dr. Dixie Harms, a nurse practitioner specializing in diabetes care, suggests starting the day with a protein-rich breakfast as a good weight-management strategy, a first line of defense in preventing chronic disease. "Management of chronic disease takes a coordinated effort with diet and lifestyle," says Harms, "A balanced breakfast including high-quality protein plus regular physical activity can help put individuals on a path to a healthier lifestyle."

Luckily, it's easy to create a nutritious breakfast. Pair eggs with fruits, vegetables, whole grains, and low-fat dairy foods as part of an overall healthy diet. For more nutrition and healthy living tips, visit www.EggNutritionCenter.org. The Egg Nutrition Center is a National Strategic Partner of the USDA's MyPlate program which helps Americans follow the Dietary Guidelines by providing resources and tips to build a healthy plate.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our obesity / weight loss / fitness section for the latest news on this subject. i Ervin RB. Prevalence of Metabolic Syndrome Among Adults 20 Years of Age and Over, by Sex, Age, Race and Ethnicity, and Body Mass Index: United States, 2003. National Health Statistics Reports 2009;13.
ii Blesso CN, Andersen CJ, Barona J, Volek JS, Fernandez ML. Whole egg consumption improves lipoprotein profiles and insulin sensitivity to a greater extent than yolk-free egg substitute in individuals with metabolic syndrome. Metabolism, published online September 2012.
iii US Department of Agriculture, Agricultural Research Service, 2011. USDA National Nutrient Database for Standard Reference, Release 23. Online. Available at: Nutrient Data Laboratory Home Page, http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00. Accessed October 24, 2011.
iv Goodrow, EF et al. Consumption of one egg per day increases serum lutein and zeaxanthin concentrations in older adults without altering serum lipid and lipoprotein cholesterol concentrations. JN 2006; 136(25):19-24.
v Blesso CN, Anderson CJ, Bolling BW, Fernandez ML. Egg intake improves carotenoid status by increasing plasma HDL cholesterol in adults with metabolic syndrome. Food & Function, published online October 2012.
vi Leidy HJ, et al. Neural Responses to Visual Food Stimuli After a Normal vs. Higher Protein Breakfast in Breakfast-Skipping Teens: A Pilot fMRI Study. Obesity, published online May 5, 2011.
vii Leidy HJ, et al. Increased dietary protein consumed at breakfast leads to an initial and sustained feeling of fullness during energy restriction compared to other meal times. BJN, published online September 2, 2008.
viii Vander Wal JS, Gupta A, Khosla P, Dhurandhar NV. Egg breakfast enhances weight loss. Int J Obes 2008;32:1545-51.
Edelman Public Relations Please use one of the following formats to cite this article in your essay, paper or report:

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posted by mudasser on 20 Dec 2012 at 3:03 am

Eggs are versatile and can be served for any meal. In addition, they cook quickly, so are perfect as the basis for fast and easy meals.

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Diabetes Drug May Restore Memory In Alzheimer's

2013-01-05T16:58:00.000-08:00

Featured Article
Academic Journal
Main Category: Alzheimer's / Dementia
Also Included In: Diabetes; Neurology / Neuroscience
Article Date: 13 Dec 2012 - 2:00 PST Current ratings for:
Diabetes Drug May Restore Memory In Alzheimer's

Researchers in Canada have discovered a drug originally intended for the treatment of diabetes may restore memory in brain cells affected by Alzheimer's disease. In tests on animal brain cells, they found that AC253, a diabetes drug that never made it to market, restored memory to levels similar to those of normal cells. Trials could start in five years, should further tests succeed, says the team.

The researchers write about their work in a paper published online in The Journal of Neuroscience on 28 November.

In a statement released on Tuesday, senior author Jack Jhamandas, a researcher with the Faculty of Medicine & Dentistry at the University of Alberta, says their discovery is "very important" because:

"... it tells us that drugs like this might be able to restore memory, even after Alzheimer's disease may have set in."

Estimates suggest in the next 30 years, 1,125,000 Canadians will be diagnosed with Alzheimer's disease.

Cells of people with Alzheimer's contain amyloid protein, which is found in particularly large amounts in cells from the memory and cognition parts of the brain. It is the presence of this protein that is believed to impair memory.

Last year, Jhamandas and his team showed that AC253 could block the toxic effects of amyloid protein that lead to brain-cell death.

For this latest study, they tested memory capacity in cells extracted from brain tissue of mice engineered to develop Alzheimer's disease and compared it to that of brain cells from healthy mice.

There is a way of testing memory capacity of cells in the lab by exposing them to a series of electrical shocks or impulses: the cells "remember" the experience.

First, the team tested the memory capacity of normal brain cells and Alzheimer's brain cells.

Then, after giving the drug AC253 to the Alzheimer's brain cells, they ran the electrical shock tests again and found their memory was restored to levels similar to those of the normal cells.

While these results show promise, the researchers caution there are a number of problems to resolve before a drug based on these findings is ready for testing. For example, AC253 doesn't cross the blood-brain barrier easily, so drug developers would have to design a version that could.

Jhamandas says clinical trials could start within about five years, should such problems be resolved and further tests succeed.

"I think what we discovered may be part of the solution, but I can't say it will be the solution," says Jhamandas, pointing to a long list of drugs that showed early promise against Alzheimer's but in further tests proved not to be viable.

"I don't think one drug or approach will solve Alzheimer's disease because it's a complicated disease, but I am cautiously optimistic about our discovery and its implications," he adds.

In a group of tests that will take at least another year, the team is now trying to discover whether giving the drug before symptoms emerge can "stop the impairment of behaviour and cognition altogether in animals destined to develop Alzheimer's" says Jhamandas.

Funds for the study came from the Canadian Institutes of Health Research.

There is currently no cure for Alzheimer's, but evidence is gradually emerging of drugs that can help slow its progression, like galantamine, which not only appears to reduce mortality rates, but also slows down declines in cognitive impairment.

And recently, scientists from the University of California showed that an active lifestyle may also slow progression of Alzheimer's.

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our alzheimer's / dementia section for the latest news on this subject. "Beta Amyloid-Induced Depression of Hippocampal Long-Term Potentiation Is Mediated through the Amylin Receptor"; Ryoichi Kimura, David MacTavish, Jing Yang, David Westaway, and Jack H. Jhamandas; The Journal of Neuroscience, 28 November 2012, 32(48): 17401-17406; DOI: 10.1523/?JNEUROSCI.3028-12.2012; Link to Abstract
Main source: The University of Alberta: News and Events. Please use one of the following formats to cite this article in your essay, paper or report:

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posted by Laura on 14 Dec 2012 at 9:10 am

This is good news for families touched by Alzheimer's disease. It seems logical since some other double-blind studies for diet drugs for Type II diabetics have shown increased brain function during testing.

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posted by Ethan on 13 Dec 2012 at 6:51 pm

It takes years because you have to get the drug to be accepted into the medical community first of all. Then you spend time doing testing on animals and then have to do this over years to see the short-term and long-term side-affects of the drug and then has to be tested by the the FDA(Food and Drug Administration) to make sure that it is safe and that it actually is proven to work. All this could add up to 5 years or even more before it is actually brought into hospitals for use. Unfortunately it takes this long but it is only for the consumers safety!

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posted by ssimpson on 13 Dec 2012 at 4:40 am

The article states that it may take five years to test this product o humans. It would be wonderfulbe tested sooner!! if a promising drug could

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'Diabetes Drug May Restore Memory In Alzheimer's'

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Eating Whole Eggs Can Improve Blood Lipids

2013-01-05T13:26:00.000-08:00

Editor's Choice
Academic Journal
Main Category: Obesity / Weight Loss / Fitness
Also Included In: Cholesterol; Hypertension
Article Date: 25 Dec 2012 - 0:00 PST Current ratings for:
Eating Whole Eggs Can Improve Blood Lipids

Eating whole eggs can improve lipoprotein profiles for patients with metabolic syndrome and also help them with weight management.

The finding came from new research that was conducted by a team led by Dr. Maria Luz Fernandez, Professor at the University of Connecticut, and was published in the journal Metabolism.

Approximately 34% of people in the United States have metabolic syndrome, a condition becoming increasingly common. According to prior research, women have a higher chance of developing metabolic syndrome than men because they are less likely to work out for at least a half of an hour each day.

A person develops metabolic syndrome when he/she has 3 or more of the following risk factors:

Patients with this condition have an increased probability of developing cardiovascular disease and diabetes, due to a diversity of risk factors.

Since there has been varied information on dietary cholesterol, many people try to stay away from particular foods, including eggs, especially those who struggle with health problems.

For the purpose of the research, middle-aged males and females with metabolic syndrome were split into 2 groups: one group ate 3 whole eggs each day and the other ate the same amount of egg substitute each day as part of a carbohydrate-restricted diet to lose weight.

After the subjects in the whole eggs group spent 3 months on the diet, the researchers found that it had no impact on their LDL cholesterol or total blood cholesterol, even though they were eating two times the amount of cholesterol than they were before the experiment began.

Both the whole eggs group and the egg substitute group had increases in HDL cholesterol, decreases in plasma triglycerides, and improved lipid profiles.

Dr. Luz Fernandez explained:

"Eating egg yolks was actually associated with enhanced health benefits in these high-risk individuals. Subjects consuming whole eggs had greater increases in HDL cholesterol and more significant reductions in the LDL/HDL cholesterol ratio than those who ate the cholesterol-free egg substitute."

Eggs actually have 64% more vitamin D than scientists believed in the past and currently have 14% less cholesterol (reduced from 215 mg to 185 mg), according to the U.S. Department of Agriculture's Agricultural Research service.

Thirteen critical vitamins and minerals, such as vitamin D and choline, can be found in one large egg. This is important because vitamin D and choline are not found plentifully in other foods.

The yolk provides most of these nutrients, including lutein and zeaxanthin, which help protect against macular degeneration and its resulting age-related blindness. Studies have demonstrated that although eggs provide just small amounts of these nutrients, receiving them from eggs may be more beneficial, or bioavailable, than receiving them from supplements.

A different report published in Food and Function discovered that eating egg yolks each day was linked with increases in plasma lutein, ß-carotene, and zeaxanthin in patients with metabolic syndrome, a condition that is normally linked to reduced levels of the same nutrients.

A critical way to halt the development of chronic disease, such as metabolic syndrome, is to control weight.

People can control their weight by keeping track of what they eat. For example, consuming all-natural, high-quality protein can help people feel satisfied for a longer period, give them energy, and helps create muscle.

Research has shown that consuming eggs for breakfast, as opposed to eating a bagel of comparable calories, keeps people feeling fuller longer and decreases the amount of food consumed throughout the day, therefore, causing a notable reduction in BMI and waist circumference.

An effective way to prevent chronic disease and manage weight, according to Dr. Dixie Harms, a nurse practitioner who specializes in diabetes care, is to begin each morning with a protein-rich breakfast.

In fact, previous research indicated that obese and overweight patients with metabolic syndrome and Type 2 diabetes experienced significant improvements in their health after just 3 weeks of diet and moderate exercise.

Harms said:

"Management of chronic disease takes a coordinated effort with diet and lifestyle. A balanced breakfast including high-quality protein plus regular physical activity can help put individuals on a path to a healthier lifestyle."

Fortunately, making a healthy breakfast is rather simple. Include foods such as fruits, veggies, eggs, whole grains, and low-fat dairy foods.

Written by Sarah Glynn
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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Reducing Car Travel As Effective As Cutting Calories

2013-01-05T09:44:00.000-08:00

Editor's Choice
Academic Journal
Main Category: Obesity / Weight Loss / Fitness
Also Included In: Nutrition / Diet
Article Date: 19 Dec 2012 - 10:00 PST Current ratings for:
Reducing Car Travel As Effective As Cutting Calories

Maintaining a healthy weight during the holiday season, or aiming to complete a healthy New Year's resolution, can be achieved by avoiding classic holiday sweets such as cookies or candy, and also long car rides, suggests new research in the journal Preventive Medicine.

As the holiday season commences, weight is a common issue. In fact, over-indulging during the holiday season can literally take hours off of your life.

The study, led by professor Sheldon H. Jacobson of the University of Illinois, points out that daily car rides and calories ingested are directly linked to body weight, and by decreasing either just slightly can lead to a decrease in body mass index (BMI).

Graduate student Banafsheh Behzad, a co-author of the study, said: "We're saying that making small changes in travel or diet choices may lead to comparable obesity reduction, which implies that travel-based interventions may be as effective as dietary interventions."

Obesity is a worldwide epidemic with multiple medical and social factors. Basically, keeping a healthy body weight is an outcome of energy intake and energy released.

Previous research has looked at contributors individually or at a local level, while the current study wanted to look at both sides through a national lens. As a continuation of earlier studies looking at driving and obesity, researchers decided to use driving as a representation for physical activity.

Jacobson explains:

"An easy way to be more physically active is to spend less time in an automobile. Any time a person sits behind the wheel of a car, it's one of the most docile activities they can do in a day. The automobile is the quickest mode of transportation we have. But a consequence of this need for speed in getting things done may be the obesity epidemic."

The investigators used data available to the public on caloric consumption, national average BMI, and driving practices. They created a multivariable model, capable of exploring how caloric intake and miles driven link with BMI, to take into account the complicated relationship of these three variables.

Results showed that if all adults in the United States drove one mile less than they do now per day, there would be an associated reduction in the national average BMI by 0.21 kg/m2 six years later. Decreasing diet by 100 calories, on the other hand, was linked with a reduced national BMI by 0.16 kg/m2 three years later.

Behzad said, "One mile is really not much. If they would just consider even taking the bus, walking the distance to the bus stop could have an impact like eating 100 calories less per day. The main thing is paying attention to caloric intake and moving more, together, can help reduce BMI."

Even a slight reduction in BMI, such as the one suggested by the model, could imply significant saved expenses. If drivers throughout the United States drove one less mile per day, fuel intake would drop as well as yearly health care expenses because less people would be categorized as overweight or obese, the authors declare.

Jacobson concludes:

"The most important thing for people to learn from this study is that they have a choice. One has to be just as careful about when you choose to drive as when you choose to eat. These small changes in our driving and dietary habits can lead to long-term significant changes in obesity issues. Those are the kind of changes we advocate."

Written by Kelly Fitzgerald
Copyright: Medical News Today
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Visit our obesity / weight loss / fitness section for the latest news on this subject. "Quantifying the association between obesity, automobile travel, and caloric intake"
Banafsheh Behzada, Douglas M. Kinga, Sheldon H. Jacobson
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A Vital Role Played By Primary Care Physicians In The Care Of Diabetes Patients

2013-01-05T05:42:00.000-08:00

Main Category: Diabetes
Also Included In: Primary Care / General Practice
Article Date: 14 Dec 2012 - 1:00 PST Current ratings for:
A Vital Role Played By Primary Care Physicians In The Care Of Diabetes Patients

Previous research has shown that patients without a consistent primary care physician (PCP) have worse outcomes than those who do, but little is known about why this is true. New research from Brigham and Women's Hospital (BWH) has brought to light the importance of the role of a primary care physician in a population of diabetes patients. Their findings are published in Diabetes Care.

"We found that primary care physicians provide better care to diabetes patients when compared to other providers in a primary care setting because they were more likely to alter medications and consistently provide lifestyle counseling," said Alexander Turchin, MD, a physician and researcher in the Division of Endocrinology at BWH and the senior author of the paper.

Dr. Turchin and his research colleagues designed a study to evaluate whether PCP's provide higher quality care to their patients by paying more attention to prescribed medications, offering lifestyle counseling more frequently or have a higher number of patient encounters when compared to other providers in a primary care setting including a covering physician or another provider such as a nurse practitioner or physician assistant.

Researchers evaluated more than 27,000 patients with diabetes who were cared for in a primary care setting at two academic medical centers. Among these patients, there were nearly 585,000 primary care encounters over an average of five years and five months. Researchers report that 83 percent of those encounters were with a primary care provider.

Additionally researchers report that covering physicians were the next most likely provider to see a patient, accounting for 13 percent of interactions, and they were also more likely to see a patient for an acute issue defined as a complaint of pain or infection.

Across all patient encounters, medication intensification, defined as either adding a new medication or increasing the dose of an existing medication, happened approximately 10 percent of the time and lifestyle counseling, as measured by documentation in the electronic health record, happened 40 percent of the time. The overall mean time between encounters was 1.6 months.

However, the odds of medication intensification were 49 and 26 percent higher respectively when a patient had an encounter with a PCP compared with a covering physician or mid-level provider. Additionally, the odds that lifestyle counseling occurred were 91 and 21 percent higher during an encounter with the PCP compared to a covering physician or another provider.

"Access to care is important and covering physicians and other providers play an important role in increasing access, especially in patients with acute complaints. With growing focus on a team based approach to practicing medicine, this finding should help guide the development of new models of primary care, especially in the care of diabetes patients. Based on this finding, we would suggest better documentation and communication of the treatment plan through the electronic medical record to other care providers in efforts to help to bridge the gaps that we observed in this study," Dr. Turchin said.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our diabetes section for the latest news on this subject. This study was funded by the Agency for Healthcare Research and Quality (5R18HS017030), National Library of Medicine (5RC1LM010460) and Diabetes Action Research and Education Foundation.
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posted by Yeming on 18 Dec 2012 at 3:08 pm

More attention should be given to primary care physicians in order to prevent and treat diabetes.

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Avoid Promoting Miracle Diets For New Year, British Lawmaker Urges Magazines

2013-01-05T01:50:00.000-08:00

Editor's Choice
Main Category: Nutrition / Diet
Also Included In: Obesity / Weight Loss / Fitness
Article Date: 27 Dec 2012 - 1:00 PST Current ratings for:
Avoid Promoting Miracle Diets For New Year, British Lawmaker Urges Magazines

Please do not promote "miracle diets" for the New Year, British Women and Equalities Minister, Jo Swinson has urged magazine editors.

Every year throughout the world, magazines are awash with miracle cure diets that guarantee incredible results after weeks of overindulgence during the Christmas and New Year holidays.

Jo Swinson, MP (Member of Parliament) for East Dunbartonshire, says magazine editors must avoid the temptation of falling into the annual diet hype among their New Year resolutions for 2013. The Minister made the request in an open letter to magazine editors.

Swinson urges editors to think twice about the consequences of promoting unrealistic and untested diets on girls and women.

Swinson said "Surely by now we're all aware that there are no miracle diets or if there are, they are miracles that come with a cost. Given that most diets fail within a very short time, it is irresponsible for magazines to offer 'tips' 'tricks' and 'simple steps' so that people can be thin. Not healthy or vibrant, just thin."

Below is a copy of the letter Swinson sent to the editors of Gossip, Men's, Health, and Women's magazines:

"Dear Editors,
Every January readers are treated to articles reminding them that they have overindulged during the end-of-year festivities and must resolve to lose their holiday weight.
I am sure that you want to promote a healthy lifestyle for your readers, but at this time of year in particular far too much of magazine coverage tends to focus on irresponsible, short term solutions and encourages readers to jump on fad diet bandwagons.
As editors you owe more to your readers than the reckless promotion of unhealthy solutions to losing weight. If your aim is to give practical, sensible advice about losing weight - and not how to drop a stone (14 lbs) in 5 days - you should encourage reasonable expectations, instead of dangerous ones, along with exercise and healthy eating.
So may I suggest a New Year's resolution for 2013? Shed the fad diets and fitness myths on your pages and instead celebrate the beauty of diversity in body shape, skin color, size and age. I think your readers will appreciate it.
Sincerely,
Jo Swinson

Ms Swinson was one of the co-founders of the "Campaign for Body Confidence". She explained that the vast majority of diets fail within a very short time. She re-emphasized that promoting thinness instead of good health is irresponsible.

A worthwhile resolution, Swinson suggests, is for all of us to resolve with colleagues, friends and family to challenge the default setting of self-criticism, and to help each other to do so.

A study carried out by researchers from the University of Arizona, Tucson, USA, showed that conversations in which people see themselves as being fat could be damaging for their mental health. Fat talk can result in lower body self-esteem and higher rates of depression, the authors added.

In their study, published in the Journal of Applied Communication Research (April 2012 issue), lead author, Analisa Arroyo, Ph.D. said that their findings suggest that expressing weight-related concerns, which is extremely common among females, has negative effects. They found that the frequency of fat-talk predicts changes in body satisfaction, depression, as well as perceived pressure to be thin across time.

Written by Christian Nordqvist
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Symptoms Similar To Those From Drug Withdrawal Possible When Starting A Diet

2013-01-04T22:48:00.000-08:00

Main Category: Nutrition / Diet
Also Included In: Obesity / Weight Loss / Fitness; Neurology / Neuroscience
Article Date: 15 Dec 2012 - 0:00 PST Current ratings for:
Symptoms Similar To Those From Drug Withdrawal Possible When Starting A Diet

Even before obesity occurs, eating fatty and sugary foods causes chemical changes in the brain, meaning that going on a diet might feel similar to going through drug withdrawal, according to a study published by Dr. Stephanie Fulton of the University of Montreal's Faculty of Medicine and its affiliated CRCHUM Hospital Research Centre. "By working with mice, whose brains are in many ways comparable to our own, we discovered that the neurochemistry of the animals who had been fed a high fat, sugary diet were different from those who had been fed a healthy diet," Fulton explained. "The chemicals changed by the diet are associated with depression. A change of diet then causes withdrawal symptoms and a greater sensitivity to stressful situations, launching a vicious cycle of poor eating."

The research team feed one group of mice a low-fat diet and a high fat diet to a second group over six weeks, monitoring how the different food affected the way the animals behave. Fat represented 11% of the calories in the low-fat diet and 58% in the high-fat diet, causing the waist size in the latter group to increase by 11% - not yet obese. Next, Fulton and her colleagues use a variety of scientifically validated techniques to evaluate the relationship between rewarding mice with food and their resulting behaviour and emotions. They also actually looked at the brains of the mice to see how they had changed.

Mice that had been fed the higher-fat diet exhibited signs of being anxious, such as an avoidance of open areas. Moreover, their brains have been physically altered by their experiences. One of molecules in the brain that the researchers looked at is dopamine. It enables the brain to rewards us with good feelings, thereby encouraging us to learn certain kinds of behaviour. This chemical is the same in humans as it is in mice and other animals. In turn, CREB is a molecule that controls the activation of genes involved in the functioning of our brains, including those that cause the production of dopamine. It contributes to memory formation. "CREB is much more activated in the brains of higher-fat diet mice and these mice also have higher levels of corticosterone, a hormone that is associated with stress. This explains both the depression and the negative behaviour cycle," Fulton said. "It's interesting that these changes occur before obesity. These findings challenge our understanding of the relationship between diet, the body and the mind. It is food for thought about how we might support people psychologically as they strive to adopt healthy eating habits, regardless of their current corpulence."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our nutrition / diet section for the latest news on this subject. About the study: The International Journal of Obesity issued the study via advanced online publication on December 11, 2012. The research was funded by the Natural Sciences and Engineering Research Council of Canada, the Canadian Diabetes Association and the Canada Foundation for Innovation. Fulton and her team are part of a research network that is working together to address the biological reasons for obesity and its related diseases, such as cardiovascular diseases, type 2 diabetes, some cancers, and of course depression. She is based at the Montreal Diabetes Centre, an institution associated with the CRCHUM and four Montreal universities that brings together facilities for clinical research, cell biology and microscopy research, and rodent physiology research
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Consuming Whole Eggs May Improve Blood Lipids According To New Research

2013-01-04T19:37:00.000-08:00

A Closer Look at the Incredible Egg

High-Quality Egg Protein and Weight Management

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posted by mudasser on 20 Dec 2012 at 3:03 am

Eggs are versatile and can be served for any meal. In addition, they cook quickly, so are perfect as the basis for fast and easy meals.

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Cholesterol Plays Key Role In Cell Signaling

2013-01-04T16:02:00.000-08:00

Featured Article
Main Category: Cholesterol
Also Included In: Biology / Biochemistry
Article Date: 31 Dec 2012 - 8:00 PST Current ratings for:
Cholesterol Plays Key Role In Cell Signaling

Healthy organisms rely on tightly controlled pathways of cellular signals that pass from protein to protein, each protein modifying the next in some way. Now an international team of researchers has discovered that cholesterol plays a key role in regulating the proteins in these pathways, and may also be important for other processes inside cells.

Principal investigator Wonhwa Cho, professor of chemistry at the University of Illinois at Chicago, and colleagues, write about their discovery in a paper published earlier in December in the journal Nature Communications.

Usually, news about cholesterol tends to focus on its role in heart disease, as a result of which it has acquired somewhat of a bad reputation. But cholesterol is an essential component of healthy cells.

Until recently, however, because it is found sandwiched between the inner and outer surfaces of cell membranes, cell biologists thought cholesterol's main work was confined to interactions with other molecules in the membrane.

For instance, in 2011, a team of scientists at the National Institute of Standards and Technology (NIST) and University of California, Irvine, using neutron diffraction, revealed how cholesterol helped to "maintain order" within the cell membrane.

But Cho and colleagues have discovered cholesterol also appears to interact with proteins in the interior of the cell.

In this latest study, they reveal how cholesterol interacts with a scaffold protein. A scaffold protein uses its physical structure to bring together other proteins so they can pass signals to each other. They have protein binding sites that offer the signaling proteins a place to latch onto.

The authors found that cholesterol binds to a region on the scaffold protein where one of its signaling partners also binds. And they discovered that disruption of the cholesterol binding to that site also stopped the partner from activating.

"Here we show that cholesterol specifically binds many PDZ domains found in scaffold proteins, including the N-terminal PDZ domain of NHERF1/EBP50 ... Disruption of the cholesterol-binding activity of NHERF1 largely abrogates its dynamic co-localization with and activation of cystic fibrosis transmembrane conductance regulator, one of its binding partners in the plasma membrane of mammalian cells," they write.

In their paper, they give a detailed description of how the scaffold protein attaches itself to the membrane and reaches into it to find and bind the cholesterol.

The team suggests this way of interacting with cholesterol could be used by many proteins inside cells and sheds light on the importance of cholesterol to healthy cell functioning.

Cho says much of the existing data on how cholesterol behaves in cell processes has been difficult to interpret. He says their discovery is important because it "will help people understand how cholesterol may regulate other cellular processes".

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our cholesterol section for the latest news on this subject. "Cholesterol modulates cell signaling and protein networking by specifically interacting with PDZ domain-containing scaffold proteins"; Ren Sheng, Yong Chen, Heon Yung Gee, Ewa Stec, Heather R. Melowic, Nichole R. Blatner, Moe P. Tun, Yonjung Kim, Morten Källberg, Takahiro K. Fujiwara, Ji Hye Hong, Kwang Pyo Kim, Hui Lu, Akihiro Kusumi, Min Goo Lee & Wonhwa Cho; Nature Communications 3, Article number 1249, Published 04 December 2012; DOI:10.1038/ncomms2221; Link to Abstract.
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Aerobic Exercise Trumps Resistance Training for Weight and Fat Loss

2013-01-04T12:40:00.000-08:00

Main Category: Obesity / Weight Loss / Fitness
Article Date: 20 Dec 2012 - 1:00 PST Current ratings for:
Aerobic Exercise Trumps Resistance Training for Weight and Fat Loss

Aerobic training is the best mode of exercise for burning fat, according to Duke researchers who compared aerobic training, resistance training, and a combination of the two.

The study, which appears in the Journal of Applied Physiology, is the largest randomized trial to analyze changes in body composition from the three modes of exercise in overweight or obese adults without diabetes.

Aerobic exercise - including walking, running, and swimming - has been proven to be an effective way to lose weight. However, recent guidelines have suggested that resistance training, which includes weight lifting to build and maintain muscle mass, may also help with weight loss by increasing a person's resting metabolic rate. Research has demonstrated health benefits for resistance training, such as improving glucose control, but studies on the effects of resistance training on fat mass have been inconclusive.

"Given that approximately two-thirds of adults in the United States are overweight due to excess body fat, we want to offer clear, evidence-based exercise recommendations that will truly help people lose weight and body fat," said Leslie H. Willis, MS, an exercise physiologist at Duke Medicine and the study's lead author.

Researchers enrolled 234 overweight or obese adults in the study. Participants were randomly assigned to one of three exercise training groups: resistance training (three days per week of weight lifting, three sets per day, 8-12 repetitions per set), aerobic training (approximately 12 miles per week), or aerobic plus resistance training (three days a week, three set per day, 8-12 repetitions per set for resistance training, plus approximately 12 miles per week of aerobic exercise).

The exercise sessions were supervised in order to accurately measure adherence among participants. Data from 119 people who completed the study and had complete body composition data were analyzed to determine the effectiveness of each exercise regimen.

The groups assigned to aerobic training and aerobic plus resistance training lost more weight than those who did just resistance training. The resistance training group actually gained weight due to an increase in lean body mass.

Aerobic exercise was also a more efficient method of exercise for losing body fat. The aerobic exercise group spent an average of 133 minutes a week training and lost weight, while the resistance training group spent approximately 180 minutes exercising a week without shedding pounds.

The combination exercise group, while requiring double the time commitment, provided a mixed result. The regimen helped participants lose weight and fat mass, but did not significantly reduce body mass nor fat mass over aerobic training alone. This group did notice the largest decrease in waist circumference, which may be attributed to the amount of time participants spent exercising.

Resting metabolic rate, which determines how many calories are burned while at rest, was not directly measured in this study. While theories suggest that resistance training can improve resting metabolic rates and therefore aid in weight loss, in this study, resistance training did not significantly decrease fat mass nor body weight irrespective of any change in resting metabolic rate that might have occurred.

"No one type of exercise will be best for every health benefit," Willis added. "However, it might be time to reconsider the conventional wisdom that resistance training alone can induce changes in body mass or fat mass due to an increase in metabolism, as our study found no change."

Duke researchers added that exercise recommendations are age-specific. For older adults experiencing muscle atrophy, studies have found resistance training to be beneficial. However, younger, healthy adults or those looking to lose weight would see better results doing aerobic training.

"Balancing time commitments against health benefits, our study suggests that aerobic exercise is the best option for reducing fat mass and body mass," said Cris A. Slentz, PhD, a Duke exercise physiologist and study co-author. "It's not that resistance training isn't good for you; it's just not very good at burning fat."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our obesity / weight loss / fitness section for the latest news on this subject. In addition to Willis and Slentz, Duke study authors include Lori A. Bateman, Lucy W. Piner, Connie W. Bales, and William E. Kraus. East Carolina University study authors include A. Tamlyn Shields and Joseph A. Houmard.
The study was funded with a grant from the National Heart, Lung, and Blood Institute, National Institutes of Health (2R01-HL057354).

Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults, Leslie H. Willis, Cris A. Slentz, Lori A. Bateman, A. Tamlyn Shields, Lucy W. Piner, Connie W. Bales, Joseph A. Houmard, and William E. Kraus, Journal of Applied Physiology December 15, 2012 vol. 113 no. 12 1831-1837, doi: 10.?1152/?japplphysiol.?01370.?2011

Duke University Medical Center

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posted by Jenny Hutchings on 20 Dec 2012 at 7:07 am

This article was written by the Duke University Medical Center, i'm afraid you will need to contact them for their reasoning in including swimming.

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posted by Dr. J on 20 Dec 2012 at 6:12 am

I believe the Duke study did not include swimming. In my opinion, swimming does not give the same aerobic results in most cases and this article should not make this assumption.

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News From The Journal Of Clinical Investigation: Dec. 21, 2012

2013-01-04T08:24:00.000-08:00

Main Category: GastroIntestinal / Gastroenterology
Also Included In: Cancer / Oncology; Obesity / Weight Loss / Fitness; Heart Disease
Article Date: 24 Dec 2012 - 1:00 PST Current ratings for:
News From The Journal Of Clinical Investigation: Dec. 21, 2012

The X-factor in liver metabolism

After you eat, your liver switches from producing glucose to storing it. At the same time, a cellular signaling pathway known as the unfolded protein response (UPR) is transiently activated, but it is not clear how this pathway contributes to the liver's metabolic switch. In this issue of the Journal of Clinical Investigation, researchers led by Phillip Scherer at the University of Texas Southwestern Medical Center report that activation of the UPR triggers the expression of Xbp1s, a protein that regulates genes needed for the metabolic switch. Scherer and colleagues found that they could induce changes in liver metabolism just by increasing expression of Xbps1. These results suggest that Xbps1 could play a role in metabolic disease.

TITLE: The Xbp1s/GalE axis links ER stress to postprandial hepatic metabolism

Low iron levels increase the risk of H. pylori-associated gastric cancer

H. pylori frequently causes gastric ulcers and is also one of the greatest risk factors for gastric cancer. H. pylori infection is also associated with another gastric cancer risk factor, iron deficiency. In this issue of the Journal of Clinical Investigation, researchers led by Richard Peek at Vanderbilt University investigated the influence of iron on H. pylori-induced gastric cancer. Peek and colleagues found that low iron accelerated the development of H. pylori-associated cancerous lesions in gerbils. Further, H. pylori strains isolated from a human population at high risk for gastric cancer were more virulent and produced greater inflammation if they came from patients with low iron levels. In an accompanying article, El-Omar Emad of Aberdeen University discusses how iron levels could be used to identify patients that are at a higher risk for gastric cancer after H. pylori infection.

TITLE: Iron deficiency accelerates Helicobacter pylori-induced carcinogenesis in rodents and humans

ACCOMPANYING ARTICLE TITLE: Iron deficiency and H. pylori-induced gastric cancer: too little, too bad

A critical genetic regulator of brown fat functionality

Obesity is a direct consequence of prolonged positive energy balance that occurs when energy intake (ie. calories) exceeds energy expenditure. In mammals, brown fat plays a critical role in energy metabolism due to its ability to burn energy by dissipating heat, a process known as thermogenesis. Therapeutics that target brown fat could possibly increase metabolism and correct the imbalance that leads to obesity. In this issue of the Journal of Clinical Investigation, researchers led by Matthias Tschöp identified a protein in mice, p62, that is required for brown fat thermogenesis. Mice that did not express p62 in fat cells became obese and developed glucose intolerance, key features of metabolic syndrome in humans. These findings indicate that p62 is an important regulator of metabolism and energy balance and is could potentially serve as a therapeutic target for the treatment of metabolic syndrome.

TITLE: p62 links beta-adrenergic input with mitochondrial function

Dendritic cells play a protective role in atherosclerosis

Atherosclerosis is characterized by a chronic inflammatory immune response that increases the formation atherosclerotic plaques and lesions that could trigger atherothrombosis. Dendritic cells (DCs) are a type of immune cell that have been shown to play a complex role in atherosclerosis. In this issue of the Journal of Clinical Investigation, researchers led by Ira Tabas and Manikandan Subramanian at Columbia University used atherosclerosis-prone mice to elucidate the role of DCs in atherosclerosis. Tabas, Subramanian, and colleagues found that a protein known as MYD88 is required for the activation of DCs, which in turn activate another group of immune cells that protect against inflammation. These results demonstrate that MYD88-mediated DC activation is protective and could be a useful therapeutic target for the treatment of atherosclerosis.

TITLE: Treg-mediated suppression of atherosclerosis requires MYD88 signaling in dendritic cells

Getting to the heart of thyroid hormone function

Thyroid hormone has profound effects on cardiovascular function and metabolism, regulating heart rate, blood pressure, food intake, and metabolic rate. Originally, thyroid hormone was thought to act directly on the target tissues; however, several recent studies have suggested that thyroid hormones effects are mediated by the central nervous system (CNS). In this issue of the Journal of Clinical Investigation, researchers led by Jens Mittag at the Karolinska Institute in Stockholm, Sweden identified a population of neurons in the hypothalamus that are required for thyroid hormone regulation of blood pressure and heart rate. Loss of these neurons in mice resulted in elevated blood pressure and heart rate. These findings demonstrate an important role for the hypothalamus in the regulation of cardiovascular function and indicate a connection between thyroid disease and cardiovascular disorders. In an accompanying commentary, Jürgen Wess of the National Institute of Diabetes and Digestive and Kidney Diseases discusses the link between developmental hypothyroidism and cardiovascular disease.

TITLE: Thyroid hormone is required for hypothalamic neurons regulating cardiovascular functions

ACCOMPANYING ARTICLE TITLE: A heartfelt response: new thyroid hormone-sensitive neurons in the hypothalamus

Immune system-associated protein regulates metabolism

Hyperglycemia results from impaired insulin activity and is a hallmark of diabetes. In this issue of the Journal of Clinical Investigation, researchers led by Chih-Hao Li at Harvard University identified IL-13, a protein more commonly associated with the immune system, as a regulator of blood glucose levels. Mice lacking IL-13 had higher blood sugar and lipid levels compared with normal mice, and exhibited glucose intolerance and insulin resistance. Treatment with recombinant IL-13 reversed these effects. Li and colleagues found that IL-13 repressed glucose production in the liver, contributing to lower blood sugar levels. These findings suggest that IL-13 is an important regulator of metabolism and is a potential therapeutic target in the treatment of diabetes. In a companion commentary, Anna Mae Diehl and colleagues discuss how IL-13 connects inflammation and glucose homeostasis.

TITLE: Direct control of hepatic glucose production by interleukin-13

ACCOMPANYING ARTICLE TITLE: The Benefits of Restraint: Pivotal Role for IL13 in Hepatic Glucose Homeostasis

Cyclin D1b is a genetic reprogrammer that drives cancer progression

Cyclin D1b is a protein that is induced during cancer progression; however, it's exact function in cancer is poorly understood. In this issue of the Journal of Clinical Investigation, researchers led by Karen Knudsen at Thomas Jefferson University's Kimmel Cancer Center examined the role of cyclin D1b in prostate cancer. Using a mouse model of the disease, they found that cyclin D1b promoted the expression of genes that allow the cancer to grow and metastasize. Additionally, Knudsen and colleagues demonstrated that cyclin D1b's effects were dependent on androgen receptor signaling. These findings identify cyclin D1b as an important regulator of prostate cancer progression and suggest that this pathway is a potential therapeutic target in the treatment of prostate cancer.

TITLE: Convergence of oncogenic and hormone receptor pathways promotes pro-metastatic phenotypes

A new framework for ovarian cancer

Ovarian cancer is one of the most deadly cancers. It has a five year survival rate below 30% and a high rate of recurrence. It is a variable disease, with many different biological underpinnings that make it difficult to treat. In this issue of the Journal of Clinical Investigation, researchers led by Roel Verhaak at MD Anderson Cancer Center examined gene expression patterns in ovarian cancer tumor samples to identify gene expression signatures that correlated with patient prognosis. Using these data, they developed a model, Classification of Ovarian Cancer (CLOVAR), that could accurately classify ovarian cancer subtypes and predict patient outcomes. This new classification system may be useful in determining which treatments will be most effective for a given patient.

TITLE: Prognostically relevant gene expression signatures of high grade serous ovarian carcinoma

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Increase In Vision Impairment Linked To Higher Prevalence Of Diabetes

2013-01-04T04:51:00.000-08:00

Editor's Choice
Academic Journal
Main Category: Eye Health / Blindness
Also Included In: Diabetes
Article Date: 12 Dec 2012 - 12:00 PST Current ratings for:
Increase In Vision Impairment Linked To Higher Prevalence Of Diabetes

Nonrefractive visual impairment, not due to needing glasses, has increased significantly among Americans in recent years, and the higher incidence of diabetes may be responsible.

The finding came from new research, conducted by a team at the Johns Hopkins University School of Medicine, Baltimore, and was published in JAMA, December 12 issue.

Background information in the report stated: "It is estimated that more than 14 million individuals in the United States aged 12 years and older are visually impaired (<20/40). Of these cases, 11 million are attributable to refractive error."

The most frequent reasons Americans experience nonrefractive visual impairment are:

Prior research has demonstrated that people with visual impairment often have diabetes. Since the eye is one of the main organs impacted by diabetes, patients can develop certain visual conditions.

"The prevalence of diagnosed diabetes has increased among adults in recent years, rising from 4.9 percent in 1990 to 6.5 percent in 1998, 7.9 percent in 2001, 10.7 percent in 2007, and 11.3 percent in 2010," the authors explained.

The researchers, led by Fang Ko, M.D., set out to evaluate the prevalence of nonrefractive visual impairment and the risk factors associated with the condition.

Data was gathered and analyzed from the National Health and Nutrition Examination Survey (NHANES), a representative sample of the American population.

Questionnaires, physical exams, and laboratory tests were given to 9,471 and 10,480 subjects aged 20 and older in 1999-2002 and 2005-2008 respectively.

Participants were considered to have nonrefractive visual impairment when their visual acuity was less than 20/40 when measured by an autorefractor - a tool which evaluates a person's refractive error.

Results showed that the prevalence of nonrefractive visual impairment increased 21%, from 1.4% in 1999-2002 to 1.7% in 2005-2008. They also found that non-Hispanic whites experienced a 40% increase, from 0.5% to 0.7%.

The factors that were linked to nonrefractive visual impairment included: povertyolder agelower education leveldiabetes diagnosed at least 10 years agoThe only risk factor that increased in prevalence between the 2 time periods analyzed was diabetes. The incidence of diabetes with more than 10 years since diagnosis increased 22% overall, from 2.8 percent to 3.6 percent. Among non-Hispanic whites aged 20-39, the prevalence of diabetes increased 133%, from 0.3% to 0.7%.

The researchers concluded:

"We report a previously unrecognized increase of visual impairment among U.S. adults that cannot be attributed to refractive error. If the current finding becomes a persisting trend, it could result in increasing rates of disability in the U.S. population, including greater numbers of patients with end-organ diabetic damage who would require ophthalmic care. These results have important implications for resource allocation in the debate of distribution of limited medical services and funding. Continued monitoring of visual disability and diabetes, as well as additional research addressing causes, prevention, and treatment, is warranted."

Written by Sarah Glynn
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our eye health / blindness section for the latest news on this subject. Prevalence of Nonrefractive Visual Impairment in US Adults and Associated Risk Factors, 1999-2002 and 2005-2008
Fang Ko, Susan Vitale, Chiu-Fang Chou, Mary Frances Cotch, Jinan Saaddine, David S. Friedman
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Brown Adipose Tissue Beneficial For Metabolism And Glucose Tolerance

2013-01-04T01:05:00.000-08:00

Main Category: Diabetes
Also Included In: Obesity / Weight Loss / Fitness
Article Date: 12 Dec 2012 - 1:00 PST Current ratings for:
Brown Adipose Tissue Beneficial For Metabolism And Glucose Tolerance

Joslin Diabetes Center scientists have demonstrated that brown adipose tissue (BAT) has beneficial effects on glucose tolerance, body weight and metabolism. The findings, which may lead to new treatments for diabetes, appear in the upcoming issue of the Journal of Clinical Investigation.

Unlike the more prevalent white adipose tissue (WAT or white fat) which stores fat, BAT (or brown fat) burns fat to produce heat. Studies in mice and humans have suggested that BAT also plays a role in regulating body weight and metabolism. This has made BAT the focus of considerable interest among scientists and pharmaceutical companies who are investigating ways to use BAT as a treatment for obesity.

The Joslin researchers were interested in learning whether BAT is involved in glucose metabolism and uncovering the mechanisms underlying BAT's effects on metabolism and body weight. The study involved the transplantation of BAT from male donor mice into the visceral cavities of mice which were fed a standard or high-fat diet.

By eight to twelve weeks following transplantation, the BAT-transplanted mice fed a normal diet showed improved glucose tolerance, increased insulin sensitivity, lower body weights and decreased fat mass. Three control groups, which had a WAT transplant, a glass bead implant or surgery without transplantation, did not show any metabolic improvements. "We were able to establish that BAT transplantation affects metabolism. This study provides further evidence that BAT is a very important metabolic organ and a potential treatment for obesity-related diseases such as diabetes, metabolic syndrome and insulin resistance," says lead author Kristin I. Stanford, PhD, a postdoctoral fellow in the Section on Integrative Physiology and Metabolism.

The mice fed a high-fat diet also exhibited beneficial effects from BAT transplantation, including improved glucose metabolism, decreased body weight and a complete reversal of insulin resistance resulting from excess fat consumption. Previous studies of BAT transplantation in mice, which transplanted BAT in a different location and had a shorter duration, did not show beneficial effects.

The transplanted BAT affected metabolism throughout the body by increasing levels of circulating Interleukin-6 (IL-6). The researchers also found that BAT transplantation increased norepinephrine and FGF-21. IL-6 has been shown in previous studies to increase energy production and decrease body weight. When the researchers transplanted BAT from donor mice genetically engineered not to produce IL-6, the mice who received the transplants showed no metabolic improvements. "This is the first study to demonstrate that an increase in BAT significantly increases levels of circulating IL-6. It suggests that an increase in BAT-derived IL-6 improves glucose metabolism throughout the body," says senior author Laurie J. Goodyear, PhD, head of the Section on Integrative Physiology and Metabolism.

The researchers are following up on the study by "looking into other ways BAT may have beneficial metabolic effects and further investigating the functions of IL-6 and other BAT-derived hormones," says Dr. Goodyear. Dr. Stanford is studying the relationship between BAT and type 1 diabetes (T1D), based on data from a collaborator that suggests that BAT may help control glucose in T1D.

Dr. Goodyear and the research team are very interested in using their findings to develop new therapies for diabetes. "We hope that manipulating BAT will help people with type 1 and type 2 diabetes," says Dr. Goodyear.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our diabetes section for the latest news on this subject.
Study co-authors include: Roeland J. W. Middelbeek, Kristy L. Townsend, Ding An, Eva B. Nygaard, Kristen M. Hitchcox, Kathleen R. Markan, Kazuhiro Nakano, Michael F. Hirshman, Yu-Hua Tseng, all of Joslin Diabetes Center.

The study was funded by the National Institutes of Health.

Joslin Diabetes Center

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Blood Glucose Levels And BMI In Very Obese Children Improved By Metformin

2013-01-03T20:05:00.000-08:00

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Diabetes; Pediatrics / Children's Health
Article Date: 13 Dec 2012 - 0:00 PST Current ratings for:
Blood Glucose Levels And BMI In Very Obese Children Improved By Metformin

Metformin therapy has a beneficial treatment effect over placebo in improving body mass index (BMI) and fasting glucose levels in obese children, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). The study showed reduction in BMI was sustained for six months.

Childhood obesity has increased globally over the last two decades and it is linked to an increase in the diagnosis of type 2 diabetes in childhood, previously a condition that was only diagnosed in adults. Metformin is a first line drug for type 2 diabetes, and has been used for many decades. In adults metformin delays the onset of type 2 diabetes, but there is no evidence that the drug has a similar effect on children.

"Our findings provide evidence that a treatment course of metformin is clinically useful, safe and well-tolerated in obese children who are at risk for type 2 diabetes," said Deborah Kendall, MD, of Royal Manchester Children's Hospital in the United Kingdom and lead author of the study. "Metformin may also provide stimulus for lifestyle changes and potentially reduce long-term risk for type 2 diabetes and its associated health problems."

This prospective, randomized, double-blind, placebo-controlled trial was conducted at six pediatric endocrine centers in the United Kingdom and involved 151 obese children and young people with hyperinsulinemia and/or impaired fasting glucose or impaired glucose tolerance. Study participants received either metformin or placebo daily for six months. This trial is the largest of its kind to focus on metformin in obese non-diabetic children and young people.

"Our results show that metformin can improve BMI and blood glucose levels in obese children, but longer term effects such as reduction in the incidence of type 2 diabetes need further study," noted Kendall.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our obesity / weight loss / fitness section for the latest news on this subject.
Other researchers working on the study include: R. Amin, F. Ivison, A. McGovern, L. Tetlow, P. Clayton and C. Hall of Royal Manchester Children's Hospital; T. Barrett of Birmingham Children's Hospital, UK; P. Dimitri, J. Wales and N. Wright of the University of Sheffield, UK; M. Kibirige of The James Cook University Hospital, UK; V. Mathew of Hull Royal Infirmary, UK; K. Matyka and H. Stirling of University Hospital Coventry and Warwickshire National Health Service Trust, UK; and A. Vail of the Centre of Biostatistics, UK.

The article, "Metformin in Obese Children and Adolescents: The MOCA Trial," appears in the January 2013 issue of JCEM.

The Endocrine Society

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Body's Food Clock Upset By Holiday Overindulgence

2013-01-03T15:33:00.000-08:00

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Academic Journal
Main Category: Nutrition / Diet
Also Included In: Obesity / Weight Loss / Fitness; Diabetes
Article Date: 27 Dec 2012 - 2:00 PST Current ratings for:
Body's Food Clock Upset By Holiday Overindulgence

Overindulgence during this feasting season can play havoc with the human body's food clock, researchers from the University of California, San Francisco reported in PNAS (Proceedings of the National Academy of Sciences).

Overeating, changing sleeping patterns, and significant changes in eating habits over the holiday period can upset the body's "food clock", a collection of genes and molecules that interact with one another and keep the human body on a metabolic even keel. The UCSF scientists inform that their new study helps reveal how this clock functions on a molecular level.

If our eating habits change, PKCy, a protein, is crucial in resetting the food clock.

Louis Ptacek, MD. and team showed that lab mice which were given food during their sleeping hours will eventually adapt their food clock and start waking up at the "sleep time feeding time", and run around in anticipation of food. However, mice which do not have the PKCy gene never adapt, and continue sleeping right through their sleep-time meal.

A desynchronized food clock may be associated with the pathology underling certain diseases and disorders, such as metabolic syndrome, diabetes and obesity, the authors explain. They added that their study has implications for understand the molecular bases for such conditions.

Dr. Ptacek wrote that this may also explain why obesity is more common among "night-owls" than "morning larks".

Dr. Ptacek added:

"Understanding the molecular mechanism of how eating at the "wrong" time of the day desynchronizes the clocks in our body can facilitate the development of better treatments for disorders associated with night-eating syndrome, shift work and jet lag."

Biological clocks are as complicated as mechanical clocks. Behind a mechanical clock one can find flywheels, cogs, reciprocating counterbalances and several other moving parts. Biological clocks consist of many interacting genes that switch on or off in an orchestrated way to keep time during each 24-hour period.

In the majority of living beings, biological clockworks depend on the circadian oscillator (a master clock) which keeps track of time and coordinates the body's biological processes with the rhythm of a 24-hour day and night cycle.

Master clocks exist in most life forms, including mustard greens, mice and humans. Over the last ten years, scientists have discovered many of their inner workings, and identified several genes whose cycles are linked to the clock. They have discovered how in mammals, our circadian rhythms are controlled by a tiny sport in the brain, called the "superchiasmatic nucleus".

The researchers know that apart from the master clock, human bodies have other clocks which operate in parallel throughout the day. The food clock is one of these - it is not tied to one specific spot in the brain, but rather several sites in different parts of the body.

The food clock helps our bodies make the most of what we eat. It regulates the genes that are involved in everything, from absorbing nutrients in our intestines to their dispersal in the bloodstream. Our food clock is designed to anticipate our eating patterns.

Even before we start a meal, our bodies start turning on some of these genes and switching others off, in preparation for a burst of nutrition. This is why we get bouts of hunger as our eating times approach.

Experts have known that if our eating patterns change, our food clock can be reset. If we eat at odd times or to excess, the food clock adapts. However, it was not until very recently that scientists understood how the food clock operated on a genetic level.

Dr. Ptacek and team discovered how the food clocks work at a molecular level. PKCY binds to BMAL, another molecule, and stabilizes it, resulting in a shift in the clocks timing.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our nutrition / diet section for the latest news on this subject. “PKC? participates in food entrainment by regulating BMAL1”
Luoying Zhang, Diya Abrahama, Shu-Ting Lin, Henrik Oster, Gregor Eichele, Ying-Hui Fu, and Louis J. Ptácek PNAS December, 2012 vol. 109 no. 50 20679-20684. doi: 10.1073/pnas.1218699110 Please use one of the following formats to cite this article in your essay, paper or report:

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posted by Frankie Obrien on 28 Dec 2012 at 1:23 pm

This concept complicates the issue of eating-when and how much. It sidesteps the subject of hunger as a trigger- physical hunger that is instinctual to human beings. In general, this sounds like someone wants to find a reason other than the truth.

Other factors are the true culprits of weight gain or "out of balance appetite", unless there is a thyroid problem or other medical reason for excessive eating. Anyway, so what if a person eats a bit excessively around the holidays? As long as the excessive eating doesn't become a regular routine, one can recover from those extra calories easily.

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'Body's Food Clock Upset By Holiday Overindulgence'

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Cholesterol Helps Regulate Key Signaling Proteins In The Cell

2013-01-03T11:30:00.000-08:00

Main Category: Cholesterol
Also Included In: Biology / Biochemistry
Article Date: 30 Dec 2012 - 0:00 PST Current ratings for:
Cholesterol Helps Regulate Key Signaling Proteins In The Cell

Cholesterol plays a key role in regulating proteins involved in cell signaling and may be important to many other cell processes, an international team of researchers has found.

The results of their study are reported in the journal Nature Communications.

Cholesterol's role in heart disease has given it a bad reputation. But inside the thin membrane of a cell, the tight regulation of cholesterol at high levels (30 to 40 percent) suggests that it plays an important role in cellular processes, says Wonhwa Cho, professor of chemistry at the University of Illinois at Chicago and principal investigator on the study.

Cho and colleagues had previously found evidence that cholesterol was directly interacting with many proteins found in the interior of the cell. The interaction seemed necessary for the proper functioning of these proteins.

"This was quite a surprising finding," said Cho, because cholesterol resides within the membrane, sandwiched between its inner and outer face. Cell biologists had thought it could only interact with other biomolecules within the membrane.

In the new study, Cho and his colleagues showed how cholesterol interacts with a scaffolding protein, one of a class of proteins that plays an important role in cell signaling. The researchers showed that cholesterol binds to a region on the protein molecule where one of its signaling partners also binds -- and that disrupting cholesterol binding to the protein makes it unable to activate its partner.

The researchers describe in detail how the protein hooks onto and reaches inside the membrane to find and bind cholesterol.

Cho believes that this strategy for interacting with cholesterol may be used by many interior cellular proteins and offers an insight into what is known about the importance of cholesterol to well-functioning cells.

Much of the existing data on the cholesterol-related regulation of cellular processes had been difficult to interpret, he said.

"This is a major finding that will help people understand how cholesterol may regulate other cellular processes," Cho said.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cholesterol section for the latest news on this subject. Ren Sheng, graduate student in chemistry at UIC, was first author of the paper. Other authors are Yong Chen, Ewa Stec, Heather Melowic, Nichole Blatner and Moe Tun, all of the UIC chemistry department; Morten Kallberg and Hui Lu of the UIC bioengineering department; Heon Yung Gee, Yonjung Kim and Min Goo Lee of the Yonse University College of Medicine in Seoul; Takahiro Fujiwara and Akhiro Kusumi of Kyoto University in Japan; and Ji Hye Hong and Kwang Pyo Kim of Konkuk University in Seoul.

This study was supported by the Chicago Biomedical Consortium with the support of the Searle Funds at the Chicago Community Trust; National Institutes of Health grant GM68849; the World Class University program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology; and a grant from the National Project for Personalized Medicine, part of the Korea Health 21 R&D Project of the Korean Ministry of Health and Welfare.

University of Illinois at Chicago

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Good Response From Pre-Diabetic Patients For Self-Directed Lifestyle Interventions

2013-01-03T08:25:00.000-08:00

Main Category: Diabetes
Also Included In: Obesity / Weight Loss / Fitness; Primary Care / General Practice
Article Date: 12 Dec 2012 - 1:00 PST Current ratings for:
Good Response From Pre-Diabetic Patients For Self-Directed Lifestyle Interventions

Efforts to help overweight patients avoid diabetes through lifestyle changes need not rely on intensive, one-on-one focused programs, a new clinical study from the Stanford University School of Medicine and the Palo Alto Medical Foundation Research Institute has found.

The study, published in the Archives of Internal Medicine, opens up a practical way for primary care physicians to help their patients at high risk for developing diabetes.

Researchers have known for 10 years that intensive intervention programs led by lifestyle coaches to encourage weight loss through healthier diet and exercise help reduce type-2 diabetes incidence. The Diabetes Prevention Program clinical research study, the results of which were published in 2002, found this strategy led to a 58 percent decrease in the incidence of type-2 diabetes, a result that surpassed the benefit of drug treatment.

The new study - headed by Jun Ma, MD, PhD, an associate investigator at the research institute and an affiliate member of the Stanford Prevention Research Center - builds off the DPP's strategy but makes full use of online resources and, in one group, a take-home DVD. If implemented, the new interventions could increase the accessibility and reach of existing educational, coach-based diabetes prevention programs, and free up time for primary care doctors, who are often frustrated with high patient loads that prevent them from providing the individualized care these patients need.

"The big issue in diabetes prevention is how to take what clearly worked for DPP - which was very intensive and one-on-one focused - and get it to the point where it could be established as a program in large group practices," said Randall Stafford, MD, PhD, professor of medicine at the Stanford Prevention Research Center and a senior investigator on the study.

Diabetes currently affects 25.8 million people in the United States, or 8.3 percent of the population. The disease is a major cause of heart disease and stroke, and is the leading cause of kidney failure, nontraumatic lower-limb amputation and new cases of blindness among adults. In 2007, diabetes-related medical costs in the United States were estimated at $174 billion. Effective health interventions that reach a maximum amount of pre-diabetic patients - those at the highest risk for developing diabetes - are urgently needed to curb the burden of the disease.

What the DPP sported in effectiveness, it lacked in its ability to broadly reach patients at the level of primary care. In the new study, Ma and Stafford set out to determine whether restructuring the DPP to take advantage of online connectivity and health monitoring could be achieved without sacrificing the benefits seen in the original program.

Pre-diabetic patients were recruited from Palo Alto Medical Foundation and randomized into three groups: a coach-led group intervention, a self-directed DVD intervention or usual care. In addition to offering practical ways to start eating healthier foods and exercising more, the curriculum in both the coach-led and DVD-based interventions also focused on the mental and behavioral strategies necessary to make the changes stick. This lifestyle instruction was delivered over a three-month intensive intervention phase.

Following the first three months of intervention, the participants regularly received encouraging messages to help them follow through with what they had learned in the initial intervention phase. During this 12-month maintenance phase, participants received supportive emails within an electronic health-record system, and monitored their health goals through the publicly available American Heart Association's Heart360 website. The primary outcome tested in the study was a change in body mass index (a calculation based on a person's height and weight), although other factors, including weight loss, waist circumference, blood pressure and blood glucose, were also measured.

The results show that participants responded to both the coach-led and self-directed interventions, although the coach-led group fared slightly better. At the beginning of the study, the participants had an average BMI of 32; a BMI of 30 or more is considered obese. After the 15-month trial, the average drop in BMI was 2.2 for the coach-led group, 1.6 for the self-directed group and 0.9 for the group that received usual care. The average weight loss was 13.9 pounds for the coach-led group, 9.9 pounds for the self-directed group and 5.3 pounds for usual care. Both interventions also led to a dip in waistline circumference as compared to the usual-care group.

Though the study was too small to generate statistically significant findings along gender lines, they turned up a hint of a gender difference: While men responded with equal success to both the coach-led and self-directed interventions, women responded better to the coach-led approach.

Stafford points out that the suggested differences between genders highlights the need for options when it comes to lifestyle interventions. "It suggests that a one-size-fits-all program isn't necessarily what we need. We need some way to offer people different styles of intervention," said Stafford.

Narrow demographics were a primary limitation of the study. Participants were all from a single clinic in Silicon Valley, and a large majority were white (78 percent), college-educated (97 percent) and earned more than $75,000 per year (88 percent). Stafford acknowledged the limited demographics of the study, but said he hopes that similar lifestyle interventions will work in more diverse populations. His group is currently conducting a National Institutes of Health-funded study testing the effectiveness of weight-loss interventions in a low-income, Latino population.

If implemented, the approaches - especially the self-directed DVD - could extend the reach and lower the cost of lifestyle intervention programs. In addition to the cost-benefit of the intervention programs themselves, the real savings will come from diabetes prevention. "Diabetes is an expensive disease to treat and its complications are both personally devastating and societally costly," said Stafford. If patients respond to self-directed programs by losing a modest amount of weight, this could be enough to prevent or significantly delay the onset of type-2 diabetes in high-risk populations, ultimately reducing the burden of this chronic disease.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our diabetes section for the latest news on this subject.
Other Stanford co-authors were instructors Veronica Yank, MD, and Lisa Rosas, PhD. They also collaborated with other researchers at the Palo Alto Medical Foundation Research Institute.

The study was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the American Heart Association, as well as internal funding from the Palo Alto Medical Foundation Research Institute.

Stanford University Medical Center

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In The Battle Against Heart Disease, Stroke, Unhealthy Behaviors Could Slow Progress

2013-01-03T04:24:00.000-08:00

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Stroke; Heart Disease; Public Health
Article Date: 17 Dec 2012 - 0:00 PST Current ratings for:
In The Battle Against Heart Disease, Stroke, Unhealthy Behaviors Could Slow Progress

Poor eating and exercise habits could be the game-changer in the fight against heart disease and stroke deaths, according to the American Heart Association's "Heart Disease and Stroke Statistical Update 2013," published in the American Heart Association journal, Circulation.

"Americans need to move a lot more, eat healthier and less, and manage risk factors as soon as they develop," said Alan S. Go, M.D., chairman of the report's writing committee and chief of the Cardiovascular and Metabolic Conditions Section of the Kaiser Permanente Northern California Division of Research in Oakland. "If not, we'll quickly lose the momentum we've gained in reducing heart attack and stroke rates and improving survival over the last few decades."

Between 1999 and 2009, the rate of deaths from cardiovascular disease (CVD) fell 32.7 percent, but still accounted for nearly one in three deaths in the nation. That's 2,150 people dying from CVD each day - about one death every 40 seconds.

In 2010, the American Heart Association set a goal to improve cardiovascular health of all Americans by 20 percent and reduce heart disease and stroke deaths 20 percent by 2020.

However, according to projections in the 2013 report, heart health may only improve by 6 percent if current trends continue. The biggest barriers to success are projected increases in obesity and diabetes, and only modest improvements in diet and physical activity. On a positive note, smoking, high cholesterol and high blood pressure rates are projected to decline.

Among heart disease and stroke risk factors, the most recent data shows: More adults age 20 and over are obese (34.6 percent) than normal or underweight (31.8 percent); 68.2 percent are overweight or obese. Among children ages 2-19, 31.8 percent are overweight or obese. Thirty-two percent of adults report no aerobic activity; 17.7 percent of girls and 10 percent of boys, grades 9-12, report fewer than an hour of aerobic activity in the past week. 13.8 percent of adults have total cholesterol of 240 mg/dL or higher. Thirty-three percent of adults have high blood pressure; African-Americans have among the highest prevalence of high blood pressure (44 percent) worldwide. 8.3 percent of adults have diagnosed diabetes, and 8.2 percent have undiagnosed diabetes; 38.2 percent have prediabetes. Despite four decades of improvement, 21.3 percent of men and 16.7 percent of women age 18 and over still smoke cigarettes; 18.1 percent of students in grades 9-12 report cigarette smoking.

"As the leader in the fight against heart disease and stroke, we are taking a more aggressive and innovative approach, including taking some pages from the playbooks of the public health sector," said Donna Arnett, Ph.D., president of the American Heart Association and chairperson of the Department of Epidemiology at the University of Alabama at Birmingham School of Public Health. "We're focusing on population-based ways to improve health factors for all Americans."

Some of these include: Working with healthcare systems to support and reward providers who help patients improve their health behaviors and manage their health risk factors. Working with insurers to cover preventive health services and reward positive health behaviors and medication adherence. Working with the education community to make changes in schools that support healthy diets and physical activity for children. Building comprehensive worksite wellness programs. Building healthier communities with improved access to healthier foods and green space for physical activity. The association has a wide range of programs and policy initiatives aimed at improving cardiovascular health through risk factor prevention and health care quality, Arnett said. Information on improving your heart health can be found at http://www.MyHeartMyLife.org.

"In this race against time, it will take nationwide efforts driven by communities and systems - a patient-by-patient approach alone won't do it," Arnett said. "But we're optimistic that if we increase our efforts for improvements in prevention and reductions in risk factors, we can be successful - we can save lives."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our obesity / weight loss / fitness section for the latest news on this subject. Additional authors and disclosures are on the manuscript.
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For The Holiday Weight-Gain Season: The Chemistry Behind Calorie Counts And Nutrition Labels

2013-01-03T01:06:00.000-08:00

Main Category: Nutrition / Diet
Also Included In: Obesity / Weight Loss / Fitness
Article Date: 22 Dec 2012 - 0:00 PST Current ratings for:
For The Holiday Weight-Gain Season: The Chemistry Behind Calorie Counts And Nutrition Labels

With the holiday season a high-risk period for packing on unwanted pounds, the American Chemical Society (ACS) today posted a new video that may lend perspective on this year's battle of the bulge. Produced by the world's largest scientific society, it explains the science behind the calorie counts and other information on those Nutrition Facts Labels on food packages. The video tells the story of how scientists first determined the calorie content of food in the 1800s, and how scientists determine fat, protein and carbohydrate levels in foods today.

The video explains that the calorie content of food was determined in the late 1800s by chemist Wilbur O. Atwater. Atwater built a four-by-eight-foot device called a respiration calorimeter, which was big enough to allow a person to step into it. It measured the amount of heat they released, the amount of oxygen they consumed and the carbon dioxide they gave off after eating a variety of foods.

Using this device, Atwater was able to measure the precise amount of energy contained in thousands of food items. He found that carbohydrates and proteins were worth 4 calories per gram and fats about 9 calories per gram, which is about 1/28th of an ounce. This 4-9-4 rule remains embodied in today's Nutrition Facts Labels.

The video, from the award-winning Digital Services Unit in the ACS Office of Public Affairs, is based on an article in the latest issue of ChemMatters, ACS' quarterly magazine for high school students.

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Menus Showing Miles Plus Calories Help People Choose Healthier Meals

2013-01-02T21:07:00.000-08:00

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Academic Journal
Main Category: Nutrition / Diet
Also Included In: Obesity / Weight Loss / Fitness; Preventive Medicine
Article Date: 22 Dec 2012 - 0:00 PST Current ratings for:
Menus Showing Miles Plus Calories Help People Choose Healthier Meals

A new US study that explores the effect of menu information on people's choice of fast food meals finds they tend to choose healthier options when shown not only the calories they contain, but also how many miles they would have to walk to burn off those calories.

Writing about their findings in a paper published online in the journal Appetite on 7 December, researchers from the University of North Carolina (UNC) said it was giving the physical activity information as miles of walking rather than minutes of walking that was more often tied to healthier meal choices.

They also reported that the vast majority of the 802 participants (82%), all women in middle-age recruited through a UNC employee newsletter, said they preferred to see physical activity based menu labels rather than labels with calorie information alone or no nutritional information.

For the study, which used a web-based survey to gather information on the participants' choices, the researchers randomly assigned them to one of four groups, each given a different menu: A menu with calorie information,A menu with calorie information and the minutes of walking required to burn off those calories,A menu with calorie information and the miles of walking required to burn off the calories, andA menu with no nutritional information (the control group for comparison).The survey asked participants to imagine they were in a fast food restaurant (like a burger chain), and were looking to choose a meal for themselves. What would they order from the menu, based on the information provided?

The options on offer included burger meals, sandwiches, sides, salads, dressing, desserts and drinks. The menu was compiled from online menus of common fast food restaurants in the US, without pictures.

One of the options was a regular burger containing 250 calories that would take 78 minutes or 2.6 miles (4.2 km) of walking to burn off.

The results showed a significant difference in the average number of calories ordered based on menu type.

The group that had menus with no nutritional information ordered on average 1,020 calories, compared with 927 calories in the group that had only calorie information, 916 calories in the group given calories and minutes of walking, and 826 calories in the group given calories and miles of walking information.

The authors write:

"The menu with calories and the number of miles to walk to burn those calories appeared the most effective in influencing the selection of lower calorie meals (p = 0.0007) when compared to the menu with no nutritional information provided)."

However, they add:

"Whether these labels are effective in real-life scenarios remains to be tested."

At the end of the survey, all participants were asked about which type of information they would prefer to see on a menu. 45% said they preferred menus with calories and minutes of walking, 37% said they preferred calories with miles of walking, 13% said calorie information only, and 5% said they preferred menus with no nutritional information.

Putting all the groups together, the results showed that 82% of participants preferred menus that showed physical activity (either minutes or miles of walking) over menus that showed only calorie information or no nutritional information at all.

An interesting feature of the study was that the researchers also inserted questions in the survey designed to test respondents' numeracy: only 31% answered all them correctly, and only 8% answered correctly the ones that were specifically about calories.

This might indicate that numerical information on calories may not be understood by most of the participants (which is somewhat surprising given that 96% of them were educated to college or university level).

Such a statistic is likely to vary with different population groups, but it is one that perhaps policymakers should bear in mind when deciding how to express nutitional information on food labels.

Perhaps it is easier to imagine oneself physically walking a certain distance than trying to work out how much percentage of one's recommended daily calorie limit a particular menu item represents.

As the Christmas holidays approach, this report might encourage more of us to imagine how many miles we may have to walk to burn off all the festive calories we consume.

One recent study suggests that we can help ourselves maintain a healthy weight over the festivities not only by avoiding classic holiday sweets such as cookies or candy, but also by reducing car travel, which apparently is as effective as cutting calories.

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our nutrition / diet section for the latest news on this subject. "Potential effect of physical activity based menu labels on the calorie content of selected fast food meals"; Sunaina Dowray, Jonas J. Swartz, Danielle Braxton, Anthony J. Viera; Appetite, Available online 7 December 2012; DOI:10.1016/j.appet.2012.11.013; Link to Abstract.
Additional source: Miles on menu 'helps healthy choices'; NHS Choices; 19 Dec 2012.
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posted by Marcia on 28 Dec 2012 at 7:19 am

I never thought that providing the number of miles it would take to burn off the selected menu item would have such an impact on selection. I love this idea and will be experimenting with it in our cafeterias.
We plan to include calories, protein, fat and sodium information on some of our most popular menu items in the cafe and after reading this article, we will add the number of miles it takes to burn off that meal.

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Inpatient Bariatric Procedures For Adolescents Appear To Have Plateaued Since 2003

2013-01-02T17:20:00.000-08:00

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Pediatrics / Children's Health
Article Date: 19 Dec 2012 - 0:00 PST Current ratings for:
Inpatient Bariatric Procedures For Adolescents Appear To Have Plateaued Since 2003

Inpatient bariatric procedures among adolescents appear to have plateaued since 2003 to about 1,000 procedures annually, and the preferred type of operation has changed to minimally invasive laparoscopic procedures from open procedures, according to a study published Online First by Archives of Pediatrics & Adolescent Medicine, a JAMA Network publication.

About 1 in 3 children in the United States is overweight or obese, a three-fold increase since 1980. Also, diseases associated with obesity previously only seen in adults, such as type 2 diabetes mellitus, are now increasingly diagnosed in children. Effective weight loss strategies are needed to curtail these changes, and bariatric surgery may be an effective strategy for achieving significant weight reduction in adolescents who are already morbidly obese, according to the study background.

Deirdre C. Kelleher, M.D., and colleagues from the Children's National Medical Center, Washington, D.C., conducted a study to determine the current rate of inpatient bariatric surgical procedures among adolescents (individuals ages 10 to 19 years) and to analyze national trends of use from 2000 to 2009. The authors used discharge data from the Healthcare Cost and Utilization Project Kids' Inpatient Database from 2000 through 2009.

"Our study confirms the previously reported growth in bariatric procedures from 2000 to 2003 among adolescents. Despite the suggestion that adolescent bariatric surgery has increased in popularity and continued to grow exponentially, inpatient surgery use leveled off from 2003 through 209, reaching a plateau of about 1,000 procedures annually," the authors comment.

The inpatient bariatric procedure rate increased from 0.8 per 100,000 in 2000 to 2.3 per 100,000 in 2003 (328 vs. 987 procedures) but the rate did not change significantly in 2006 (2.2 per 100,000) or 2009 (2.4 per 100,000), with 925 vs. 1,009 procedures. The use of laparoscopic adjustable gastric banding (LAGB) approached one-third (32.1percent) of all procedures by 2009, the study results indicate.

"While the rate of adolescent inpatient procedures did not increase from 2003 through 2009, the preferred type of operative approach changed from open to laparoscopic, further mirroring the trends in adults. Laparoscopic RYGB [Roux-en-Y gastric bypass] almost completely replaced open RYGB, and the use of LAGB increased after its approval for adults in 2001," the authors comment.

According to the study results, bariatric surgical procedures were performed in patients as young as 12 year old, however they were increasingly performed in adolescents older than 17 years (70.8 percent in 2003 and 77.5 percent in 2009). Most of the patients were female. Private insurance also remained the primary payer source throughout the study period, although Medicaid use increased from 7.7 percent in 2003 to 17.2 percent in 2009, according to study results.

"The data show that adolescent bariatric surgery trends mirror those observed in the adult population, with a plateau in volume during the mid-2000s and a shift toward less invasive procedures. They also point to low use of this potentially life-altering treatment in adolescent boys and groups of lower socioeconomic status," the authors conclude.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our obesity / weight loss / fitness section for the latest news on this subject. Arch Pediatr Adolesc Med.. Published online December 17, 2012. doi:10.1001/2013/jamapediatrics.286. Please use one of the following formats to cite this article in your essay, paper or report:

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The Role Of The Innate Immune Cells In The Development Of Type 1 Diabetes

2013-01-02T13:24:00.000-08:00

Main Category: Diabetes
Also Included In: Immune System / Vaccines
Article Date: 31 Dec 2012 - 0:00 PST Current ratings for:
The Role Of The Innate Immune Cells In The Development Of Type 1 Diabetes

Julien Diana and Yannick Simoni of the "Immune Mechanisms in Type 1 Diabetes" (Inserm/Universite Paris Descartes), directed by Agnes Lehuen, have just published the results of their work on type 1 diabetes in the Nature Medicine journal. This is a disease characterised by the self-destruction of the p pancreatic cells that produce insulin. The researchers reveal the role of the innate immune cells, especially the dendritic cells, that cause the activation of the killer T-lymphocytes whose action is directed against the p pancreatic cells. The results obtained in mice make it possible to consider new ways of regulating the auto-immune reaction generated by the innate immune cells.

Type 1 diabetes, or insulin-dependent diabetes, is an auto-immune disease characterised by the destruction of insulin-producing pancreatic ß cells that are present in the Islets of Langerhans which are themselves in the pancreas. The peculiarity of this type of diabetes lies in the fact that the cells are destroyed by T lymphocytes that kill the patient's immune system. This is an auto-immune reaction. Much of the research has highlighted the role of auto-reactive T lymphocytes in the pancreatic ß cells. Yet the mechanisms involved in the initial activation of the immune system that triggers the sequence of events leading to the death of the cells are still ill-defined.

The work of the team working on "Immune mechanisms of Type 1 diabetes" (Inserm/Université de Paris Descartes) in NOD (Non-obese diabetic) mice, the model used for studying Type 1 diabetes, reveals the essential role played by the cells of the innate immune system[1] that were not hitherto considered to be involved in diabetes. These cells were known to play a role in other auto-immune diseases such as lupus and psoriasis. In this study, researchers managed to describe the mechanisms initiating the activation of T lymphocytes attaching themselves to the pancreatic ß cells.

The innate immune system is normally activated when an infection occurs. This is when the mobilisation and activation of neutrophils and dendritic cells is observed, constituting the first stages of the immune response. Abnormally in NOD diabetic mice, the natural physiological death of pancreatic ß cells, occurring as the process progresses, involves an innate auto-immune response in the pancreas. Researchers have provided details of the introduction of a sequence of activation events in these innate immune cells in the Islets of Langerhans.

The natural deterioration of the ß cells leaves cell debris in the tissues that abnormally activate the neutrophils. These alarm cells in the immune system warn the dendritic cells (pDC), which in turn cause the production of IFN a interferon, an alarm molecule. The interferon a then stimulates the T lymphocytes which, by recognising functional pancreatic ß cells, cause these cells to die.

"We have observed in mice that treatment prevents activation of the innate immune cells, neutrophils and dendritic cells, warning of the onset of diabetes by inhibiting the appearance of auto-immune T responses aimed at the pancreas" explains Agnès Lehuen, head of the Inserm team.

These results show, for the first time, the important role played by innate immune cells in the sequence of events leading to the onset of Type 1 diabetes. Researchers continue to strive to understand how to regulate the auto-immune reaction produced by dendritic cells without compromising the innate immune system, an essential one in cases of infection. Several routes are being taken to attempt to regulate the production of the INF a alarm molecule that precedes activation of the killer T-cells, for example, by specifically targeting certain activation routes for the pDC dendritic cells.

"These therapeutic approaches are currently being tested in other auto-immune diseases such as lupus and psoriasis. Such innovative treatments could be useful in the prevention of Type 1 diabetes. It will first be necessary, however, to perform studies in diabetic and pre-diabetic patients to be able to better understand how the innate immune cells function, something that has not been studied until recently in auto-immune diabetes," concludes Agnès Lehuen.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our diabetes section for the latest news on this subject. [1] System present from birth that makes it possible to initiate an immune response to infection, regardless of the infectious agent involved. It is distinguished from the “acquired” or so-called “adaptive” immune system that is a specific response involving recognition of the infectious agent and the memorising of the infectious event.

The research benefited from a grant from LabEx INFLAMEX as part of investment for the future and for the Ile-de-France region.

INSERM (Institut national de la santé et de la recherche médicale)

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