Friday, August 27, 2010

Federal school lunches -- but not breakfasts -- linked to childhood obesity, research finds

Federal School Lunches -- But Not Breakfasts -- Linked to Childhood Obesity, Research Finds


ScienceDaily (Aug. 26, 2010) — With children going back to school, parents are concerned that their youngsters are staying fit and eating right, especially those who dine in a school cafeteria.



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New research funded by the U.S. Department of Agriculture finds that children who eat school lunches that are part of the federal government's National School Lunch Program are more likely to become overweight.
The same research study found, however, that children who eat both the breakfast and lunch sponsored by the federal government are less heavy than children who don't participate in either, and than children who eat only the lunch, says economist Daniel L. Millimet at Southern Methodist University in Dallas.
Millimet authored the study with economists Rusty Tchernis, Georgia State University, and Muna S. Hussain, Kuwait University.
"The fact that federally funded school lunches contribute to the childhood obesity epidemic is disconcerting, although not altogether surprising," said Millimet, whose research expertise is the economics of children, specifically topics related to schooling and health.
The new study was published in the Summer issue of The Journal of Human Resources.
The U.S. Department of Agriculture oversees the federal lunch and breakfast programs. Through USDA the federal government reimburses schools for a portion of school lunch costs and also donates surplus agricultural food items. While USDA does require that the meals meet certain nutritional standards, schools choose the specific foods.
A la carte items outside the guidelines
Schools also can serve individual food items a la carte, which fall outside the scope of the federal guidelines and allow students to choose additional foods.
For their study, the researchers analyzed data on more than 13,500 elementary school students. Students were interviewed in kindergarten, first and third grades, and then again in later grades. "First, it is very difficult to plan healthy but inviting school lunches at a low price," Millimet said. "Second, given the tight budgets faced by many school districts, funding from the sales of a la carte lunch items receives high priority. That said, it's comforting to know that the U.S. Department of Agriculture, which oversees the federal school nutrition programs, takes the issue very seriously. The USDA sponsors not only my research, but that of others as well, to investigate the issues and possible solutions."
The USDA is partnering with First Lady Michelle Obama to fight what experts say is a childhood obesity epidemic among America's school children. The First Lady on May 18 released the results and recommendations of The White House Task Force on Childhood Obesity report, which said that more than 30 percent of American children ages 2 to 19 are overweight or obese. The report recommends serving healthier foods in schools.
Lunches may not be in compliance
Judging from the results of the study, Millimet said, the food being served in school lunches may not maintain a healthy weight in children. The food in school breakfasts appears to be healthier, however.
"Technically what is going on is that the federal government establishes nutrition guidelines for lunches and breakfasts if schools wish to receive federal funding," Millimet said. "But there's evidence that school lunches are less in compliance with these guidelines than breakfasts. The other possible issue is that these days schools try to make money from a la carte items at lunch. And it's possible that even if the school lunch is healthy, kids buying lunch are more likely to tack on extra items that are not healthy."
Nutritionists strongly advocate eating breakfast for a healthy lifestyle, Millimet said, noting that -- up to a point -- any breakfast is better than no breakfast.
The National Student Lunch Program supplies meals to about 30 million children in 100,000 public and nonprofit private schools, according to the USDA.
The School Breakfast Program gives cash assistance to more than 80,000 schools for about 10 million children.
Obesity among students takes jump
The study cites data from the National Health and Nutrition Examination Survey taken between 1971 and 1974 and again from 2003 to 2004 that found the prevalence of overweight preschool children ages 2-5 jumped from 5 percent to 13.9 percent. Among school-aged children, it jumped from 4 percent to 18.8 percent for children 6-11; and 6.1 percent to 17.4 percent for those 12-19.
Millimet is a professor and director of undergraduate studies in the SMU Department of Economics. Tchernis is an associate professor in Georgia State University's Andrew Young School of Policy Studies, and Hussain is an assistant professor in Kuwait University's Department of Economics.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Southern Methodist University. The original article was written by Margaret Allen.




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Daniel L. Millimet, Rusty Tchernis and Muna Husain. School Nutrition Programs and the Incidence of Childhood Obesity. The Journal of Human Resources., 45(3):640-654 (2010) [link]





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A moment on the lips, a year on the hips

A Moment on the Lips, a Year on the Hips


ScienceDaily (Aug. 26, 2010) — A short period of excess food consumption can have long term effects on your body weight and fat storage even after the initial weight is lost. A study published in BioMed Central's open access journal Nutrition & Metabolism has found that a four-week episode of increased energy intake and decreased exercise can cause increased weight and fat mass more than two years later when compared to control individuals.



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Åsa Ernersson worked with a team of researchers from Linköping University Sweden to investigate the long term effects of a sedentary and gluttonous lifestyle. They capped the physical activity of 18 individuals and used excessive food consumption to increase their energy intake by an average of 70% for four weeks. A separate control group ate and exercised as normal.
The intervention group gained an average of 6.4 kg in body weight, which was mostly lost 6 months later. However, one year later the intervention group showed an increased fat mass compared to baseline; the differences were even greater after two and a half years. Ernersson said "The long term difference in body weight in the intervention and control groups suggests that there is an extended effect on fat mass after a short period of large food consumption and minimal exercise."
The study provides interesting new evidence to suggest that even a short period of excessive eating and a lack of exercise can potentially change an individual's physiology, causing it to be harder to lose and keep off weight. Ernersson summarised, "The change of fat mass was larger than expected when compared to the controls, it suggests that even short-term behavioural changes may have prolonged effects on health."


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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by BioMed Central Limited, via AlphaGalileo.




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Asa Ernersson, Fredrik H Nystrom and Torbjorn Lindstrom. Long-term increase of fat mass after a four week intervention with fast food based hyper-alimentation and limitation of physical activity. Nutrition & Metabolism, (in press) [link]





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Fat distribution plays a role in weight loss success in patients at risk of diabetes

Fat Distribution Plays a Role in Weight Loss Success in Patients at Risk of Diabetes


ScienceDaily (Aug. 26, 2010) — Why is it that some people lose weight and body fat when they exercise and eat less and others don't? German researchers say MRI and magnetic resonance (MR) spectroscopy can provide the answer -- and help predict who will benefit from lifestyle changes. Results of the study are published online and will appear in the November issue of the journal Radiology.



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"You may have two individuals who weigh the same and have the same body mass index (BMI), but have very different levels of internal fat," said lead researcher and physicist Jürgen Machann, Dipl. Phys., from University Hospital Tübingen in Tübingen, Germany. "Abdominal and liver fat are the two most important factors in predicting whether a lifestyle intervention will be successful."
Machann and researchers performed MRI and MR spectroscopy on 243 individuals prior to and nine months after a lifestyle intervention. The intervention called for a weight loss of 5 percent, reducing fat intake to a maximum of 30 percent of total calories (including less than 10 percent in the form of saturated fat) and engaging in moderate physical activity such as walking at least three hours a week.
Each of the participants, which included 144 females (mean age 44.5 years) and 99 males (mean age 47.3), was considered at risk of developing type 2 diabetes as a result of obesity, measured by a body mass index (BMI) of 27 or greater or having an impaired glucose tolerance or a first-degree relative with the disease.
"Common methods, such as body impedance analysis, may determine that a body consists of 25 percent fat, but that does not tell you how the fat is distributed," Machann said. "BMI is a good measure for obesity but not necessarily a predictor for health risk, because not only the amount of fat, but also its distribution are essential. Only by looking inside the body can you establish the amount of visceral (abdominal) and liver fat."
MRI allowed researchers to differentiate fatty tissue from lean tissue throughout the body. MR spectroscopy generated additional data on the fat content of individual organs, such as the liver.
Researchers used improved insulin sensitivity to measure the success of the lifestyle intervention. Individuals with type 2 diabetes do not respond correctly to insulin, a hormone secreted by the pancreas that aids in metabolism. In pre-diabetes, cells become resistant to the action of insulin.
After nine months of participating in the lifestyle intervention, insulin sensitivity improved in 71 percent of the men and 58 percent of the women. Individuals with improved insulin sensitivity lost significant amounts of visceral fat (a mean reduction of 19 percent for women and 20 percent for men) and liver fat (a mean reduction of 35 percent for women and 44 percent for men) while reducing 3 to 5 percent of body weight.
"The participants who improved their health status as a result of diet and exercise started out with lower baseline levels of abdominal and liver fat," Machann said. "In our study, these two factors predetermined whether or not a lifestyle intervention would be successful for a particular individual."
Individuals who did not improve insulin sensitivity as a result of lifestyle changes lost much smaller amounts of visceral fat (a mean reduction of 4 percent for women and 6 percent for men). The men also lost less liver fat (a mean of 15 percent), and women gained a mean of 22 percent in liver fat.
"Our results demonstrate that with MRI and MR spectroscopy, we can determine who will benefit from dietary changes and exercise and who will need other interventions," Machann said.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Radiological Society of North America, via EurekAlert!, a service of AAAS.




Journal Reference:

Machann et al. Follow-up Whole-Body Assessment of Adipose Tissue Compartments during a Lifestyle Intervention in a Large Cohort at Increased Risk for Type 2 Diabetes. Radiology, 2010; DOI: 10.1148/radiol.10092284





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Wednesday, August 25, 2010

Exercising restores sensitivity of neurons that make one feel full

Exercising Restores Sensitivity of Neurons That Make One Feel Full


ScienceDaily (Aug. 24, 2010) — There is now another good reason to exercise. Besides burning calories, exercise restores the sensitivity of neurons involved in the control of satiety (feeling full), which in turn contributes to reduced food intake and consequently weight loss. This is the conclusion of a study led by Brazilian researchers at the University of Campinas, and the findings will be published next week in the online, open access journal PLoS Biology. This disclosure may bring hope to over 40% of the population that suffers from weight problems and obesity around the world.



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The increase in obesity has become one of the most important clinical-epidemiological phenomena. Factors such as changing eating habits and a sedentary lifestyle both have a role in the pathogenesis of this disease. It is postulated that excessive consumption of fat creates failures in the signal transmitted by neurons controlling satiety in a region of the brain called the hypothalamus. These failures can lead to uncontrollable food intake and, consequently, obesity.
The group led by José Barreto C. Carvalheira demonstrated that exercising obese rodents showed signals of restored satiety in hypothalamic neurons and decreased food intake. "In obese animals, exercise increased IL-6 and IL-10 protein levels in the hypothalamus, and these molecules were crucial for increasing the sensitivity of the most important hormones, insulin and leptin, which control appetite," Carvalheira explained. Physical activity contributes to the prevention and treatment of obesity, not only by increasing energy expenditure but also by modulating the signals of satiety and reducing food intake.
Physical activity has always been considered a cornerstone in the treatment of obesity, however, only now have the effects of exercise on the control of body weight been understood. Thus, these findings, besides reinforcing the necessity for regular exercise also change the current paradigm established between physical activity and weight loss.
Funding: This study was supported by grants from Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) and Conselho Nacional de desenvolvimento científico e tecnológico (CNPq).

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Public Library of Science, via EurekAlert!, a service of AAAS.




Journal Reference:

Ropelle ER, Flores MB, Cintra DE, Rocha GZ, Pauli JR, et al. IL-6 and IL-10 Anti-Inflammatory Activity Links Exercise to Hypothalamic Insulin and Leptin Sensitivity through IKKb and ER Stress Inhibition. PLoS Biol, 8(8): e1000465 DOI: 10.1371/journal.pbio.1000465





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Tuesday, August 24, 2010

Cinnamon extracts may reduce risk of diabetes and heart disease, study suggests

Cinnamon Extracts May Reduce Risk of Diabetes and Heart Disease, Study Suggests


ScienceDaily (Aug. 24, 2010) — A study led by U.S. Department of Agriculture (USDA) chemist Richard Anderson suggests that a water soluble extract of cinnamon, which contains antioxidative compounds, could help reduce risk factors associated with diabetes and heart disease.



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The work is part of cooperative agreements between the Beltsville Human Nutrition Research Center (BHNRC) operated by USDA's Agricultural Research Service (ARS) at Beltsville, Md.; Integrity Nutraceuticals International of Spring Hill, Tenn., and the Joseph Fourier University in Grenoble, France. Anderson works in the Diet, Genomics and Immunology Laboratory of BHNRC. ARS is USDA's principal intramural scientific research agency.
For the study, conducted in Ohio, coauthor Tim N. Ziegenfuss, now with the Center for Applied Health Sciences based in Fairlawn, Ohio, enrolled volunteers and collected samples.
Twenty-two obese participants with impaired blood glucose values--a condition classified as "prediabetes"--volunteered for the 12-week experimental research study. Prediabetes occurs when cells are resistant to the higher-than-normal levels of insulin produced by the pancreas (in an attempt to help remove elevated glucose levels from blood).
The volunteers were divided randomly into two groups and given either a placebo or 250 milligrams (mgs) of a dried water-soluble cinnamon extract twice daily along with their usual diets. Blood was collected after an overnight fast at the beginning of the study, after six weeks, and after 12 weeks to measure the changes in blood glucose and antioxidants.
The study demonstrated that the water-soluble cinnamon extract improved a number of antioxidant variables by as much as 13 to 23 percent, and improvement in antioxidant status was correlated with decreases in fasting glucose, according to Anderson.
Only more research will tell whether the investigational study supports the idea that people who are overweight or obese could reduce oxidative stress and blood glucose by consuming cinnamon extracts that have been proven safe and effective. In the meantime, weight loss remains the primary factor in improving these numbers, according to ARS scientists.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by USDA/Agricultural Research Service, via EurekAlert!, a service of AAAS. The original article was written by Rosalie Marion Bliss.




Journal Reference:

Anne-Marie Roussel, Isabelle Hininger, Rachida Benaraba, Tim N. Ziegenfuss, and Richard A. Anderson. Antioxidant Effects of a Cinnamon Extract in People with Impaired Fasting Glucose That Are Overweight or Obese. Journal of the American College of Nutrition, 2009 28: 16-21 [link]





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Decade-long trial confirms benefts of steroid withdrawal for transplant patients

Decade-Long Trial Confirms Benefts of Steroid Withdrawal for Transplant Patients


ScienceDaily (Aug. 24, 2010) — A University of Cincinnati (UC) analysis of 10 years of data from local kidney transplant patients shows that patients removed from a corticosteroid regimen shortly after surgery have better graft survival rates, better survival rates and fewer cardiovascular events than patients kept on the traditional regimen of long-term steroids.



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The analysis shows that, out of 904 patients transplanted at UC Health University Hospital and Christ Hospital, early corticosteroids withdrawal (ECSWD) patients had an 83.8 percent graft survival rate and a 91.7 percent patient survival rate, as compared to 68.6 percent graft survival and 83.6 percent patient survival for chronic corticosteroid (CCS) patients. UC's survival rates were numerically higher than national rates from the United Network for Organ Sharing (UNOS) registry.
Corticosteroids, in combination with other immunosuppressive drugs, have historically been prescribed to transplant patients to help suppress the body's immune response and allow the transplanted organ to function after surgery. But they also come with an increased risk of high blood pressure, high cholesterol, weight gain, diabetes and cardiovascular disease and events.
With development of better immunosuppressive drugs, that cardiovascular risk has come to be the chief concern for transplant patients' survival, not the loss of their new organ, explains Adele Rike Shields, PharmD, UC research assistant professor of surgery and clinical transplant pharmacist at Christ Hospital.
Four years ago, Shields says, UC researchers showed ECSWD patients had a significant reduction in cardiovascular events as opposed to CCS patients. But researchers still weren't certain whether ECSWD patients have worse long-term graft functioning due to a risk of acute rejection of the organ.
With 10 years of data, Shields says they can now answer that question definitively.
"This is the first study with enough long-term follow-up to show that we're not causing an increase in graft loss with early corticosteroid withdrawal," says Shields. "We have just as good, if not better graft results and the patients' survival is better because of their reduced cardiovascular risk."
She presented the work last week at the International Congress of The Transplantation Society in Vancouver.
Not only does the analysis show that ECSWD patients have decreased cardiovascular events, Shields says they also have a reduced risk of malignancies not associated with immunosuppressive drugs. ECSWD patients showed a 2.2 percent rate of non-PTLD cancer, one-third the rate of malignancies in CCS patients. PTLD, or post-transplant lymphoproliferative disorder, is the name given to a group of lymphomas occurring in immunosuppressed patients.
UC transplant researchers have focused on steroid withdrawal under E. Steve Woodle, MD, chief of the division of transplant surgery. Woodle calls the data from the 10-year analysis "highly statistically significant."
"To my knowledge, we are the first of any transplant program to demonstrate this magnitude of an effect," he says. "We now know without a doubt that our original hypothesis generated more than 15 years ago does indeed benefit our patients. This is the final nail in the coffin for steroid based immunosuppression for our program."

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Stress of freshman year can trigger eating disorders for some young people

Stress of Freshman Year Can Trigger Eating Disorders for Some Young People


ScienceDaily (Aug. 23, 2010) — While the start of college is a positive, momentous event for many young people, it also can be an episode that pushes some into a dangerous battle with eating disorders, says University of Alabama at Birmingham Associate Professor of Psychology Mary Boggiano, Ph.D., who fought her own battle against bulimia as a college student. Hear her story.



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Stress can trigger an eating disorder, and for the college student who is away from home for the first time, the stress of moving into a totally different environment and meeting new people can make them more susceptible to developing an eating disorder, says Boggiano. Even new positive events are processed by the brain as stressful, she says.
"A lot of students have heard about the 'freshman 15,'" says Boggiano. "To keep from gaining weight, some students engage in risky behaviors such as excessive dieting or purging food. In many cases, people learn about the risky behaviors from others students in their dorm or over the Internet, so that obsession about weight can become infectious."
Boggiano says the common signs of an eating disorder include:

A preoccupation with calculating calories, fat grams and carbohydrate grams
A need to weigh oneself more than once a day
Allowing the numbers on the scale to determine mood
Exercising, skipping meals or purging after overeating
Exercising to burn calories rather than for health or for fun
An inability to stop eating once eating begins
Eating in secret
Feeling guilty, ashamed or disgusted after overeating
Basing self-worth on looks or weight
Worrying continuously about weight and body shape
Abusing diet pills or laxatives

Eating disorders can lead to long-term health problems, and even death.
For any young people who suspect they might be developing an eating disorder, Boggiano encourages them to seek help at free campus counseling centers, through a pastor or family doctor or through programs like Overeaters Anonymous.
"Whatever you do, don't try to take care of it by yourself," says Boggiano. "It will only get worse."
Boggiano, who studies the psychobiology of eating disorders and obesity, knows this from personal experience as a young adult.
"My problems with bulimia nervosa actually began during my senior year in high school," she says. "I was a top student, salutatorian of my class. But, I became obsessed with my weight and the shape of my body. I started starving myself, but this led to binge eating and eventually vomiting after the binges, several times a day, and eventually I began abusing laxatives. When I started college, the disorder got worse."
The two most common forms of eating disorders are anorexia nervosa, when a person stops eating or eats very little to control their weight, and bulimia nervosa, when a person vomits or uses laxatives to get rid of the food they have eaten to prevent weight gain. Both types of eating disorders can eventually lead to serious health problems and even death.
Another form of eating disorder, binge eating disorders (or BED), is when an individual eats unusually large amounts of food, uncontrollably, in a short period of time until they are uncomfortable but do not purge or compensate afterward.
"This often leads to weight gain, which is upsetting to them," says Boggiano, "yet to overcome the distress, they turn to food. It's a vicious cycle." She is currently exploring brain markers of stress-induced binge-eating and the chemistry behind the action of high-fat and sugar foods to trigger relapses back to binge eating and obesity.

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Saturday, August 21, 2010

With muscle-building treatment, mice live longer even as tumors grow

With Muscle-Building Treatment, Mice Live Longer Even as Tumors Grow


ScienceDaily (Aug. 19, 2010) — In the vast majority of patients with advanced cancer, their muscles will gradually waste away for reasons that have never been well understood. Now, researchers reporting in the August 20 issue of Cell, have found some new clues and a way to reverse that process in mice. What's more, animals with cancer that received the experimental treatment lived significantly longer, even as their tumors continued to grow.



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"This is the first demonstration that muscle mass plays a key role in cancer survival," said H.Q. Han of Amgen Research.
While it has long been recognized that this muscle wasting condition, known as cachexia, affects advanced cancer patients' quality of life, Han explained, its importance for survival had primarily been a matter of speculation. Nearly 30 percent of cancer-related deaths have been attributed to cachexia, but that was based on correlative evidence only. That is, there has seemed to be a connection in cancer patients between weight loss and mortality.
Still, cachexia had typically been considered a "multi-factorial" process with many causes. "That would make it hard to target," Han said. Indeed, few therapeutic options are available and efforts to treat this aspect of the disease haven't been top of mind. Given the new results, that could change.
The researchers suspected that a pathway known as ActRIIB might be involved. ActRIIB is what's known as an activin type 2 receptor. There was evidence to suggest that tumors secrete activin, such that circulating levels of the protein rise in those with cancer. Activin is closely related to another protein, called myostatin, which is known to be important in muscle. Animals lacking myostatin or taking treatments that block it grow bigger muscles. There was some evidence to suggest that activin blockers might have a similar effect.
Based on that hunch, the researchers treated mice with cancer and associated cachexia with a recombinant and soluble version of the ActRIIB receptor (sActRIIB), a kind of molecular "decoy" that potently inhibited both activin and myostatin activity. That treatment reversed the animals' muscle loss and prolonged their survival by several weeks on average. That was despite the fact that the tumors appeared to be unaffected. The animals also kept losing fat and still had high levels of inflammatory factors.
"In tumor-bearing mice with profound cachexia, blocking this pathway not only prevents muscle wasting but completely reverses the loss of muscle, strength and anorexia," Han said. (Anorexia is another symptom of cachexia, but appetite stimulants and nutritional supplements don't help much.)
The researchers also found something that had apparently gone unnoticed before. Just as the skeletal muscles of mice with cancer withered away, so too did their heart muscle. The ActRIIB inhibiting treatment completely reversed that too.
Han said that finding may point to an unappreciated role for heart atrophy in muscle wasting conditions more broadly.
Further experimentation showed that the ActRIIB blockade prevented muscle proteins from being marked for degradation and markedly stimulated muscle stem-cell growth. Muscle stem cells were successfully activated even in muscle that had lost 50 percent of its weight prior to treatment, Han said.
"This is the first indication that there may be a major medical benefit in extending life span by combating cachexia," Han said, emphasizing however that there is a long way to go from preclinical studies in mice to clinical trials in human patients.
Still, he added, "as drug discovery scientists, we are very excited by the implications. This suggests a promising strategy for treating cachexia and underscores the need for further investigation and translational research to fully understand this pathway and explore the benefits of its antagonism."
The researchers say it will be important to explore levels of myostatin and other components of the ActRIIB pathway in various patient groups. "The dramatic, reversible changes in body mass shown here emphasize the importance of obtaining such information not only for understanding disease mechanisms but also to provide a fuller rationale for anti-activin therapies," they wrote. "However, since the inhibition of ActRIIB signaling by sActRIIB induces growth of normal muscle, this treatment is likely to be anabolic and help combat muscle loss in many catabolic conditions, even if the wasting is not triggered by excessive signaling by activin or related ligands of the ActRIIB pathway."
Han says he and his colleagues hope the findings will renew interest among cancer researchers and oncologists in cachexia. "Our results argue that blocking the catabolic actions of tumors should be a major therapeutic objective, not only to enhance quality of life but also to prolong survival," he said.
The researchers include Xiaolan Zhou, Amgen Research, Thousand Oaks, CA; Jin Lin Wang, Amgen Research, Thousand Oaks, CA; John Lu, Amgen Research, Thousand Oaks, CA; Yanping Song, Amgen Research, Thousand Oaks, CA; Keith S. Kwak, Amgen Research, Thousand Oaks, CA; Qingsheng Jiao, Amgen Research, Thousand Oaks, CA; Robert Rosenfeld, Amgen Research, Thousand Oaks, CA; Qing Chen, Amgen Research, Thousand Oaks, CA; Thomas Boone, Amgen Research, Thousand Oaks, CA; W. Scott Simonet, Amgen Research, Thousand Oaks, CA; David L. Lacey, Amgen Research, Thousand Oaks, CA; Alfred L. Goldberg,2 and H.Q. Han, Amgen Research, Thousand Oaks, CA.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Cell Press, via EurekAlert!, a service of AAAS.




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Xiaolan Zhou, Jin Lin Wang, John Lu, Yanping Song, Keith S. Kwak, Qingsheng Jiao, Robert Rosenfeld, Qing Chen, Thomas Boone, W. Scott Simonet, David L. Lacey, Alfred L. Goldberg, H.Q. Han. Reversal of Cancer Cachexia and Muscle Wasting by ActRIIB Antagonism Leads to Prolonged Survival. Cell, Volume 142, Issue 4, 531-543, 20 August 2010 DOI: 10.1016/j.cell.2010.07.011





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Wednesday, August 18, 2010

Moderate drinking, especially wine, associated with better cognitive function

Moderate Drinking, Especially Wine, Associated With Better Cognitive Function


ScienceDaily (Aug. 18, 2010) — A large prospective study of 5033 men and women in the Tromsø Study in northern Norway has reported that moderate wine consumption is independently associated with better performance on cognitive tests. The subjects (average age 58 and free of stroke) were followed over 7 years during which they were tested with a range of cognitive function tests.



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Among women, there was a lower risk of a poor testing score for those who consumed wine at least 4 or more times over two weeks in comparison with those who drink < 1 time during this period. The expected associations between other risk factors for poor cognitive functioning were seen, i.e. lower testing scores among people who were older, less educated, smokers, and those with depression, diabetes, or hypertension.
It has long been known that "moderate people do moderate things." The authors state the same thing: "A positive effect of wine . . . could also be due to confounders such as socio-economic status and more favourable dietary and other lifestyle habits."
The authors also reported that not drinking was associated with significantly lower cognitive performance in women. As noted by the authors, in any observational study there is the possibility of other lifestyle habits affecting cognitive function, and the present study was not able to adjust for certain ones (such as diet, income, or profession) but did adjust for age, education, weight, depression, and cardiovascular disease as its major risk factors.
The results of this study support findings from previous research on the topic: In the last three decades, the association between moderate alcohol intake and cognitive function has been investigated in 68 studies comprising 145,308 men and women from various populations with various drinking patterns. Most studies show an association between light to moderate alcohol consumption and better cognitive function and reduced risk of dementia, including both vascular dementia and Alzheimer's Disease.
Such effects could relate to the presence in wine of a number of polyphenols (antioxidants) and other micro elements that may help reduce the risk of cognitive decline with ageing. Mechanisms that have been suggested for alcohol itself being protective against cognitive decline include effects on atherosclerosis ( hardening of the arteries), coagulation ( thickening of the blood and clotting), and reducing inflammation ( of artery walls, improving blood flow).

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Boston University Medical Center, via EurekAlert!, a service of AAAS.




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Arntzen et al. Moderate wine consumption is associated with better cognitive test results: a 7 year follow up of 5033 subjects in the Tromsø Study : Alcohol consumption and cognitive function. Acta Neurologica Scandinavica, 2010; 12223 DOI: 10.1111/j.1600-0404.2010.01371.x





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Even modest weight gain can harm blood vessels, researchers find

Even Modest Weight Gain Can Harm Blood Vessels, Researchers Find


ScienceDaily (Aug. 18, 2010) — Mayo Clinic researchers found that healthy young people who put on as little as 9 pounds of fat, specifically in the abdomen, are at risk for developing endothelial cell dysfunction. Endothelial cells line the blood vessels and control the ability of the vessels to expand and contract.



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"Endothelial dysfunction has long been associated with an increased risk for coronary artery disease and cardiovascular events," says Virend Somers, M.D., Ph.D., a cardiologist at Mayo Clinic. "Gaining a few pounds in college, on a cruise, or over the holidays is considered harmless, but it can have cardiovascular implications, especially if the weight is gained in the abdomen."
For the study, which was published in this week's Journal of the American College of Cardiology, Dr. Somers and his team recruited 43 healthy Mayo Clinic volunteers with a mean age of 29 years. They were tested for endothelial dysfunction by measuring the blood flow through their arm arteries. The volunteers were assigned to either gain weight or maintain their weight for eight weeks, and their blood flow was tested. The weight-gainers then lost the weight and were tested again.
Among those who gained weight in their abdomens (known as visceral fat), even though their blood pressure remained healthy, researchers found that the regulation of blood flow through their arm arteries was impaired due to endothelial dysfunction. Once the volunteers lost the weight, the blood flow recovered. Blood flow regulation was unchanged in the weight-maintainers and was less affected among those who gained weight evenly throughout their bodies.
Dr. Somers says the study is unable to offer conclusions about whether recovery of blood flow is possible if the weight is kept on for several years. "Patients should know that having a big belly may be more harmful than simply being obese," he says. "Letting weight creep on during college or as the result of aging should not be accepted as normal.
"Physicians should know that the location of fat is important. Greater attention should be given to the circumference of a patient's waistline, not just their body mass index (BMI)." BMI is a formula that uses height and weight to estimate body fat and associated health risks.
The study was funded by the National Institutes of Health. Mayo Clinic co-authors are Diane Davison; Prachi Singh, Ph.D.; Christine Huyber; Francisco Lopez-Jimenez, M.D.; and Michael Jensen, M.D. Co-authors formerly at Mayo Clinic are Abel Romero-Corral, lead author; Fatima Sert-Kuniyoshi, Ph.D.; Justo Sierra-Johnson, M.D., Ph.D.; Marek Orban, M.D.; Apoor Gami, M.D.; Snigdha Pusalavidyasagar, M.B.B.S.; and Susanne Votruba, Ph.D.

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Novel diabetes hope comes from Chinese herbs

Novel Diabetes Hope Comes from Chinese Herbs


ScienceDaily (Aug. 16, 2010) — Emodin, a natural product that can be extracted from various Chinese herbs including Rheum palmatum and Polygonum cuspidatum, shows promise as an agent that could reduce the impact of type 2 diabetes. Findings published in this month's edition of the British Journal of Pharmacology show that giving emodin to mice with diet-induced obesity lowered blood glucose and serum insulin, improved insulin resistance and lead to more healthy levels of lipid in the blood. It also decreased body weight and reduced central fat mass.



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"If repeated in humans, all of these changes would be beneficial for people affected by type 2 diabetes or other metabolic diseases associated with insulin resistance," says lead author Dr Ying Leng, who works in the Shanghai Institute of Materia Medica, Chinese Academy of Science, Shanghai, China.
Research is increasingly showing that an enzyme known as 11β-HSD1 plays a role in the body's response to sugar contained in a person's diet. When someone eats sugar-containing food a lot of glucose floods into the blood stream. In response, the body releases insulin and this hormone triggers various actions that help to clear excess glucose from the blood. The body, however, also has another set of hormones known as glucocorticoids, which have the opposite effect to insulin. And this is where 11β-HSD1 fits in, because this enzyme increases glucocorticoids' ability to act.
The research revealed for the first time that emodin is a potent selective inhibitor of 11β-HSD1, and as a result it effectively limits the effect of the glucocorticoids, and ameliorates diabetes and insulin resistance.
"Our work showed that this natural extract from Chinese herbs could point the way to a new way of helping people with type 2 diabetes as well as other metabolic disorders. To develop it further, researchers would need to develop chemicals that have similar effects as emodin, and see which if any of these could be used as a therapeutic drug," says Dr Leng.

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Ying Feng, Su-ling Huang, Wei Dou, Song Zhang, Jun-hua Chen, Yu Shen, Jian-hua Shen, Ying Leng. Emodin, a natural product, selectively inhibits 11β-hydroxysteroid dehydrogenase type 1 and ameliorates metabolic disorder in diet-induced obese mice. British Journal of Pharmacology, 2010; 161: 113-126 DOI: 10.1111/j.1476-5381.2010.00826.x





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Tuesday, August 17, 2010

Patients with diabetes may need fewer medications after bariatric surgery

Patients With Diabetes May Need Fewer Medications After Bariatric Surgery


ScienceDaily (Aug. 16, 2010) — Bariatric surgery appears to be associated with reduced use of medications and lower health care costs among patients with type 2 diabetes, according to a report in the August issue of Archives of Surgery, one of the JAMA/Archives journals.



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"The rapidly growing epidemics of obesity and diabetes threaten to overburden the world's health care systems," the authors write as background information in the article. "From an epidemiological standpoint, once these diseases develop they are rarely reversed. Dietary, pharmaceutical and behavior treatments for obesity are associated with high failure rates, and medical management of diabetes is also often unsuccessful. Despite many efforts to improve the control of glucose levels in diabetes, including clinical guidelines and patient and provider education, less than half of all patients with type 2 diabetes mellitus achieve the American Diabetes Association recommendation of a hemoglobin A1C level of less than 7 percent."
The use of bariatric surgery -- that results in long-term weight loss, improved lifestyle and decreased risk of death -- has tripled in the past five years, the authors note. Martin A. Makary, M.D., M.P.H., and colleagues at the Johns Hopkins Bloomberg School of Public Health and The Johns Hopkins University School of Medicine, Baltimore, studied 2,235 U.S. adults (average age 48.4) with type 2 diabetes who underwent bariatric surgery during a four-year period, from 2002 to 2005. They used claims data to measure the use of diabetes medications before and after surgery, along with health care costs per year.
Of the 2,235 patients, 1,918 (85.8 percent) were taking at least one diabetes medication before surgery, with an average of 4.4 medications per patient. Six months after surgery, 1,669 of 2,235 patients (74.7 percent) had eliminated their diabetes medications. Of the 1,847 patients with available data one year after surgery, 1,489 (80.6 percent) had eliminated medications; after two years, 906 of 1,072 (84.5 percent) had done so. This reduction was observed in all classes of diabetes medications.
"We observed that independence from diabetes medication was almost immediate within the initial months after surgery and did not correlate with the gradual weight loss expected," the authors write. "This supports the theory that the resolution of diabetes is not due to weight loss alone but is also mediated by gastric hormones, with the three most implicated being peptide YY, glucagonlike peptide and pancreatic polypeptide. As a known mediator of insulin regulation, glucagonlike peptide levels have been noted to increase immediately after bariatric surgery and may explain why surgeons have noted complete resolution of diabetes in some cases within days after surgery."
Health care costs averaged $6,376 per year in the two years before surgery, and the median or midpoint cost of the surgery and hospitalization was $29,959. Total annual health care costs increased by 9.7 percent ($616) in the year following the procedure, but decreased by 34.2 percent ($2,179) in year two and by 70.5 percent ($4,498) in year three.
"Based on these data, we have identified several important implications for health care delivery and public policy," the authors conclude. "Foremost, eligible obese patients should be properly informed of the risks and benefits of bariatric surgery compared with non-surgical health management. Health care providers should consider discussing bariatric surgery in the treatment of obese patients with type 2 diabetes. Health insurers, private and public, should pay for bariatric surgery for appropriate candidates, recognizing a potential annualized cost savings in addition to the benefit to health."

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Martin A. Makary; Jeanne M. Clarke; Andrew D. Shore; Thomas H. Magnuson; Thomas Richards; Eric B. Bass; Francesca Dominici; Jonathan P. Weiner; Albert W. Wu; Jodi B. Segal. Medication Utilization and Annual Health Care Costs in Patients With Type 2 Diabetes Mellitus Before and After Bariatric Surgery. Arch Surg, 2010; 145 (8): 726-731 [link]





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Birth control pill equally effective for women regardless of their weight

Birth Control Pill Equally Effective for Women Regardless of Their Weight


ScienceDaily (Aug. 16, 2010) — The first study to compare the effectiveness of the birth control pill in women with marked weight differences has found that the pill works equally well in women with obesity and thinner women. This new finding by physician-scientists at NewYork-Presbyterian Hospital/Columbia University Medical Center refutes a long-held conviction among many doctors that the pill may not reliably prevent pregnancy in women who are overweight or obese.



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With obesity a significant health issue in the United States -- the U.S. government estimates that nearly 65 percent of adult women ages 20 and older are overweight or obese -- the reliability of the birth control pill in this population is critical, especially since pregnancy itself is riskier among women with obesity.
"As a physician, I am relieved by the results of this study. When I prescribe oral contraceptives to my patients with obesity, I can feel confident that I am giving them something that will work," says principal investigator Dr. Carolyn Westhoff, professor of obstetrics and gynecology and director of the Division of Family Planning at Columbia University College of Physicians and Surgeons, and an obstetrician/gynecologist at NewYork-Presbyterian Hospital/Columbia University Medical Center.
In the study, published in the August issue of the journal Obstetrics & Gynecology, Dr. Westhoff and her colleagues did not rely, as previous studies had, on women's recollections of how much they may have weighed at a time when the pill had failed and they became pregnant.
"We wanted to study what was actually happening in the ovaries of women and not depend on memory, which is notoriously faulty," Dr. Westhoff says.
Dr. Westhoff and her colleagues designed a prospective study where 226 women of normal weight or who were overweight, and between the ages of 18 and 35, were randomly assigned to take either a lower- or higher-dose version of the pill. The researchers purposely used the different dose levels to assess whether heavier women required higher dosing, as has been previously believed.
After three or four months of using the oral contraceptives -- the time it usually takes for a woman's body to acclimate to the pill -- the women had multiple ultrasounds and blood tests to determine if ovulation was being suppressed. The goal of oral contraception is to suppress ovulation.
Of the 150 women who used the pill consistently, three of the 96 women with normal weight ovulated, as did one of the 54 women with obesity. The researchers also found that when women were not taking the pill regularly, they ovulated with greater frequency.
"Our findings strengthen the message to patients that the pill will only work if it is taken every day. Weight does not seem to have an impact on suppression of ovulation, but consistency of pill-taking does," Dr. Westhoff says.
Importantly, the lower-dose pill seemed to be as effective as the higher-dose pill in suppressing ovulation in women with obesity. This is a crucial finding because women with obesity are at greater risk for developing blood clots from taking either type of pill, although the overall risk is small.
"Knowing that the lower dose works as well as the higher dose will allow physicians to not only help women with obesity avoid unwanted pregnancies, but also protect them from the possible health risks associated with higher doses," Dr. Westhoff says.
"For a woman to fear relying on her oral contraceptive to prevent an unwanted pregnancy is a huge burden. This study should put those fears to rest," Dr. Westhoff says.
Study co-authors included Dr. Jodi P. Lerner of NewYork-Presbyterian Hospital/Columbia University Medical Center; Ms. Emma K. T. Benn, Ms. Elizabeth R. Mayeda, Ms. Myunghee Paik and Ms. Anupama H. Torgal of Columbia University Medical Center; and Dr. Frank Z. Stanczyk of the University of Southern California, Los Angeles.
The research was supported by grants from the National Institutes of Health; oral contraceptives were provided by Duramed Pharmaceuticals.

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SPF on your plate: Researcher connects the Mediterranean diet with skin cancer prevention

SPF on Your Plate: Researcher Connects the Mediterranean Diet With Skin Cancer Prevention


ScienceDaily (Aug. 16, 2010) — We all want that summer glow that comes from a day at the beach, but taking in the rays can have long-term implications for our health. Now Dr. Niva Shapira of Tel Aviv University's School of Health Professions suggests a way to make fun in the sun safer -- and it's all in our food.



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In a study recently published in Nutrition Reviews, Dr. Shapira has shown that a diet rich in antioxidants and omega-3 fatty acids, like the diet eaten in Mediterranean regions where melanoma rates are extremely low, can help protect us from skin cancer.
The sun's rays damage both the skin and the immune system by penetrating the skin and causing photo-oxidation, she explains, affecting both the cells themselves and the body's ability to repair any damage. Her prescription is to "go Greek" with foods such as olive oil, fish, yogurt and colorful fruits and vegetables to fight the oxidizing effect of the sun, as well as regular applications of sunscreen and appropriate body coverings such as hats, beach coverups, and other sportswear.
Drinking to your health
Previous research demonstrated that the sun's UV rays damage the skin by exciting its molecules and causing them to become oxidized, says Dr. Shapira. "My theory was that if you prepared the body with sufficient and relevant antioxidants, damage could be reduced."
For a study at the Baltic Sea, Dr. Shapira and Prof. Bodo Kuklinski of Rostock University organized two groups. One group was provided a drink high in antioxidants, while the other enjoyed beverages such as sodas. Those who hydrated with the antioxidant-rich drink had fifty percent fewer oxidation products (i.e. MDA) in their blood at the end of the two-week period, which included five to six hours of exposure to the sun daily. Further studies proved that these antioxidants, especially carotenoids -- fruit and vegetable pigments like red from tomatoes and watermelons and orange from carrots and pumpkins that accumulate in the skin where they serve as a first line of protection -- had delayed the phenomenon of skin erythema, which indicates the initiation of tissue and DNA damage that can lead to skin cancer.
This information is invaluable, especially in light of climate change, notes Dr. Shapira. As temperature and humidity get stronger, which aggravates the damaging effect of solar UV rays, it is increasingly difficult for sunscreen alone to protect effectively. So while covering up, slathering on the sunscreen, and avoiding the sun during peak hours are still important to prevent a burn, consider dietary changes too, to promote skin health.
Go fish with a glass of red … and other colors
It might be tempting to load up on dietary supplements instead of changing the diet, but according to Dr. Shapira, supplements are simply not as effective. Foods provide nutrient "synergy," she says. "In foods, many vitamins and various antioxidants and bioactive ingredients work to support one another and the body's natural protective mechanisms. Synergies between the nutrients in your food, which make a significant contribution to health, may contrast with the relative isolation of a vitamin supplement."
The research is getting attention: for the first time, the Israeli Cancer Association has included the nutritional information as part of their "Smart in the Sun" advisories.
It's not necessary to move to Greece, Israel or Turkey to get the benefit of the diet. Most of the appropriate foods are stocked in American grocery stores. Olive oil, fresh fish, fruits and vegetables, red wine in moderation, whole grains, beans and lots of water should be at the top of the shopping list, Dr. Shapira advises.
And there are some foods to avoid, she points out. Go light on red meat, processed foods, and alcohol (red wine is preferable), and be wary of foods that contain the photosensitizing compound psoralen, such as parsley, celery, dill, cilantro and figs.

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Monday, August 16, 2010

Diabetes risk in children increases risk for weak bones

Diabetes Risk in Children Increases Risk for Weak Bones


ScienceDaily (Aug. 16, 2010) — Children at risk for diabetes before they reach puberty also appear to be at risk for weak bones, Medical College of Georgia researchers report.



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A study of 140 overweight children age 7-11 who got little regular exercise found that the 30 percent with signs of poor blood sugar regulation had 4-5 percent less bone mass, a measure of bone strength, said Dr. Norman Pollock, bone biologist at MCG's Georgia Prevention Institute.
The study is the first to suggest the association between weaker bones and type 2 diabetes risk in children. Type 2, which is becoming more common in children, is often associated with obesity and inactivity; type 1 diabetes, believed to result from genes and environmental triggers, is known to be associated with poor bone health.
"This finding provides the first clue linking childhood obesity to skeletal fractures," said Pollock, first author on the study published in the Journal of Bone and Mineral Research. "While overweight children may have more bone mass than normal-weight kids, it may not be big or strong enough to compensate for their larger size."
It's not as simple as saying that everyone who is overweight has weak bones, he notes. It may have more to do with how fat is distributed throughout the body. For instance pre-diabetics tend to have more fat around their abdominal area, specifically visceral fat, a type of fat deep in the belly that is linked to diabetes and cardiovascular disease.
In this study, higher amounts of visceral fat were associated with lower bone mass while more body fat overall was associated with higher bone mass. "Taken together, it seems that excessive abdominal fat may play a key role linking pre-diabetes to lower bone mass," Pollock said.
The findings appear to be another wakeup call for parents about the potential lifelong consequences of an overweight childhood. And increased physical activity might be a relatively simple fix.
"Our greatest window of opportunity to enhance bone strength and ultimately reduce the risk of osteoporosis is during childhood, before the capacity to build bone diminishes," Pollock said. "One of the best things you can do for bone development and general health is exercise."
"Children have a lot of potential and a whole lot of time to make positive changes," echoed Dr. Catherine Davis, clinical health psychologist at the Georgia Prevention Institute and study co-author whose research has shown that regular physical activity reduces children's body fat and diabetes risk and even improves learning. "If you could patent exercise as a drug, somebody would be really, really rich."
Next steps include learning more about how abdominal fat impairs bone mass, including looking at the activity of cells that make and destroy bone -- the bone makers should be more active in children -- as well as vitamin D and vitamin K metabolism.

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Thursday, August 12, 2010

Building muscle doesn't require lifting heavy weights, study shows

Building Muscle Doesn't Require Lifting Heavy Weights, Study Shows


ScienceDaily (Aug. 12, 2010) — Current gym dogma holds that to build muscle size you need to lift heavy weights. However, a new study conducted at McMaster University has shown that a similar degree of muscle building can be achieved by using lighter weights. The secret is to pump iron until you reach muscle fatigue.



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The findings are published in PLoS ONE.
"Rather than grunting and straining to lift heavy weights, you can grab something much lighter but you have to lift it until you can't lift it anymore," says Stuart Phillips, associate professor of kinesiology at McMaster University. "We're convinced that growing muscle means stimulating your muscle to make new muscle proteins, a process in the body that over time accumulates into bigger muscles."
Phillips praised lead author and senior Ph.D. student Nicholas Burd for masterminding the project that showed it's really not the weight that you lift but the fact that you get muscular fatigue that's the critical point in building muscle. The study used light weights that represented a percentage of what the subjects could lift. The heavier weights were set to 90% of a person's best lift and the light weights at a mere 30% of what people could lift. "It's a very light weight," says Phillips noting that the 90-80% range is usually something people can lift from 5-10 times before fatigue sets in. At 30%, Burd reported that subjects could lift that weight at least 24 times before they felt fatigue.
"We're excited to see where this new paradigm will lead," says Phillips, adding that these new data have practical significance for gym enthusiasts but more importantly for people with compromised skeletal muscle mass, such as the elderly, patients with cancer, or those who are recovering from trauma, surgery or even stroke.

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Burd et al. Low-Load High Volume Resistance Exercise Stimulates Muscle Protein Synthesis More Than High-Load Low Volume Resistance Exercise in Young Men. PLoS ONE, 2010; 5 (8): e12033 DOI: 10.1371/journal.pone.0012033





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Free statins with fast food could neutralize heart risk, scientists say

Free Statins With Fast Food Could Neutralize Heart Risk, Scientists Say


ScienceDaily (Aug. 12, 2010) — Fast food outlets could provide statin drugs free of charge so that customers can neutralise the heart disease dangers of fatty food, researchers at Imperial College London suggest in a new study.



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Statins reduce the amount of unhealthy "LDL" cholesterol in the blood. A wealth of trial data has proven them to be highly effective at lowering a person's heart attack risk.
In a paper published in the American Journal of Cardiology, Dr Darrel Francis and colleagues calculate that the reduction in cardiovascular risk offered by a statin is enough to offset the increase in heart attack risk from eating a cheeseburger and a milkshake.
Dr Francis, from the National Heart and Lung Institute at Imperial College London, who is the senior author of the study, said: "Statins don't cut out all of the unhealthy effects of burgers and fries. It's better to avoid fatty food altogether. But we've worked out that in terms of your likelihood of having a heart attack, taking a statin can reduce your risk to more or less the same degree as a fast food meal increases it."
One statin, simvastatin, is already available in low doses (10mg) over the counter at pharmacies without a prescription. Other statins are so far only prescribed by doctors, and limited by cost to patients at particular risk of heart attack or stroke. However, the cost of the tablets has fallen sharply in recent years (from ~£40/month to ~£1.50/month), such that the cost to the NHS of seeing a doctor is much greater than the cost of the tablet.
"It's ironic that people are free to take as many unhealthy condiments in fast food outlets as they like, but statins, which are beneficial to heart health, have to be prescribed," Dr Francis said.
Statins have among the best safety profiles of any medication. A very small proportion of regular statin users experience significant side effects, with problems in the liver and kidneys reported in between 1 in 1,000 and 1 in 10,000 people.
"Everybody knows that fast food is bad for you, but people continue to eat it because it tastes good. We're genetically programmed to prefer high-calorie foods, and sadly fast food chains will continue to sell unhealthy foods because it earns them a living.
"It makes sense to make risk-reducing supplements available just as easily as the unhealthy condiments that are provided free of charge. It would cost less than 5p per customer -- not much different to a sachet of ketchup.
"When people engage in risky behaviours like driving or smoking, they're encouraged to take measures that minimise their risk, like wearing a seatbelt or choosing cigarettes with filters. Taking a statin is a rational way of lowering some of the risks of eating a fatty meal."
Studies have shown a clear link between total fat intake and blood cholesterol, which is strongly linked to heart disease. Recent evidence suggests that trans fats, which are found in high levels in fast food, are the component of the Western diet that is most dangerous in terms of heart disease risk.
Dr Francis and his colleagues used data from a previous large cohort study to quantify how a person's heart attack risk increases with their daily intake of total fat and trans fat. He compared this with the decrease in risk from various statins, based on a meta-analysis of seven randomised controlled trials.
The results showed that most statin regimes are able to compensate for the relative risk increase from eating a cheeseburger and a small milkshake.
The researchers note that studies should be conducted to assess the potential risks of allowing people to take statins freely, without medical supervision. They suggest that a warning on the packet should emphasise that no tablet can substitute for a healthy diet, and advise people to consult their doctor for more advice.

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Emily A. Ferenczi, Perviz Asaria, Alun D. Hughes, Nishi Chaturvedi, Darrel P. Francis. Can a Statin Neutralize the Cardiovascular Risk of Unhealthy Dietary Choices? The American Journal of Cardiology, 2010; 106 (4): 587 DOI: 10.1016/j.amjcard.2010.03.077





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Wednesday, August 11, 2010

Focusing on immediate health effects may improve weight loss success

Focusing on Immediate Health Effects May Improve Weight Loss Success


ScienceDaily (Aug. 11, 2010) — Most weight loss programs try to motivate individuals with warnings of the long-term health consequences of obesity: increased risk for cancer, diabetes, hypertension, heart disease and asthma. New research suggests the immediate health benefits -- such as reduced pain -- may be the most effective motivator for helping obese individuals shed extra weight and commit to keeping it off.



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In a pilot research study, University of Cincinnati (UC) researchers found that 21 percent of participants in a local dietary weight loss program reported significantly less pain in the lower extremities and back after losing an average of 10 pounds. Additionally, study participants reported a 20 to 30 percent reduction in overall bodily pain after weight loss.
Researchers say their results indicate that even small weight loss can relieve pain and reduce the burden excessive weight puts on the musculoskeletal system.
"By focusing on an immediate benefit that can be felt -- like pain reduction -- instead of the future health impact of obesity, weight loss programs may be able to inspire overweight individuals to lose weight," says Susan Kotowski, PhD, study collaborator and director of the Gait and Movement Analysis Laboratory in the UC College of Allied Health Sciences.
Kotowski and colleague Kermit Davis, PhD, report their findings in the August 2010 issue of the journal Work.
According to the Centers for Disease Control and Prevention (CDC), 44 million Americans are considered clinically obese. Since 1975, the number of obese Americans has risen from 47 percent to 66.3 percent. Previous studies have estimated obesity-attributable medical expenditures in the United States at $75 billion, with half of these costs financed by Medicare or Medicaid.
"Obesity has become a national health crisis, but compliance for weight loss programs is notoriously poor. One potential reason for this is that current programs target long-term diseases, with little direct relevance to the person's current health status," adds Davis, senior author of the study and director of the Low Back Biomechanics and Workplace Stress Laboratory at the UC College of Medicine's environmental health department. "Our study results challenge people to rethink the way they structure weight loss programs."
For this pilot study, UC researchers partnered with a Cincinnati-based weight loss clinic to recruit study volunteers. Thirty two women between the ages of 22 and 76 participated in the study and data was collected over the course of a 12-week dietary weight loss regimen.
Researchers collected baseline individual weight and musculoskeletal pain data related to nine body regions: neck, shoulders, elbows, hands and wrists, upper back, lower back, hips, knees and lower legs and feet. Participants were then tracked each week to record any weight loss and asked to rate their pain on a scale of zero to 10 every other week.
Significant associations were found between weight loss and overall pain reduction, as well as pain reduction in the elbow, hip region and upper and lower back.
Researchers say these preliminary results could have ramifications for companies with a high prevalence of overweight workers with musculoskeletal problems -- particularly in industries that require manual or repetitive weight-bearing labor.
"From an ergonomics perspective, we can only do so much to alter the work environment to remove body stressors," explains Kotowski. "Excess weight adds additional stress to the musculoskeletal system and that can only be relieved through weight loss."

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Tuesday, August 10, 2010

Bariatric surgery in diabetic adults improves insulin sensitivity better than diet, study finds

Bariatric Surgery in Diabetic Adults Improves Insulin Sensitivity Better Than Diet, Study Finds


ScienceDaily (Aug. 9, 2010) — Gastric bypass surgery improves Type 2 diabetes by other mechanisms in addition to weight loss and does so better than a low-calorie diet despite achieving equal weight loss, a new study finds.



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The results are being presented at The Endocrine Society's 92nd Annual Meeting in San Diego.
"Our study shows that in the short term, weight loss by diet alone does not achieve the same improvements in diabetes as gastric bypass surgery," said the presenting author, Judith Korner, MD, PhD, assistant professor of medicine at Columbia University College of Physicians and Surgeons, New York.
Korner and her colleagues found that gastric bypass surgery better improved insulin sensitivity, the body's ability to successfully clear glucose sugar from the bloodstream into the cells. Insulin sensitivity is impaired in people with Type 2 diabetes, and obesity adds to this problem. The result is a buildup of sugar in the blood.
The study compared the effects on diabetic adults of a low-calorie diet versus Roux-en-Y gastric bypass, the most common gastric bypass procedure. Roux-en-Y gastric bypass decreases the size of the stomach and reroutes the digestive tract to bypass most of the stomach and part of the small intestine. After gastric bypass, many diabetic patients achieve normal blood glucose control or vastly improved control, and some may no longer require diabetes medications.
In the study, seven obese patients with Type 2 diabetes received a daily 800-calorie liquid diet and no surgery, while seven other obese diabetic adults underwent gastric bypass surgery. The study ended when both groups lost the same amount of weight: an average of 8 percent of body weight. However, the surgery-treated patients lost the weight faster: in about 3.5 weeks compared with 8 weeks for the dieters.
Surgical patients were able to discontinue all of their diabetes medications by the study's end, but the dieters reduced their medication use by 55 percent, Korner reported.
The researchers found significant improvements in the surgery group in measures of insulin sensitivity and function of beta cells, the insulin-producing cells in the pancreas. Improvements in insulin sensitivity in the low-calorie diet group was not statistically significant and beta cell function improved to a lesser extent.
Korner speculated that hormonal changes may be responsible for the improvements resulting from Roux-en-Y surgery in individuals with Type 2 diabetes.
"It will be important to understand how surgery works to produce these results so that we can develop medical therapies of equivalent efficacy," she said.
The National Institute of Diabetes and Digestive and Kidney Diseases funded this study.

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Larger waist associated with greater risk of death

Larger Waist Associated With Greater Risk of Death


ScienceDaily (Aug. 9, 2010) — Individuals with a large waist circumference appear to have a greater risk of dying from any cause over a nine-year period, according to a report in the August 9/23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.



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Having a large waist circumference has previously been associated with inflammation, insulin resistance, type 2 diabetes, abnormal cholesterol levels and heart disease, according to background information in the article. This may be because waist circumference is strongly correlated with fat tissue in the viscera -- surrounding the organs in the abdomen -- which is thought to be more dangerous than fat tissue under the skin.
Eric J. Jacobs, Ph.D., and colleagues at the American Cancer Society, Atlanta, examined the association between waist circumference and risk of death among 48,500 men and 56,343 women age 50 and older (median or midpoint age, 69 years in men and 67 years in women). All had participated in the Cancer Prevention Study II Nutrition Cohort, for which they completed a mailed questionnaire about demographic, medical and behavioral factors in 1992 or 1993 and provided information about weight and waist circumference in 1997. Deaths and their causes were tracked through the National Death Index until Dec. 31, 2006; a total of 9,315 men and 5,332 women died during this timeframe.
After adjusting for body mass index (BMI) and other risk factors, very large waists (120 centimeters or 47 inches or larger in men, and 110 centimeters or 42 inches or larger in women) were associated with approximately twice the risk of death during the study period. A larger waist was associated with higher risk of death across all categories of BMI, including normal weight, overweight and obese; however, among women, the association was strongest for those at a normal weight.
"The reason for the stronger association between waist circumference and mortality among women with low BMI in our study is unclear," the authors write. "Future detailed analyses of the relationship between waist circumference and visceral adipose tissue or measures of insulin resistance within categories of BMI could identify biological reasons for potential differences in the strength of the association between waist circumference and mortality."
The results may affect the development of future guidelines for obesity, the authors suggest. "Currently available clinical guidelines from the National Institutes of Health are based on evidence from the 1990s," they write. "These guidelines recommend that waist circumference be used to identify increased disease risk only among individuals in the overweight and obese categories of BMI. In addition, the NIH guidelines recommend weight loss goals for all patients in the obese category of BMI (30 or greater), but they do not specifically recommend weight loss goals for abdominally obese patients (waist circumference of 88 centimeters or larger in women or 102 centimeters or larger in men) who are in the normal or overweight BMI category unless they also have two or more cardiovascular risk factors or a desire to lose weight."

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Journal Reference:

Jacobs et al. Waist Circumference and All-Cause Mortality in a Large US Cohort. Archives of Internal Medicine, 2010; 170 (15): 1293 DOI: 10.1001/archinternmed.2010.201





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'Lap-band' weight loss surgery in very obese adults improves mental health, study finds

'Lap-Band' Weight Loss Surgery in Very Obese Adults Improves Mental Health, Study Finds


ScienceDaily (Aug. 10, 2010) — One year after weight loss surgery with laparoscopic gastric banding, extremely obese adults demonstrate not only better physical health but also improved psychological health, a new study shows.



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The results are being presented at The Endocrine Society's 92nd Annual Meeting in San Diego.
"Surgical treatment, such as laparoscopic gastric banding, is increasingly recognized as the most effective means of achieving weight loss and improving blood sugar control in morbidly obese patients with Type 2 diabetes," said study co-author Andrew Johnson, MD, of Southmead Hospital in Bristol, U.K.
"However, until now, the long-term psychological status of morbidly obese individuals undergoing gastric banding has been unclear despite its increasing use," said Johnson, a consultant physician specializing in diabetes and endocrinology.
Laparoscopic gastric banding, also called the "Lap-Band" procedure, is a minimally invasive weight loss surgery. It involves repeated adjustment of a band to gradually make the stomach smaller and limit food consumption.
Four men and 21 women (ranging in age from 30 to 58 years) participated in the study and had the weight loss surgery. Of these 25 patients, 16 had Type 2 diabetes and nine did not. All had a body mass index (BMI, a measure of body fat) that classified them as morbidly obese.
Participants completed psychological testing before surgery and six and 12 months after surgery. These tests measured general anxiety and depression, quality of life, and social anxiety, that is, anxiety related to what others might think of one's appearance.
Compared with before surgery, patients' psychological test scores improved significantly at both six and 12 months after surgery. They had better psychological and physical quality of life, reductions in levels of general anxiety and depression, and reductions in their levels of social anxiety.
As shown in other studies, gastric banding significantly reduced BMI and hemoglobin A1c, a measure of blood sugar control over time.
"These results provide evidence one year after gastric banding that psychological health improves in parallel with physiological health," Johnson said.
Researchers at the University of the West of England in Bristol also contributed to this study.

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Sunday, August 8, 2010

Light shed on triglyceride metabolism

Light Shed on Triglyceride Metabolism


ScienceDaily (Aug. 8, 2010) — New findings reported in the July issue of Cell Metabolism, are offering new leads as to why some people might suffer from high levels of triglycerides. High triglycerides are a risk factor for atherosclerosis and cardiovascular disease. They can also lead to inflammation of the pancreas, the researchers said.



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The team led by Loren Fong and Stephen Young of the University of California, Los Angeles, has identified the component responsible for bringing a key triglyceride-processing enzyme (called lipoprotein lipase or LPL for short) into the capillaries, where it does its work.
"LPL is required for normal metabolism of triglycerides in blood," Fong said. "If there is no LPL, triglycerides accumulate."
Scientists have known for decades that the LPL enzyme is produced in fat and muscle before it makes its way into blood vessels. What they didn't know until now was how it got there.
It seems that a protein known as GPIHBP1 is the key. Mice lacking that protein end up with LPL built up outside of their muscle and fat tissue instead of where it belongs in capillaries. They show that GPIHBP1 normally sits on the surface of capillary cells, where it actively transports LPL.
The new findings offer an explanation for what had been a surprising finding; Gpihbp1-deficient mice develop severe hypertriglyceridemia, even when they eat a normal diet of mouse chow. Very recently, other researchers have also shown that some people with elevated triglyceride levels carry mutations in their GPIHBP1 gene.
Fong and Young say they don't yet know exactly how GPIHBP1 does its job of transporting LPL into capillaries. It's likely that other as-yet unknown players are involved. Their team also suspects that GPIHBP1 may influence triglyceride metabolism in other ways, aside from its transport function.
There is also much left to learn about how the process is regulated in response to diet or other factors. For instance, "if you eat a fatty meal with more lipids, does this transport go faster?" Fong asked.
The findings may help sort out the causes of hypertriglyceridemia, which in many instances remain unclear.
"In humans, mechanisms for severe cases of hypercholesterolemia have come into focus, but the same cannot be said for many cases of severe hypertriglyceridemia," the researchers wrote. Many patients with very high triglyceride levels don't have mutations in any of the genes with known links to the condition and some have no obvious abnormalities in LPL levels either.
"It seems possible that defective transport of LPL into the capillaries could underlie at least some cases of hypertriglyceridemia in humans," they said.
The researchers include Brandon S.J. Davies, University of California, Los Angeles, Los Angeles, CA; Anne P. Beigneux, University of California, Los Angeles, Los Angeles, CA; Richard H. Barnes II, University of California, Los Angeles, Los Angeles, CA; Yiping Tu, University of California, Los Angeles, Los Angeles, CA; Peter Gin, University of California, Los Angeles, Los Angeles, CA; Michael M. Weinstein, University of California, Los Angeles, Los Angeles, CA; Chika Nobumori, University of California, Los Angeles, Los Angeles, CA; Rakel Nyren, Umea University, Umea, Sweden; Ira Goldberg, Columbia University College of Physicians and Surgeons, New York, NY; Gunilla Olivecrona, Umea University, Umea, Sweden; Andre´ Bensadoun, Cornell University, Ithaca, NY; Stephen G. Young, University of California, Los Angeles, Los Angeles, CA; and Loren G. Fong, University of California, Los Angeles, Los Angeles, CA.

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Journal Reference:

Brandon S.J. Davies, Anne P. Beigneux, Richard H. Barnes, Yiping Tu, Peter Gin, Michael M. Weinstein, Chika Nobumori, Rakel Nyrén, Ira Goldberg, Gunilla Olivecrona, André Bensadoun, Stephen G. Young, Loren G. Fong. GPIHBP1 Is Responsible for the Entry of Lipoprotein Lipase into Capillaries. Cell Metabolism, July 7, 2010 DOI: 10.1016/j.cmet.2010.04.016





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