More than 13 million Americans have survived a heart attack or have been diagnosed with coronary heart disease (CHD), the number one cause of death in the United States. In addition to medications, lifestyle changes, such as a healthy diet and exercise, are known to reduce the risk for subsequent cardiac events. Despite this evidence, a high proportion of heart attack survivors do not follow their doctor's advice to adhere to a healthy diet, according to researchers at the University of Massachusetts Medical School (UMMS).
Many studies have centered on determining dietary risk factors for developing CHD, but few investigations have studied the diets of CHD patients following diagnosis. In "Dietary Quality 1 Year after Diagnosis of Coronary Heart Disease," published in the February issue of the Journal of the American Dietetic Association, researchers measured the diet quality of 555 CHD patients one year after a diagnostic coronary angiography. Using the Alternative Health Eating Index (AHEI) to assess diet quality, they found that a high proportion of those patients had not made the necessary improvements to their diets to help reduce the risk of a secondary CHD event. Proven to be a strong predictor of CHD, the AHEI is a measure that isolates dietary components that are most strongly linked to CHD risk reduction.
"This study found that CHD patients' diets had not improved in the year after being diagnosed," said Yunsheng Ma, MD, PhD, MPH, assistant professor of medicine and one of the study's lead authors. "We know that a healthy diet is one of the most important components of a healthy lifestyle, especially for patients following a cardiac event, and yet patients are not acting on this knowledge."
To determine the quality of CHD patients' diets, Dr. Ma and colleagues collected data from a 24-hour dietary recall one year after the participants' CHD diagnoses. The dietary recall is an assessment tool administered by a dietitian, who interacts with the patient to examine the patient's entire food intake from a 24-hour period, including complete food descriptions, preparation and amount. Prior to the recall, patients were given food models that identified different foods and serving sizes, to improve recall and estimation. Nutrient scores were computed, and the AHEI was then calculated to determine dietary quality, which included intake of fruits, vegetables, nuts and soy, ratio of white to red meat, cereal fiber, trans-fat, ratio of polyunsaturated fat to saturated fat, and alcohol.
Of a maximum 80 points - which indicates the healthiest diet - the average AHEI score was 30.8, with individual scores ranging between 5.1 and 69.8. The mean AHEI score was poorer than scores reported for samples of healthy individuals from the Health Professional's Follow-up Study and the Nurses' Health Study. In a previous study by Ma and colleagues, the AHEI of several popular weight loss plans was calculated; the highest scoring diet was the Ornish Diet (AHEI = 64.6) and lowest scoring diet was the Atkins diet (AHEI= 42.3). The fact that one year after a coronary event patients with known CHD still have lower AHEI scores than these popular diets may be indicative of the complex issues of effecting and sustaining behavioral change and the confusion patients may face in navigating through dietary recommendations. When examining AHEI components, only 12.4 percent of the participants met the optimal daily consumption of vegetables and 7.8 percent for fruit. Only 8 percent of the patients met the cereal fiber recommendation, and 5.2 percent of the participants limited their trans-fat intake to 0.5 percent of total calories or less. "In addition, nearly 11 percent of calories were from saturated fat (less than 7 percent is recommended), while total fiber was only 16.8 grams per day (25 grams or more per day is recommended).".
The researchers evaluated the association of each patient's diet in relation to his or her sociodemographic and clinical standings and found that low dietary quality was associated with smoking, lower educational levels, obesity, high-fat intake and a lower calorie intake. On average, smokers scored six units lower than non-smokers; participants with education beyond high school scored three units higher than participants with a high school education; and obese participants scored four units lower than normal weight or overweight participants.
"An overwhelming number of CHD patients, roughly 80 percent, do not attend cardiac rehabilitation programs, which instruct CHD patients about proper diet and exercise," said Ira Ockene, MD, the David and Barbara Milliken Professor of Preventive Cardiology and professor of medicine at UMMS and cardiologist at UMass Memorial Medical Center. "Changing one's eating habits is a long-term process, and optimal care should include cardiac rehabilitation and appointments with dietitians, which can build upon the patient's initial foundations to improve his or her diet and overall health."
According to study co-author and UMass Memorial Medical Center registered dietitian Barbara Olendzki, RD, MPH, an assistant professor of medicine at UMMS, "Physicians and health care providers should consider placing more of an emphasis on dietary counseling, along with exercise, for CHD patients. Nutrition counseling and patient dietary changes can lead to significant improvements in subsequent CHD risk and better quality of life."
Dr. Ma agreed and suggested that, "It is important for physicians to refer CHD patients to the cardiac rehabilitation programs and encourage attendance. Future studies should be conducted and directed toward integrating nutrition education materials in cardiac rehabilitation programs. Nutrition education can have a significant impact on a patient's overall dietary quality and body-weight control and on subsequent cardiac events and mortality."
Coronary Heart Disease Patients Continue Poor Diets
The Risk Of Alzheimer's Disease May Be Reduced By Fruit Consumption
Apples, bananas, and oranges are the most common fruits in both Western and Asian diets, and are important sources of vitamins, minerals, and fiber. A new study in the Journal of Food Science explores the additional health benefits of these fruits and reveals they also protect against neurodegenerative diseases, including Alzheimer's Disease.
Researchers at Cornell University investigated the effects of apple, banana, and orange extracts on neuron cells and found that the phenolic phytochemicals of the fruits prevented neurotoxicity on the cells.
Among the three fruits, apples contained the highest content of protective antioxidants, followed by bananas then oranges.
The authors concluded "[their] study demonstrated that antioxidants in the major fresh fruits consumed in the United States and Korea protected neuronal cells from oxidative stress….Additional consumption of fresh fruits such as apple, banana, and orange may be beneficial to improve effects in neurodegenerative diseases such as Alzheimer's."
Eating Chocolate Could Lead To Weaker Bones
"Eating chocolate could lead to weaker bones," reported the Daily Express today. The Daily Telegraph also covered a new study that has shown that women who ate chocolate every day had less dense bones than those who ate it less than once a week. The Daily Mail quotes the lead researcher as saying, "These findings could have important implications for prevention of osteoporotic fracture."
The research behind this claim is a cross-sectional study, which by virtue of its design, cannot prove that chocolate consumption causes low bone density in women. Other diet, lifestyle, or environmental factors could have caused the decreased bone density. This finding was also only in women over 70 and so cannot apply to younger women or men. Studies with more robust designs would be needed to confirm this association.
Where did the story come from?
Dr Jonathan Hodgson and colleagues from the Royal Perth Hospital Unit carried out the research. The study was supported by a research grant from Healthway Health Promotion Foundation of Western Australia and from the National Health and Medical Research Council of Australia. The study was published in the : American Journal of Clinical Nutrition.
What kind of scientific study was this?
The study was a cross-sectional study of Australian women aged over 70 who had participated in a five-year randomised controlled trial of calcium supplementation to prevent osteoporotic fractures. For this latest publication, the authors looked at the data available on women's chocolate consumption and bone density measurements at the end of the original study (i.e. at five years).
Although 1,460 women were included in the original study, only 1,001 were included in this cross-sectional study. This was primarily because the researchers excluded women who were not able to walk. The women's chocolate intake and overall diet (including beverages) was assessed through a questionnaire. Bone density and strength measurements were made using three different imaging techniques (ultrasound, computed tomography, X-ray absorptiometry) at three different body sites (the heel, the shin and the hip).
The researchers then used statistical methods to explore whether there was a link between total chocolate intake (including solid chocolate and "chocolate containing beverages") and bone density and strength. In their analysis, they took into account other factors that may affect this relationship, including age, BMI, smoking status, physical activity, and other dietary factors.
What were the results of the study?
Increased chocolate consumption was associated with lower mean bone density at all the measured sites. When the researchers took into account other factors, such as age, BMI and lifestyle, that could potentially affect this relationship, they found that some of these relationships (e.g. when bone density and strength were measured in the shin) were no longer significant.
What interpretations did the researchers draw from these results?
The researchers conclude that this is the first study to investigate the relationship between chocolate intake and bone structural measurements. They say that although further studies are needed to confirm the findings, their study raises concerns that frequent chocolate consumption may increase the risk of osteoporosis and bone fracture.
What does the NHS Knowledge Service make of this study?
This study has weaknesses that are due to the nature of the study design. The authors themselves say that "additional cross-sectional and longitudinal studies are needed to confirm these observations".
- Although the study took into account the effects of some factors that could influence the association, there are likely to be others that were not considered. On this point, the researchers say that it is possible that chocolate is a surrogate for some other factor (diet, lifestyle, or environmental) which was not considered or was measured inadequately and therefore chocolate may not be responsible for the observed relation.
- The researchers excluded about 200 women who were not able to walk. This would have introduced a bias if those women had different patterns of chocolate intake and bone density than those who were included. - The consumption of solid chocolate and "chocolate containing beverages" was combined in their measure of chocolate intake. The study then was not only about "eating" chocolate as the papers have imply.
- The researchers analysed chocolate consumption at one time point (at five years). Although the researchers assessed the persistence of chocolate intake (by comparing intake at year one and year five), they did not use this figure in their analyses. They also did not assess this for "chocolate containing beverages".
- The study was in women aged over 70 and the findings will not apply to younger women (premenopausal or not) or to men.
Until prospective studies confirm a harmful link between chocolate consumption and bone health, women should not be unduly concerned by the results of this study. Because of its high fat and sugar content, chocolate should be consumed in sensible amounts.
Tuna Sushi Mercury Levels Alarmingly High
If you consume just six pieces of tuna sushi per week your mercury blood levels could easily exceed US government safety limits, according to a recent study carried out by The New York Times which examined 20 shops and restaurants in Manhattan, New York.
In fact, The New York Times (NYT) reports that levels in five of the outlets were so high that authorities might be legally forced take the fish off the market. Michael Gochfeld, Professor of Environmental and Occupational Medicine at the Robert Wood Johnson Medical School, New Jersey, told the NYT that mercury levels found in these restaurant samples were such that a human should not consume a sushi tuna meal more than once every 21 days.
Mercury levels in the tuna sushi at these outlets were significantly higher than that found in regular canned tuna. The researchers report that most of the tuna at these shops and restaurants is bluefin tuna. Bluefin tuna usually has higher mercury levels than other types of tuna.
Drew Neiporent, a managing partner of Nobu Next Door, one of the outlets found to have high tuna sushi mercury levels said he was "startled" at the findings. He added that anything which may pose a hazard to his customers' health should be taken off the menu immediately.
Should We Be Concerned About Mercury in Fish?
Swordfish and shark are sought after in many restaurants, especially when grilled or broiled. Some people are concerned that large predatory fish, the ones at the top of the food chain, may have high levels of methyl mercury - in some cases levels higher than the 1 part per million limit for human consumption which is recommended by the Food and Drug Administration (FDA).
Scientists who work for the FDA and are responsible for seafood safety say that these large predatory fish are safe, as long as you don't eat them too frequently - not more than once a week.
According to Mike Bolger, Ph.D., FDA, about 2,700 to 6,000 tons of mercury are released into the atmosphere each year naturally by degassing from the Earth's crust and oceans. Add to this up to 3,000 tons which are released naturally into the atmosphere are a result of mankind's activities, such as burning household and industrial waste.
Methyl mercury binds tightly to the proteins in fish tissue, including muscle. Cooking does not significantly bring down methyl mercury levels in fish. Most fishes contain trace amounts of methyl mercury. Those found in/near areas where there is industrial mercury pollution can have significantly higher mercury levels.
Fortunately, most fishes rarely have levels of mercury that could pose a hazard to human health if they are consumed. The larger the fish, or the higher up it is in the food chain, the higher its mercury levels are likely to be, say experts. This does not mean larger fishes have dangerous levels of mercury, it just means they are more likely to have higher mercury levels than smaller fishes.
Ms Fitness Competitor - Else Lautala (VIDEO)
Country : Finland
Born: 04.04.1979
Height: 167cm / 5´6
Weight: 53kg / 122lb
Size: 36 (xs)
Shoe: 37 1/2 (US 5 1/2)
Motto: Keep smiling!
The American Society of Plastic Surgeons Addresses Concerns Regarding BOTOX Treatments
The American Society of Plastic Surgeons (ASPS) addressed concerns regarding the use of botulinum toxin products and adverse events following a recent petition from a consumer group.
On January 23, Public Citizen requested the U.S. Food and Drug Administration (FDA) implement labeling changes and a written communication to physicians.
More than one million people have been treated with BOTOX Cosmetic. Complications and adverse events from BOTOX Cosmetic treatments are rare.
"As patient advocates, plastic surgeons are primarily concerned about the safety of our patients," said Richard A. D'Amico, MD, ASPS president. "We have a keen interest and expertise in informing patients about intended use of the product and risks and benefits."
ASPS believes that the safety issues identified in the petition are currently addressed in the manufacturer labeling with detailed information and guidance, including approved indications, contraindications, warnings, drug interactions, precautions, and reported adverse event information.
The ASPS works closely with the FDA on a range of issues and strongly supports existing labeling requirements agreed to between the manufacturers and the FDA.
Almost all drugs and devices have adverse events and complications associated with them. It is important for physicians to have a proper medical history of patients prior to them receiving any treatment. Patients should be fully informed and educated about risks and benefits.
ASPS will continue to work closely with the FDA and manufacturers on an ongoing basis regarding physician and patient education.
For referrals to ASPS Member Surgeons certified by the American Board of Plastic Surgery, visit http://www.plasticsurgery.org where you can also learn more about cosmetic and reconstructive plastic surgery.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 90 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
Lack Of Standard Definition Of Risk Factors For Metabolic Syndrome Makes Measuring The Problem Difficult
About nine percent of teenagers may have metabolic syndrome, a clustering of risk factors that put them on the path toward heart disease and diabetes in adulthood. This shocking statistic represents some of the first concentrated efforts to define and measure metabolic syndrome in children and adolescents - a necessary starting point for combating the problem, but one that has proven even trickier in youth than it has been in adults.
With the number of obese children in the United States rising at an alarming rate, pediatricians, family practitioners and researchers are concerned about what it means to for children's future health. The U.S. cholesterol guidelines have defined the metabolic syndrome for adults who have a cluster of risk factors, including increased waist circumference (central adiposity), hypertension (or elevated blood pressure), low HDL cholesterol, elevated triglycerides and an elevated fasting glucose. Even though these same components can be found in children, they have not been developed into a universal definition or diagnosis. In fact, they have only recently gained attention with the first publication on the syndrome by Stephen Cook, M.D., M.P.H., assistant professor of Pediatrics at the University of Rochester Medical Center, in 2003, which was based on national data from 1988 to 1994.
In the summer of 2006, a handful of national experts were convened by the National Institutes of Health with a task to define the metabolic syndrome for children and adolescents. The Pediatric Metabolic Syndrome Working Group (PMSWG) chose to tackle this problem affecting overweight and obese youth, tapping Cook to participate. The National Institute of Child Health and Human Development, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases and the National Institutes of Health Office of Rare Diseases sponsored the conference.
As part of the committee, Cook performed a study, published with a collection of reports from the working group in February's Journal of Pediatrics, which analyzes how many teens in the U.S. could be considered to have the metabolic syndrome based on four different definitions of it.
Based on the most recently available data from the National Health and Nutrition Examination Survey from 1999 to 2002, the study shows that the definition Cook developed in Rochester (a waist circumference at or above the 90th percentile for age and sex; blood pressure at or above the 90th percentile; a high triglyceride level at or above 110 mg/dL; a low HDL cholesterol level at or below 40 mg/dL; and an impaired glucose metabolism at or above 100 mg/dL), reveals that 2.9 million teens - 9.4 percent of teens overall, and over a third of obese teens - meet the definition of the metabolic syndrome.
The original work by Cook and colleagues published in 2003 showed only 4 percent of teens meet this definition and that the increased prevalence is driven by the rise in obesity.
Using two other well-reported definitions with more stringent cut points, the study also reports rates as low as 2 percent (or 600,000 teens); using analyses that apply the U.S. adult definitions, it reported rates of 1.8 million teens - 5.8 percent of all teens, and 25 percent of obese teens.
"Even if there is no consensus on a pediatric-specific definition, the fact that 1 in 4 obese teens meet the adult definition for this clustering of cardiovascular disease risk factors is enough of a concern," said Cook, who is a pediatrician and adult-internist at Golisano Children's Hospital at Strong. "Many longitudinal studies have shown that adults with this definition are at increased risk for developing type 2 diabetes, heart disease and dying prematurely from heart disease."
While one goal of the committee was to define the metabolic syndrome in pediatric populations, the bigger picture was to recognize the importance of obesity on cardiovascular risk for pediatric populations.
"We are not saying that adolescents who meet a definition for metabolic syndrome are going to develop diabetes or have a heart attack in the next few years, but some of the longitudinal studies presented at this meeting showed they were at very high risk for developing diabetes or heart disease in their 30s," Cook said. "When you consider all the success we've had with lowering the death rate from heart disease for middle aged and older adults, it's really disheartening to see actual data showing heart disease going up in young adults."
Cook said there have been advances in technology, pharmaceuticals and tremendous public health victories seen with reductions in tobacco use and exposure, so the increased rates in cardiovascular risk factors in young adults must be considered "the first wave of severe consequences of the modern obesity epidemic."
Study Confirms Link Between Burgers Consumption And An Increase In Metabolic Risk Factors
Otherwise-healthy adults who eat two or more servings of meat a day - the equivalent of two burger patties - increase their risk of developing metabolic syndrome by 25 percent compared with those who eat meat twice a week, according to research published in Circulation: Journal of the American Heart Association.
Metabolic syndrome is a cluster of cardiovascular disease and diabetes risk factors including elevated waist circumference, high blood pressure, elevated triglycerides, low levels of high-density lipoprotein (HDL or "good") cholesterol and high fasting glucose levels. The presence of three or more of the factors increases a person's risk of developing diabetes and cardiovascular disease.
But it's not just meat that adds inches to the waist, increases blood pressure and lowers HDL - "it's fried foods as well," said Lyn M. Steffen, Ph.D., M.P.H., R.D., co-author of the study and an associate professor of epidemiology at the University of Minnesota.
Dairy products, by contrast, appeared to offer some protection against metabolic syndrome.
Steffen said that, "Fried foods are typically synonymous with commonly eaten fast foods, so I think it is safe to say that these findings support a link between fast-food consumption and an increase in metabolic risk factors."
The findings emerged from an analysis of dietary intake by 9,514 participants in the Atherosclerosis Risk In Communities (ARIC) study. ARIC is a collaborative study funded by the National Heart, Lung, and Blood Institute.
Unlike other researchers who have investigated relationships between nutrients and cardiovascular risk, "we specifically studied food intake. When making recommendations about dietary intake it is easier to do so using the framework of real foods eaten by real people," Steffen said.
Researchers assessed food intake using a 66-item food frequency questionnaire. From those responses, they categorized people by their dietary preferences into a Western-pattern diet or a prudent-pattern diet.
In general, the Western-pattern diet was heavy on refined grains, processed meat, fried foods, red meat, eggs and soda, and light on fish, fruit, vegetables and whole grain products.
Prudent diet eating patterns, by contrast, favored cruciferous vegetables (e.g., cabbage, radish and broccoli), carotenoid vegetables (e.g., carrots, pumpkins, red pepper, cabbage, broccoli and spinach), fruit, fish and seafood, poultry and whole grains, along with low-fat dairy.
Researchers also assessed associations with individual food items: fried foods, sweetened beverages (regular soda and fruit drinks), diet soda, nuts and coffee.
After nine years of follow-up, 3,782 (nearly 40 percent) of the participants had three or more of the risk factors for metabolic syndrome.
At baseline, participants were 45 to 64 years old - ages at which many people gain weight.
Steffen said that weight gain over the years of follow-up might explain some of the cases of metabolic syndrome. But "after adjusting for demographic factors, smoking, physical activity and energy intake, consumption of a 'Western' dietary pattern was adversely associated with metabolic syndrome," she said.
"One surprising finding was while it didn't increase the risk of metabolic syndrome, there was no evidence of a beneficial effect of consuming a prudent diet either. I had expected to find a beneficial effect because we have seen that in other studies."
When Steffen and colleagues analyzed the results by specific foods, they found that meat, fried foods and diet soda were all significantly associated with increased risk of metabolic syndrome, but consumption of dairy products was beneficial.
The study did not address the mechanisms involved in the increased risk of metabolic syndrome seen with certain foods, but Steffen speculated that "it may be a fatty acid mechanism since saturated fats are a common link and certainly overweight and obesity are contributing to the development of metabolic syndrome." She also said more research on the relationship between diet soda and its association to metabolic syndrome is needed.
The fact that 60.5 percent of the ARIC population had metabolic syndrome at the start of the study or developed it during nine years of follow-up is troubling, researchers said.
Steffen said the study's results are clear: Too much meat, fried foods and diet soda, do not add up to a healthy life.
American Heart Association dietary guidelines for healthy Americans age 2 and older include:
* Limit saturated fat, trans fat, cholesterol and sodium in the diet.
* Minimize the intake of food and beverages with added sugars.
* Eat a diet rich in vegetables, fruits and whole-grain foods.
* Select fat-free and low-fat dairy.
* Eat fish at least twice per week.
* Emphasize physical activity and weight control.
* Avoid use of and exposure to tobacco products.
* Achieve and maintain healthy cholesterol, blood pressure and blood glucose levels.
Physical Decline In The Elderly More Acute If Vitamin E Levels Are Low
An elderly person whose vitamin E blood levels are low is more likely to experience faster physical decline than an elderly person whose levels are normal, say researchers from the Yale School of Medicine. Low serum concentration of vitamin E is an indication of poor nutrition.
You can read about this in the Journal of the American Medical Association (JAMA), January 23rd issue.
Benedetta Bartali, Nutritionist, a Brown-Coxe Postdoctoral Fellow at Yale School of Medicine, and team looked at 698 people, all aged at least 65 years. They were randomly selected from the population registry of two councils near Florence, Italy. Blood samples were collected to measure micronutrient levels of folate, iron, and vitamins B6, B12, D and E. All participants' physical decline over a three-year period were assessed, using an objective test that involved three tasks:
-- walking speed
-- getting up from a chair repeatedly
-- standing balance
Bartali said "We evaluated the effects of several micronutrients and only vitamin E was significantly associated with decline in physical function. The odds of declining in physical function was 1.62 time greater in persons with low levels of vitamin E compared with persons with higher levels. It is unlikely that vitamin E is simply a marker for poor nutrition because our results are independent of energy intake, and the effect of low levels of other micronutrients was not significant. Our results suggest that an appropriate dietary intake of vitamin E may help to reduce the decline in physical function among older persons. Since only one person in our study used vitamin E supplements, it is unknown whether the use of vitamin E supplements would have the same beneficial effect."
Additional studies are required to determine whether low levels of other antioxidants are also factors influencing physical decline during old age, Bartali added.
As an antioxidant, vitamin E seems to help prevent/reduce the proliferation of free radicals in the body, which are linked to physical decline. This may well contribute towards the reduction of muscle or DNA damage and the development of pathological conditions like atherosclerosis.
The researchers also said that additional studies are required to determine the mechanisms of how low levels of vitamin E contribute to physical function decline.
The authors concluded "In conclusion, the current study provides empirical evidence that a low concentration of vitamin E is associated with subsequent decline in physical function in a population-based sample of older persons living in the community. Although the findings from this epidemiological study cannot establish causality, they provide a solid base that low concentration of vitamin E contributes to decline in physical function. Clinical trials may be warranted to determine whether optimal concentration of vitamin E reduces functional decline and the onset of disability in older persons with a low concentration of vitamin E."
"Serum Micronutrient Concentrations and Decline in Physical Function Among Older Persons"
Benedetta Bartali, RD, PhD; Edward A. Frongillo, PhD; Jack M. Guralnik, MD, PhD; Martha H. Stipanuk, PhD; Heather G. Allore, PhD; Antonio Cherubini, MD, PhD; Stefania Bandinelli, MD; Luigi Ferrucci, MD, PhD; Thomas M. Gill, MD
JAMA. 2008;299(3):308-315.
Click here to view abstract online
Foods Rich in Vitamin E
(Source - Northwestern University, Dept of Preventive Medicine)
- Almond oil, 1Tbl - 5.0 mg of vitamin E
- Almonds, 1/2 cup - 2.2 mg of vitamin E
- Avocado, whole - 2.8 mg of vitamin E
- Canola oil, 1 Tbl - 2.9 mg of vitamin E
- Catfish, 3.5 oz - 1.3 mg of vitamin E
- Corn oil, 1 Tbl - 2.9 mg of vitamin E
- Grapes, 1 cup - 1.1 mg of vitamin E
- Mango, fresh - 2.3 mg of vitamin E
- Margarine, 1 Tbl - 1.6 mg of vitamin E
- Mayonnaise, 1 Tbl - 1.7 mg of vitamin E
- Mustard greens, 1/2 cup - 1.4 mg of vitamin E
- Olive oil, 1 Tbl - 1.7 mg of vitamin E
- Papaya cubes, 1 cup - 1.6 mg of vitamin E
- Peanut butter, 2 Tbl - 3.3 mg of vitamin E
- Peanut oil, 1 Tbl - 1.7 mg of vitamin E
- Peanuts, 1/2 cup - 2.5 mg of vitamin E
- Pinto beans, 1/2 cup - 1.1 mg of vitamin E
- Sunflower oil, 1 Tbl - 7.0 mg of vitamin E
- Sunflower seeds, 1/4 cup - 17.0 mg of vitamin E
- Swiss chard, 1/2 cup - 1.7 mg of vitamin E
- Wheat germ, 2 Tbl - 2.6 mg of vitamin E
Why Is Broccoli Good For You?
Broccoli has high levels of antioxidants
"Eating steamed broccoli reduces the risk of a heart attack by boosting the body's ability to fight off cell damage", The Daily Telegraph reported.
New research suggests that a mechanism involving antioxidants found in the Brassicaceae family of vegetables (cauliflower, broccoli, cabbage and Brussels sprouts) prevents the build-up of free radicals. Excessive production of free radicals can harm cells and even trigger cancers. The paper quotes other researchers who have long believed that antioxidant substances have health benefits. However, many studies have failed to show an effect.
The rats which were fed broccoli during this study showed some changes in proteins and heart function compared to those fed only water. However, without knowing if the activation of heart-protective proteins in response to antioxidants would be the same in humans, it would be premature to claim that eating broccoli specifically reduces your chance of a heart attack, as opposed to a healthy eating pattern in general.
Where did the story come from?
Subhendu Mukherjee and two colleagues at the Cardiovascular Research Center, University of Connecticut School of Medicine in the US, carried out this research. The study was published in the scientific journal The Journal of Agricultural and Food Chemistry.
What kind of scientific study was this?
This was a laboratory study conducted in rats which investigated whether eating broccoli could be beneficial to the heart. The researchers suspected this might be the case as broccoli contains high amounts of selenium, an inorganic chemical that is thought to mop up free radicals and glucosinolates (organic compounds derived from sugar and also found in many other green vegetables). Glucosinates are toxic in high doses, but are converted to sulphoraphanes by chewing and these are thought to protect against cancer and heart disease.
The researchers fed broccoli (in a slurry made with water) to a group of six rats, while six control animals were fed only water. After 30 days, the hearts of the animals were removed and the blood supply cut off for 30 minutes, followed by two hours where the blood flow was returned. This was intended to be the experimental equivalent of a heart attack. The researchers then performed a variety of tests on the hearts and the heart muscle cells.
What were the results of the study?
When compared to the control group, the rats which were fed broccoli showed improved heart muscle function after the experimental heart attack: they had a smaller amount of dead heart muscle and heart muscle cells. These changes were accompanied by changes in several proteins found in the cell nuclei, and other chemicals thought to protect the heart.
What interpretations did the researchers draw from these results?
The researchers report that the experimental heart attack led to the death of heart muscle cells by causing a change in the mitochondria within these cells and the release of a protein that 'programmes' the cell for death. Broccoli consumption appeared to reduce the number of heart muscle cells programmed for cell death and also the levels of protein released, which indicated that it was able to generate some kind of "anti-cell death" signal. They examined several components of these pathways and claim that broccoli appears to rescue the heart muscle in the experimental model heart attack through some form of survival pathway.
What does the NHS Knowledge Service make of this study?
This study has investigated the pathways thought to protect heart muscle from cell death during a heart attack, using a rat model of the disease.
The researchers claim that broccoli is a unique vegetable in this respect, and implied in the title of their paper that their results might apply to mammals in general. However, how these results apply to heart attacks in humans remains to be seen. It is also not known whether these results could be achieved with other vegetable diets in rats.
Until further research can confirm these findings, the best advice may be to protect heart muscle by following conventional advice: eat healthy food, engage in moderate physical activity and avoid smoking. There is also no harm in eating broccoli as part of a healthy, balanced diet.
Tuna Sushi Mercury Levels Alarmingly High
If you consume just six pieces of tuna sushi per week your mercury blood levels could easily exceed US government safety limits, according to a recent study carried out by The New York Times which examined 20 shops and restaurants in Manhattan, New York.
In fact, The New York Times (NYT) reports that levels in five of the outlets were so high that authorities might be legally forced take the fish off the market. Michael Gochfeld, Professor of Environmental and Occupational Medicine at the Robert Wood Johnson Medical School, New Jersey, told the NYT that mercury levels found in these restaurant samples were such that a human should not consume a sushi tuna meal more than once every 21 days.
Mercury levels in the tuna sushi at these outlets were significantly higher than that found in regular canned tuna. The researchers report that most of the tuna at these shops and restaurants is bluefin tuna. Bluefin tuna usually has higher mercury levels than other types of tuna.
Drew Neiporent, a managing partner of Nobu Next Door, one of the outlets found to have high tuna sushi mercury levels said he was "startled" at the findings. He added that anything which may pose a hazard to his customers' health should be taken off the menu immediately.
Should We Be Concerned About Mercury in Fish?
Swordfish and shark are sought after in many restaurants, especially when grilled or broiled. Some people are concerned that large predatory fish, the ones at the top of the food chain, may have high levels of methyl mercury - in some cases levels higher than the 1 part per million limit for human consumption which is recommended by the Food and Drug Administration (FDA).
Scientists who work for the FDA and are responsible for seafood safety say that these large predatory fish are safe, as long as you don't eat them too frequently - not more than once a week.
According to Mike Bolger, Ph.D., FDA, about 2,700 to 6,000 tons of mercury are released into the atmosphere each year naturally by degassing from the Earth's crust and oceans. Add to this up to 3,000 tons which are released naturally into the atmosphere are a result of mankind's activities, such as burning household and industrial waste.
Methyl mercury binds tightly to the proteins in fish tissue, including muscle. Cooking does not significantly bring down methyl mercury levels in fish. Most fishes contain trace amounts of methyl mercury. Those found in/near areas where there is industrial mercury pollution can have significantly higher mercury levels.
Fortunately, most fishes rarely have levels of mercury that could pose a hazard to human health if they are consumed. The larger the fish, or the higher up it is in the food chain, the higher its mercury levels are likely to be, say experts. This does not mean larger fishes have dangerous levels of mercury, it just means they are more likely to have higher mercury levels than smaller fishes.
New York Restaurants To Show Calories On Menus
The New York City Board of Health voted yesterday, 22nd January, to make the city's restaurant chains show calorie information on their menus and menu board.
The new regulation comes into force on 31st March this year and applies to any chain restaurant in New York City that has 15 or more outlets anywhere in the US. This represents about 10 per cent of the City's restaurants, according to a statement from the health department.
The intention is to give restaurant customers a way to make an informed and healthier food choice when they go out to eat. This is an important step in addressing the City's obesity epidemic, which affects over 50 per cent of New Yorkers. And with obesity, comes an increase in the number of people with type 2 diabetes, as Health Commissioner for New York City, Dr Thomas R Frieden explained:
"Obesity and diabetes are the only major health problems that are getting worse in New York City."
"Today, the Board of Health passed a regulation that will help New Yorkers make healthier choices about what to eat; living longer, healthier lives as a result," he added.
Research shows that people who eat fast food on a regular basis tend to eat more calories than those who do not.
While many chain restaurants display calorie information, they do so in a way that is not obvious or easy to see when customers are actually ordering their food. For instance, the information could be on a website, in a brochure, or a food wrapper.
By making them display this information on the menu itself, and on the menu boards, customers will see the information at the time they make their food choice, thus reducing the likelihood that they will underestimate the calorie content of the food they are about to order.
When people can see calorie information at the point of making a choice, they use it, said the Health Department. Nearly three quarters of shoppers said they looked at calorie information on labels when buying food in supermarkets, and about half said the information affected what they chose to buy.
Health officials said it is easier for chain restaurants to show the calorie values of their dishes because they tend to be standardized recipes and portions.
They estimate that this measure will reduce the number of obese New Yorkers by 150,000 over the next five years, and prevent 30,000 of the City's dwellers from getting type 2 diabetes.
According to the New York Times, Dr Frieden is anticipating a reduction in the high calorie dishes offered by some restaurants, citing as an example appetizers that exceed the 2,000 calorie mark.
He said his department had shown that consumers often underestimate the calorie value of menu dishes, but when they have the correct information, they tend to opt for dishes with a lower calorie count.
Chuck Hunt, a spokesman for the New York State Restaurant Association told the newspaper that his group, which had already successfully challenged an earlier ruling in the Federal District Court in Manhattan, was thinking of suing over the new ruling.
He said the new rule was unwieldy and wasn't going to work. Many restaurants operated as franchises and could not afford to obey the rules. He also said listing calorie content on supermarket food had not stopped the obesity epidemic.
Health officials said last year when they were revising the ruling after it been rejected by a judge for breaking federal laws, that many restaurant customers have no idea how many calories they are about to consume when they order their meals.
For example, they don't know that a typical McDonald's Big Mac, large fries and medium Coke has 1,320 calories, equal to two thirds of the average adult's daily need. And a Burger King triple Whopper with cheese has nearly as many calories, 1,230, and that's without the fries and coke.
Diabetes Remission In Obese Patients More Likely With Weight Loss Surgery
Gastric banding surgery appeared to be more effective than conventional weight loss and diabetes control at helping obese patients with type 2 diabetes lose weight and achieve remission of diabetes, revealed the results of a preliminary study by researchers in Australia.
The study is published in the January 23rd issue of the Journal of the American Medical Association (JAMA) and is the work of Dr John B Dixon, of Monash University, Melbourne, Australia, and colleagues.
Recent studies have shown that weight loss plays a strong factor in improvement in glucose control in type 2 diabetes, which with obesity will be the greatest public health challenge of the next ten or twenty years, wrote the authors. Increasing rates of obesity are strongly linked to increasing prevalence of diabetes.
Conventional methods of weight loss that rely on drugs and lifestyle changes tend to achieve only modest weight loss, a problem made even more difficult for type 2 diabetics because they have greater difficulty losing weight than people without diabetes.
Some observational studies have suggested that surgically induced ways of losing weight, such as gastric banding, achieve sustained weight loss and may be an effective way to treat type 2 diabetes. Dixon and colleagues decided to investigate this using a randomized controlled trial.
The trial, which took place at the Monash University Obesity Research Center in Australia and involved 60 obese patients, started in December 2002 and finished in December 2006. The patients had been recently diagnosed with type 2 diabetes (within the previous two years). Obesity was defined as having a body mass index (BMI) above 30 and below 40. A person's BMI is their weight in kilos divided by the square of their height in metres.
The patients were randomized to two treatment groups: a surgical group and a conventional therapy group. In the surgical group patients received laparoscopic adjustable gastric banding with conventional diabetes care. In the conventional group patients had conventional diabetes therapy, with a focus on weight loss through changes in lifestyle.
The researchers used glycated hemoglobin (HbA1c) levels to measure blood glucose, monitored the patients' weight loss and measures of metabolic syndrome.
Remission was defined as having a fasting glucose level below 126 mg/dL and value of less than 5.2 per cent, while not receiving glycemic therapy.
The results showed that:
* 55 of the 60 patients completed the two year follow up.
* There were no serious complications among the patients in either group.
* 22 (72 per cent) of the surgical group patients and 4 (13 per cent) of the conventional therapy group achieved remission of type 2 diabetes.
* This represented a remission rate of 76 per cent for the surgery group and 15 per cent for the conventional therapy group.
* The surgical group lost 21 per cent of their weight on average, compared with under 2 per cent in the conventional therapy group after 2 years.
* This translates to an over 60 per cent excess weight loss in the surgical group (based on BMI of 25 as ideal) compared with just over 4 per cent in the conventional therapy group.
* After 2 years follow up, the surgical group displayed a 5 times higher remission rate and 4 times greater reduction in blood glucose (glycated hemoglobin) than the convention therapy group.
* Greater weight loss after 2 years and a lower level of blood glucose at the start of the study were independently linked with remission, but weight loss accounted for most of the variance.
The authors concluded that:
"Participants randomized to surgical therapy were more likely to achieve remission of type 2 diabetes through greater weight loss."
However, they said a larger study in a more diverse population, that takes into account longer term outcomes, is needed to confirm these preliminary results.
The researchers also wrote that these results pointed to the degree of weight loss, and not necessarily the way it was achieved, as the major driver of glycemic improvement and diabetes remission among the obese patients.
The implication of this is that it may be more important to aim for intensive weight loss than simple lifestyle change when treating type 2 diabetes, they wrote.
"This study shows that few participants achieved remission with a body weight loss of less than 10 percent, a level expected to produce important health benefits," added the researchers.
Commenting in an accompanying editorial, Drs David E Cummings and David R Flum, of the University of Washington, Seattle, wrote " ... there is much to learn about surgical treatments for diabetes."
"Researchers are striving to elucidate surgical mechanisms of diabetes improvement, hoping ultimately to harness the effects of 'surgery in a pill'; i.e. a formulation providing the desired effects without operative risks," they added.
They suggested the future looks "brighter" for patients and that the results coming out of studies of surgical ways of treating diabetes may be "the most profound since the discovery of insulin".
In the face of an expanding epidemic, "policy and health care leaders are grappling with the costs and risks of surgical interventions, which must be balanced against the costs and risks of not taking advantage of surgically induced diabetes remission", they wrote.
"Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial."
John B. Dixon; Paul E. O'Brien; Julie Playfair; Leon Chapman; Linda M. Schachter; Stewart Skinner; Joseph Proietto; Michael Bailey; Margaret Anderson.
JAMA. 2008;299(3):316-323.
Vol. 299 No. 3, January 23, 2008.
Why High-Protein, Low-Fat, And Low-Carbohydrate Diets Suppress Hunger ?
Many popular diet plans are based on changing the proportion of carbohydrates, proteins, and fats one ingests as a method to promote weight loss. There has been some controversy regarding the effectiveness of these diets, but a new study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM) could shed light on potential mechanisms by which various diets promote weight loss.
This study examined the relative ability of different nutrient types to suppress ghrelin, which is secreted by the stomach and is the only known appetite-stimulating hormone. Circulating ghrelin levels increase shortly before meals and then decrease promptly after ingestion of food.
"We found that when fat is consumed, levels of ghrelin remain relatively high, which could in turn stimulate hunger," said Dr. Karen Foster-Schubert of the University of Washington School of Medicine in Seattle, Washington. "Protein consumption resulted in the greatest suppression of ghrelin over a long period and, interestingly, consumption of carbohydrates resulted in a strong ghrelin suppression initially, although subsequent ghrelin levels rebounded well above baseline."
In this study, subjects were given three beverages with widely varying compositions of macronutrients (carbohydrates, fats, and proteins). Blood samples were taken before the first beverage was ingested and every 20 minutes for six hours thereafter. Researchers then measured the ghrelin levels in each sample.
"These findings open the door to future research on the effectiveness of varying methods of dieting," said Foster-Schubert. "Improving our understanding of the regulation of ghrelin by ingested macronutrients could facilitate rational design of weight-reducing diets."
Other researchers involved in this study include Joost Overduin, Holly Callahan, and David Cummings of the University of Washington School of Medicine in Seattle, Washington; and Jianhua Liu, Bruce Gaylinn, Michael Thorner, and Catherine Prudom of the University of Virginia in Charlottesville, Virginia.
A rapid release version of this paper has been published on-line and will appear in the April 2008 issue of JCEM, a publication of The Endocrine Society.
Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at http://www.endo-society.org.
Endocrine Society
8401 Connecticut Ave., Ste 900
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Do antioxidant supplements reduce the risk of cancer and deaths related to cancer ?
That's a question answered by Mayo researchers in an article in the January issue of Mayo Clinic Proceedings. While some trials have suggested that antioxidants have beneficial effects, results from other trials have been negative. It has been unclear which antioxidant compounts are more beneficial (or more harmful), and how individual antioxidants affect target organs and specific patient populations. To examine these issues, Mayo researchers conducted a systematic review on the topic.
"Systematic reviews can provide reliable summaries of the research, and help understand why different studies give different results," says Victor Montori, M.D., senior author on the study and lead for Mayo Clinic's Knowledge and Encounter Research (KER) unit. For the study, two authors reviewed all randomized trials on antioxidants for cancer prevention(1968-2005) and identified 12 clinical trials with a total eligible population of 104,196. The review yielded a number of interesting findings including:
* Overall, antioxidant supplementation did not reduce the risk of cancer.
* Beta carotene supplementation was actually found to increase the risk of smoking-related cancers, as well as cancer mortality, and thus should be avoided, especially by tobacco users.
* Vitamin E appeared to have no beneficial or harmful effects.
* Selenium supplementation was found to lower the risk of cancer in men (not in women), but the number of trials were few and further research is required. A large trial assessing the effect of selenium in lowering the risk of prostate cancer is currently underway.
The bottom line according to Aditya Bardia, M.D., lead author of the study, is that antioxidants do not lower the risk of cancer and beta carotene might actually increase cancer risk among smokers. Selenium might have beneficial properties, but it cannot be recommended for general use until more evidence is available.
In addition to Drs. Montori and Bardia, authors of the article include James Cerhan, M.D., Ph.D.; Amit Sood, M.D.; Paul Limburg, M.D.; and Patricia Erwin, all of Mayo Clinic; and Imad Tleyjeh, M.D., King Fahd Medical City, Riyadh, Saudi Arabia.
Cancer And Osteoporosis May Be Combatted By Olive Oil
In the 1960s, Ancer Keys, a US expert on nutrition, studied the health benefits of the Mediterranean diet for the first time. Since then many studies on the benefits of olive oil have been conducted. According to several studies performed in Italy, Spain and Greece (the main olive-oil-producing countries), the incidence of diseases is lower in these countries than in Northern Europe.
The Environmental, Biochemical and Nutritional Analytical-Control Research Group, directed by Professors Alberto Fernández Gutiérrez and Antonio Segura Carretero, used the most advanced analytical techniques for a precise study on the antioxidant properties of olive oil, characterized by its polyphenolic composition and its potential to combat degenerative diseases.
The study was completed with the collaboration of the Institut of Nutrition and Food Technology of the University of Granada and the Nutrition Team of the Hospital Virgen de las Nieves (Granada). Together with the Research Group, they have determined that consumption of olive oil rich in polyphenols (natural antioxidants) improves the lives of people suffering from oxidative stress, and is also highly beneficial for the prevention of cell aging and osteoporosis.
This research has stirred the interest of the Control Board of the Designation of Origin Sierra Segura. After analysing samples from 15 olive oil mills, researchers have demonstrated that olive oil is very rich in polyphenols. According to Professors Alberto Fernández and Antonio Segura, "as preventive substances, polyphenols help to combat any oxidative disease associated with the degenerative process."
The Environmental, Biochemical and Nutritional Analytical-Control Research Group of the University of Granada has carried out several related studies, such as the creation of a system aimed at guaranteeing the quality of bee honey and determining its geographical origin, or the polyphenolic characterization of food products such as honey, beer and propolis.
Is Transcranial Magnetic Stimulation A New Treatment Of Bulimia Nervosa?
A group of investigators of the Innsbruck University (Austria) reports on a new modality of treatment for bulimia nervosa, transcranial magnetic stimulation, in the 2008 January issue of Psychotherapy and Psychosomatics. Transcranial magnetic stimulation is a non-invasive, neurophysiological method, which affects cortical neurons with a short magnetic pulse.Bulimia nervosa (BN) is often associated with depressive symptoms and treatment with antidepressants has shown positive effects. A shared deficient serotonergic transmission was postulated for both syndromes. The left dorsolateral prefrontal cortex was argued to regulate eating behaviour and to be dysfunctional in eating disorders.Fourteen women meeting DSM-IV criteria for BN were included in a randomised placebo-controlled double-blind trial. In order to exclude patients highly responsive to placebo, all patients were first submitted to a one-week sham treatment. Randomisation was followed by 3 weeks of active treatment or sham stimulation. As the main outcome criterion we defined the change in binges and purges. Secondary outcome variables were the decrease of the Hamilton Depression Rating Scale (HDRS), the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Scale (YBOCS) over time.
The average number of binges per day declined significantly between baseline and the end of treatment in the two groups. There was no significant difference between sham and active stimulation in terms of purge behaviour, BDI, HDRS and YBOCS over time.
These preliminary results indicate that repetitive transcranial magnetic stimulation (rTMS) in the treatment of BN does not exert additional benefit over placebo. A larger number of patients might clarify a further role of rTMS in the treatment of BN.
PSYCHOTHERAPY AND PSYCHOSOMATICS
http://www.karger.com/pps
Fitness and Adiposity as Mortality Predictors in Older Adults
Although levels of physical activity and aerobic capacity decline with age and the prevalence of obesity tends to increase with age, the independent and joint associations among fitness, adiposity, and mortality in older adults have not been adequately examined.
Cohort of 2603 adults aged 60 years or older (mean age, 64.4 [SD, 4.8] years; 19.8% women) enrolled in the Aerobics Center Longitudinal Study who completed a baseline health examination during 1979-2001. Fitness was assessed by a maximal exercise test, and adiposity was assessed by body mass index (BMI), waist circumference, and percent body fat. Low fitness was defined as the lowest fifth of the sex-specific distribution of maximal treadmill exercise test duration. The distributions of BMI, waist circumference, and percent body fat were grouped for analysis according to clinical guidelines.There were 450 deaths during a mean follow-up of 12 years and 31 236 person-years of exposure. Death rates per 1000 person-years, adjusted for age, sex, and examination year were 13.9, 13.3, 18.3, and 31.8 across BMI groups of 18.5-24.9, 25.0-29.9, 30.0-34.9, and ≥35.0, respectively (P = .01 for trend); 13.3 and 18.2 for normal and high waist circumference (≥88 cm in women; ≥102 cm in men) (P = .004); 13.7 and 14.6 for normal and high percent body fat (≥30% in women; ≥25% in men) (P = .51); and 32.6, 16.6, 12.8, 12.3, and 8.1 across incremental fifths of fitness (P < .001 for trend). The association between waist circumference and mortality persisted after further adjustment for smoking, baseline health status, and BMI (P = .02) but not after additional adjustment for fitness (P = .86). Fitness predicted mortality risk after further adjustment for smoking, baseline health, and either BMI, waist circumference, or percent body fat (P < .001 for trend).
Conclusions
In this study population, fitness was a significant mortality predictor in older adults, independent of overall or abdominal adiposity. Clinicians should consider the importance of preserving functional capacity by recommending regular physical activity for older individuals, normal-weight and overweight alike.
New Dimensions Weight Loss Surgery - REALIZE(TM) Personalized Banding Solution
New Dimensions Weight Loss Surgery is the first bariatric program in central and south Texas to offer the new REALIZE™ Personalized Banding Solution, which is comprised of two important tools - the REALIZE Adjustable Gastric Band surgery and the REALIZE mySUCCESS™ patient support system (http://www.realizeband.com). The band helps control a patient's hunger while the interactive, online system will help guide, motivate and support patients through their journey to long-term weight loss and a healthier life.
The REALIZE Adjustable Gastric Band is a new device that is surgically implanted around the stomach to help people with morbid obesity lose weight and improve or resolve obesity-related health conditions including type 2 diabetes, sleep apnea and high cholesterol. REALIZE mySUCCESS is a dynamic online program that provides support to help patients successfully achieve long-term weight loss with the REALIZE band. Through REALIZE mySUCCESS, patients and their doctors can set goals and continuously watch the progress being made - especially for the first three years, as patients adjust to new lifestyles and so their doctors can step in precisely when needed to keep them on track.
The REALIZE mySUCCESS online program offers a tailored progress plan to develop new health habits in the areas of physical activity, nutrition, and emotional well-being. The application provides a vital link to the patient's health care team between visits, enabling their bariatric program to track their progress, and gather information to help to determine the patient's correct band fill level. Patients can utilize the site to develop fitness plans and track their exercise, review recipes and keep a detailed food journal, communicate with other patients and track weight loss progress, and much more.
"While the surgery is among the most effective treatments for morbid obesity, it is just one stop along the patient's journey. Patients must make changes to their diet and lifestyle after surgery to achieve long-term success. The combination of the REALIZE band and its innovative online patient support program marks a new approach in bariatric surgery," said Mickey Seger, MD, president of New Dimensions Weight Loss Surgery.
Dr. Seger and two of his partners, Dr. John Pilcher and Dr. Lloyd Stegemann, were selected as national proctors by Ethicon Endo-Surgery to teach other bariatric surgeons how to use the REALIZE band, which was approved by the U.S. Food and Drug Administration (FDA) on Friday, September 28, 2007.
Metabolism Affected By Probiotics , Nestle Says
Probiotics, such as yoghurt drinks containing live bacteria, have a tangible effect on the metabolism, according to the results of a new study published15 January in the journal Molecular Systems Biology.
The research is the first to look in detail at how probiotics change the biochemistry of bugs known as gut microbes, which live in the gut and which play an important part in a person's metabolic makeup. Different people have different types of gut microbes inside them and abnormalities in some types have recently been linked to diseases such as diabetes and obesity.
For the study, researchers from Imperial College London and Nestlé Research Center, Lausanne, Switzerland, gave two different types of probiotic drink to mice that had been transplanted with human gut microbes. Probiotics contain so-called 'friendly' bacteria and there is some evidence to suggest that adding 'friendly' bacteria to the gut can help the digestive system.
The researchers compared the levels of different metabolites in the liver, blood, urine, and faeces, of mice who had received treatment with probiotics and those that had not.
They found that treatment with probiotics had a whole range of biochemical effects and that these effects differed markedly between the two probiotic strains, Lactobacillus paracasei and Lactobacillus rhamnosus. Adding 'friendly' bacteria changed the makeup of the bugs in the gut, not only because this increased the number of such bacteria, but also because the 'friendly' bacteria worked with other bacteria in the gut, amplifying their effects.
One of the many biochemical changes observed by the researchers was a change in how mice treated with probiotics metabolised bile acids. These acids are made by the liver and their primary function is to emulsify fats in the upper gut. If probiotics can influence the way in which bile acids are metabolised, this means they could change how much fat the body is able to absorb.
Professor Jeremy Nicholson, corresponding author on the study from the Department of Biomolecular Medicine at Imperial College, explained "Some argue that probiotics can't change your gut microflora - whilst there are at least a billion bacteria in a pot of yoghurt, there are a hundred trillion in the gut, so you're just whistling in the wind.
"Our study shows that probiotics can have an effect and they interact with the local ecology and talk to other bacteria. We're still trying to understand what the changes they bring about might mean, in terms of overall health, but we have established that introducing 'friendly' bacteria can change the dynamics of the whole population of microbes in the gut," he said.
The researchers hope their new insights about how probiotics and gut microbes interact will ultimately enable the development of new probiotic therapies, which can be tailored for people with different conditions and different metabolic makeups.
Dr. Sunil Kochhar, another author on the study from the Nestlé Research Center, added: "Understanding changes in the molecular events triggered by the so-called beneficial bacteria in the host metabolism is an important prerequisite in our efforts to develop customized nutritional solutions to maintain and/or enhance our consumer's health and wellness at an individual level. The results of this study are highly promising to address personalized nutrition."
Most Effective Weight Loss Diet Revealed
Scientists at Aberdeen's Rowett Research Institute have shown that a high protein, low carbohydrate diet is most effective at reducing hunger and promoting weight loss, at least in the short term. Their work has just been published in the American Journal of Clinical Nutrition.
Healthy, obese men were given two different diets during their stay in the Rowett's specialised Human Nutrition Unit. Both diets had a high protein content (30% of total energy value of the diet) but they differed in the amount of carbohydrate: One diet was low in carbohydrate (4%) and the other contained a moderate amount of carbohydrate (35% total energy value).
"Our volunteers found both diets to be equally palatable, but they felt less hungry on the high-protein low-carbohydrate diet compared with the diet which contained high-protein but moderate amounts of carbohydrate," said Dr Alex Johnstone, the Rowett's weight-loss expert who led the study.
"Weight loss during the two four week study periods was greater on the high-protein low-carbohydrate diet, averaging 6.3 kg per person, compared with 4.3 kg on the moderate carbohydrate diet," said Dr Johnstone.
An important part of this study was to unravel the physiological mechanisms behind this type of diet. It is known that when people eat low carbohydrate diets, within a relatively short time their body has to switch from using glucose as a fuel to using something different called ketone bodies. Ketone bodies are appetite-suppressing and they may have an effect on the appetite centres in the brain. It's also well known that protein itself is very good at making people feel full-up.
"In this study, we showed that on the high-protein low-carbohydrate diet the volunteers became ketogenic within 1-2 days of starting this diet and so it may be that high-protein, low-carbohydrate diets are particularly effective because of the combined effect of the protein and the ketone bodies," said Dr Johnstone.
"We showed that the volunteers on the ketogenic diet reduced their energy intake without increasing their hunger and this was a very important factor in their ability to stick to the diet."
Dr Johnstone sounds a note of caution about her findings: "A paper published last year from the same study showed that low carbohydrate diets may have consequences for the health of the gut by dramatically reducing the numbers of particular types of bacteria. So we will be looking in more detail at the complex way in which we respond to changes in our diet before we can say whether low-carbohydrate ketogenic diets are a suitable tool for everyone who wants to lose weight."
When the phase of the study which involved the volunteers finished in October 2004, it attracted considerable interest because of its celebrity volunteer, Cameron Stout, who lost just over 12 kg during his nine week stay at the Rowett Institute. At the time, Cameron mentioned his surprise at not feeling hungry during the study and said he had adjusted to eating smaller portions. How does he feel now, three years later?
"I had a great experience with the nutrition study at the Rowett. The food was excellent and the staff looked after us very well. Because I have such an irregular lifestyle I don't find it easy to stick rigidly to all that I learnt while I was at the Institute, but I try to make an effort most of the time. For me it was mainly about breaking bad habits and I guess we all have food vices we need to deal with!" said Cameron.
ROWETT INSTITUTE
Greenburn Road, Bucksburn
Aberdeen AB21 9SB
http://www.rowett.ac.uk
Mediterranean Diet During Pregnancy Helps To Ward Off Childhood Asthma And Allergy
Leanne Male, Assistant Director of Research, Asthma UK says: 'This study adds to previous research which shows that a Mediterranean diet, which traditionally contains higher levels of fresh fruit and vegetables, can have a beneficial effect on asthma symptoms and specifically in this study that these benefits can be passed onto the pregnant mother's unborn child.
This supports our advice to pregnant mothers to eat a healthy, balanced diet and is of particular significance to mothers in the UK as we have one of the highest rates of childhood asthma worldwide, with one in ten children suffering from the condition.
Notes
1. Asthma UK is the charity dedicated to improving the health and well-being of the 5.2 million people in the UK whose lives are affected by asthma. Asthma UK Scotland is dedicated to improving the health and well-being of the 390,000 people in Scotland whose lives are affected by asthma.
2. For up-to-date news on asthma, information and publications, visit the Asthma UK website http://www.asthma.org.uk.
3. For independent and confidential advice on asthma, call the Asthma UK Adviceline, which is staffed by asthma nurse specialists. It is open weekdays from 9am to 5pm on 08457 01 02 03. Or email an asthma nurse at http://www.asthma.org.uk/adviceline.
http://www.asthma.org.uk
Unusual Ways to Lose Weight: The Ultimate Sex Diet
Forget the Atkins diet and endurance yoga. For, Kelly Brook insists that the best way to stay in shape is to have lots of sex. Well, that's what she told a magazine recently. "Sex keeps me fit and healthy. What can be better than that? It's not about crazy diets or g ym wo rk - outs. At the end of the day, I'm a normal girl and I'm not going to deny myself desserts," she said, adding, "I don't diet and I don't feel under pressure to be a certain shape or size. I am what I am. I keep my figure by eating what I want, but not in bulk." She added that she enjoys making healthy food for her and fiance Billy Zane, including soups, vegetarian and fish dishes: "I always have three meals a day, but if I'm working late, I'll do burger and chips."
What is a Sex Diet?
A Sex Diet is a program which relies on the benefits of love, sex, and intimacy to promote good health. When done properly, sex has been shown to help many people with weightloss, fitness, depression issues, cardiac health, etc.
What is a Sex Diet NOT?
A Sex Diet is NOT a "diet" based on depriving your body of certain foods. It is NOT meant to be undertaken with multiple partners (the benefits of sex are shown to be maximized in monogamous relationships. Using non-monogamous relationships for a Sex Diet can actually be detrimental).
I have a lack of sex drive. How can a Sex Diet help me?
A lack of sex drive can be caused by a variety of factors (including certain medications). One cause is a low testosterone level (this applies to both men and women). If this is the case, a Sex Diet can actually HELP your problem, as certain types of foreplay (i.e. LOVING Pillow Fights, Wrestling, etc.) can actually INCREASE your body's testosterone production. Also, if you have emotional and/or psychological issues, I would highly recommend seeing a psychologist or psychiatrist, and reading The Ultimate Sex Diet by Kerry McCloskey as I think she deals with this topic well.
There are so many "fad diets". Is this another one?
Nope. Sex Dieting is becoming a hot topic in the medical community (amongst sexologists, reproductive health specialists, etc.) Sex Diets do not involve purchasing any "milkshakes" or nasty tasting "low-carb bars". I would, however, encourage you to buy The Ultimate Sex Diet, as it's probably the most comprehensive book on the topic and gives many suggestions that I've found invaluable, including exercise and aphrodesiacs to help you build a program. She also helps you come up with the right attitude to approach your sex diet.
Chewing Gum Sweetener Can Cause Dangerous Weight Loss
Many sugar-free chewing gums contain a sweetener called sorbitol. Sorbitol is a laxative which is poorly absorbed by the small intestine. An article in this week's British Medical Journal (BMJ) warns of the dangers of excess sorbitol intake.The warning comes after doctors came across two patients who had chronic diarrhea, abdominal pain and dangerously excessive weight loss. After lengthy investigations which could not identify why the patients were losing so much weight and had chronic diarrhea and pains, a detailed analysis of eating habits put the problem down to eating too much chewing gum with sorbitol.
One of the patients, a 21-year-old woman, had been eating the equivalent of 18-20g of sorbitol each day. The average stick of gum has about 1.25g sorbitol - so, she was chewing through 15-18 sticks of gum each day. The other patient, a 46-year-old man, was chewing about 20 sticks of sorbitol-containing gum plus approximately 200g of sweets (candy) each day - his total sorbitol daily intake was about 30g, the authors wrote.
As soon as sorbitol intake was stopped, both patients started having normal bowel movements (diarrhea subsided) and normal weight gain was achieved.
The authors say consumers are generally unaware of the possible side-effects of sorbitol, even though details are included in the small print of foods containing it. When consumers have gastronomical problems they are unaware that they may be caused by the laxative effects of sorbitol.
The authors conclude that sorbitol consumption may not only cause chronic diarrhea and functional bowel complaints, but also significant unplanned weight loss of about 20% of body weight. Any investigation of unexplained weight loss should include a detailed dietary history with regard to sorbitol-containing foods.
What is Sorbitol?
Also known as glucitol, sorbitol is a sugar alcohol. The body metabolizes it slowly. It is obtained by reduction of glucose changing the ether group to an addition hydroxyl group - hence the name sugar alcohol.
Sorbitol can be found in cough syrups, sugar free mints, chewing gum, diet foods, diet drinks and ice creams. Sorbitol occurs naturally in some stone fruits and berries from trees of the Sorbus genus.
Sorbitol provides dietary energy of 2.6 kilocalories (11 kilojoules) per gram, compared to sugar which provides about 4 kilocalories (17 kilojoules). Sorbitol retains 60% of the sweetness.
As a food additive Sorbitol has an E-number E420 and is categorized as a sweetener, emulsifier and humectant.
Sorbitol is also used as a non-stimulant laxative. It is either an oral suspension or a suppository. It draws water into the large intestine, stimulating bowel movements.
New Weight-Loss Drug: Taranabant - Blocking Cannabinoid ("Marijuana")Receptors
The first clinical studies of an experimental drug have revealed that obese people who take it for 12 weeks lose weight, even at very low doses. Short-term studies also suggest that the drug, called taranabant - the second drug designed to fight obesity by blocking cannabinoid receptors in the brain - causes people to consume fewer calories and burn more, researchers report in the January issue of Cell Metabolism, a publication of Cell Press. Cannabinoid receptors are responsible for the psychological effects of marijuana (Cannabis sativa), and natural "endocannabinoids" are important regulators of energy balance.
"The effects of marijuana on appetite have been known for millennia from its medicinal and recreational use," said study author Steven Heymsfield of Merck Research Laboratories. "The ingredient responsible stimulates cannabinoid receptors. When you block the cannabinoid system with an antagonist like taranabant, you suppress appetite." However, the drug, developed by Merck, also comes with an increased risk of adverse side effects at higher doses, the study shows, including mild to moderate gastrointestinal and psychiatric effects.
The first proof of concept that so-called cannabinoid 1 receptor (CB1R) inverse agonists might offer an obesity therapy came from studies of another drug, developed by Sanofi-Aventis, called rimonabant. That drug is now in use for weight loss in several European countries as an adjunct to diet and exercise but has not received FDA approval for use in the United States.
Taranabant is a structurally novel, highly selective, potent CB1R inverse agonist, Heymsfield's team said. Preclinical studies in animals showed that it can cause weight loss at doses that block just 30 percent of cannabinoid receptors. To extend those findings to humans in the new studies, the researchers first used positron emission tomography (PET) imaging to identify a dose that would bind about 30 percent of cannabinoid receptors in the human brain. They found that 4 to 6 milligrams of taranabant was enough to achieve that goal.
A multicenter, double-blind, placebo-controlled clinical trial including 533 obese patients showed that the drug induces significant weight loss at doses ranging from 0.5 to 6 milligrams. "That was surprising," Heymsfield said. "We didn't expect weight loss at all doses."
The researchers then conducted separate food intake and energy expenditure studies in overweight and moderately obese people who took a single 4- or 12-milligram dose of taranabant. Those studies showed that people taking 12 milligrams of the drug consumed 27 percent fewer calories than those taking a placebo. People taking the drug also expended more energy while at rest and appeared to burn more fat.
The studies also found that higher doses of the drug caused two types of adverse events, Heymsfield said. These negative side effects included gastrointestinal upset, including nausea and vomiting, as well as increased irritability. Marijuana is often used to combat the nausea associated with chemotherapy drugs, Heymsfield noted, and it also tends to make people mellower. "Here, again, [these drugs] have the opposite effect."
A larger, phase III clinical trial of taranabant is now underway to further explore its effects, Heymsfield said. "All we have here is 12 weeks; we don't yet know what will happen at six months or a year."
Type 2 Diabetes And Carrot Cake Study On Sugar
Patients with type 2 diabetes are often advised to cut out sucrose (table sugar) all together. However, in recent years this traditional advice has been questioned by some researchers who suggest that moderate amounts of sugar can be safely consumed as part of the diet of patients with diabetes. Now a new study has been published that is consistent with this revised approach. It showed that patients who increased their daily sugar intake (in the form of carrot cake) but maintained a stable body weight, showed no adverse changes in their blood glucose.
The study was conducted by the Department of Nutrition and Dietetics at London's Hammersmith Hospital. Three slices of carrot cake were added to the daily diets of nine, overweight type 2 diabetes patients over 24 days (bringing their daily total to 88g or 18 teaspoons of sugar). Consumption of the carrot cake slices was evenly distributed across the day. Several measurements were recorded at the beginning and end of the study, including the patients' weight, blood sugar (glucose) levels, cholesterol levels, and insulin sensitivity (which is a measure of how well the body responds to the hormone insulin).
Professor Gary Frost, who led the study, explained 'In this study, the energy intake of these patients was balanced to their body weight, and their sucrose intake was spread evenly over a day. Correspondingly, they did not gain weight or show an increase in blood glucose levels at the end of the study; in addition, their cholesterol levels and insulin sensitivity did not change.' He added 'the results of this small, short-term study support other scientific studies, which suggest that there could be more flexibility with sucrose in the diets of patients with type 2 diabetes. There is evidence from other studies (reviewed by Kirk et al 2000) that inclusion of sucrose may help people to lower their fat intake, which in turn may be beneficial to overall health'.
Professor Frost continued 'This research is in line with the dietary guidelines set by the American Diabetes Association (2007), which state that sucrose does not cause a greater increase in blood glucose levels than an equivalent amount of starch. Therefore sucrose or sucrose-containing foods should be treated similarly to other carbohydrate containing foods by people with diabetes; either substituted for other carbohydrates in the total daily intake, or managed with appropriate diabetes medication.
Natural Gut Hormones May Provide A Treatment For Obesity
Researchers from the Garvan Institute of Medical Research have shown that a hormone released naturally from the gut could be used to treat obesity and Type 2 diabetes.
After a meal, the hormone peptide YY (PYY) is released into the blood from the gastrointestinal tract. PYY then acts on the brain, contributing to a feeling of satiety and inhibiting the desire to continue eating.
These effects of PYY suggested that it could be used as a weight loss medication. The major unknown was whether or not the effects would last beyond a few weeks, one of the critical requirements of weight loss medications.
Using mice genetically engineered to produce more PYY, Professor Herbert Herzog, Head of Garvan's Neuroscience Program, and Dr Amanda Sainsbury-Salis, a senior scientist within the Neuroscience Program, showed that long-term increases in PYY can induce and maintain lower body fat levels in mice. The results were published online last week in the international journal Neuropeptides.
"At a time when people are considering radical treatments for obesity, including surgical intervention, we're very pleased to have identified a more natural alternative," said Dr Sainsbury-Salis. "If people respond to PYY in the same way as mice, supplements of the hormone should reduce body fat significantly over time."
"The other exciting thing about PYY is that it significantly improves a person's ability to clear glucose, or sugar, from the blood. It should therefore have the ability to prevent glucose intolerance, a known precursor of Type 2 diabetes."
In addition to reducing body fat and improving glucose tolerance, the team showed that elevated PYY also increases thyroid function, which in turn increases body temperature and metabolic rate. So when a PYY-overproducing mouse is fed the same diet as a control mouse, it has less body fat.
Dr Sainsbury-Salis believes these findings pave the way for development of PYY or PYY-like compounds as weight-loss medicines to be used in conjunction with a healthy diet and regular physical activity.
"The advantage of developing weight loss medications based on gut-derived satiety hormones is that they enhance a process that occurs naturally. It is expected, therefore, that side effects will be minimal."
Professor Herbert Herzog is also considering the other side of the equation. In other words, blocking the action of PYY as a possible treatment for the wasting associated with late-stage cancer and anorexia nervosa.
While intense research efforts are aimed at developing gut-derived satiety hormones such as PYY into medications that will help people attain and maintain a healthy body weight, it is likely to be some years before PYY-like products reach the market.
"We don't yet know why some people produce less PYY than others, and are therefore more prone to weight gain," said Dr Sainsbury-Salis. "We do know, however, that adequate food and nutrients are required to stimulate PYY release. This highlights the importance of weight loss regimes that don't leave you feeling hungry, as well as minimizing 'empty kilojoules' such as chips and biscuits and instead choosing nutrient-rich foods.
Reference
Boey D, Lin S, Enriquez RF, Lee NJ, Slack K, Couzens M, Baldock PA, Herzog H, Sainsbury A: PYY transgenic mice are protected against diet-induced and genetic obesity. Neuropeptides.
Healthy Living Probably Gives You 10 More Years
A study of middle aged and older people living in Norfolk, UK, has suggested that not smoking, being active, eating enough fruit and vegetables and drinking only moderate amounts of alcohol can increase lifespan by an average of 10 years compared to people who do none of these things.
The study is published in the online open access journal Public Library of Science Medicine (PLoS Medicine) and is the work of researchers based at the University of Cambridge, and the Medical Research Council, in the UK.
The purpose of the study was to give members of the public and health professionals some clear straightforward information about healthy behaviours and their likely impact on longevity, because much of what is currently available is confusing and appears contradictory. What is a healthy diet? What is enough exercise? How much alcohol is harmful? Also, while there is plenty of research on the impact of individual factors, there is very little on combined effects.
By focussing on four simple health behaviours, as a combination, the researchers hoped to motivate people to make the small changes that can make a big difference to their lives.
The study is part of a European research initiative called the European Prospective Investigation into Cancer and Nutrition (EPIC) that is collecting data on lifestyles, disease and health outcomes in a number of European locations.
The EPIC data allowed the researchers to investigate a cohort based in Norfolk, UK, comprising some 20,000 men and women aged 45 to 79 who were examined and completed lifestyle questionnaires between 1993 and 1997. Deaths among the participants were recorded until 2006. None of the participants had cancer, heart disease or circulation disorders when they took part in the study.
Four types of data were recorded from each participant which resulted in a health score of 0 to 4. One point was given for each of the following health behaviours: non-smoker, physically active, moderate alcohol intake, consuming the equivalent of five servings of fruit and vegetables a day.
Non-smoker was defined as currently not smoking, physically active was having a physically active job (i.e. non-sedentary like plumber or nurse), or having a sedentary job and exercising. Moderate alcohol intake was defined as having between 1 and 14 units a week (a unit is about half a pint of beer, a small glass of wine, or a shot of spirit). Fruit and vegetable intake was assessed from the participant's blood vitamin C.
After taking into account age, the results showed that people with a health behaviour score of 0 were four times more likely to have died by the end of the follow up period as people with a score of 4. The most common cause of death was cardiovascular disease.
People with a score of 2 were twice as likely to have died in the follow up period.
The researchers said these findings suggest that if middle aged or older people were to adopt 4 simple healthy behaviours, they could make a 4-fold improvement to their chances of surviving for another decade or more.
They also suggest that the risk of death goes down as the number of positive healthy behaviours goes up, especially death from cardiovascular conditions.
Another way to look at this result is a person who does none of the four healthy behaviours (scores 0 on this simple scale) has the same risk of dying as a person who is 14 years older who does all of them (scores 4 on this scale).
Although the participants in this study came from all walks of life and social backgrounds, they were predominantly white. The findings need to be confirmed with other populations and the analysis needs to look into impact on quality of life as well as risk of death, suggested the researchers.
Nonetheless, the study is intriguing and helps to pin down in a user friendly and informative way some simple changes that middle aged and older people can make with a reasonable expectation of making a significant impact on their lifespan.
Spread the word. Even Homer Simpson could do this!
"Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study."
Khaw KT, Wareham N, Bingham S, Welch A, Luben R, et al.
PLoS Medicine January 2008, Vol. 5, No. 1, e12.
