Eating fewer, regular-sized meals with higher amounts of lean protein can make one feel more full than eating smaller, more frequent meals, according to new research from Purdue University.

“We found that when eating high amounts of protein, men who were trying to lose weight felt fuller throughout the day; they also experienced a reduction in late-night desire to eat and had fewer thoughts of food,” said Heather J. Leidy, an assistant professor of nutrition and exercise physiology at the University of Missouri who was a postdoctoral researcher at Purdue for this study.

“We also found that despite the common trend of eating smaller, more frequent meals, eating frequency had relatively no beneficial impact on appetite control. The larger meals led to reductions in appetite, and people felt full. We want to emphasize though that these three larger meals were restricted in calories and reflected appropriate portion sizes to be effective in weight loss.”

The findings are reported in this month’s issue of Obesity. This research was funded by the National Pork Board and the American Egg Board, and additional support was provided by the Purdue Ingestive Behavior Research Center and National Institutes of Health’s Indiana Clinical and Translational Sciences Institute.

“Our advice for people trying to lose weight is to add a moderate amount of protein at three regular meals a day to help appetite control and the feeling of fullness,” said Wayne W. Campbell, Purdue professor of foods and nutrition. “Egg and lean pork products are good sources for protein, and if they are incorporated at meals when people do not normally consume protein, such as at breakfast and lunch, they may prove to be a nice strategy to control weight; promote satiety, which is the feeling of being full; and retain lean tissue mass, which is essential for people as they age.”

Leidy said men were studied because they tend to eat more meat and are not studied as often as women. Twenty-seven obese and overweight men were divided into a high-protein group and a normal-protein group. They all consumed a calorie-restricted diet for 12 weeks – which was 750 calories less than their normal diet – an average of about 2,400 calories per person. The amount of protein varied between each group.

The normal-protein diet was composed of 14 percent of energy from protein, 60 percent from carbohydrate and 26 percent from fat, and the high-protein diet had the same amount of fat but 25 percent of energy from protein and 49 percent from carbohydrate.

For example, the normal-protein group’s main sources of protein at a breakfast would be sausage made from vegetable proteins. In comparison, the main source for the high-protein group would be sausage, also made from vegetable proteins, as well as an egg substitute and Canadian bacon. The high-protein diet specifically included 25 percent of total protein intake from pork and 15 percent from egg products. Both sources helped contribute the amino acids and nutrients people need daily, Campbell said. This amount of protein for the high-protein group was estimated at 200 calories per meal.

Another difference between the groups is that the normal-protein diet did not include proteins from flesh foods such as meat.

Beans, legumes and soy products also are high sources of protein, but they are not as prevalent in Americans’ diets as dairy and meat products, Campbell said. About 40 percent of the protein Americans consume comes from meat products such as pork, chicken, beef and fish, and another 5 percent comes from eggs and egg products.

“The studies have not been done to show the superiority of these proteins with comparable quantities consumed,” he said. “What our studies are showing is that by increasing protein in the diet with these food products, the benefits of higher protein intake are noticeable.”

Eating frequency also was tested because it is a common belief that eating more frequent, smaller meals a day can lead to weight loss. One of the reasons for this belief is that older studies suggest people who are overweight and obese tend to eat fewer meals.

“As a result, the idea was that fewer, larger meals were contributing or encouraging over-consumption and resulting in obesity and that the people who were more successful with weight control were eating smaller, more frequent meals,” Campbell said. “But our findings turn that on its head. There also seems to be a growing consensus that these other dietary habits may not be accurately reported because obese and overweight people tend to conceal how frequently and how much they eat.”

Eating frequency was determined starting at week seven for three days. Participants consumed the same amount of calories but with a different distribution: three times a day by eating every five hours or six times a day eating every two hours. The large meals were about 750 calories each. The smaller meals consumed every two hours were estimated at about 375 calories each. Participants also recorded their feelings about hunger and feeling full on a time-stamped electronic device every waking hour.

“First, although we found that daily hunger, desire to eat and preoccupation with thoughts of food were not different between the normal- verses higher-protein groups, the higher-protein group experienced greater fullness through the day,” Leidy said. “Second, we had more individuals struggle with complying with consuming six meals a day, specifically, of those in the study who were not compliant, 90 percent were specifically unable to follow the six-meal-a-day eating pattern. People told us anecdotally that they couldn’t stop work to eat a meal, even if it was small.”

It also is important to note that the more frequent meals were literally the main meals split in half, and the participants were not snacking, she said.

“The definition for a snack can vary, but it is usually accepted to be under 250 calories and between meals,” Leidy said. “Unfortunately, many people easily exceed that today when they combine oversized soft drinks and large portion sizes.”

This study also follows an acute clinical study conducted in a laboratory setting by the same researchers that was published in Obesity in September. In that study, they found that higher protein intake promotes satiety and challenged the concept that smaller, more frequent meals increases the feeling of fullness.

Other research by Leidy and Campbell have shown that restricted-calorie diets high in protein also help retain lean body mass as people lose weight, which is critical for older adults, Campbell said. However, a loss in bone density for postmenopausal women was linked to eating high protein from meat sources.

“Unfortunately, older people are not immune to the obesity epidemic, and they also are likely to lose muscle as they age,” Campbell said. “The combination of overweight, over fat and under muscle is not a good combination for health or quality of life. One of the themes of our research group is to help adults successfully age, and we would like to evaluate the effectiveness of a higher-protein diet with these types of food in this age group while also monitoring key aspects of long-term health such as metabolic syndrome, which includes blood pressure and glucose and cholesterol levels.”

The most recent article was co-authored by Purdue doctoral student Minghua Tang, postdoctoral research associate Cheryl L.H. Armstrong and undergraduate student Carmen B. Martin.

Source:
Amy Patterson Neubert
Purdue University
Obesity / Weight Loss / Fitness From Medical News Today

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Physicians at The University of Texas Health Science Center at Houston (UTHealth) have begun enrollment for a pilot study on a promising surgical approach for the management of Type 2 diabetes.

The procedure being tested is designed for adults who have Type 2 diabetes and who are overweight or obese but not morbidly obese. Millions of Americans have Type 2 diabetes and most are overweight.

Involving surgery to the small intestine and stomach, the procedure, which is called an ileal transposition with sleeve gastrectomy, is intended to improve or resolve Type 2 diabetes. It will be performed at Memorial Hermann-Texas Medical Center.

Type 2 diabetes is a serious health problem and can lead to blindness, limb amputation and heart disease. It is characterized by an elevated blood sugar level associated with the body’s inability to produce enough insulin and/or to use it properly.

The researchers’ goal is to enhance the ability of a person with Type 2 diabetes to maintain a normal blood sugar level by moving a section of intestine closer to the stomach and reducing the size of the stomach.

Currently, many with Type 2 diabetes must take medication on a daily basis to keep sugar levels in check.

The surgical procedure has been associated with encouraging results in clinical research conducted abroad. If the procedure proves effective, it could allow some people with Type 2 diabetes to cut back or quit their medications.

The objectives of the study include evaluating the safety of the procedure and determining its effectiveness compared to dietary and medical management of Type 2 diabetes.

“No one has compared this surgery directly to medical therapy in a randomized, prospective study like this,” said Brad Snyder, M.D., the principal investigator of the study and an assistant professor of surgery at the UTHealth Medical School.

The UTHealth doctors plan to treat 10 people with Type 2 diabetes surgically and 10 medically. Participants will be followed over a two-year period and their outcomes compared.

“If we can get patients into remission and off their medications, then we could open the door for people who want to pursue careers as firefighters, police officers and commercial pilots who may at times be limited by this disease,” Snyder said.

An estimated 26 million people in the United States have diabetes, reports the Centers for Disease Control and Prevention. In adults, Type 2 diabetes accounts for about 90 -95 percent of all diagnosed cases of diabetes. Also known as adult onset diabetes and non-insulin dependent diabetes mellitus, Type 2 diabetes is associated with older age, physical inactivity and certain ethnic groups.

“This disease takes a terrible toll on both patients and their families,” said Erik Wilson, M.D., a study investigator and an associate professor of surgery at the UTHealth Medical School.

The ileum is the final section of the small intestine and transposition means to change place. Human studies have shown that when you place the ileum closer to the stomach, food from the stomach enters the ileum quickly and hormones that help regulate diabetes are easily stimulated.

In the procedure, surgeons remove a section of the ileum that is about 5 feet in length and reattach it. In addition, they remove about 80 percent of the stomach. It is a “band-aid” procedure that is performed through tiny incisions on the abdomen. As with surgical procedures, there is a risk of complication and the risk is anticipated to be in the 1 to 2 percent range.

The procedure is similar to a treatment for morbid obesity – metabolic and bariatric surgery, which can involve surgery on the stomach and intestines. Research shows that oftentimes Type 2 diabetes improves or resolves in morbidly obese patient following gastric bypass surgery.

“We’re not completely sure why people with morbid obesity and Type 2 diabetes experience this improvement following surgery,” Snyder said. It could be a combination of the different metabolism of food, the improvement of insulin action or the improvement in insulin secretion, he said.

“This research will help us find some answers and could lead to future treatments,” Snyder said.

Metabolic and bariatric surgery is typically limited to people with a body mass index of 40 kg/m² or more, or a BMI of 35 kg/m² or more with an obesity-related condition in accordance with National Institutes of Health (NIH) parameters for bariatric surgery. BMI is a calculation based on height and weight.

This pilot study for the surgical management of Type 2 diabetes is restricted to people with a body mass index (BMI) of 25 to 34 kg/m², which includes people who are overweight or obese. Participants must be between 21 and 55 years of age and being treated for Type 2 diabetes.

The clinical trial team includes Philip Orlander, M.D., a professor of medicine and director of the Division of Endocrinology, Diabetes and Metabolism at the UTHealth Medical School, who medically treats people with Type 2 diabetes. When treating patients, Orlander often begins by recommending they lose weight through conventional means such as restricting their calories and exercising more, as well as taking commonly used medications for diabetes. If that fails and they are eligible for bariatric surgery, Orlander will recommend bariatric surgery as a way to control their Type 2 diabetes.

“The average person with Type 2 diabetes may be on 10 different medications to control their blood sugar, cholesterol and blood pressure,” Orlander said. “When we send people to bariatric surgery, a significant portion may be able to stop all of their diabetes, cholesterol and blood pressure medications.”

Frank Moody, M.D., a professor of surgery at the UTHealth Medical School with a longtime interest in the surgical treatment of digestive system diseases, is assisting the research team and said the study could shed light on hormones involved in the metabolic process. “The team will be looking at the impact of surgery on the processing of sugars by the diabetic subjects with an expectation of fixing the break in their metabolism,” Moody said.

If successful, the next step could involve a large clinical trial, Snyder said. “Our intention is to gather this primary data in a small group to show the safety and likely significance as well.”

Snyder, Wilson and Orlander are collaborating on the study with Kelly Wirfel, M.D., an assistant professor of medicine at the UTHealth Medical School. Snyder and Wilson are members of a UT Specialty Surgery Center called Minimally Invasive Surgeons of Texas (MIST) and are on the medical staff of Memorial Hermann-TMC. Wilson is the director of MIST, chief of Elective General Surgery for the UTHealth Medical School and medical director of Bariatric Surgery for Memorial Hermann-TMC.

The study is titled “A Surgical Approach to the Management of Type 2 Diabetes Mellitus in Patients with a BMI between 25-34 kg/m².” The study was approved by the UTHealth Committee for the Protection of Human Subjects and is anticipated to take about three years to complete.

Source:
University of Texas Health Science Center at Houston
Diabetes From Medical News Today

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The study, conducted by the Joslin Diabetes Center on people who have lived with type 1 diabetes for more than 50 years, presents a strong case for the existence of a Some people with diabetes possess yet-unidentified factors that reduce the risk for and even prevent them from developing diabetes-related complications, despite living with the disease for decades, a study published in the April issue of Diabetes Care has found.

The study, conducted by the Joslin Diabetes Center on people who have lived with type 1 diabetes for more than 50 years, presents a strong case for the existence of a protective mechanism in some individuals that allows them to live relatively free of the problems typically associated with long-term duration of diabetes. These mechanisms, the study found, may be different for microvascular (such as kidney, nerve and eye disease) than macrovascular complications (such as heart disease).

“If we can identify what constitutes this protective mechanism, we have the potential to induce such protections in others living with diabetes,” said lead researcher George King, Chief Scientific Officer of the Joslin Diabetes Center and Professor of Medicine at Harvard Medical School. “That’s huge.”

Researchers looked at 351 U.S. residents known as the “Medalist” cohort and found that a subgroup of people who had lived with type 1 diabetes for more than 50 years remained free from such complications as proliferative diabetic retinopathy (PDR), a serious eye disease that can lead to blindness (42.6 percent of them); nephropathy, or kidney damage (86.9 percent of them); neuropathy, or nerve damage (39.4 percent); and cardiovascular disease (51.5 percent). Of those who did not develop PDR, 96 percent with no retinopathy progression in the first 17 years of their disease never experienced a worsening of symptoms, meaning that they likely possessed some type of protection specific to this complication.

Surprisingly, glycemic control was not a factor in providing this protective mechanism.

“That doesn’t mean of course that glycemic control doesn’t help to prevent complications. Numerous other studies have shown that it unquestionably does. In this case, it means only that there is a separate, protective mechanism in play that is not related to glycemic control that also helps to protect against diabetes-related problems. We are still working on identifying just what that is,” King said.

It’s important to note that most of the people in this study developed type 1 diabetes before strict glycemic control was even possible or used as the standard of medical care, the researchers write. The people in this study likely lived for several decades, therefore, without maintaining strict control.

The study also found that those with high plasma carboxyethyl-lysine and pentosidine, or advanced glycation end products (AGEs), were 7.2 times more likely to have some kind of complication than those who had low levels of this combination of AGEs. AGEs are compounds that develop in the body after long exposure to high glucose levels and have generally been regarded as playing a role in diabetes-related complications. However, those with other types of AGE molecules exhibited protective features. Thus, this study suggests that not all AGEs are alike in their actions and raises the exciting possibility that some AGEs may be markers for protection against one or more diabetic complications.

In an accompanying editorial, Dr. Aaron Vinik, Director, Eastern Virginia Medical School Diabetes Research Center, writes that “the accumulation of AGEs may be one of the important factors in metabolic memory,” a phenomenon in which an initial period of good glycemic, lipid and blood pressure control results in a prolonged period of health benefits that last beyond the period of control.

However, while it is clear that for some there is a protective mechanism at play, it’s unclear whether metabolic memory is playing a role because glycemic control was not considered important until 1993, long after the study began.

What’s most interesting, Vinik points out, is that sRAGE (the circulating soluble receptor for AGEs) is deficient in those who have the most severe complications, and is present at high levels in those with the most longevity. “If this is the missing link, it is huge for the possible emergence of a new biomarker and the potential for therapy that might increase circulating sRAGE or sRAGE itself,” he said.

Source:
American Diabetes Association in some individuals that allows them to live relatively free of the problems typically associated with long-term duration of diabetes. These mechanisms, the study found, may be different for microvascular (such as kidney, nerve and eye disease) than macrovascular complications (such as heart disease).

“If we can identify what constitutes this protective mechanism, we have the potential to induce such protections in others living with diabetes,” said lead researcher George King, Chief Scientific Officer of the Joslin Diabetes Center and Professor of Medicine at Harvard Medical School. “That’s huge.”

Researchers looked at 351 U.S. residents known as the “Medalist” cohort and found that a subgroup of people who had lived with type 1 diabetes for more than 50 years remained free from such complications as proliferative diabetic retinopathy (PDR), a serious eye disease that can lead to blindness (42.6 percent of them); nephropathy, or kidney damage (86.9 percent of them); neuropathy, or nerve damage (39.4 percent); and cardiovascular disease (51.5 percent). Of those who did not develop PDR, 96 percent with no retinopathy progression in the first 17 years of their disease never experienced a worsening of symptoms, meaning that they likely possessed some type of protection specific to this complication.

Surprisingly, glycemic control was not a factor in providing this protective mechanism.

“That doesn’t mean of course that glycemic control doesn’t help to prevent complications. Numerous other studies have shown that it unquestionably does. In this case, it means only that there is a separate, protective mechanism in play that is not related to glycemic control that also helps to protect against diabetes-related problems. We are still working on identifying just what that is,” King said.

It’s important to note that most of the people in this study developed type 1 diabetes before strict glycemic control was even possible or used as the standard of medical care, the researchers write. The people in this study likely lived for several decades, therefore, without maintaining strict control.

The study also found that those with high plasma carboxyethyl-lysine and pentosidine, or advanced glycation end products (AGEs), were 7.2 times more likely to have some kind of complication than those who had low levels of this combination of AGEs. AGEs are compounds that develop in the body after long exposure to high glucose levels and have generally been regarded as playing a role in diabetes-related complications. However, those with other types of AGE molecules exhibited protective features. Thus, this study suggests that not all AGEs are alike in their actions and raises the exciting possibility that some AGEs may be markers for protection against one or more diabetic complications.

In an accompanying editorial, Dr. Aaron Vinik, Director, Eastern Virginia Medical School Diabetes Research Center, writes that “the accumulation of AGEs may be one of the important factors in metabolic memory,” a phenomenon in which an initial period of good glycemic, lipid and blood pressure control results in a prolonged period of health benefits that last beyond the period of control.

However, while it is clear that for some there is a protective mechanism at play, it’s unclear whether metabolic memory is playing a role because glycemic control was not considered important until 1993, long after the study began.

What’s most interesting, Vinik points out, is that sRAGE (the circulating soluble receptor for AGEs) is deficient in those who have the most severe complications, and is present at high levels in those with the most longevity. “If this is the missing link, it is huge for the possible emergence of a new biomarker and the potential for therapy that might increase circulating sRAGE or sRAGE itself,” he said.

Source:
American Diabetes Association
Diabetes From Medical News Today

http://www.medicalnewstoday.com

A new study on the use of prostate-specific antigen (PSA)-based prostate cancer screening in the United States found that many elderly men may be undergoing unnecessary prostate cancer screenings. Using data from surveys conducted in 2000 and 2005, researchers report that nearly half of men in their seventies underwent PSA screening in the past year almost double the screening rate of men in their early fifties, who are more likely to benefit from early prostate cancer diagnosis and treatment. Further, men aged 85 and older were screened just as often as men in their early fifties.

Because prostate cancer tends to be slow-growing, data show that many men particularly those in their seventies and older will die of other causes before prostate cancer becomes a problem that requires medical attention. The new findings underscore a long-standing concern that overuse of PSA screening and PSA-based treatment decisions may lead to unnecessary treatment of many older men and potential complications such as incontinence, impotence and bowel dysfunction.

“Our findings show a high rate of elderly and sometimes ill men being inappropriately screened for prostate cancer. We’re concerned these screenings may prompt cancer treatment among elderly men who ultimately have a very low likelihood of benefiting the patient and paradoxically can cause more harm than good,” said senior author Scott Eggener, MD, assistant professor of surgery at the University of Chicago. “We were also surprised to find that nearly three-quarters of men in their fifties were not screened within the past year. These results emphasize the need for greater physician interaction and conversations about the merits and limitations of prostate cancer screening for men of all ages.”

While large declines in prostate cancer metastases and death rates in the last 20 years coincide with widespread use of PSA-based screening, questions remain about its use. Data have been unclear about when men should be considered for PSA screening and when screening should stop, and recent studies have provided conflicting evidence on whether routine PSA screening in the general population of men actually reduces the risk of dying from prostate cancer. Based on these concerns, major organizations such as the American Cancer Society now encourage men who expect to live at least 10 years to talk with their doctor about the risks and benefits of screening, starting at age 50 for men with an average risk or at age 45 for men with a higher risk.

In this study, the researchers examined results from health surveys of randomly selected households conducted in 2000 and 2005 as part of the federal government-sponsored National Health Interview Survey. In addition to reviewing survey data, which included information on age, smoking, mass-body index, underlying medical conditions and other factors, the investigators calculated the estimated five-year life expectancy of each man over 40 who had received a PSA test.

They divided survey results of men age 70 and older into five-year age groups (70 to 74, 75 to 79, 80 to 84, and 85 years and older). In all, 2,623 men ages 70 and older were included in the analysis, while nearly 12,000 men between the ages of 40 and 69 served as controls.

The overall PSA screening rate within the past year for men aged 40 and older was 23.7 percent in 2000 and 26.0 percent in 2005. The PSA screening rate was lowest in the 40 to 44 age group (7.5 percent). Researchers found that the PSA screening rate was 24.0 percent in men ages 50 to 54, increasing with age until a peak of 45.5 percent in ages 70 to 74. Screening rates then declined with age, with 24.6 percent of men 85 or older reporting being screened.

Among men who were 70 or older, the investigators did find that PSA screening was more common in men with a greater estimated five-year life expectancy. For example, approximately 47.3 percent of men who were unlikely to die in five years (an estimated chance of 15 percent or less) were screened, 39.2 percent of men with an intermediate chance (16 to 48 percent probability) of dying received screening, and 30.7 percent of those with the highest probability of death (48 percent or greater) in five years were screened.

Eggener offered some possible explanations for the results, noting that screening rates may reflect how frequently men visit primary care physicians. Older men tend to have more health problems that require doctor visits, and this may in turn result in more frequent PSA testing than younger men, who see their doctors less. The authors suggest that physicians should be more selective in recommending PSA testing for older men, particularly those with a limited life expectancy, and consider more routinely screening younger, healthier men who are most likely to benefit from early prostate cancer diagnosis and related treatment. Men are encouraged to talk with their doctor about their individual risk for prostate cancer, and about the risks and benefits of prostate cancer screening.

Source: American Society of Clinical Oncology (ASCO)

Prostate / Prostate Cancer From Medical News Today

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The paper, published today in the International Journal of Obesity, was the result of a study funded by the National Institutes of Health’s National Center for Complementary and Alternative Medicine.

Nearly 500 participants from Kaiser Permanente in Oregon and Washington took part in the study, which measured whether sleep, stress, depression, television viewing, and computer screen time were correlated with weight loss. Several previous studies have found an association between these factors and obesity, but few have looked at whether these factors predict weight loss.

“This study suggests that when people are trying to lose weight, they should try to get the right amount of sleep and reduce their stress,” said lead author Charles Elder, MD, MPH, an investigator with the Kaiser Permanente Center for Health Research in Portland, Ore., who also leads Integrative Medicine at Kaiser Permanente Northwest. “Some people may just need to cut back on their schedules and get to bed earlier. Others may find that exercise can reduce stress and help them sleep. For some people, mind/body techniques such as meditation also might be helpful.”

The study involved two phases: during the first phase, participants were asked to lose at least 10 pounds over six months. If they succeeded, they moved to the second year-long phase of the study, which tested a complementary acupressure technique against more traditional weight-maintenance strategies. Findings from phase two are not yet available.

During the study’s first phase, all participants attended weekly meetings at which they were weighed and advised to reduce calorie intake by 500 calories per day, adopt a low-fat, low-sugar diet with lots of fruits and vegetables, increase physical activity to 180 minutes a week, and keep daily food records. People who kept more food records and attended more meetings were more likely to lose weight during this phase of the trial.

Participants also were asked to report levels of insomnia, stress and depression, and to record how much time they slept and spent watching television or using a computer. The research team found that sleep and stress levels were good predictors of weight loss, but depression and screen time were not.

People with the lowest stress levels who also got more than six hours, but not more than eight hours, of sleep were most likely to lose at least 10 pounds. In fact, nearly three-quarters of this group moved on to the second phase of the trial, and were twice as likely to be successful as those who reported the highest stress levels and got six or fewer hours of sleep per night.

Participants who qualified for the second phase were divided into two groups: one received monthly guided instruction in the Tapas Acupressure Technique, which involves lightly touching specific pressure points on the face and back of the head while focusing on a problem (i.e., maintaining weight loss). The other group also met monthly with a trained interventionist and a support group, but used more traditional nutrition and exercise techniques to keep weight off. Both groups met for six months and then were followed for another six months to see which group kept more weight off. Results of that phase of the trial should be available in late 2011 or early 2012.

The study authors caution that their findings may not apply to all groups trying to lose weight. The authors also noted that the participants were highly motivated, and that 90 percent had attended at least some college.

These studies are part of ongoing research at Kaiser Permanente to better understand weight loss and the key factors to maintaining optimum weight. Another Kaiser Permanente Center for Health Research study last year found that the more people logged on to an interactive weight management website, the more weight they kept off. Researchers at the Kaiser Permanente Center for Health Research also found that keeping a food diary can double a person’s weight loss and that both personal contact and web-based support can help with long-term weight management.

Study authors include: Charles R. Elder, MD, MPH, Christina M. Gullion, PhD, Kristine L. Funk, MS, Lynn L. DeBar, PhD, Nangel M. Lindberg, PhD, and Victor J. Stevens, PhD, all from the Kaiser Permanente Center for Health Research in Portland, Ore.

Source:
Kaiser Permanente Center for Health Research
Obesity / Weight Loss / Fitness From Medical News Today

http://www.medicalnewstoday.com

A new study from Northwestern Medicine shows a high-fiber diet could be a critical heart-healthy lifestyle change young and middle-aged adults can make. The study found adults between 20 and 59 years old with the highest fiber intake had a significantly lower estimated lifetime risk for cardiovascular disease compared to those with the lowest fiber intake.

The study will be presented March 23 at the American Heart Association’s Nutrition, Physical Activity and Metabolism/Cardiovascular Disease Epidemiology and Prevention Scientific Sessions 2011 in Atlanta, Ga. This is the first known study to show the influence of fiber consumption on the lifetime risk for cardiovascular disease.

“It’s long been known that high-fiber diets can help people lose weight, lower cholesterol and improve hypertension,” said Donald M. Lloyd-Jones, M.D., corresponding author of the study and chair of the department of preventive medicine at Northwestern University Feinberg School of Medicine and a cardiologist at Northwestern Memorial Hospital. “The results of this study make a lot of sense because weight, cholesterol and hypertension are major determinants of your long-term risk for cardiovascular disease.”

A high-fiber diet falls into the American Heart Association’s recommendation of 25 grams of dietary fiber or more a day. Lloyd-Jones said you should strive to get this daily fiber intake from whole foods, not processed fiber bars, supplements and drinks.

“A processed food may be high in fiber, but it also tends to be pretty high in sodium and likely higher in calories than an apple, for example, which provides the same amount of fiber,” Lloyd-Jones said.

For the study, Hongyan Ning, M.D., lead author and a statistical analyst in the department of preventive medicine at Feinberg, examined data from the National Health and Nutrition Examination Survey, a nationally representative sample of about 11,000 adults.

Ning considered diet, blood pressure, total cholesterol, smoking status and history of diabetes in survey participants and then used a formula to predict lifetime risk for cardiovascular disease.

“The results are pretty amazing,” Ning said. “Younger (20 to 39 years) and middle-aged (40 to 59 years) adults with the highest fiber intake, compared to those with the lowest fiber intake, showed a statistically significant lower lifetime risk for cardiovascular disease.”

In adults 60 to 79 years, dietary fiber intake was not significantly associated with a reduction in lifetime risk of cardiovascular disease. It’s possible that the beneficial effect of dietary fiber may require a long period of time to achieve, and older adults may have already developed significant risk for heart disease before starting a high-fiber diet, Ning said.

As for young and middle-aged adults, now is the time to start making fiber a big part of your daily diet, Ning said. “The study suggests that starting a high-fiber diet now may help improve your long-term risk.”

Source:
Erin White
Northwestern University
Nutrition / Diet From Medical News Today

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“Before our discovery, the mechanism behind how exactly the insulin-producing beta cells in the islet of Langerhans of the pancreas fail in type 2 diabetes was incompletely understood, making it difficult to design new and better therapies, says Mehboob Hussain, M.D., associate professor of pediatrics, medicine and biological chemistry. “Our research cracks open a decades-long mystery.”

After a meal, the pancreas produces insulin to move glucose from the blood into cells for fuel. People with type 2 diabetes either don’t secrete enough insulin or their cells are resistant to its effects.

In a study designed to figure out more precisely how the pancreas releases insulin, Hussain’s group looked at how other cells in the body release chemicals. One particular protein, Snapin, found in nerve cells, caught their eye because it’s used by nerve cells to release chemicals necessary for cell communication. Snapin also is found in the insulin-secreting pancreatic beta cells.

To test the role of Snapin, researchers engineered a change to the Snapin gene in mice to keep Snapin permanently “on” in the pancreas. Researchers removed the pancreas cells and grew them in a dish for a day, then added glucose to the cells and took samples to measure how much insulin was released.

When the scientists compared that measurement to what was released by pancreas cells in normal mice, they found that normal mice released about 2.8 billionths of a gram of insulin per cell, whereas the cells from “Snapin-on” mice released 7.3 billionths of a gram of insulin per cell – about three times the normal amount.

“We were surprised to find that the Snapin-on mice didn’t have more or bigger pancreas cells, they just made more insulin naturally,” says Hussain. “This means all our insulin-secreting cells have this amazing reserve of insulin that we didn’t really know existed and a switch that controls it.”

To see if permanently turning off Snapin would reduce insulin release and further demonstrate that Snapin controls the process, the researchers first grew normal mouse pancreas cells in a dish, and treated them with a chemical that stopped them from making the Snapin protein. They again bathed the cells in glucose and measured how much insulin was released by the cells. Normal cells released 5.8 billionths of a gram of insulin, whereas cells with no Snapin only released 1.1 billionths of a gram of insulin – about 80 percent less.

“These results convinced us that Snapin is indeed the switch that releases insulin from the pancreas,” says Hussain.

Biology / Biochemistry From Medical News Today

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People with diabetes could be helped by a new type of self-monitoring blood glucose sensor being developed by Arizona State University engineers and clinicians at Mayo Clinic in Arizona.

More than 23 million people in the United States have diabetes. The disease is the fifth leading cause of death in the United States. It contributes to a higher risk for heart disease, blindness, kidney failure, lower extremity amputations and other chronic conditions.

Many people with diabetes suffer due to the difficulty of managing their blood glucose levels. It’s recommended that they monitor their own glucose levels, but current monitoring devices typically require patients to perform the painful task of pricking their finger to draw blood for a test sample – and many patients must do it several times each day.

The new sensor would enable people to draw tear fluid from their eyes to get a glucose-level test sample.

Glucose in tear fluid may give an indication of glucose levels in the blood as accurately as a test using a blood sample, the researchers say.

“The problem with current self-monitoring blood glucose technologies is not so much the sensor. It’s the painful finger prick that makes people reluctant to perform the test. This new technology might encourage patients to check their blood sugars more often, which could lead to better control of their diabetes by a simple touch to the eye,” says bioengineer Jeffrey T. LaBelle.

LaBelle, the designer of the device technology, is a research professor in the School of Biological and Health Systems Engineering, one of ASU’s Ira A. Fulton Schools of Engineering.

He is leading the ASU-Mayo research team along with Mayo Clinic physicians Curtiss B. Cook, an endocrinologist, and Dharmendra (Dave) Patel, chair of Mayo’s Department of Surgical Ophthalmology.

The team reported on their early work on the sensor in the Journal of Diabetes Science and Technology last year and at various regional and national conferences.

Because of its potential impact on health care, the technology has drawn interest from BioAccel, an Arizona nonprofit that works to accelerate efforts to bring biomedical technologies to the marketplace.

“A critical element to commercialization is the validation of technology through proof-of -concept testing,” says Nikki Corday, BioAccel business and development manager. “Positive results will help ensure that the data is available to help the research team clear the technical hurdles to commercialization.”

Researchers must now compile the proper data set to allow for approval of human testing of the device.

“With funding provided by BioAccel, the research team will conduct critical experiments to determine how well the new device correlates with use of the current technology that uses blood sampling,” says Ron King, BioAccel’s chief scientific and business officer.

The results should help efforts to secure downstream funding for further development work from such sources as the National Institutes of Health and the Small Business Incentive Research Program, King says.

BioAccel will also provide assistance using a network of technical and business experts, including the New Venture Group, a business consulting team affiliated with the W. P. Carey School of Business at ASU under the supervision of associate professor Daniel Brooks.

The ASU-Mayo research team began the project with funds from a seed grant from Mayo Clinic. Researchers got assistance in the laboratory from ASU students involved in research at ASU’s Biodesign Institute and the Ira A. Fulton Schools of Engineering Fulton Undergraduate Research Initiative program.

Team members assessed how current devices were working – or failing – and how others have attempted to solve monitoring problems, LaBelle says.

They came up with a device that can be dabbed in the corner of the eye, absorbing a small amount of tear fluid like a wick that can then be used to measure glucose.

The major challenges are performing the test quickly, efficiently, with reproducible results, without letting the test sample evaporate and without stimulating a stress response that causes people to rub their eyes intensely, LaBelle says.

A study commissioned by the American Diabetes Association reported that in 2007 the national economic burden related to diabetes was more than $170 billion – including about $116 billion in additional health care costs and $58 billion in lost productivity from workers debilitated by the disease.

Source:
Mayo Clinic
Diabetes From Medical News Today

http://www.medicalnewstoday.com

As evidence regarding the health benefits of consuming dark chocolate and cocoa mounts, there has been an increasing debate about which cocoa and chocolate products deliver the most beneficial compounds, known as flavanols, and if steps in cocoa and chocolate production diminish the levels of cocoa flavanols.

In a recently published paper, scientists reported on the effect of conventional production methods of cocoa beans on the levels of flavanols, natural antioxidants. The study, conducted by researchers at the Hershey Center for Health & Nutrition®, investigated cocoa beans and cocoa powders and described production steps that retain naturally occurring flavanols and reported that alkali processing causes a loss of up to 98% of one important flavanol, epicatechin, in the final product.

The study, published in the Journal of Agricultural and Food Chemistry, compared the effects of various common production methods on freshly harvested unfermented and naturally farm-fermented beans. Levels of epicatechin and catechin, a less active flavanol antioxidant, were compared in beans that were unfermented and in beans that underwent medium (about 5 days) and long fermentation (about 10 days). Long fermentation previously has been shown to impact the level of epicatechin in cocoa beans, and the authors reported loss of both flavanols as fermentation time increased.

Beans were roasted to temperatures of 120°C and the researchers found that temperatures of 70°C or higher caused some loss (up to 88% at 120oC) of epicatechin. Catechin levels, however, increased as roasting temperature increased. Additionally, natural cocoa powders and powders that had been treated with different levels of alkali also were measured. The study found that by far the greatest flavanol losses occurred during alkali processing. The results also suggested that epicatechin may be converted to catechin by alkali processing.

“This study is meant to address the impact of processing on the level of beneficial flavanol antioxidants found in cocoa beans” said Dr. Mark Payne, lead author of the paper. “We found that the processing step which causes the most loss in the flavanol epicatechin is the alkali processing step. Here the epicatechin, which is thought to be most beneficial, appears to be converted to catechin which has been shown to be less active in the body.”

“Most of the world’s cocoa beans undergo a natural, field fermentation on the farm and then roasting,” said Dr. David A. Stuart, co-director of the Hershey Center. “Both steps are critical to the flavor development for chocolate and cocoa powder. It is important that we understand the balance in creating the wonderful flavor of chocolate with the health benefits of cocoa powder and dark chocolate. This study has gone a long way in furthering that understanding and is the first systematic study of the whole process, from bean to powder, that we are aware of.”

Notes: The Hershey Center For Health & Nutrition® investigates and promotes the chemistry and health benefits of cocoa, chocolate, nuts and other ingredients.

Source:
Mark J Payne
The Hershey Company
Nutrition / Diet From Medical News Today

http://www.medicalnewstoday.com

The Mediterranean diet has proven beneficial effects not only regarding metabolic syndrome, but also on its individual components including waist circumference, HDL-cholesterol levels, triglycerides levels, blood pressure levels and glucose metabolism, according to a new study published in the March 15, 2011, issue of the Journal of the American College of Cardiology. The study is a meta-analysis, including results of 50 studies on the Mediterranean diet, with an overall studied population of about half a million subjects.

“The prevalence of the metabolic syndrome is increasing rapidly throughout the world, in parallel with the increasing incidence of diabetes and obesity, and is now considered a major public health problem,” said lead investigator Demosthenes Panagiotakos, Ph.D., associate professor in Biostatistics-Epidemiology of Nutrition, Department of Science of Dietetics – Nutrition, Harokopio University of Athens. “Additionally, the metabolic syndrome is one of the main causes of cardiovascular disease (directly or indirectly), associated with personal and socio-economic burdens. As a result, prevention of this condition is of considerable importance.”

The Mediterranean diet is a dietary pattern characterized by high consumption of monounsaturated fatty acids, primarily from olives and olive oils; daily consumption of fruits, vegetables, whole grain cereals, and low-fat dairy products; weekly consumption of fish, poultry, tree nuts, and legumes; a relatively low consumption of red meat; and a moderate daily consumption of alcohol, normally with meals.

The Mediterranean diet, according to Dr. Panagiotakos and Christina-Maria Kastorini, MSc, Ph.D. cand., is one of the best-known and well-studied dietary patterns, which has been shown to be associated with decreased mortality from all causes, lower risk for cardiovascular disease, type 2 diabetes, obesity and some types of cancer. Additionally, it has a beneficial effect on abdominal obesity, lipids levels, glucose metabolism and blood pressure levels, which are also risk factors for the development of cardiovascular disease and diabetes. The antioxidant and anti-inflammatory effects of the Mediterranean diet as a whole, as well as the effects of the individual components of the diet, and especially olive oil, fruits and vegetables, whole grains and fish, also confer to the beneficial role of this pattern.

“To the best of our knowledge, our study is the first work that has systematically assessed, through a large meta-analysis, the role of the Mediterranean diet on metabolic syndrome and its components,” he said. “Our results add to the existing knowledge, and further demonstrate the protective role and the significance that lifestyle factors, and mainly dietary habits, have when it comes to the development and progression of the metabolic syndrome.”

Encouraging adherence to a healthy dietary pattern like the Mediterranean diet, as well as the adoption of an active lifestyle, seems to be a cornerstone in developing public health strategies for the prevention of the metabolic syndrome, Dr. Panagiotakos suggested. Taking into account the limited financial resources many countries face in the 21st century, better eating seems to be an effective and affordable means for preventing cardiovascular diseases, at the population level, he suggested. In addition to its various health benefits, this dietary pattern can be easily adopted by all populations and various cultures.

Source:
Amanda Jekowsky
American College of Cardiology
Nutrition / Diet From Medical News Today

http://www.medicalnewstoday.com