Bradley Waggoner, MD

Component in Common Dairy Foods May Cut Diabetes Risk

Scientists at the Harvard School of Public Health (HSPH) and collaborators from other institutions have identified a natural substance in dairy fat that may substantially reduce the risk of type 2 diabetes. The compound, trans-palmitoleic acid, is a fatty acid found in milk, cheese, yogurt, and butter. It is not produced by the body and so only comes from the diet.

Reporting in the December 21, 2010, issue of Annals of Internal Medicine, investigators led by Dariush Mozaffarian, associate professor in the Department of Epidemiology at HSPH and Division of Cardiovascular Medicine, Brigham and Women’s Hospital and Harvard Medical School, and Gökhan S. Hotamisligil, J.S. Simmons Professor of Genetics and Metabolism and chair of the Department of Genetics and Complex Diseases at HSPH, explain that trans-palmitoleic acid may underlie epidemiological evidence in recent years that diets rich in dairy foods are linked to lower risk of type 2 diabetes and related metabolic abnormalities.  Health experts generally advise reducing full-fat dairy products, but trans-palmitoleic acid is found in dairy fat.

The HSPH researchers examined 3,736 participants in the National Heart, Lung, and Blood Institute-funded Cardiovascular Health Study, who have been followed for 20 years in an observational study to evaluate risk factors for cardiovascular diseases in older adults. Metabolic risk factors such as blood glucose and insulin levels, and also levels of circulating blood fatty acids, including trans-palmitoleic acid, were measured using stored blood samples in 1992, and participants were followed for development of type 2 diabetes.

At baseline, higher circulating levels of trans-palmitoleic acid were associated with healthier levels of blood cholesterol, inflammatory markers, insulin levels, and insulin sensitivity, after adjustment for other risk factors. During follow-up, individuals with higher circulating levels of trans-palmitoleic acid had a much lower risk of developing diabetes, with about a 60% lower risk among participants in the highest quintile (fifth) of trans-palmitoleic acid levels, compared to individuals in the lowest quintile.

“This type of observational finding requires confirmation in additional observational studies and controlled trials, but the magnitude of this association is striking,” said Mozaffarian, lead author of the study. “This represents an almost three-fold difference in risk of developing diabetes among individuals with the highest blood levels of this fatty acid.”

In contrast to the types of industrially produced trans fats found in partially hydrogenated vegetable oils, which have been linked to higher risk of heart disease, trans-palmitoleic acid is almost exclusively found in naturally-occurring dairy and meat trans fats, which in prior studies have not been linked to higher heart disease risk.

“There has been no clear biologic explanation for the lower risk of diabetes seen with higher dairy consumption in prior studies. This is the first time that the relationship of trans-palmitoleic acid with diabetes risk has been evaluated,” said Mozaffarian. “We wonder whether this naturally occurring trans fatty acid in dairy fats may partly mimic the normal biologic role of its cis counterpart, cis-palmitoleic acid, a fatty acid that is produced in the body. In animal experiments, cis-palmitoleic acid protects against diabetes.” 

“Unfortunately, with modern diets, synthesis of cis-palmitoleic acid is now driven by high amounts of carbohydrate and calories in the diet, which might limit its normal protective function. We wonder whether trans-palmitoleic acid may be stepping in as a “pinch hitter” for at least some of the functions of cis-palmitoleic acid,” said Mozaffarian.

Hotamisligil, the study’s senior author, also emphasized the magnitude of the risk reduction. “This is an extremely strong protective effect, stronger than other things we know can be beneficial against diabetes. The next step is to move forward with an intervention trial to see if there is therapeutic value in people.”

Because trans-palmitoleic acid, also known as trans-palmitoleate, is a natural compound, Hotamisligil said that conducting clinical trials should be possible. “This study represents the power of interdisciplinary work bridging basic science with population studies to realize exciting translational possibilities,” he said.

Support for the study was provided by the National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health and the National Institutes of Health Office of Dietary Supplements and National Institute of Neurological Disorders and Stroke. A subset of additional fatty acid measurements were supported by a Searle Scholar Award.

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Harvard School of Public Health, (2010, December 20).

Journal Reference: “Trans-Palmitoleic Acid, Metabolic Risk Factors, and New-Onset Diabetes in U.S. Adults,” Dariush Mozaffarian, Haiming Cao, Irena B. King, Rozenn N. Lemaitre, Xiaoling Song, David S. Siscovick, and Gökhan S. Hotamisligil, Annals of Internal Medicine, December 21, 2010.

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Limiting Salt Lowers Blood Pressure and Health Risks in Diabetes

For patients living with diabetes, reducing the amount of salt in their daily diet is key to warding off serious threats to their health, a new review of studies finds.

In the Cochrane review, the authors evaluated 13 studies with 254 adults who had either type 1 or type 2 diabetes. For an average duration of one week, participants were restricted to large reduction in their daily salt intake to see how the change would affect their blood pressure.

“We were surprised to find so few studies of modest, practical salt reduction in diabetes where patients are at high cardiovascular risk and stand much to gain from interventions that reduce blood pressure,” said lead reviewer Rebecca Suckling. “However, despite this, there was a consistent reduction in blood pressure when salt intake was reduced.”

Suckling is part of the Blood Pressure Unit at St. George’s Hospital Medical School, in London.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

Patients with diabetes need to be extra cautious to maintain their blood pressure at an acceptable range of less than 130/80 mmHg. However, in the 2003-2004 period, 75 percent of adults with diabetes had blood pressure greater than or equal to 130/80 mmHg or used prescription hypertension medications, according to the American Diabetes Association (ADA).

High salt intake is a major cause for increased blood pressure and, in those with diabetes, elevated blood pressure can lead to more serious health problems, including stroke, heart attack and diabetic kidney disease. The ADA also reports that diabetic kidney disease is the leading cause of chronic kidney disease, accounting for 44 percent of new cases in 2005.

In the Cochrane review, the participants’ average salt intake was restricted by 11.9 grams a day for those with type 1 diabetes and by 7.3 grams a day for those with type 2.

The reviewers wrote that reducing salt intake by 8.5 grams a day could lower patients’ blood pressure by 7/3 mmHg. This was true for patients with both type 1 and type 2 diabetes. The reviewers noted that this reduction in blood pressure is similar to that found from taking blood pressure medication.

Suckling acknowledged that studies in the review only lasted for a week and that the type of salt restriction probably would not be manageable for longer periods.

“The majority of studies were small and only of a short duration with large changes in salt intake,” she said. “These studies are easy to perform and give information on the short-term effects of salt reduction.”

However, Suckling said, the review also found that in studies greater than two weeks, where salt was reduced by a more achievable and sustainable amount of 4.5 grams a day, blood pressure was reduced by 6/4 mmHg.

Diabetes specialist Todd Brown, M.D., of the Division of Endocrinology and Metabolism at Johns Hopkins University, said that practicing low-salt diets of these types is quite challenging for most patients with diabetes even though they know the health risks.

“The effects of salt on blood pressure are well known to health professionals and most patients, but what is less well known is where the salt comes from in our diet,” Brown said.

“The overwhelming majority comes from the processed foods that we eat,” he said. “If we are going to realize the benefits of sodium reduction on blood pressure and other health outcomes, we should focus less on the salt shaker and more on what we buy in the supermarket and at chain restaurants.”

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Health Behavior News Service, Part of the Center for Advancing Health (2010, December 7). 

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Carbohydrate Claims Can Mislead Consumers, Study Finds

Food manufacturers advertise a variety of foods on grocery store shelves by using nutrient claims on the front of packaging. A study in the September/October issue of the Journal of Nutrition Education and Behavior evaluates how consumers are interpreting certain carbohydrate-related content claims and the effects of claims on consumer perceptions of food products. Findings from this study reveal that consumers misinterpret low carbohydrate claims to have health benefits and weight loss qualities beyond their nutrition facts.

In the early 2000s, low-carbohydrate claims gained huge popularity in response to such books as Dr. Atkin's New Diet Revolution and The South Beach Diet. In a study published in AC Nielsen Consumer Insights, it was noted that there was a 516% sales increase in low-carbohydrate food products from 2001 to 2005 showing that front of package claims can play a large part in consumer decisions.

Existing research suggests that consumers are less likely to turn to the back of a package to look at the Nutrition Facts panel when there is a claim on the front of the package. In the new study, researchers at the United States Food and Drug Administration, Center for Food Safety and Applied Nutrition sought to determine whether low-carbohydrate claims might lead consumers to perceive products to have benefits that are not necessarily related to being low in carbohydrate. Using an online questionnaire, 4,320 consumer panelists rated products for their perceived healthfulness, helpfulness for weight management, and caloric content based on front-of-package-only conditions (nutrition claims versus no nutrition claims) and availability of Nutrition Facts panels.

This study documents that in the absence of Nutrition Facts panels, "low-carbohydrate claims led to more favorable perceptions about products' helpfulness for weight management, healthfulness, and caloric content. Because an individual packaged food product's usefulness for weight management as part of an overall diet, its healthfulness, and total calorie content are not dependent solely on the amount of total carbohydrate it contains, the study demonstrated that consumers could misattribute benefits to products that claim to be low in carbohydrate."

However, the researchers found that when the Nutrition Facts panels are available "participants' perceptions became more consistent with the nutrition profile of the products…By showing the claims and the NF [nutrition facts] side-by-side, both pieces of information were equally accessible to participants as they answered the study questions. The presence of the NF, however, allowed participants to use this more diagnostic information to judge the product."

One limitation mentioned in this study by Dr. Judith Labiner-Wolfe, former consumer science specialist at the United States Food and Drug Administration (now an evaluation specialist at the United States Department of Health and Human Services' Office on Women's Health) and colleagues is that "the online venue for viewing the stimuli and answering the study questions may have fewer distractions than situations in which consumers make real product judgments, such as in a busy grocery store. Therefore, this study may overestimate the effect of the Nutrition Facts panel. Findings from this research are consistent with previous experimental studies that found participants misattribute health benefits to products with claims and that nutrition information has an independent effect on perceptions." The authors' state, "although exposure to the Nutrition Facts has the potential for mitigating inappropriate benefits attributed to products claiming to be low carbohydrate, previous consumer research suggests that when a food product carries a front-of-package claim, consumers are less likely to turn the package over to look at the Nutrition Facts panel."

Within the article, the researchers emphasize the important role nutrition educators have in helping consumers better understand the limited meaning of front- of- package claims and to further emphasize the importance of using the Nutrition Facts panel when making food choices.

The article is "Effect of Low-carbohydrate Claims on Consumer Perceptions about Food Products' Healthfulness and Helpfulness for Weight Management" by Judith Labiner-Wolfe, PhD; Chung-Tung Jordan Lin, PhD; and Linda Verrill, PhD. It appears in the Journal of Nutrition Education and Behavior, Volume 42, Issue 5 (September/October 2010) published by Elsevier.

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Elsevier Health Sciences (2010, October 11). Carbohydrate claims can mislead consumers, study finds. ScienceDaily. Retrieved November 7, 2010, from ScienceDaily.com.

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GSU Professor Finds Link Between Obesity and Federal School Nutrition Programs

With obesity becoming an epidemic among school-aged children in this country, a Georgia State University professor has found a link between overweight children and federal school nutrition programs.

Research reveals that children who eat lunch as part of the National School Lunch Program (NSLP) have an increased likelihood of becoming overweight, according to research co-authored by Rusty Tchernis, associate professor with Georgia State University’s Andrew Young School of Policy Studies¹. The findings also show that the School Breakfast Program (SBP) is a “valuable tool in the current battle against childhood obesity,” according to the research.

“Overweight children are more likely to become obese adults,” Tchernis said. “So the only way to reduce obesity is to prevent it from happening in children.”

The study, "School Nutrition Programs and the Incidence of Childhood Obesity,” will be published in the summer edition of The Journal of Human Resources.

The research – co-authored also by Muna Husain and Daniel Millimet, both of Southern Methodist University – was funded with a $200,000 grant from the U.S. Department of Agriculture through 2011.

For the study, Tchernis and his co-authors analyzed the relationship between the SBP and the NSLP and obesity using data on over 13,500 primary school students. Students were interviewed in kindergarten, first and third grades, and then again in later grades.

Other findings show that those who participate in both federal programs end up less heavy than those who don’t participate in either, or those who only eat lunch as part of NSLP.

The NSLP provides lunch to more than 30 million children every day in approximately 101,000 schools, with 17.5 million students receiving reduced price or free meals, according to the program’s website.

In recent years, some schools have banned soda as well as vending machines containing unhealthy snacks. Many school districts also are considering measures that could impact the government’s program, using “Farm to School” programs.

“Some children don’t know how to peel oranges,” Tchernis said. “It’s surprising how little children know about food.”

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¹Reprinted from materials provided by Georgia State University , via Andrew Young School of Policy Studies.

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TV Food Advertisements Promote Imbalanced Diets

Making food choices based on television advertising results in a very imbalanced diet according to a new study comparing the nutritional content of food choices influenced by television to nutritional guidelines published in the June issue of the Journal of the American Dietetic Association¹.

Investigators found that a 2,000-calorie diet consisting entirely of advertised foods would contain 25 times the recommended servings of sugars and 20 times the recommended servings of fat, but less than half of the recommended servings of vegetables, dairy, and fruits. In fact, the excess of servings in sugars and fat is so large that, on average, eating just one of the observed food items would provide more than three times the recommended daily servings (RDS) for sugars and two and a half times the RDS for fat for the entire day.

"The results of this study suggest the foods advertised on television tend to oversupply nutrients associated with chronic illness (eg, saturated fat, cholesterol, and sodium) and under supply nutrients that help protect against illness (eg, fiber, vitamins A, E, and D, calcium, and potassium)," according to lead investigator Michael Mink, PhD, Assistant Professor and MPH Program Coordinator, Armstrong Atlantic State University, Savannah, GA.

Researchers analyzed 84 hours of prime time and 12 hours of Saturday morning broadcast television over a 28-day period in 2004. ABC, CBS, Fox and NBC were sampled on a rotating basis to develop a complete profile of each network. The Saturday-morning cartoon segment (from 8:00 am to 11:00 am) was included to capture food advertisements marketed primarily to children.

All 96 hours of observations were videotaped and reviewed later to identify food advertisements and specific food items being promoted. Only food items that were clearly promoted for sale during an advertisement were recorded. Each food item was then analyzed for nutritional content. Observed portion sizes were converted to the number of servings.

The article indicates that the observed food items fail to comply with Food Guide Pyramid recommendations in every food group except grains. The average observed food item contained excessive servings of sugars, fat, and meat and inadequate servings of dairy, fruit and vegetables. The situation was similar for essential nutrients, with the observed foods oversupplying eight nutrients: protein, selenium, sodium, niacin, total fat, saturated fat, thiamin and cholesterol. These same foods undersupplied 12 nutrients: iron, phosphorus, vitamin A, carbohydrates, calcium, vitamin E, magnesium, copper, potassium, pantothenic acid, fiber, and vitamin D.

The authors advocate nutritional warnings for imbalanced foods similar to those mandated on direct-to-consumer drug advertisements. They recommend investigating health promotion strategies that target consumers, the food industry, public media, and regulation focusing on a three-pronged approach.

"First, the public should be informed about the nature and extent of the bias in televised food advertisements. Educational efforts should identify the specific nutrients that tend to be oversupplied and undersupplied in advertised foods and should specify the single food items that surpass an entire day's worth of sugar and fat servings. Second, educational efforts should also provide consumers with skills for distinguishing balanced food selections from imbalanced food selections.

For example, interactive websites could be developed that test a participant's ability to identify imbalanced food selections from a list of options. This type of game-based approach would likely appeal to youth and adults. Third, the public should be directed to established nutritional guidelines and other credible resources for making healthful food choices."

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¹Reprinted from materials provided by Elsevier Health Sciences , via EurekAlert!, a service of AAAS.

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Managing the Emotions Behind Eating

How many times have you, after a particularly hard day, reached for some chocolate or ice cream? It's common for many people, but for those trying to lose weight, it can be detrimental to their long term success, and most weight-loss programs never even address it.

They focus on choosing healthier foods and exercising more, but they never answer a key question: how can people who have eaten to cope with emotions change their eating habits, when they haven't learned other ways of coping with emotions?

Researchers at Temple's Center for Obesity Research¹ are trying to figure out the answer as part of a new, NIH-funded weight loss study. The new treatment incorporates skills that directly address the emotional eating, and essentially adds those skills to a state-of-the art behavioral weight loss treatment.

"The problem that we're trying to address is that the success rates for long-term weight loss are not as good as we would like them to be," said Edie Goldbacher, a postdoctoral fellow at CORE. "Emotional eating may be one reason why people don't do as well in behavioral weight loss groups, because these groups don't address emotional eating or any of its contributing factors."

The study has already had one wave of participants come through, and many participants have seen some success in the short term, but have also learned the skills to help them achieve long term success.

Janet Williams, part of that first cohort, said she lost about 17 pounds over 22 weeks, and still uses some of the techniques she learned in the study to help maintain her weight, which has not fluctuated.

"The program doesn't just help you identify when you eat," said Williams. "It helps you recognize triggers that make you eat, to help you break that cycle of reaching for food every time you feel bored, or frustrated, or sad."

Williams said that the program teaches various techniques to help break that cycle, such as the "conveyor belt," in which participants, when overcome with a specific emotion, can recognize it and take a step back, before reaching for chips or cookies, and put those feelings on their mental "conveyor belt" and watch them go away.

"I still use the skills I learned in the study," she said. "I've learned to say, 'I will not allow this emotional episode to control my eating habits.'"

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¹Temple University. http://www.temple.edu/

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Phosphorous in Sodas and Processed Foods Accelerates Signs of Aging Say Harvard Scientists

Here's another reason to kick the soda habit. New research published online in the FASEB Journal¹ shows that high levels of phosphates may add more "pop" to sodas and processed foods than once thought. That's because researchers found that the high levels of phosphates accelerate signs of aging. High phosphate levels may also increase the prevalence and severity of age-related complications, such as chronic kidney disease and cardiovascular calcification, and can also induce severe muscle and skin atrophy.

"Humans need a healthy diet and keeping the balance of phosphate in the diet may be important for a healthy life and longevity," said M. Shawkat Razzaque, M.D., Ph.D., from the Department of Medicine, Infection and Immunity at the Harvard School of Dental Medicine. "Avoid phosphate toxicity and enjoy a healthy life."

To make this discovery, Razzaque and colleague examined the effects of high phosphate levels in three groups of mice. The first group of mice was missing a gene (klotho), which when absent, causes mice to have toxic levels of phosphate in their bodies. These mice lived 8 to 15 weeks. The second group of mice was missing the klotho gene and a second gene (NaPi2a), which when absent at the same time, substantially lowered the amount of phosphate in their bodies. These mice lived to 20 weeks. The third group of mice was like the second group (missing both the klotho and NaPi2a genes), except they were fed a high-phosphate diet. All of these mice died by 15 weeks, like those in the first group. This suggests that phosphate has toxic effects in mice, and may have a similar effect in other mammals, including humans.

"Soda is the caffeine delivery vehicle of choice for millions of people worldwide, but comes with phosphorous as a passenger" said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal. "This research suggests that our phosphorous balance influences the aging process, so don't tip it."

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¹FASEB Journal. http://www.fasebj.org

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New Eating Device Retrains Dietary Habits and Helps Children Lose Weight

A new computerized device that tracks portion size and how fast people eat is more successful in helping obese children and adolescents lose weight than standard treatments, according to research published on bmj.com¹.

The Mandometer device, a portable computerized weighing scale, was developed at the Karolinska Institutet in Stockholm. It helps to retrain individuals to eat less and more slowly by providing real-time feedback during meal times. The device plots a graph showing the rate at which food actually disappears from the plate, compared to the ideal graph programmed in by a food therapist.

Childhood obesity is an increasing global problem and there is little evidence to support one specific treatment program. While it is unknown whether specific eating patterns are common in all obese people, in this study the patients ate large portions very quickly.

Researchers at Bristol Royal Hospital for Children and the University of Bristol, led by Professor Julian Hamilton-Shield, carried out a randomized controlled trial of 106 obese patients aged between 9-17 years.

One group of participants received Mandometer therapy to lose weight and the other were provided with standard care. Both groups were encouraged to increase their levels of physical activity to 60 minutes of exercise a day and to eat a balanced diet based on the Food Standards Agency "eatwell plate."

Participants were assessed after 12 months and followed up at 18 months. During the research period they were also regularly monitored and offered telephone support and encouragement.

After 12 months, the Mandometer group not only had a significantly lower average body mass index and body fat score than the standard care group, but their portion size was smaller and their speed of eating was reduced by 11% compared with a gain of 4% in the other group. Levels of 'good cholesterol' were also significantly higher in the Mandometer group.

The improvement in body mass index was maintained six months after the end of treatment, suggesting an element of longer term behavioral change, add the authors.

"Mandometer therapy, focusing on eating speed and meal size, seems to be a useful addition to the rather sparse options available for treating adolescent obesity effectively without recourse to pharmacotherapy," say the authors.

They acknowledge that the Mandometer requires further evaluation in other settings and with different groups of patients, but conclude that "Retraining eating behavior and reinforcing feelings of satiety, however, does seem to improve weight loss in obese adolescents."

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¹ http://www.bmj.com. Full text of this study can be found at the BMJ Journal's website.

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What You Eat After Exercise Matters

Many of the health benefits of aerobic exercise are due to the most recent exercise session (rather than weeks, months and even years of exercise training), and the nature of these benefits can be greatly affected by the food we eat afterwards, according to a study published in the Journal of Applied Physiology

“Differences in what you eat after exercise produce different effects on the body’s metabolism,” said the study’s senior author, Jeffrey F. Horowitz of the University of Michigan. This study follows up on several previous studies that demonstrate that many health benefits of exercise are transient: one exercise session produces benefits to the body that taper off, generally within hours or a few days.

“Many of the improvements in metabolic health associated with exercise stem largely from the most recent session of exercise, rather than from an increase in ‘fitness’ per se,” Dr. Horowitz said. “But exercise doesn’t occur in a vacuum, and it is very important to look at both the effects of exercise and what you’re eating after exercise.”

Specifically, the study found that exercise enhanced insulin sensitivity, particularly when meals eaten after the exercise session contained relatively low carbohydrate content. Enhanced insulin sensitivity means that it is easier for the body to take up sugar from the blood stream into tissues like muscles, where it can be stored or used as fuel. Impaired insulin sensitivity (i.e., “insulin resistance”) is a hallmark of Type II diabetes, as well as being a major risk factor for other chronic diseases, such as heart disease.

Interestingly, when the research subjects in this study ate relatively low-calorie meals after exercise, this did not improve insulin sensitivity any more than when they ate enough calories to match what they expended during exercise. This suggests that you don’t have to starve yourself after exercise to still reap some of the important health benefits.

The paper, “Energy deficit after exercise augments lipid mobilization but does not contribute to the exercise-induced increase in insulin sensitivity,” appears in the online edition of the journal. The authors are Sean A. Newsom, Simon Schenk, Kristin M. Thomas, Matthew P. Harber, Nicolas D. Knuth, Haila Goldenberg and Dr. Horowitz. All are at the University of Michigan. The American Physiological Society published the research.

The study included nine healthy sedentary men, all around 28-30 years old. They spent four separate sessions in the Michigan Clinical Research Unit in the University of Michigan Hospital. Each session lasted for approximately 29 hours. They fasted overnight before attending each session, which began in the morning.

The four hospital visits differed primarily by the meals eaten after exercise. The following describes the four different visits:

• They did not exercise and ate meals to match their daily calorie expenditure. This was the control trial.

• They exercised for approximately 90 min at moderate intensity, and then ate meals that matched their caloric expenditure. The carbohydrate, fat, and protein content of these meals were also appropriately balanced to match their expenditure.

• They exercised for approximately 90 min at moderate intensity and then ate meals with relatively low carbohydrate content, but they ate enough total calories to match their calorie expenditure. This reduced-carbohydrate meal contained about 200 grams of carbohydrate, less than half the carbohydrate content of the balanced meal.

• They exercised for approximately 90 min at moderate intensity and then ate relatively low-calorie meals, that is, meals that provided less energy than was expended (about one-third fewer calories than the meals in the other two exercise trials). These meals contained a relatively high carbohydrate content to replace the carbohydrate “burned” during exercise.

The exercise was performed on a stationary bicycle and a treadmill. The order in which the participants did the trials was randomized.

In the three exercise trials, there was a trend for an increase in insulin sensitivity. However, when participants ate less carbohydrate after exercise, this enhanced insulin sensitivity significantly more. Although weight loss is important for improving metabolic health in overweight and obese people, these results suggests that people can still reap some important health benefits from exercise without undereating or losing weight, Dr. Horowitz said.

The study also reinforces the growing body of evidence that each exercise session can affect the body’s physiology and also that differences in what you eat after exercise can produce different physiological changes.

The research team is now performing experiments with obese people, aimed at better identifying the minimum amount of exercise that will still improve insulin sensitivity at least into the next day.

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Story Source: Adapted from materials provided by  The American Physiological Society.

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Overweight in 20s could lead to serious problems in 40s

People who are obese and have type 2 diabetes in their 20s will be at higher risk of having a heart attack or stroke in their 40s if they do not change their lifestyle.

"If your blood pressure is 136/88 and you’re a man with a waist over 40 or a woman with a waist over 35 it spells trouble," said Dr. Dale J. Hamilton, diabetes clinical services chief at The Methodist Hospital in Houston. "These are two of the five symptoms of metabolic syndrome, a problem that can lead to type 2 diabetes. All you need is three to begin seeing increased atherosclerosis."

"High triglyceride levels over 150, insulin resistance and a low LDL (good cholesterol) are factors of metabolic syndrome, along with high blood pressure and central obesity. According to the American Heart Association more than 47 million Americans have it. Many of these patients will end up suffering with type 2 diabetes, which can eventually lead to coronary artery disease and stroke.

"Small changes every day can help curb big problems later on," Hamilton said. "Losing five to 10 pounds will help lower blood pressure. Reducing saturated fats, carbohydrates, and eating about two-thirds the amount you eat now will help you lose weight around the middle. Walk 45 minutes a day instead of 30."

Some experts believe replacing sugar with high fructose corn syrup in processed foods in the United States and Canada in the 1990s has played a role in the rise of type 2 diabetes cases. High fructose corn syrup is made by changing the sugar in corn starch to fructose, another form of sugar. It has become popular because it extends the shelf life of processed foods and is cheaper than sugar. It has also become a popular ingredient in many sodas and fruit-flavored drinks.

"The problem with high fructose corn syrup is that it promotes central obesity," Hamilton said. "Another problem with it is that it fools your body into thinking you are hungry. I don’t think you need to eliminate it from your diet, you just need to be aware of how much of it you are consuming on a daily basis because too much can lead to serious weight gain."

Keep in mind, he said, type 2 diabetes symptoms often go untreated because there are few or no symptoms until it is too late.

"Having three or more of the risk factors associated with type 2 diabetes over an extended period of time is the equivalent of already having a heart attack," Hamilton said. "These risk factors need to be treated aggressively in order to curb the problem and give you a better chance at a longer, healthier life."

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Story Source: Adapted from materials provided by  The Methodist Hospital - Houston.

Medical Advice Disclaimer: The content of this blog entry is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, or other qualified health provider with any questions you may have regarding a medical condition.

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