New Study Demonstrates Glucose Device Rapidly Alleviates Major Symptom of Type 1 Diabetes in Children

August 28, 2008 (Newswise) - Hypoglycemia, a low blood sugar condition common in people with diabetes, occurs when doses of insulin or oral medications are not balanced properly by food ingestion. Sometimes known as “insulin reaction,” hypoglycemia can occur in both type 1 and type 2 diabetics, including those who are not insulin-dependent.

A study sponsored by Toronto, Ontario-based Generex Biotechnology suggests that a novel glucose-delivering device, Glucose RapidSpray™, provides a higher degree of glycemic control in children with type 1 diabetes, as well as greater compliance.

On the surface, hypoglycemia is “easy” to treat since patients need only consume an appropriate dose of glucose to counteract their low blood sugar. In practice, however, the condition is difficult to treat, particularly in children younger than five years of age, because of difficulties in administering the correct glucose dose as well as patient compliance. Some children with hypoglycemia have difficulty swallowing, which makes administration of oral glucose agents problematic. Another factor is the child’s body weight, typically quite low, which requires small, precise glucose dosages. Also of concern is the potential for hyperglycemic (high blood sugar) rebound, caused by too-high dosing and a counter-regulatory hormone response.

Researchers at Morozovskaya Children City Clinical Hospital in Moscow, Russia and the University Campus Bio-Medico, Rome, Italy presented data at the 44th annual meeting of the European Association for the Study of Diabetes (EASD) in Rome on September 8th. The abstract, entitled, “Glucose RapidSpray™ for a New Management of Hypoglycemia in Children up to 5 Years of Age with Type 1 Diabetes,” demonstrated how this new approach to hypoglycemia treatment that could change the way this disorder is managed in millions of pediatric diabetes patients worldwide.

The EASD Annual Meeting, which brings together more than 12,000 delegates in the healthcare industry, is a premier platform for professional exchange in the field of diabetes. The EASD brings together scientists, physicians, laboratory workers, nurses and students from all over the world who are interested in diabetes and related subjects.

The study involves administration of precise doses of glucose through the Glucose RapidSpray™ (GRS) device, developed by Generex Biotechnology, during the first signs of hypoglycemia in children with type 1 diabetes. The goal of the study was to improved metabolic control as measured by hemoglobin (HbA1c) over a six-month follow up period. HbA1c, also known as glycated hemoglobin, is a measure of blood sugar control over a long period of time, typically the past two to three months.

The Glucose RapidSpray configuration during the study consisted of a 10-milliliter bottle containing ten grams of glucose solution plus artificial flavors and an excipient to facilitate buccal absorption of glucose. The device works by delivering a fine spray containing glucose in quantities as small as half a gram.

The study randomized twenty-seven children with type 1 diabetes into two groups. One group received Glucose RapidSpray on an as-needed basis depending on hypoglycemic symptoms. The control group treated hypoglycemia using traditional methods that include sugar pills, fruit juice, and candies.

Investigators noted HbA1c, number and types of hypoglycemic episodes, compliance, and quality of life in the test subjects at the beginning of the study, at three months, and at the end of the study (six months).

The groups were similar in characteristics at the beginning of the study. At three months both groups showed a significant improvement in HbA1c, but improvement was similar between groups.

However, at six months there was a statistically significant difference in the improvement of the HbA1c in the Glucose RapidSpray-treated group compared with the control group (0.98% vs. 0.60% difference, respectively, p<0.02). Those receiving treatment through Glucose RapidSpray also had a tendency towards for fewer hypoglycemic episodes during the day (p=0.09). Children appeared to comply with GRS treatment more readily, and parents felt more comfortable managing hypoglycemic episodes using the device compared with conventional sources of glucose.

Professor Paolo Pozzilli of the University Campus Bio-Medico in Rome added, "It is a very interesting result which offers a new opportunity for managing early signs of hypoglycaemia to parents of young children with type 1 diabetes. It also underlines how joint projects between two Universities can work well together."

“The benefits of Glucose RapidSpray are striking given the difficulty of managing hypoglycemic episodes in very young children,” noted Anna E. Gluskin, CEO of Generex Biotechnology. “We expect this study will lead to greater awareness of this simple, effective, inexpensive device for fine-tuning blood sugar levels in insulin-dependent diabetics.”

Posted by dlife at 03:21 PM | Comments (0)

Class Of Diabetes Drugs Carries Significant Cardiovascular Risks

August 28, 2008 (EurekAlert) - A class of oral drugs used to treat type 2 diabetes may make heart failure worse, according to an editorial published online in Heart Wednesday by two Wake Forest University School of Medicine faculty members.

"We strongly recommend restrictions in the use of thiazolidinediones (the class of drugs) and question the rationale for leaving rosiglitazone on the market," write Sonal Singh, M.D., M.P.H., assistant professor of internal medicine, and Curt D. Furberg, M.D., Ph.D., professor of public health sciences. Rosiglitazone and pioglitazone are the two major thiazolidinediones.

In the editorial Singh and Furberg say, "At this time, justification for use of thiazolidinediones is very weak to non-existent."

Oral drugs are given to control diabetes by lowering blood sugar.

But diabetics also experience elevated rates of high blood pressure and high levels of cholesterol and triglyceride, which "further compound their already increased risk of developing ischemic heart disease," Singh and Furberg say. Heart disease and high blood pressure "represent conditions that are major precursors of congestive heart failure."

About 22 percent of diabetics have heart disease. Among elderly patients with diabetes, more than half will develop congestive heart failure over a 10-year period, the editorial says.

The thiazolidinediones were approved for use based on the ability to reduce blood sugar.

In contrast, "we reported [in the journal Diabetes Care] in June 2007 that thiazolidinediones doubled the risk of congestive heart failure in patients with type 2 diabetes," is says. "The increased heart failure appears to be a class effect."

Singh and Furberg reported in The Journal of the American Medical Association in 2007 after an analysis of four long-term trials that use of rosiglitazone was associated both with increased heart attacks and a doubling of heart failure.

They said that results from three large randomized clinical trials published this past June all failed to demonstrate that intensive control of blood sugar reduces mortality or events from cardiovascular disease in patients with type 2 diabetes.

The three trials were ACCORD, ADVANCE, and the Veterans Affairs Diabetes study. In ACCORD, the patients who received intensive treatment to control blood sugar actually had more cardiovascular disease mortality than patients receiving standard treatment.

In ADVANCE, intensive control of blood sugar produced no benefit; there was no effect on cardiovascular events or deaths from cardiovascular causes compared to standard oral diabetes agents.

In the VA Diabetes trial, when intensive blood sugar control produced levels of blood sugar that were too low and led to loss of consciousness, that was a strong predictor of future cardiovascular events.

"The unfavorable findings from the three trials have not been fully realized by the medical community," Singh and Furberg say.

They say that at a recent U.S. Food and Drug Administration advisory committee meeting, there was "overwhelming support for requiring reductions" of heart disease and heart failure "before approval of new oral hypoglycemic agents."

Singh said in an interview, "Safer, cheaper and more effective treatment alternatives are available that do not carry these negative cardiovascular risks in patients with diabetes. The rationale for the use of the thiazolidinediones is unclear."

Posted by dlife at 09:36 AM | Comments (2)

Researchers Create Insulin-Producing Cells from Adult Pancreatic Cells

August 27, 2008 (HHMI) - Howard Hughes Medical Institute researchers have converted adult pancreatic cells into insulin-producing beta cells in living mice. This is a first because the researchers directly changed the functional identity of adult cells without using embryonic stem cells or relying on techniques that reverse a cell's genetic programming to its earliest stages.

Remarkably, the investigators repurposed the adult cells quickly by using viruses to shuttle just three regulatory genes that triggered the remarkable developmental changes. It took only a brief blip of activity by the regulatory genes to imbue the cells with their new job descriptions, which they have retained for as long as nine months.

The experiments, which are reported on August 27, 2008, in an advance online publication in the journal Nature, realize a longtime goal in regenerative medicine: To produce specialized repair cells directly from a pool of adult cells that are healthy, abundant and easily obtained. Until now, repair cells have been generated from embryonic stem cells or more recently from pluripotent stem cells created by fully reprogramming adult cells.

“What this shows is that you can go directly from one type of adult cell to another, without going back to the beginning,” said Douglas A. Melton, a Howard Hughes Medical Institute (HHMI) investigator at Harvard University and co-director of the Harvard Stem Cell Institute. “You could say, for example, it's like turning a scientist into a lawyer without sending her all the way back to kindergarten.”

In this case, the strategy was used in mice to convert exocrine cells, which compose 95 percent of the pancreas, to the relatively scarce beta cells that produce insulin. For more than a decade, Melton has studied how embryonic stem cells give rise to the pancreas and its insulin-producing beta cells, which are destroyed in patients with type 1 diabetes. Ultimately, his studies could lead to ways to generate new pancreatic beta cells that could be used as a treatment for diabetes. However, Melton cautioned that the new results are a proof of principle and do not have immediate medical applications.

Exocrine cells are specialized to churn out an array of digestive enzymes. Although they, like all cells, carry the genes that enable insulin production, those genes have been silenced. Melton's experiments attempted to modify the genome of the exocrine cell to “awaken” certain genes and activate the insulin-producing features of beta cells.

The concept of adult cell-switching, or “lineage switching” as it is sometimes called, has been a major goal of regenerative medicine researchers. This approach has advantages because it avoids using stem cells derived from human embryos.

With the advent of newer techniques that obviate the need for human embryonic cells, researchers have been racing to incorporate those ideas into their own work. In a major breakthrough in 2006, Japanese researcher Shinya Yamanaka and his colleagues made stem cells from adult mouse skin cells (fibroblasts) by inserting four specific genes that were active in mouse embryonic stem cells. Those genes, which code for transcription factors, reprogrammed the skin cells so they became pluripotent and therefore had the capacity to develop into any type of tissue. These “induced pluripotent stem cells” or iPS cells, could in theory be guided in the laboratory to become specialized cells that might repair damaged nerves, hearts, or other organs.

Melton and postdoctoral fellow Qiao “Joe” Zhou, first author on the Nature paper, were encouraged by the revelation that a handful of transcription factor genes reactivated the embryonic program of adult skin cells. They wondered whether an equally small number of transcription factors could turn off the specialized functions of a given adult cell and turn on those needed to generate the target repair cell.

Starting from a list containing all 1,100 transcription factors in mice, the HHMI scientists selected 200 that were active in cells that form the pancreas. They later narrowed that list to just 28 transcription factors that were most active in the region of the pancreas that contains beta cells. The researchers next used retroviruses to ferry genes for nine of the 28 transcription factors into the exocrine cells of live mice.

Melton and Zhou were surprised to learn that, in fact, only three of the nine genes were necessary to turn exocrine cells into beta cells - an “extreme makeover,” as one of Melton's colleagues termed it. Those genes were Ngn3, Pdx1, and Mafa.

The maneuver converted about 20 percent of the exocrine cells to beta cells that produced insulin. This was enough to reduce blood sugar levels in diabetic mice. The expression of the three transcription factor genes disappeared less than two months after they were introduced with the virus - but the converted cells remained.

While they believe that it will be possible to convert a wide range of adult cells to other cell types using a small number of regulatory genes, the scientists say a number of questions need to be explored. Among them: How closely related to the desired target cell does the donor cell need to be? What other types of cells can be converted to beta cells? And - since using viruses to ferry genes into human patients poses unacceptable risks — can the same outcome be accomplished with chemicals or other drugs?

George Daley, an HHMI investigator and stem cell researcher at Children's Hospital Boston, commented that “Melton's work is going to inspire an explosion of experiments in directing the fate of tissues in one way or another in ways that may be more practical than having to reprogram them back to pluripotency.” Daley and colleagues reported recently they had converted cells from individuals with 10 degenerative diseases into stem cells with the same genetic errors. These newly created stem cells will allow researchers to reproduce human tissue formation in a Petri dish as it occurs in individuals with any of the diseases,

Both Melton and Daley emphasized that the apparent success of the shortcut method in no way eliminates the need for continued research on strategies that use iPS cells or stem cells obtained from human embryos.

Posted by dlife at 09:20 AM | Comments (0)

Terminally Ill Rodents With Type 1 Diabetes Restored To Full Health With Single Dose Of Leptin

August 26, 2008 (Southwestern Medical Center) - Terminally ill rodents with type 1 diabetes have been restored to full health with a single injection of a substance other than insulin by scientists at
UT Southwestern Medical Center.

Since the discovery of insulin in 1922, type 1 diabetes (insulin-dependent diabetes) in humans has been treated by injecting insulin to lower high blood sugar levels and prevent diabetic coma. New findings by UT Southwestern researchers, which appear online and in a future issue of the Proceedings of the National Academy of Sciences, suggest that insulin isn’t the only agent that is effective. Leptin, a hormone produced by the body’s fat cells, also lowers blood glucose levels and maintains them in a normal range for extended periods, they found.

“The fact that these animals don’t die and are restored to normal health despite a total lack of insulin is hard for many researchers and clinicians to believe,” said Dr. Roger Unger, professor of internal medicine and senior author of the study. “Many scientists, including us, thought it would be a waste of time to give leptin in the absence of insulin. We’ve been brainwashed into thinking that insulin is the only substance that can correct the consequences of insulin deficiency.

The mechanism of leptin’s glucose-lowering action appears to involve the suppression of glucagon, a hormone produced by the pancreas that raises glucose levels. Normally, glucagon is released when the glucose, or sugar, level in the blood is low. In insulin deficiency, however, glucagon levels are inappropriately high and cause the liver to release excessive amounts of glucose into the bloodstream. This action is opposed by insulin, which tells the body’s cells to remove sugar from the bloodstream.

In type 1 diabetes, which affects about 1 million people in the U.S., the pancreatic islet cells that produce insulin are destroyed. Type 1 diabetics must take insulin multiple times a day to metabolize blood glucose and regiment their diets. In comparison, patients with non-insulin dependent, or type 2, diabetes make insulin, but their bodies don’t respond well to it. Type 2 diabetes affects between 18 million and 20 million people in this country.

In the current study, researchers tested for the first time whether a single injection of the leptin gene given to insulin-deficient mice and rats on the verge of death from diabetic coma could reverse the severe condition and prevent the animals from dying. The animals that received the leptin gene began producing excessive amounts of leptin, which reversed all the measurable consequences of type 1 diabetes including weight loss, hyperglycemia and ketoacidosis, a potentially fatal condition that develops when the body doesn’t have enough insulin to meet basic metabolic requirements. Much of the effect was mediated by complete suppression of the high glucagon levels, said Dr. Xinxin Yu, assistant instructor of internal medicine and lead author of the study.

“These animals were actually dying,” Dr. Yu said. “But if we gave them the leptin gene, within two weeks, the terminally ill rodents were restored to full health without any other treatment.”

Dr. Unger said it’s too premature to know whether leptin might someday replace insulin as a treatment for diabetic patients, but this study demonstrates that leptin could at least handle some of insulin’s job requirements and do it for longer periods of time. Injected insulin is biologically active for only three to four hours.

“My hope is that you could give leptin for one type of action – glucagon’s suppression, for example – and insulin for another. Or perhaps give a substance other than insulin entirely,” Dr. Unger said. “What would be a tremendous advance would be the ability to give an oral agent that suppresses glucagon without injections.”

Dr. Yu said the research team hypothesizes that leptin combats diabetes not only by suppressing glucagon’s action on the liver, but also by boosting the insulin-like actions of IGF-1 (insulin-like growth factor-1), a hormone that promotes growth and mimics insulin.

“One of the things that happens when a child gets type 1 diabetes is their growth is stunted until they’re given insulin,” Dr. Unger said. “The same is true with these mice. However, we found that if you take a diabetic rat that’s not receiving insulin and make it hyperleptinemic, it almost catches up growthwise.”

While the treated animals’ blood glucose levels inched back up over time, their hyperglycemia (high blood sugar) consistently remained well below the elevated pre-treatment levels. The untreated rodents, on the other hand, died within two or three days. The researchers tracked the treated rodents for 25 weeks.

The next step is to study other potential glucagon suppressants and begin leptin clinical trials within the next year.

Other UT Southwestern researchers involved in the study were Dr. May-Yun Wang, assistant professor of internal medicine; Dr. Zhao Wang, postdoctoral researcher in internal medicine; and former postdoctoral fellow Dr. Byung-Hyun Park.

The work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, the Department of Veterans Affairs, and the Juvenile Diabetes Research Foundation.

Visit http://www.utsouthwestern.org/endocrinology to learn more about clinical services in endocrinology at UT Southwestern.

Posted by dlife at 11:13 AM | Comments (1)

Caesarean Babies More Likely To Develop Diabetes

August 26, 2008 (EurekAlert) - Babies delivered by Caesarean section have a 20 per cent higher risk than normal deliveries of developing the most common type of diabetes in childhood, according to a study led by Queen's University Belfast.

The team, led by Dr Chris Cardwell and Dr Chris Patterson, examined 20 published studies from 16 countries including around 10,000 children with Type 1 diabetes and over a million control children.

They found a 20 per cent increase in the risk of children born by Caesarean section developing the disease. The increase could not be explained by factors such as birth weight, the age of the mother, order of birth, gestational diabetes and whether the baby was breast-fed or not, all factors associated with childhood diabetes in previous studies.

Dr Cardwell, from the School of Medicine, Dentistry and Biomedical Sciences, said: "This study revealed a consistent 20 per cent increase in the risk of Type 1 diabetes. It is important to stress that the reason for this is still not understood. It is possible that children born by Caesarean section differ from other children with respect to some unknown characteristic which consequently increases their risk of diabetes, but it is also possible that Caesarean section itself is responsible.

"Type 1 diabetes occurs when the immune system destroys the insulin producing cells in the pancreas, and one theory suggests that being born by Caesarean section may affect the development of the immune system because babies are first exposed to bacteria originating from the hospital environment rather than to maternal bacteria."

Dr Chris Patterson said: "The study findings are interesting, but unless a biological mechanism is established it would be unwise to read too much into this association between Caesarean section delivery and diabetes.

"Fortunately figures from the Northern Ireland Type 1 diabetes register indicate that only around two per 1,000 children will develop diabetes by their 15th birthday so a 20 per cent increase is on quite a low baseline risk."

Diabetes is a serious condition that, if not managed, can lead to fatal complications including heart disease, stroke, kidney failure and amputations. There are 2.3 million people in the UK diagnosed with diabetes and 250,000 with Type 1 diabetes. In Northern Ireland over 62,000 people have diabetes, 6,000 of them with Type 1 diabetes.

Around one in four babies in Northern Ireland are delivered by Caesarean section, which is significantly higher that the World Health Organisation's recommended rate of 15 per cent.

Iain Foster, Director of Diabetes UK Northern Ireland, said: "Not all women have the choice of whether to have a Caesarean section or not, but those who do may wish to take this risk into consideration before choosing to give birth this way.

"We already know that genetics and childhood infections play a vital role in the development of Type 1 diabetes in children, but the findings of this study indicate that the way a baby is delivered could affect how likely it is to develop this condition later in life. Diabetes UK Northern Ireland would welcome more research in this area."

Posted by dlife at 11:11 AM | Comments (0)

Potential Diabetes Treatment Selectively Kills Autoimmune Cells From Human Patients

August 26, 2008 (Science Daily) - In experiments using blood cells from human patients with diabetes and other autoimmune disorders, Massachusetts General Hospital (MGH) researchers have confirmed the mechanism behind a potential new therapy for type 1 diabetes.

A team led by Denise Faustman, MD, PhD, director of the MGH Immunobiology Laboratory, showed that blocking a metabolic pathway regulating the immune system specifically eliminated immune cells that react against a patient's own tissues.

Faustman and her colleagues previously discovered a technique that reversed type 1 disease in a mouse model. The current study, which will appear in the Proceedings of the National Academy of Sciences and has been released online, is the first demonstration of this strategy in human cells and supports the viability of a clinical trial that is currently underway.

"Our studies in mice showed that we could selectively kill the defective autoimmune cells that were destroying insulin-producing islets," says Faustman. "These results show that the same selective destruction can occur in humans cells and connect what we saw in our animal studies with the protocol we are pursuing in our Phase I clinical trial."

Type 1 diabetes and other autoimmune diseases are caused when the body's immune cells mistakenly attack an individual's own cells. In several studies over the past decade, Faustman's team showed that triggering the expression of the immune-system modulator tumor necrosis factor (TNF) in diabetic mice led to the death of the T cells responsible for destroying insulin-producing pancreatic islets. After receiving this treatment, the animals were able to regenerate healthy islet cells that produced normal levels of insulin, effectively curing the animals' diabetes.

The current study used T cells from more than 1,000 patients with type 1 diabetes, other autoimmune disorders and healthy controls. First the researchers found that treatment with TNF killed CD8 T cells, the immune system's "killer" cells, from diabetic patients but not CD4 "helper" T cells. TNF treatment also induced the death of CD8 T cells from other autoimmune disease patients but had no negative effect on cells from healthy controls.

Since TNF interacts with immune cells through two different receptors – TNFR1 and TNFR2, which activate different signaling pathways – the researchers next tested several TNF agonists, substances that mimic the molecule's actions. One of those TNF agonists acts through TNFR1, which is expressed on all T cells, and three act through TNFR2, only found on subpopulations of T cells. While neither the TNFR1 agonist nor two of the three substances that activate the TNFR2 pathway had any significant effects, a third TNFR2 agonist induced cell death in particular CD8 cells from patients with diabetes and other autoimmune disorders. As with TNF treatment, no cell death occurred in cells from healthy participants.

Further experiments with blood samples from several diabetic patients revealed that the population of CD8 T cells responsible for the autoimmune destruction of pancreatic islets consistently died after treatment with the TNFR2 agonist, while similar cells from a non-diabetic proliferated. However, CD8 cells from diabetic participants that were targeted against two common viruses were not killed by exposure to the TNFR2 agonist, confirming that the protocol only leads to the death of T cells responsible for an autoimmune reaction.

The clinical trial based on Faustman's earlier studies is testing whether use of bacillus Calmette-Guerin (BCG), a generic drug that temporarily elevates TNF levels, will reduce autoimmune T cells in patients with type 1 diabetes. The current Phase 1 trial, which has been approved by the FDA and is directed by David M. Nathan, MD, director of the MGH Diabetes Center, focuses on determining the optimal dose and timing of BCG administration. More information on the 18-month trial, which began in March, is available at http://www.faustmanlab.org/.

Posted by dlife at 11:08 AM | Comments (0)

New Study Shows Health Benefits of Probiotic Could Extend Beyond Gastrointestinal System

August 25, 2008 (Newswise) - Data from a recent study demonstrate the anti-inflammatory and pathogen protection benefits of Bifidobacterium infantis 35624 a probiotic bacterial strain of human origin. Gastrointestinal benefits of probiotics have been well-documented, but more and more research is revealing that probiotic benefits extend to the entire body. The report was published in the August issue of the Public Library of Science (PLoS) Pathogens .

The inflammatory response is a key part of the immune system’s battle against invaders. The normal response to infection is rapid and effective, however, the immune response may occasionally cause inflammation and damage to healthy tissue.

“Inflammation is a major factor in a number of chronic diseases affecting millions of people and can cause an unwanted impact on healthy tissue,” said Dr. Liam O’Mahony, lead investigator. “Past research has shown that the probiotic Bifidobacterium infantis 35624 can positively impact the body’s immune defense3, and this most recent data suggests that its benefits are not restricted to the gastrointestinal tract.”

Inflammation is associated with a wide range of conditions, such as inflammatory bowel disease, arthritis, bacterial-induced colitis, type I diabetes and organ transplantation. Bifidobacterium infantis 35624 has previously shown ability to modulate the inflammatory response in a clinical trial of patients with irritable bowel syndrome.2 The new data suggests additional health benefits of this particular probiotic strain.

The published study examined the effect of Bifidobacterium infantis 35624 administration on immunity to Salmonella (Salmonella typhimurium), harmful bacteria that can cause intestinal infections and trigger the body’s inflammatory response. Bifidobacterium infantis 35624, a probiotic strain isolated from healthy human gastrointestinal tissue, was administered to mice in freeze-dried powder at least three weeks prior to salmonella infection. Animals that received Bifidobacterium infantis 35624 showed dramatically increased numbers of certain immune cells that control the immune system response to harmful pathogens, in this case Salmonella.

Additionally, data show increased numbers of T-regulatory (Treg) cells, or cells that suppress inflammatory disease in a wide range of autoimmune diseases. Administration of Bifidobacterium infantis 35624 resulted in the induction of these Treg cells, which protected the host from excessive inflammation during the course of infection. Researchers concluded that the introduction of Bifidobacterium infantis 35624 results in enhanced protection from infection, while limiting pro-inflammatory damage caused by superfluous activation of the innate immune system.

About Alimentary Health

Alimentary Health is a development stage specialty biotechnology company located in Ireland. The company is focused on the discovery, development and commercialization of proprietary probiotic and pharmabiotic treatments for gastrointestinal disorders and other inflammatory conditions. Alimentary Health is the foundation industry partner of the Alimentary Pharmabiotic Center based at University College Cork, Ireland. www.alimentaryhealth.ie

Posted by dlife at 03:04 PM | Comments (1)

Are Your Eyes A Window To Diabetes-Related Health Issues?

August 20, 2008 (Science Daily) - Scientists at Aston University in Birmingham, UK are carrying out a unique study using the eyes to detect early signs of health problems which could lead to diabetes, and they’re looking for volunteers to help.

A team of scientists from Aston’s Ophthalmic Research Group (ORG) are looking for healthy 20-65 year olds to take part in a free health check - results of which could help in detecting risk for diabetes or early diabetic changes. The scientists are particularly interested in the differences in these factors between the South Asian community and Caucasian population in Birmingham.

People who sign up for their free health check will undergo a simple ultrasound test (to assess cardiovascular health), an eye test (to measure blood flow and blood vessel diameter) and a blood test (to check for glucose and cholesterol levels). Researchers (led by Ophthalmology lecturer Dr Doina Gherghel) would like to test South Asian (Indian, Sri Lankan, Pakistani and Bangladeshi) or Caucasian people, with or without a family history of diabetes in one or both parents.

Sunni Patel, Optometry PHD student and member of the ORG, Aston University, said:

“In the UK alone, two million people have diabetes and up to 750,000 are believed to be carriers of the condition without even realising. The figures amongst the South Asian community are particularly significant – with one in three people of Pakistani, Indian, Sri Lankan or Bangladeshi descent being affected.

“These are worrying statistics but, by diagnosing the disease in patients early on, a number of measures can be put in place to minimise any related health issues. Findings from this research could really help with early diagnosis. If opticians were equipped with the knowledge and technology to spot health concerns which could indicate the first signs of diabetes, the UK’s early diagnosis rate could be improved significantly."

Posted by dlife at 03:26 PM | Comments (2)

Joslin Study Identifies Protein That Produces 'Good' Fat

August 20, 2008 (EurekAlert) - A study by researchers at the Joslin Diabetes Center has shown that a protein known for its role in inducing bone growth can also help promote the development of brown fat, a "good" fat that helps in the expenditure of energy and plays a role in fighting obesity.

"Obesity is occurring at epidemic rates in the U.S. and worldwide and that impacts the risk and prognosis of many diseases," said Yu-Hua Tseng, Ph.D. an Assistant Investigator in the Joslin Section on Obesity and Hormone Action and lead author of the paper published in the August 21 issue of Nature. "We hope this study can be translated into applications to help treat or prevent obesity."

Tseng noted that obesity is a major risk factor for type 2 diabetes and is closely linked to the metabolic syndrome, a collection of medical problems associated with insulin resistance that can lead to an increased risk of atherosclerosis, the buildup of plaque in coronary arteries that leads to heart attack and stroke.

In laboratory studies of mouse cells, Tseng and her colleagues identified that a bone-inducing protein called BMP-7 drives precursor cells that give rise to mature brown fat cells. According to Tseng, there are two main types of fat cells in the body – white and brown.

"White fat cells are the 'conventional' form of fat designed to store energy. By contrast, the main role of brown fat is to burn calories by generating heat. Brown fat cells largely disappear by adulthood in humans, but their precursors still remain in the body," Tseng explained.

A 2005 Joslin study by Dr. Tseng and colleagues discovered genes that control the creation of the precursor cells of brown fat. Another more recent 2007 Joslin study led by C. Ronald Kahn, M.D., head of the Joslin Section on Obesity and Hormone Action and also a co-author of the current Nature study, found clusters of brown fat cells dispersed between bundles of muscle fibers in an obesity-resistant strain of mice.

Now, this latest study identified BMP-7 as the protein capable of inducing the formation and function of brown fat cells. According to the paper, delivery of BMP-7 into mice using adenovirus as a vector resulted in an increase in the development of brown fat tissue. In one of the experiments, the mice that developed brown fat tissue gained less weight than those that did not. In another experiment, mice that received injections of progenitor cells – similar to stem cells – that had been pre-treated with BMP-7 also developed additional brown fat tissue.

The study sought to address a fundamental question in adipocyte biology, namely what controls the development of fat depots. BMPs are a family of proteins known to regulate organ formation during embryonic development. In this study, Dr. Tseng and her colleagues proposed that different members of BMPs determine brown versus white fat cell fate. Scientists hope that improved knowledge of fat development will lead to new drugs or therapeutic approaches to fight obesity.

"Diet and exercise are still the best approaches for weight reduction in the general population," Tseng said. "However, for people who are genetically predisposed to obesity, these approaches may have very little effect."

"As we learn more about the controls of brown fat development, medical interventions to increase energy expenditure by brown fat inducing agents, such as BMP-7, may provide hope to these individuals in losing weight and preventing the metabolic disorders associated with obesity," she said.

Posted by dlife at 09:32 AM | Comments (1)

New Research Suggests Diabetes Transmitted From Parents To Children

August 20, 2008 (EurekAlert) - A new study in the September issue of the Journal of Lipid Research suggests an unusual form of inheritance may have a role in the rising rate of diabetes, especially in children and young adults, in the United States.

DNA is the primary mechanism of inheritance; kids get half their genes from mom and half from dad. However, scientists are just starting to understand additional kinds of inheritance like metabolic programming, which occurs when an insult during a critical period of development, either in the womb or soon after birth, triggers permanent changes in metabolism.

In this study, the researchers looked at the effects of a diet high in saturated fat on mice and their offspring. As expected, they found that a high-fat diet induced type 2 diabetes in the adult mice and that this effect was reversed by stopping the diet.

However, if female mice continued a high-fat diet during pregnancy and/or suckling, their offspring also had a greater frequency of diabetes development, even though the offspring were given a moderate-fat diet. These mice were then mated with healthy mice, and the next generation offspring (grandchildren of the original high-fat fed generation) could develop diabetes as well.

In effect, exposing a fetal mouse to high levels of saturated fats can cause it and its offspring to acquire diabetes, even if the mouse goes off the high-fat diet and its young are never directly exposed.

The study used mice so it's not time to warn women to eat differently during pregnancy and breastfeeding but earlier research has shown that this kind of inheritance is at work in humans. For example, there is an increased risk of hypertension and cardiovascular disease in children born of malnourished mothers.

Posted by dlife at 09:30 AM | Comments (1)

Arsenic Exposure May Be Associated With Type 2 Diabetes

August 19, 2008 (EurekAlert) - In a study involving a representative sample of U.S. adults, higher levels of arsenic in the urine appear to be associated with increased prevalence of type 2 diabetes, according to a report in the August 20 issue of JAMA.

Arsenic from inorganic sources is highly toxic and causes cancer in humans, according to background information in the article. Millions of individuals worldwide are exposed to drinking water contaminated with inorganic arsenic, including 13 million Americans whose public water supply contains more than the U.S. Environmental Protection Agency standard of 10 micrograms per liter. Exposure to high concentrations of the element in drinking water and in the workplace has been shown to be associated with diabetes, but little is known about the effect of lower levels on diabetes risk. In contrast, arsenobetaine—an organic arsenic compound derived eating seafood—is considered non-toxic.

Ana Navas-Acien, M.D., Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues studied 788 adults age 20 and older who had their urine tested for arsenic levels as part of the government-conducted 2003-2004 National Health and Nutrition Examination Survey (NHANES).

Overall, 7.7 percent of the participants had type 2 diabetes. After adjusting for diabetes risk factors and biomarkers of seafood intake, participants with type 2 diabetes had a 26 percent higher level of total arsenic in their urine than those without the disease. Levels of arsenobetaine were similar between the two groups.

After the same adjustment for related factors, the researchers found that participants in the top one-fifth of total urine arsenic levels (16.5 micrograms per liter) had 3.6 times the odds of having type 2 diabetes as those in the lowest one-fifth (3.0 micrograms per liter), and those in the top one-fifth of dimethylarsinate levels (6.0 micrograms per liter) had 1.5 times the odds as those in the lowest one-fifth (2.0 micrograms per liter). Dimethylarsinate is a compound into which inorganic arsenic is metabolized before excretion.

"The potential role of arsenic in diabetes development is supported by experimental and mechanistic evidence," the authors note. Insulin-sensitive cells that are exposed to insulin and sodium arsenite appear to take in less glucose than cells exposed only to insulin. Arsenic could also influence genetic factors that interfere with insulin sensitivity and other processes, or could contribute to oxygen-related cell damage, inflammation and cell death (which have also been related to diabetes).

"From a public health perspective, confirmation of a role for arsenic in diabetes development would add to the concerns posed by the carcinogenic, cardiovascular, developmental and reproductive effects of inorganic arsenic in drinking water, and could substantially modify risk assessment and risk-benefit analyses estimating the consequences of arsenic exposure," the authors conclude. "Given widespread exposure to inorganic arsenic from drinking water worldwide, elucidating the contribution of arsenic to the diabetes epidemic is a public health research priority with potential implications for the prevention and control of diabetes."

(JAMA. 2008;300[7]:814-822. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This work was supported by a grant from the National Institute of Environmental Health Sciences in Urban Environmental Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Limit Arsenic Exposure While Research Continues

"Stemming the pandemic of type 2 diabetes is a public health priority and will require a multifaceted approach," write Molly L. Kile, M.S., Sc.D., and David C. Christiani, M.D., M.P.H., M.S., of the Harvard School of Public Health, Boston, in an accompanying editorial. "This must include improving the understanding of the etiology of diabetes and identifying modifiable factors that can be incorporated into prevention strategies."

"To date, this approach has focused on medication and lifestyle modification, but the role of environmental exposures must also be considered," they continue. "While many questions remain about the role of arsenic in diabetogenesis, they can only be answered by additional research."

"In the meantime, arsenic exposure from drinking water is a widespread environmental pollutant that affects millions of individuals around the world," Drs. Kile and Christiani conclude. "It is prudent to minimize arsenic exposure while its effect on metabolic diseases continues to be researched."

(JAMA. 2008;300[7]:845-846. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.

Posted by dlife at 03:23 PM | Comments (1)

New Report: Adult Obesity Rates Rise in 37 States, Obesity Rates Now Exceed 25 Percent in More Than Half of States

August 19, 2008 (Robert Wood Johnson Foundation) - Adult obesity rates increased in 37 states in the past year, according to the fifth annual F as in Fat: How Obesity Policies Are Failing in America, 2008 report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). Rates rose for a second consecutive year in 24 states and for a third consecutive year in 19 states. No state saw a decrease. Though many promising policies have emerged to promote physical activity and good nutrition in communities, the report concludes that they are not being adopted or implemented at levels needed to turn around this health crisis.

More than 25 percent of adults are obese in 28 states, which is an increase from 19 states last year. More than 20 percent of adults are obese in every state except Colorado. In 1991, no state had an obesity rate above 20 percent. In 1980, the national average of obese adults was 15 percent. Now, an estimated two-thirds of American adults are overweight or obese, and an estimated 23 million children are either overweight or obese (the report does not include new state-level data for children this year).

The F as in Fat report finds that rates of type 2 diabetes, a disease typically associated with obesity, grew in 26 states last year. Four states now have diabetes rates that are above 10 percent, and all 10 states with the highest rates of diabetes and hypertension are in the South. The report also found a relationship between poverty and obesity levels. Seven of the 10 states with the highest obesity rates are also in the top 10 for highest poverty rates.

"America’s future depends on the health of our country. The obesity epidemic is lowering our productivity and dramatically increasing our health care costs. Our analysis shows that we're not treating the obesity epidemic with the urgency it deserves,” said Jeff Levi, Ph.D., executive director of TFAH. “Even though communities have started taking action, considering the scope of the problem, the country’s response has been severely limited. For significant change to happen, combating obesity must become a national priority.”

The F as in Fat report is a follow-up analysis of the annual Behavioral Risk Factor Surveillance Survey (BRFSS) by the federal Centers for Disease Control and Prevention (CDC). The latest survey results showed Mississippi with the highest rate of obesity and Colorado with the lowest rate. Eleven of the 15 states with the highest obesity rates are in the South. Northeastern and Western states continue to have the lowest obesity rates. F as in Fat provides a trend analysis of the BRFSS data using a methodology recommended by the CDC. Rankings are based on three years of data (2005-07) that are averaged for each state’s obesity rate. This methodology reflects a truer representation of the data for comparative purposes in order to rank states and examine changes over time.

The report also provides an annual review of state and federal policies aimed at reducing or preventing obesity in children and adults.It shows that many policies are missing critical components or require a more comprehensive approach to be truly effective. Among the examples highlighted:

* While all 50 states and the District of Columbia have passed laws related to physical education and/or physical activity in schools, only 13 states include enforceability language. Of these states, only four have sanctions or penalties if the laws are not implemented.
* While the Dietary Guidelines for Americans were updated in 2005, the U.S. Department of Agriculture (USDA) school meal program has yet to adopt the recommendations.
* Eighteen states have enacted legislation requiring school meals to exceed USDA nutrition standards. However, only seven of these laws have specific enforcement provisions, and only two state laws include sanctions if its requirements are not met.
* Ten states do not include specific coverage for nutrition assessment and counseling for obese or overweight children in their Medicaid programs (Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefits).
* Twenty states explicitly do not cover nutritional assessment and consultation for obese adults under Medicaid.
* Only Georgia and Vermont have specific guidelines for treating obese adults in their Medicaid programs. In Nebraska and South Carolina, the Medicaid programs specifically state that obesity is not an illness and is therefore not covered.
* Forty-five states allow using obesity or health status as a risk factor to deny coverage or raise premiums. Only five states do not allow using obesity or health status to deny coverage or raise premiums.

“Despite widespread acknowledgement that obesity is endangering the health of millions of Americans, the country is still failing to respond clearly or comprehensively,” said Risa Lavizzo-Mourey, M.D., M.B.A., RWJF president and C.E.O. “We must work together, governments, schools and communities, to improve nutrition and increase physical activity for all ages. We must ensure that strong policies are implemented and enforced in every state, not only to help reverse existing obesity rates, but to prevent obesity among our nation’s children—and generations to come.”

"The report shows the serious impact that the obesity crisis is having on our country's health and economic well-being," said former President Bill Clinton, who co-leads the Alliance for a Healthier Generation, a partnership between the William J. Clinton Foundation and the American Heart Association that works to advance innovative approaches combating childhood obesity and helping children live healthier lives. "We need to continue to work to create a real push towards reversing the obesity epidemic. It is time we make it a national priority," President Clinton added.

The F as in Fat report concludes with a recommendation that the country set a national goal of reversing the childhood obesity epidemic by 2015. To help achieve that goal, the report’s top recommendation calls on the federal government to convene partners from state and local governments, businesses, communities, and schools to create and implement a realistic, comprehensive National Strategy to Combat Obesity. Some key policy recommendations include:

* Investing in effective community-based disease-prevention programs that promote increased physical activity and good nutrition;
* Improving the nutritional quality of foods available in schools and childcare programs;
* Increasing the amount and quality of physical education and activity in schools and childcare programs;
* Increasing access to safe, accessible places for physical activity in communities. Examples include creating and maintaining parks, sidewalks and bike lanes and providing incentives for smart growth designs that make communities more livable and walkable;
* Improving access to affordable nutritious foods by providing incentives for grocery stores and farmers’ markets to locate in underserved communities;
* Encouraging limits on screen time for children through school-based curricula and media literacy resources;
* Eliminatingthe marketing of junk food to kids;
* Encouraging employers to provide workplace wellness programs;
* Requiring public and private insurers to provide preventive services, including nutrition counseling for children and adults; and
* Providing people with the information they need about nutrition and activity to make educated decisions, including point-of-purchase information about the nutrition and calorie content of foods.

The full report with state rankings in all categories is available on TFAH’s Web site at www.healthyamericans.org and RWJF’s Web site at www.rwjf.org. The report was supported by a grant from RWJF.

Posted by dlife at 03:21 PM | Comments (0)

Information for Healthcare Professionals Exenatide (Marketed As Byetta)

August 18, 2008 (FDA) - Since issuing Information for Healthcare Professionals in October 2007, FDA has received reports of 6 cases of hemorrhagic or necrotizing pancreatitis in patients taking Byetta. Byetta is a medicine given by subcutaneous injection to help treat adults with type 2 diabetes. Of the 6 cases of hemorrhagic or necrotizing pancreatitis, all patients required hospitalization, two patients died and four patients were recovering at time of reporting. Byetta was discontinued in all 6 cases.

Byetta and other potentially suspect drugs should be promptly discontinued if pancreatitis is suspected. There are no signs or symptoms that distinguish acute hemorrhagic or necrotizing pancreatitis associated with Byetta from the less severe form of pancreatitis. If pancreatitis is confirmed, initiate appropriate treatment and carefully monitor the patient until recovery. Byetta should not be restarted. Consider antidiabetic therapies other than Byetta in patients with a history of pancreatitis.

FDA is working with the maker of Byetta, Amylin Pharmaceuticals, Inc., to add stronger and more prominent warnings in the product label about the risk of acute hemorrhagic or necrotizing pancreatitis.

Posted by dlife at 02:09 PM | Comments (0)

Levels Of C-reactive Protein In The Blood Do Not Cause Diabetes

August 13, 2008 (Science Daily) - Eric Brunner from the Royal Free and University College London Medical School, London, and colleagues, examine the association between levels of C-reactive protein, a marker for inflammation in the blood, and the risk of type 2 diabetes.

Previous research has suggested that raised levels of this marker are linked with an increased risk of diabetes but to date it has not been clear whether C-reactive protein actually causes the condition.

Brunner and colleagues use a technique called Mendelian randomization to control for the effect of other variables (such as obesity, blood pressure, and socio-economic position) which might play a role in the development of diabetes.

The researchers show that levels of C-reactive protein in the blood are not likely to cause diabetes.

In a related Perspective, Bernard Keavney from the University of Newcastle – who was not involved in the research – discusses the significance of the findings, commenting that technical advances in gene sequencing will, in future, make it easier to carry out such studies.

Posted by dlife at 12:08 PM | Comments (0)

MSG Use Linked to Obesity

August 13, 2008 (Newswise) - People who use monosodium glutamate, or MSG, as a flavor enhancer in their food are more likely than people who don’t use it to be overweight or obese even though they have the same amount of physical activity and total calorie intake, according to a University of North Carolina at Chapel Hill School of Public Health study published this month in the journal Obesity.

Researchers at UNC and in China studied more than 750 Chinese men and women, aged between 40 and 59, in three rural villages in north and south China. The majority of study participants prepared their meals at home without commercially processed foods. About 82 percent of the participants used MSG in their food. Those users were divided into three groups, based on the amount of MSG they used. The third who used the most MSG were nearly three times more likely to be overweight than non-users.

“Animal studies have indicated for years that MSG might be associated with weight gain,” said Ka He, M.D., assistant professor of nutrition and epidemiology at the UNC School of Public Health. “Ours is the first study to show a link between MSG use and weight in humans.”

Because MSG is used as a flavor enhancer in many processed foods, studying its potential effect on humans has been difficult. He and his colleagues chose study participants living in rural Chinese villages because they used very little commercially processed food, but many regularly used MSG in food preparation.

“We found that prevalence of overweight was significantly higher in MSG users than in non-users,” He said. “We saw this risk even when we controlled for physical activity, total calorie intake and other possible explanations for the difference in body mass. The positive associations between MSG intake and overweight were consistent with data from animal studies.”

As the percentage of overweight and obese people around the world continues to increase, He said, finding clues to the cause could be very important.

“The U.S. Food and Drug Administration and other health organizations around the world have concluded that MSG is safe,” He said, “but the question remains – is it healthy?”

Co-authors on the study included Liancheng Zhao and colleagues from Fu Wai Hospital and Cardiovascular Institute at the Chinese Academy of Medical Sciences in Beijing. Other researchers on this study were from Northwestern University in Chicago and the INTERMAP Cooperative Research Group.

Posted by dlife at 10:23 AM | Comments (6)

Overweight Hispanic Children At Significant Risk For Pre-diabetes, According To New Study

August 12, 2008 (Science Daily) - A study by researchers at the University of Southern California (USC) found that overweight Hispanic children are at significant risk for pre-diabetes, a condition marked by higher than normal blood glucose levels that are not yet high enough for a diagnosis of diabetes.

The persistence of pre-diabetes during growth is associated with progression in risk towards future diabetes, according to the study, which will be published in an upcoming issue of the journal Diabetes, and is now available online.

With a population of more than 35 million, Hispanics are the largest and fastest growing minority group in the United States. Despite the fact that Hispanics are at high risk for developing type 2 diabetes, few previous studies have looked at physiological causes of the disease within this population.

Researchers led by Michael I. Goran, Ph.D., professor of preventive medicine, physiology and biophysics and pediatrics, and director of the USC Childhood Obesity Research Center at the Keck School of Medicine of USC, followed a cohort of 128 overweight Hispanic children in East Los Angeles. The children were tested over four consecutive years for glucose tolerance, body mass index, total body fat and lean mass and other risk factors for type 2 diabetes. The study found that an alarming 13% of the children had what the investigators termed "persistent pre-diabetes."

Most prior studies examining pre-diabetes in overweight and obese children looked at a one-time assessment of metabolic risk factors for type 2 diabetes, but fluctuations over time led to poor reliability for these tests. In the new study, Goran and colleagues examined longitudinal data to look at a progression of risk factors over four years. Children were identified as having persistent pre-diabetes if they had three to four positive tests over four annual visits.

The children who had persistent pre-diabetes had signs of compromised beta-cell function, meaning that their bodies were unable to fully compensate to maintain blood glucose at an appropriate level, and they had increasing accumulation of visceral fat or deposition of fat around the organs. Both of these outcomes point towards progression in risk towards type 2 diabetes.

"What this study shows is that doctors should be doing regular monitoring of these children over time, because a one-time checkup might not be enough to tell if they are at risk for developing diabetes," Goran says.

Visceral fat, which pads the spaces between abdominal organs, has been linked to metabolic disturbances and increased risk for cardiovascular disease and type 2 diabetes.

Increased obesity has been identified as a major determinant of insulin resistance. Lower beta-cell function is a key component in the development of type 2 diabetes, as the cells are unable to produce enough insulin to adequately compensate for the insulin resistance.

"To better treat at-risk children we need better ways to monitor beta-cell function and visceral fat buildup," Goran says. "Those are tough to measure but are probably the main factors determining who will get type 2 diabetes."

Future studies will examine different interventions, including improving beta-cell function and reducing visceral fat.

"The study provides great insight into the risk factors that lead to the progression towards type 2 diabetes in this population," says Francine Kaufman, professor of pediatrics at the Keck School of Medicine at USC and head of the division of endocrinology and metabolism at Childrens Hospital Los Angeles, who was not directly involved in the study. "Only by understanding how this devastating disease develops will be able to begin taking steps to prevent it."

The study was supported by the National Institutes of Health and the General Clinical Research Center, National Center for Research Resources.

Posted by dlife at 12:03 PM | Comments (0)

Low Vitamin D Levels Pose Large Threat to Health

August 7, 2008 (Newswise) - Researchers at Johns Hopkins are reporting what is believed to be the most conclusive evidence to date that inadequate levels of vitamin D, obtained from milk, fortified cereals and exposure to sunlight, lead to substantially increased risk of death.

In a study set to appear in the Archives of Internal Medicine online Aug. 11, the Johns Hopkins team analyzed a diverse sample of 13,000 initially healthy men and women participating in an ongoing national health survey and compared the risk of death between those with the lowest blood levels of vitamin D to those with higher amounts. An unhealthy deficiency, experts say, is considered blood levels of 17.8 nanograms per milliliter or lower.

Of the 1,800 study participants known to have died by Dec. 31, 2000, nearly 700 died from some form of heart disease, with 400 of these being deficient in vitamin D. This translates overall to an estimated 26 percent increased risk of any death, though the number of deaths from heart disease alone was not large enough to meet scientific criteria to resolve that it was due to low vitamin D levels.

Yet, researchers say it does highlight a trend, with other studies linking shortages of vitamin D to increased rates of breast cancer and depression in the elderly. And earlier published findings by the team, from the same national study, have established a possible tie-in, showing an 80 percent increased risk of peripheral artery disease from vitamin D deficits.

Researchers note that other studies in the last year or so in animals and humans have identified a connection between low levels of vitamin D and heart disease. But these studies, they say, were weakened by small sample numbers, lack of diversity in the population studied and other factors that limited scientists’ ability to generalize the findings to the public at large.

“Our results make it much more clear that all men and women concerned about their overall health should more closely monitor their blood levels of vitamin D, and make sure they have enough,” says study co-lead investigator Erin Michos, M.D., M.H.S.

“We think we have additional evidence to consider adding vitamin D deficiency as a distinct and separate risk factor for death from cardiovascular disease, putting it alongside much better known and understood risk factors, such as age, gender, family history, smoking, high blood cholesterol levels, high blood pressure, lack of exercise, obesity and diabetes,” says Michos.

Vitamin D is well known to play an essential role in cell growth, in boosting the body’s immune system and in strengthening bones.

“Now that we know vitamin D deficiency is a risk factor, we can better assess how aggressively to treat people at risk of heart disease or those who are already ill and undergoing treatment,” says Michos, who adds that test screening for nutrient levels is relatively simple. It can, she says, be made part of routine blood work and done while monitoring other known risk factors, including blood pressure, glucose and lipid levels.

Heart disease remains the nation’s leading cause of death, killing more than a million Americans each year. Nearly 10 percent of those with the condition have not one identifiable, traditional risk factor, which the experts say is why a considerable extent of the disease goes unexplained.

Michos, an assistant professor at the Johns Hopkins University School of Medicine and its Heart and Vascular Institute, recommends that people boost their vitamin D levels by eating diets rich in such fish as sardines and mackerel, consuming fortified dairy products, taking cod-liver oil and vitamin supplements, and in warmer weather briefly exposing skin to the sun’s vitamin-D producing ultraviolet light.

Aware of the cancer risks linked to too much time spent in the sun, she says as little as 10 to 15 minutes of daily exposure to the sun can produce sufficient amounts of vitamin D to sustain health. The hormone-like nutrient controls blood levels of calcium and phosphorus, essential chemicals in the body.

If vitamin supplements are used, Michos says there is no evidence that more than 2,000 international units per day do any good. Study results show that heart disease death rates flattened out in participants with the highest vitamin D levels (above 50 nanograms per milliliter of blood), signaling a possible loss of the vitamin’s protective effects at too-high doses.

The U.S. Institute of Medicine suggests that an adequate daily intake of vitamin D is between 200 and 400 international units (or blood levels nearing 30 nanograms per milliliter). Previous results from the same nationwide survey showed that 41 percent of men and 53 percent of women are technically deficient in the nutrient, with vitamin D levels below 28 nanograms per milliliter.

Michal Melamed, M.D., M.H.S., study co-lead investigator who started the research as a clinical fellow at Johns Hopkins, says no one knows yet why or how vitamin D’s hormone-like properties may protect the heart, but she adds that there are plenty of leads in the better known links the vitamin has to problems with muscle overgrowth and high blood pressure, in addition to its control of inflammation, which scientists are showing plays a stronger role in all kinds of heart disease. But more research is needed to determine the nutrient’s precise biological action.

Researchers say their next steps are to test various high doses of vitamin D to find out if the nutritional supplementation results in fewer deaths and lower incidence of heart disease, including heart attack or moments of prolonged and severe chest pain.

The team also plans to investigate what biological triggers, such as obesity or hypertension, might offset or worsen the action of vitamin D on heart muscle, or whether vitamin D sets off some other reaction in the heart.

Melamed says that because vitamin D levels are known to fluctuate in direct proportion with daily physical activity, the growing epidemic of obesity and indoor sedentary lifestyles lend more urgency to act on the vitamin D factor.

Funding for this study was provided by the National Institutes of Health, the P.J. Schafer Cardiovascular Research Fund and the Paul Beeson Physician Faculty Scholars in Aging Program. Michos has received previous consulting fees from vitamin D therapeutics manufacturer Abbott Pharmaceuticals. The terms of these arrangements are being managed by the Johns Hopkins University in accordance with its conflict of interest policies.

Besides Michos and Melamed, other Hopkins researchers involved in this study, conducted solely at Hopkins, were Wendy Post, M.D.; and Brad Astor, Ph.D. Melamed is now an assistant professor at the Albert Einstein College of Medicine of Yeshiva University in New York City.

Posted by dlife at 05:17 PM | Comments (1)

Cognitive Problems Associated With Diabetes Duration And Severity

August 11, 2008 (EurekAlert) - Individuals with mild cognitive impairment appear more likely to have earlier onset, longer duration and greater severity of diabetes, according to a report in the August issue of Archives of Neurology, one of the JAMA/Archives journals.

Mild cognitive impairment is a transitional stage between normal aging and dementia, according to background information in the article. Previous studies have found an association between mild cognitive impairment and diabetes. Poor blood glucose control over time may lead to neuron loss, and diabetes is associated with cardiovascular disease risk and stroke, which also may increase the risk of cognitive impairment.

Rosebud O. Roberts, M.B.Ch.B., M.S., and colleagues at Mayo Clinic, Rochester, Minn., studied individuals from Olmsted County, Minnesota, who were age 70 to 89 on Oct. 1, 2004. Participants received a neurological examination, neuropsychological evaluation and tests of blood glucose levels, and completed an interview with questions about diabetes history, treatment and complications. A medical records linkage system was used to confirm diabetes history.

Rates of diabetes were similar among 329 individuals with mild cognitive impairment (20.1 percent) and 1,640 participants without mild cognitive impairment (17.7 percent). However, mild cognitive impairment was associated with developing diabetes before age 65, having diabetes for 10 years or longer, being treated with insulin and having diabetes complications.

"Severe diabetes mellitus is more likely to be associated with chronic hyperglycemia [high blood glucose], which, in turn, increases the likelihood of cerebral microvascular disease and may contribute to neuronal damage, brain atrophy and cognitive impairment," the authors write. That individuals with the eye disease diabetic retinopathy were twice as likely to have mild cognitive impairment supports the theory that diabetes-related damage to blood vessels in the brain may contribute to the development of cognitive problems.

"Our findings suggest that diabetes mellitus duration and severity, as measured by type of treatment and the presence of diabetes mellitus complications, may be important in the pathogenesis of cognitive impairment in subjects with diabetes mellitus," they conclude. "In contrast, late onset of diabetes mellitus, short duration of diabetes mellitus or well-controlled diabetes mellitus may have a lesser effect."

Posted by dlife at 08:55 AM | Comments (0)

Dispelling Diabetes Myths For Baby Boomers

August 8, 2008 (Newswise) - According to Dr. Gerald Bernstein, patient perception about diabetes has not changed much in the over forty years he has been practicing medicine at two major NYC hospitals. In fact, he still sees the same viewpoints today as when he was a former director of the Beth Israel Health Care Systems Diabetes Management Program years ago.

“In this day and age, I still get patients who believe that they developed diabetes from eating too much sugar,” says Dr. Bernstein. Although doctors and researchers are still unsure what causes the disease, Dr. Bernstein insists, “bad eating habits such as too much refined sugars, empty carbohydrates, and fructose does not cause diabetes.”

Below are some of the most prevalent myths surrounding diabetes. “Baby boomers who were raised with misconceptions about the disease may be at risk,” advises Dr. Bernstein, who is also the director of medical affairs at Generex Biotechnology Corporation, a biotechnology company engaged in the research, development, and commercialization of drug delivery systems and technologies for patients with diabetes. “There is no substitute for knowledge.”

Diabetes Will Make You Go Blind: According to Dr. Bernstein, while it is true that all people with diabetes are at risk of blindness, heart problems, and renal disease, it is equally true that in this day and age a smaller percentage actually experience the full brunt of such complications than 30 years ago. “The better the patient controls his or her blood sugar, the less likely the more serious complications associated with diabetes will progress. Anyone already experiencing the side effects of diabetes needs to achieve and maintain the most stringent possible control in order to minimize their further progression.”

Since I Don’t Have To Inject Insulin, My Diabetes Isn’t A Serious Condition: A surprising number of people still believe this falsehood. Non insulin-dependent diabetes mellitus (type 2 diabetes) can produce destructively high blood glucose levels if not kept under control. Type 2 diabetes often grows more severe with time, so a patient who starts with low numbers will probably need to progress to from diet-and-exercise-based blood sugar control, then to oral diabetes medications. It is often better to start with insulin early rather than waiting to use it as a last resort.

Many older patients are finding their “oral meds” have become ineffective with time, and may need to switch to insulin injections to maintain effective diabetes control. “Type 2 diabetes, even pre-diabetes is serious even if your blood sugar isn’t that high,” warns Dr. Bernstein. New methods such as an oral insulin such as Generex Oral-lyn™, an insulin spray for the treatment of type I and type II diabetes that works by delivering insulin via the membranes of the oral cavity via a simple inhaler-like device.

I Can’t Eat What I Like Anymore: That’s a misconception considering that what is now coined the “diabetic diet” is actually a well-balanced, sensible food plan that would be healthy for anyone to adopt, with or without the disease. “Keep in mind, you can ‘have your cake and eat it too’ but if you want to eat something rich in carbs, you will need to balance it out by cutting an equivalent amount of carbs or sugar from somewhere else in your diet,” suggests Dr. Bernstein. “Patients have a good deal more flexibility in their diets than they might suspect; the rest is just a matter of care and moderation.” Very often you can eat what you want BUT just not as much as you want.

I Can Tell If My Blood Sugar Levels Are Too High Or Too Low: “This myth is dangerous because you can wind up in the hospital if you ignore symptoms of hyperglycemia, which is hard to detect by the way you feel,” says Dr. Bernstein. “Making do without a regular blood glucose tests is like flying without a parachute or crossing the street with your eyes closed. You’re guessing. Learn your body’s signals when you get into trouble, but be certain to use your glucose monitor to be sure.” Dr. Bernstein also advises people with diabetes to carry a Glucose RapidSpray™, that can quickly, conveniently and efficiently deliver glucose to the mouth via an easy to use spray bottle at the first sign of glucose deficiency.

Diabetes Is The Beginning Of The End: “I still get patients who believe their lives are over once complications set it,” says Dr. Bernstein. “The reality is that with the development of proper skills and mindset and the possession of monitoring equipment, patients with diabetes can continue to live full lives, even with severe complications. Many diabetics, even insulin-dependent, live well into old age.

“Pay attention to your body. Keep ahead of what your diabetes is doing—for baby boomers, this is no time for surprises! Consult with your doctor, or your diabetes educator. Discuss exercise plans, and any adjustment in medications, with your doctor, first.”

Posted by dlife at 09:29 AM | Comments (0)

New Survey Explores The Impact Of Insulin Injections On People With Diabetes

August 7, 2008 (EurekAlert) - The American Association of Diabetes Educators (AADE) today announced results from a survey conducted by Harris Interactive highlighting communication between people with diabetes that require insulin injections and their healthcare providers. According to the survey results, 33 percent of respondents have experienced some level of dread relating to insulin injections (eight percent strongly agreed/25 percent somewhat agreed), 14 percent of individuals surveyed felt that the insulin injections had a negative impact on their life (three percent experience a major negative impact/11 percent experience a moderate negative impact) and more than 29 percent of individuals surveyed felt that injecting insulin was the hardest aspect of their diabetes care (eight percent strongly agree/21 percent somewhat agree). However, even though insulin injections had such an impact on these individuals, 52 percent do not proactively discuss their concerns regarding the physical and emotional aspects of injecting with their healthcare provider.

For a proportion of the individuals surveyed, 37 percent, this was due in part to a misconception that discussing these issues would be a bother to their healthcare provider. Yet, a corresponding survey of healthcare professionals (PCPs, endocrinologists and diabetes educators) paints a different story. Seventy-one percent of healthcare professionals are aware of the impact that insulin injections have on their patients' quality of life and 40 percent have initiated a dialogue in the past with their patients about these issues. According to the Centers for Disease Control and Prevention (CDC), there are 24 million people in the U.S. with diabetes, and more than six million of them take injections of some kind as part or all of their treatment. (1)

"There are millions of individuals living in the U.S. with diabetes that take injections." said Amparo Gonzalez, RN, BSN, CDE, president of the AADE. "When developing the survey we had two goals in mind, the first was to encourage patients to take a more proactive role in communicating with their healthcare team about their concerns regarding insulin injections. The second was to dispel the myth that healthcare providers were unaware of or were unwilling to address the quality of life issues surrounding insulin injections. It is our hope that the results from this survey accomplish both these goals and that patients and providers will begin talking regularly about these important issues. If we can improve the quality of life for 33 percent of people with diabetes who are insulin dependent, then we can be one step closer to lessening the impact of the disease on our patients' lives."

To reinforce the goals of the Injection Impact Report, and to continue to address the issues surrounding communication and barriers to patient adherence, the AADE created the Injection Impact Report Discussion Group comprised of a team of physicians, diabetes educators, patients and other healthcare providers whose mission is to heighten awareness of injection issues. In response to the results from the Injection Impact Report, the Discussion Group is developing tools for patients and healthcare providers to help foster increased communication around these issues.

"Diabetes is unique in that it requires significant commitment and adherence by the patient to keep it in control. If patients are not comfortable communicating issues related to their quality of life, over time they may adhere less and less to their regimen, putting them increasingly at risk for complications," said Davida Kruger, MSN, APN-BC,BC-ADM, diabetes nurse practitioner and member of the Injection Impact Report Discussion Group. "As this survey shows, a percentage of individuals living with diabetes and taking insulin are altering what they eat during the day to avoid injections or even skipping the injection entirely. Even if that only happens rarely, omission of insulin depending on the circumstance may have an impact on a patient's overall health and potentially leave them at risk for serious diabetes-related complications."

Diabetes educators are an excellent resource for answers concerning quality of life and day-to-day concerns with diabetes management. The Injection Impact Report Discussion Group wants patients to utilize their diabetes educator in dealing with any issues around injections, and also encourages physicians to work with diabetes educators in their practices to develop programs to aid patients in their diabetes management. By working together, patients, diabetes educators and physicians can improve these statistics and improve diabetes management and lives of people with diabetes.

"I am not surprised that many people with diabetes are not talking with the doctors or diabetes educators about their injections," said Debra Lofton, a member of the Injection Impact Report Discussion Group who takes insulin injections for her diabetes. "For years I skipped meals or injections to avoid the hassle and discomfort of taking them, but when it came to talking with my doctor about it, I did not speak up as much as I could have. When I did finally talk to my diabetes educator about my injections I learned there were other, less painful ways to manage my diabetes effectively. I am so happy I finally said something."

About the Injection Impact Report

The surveys were conducted online within the United States by Harris Interactive on behalf of the American Association of Diabetes Educators and Patton Medical Devices between June 12th and July 7th, 2008. The survey of people with diabetes included 502 people who inject insulin using a syringe or insulin pen to manage their diabetes. The survey of healthcare professionals included 301 healthcare professionals that treat people with diabetes that inject insulin, including 101 primary care physicians, 100 endocrinologists, and 100 diabetes educators. Physicians were recruited from the American Medical Association (AMA) physician list. Data from the patient and physician surveys were weighted as necessary to be representative of the respective populations. No estimates of theoretical sampling error can be calculated; a full methodology is available.

Posted by dlife at 09:19 AM | Comments (0)

Researchers Report Periodontal Disease Independently Predicts New Onset Diabetes

August 6, 2008 (EurekAlert) - Periodontal disease may be an independent predictor of incident Type 2 diabetes, according to a study by researchers at Columbia University Mailman School of Public Health. While diabetes has long been believed to be a risk factor for periodontal infections, this is the first study exploring whether the reverse might also be true, that is, if periodontal infections can contribute to the development of diabetes. The full study findings are published in the July 2008 issue of Diabetes Care.

The Mailman School of Public Health researchers studied over 9,000 participants without diabetes from a nationally representative sample of the U.S. population, 817 of whom went on to develop diabetes. They then compared the risk of developing diabetes over the next 20 years between people with varying degrees of periodontal disease and found that individuals with elevated levels of periodontal disease were nearly twice as likely to become diabetic in that 20 year timeframe. These findings remained after extensive multivariable adjustment for potential confounders including, but not limited to, age, smoking, obesity, hypertension, and dietary patterns.

"These data add a new twist to the association and suggest that periodontal disease may be there before diabetes," said Ryan T. Demmer, PhD, MPH, associate research scientist in the Department of Epidemiology at the Mailman School of Public Health and lead author. "We found that over two decades of follow-up, individuals who had periodontal disease were more likely to develop Type 2 diabetes later in life when compared to individuals without periodontal disease."

Also of interest, the researchers found that those study participants who had lost all of their teeth were at intermediate risk for incident diabetes. "This could be suggestive that the people who lost all of their teeth had a history of infection at some point, but subsequently lost their teeth and removed the source of infection," noted Dr. Demmer. "This is particularly interesting as it supports previous research originating from The Oral Infections and Vascular Disease Epidemiology Study (INVEST) which has shown that individuals lacking teeth are at intermediate risk for cardiovascular disease" said Moïse Desvarieux, MD, PhD, director of INVEST, associate professor and Inserm Chair of Excellence in the Department of Epidemiology at the Mailman School and senior author of the paper.

The contributory role of periodontal disease in the development of Type 2 diabetes is potentially of public health importance because of the prevalence of treatable periodontal diseases in the population and the pervasiveness of diabetes-associated morbidity and mortality. However, observes Dr. Demmer, more studies are needed both to determine whether gum disease directly contributes to type 2 diabetes and, from there, that treating the dental problem can prevent diabetes. In addition to Dr. Desvarieux, David R. Jacobs Jr., PhD, professor in the Department of Epidemiology and Community Health at the University of Minnesota, also contributed to the research.

Posted by dlife at 01:46 PM | Comments (0)

Study: Spices May Protect Against Consequences Of High Blood Sugar

August 5, 2008 (EurekAlert) - Herbs and spices are rich in antioxidants, and a new University of Georgia study suggests they are also potent inhibitors of tissue damage and inflammation caused by high levels of blood sugar.

Researchers, whose results appear in the current issue of the Journal of Medicinal Food, tested extracts from 24 common herbs and spices. In addition to finding high levels of antioxidant-rich compounds known as phenols, they revealed a direct correlation between phenol content and the ability of the extracts to block the formation of compounds that contribute to damage caused by diabetes and aging.

"Because herbs and spices have a very low calorie content and are relatively inexpensive, they're a great way to get a lot of antioxidant and anti-inflammatory power into your diet," said study co-author James Hargrove, associate professor of foods and nutrition in the UGA College of Family and Consumer Sciences.

Hargrove explained that when blood sugar levels are high, a process known as protein glycation occurs in which the sugar bonds with proteins to eventually form what are known as advanced glycation end products, also known as AGE compounds. The acronym is fitting because these compounds activate the immune system, resulting in the inflammation and tissue damage associated with aging and diabetes.

The researchers found a strong and direct correlation between the phenol content of common herbs and spices and their ability to inhibit the formation of AGE compounds. Spices such as cloves and cinnamon had phenol levels that were 30 percent and 18 percent of dry weight, respectively, while herbs such as oregano and sage were eight and six percent phenol by dry weight, respectively. For comparison, blueberries – which are widely touted for their antioxidant capabilities – contain roughly five percent phenol by dry weight.

Study co-author Diane Hartle, associate professor in the UGA College of Pharmacy, said various phenols are absorbed differently by the body and have different mechanisms of action, so it's likely that a variety of spices will provide maximum benefit.

"If you set up a good herb and spice cabinet and season your food liberally, you could double or even triple the medicinal value of your meal without increasing the caloric content," she said.

She added that controlling blood sugar and the formation of AGE compounds can also decrease the risk of cardiovascular damage associated with diabetes and aging. She explained that high blood sugar accelerates heart disease partly because AGE compounds form in the blood and in the walls of blood vessels. The AGE compounds aggravate atherosclerosis, which produces cholesterol plaques.

The UGA researchers tested for the ability to block AGE compounds in a test tube, but animal studies conducted on the health benefits of spices lend support to their argument. Cinnamon and cinnamon extracts, for example, have been shown to lower blood sugar in mice. Interestingly, cinnamon lowers blood sugar by acting on several different levels, Hargrove said. It slows the emptying of the stomach to reduce sharp rises in blood sugar following meals and improves the effectiveness, or sensitivity, of insulin. It also enhances antioxidant defenses.

Hargrove said their findings suggest it's likely that the herbs and spices they studied will provide similar benefits in animal tests. He points out that because humans have been consuming herbs and spices for thousands of years, they come without the risk of possible side effects that accompany medications.

"Culinary herbs and spices are all generally recognized as safe and have been time-tested in the diet," he said. "Indeed, some of spices and herbals are now sold as food supplements because of their recognized health benefits."

Study co-author Phillip Greenspan, associate professor in the College of Pharmacy, noted that most people don't get their recommended five to nine servings of fruits and vegetables a day. Rather than seasoning their food with salt – which provides no beneficial phenols and has been linked to high blood pressure – he recommends that people use a variety of herbs and spices to help boost the nutritional quality of their meals.

"When you add herbs and spices to food, you definitely provide yourself with additional benefits besides taste," Greenspan said.

Posted by dlife at 10:29 AM | Comments (4)

Eating Fish May Prevent Memory Loss and Stroke in Old Age

August 4. 2008 (Newswise) - Eating tuna and other types of fish may help lower the risk of cognitive decline and stroke in healthy older adults, according to a study published in the August 5, 2008, issue of Neurology®, the medical journal of the American Academy of Neurology.

For the study, 3,660 people age 65 and older underwent brain scans to detect silent brain infarcts, or small lesions in the brain that can cause loss of thinking skills, stroke or dementia. Scans were performed again five years later on 2,313 of the participants. The people involved in the study were also given questionnaires about fish in their diets.

The study found that people who ate broiled or baked tuna and other fish high in omega-3 fatty acids (called DHA and EPA) three times or more per week had a nearly 26 percent lower risk of having the silent brain lesions that can cause dementia and stroke compared to people who did not eat fish regularly. Eating just one serving of this type of fish per week led to a 13 percent lower risk. The study also found people who regularly ate these types of fish had fewer changes in the white matter in their brains.

“While eating tuna and other types of fish seems to help protect against memory loss and stroke, these results were not found in people who regularly ate fried fish,” said Jyrki Virtanen, PhD, RD, with the University of Kuopio in Finland. “More research is needed as to why these types of fish may have protective effects, but the omega-3 fatty acids EPA and DHA would seem to have a major role.”

Types of fish that contain high levels of DHA and EPA nutrients include salmon, mackerel, herring, sardines, and anchovies.

“Previous findings have shown that fish and fish oil can help prevent stroke, but this is one of the only studies that looks at fish’s effect on silent brain infarcts in healthy, older people,” said Virtanen. Research shows that silent brain infarcts, which are only detected by brain scans, are found in about 20 percent of otherwise healthy elderly people.

The study was supported by the National Heart, Lung and Blood Institute, the National Institute of Neurological Disorders and Stroke, the Finnish Cultural Foundation, Helsingin Sanomat Centennial Foundation, the Finnish Foundation for Cardiovascular Research, the Yrjö Jahnsson Foundation and the University of Kuopio.

The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease, and multiple sclerosis.

For more information about the American Academy of Neurology, visit http://www.aan.com.

Posted by dlife at 04:11 PM | Comments (0)

Obesity on the Kids’ Menus at Top Chains

August 4, 2008 (CSPI News Release) - Nearly every single possible combination of the children’s meals at KFC, Taco Bell, Sonic, Jack in the Box, and Chick-fil-A is too high in calories, according to the nonprofit Center for Science in the Public Interest, which today released the results of an investigation into the nutritional quality of kids’ meals at 13 top restaurant chains. Ninety-three percent of 1,474 possible choices at the 13 chains exceed 430 calories—an amount that is one-third of what the Institute of Medicine recommends that children aged four through eight should consume in a day.

Chili’s has 700 possible kids’ meal combinations, but 658, or 94 percent, of those are too high in calories, including one comprised of country-fried chicken crispers, cinnamon apples, and chocolate milk (1,020 calories) and another comprised of cheese pizza, homestyle fries, and lemonade (1,000 calories). Burger King has a “Big Kids” meal with a double cheeseburger, fries, and chocolate milk (910 calories), and Sonic has a “Wacky Pack” with 830 calories worth of grilled cheese, fries, and a slushie.

KFC has a wide variety of side items, but there are few meal combinations that keep a reasonable ceiling on calories, according to the study. One example of a high-cal combo KFC kid’s meal (the chain calls them “Laptop Meals”) has popcorn chicken, baked beans, biscuit, Teddy Grahams, and fruit punch, which has 940 calories. (KFC has since dropped Baked Cheetos from its kids’ meals, and some outlets vary the number of chicken strips or sides.)

Most of the kids’meals (93 percent) at McDonald’s and Wendy’s are too high in calories, as are the possibilities at Burger King (92 percent), Dairy Queen (89 percent), Arby’s (69 percent), and Denny’s (60 percent—though its kids’ meals don’t include drinks). (Since CSPI’s study was completed, Burger King has introduced one new children’s meal with macaroni and cheese, apple “fries,” and 1 percent milk, which has a reasonable 420 calories.)

Subway’s kids’ meals came out on top. Only a third of its Fresh Fit for Kids meals, which include a mini-sub, juice box, and one of several healthful side items (apple slices, raisins, or yogurt), exceed the 430-calorie threshold. Subway is the only chain that doesn’t offer soft drinks with kids’ meals.

“Parents want to feed their children healthy meals but America’s chain restaurants are setting parents up to fail,” said CSPI nutrition policy director Margo G. Wootan. “McDonald’s, Burger King, KFC, and other chains are conditioning kids to expect burgers, fried chicken, pizza, French fries, macaroni and cheese, and soda in various combination at almost every lunch and dinner.”

Besides being almost always too high in calories, 45 percent of the kids’ meals at the 13 chains studied by CSPI are too high in saturated and trans fat, and 86 percent are too high in sodium. That’s alarming, according to CSPI, because a quarter of children between the ages of five and ten show early signs of heart disease, such as high LDL (the “bad” cholesterol) or elevated blood pressure.

“People may not get a heart attack until their 50s or 60s, but arteries begin to clog in childhood,” said Wootan. “Most of these kids’ meals appear to be designed to put America’s children on the fast-track to obesity, disability, heart attack, or diabetes.”

Though the overwhelming majority of chain restaurant kids’ meals are nutritionally poor, calorie counts on menus and menu boards would help parents assemble healthier meals for their children. If Arby’s kids’ meals had calorie counts, parents could see that substituting a fruit cup and a juice box for fries and a soda would cut a popcorn chicken meal from 720 calories to 420. If Denny’s listed calories on menus, parents could see the surprising difference between the calories in Big Dipper French Toastix (770) and Smiley-Alien Hotcakes (without meat, 370).

CSPI has advocated laws or regulations that require chain restaurants to list calories on menus and menu boards. They’ve already begun appearing in New York City. San Francisco, King County (Seattle), WA., Multnomah County (Portland), OR, and Santa Clara County, CA, also have passed menu labeling policies. Similar policies have been introduced in over 20 other states and localities over the last two years. California’s legislature may be on the verge of passing a statewide menu labeling bill, which lobbyists for the chain restaurant industry are fighting tooth and nail. The California Center for Public Health Advocacy, an advocacy group leading the fight for menu labeling legislation in that state, collaborated with CSPI on the study released today.

CSPI only scrutinized the chains that have dedicated children’s menus (19 out of the top 25 chains) and that provide nutrition information on their web sites or elsewhere (13 chains). Applebee’s, T.G.I. Friday’s, Outback Steakhouse, Olive Garden, Red Lobster, and IHOP do not disclose nutrition information for most menu items even upon request.

Posted by dlife at 03:51 PM | Comments (0)

Lowering Cholesterol Early In Life Could Save Lives

August 4, 2008 (EurekAlert) - With heart disease maintaining top billing as the leading cause of death in the United States, a team of University of