October 8, 2009 (EurekAlert) - Celiac disease (CD) is an inherited intestinal disorder characterized by life-long intolerance to the ingestion of gluten, a protein found in wheat, rye, and barley. Although CD can be diagnosed at any age, it commonly occurs during early childhood (between 9 and 24 months). Reduced bone mineral density is often found in individuals with CD. A new article in the journal Nutrition Reviews examines the literature on the topic and reveals that a gluten-free diet can affect children's recovery.Metabolic bone disease remains a significant and common complication of CD. Reduced bone mineral density can lead to the inability to develop optimal bone mass in children and the loss of bone in adults, both of which increase the risk of osteoporosis. There also exists an additional risk of fracture in people with CD.

However, evidence suggests that a gluten-free diet (GFD) promotes a rapid increase in bone mineral density that leads to complete recovery of bone mineralization in children. A GFD improves, although rarely normalizes, bone mineral density in adults. Children may attain normal peak bone mass if the diagnosis is made and treatment is given before puberty, thereby preventing osteoporosis in later life.

Also, nutritional supplements consisting of calcium and vitamin D seem to increase the bone mineral density of children and adolescents with CD.

"Our findings reinforce the importance of a strict gluten-free diet, which remains the only scientific proven treatment for celiac disease to date," the authors conclude. "Early diagnosis and therapy are critical in preventing celiac disease complications, like reduced bone mineral density."

October 6, 2009 (Newswise) - St. Jude Children's Research Hospital investigators have discovered how destructive immune cells gain access to insulin-producing cells and help cause diabetes.The finding points to possible new strategies to halt or prevent type I diabetes.

Working in mice, researchers demonstrated that to enter key areas of the pancreas known as the islets of Langerhans, immune cells known as T cells must recognize a marker on the surface of insulin-producing cells housed there. T cells play a key role in regulating immune response. Once inside the islets, T cells trigger the inflammation that can lead to destruction of the insulin-producing beta cells.

The result is type I diabetes.

The report answers a fundamental question about the role of T cell entry and accumulation in the islets in development of type I disease, a disease that affects as many as 3 million Americans. The research appears in the October 16 edition of the journal Immunity. Dario Vignali, Ph.D., is the paper's senior author and vice chair of the St. Jude Immunology department.

The St. Jude results contradict a widely held theory that only a small percentage of T cells that infiltrate the islets were actively involved in causing type I diabetes. The old scenario held that most of the T cells found in the islets were recruited to the site by a small number of specialized T cells. Those recruited or bystander T cells were thought to play no role in causing diabetes. Furthermore, it was thought that any T cell could gain access to the islets.

"The new research argues that every T cell in the islet is important. What these T cells recognize that allowed them to gain access to the islets may provide us with clues as to what might be needed to prevent diabetes," Vignali said.

"Understanding the molecular differences between the T cells in the islets and the T cells in the periphery might also start to tell us a lot about what it takes to make a T cell attack the beta cells and cause diabetes."

Without insulin to turn food into fuel for cells, patients develop type I diabetes and are left dependent on insulin injections, an insulin pump or in rare cases a pancreas transplant. Unlike the more common form of the disease, known as type II diabetes, type I diabetes usually affects children and is sometimes called juvenile diabetes. About 15,000 new cases are diagnosed annually in the United States. Even with treatment, patients with type I diabetes are at risk for blindness, kidney failure and other complications.

"This paper also presents a new clinical intervention strategy-blocking T cells from even getting into the islet cells in the first place," Vignali added.

If any T cell could enter the islets, then it would be less likely that there were any "special rules" for entering islets and thus nothing unique about entry into the islets that might be targeted by treatment, he explained.

Understanding how T cell access to islets is controlled also raises hopes for developing a therapy to re-educate the immune system to tolerate rather than attack the beta cells. The St. Jude research points to a new route into islet cells.

For this study, scientists used a technique Vignali's laboratory developed in 2006. The technique allows researchers to quickly modify T cell production in mice. Normally mice make millions of T cells that can recognize many different cells and microorganisms. Each T cell carries on its surface a receptor that recognizes and binds to just one specific antigen, or marker, on the surface of the T cell's intended target.

The modification technique allowed researchers to create strains of mice with only two types of T cells, each with different receptors. One population carried a receptor that recognized the insulin-producing beta cells and could cause diabetes. The other group was programmed to recognize a different antigen. Researchers reported they could not induce the latter group of T cells to enter the islets.

Then investigators created and tracked T cells with three types of receptors-receptors from T cells with a proven ability to enter islet cells and cause diabetes, those able to enter islets and cause inflammation, but not diabetes, and a third group of receptors with no connection to type 1 diabetes or islet cells. The scientists reported that none of the T cells, even those with a demonstrated ability to cause diabetes in mice, could induce bystander T cells to enter the islet cells.

Finally, investigators tracked T cells carrying receptors from mice that naturally developed type I diabetes. They created mice with 17 new T cell receptors, five from the spleen of diabetic mice and 12 from T cells isolated in the islets of those diabetic mice. If the islets control T cells entry, then islets in the new mouse strains would be infiltrated by T cells with islet-derived, but not spleen-derived, receptors.

That is what happened. "About 70 percent of the receptors that came from the islets could mediate T cell migration back into the islets, while none of the receptors that came from the spleen could do likewise," Vignali said. The islet-derived receptors were also linked to rapid development of diabetes, with one-third causing diabetes during the 10-week study.

Vignali said it is unclear if the findings will hold true for other autoimmune diseases, such as rheumatoid arthritis or Crohn's disease. The authors noted that the structure, location and other factors might make the islet cells unique.

Greig Lennon, Maria Bettini and Amanda Burton, of St. Jude, shared first authorship on this study. The other authors were Erica Vincent and Paula Arnold of St. Jude, and Pere Santamaria of the University of Calgary, Alberta, Canada.

The work was supported in part by the Juvenile Diabetes Research Foundation International, the National Institutes of Health and ALSAC.

October 2, 2009 (Newswise) - "Weight loss is emerging as one of the best and safest ways to treat type 2 diabetes," asserts Osama Hamdy, M.D., Ph.D., Medical Director of the Obesity Clinical Program at Joslin Diabetes Center.In a study concluded last year, 115 people with type 2 diabetes who participated in Joslin's Why WAIT (Weight Achievement and Intensive Treatment) program lost an average of 10.3 percent of their initial weight (or 24 pounds) and an average of 3.7 inches from their waists after 12 weeks. They maintained an average loss of 7.6 percent (or 18.8 pounds) on their own for at least a year and a half afterwards.

Participants' risk for coronary artery disease was down significantly and their blood glucose control so improved that fewer medications--and in some cases, no medications--are now necessary.
These results and related scientific studies have convinced Dr. Hamdy that weight loss is the best way to treat type 2 diabetes.

"For 30 years, the treatment for type 2 diabetes has been to add more medications to get blood glucose under control," points out Dr. Hamdy. "Many of those medications cause weight gain, so people end up with too much medicine and more weight."

A recent study showed that patients with diabetes who gain weight while taking diabetes medications have an additional health care cost of $1,719 per year compared to patients who don't gain weight.
Weight gain is particularly undesirable because about 85 to 90 percent of those with type 2 diabetes are already overweight or obese to start with. Excess weight, particularly around the waist, is a major risk factor for diabetes and one of its most deadly complications, cardiovascular events such as heart attacks and strokes.

Clinical studies conducted by Dr. Hamdy and his colleagues at Joslin and elsewhere have clearly shown that a 7 percent weight loss, combined with moderately intensive exercise, improves insulin sensitivity, lowers blood glucose levels, improves the function of blood vessels, and reduces the inflammation in these vessels that can lead to heart disease. A 7 percent loss of weight for someone who starts at 250 pounds, for example, is a modest 17.5 pounds.

Weight loss-guided by a structured diet, a gradual increase of daily exercise and adjustment of diabetes medications-helps control diabetes, says Dr. Hamdy, and if accomplished in the early stages, can even reverse the disease process, causing remission of the diabetes. About 20 percent of Why WAIT participants no longer require diabetes medication.

The Challenge
Surveys have found that one-third to one-half of primary care physicians don't recommend weight management to their overweight or obese patients. They don't believe patients are motivated enough or they think it will be too costly, as health care insurers don't typically cover the cost of weight loss programs. Studies also find that despite initial weight loss success, people typically regain the weight and only 25 percent can maintain the weight loss for a year
after treatment.

Is it possible to take what has been learned about making lifestyle changes in large clinical research trials like the Diabetes Prevention Program, in which people are intensively supported for six months and longer, and apply it to everyday clinical practice in a shorter timeframe? And what is the best way to help people reach that long-term goal: keeping the weight off?

These are the challenges that Dr. Hamdy and his multidisciplinary Why WAIT team set out to conquer. They developed a three-month program, mostly covered by insurance, and began to enroll 10 to 15 people per session in 2005. Participants come into Joslin once a week for two evening hours and apply what they learn at home.

The Results
The Why WAIT team reported on how the participants fared a year and a half after finishing the program at the American Diabetes Association's annual scientific meeting in June, 2009.
Though some had gained back some of the weight they lost, the average loss was 7.6 percent--still above the golden percentage it takes to achieve health benefits.

Just over half (51 percent) of the participants continued to lose weight; typically those who stuck with the program's meal and exercise plans. They were also the ones who maintained excellent blood pressure and diabetes control, and did it using less medication.

Over the course of the program, A1C levels dropped from a starting average of 7.5 percent to 6.6 percent. (Tests of A1C--short for "glycoslated hemoglobin A1C"--measure the glucose that clings to hemoglobin molecules in red blood cells. They are commonly employed in diabetes management to give a good indication of how much extra glucose has been in the bloodstream over the previous few months.) Almost 70 percent of participants lowered their A1C to below 6.5 percent and 82 percent to below 7 percent, which is within Joslin's Clinical Guidelines. Those who maintained their weight loss over the first year also maintained the lower A1C.

The program also resulted in positive changes in participants' cardiovascular disease risk profile-reflected in their improved levels of lipids, blood pressure, and C-reactive protein (a marker for inflammation linked to cardiovascular disease).

The reduction in diabetes medications saved an average of $561.37 per patient per year. Additionally, a recent study showed that just 1% of weight loss in patients with diabetes saved $256 on total health care cost and $131 on diabetes-related cost in a year. A 7.6% weight loss in the Why WAIT program could save $1,946 (or 27%) of the health care cost and $996 (or 44%) of the diabetes-related cost.

How They Did It
A key innovation of the Why WAIT model is how diabetes medications are managed. "We begin by switching participants from medications that cause weight gain to ones that either maintain body weight or help weight loss," says Dr. Hamdy. Every week patients' blood glucose values are reviewed and their diabetes medications are adjusted.

"In our model, the focus is on body weight as the core of diabetes treatment," says Dr. Hamdy. "We've allowed the weight loss itself to help people achieve blood glucose control."

Rooting for the participants and every pound lost along the way are a dietitian, an exercise physiologist, a behavioral psychologist and a nurse educator.

As a team, they deliver five major components of the Why WAIT program:

The principle is simple: eat less and properly and exercise more. "But doing these things and sticking to them is hard," admits Ann Goebel-Fabbri, Ph.D., a Joslin psychologist. "We're requiring people to make multiple changes in their lives simultaneously."

There are no eliminations or rejection like on a television show. There is no blame or shame, as overweight people can sometimes feel in the healthcare or gym environment. But there is gradual, steady weight loss.

Recipes for Success
In the Why WAIT program, calories per day are only cut down by 250 to 500-the equivalent of one-half to a full cup of rich ice cream. In concert with gradually increasing exercise, people lose about one to two pounds every week.

A big part of the program's success, Dr. Hamdy believes, is that the diet is high-protein and low-carb. It strictly follows Joslin's "Clinical Nutrition Guideline for Overweight and Obese Adults with Type 2 Diabetes, Prediabetes or Those at High Risk for Developing Type 2 Diabetes," which recommends the ratio of nutrients to be consumed in a day as 20-30 percent protein, around 40 percent carbohydrate higher in fiber and lower in glycemic index, and 30 percent fat (mono or polyunsaturated fat with less saturated fat and no transfat).

This is a higher percentage of protein and a lower percentage of carbohydrate than has been typically recommended for those with diabetes. "Our guidelines were developed to achieve slow but steady weight loss and better diabetes control, and especially to prevent cardiovascular complications," points out Dr. Hamdy. "It is safe and effective for weight loss, helps people feel more full, results in higher energy levels, and helps reduce blood pressure."

Protein should come from lean sources such as poultry or fish, rather than meat, which is higher in saturated fats, says Gillian Arathuzik, RD, CDE, the program dietitian.

Dealing with Set-Backs
A central theme is that improvement doesn't have to be all or nothing. "There are so many ways to slip up in eating, or by not exercising or monitoring enough," points out Dr. Goebel-Fabbri. "When this happens, it's very easy to move right into self-blame and negative thinking that this is never going to work."

The team uses a highway metaphor to turn this thinking around: If you are trying to drive to Boston and end up in Hartford, Conn., you don't say I'm going to have to get out and stay here; you get right back in the car and head in the direction you want to go.

A large part of what the team does is to help everyone stay motivated. But the "big bang" of motivation is the weight change people see every week. They find that they feel better; their blood glucose numbers are dropping and their energy, lung capacity and flexibility are improving.

On the Right Track
The average age of Why WAIT participants is 54, but 20 percent of them are over age 70. "One participant completed the program at age 81," says Joan Beaton, program coordinator. Most of them have never exercised before. So the emphasis is on gradually introducing varied exercise into their lives, from 20 to 30 minutes a day three to four times a week, to eventually 45 to 60 minutes a day six times a week.

During the program, Why WAIT participants go once a week to the gym at Joslin, a friendly "teaching gym" with equipment designed for larger bodies and those with orthopedic complications. "They experience different exercises, build confidence and become more comfortable with their bodies," explains Jacqueline Shahar, M.Ed., R.C.E.P., C.D.E., Joslin's Manager of Exercise Physiology.

The key is for participants to take home what they've learned. Not everybody has access to a gym. "Everyone leaves with an exercise program that is adapted to their particular lifestyle and medical needs," says Shahar.

The Million-Dollar Question
"Weight-based diabetes management through Why WAIT is a revolutionary new model for managing diabetes," says Dr. Hamdy. "It is totally different from classic model of medication-based diabetes management. The novel model results in less medication, better control, reduced cost, healthier weight, lower cardiovascular risk and above all improved quality of life."

Even those who are severely obese and choose bariatric surgery for weight loss would benefit from first losing weight through a program like this, Hamdy believes. He and his colleagues are about to start a study to compare the Why WAIT model to bariatric surgery.

But the million-dollar question is how to help people maintain weight loss beyond one to five years.
"We know people need consistent support afterwards and we are trying to create the best maintenance program," he says.

"Our recent study among Why WAIT participants showed that people who exercised most after the program are those who maintained the weight loss for 18 month," says Shahar.

The team offers each "graduate" a case manager who checks in with them monthly and is available for questions any time. Hamdy says this is like a booster shot to help with barriers to staying on track--be it fitting enough exercise in their lives or sticking to the diet at holidays.

October 2, 2009 (Newswise) - When Sonia Sotomayor was named Supreme Court nominee, the type 1 diabetes community seized the news as proof that diabetes is no longer a life-limiting condition.Unfortunately, the number of children with type 1 diabetes - Ms. Sotomayor was diagnosed at age 8 - is on the upswing. In type 1 diabetes, formerly known as juvenile-onset diabetes, the pancreatic beta cells that produce insulin are destroyed by an autoimmune process. Type 1 diabetics must regiment their diets and take insulin multiple times a day to control blood sugar levels and prevent diabetic coma. Although there is much excitement in the field, to date there is no cure for type 1 diabetes.

Doctors don't know why the numbers are rising or what causes type 1 diabetes, but Dr. Soumya Adhikari, assistant professor of pediatrics at UT Southwestern Medical Center, said the warning signs are clear.

"The biggest thing to watch out for is somebody who starts having to go to the bathroom (to urinate) all the time or drinking all the time," said Dr. Adhikari, who practices at Children's Medical Center Dallas. "In the Texas heat, people typically see that and think, 'It's hot - they're probably urinating more because they are drinking more,' and nine out of 10 times that's right. But, if it seems atypical compared to what they did last summer or they're losing weight or otherwise seem ill, it's probably worth at least considering having their blood sugar tested."

Other symptoms can include abdominal pain, sudden vision changes, drowsiness, nausea, and heavy, labored breathing.

September 13, 2009 (EurekAlert) - The master gene that causes blood stem cells to turn into disease-fighting 'Natural Killer' (NK) immune cells has been identified by scientists, in a study published in Nature Immunology today. The discovery could one day help scientists boost the body's production of these frontline tumour-killing cells, creating new ways to treat cancer.
The researchers have 'knocked out' the gene in question, known as E4bp4, in a mouse model, creating the world's first animal model entirely lacking NK cells, but with all other blood cells and immune cells intact. This breakthrough model should help solve the mystery of the role that Natural Killer cells play in autoimmune diseases, such as diabetes and multiple sclerosis. Some scientists think that these diseases are caused by malfunctioning NK cells that turn on the body and attack healthy cells, causing disease instead of fighting it. Clarifying NK cells' role could lead to new ways of treating these conditions.

The study was carried out by researchers at Imperial College London, UCL and the Medical Research Council's National Institute for Medical Research.

Natural Killer cells - a type of white blood cell - are a major component of the human body's innate, quick-response immune system. They provide a fast frontline defence against tumours, viruses and bacterial infections, by scanning the human body for cells that are cancerous or infected with a virus or a bacterial pathogen, and killing them.

NK cells - along with all other types of blood cell, both white and red - are continuously generated from blood stem cells in the bone marrow over the course of a person's lifetime. The gene E4bp4 identified in today's study is the 'master gene' for NK cell production, which means it is the primary driver that causes blood stem cells to differentiate into NK cells.

The researchers behind today's study, led by Dr Hugh Brady from the Department of Life Sciences at Imperial College London, are hoping to progress with a drug treatment for cancer patients which reacts with the protein expressed by their E4bp4 gene, causing their bodies to produce a higher number of NK cells than normal, to increase the chances of successfully destroying tumours.

Currently, NK cells isolated from donated blood are sometimes used to treat cancer patients, but the effectiveness of donated cells is limited because NK cells can be slightly different from person to person. Dr Brady explains: "If increased numbers of the patient's own blood stem cells could be coerced into differentiating into NK cells, via drug treatment, we would be able to bolster the body's cancer-fighting force, without having to deal with the problems of donor incompatibility."

Dr Brady and his colleagues at the MRC National Institute for Medical Research proved the pivotal role E4bp4 plays in NK production when they knocked the gene out in a mouse model. Without E4bp4 the mouse produced no NK cells whatsoever but other types of blood cell were unaffected. As well as proving their hypothesis about the function of the E4bp4 gene, this animal model will allow medical researchers, for the first time, to discover if NK cell malfunction is behind a wide range of medical conditions, including autoimmune disorders, inflammatory conditions, persistent viral infections, female infertility and graft rejection.

Dr Brady explains: "Since shortly after they were discovered in the 1970s some scientists have suspected that the vital disease-fighting NK cells could themselves be behind a number of serious medical conditions, when they malfunction. Now finally, with our discovery of the NK cell master gene and subsequent creation of our mouse model, we will be able to find out if the progression of these diseases is impeded or aided by the removal of NK cells from the equation. This will solve the often-debated question of whether NK cells are always the 'good guys', or if in certain circumstances they cause more harm than good."

The researchers were initially studying the effect of E4bp4 in a very rare but fatal form of childhood leukaemia when they discovered its importance for NK cells.

September 11, 2009 (EurekAlert) - The recent report out of the Annals of Internal Medicine profiling President John F. Kennedy's autoimmune disease surprised many Americans due to his appearance throughout his presidency of health and vitality. However, those who study autoimmune diseases know that the outward manifestation of many autoimmune diseases can often lead the public to believe that the person suffering is perfectly healthy. It is this outward appearance of health that is one of the major barriers for patients who suffer from autoimmune diseases to obtain a proper diagnosis. A study by the American Autoimmune Related Diseases Association (AARDA) showed that typically it take an autoimmune patient four years and visits with upwards of four physicians to obtain a proper diagnosis and begin treatment.President Kennedy is not the only popular public figure to have suffered from autoimmune diseases largely in silence. For example, men such as former President George H.W. Bush suffers from Graves' disease, a glandular autoimmune disease affecting the thyroid gland. In addition, Fox Business News anchor Neil Cavuto, the late comedian and actor Bernie Mac, and Poison lead singer and reality television star Bret Michaels, as well as Seattle Seahawks wide receiver Bobby Engram all developed some form of autoimmune disease. Although, typically autoimmune diseases affect women more often than men, with some ratios, such as in the case of lupus as high as 9:1, it is clear that men, too, get autoimmune diseases.

Autoimmune disease patients who outwardly appear to be fine but are battling daily limitations involved with chronic illness such as fatigue, muscle weakness, and chronic pain can often encounter difficulties on the job, as well as with friends and family. A recent comment from a patient on AARDA's Autoimmunity Forum exemplifies these problems: "In alot of cases those with autoimmune look healthy. So, those people around them who may not fully understand the nature of each particular illness think that they are lazy or crazy. Even doctors treat you like you are a hypochondriac. All of this makes those with autoimmune feel like they are nuts. Families and friends do not understand why you can't sleep, or why you are so tired. You hear things like 'if you would just do this or do that...' but all that does it make you feel worse because you know you have very little control over this illness that has taken over your WHOLE LIFE!!"

In the same AARDA study that determined how difficult it is to obtain a diagnosis, it was also found that patients were often told that they were chronic complainers or too concerned with their health.
While the statistics do indicate that this is a major women's health issue, the current report surrounding President Kennedy's autoimmune problems highlight the fact that women's propensity for autoimmune diseases is not the whole story. According to Virginia T. Ladd, President and Executive Director of the AARDA, "Men, too, can get autoimmune diseases; and when men do acquire an autoimmune disease, it is often found that they have a more severe case of that disease. It is because of this that we at AARDA launched our "Men Get Autoimmune Diseases, Too" campaign in 2008. We wanted to ensure that (1) men who began having symptoms would think to consider autoimmune diseases as a possibility and would have the knowledge to express their concern with a primary care physician -- even if they have the outward appearance of perfect health. (2) Additionally, we wanted to ensure that men know that autoimmune diseases have a genetic component in that they tend to cluster in families, meaning that if your mother has lupus, your cousin has Addison's disease, and your great-grandfather suffered from rheumatoid arthritis, then you could be at higher risk."

There are more than 80 diseases that are currently classified as autoimmune, of which ankylosing spondylitis, type 1 diabetes, Wegener's granulomatosis, and psoriasis have been shown just as likely to develop in men as in women. For more information about autoimmune diseases, contact AARDA on the Web at www.aarda.org or by phone at 586-776-3900.

August 21, 2009 (EurekAlert) - Despite mounting public health concerns about obesity and persistent social pressures dictating that slim is beautiful, young women in their '20s consistently exercise less than young men.And young black women showed significant declines in exercise between 1984 and 2006, according to a University of Michigan study to be published in the October issue of the American Journal of Public Health.

The study is one of the first to analyze long-term patterns in weight-related activities, and to assess how these patterns vary by gender, race and ethnicity, and socioeconomic status.

The disparities in health behaviors the study reveals are consistent with disparities in the prevalence of obesity, particular among women, according to Philippa Clarke, lead author of the study and a researcher at the U-M Institute for Social Research (ISR).

The study is based on data obtained every two years from 17,314 men and women who were aged 19 to 26 between 1984 and 2006. The participants were part of a follow-up panel drawn from the Monitoring the Future Study, conducted by ISR. The analysis was funded by the Robert Wood Johnson Foundation, as part of the Youth, Education, and Society Project, also based at ISR.

For the study, the researchers looked at trends over a 23-year-period in six different health behaviors. They measured how often participants reported eating breakfast, and eating at least some green vegetables and fruit; how often they exercised vigorously (jogging, swimming, or calisthenics); how often they got at least seven hours of sleep, and how much television they watched on an average weekday.

"Agreement is growing that the source of the obesity epidemic lies in an environment that produces an energy gap, where energy intake exceeds energy expenditure even by as little as 100 excess calories per day," wrote Clarke and co-authors Patrick O'Malley, Lloyd Johnston, John Schulenberg and Paula Lantz, all researchers at ISR.

The finding that young women consistently exercised less than young men, suggests that differences in energy expenditure could play a role in gender disparities in obesity and overweight.

The frequency of eating fruit and vegetables remained relatively stable among young adult women but declined significantly among young men. Young men also reported eating breakfast less often than did young women.

Both men and women reported a steady decline in the frequency of getting at least seven hours of sleep each night.

Despite the focus on television viewing as an important determinant of obesity, the researchers found that the amount of time men and women spent watching TV stayed relatively stable.

When the researchers compared behaviors of different racial and ethnic groups, they found some major differences. For example, although white women showed a steady increase in the frequency of eating breakfast, the trajectory for non-Hispanic black women declined until 1996 and only began to increase in 2000.

Although fruit and vegetable consumption changed little among young adults, consumption of both was consistently lower among black and Hispanic men and women in any given year.

And although the frequency of exercise remained relatively stable among young adult women in general, among black women, the frequency of exercising steady declined.

In addition, black and Hispanic women showed greater declines than white women in the frequency of getting at least seven hours of sleep a night. They also were less likely than white women to report eating breakfast, and eating fruits and vegetables.

Among men, those from lower socioeconomic backgrounds reported dramatic declines in sleep, after adjusting for race and ethnicity.

Minority racial and ethnic groups, and women from lower socioeconomic groups, also reported watching television more often than whites and women from more affluent backgrounds.

August 20, 2009 (OHRI) - Scientists at the Ottawa Hospital Research Institute and the University of Ottawa have discovered what may be an important clue to the cause of type 1 diabetes. Dr. Fraser Scott and his team tested 42 people with type 1 diabetes and found that nearly half had an abnormal immune response to wheat proteins. The study is published in the August 2009 issue of the journal Diabetes.Early in life, the immune system is supposed to learn to attack foreign invaders such as viruses and bacteria, while leaving the body's own tissues and harmless molecules in the environment alone (including food in the gut). When this process goes awry, autoimmune diseases and allergies can develop. Type 1 diabetes is an autoimmune disease that occurs when the immune system mistakenly attacks the pancreas, the organ that regulates blood sugar. Dr. Scott's research is the first to clearly show that immune cells called T cells from people with type 1 diabetes are also more likely to over-react to wheat. His research also shows that the over-reaction is linked to genes associated with type 1 diabetes.

"The immune system has to find the perfect balance to defend the body against foreign invaders without hurting itself or over-reacting to the environment and this can be particularly challenging in the gut, where there is an abundance of food and bacteria," said Dr. Scott, a Senior Scientist at the Ottawa Hospital Research Institute and Professor of Medicine at the University of Ottawa. "Our research suggests that people with certain genes may be more likely to develop an over-reaction to wheat and possibly other foods in the gut and this may tip the balance with the immune system and make the body more likely to develop other immune problems, such as type 1 diabetes."

In a commentary accompanying the paper, diabetes expert Dr. Mikael Knip of Finland said "These observations add to the accumulating concept that the gut is an active player in the diabetes disease process."

Dr. Scott's previous research has shown that a wheat-free diet can reduce the risk of developing diabetes in animal models, but he notes that more research will be required to confirm the link and determine possible effects of diet changes in humans. Research is also needed to investigate links with celiac disease, another autoimmune disease that has been linked to wheat.

This research was funded by the Juvenile Diabetes Research Foundation and the Canadian Institutes of Health Research. The authors include Dr. Majid Mojibian, Dr. Habiba Chakir, Dr. David E. Lefebvre, Jennifer A. Crookshank, Brigitte Sonier and Dr. Erin Keely, as well as Dr. Scott. Patients were enrolled at The Ottawa Hospital and the Children's Hospital of Eastern Ontario.

An estimated 246 million people have diabetes worldwide. Type 1 diabetes is the most severe form, representing about 10 per cent of all cases. Insulin injections can help control blood sugar levels in those affected but there is no cure.

August 10, 2009 (Newswise) - Four healthy lifestyle factors-never smoking, maintaining a healthy weight, exercising regularly and following a healthy diet-together appear to be associated with as much as an 80 percent reduction in the risk of developing the most common and deadly chronic diseases, according to a report in the August 10/24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Cardiovascular disease, cancer and diabetes-chronic diseases that together account for most deaths-are largely preventable, according to background information in the article. "An impressive body of research has implicated modifiable lifestyle factors such as smoking, physical activity, diet and body weight in the causes of these diseases," the authors write.

To further describe the reduction in risk associated with these factors, Earl S. Ford, M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues assessed data from 23,513 German adults age 35 to 65. At the beginning of the European Prospective Investigation Into Cancer and Nutrition-Potsdam (EPIC-Potsdam) study-between 1994 and 1998-participants completed an assessment of their body weight and height, a personal interview that included questions about diseases, a questionnaire on sociodemographic and lifestyle characteristics and a food frequency questionnaire.

Their responses were assessed for adherence to four healthy lifestyle factors: never smoking, having a body mass index lower than 30, exercising for at least three and a half hours per week and following healthy dietary principles (for example, having a diet with high consumption of fruits and vegetables while limiting meat consumption). Follow-up questionnaires were administered every two to three years.

Most participants had one to three of these health factors, fewer than 4 percent had zero healthy factors and 9 percent had all four factors. Over an average of 7.8 years of follow-up, 2,006 participants developed new cases of diabetes (3.7 percent), heart attack (0.9 percent), stroke (0.8 percent) or cancer (3.8 percent).

After adjusting for age, sex, education level and occupation, individuals with more healthy lifestyle factors were less likely to develop chronic diseases. Participants who had all four factors at the beginning of the study had a 78 percent lower risk of developing any of the chronic diseases during the follow-up period than those who had none of the healthy factors. The four factors were associated with a 93 percent reduced risk of diabetes, 81 percent reduced risk of heart attack, 50 percent reduced risk of stroke and 36 percent reduced risk of cancer.

The largest reduction in risk was associated with having a BMI lower than 30, followed by never smoking, at least 3.5 hours of physical activity and then adhering to good dietary principles.

"Our results reinforce current public health recommendations to avoid smoking, to maintain a healthy weight, to engage in physical activity appropriately and to eat adequate amounts of fruits and vegetables and foods containing whole grains and to partake of red meat prudently," the authors write. "Because the roots of these factors often originate during the formative stages of life, it is especially important to start early in teaching the important lessons concerning healthy living."

August 10, 2009 (Newswise) - Patients suffering with chronic autoimmune diseases from every corner of the globe can now find one another online to provide support, share experiences, and form relationships. The new Autoimmunity Forum launched by the American Autoimmune Related Diseases Association (AARDA) is a virtual support group community nearly 400 members strong.According to AARDA Executive Director and President, Virginia T. Ladd, "Today, patient advocate groups have to find patients where they are in order to assist them in getting the support and coping mechanisms that they need. While there are more than 80 autoimmune diseases and more than 23.5 million Americans who suffer from them, finding a local support group can be quite a challenge. By providing this new online service, AARDA hopes to provide an interactive source of information that has been tested by group members' own life experiences and make it accessible for autoimmune patients from every walk of life and every corner of the globe."

Autoimmune diseases are caused by autoimmunity, which is a result of a misdirected immune system that causes one's own immune system to attack the self. Which diseases are autoimmune? Lupus, type I diabetes, scleroderma, celiac, multiple sclerosis (MS), Crohn's disease, autoimmune hepatitis, and rheumatoid arthritis are all autoimmune diseases.

AARDA's Autoimmunity Forum, while new, has already been abuzz with patients discussing a myriad of subjects ranging from dealing with medications, insomnia, diagnosis frustration to simply sharing advice. Main subject categories are the following:

• Helping Hands - Targeted to autoimmune patient caregivers and family members - patients and caregivers discuss problems, issues, and concerns.
• Share Your Story - Patients share their own journey with autoimmune disease - allowing patients dealing with a similar ordeal to benefit from their experience.
• Doctor and Patient Relationships - Patients discuss problems, issues, and concerns about their medical provider.
• Autoimmune Diseases - Discuss breaking news and research discoveries regarding autoimmune diseases and/or gain more information about individual diseases.
• Coping with Autoimmunity - Patients share special coping techniques.
• General - Sharing and chatting with other autoimmune disease patients

To join the conversation, visit AARDA's Autoimmunity Forum (http://www.aarda.org/forum2/) today. For more information on autoimmune diseases or our online forum, contact AARDA by email (aarda@aarda.org), by phone (586-776-3900), or on the Web (www.aarda.org).