Researchers Uncover Potential Breakthrough Cure for Type 1 Diabetes

Exciting possibilities but we also have to remember these studies/results are based on MICE (not humans). Definately keeping an eye on this one.

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"We've all been brought up to think insulin is the all-powerful hormone without which life is impossible, but that isn't the case," says Dr. Roger Unger from UT Southwestern Medical Center....

In this published study, UT Southerwestern Medical Center researchers obtained normal blood sugars when they prevented the release of glucagon from the liver and the release of insulin from the beta-cells.

The new findings suggest that Type 1 diabetes could be converted to an asymptomatic, non-insulin-dependent disorder by eliminating the actions of a specific hormone.

As we have learned from the thousands of diabetes studies and the coming and going of cures for diabetes, there are many mechanisms and reactions involved in the conversion of glucose to energy, so caution needs to be taken with the results of this study, until it can be duplicated especially in human subjects.

Scientists at UT Southwestern Medical Center studied the hormone glucagon, which prevents low blood sugar in healthy people and causes high blood sugar in people with Type 1 diabetes. When glucagon was suppressed in mice, the hormone insulin became unimportant. Glucose tolerance returned to normal.

These findings in mice show that insulin becomes completely superfluous and its absence does not cause diabetes or any other abnormality when the actions of glucagon are suppressed. Glucagon, a hormone produced by the pancreas, prevents low blood sugar levels in healthy individuals. It causes high blood sugar in people with Type 1 diabetes.

Dr. Unger, professor of internal medicine and senior author of the study stated that, "We've all been brought up to think insulin is the all-powerful hormone without which life is impossible, but that isn't the case." "If diabetes is defined as restoration of glucose homeostasis to normal, then this treatment can perhaps be considered very close to a 'cure.'"

Insulin treatment has been the gold standard for Type 1 diabetes (insulin-dependent diabetes) in humans since its discovery in 1922. But even optimal regulation of Type 1 diabetes with insulin alone cannot restore normal glucose tolerance. These new findings demonstrate that the elimination of glucagon action restores glucose tolerance to normal.

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 directs the body's cells to remove sugar from the bloodstream.

Dr. Unger's laboratory research previously found that insulin's benefit resulted from its suppression of glucagon.

In Type 1 diabetes, which affects about 1 million people in the U.S., the pancreatic islet cells that produce insulin are destroyed. As a countermeasure to this destruction, Type 1 diabetics currently must take insulin multiple times a day to metabolize blood sugar, regulate blood-sugar levels and prevent diabetic coma. They also must adhere to strict dietary restrictions.

In this study, UT Southwestern scientists tested how mice genetically altered to lack working glucagon receptors responded to an oral glucose tolerance test. The test -- which can be used to diagnose diabetes, gestational diabetes and prediabetes -- measures the body's ability to metabolize, or clear, glucose from the bloodstream.

The researchers found that the mice with normal insulin production but without functioning glucagon receptors responded normally to the test. The mice also responded normally when their insulin-producing beta cells were destroyed. The mice had no insulin or glucagon action, but they did not develop diabetes.

"These findings suggest that if there is no glucagon, it doesn't matter if you don't have insulin," said Dr. Unger, who is also a physician at the Dallas VA Medical Center. "This does not mean insulin is unimportant. It is essential for normal growth and development from neonatal to adulthood. But in adulthood, at least with respect to glucose metabolism, the role of insulin is to control glucagon.

"And if you don't have glucagon, then you don't need insulin."

Dr. Young Lee, assistant professor of internal medicine at UT Southwestern and lead author of the study, said the next step is to determine the mechanism behind this result.

"Hopefully, these findings will someday help those with Type 1 diabetes," Dr. Lee said. "If we can find a way to block the actions of glucagon in humans, then maybe we can minimize the need for insulin therapy."

Dr. Unger said anything that reduces the need for injected insulin is a positive.

"Matching the high insulin levels needed to reach glucagon cells with insulin injections is possible only with amounts that are excessive for other tissues," he said. "Peripherally injected insulin cannot accurately duplicate the normal process by which the body produces and distributes insulin. If these latest findings were to work in humans, injected insulin would no longer be necessary for people with Type 1 diabetes."

Dr. May-Yun Wang, assistant professor of internal medicine at UT Southwestern, and researchers from the Albert Einstein College of Medicine also contributed to the work. The study was supported in part by the VA North Texas Health Care System, the American Diabetes Association and the National Institutes of Health.

Diabetes January 26, 2011 vol. 60 no. 2 391-397

Sports Nutrition Guru

Got to meet & talk with an idol of mine, Ellen Coleman, RD, MA, MPH.



Lovely woman. We had a short but interesting conversation about Paleo. We're both on the same page.

I'll explain Paleo next time I'm blogging here.

Chocolate Good for the Heart

Summary: In a cross-sectional study involving 4,970 participants aged
25-93 years who participated in the National Heart, Lung, and Blood
Institute (NHLBI) Family Heart Study, results indicate an inverse
association between chocolate consumption and risk of coronary heart
disease (CHD). After adjusting for potential confounders, chocolate
intake 5+ times/week was associated with a 57% reduced risk of CHD,
compared with no chocolate intake.

Chocolate consumption is inversely associated with calcified atherosclerotic plaque in the coronary arteries: The NHLBI Family Heart Study. Djoussé L, Hopkins PN, Arnett DK, Pankow JS, Borecki I, North KE, Curtis Ellison R.

Division of Aging, Brigham & Women Hospital and Harvard Medical School, 1620 Tremont Street, 3rd Floor, Boston, MA 02120, USA; Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA, USA.

Abstract
BACKGROUND & AIMS: While a diet rich in anti-oxidant has been favorably associated with coronary disease and hypertension, limited data have evaluated the influence of such diet on subclinical disease. Thus, we sought to examine whether chocolate consumption is associated with calcified atherosclerotic plaque in the coronary arteries (CAC).

METHODS: In a cross-sectional design, we studied 2217 participants of the NHLBI Family Heart Study. Chocolate consumption was assessed by a semi-quantitative food frequency questionnaire and CAC was measured by cardiac CT. We defined prevalent CAC using an Agatston score of at least 100 and fitted generalized estimating equations to calculate prevalence odds ratios of CAC.

RESULTS: There was an inverse association between frequency of chocolate consumption and prevalent CAC. Odds ratios (95% CI) for CAC were 1.0 (reference), 0.94 (0.66-1.35), 0.78 (0.53-1.13), and 0.68 (0.48-0.97) for chocolate consumption of 0, 1-3 times per month, once per week, and 2+ times per week, respectively (p for trend 0.022), adjusting for age, sex, energy intake, waist-hip ratio, education, smoking, alcohol consumption, ratio of total-to-HDL-cholesterol, non-chocolate candy, and diabetes mellitus. Controlling for additional confounders did not alter the findings. Exclusion of subjects with coronary heart disease or diabetes mellitus did not materially change the odds ratio estimates but did modestly decrease the overall significance (p = 0.07).

CONCLUSIONS: These data suggest that chocolate consumption might be inversely associated with prevalent CAC.

Its a Matter of National Security

US Obesity rates is now a matter of National Defense. Smaller pool of potential recruits. Not to mention the growing number of current members who are not "fit to fight" any more (e.g. weight creep, poor nutritional habits, inactivity, injuries).




More Military-Aged Americans Are Too Fat to Fight
Released: 10/15/2010 7:05 AM EDT
Source: Cornell University


Newswise — At a time when American military forces are stretched thin overseas, a growing number of potential recruits are too fat to enlist, according to an analysis by Cornell University researchers.

In the past half-century, the number of women of military age who exceed the U.S. Army’s enlistment standards for weight-to-height ratio and body fat percentage has more than tripled. For military-age men, the figure has more than doubled.

As of 2007-08, 5.7 million American men and 16.5 million women of military age were ineligible for duty because they were overweight or obese, according to John Cawley, Cornell associate professor of policy analysis and management, and a Cornell economics doctoral student Catherine Maclean.

The findings, published in September by the National Bureau of Economic Research in a working paper titled, “Unfit for Service: The Implications of Rising Obesity for U.S. Military Recruitment,” are cause for alarm for the four U.S. military branches, which together must attract more than 180,000 new service members each year.

“Almost one in four applicants to the military are rejected for being overweight or obese – it’s the most common reason for medical disqualification,” Cawley said. “It is well-known that the military is struggling to recruit and retain soldiers. Having a smaller pool of men and women who are fit enough to serve adds to the strain and creates even more problems for national defense.”

The study follows a similar report last spring by retired generals and admirals. But Cawley and Maclean chart the climbing obesity rates over a much longer period, using data from the National Health and Nutrition Examination Surveys spanning 1959-2008. Moreover, the Cornell study estimates the number of civilians who meet the body fat requirements of each military branch, which had not been tracked previously.

“It’s another example of the underappreciated public consequences of obesity,” Cawley said. “We tend to think of obesity as a personal, individual health problem. But the fact that U.S. military leaders view it as a threat to national security and military readiness shows its far-reaching impact.”

The paper is available online: http://www.nber.org/papers/w16408

Best Tasting Health Cereals from Bon Appetit

This blog on Bon Appetit Magazine is doing a taste test tour of supermarket foods. I love the Quaker Oat Squares for dry snacking. Kashi GoLean is a great high protein (soy) cereal that works for breakfast & snacking. Barbara's Bakery also have gluten-free Puffins.

Supermarket Standoff: Healthy Cereals
4:00 PM / August 10, 2010 / Posted by Julia Bainbridge

Call them healthy, call them grown-up; whatever you want to call them, this group of cereals doesn't include Fruit Loops and Cap'n Crunch. We wanted to find out which were the best tasting out of the so-called "healthy" cereals sold in national supermarkets. So we compiled a list of thirteen boxes, picked them up along with some milk, and settled in our conference room early this Monday morning to crunch, much, and scribble on score sheets. Flakes, squares, clusters--all shapes and sizes were included. We also got nutritionist Sandra Frank to weigh in, breaking down which three cereals are the best for you out of the already good-for-you pack. Find both our winners for taste and Frank's picks for health after the jump.

The Results:

Our Favorites for Flavor

TIED FOR #1

Quaker Oatmeal Squares
Nutrition: Serving size 1 cup = 210 calories, 2.5g fat, 250mg sodium, 210mg potassium, 44g carbs, 10g sugars, 6g protein, 10% vitamin A, 50% vitamin C, 0% calcium, 10% iron, 100% vitamin E, etc.
Cost: $4.29 at Stop & Shop in Glen Cove, NY
Blind Tasting Notes: "Hearty and substantial"; "Not too sweet"; "Nice crunch/density"; "A good snacking cereal"


Barbara's Bakery Shredded Spoonfuls
Nutrition: Serving size 3/4 cup = 120 calories, 1.5g total fat, 200mg sodium, 125mg potassium, 24g carbs, 5g sugars, 4g protein, 0% vitamin A, 8% vitamin C, 2% calcium, 4% iron, 4% vitamin E
Cost: $3.69 at Whole Foods in New York, NY
Blind Tasting Notes: "Has some sweetness but not a ton"; "Crispy"; "Crunchy and slightly sweet"


Barbara's Bakery Puffins
Nutrition: Serving size 3/4 cup = 90 calories, 1g total fat, 190mg sodium, 85mg potassium, 23g carbs, 5g sugars, 2g protein, 0% vitamin A, 25% vitamin C, 0% calcium, 2% iron
Cost: $3.49 at Whole Foods in New York, NY
Blind Tasting Notes: "Delish!"; Cinnamon-y"; "Surprisingly good if it's healthy"; "Wonderfully crisp texture and light sweetness"; "Light but crunchy"

#2

Whole Foods Market 365 Everyday Value Raisin Bran
Nutrition: Serving size 1 cup = 200 calories, 0.5g fat, 210mg sodium, 210mg potassium, 44g carbs, 15g sugars, 6g protein, 0% vitamin A, 0% vitamin C, 2% calcium, 15% iron
Cost: $2.69 at Whole Foods in New York, NY
Blind Tasting Notes: "Like Raisin Bran with more heft"; "A very crunchy flake"; "Nice sweetness"; "Like the raisins, but flakes are tough to chew"


TIED FOR #3

Cheerios
Nutrition: Serving size 1 cup = 100 calories, 2g fat, 190mg sodium, 170mg potassium, 20g carbs, 1g sugars, 3g protein, 10% vitamin A, 10% vitamin C, 10% calcium, 45% iron, 10% vitamin D
Cost: $4.49 at Whole Foods in New York, NY
Blind Tasting Notes: "Yummy"; Classic"; "Almost burnt grainy flavor--tastes healthy"; "Light"; "This is what I ate as a kid"; "The old standby; a workhorse"

Fiber One Honey Clusters
Nutrition: Serving size 1 cup = 160 calories, 1.5g fat, 230mg sodium, 180mg potassium, 44g carbs, 6g sugars, 3g protein, 20% vitamin A, 0% vitamin C, 10% calcium, 25% iron, 15% vitamin D, 70% vitamin E
Cost: $4.99 at Stop & Shop in Glen Cove, NY
Blind Tasting Notes: "Caramel/butterscotch flavor"; Nice maple syrup note"; "Good crunch, good cluster, nice plain flake"

Nutritionist Sandra Frank's Picks
Note: "Adding variety helps you obtain the different nutrients you need, as well as keeping your meals interesting," says Frank. In other words, these cereals are healthy, but eating them every morning is not.

#1 Cheerios
Nutrition: Serving size 1 cup = 100 calories, 2g fat, 190mg sodium, 170mg potassium, 20g carbs, 1g sugars, 3g protein, 10% vitamin A, 10% vitamin C, 10% calcium, 45% iron, 10% vitamin D
Cost: $4.49 at Whole Foods in New York, NY
Frank's Comments: "Cheerios is lowest in calories per one cup serving. It is considered low in fat and a good source of fiber. For those watching your waistline, this is the best choice. In addition, Cheerios provides 45% of the daily value of iron."
Our Assessment: We ranked this in third place, so it's good news that it's also healthy. We should note, though, that some of us weren't fans of this cereal, commenting that it tastes like cardboard or sawdust.

#2 Kashi GoLean
Nutrition: Serving size 1 cup = 140 calories, 1g fat, 85mg sodium, 480mg potassium, 30g carbs, 6g sugars, 13g protein, 0% vitamin A, 0% vitamin C, 6% calcium, 10% iron
Cost: $3.49 at Whole Foods in New York, NY

Frank's Comments: "Need fiber? Go with Kashi GoLean. It scored highest in fiber, protein, and potassium and the lowest in sodium per serving. It is defined as a low fat, low sodium, and high fiber food."
Our Assessment: Uh oh. "Tastes about as dull as rice cakes. Does nothing for me"; "Too mealy and dry"; Yuck. No flavor and weird texture." Those were some of the comments we received about Kashi GoLean. Some of us were more into it, though: "Great assortment of textures and flavors"; "Nice sweetness." And some were confessional: "I eat this at home because I know it's healthy, but it really tastes like cardboard."

#3 Barbara's Bakery Puffins
Nutrition: Serving size 3/4 cup = 90 calories, 1g total fat, 190mg sodium, 85mg potassium, 23g carbs, 5g sugars, 2g protein, 0% vitamin A, 25% vitamin C, 0% calcium, 2% iron
Cost: $3.49 at Whole Foods in New York, NY

Frank's Comments: "Barbara's Bakery Puffins came in as the second lowest in calories. It is a low fat and a high fiber food. The ratio of fiber to calories placed it third. The good outweighs the lower iron content, but make sure you include iron-rich foods throughout the day. Some foods rich in iron include: lean meats, liver, seafood, shrimp, salmon, poultry, eggs (yolks contain iron), kidney beans, lima beans, black beans, pinto beans, soy beans and lentils; dark green vegetables (spinach, collard greens, mustard greens, broccoli, asparagus, swiss chard); nuts and; dried fruits."

Our Assessment: Hooray! We ranked this number one! We urge you to go for Barbara's Puffins if you want a healthy cereal that tastes scrumptious.

"There were a lot of factors to consider, so I turned to the labeling laws and the diet manual for assistance," says Frank. Nutrition ratings considered the following:

1.A food is considered low fat if it has 3 grams or less fat per serving.
2.A good source of fiber contains 10 to 19 percent of the daily value for fiber (2.5 to 4.75 grams) per serving.
3.Low sodium is defined as a food containing 140 milligrams or less sodium per serving.
4.Lowest calories per one cup (not per serving).
5.Iron fortification.

NY Times Editorial - Beware Claims About Foods

Snake Oil for Breakfast
Published: June 11, 2010
http://www.nytimes.com/2010/06/12/opinion/12sat4.html?th&emc=th

More than a century after President Theodore Roosevelt signed the Pure
Food and Drug Act, deception is still a far too popular marketing tool
for food makers.

The Federal Trade Commission barred Kellogg’s last year from running ads
saying Mini-Wheats are “clinically shown to improve kids’ attentiveness
by 20 percent.” To claim “benefits to cognitive health, process or
function provided by any cereal or any morning food or snack food,” was
a no-no, unless the claims were true. But the F.T.C.’s order covered
only cognitive abilities. So just as it was signing its consent,
Kellogg’s was starting a new campaign in which “Snap, Crackle and Pop”
called out to parents from the Rice Krispies box promising to help
“support your child’s IMMUNITY.”

Last week, the F.T.C. said that it had closed that loophole, reaching an
agreement with Kellogg’s that would bar the company from making any
claims about the health benefits of their food unless they were backed
by scientific evidence and not misleading.

Businesses have been making dubious claims about their products at least
since the 17th century, when the British clergyman Anthony Daffy sold
Daffy’s Elixir as a cure for scurvy as well as agues, gout, rheumatism,
rickets, worms and other ailments. Hucksterism — no matter how
implausible the claim — lives on.

In 2004, the F.T.C. barred KFC from saying its fried chicken was
compatible with low-carbohydrate weight-loss programs — because such
diets specifically advise against breaded, fried foods. The Food and
Drug Administration sent letters to 17 food companies in March warning
them about misleading product labels. Dreyer’s claimed there is no
trans-fat in its ice cream but forgot to mention it has lots of
saturated fat. POM Wonderful claimed its pomegranate juice helps treat,
prevent or cure hypertension, diabetes and cancer.

This might be par for the course for an era of swift-boating political
ads and a torrent of television commercials plumping for myriad wonder
drugs (sudden death may result). It leaves the consumer in a quandary:
what part of the label can be believed?

Protein Drinks May Be Harmful

A study by Consumer Reports found that most people do not need to add a protein supplement to their diet and that some protein drinks contain contaminants and metals that can cause serious health problems.

Manufacturers of protein drinks once marketed only to body builders, athletes and health fanatics, however in recent years they have aimed promotion of these supplement products to busy professionals, working mothers, pregnant women, young adults and even children. Some protein drinks entice consumers with advertising claims including weight loss, muscle building, energy boosting or anti-aging. They encourage consumers not only to supplement their daily diet with these products, but also to use them to replace meals.

The Consumer Reports investigation sent fifteen protein drinks to an independent laboratory for analysis, reviewed government documents and interviewed health experts, fitness experts and consumers. They found that most people get enough protein in their regular diet and do not need these supplements. Consumer Reports recommends that people who need more protein, can find it in healthier, cheaper sources such as milk, eggs and chicken breast.

The results of the laboratory analysis found that all fifteen of the protein drinks tested contained one or more of the contaminants arsenic, cadmium, lead and mercury. Three of the products tested raised particular concern because consuming more than three servings per day could expose the consumer to levels of these contaminants that are above recommended limits:

- Eas Myoplex (Arsenic and Cadmium)
- Muscle Milk Chocolate (Cadmium and Lead)and;
- Muscle Milk Vanilla Crème (Lead)

“It is our company mission to do everything possible to ensure that our products are superior in quality, reliability, authenticity and safety,” said Greg Pickett, Founder of CytoSport, Inc. who manufactures Muscle Milk. “Additionally, our products are rigorously tested by both us and independent third party agencies including NSF International to ensure their safety and efficacy.”

The article detailing the study appears in the July 2010 issue of Consumer Reports Magazine. The non-profit consumer organization Consumers Union publishes the monthly periodical.

Watch the Early Show on CBS as they take a hidden camera into nutrition stores in New York City where salespeople failed to warn of dangers and even said taking more than the recommended doses would cause no harm.

“What we're concerned about here is the chronic low level exposure of a heavy metal. And what people should know, is that heavy metals, once they come into our bodies, once they're metabolized, they tend to stay there for a long period of time,” Urvashi Rangan of Consumer Reports told
CBS. According to the American Heart Association, people who have an excess of protein in their diet may be at higher risk of kidney and liver disorders, and osteoporosis. While everyone can suffer adverse health effects from exposure to heavy metals, children, growing teens, pregnant women and their unborn children are especially at risk.

Lead exposure can cause developmental problems such as damage to the brain and nervous system or slowed growth in growing children and teens. In adults, it can cause reproductive problems, high blood pressure and hypertension, nerve disorders, effect memory or concentration or cause muscle and joint pain. Ingesting very high levels of arsenic can result in death. Exposure to lower levels can cause nausea and vomiting, decreased production of red and white blood cells, abnormal heart rhythm, damage to blood vessels and a sensation of “pins and needles” in hands and feet. Cadmium is a known carcinogen, meaning cancer causing. Ingesting cadmium can damage kidneys and bones. Exposure to mercury can permanently damage the brain and kidneys. Effects on brain functioning may result in irritability, shyness, tremors, changes in vision or hearing and memory problems.

“The results of this analysis aren't alarming,” Andrew Shao of the Council for Responsible Nutrition told CBS. “The heavy metals that were found are well below the limits FDA Food and Drug Administration) would be concerned about, so they don't pose a health risk to consumers at all.”

Chocolate Milk is a 'Natural' for Post-Exercise Recovery

New research suggests drinking chocolate milk after a workout offers advantages for post-exercise performance and muscle repair

BALTIMORE (June 2, 2010) – One of the best post-exercise recovery drinks could already be in your refrigerator, according to new research presented at the American College of Sports Medicine conference this week. In a series of four studies, researchers found that chocolate milk offered a recovery advantage to help repair and rebuild muscles, compared to specially designed carbohydrate sports drinks.

Experts agree that the two-hour window after exercise is an important, yet often neglected, part of a fitness routine. After strenuous exercise, this post-workout recovery period is critical for active people at all fitness levels – to help make the most of a workout and stay in top shape for the next workout.

The new research suggests that drinking fat free chocolate milk after exercise can help the body retain, replenish and rebuild muscle to help your body recover. Drinking lowfat chocolate milk after a strenuous workout could even help prep muscles to perform better in a subsequent bout of exercise. Specifically, the researchers found a chocolate milk advantage for:

Building Muscle – Post-exercise muscle biopsies in eight moderately trained male runners showed that after drinking 16 ounces of fat free chocolate milk, the runners had enhanced skeletal muscle protein synthesis – a sign that muscles were better able to repair and rebuild – compared to when they drank a carbohydrate only sports beverage with the same amount of calories. The researchers suggest that "athletes can consider fat-free chocolate milk as an economic nutritional alternative to other sports nutrition beverages to support post-endurance exercise skeletal muscle repair."1

Replenishing Muscle "Fuel" – Replacing muscle fuel (glycogen) after exercise is essential to an athlete's future performance and muscle recovery. Researchers found that drinking 16 ounces of fat free chocolate milk with its mix of carbohydrates and protein (compared to a carbohydrate-only sports drink with the same amount of calories) led to greater concentration of glycogen in muscles at 30 and 60 minutes post exercise.2

Maintaining Lean Muscle – Athletes risk muscle breakdown following exercise when the body's demands are at their peak. Researchers found that drinking fat free chocolate milk after exercise helped decrease markers of muscle breakdown compared to drinking a carbohydrate sports drink.3

Subsequent Exercise Performance – Ten trained men and women cyclists rode for an hour and a half, followed by 10 minutes of intervals. They rested for four hours and were provided with one of three drinks immediately and two hours into recovery: lowfat chocolate milk, a carbohydrate drink with the same amount of calories or a control drink. When the cyclists then performed a subsequent 40 kilometer ride, their trial time was significantly shorter after drinking the chocolate milk compared to the carbohydrate drink and the control drink.4

Why Chocolate Milk?

Chocolate milk's combination of carbohydrates and high-quality protein first made researchers take notice of a potential exercise benefit. The combination of carbs and protein already in chocolate milk matched the ratio found to be most beneficial for recovery. In fact, studies suggest that chocolate milk has the right mix of carbs and protein to help refuel exhausted muscles, and the protein in milk helps build lean muscle. This new research adds to a growing body of evidence suggesting milk can be just as effective as some commercial sports drinks in helping athletes refuel and recover.

Milk also provides fluids for rehydration and electrolytes, including potassium, calcium and magnesium lost in sweat, that both recreational exercisers and elite athletes need to replace after strenuous activity. Plus, chocolate milk is naturally nutrient-rich with the advantage of additional nutrients not found in most traditional sports drinks. Penny-for-penny, no other post-exercise drink contains the full range of vitamins and minerals found in chocolate milk.

Sources:

1. Lunn WR, Colletto MR, Karfonta KE, Anderson JM, Pasiakos SM, Ferrando AA, Wolfe RR, Rodriguez NR. Chocolate milk consumption following endurance exercise affects skeletal muscle protein fractional synthetic rate and intracellular signaling. Medicine & Science in Sports and Exercise. 2010;42:S48.

2. Karfonta KE, Lunn WR, Colletto MR, Anderson JM, Rodriguez NR. Chocolate milk enhances glycogen replenishment after endurance exercise in moderately trained males. Medicine & Science in Sports & Exercise. 2010;42:S64.

3. Colletto MR, Lunn W, Karfonta K, Anderson J, Rogriguez N. Effects of chocolate milk consumption on leucine kinetics during recovery from endurance exercise. Medicine & Science in Sports & Exercise. 2010;42:S126.

4. Ferguson-Stegall L, McCleave E, Doerner PG, Ding Z, Dessard B, Kammer L, Wang B, Liu Y, Ivy J. Effects of chocolate milk supplementation on recovery from cycling exercise and subsequent time trial performance. Medicine & Science in Sports & Exercise. 2010;42:S536.

About the National Milk Mustache "got milk?"® Campaign

The Milk Processor Education Program (MilkPEP), Washington, D.C., is funded by the nation's milk processors, who are committed to increasing fluid milk consumption. The National Fluid Milk Processor Promotion Board, through MilkPEP, runs the National Milk Mustache "got milk?"® Campaign, a multi-faceted campaign designed to educate consumers about the health benefits of milk. For more information, go to www.whymilk.com. Deutsch, A Lowe and Partners Company, is the creative agency for the National Milk Mustache "got milk?"® Campaign.

Milk Does More for Muscle Building and Fat Losing!

Milk: 2 glasses a day tones muscles, keeps the fat away in women, study shows

HAMILTON, CANADA – Women who drink two large glasses of milk a day after their weight-lifting routine gained more muscle and lost more fat compared to women who drank sugar-based energy drinks, a McMaster study has found.

The study appears in the June issue of Medicine and Science in Sport and Exercise.

"Resistance training is not a typical choice of exercise for women," says Stu Phillips, professor in the Department of Kinesiology at McMaster University. "But the health benefits of resistance training are enormous: It boosts strength, bone, muscular and metabolic health in a way that other types of exercise cannot."

A previous study conducted by Phillips' lab showed that milk increased muscle mass and fat loss in men. This new study, says Phillips was more challenging because women not only steer clear of resistance training they also tend to steer away from dairy products based on the incorrect belief that dairy foods are fattening.

"We expected the gains in muscle mass to be greater, but the size of the fat loss surprised us," says Phillips. "We're still not sure what causes this but we're investigating that now. It could be the combination of calcium, high-quality protein, and vitamin D may be the key, and. conveniently, all of these nutrients are in milk.

Over a 12-week period, the study monitored young women who did not use resistance-training exercise. Every day, two hours before exercising, the women were required not to eat or drink anything except water. Immediately after their exercise routine, one group consumed 500ml of fat free white milk; the other group consumed a similar-looking but sugar-based energy drink. The same drinks were consumed by each group one hour after exercising.

The training consisted of three types of exercise: pushing (e.g. bench press, chest fly), pulling (e.g. seated lateral pull down, abdominal exercises without weights), and leg exercises (e.g. leg press, seated two-leg hamstring curl). Training was monitored daily one on one by personal trainers to ensure proper technique.

"The women who drank milk gained barely any weight because what they gained in lean muscle they balanced out with a loss in fat" said Phillips. "Our data show that simple things like regular weightlifting exercise and milk consumption work to substantially improve women's body composition and health." Phillips' lab is now following this study up with a large clinical weight loss trial in women.
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If you are not allergic to milk protein, nonfat milk is a good source of protein, calcium and Vitamin D. 500 ml nonfat milk is about 2 cups (180 kcal, 16 g protein, 24 g CHO). Lots of studies about building lean muscle mass after weight lifting exercise support a mixture of carbohydrate & protein. Some have suggested a ratio of 4 g CHO per 1 g PROT as an optimal ratio (found in chocolate milk). Maybe there is something in the Vitamin D (serum levels were measureable higher in the test group, consistent with fortification of milk). Unfortunately, so many women skip dairy products because they are worried about calories or concerned that milk is not "food for humans". Even people with lactose intolerance can usually tolerate small amounts liquid milk and 6-8oz servings of yogurt.

Chocolate & Heart Risk

Study: Chocolate could reduce heart risk
By MARIA CHENG - AP Medical Writer

LONDON (AP) -- The Easter Bunny might lower your chances of having a heart problem. According to a new study, small doses of chocolate every day could decrease your risk of having a heart attack or stroke by nearly 40 percent.

German researchers followed nearly 20,000 people over eight years, sending them several questionnaires about their diet and exercise habits.

They found people who had an average of six grams of chocolate per day - or about one square of a chocolate bar - had a 39 percent lower risk of either a heart attack or stroke. The study is scheduled to be published Wednesday in the European Heart Journal.

Previous studies have suggested dark chocolate in small amounts could be good for you, but this is the first study to track its effects over such a long period of time. Experts think the flavonols contained in chocolate are responsible. Flavonols, also found in vegetables and red wine, help the muscles in blood vessels widen, which leads to a drop in blood pressure.

"It's a bit too early to come up with recommendations that people should eat more chocolate, but if people replace sugar or high-fat snacks with a little piece of dark chocolate, that might help," said Brian Buijsse, a nutritional epidemiologist at the German Institute of Human Nutrition in Nuthetal, Germany, the study's lead author.

The people tracked by Buijsse and colleagues had no history of heart problems, had similar habits for risk factors like smoking and exercise, and did not vary widely in their Body Mass Index.

Since the study only observed people and did not give them chocolate directly to test what its effects were, experts said more research was needed to determine the candy's exact impact on the body. The study was paid for by the German government and the European Union.

Doctors also warned that eating large amounts of chocolate could lead to weight gain, a major risk factor for heart problems and strokes.

"This is not a prescription to eat more chocolate," said Dr. Robert Eckel, a professor of medicine at the University of Colorado and a past president of the American Heart Association. He was not linked to the study. "If we all had (a small amount) of chocolate every day for the rest of our lives, we would all gain a few pounds."

Eckel said it was amazing to find such a small amount of chocolate could have such a protective effect, but that more studies needed to be done to confirm its conclusions.

Alice Lichtenstein, a nutritionist at Tufts University School of Medicine, said it was difficult to link the reduction in heart disease and stroke risk to the chocolate alone, since there may have been other differences between the study participants.

"The relationship between chocolate and good health outcomes is still uncertain," she said. "If somebody really enjoys eating chocolate, then they should have a small amount of that and just really enjoy it," she said.

© 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Learn more about our Privacy Policy.

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I have a presentation "For The Love of Chocolate" that I enjoy giving. It's wonderful to get reinforcement that enjoying a small amount of good quality chocolate is potentially healthy. 1 oz dark chocolate will cost you about 150 calories (or about a good brisk 1 1/2 mile walk).

Juiced Fasts: Do You Need Them?

I was recently interviewed for a piece about Juice Fasting (not necessarily for weight loss but that is definately a side effect). Do our bodies need this for "detoxing"?
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This Is Not Your Grandmother’s Diet

A new batch of juice cleanses aims to improve your overall health
By Geraldine Campbell February 18th, 2010 - 12:00am

Liquid fasts, from the squeezed-to-order Blueprint Cleanse to L.O.V.E. (Live, Organic, Vegan Experience), are the next big thing (again). But the latest crop of detox diets isn’t necessarily about losing weight—though that’s still part of it—it’s about kick-starting a healthier lifestyle. Think of it as dieting 2.0.

While you’re eliminating junk food, caffeine and alcohol from the mix, the premise behind juicing is that it frees up the body’s energy to engage in deep cleaning.

“The energy normally spent on breaking down a sandwich, a Twinkie or even a big healthy salad can now be redirected to helping the body ‘clean house,’” Blueprint Cleanse founder Zoe Sakoutis says. “We like to think of it as a way to press the re-set button and start with a clean slate.” More specifically, Sakoutis says juicing can boost your immune system, improve thyroid function, alleviate allergies and increase energy, not to mention giving your sex drive a jump.

But nutritionists aren’t sold on the benefits of a juice-only diet. For one, there’s no real physiological evidence to support the idea that your body goes into a warp-like cleaning overdrive, or that guzzling liquid seaweed will draw out stored toxins. “Your liver, kidneys, skin and digestive tract do a pretty darn good job at ridding excess toxins daily,” says Christy Maskeroni, the director of nutrition at CLAY, a cutting-edge holistic health club in New York City.

Holly Brewer, a Canyon Ranch nutritionist for the past eight years and the pediatric dietitian on staff at Sunrise Hospital, isn’t drinking the Kool-Aid, either. “While these drinks are adding more calories, they’re still not complete. Anytime you squeeze a fruit, you’re basically just getting water and carbohydrates. The vast majority of the nutrients in fruits and vegetables come from the solid mass.” Bottom line, Brewer says: “Eat your fruit; don’t drink it.” Still, Maskeroni and Brewer admit that some people need to go cold turkey before they can build back to a balanced diet. “A juice cleanse may help jumpstart the desire for a healthier lifestyle,” Maskeroni says.

“It’s not a miracle cure,” Brewer says, “but one to two days won’t hurt you.”
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Bottom line: If this is what you need to help "jump start" a change in your eating habits, it won't hurt. But it isn't necessary. And these programs are missing many essential nutrients - most importantly, PROTEIN! Best way to make a significant change in your life is to THROW OUT all the junk in the house and then refill on a daily basis with FRESH produce (get only what you need for the next 24-48 hours). Pick your proteins lean (and also fresh, but you can safely stock up and freeze). Choose only whole grains. If it's in a box with a flavoring packet, don't buy it (full of sodium, preservatives and too many multisyllable additives).

Enjoy a Little Chocolate

Another reason to include real chocolate (aka "dark" chocolate or >40% cacao) in your life. According to a research analysis that will be presented at a neurology meeting in April, two out of three studies showed a decrease risk of stroke in people who consumed about an ounce and a half of chocolate per week. Nice news to read on Valentine's Day.

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Can chocolate lower your risk of stroke?
ST. PAUL, Minn. – Eating chocolate may lower your risk of having a stroke, according to an analysis of available research that will be released today and presented at the American Academy of Neurology's 62nd Annual Meeting in Toronto April 10 to April 17, 2010. Another study found that eating chocolate may lower the risk of death after suffering a stroke.

The analysis involved reviewing three studies on chocolate and stroke.

"More research is needed to determine whether chocolate truly lowers stroke risk, or whether healthier people are simply more likely to eat chocolate than others," said study author Sarah Sahib, BScCA, with McMaster University in Hamilton, Ontario, Canada. Sahib worked alongside Gustavo Saposnik, MD, MSc, where the study was completed at St. Michael's Hospital and the University of Toronto.

Chocolate is rich in antioxidants called flavonoids, which may have a protective effect against stroke, but more research is needed.

The first study found that 44,489 people who ate one serving of chocolate per week were 22 percent less likely to have a stroke than people who ate no chocolate. The second study found that 1,169 people who ate 50 grams of chocolate once a week were 46 percent less likely to die following a stroke than people who did not eat chocolate.

The researchers found only one additional relevant study in their search of all the available research. That study found no link between eating chocolate and risk of stroke or death.

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The American Academy of Neurology, an association of more than 22,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Parkinson's disease, ALS (Lou Gehrig's disease), dementia, West Nile virus, and ataxia. For more information about the American Academy of Neurology and the AAN Annual Meeting, visit http://www.aan.com.

Non-late-breaking abstracts to be presented at the AAN Annual Meeting will be posted online in advance of the AAN Annual Meeting at 4 pm, ET, Wednesday, February 17, 2010, at http://www.aan.com/go/science/abstracts.

All RDs Are Nutritionists - But Not All Nutritionists Are RDs

Nutritionist. Food Coach. How Good Is Their Diet Advice?

Anyone can claim to be a "nutritionist" or "food coach."
So here's what you should look for

By Katherine Hobson
Posted on US News & World Report: February 5, 2010

If you feel the need for professional help with your eating habits or diet, you may assume a nutritionist is the person to talk to. As it turns out, that's not a particularly specific or useful term—a point driven home by recent advice published in a magazine from a "nutritionist" who claimed weight loss is aided by eating carbs and protein at separate meals, a notion not supported by science.

By no means is everyone calling herself a nutritionist (or a nutritional consultant, food coach, or weight-loss specialist) dispensing hogwash. But for consumers attempting to make an informed choice, the titles are meaningless; they don't capture the possessor's education, experience, or credentials. And those are all important when it comes to seeking eating advice, given the proliferation of fad diets and quick weight-loss schemes. “I can’t think of a field that has more quackery than nutrition,” says Lisa Sasson, a clinical associate professor of nutrition and food studies at New York University.

One specific title to look for: registered dietitian. In order to call himself an R.D., a person must have an undergraduate degree in nutrition or dietetics—or the equivalent in coursework—from an accredited institution, says Dee Sandquist, an R.D. and spokesperson for the American Dietetic Association, the professional organization that credentials R.D.'s (through the Commission on Dietetic Registration). On top of that, R.D.'s have to complete a yearlong, supervised internship and pass a national exam. And they must get credits in continuing education on an ongoing basis. Anyone calling herself simply a dietitian is also legally supposed to be an R.D.

The American College of Nutrition also issues C.N.S. (certified nutrition specialist) credentials for people with advanced degrees—master's, doctorate, M.D.—in nutrition or related areas. They, too, have to sit for an exam and also earn continuing education credits, says Madelyn Fernstrom, director of the nutrition and weight management program at the University of Pittsburgh Medical Center and author of The Real You Diet. Either an R.D. or C.N.S. designation means the holder has relevant education and experience, has passed an exam, and will make evidence-based recommendations, says Fernstrom.

I saw Fernstrom identified as a "board-certified nutritionist," referring to her C.N.S. certification. (She has a Ph.D. from MIT.) But the term "nutritionist" alone is meaningless. "It's not a bad thing," says Fernstrom. "But it's like saying you're a cook—you could be working in Denny's or at a five-star restaurant." So ask: What's the nutritionist's educational background? Does she have an R.D. or a C.N.S.? What experience does she have? Has she treated patients like you before? Is her practice grounded in scientific evidence? "You don't have to discount someone who has some other certification, but do your homework," Fernstrom says. "It's just like reading labels."

Making matters even more confusing is that most states have some kind of licensing, registration, or certification system in place but the systems vary in rigor. Some won't allow anyone to practice without meeting certain requirements, others allow qualified persons to use the titles "dietitian" or "nutritionist" but let others practice under different job titles, and others simply require people, regardless of credentials, to register with the state. (Here are the laws, state by state.) To be certain you're getting someone who has met national industry standards, look for an R.D. or C.N.S. credential.

If you have specific needs—say, you're an athlete who wants to know how to recover from races, are a newly diagnosed diabetic seeking help in planning meals, or are seeking help for your overweight child—be even more pointed in your questioning. Ask what specialized education or experience the person has. The ADA, for example, has additional credentials for R.D.'s who want to focus on kidney disease or cancer patients, children, the elderly, or athletes. The "Ask the Dietitian" website, run by Joanne Larsen, a registered dietitian, has some additional tips for vetting anyone offering nutrition advice. Among them: Question eating plans that require the purchase of certain supplements, avoid diets that eliminate entire food groups or prescribe "magic" foods that must be eaten daily, and ask for research—not testimonials—to substantiate claims.

One title that's grown in popularity is "coach." People seeking guidance or help in their career, for example, may hire a business, life, or personal coach. There also are people who call themselves wellness, weight-loss, food, or health coaches. Rather than calculating how many grams of protein or carbohydrate someone should eat or tracking a client's weight, they're more likely to help a customer define his or her goals and needs and figure out how to meet them. Denise Holz, a weight-loss coach in Seattle, says she helps her clients—both in person and over the phone—to eat mindfully, teaching them to be present, slow down, and focus on taste while they eat. And she helps them figure out what's really causing the bad eating habits they want to change. Doing that, she says, helps them address the underlying issues and learn to eat in accordance with their true hunger and taste. "They approach food in a whole new way," Holz says. "They don't have to sneak, don't have to feel bad about themselves."

If coaching rather than (or in combination with) nutritional advice sounds like what you're after, be aware that, like "nutritionist," anyone can call himself a "coach," says Sasson. There are some certification bodies, including the International Coach Federation. And a company called Wellcoaches Corp., in partnership with the American College of Sports Medicine, now trains and certifies healthcare professionals in wellness coaching. Its training, says Margaret Moore, the company's founder, chairman, and CEO, is "based on theories that have evidence behind them" about things like how to motivate people. Until there's some kind of national credential (similar to an R.D.), ask prospective coaches about their education, training, and experience, says Moore. "They should have a background in what they're coaching and should be able to talk the language of what makes people change," she says. "Ask about their track record and talk to current or former clients. And find someone who fits with you—if your personalities don't jibe, it's not going to work." Sort of like finding the perfect diet.

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When I am asked "what is the difference between a Registered Dietitian and a Nutritionist", I always ask "Who makes the decisions about food & meals in your home?". That would be your personal nutritionist. As an RD I'm uniquely trained in medical nutrition therapy for a wide variety of health conditions. And have further specialized to deal with diabetes, pediatrics and many GI disorders. Another important skill is the ability to interpret and explain the research results and real meaning behind all the headlines announcing some nutrition or weight loss breakthrough.

I'm sorry there are NO magic bullets. There are NO "one diet fits all". There are NO shortcuts if you want good health. If it sounds too good to be true. If it makes amazing promises. If it claims to be a secret that the medical professionals don't want you to know. It's going to be a waste of your time & money (and possibly even dangerous). Please consult a licensed/certified health care professional. Ask to see his/her credentials & where they went to school/did their internship. Shop around to find someone who can help you succeed.

Are You a Couch Potato?

"Couch Potatoes Endanger Their Lives, Australian Study"

If you think vegging out in front of the tube after a stressful day is the best way to unwind, you may want to think again.

A study by the Australian Science Media Centre followed 8,800 adults over a six-year period and found that people who watched four hours or more television per day — as compared to less than two hours — had an 80 percent higher risk of death from cardiovascular disease. The findings were independent of traditional risk factors such as smoking or obesity.

The study says watching the television itself is not the problem, but rather sitting while you watch.

To combat these effects, researchers suggest not only regular exercise, but also to stand up and "get moving" during any prolonged period — be it in front of your television, computer, at work or during transport.
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The Q&A session with the researchers can be found HERE. The journal Circulation will have the published article up shortly.

What do you think of the study?

Again, There is NO Magic Bullet

Headline news in the diet field.

Setting the record straight on weight loss
It's time to set the record straight. The only reliable way to lose weight is to eat less or exercise more. Preferably both.

So why bother to state the obvious? Because a body of scientific literature has arisen over recent years, suggesting that fat oxidation – burning the fats we eat as opposed to the carbohydrates – is enough to promote fat loss. It isn't.

Sydney scientists have demonstrated that mice genetically altered to burn fats in preference to carbohydrates, will convert the unburned carbohydrates into stored fat anyway, and their ultimate weight and body composition will be the same as normal mice.

It all comes down to an enzyme known as ACC2 (acetyl-CoA carboxylase), which controls whether cells burn fats or carbohydrates. When it was shown that 'blocking' ACC2 will force cells to burn fats in preference to carbohydrates, many assumed that such 'fat burning' could make fat stores evaporate, and make people thin without changing food intake or energy expenditure.

Associate Professor Greg Cooney, from Sydney's Garvan Institute of Medical Research, discusses misconceptions surrounding ACC2 in findings that appear in the prestigious international journal, Cell Metabolism, article available online today.

"Our data urges a correction in people's concept of a magic bullet - something that will miraculously make them thin while they sit on the couch watching television," said Professor Cooney.

"While none of the large pharmaceutical companies have marketed ACC2 inhibitors, there are many kinds of so-called 'fat-burning pills' available in the health food, body building and alternative medicine markets, where limited clinical effectiveness data are required."

"Many such products can also contain potentially harmful stimulants or come with a recommendation to follow a calorie-controlled diet and do more exercise while taking them. If you follow those recommendations, then of course you'll lose weight - but you'd lose it anyway."

"The energy you use in your home can come from a coal-fired power station, hydroelectric power, or a wind turbine. You won't know which because the end result is electricity."

"The energy that fuels your body can come from fats, proteins or carbohydrates. You won't know which because the end result is ATP, or cellular energy."

"Your body will use the energy it needs and store the leftover fats, proteins or carbohydrates as fat. When you do the sums, it's ultimately a matter of calories in and calories out."

"It's important to stress that the focus of our study was limited to an analysis of the impact of fat oxidation on overall fatness. We didn't investigate all impacts of fat oxidation – and so we don't rule out benefits of burning off fats in specific tissues."

"For example, manipulating fat metabolism may - or may not - lead to better insulin action in muscles or in the liver. Should insulin action be improved, that would obviously benefit obese people with Type 2 diabetes. But we can't comment either way until we do the experiments."

And the take-home message? Follow a healthy, balanced diet and get plenty of exercise.


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ABOUT GARVAN

The Garvan Institute of Medical Research was founded in 1963. Initially a research department of St Vincent's Hospital in Sydney, it is now one of Australia's largest medical research institutions with nearly 500 scientists, students and support staff. Garvan's main research programs are: Cancer, Diabetes & Obesity, Immunology and Inflammation, Osteoporosis and Bone Biology, and Neuroscience. The Garvan's mission is to make significant contributions to medical science that will change the directions of science and medicine and have major impacts on human health. The outcome of Garvan's discoveries is the development of better methods of diagnosis, treatment, and ultimately, prevention of disease.

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Translation: Calories count! There is no magic bullet that will allow you to lose weight without controlling your energy balance. Eat less and exercise more.
There are some benefits to what foods/nutrients you eat and when you eat that can make you more successful in this endeavor, just as there are some more effective exercise/activity patterns that can influence how much weight is lost (but not *where* the fat comes off).

A Cure for Celiac???

New hope for celiac disease sufferers?
By Cathryn Delude, posted December 21, 2009

In a sense, the 2 million plus Americans with celiac disease are lucky. No other autoimmune disease has such a safe and effective treatment.

Purging the diet of gluten -- the protein in wheat, rye and barley that triggers an immune reaction in the gut -- can reverse the disease and reduce intestinal inflammation. That's important, because studies now show that the consequences of untreated celiac disease are graver than previously thought, causing anemia, arthritis, osteoporosis, hepatitis, neurological problems and even malignancies, as well as increased general mortality.

Still, it is very difficult to eliminate gluten entirely. It lurks in disparate sources such as vinegars, soy sauce, medications, lip balm and Play-Doh (which some children consider edible); and even gluten-free foods, which are expensive, may contain enough traces to cause symptoms. "When we study celiac patients who have been doing their best to follow a gluten-free diet, even after five years we see lots of damage in the small intestines in about half of them," said Dr. Robert Anderson, a gastroenterologist in Melbourne, Australia, who is working on a vaccine to prevent or switch off the reaction to gluten.

His is one of many efforts underway to develop new, non-dietary treatments for celiac disease. Ultimately, celiac patients may be able to take a pill before a meal so they could, for example, have stuffing with their holiday turkey. Or, as is Anderson's goal, they could go for a series of treatments similar to allergy shots that would teach their immune systems to tolerate gluten.

"It's very exciting that the pathophysiology of celiac disease is understood to such a degree that we can design potential therapies," said Dr. Peter Green, director of the Celiac Disease Center at Columbia University College of Physicians and Surgeons in New York.

There are two categories of treatments being developed. One would supplement a gluten-free diet and protect patients from occasional gluten exposure; the other would train the immune system to tolerate gluten and allow patients to eat a regular diet.

Enzyme therapy

Within the first category, one approach uses oral enzymes that target gluten. We cannot completely digest gluten because humans lack digestive enzymes that can break it down, but researchers at Stanford University combined enzymes from bacteria and barley that finish what our own digestive juices cannot. They showed in rats that when gluten is broken down into smaller fragments, it no longer causes inflammation in the intestines. Alvine Pharmaceuticals, based in San Carlos, Calif., has developed this "glutenase" therapy and is now recruiting patients for a Phase II clinical trial.

In this trial, as with the others, participants have had a diagnosis of celiac disease confirmed by a biopsy but have had it under control on a gluten-free diet. They are given either a drug or placebo, along with a gluten challenge, often the equivalent of one or two slices of bread.

"From the early data it looks like the oral enzymes break down enough gluten to be useful," said Dr. Daniel Leffler, director of clinical research for the Celiac Center at Beth Israel Deaconess Medical Center in Boston. Leffler was not involved in the enzyme trial but is an investigator in a nearly completed Phase II trial testing a different drug, larazotide, developed by Alba Therapeutics in Maryland.

The larazotide approach leaves the gluten peptides, or small fragments of proteins,intact but aims to prevent them from penetrating beneath the lining of the gut into the mucous layer where the immune reaction occurs. In celiac disease, as in many autoimmune diseases, including Type 1 diabetes, this intestinal barrier is "leaky" or permeable.

Larazotide is a bioengineered drug designed to close those leaks to keep out gluten and prevent or reverse the disease. In preliminary results from about 300 patients in Phase I and II trials, the drug did seem to benefit patients, who had fewer adverse symptoms after eating gluten. It also reduced the levels of the antibody that serves as a blood marker for the immune response to gluten. But interestingly, the drug did not seem to reduce intestinal permeability.

"So the drug works, but maybe through a different mechanism that we don't understand yet," said Green, who is on the clinical advisory board for both Alba and Alvine. He predicts that, if ultimately found effective, the oral enzymes and larazotide would be marketed as supplements to a gluten-free diet but that many patients would want them to actually replace the restrictive diet. It's unclear not only whether such a use would be possible but also whether it would be a daily regimen or followed only when dining out or traveling, for instance.

Immunotherapy

The second category of treatment, known as immunotherapy, is more investigational but also more exciting, Leffler said. It would allow patients to eat a regular diet by quelling immune response in the gut. This response is driven by immune cells known as T cells, which react when other immune cells display gluten fragments on their surface.

In Australia, a company founded by Anderson, called Nexpep, is packaging the gluten peptides that trigger this immune response into a vaccine that will desensitize the immune reaction. The theory, which he says works in animals, is that by introducing these peptides through injections under the skin rather than through the gut, the immune cells learn to tolerate them and no longer display them to the T cells. That can theoretically prevent or turn off the reaction that damages the intestines

Anderson expects Phase I safety trials of this vaccine, Nexvax2, to be completed in mid-2010. He anticipates that patients would receive a series of injections of the vaccine, followed by occasional maintenance doses.

"If we can figure out how to give the drug, how frequently and when we need maintenance therapy," he added, "then we can use the same principle to explore treatments for other autoimmune diseases." Several other groups are also developing vaccines for celiac disease, but this one is furthest along.

A low-tech immunotherapy approach might require just one inoculation -- of hookworm. It is known that a non-pathogenic hookworm introduced to the gut can relieve asthma symptoms. Researchers suspect that it is because we evolved with intestinal parasites that trained our immune system to tolerate environmental irritants, but our hygienic modern living has deprived us of this beneficial symbiosis.

Researchers at the Brisbane Princess Alexandra Hospital in Queensland, Australia, tested the effects of hookworm inoculation on 20 patients with celiac disease to see if it would blunt the immune response to gluten. In addition to hoping to provide relief for celiac patients, the researchers want to learn if this could be an effective therapy for inflammatory bowel disease and Crohn's disease.

The results have not been published, but when the Phase II trial was over and the patients were offered a medication that would kill the parasites, they all opted to keep their hookworms.

health@latimes.com
Copyright © 2009, The Los Angeles Times
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Extending the Honeymoon in Type 1 Diabetes - New Use for an Old Drug

FDA-approved drug may slow beta cell destruction in type 1 diabetes patients

DALLAS — Dec. 4, 2009 — New findings by UT Southwestern researchers suggest that a drug already used to treat autoimmune disorders might also help slow the destruction of insulin-producing cells in patients recently diagnosed with insulin-dependent (type 1) diabetes.

In type 1 diabetes, formerly known as juvenile diabetes, cells in the pancreas called beta cells, which produce insulin, are destroyed by an autoimmune process.

Researchers at UT Southwestern and 14 other centers worldwide found that injections of the drug rituximab slowed beta cell destruction in the pancreas of those newly diagnosed with type 1 diabetes for at least a year, suggesting a potential treatment option that might improve management and reduce long-term complications of the disease.

“Our findings in no way suggest that rituximab should be used as a treatment or that it will eliminate the need for daily insulin injections,” said Dr. Raskin, principal investigator of the trial’s local effort. “This is not a cure for type 1 diabetes.

“The results do, however, provide evidence that B cells play a significant role in type 1 diabetes and that selective suppression of these B cells may deter the destruction of the body’s beta cells.”

Prior research has shown that two types of immune cells — B cells and T cells — help trigger type 1 diabetes. T cells attack and destroy the insulin-producing beta cells. The B cells, however, don’t directly attack insulin-producing cells, but researchers have speculated that they trigger the T cells to attack. Rituximab directly attacks and destroys the beta cells.

For the current study, researchers conducted a randomized, double-blind study in which 81 participants received infusions of either rituximab or a placebo once a week for four weeks. The participants, who ranged in age from 8 to 40 years and had been diagnosed with type 1 diabetes within 100 days of enrollment in the study, returned approximately every three months for two years to undergo blood tests and meet with a physician. Two-thirds of the 81 participants received the drug.

The scientists found that after one year, the participants who received rituximab needed lower doses of insulin and were able to produce more of their own insulin than those who received the placebo. They also had better control of their blood sugar.

Dr. Raskin said researchers do not think rituximab could ever be used to completely reverse type 1 diabetes because the pancreas typically is too damaged by the time diabetes is diagnosed.

He also said that while the exact mechanism of how rituximab affects type 1 diabetes remains unclear, the study clearly shows that a therapy that targets B cells may improve beta-cell function in early type 1 diabetes.

The next step, Dr. Raskin said, is to evaluate the potential effects of rituximab in diabetes.

Other UT Southwestern researchers involved in the study include Dr. Perrin White, professor of pediatrics; Dr. Bryan Dickson, associate professor of pediatrics; Dr. Soumya Adhikari, assistant professor of pediatrics; Dr. Mark Siegelman, associate professor of pathology; Marilyn Alford, senior advanced practice nurse in internal medicine; Tauri Harden, a former advanced practice nurse in internal medicine; Erica Cordova, registered nurse at Parkland Memorial Hospital; and Nenita Torres and Maria Lourdes Pruneda, senior research nurses in internal medicine.

The study is supported by the Juvenile Diabetes Research Foundation International, the American Diabetes Association and the Type 1 Diabetes TrialNet Study Group, a clinical trials network funded by the National Institutes of Health.

Visit www.utsouthwestern.org/endocrinology to learn more about UT Southwestern’s clinical services in endocrinology, including diabetes.

BUZZ: Movie Popcorn is Bad For You (Duh!)

I love reading headlines related to food and nutrition. This is what showed up on my Yahoo BUZZ today:

Horror at the Movies: Popcorn
by Claudine Zap (posted 21 Nov 2009)

We would want to be the last ones to ruin movie night, but this just in from Center for Science in the Public Interest: Chowing down on a medium popcorn and soda is the calorie equivalent to three McDonald's quarter-pounders and 12 — yes 12 — pats of butter. And it gets worse: About 90% of this 1,600 calorie bomb comes from fat.

‘Two Thumbs Down’ for Movie Theater Popcorn
(posted 18 Nov 2009)

New Lab Tests of Movie Theater Popcorn Show It’s Still the Godzilla of Snacks

WASHINGTON—It's hard to picture someone mindlessly ingesting three McDonald's Quarter Pounders with 12 pats of butter while watching a movie. But according to new laboratory analyses commissioned by the nonprofit Center for Science in the Public Interest, that food is nutritionally comparable to what you’d find in a medium popcorn and soda combo at Regal, the country’s biggest movie theater chain: 1,610 calories and three days’ worth—60 grams—of saturated fat. (Nutrition aside, that combo costs $12—for raw ingredients that must cost Regal pennies.)

The study, published as the cover story in the December issue of Nutrition Action Healthletter, updates a famous exposé the group conducted 15 years ago. For Regal and AMC, CSPI tested samples from theaters in the Washington, D.C., area. For Cinemark, samples came from Texas, Illinois, and Maryland.

The oversized boxes and bags (four to five ounces) of candy sold at movie chains are universally high in calories. A 5-ounce bag of Twizzlers has 460 calories and 15 teaspoons of sugar. A 7-ounce box of Nerds has 790 calories and 46 teaspoons of sugar. Chocolate candies like Butterfinger Minis, Raisinets, Sno-Caps, or M&M's have between 400 and 500 calories and at least a half day’s worth of saturated fat. An 8-ounce bag of Reese's Pieces is just a cup of candy. But with 1,160 calories and 35 grams of saturated fat, it's like eating a 16-ounce T-bone steak plus a buttered baked potato.
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Another interesting thing about popcorn, is that eating it while watching a movie leads us into mindless eating. Tons of it. For some real interesting insights into portion size influencing our eating habits, take a read of this:

Big portions influence overeating as much as taste, even when the food tastes lousy, Cornell study finds
By Susan S. Lang (posted 5 Nov 2005)

Large portions push people to overeat -- even to overeat foods they don't like.

According to a new Cornell University study, when moviegoers were served stale popcorn in big buckets, they ate 34 percent more than those given the same stale popcorn in medium-sized containers. Tasty food created even larger appetites: Fresh popcorn in large tubs resulted in people eating 45 percent more than those given fresh popcorn in medium-sized containers.

"We're finding that portion size can influence intake as much as taste," said Brian Wansink, the John S. Dyson Professor of Marketing and of Applied Economics at Cornell. "Large packages and containers can lead to overeating foods we do not even find appealing."

Wansink and Junong Kim, assistant professor of marketing at the University of Central Florida, gave 158 moviegoers either medium (4.2 oz) or large (8.4 oz) tubs of free popcorn that was either fresh or 14 days old. The researchers asked the moviegoers to describe the popcorn after the movie, and they weighed how much popcorn was left in the containers. As expected, the 14-day-old popcorn was described with such remarks as "stale" and "it was terrible."

When the moviegoers were asked if they thought they ate more because of the size of the container, 77 percent of those given the large tubs said they would have eaten the same amount if given a medium container. "This means that the moviegoers were unaware that the exceptional amount they ate was due to the size of the container," said Wansink, who also is the author of the new book, "Marketing Nutrition: Soy, Functional Foods, Biotechnology, and Obesity," and director of the Cornell Food and Brand Lab, made up of a group of interdisciplinary researchers who have conducted more than 200 studies on the psychology behind what people eat and how often they eat it.

Several of Wansink's previous studies show that larger portions prompt people to eat more not because of a clean-your-plate mentality, but because large packages and portions suggest larger consumption norms. "They implicitly suggest what might be construed as a 'normal' or 'appropriate' amount to consume," said Wansink, who tested this concept in 1996 with volunteers given different-sized bags of M&Ms that were too large to be finished while watching a videotape; those given larger bags ate twice as much as those with smaller bags.
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For some interesting reading, I highly recommend his book Mindless Eating – Why We Eat More Than We Think, by Brian Wansink. Published by Bantam-Dell (2006).

So what do I eat at the movies? Sometimes I brought in my own snacks (grapes or raisins; one evening I even packed an entire dinner in to-go containers and used a big purse). But lately I just don't get anything to eat or drink. It's not like we're going to starve during the 2 hr show. It's one way to break that behavior change of tv & movies connected to food & eating. And think of all the money you save by skipping the snack bar.

Positive Placebo Power

Experts: Placebo power behind many natural cures
By MARILYNN MARCHIONE, AP Medical Writer Marilynn Marchione, Ap Medical Writer – Tue Nov 10, 3:16 pm ET

EDITOR'S NOTE: Ten years and $2.5 billion in research have found no cures from alternative medicine. Yet these mostly unproven treatments are now mainstream and used by more than a third of all Americans. This is one in an occasional Associated Press series on their use and potential risks.

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People looking for natural cures will be happy to know there is one. Two words explain how it works: "I believe."

It's the placebo effect — the ability of a dummy pill or a faked treatment to make people feel better, just because they expect that it will. It's the mind's ability to alter physical symptoms, such as pain, anxiety and fatigue.

In just the past few weeks, the placebo effect has demonstrated its healing powers. In tests of a new drug to relieve lupus symptoms, about a third of patients felt better when they got dummy pills instead of the drug.

The placebo effect looms large in alternative medicine, which has many therapies and herbal remedies based on beliefs versus science. Often the problems they seek to relieve, such as pain, are subjective.

"It has a pejorative implication — that it's not real, that it has no medicinal value," said Dr. Robert Ader, a psychologist at the University of Rochester in New York who has researched the phenomenon.

But placebos can have real and beneficial effects, he said.

"Much of the results of certain alternative procedures are largely placebo effects, unless you believe there are people who exert magical powers so they can hold their hands over your body and cure you of disease," Ader said. "Make you feel better? That's entirely possible, especially if you believe it."

The placebo effect accounts for about a third of the benefits of any treatment — even carefully tested medicines, scientists say. This dates to a landmark report in 1955 called The Powerful Placebo. Viewed as groundbreaking, the analysis of dozens of studies by H.K. Beecher found that 32 percent of patients responded to a placebo.

Later studies found that dummy pills could raise pulse rates, blood pressure and reaction speed when people were told they had taken a stimulant; the opposite occurred when people were told that a drug would make them drowsy.

How does it work? Scientists do not always know, but there are many possible ways. Brain imaging shows that beliefs ("I know these pills will help") can cause biological changes and affect levels of chemical messengers and stress hormones that signal pain or pleasure.

Emotions, too, can trigger physical changes. Take the case of a child with croup. Crying tightens the airways and makes it tougher to breathe. Many people believe that cool mist is helpful, but when it has been tested in hospital studies with croup tents, it has not been found to help, said Dr. Owen Hendley, a pediatrician at the University of Virginia.

Try it at home, though, and you may get a different result.

"The child sits in the lap of the mother and the mother holds the mist maker close to the child. The child settles down, the mother settles down. The setting, and the mother feeling that it is helping, makes everybody calmer," and the child actually is able to breathe better, Hendley explained.

If it were not for the placebo effect, "physicians would not be nearly as successful as we are," said Dr. Thomas Schnitzer, a Northwestern University arthritis specialist. He helped lead a big study that found glucosamine and chondroitin supplements were no better than dummy pills for arthritic knee pain.

Doctors sometimes exploit the placebo effect to help patients. One survey found that many doctors admitted sometimes giving patients sugar pills or drugs or vitamins that would not really help their condition, in an effort to trigger a placebo effect.

In Baltimore, the University of Maryland Medical Center's shock trauma center is offering some patients Reiki therapy, which claims to heal through invisible energy fields manipulated by a special "master." The hospital's anesthesia chief, Dr. Richard Dutton, says it is self-hypnosis and compares it to Lamaze classes that teach pregnant women breathing exercises to take their minds off the pain of labor.

Roy A. Armstrong's family agreed to it after he was injured in a motorcycle crash last year. The 39-year-old suffered cardiac arrest and had many broken bones. As he lay tethered to a breathing machine, nurse Donna Audia and a partner circled his bed, waving their arms through the air and touching his head while humming and making tunes by rubbing a crystal bowl with a wand.

Armstrong was too sedated to remember anything, but "I think in some way it helped him to get better," his wife said. He is still recovering through physical therapy.

Dutton said: "You can call it a placebo effect, you can call it a chicken soup effect. It's all about creating the right mental state in the person. The patients tell us they seem to like it. And in pain management, that's the whole goal. If 30 percent of your patients get better on placebo, why not give it to them?"

Swear-by-it stories and anecdotal reports of benefit are one thing. Proving a treatment helps is quite another. Many alternative medicine studies have not included a placebo group — people who unknowingly get a dummy treatment so its effect can be compared.

Acupuncture is especially hard to research. Positive studies tend to lack comparison groups that have been given a sham treatment. Or they are often done in China, where the treatment is an established part of health care.

One U.S. study found that true acupuncture relieved knee arthritis pain better than fake acupuncture, in which guide tubes were placed but no needles were inserted. But a European study involving twice as many patients and using a more realistic sham procedure found the fake treatment to be just as good. The conclusion: Pain relief was due to the placebo effect.

Advertisements and testimonials from product users can encourage a placebo effect. The Federal Trade Commission last summer reached a settlement over advertising claims for Airborne, a product "invented by a teacher" that was supposed to ward off germs spread through the air.

"Products like Airborne are what we call `credence products.' That's a fancy word for saying it's difficult or impossible for consumers to determine if the product has done anything for them," said commission lawyer Rich Cleland. "Part of that is because of the placebo effect. Part of that is because people don't want to believe they've been ripped off."

Barbara Domen, a former kindergarten teacher in Caswell Beach, N.C., said she was prone to colds and used Airborne six or seven times a year when she flew on planes.

"It worked for me," although it could be because since she retired, "I'm away from all the germs," she said. She skipped it on one flight and caught a terrible cold.

"Maybe it's psychological, but I think I'll continue to use it," she said.

Some placebo effects are due to conditioning, or ascribing benefits to something you did that may in fact have played no role in your improvement. Insomnia is an example, said Michael Perlis, a psychologist and neuroscientist at the University of Pennsylvania.

If you have trouble sleeping one night, your body's need for sleep makes it very likely you'll sleep well the next night. If you take a sleeping pill, you think you slept well because of the pill, he said.

Do any herbal remedies work for insomnia? "Not that I know of," Perlis said. "But all of them have potential to be useful with time. It has nothing to do with them — it has everything to do with conditioning."

FDA article on placebos (2000)
American Cancer Society article on placebos (2009)