Pollutants may contribute to illness and becoming overweight

ScienceDaily (June 26, 2012) — Lack of physical activity and poor diet alone cannot explain the dramatic rise in obesity and diabetes occurring in many countries, believe some researchers. It is time to face the possibility that hazardous chemicals may also share part of the blame.

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The population of the Western world is increasingly falling prey to metabolic syndrome, which is the name for a group of risk factors -- such as overweight and insulin resistance -- that occur together and increase the risk for coronary artery disease, stroke, and type-2 diabetes.

What can explain this sharp upsurge in the incidence of metabolic syndrome? Both genetics and environmental factors such as diet and physical exercise play a part, but researchers are still missing some key pieces to the puzzle.

"Many studies now indicate that persistent organic pollutants play a major role," says Jerome Ruzzin, a post-doctoral researcher at the University of Bergen.

From fatty foods

For several years, Dr Ruzzin has been receiving funding from the Research Council of Norway's Programme on Environmental Exposures and Health Outcomes (MILPAAHEL) to study the effects of persistent organic pollutants (POPs). He believes these substances have much more of a health impact than most people realize.

"Today's adults are the first generation to experience serious health problems from these substances. If we do not take this challenge seriously," he cautions, "there is every reason to be concerned about the coming generations as well."

POPs enter our bodies when we consume fatty foods such as dairy products, meat, and particularly fatty fish. One of Dr Ruzzin's research findings on mice is that eating salmon that contains high levels of POPs can lead to insulin resistance, one of the main causes of metabolic syndrome. Popping up everywhere

In two recent scientific articles, Dr Ruzzin has sounded the alarm about the harmful health effects of POPs.

"A great number of studies are now showing that people with high concentrations of POPs in their body are developing metabolic syndrome. We are talking about ordinary people who live in normal environments," stress Dr Ruzzin, "so this means that we are being exposed to far too high levels of POPs that may have a major impact on our health."

Typically, dietary changes are prescribed to treat metabolic syndrome. But according to Dr Ruzzin, too little is known about the effects of pollutants in specific foods to make any detailed health recommendations. This is why he believes we should waste no time in launching more studies that examine the combination of pollutants and nutrients in humans.

Dangerous cocktail effect

Studies have shown that POPs, even at concentrations below their danger level individually, can interact with other POPs or hazardous substances to cause serious consequences. This combined "cocktail effect" worries Dr Ruzzin.

"Current threshold values for pollutants are probably too high," says Dr Ruzzin, "which means that the regulatory framework needs changing. Food producers need to eliminate hazardous substances to a far greater extent than they do at present, and we consumers need more information about the kinds of chemicals we could be ingesting with their food products."

Deformed genitalia

Danish studies have shown that even small amounts of different chemicals found in everyday products can have a cocktail effect. Malformations of the sex organs are one possible consequence. Researcher Sofie Christiansen of the Technical University of Denmark is concerned.

"There is no doubt that the importance of interactions between different hormone-disrupting chemicals has been underestimated," she asserted in connection with a conference on environmentally hazardous substances co-hosted by the Research Council and the Norwegian Climate and Pollution Agency this January.

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Phthalate, environmental chemical is linked to higher rates of childhood obesity

ScienceDaily (June 26, 2012) — Obese children show greater exposure than nonobese children to a phthalate, a chemical used to soften plastics in some children's toys and many household products, according to a new study, which found that the obesity risk increases according to the level of the chemical found in the bloodstream.

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The study will be presented Saturday at The Endocrine Society's 94th Annual Meeting in Houston.

The chemical, di-ethylhexyl phthalate (DEHP), is a common type of phthalate, a group of industrial chemicals that are suspected endocrine disruptors, or hormone-altering agents.

In the study, children with the highest DEHP levels had nearly five times the odds of being obese compared with children who had the lowest DEHP levels, study co-author Mi Jung Park, MD, PhD, said.

"Although this study cannot prove causality between childhood obesity and phthalate exposure, it alerts the public to recognize the possible harm and make efforts to reduce this exposure, especially in children," said Park, a pediatric endocrinologist in Seoul, Korea, at Sanggye Paik Hospital and professor at Inje University College of Medicine.

Phthalates are found in some pacifiers, plastic food packages, medical equipment and building materials such as vinyl flooring, and even in nonplastic personal care products, including soap, shampoo and nail polish.

Prior research has shown that phthalates may change gene expression associated with fat metabolism, according to Dr. Park. Because past research suggested a link between concentrations of phthalate metabolites and increased waist size in adults, her group studied a possible connection with childhood obesity.

Dr.Park and colleagues measured serum levels of DEHP in 204 children: 105 obese and 99 healthy-weight youth ages 6 to 13 years. The researchers divided these DEHP measurements into four groups from the lowest detectable level (40.2 nanograms per milliliter, or ng/mL) to the highest (69.7 to 177.1 ng/mL).

They found that the obese children had a significantly higher average DEHP level than did the nonobese controls (107 versus 53.8 ng/mL, respectively). In particular, a high DEHP level correlated with body mass index and percentage of fat mass. This increased risk of obesity with elevation of DEHP levels was independent of factors such as physical activity and daily calorie intake, according to the authors.

"More research in people is needed to determine whether DEHP exposure contributes to childhood obesity," Dr.Park said.

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Curry spice, omega-3 fatty acid preserve walking ability following spinal-cord injury

ScienceDaily (June 26, 2012) — UCLA researchers discovered that a diet enriched with a popular omega-3 fatty acid and an ingredient in curry spice preserved walking ability in rats with spinal-cord injury. Published June 26 in the Journal of Neurosurgery: Spine, the findings suggest that these dietary supplements help repair nerve cells and maintain neurological function after degenerative damage to the neck.

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"Normal aging often narrows the spinal canal, putting pressure on the spinal cord and injuring tissue," explained principal investigator Dr. Langston Holly, associate professor of neurosurgery at the David Geffen School of Medicine at UCLA. "While surgery can relieve the pressure and prevent further injury, it can't repair damage to the cells and nerve fibers. We wanted to explore whether dietary supplementation could help the spinal cord heal itself."

The UCLA team studied two groups of rats with a condition that simulated cervical myelopathy -- a progressive disorder that often occurs in people with spine-weakening conditions like rheumatoid arthritis and osteoporosis. Cervical myelopathy can lead to disabling neurological symptoms, such as difficulty walking, neck and arm pain, hand numbness and weakness of the limbs. It's the most common cause of spine-related walking problems in people over 55.

The first group of animals was fed rat chow that replicated a Western diet high in saturated fats and sugar. The second group consumed a standard diet supplemented with docosahexaenoic acid, or DHA, and curcumin, a compound in turmeric, an Indian curry spice. A third set of rats received a standard rat diet and served as a control group.

Why these supplements? DHA is an omega-3 fatty acid shown to repair damage to cell membranes. Curcumin is a strong antioxidant that previous studies have linked to tissue repair. Both reduce inflammation.

"The brain and spinal cord work together, and years of research demonstrate that supplements like DHA and curcumin can positively influence the brain," said coauthor Fernando Gomez-Pinilla, professor of neurosurgery. "We suspected that what works in the brain may also work in the spinal cord. When we were unable to find good data to support our hypothesis, we decided to study it ourselves."

The researchers recorded a baseline of the rats walking and re-examined the animals' gait on a weekly basis. As early as three weeks, the rats eating the Western diet demonstrated measurable walking problems that worsened as the study progressed. Rats fed a diet enriched with DHA and curcumin walked significantly better than the first group even six weeks after the study's start.

Next, the scientists examined the rats' spinal cords to evaluate how diet affected their injury on a molecular level. The researchers measured levels of three markers respectively linked to cell-membrane damage, neural repair and cellular communication.

The rats that ate the Western diet showed higher levels of the marker linked to cell-membrane damage. In contrast, the DHA and curcumin appeared to offset the injury's effect in the second group, which displayed equivalent marker levels to the control group.

Levels of the markers linked to neural repair and cellular communication were significantly lower in the rats raised on the Western diet. Again, levels in the animals fed the supplemented diet appeared similar to those of the control group.

"DHA and curcumin appear to invoke several molecular mechanisms that preserved neurological function in the rats," said Gomez-Pinilla. "This is an exciting first step toward understanding the role that diet plays in protecting the body from degenerative disease."

"Our findings suggest that diet can help minimize disease-related changes and repair damage to the spinal cord," said Holly. "We next want to look at other mechanisms involved in the cascade of events leading up to chronic spinal-cord injury. Our goal is to identify which stages will respond best to medical intervention and identify effective steps for slowing the disease process."

Holly's and Gomez-Pinilla's coauthors included Dr. Donald Blaskiewicz, Aiguo Wu, Cameron Feng and Zhe Ying, all of UCLA. Their research was supported by grants from the National Institutes of Health (RO1 NS056413) and the Craig H. Neilsen Foundation.

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Dieting? Study challenges notion that a calorie is just a calorie

ScienceDaily (June 26, 2012) — A new study published June 26 in the Journal of American Medical Association challenges the notion that "a calorie is a calorie." The study, led by Cara Ebbeling, PhD, associate director and David Ludwig, MD, director of the New Balance Foundation Obesity Prevention Center Boston Children's Hospital, finds diets that reduce the surge in blood sugar after a meal--either low-glycemic index or very-low carbohydrate-may be preferable to a low-fat diet for those trying to achieve lasting weight loss. Furthermore, the study finds that the low-glycemic index diet had similar metabolic benefits to the very low-carb diet without negative effects of stress and inflammation as seen by participants consuming the very low-carb diet.

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Weight re-gain is often attributed to a decline in motivation or adherence to diet and exercise, but biology also plays an important role. After weight loss, the rate at which people burn calories (known as energy expenditure) decreases, reflecting slower metabolism. Lower energy expenditure adds to the difficulty of weight maintenance and helps explain why people tend to re-gain lost weight.

Prior research by Ebbeling and Ludwig has shown the advantages of a low glycemic load diet for weight loss and diabetes prevention, but the effects of these diets during weight loss maintenance has not been well studied. Research shows that only one in six overweight people will maintain even 10 percent of their weight loss long-term.

The study suggests that a low-glycemic load diet is more effective than conventional approaches at burning calories (and keeping energy expenditure) at a higher rate after weight loss. "We've found that, contrary to nutritional dogma, all calories are not created equal," says Ludwig, also director of the Optimal Weight for Life Clinic at Boston Children's Hospital. "Total calories burned plummeted by 300 calories on the low fat diet compared to the low carbohydrate diet, which would equal the number of calories typically burned in an hour of moderate-intensity physical activity," he says.

Each of the study's 21 adult participants (ages 18-40) first had to lose 10 to 15 percent of their body weight, and after weight stabilization, completed all three of the following diets in random order, each for four weeks at a time. The randomized crossover design allowed for rigorous observation of how each diet affected all participants, regardless of the order in which they were consumed:

A low-fat diet,which reduces dietary fat and emphasizes whole grain products and a variety of fruits and vegetables, composed of 60 percent of daily calories from carbohydrates, 20 percent from fat and 20 percent from protein. A low-glycemic index diet made up of minimally processed grains, vegetables, healthy fats, legumes and fruits, with 40 percent of daily calories from carbohydrates, 40 percent from fat and 20 percent from protein. Low glycemic index carbohydrates digest slowly, helping to keep blood sugar and hormones stable after the meal. A low-carbohydrate diet, modeled after the Atkins diet, composed of 10 percent of daily calories from carbohydrates, 60 percent from fat and 30 percent from protein.

The study used state-of-the-art methods, such as stable isotopes to measure participants' total energy expenditure, as they followed each diet.

Each of the three diets fell within the normal healthy range of 10 to 35 percent of daily calories from protein. The very low-carbohydrate diet produced the greatest improvements in metabolism, but with an important caveat: This diet increased participants' cortisol levels, which can lead to insulin resistance and cardiovascular disease. The very low carbohydrate diet also raised C-reactive protein levels, which may also increase risk of cardiovascular disease.

Though a low-fat diet is traditionally recommended by the U.S. Government and Heart Association, it caused the greatest decrease in energy expenditure, an unhealthy lipid pattern and insulin resistance.

"In addition to the benefits noted in this study, we believe that low-glycemic-index diets are easier to stick to on a day-to-day basis, compared to low-carb and low-fat diets, which many people find limiting," says Ebbeling. "Unlike low-fat and very- low carbohydrate diets, a low-glycemic-index diet doesn't eliminate entire classes of food, likely making it easier to follow and more sustainable."

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Effect of three common diets on energy expenditure following weight loss detailed

ScienceDaily (June 26, 2012) — In an examination of the effect on energy expenditure and components of the metabolic syndrome of 3 types of commonly consumed diets following weight loss, decreases in resting energy expenditure and total energy expenditure were greatest with a low-fat diet, intermediate with a low-glycemic index diet, and least with a very low-carbohydrate diet, suggesting that a low-fat diet may increase the risk for weight regain compared to the other diets, according to preliminary research published in the June 27 issue of JAMA.

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"Many people can lose weight for a few months, but most have difficulty maintaining clinically significant weight loss over the long term. According to data from the National Health and Nutrition Examination Survey (1999-2006), only 1 in 6 overweight and obese adults report ever having maintained weight loss of at least 10 percent for 1 year," according to background information in the article. One explanation for the poor long-term outcome is that weight loss elicits biological adaptations -- specifically a decline in energy expenditure and an increase in hunger -- that promote weight. According to the authors, the effect of dietary composition on energy expenditure during weight-loss maintenance has not been studied.

Cara B. Ebbeling, Ph.D., of Children's Hospital Boston, and colleagues conducted a study to evaluate the effects of 3 weight-loss maintenance diets on energy expenditure, hormones, and components of the metabolic syndrome. The study, conducted between June 2006 and June 2010, included 21 overweight and obese young adults. After achieving 10 percent to 15 percent weight loss while consuming a run-in diet, participants consumed an isocaloric low-fat diet (60 percent of energy from carbohydrate, 20 percent from fat, 20 percent from protein; high glycemic load), low-glycemic index diet (40 percent from carbohydrate, 40 percent from fat, and 20 percent from protein; moderate glycemic load), and very low-carbohydrate diet (10 percent from carbohydrate, 60 percent from fat, and 30 percent from protein; low glycemic load) in random order, each for 4 weeks. The primary outcome measured was resting energy expenditure (REE), with secondary outcomes of total energy expenditure (TEE), hormone levels, and metabolic syndrome components.

The researchers found that energy expenditure during weight-loss maintenance differed significantly among the 3 diets. The decrease in REE from pre-weight-loss levels, measured by indirect calorimetry in the fasting state, was greatest for the low-fat diet (average relative to baseline, -205 kcal/d), intermediate with the low-glycemic index diet (-166 kcal/d), and least for the very low-carbohydrate diet (-138 kcal/d). The decrease in TEE also differed significantly by diet (average -423 kcal/d for low fat; -297 kcal/d for low glycemic index; and -97 kcal/d for very low carbohydrate).

"Hormone levels and metabolic syndrome components also varied during weight maintenance by diet (leptin; 24-hour urinary cortisol; indexes of peripheral and hepatic insulin sensitivity; high-density lipoprotein

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Significant cardiovascular risk with Atkins-style diets, experts warn

ScienceDaily (June 27, 2012) — Women who regularly eat a low carbohydrate, high protein diet are at greater risk of cardiovascular disease (such as heart disease and stroke) than those who do not, a study just published on the British Medical Journal website suggests.

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Although the actual numbers are small (an extra 4-5 cases of cardiovascular disease per 10,000 women per year) the authors say that this is a 28% increase in the number of cases and that these results are worrying in a population of young women who may be exposed to these dietary patterns and face the excess risk for many years.

Low carbohydrate-high protein diets are frequently used for body weight control. Although they may be nutritionally acceptable if the protein is mainly of plant origin (e.g. nuts) and the reduction of carbohydrates applies mainly to simple and refined ones (i.e. unhealthy sweeteners, drinks and snacks), the general public do not always recognise and act on this guidance.

Studies on the long term consequences of these diets on cardiovascular health have generated inconsistent results. So a team of international authors carried out a study on just under 44,000 Swedish women aged between 30 and 49 years from 1991-92 (with an average follow-up of 15 years).

Women completed an extensive dietary and lifestyle questionnaire and diet was measured on the low carbohydrate-high protein (LCHP) score where a score of two would equal very high carbohydrate and low protein consumption through to 20 which would equal very low carbohydrate and high protein consumption.

Factors likely to influence the results were taken into account including smoking, alcohol use, diagnosis of hypertension, overall level of activity and saturated / unsaturated fat intake.

After these variables were included, results showed that 1270 cardiovascular events took place in the 43,396 women (55% ischaemic heart disease, 23% ischaemic stroke, 6% haemorrhagic stroke, 10% subarachnoid haemorrhage and 6% peripheral arterial disease) over 15 years.

The incidence of cardiovascular outcomes increased with an increasing LCHP score.

Unadjusted figures show that, compared with an LCHP score of six or less, cardiovascular diseases increased by 13% for women with a score from 7 to 9, to 23% for those with a score from 10 to 12, to 54% for those with a score from 13 to 15, and to 60% for those with a score of 16 or higher.

After adjusting for other cardiovascular risk factors, there was still a significant 5% increase in the likelihood of a cardiovascular event or death with every two point increase in the LCHP score. The 5% increase resulted from a daily decrease of 20g of carbohydrates (equivalent to a small bread roll) and a daily increase of 5g of protein (equivalent to one boiled egg).

In absolute terms, the adjusted figures represent an additional four to five cases of cardiovascular diseases per 10,000 women per year compared with those who did not regularly eat a low carbohydrate, high protein diet.

Increasing level of education and physical activity reduced the risk of cardiovascular disease whilst increasing levels of smoking increased the risk.

The authors conclude that LCHP diets "used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins" are associated with cardiovascular risk. This study doesn't, however, address the questions concerning the possible benefit of short-term effects of LCHP diets that can be used to control weight or insulin resistance, which the authors say needs further investigation.

An accompanying editorial argues that the short term benefits of weight loss seem outweighed by longer term cardiovascular harms. Anna Floegel from the German Institute of Human Nutrition and Tobias Pischon from the Max Delbrück Center for Molecular Medicine in Germany, say that the discrepancy between conclusions from different types of studies in this field "need to be resolved before low carbohydrate-high protein diets can be safely recommended to patients."

In the meantime, they suggest that any benefits gained from these diets in the short-term "seem irrelevant in the face of increasing evidence of higher morbidity and mortality from cardiovascular diseases in the long term."

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Kids who cook are hungrier for healthy food choices

ScienceDaily (June 27, 2012) — Getting kids to pass up junk food in favour of healthier fruits and veggies has led to many a mealtime meltdown for parents everywhere. Now, researchers from the University of Alberta offer a simple solution: give them an apron.

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A province-wide survey of Grade 5 students in Alberta suggests the best way to get your child to eat healthier foods -- and actually enjoy them -- is to have them help with meal preparation.

"Kids who like fruits and vegetables more tend to eat them more frequently and have better diets," said lead author Yen Li Chu, a post-doctoral fellow in the School of Public Health. "These data show that encouraging kids to get involved in meal preparation could be an effective health promotion strategy for schools and parents."

Published last month by Public Health Nutrition in an early online release, the study involved a survey of students in 151 schools across Alberta to learn about kids' experiences with cooking and food choices.

Nearly one-third of children reported helping with meal prep at least once a day; another one-third said they helped one to three times a week. A quarter of children helped once a month, and 12.4 per cent avoided the kitchen completely.

In general, children preferred fruits to veggies, but children who helped with cooking showed a greater preference for both. Vegetable preference was also 10 per cent higher among children who helped cook.

The data also showed that kids who did meal prep and cooking were more confident about the importance of making healthier food choices.

Paul Veugelers, co-author and Canada Research Chair in Population Health at the U of A, said getting children to eat healthier food promotes bone and muscle development, learning and self-esteem.

"Good food is important for us. It keeps weight gain away -- and more important than that, it keeps chronic disease away," Veugelers said. "The overarching objective of our work is to lower the burden of chronic disease in our society. A healthy diet is right at the top."

Chu said the results underscore the value of getting kids interested in mealtime activities in the home, but added there could be room for schools to get involved, too.

"You can go into schools and have cooking classes and cooking clubs to help them boost their fruit and vegetable intake and make healthier choices," she said.

Though this survey dealt with Grade 5 students, the lessons are equally applicable to older youth, including post-secondary students, added Veugelers.

"For many of them, it may be the first time they leave home, the first time in their lives they're responsible for their own diets," he said. "There are lessons here for them too, to form groups and take turns cooking, and pay attention to good meal preparation."

This work was part of the Real Kids Alberta evaluation funded by Alberta Health. Real Kids Alberta is a collaborative initiative between the School of Public Health and Alberta Health to provide directions to improve eating habits and activity levels in Alberta children and youth.

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'War on drugs' is fueling HIV epidemic: report

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Rapid HIV Test Could Reduce Stigma and Curtail Disease

The Centers for Disease Control and Prevention has launched an initiative to motivate people to get tested for HIV. A free rapid test is being offered in select pharmacies nationwide, within their small clinics, which involves a swab test that renders results in approximately 20 minutes, the Associated Press reports. If the result is positive, the patient is sent to a department of health or other clinic to have the result confirmed by blood test.

With an estimated 1.1 million Americans infected with the disease and an estimated 20 percent of them unaware, this is a wise move to help to curtail the spread of the disease. So many people are unaware of the facts about HIV and AIDS that perhaps being confronted by the testing center and the information offered there will prompt people to know more. In the back of so many minds is the fear the possibility of infection exists.

Too many people still believe HIV and AIDS are the disease of gay men and drug users. While statistics still confirm these groups are still at higher risk, the truth is the condition is increasing in women, particularly minority women. HIV is more easily spread from man to woman because the virus exists in a man's semen, which can live inside the vagina for several days. But the female bodily fluids from which a man can contract the virus through intercourse with a woman have more limited means to enter the penis and infect a man's body.

In order for this condition to be dealt with, the stigma must decrease. There have been tremendous strides made in regard to treating the disease, making it possible for those infected to live productive and happy lives, to enjoy careers and have families. In fact, with treatment, the chances of a woman passing along the virus to her unborn child are reduced to as low as 2 percent.

Symptoms of the illness often don't appear for nearly 10 years in many patients. It is important to be tested for this virus, regardless of whether any sexual partners "appear" to be ill and whether a person has had few or several partners. It's better to know early. Though there is no cure, treatment is possible to help to maintain a normal life.

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Walgreen, others offer free HIV tests in CDC pilot

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Bacterial Vaginosis Increases Female-to-Male HIV Transmission Risk

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German court bans circumcision of young boys

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