Team McCallum

R&D for Lifetime of Life

Walking v diabetes+.

Dr Terry Dwyer and colleagues have found that walking cuts the risk of diabetes in a study of 600 adults in Tasmania. While the team focussed on diabetes, the results suggest a protective effect against metabolic syndrome and cardiovascular disease.

Roughly 600 adults aged around 50 in 2000 were tracked for 5 years.  At the start, most were overweight or obese and as a whole, the group gained weight over the period.

The volunteers were fitted with pedometers for 2 days in 2000. One finding was that those with higher daily step counts at this start time ended with a better body mass index (BMI), better waist to hip ratio and better insulin sensitivity, compared to those less active.

After 5 years, the group wore pedometers for another 2 days. As a whole, the group gained weight and became less active.  However, one third stayed active or increased their steps in the period, and again these were the ones with better measures on BMI, waist-hip ratio and insulin sensitivity.

The following figures are for those walking 10,000 steps, which is about 5 miles or 8km.

For a person of average height, weight dropped was just under 3kg, or about 6lbs. This corresponds to a BMI reduction of 0.83kg/metre squared. Insulin sensitivity increased by about 12%, with men doing slightly better than women.

These results are all ‘dose-dependent’. In other words, walking less still resulted in some improvements.

When the researchers factored in BMI, the differences between those active and those not disappeared, so the team attributed the improvement to a cut in body fat.

The researchers were looking at diabetes, and the improvement in insulin sensitivity would result in a considerably reduced risk of the disease.

The figures also strongly suggest there would be an improvement in other diseases linked to BMI and larger waists, including high blood pressure, metabolic syndrome, cardiovascular disease and more.

The impact on the waist is interesting, since fat stored around the waist is linked to adiposopathy (sick fat), and this study suggests that walking is a way to burn ‘sick’ fat preferentially to ‘healthy’ fat, reducing the waist to hip ratio.

January 17, 2011 Posted by | Accelerometer, Activity, Adiposopathy - sick fat, Aging, BMI - body mass index, CVD - cardiovascular disease, Diabetes, Exercise, High blood pressure, Metabolic syndrome, Success, Waist circumference, Walking, Weight management | Leave a comment

Eating well?

Two stories published today illustrate the difference between how well people think they eat and how well they really eat.

In Ecuador, Dr Simin Nikbin Meydani examined the diet and health of 350 men and women aged 65+ living in 3 poor neighbourhoods around the capital, Quito. Despite being poor, these people seemed to be eating well, with 33% of the men overweight and 55% of the women overweight.

In reality, their diet was heavily based on white rice, potatoes, sugar and white bread. Foods to provide micronutrients, such as chicken, legumes, fruit and vegetables, were sparse.

Using standard definitions, the team found that 19% of the men and 81% of the women had metabolic syndrome. High levels of C-reactive protein, a marker associated with cardiovascular disease risk, were found in 50% of the population. By analysing diet components, the team was able to tie risk of metabolic syndrome to under-consumption of vitamin C and vitamin E in this population.

The research was published in Public Health Nutrition.

Meanwhile, in the US, a survey of over 1,200 people found that many thought they were eating better than they really were.

53% thought their diet was somewhat healthy, 32% thought very healthy and 6% thought extremely healthy.

However, only 30% ate their 5 portions of fruit and vegetables a day, only half watched how many sweets they ate and 43% drank at least one can of sugar-sweetened beverage each day.

Of those who said they were at a healthy weight, 30% were clinically in the overweight range, and 35% were obese.

While 81% claimed to be active, the average amount of time spent moderately active was one hour, with a large chunk clocking up 5 hours per day sitting down.

The study was conducted by Consumer Reports.

January 4, 2011 Posted by | Activity, CVD - cardiovascular disease, Diet, Fruit, Gender, Health, Metabolic syndrome, Obesity, Soft drinks, Success, Sugar, United States, Vegetables, Vitamin C - ascorbic acid, Vitamin E, Weight management | Leave a comment

Best infant formula milk?

Babies fed on formula milk made from cows’ milk show more rapid weight gain in their first year than those who are breast fed. The excess weight gain in this period is linked to an increased risk of obesity, diabetes, metabolic syndrome and other diseases later in life.

Researchers from Philadelphia wanted to know if all types of formula milk suffered from this problem, so set up a test between a cows’ milk based formula (Enfamil), and a protein hydrolysate formula (Nutramigen). Protein hydrolysate formula is typically used for babies who are allergic to cows’ milk.

The babies’ weight and height started off the same when they were randomly allocated to milk type when just 2 weeks old.

By two and a half months, babies on cows’ milk were noticeably heavier, but not taller. At seven and a half months, when the study ended, those in the cows’ milk group averaged two pounds more than those in the protein hydrolysate group. Again this was excess weight gain rather than extra height. The protein hydrolysate group was only a little heavier than breast fed babies.

The researchers speculated that the protein hydrolysate breaks down into amino acids with a similar profile to human milk and that leads to baby feeling fuller faster. Videotapes of feeding showed the protein hydrolysate stopped feeding after fewer calories.

The study appears in the January issue of Pediatrics.

December 30, 2010 Posted by | Child Health, Diabetes, Health, Metabolic syndrome, Obesity, Pregnancy, Success, Weight management | Leave a comment

Long life and health.

In Feb 2010, our top story was that researchers in Australia had found that the body mass index (BMI) guidelines used for the general public are not the best ones for seniors. Later in the year, this article was cited by another one entitled “Survival of the Fattest”.

The BMI ranges used by the Australian team were 18.5 to 25 as normal, 25 to 30 as overweight, over 30 as obese, and under 18.5 as underweight.

The research published in the Journal of the American Geriatrics Society compared all-cause mortality, and cause specific mortality (cardiovascular disease, cancer, chronic respiratory disease) across the groups. Nearly 5,000 men and 5,000 women aged 70 to 75 at the start of the study were followed for a period of 10 years.

Compared to the normal weight group, those overweight had an 18% less risk of dying during the study. Even the obese group came in at the same risk as the normal weight people.

Another key finding was that being physically active made a large difference. Compared to an active lifestyle, men who were sedentary increased their risk of death by 28%, while inactive women more than doubled their risk.

The short meassage was fatten up a bit, but make sure you stay active. (Staying active is a theme we’ll return to in the rest of the year’s highlights).

This Australian research has already been cited by 5 other articles published in 2010.

In Sep 2010, 2 researchers wrote an article in the Journals of Gerontology Series A entitled ” Adaptive Senectitude: The Prolongevity Effects of Aging.”

This raised the question that some of the effects we normally think of as declines in old age, (including high blood pressure, metabolic syndrome, and obesity) may in fact be protective, while anti-oxidants and hormone supplements may be damaging. Or in other words, we don’t yet understand optimal aging.

Today, 29 Dec 2010, a group of scientists which appears to be related to those carrying out the February study has published in the Australasian Journal on Ageing, uder the title ” Are the national guidelines for health behaviour appropriate for older Australians? Evidence from the Men, Women and Ageing project”.

Here is their recipe for long life and health.

“Current BMI guidelines may be too narrow because BMI in the overweight range appears to be protective for both older men and women. Across all levels of BMI, even low levels of physical activity decrease mortality risk compared with being sedentary. Our findings suggest that consideration should be given to having different alcohol guidelines for older men and women and should include recommendations for alcohol-free days. The benefit of quitting smoking at any age is apparent for both women and men.”

December 29, 2010 Posted by | Activity, Aging, Alcohol, BMI - body mass index, Health, High blood pressure, Metabolic syndrome, Obesity, Smoking, Success, Weight management | Leave a comment

Vitamin D v metabolic syndrome.

Researchers from the University of California Davis Medical Center found that patients with metabolic syndrome (but otherwise healthy) were much more likely to have insufficient vitamin D in their blood than controls without metabolic syndrome.  The patients came from around Sacramento, a part of northern California with plenty of sun, making the results more surprising.

Dr Ishwarlal Jialal and team compared 44 patients who had metabolic syndrome, but without diabetes or cardiovascular disease (CVD), against 37 healthy controls matched for age and gender.

The Institute of Medicine (IOM) has very recently published recommended levels of calcium and vitamin D, and based on best evidence, worked on a level of 20ng/ml of vitamin D in the blood as sufficient.

Dr Jialal found that 8% of controls had insufficient vitamin D at the IOM level, but in the metabolic syndrome group it was 30%.

The average value of vitamin D in blood in the metabolic syndrome group was found to be 23.1ng/ml, which suggests the IOM recommended level of 20 ng/ml may be too low. In the control group, it averaged 27.8ng/ml.

Dr Jialal also found there was no difference in levels in winter and summer, which reinforces the finding that in northern California, normal activity in sunlight is not enough to generate adequate vitamin D levels. This contrasts with southern California, where research has shown there in no difference in vitamin D between those with and without metabolic syndrome, while in Florida (even farther south) diabetics do not tend to have low vitamin D.

Sacramento is about 39 degrees north. As most of Europe is at or north of this, it would put most Europeans at risk, unless they are out in the sun more than this US sample, or getting it from food sources.

Metabolic syndrome is a risk factor for diabetes, CVD and stroke.

December 2, 2010 Posted by | Activity, CVD - cardiovascular disease, Diabetes, Health, IOM - Institute of Medcine, Metabolic syndrome, Stroke, Success, United States, Vitamin D | Leave a comment

Calcium and vitamin D by IOM.

The Institute of Medicine (IOM) was asked by US and Canadian health authorities to conduct an independent, evidence based review of the dietary requirements for calcium and vitamin D.

Overall, the committee concludes that the majority of Americans and Canadians are receiving adequate amounts of both calcium and vitamin D. Further, there is emerging evidence that too much of these nutrients may be harmful.”

Prof A Catherine Ross chaired the committee conducting this update, the first since 1997. The team reviewed over 1,000 studies on vitamin D and calcium and took further evidence from experts.

The review covered all health outcomes,  including cancer, cardiovascular disease, high blood pressure, diabetes, metabolic syndrome, falls, immune response, neuropsychological functioning, physical performance, preeclampsia, and reproductive outcomes. It found that only in relation to bone health are the results unequivocal, and based its recommendations on this.

The committee noted that studies appearing in the media re population levels of deficiency are using arbitrary levels that have not been established by a central authority, and so have little validity.

Based on available data, the committee found almost all individuals get sufficient vitamin D when their blood levels are at or above 20 nanograms per milliliter as it is measured in the US, or 50 nanomoles per liter as measured in Canada.

Also, the committee considered that few people are getting their vitamin D from sunlight, and based their recommendations on this.

A full breakdown of the recommendations by age range and gender is at the IOM short report on calcium and vitamin D. Please note a number of special situations are omitted from this but are covered by the full 678 page report, so check with your physician.

Some subgroups—particularly those who are older and living in institutions or who have dark skin pigmentation—may be at increased risk for getting too little vitamin D.

National surveys in both the United States and Canada indicate that most people receive enough calcium, with the exception of girls ages 9-18, who often do not take in enough calcium. In contrast, postmenopausal women taking supplements may be getting too much calcium.

Too much calcium is linked with kidney stones, while too much vitamin D is linked to kidney and other tissue damage. The short report therefore gives 3 values for each group – the estimated average amount (enough for the average person), the recommended dietary allowance (the level at which nearly everyone gets enough) and the upper level intake (the level at which more will cause harm rather than good).

In conclusion, “the committee emphasizes that, with a few exceptions, all North Americans are receiving enough calcium and vitamin D. Higher levels have not been shown to confer greater benefits, and in fact, they have been linked to other health problems, challenging the concept that “more is better.””

November 30, 2010 Posted by | Aging, Calcium, Canada, Cancer, Child Health, Cognitive decline, CVD - cardiovascular disease, Diabetes, Gender, High blood pressure, IOM - Institute of Medcine, Metabolic syndrome, Success, United States, Vitamin D | Leave a comment

Fat kids v teen heart risk.

A study in the UK has looked at over 5,200 children, to see whether being overweight at age 9-12 is associated with cardiovascular risk factors at age 15-16. It also investigated whether body mass index (BMI) is useful, or whether other measures are better.

Dr Debbie A Lawler and colleagues took measurements of BMI, waist circumference and fat/lean mass by dual energy x-rays at start point and end point. For 75% of the children, the start was before age 10.

At the end, at age 15-16, a wide range of risk markers associated with cardiovascular disease (CVD) were measured.

Different detailed results were found for boys and for girls. However, in general, those overweight at the start point were at higher risk  of factors linked to CVD. (The ‘overweight’ definition used was that of the International Obesity Task Force.)

The following risk factors were all predicted – high systolic blood pressure, high ‘bad’ LDL cholesterol, low ‘good’ HDL cholesterol, high triglycerides, high insulin in blood. BMI was linked to high fasting glucose levels in boys only, and risk for some of the others was worse in boys than girls.

Diastolic blood pressure at the end was not predicted by BMI at the start measurement.

Girls who went from overweight at the first point into the normal range by the end were found to have no more risk than those girls in the normal range at both times. However, boys who improved their weight status also improved their risk profile, but it remained poorer than those in the normal range at both times.

Finally, the team found that although BMI is much criticised, it was as good a predictor as the other two methods, even the very precise x-ray method. So BMI was validated as a simple and easy way to predict a child’s future health profile.

November 28, 2010 Posted by | BMI - body mass index, Child Health, Cholesterol, CVD - cardiovascular disease, Gender, Health, High blood pressure, Metabolic syndrome, Obesity, Success, Waist circumference, Weight management | Leave a comment

What you should know about SICK fat.

The International Journal of Clinical Practice is running a special section in its December issue covering male health. Dr Harold E Bays, Dr Joseph M Gonzalez-Campoy, and Dr Alan B Schorr, 3 experts in metabolic syndrome and related conditions, have written a reference summary on the topic.

It is called “What men should know about metabolic syndrome, adiposopathy and ‘sick fat’, but it also covers women. So it’s really a summary of adiposopathy, where ‘adiposo’ means fat, and ‘pathy’ means sick or diseased, hence SICK FAT.

The article is free, and quite short, but it is fairly technical.

In simple English, the 3 doctors are suggesting that metabolic syndrome is a rather loose term covering a series of problems that lay people understand better in other terms – high blood pressure, blood fats that are wrong, blood sugar level wrong, type 2 diabetes and increased risk of cardivascular disease (CVD) and other illnesses.

The first key point is that fat is not an inactive store of calories. It has a wide range of hormonal functions essential for human health. So there is ‘good’ fat.

However, visceral fat (that stored around the organs inside the abdomen) can turn from healthy fat into sick fat (adiposopathy). Sick visceral fat does not look like or work like healthy visceral fat. When it turns sick, it churns out a range of inflammatory substances, increases blood pressure and unbalances a range of hormones.

It decreases testosterone levels in men and increases them in women, closing the gender gap. “One of the biochemical consequences of obesity is often a closer approximation of the genders with regard to sex hormone levels.”

There is a quick review of all the major treatments for metabolic syndrome diseases, ranging from exercise and good diet through all the major medications to bariatric surgery (stomach bypass or banding). This shows the impact on blood sugar levels, blood pressure and blood fat profiles work similarly across all.

The experts then discuss which path is wiser – treating the results of sick fat, or curing the sick fat. They concluded “An emerging concept is that the development of antiobesity agents must not only reduce fat mass (adiposity) but must also correct fat dysfunction (adiposopathy).”

They conclude that scientists have known about the disease-causing potential of fat for more than 50 years, but that it is only in the last 10 years that fat has been thought of as being a major active component in the human hormone system.  “Clinicians may find that: ‘A discussion as to how increasing body weight may cause their fat to becomesick,or how losing body weight may cause their fat to becomehealthier, might be better than discussing the diagnostic components defining themetabolic syndrome.’”

The only notable omissions from an excellent round-up are – why visceral fat turns sick in the first place – and – whether there is a smarter or faster way to cure sick fat than simply overall weight loss.

Our recent articles on fructose (in the form of pure fruit drinks) and sugar-sweetened beverages suggest that both dump in more fructose than the body can handle at one go. This suggests one trigger for making it sick, and one way to cure it faster, though this is unlikely to be the only cause/cure.

Click here for a full copy of the article by the 3 doctors.

November 15, 2010 Posted by | Adiposopathy - sick fat, CVD - cardiovascular disease, Diabetes, Diet, Exercise, Gastric banding, Health, HFCS - high-fructose corn syrup, High blood pressure, Metabolic syndrome, Obesity, Soft drinks, Success, Weight management | Leave a comment

Fructose v gout.

Two years ago, Dr Hyon K Choi reported in the British Medical Journal that fructose raised the risk of gout in men. Now, in the Journal of the American Medical Association, Dr Choi has reported the same findings in women.

Gout affects around 5% of women in their 70s, and rates of gout have been rising in the US, nearly trebling between 1977 and 1996.

This increase corresponds with an increase in fructose consumption in sweetened soft drinks and fruit juices. These drinks contain large amounts of fructose, the only carbohydrate known to increase uric acid levels in humans, leading to gout.

It has been shown that the increase in uric acid for a given load of fructose is higher in people prone to gout or with a history of high uric acid than it is in the general population.

Emerging evidence is linking gout to insulin resistance, metabolic syndrome, diabetes, heart attacks and premature death.

For this study, Dr Choi used the Nurses Health Study, which provided detailed information on the diet of 79,000 women from 1984 to 2002.

Known risk factors for gout include alcohol consumption and body mass index (BMI), while dairy is protective. Dr Choi stripped these out to look at the impact of other factors.

Compared to drinking less than one drink/month, women drinking 1 drink of sweetened soft drink had a 74% higher risk of getting gout, and on 2 or more servings/day the risk was increased by double this (140%). When looking at juice (which has natural fructose) the risk was 41% up for 1/day, and 140% up for 2/day. The drink sizes here are 6oz, while a standard US/UK drink size is 12oz/33cl.

As with the study in men, diet soft drinks did not increase the risk of gout.

Some media reports named orange juice as a culprit, but Dr Choi’s full report shows that this came from the simple fact that much more orange juice was being consumed than apple juice or other fruit juices. The fructose content of most fruit juices is quite similar to that of orange juice, so should lead to the same effect.

November 12, 2010 Posted by | Alcohol, CVD - cardiovascular disease, Diabetes, Gout, Health, HFCS - high-fructose corn syrup, Metabolic syndrome, Soft drinks, Success | 1 Comment

Exercise and disease genes.

A group of scientists from Finland and the US have found that there is a genetic component to exercise, that this component is strongly linked to disease resistance, and that those without these genes are prone to obesity, metabolic syndrome and the illnesses which arise from this. This was not a study in ‘fat’ genes but in ‘exercise’ genes.

The team took rats and gave them free access to a running wheel. Those which freely chose to run the most were called high capacity runners (HCRs). Those that chose to run very little were called low capacity runners (LCRs). Then the team made sure that HCRs bred only with HCRs, and LCRS with LCRs.

Different features of the final findings appeared at different generations, as a mix of genetics and environment kicked in.

The team did not look at single genes. Instead, they considered related groups they called centroids, where a centroid is associated with a known biological system (such as fatty acid use by muscles). In total, they found 7 centroids covering 141 genes were signficantly different between HCRs and LCRs.

There were enormous differences between the rats by the 18th generation. HCRs voluntarily ran over 6 times farther and had a higher resting metabolic rate. The LCRs were 25% heavier, and since the HCRs had more muscle mass, the increase was largely in fat. The LCRs had the signs of metabolic syndrome – higher blood glucose, higher insulin, higher triglycerides and lower ‘good’ cholesterol.

The HCRs also had an upregulated immune system, making them more resistant to all types of disease,

The study appears in the journal FASEB. According to the editor of FASEB, Dr Gerald Weissman, “Genes that increase resistance to common diseases in high-runner rats are also present across species”.

So in addition to ‘fat’ genes, there are ‘exercise’ genes and ‘health’ genes.

November 1, 2010 Posted by | Exercise, Genetics, Health, Metabolic syndrome, Obesity, Success, Weight management | Leave a comment