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

Udiet: the battlefield.

2010 was stuffed with debate over the reasons why people in developed countries are getting heavier.

 The most simplistic explanations focussed on overeating, or inactivity, or both. HFCS (high fructose corn syrup) also came in for a beating. The problem with this is that Europe imports very little HFCS, but countries in Europe are reporting more and more problems associated with obesity.

 www.obesitymyths.com comes up with a much larger range of interesting possibilities. But in 2005, the New York Times linked this site to sponsorship from fast food producers such as Coca-Cola and McDonald’s, in this article.

Two reputable groups of scientists published work where they found that the mantra of ‘eat less and exercise more’ doesn’t cover all of the potential reasons.

 A government group in the UK called Foresight was asked to predict what will happen there over time, based on best evidence, and building in realistic assumptions. In order to do so, they had to scour published research to identify the drivers of obesity and build a very detailed model of which drivers are most important. Written in simple English, this is probably the best explanation there is of the obesity epidemic.

The full report is available as a free PDF download here. However, at over 160 pages, it won’t be everyone’s cup of tea.

The second group of scientists published a summary of obesity drivers in November 2009. Again, this is available free using this link.

Their findings outline the battlefield for the Udiet.

1. Overeating, particularly re heavily marketed energy dense foods.

2. Underactivity, again with an organisation driver behind it.

3. Infection caused by bacteria and viruses.

4. Epigenetics, whereby prenatal and early postnatal exposure to the environment alters how genes are expressed without changing the genes. For example, babies born very underweight at birth who are incubated and fed rich diets to catch up weight have a higher risk of obesity and associated issues later in life.

5. Increasing maternal age. Animal studies have shown that babies born to older mothers are fatter than those born to younger mothers.

6. BMI breeding effect. Studies have found that those with a body mass index somewhat above average are producing slightly more children, on average, than the rest of the population, causing the population BMI to increase over time.

7. Assortitative mating is taking place. This hypothesis is that those with higher BMI prefer partners of similar kind, and due to the genetic effect, this leads to even heavier children. A wide range of population studies support this idea.

8. Sleep debt is happening, and leads to increased eating, increased fat deposition and lowered activity. Research shows metabolic changes occur to support this, and also leads to higher risk of diabetes and heart disease. For example, one study shows that getting one and a half hours less sleep than ideal over a two week period results in a diabetic-like profile for glucose and insulin.

9. Endocrine disruptors interfere with estrogen and androgen signalling, and have been building up in the human environment for some time.  These have been found to be involved in obesity in animals and in humans.

10. Commonly used medicines are known to contribute to weight gain. These include medicines for diabetes, high blood pressure, steroids, contraceptives, and anti-histamines.

11. Artificial ambient temperature. The hotter your environment, the less energy you burn keeping warm. The UK home went from 13 centigrade in 1970 to 18 centigrade by 2000. US homes went from 18 centigrade in 1923 to nearly 25 centigrade in 1986.

12. Mothers input. The state of the mother’s glucose and insulin handling systems directly affect the number of fat cells and the fat cell content of the baby.

13. Reduction in smoking rate. The scientists considered this so well documented they excluded it from their list.

14. Altered US demographics. A 2006 article along the same lines had found that alterations in the US population were increasing the races which tend toward higher BMI, therefore  increasing the average BMI of the nation.

The aim of the scientists’ report was not to remove the first two reasons from focus, but to show that the battlefield is considerably more complex than simply food and exercise.

These 14 points are not comprehensive. For example, other researchers have found that altering the circadian rhythm, by staying up late in artificial light and not synchronising your body clock to early morning light, is also a risk factor for weight gain. Also, breastfeeding v formula milk wasn’t mentioned, although formula milk is associated with higher risk of obesity.

January 9, 2011 Posted by | Activity, BMI - body mass index, Breastfeeding, Child Health, CVD - cardiovascular disease, Diabetes, Environment, Epigenetics, Exercise, HFCS - high-fructose corn syrup, High blood pressure, Obesity, Pregnancy, Pregnancy, Success, Thermogenesis, UK, United States, Weight management | Leave a comment

Udiet: The Designer Diet.

2010 was stuffed with research published on the topic of weight management – how best to take weight off and how best to keep it off.

Udiet is a look at the most interesting findings from 2010, and to kick the story off, 2011 has already seen further work published on the first topic – why a diet has to be designed around you.

Medical research is full of studies that mention ‘responders’ and ‘non-responders’. A particular course of treatment should work for the general population, but in practice some respond as predicted, and some simply don’t, or worse.

Two days ago it was announced that Johnson and Johnson agreed to commercialise an invention of Dr Daniel Haber and colleagues. They have found a way to take a small blood sample and scan it for signs of a number of different cancers. The device gives results in 8 hours and also supplies information of the genetic profile of any cancer.

The device was invented over 2 years ago but Haber and team have been working to take it out of the lab setting and make it general purpose. Other teams are developing other devices with the same aim in mind.

Currently, a number of cancer treatments are on the basis of applying treatment then waiting several weeks to see if the patient is a responder. The aim of these new devices is to get the correct profile in advance, so you know what the cancer will respond to. Cancer treatment designed around you.

Yesterday, it was the turn of hepatitis-C to figure in the news. Standard treatment works for responders, but only about half of patients fall into this category. Non-responders need different treatment. Dr Matthew L Albert and Dr Stanislas Pol have found a biomarker that predicts whether a patient is a responder or not, and they are working with Rules Based Medicine Inc to bring this to the market.

2010 showed that the idea of responders and non-responders works in weight management. What works for one person, or for most, may not work for you.

Hence the Udiet – the diet designed around you. We publish the findings of 2010. Keeping in mind the concept of responders and non-responders, you apply the ones that work for you.

January 6, 2011 Posted by | Diet, Obesity, Psychology, Success, 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

Alcobesity increases in US.

Dr Richard A  Grucza, and colleagues at the Washington University School of Medicine in St Louis, found that ‘alcobesity’ is on the rise in the US.

Before this research, it was known that where alcohol abuse runs in families, due to genes, there is also an increased risk of other behaviour that stimulates the same reward centres in the brain, so the risk of substance abuse is also higher.

Dr Grucza compared two national US studies, one in 1991-1992 and the other in 2001-2002, each of which involved just under 40,000 adults.

In the 1992 study, a link between alcohol abuse running in the family and obesity running in the family was weak, at just 6% higher risk and not reaching statistical significance.

But by 2002, this had climbed to 26% for men and was statistically significant. While in women the additional risk was a whopping 48% higher.

The team ruled out other possible explanations, such as stopping smoking in this period, leaving them trying to explain the following. If there is a cross-over genetic effect, where when alcoholism runs in families people are also more at risk of obesity, how can this be explained when genetics have not altered in so short a time?

The idea that excess alcohol consumption, which means excess calories, might be making people fat was ruled out. Alcoholics tend to be thin as they get a large percentage of their calories from alcohol rather than food. And the subjects tended to be either obese, or alcoholic, rather than both.

So genetics gives some people a higher risk of alcoholism (or of substance abuse) while for others the risk is food ‘abuse’.

The researchers speculated that the change from the 90s to the naughties is in the make-up of food, with particular emphasis on fat, sugar and salt, that now  makes food hyper-palatable.

And that those people genetically at risk of reward centres that dance to the tune of alcohol or other drugs, may find their reward centres fire up on hyper-palatable food. The particular preference leads to an addiction to either alcohol, (or drugs), or to obesity, so explaining the rise of  ‘alcobesity’ in the US.

January 2, 2011 Posted by | Alcohol, Brain, Gender, Genetics, Health, Obesity, Success, Sugar, 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

Eat yourself healthy.

First published in January 2010, here’s a list of food that not only tastes great, but also improves your health profile.

Almonds. Research just published in Dec 2010 show that these improve insulin resistance in those beginning to develop diabetes.

Apples (unpeeled) for quercetin. Located just under the skin of an apple, quercetin has been found to kill viruses directly. It also increases the level of sirtuin 1. Sirtuin 1 helps in the repair of damaged DNA, and is linked to improvements in type 2 diabetes, aging, and Alzheimer’s. It also appears to increase exercise capacity.

Baked beans for soluble fibre. This helps lower blood sugar levels and cholesterol. Research published in Jan 2010 found that higher blood sugar levels (irrespective of body mass index) are linked to an increased risk of cancer.

Chillies. Linked to an increase in calories burned as you break down food, lasting up to 2 hours after you eat them. Easy weight control!

Dark chocolate (or cocoa). Various studies published in 2010 found that eating just a couple of cubes of dark chocolate a day, or a cocoa at night, was linked to lower risk of heart attack and stroke.

Frozen peas for vitamins B and C. The B vitamins help the nervous system, the vitamin C helps cut the length of colds.

Green tea. Too many benefits to list! Research published in Jan 2010 found it cut the risk of lung cancer, in both smokers and non-smokers.

Oily fish for omega-3. Another one with too many benefits to list. In an area of the US known as the ‘stroke belt and buckle’, which has much higher rates of stroke than normal, Dec 2010 research linked this to low consumption of oily fish, and with high consumption of fried non-oily fish, which greatly increases uptake of omega-6, to the detriment of omega-3.

Grapefruit. Research in 2005 showed that eating fresh grapefruit before meal led to weight loss. Research published in 2010 tied this down to the active ingredient naringen. Check out all medications before using grapefruit because this potent chemical interferes with quite a wide range.

New potatoes. When new, these have a better glycemic profile, breaking down more slowly and providing a long acting, less peaked energy response than baked potatoes. And in December the head of the US potato marketing board finished a month of eating absolutely nothing but potatoes, to show that they get more criticism than they deserve.

Oats for beta glucan. This soluble fibre lowers ‘bad’ cholesterol.

Olives for monounsatured fat and phenolics. The list of research in 2010 on the benefits of olive oli on the cardivascular system goes on and on.

Parsley for chlorophyl. A good source of antioxidants, but chewing a little parsley after a meal mops up any unpleasant odours.

Poached or boiled eggs, but not fried, for lecithin. Research shows two eggs for breakfast will cut 400 calories from your overall intake during the day. If you are not interested in the weight loss angle, the lecithin gets converted into a neurotransmitter involved in good memory.

Pomegranate juice. A very small glass per day has been found to reverse artery damage caused by cholesterol.

Prunes for ferulic acid, which helps to keep your bowels regular.

Tomatoes. Another in the ‘too many benefits to list category’. As an example, eating tomato products is linked with a reduction in the risk of prostate cancer in men.

Wholewheat pasta. Another one that gives a long lasting energy source without pushing blood sugar levels through a dangerous peak. It has to be wholewheat!

Turmeric spice for curcumin. The active ingredient, curcumin, turned up ever so frequently in 2010, Protective against too many cancer types to list. Appears to protect the brain against the effects of stroke. Looks to have a neuro=protective effect in brain degeneration diseases, including MS, Alzheimer’s and more. Plus, it makes your rice look really nice!

December 25, 2010 Posted by | Aging, Alzheimer's, Cancer, Capsaicin - chillis, Chocolate, Cholesterol, Curcumin - turmeric, CVD - cardiovascular disease, Diabetes, Diet, Fibre, Fish, Fish oil, Glycemic index, Grapefruit, Green Tea, Health, Multiple sclerosis, Obesity, Olive oil, Omega-3, Omega-6, Parkinson's, Pomegranate, Stroke, Success, Vitamin C - ascorbic acid, Weight management, Whole grain | 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

Exercise v diabetes.

Dr Timothy S Church reported in the Journal of the American Medical Association that a combination of resistance and aerobic exercise of around 140 minutes per week was successful in improving a key marker in type 2 diabetics already on medication.

262 sedentary men and women, average age 56, were randomly allocated to one of – a control group (no exercise), resistance training, aerobic training, and combined resistance and aerobic training.

The resistance training group exercised 3 times a week. The aerobic group did enough exercise to burn 12 kcal per kilo of bodyweight per week. The combined group did aerobics to expend 10 kcal per kilo per week plus 2 sessions of resistance training, which totalled around 140 minutes. This is fairly close to 2008 guidelines of 150 minutes of exercise per week.

The program ran for 9 months, and medicine continued to be used as prescribed by a physician.

Compared to controls, the other groups decreased waist circumference by around and inch. The resistance training group lost 3.1 lbs of fat, while the combination group lost 3.7 lbs of fat (both retaining lean tissue unchanged).

The key outcome measure was glycated hemoglobin (HbA1C). This is a measure of the long term average level of blood sugar.

While the resistance-only and aerobics-only groups had lower values of HbA1C than controls, these were not great enough to be statistically significant, so these forms of exercise on their own don’t have enough impact.

For the combined exercise group, the cut in HbA1C compared to controls was big enough to be significant. This supports the 2008 guidelines, that a mix of both at around 150 minutes per week is beneficial.

During the study, the control group increased its use of diabetic medicines, while in the combined exercise group the use of medication to treat diabetes dropped.

November 26, 2010 Posted by | Diabetes, Exercise, Success, Waist circumference, Weight management | Leave a comment