Dr. Xifeng Wu[/caption]
Xifeng Wu, M.D., Ph.D
Professor of Epidemiology and
[caption id="attachment_22380" align="alignleft" width="150"]
Dr. Melkonian[/caption]
Dr. Stephanie Claire Melkonian PhD
Epidemiologist, Postdoctoral Research Fellow
The University of Texas MD Anderson Cancer Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Glycemic index (GI) assigns foods an indexed value to show how quickly and how much carbohydrates in the food cause blood glucose levels to rise after eating and is a measure of overall carbohydrate quality. Glycemic load (GL) is a related measure that is calculated by multiplying Glycemic index by the amount of carbohydrates in grams in that specific food and by the amount consume, then dividing by 100. Previous studies have investigated the association of GI and GL with certain types of cancer, including colorectal, stomach, and pancreatic cancer, but there has been limited research into the association with lung cancer.
We conducted a study using patients and control subjects from an ongoing case-control study of lung cancer conducted at MD Anderson. The patients were newly diagnosed and had not received treatment other than surgery. The healthy control subjects were selected from patient lists at Kelsey-Seybold Clinics, a large physician group in the Houston area. The study results encompass 1,905 cases and 2,413 controls. Using data collected from in-person interviews regarding health histories and dietary behaviors, we were able to categorize the study subjects according to their dietary Glycemic index and GL.
What we found was that individuals in the highest category of GI were at an almost 50% increased risk for developing lung cancer as compared to those in the lowest group. This association was different based on different subtypes of cancer. Most interestingly, however, among those individuals that never smoked, high Glycemic index was associated with an almost 2 fold increased risk of lung cancer. In other words, we found a more profound association between GI and lung cancer in never smokers in this study.
Anna Hedström PhD student[/caption]
Anna Hedström PhD student
Karolinski Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies on the influence of coffee consumption on multiple sclerosis (MS) risk have yielded inconclusive results, perhaps largely due to statistical power problems since these studies comprised few cases. Caffeine consumption has a protective effect on neuroinflammation and demyelination in animal models of MS. We therefore aimed to investigate whether coffee consumption is associated with MS risk, using two large population-based case-control studies (a Swedish study comprising 1620 cases and 2788 controls, and a United States study comprising 1159 cases and 1172 controls).
The risk of multiple sclerosis was reduced by approximately 30% among those who reported a high coffee consumption, around six cups daily, compared to those who reported no coffee consumption. The risk of multiple sclerosis decreased with increasing coffee consumption. Potentially important influential factors were taken into consideration, such as smoking and adolescent obesity.
Dr. Sohyun Park[/caption]
Sohyun Park, PhD
Epidemiologist
Epidemiology and Surveillance Team
Obesity Prevention and Control Branch
Division of Nutrition, Physical Activity, and Obesity
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Atlanta, Georgia
Medical Research: What is the background for this study? What are the main findings?
Dr. Park: The 2013 BRFSS provides the most recent state data for this behavior using a short screener which showed that about 1 in 3 adults consumed sugar-sweetened beverages (SSBs) at least once per day, and SSB intake differed by state and by certain subgroups.
The main findings of the study showed the following among the 23 states and DC surveyed the prevalence of adults who consumed sugar-sweetened beverages at least once daily was:
Dr. Lisanne De Barse[/caption]
Lisanne de Barse PhD
Department of Epidemiology
Erasmus Medical Center Rotterdam
MedicalResearch: What is the background for this study?
Dr. de Barse: Fussy (or “picky”) eating behaviour, which is characterised by consistent rejection of particular foods, is common in childhood and a source of concern for parents. It is not well understood what affects fussy eating. It is, however, well known that internalizing psychiatric problems of parents (i.e. anxiety and depression) have an impact on children’s health and development. Studies have also shown that mothers’ internalizing problems during the child’s preschool period was linked to child fussy eating. It was not clear whether the child’s eating problems causes stress and psychiatric symptoms in mothers or whether mothers’ symptoms predict child eating behaviour. Nor was it known what potential impact the dads’ state of mind have. The purpose of this study was to examine whether mothers’ and fathers’ internalizing problems during pregnancy and during the child’s life predicts child fussy eating.
MedicalResearch: What are the main findings?
Dr. de Barse: Our main findings indicate that mothers’ anxiety and depressive symptoms during pregnancy could have an influence on children’s fussy eating. This was irrespective of mothers’ internalizing symptoms at the child’s preschool period. We also found indications that fathers’ anxiety and depressive symptoms might influence children’s fussy eating behaviour. This was studied in Generation R, a study that has been tracking the health and wellbeing of children from conception onwards, conducted by the Erasmus Medical Centre, in Rotterdam, the Netherlands.
Avocado- Wikipedia image[/caption]
Sachin A. Shah, Pharm.D.
Residency Director & Regional Coordinator -
Travis AFB
Associate Professor of Pharmacy Practice
TJ Long School of Pharmacy and Health Sciences
University of the Pacific
Medical Research: What is the background for this study? What are the main findings?
Dr. Shah: The link between serum cholesterol and cardiovascular mortality has been well established. Dietary sources of cholesterol can play a major role toward a beneficiary or unfavorable lipid profile. Fatty acids in foods typically fall within one of the four categories: saturated fats (SFAs), common in animal sources, trans fats (TFAs), common in processed foods, polyunsaturated fats (PUFAs), and monounsaturated fats (MUFAs), both common in plant-derived sources. Although low-fat diets are generally recommended, studies have indicated that altering the types of fats you consume may further modify the risk of dyslipidemia. We performed a meta-analysis of existing studies to determine the impact of avocados on the lipid profile.
Ten unique studies incorporating 229 subjects were included. Avocado consumption significantly reduced TC, LDL-C, and TG by 18.80 mg/dL, 16.50 mg/dL, 27.20 mg/dL respectively. HDL-C decreased non-significantly.
Dr. Francis Tayie[/caption]
Francis Tayie, PhD, MPhil, MS. BSc(HONS)
Food, Nutrition and Dietetics
Department of Human Environmental Studies
Southeast Missouri State University
Medical Research: What is the background for this study?
Dr. Tayie: This article which is the first report to show a positive link between alcoholic beverage consumption and increased moisture intake, also reports increases in calorie intake above what is supplied by alcohol, as well as increased body weight status. The general view is that alcoholic beverages do not contribute to moisture intake. This view is generally due to the diuretic effect of the ethanol in alcoholic beverages, specifically depression of vasopressin resulting in increased loss of moisture via the kidneys. Nevertheless, much of the water in alcoholic beverages, especially in light drinks such as beer and wine may be retained, as indicated in this study.
Alcoholic calories count!! The view that alcoholic beverages do not contribute calories to the intake of drinkers is largely debatable. Most of the confusion results from the complex metabolism of the ethanol in alcoholic beverages. Metabolism of ethanol utilizes specific metabolic pathways different from the metabolism of macronutrients.
Notably, the
Prof. Tine Rask Licht[/caption]
Tine Rask Licht, Professor
Head of Research Group on Gut Microbiology and Immunology
Technical University of Denmark
National Food Institute Søborg
Medical Research: What is the background for this study? What are the main findings?
Response: During childhood, the intestinal microbiota is under establishment. This period thus represents a ’window’, where the microbiota is likely to be more susceptible to be affected by external factors such as diet. Currently, it is well known that breast feeding has a major impact on the microbiota of young infants, but only very few studies have addressed the effect of the ‘next step’ in diet exposure, represented by complementary feeding.
We studied two cohorts of children, born to normal-weight and obese mothers, respectively, and mapped the composition of bacteria in their fecal microbiota at age 9 months and 18 months. We found that at 9 months, the microbiota was clearly affected by the composition of the complementary diet, but not by maternal obesity.
Dr. Clett Erridge[/caption]
Dr. Clett Erridge PhD
Department of Cardiovascular Sciences
University of Leicester
Clinical Science Wing
Glenfield General Hospital
Leicester
Medical Research: What is the background for this study? What are the main findings?
Dr. Erridge: We have spent many years seeking potential stimuli that might be responsible for triggering the chronic inflammatory processes that underpin atherosclerosis. Our earlier work focused mainly on the questions of whether and how various molecules related to lipoprotein particles, oxidised lipids and fatty acids interacted with receptors of the innate immune system, which we believe are central players in the initiation of atherosclerosis. However, we were surprised to discover (as a result of some control experiments that we expected to yield a null result), that extracts of some, but not all, foods trigger inflammatory cytokine production in human monocytes via stimulation of the innate immune receptors Toll-like receptor (TLR)-2 and TLR4. The molecules responsible for triggering these responses (collectively termed PAMPs, 'pathogen-associated molecular patterns'), were found to arise in foods that have been finely chopped and stored at refrigeration temperature or above for some time, as a result of the growth and activity of common food spoilage bacteria. The foods most commonly affected are minced meats, ready chopped vegetables, some cheeses and chocolates.
The present study found that in 11 healthy volunteers who habitually consumed food products rich in PAMPs, switching to a low PAMP diet for 7 days resulted in an 18% reduction in LDL-cholesterol, 11% reduction in white blood cell count, a 1.5 cm reduction in waist circumference and a 0.6 kg reduction in body weight. Switching back to a high PAMP diet, in which the same volunteers were then fed meals tested and proven to be high in PAMPs, for just 4 days reversed these beneficial effects.
A second study in 13 healthy volunteers then showed that PAMPs can exert effects on white cell markers of inflammation within 24 h of consumption, when volunteers were fed either fresh or processed onion-based meals, which were nutritionally identical other than for content of bacteria and PAMPs.
MedicalResearch.com Interview with: [caption id="attachment_21402" align="alignleft" width="120"] Dr. Martha Morris[/caption] Dr. Martha Clare Morris ScD Section on Nutrition and Nutritional Epidemiology Department of Internal Medicine Rush University Medical Center Chicago, Illinois Medical Research: What is the background for this study? What are the main findings? Dr. Morris: We examined seafood consumption in a cohort of older residents of the...
Dr. Maryam Farvid[/caption]
Dr. Maryam S. Farvid, PhD
Takemi Fellow
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Farvid: Previous studies of fiber intake and breast cancer have almost all been non-significant, but none of them examined diet during adolescence or early adulthood, a period when breast cancer risk factors appear to be particularly important. Current study supports protective role of dietary fiber intake on breast cancer. The women who reported the highest amount of fiber consumed during high school, about 28 grams daily, had a 16% lower risk of overall breast cancer compared with those who said they consumed an about 15 grams a day. Also highest verses lowest intake of fiber during early adulthood was associated with a 19% lower risk of overall breast cancer. The associations were more apparent for premenopausal breast cancer than postmenopausal breast cancer. Each 10 grams increase in adolescent fiber intake may lead to a 20% lower risk of premenopausal breast cancer, as was a 15% for overall breast cancer.
Dr. Simin Meydani[/caption]
Simin Nikbin Meydani, D.V.M., Ph.D.
Director, JM USDA-HNRCA at Tufts University
Professor of Nutrition and Immunology
Friedman School of Nutrition Science and Policy
and Sackler Graduate School at Tufts University
Boston, MA 02111
Medical Research: What is the background for this study?
Dr. Meydani: A significant number of older people are zinc deficient which can result in a compromised immune system which weakens as the body ages, making older adults more susceptible to infections and higher incidence and morbidity from pneumonia. Older adults with impaired immune response, particularly T cell-mediated function, have a higher susceptibility to infections and cancer. Our research team from the Jean Mayer USDA Human Nutrition Research Center on Aging created a small double-blind, placebo-controlled trial involved adults age 65 or older from three Boston-area nursing homes to determine the feasibility of increasing serum zinc concentrations in older adults. The full findings are published in The American Journal of Clinical Nutrition.
These results have a significant public health implication for the older adults because it shows directly that correction of a nutrient deficiency can improve immune response in older adult (a biological function which consistently has been shown to be impaired with aging).
Rajan Anthony Sonik[/caption]
Rajan Anthony Sonik
Lurie Institute for Disability Policy
Heller School for Social Policy and Management
Brandeis University
Waltham, MA
Medical Research: What is the background for this study? What are the main findings?
Response: We know that food insecurity (experiencing hunger, insufficient food, or concerns about having enough food) is associated with a host of health problems, ranging from behavior health conditions to iron deficiencies. However, understanding the relationship between food insecurity and healthcare utilization and cost patterns has been more difficult to assess with available data. Presumably, rises in food insecurity should worsen health, which in turn should increase healthcare utilization and ultimately costs.
To examine this topic, I actually looked at this in the opposite way by asking if a decrease in food insecurity might lead to decrease in costs. The opportunity to do so arose in the form of the April 2009 increase in benefit levels for the Supplemental Nutrition Assistance Program (SNAP; formerly the Food Stamps Program) that were part of the American Recovery and Reinvestment Act (commonly referred to as the “stimulus package”). SNAP has been shown to alleviate food insecurity, and so this increase in benefits created the chance to explore my question. I analyzed Massachusetts data from October 2006 to August 2012 using interrupted time series models and found that inpatient Medicaid cost growth in Massachusetts fell by 73% (p = 0.003) after the increase in SNAP benefits. Moreover I found that decreased admissions were the primary driver of this outcome rather any patterns in health care inflation. In addition, I found that, for people with selected chronic illnesses that create heightened sensitivity to food insecurity, the drop in cost growth was even greater (the diseases studied were sickle cell disease, diabetes, malnutrition/failure to thrive, inflammatory bowel disease, asthma, and cystic fibrosis).
Dr. Helmut Schröder[/caption]
Helmut Schröder, Ph.D.
Head Cardiovascular Epidemiology and Nutrition Research Group,
CIBER Epidemiology and Public Health
Senior Research Scientist
Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC)
IMIM-Hospital del Mar Medical Research Institute
Parc de Recerca Biomèdica de Barcelona
Barcelona,Spain
Medical Research: What is the background for this study? What are the main findings?
Dr. Schröder: A healthy diet is paramount for physical and mental health. Healthy dietary patterns are more expensive than unhealthy choices. But it is unknown how increases in individual diet cost, driven by rising food prices, affects consumers’ food choices and, consequently, overall diet quality. It is of particular concern that low diet quality is more often found in segments of the population with the lowest socioeconomic status. The he aim of our research was to determine the prospective association between changes in individual diet cost and changes in diet quality in the REGICOR (Registre Gironí del Cor) cohort, a representative Spanish population. Additionally, we determined the impact of changes in diet cost on body weight.
We have found that an increase in the energy-adjusted diet cost predicted a shift to a healthier diet and to better weight management. Diet quality strongly increased if money previously spent on unhealthy food choices such as fast food and pastry is instead spent on vegetables and fruits. Furthermore, we have seen that a 1.4€ increase in average spending on food is associated with the consumption of 74 grams more vegetables and 52 grams more fruit, per person per day, for a 1000 kcal diet. Conversely, a reduction of 0.06€ in average spending is linked to a decrease of 121 grams of vegetables and 94 grams of fruit, as well as increased consumption of foodstuffs like fast food and baked goods.
Prof. Stuart Phillips[/caption]
Professor Stuart M. Phillips Ph.D.,
FACSM, FACN
Department of Kinesiology, McMaster University, Canada
Exercise Metabolism Research Group – Protein Metabolism Research Lab
Director, Physical Activity Centre for Excellence
Medical Research: What is the background for this study? What are the main findings?
Prof. Phillips: During weight loss with diet only people lose both muscle and fat and muscle. The long-term health consequences of losing metabolically active muscle versus fat are not likely to be beneficial. In the context of this study we thought perhaps the preservation of muscle would also be important in very active young men. We wanted to see whether when men were in a very large energy deficit (40% less energy than they required) higher protein (2.4 g/kg/d) could preserve muscle mass and still result in increased function (strength) and fitness.
Our results show that during a marked energy deficit that consumption of 2.4 g protein/kg/d was more effective than consumption of a diet containing 1.2 g protein/kg/d in promoting increases in LBM (1.2 vs 0.1kg increase) and losses of fat mass (-4.8kg vs. -3.5kg) when combined with a high volume of resistance and anaerobic exercise.
Dr. Monica Bertoia[/caption]
MedicalResearch.com Interview with:
Monica L. Bertoia, MPH, PhD
Instructor in Medicine, Channing Division of Network Medicine
Brigham and Women’s Hospital & Harvard Medical School
Research Associate, Department of Nutrition
Harvard T. H. Chan School of Public Health
Boston, MA 02115
Medical Research: What is the background for this study? What are the main findings?
Response: Most weight loss studies have focused on one type of flavonoid, the flavan-3-ols found in green tea, and are limited to small numbers of overweight and obese study participants. We examined 7 subclasses of flavonoids and weight change in 124,086 healthy adults who reported their diet and weight repeatedly over up to 24 years.
Jonathan Welburn[/caption]
Jonathan Welburn
PhD Student and Research Assistant
Department of Industrial and Systems Engineering
University of Wisconsin, Madison
Medical Research: What is the background for this study? What are the main findings?
Response: This study addresses rising concerns associated with increasing levels of food imported into the United States. We use data on FDA import violations to quantify risks to food safety. Using this data, we provide insight on food safety risks that are not easy to obtain by other means. Our results suggest that the risk level of imported food is higher for foods from low-GDP countries. High-GDP countries, on the other hand, may be better able to reduce risks through standards and regulations. Consequently, importers may wish to pay a little more for products from high-GDP countries or work closely with suppliers from low-GDP countries to ensure good safety practices.
Dr. Refaat Hegazi[/caption]
MedicalResearch.com Interview with:
Dr. Refaat Hegazi, MD, PhD MS MPH
Abbott medical director and study author
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Hegazi: The NOURISH study that was recently published in Clinical Nutrition showed that a specialized oral nutrition supplement (with high protein, HMB and Vitamin D) was associated with a 50 percent lower death rate in older, malnourished patients with a heart or lung disease, 90 days after leaving the hospital.
The study was conducted with the utmost scientific rigor and is one of the largest nutrition clinical studies of its kind. In the study, we evaluated the effects of this specialized nutrition supplement compared to a placebo supplement on the incidence of hospital readmission or death through 90-days after leaving the hospital. The population studied has never been evaluated before in this way.
Results showed no significant differences between the two groups for the primary composite (i.e. combined) endpoint of hospital readmissions or death. However, the study individual components and additional analyses showed:
Dr. Marie St-Onge[/caption]
Marie-Pierre St-Onge, Ph.D, FAHA
Assistant Professor, Department of Medicine
New York Obesity Nutrition Research Center
Institute of Human Nutrition
College of Physicians & Surgeons, Columbia University
New York, NY 10032
Medical Research: What is the background for this study? What are the main findings?
Dr. St-Onge: We have shown that sleep affects food intake: restricting sleep increases energy intake, particularly from fat (others also find increased sugar intake). We wanted to know if the reverse was also true: does diet affect sleep at night?
Medical Research: What should clinicians and patients take away from your report?
Dr. St-Onge: Diet quality can play an important role in sleep quality. Sleep can be affect after only a single day of poor dietary intakes (high saturated fat and low fiber intakes). It is possible that improving one’s diet can also improve their sleep.
Dr. Lindsey Taillie[/caption]
More on Nutrition on MedicalResearch.com
MedicalResearch.com Interview with:
Dr. Lindsey Taillie PhD
Research Assistant Professor
Department of Nutrition
University of North Carolina at Chapel Hill
Medical Research: What is the background for this study?
Dr. Taillie: Walmart is the US’ biggest grocer retailer. With over 50% more sales than the next largest grocery retailer, Kroger, Walmart has a major influence on what Americans buy and eat. Previous research suggests this growing dominance of Walmart could also contributing to our growing waistlines: Walmart has been linked to less healthy food purchases and higher levels of obesity. At the same time, public health scientists and advocates are also increasingly concerned about ensuring that everyone—and especially the poor—have access to healthy food stores to buy fruits, vegetables and other nutritious foods.
But what’s a healthy store? Typically we think of these as traditional grocery stores and supermarkets, but not massive supercenters like Walmart (or convenience or drug stores). However, it’s very difficult to actually test how stores affect the healthfulness of our diets. For example, the reason why some food store purchases seem healthier is because more health-conscious consumers shop there to begin with, not necessarily because the food is actually healthier. Where stores choose to locate is not random, either—stores like Walmart might choose to open a store in a certain neighborhood because of other characteristics (low rent, more space, etc.), which themselves can be associated with poor diets and more obesity. People also shop at more than one type of food store, so unhealthy foods at one store might offset healthier foods purchased at another.
Dr. Sandra Jackson[/caption]
MedicalResearch.com Interview with:
Sandra L Jackson PhD
Epidemic Intelligence Service, CDC
Division for Heart Disease and Stroke Prevention
National Center for Chronic Disease Prevention and Health Promotion
Atlanta, Georgia
Medical Research: What is the background for this study? What are the main findings?
Dr. Jackson: Sodium reduction is an important public health strategy to reduce cardiovascular disease, and this study was the latest in CDC’s ongoing effort to monitor U.S. sodium intake. These findings reveal that nearly all Americans – regardless of age, race and gender – consume more sodium than is recommended for a healthy diet.
Specifically, over 90 percent of children (2 to 18) and 89 percent of adults (19 and up) eat more than the recommended limits in the 2015-2020 Dietary Guidelines for Americans, and that doesn’t even include salt added at the table. The newly released guidelines recommend limiting sodium to less than 2,300 mg per day for people over the age of 14, and less for those younger.
The analysis also examined specific populations. Among adults, a larger proportion of men (98 percent) than women (80 percent) consume too much sodium. Among people at greater risk of developing heart disease or stroke – such as people age 51 and older, African Americans and individuals with high blood pressure or pre-hypertension (blood pressure higher than normal but not in the “high” range) – more than three out of four exceed 2,300 mg per day. Adults with hypertension consume slightly less sodium than other adults, and may be trying to follow physician’s advice to reduce sodium. However, 86 percent of adults with hypertension still consume too much.
Dr. Fox[/caption]
MedicalResearch.com Interview with:
Dr. Caroline Fox, MD MPH
National Heart, Lung, and Blood Institute
Assistant Clinical Professor of Medicine
Harvard Medical School
Medical Research: What is the background for this study? What are the main findings?
Dr. Fox: There is evidence linking sugar sweetened beverages with obesity and type 2 diabetes. There is also evidence suggesting that specific adipose tissue depots may play a role in the pathogenesis of these diseases. We found that higher levels of sugar sweetened beverage (SSB) intake was associated with more visceral fat (fat in the stomach cavity) over 6 years.
Prof. Peter Lay[/caption]
MedicalResearch.com Interview with:
Prof. Peter Lay PhD
Professor of Inorganic Chemistry
School of Chemistry | Faculty of Science
Director, Vibrational Spectroscopy Core Facility
Research Portfolio
The University of Sydney
Medical Research: What is the background for this study? What are the main findings?
Response: My group has been studying the molecular mechanisms of chromium(VI)-induced cancers and the biochemistry of vanadium over the last three decades. Vanadium drugs have been in clinical trials for their anti-diabetic effects that occur via species with very similar chemistry to chromium(VI). The more we understood the biochemistry of each, the more we questioned whether the efficacies of anti-diabetic chromium(III) supplements were associated with the generation of carcinogenic chromium(VI) and chromium(V). To test this, we conducted experiments to either provide evidence for our hypothesis or disprove it. This work commenced some 15 years ago with studies on the changes in the nature of chromium(III) supplements exposed to simulated gastrointestinal juices, as well as in human and animal blood serum over times that mimicked the residence time of the supplements in the human body.
We discovered that all supplements were changed to a range of different Cr(III) species in both the GI tract and the blood.1,2 Common species were observed, but the rates at which they formed were dependent on the nature of the chromium(III) supplement. Both the supplements themselves and the chromium(III) species that formed in blood serum were partially oxidised to Cr(VI) at concentrations of the oxidant, hydrogen peroxide (a type of bleach), found in the blood of people with type II diabetes.1,2 One of the clinical features of patients with type II diabetes is increased levels of oxidants, such as hydrogen peroxide, in their blood and cells. These oxidants are associated with many of the side-effects of type II diabetes that are associated with reduced life expectancy.
These transformed chromium(III) species bound to blood proteins were more easily oxidised to chromium(VI) than the administered Cr(III) supplements. The faster a particular chromium(III) supplement reacted with blood proteins to form these easily oxidised chromium(III)-protein species, the more active was the Cr(III) supplement in its anti-diabetic activity in animal and human studies reported by other groups.1-5 According to many health and regulatory bodies, chromium(III) has minimal or no efficacy in glucose metabolism and no other beneficial effects, such as weight loss or muscle building, in well conducted human and animal trials with non-diabetic subjects. This is consistent with our proposed mechanism of action. It is only under oxidising physiological conditions associated with type II diabetes that chromium(III) can be partially transformed to sufficient concentrations of carcinogenic chromium(VI) to enable significant biological activity. In a large clinical trial where diabetic patients were treated with high doses of chromium(III) picolinate (one of the least efficacious supplements in animal studies), there was no efficacy in patients with controlled type II diabetes. Only those patients with uncontrolled type II diabetes exhibited improved glucose metabolism. These patients, who have the highest concentrations of oxidants with the ability to transform chromium(III) to chromium(VI) in blood, are therefore at the greatest risk of developing Cr-induced cancers. Even where efficacy was observed, glucose metabolism was only reduced to the levels in patients with controlled type II diabetes; i.e., no patients exhibited a return to normal glucose metabolism.4,5
Coupled with all of this information our separate studies showed that chromium(VI) and chromium(V), but not chromium(III), are strong inhibitors of protein tyrosine phosphatase (PTP) enzymes. The relevance of this is that drugs that inhibit PTPs activate circulating insulin in people with type II diabetes. That is, it causes insulin to bind more strongly to cells involved in glucose metabolism (such as fat cells) to bring about the cascade of biochemical reactions that import glucose into cells and metabolise it.1-5
Thus we were able to link all of the animal, human and in vitro studies to show that physiological conditions under which chromium(III) had the highest probability of being transformed to chromium(VI) were also those in which chromium(III) supplements were most active.1-5 Moreover, we were able to provide a mechanism of activity that required chromium(VI) and chromium(V) to be generated for insulin enhancing activity.1-5 What remained was to establish whether we could observe Cr(VI) and Cr(V) in cells treated with chromium(III) supplements. This has now been established in our most recent study6 that have just been published. Contrary to the press releases of the dietary supplement industry, the published paper was carefully planned to mimic those conditions found in vivo. The chromium(III) supplement chosen was that which had a chemical structure most closely resembling those generated in blood plasma. Thus we were able to complete the circle in linking our extensive studies on the biochemistry of chromium(III) species generated from chromium(III) supplements in the blood and show that such species were absorbed by the relevant cells and partially oxidised to chromium(VI) and chromium(V).
Prof. Keast[/caption]
MedicalResearch.com Interview with:
Russell Keast Ph.D., CFS Professor
Centre for Advanced Sensory Science (CASS)
School of Exercise and Nutrition Sciences, Faculty of Health
Deakin University
Melbourne Burwood Campus
Burwood, VIC 3125
Medical Research: What is the background for this study? What are the main findings?
Dr. Keast: Fatty acids are detected at various stages of food consumption and digestion via interactions with nutrient receptors upon the tongue and within the gastrointestinal (GI) tract. This chemoreception initiates functional responses, i.e., taste perception, peptide secretion and alterations in GI motility that play a fundamental role in food consumption, hedonics and satiety. In obesity, both GI and taste detection of fatty acids is attenuated and this may predispose individuals to increased consumption of high-fat foods, or foods containing greater concentrations of fat. In other word overweight and obese people are less sensitive to fat and this is associated with overconsumption of fatty foods leading to weight gain.
Kawther Hashem[/caption]
MedicalResearch.com Interview with:
Kawther Hashem MSc RNutr (Public Health)
Nutritionist and Researcher
Action on Sugar
Wolfson Institute of Preventive Medicine,
Queen Mary, University of London
London UK
Medical Research: What is the background for this study? What are the main findings?
Response: The calculations showed that a 40% reduction in free sugars added to Sugar Sweetened Beverages (SSBs) over five years would lead to an average reduction in energy intake of 38 kcal per day by the end of the fifth year. This would lead to an average reduction in body weight of 1.20kg in adults, resulting in a reduction in overweight and obese adults by approximately half a million and 1 million respectively. This would in turn prevent between 274,000-309,000 obesity-related type 2 diabetes over the next two decades. Policies such as this will reduce cases of overweight and obesity and type 2 diabetes, this will have a major clinical impact and reduce healthcare costs.
Dr. Dalane Kitzman[/caption]
MedicalResearch.com Interview with:
Dalane W. Kitzman, M.D.
Professor, Cardiology
Sticht Center on Aging
Gerontology and Geriatric Medicine
Translational Science Institute
Wake-Forest Baptist Health
Winston-Salem, NC
Medical Research: What is the background of the research?
Dr. Kitzman: Heart Failure With Preserved Ejection Fraction (HFPEF) is a relatively recently recognized disorder. It used to be thought that it was rare. However, we now realize that HFPEF is the dominant form of heart failure in America. It is also the fastest growing cardiovascular disorder. Interestingly, this disorder occurs almost exclusively among older persons, particularly women. The need is great because outcomes in persons with HFPEF (death, rehospitalization, health care costs) are worsening. This stands in contrast to most other cardiovascular disorders which are on the decline and / or are experiencing greatly improved outcomes. Remarkably, all of the large studies that have used medications in HFPEF that seemed they should be ‘sure bets’ showed no benefit for their primary outcomes. Thus, this is also the only major cardiovascular disorder where there is no proven medication treatment. That means physicians take ‘educated guesses’ in choosing treatment for this large group of patients.
The main symptom in patients with chronic HFPEF is shortness of breath and and fatigue with exertion. We showed in 2002 in JAMA that when we objectively measured this symptom with expired gas analysis (Peak VO2), this was as severely decreased in HFPEF as in patients with HFREF (severely reduced EF), the classic, well accepted form of heart failure. That and other studies helped lead to acceptance of HFPEF as a true Heart Failure disorder.
We first showed 5 years ago that 4 months of exercise training improves peak VO2 and quality of life in patients with HFPEF. In fact, exercise remains the only proven means to improve these patients’ chronic symptoms.
The goal of our study was to determine if weight loss diet also improved peak VO2 and quality of life in HFPEF patients, alone and in combination with exercise training. This was based on the under-recognized fact that over 80% of Heart Failure With Preserved Ejection Fraction patients are overweight or obese. It was already known that weight loss diet in other groups of older persons improves peak VO2 and quality of life. And small studies of weight loss surgery in the other form of HF (HFREF) suggested that weight loss can improves symptoms, peak VO2, and quality of life. However, there had never been a study of weight loss, by diet or other means, in HFPEF. In fact, it had been thought, based on observational data, that weight loss diet might be contraindicated in HFPEF.
So we recruited 100 overweight / obese patients age 60 years and older with this disorder from our community; 80% were women. The exercise was standard exercise training that we’d previously shown was effective. The meals for the weight loss diet were prepared in our metabolic kitchen by a regisered dietition. Patients made out menus selecting preferred foods. Well balanced, healthy, nutritious, but very palatable. The portions were controlled so that there was a 350 caloric deficit per day deficit, on average. Pateints made their own breakfast with guidance, unlimited of certain fruits and vegetables, and occasional “free days”, such as for holidays. Patients loved the meals and wanted to continue after the 5 month study.