How Related Are Weight And Health?
August 14, 2008
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The conventional wisdom is that if you are normal sized you are healthy and if you are overweight you are unhealthy. However, a recent analysis has suggested that it is not that simple and that weight and health may not be related in a straightforward way.
More data from NHANES (National Health and Nutrition Examination Survey) suggests that some “normal weight” people are unhealthy and that some people considered overweight do not have signs of cardiac disease or other diseases that have been conventionally associated with obesity.
Of course being thin has never necessarily meant healthy. For instance, my mother who suffers form Crohn’s disease is thin due to her disease. However, in this analysis of the NHANES surveys, of those with normal weight there were a significant proportion who had what the authors called “metabolic markers of obesity”.
What were considered to be metabolic markers of obesity? They included high blood pressure, elevated triglycerides, high fasting blood glucose, high levels of C reactive protein (hsCRP) and low levels of HDL (the good) cholesterol.
The proportion of normal weight people with these markers increased with age, from 10.3% for ages 20 to 24 years , 16.9% between 35 and 49 years, 41.7% between 50 and 64 years, 54.7% between 65 and 79 years, and 56.2% 80 years and older.
Conversely, for those considered overweight and would be expected to have the metabolic markers, there were many who were in the optimal range. Healthy levels of the markers decreased with age, but represented a substantial proportion of the survey participants. The ranges were 47.7% between 20 and 34 years, 31.1% between 35 and 49 years, 20.4% between 50 and 64 years, 14.3% between 65 and 79 years, and 22.1% 80 years and older.
This sort of goes against what we are told. It will be interesting to see how the discussion of the data develops. The data does suggest that you need to go and get tested for cholesterol, glucose, triglycerides etc, whatever your size. Find out what your numbers are, then go from there.
Technorati Tags: weight, metabolic, obesity, NHANES
Popularity: 11% [?]
Low Fat vs. Low Carb vs. Mediterranean Diet
July 19, 2008
A new study compared low fat, low carb and Mediterranean diets. The findings were that those on the low carb and Mediterranean diets, lost more weight and had more improved cholesterol and triglyceride levels, than those on the low fat diet.
The study was conducted at a remote nuclear facility in Israel, so there was control over the diets of the participants. There were many more men than women in the study, so the findings for women may be less general. The low fat and Mediterranean were calorie restricted, the low carb diet was not calorie restricted.
All dieters lost weight, but those on the low fat diet lost the least. Men lost most on the low carb diet, whereas women lost most on the Mediterranean diet.
HDL cholesterol (the good cholesterol) increased most on the low carb diet, closely followed by the Mediterranean diet and the worst was the low fat diet. LDL cholesterol (the bad cholesterol) decreased the most on the Mediterranean diet, the low carb diet was intermediate and there was only a small decrease on the low fat diet. Triglycerides dropped most with the low carb diet, the Mediterranean diet had a slightly small drop and the low fat diet had a much smaller drop.
These results suggest that low carb and Mediterranean diets may be more effective than a low fat diet both for weight loss and improving cholesterol and triglyceride levels.
Since the low carb and Mediterranean diets are almost equally effective, then choosing the diet that suits your tastes and lifestyle, is going to be what is most successful.
The study is published in the New England Journal of Medicine 359:229-241, 2008.
photo credit: sethschoen
[tags]low fat, low carb, Mediterranean, diet, weight, cholesterol, triglycerides[/tag]
Popularity: 33% [?]
Worms: The Answer To Immune Problems?
July 3, 2008
There have been several articles recently about how worms may be good for you, not the kind in the soil but those that are parasites in the human body. The idea is that worms (helminths) may help calm the immune system.
What makes the perfect parasite? For those that want to survive in the body, it is stopping the body responding and attacking you, or trying to get rid of you. A happy parasite wants a happy host.
Further some organisms end up in a symbiotic relationship. Symbiosis is often defined as a relationship where there is benefit to both participants.
So what do immune-dreived health problems have to do with worms?
In order to stay in the digestive tract many worms suppress parts of the immune system. This way the body does not try to attack the worms. So when infected with worms the body will turn down some (but not all) immune responses. This is not a new idea, it has been known for quite a while.
What is new is the suggestion the body got used to having the worms and was in balance with them. So that in modern times with improvements in sanitation and medication, when we lost our worms our immune systems got out of whack and in some people got revved up. In other words perhaps it was of a symbiotic relationship, beneficial to all.
Why has this new idea been proposed?
One thing that everybody agrees on is that in recent times there has been a huge increase in immune diseases ranging from hay fever to inflammatory bowel disease. These are all diseases where the immune system becomes more active.
So, of course, this leads to the question, why has there been this very sudden increase in a wide range of immune diseases?
There are all kinds of theories. One is the hygiene hypothesis. The idea is that being no longer exposed to certain bacteria, fungi, worms etc., that our immune systems are not trained properly, and may in many people get out of control.
One of the first demonstrations of role of worms was the experimental infection of 29 patients with active Crohn’s disease (an inflammatory bowel disease) with pig whipworm. An amazing 23 patients showed improvement, with 21 of these going into remission. Gut 54:87-90, 2005 (PubMed). Later studies have shown good results with ulcerative colitis, another inflammatory bowel disease.
Are we going to be getting worm egg prescriptions in the future? Unlikely. There is now a push to find the range of mechanisms that the worms use to suppress the human responses. It is very likely that drugs based on this knowledge will be tested for use on many diseases that have an inflammatory component. These will include hay fever, asthma, eczema, multiple sclerosis and the inflammatory bowel diseases. It will also include diseases that you might not realize involve immune responses such as diabetes and atherosclerosis (blocking of arteries).
photo credit: moneydick The image is of Caenorhabditis elegans a harmless roundworm that lives in the soil.
Technorati Tags: worms, helminths, parasite, allergy, inflammatory disease, Crohn’s
Popularity: 38% [?]
Foods You Should Be Eating?
July 1, 2008
The NY Times today has a list of 11 foods that you should be eating, but likely are not. How many do you eat?
They are 1) beets, 2) cabbage, 3) chard, 4) cinnamon, 5) pomegranate juice, 6) dried plums (newish name for prunes), 7) pumpkin seeds, 
turmeric*, 9) sardine, 10) frozen blueberries and 11) canned pumpkin.
I didn’t do very well. I regularly eat cabbage, chard, pomegranate juice, frozen blueberries and canned pumpkin. I loathe beets, so maybe for me the list should be 10. I am not very keen on sardines but will eat them. Perhaps I can find some way to disguise them a bit.
I started to buy canned pumpkin for the dog. It is good for dogs to get a dollop a day, particularly when they are getting old and/or have a significant part of their diet as raw meat, offal etc. They benefit from beta carotene too. So I usually have a dish of canned pumpkin (don’t leave in the can) in the fridge and often add a human dollop or two, to stews etc.
Wasn’t too keen on chard until one day I tried removing the stems, chopping them into about 1 inch lengths and frying them for a good few minutes before adding the wet leaves. Shame it is not cheaper.
Pomegranate juice and vodka is pretty good.
Between them these foods have a whole range of benefits such as anti-cancer, anti-inflammatory, antioxidants, lower cholesterol, improve diabetes, etc. See the article or more info.
So, I guess next time I go to the store, I might buy some prunes and pumpkin seeds and at home will cook with more cinnamon and turmeric. Will have to think about the sardines.
* I have no idea where the happy face came from and why it replaced number eight. Deleting and retyping the text surrounding it does not help, it pops back up again instead of 8). I usually type the posts in Word and then copy and paste. Probably some weird piece of code that came from Word.
Technorati Tags: beets, pomegranate, chard, canned pumpkin
Popularity: 45% [?]
LDL Cholesterol Lowering Drugs: The Statins
June 20, 2008
Continuing from yesterday’s theme, I thought I would write a short explanation of the statin family of drugs, that are used for treating bad levels of cholesterol. Statins are the most prescribed drugs in the US. In fact, Atorvastatin (Lipitor), much of the time, has been the most prescribed drug for the last couple of years. (It was toppled by Viagra for a while, but came back.)
It is important to remember that your body has to have cholesterol. The major uses are; as part of the membranes of cells, and in the formation of a number of hormones.
No matter how much cholesterol you eat, your body (mainly the liver) will always make some cholesterol.
LDL (low density lipid) cholesterol contains cholesterol that is made by, or reprocessed by the liver. It is transported by the blood throughout the body, and cells that need some cholesterol will take what they need from the blood. So you need to have LDL cholesterol circulating in your blood. It is just that when there is too much that there may be problems.
Currently, the standard for treating high LDL cholesterol levels are the statins. The statins include lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), atorvastatin (Lipitor) and rosuvastatin (Crestor). The first name of each pair is the name of the drug, the second name in brackets is the commercial name for that drug. Yesterdays post about red yeast rice involves lovastatin.
These drugs are all inhibitors of the enzyme HMG CoA reductase. This enzyme is a major enzyme in the process of making of cholesterol by cells. When the enzyme is inhibited, cells in the body make less cholesterol. Then, when the cells get short of cholesterol they start to take up cholesterol from the blood to meet their requirements, then the level of LDL cholesterol in the blood drops.
(Statins are thought to have a number of other good effects too, independent of their cholesterol lowering ability. These are wide ranging and the subject of much research and controversy.)
To summarize, statins decrease the amount of cholesterol that the body can make, so then to meet requirements cells take up LDL cholesterol from the blood, which cause the level of LDL cholesterol in the blood to decrease.
photo credit: tellumo The sign is in Sausalito.
Technorati Tags: cholesterol, LDL cholesterol, drug, statin, lovastatin, atorvastatin, Lipitor
Popularity: 33% [?]
Red Yeast Rice For Cholesterol Lowering?
June 18, 2008
There has been quite a bit of news lately about red yeast rice and its use for lowering cholesterol. The short answer is yes red yeast rice can lower cholesterol. However, there are some important considerations when deciding whether to use this supplement for cholesterol lowering.
What is red yeast rice?
This is rice that has been mixed with red yeast (Monascus pupureus) and allowed to ferment. The resulting fermentation products include a group of substances that have cholesterol lowering ability. One of these substances is the compound known as monacolin K, also known as lovastatin (Mevacor). Lovastatin was the first of the prescription statins available for lowering cholesterol. The commercial synthesized statins also include Zocor, Lipitor, Pravachol, Lescol and Crestor.
What are the potential problems with taking red yeast rice?
Some brands do not control (or measure) the amount of the active ingredient. Different batches may have almost none, or huge doses of monacolin K. Almost none is obviously not going to be any help with lowering cholesterol. Too much can result in muscle damage, also known as myopathy. (PubMed)
If the red yeast rice fermentation is not properly controlled there can be harmful products made too. When a number of red yeast rice preparation were tested some of them contained citrinin, which is a toxin that will damage your kidneys. (PubMed above)
Red yeast rice can have interactions with other medications. Some which will increase the risk of muscle damage or other side effects. This list of medications that potentially may result in side effects includes all drug interactions and cautions listed for lovastatin. As with the commercial cholesterol lowering statins Mevacor, Zocor and Lipitor, no grapefruit or grapefruit-containing products should be consumed. Grapefruit, also, increases the risk of muscle damage. If you are taking any other medications fully investigate whether combined with red yeast rice there may be side effects.
The FDA has banned some brands of red yeast rice products. However, it is likely in the future that products with strict manufacturing guidelines and extensive analysis will eventually be available.
As always caveat emptor (buyer beware).
Technorati Tags: red yeast rice, lovastatin, citrinin, cholesterol lowering
Popularity: 37% [?]
Japan Aims To Measure 56 Million Waists
June 16, 2008
Japan now has a national law that all adults between 40 and 72 must have their waists measured. This is 56 million waists, or 44% of the population. Those whose waists are too big will get diet and exercise advice, and follow-up visits.
Like all countries Japan is concerned about the expanding waistlines of the population. The national program is an attempt to see if they can stop and reverse the trend. Read the good article about this in the NYTimes health section.
The article describes how the Japanese Health Ministry started to educate the populace about metabolic syndrome [where a person has 3 or more of the following, high levels of blood glucose, high levels of triglycerides, low levels of HDL (good) cholesterol, high blood pressure, abdominal obesity] several years ago. The aim being to try make sure that everybody knows about metaobolic syndrome.
The name metabolic syndrome was shortened to “Metabo”. Apparently there are anti-Metabo songs, one of which includes “the warning against trouser buttons popping and flying away”.
I think Japan is to be congratulated for trying to do something about the growing problem (pun intended), before it becomes very serious. Investment now in the program may save them a lot of money in healthcare costs down the road.
An important question that may be answered by this is whether a program such as this one, actually has any effect on peoples behavior and whether in the long run it will make any difference at-all. Will Japan fall prey to the scourge of Metabo?
Technorati Tags: Japan, waists, metabolic syndrome, metabo
Popularity: 38% [?]
Garlic for Blood Pressure, Heart Disease, Stroke, Diabetes And Antioxidant Status
May 15, 2008
Garlic has long been known to be good for you. In the last few years it has been demonstrated that it may play a beneficial role in many aspects of health including lowering blood pressure, reducing the risk of heart attack and stroke, and improving antioxidant status.
Garlic has been shown recently to decrease blood pressure and to help lessen the risk of heart attack. The decrease in blood pressure is due to widening of the inside of blood vessels which makes the pressure drop.
There are several reasons why garlic may reduce both stroke and heart disease risk. One potential reason is that the antioxidant properties may reduce the oxidation of blood lipids, leading to a reduction in the rate of development of atherosclerosis (blocking of arteries). We are all developing atherosclerosis, so the aim is to make it slow enough that it never has any health impact. Garlic has also been shown to lower the level of platelet aggregation. Platelets are cells that circulate in the blood that are involved in clot formation, by sticking together and to cells in the walls of blood vessels. Lowering the level of platelet aggregation reduces the formation and growth of clots, which in turn lowers the risk of heart attack and stroke.
Garlic has several other suggested health benefit including reducing inflammation, neurodegeneration (including possibly Alzheimer’s), diabetes and cancer. It has been suggested that garlic can reduce blood sugar levels.
To get the most benefit from garlic it should be “aged”. This means that garlic should be crushed and then left for 10 to 15 minutes before use. The reason for this is that when the garlic cells are broken by crushing, an enzyme is released that converts alliin to allicin. Leaving the crushed garlic for a while gives the enzyme time to work. It is allicin that our body uses either directly or indirectly for most of the health benefits.
Eat more garlic!
Technorati Tags: garlic, allicin, blood pressure, heart disease, stoke, diabetes, antioxidant
Popularity: 86% [?]
Occasional Short Fasts May Be Healthy
May 5, 2008
Recent research has shown that short occasional fasts may have health benefits. Evidence is suggesting the controlled brief fasting may actually be good for you.
It may be that our bodies have developed to expect intermittent periods of time without food. Our prehistoric ancestors would have had periods when there was little food available. The occasional lack of food may have been important in how our physiological mechanisms developed.
Researchers studying members of the Church of Latter Day Saints have found that those members who fasted once per month had a lower risk of cardiovascular disease, than either members who did not fast or non-members.
One possible explanation is that when the body does not receive any food, that various control mechanisms in the body reset.
For instance many people who have metabolic syndrome have increased levels of glucose circulating in their blood. The body has become less able to regulate glucose levels and keep them in a normal range. This is not good since higher levels of blood glucose are associated with an increased rate of atherosclerosis and a greater risk of cardiovascular disease. It may be that when there is no food eaten that the glucose level drop for a period of time that the body resets the mechanisms for sensing and controlling glucose.
How often and how long to fast? The church members fasted once a month and missed two meals. Probably a fast should not be longer than a day and liquids with no calories such as water and tea should be consumed.
Technorati Tags: fasting, glucose, heart disease
Popularity: 51% [?]
Daily Aspirin – Some New Benefits
May 2, 2008
Aspirin and aspirin-like compounds (i.e. derivatives of salicylic acid) have a number of health benefits. Two new potential benefits are reducing the risk of a type of breast cancer and increasing insulin secretion.
Aspirin has long been used for mild to moderate pain relief. It is commonly used for pain relief for headaches and for as anti-inflammatory particularly for joint conditions.
For a number of years, low dose aspirin has been recommended for those with cardiovascular disease including stroke and angina. Aspirin is a platelet aggregation inhibitor. Blood clots form when platelets release clotting factors and aggregate (clump together). Blood clots can cause heart attacks and some types of stroke, so reduction in clotting ability of the blood is protective. Therefore, taking aspirin will reduce the likely hood of clots forming.
Recent research suggests that daily aspirin may reduce the risk of estrogen-sensitive breast cancer. There are different types of breast cancer. The most common is estrogen receptor-positive breast cancer, accounting for about three quarters of diagnoses. The reduction in risk was only seen with aspirin and not other NSAIDS (non-steroidal anti-inflammatory drugs, i.e. painkillers).
The other study looked an aspirin-like drug on healthy obese individuals. Those that took the drug daily produced more insulin. Being overweight increases the risk of getting diabetes. Those with type 2 diabetes produce less insulin, become insulin resistant (insulin is not as effective) or do both. An increase in the level of insulin will benefit all diabetics since it help with both less insulin production or resistance. Aspirin had previously been shown to reduce glucose levels in diabetic patients.
Of course aspirin and related compounds can have negative side effects including stomach bleeding, gastrointestinal ulceration and tinnitus (ringing in the ears). Talk to your physician if you think you might want to start taking aspirin regularly.
photo credit: greefus groinks
Technorati Tags: aspirin, salicylic acid, breast cancer, diabetes
Popularity: 46% [?]
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