michael.massing + peer-reviewed + research   741

Increasing Adiposity | Lifestyle Behaviors | JAMA | The JAMA Network
Ninety years ago, an editorial in JAMA questioned the prevailing approach to obesity treatment: “When we read that ‘the fat woman has the remedy in her own hands—or rather between her own teeth’ . . . there is an implication that obesity is usually merely the result of unsatisfactory dietary bookkeeping. . . [Although logic suggests that body fat] may be decreased by altering the balance sheet through diminished intake, or increased output, or both . . . [t]he problem is not really so simple and uncomplicated as it is pictured.”1 Since then, billions of dollars have been spent on research into the biological factors affecting body weight, but the near-universal remedy remains virtually the same, to eat less and move more. According to an alternative view, chronic overeating represents a manifestation rather than the primary cause of increasing adiposity. Attempts to lower body weight without addressing the biological drivers of weight gain, including the quality of the diet, will inevitably fail for most individuals. This Viewpoint summarizes the evidence for this seemingly counterintuitive hypothesis, versions of which have been debated for more than a century.2
fat  management  control  carbohydrates  insulin  high  glycemic  processed  food  peer-reviewed  research  correlation  causation  diet  foods 
5 weeks ago by Michael.Massing
Always Hungry? Here’s Why - The New York Times
As it turns out, many biological factors affect the storage of calories in fat cells, including genetics, levels of physical activity, sleep and stress. But one has an indisputably dominant role: the hormone insulin. We know that excess insulin treatment for diabetes causes weight gain, and insulin deficiency causes weight loss. And of everything we eat, highly refined and rapidly digestible carbohydrates produce the most insulin.
fat  management  control  carbohydrates  insulin  high  glycemic  processed  food  peer-reviewed  research  correlation  causation  diet  foods 
5 weeks ago by Michael.Massing
Think you know why obesity rates are rising? You’re probably wrong. | Public Health
Work isn’t taking time away from cooking: We’re actually working fewer hours; what’s increased is leisure time and transportation time.

We may be exercising more. Four minutes more per day in 2012 than in 2003, although that’s self reported. The authors also believe a decline in physically demanding work doesn’t account for obesity rates, since obesity has risen equally among all groups, including children.

Food isn’t too expensive. Or at least, we’re only spending less than 10% of our income on it, compared to 20% in the 1950s and 25% in the 1930s (which is comparable to medium-income countries today). The implication: we could afford to spend more on food, we just don’t want to.

We’re eating lots of fruit and veggies. Now, it’s not enough to meet guidelines (in fact, even if we ate all the veggies produced in the US, we still wouldn’t meet the guidelines). But fruit and vegetable availability has increased over time, and consumption has been relatively steady.

It’s not food deserts. Low-income neighborhoods have fewer supermarkets, but distance to a supermarket doesn’t correlate with obesity or the quality of a person’s diet. When a new supermarket opens, residents’ fruit and vegetable consumption doesn’t change.

It could be TV and video games. That fits the time trend; they specifically track the introduction of VCRs.

It could be sodapop. Consumption of sugar-sweetened beverages is going up and up, and the timing is right.

Or carbs in general. The authors don’t dig into this one, but see this JAMA article (or the accompanying NYT op-ed) for an explanation. Carbs promote insulin which promotes hunger and weight gain. And back to the economists, they point out that carb intake increased most sharply during the 1980s focus on lowering dietary fat.
obesity  correlation  causation  trend  peer-reviewed  research  public  health  epidemiology  earnest 
5 weeks ago by Michael.Massing
Do multivitamin supplements increase mortality risk? | Public Health
An unescapable facet of public health is that we lumber forward with our scientific methods in an inescapable fight against powerful industries that produce the conditions in which ill-health forms and is reproduced.
vitamin  supplements  benefit  mortality  risk  peer-reviewed  research 
5 weeks ago by Michael.Massing
Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. - PubMed - NCBI
9 of 11 trials testing high-dosage vitamin E (> or =400 IU/d) showed increased risk (risk difference > 0) for all-cause mortality in comparisons of vitamin E versus control. The pooled all-cause mortality risk difference in high-dosage vitamin E trials was 39 per 10,000 persons (95% CI, 3 to 74 per 10,000 persons; P = 0.035). For low-dosage vitamin E trials, the risk difference was -16 per 10,000 persons (CI, -41 to 10 per 10,000 persons; P > 0.2). A dose-response analysis showed a statistically significant relationship between vitamin E dosage and all-cause mortality, with increased risk of dosages greater than 150 IU/d.
High-dosage (> or =400 IU/d) trials were often small and were performed in patients with chronic diseases. The generalizability of the findings to healthy adults is uncertain. Precise estimation of the threshold at which risk increases is difficult.
High-dosage (> or =400 IU/d) vitamin E supplements may increase all-cause mortality and should be avoided.
vitamin  E  mortality  risk  dosage  dose-dependent  peer-reviewed  research 
5 weeks ago by Michael.Massing
Is Sexual RacismReallyRacism? Distinguishing Attitudes Toward Sexual Racism and Generic Racism Among Gay and Bisexual Men | SpringerLink
Sexual racism is a specific form of racial prejudice enacted in the context of sex or romance. Online, people use sex and dating profiles to describe racialized attraction through language such as “Not attracted to Asians.” Among gay and bisexual men, sexual racism is a highly contentious issue. Although some characterize discrimination among partners on the basis of race as a form of racism, others present it as a matter of preference. In May 2011, 2177 gay and bisexual men in Australia participated in an online survey that assessed how acceptably they viewed online sexual racism. Although the men sampled displayed diverse attitudes, many were remarkably tolerant of sexual racism. We conducted two multiple linear regression analyses to compare factors related to men’s attitudes toward sexual racism online and their racist attitudes more broadly. Almost every identified factor associated with men’s racist attitudes was also related to their attitudes toward sexual racism. The only differences were between men who identified as Asian or Indian. Sexual racism, therefore, is closely associated with generic racist attitudes, which challenges the idea of racial attraction as solely a matter of personal preference.
sexual  racism  gay  community  ethos  mores  Australia  correlation  peer-reviewed  research  self-esteem  internalized 
8 weeks ago by Michael.Massing
Sexual racism in gay communities: negotiating the ethnosexual marketplace
This qualitative study was an in-depth examination of sexual racism (i.e., racism occurring in sexual contexts) within the gay community of the Seattle metropolitan area. Data was collected through key informant interviews and focus groups with self-identified gay Asian/Pacific Islander, African American/Black, and White men. Data analyses using a grounded theory approach revealed a variety of social locations in which sexual racism manifests including the internet, pornographic media, gay clubs and bars, casual/anonymous sexual encounters, and romantic relationships. Within these locations, sexual racism was reported to take different forms, manifesting as ethnosexual stereotypes, racial fetishism, and race-based sexual rejection. Participants of color identified internalized sexual racism, decreased self-esteem, and psychological distress as the primary psychological consequences of sexual racism. The data analyses revealed quantitatively and qualitatively distinct racial pressures operating in the gay community in Seattle. Participants estimated that compared to the heterosexual community, their gay community was more racially stratified and exhibited higher rates of sexual racism. They described the uniquely sexual basis of racial stereotypes and pointed to a skewed set of social norms operating in the gay community which allow greater expression of sexual racism than in the heterosexual community. Finally, the data revealed key differences in the psychological impact of sexual racism reported by Asian and Black gay men. An emergent hypothesis is presented outlining the relationships between experienced sexual racism and its sequelae, as well as protective factors. Theoretical, research, and clinical implications are discussed.
sexual  racism  gay  community  ethos  mores  US  Seattle  peer-reviewed  research  self-esteem  internalized 
8 weeks ago by Michael.Massing
Persistence of the efficacy of zoster vaccine in the shingles prevention study and the short-term persistence substudy. - PubMed - NCBI
In the STPS as compared to the SPS, vaccine efficacy for HZ burden of illness decreased from 61.1% to 50.1%, vaccine efficacy for the incidence of PHN decreased from 66.5% to 60.1%, and vaccine efficacy for the incidence of HZ decreased from 51.3% to 39.6%, although the differences were not statistically significant. Analysis of vaccine efficacy in each year after vaccination for all 3 outcomes showed a decrease in vaccine efficacy after year 1, with a further decline thereafter. Vaccine efficacy was statistically significant for the incidence of HZ and the HZ burden of illness through year 5.
shingles  prevention  study  followup  short-term  persistence  herpes  zoster  vaccine  efficacy  peer-reviewed  research 
april 2017 by Michael.Massing
Salacia reticulata (Kothala himbutu) revisited; a missed opportunity to treat diabetes and obesity?
The evidence available from animal and human studies point towards effective reduction of plasma glucose and weight in SR treated subjects. Alpha glucosidase inhibition is the most likely mechanism for the reduction of postprandial glucose. Reduction of fasting glucose, improvement in glucose handling following glucose loading and weight is most likely explained by decreased insulin resistance mediated through increasing adiponectin, suppression of lipogenesis and increased lipolysis.

Meticulously planned studies both animal and human, addressing the unresolved issues as well as studies that involve larger number of human subjects specifically addressing long-term outcomes and safety of SR treatment needs to be performed in the future.
Salacia  reticulata  diabetes  glucose  blood  insulin  postprandial  plasma  HbA1c  serum  lipids  peer-reviewed  research  in  vivo  vitro  clinical  human  body  fat  management  review  overview 
april 2017 by Michael.Massing
Anti-diabetic and Anti-hyperlipidemic Effects and Safety of Salacia reticulata and Related Species. - PubMed - NCBI
Extracts of Salacia reticulata Wight (Hypocrataceae) roots, stems, and leaves have been used in Asia for hundreds of years for the folkloric treatment of diabetes and other health problems. Constituents that have been identified as exhibiting anti-diabetic effects include salacinol, kotalanol, ponkorinol, salaprinol, and their corresponding de-0-sulfonated compounds. Mangiferin, kotalagenin 16-acetate and various proanthocyanidin oligomers have also been isolated. Studies indicate that Salacia extracts modulate multiple targets that influence carbohydrate and lipid metabolism including α-glucosidase, aldose reductase, pancreatic lipase, peroxisomal proliferator-activated receptor-α, glucose transporter-4 mediated glucose uptake, and angiotensin II type 1 receptor. Furthermore, Salacia extracts exhibit free radical scavenging, antioxidant and hepatoprotectant activities. In human studies, Salacia extracts have been shown to decrease plasma glucose and insulin levels, decrease HbA1c, and modulate serum lipid levels with no adverse effects being reported. Similar results have been demonstrated in rat and mouse models as well as in vitro systems. Safety of S. reticulata and other Salacia species as S. oblonga and S. chinensis in rats and mice indicate that extracts are exceedingly safe. No clinical studies have examined the effects of Salacia extracts on human weight loss, although weight loss and decreases in weight gain have been demonstrated in animal models. Because of the large number of pharmacologically active compounds, it is difficult to establish standards for extracts.
Salacia  reticulata  diabetes  glucose  blood  insulin  postprandial  plasma  HbA1c  serum  lipids  peer-reviewed  research  in  vivo  vitro  clinical  human  body  fat  management 
april 2017 by Michael.Massing
Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study
Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks.

At week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction (p < 0.05) and attachment gain (p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group.

The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.
periodontitis  scaling  root  planing  SRP  Lactobacillus  reuteri  probiotic  adjunct  therapy  peer-reviewed  research 
april 2017 by Michael.Massing
The Obesity-Impulsivity Axis: Potential Metabolic Interventions in Chronic Psychiatric Patients. - PubMed - NCBI
Recently, a strong association was found between impulsivity and obesity which may explain the high prevalence of metabolic disorders in individuals with mental illness even in the absence of exposure to psychotropic drugs. As the overlapping neurobiology of impulsivity and obesity is being unraveled, the question asked louder and louder is whether they should be treated concomitantly. The treatment of obesity and metabolic dysregulations in chronic psychiatric patients is currently underutilized and often initiated late, making correction more difficult to achieve. Addressing obesity and metabolic dysfunction in a preventive manner may not only lower morbidity and mortality but also the excessive impulsivity, decreasing the risk for aggression. In this review, we take a look beyond psychopharmacological interventions and discuss dietary and physical therapy approaches.
self  treatment  management  behavior  dietary  diet  intervention  correlation  obesity  impulsivity  impulse  control  metabolic  disorder  metabolism  mental  illness  neurobiology  peer-reviewed  research  aggression  physical  therapy 
april 2017 by Michael.Massing
A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving. - PubMed - NCBI
In a small pilot trial, patients with atypical depression demonstrated significant positive therapeutic response to chromium picolinate. This finding is of interest because of the demonstrated link between depression, decreased insulin sensitivity, and subsequent diabetes and chromium picolinate's insulin enhancing effect.
: In this double-blind, multicenter, 8-week replication study, 113 adult outpatients with atypical depression were randomized 2:1 to receive 600 mug/day of elemental chromium, as provided by chromium picolinate (CrPic), or placebo. Primary efficacy measures were the 29-item Hamilton Depression Rating Scale (HAM-D-29) and the Clinical Global Impressions Improvement Scale (CGI-I).
: Of the 113 randomized patients, 110 (70 CrPic, 40 placebo) constituted the intent-to-treat (ITT) population (i.e., received at least one dose of study medication and completed at least one efficacy evaluation) and 75 (50 CrPic, 25 placebo) were evaluable (i.e., took at least 80% of study drug with no significant protocol deviations). In the evaluable population, mean age was 46 years, 69% were female, 81% were Caucasian, and mean body mass index (BMI) was 29.7. There was no significant difference between the CrPic and placebo groups in both the ITT and evaluable populations on the primary efficacy measures, with both groups showing significant improvement from baseline on total HAM-D-29 scores during the course of treatment (p < 0.0001). However, in the evaluable population, the CrPic group showed significant improvements from baseline compared with the placebo group on 4 HAM-D-29 items: appetite increase, increased eating, carbohydrate craving, and diurnal variation of feelings. A supplemental analysis of data from the subset of 41 patients in the ITT population with high carbohydrate craving (26 CrPic, 15 placebo; mean BMI = 31.1) showed that the CrPic patients had significantly greater response on total HAM-D-29 scores than the placebo group (65% vs. 33%; p < 0.05) as well as significantly greater improvements on the following HAM-D-29 items: appetite increase, increased eating, carbohydrate craving, and genital symptoms (e.g., level of libido). Chromium treatment was well-tolerated.
: The study did not include a placebo run-in period, did not require minimum duration or severity of depression, and enrolled patients with major depression, dysthymia, or depression NOS.
: In a population of adults with atypical depression, most of whom were overweight or obese, CrPic produced improvement on the following HAM-D-29 items: appetite increase, increased eating, carbohydrate craving, and diurnal variation of feelings. In a subpopulation of patients with high carbohydrate craving, overall HAM-D-29 scores improved significantly in patients treated with CrPic compared with placebo. The results of this study suggest that the main effect of chromium was on carbohydrate craving and appetite regulation in depressed patients and that 600 mug of elemental chromium may be beneficial for patients with atypical depression who also have severe carbohydrate craving. Further studies are needed to evaluate chromium in depressed patients specifically selected for symptoms of increased appetite and carbohydrate craving as well as to determine whether a higher dose of chromium would have an effect on mood.
carbohydrate  craving  chromium  picolinate  peer-reviewed  research  depression  psychotropic  effects 
march 2017 by Michael.Massing
Dietary chromium supplementation for targeted treatment of diabetes patients with comorbid depression and binge eating. - PubMed - NCBI
Dietary chromium supplementation for the treatment of diabetes remains controversial. The prevailing view that chromium supplementation for glucose regulation is unjustified has been based upon prior studies showing mixed, modest-sized effects in patients with type 2 diabetes (T2DM). Based on chromium's potential to improve insulin, dopamine, and serotonin function, we hypothesize that chromium has a greater glucoregulatory effect in individuals who have concurrent disturbances in dopamine and serotonin function--that is, complex patients with comorbid diabetes, depression, and binge eating. We propose, as suggested by the collective data to date, the need to go beyond the "one size fits all" approach to chromium supplementation and put forth a series of experiments designed to link physiological and neurobehavioral processes in the chromium response phenotype.
chromium  picolinate  comorbidity  depression  T2D  type  2  diabetes  individual  response  variability  treatment  intervention  psychotropic  appetite  carbohydrate  craving  peer-reviewed  research  Plexus  opinion  overview 
march 2017 by Michael.Massing
Psychiatric Disorders and Polyphenols: Can They Be Helpful in Therapy? - PubMed - NCBI
The prevalence of psychiatric disorders permanently increases. Polyphenolic compounds can be involved in modulation of mental health including brain plasticity, behaviour, mood, depression, and cognition. In addition to their antioxidant ability other biomodulating properties have been observed. In the pathogenesis of depression disturbance in neurotransmitters, increased inflammatory processes, defects in neurogenesis and synaptic plasticity, mitochondrial dysfunction, and redox imbalance are observed. Ginkgo biloba, green tea, and Quercus robur extracts and curcumin can affect neuronal system in depressive patients. ADHD patients treated with antipsychotic drugs, especially stimulants, report significant adverse effects; therefore, an alternative treatment is searched for. An extract from Ginkgo biloba and from Pinus pinaster bark, Pycnogenol, could become promising complementary supplements in ADHD treatment. Schizophrenia is a devastating mental disorder, with oxidative stress involved in its pathophysiology. The direct interference of polyphenols with schizophrenia pathophysiology has not been reported yet. However, increased oxidative stress caused by haloperidol was inhibited ex vivo by different polyphenols. Curcumin, extract from green tea and from Ginkgo biloba, may have benefits on serious side effects associated with administration of neuroleptics to patients suffering from schizophrenia. Polyphenols in the diet have the potential to become medicaments in the field of mental health after a thorough study of their mechanism of action.
polyphenols  depression  psychotropics  treatment  peer-reviewed  research  overview  pycogenol  green  tea  extract  gingko 
march 2017 by Michael.Massing
Natural polyphenols in the management of major depression. - PubMed - NCBI
Natural polyphenols, the non-essential micronutrients, found in array of plant products, are known to affect various physiological and biochemical functions in the body. Studies have shown the protective effect of these polyphenols in different neurological and mental disorders. These polyphenols modulate monoaminergic neurotransmission in the brain and thus possess antidepressant-like activity at least in animal models of depression.
The present review discusses the use of these natural polyphenols in the treatment of major depression. The review article discusses the antidepressant potential of some important polyphenols such as amentoflavone, apigenin, chlorogenic acid, curcumin, ferulic acid, hesperidin, rutin, quercetin, naringenin, resveratrol, ellagic acid, nobiletin and proanthocyanidins. The mechanism of action of these polyphenols in the treatment of major depression is also discussed in detail.
There is an exciting prospect in the discovery of natural polyphenols as therapeutic agents in the treatment of major depression.
polyphenols  depression  psychotropics  treatment  peer-reviewed  research  chlorogenic  acid 
march 2017 by Michael.Massing
Dietary supplementation of n-3 PUFA reduces weight gain and improves postprandial lipaemia and the associated inflammatory response in the obese JC... - PubMed - NCBI
JCR:LA-cp rats (14 weeks of age) were fed either a control, isocaloric, lipid balanced diet (15% w/w total fat, 1.0% cholesterol, P:S ratio 0.4), a lipid balanced diet with 5% n-3 PUFA [fish oil derived eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA)] or a lipid balanced diet with 10% n-3 PUFA for 3 weeks. Fasting plasma lipid, cytokine levels, postprandial chylomicron (apoB48) metabolism and the postprandial inflammatory response [haptoglobin and lipopolysaccharide binding protein (LBP)] were assessed following a standardized 'oral fat challenge'.
n-3 PUFA treatment resulted in a significant improvement (i.e. decrease) in the postprandial response for triglyceride (45%) (p < 0.05), apoB48 (45%) (p < 0.03) and LBP (33%) (p < 0.05) compared to controls (measured as area under the clearance curve). In contrast, we observed a significant elevation in postprandial haptoglobin (165%) (p < 0.001) in obese rats supplemented with 10% n-3 PUFA. Treatment with 5% n-3 PUFA in the JCR:LA-cp obese animals resulted in a complementary decrease in total body weight gain (6%) (p < 0.001) and an increase (i.e. improvement) in adiponectin (33%) (p < 0.05) compared to controls, without a concomitant reduction in food intake.
Acute dietary n-3 PUFA dietary supplementation can improve fasting as well as postprandial lipid metabolism and components of the associated inflammatory response in the JCR:LA-cp rat. Further, moderate dose n-3 PUFA supplementation may reduce corresponding body weight during conditions of hypercholesterolaemia and/or modulate inflammation associated with obesity and the metabolic syndrome
fish  oil  omega-3  fatty  acids  EPA  DHA  peer-reviewed  research  overview  risk  benefit  diabetes  triglycerides  dyslipidemia  animal  in  vivo 
march 2017 by Michael.Massing
Effects of eicosapentaenoic acid (EPA) treatment on insulin sensitivity in an animal model of diabetes: improvement of the inflammatory status. - PubMed - NCBI
The major goal of this study was to analyze the effects of fatty acid supplementation on both insulin sensitivity and inflammatory status in an animal model of type 2 diabetes. Diabetic rats (Goto-Kakizaki model) were treated with eicosapentaenoic acid (EPA) or linoleic acid at 0.5 g/kg body weigh (bw) dose. In vivo incorporation of (14)C-triolein into adipose tissue was improved by the ω-3 administration. In vitro incubations of adipose tissue slices from EPA-treated rats showed an increase in (14)C-palmitate incorporation into the lipid fraction. These observations were linked with a decreased rate of fatty acid oxidation. EPA treatment resulted in a decreased fatty acid oxidation in incubated strips from extensor digitorum longus (EDL) muscles. The changes in lipid utilization were associated with a decrease in insulin plasma concentration, suggesting an improvement in insulin sensitivity. These changes in lipid metabolism were associated with an activation of AMP-activated protein kinase (AMPK) in white adipose tissue. In addition, EPA treatment resulted in a decreased content of peroxisome proliferator-activated receptor-α (PPARα) and PPARδ and in increased GLUT4 expression in skeletal muscle. Moreover, EPA increased 2-deoxy-D-[(14)C]glucose (2-DOG) uptake in C2C12 myotubes, suggesting an improvement in glucose metabolism. Concerning the inflammatory status, EPA treatment resulted in a decreased gene expression for both tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) both in skeletal muscle and adipose tissue. The data suggest that EPA treatment to diabetic rats clearly improves lipid metabolism although the evidences on insulin sensitization are less clear.
omega-3  fatty  acids  EPA  DHA  peer-reviewed  research  inflammation  benefit  diabetes  triglycerides  dyslipidemia  insulin  sensitivity  in  vivo  animal 
march 2017 by Michael.Massing
Role of ω3 long-chain polyunsaturated fatty acids in reducing cardio-metabolic risk factors. - PubMed - NCBI
Fish oil, rich in eicosapentaenoic (EPA, 20:5ω3) and docosahexaenoic (DHA, 22:6ω3) acids, has been found to cause a modest reduction in blood pressure at a dose level of >3g/d both in untreated and treated hypertensives. Whilst a multitude of mechanisms may contribute to the blood pressure lowering action of ω3 LC-PUFA, improved vascular endothelial cell function appears to play a central role. Recent studies which evaluated the potential benefits of fish oil in type-2 diabetes have helped to alleviate concerns raised in some previous studies which used relatively large dose (5-8 g/d) and reported a worsening of glycemic control. Several meta-analyses have confirmed that the most consistent action of ω3 LC-PUFA in insulin resistance and type-2 diabetes is the reduction in triglycerides. In some studies, fish oil has been found to cause a small rise in LDL-cholesterol, but a change in the LDL particle size, from the smaller more atherogenic form to the larger, less damaging particle size, have also been noted. ω3 LC-PUFA are effective modulators of the inflammation that accompanies several cardio-metabolic abnormalities. Taking into consideration the pleiotropic nature of their actions, it can be concluded that dietary supplementation with ω3 LC-PUFA will lead to improvements in cardio-metabolic health parameters. These fatty acids pose only minor side effects and more importantly, do not interact adversely with the common drug therapies used in the management and treatment of hypertension, dyslipidemia, type-2 diabetes, and obesity/metabolic syndrome, but in some instances work synergistically, thereby providing additional cardiovascular benefits.
fish  oil  omega-3  fatty  acids  EPA  DHA  peer-reviewed  research  overview  risk  benefit  diabetes  triglycerides  dyslipidemia 
march 2017 by Michael.Massing
Omega-3 Supplementation and the Neural Correlates of Negative Affect and Impulsivity: A Double-Blind, Randomized, Placebo-Controlled Trial in Midli... - PubMed - NCBI
In clinical trials, omega-3 fatty acid supplementation improves symptoms in psychiatric disorders involving dysregulated mood and impulse control, yet it is unclear whether in healthy adults omega-3 fatty acid supplementation affects mood, impulse control and the brain systems supporting these processes. Accordingly, this study tested the hypotheses that eciosapentaenoic (EPA) and docosahexaenoic (DHA) acid supplementation reduces negative affect and impulsive behaviors in healthy adults and that these changes correspond to alterations in corticolimbic and corticostriatal brain systems which support affective and impulsive processes.
Healthy volunteers (N = 272) consuming 300 mg/day or less of EPA and DHA were enrolled in a double-blind, randomized, placebo controlled clinical trial. Participants received either capsules providing 1000 mg of EPA and 400 mg of DHA versus identical appearing soybean oil capsules per day for 18 weeks. Negative affect and impulsivity were measured by questionnaire and ecological momentary assessment (EMA), as well as functional alterations in corticolimbic and corticostriatal brain systems evoked by standardized fMRI tasks.
There were no group-by-time interactions for any questionnaire or EMA measures of mood and impulsivity. Likewise, no group-by-time interactions were observed for fMRI responses evoked within corticolimbic and corticostriatal systems.
In healthy adults with low intake of omega-3 fatty acids, moderate-dose supplementation for 18 weeks did not alter affect or impulsive behaviors, nor alter corticolimbic and corticostriatal brain functionality.
impulse  control  impulsivity  mood  disorders  omega-3  EPA  DHA  supplements  brain  treatment  psychiatric  peer-reviewed  research 
march 2017 by Michael.Massing
The effects of low dose n-3 fatty acids on serum lipid profiles and insulin resistance of the elderly: a randomized controlled clinical trial. - PubMed - NCBI
This study assessed the effects of low-dose n-3 fatty acids on serum lipid profile, lipoprotein(a), apolipoprotein B, fasting glucose, insulin, and insulin resistance in a group of elderly Iranians.
A 6-month randomized, double-blind placebo-controlled clinical trial was carried out in 124 elderly residents of Kahrizak Charity Foundation aged >or= 65. The intervention group was supplemented with 1 g/day fish oil capsule (with 180 mg eicosapentaenoic acid, EPA; and 120 mg docosahexaenoic acid, DHA; a total of 300 mg n-3 fatty acids as effective constituents). Fasting blood samples were collected at baseline and after 6 months of the trial.
There were no significant effects of fish oil on the studied variables in the intervention group. In the placebo group, serum triglyceride significantly increased and high-density lipoprotein cholesterol significantly decreased (p = 0.01 and p = 0.009, respectively). By repeated measurement analysis after adjustments, the overall decrease in serum triglycerides compared with placebo was significant (p = 0.04).
Supplementation with low dose n-3 fatty acids for 6 months could significantly protect elderly Iranians from a rise in serum triglycerides.
supplements  fish  oil  EPA  cholesterol  dyslipidemia  high  risk  benefit  blood  lipids  insulin  resistance  aging  peer-reviewed  research 
march 2017 by Michael.Massing
Gut bacteria may play a role in Alzheimer’s disease -- ScienceDaily
Gut bacteria may play a role in Alzheimer’s disease

#alzheimersdisease #GutBacteria #microbiome #hcsm #hcsmeu
gut  flora  bacteria  Alzheimer's  brain  correlation  peer-reviewed  research  in  vivo  animal  etiology  progression  GutBacteria  hcsmeu  hcsm  microbiome  alzheimersdisease 
february 2017 by Michael.Massing
Depression From the Inside Out
My depression feels like nothing. It feels numb. It feels like not feeling. As with neuropathic pain, I can be unaware of it for long stretches of time, until I look into a mirror and see the classical mask of tragedy—that’s pain. For depression, I’m more likely to look around me, and ask myself: am I living like a depressed person? Here are six instances where the answer was yes.
Douglas  Michael  Massing  T2D  depression  type  2  diabetes  peer-reviewed  research 
november 2016 by Michael.Massing
Probiotic Therapy for Irritable Bowel Syndrome
Probiotics will likely have an emerging adjunctive therapeutic role in treating IBS. The studies to date simultaneously provide interesting observations and raise fundamental questions. Overall, many of the studies involved were small in size, of short duration, and had significant design flaws, but there is growing evidence that B. infantis is becoming the frontrunner for treatment of IBS. If larger, well-controlled studies involving other strains of probiotics are performed, we may begin to have other options regarding different probiotic species and for the treatment of more specific subsets of IBS symptoms.47

Additional issues that still need to be determined include the most effective probiotic strain, dose, and duration of therapy; whether patients should be treated for specific IBS symptoms only; and whether there is a role for maintenance IBS therapy or only IBS therapy on an as-needed basis. In addition, cost-effectiveness analysis and safety profiles still need to be addressed in large, well-designed trials. As probiotics are not considered pharmaceutical drugs, they are not currently regulated by the US Food and Drug Administration, which would promote standardization for consistent clinical trials in the future.

Probiotics may have a role as a delivery vehicle for therapeutic payloads that are released at targeted areas of inflammation throughout the intestinal tract. The majority of this research has involved probiotics in the treatment of inflammatory bowel disease, but these studies may translate into future studies for IBS. One such example is the study conducted by Steidler and Neirynck in which recombinant Lactococcus lactis, engineered to secrete interleukin-10, was administered to mice with experimental inflammatory bowel disease, which showed that the probiotic was similar to steroids.48

A recent systematic review performed by the American College of Gastroenterology Task Force on the management of IBS concluded that Lactobacillus does not appear to be effective in single organism studies and studies involving combinations of probiotics, though Bifidobacterium demonstrates some efficacy (Grade 2C evidence).47 Future avenues of research should focus on treating subtypes of IBS; evaluation of patients according to the Rome III criteria; safety, dosing, and concentrations of certain probiotics; and duration of treatment.
probiotics  supplements  peer-reviewed  research  inflammatory  bowel  syndrome  disease  review  Lactobacillus  Bifidobacterium  IBS  infantis 
august 2016 by Michael.Massing
Dexcom's Evidence Builds Case for CGM Dosing Ahead of Key FDA Meeting
Collectively, the Dexcom abstracts showed that (1) patients who engaged more frequently with their CGM device had better glucose control,2,3 (2) patients who set their low-glucose alerts (LGL) at lower levels had less variation in glucose,2 and (3) those who use CGM consistently perform fewer blood glucose tests, but have better glycemic control.3
CGM  continuous  glucose  monitoring  SMBG  self-monitored  blood  clinical  research  peer-reviewed  outcome  management  in  vivo  human 
july 2016 by Michael.Massing
Empagliflozin Slows Progression of Renal Disease in Diabetes
Dr Wanner noted, however, that the EMPA-REG trial lasted only 3 years, "so we are certainly looking to the future for more on this."

And both he and discussant of the findings at ADA, endocrinologist and epidemiologist, William Herman, MD, MPH, of the University of Michigan, Ann Arbor, stressed that the results are applicable only "to the population studied in the EMPA-REG trial" (ie, older patients with type 2 diabetes at high cardiovascular risk).

Currently, about a third of the population of type 2 diabetes fall into that category, Dr Herman said....

But Dr Herman pointed out in his talk that "the absolute differences are relatively small" in EMPA-REG and the number needed to treat with empagliflozin to achieve the renal benefits was 200.

In addition, it's possible that the findings "had to do with medications not administered," he said. "So it may not be a benefit of empagliflozin but the fact that those in the empagliflozin group did not receive medications causing harm [as patients in the trial were also allowed certain other standard therapies for diabetes]."

Overall, as well as the demonstrated renal effects, empagliflozin is "moderately effective" at lowering HbA1c and results in a 2- to 3-kg reduction in body weight, with no issue with hypoglycemia, although it does increase the risk of genitourinary infections, Dr Herman surmised....

"The range of cost between a generic established evidence-based oral therapy like metformin, the sulfonylureas, and now pioglitazone and the new agents is 100-fold. That is a big increase for, in some cases, a modest theoretical or practical advantage. So it's a problem for physicians and patients in the US."
kidney  renal  disease  drug  effects  benefit  clinical  trial  peer-reviewed  research  in  vivo  human  NNT  risk  cost  pharma  caveat 
july 2016 by Michael.Massing
Niacin Alternatives for Dyslipidemia: Fool's Gold or Gold Mine? Part I: Alternative Niacin Regimens. - PubMed - NCBI
Niacin was the first drug demonstrating lowered cholesterol prevents coronary heart disease (CHD) events, with two clinical CHD outcome studies establishing a cardioprotective niacin regimen: 1 g thrice daily with meals. Though cardioprotective, skin toxicity limits niacin's use, fostering several variations to improve tolerability. One of these, an extended-release (ER) alternative, proved immensely successful commercially, dominating clinical practice despite departing from the established regimen in several critical ways. Hence, improved tolerability may have come at the cost of diminished efficacy, posing a conundrum: Does it still help the population at risk for CHD to broaden a drug's acceptance by "watering it down"? This question is crucial at this stage now that the ER alternative failed to recapitulate the benefits of the established cardioprotective niacin regimen in two trials of the alternative approach: AIM-HIGH and HPS2-THRIVE. Part I of this review discusses how vastly the ER alternative departs from the established cardioprotective regimen, why that is important physiologically, and how it may explain the findings of AIM-HIGH and HPS2-THRIVE. Given important gaps left by statin therapy, the established cardioprotective niacin regimen remains an important evidence-based therapy for the statin intolerant or statin averse.
niacin  vitamin  B  3  overview  peer-reviewed  research  blood  glucose  supplement  interaction  risk  benefit  cholesterol  lipids  HDL  treatment  dyslipidemia  systematic  review  statin  intolerance  ER  dosage  administration  guidelines  standards 
june 2016 by Michael.Massing
Effects of niacin on glucose control in patients with dyslipidemia. - PubMed - NCBI
Niacin (nicotinic acid), the most effective available pharmacotherapy for increasing high-density lipoprotein cholesterol, also lowers triglycerides and hence may be useful, alone or in combination with hydroxymethylglutaryl coenzyme A reductase inhibitors (statins), to offset residual cardiovascular risk in patients with mixed or diabetic dyslipidemia. We conducted a review of published consensus guidelines since 2000 and an English-language PubMed search of prospective, randomized controlled trials and open-label studies from January 1, 1990, through December 31, 2007, concerning the effects of niacin, alone or in combination with statins, on glycemic regulation in dyslipidemic patients (with or without diabetes mellitus). For search terms, we used the title words niacin or nicotinic acid and key words including diabetes, diabetic, dyslipidemia, glucose, glycemic, HbA1c, hemoglobin, hyperglycemia, human, insulin, postprandial, and safety. Retrospective and observational studies, case reports, and case studies were excluded. On the basis of our analysis, the effects of niacin (< or =2.5 g/d), alone or in combination with statins, on fasting glucose (an increase of 4%-5%) and hemoglobin A1c levels (an increase of < or =0.3%) are modest, transient or reversible, and typically amenable to adjustments in oral hypoglycemic regimens without discontinuing niacin. Niacin therapy was infrequently associated with incident diabetes or the need for new insulin prescriptions. Studies showed important clinical benefits of niacin or niacin-statin regimens despite modest effects on glucose control. On a population basis, significant reductions in incidences of cardiovascular events and the degree of atherosclerotic progression associated with long-term niacin (or niacin-statin) therapy in patients with diabetic dyslipidemia outweigh the typically mild effects of this therapy on glycemic regulation. Consensus guidelines recommend monitoring glycemic control after initiating niacin treatment or increasing its dosage.
niacin  vitamin  B  3  overview  peer-reviewed  research  blood  glucose  supplement  interaction  risk  benefit  cholesterol  lipids  HDL  treatment  dyslipidemia  systematic  review 
june 2016 by Michael.Massing
Use of niacin in patients with diabetes
when administered at doses of 2.5 g per day or less, niacin does not appear to have a clinically significant effect on glucose and HbA1c in most patients. Adverse glycemic effects seem to be most prominent during upward titration of niacin. The effects are often transient and return to near baseline levels after a relatively short time. It appears that glycemic effects are more pronounced in patients with type 2 diabetes compared with those without diabetes.

It should also be noted that most of these trials included patients with relatively well-controlled diabetes, so the glycemic effects of niacin in patients with poorly controlled diabetes may be more significant. Niacin offers many CV benefits, and any effect on glucose can typically be accounted for with mild adjustments in diabetes therapy as necessary.
niacin  vitamin  B  3  overview  peer-reviewed  research  blood  glucose  supplement  interaction  risk  benefit  cholesterol  lipids  HDL  treatment  dyslipidemia 
june 2016 by Michael.Massing
Numbers Matter: 1-Hour Post Prandial Glucose Possible Predictor of Prediabetes Risk
A 1-h glucose value > 155 mg/dl predicts mortality even when the 2-h level is < 140 mg/dl.
An elevated 2-hour glucose level indicated increased mortality risk, independent of the 1-hour level.
Patients with a 2-hour glucose level less than 140 mg/dL but an elevated 1-hour glucose had a 28% increased mortality risk

One-hour post-load plasma glucose level during the OGTT predicts mortality: observations from the Israel Study of Glucose Intolerance, Obesity and Hypertension. Diabet Med. 2016 Mar 21. doi: 10.1111/dme.13116. [Epub ahead of print]
diabetes  diagnostic  standards  impaired  fasting  glucose  tolerance  blood  mortality  risk  IGT  threshold  diagnosis  screening  peer-reviewed  research  human  in  vivo 
june 2016 by Michael.Massing
One-Sided Social Media Comments Influenced Opinions And Intentions About Home Birth: An Experimental Study
As people increasingly turn to social media to access and create health evidence, the greater availability of data and information ought to help more people make evidence-informed health decisions that align with what matters to them. However, questions remain as to whether people can be swayed in favor of or against options by polarized social media, particularly in the case of controversial topics. We created a composite mock news article about home birth from six real news articles and randomly assigned participants in an online study to view comments posted about the original six articles. We found that exposure to one-sided social media comments with one-sided opinions influenced participants’ opinions of the health topic regardless of their reported level of previous knowledge, especially when comments contained personal stories. Comments representing a breadth of views did not influence opinions, which suggests that while exposure to one-sided comments may bias opinions, exposure to balanced comments may avoid such bias.
health  literacy  social  media  bias  #HCSM  peer-reviewed  research  in  vivo  human  hcsm 
june 2016 by Michael.Massing
dLife Diabetes News - Diabetes | Type 1 Diabetes | Type 2 Diabetes - www.dlife.com
Previous research conducted by the same researchers at Lund University in 2009 showed a gene variant to melatonin receptor 1B increases risk for type 2 diabetes. The variant causes the level of the melatonin receptors in beta cells to increase, making them more sensitive to melatonin and stopping them from secreting insulin.
"A third of all people carry this specific gene variant," Hindrik Mulder, a professor at Lund University, said in a press release. "Our results show that the effect of melatonin is stronger in them. We believe that this explains their increased risk of developing type 2 diabetes."
For the study, researchers recruited 23 healthy carriers of the gene variant and 22 people without the variant, treating them with four milligrams of melatonin before bed for three months.
The researchers found insulin secretion was lower among participants with the genetic variation, and that blood glucose levels were higher among all participants after melatonin treatment -- but most significantly in those with the variation.
genetic  risk  etiology  factor  T2D  type  2  diabetes  melatonin  correlation  peer-reviewed  research  circadian  rhythms  hormone  drug  effects  contraindication  pancreas  insulin  beta  cells  light  body  clock  mutation 
may 2016 by Michael.Massing
D-is-for-Diabetes: Medicare's Competitive Bidding Program Puts Beneficiaries' Lives at Risk
The Forum built upon the GAO's analysis by examining access to diabetes testing supplies for Medicare beneficiaries living with diabetes and requiring insulin therapy.  Working with some of the nation's leading endocrinologists,* the Forum's study found that the Competitive Bidding Program disrupted beneficiaries' ability to access diabetes testing supplies, and this disruption was associated with an increase in mortality, higher hospitalization rates and inpatient costs.

"Self-monitoring blood glucose supplies are a critical component of diabetes care among insulin-treated individuals and the value of safe, effective testing supplies cannot be underestimated," said Jaime Davidson, M.D., clinical professor of Medicine at the University of Texas Southwestern Medical Center, and an author of the study. "We are particularly concerned about the disruption we detected in our analysis given the predominant use of rapid- and short-acting insulin by Medicare beneficiaries, who are at significantly greater risk for hypoglycemia than younger individuals with insulin-treated diabetes."

"We are troubled that CMS failed to detect these 'unintended' consequences and, instead, reported that the program was a success," said Gary A. Puckrein, Ph.D., president and CEO of the National Minority Quality Forum and a study author. "Based on our findings and employing the safety monitoring protocols commonly used to protect human subjects, we believe policymakers should immediately suspend the program until CMS can demonstrate its ability to effectively monitor the effects of the program, correct the structural flaws causing this problem and ensure that the lives of America's greatest generation are no longer at risk." 

The ahead of print article "Impact of CMS Competitive Bidding Program on Medicare Beneficiary Safety and Access to Diabetes Testing Supplies: A Retrospective, Longitudinal Analysis" can be found online: Impact of CMS Competitive Bidding Program on Medicare Beneficiary Safety and Access to Diabetes Testing Supplies: A Retrospective, Longitudinal Analysis . The full article will also be published here: http://dx.doi.org/10.2337/dc15-1264.
watchdog  diabetes  insulin-dependent  SMBG  supplies  cost  benefit  mortality  hospitalization  competitive  bidding  Medicare  in  vivo  situ  human  peer-reviewed  research  health  disparities  healthcare 
may 2016 by Michael.Massing
Impact of CMS Competitive Bidding Program on Medicare Beneficiary Safety and Access to Diabetes Testing Supplies: A Retrospective, Longitudinal Analysis | Diabetes Care
RESEARCH DESIGN AND METHODS The study population consisted of insulin users: 43,939 beneficiaries in the nine test markets (TEST) and 485,688 beneficiaries in the nontest markets (NONTEST). TEST and NONTEST were subdivided: those with full self-monitoring of blood glucose (SMBG) supply acquisition (full SMBG) according to prescription and those with partial/no acquisition (partial/no SMBG). Propensity score–matched analysis was performed to reduce selection bias. Outcomes were impact of partial/no SMBG acquisition on mortality, inpatient admissions, and inpatient costs.

RESULTS Survival was negatively associated with partial/no SMBG acquisition in both cohorts (P < 0.0001). Coterminous with CBP (2010–2011), there was a 23.0% (P < 0.0001) increase in partial/no SMBG acquisition in TEST vs. 1.7% (P = 0.0002) in NONTEST. Propensity score–matched analysis showed beneficiary migration from full to partial/no SMBG acquisition in 2011 (1,163 TEST vs. 605 NONTEST) was associated with more deaths within the TEST cohort (102 vs. 60), with higher inpatient hospital admissions and associated costs.

CONCLUSIONS SMBG supply acquisition was disrupted in the TEST population, leading to increased migration to partial/no SMBG acquisition with associated increases in mortality, inpatient admissions, and costs. Based on our findings, more effective monitoring protocols are needed to protect beneficiary safety.

Received June 12, 2015.
Accepted January 9, 2016.
© 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Impact of CMS Competitive Bidding Program on Medicare Beneficiary Safety and Access to Diabetes Testing Supplies: A Retrospective, Longitudinal Analysis
Gary A. Puckrein, Gail Nunlee-Bland, Farhad Zangeneh, Jaime A. Davidson, Robert A. Vigersky, Liou Xu, Christopher G. Parkin, David G. Marrero
Diabetes Care 2016 Mar; http://dx.doi.org/10.2337/dc15-1264
diabetes  insulin-dependent  SMBG  supplies  cost  benefit  mortality  hospitalization  competitive  bidding  Medicare  in  vivo  situ  human  peer-reviewed  research 
may 2016 by Michael.Massing
Can Postprandial Blood Glucose Excursion Be Predicted in Type 2 Diabetes?
Three-day BG profiles for 37 type 2 diabetic subjects, with A1C levels of 7.7%, treated with sulfonylurea and metformin, and well titrated on insulin glargine, were analyzed using a continuous glucose monitoring system. Food intake from 680 meals was recorded and quantified during continuous glucose monitoring.


The median BG excursion (ΔBG) was higher at breakfast than at lunch or dinner (111 [81; 160] vs. 69.5 [41.5; 106] and 82.5 mg/dl [53; 119] mg/dl, P < 0.0001). There was a weak overall correlation between ΔBG and carbohydrate intake. Correlation improved when mealtime was taken into account. Simple relationships were established: ΔBG (mg/dl) = 65 × carbohydrate/body weight + 73 for breakfast (R2 = 0.20, P < 0.0001); the slope was reduced by half at lunch and by one-third at dinner. Twelve relevant variables likely to affect ΔBG were integrated into a polynomial equation. This model accounted for 49% of ΔBG variability. Two groups of patients were identified: responders, in whom ΔBG was well correlated with carbohydrate intake (R2 ≥ 0.30, n = 8), and nonresponders (R2 < 0.30, n = 29). Responders exhibited a greater insulinopenic profile than nonresponders.


The carbohydrate intake in responders clearly drives ΔBG, whereas, in nonresponders, other factors predominate. This sort of characterization should be used to guide therapeutic choices toward more targeted care with improved type 2 diabetes management.
postprandial  blood  glucose  excursion  correlation  meal  time  planning  variable  response  food  variation  peer-reviewed  research  in  vivo  human  clinical  behavioral  diet  trial 
may 2016 by Michael.Massing
Why Very Low Calorie Diets (VLCD) won’t solve the diabetes crisis | HealthInsightUK
“We believe this shows that Type 2 diabetes is all about energy balance in the body,” explained Professor Taylor, “if you are eating more than you burn, then the excess is stored in the liver and pancreas as fat which can lead to Type 2 diabetes in some people. What we need to examine further is why some people are more susceptible to developing diabetes than others.”

Clearly Prof Taylor did not think that the lack of carbohydrate in the diet was in any way relevant – only weight loss and keeping it off. Even though the low carbs would mean that the patients’ blood sugars were regularised. We know they went into a state known as ketosis when the body switches from burning glucose from carbohydrates to using fat from the diet and from storage for energy.

Some of this gets turned into energy packets called ketones in the liver. It is the state of ketosis that results in fast and substantial weight loss. What is really odd is that at no point did Prof Taylor or Diabetes UK ask whether the critical issue was the low calories or the ketosis or the lack of carbohydrate. This lack of critical thinking may be linked to the fact that weight-loss shakes maker Optifast part funded the original study and may not want people to know that you can get into a state of ketosis with just food from the local store.
diabetes  type  2  T2D  caloric  restriction  peer-reviewed  research  criticism  body  fat  organ  weight  loss  Newcastle  protocol  treatment  remission  symptom  reversal  ketosis 
may 2016 by Michael.Massing
JAMA Network | JAMA | The Association Between Income and Life Expectancy in the United States, 2001-2014
Life expectancy for low-income individuals was positively correlated with the local area fraction of immigrants (r = 0.72, P < .001), fraction of college graduates (r = 0.42, P < .001), and government expenditures (r = 0.57, P < .001).

Conclusions and Relevance  In the United States between 2001 and 2014, higher income was associated with greater longevity, and differences in life expectancy across income groups increased over time. However, the association between life expectancy and income varied substantially across areas; differences in longevity across income groups decreased in some areas and increased in others. The differences in life expectancy were correlated with health behaviors and local area characteristics.
longevity  human  geography  survival  class  income  poverty  location  residence  peer-reviewed  public  health  research  analysis  immigration  education  correlation  local  spending  budgets  migration 
april 2016 by Michael.Massing
Alcohol Health Benefits Are Exaggerated, As Positive Effects Apply Only To Narrow Range Of People
For the current study, the researchers gathered Health Survey data from 18,368 and 34,523 adults divided into separate age groups (50-64 years and 65 years and over) and distilled down further by sex. Participants answered questions about their weekly consumption and how much they drank on their heaviest day.

Compared with never-drinkers, only one group reaped any protective rewards from light drinking: women over the age of 65 who reported consuming 10 units or less on average per week. Still, the authors of the study warn their conclusions may not be perfectly accurate. The evidence, they note in the conclusion, suggests "that people may alter their response according to perceived social desirability."

Source: Knott CS, Coombs N, Stamatakis E, Biddulph JP. All cause mortality and the case for age specific alcohol consumption guidelines: pooled analyses of up to 10 population based cohorts. BMJ. 2015.
alcohol  risk  benefit  women  women's  health  peer-reviewed  research  in  vivo  situ  human  meta-analysis 
april 2016 by Michael.Massing
The Rich Live Longer Everywhere. For the Poor, Geography Matters. - The New York Times
Places where poor citizens had long life spans also tended to have a high concentration of college graduates and high local government spending.
longevity  human  geography  survival  class  income  poverty  location  residence  peer-reviewed  public  health  research  analysis 
april 2016 by Michael.Massing
Exaggerated effects of particulate matter air pollution in genetic type II diabetes mellitus (PDF Download Available)
Researchers found that exposure to air pollution, over a period of 24 weeks, exaggerates insulin resistance and fat inflammation. “[O]besity has reached epidemic proportions with 34% of adults in the US, ages 20 and over, meeting the criteria...Obesity and diabetes are very prevalent in urban areas and there have been no studies evaluating the impact of poor air quality on these related conditions until now.”
Type 2 diabetes...has soared worldwide with a projected 221 million people expected to suffer from this disease in 2010, a 46 percent increase compared to 1995...[S]cientists fed male mice a diet high in fat over a 10-week period to induce obesity and then exposed them to either filtered air or air with particulate matter for six hours a day, five days a week, over a 24-week period...The air pollution level inside the chamber containing particulate matter was comparable to levels a commuter may be exposed to in...many metropolitan areas in the U.S.
[description by Diabetes in Control - expired link]
in  vivo  animal  correlation  pollution  environment  risk  body  fat  inflammation  heart  circulation  insulin  epidemic  poison  etiology  resistance  T2D  diabetes  type  2  research  peer-reviewed  environmental  factor  public  health 
april 2016 by Michael.Massing
Association Between Fine Particulate Matter and Diabetes Prevalence in the U.S.
OBJECTIVE Recent studies have drawn attention to the adverse effects of ambient air pollutants such as particulate matter 2.5 (PM2.5) on human health. We evaluated the association between PM2.5 exposure and diabetes prevalence in the U.S. and explored factors that may influence this relationship.

RESEARCH DESIGN AND METHODS The relationship between PM2.5 levels and diagnosed diabetes prevalence in the U.S. was assessed by multivariate regression models at the county level using data obtained from both the Centers for Disease Control and Prevention (CDC) and U.S. Environmental Protection Agency (EPA) for years 2004 and 2005. Covariates including obesity rates, population density, ethnicity, income, education, and health insurance were collected from the U.S. Census Bureau and the CDC.

RESULTS Diabetes prevalence increases with increasing PM2.5 concentrations, with a 1% increase in diabetes prevalence seen with a 10 μg/m3 increase in PM2.5 exposure (2004: β = 0.77 [95% CI 0.39–1.25], P < 0.001; 2005: β = 0.81 [0.48–1.07], P < 0.001). This finding was confirmed for each study year in both univariate and multivariate models. The relationship remained consistent and significant when different estimates of PM2.5 exposure were used. Even for counties within guidelines for EPA PM2.5 exposure limits, those with the highest exposure showed a >20% increase in diabetes prevalence compared with that for those with the lowest levels of PM2.5, an association that persisted after controlling for diabetes risk factors.

CONCLUSIONS Our results suggest PM2.5 may contribute to increased diabetes prevalence in the adult U.S. population. These findings add to the growing evidence that air pollution is a risk factor for diabetes.
diabetes  human  population  environmental  risk  factor  environment  etiology  particulate  matter  correlation  in  vivo  siu  peer-reviewed  research  public  health 
april 2016 by Michael.Massing
UNC study helps clarify link between high-fat diet and type 2 diabetes — UNC School of Medicine
New research from the University of North Carolina at Chapel Hill School of Medicine adds clarity to the connection. The study published online April 10 in the journal Nature Immunology finds that saturated fatty acids but not the unsaturated type can activate immune cells to produce an inflammatory protein, called interleukin-1beta.

“The cellular path that mediates fatty acid metabolism is also the one that causes interleukin-1beta production,” says senior study co-author Jenny Y. Ting, PhD, William Kenan Rand Professor in the Department of Microbiology and Immunology.

“Interleukin-1beta then acts on tissues and organs such as the liver, muscle and fat (adipose) to turn off their response to insulin, making them insulin resistant.  As a result, activation of this pathway by fatty acid can lead to insulin resistance and type 2 diabetes symptoms.”  Ting is also a member of the UNC Lineberger Comprehensive Cancer Center, and the UNC Inflammatory Diseases Institute.
insulin  resistance  mechanism  risk  factor  diabetes  type  2  T2D  inflammation  correlation  etiology  saturated  fat  peer-reviewed  research  diet  food  earnest  liver  fatty  body  metabolic  syndrome  disorder  public  health 
april 2016 by Michael.Massing
Type 2 Diabetes Genetic Predispositions
The study included 6,501 participants (81.1% non-Hispanic white, 12.7% non-Hispanic black, and 6.2% Mexican-American). 38 type 2 diabetes-related single nucleotide polymorphisms (SNPs) were genotyped. Association between aggregate genetic risk for type 2 diabetes and all-cause mortality was investigated.

After adjusting for age, sex, BMI, smoking, alcohol, and hypertension, increased mortality risk was observed for every type 2 diabetes allele an individual had, independent of BMI (OR 1.04, 95% CI 1.00 – 1.07, P = 0.05). These findings were consistent with non-Hispanic whites and non-Hispanic blacks, but not with Mexican Americans. Mexican Americans showed a negative trend even after adjustments. The analysis was repeated with Cox regression that showed generally similar results. Association of increased risk of mortality was evaluated by ethnicity, which yielded similar results for non-Hispanic whites, and non-Hispanic blacks, but not for Mexican Americans (OR 0.95, 95% CI 0.89 – 1.01, P = 0.01).

When BMI was accounted for, the mortality risk per allele was higher among obese non-Hispanic whites as compared to normal-weight non-Hispanic whites. There was a negative trend observed in normal-weight Mexican Americans (BMI <25 kg/m2, OR 0.91, 95% CI 0.82 – 1.00)....

Individuals with diabetes carrying type 2 diabetes alleles have an increased risk of mortality.
High BMI (> 25 kg/mm3) is associated with increased risk of mortality in individuals with high genetic predisposition to type 2 diabetes.
Individuals with diabetes should maintain a normal-body weight to reduce the risk of mortality, especially the ones genetically predisposed to type 2 diabetes.
Researched and prepared by Sabair Pradhan, Doctor of Pharmacy Candidate USF College of Pharmacy, reviewed by Dave Joffe, BSPharm, CDE
mortality  risk  factor  race  ethnicity  peer-reviewed  research  genetic  etiology 
april 2016 by Michael.Massing
Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areas -- Connolly et al. 54 (3): 173 -- Journal of Epidemiology & Community Health
OBJECTIVE To establish the relation between socioeconomic status and the age-sex specific prevalence of type 1 and type 2 diabetes mellitus. The hypothesis was that prevalence of type 2 diabetes would be inversely related to socioeconomic status but there would be no association with the prevalence of type 1 diabetes and socioeconomic status.

SETTING Middlesbrough and East Cleveland, United Kingdom, district population 287 157.

PATIENTS 4313 persons with diabetes identified from primary care and hospital records.

RESULTS The overall age adjusted prevalence was 15.60 per 1000 population. There was a significant trend between the prevalence of type 2 diabetes and quintile of deprivation score in men and women (χ2 for linear trend, p<0.001). In men the prevalence in the least deprived quintile was 13.4 per 1000 (95% confidence intervals (95% CI) 11.44, 15.36) compared with 17.22 per 1000 (95% CI 15.51, 18.92) in the most deprived. For women the prevalence was 10.84 per 1000 (95% CI 9.00, 12.69) compared with 15.48 per 1000 (95% CI 13.84, 17.11) in the most deprived. The increased prevalence of diabetes in the most deprived areas was accounted for by increased prevalence of type 2 diabetes in the age band 40–69 years. There was no association between the prevalence of type 1 diabetes and socioeconomic status.

CONCLUSION These data confirm an inverse association between socioeconomic status and the prevalence of type 2 diabetes in the middle years of life. This finding suggests that exposure to factors that are implicated in the causation of diabetes is more common in deprived areas.
diabetes  prevalence  socioeconomic  status  SES  correlation  peer-reviewed  research  poverty  education  risk 
march 2016 by Michael.Massing
Socioeconomic Status and Risk of Diabetes-Related Mortality in the U.S.

Having less than a high school education was associated with a twofold higher mortality from diabetes, after controlling for age, gender, race/ethnicity, marital status, and body mass index, compared with adults with a college degree or higher education level (relative hazard [RH] = 2.05, 95% confidence interval [CI] 1.78, 2.35). Having a family income below poverty level was associated with a twofold higher mortality after adjustments compared with adults with the highest family incomes (RH=2.41, 95% CI 2.05, 2.84).....


Findings from this nationally representative cohort demonstrate a socioeconomic gradient in diabetes-related mortality, with both education and income being important determinants of the risk of death.
diabetes  mortality  socioeconomic  status  SES  correlation  peer-reviewed  research  poverty  education  risk 
march 2016 by Michael.Massing
Antidepressant Medication as a Risk Factor for Type 2 Diabetes and Impaired Glucose Regulation
Antidepressant Medication as a Risk Factor for Type 2 Diabetes and Impaired Glucose Regulation
Systematic review
Katharine Barnard, PHD1⇑, Robert C. Peveler, FRCPSYCH2 and Richard I.G. Holt, FRCP1
diabetes  depression  risk  comorbidities  affective  mood  disorders  correlation  stress  distress  factor  peer-reviewed  research  clinical  in  vivo  situ  human  antidepressant  SSRI  systematic  review  etiology  public  health 
march 2016 by Michael.Massing
Depression, Diabetes Linked in Women
For depression and incident diabetes, they found:

There were 2,844 new cases of diabetes over the 10 years of follow-up.
Compared with the reference group, participants with Mental Health Index scores of 76 through 85, 53 through 75, or 52 and below had a monotonic elevated risk of developing diabetes, and the trend was significant at P=0.002 in the multivariate analysis.
Participants with scores of 52 or less had an adjusted relative risk of developing diabetes of 1.17, with a 95% confidence interval from 1.05 to 1.30.
Those using antidepressants were at higher relative risk after adjustment for covariates — of 1.25, with a 95% confidence interval from 1.10 to 1.41.
On the other hand, the parallel analysis showed:

There were 7,415 new cases of clinical depression over the decade of follow-up.
Compared with the reference group, those with diabetes had a relative risk of developing clinical depression — after controlling for covariates – of 1.29, with a 95% confidence interval from 1.18 to 1.40.
The relative risks rose with disease severity: 1.25 and 1.24 for those without medications or using oral hypoglycemic agents, respectively, and 1.53 for those on insulin. The associations remained significant after adjusting for diabetes-related comorbidities.
Hu and colleagues noted that the study’s strengths include its large size and prospective design. On the other hand, much of the data was self-reported and the participants were registered nurses and most were white, so the results might not apply to different populations.

Practice Pearl:

Point out that this study, in conjunction with prior studies, indicates the importance of screening for depression in patients with diabetes, and screening for diabetes in patients with depression.

Pan A, et al “Bidirectional association between depression and Type 2 diabetes mellitus in women” Arch Intern Med 2010; 170(21): 1884-1891.
diabetes  depression  risk  comorbidities  affective  mood  disorders  correlation  stress  distress  factor  peer-reviewed  research  clinical  in  vivo  situ  human  antidepressant  population  prospective  etiology 
march 2016 by Michael.Massing
A Link Between Antidepressants and Type 2 Diabetes
What she found was the risk of diabetes almost doubled for the patients who were using two types of therapies at the same time, tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). Brown says people are usually prescribed multiple medications "if they have severe depression or if they are having a problem finding the right therapy."

Overall, 41.9% were taking a tricyclic antidepressant only, 38.7% were taking an SSRI only, 7.7% were taking one of each, and 11.8% were taking at least three medications, at least one of which was not a tricyclic antidepressant or SSRI.
After adjusting for age, sex, number of physician visits, and use of augmentation therapy, only use of one each of a tricyclic antidepressant and an SSRI was associated with an increased risk for type 2 diabetes compared with use of a tricyclic antidepressant alone (adjusted OR 1.89, 95% CI 1.35 to 2.65, P0.001).

Brown L, et al "Type of antidepressant therapy and risk of type 2 diabetes in people with depression"Diabetes Research and Clinical Practice 2008; DOI: 10.1016/j.diabres.2007.07.009.
diabetes  depression  risk  comorbidities  affective  mood  disorders  correlation  stress  distress  factor  peer-reviewed  research  clinical  in  vivo  situ  human  antidepressant  tricyclic  SSRI  population  retrospective  etiology 
march 2016 by Michael.Massing
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