Tuesday, July 29, 2008

Does Fructose Make You Fatter?

Tara Parker-Pope
NYT July 24, 2008

High-fructose corn syrup is a sweetener used in many processed foods ranging from sodas to baked goods. While the ingredient is cheaper and sweeter than regular sugar, new research suggests that it can also make you fatter.
In a small study, Texas researchers showed that the body converts fructose to body fat with “surprising speed,'’ said Elizabeth Parks, associate professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas. The study, which appears in The Journal of Nutrition, shows how glucose and fructose, which are forms of sugar, are metabolized differently.
In humans, triglycerides, which are a type of fat in the blood, are mostly formed in the liver. Dr. Parks said the liver acts like “a traffic cop” who coordinates how the body uses dietary sugars. When the liver encounters glucose, it decides whether the body needs to store it, burn it for energy or turn it into triglycerides.
But when fructose enters the body, it bypasses the process and ends up being quickly converted to body fat.
“It’s basically sneaking into the rock concert through the fence,” Dr. Parks said. “It’s a less-controlled movement of fructose through these pathways that causes it to contribute to greater triglyceride synthesis. The bottom line of this study is that fructose very quickly gets made into fat in the body.”
For the study, six people were given three different drinks. In one test, the breakfast drink was 100 percent glucose. In the second test, they drank half glucose and half fructose; and in the third, they drank 25 percent glucose and 75 percent fructose. The drinks were given at random, and neither the study subjects nor the evaluators were aware who was drinking what. The subjects ate a regular lunch about four hours later.
The researchers found that lipogenesis, the process by which sugars are turned into body fat, increased significantly when the study subjects drank the drinks with fructose. When fructose was given at breakfast, the body was more likely to store the fats eaten at lunch.
Dr. Parks noted that the study likely underestimates the fat-building effect of fructose because the study subjects were lean and healthy. In overweight people, the effect may be amplified.
Although fruit contains fructose, it also contains many beneficial nutrients, so dieters shouldn’t eliminate fruit from their diets. But limiting processed foods containing high-fructose corn syrup as well as curbing calories is a good idea, Dr. Parks said.
“There are lots of people out there who want to demonize fructose as the cause of the obesity epidemic,” she said. “I think it may be a contributor, but it’s not the only problem. Americans are eating too many calories for their activity level. We’re overeating fat, we’re overeating protein and we’re overeating all sugars.”

Sunday, July 27, 2008

Defending Against Disease With Vitamin D

New Studies Suggest It Isn't Just Bones That Might Benefit
July 15, 2008; Page D1

Sunlight, as a source of vitamin D, is free and abundant, at least in most of the world. Supplements are almost as cheap. Yet a growing number of experts think that many people aren't getting enough vitamin D -- particularly those who work and play indoors and slather on sunscreen. And the more experts learn about what D does, the more worrisome a deficiency seems.

It's long been known that D is crucial for strong bones. But new research suggests that it also protects against a wide variety of diseases. A study in the Archives of Internal Medicine last month found that men with low D had a higher risk for heart attacks. Other studies have linked low D with cancer of the breast, ovary, prostate, stomach, bladder, esophagus, kidney and lung. Low levels of D also have been associated with high blood pressure, stroke, diabetes, periodontal disease, rheumatoid arthritis, multiple sclerosis, macular degeneration, mental illness and chronic pain.

"It sounds crazy -- until you realize that vitamin D turns into a steroid hormone that's involved in the maintenance of over 200 human genes," says John J. Cannell, founder of the nonprofit Vitamin D Council in Atascadero, Calif.

The strongest source, by far, is ultraviolet B rays from the sun, which convert a form of cholesterol into vitamin D in the skin. A person sitting outside in a bathing suit in New York City gets more vitamin D in 20 minutes than from drinking 200 glasses of milk. But UVB rays vary greatly depending on latitude, cloud cover, time of year and time of day. Above 42 degrees north latitude (a line from the northern California border to Boston), the sun's rays don't provide sufficient D from November through February. Researchers looking at latitude and disease rates have found some intriguing patterns. Type 1 diabetes, for example, is much rarer in countries like Cuba than in either New Zealand and Sweden.

Dark-skinned and elderly people don't process vitamin D from the sun as efficiently as younger, fair-skinned people. UVB rays also don't penetrate glass or sunscreen with a factor of 8 or more.

It's difficult to get much D through diet. Few foods contain it naturally -- mainly fatty fish like salmon, mackerel and tuna, as well as liver and egg yolks. Since the 1930s, most milk in the U.S. has been fortified with D to prevent rickets, a bone-softening disease.

It's widely accepted that most people need some supplemental D -- the question is, how much? Current U.S. guidelines, issued in 1997, call for 200 international units from birth through age 50; 400 IUs from 51 through age 70 and 600 IUs from 71 on. But many experts and the American Medical Association are urging the government to revisit those numbers in light of the latest research, and the Institute of Medicine is in discussions to do so.

Some groups aren't waiting. The American Academy of Pediatrics says breast-fed infants should get 400 IUs of supplemental D daily. The National Osteoporosis Foundation urges adults over age 50 to get at least 800 to 1,000 IUs to prevent fractures. Look for D3, which is more potent than D2.

You can learn your vitamin D level with a blood test, which costs about $100. It should measure 25-hydroxyvitamin D, not 1,25-dihydroxyvitamin D. A concentration of less than 20 nanograms per milliliter is considered deficient. Many cancer-prevention benefits have been seen at levels of 30 ng/ml or more. Alan Pocinki, an internist in Washington, D.C., has been testing his patients -- mostly white-collar workers with indoor jobs -- and found about half are below 20 ng/ml.

It's not possible to overdose on vitamin D from the sun; it degrades in the skin at high levels. For supplements, the Institute of Medicine set an upper limit of 2,000 IUs per day, but some experts think that's too low. Vitamin D toxicity can involve kidney stones and heart arrhythmias, but cases are very rare.

Does all this D-iscussion leave you D-izzy? "Many people are confused by the conflicting messages," says Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, which suggests getting D from supplements, not the sun. "We need to know more about what the health benefits are, and what the right level is. We're a country of different ethnicities and locations and sensitivities. We probably can't make a one-size-fits-all recommendation."

GETTING YOUR D

Sunlight:
• 20 minutes of noontime sun in New York City in July: 20,000
Foods:
• Cod Liver Oil, 1 Tbs: 1,360
• Salmon, 3.5 oz: 360
• Tuna, canned, 3 oz: 200
• Milk, D-fortified, 1 cup: 98
• Egg yolk, 1: 20
• Liver, 3.5 oz: 15
Supplements:
• Most multivitamins: 400
• Others: 200 to 10,000
Note: In international units

Source: National Institutes of Health, Office of Dietary SupplementsIt's difficult to get much D through diet. Few foods contain it naturally -- mainly fatty fish like salmon, mackerel and tuna, as well as liver and egg yolks. Since the 1930s, most milk in the U.S. has been fortified with D to prevent rickets, a bone-softening disease.

Monday, July 21, 2008

Drugs to Build Bones May Weaken Them

By TARA PARKER-POPE
Published: July 15, 2008

A series of case reports indicates that a rare type of leg fracture is linked to osteoporosis treatment.

http://www.nytimes.com/2008/07/15/health/15well.html?ex=1373774400&en=ed0426a8f9721c44&ei=5124&partner=permalink&exprod=permalink

Friday, July 11, 2008

Resveratrol May Prevent Breast Cancer

In Test Tube, Red Wine Supplement Blocks Estrogen Toxicity
By Daniel J. DeNoon
WebMD Health
July 7, 2008 --

Resveratrol, a nutrient found in red wine, keeps estrogen from causing breast cancer in test-tube studies.

Prolonged exposure to estrogen is a major risk factor for breast cancer. Most research has focused on the interactions between estrogen and estrogen receptors on breast cancer cells.

But when the body's system for processing estrogen gets out of balance, dangerous estrogen metabolites appear. These toxic compounds react with DNA in breast cells and jump-start the growth of tumors.

Now Eleanor G. Rogan, PhD, and colleagues at the University of Nebraska show that resveratrol decreases the processing of estrogen into these dangerous compounds. Perhaps more importantly, it also blocks interactions between estrogen metabolites and cellular DNA.

And that's not all. Rogan's team finds that resveratrol increases production of an enzyme that destroys dangerous estrogen metabolites.

"Resveratrol has the ability to prevent the first step that occurs when estrogen starts the process that leads to cancer," Rogan says in a news release. "We believe that this could stop the whole progression that leads to breast cancer down the road."

The Rogan team's findings come from studies of human breast cells grown in the laboratory. It's a long way from showing that resveratrol can actually prevent cancer in women.

Even so, there's a hopeful sign: Resveratrol had anticancer effects at very low doses.

"This is dramatic because it was able to be done with fairly low concentrations of resveratrol," Rogan says.

A resveratrol concentration of 10 micromoles per liter was able to keep estrogen metabolites from interacting with DNA. A glass of red wine has a resveratrol concentration between 9 and 28 micromoles per liter.

However, a 2007 study in the U.K. suggested that even very high doses of resveratrol do not achieve blood concentrations as high as those needed for anticancer effects.

Resveratrol is a naturally occurring antioxidant found in the skins of red grapes, red wine, red or purple grape juice, peanuts, blueberries, and cranberries. It's also available in dietary supplements.

Although many health claims have been made for resveratrol, the risks and benefits of taking this supplement have not been formally tested in definitive clinical trials.

Rogan and colleagues report their findings in the July issue of Cancer Prevention Research.

Higher vitamin D levels linked to reduced telomere shortening

The November, 2007 issue of the American Journal of Clinical Nutrition published an article describing the discovery of British and American researchers of an association between longer telomeres and increased levels of vitamin D. Telomeres are caps on the ends of chromosomes which have been found to shorten with age, as well as with increased oxidative stress and inflammation. The finding suggests that vitamin D may play a role in slowing the onset of age-related diseases.

Dr J. Brent Richards at King's College, London School of Medicine and colleagues studied 2,160 female twins aged 19 to 79 for the current research. Blood samples were analyzed for serum vitamin D levels, C-reactive protein (CRP, a marker of inflammation) and additional factors, and telomere length was measured in the DNA of peripheral white blood cells (leukocytes).

As expected, older participants had shorter telomeres; however, leukocyte telomere length (LTL) was greater among subjects whose levels of vitamin D were high compared to those with low concentrations, a finding which persisted after adjustment for age and other factors. Participants in the top one-third of serum vitamin D levels had telomeres that averaged 107 base pairs longer than those in the lowest third, equivalent to a five year difference in chronologic aging.

Telomere length was also greater in those with lower C-reactive protein levels than in subjects with higher concentrations. When participants who had the highest CRP and lowest vitamin D concentrations were compared with those who had the lowest CRP and highest vitamin D levels, the difference in telomere length was equivalent to 7.6 years of aging.

In a subset analysis of vitamin D supplement users, those who supplemented were also found to have longer telomeres than those who did not supplement with the vitamin.

In their discussion concerning mechanisms of action, the authors note that inflammation and oxidative stress are key determinants in the biology of aging, and that vitamin D decreases mediators of systemic inflammation such as interleukin-2 and tumor necrosis factor-alpha. While habits that increase oxidative stress and inflammation may be difficult to change, they observe that “vitamin D concentrations are easily modifiable through nutritional supplementation or sunshine exposure.”

“Although both LTL and serum vitamin D concentrations decrease with age and are thus possible markers of aging in general, we have shown that the positive association between LTL and vitamin D concentrations is independent of age and many other covariates,” the authors conclude. “Longitudinal studies or randomized controlled trials of supplementation exploring the effect of vitamin D on LTL will be necessary to unequivocally establish the relation between vitamin D and leukocyte telomere dynamics; but for the moment, our data suggest another potential benefit of vitamin D—on the aging process and age-related disease.”

Using food diaries doubles weight loss, study shows

USA TODAY
07-08-08

Dieters who write down everything they eat each day lose twice as much weight as those who don't, according to one of the largest weight-loss studies ever conducted.

This confirms the importance of keeping a food diary -- advice that nutritionists and weight-loss programs have pushed for years.

Scientists at four clinical research centers recruited 1,685 overweight or obese adults who weighed an average 212 pounds. Forty-four percent were African Americans.

The participants were offered 20 weekly group sessions led by nutritionists and behavior counselors and encouraged to try to lose at least 9 pounds in six months. They were told to consume about 500 fewer calories a day, eat plenty of fruits and vegetables, do about 180 minutes of moderate-intensity physical activity a week, and keep daily food and exercise records.

The findings reported in the August issue of the American Journal of Preventive Medicine:

*Dieters who kept their food diary six or more days a week lost an average of about 18 pounds in six months, compared with about 9 pounds for those who didn't keep food diaries.

*The biggest losers also attended most of the group meetings and did more exercise. Some did 300 minutes or more of physical activity a week, but the average participant in the study did about 117 minutes a week.

*69% of the participants lost 9 pounds or more, which is enough to improve some health measures such as blood pressure, joint pain and pre-diabetes.

*69% of black men and 59% of black women lost at least 9 pounds.

"There is a misconception that nobody can lose weight, but in this study, two-thirds of them lost enough weight to make a difference to their health," says Victor Stevens, senior investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. The National Heart, Lung, and Blood Institute sponsored the study.

These weight-loss techniques work well with everybody, including African Americans, who are often underrepresented in studies and yet suffer from a high rate of obesity and weight-related illnesses, he says.

Food diaries are a "powerful self-management technique. They help you figure out where the extra calories are coming from," he says. It works best if someone else looks over your food record. "When you put yourself in a position where you are accountable for your behavior, it changes behavior."

Many people are getting lots of extra calories by eating large portions at restaurants, Stevens says. He is currently working with a client who was consuming 1,500 calories of fast food at lunch. The dieter is now bringing a 500-calorie lunch to work, saving 1,000 calories a day.

Dawn Jackson Blatner, a registered dietitian in Chicago, tells people that a food diary "is the best way to monitor every crumb, morsel, nibble, sip, swallow and bite you take."

Wednesday, July 2, 2008

The 11 Best Foods You Aren’t Eating

By Tara Parker-Pope
Published: June 30, 2008
An unusual list of foods that probably aren't in your shopping cart.

http://well.blogs.nytimes.com/2008/06/30/the-11-best-foods-you-arent-eating/

Lying About Your Vegetables

By Tara Parker-Pope
Published: July 1, 2008
Many people overstate their fruit and vegetable consumption, a new study suggests.

http://well.blogs.nytimes.com/2008/07/01/lying-about-your-vegetables/