Prostate Cancer

It's probably my age but at this moment I know three men going through treatment for prostate cancer. One in 6 men get diagnosed with prostate cancer but luckily few actually die of prostate cancer.

Jumping in and getting treated aggressively as soon as prostate cancer is diagnosed seems a bad idea as most prostate cancers develop slowly and the side affects of treatment can be very unpleasant. However waiting too long for treatment can also go badly wrong. Once prostate cancer escapes into the hips - life can be very painful.

Dendreon Corporation just received FDA approval for their prostate cancer drug Provenge. This is a vaccination which helps the body fight the cancer more effectively. Most vaccinations strengthen the immune system prior to an infection but interestingly Provenge is taken after prostate cancer is diagnosed. The procedure is to take a blood sample, extract specific white blood cells and then these blood cells are incubated with a protein found on the surface of prostate tumors. Then the white blood cells are infused back into the patient they came from - usually three infusions each two weeks apart - so the treatment takes about a month.

If I ever leave it late getting prostate cancer treatment then Provenge might just be my get out of jail card.

Two of the men getting prostate cancer treatment have decided upon Proton Beam treatment. There are currently five proton beam facilities in the USA with a sizth underconstruction. The facility in Jacksonville, Florida is convenient for anyone in the Atlanta, Georgia area.

Protons are positively charged hydrogen atoms stripped of an electron and then accelerated to a very, very high speed. Proton beam treatment - click the play arrow on the video to see how it works - seems to have fewer side affects than traditional radiation and chemo treatments. The charges seem to run around $300,000 but if you are over 65 then Medicare will probably pick up most of the costs.

During treatment most men stay active - click the play button on the video - and feeling OK - unlike traditional radiationtherapy.

The third man of the three I know going through prostate treatment opted for radiation therapy - low and high intensity radiation.

Any man getting on in years has to worry about prostate cancer and if I need to urinate too often then the worry stays with me for a while.

Exercise Keeps you Young ?

Could it be true that exercise keeps you young ?

One hears the stories about someone running marathons and then keeling over with a heart attack. It can be disheartening. Should I join the couch potatoes ?

A group of researchers in Germany faced with the fact that the underlying molecular mechanisms of the vasculo-protective effects of physical exercise are incompletely understood set up an exercise project to find out what happens to the Telomeres.

If there is a 'bottom line' then it is to get your V02 Max up and keep it up and the Telomeres will stay long and young!

Telomere erosion is a central component of aging. Telomeres are the 'caps' the ends of the chromosomes and they protect the chromosomes from damage but when the telomeres are themselves eroded away, the cell can no longer divide. It just dies and nothing takes its place.

 The study in Germany examined the effects of exercising on telomere biology:

• Firstly in mice 
• Secondly the effects of long-term endurance training on telomere biology in humans.

The 50-ish marathon runners had telomeres only slightly shorter than 20-ish runners but the sedentary 50 year olds had already lost 40% of the telomere length.

Telomeres made news in December 2009 when Nobel prize for Medicine was won for research on Telomeres. Watch the interview in Stockholm with the three winners: 

• Elizabeth Blackburn
• Carol Greider
• Jack Szostak

I'm not sure if the nutritional treatment to keep the telomeres at a healthy length is snake oil or not but this is an interesting one

•  watch the presentation by Dr Joseph Raffaele.

Dr Sunshine

Dr Sunshine, otherwise known as Michael Hollick, was interviewed by the New York Times Magazine this morning. I've been convinced by Dr Sunshine to increase my Vitamin D intake - now at 3,000 IUs a day, every day - but there are times when I think that I would not loan any money to Michael Hollick.

Read this interchange between Michael and the writer Deborah Solomon:

What bothers me about your research is the inflated claims you make for it. You say that one pill can prevent and treat everything from cancer to autism to depression. There has never been a medication that did all that.

I never said autism.

It’s on the cover of your book!


Read all of a punchy little interview.

Of course he was promoting his most recent book - out April 1, 2010. Probably worth reading.

Run a 10K Race in less than 1 hour

One of my big health and fitness objectives for 2010 is to run a 10K race in under an hour. It must be nearly a decade since I ran 10K at that speed. So, will my legs still do it.

10K (kilometers) is 6.2 miles.

I'm going to train mostly on a treadmill to be kind to my knees. I've blog'd frequently about my knees but they are not bad at the moment and the intention is to run 3 times a week - Monday, Wednesday and Friday.

So how fast do I need to be able to run ?

Running on a treadmill is about 10% faster than on the road; some say 11.5% faster.
10% faster means I need to run 10K in 54 minutes in order to run 60 minutes on the road.
11.5% faster would mean running 10K in 53 minutes 6 seconds.

So can I run the distance at 5 mins 24 seconds for every kilometer ? Translated in miles this means running every mile in 8 mins 43 seconds.

Where am I now in terms of speed?

I can run 3 miles at a speed of 8 minutes 42 seconds i.e. just inside the target speed but I need to run for twice as far at that speed ?

The PLAN

JANUARY 2010 - Build a base of stamina by running the 10K distance every week and sometimes more than once a week but at a slower pace than the target pace (fairly obviously). The idea behind long slow running distance is to build an expanded network of capillaries in the leg muscles and to increase the weight of aerobic enzymes in the leg muscles.

How did the plan workout ?

Mileage in January:
week 1 = 16 miles
week 2 = 17 1/4 miles
week 3 = 18 miles
week 4 = 19 1/2 miles

The longest run was 8 miles and the fastest 6.2 miles (10K) was 62 minutes.

FEBRUARY 2010 - Increase speed by running faster over shorter distances - each week increase speed slightly. The objective is to increase how much blood the heart pumps at each stroke and to improve tolerance to lactate in muscles and blood.

How did plan workout ? 

Ran 3.1 miles (5K) in 26 mins 48 seconds (6.9 mph and faster finish)  (on treadmill)

Ran for 8 minutes at 7.4 mph

Ran for 4 minutes at at 7.8 mph.

March 2010 - Run at February speeds but go longer trying to get to a run of 5 miles at 6.9 mph and try a 5K event i.e. run on road and see difference road to treadmill.

PLYOMETRICS

Plyometric jumping can take your running training to a new higher level but you have to be ready.

This means:

• being able to squat at least half your body weight and ideally more than just half
• you are able to run a 10K, without struggling too much.

Plyometrics is a type of exercise training designed to produce fast, powerful movements, and improve the functions of the nervous system, generally for the purpose of improving performance in sports. Plyometric movements, in which a muscle is loaded and then contracted in rapid sequence, use the strength, elasticity and innervation of muscle and surrounding tissues to jump higher, run faster, throw farther, or hit harder, depending on the desired training goal. Plyometrics is used to increase the speed or force of muscular contractions, providing explosiveness for a variety of sport-specific activities.

The American Council on Exercise has some sound, cautious advice about plyometrics.

Donald Chu has some excellent detail on how to improve your running performance by adding plyometrics to your training.

Soy and Osteoporosis Prevention: What’s the Connection?

The Johns Hopkins Health Alerts had an interesting piece Soy and Osteoporosis - does Soy help aleviate Osteoporosis ?

The risk of developing osteoporosis increases as we grow older. Exercise, proper nutrition, and – when appropriate – medication can all help to prevent osteoporosis. But what about isoflavones?

To cut to the chase the answer is NO. The isoflavones in Soy do not help alleviate Osteoporosis. As you might have read in other blogs I'll take supplements which have a good chance of working but soy can be written off.

Original research at American Journal of Clinical Nutrition.

Runners Knees ? They hurt much of the time ?

Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial



Right now I limit myself to running three times a week only so that I don't totally wreck my knees. It's a delicate balance as I hate painful knees but I want to run a 10K in less than an hour during 2010.

I'm experimenting with UC-II to see if it does any good!

The research reports say that it's more effective than glucosamine and chondroitin. I've tried both of these and they have no effect on my knees so I'm hoping that UC-II is better.

Currently, glucosamine and chondroitin are the two most commonly used nutraceuticals in humans as well as in animals to alleviate pain associated with arthritis (6). However, recent randomized controlled trials and meta-analysis of these supplements have shown only small-to-moderate symptomatic efficacy in human OA (7).

An emerging novel nutraceutical ingredient known as UC-II has received considerable attention in the treatment of OA. UC-II is a novel undenatured type II collagen derived from chicken sternum cartilage.

Let's get physical: Nine facts about fitness - New Scientist

Let's get physical: Nine facts about fitness - New Scientist

New Scientist is launched into the mailbox every week and every week it teaches me something new.

What counts as Exercise ? The standard is now 150 minutes a week of moderate intensity.

So what is moderate intensity ? For most people it means walking at 100 steps a minute. This gets you to 3 METS - the lowest level to qualify as moderate.

So what is a MET ? 1 MET is when you are lying flat doing nothing i.e. just about as low energy as it gets.

3 METS means burning 3 times as much energy as the 1 MET state.

Moderate intensity is between 3 and 6 METS.

So what is 6 METS ? A slow jog should get you to 6 METS.

Click on the link to New Scientist and learn much more and if you want to be amused read the comments at the bottom of the article because a long discussion broke out about how to cheat New Scientist and evade some of their rules.

Vigorous Exercise _ Good for the Brain

Reuters carried this story about vigorous exercise improving the aging brain. One question that the writer, Megan Brooks put to Dr Laura Baker, the leading researcher on the study was "Might it be possible to get the same brain benefit from lower intensity aerobic exercise?". My thought was "Why take a chance ?" If you know vigorous exercise will push back the impact of an aging brain, why take the chance of just doing the minimum intensity.

Exercise protects and improves the aging brain

Megan Brooks

Fri Jan 15, 2010 3:32pm EST

NEW YORK (Reuters Health) - Two new studies provide more evidence that regular aerobic exercise not only staves off the problems with thinking and memory that often come with age, but it can actually help turn back the clock on brain aging.

Health

In one study, researchers found evidence that engaging in moderate physical activity such as brisk walking, swimming, or yoga in midlife or later may cut the risk of developing mild thinking problems.

In the other study, a group of elderly individuals who already had mild problems had improvements in their mental agility after six months of high-intensity aerobic activity.

People with mild mental impairments of the kind studied - known as mild cognitive impairment -- typically have some memory difficulties, such as forgetting people's names or misplacing items. Each year, 10 to 15 percent of individuals with mild cognitive impairment will develop dementia, as compared with 1 percent to 2 percent of the general population. Previous studies in animals and humans have suggested that exercise may improve thinking and memory.

To investigate further, Seattle-based researchers studied 33 adults with mild cognitive impairment. Twenty-three spent 45 to 60 minutes on a treadmill or stationary bicycle four days a week for six months, while the other 10 "control" subjects did stretching exercises but kept their heart rate low.

Six months of intense aerobic exercise "improved cognitive abilities of attention and concentration, organization, planning, and multi-tasking," study chief Dr. Laura Baker noted in an email to Reuters Health. In contrast, cognitive function test scores continued to decline in the group that didn't have vigorous exercise.

Might it be possible to get the same brain benefit from lower intensity aerobic exercise?

"In theory, yes," Baker said, "but we are just now starting the studies that will help us know how little is enough. In the next five years, we'll have a much better idea about the minimum 'dose' of exercise needed (how often, duration of exercise sessions, how much exertion is needed) without compromising the cognitive benefits."

Baker, who is from the University of Washington School of Medicine and the Veterans Affairs Medical Center, Geriatric Research, Education, and Clinical Center, also noted that the average magnitude of mental improvement with aerobic exercise was "bigger for women than for men."

And while she's not exactly sure why, she noted that, for the women in the study, aerobic exercise improved the body's sensitivity to insulin, a hormone that plays an important role in providing energy to the muscles and organs of the body and to the brain. "Contrary to our expectations, aerobic exercise did not improve insulin sensitivity for the men," Baker said.

EXERCISE TO WARD OFF MENTAL DECLINE

The other study, by Dr. Yonas E. Geda and colleagues at Mayo Clinic in Rochester, Minnesota, involved 1,324 elderly adults free of dementia in 2006-2008. Experts determined that 198 had mild cognitive impairment and 1,126 had normal cognitive function.

Those who said they had engaged in moderate exercise such as brisk walking, aerobics, yoga, strength training or swimming in their 40s, 50s and beyond were less apt to have mild cognitive impairment, the researchers found.

Moderate exercise in midlife was associated with a 39 percent reduced likelihood of developing mild cognitive impairment, and moderate exercise in late life was associated with a 32 percent reduction in the odds of mental decline. The findings were consistent among men and women.

These two studies, both published in the Archives of Neurology, contribute to a growing body of literature supporting the benefits of a physically active lifestyle on the brain.

SOURCE: Archives of Neurology, January 2010.

HBO: Documentaries: The Alzheimer's Project: Watch the Films: The Supplementary Series: Identifying Mild Cognitive Impairment

Running 10K at 66

No. 1 Health Objective for 2010 - Run a 10K event - 6.2 miles in less than 60 minutes.

Can I still do it ? Only time will tell.

Why ? I just like the feeling that running gives me and running seems a healthy activity - maybe the healthiest. Runners who keep running into old age seem to do better every possible way compared to people who stop running (and many times better than those who have never pushed their bodies hard). Read the report on a study of runners (and the control group of non-runners) which has now been on-going for over 20 years. At the start everyone was at least 50 years old and by now they have progressed into their '70s and older.

So I want to run 10K (6.2 miles) in under an hour before the end of 2010. What can I achieve right now ? I can run 10K on a treadmill in 62 minutes. Not bad but a long way short of objective because running on a treadmill is easier than running on the road and that's what I need to do at a running event.

This is my plan for 2010:

1) Increase endurance so that 10K is easy not really hard - target to achieve a long run 0f 15K i.e. 50% above race distance

2) Run 10K on a treadmill in 59 minutes by gradually over time increasing running pace.

3) Add a 1% incline to the treadmill to start to replicate running outside compared to on a treadmill and try to get to 59 minutes.

4) Run 5K on the road with a target time of less than 28 minutes.

5) Run 10K to see where I stand time wise.

This leads to the big question. How to improve my running time. I need to be able to run 10K at least 5 minutes faster on the treadmill than I can currently manage.

An important running concept is VO₂max

There are two ways to go:

- hard, fast intervals

- long, slow distance.

After reading the long article by Seiler and Tønnessen I'm going to start train with long slow distance. This means running a lot at below race pace.

The body adapts to endurance training by:

a) increasing the flow of blood to leg muscles by growing additional tiny blood vessels all the way to the muscle fibers so that oxygen carried in red blood corpuscles has as short a distance as possible to get to the muscles that need oxygen. Lots of long, slow distance encourage the body to become more efficient at running distance. This is called peripheral adaptation.

b) encourage the heart to produce stronger contractions, to eject a bigger fraction of the blood in the heart at every contraction and to increase the diameter of major blood vessels close to the heart. This is central adaptation.

Central adaptation needs faster running pace taking heart rate up close to maximum. More on this over the months after I make good progress with long, slow distance.

Our species probably evolved to run and that might be why running seems to be the healthy activity and it might even encourage a larger brain.

Of course, one can dream about running distance in the Kenya mountains - enjoy this video.

I'm a Boniva man - once a month (last Sunday in the month - unless there are 5 Sunday's when it becomes the second to last Sunday). I've read the long, long document wrapped up with the tablets but I was surprised, no amazed when reading Jane Brody's piece in the New York Times this week "Options for Bone Loss, but I'm no Magic Pill."

The whole piece is very interesting but these 2 points grabbed my attention:

1. . . . the most disturbing side effect of these drugs has been a growing number of patients who experience an otherwise uncommon injury — a low-trauma fracture of the thigh bone or other major bone — and a delay in healing or complete failure of a fracture to heal, especially after many years on bisphosphonates. It is believed that in slowing bone turnover, the drugs may impede the repair of normally occurring microfractures and eventually result in a major fracture.

2. These side effects have prompted a warning that after five years on bisphosphonates, people should take a break from the drugs for at least a year.

So I went back and read that long, long screed termed Highlights of Prescribing Information and the take a break after 5 years is no where to be seen. I have no reason to disbelieve Jane Brody so I have to think that long, long screed inside the Boniva pack is "light" on information.

If you are wondering what osteoporosis exactly looks like, click on the image below to see Dr Susan Ott's collection of bone images from her web site on osteoporosis and bone physiology.

Knee Cartilage and Vitamin D

I'm back to running 12 to 15 miles a week and I've been just a tad surprised that my knees have not been hurting non-stop but I've given all the thanks to my knee lubrication in 2008. However increasing my Vitamin D intake might well have been helping as well.

The research, in Tasmania, Australia, looked at men and women aged 51 to 79 years with an average of 61 years. This is right in my age range and hence the interest.

The paper has the title Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: The Tasmanian older adult cohort study

Dr. Changhai Ding is a long time researcher on cartilage, osteoarthritis and knees (look at his long list of research papers) said "Cartilage loss is the hallmark of osteoarthritis."

I've increased my Vitamin D intake up to 3,000 IU's a day and hopefully this has increased the level of serum 25-hydroxyvitamin D [25 OHD] . The research was carried out in Tasmania, Australia and maybe that was why the mean 25-hydroxyvitamin D [25 OHD] baseline was 52.6 nmol/L - the sunny climate gave high Vitamin D levels. In northern climates a Vitamin D level of 30 nmol/L and up is seen as normal.

The next thing to do is to get my Vitamin D level measured to find out if my less painful knees are related to much higher Vitamin D levels (bearing in mind my levels were around 30 nmol/L in April 2009).

Soy - good for mens bones ?

Soy - good for mens bones ? NO - unfortunately.

A 10 year study in Singapore which followed 63,000 men and women came to the conclusion that consumption of soy, tofu and isoflavones had no protective benefits for men.

Gender-specific Associations Between Soy and Risk of Hip Fracture in the Singapore Chinese Health Study

For both genders, hip fracture risk was positively associated with cigarette smoking and was inversely associated with body mass index. There was a statistically significant association of tofu equivalents, soy protein, and isoflavones with hip fracture risk among women but not among men.

Should men eat a lot of soy ?

Probably not - read more.

XEROSTOMIA - Dry Mouth

Who would have thought that you could say Dry Mouth in a really complicated, obscure way by using the word xerostomia - try using that in scrable and see everyone object.

The January 2010 edition of Mayo Clinic Health Letter had advice for people like me who take omeprazole to stop acid reflux which was not that welcome. When one stops taking omeprazole (or the alternatives like Nexium; Prevacid; Prilosec; Protonix; Aciphex) the stomach plays a good trick - it now produces even more acid than before.
I've been trying to gradually taper off Omeprazole and what Mayo tells me is "I'm wasting my time." Tapering doesn't reduce the impact of coming off Omeprazole - sad! I'm now down to taking Omeprazole on Sunday and Wednesday. I have been feeling acid reflux more but how long will it last ?

My interest in xerostomia is because I often wake up in the middle of the night, and the morning, with a very dry mouth. It turns out that this can be bad for teeth enamel because saliva neutralizes acid (coming up from the stomach) that could dissolves tooth enamel and the saliva also stops bacteria that can grow on the teeth surface and also dissolve tooth enamel.

Making sure that tooth enamel does not get wrecked due to easing back on Omeprazole involves getting enough fluoride. Luckily I don't drink much bottled water - I can drink tap water without any trouble. If you do drink a lot of bottled water you might be low on fluoride. Then again if you drink all of your water filtered then that can be a problem; filtration takes fluoride out of the water.

It's never easy.

Current vitamin D doses insufficient for mothers-to-be

By Stephen Daniells, 16-Sep-2009

Many mothers to be are not getting enough vitamin D, even those taking supplements at the recommended doses, says a new study from Northern Ireland.

Almost all of the women in the study had blood levels of the vitamin below 80 nmol/l, a level which is widely considered to be the cut-off for vitamin D sufficiency, showing that current recommendations may be insufficient.

Currently in the UK, pregnant women are recommended by the Food Standards Agency (FSA) to take supplements with a daily dose of 10 micrograms vitamin D. In the US and Canada, where no specific recommendations exist for pregnant women, adequate intakes are inline with the general population and set at 5 micrograms per day.

Dr Maria Barnes from the University of Ulster, Coleraine, told NutraIngredients.com that, as their study was observational, it was impossible to determine the dose of vitamin D required to improve maternal vitamin D status.

“Clearly such recommendations can only be established following a number of well designed double-blinded, randomised placebo controlled vitamin D intervention studies during pregnancy,” said Dr Barnes.

“However, from our study it is evident that general dietary supplementation given to pregnant women may be inadequate to maintain or improve vitamin D status, particularly during wintertime,” she added.

The researchers, from Queen's University, Belfast, the University of Ulster, and Belfast City Hospital report their findings in the British Journal of Nutrition.

Bigger doses needed

A wider debate is ongoing in nutrition circles regarding vitamin D intakes. Late last year the American Academy of Pediatrics (AAP) said children should be consuming 400 International Units (IUs), or 10 micrograms per day. This would mean doubling the current US recommendations. Others have recommended increasing levels to 2,000 IUs.

The US National Academy of Sciences' Institute of Medicine (IOM) said it will be reviewing its recommendations “in the not too distant future”.

According to Dr Barnes and her co-workers, children born to vitamin D-deficient mothers are at an increased risk of rickets, while maternal insufficiency may detrimentally affect bone build-up, and increase the risk of type-1 diabetes and asthma.

Study details

The researchers recruited 99 pregnant women at 12, 20 and 35 weeks of gestation, and 38 non-pregnant controls living at a latitude of 54 to 55 °N. S

Vitamin D levels, calculated using serum concentrations of 25- hydroxyvitamin D (25(OH)D), the non-active 'storage' form of the vitamin in the body, showed that 35, 44 and 16 per cent were vitamin D deficient at 12, 20 and 35 weeks of gestation. Furthermore, 96, 96 and 75 per cent were vitamin D insufficient at the same gestation stage.

While women taking supplements did have higher vitamin D levels, “vitamin D insufficiency was still evident even in the face of supplement use”, wrote Dr Barnes and her co-workers.

“To our knowledge, the present study is the first to measure vitamin D status in free-living Caucasian women with uncomplicated pregnancies, which collected samples longitudinally throughout pregnancy whilst concurrently sampling non-pregnant age-matched controls,” stated the researchers.

“Given the potential consequences of hypovitaminosis D on health outcomes, vitamin D supplementation, perhaps at higher doses than currently available, is needed to improve maternal vitamin D nutriture,” they concluded.

Data on D

Vitamin D refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. The former, produced in the skin on exposure to UVB radiation (290 to 320 nm), is said to be more bioactive.

While our bodies do manufacture vitamin D on exposure to sunshine, the levels in some northern countries are so weak during the winter months that our body makes no vitamin D at all, meaning that dietary supplements and fortified foods are seen by many as the best way to boost intakes of vitamin D.

Source: British Journal of Nutrition
September 2009, Volume 102, Issue 06, Pages 876-881, doi:10.1017/S0007114509297236
“Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study”
Authors: V.A. Holmes, M.S. Barnes, H.D. Alexander, P. McFaul, J.M.W. Wallace

Cancer Safety Fears Of Most Common Heartburn Treatment Rejected By Major Clinical Study

Cancer Safety Fears Of Most Common Heartburn Treatment Rejected By Major Clinical Study

I'm taking Omeprazole - a proton pump inhibitor to try and avoid the threat of esophagus cancer due to repeated flooding with stomach acid. This study confirms that the medicine does not itself cause cancer. One kind of thought this must be true but good to have a serious 2 year study make sure.

Of course my alternative healthcare provider say that it's all non-sense. The stomach needs to have a lot of acid and if the acid producing cells in the stomach lining are prevented from working then bacteria accumulate in the stomach and produce even stronger acid.

I kind of doubt this but there is always someone with a different point of view.

Full without food: Can surgery cure obesity? - health - 02 September 2009 - New Scientist

Full without food: Can surgery cure obesity? - health - 02 September 2009 - New Scientist


Over the past decade, genetic and endocrinological research has pointed to a complex set of hormones and neural signals that control food intake (New Scientist, 9 August 2003, p 38). There seem to be two systems at work: one that aims to keep body-fat stores constant over long periods of time, and another that controls food intake over the course of a day.

It is this short-term control mechanism that has been thrust into the limelight thanks to gastric bypass surgery. "Suddenly, the signalling from the gut has turned out to be much more potent than people believed - and possibly a better drug target," says Nick Finer, an endocrinologist at University College London.

Our digestive system produces both hormones that make you hungry and those that make you feel full, or sated. Ghrelin, produced by the lower part of the stomach, is a powerful promoter of hunger, while the small intestine releases a number of hormones when it senses the presence of food. These aid digestion as well as producing feelings of satiety, and include cholecystokinin, glucagon-like peptide-1 (GLP-1), oxyntomodulin and PYY.

Current thinking is that changes to the levels of any or all of these hormones could be responsible for the effects of the bypass. Shrinking the stomach seems to reduce ghrelin production, which would curtail hunger signals. A bypass also delivers nutrients to the more distant parts of the small intestine faster and in greater quantities than normal, which would stimulate the release of more satiety hormones.

The other surprising outcome from bypass surgery is its effects on type 2 diabetes, a condition in which people can no longer regulate their blood sugar. After eating, the pancreas normally releases insulin, a hormone that reduces excess glucose in the blood. In type 2 diabetes, though, the body cannot respond to insulin properly or the pancreas fails to make enough of the hormone, or sometimes both.

Type 2 diabetes is much more common in people who are overweight, and it was expected that the weight loss following a bypass would improve symptoms. But doctors have been amazed by just how quickly this happens - sometimes in a matter of hours and certainly long before any significant weight loss occurs. Many bypass patients have been able to throw away their diabetes drugs. "If you change the anatomy of the bowel, you improve diabetes like nothing else has ever done," says Francesco Rubino at Cornell University-New York Presbyterian Hospital in New York. The upshot is that bypass surgery is now being considered for diabetics of lower and lower weight - perhaps even approaching normal weight if their diabetes is severe enough.

(see "A surgical cure for diabetes?").

new glucagon and GLP-1 co-agonist eliminates obesity

Qnexa Obesity

Qnexa Obesity

VIVUS announces that obese patients on Qnexa had a weight lost averaging 14.7%.

Read full details.

What Vivus says about the trial:

• The EQUATE trial demonstrated superior weight loss with both the full-dose and mid-dose of Qnexa, as compared to the individual components and placebo.
  
• Subjects treated with full-dose and mid-dose Qnexa had an average weight loss of 9.2% and 8.5% respectively, as compared to weight loss of 1.7% reported in the placebo group (ITT LOCF p<0.0001).
  
• Average weight loss was 19.8 pounds and 18.2 pounds in the treatment arms as compared to 3.3 pounds in the placebo group.
  
• Qnexa was well tolerated with no drug-related serious adverse events in the study.

Read more.

Time to get excited about real help for serious weight loss ?

• Remember this is not really new technology because Qnexa is a combination of phentermine and topamax.
• There are side affects - lots of them.
• Qnexa is not yet available. In fact it has yet been submitted for approval by FDA.

Benefits of exercise differ by sex and race | Health | Reuters

How much health benefit you get from physical exercise might depend on your gender, and your race, new research suggests.

The work is based on data from more than 15,000 middle-aged African
American and Caucasian men and women who have been participating since
the late 1980s in the large Atherosclerosis Risk in Communities Study.

Benefits of exercise differ by sex and race | Health | Reuters


The key points:

• exercise helps promote health across the races and genders
• there are differences which are significant
• mild to moderate exercise decreased triglycerides only in white people
• increased activity reduced LDL in women but not men

Why so much variation ? No one knows. These are new results which might be contradicted by later research. This particular study used questionnaires which obviously depend upon the honest of participants.

What I've learned this month: Kidney Stones; Osteoporosis; Prostate Cancer; Calcium intake

Kidney Stones and how to prevent them forming.

I have a kidney stone but the doctor is certain that it's old and will probably never descend. I think he really meant that it will never come down but he was being careful just in case the unexpected happens.

The Mayo Clinic Health Letter, September 2009, has the happy line that "you wont soon forget the pain of first passing your first kidney stone." Then it goes on to mention there's a 50% chance that you'll pass another one within 10 years !



What to do ? Prevention strategies concentrate on reducing calcium, uric acid and maybe oxalate in the urine.

• Drink a lot of fluid - 12 cups a day (preferably water)
• Reduce meat eating to less than 8 ounces a day
• Reduce sodium in your food

Now we come to the tricky parts:

• Vitamin D, which I take to help deal with osteoporosis, can increase the risk for kidney stones, if your body is predisposed to making calcium kidney stones.
• If your stones are of the calcium oxalate type then limiting oxalate containing foods is worth thinking about. We are talking about spinach, beets, peanuts, potatoes and chocolate. Of course, all of these are also a good way of increasing calcium intake to address any osteoporosis issues.
• Getting calcium up in your diet helps reduce oxalate absorbed in the intestine because calcium bind to oxalate in the intestine and blocks oxalate absorption.
  
• I get my calcium up via Greek yogurt and calcium citrate tablets. I also think that calcium citrate is easier to absorb if one is also taking a Proton Pump Inhibitor, such as Omeprazole like me, rather than calcium carbonate.

What about Prostate Cancer and Calcium ?
Always a cheery topic !

September, 2009 edition of Nutrition Action was, as usual, stuffed full of interesting bits but the piece starting "What can men do to lower their risk of prostate cancer ? 'Avoid high milk intake' says Harvard's Walter Willett" caught the eye.

The NIH and AARP study tracked milk drinkers for 6 years. The study found no link between prostate cancer and consumption of whole milk or non-fat milk or yogurt or cheese. However the study found that men who drank at least 2 cups of skim-milk a day had a 23% higher risk of advanced prostate cancer than those who drank no skim milk. Strange in the extreme.

So how might milk increase or encourage prostate tumors ?

One theory is that it's connected to IGF-1 (Insulin-like Growth Factor). Milk increases it and it's possible that higher levels of IGF-1 is related to more aggressive prostate cancer tumors. So why milk and not yogurt or cheese ? The theory is that the fermentation leading to both cheese and yogurt denatures IGF-1. Of course it might be the calcium. Excess calcium might account for the higher prostate cancer risk.

The Health Professional Follow-up Study tracked 47,000 men for 16 years and found that those who took in more than 2,000 mg a day of calcium had a risk of fatal prostate cancer 2 1/2 higher than those who took in less than 750 mg a day of calcium.

So what have I learned so far this month ?

Dealing with Acid Reflux (GERD) with a Proton Pump Inhibitor like Omeprazole might have lead to osteoporosis. Dealing with osteoporosis with higher calcium intake might, over time, lead to prostate cancer.

Somehow the chain has to be broken. At the moment I'm getting my supplemental calcium up to around 1,200 mg a day and getting all (nearly) all my dairy intake from yogurt and cheese. Normally I don't drink milk of any kind.

What I've Learned this month: Kidney Stones;Prostate Cancer; Omega-3 fish; Lactate Threshold Training.

Kidney Stones and how to prevent them forming.

I have a kidney stone but the doctor is certain that it's old and will probably never descend. I think he really meant that it will never come down but he was being careful just in case the unexpected happens.

The Mayo Clinic Health Letter, September 2009,  has the happy line that "you wont soon forget the pain of first passing your first kidney stone." Then it goes on to mention there's a 50% chance that you'll pass another one within 10 years !

What to do ? Prevention strategies concentrate on reducing calcium, uric acid and maybe oxalate in the urine.

• Drink a lot of fluid - 12 cups a day (preferably water)
• Reduce meat eating to less than 8 ounces a day
• Reduce sodium in your food

Now we come to the tricky parts:

• Vitamin D, which I take to help deal with osteoporosis, can increase the risk for kidney stones, if your body is predisposed to making calcium kidney stones.
• If your stones are of the calcium oxalate type then limiting oxalate containing foods is worth thinking about. We are talking about spinach, beets, peanuts, potatoes and chocolate. Of course, all of these are also  a good way of increasing calcium intake to address any osteoporosis issues.
• Getting calcium up in your diet helps reduce oxalate absorbed in the intestine because calcium bind to oxalate in the intestine and blocks oxalate absorption.
  
• I get my calcium up via Greek yogurt and calcium citrate tablets. I also think that calcium citrate is easier to absorb if one is also taking a Proton Pump Inhibitor, such as Omeprazole like me, rather than calcium carbonate.
  

What about Prostate Cancer and Calcium ?
Always a cheery topic !

September, 2009 edition of Nutrition Action was, as usual, stuffed full of interesting bits but the piece starting "What can men do to lower their risk of prostate cancer ? 'Avoid high milk intake' says Harvard's Walter Willett" caught the eye.

The NIH and AARP study tracked milk drinkers for 6 years. The study found no link between prostate cancer and consumption of whole milk or non-fat milk or yogurt or cheese. However the study found that men who drank at least 2 cups of skim-milk a day had a 23% higher risk of advanced prostate cancer than those who drank no skim milk. Strange in the extreme.

So how might milk increase or encourage prostate tumors ?

One theory is that it's connected to IGF-1 (Insulin-like Growth Factor). Milk increases it and it's possible that higher levels of IGF-1 is related to more aggressive prostate cancer tumors.

So why milk and not yogurt or cheese ?

The theory is that the fermenation leading to both cheese and yogurt denatures IGF-1.

Of course it might be the calcium. Excess calcium might account for the higher prostate cancer risk. The Health Proffessional Follow-up Study tracked 47,000 men for 16 years and found that those who took in more than 2,000 mg  a day of calcium had a risk of fatal prostate cancer 2 1/2 higher than those who took in less than 750 mg a day of calcium.

So what have I learned so fat this month ? Dealing with Acid Reflux (GERD) with a Proton Pump Inhibitor like Omeprazole might have lead to osteoporosis. Dealing with osteoporosis with higher calcium intake might, over time, lead to prostate cancer.

Somehow the chain has to be broken. At the moment I'm getting my supplemental calcium up to around 1,200 mg a day and getting all (nearly) all my dairy intake from yogurt and cheese. Normaly I don't drink milk of any kind.

Exercise - Waste of Time ?

Time Magazine must be delighted with the storm of protest generated by their cover story - Why Exercise Won't Make You Thin.

The writer is John Cloud who asks "I still have gut fat that hangs over my belt when I sit. Why isn't all the exercise wiping it out?"

John Cloud is no stranger to storms of protest threatening his existence but he has an excellent turn of phrase.

As a Personal Trainer I really liked John Cloud's line:
"On Wednesday a personal trainer will work me like a farm animal for an hour, sometimes to the point that I am dizzy — an abuse for which I pay as much as I spend on groceries in a week."

As it turns the answers to John Cloud's questions about how avoid over-eating can be found on the Time web-site. Look at this video of nutrition advice (good advice) made in the Time & Life cafeteria.

The American Council on Exercise (one of my personal training qualifications is through ACE) took John Cloud's article very seriously and published almost a peer-reviewed journal article.
Lots to read - all of it good:

Editorial: Why Time Magazine’s Article on Exercise and Weight Loss Could Be Harmful to Your Health

By Cedric X. Bryant, Ph.D., F.A.C.S.M., Chief Science Officer, American Council on Exercise

The cover story of the August 9, 2009, issue of Time magazine featured an article entitled, “Why Exercise Won’t Make You Thin.” In this piece, author John Cloud made several inaccurate and unsubstantiated claims regarding the value of exercise, particularly as it relates to weight loss. What follows is a summary of some of the most misleading assertions made in this highly publicized article, as well as the American Council on Exercise’s response to these assertions:

• First and foremost, the article categorically implies that exercise has no meaningful role in weight loss. Such a conclusion is as false as it is reckless. The author’s “evidence” is the fact that he has “gut fat that hangs over his belt when he sits,” despite maintaining a regular exercise habit. In all likelihood, his unwanted abdominal girth is probably a by-product of genetics and/or consuming more calories than he expends


• Weight loss and maintenance are a matter of simple accounting that is dependent upon energy balance. In order for weight loss to occur, individuals must burn more calories than they consume. Regrettably, many individuals who regularly exercise are unable to meet their weight-loss goals because they eat too much. In reality, however, their “personal weight situation” and overall health profile would be far worse were it not for the extra calories they expend while exercising.


• An overwhelming body of scientific evidence exists that confirms the positive role that exercise plays in weight loss and maintenance (Hill and Wyatt, 2005; Jakicic and Gallagher, 2003; Jakicic et al., 2001). These findings refute the notion (advanced by the author) that exercise impairs weight-loss efforts by substantially and uncontrollably increasing appetite. Recent research suggests that appetite may be suppressed for 60-90 minutes following vigorous exercise by affecting the release of certain appetite hormones. It also appears that aerobic exercise is more effective at suppressing appetite than non-aerobic forms of exercise (Broom et al., 2009). In general, individuals who participate in moderate exercise tend to eat approximately the same number of calories (or only slightly more) than they would if they did not exercise. Elite-level athletes typically consume high volumes of food after their exercise workouts, but they almost always expend more calories than they consumed (Blundell and King, 1999). It is important to keep in mind, however, that appetite is influenced several factors and is a very complex process making it difficult to generalize the impact of exercise on appetite. The bottom-line is that exercise and diet go hand-in-hand with successful weight management.


• Surprisingly (and disappointingly) the author failed to mention the tremendously important role that exercise plays in the maintenance of weight loss. According to data from the renowned National Weight Control Registry, consistent exercise participation is the single best predictor of long-term weight maintenance. In others words, if individuals want to be successful in getting off the weight-loss rollercoaster (i.e., repeatedly losing weight and regaining it), they need to regularly engage in physical activity.

Read all of the ACE position.

The Pennington Biomedical Research Center had John Cloud visit for a day and I'm thinking they regret the invitation - Pennington put out this correction !


Much outrage about John Cloud but my vote for the best rebuttal is this one:

• On studies that have a diet only, exercise only, and exercise plus diet groups, the exercise plus diet groups (with scant exception) come out on top when it comes to weight/fat loss. Diet only, almost always beats out exercise only.
• One very well conducted 12 week study by Kramer et. al., which included both aerobic, strength training, and a dietary control, showed the following results. Fat mass losses - diet only: 6.7kg, diet/cardio: 7kg, diet/cardio/resistance: 10kg. Most noteworthy - the D+C+R group lost almost no lean tissue whatsoever, whereas the diet only group lost almost 3kg worth of lean tissue.
• Putting on and saving muscle tissue will have a lasting impact on your body's ability to lose fat. Plus you will look much better.
• Exercise becomes more important once you have lost the weight. Exercise should be a central strategy in preventing a re-gain.
• Pertaining to the above, the National Weight Loss Registry (which tracks those who have lost and kept off at least 30 lbs), shows that high levels of physical activity are a primary predictor of success.