http://www.m.webmd.com/diabetes/news/20151028/despite-advances-type-2-diabetics-still-face-elevated-death-risk-study

Type 2 Diabetics Still Face Elevated Death Risk

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- Medical science has made tremendous progress in prolonging the lives of people with type 2 diabetes. But, the prognosis still remains poor for patients who don't keep their blood sugar levels under control, according to results from a large-scale Swedish study.

People with type 2 diabetes carry a 15 percent increased risk of premature death compared to healthy people, the researchers reported in the Oct. 29 issue of the New England Journal of Medicine.

Those odds aren't great, but they're much better than they were as recently as 15 years ago, said senior author Dr. Marcus Lind, a physician at the University of Gothenburg in Sweden.

"Up to the year 2000, the excess risk of mortality in individuals with type 2 diabetes was generally considered to be doubled compared to the general population, implying a doubled risk to die during the following years," Lind said.

Now, the overall death rate for diabetics has "dropped to historical low levels," he added.

However, the risk of death is much higher in people younger than 65, those who poorly control their blood sugar levels, and those who've suffered kidney damage from type 2 diabetes, the researchers found.

The upshot is this -- type 2 diabetics have to do their part in managing their condition if they want the benefits that medical advances have wrought, said Dr. Robert Ratner, chief scientific and medical officer for the American Diabetes Association.

"If you develop diabetes, there is good evidence that attention to glucose [blood sugar] control and other cardiovascular risk factors from the onset can reduce any individual's risk of death," Ratner said.

The new study used data from the Swedish National Diabetes Register to compare the death rate among just over 435,000 people with type 2 diabetes with that of a healthy control group of 2.1 million people.

Type 2 diabetes occurs when the body loses its ability to effectively use insulin, a hormone that helps process blood sugar into fuel for cells. Patients can wind up with high levels of glucose in their blood, which is damaging to many systems throughout the body.

Type 2 diabetics younger than 65 have a death risk substantially greater than that of older diabetics, according to the study findings. Excess risk of death was two to three times higher among those younger than 55, compared to between 30 percent and 40 percent higher for diabetics aged 65 to 75.

"What you begin to see is the increased risk of mortality in diabetes is highest the younger you are," Ratner said. "The significant impact is really in those individuals under the age of 75, and it gets progressively greater as you go younger."

The study authors speculated that the higher death rates seen among younger diabetics might owe, in part, to some gap in the care offered to these people.

Poor control of blood sugar levels can make that bad situation even worse for younger diabetics, the researchers found.

Anyone who didn't manage their diabetes through lifestyle changes, insulin or medication faced a greatly increased risk of death, said study co-author Dr. Mikhail Kosiborod. He is a cardiologist at Saint Luke's Mid America Heart Institute and a professor of medicine at the University of Missouri-Kansas City.

"If you look at the data, regardless of the age we look at, regardless of everything else, the worse the glycemic control the higher the mortality," Kosiborod said.

But diabetics under 55 with poorly controlled blood sugar had a more than fourfold increased risk of early death, compared to healthy people. That risk was 55 percent higher for diabetics 75 and older who didn't bother to manage their diabetes, the findings showed.

Finally, a patient's death risk skyrockets if poorly controlled diabetes results in damage to their kidneys, the researchers said.

Diabetics younger than 55 who've entered end-stage kidney disease are 14 times more likely to die than a healthy person, according to the study.

End-stage kidney disease also multiplies the death risk sevenfold for diabetics 55 to 64, and sixfold for diabetics 65 to 74, the investigators found.

"Renal [kidney] disease and worsened kidney function are huge risk factors for overall mortality, regardless of age group," Kosiborod said.

Kosiborod concluded that "the strong message from our data is that if you are a young patient, there's a lot you can do to protect your health."

These steps include eating right, quitting smoking, and controlling blood pressure and cholesterol levels, he said.

But the best thing a person can do is try to avoid getting type 2 diabetes in the first place, Kosiborod added.

Type 2 diabetes prevention is possible, he said. "Clinical trials have shown that aggressive and intensive lifestyle interventions can prevent diabetes. You should do everything you possibly can to prevent this condition from occurring," Kosiborod said.

http://www.m.webmd.com/diet/news/20151027/secret-to-staying-slim-may-be-as-close-as-your-fruit-bowl?src=RSS_PUBLIC

Secret to Staying Slim: Your Fruit Bowl?

By Robert Preidt

HealthDay Reporter

TUESDAY, Oct. 27, 2015 (HealthDay News) -- The food sitting out on your kitchen counter offers clues about your weight, a new study reveals.

Cornell University researchers photographed kitchen counters in more than 200 American homes and then checked the weight of the women living in those houses.

Women who had breakfast cereal sitting on the counter weighed 20 pounds more than women who didn't have cereal boxes on display. And women in homes with soft drinks sitting on the counter weighed 24 to 26 pounds more than those living in homes without soft drinks on the counter, the investigators found.

"It's your basic 'see-food diet' -- you eat what you see," lead author Brian Wansink, professor and director of Cornell's Food and Brand Lab, said in a university news release.

"As a cereal lover, that shocked me. Cereal has a health-halo, but if you eat a handful every time you walk by, it's not going to make you skinny," he explained.

On the flip side, women who had a stocked fruit bowl on their countertops weighed 13 pounds less than women without the easily accessible fruit.

Although this study found an association between what was on the counter and a person's weight, it wasn't designed to prove a cause-and-effect relationship.

The study was published online recently in the journal Health Education and Behavior.

"We've got a saying in our lab: 'If you want to be skinny, do what skinny people do.' If skinny people make their homes 'slim by design' by clearing the counters of everything but the fruit bowl, it won't hurt us to do the same," Wansink said.

Ranking the the least and most obese states in the country

http://bgr.com/2015/10/27/highest-obesity-rates-by-state/

There's no getting around it: America has a weight problem. Despite widespread efforts from a number of entities to encourage physical activity and promote healthier eating habits, obesity remains a serious and growing problem across the country.

Today, 35% of Americans are considered obese, a jarring figure that prompted the OECD to recently label the United States the most obese country in the world. Compounding the problem is that unhealthy lifestyle habits are imparted onto children at an early age. As a result, the percentage of obese children in the U.S. is greater than in any other country in the world.

Not too long ago, the non-profit organization Trust for America's Health put out an in-depth report covering the state of obesity in the United States for 2015. Underscoring the seriousness with which we need to take this growing health problem, the report boldly claims that "if we fail to change the course of the nation's obesity epidemic, the current generation of young people may be the first in American history to live shorter, less healthy lives than their parents."

The report in its entirety is well worth taking a look at, but there are a few data points we felt were worth sharing, especially pertaining to how obesity rates break down on a state by state basis.

According to the report, "22 states have adult obesity rates above 30 percent, 45 states have rates above 25 percent, and every state is above 20 percent." By way of contrast, no state back in 1980 had an obesity rate greater than 15%.

Breaking things down state by state, below are the states with the highest obesity rates.

1. Arkansas – 35.9% of population is obese
2. West Virginia – 35.7% of population is obese
3. Mississippi – 35.5% of population is obese
4. Louisiana – 34.9% of population is obese
5. Alabama – 33.5% of population is obese
6. Oklahoma – 33.0% of population is obese
7. Indiana – 32.7% of population is obese
8. Ohio – 32.6% of population is obese
9. North Dakota – 32.2% of population is obese
10. South Carolina – 32.1% of population is obese

And listed below are the states with the lowest obesity rates.

1. Colorado – 21.3% of population is obese
2. D.C. – 21.7% of population is obese
3. Hawaii – 22.1% of population is obese
4. Massachusetts – 23.3% of population is obese
5. California – 24.7% of population is obese
6. Vermont – 24.8% of population is obese
7. Utah – 25.7% of population is obese
8. Florida – 26.2% of population is obese
9. Connecticut – 26.3% of population is obese
10. Montana – 26.4% of population is obese

Fruit and Vegetable Intake and Coronary Calcium

"Is fruit and vegetable consumption during young adulthood associated with coronary atherosclerosis later in life?

...

Conclusions:

The authors concluded that higher intake of fruits and vegetables during young adulthood was associated with lower risk for CAC after 20 years of follow-up.

Perspective:

These data support the current recommendations for a diet high in fruits and vegetables, and reinforce the need for programs to promote healthy dietary patterns early in life."

http://www.acc.org/latest-in-cardiology/journal-scans/2015/10/27/14/27/the-association-of-fruit-and-vegetable-consumption?utm_campaign=website&utm_source=clinical_topics&utm_medium=email_notification

Not all new medicines work out. Even though the science behind them may be sound and preliminary studies may show safety. When put to the test, they sometimes fail to show a benefit. 

Patients routinely talk to me about the price of medications. The development and testing of medications is staggering. When I see a negative study such as this, I am reminded about just how much money GlaxoKlineSmith has already placed in this drug's development - only to have it be shown not to work. 

I hope you find this interesting

http://www.medpagetoday.com/Cardiology/MyocardialInfarction/54340

Anti-Inflammatory Flops in Acute MI

The novel anti-inflammatory agent losmapimod failed to improve heart attack outcomes, GlaxoSmithKline announced in top-line results for the LATITUDE-TIMI 60 trial.

The p38 MAP kinase inhibitor did not reduce the primary composite endpoint of cardiovascular death, myocardial infarction, or severe recurrent ischemia requiring urgent coronary artery revascularization at an interim analysis.

The findings came from part A of the phase III trial, with 3,503 ST-segment or non-ST-segment elevation myocardial infarction (STEMI or NSTEMI) patients, designed to support a larger part B with more than 20,000 additional patients.

While the part A results will be presented in full at an upcoming scientific meeting, the second portion of the trial will be scrapped, GlaxoSmithKline said.

The subset of STEMI patients did show reductions of 30% to 50% in prespecified endpoints of cardiovascular death, heart failure hospitalization, and the composite of the two, but these did not reach statistical significance because of small numbers of events. GSK said it would consider that option for future development, although some industry observers such as FierceBiotech were skeptical.

Losmapimod's p38 MAP kinase target is "associated with the acute inflammation and cellular injury that occurs in the blood vessels and in the heart during and immediately after an acute coronary syndrome," the company noted in a press release.

I've written before about the growing link between poor sleep and weight gain. 

It's becoming more and more evident that if you want to lose weight or maintain a healthy weight, it's very important to get a good night sleep. 

Enjoy the read...

http://mobile.nytimes.com/blogs/well/2015/10/26/poor-sleep-may-spur-college-weight-gain/?partner=rss&emc=rss&referer=

Poor Sleep May Spur College Weight Gain

As the first semester of the school year reaches the halfway mark, countless college freshmen are becoming aware that their clothes are feeling rather snug.

While the so-called freshman 15 may be hyperbole, studies confirm that many students do put on five to 10 pounds during that first year away from home. Now new research suggests that an underlying cause for the weight gain may be the students' widely vacillating patterns of sleep.

A study in the journal Behavioral Sleep Medicine looked at the sleep habits of first-semester freshmen. Researchers followed 132 first-year students at Brown University who kept daily sleep diaries. After nine weeks, more than half of them had gained nearly six pounds.

There are many poor sleep habits that might have exacerbated their weight gains, a growing body of research indicates.

Was it abbreviated sleep? Optimally, experts say, teenagers need about nine hours and 15 minutes a night. These freshmen averaged about seven hours and 15 minutes. In a study earlier this year, in the journal PLOS One, researchers found that when teenagers are sleep-deprived, they more readily reach for candy and desserts....

Sleep Apnea Is Tied to Gout - NYTimes.com

A new study has found that sleep apnea is associated with an increased risk for gout, a painful disease of the big toe and other joints caused by elevated levels of uric acid in the blood.

Observational studies have shown that people with sleep apnea have a higher prevalence of excess uric acid, but until now it has been unclear whether sleep apnea is associated with gout, and how strongly.

Using records in a British health database, researchers studied 9,865 people, average age 54, with sleep apnea and matched them to 43,598 controls without the disorder. Because sleep apnea is associated with being overweight, the participants were matched for B.M.I., among many other characteristics. The study is in Arthritis & Rheumatology.

After one year, compared with controls, people with sleep apnea were about 50 percent more likely to have had an attack of gout, and the increased risk was found without regard to sex, age or obesity.

The conclusion suggests that treating sleep apnea would reduce gout attacks, but the lead author, Yuqing Zhang, a professor of medicine at Boston University, is cautious.

"Our findings call for future studies to evaluate the effect of treating sleep apnea on serum uric acid levels and the risk of gout," he said.

http://mobile.nytimes.com/blogs/well/2015/10/22/sleep-apnea-is-tied-to-gout/?partner=rss&emc=rss&_r=0&referer=

Mediterranean Diet May Keep Your Mind Healthier in Old Age – WebMD

http://www.m.webmd.com/food-recipes/news/20151021/mediterranean-diet-may-keep-your-mind-healthier-in-old-age?src=RSS_PUBLIC

This Diet May Keep Your Mind Healthier in Old Age

By Maureen Salamon

HealthDay Reporter

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- In news that sounds a bit like it came straight from a sci-fi thriller, researchers say that eating too much meat might shrink your brain.

On the flip side, however, eating healthy foods from the so-called Mediterranean diet may help your brain stay in good shape as you get older, the new study suggests. The researchers said that people over 65 who ate more fish, vegetables, fruit, grains and olive oil had a larger brain volume than a similar group who didn't follow a Mediterranean diet.

"It was encouraging to see that the more you adhere to this Mediterranean diet, the more protection you get against brain atrophy [shrinkage]," said study author Yian Gu, an assistant professor of neuropsychology at Columbia University in New York City. "For people interested in the diet and lifestyle factors leading to better health, I think this is another study consistent with previous studies that indicate the Mediterranean diet is a healthy diet," she added.

But Gu noted that her study's observational findings cannot prove a definitive cause-and-effect relationship between diet and brain volume. The study was only designed to find an association.

Findings from the research were published online Oct. 21 in the journal Neurology.

Previous research has linked the Mediterranean diet to a lower risk of Alzheimer's disease, the study said. The diet stresses the consumption of vegetables, legumes (beans, peas and lentils), fruits, cereals, fish and monounsaturated fats such as olive oil, the study authors said. The eating plan also includes a low intake of meat, poultry, saturated fats and dairy products, as well as mild to moderate amounts of alcohol, according to the researchers.

For the study, Gu and her colleagues split 674 adults into two groups based on how closely their diets aligned with the Mediterranean diet. Their average age was 80 years. All participants underwent MRI scans of their brains to measure total brain volume and thickness. They also completed questionnaires about their food choices and eating patterns.

The researchers found that brain volumes of those who didn't follow a Mediterranean diet were smaller than those who did. The difference was minor in overall size -- equated to about five years of aging, the study authors said.

But, more specifically, the investigators found that eating more fish and less meat was associated with even less brain shrinkage.

Gu said scientists don't yet know exactly why the Mediterranean diet seems healthier for the brain. However, other research has established that a higher intake of fish and vegetables and a lower intake of meat are beneficial for brain cell growth, she said.

Dr. Joseph Masdeu, director of the Nantz National Alzheimer Center at Houston Methodist Hospital, praised the research as "an elegant way of looking at this [issue]."

Masdeu, who wasn't involved in the research, said, "I think the take-home message is clear . . . a diet containing less meat and perhaps more fish is good for you. There are negative studies [focusing on] the Mediterranean diet as well, but several confirming a positive effect. So it's tentative, but it's the strongest preventive approach we have [promoting brain health] together with exercise."

Using the study findings, Gu contended that eating at least 3 to 5 ounces of fish weekly, or no more than 3.5 ounces of meat each day, could protect the brain from shrinkage.

She acknowledged that study participants may have inaccurately recalled their food consumption habits in the questionnaires used.

"We asked people to recall their past dietary habits, so that's prone to recall bias," she said.

Dr. Malaz Boustani, a spokesperson for the American Federation for Aging Research, said the new study provided "very good messaging" for the public.

"This is an encouraging study that will really make us work harder to see how we can actually encourage people . . . to change their diet to accommodate the Mediterranean diet," said Boustani, also founding director of the Sandra Eskenazi Center for Brain Care Innovation at Indiana University. "It makes it very easy for people to do the right thing."

Lifting Weights, Twice a Week, May Aid the Brain - NYTimes.com

Exercise is good for the brain. We know that. But most studies of exercise and brain health have focused on the effects of running, walking or other aerobic activities.

Now a new experiment suggests that light resistance training may also slow the age-related shrinking of some parts of our brains...

http://mobile.nytimes.com/blogs/well/2015/10/21/lifting-weights-twice-a-week-may-aid-the-brain/?partner=rss&emc=rss&referer=