February 16, 2009
Neutralizing Acidosis to Reduce Bone Loss Among Mature Adults

A new study published in the Journal of Clinical Endocrinology and Metabolism suggests that neutralizing an acid-producing diet may be an important key to reducing bone loss in aging. The study comes on the heels of several recent papers suggesting that consuming higher-than-recommended amounts of calcium may not be the main answer to protecting bone health. In addition to contributing to heart damage, researchers in New Zealand have found that excess intake of calcium may also increase women's risks of suffering a heart attack.

The new study, funded in part by the Agricultural Research Service (ARS) of the U.S. Department of Agriculture, was led by physician and nutrition specialist Bess Dawson-Hughes at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts.

Fruits and vegetables are metabolized to bicarbonate and are thus alkali-producing. Unfortunately, the typical American diet is rich in protein and cereal grains that are metabolized to acid, and are thus acid-producing. With aging, diets high in grains and protein and low in fruits and vegetables contribute to a mild but slowly increasing state of metabolic "acidosis."

"The authors concluded that increasing
the alkali content of the diet, for example
by consuming more fruits and vegetables,
merits further study as a safe and low-cost
approach to improving skeletal health
in older men and women."

The researchers conducted a placebo-controlled study involving healthy male and female volunteers aged 50 or older. Key measurements were taken at the beginning and end of the intervention, which lasted three months.

A group of 78 volunteers had been provided either of two bicarbonates – potassium or sodium – along with their usual diet and exercise regimes. Key bone mineral nutrients were controlled to reduce variation in study outcomes. The bicarbonate groups consumed an amount of bicarbonate equivalent to about 9 servings of fruits and vegetables daily. This allowed the researchers to look at possible acid-neutralizing effects from an adequate, but not high, alkali load.

The results showed that the 78 volunteers in the bicarbonate groups had more significant reductions in biomarkers that are associated with bone loss and fracture than the 84 in the no-bicarbonate, or control, group.

The authors concluded that increasing the alkali content of the diet, for example by consuming more fruits and vegetables, merits further study as a safe and low-cost approach to improving skeletal health in older men and women.

Source: ScienceDaily, USDA/Agricultural Research Service (2009, February 11). Neutralizing Acidosis And Bone Loss Among Mature Adults. Retrieved February 11, 2009.

February 1, 2009
Researchers Link Poor Sleep with Elevated Blood Sugar Levels and Type 2 Diabetes

A recent survey indicates that as many as 40 million Americans suffer from disrupted and inadequate sleep. Impaired sleep exerts a heavy toll on emotional and physical health; degrading mental abilities, productivity and performance, and increasing stress, irritability, depression and daytime drowsiness. According to the US National Sleep Foundation, sleep deprivation also reduces concentration, alertness, and reflexes, making sleep-deprived individuals more prone to falls and accident-induced injury.

Now, in a series of new studies published in journal Nature Genetics, a team of international scientists has shown how Type 2 diabetes and elevated blood sugar levels are linked to abnormal sleep patterns via a protein that senses the sleep-inducing hormone melatonin.

The research suggests that diabetes and higher than normal blood sugar levels could partly be tackled by treating sleep problems.

Two studies pooled data from earlier studies that had measured blood sugar levels and had collected DNA samples from participants. The larger study included 36,610 people; the other had 2,351. In both studies, people with a single DNA change in a single gene that controls receptors for melatonin were more likely to have high blood sugar levels and develop diabetes than those without the DNA change. "The finding that the melatonin receptor has an influence on diabetes was unexpected," Groop says.

"The finding that the melatonin receptor
has an influence on diabetes was
unexpected," Groop says.

A third paper covering over 18,000 participants from two earlier studies showed that the same DNA alteration was linked to high blood sugar levels, low insulin levels and most important, a greater risk of developing type 2 diabetes. The researchers also looked at how melatonin might directly interact with insulin-producing cells.

The melatonin receptor had been thought to reside primarily in the brain – home of the body's master clock. Groop and his colleagues showed that insulin-producing beta cells, located in the pancreas of mice, rats and humans, also have melatonin receptors.

Its presence on the insulin-secreting cells suggests that the melatonin receptor may directly control insulin production. When scientists added melatonin to human beta cells in the lab, insulin production went down. A connection between melatonin and insulin makes sense since in the dead of night, when melatonin levels are high and the need for insulin should be low. Researchers don't yet know how melatonin levels are different in sleep-deprived people, nor how this difference could lead to higher blood sugar levels.

The link between sleep and blood sugar didn't surprise some sleep researchers. Buxton says that evidence for that relationship has accumulated for years. "However, such a direct role for melatonin was very surprising," he says

Researcher James Gangwisch of Columbia University in New York City says the identification of the melatonin receptor as an important regulator of blood sugar fits well with earlier studies looking at the effects of poor sleep on blood sugar levels.

In 2007, Gangwisch showed that people who get less than five hours of sleep a night are significantly more likely to have Type 2 diabetes. Other lab experiments confirm this trend: Healthy young adults prevented from entering deep sleep for just three nights couldn't properly regulate blood sugar levels, at least temporarily, a 2008 study showed. What's more, the subjects became more resistant to insulin during the study, eventually reaching levels of insulin sensitivity that resemble the insulin resistance of diabetic people.

Sleep-deprived subjects, Gangwisch says, crave starchy, sweet foods and don't regulate blood sugar well.

"This paper ties those two things together," says Goncalo Abecasis of the University of Michigan School of Public Health in Ann Arbor, and a coauthor of one of the studies. "Sleep disrupts the circadian clock, and the melatonin receptor disrupts the circadian clock. These are two different ways to interrupt the clock, but both lead to the same endpoint of diabetes."

Reference
Bouatia-Naji et al. A variant near MTNR1B is associated with increased fasting plasma glucose levels and type 2 diabetes risk. Nature Genetics, Dec 7, 2008; DOI: 10.1038/ng.277

December 2, 2008
Calcium and Vitamin D may not be the Only Protection Against Bone Loss

Diets that are high in protein and cereal grains produce an excess of acid in the body which may increase calcium excretion and weaken bones, according to a new study.

The study found that increasing the alkali content of the diet, with a pill or through a diet rich in fruits and vegetables has the opposite effect and strengthens skeletal health.

"Heredity, diet, and other lifestyle factors contribute to the problem of bone loss and fractures," said Bess Dawson-Hughes, M.D., of Tufts University in Boston, Mass. and lead author of the study. "When it comes to dietary concerns regarding bone health, calcium and vitamin D have received the most attention, but there is increasing evidence that the acid/base balance of the diet is also important."

Average older adults consume diets that, when metabolized, add acid to the body, said Dr. Dawson-Hughes. With aging, we become less able to excrete the acid. One way the body may counteract the acid from our diets is through bone resorption, a process by which bones are broken down to release minerals such as calcium, phosphates, and alkaline (basic) salts into the blood. Unfortunately, increased bone resorption leads to declines in bone mass and increases in fracture risk.

"When fruits and vegetables are metabolized they add bicarbonate, an alkaline compound, to the body," said Dr. Dawson Hughes. "Our study found that bicarbonate had a favorable effect on bone resorption and calcium excretion. This suggests that increasing the alkali content of the diet may attenuate bone loss in healthy older adults."

"Our study found that bicarbonate had
a favorable effect on bone resorption and
calcium excretion. This suggests that increasing
the alkali content of the diet may attenuate
bone loss in healthy older adults."

In this study, 171 men and women aged 50 and older were randomized to receive placebo or doses of either: potassium bicarbonate, sodium bicarbonate, or potassium chloride for three months. Researchers found that subjects taking bicarbonate had significant reductions in calcium excretion, signaling a decrease in bone resorption.

"In this study, we demonstrated that adding alkali in pill form reduced bone resorption and reduced the losses of calcium in the urine over a three month period," said Dr. Dawson-Hughes. "This intervention warrants further investigation as a safe and well tolerated supplement to reduce bone loss and fracture risk in older men and women."

Other researchers working on the study include Susan Harris, Nancy Palermo, Helen Rasmussen, and Gerard Dallal of Tufts University in Boston, Mass., and Carmen Castaneda-Sceppa of Northeastern University in Boston, Mass.

Reference:

Treatment with Potassium Bicarbonate Lowers Calcium Excretion and Bone Resorption in Older Men and Women. Journal of Clinical Endocrinology & Metabolism, January 2009.

January 2, 2009
Osteoporosis Drugs Linked (Again) to Serious Damage to Jaw Bone

Researchers at the University of Southern California, School of Dentistry released results of clinical data that links oral bisphosphonates to increased jaw necrosis. The study is among the first to acknowledge that even short-term use of common oral osteoporosis drugs may leave the jaw vulnerable to devastating necrosis, according to a new report.

Osteoporosis currently affects 10 million Americans. Fosamax is the most widely prescribed oral bisphosphonate, ranking as the 21st most prescribed drug on the market since 2006, according to a 2007 report released by IMS Health.

This is the first large institutional study in the U.S. to investigate the relationship between oral bisphosphonate use and jaw bone death, said principal investigator Parish Sedghizadeh, assistant professor of clinical dentistry with the USC School of Dentistry.

After controlling for referral bias, nine of 208 healthy School of Dentistry patients who take or have taken Fosamax for any length of time were diagnosed with osteonecrosis of the jaw (ONJ). The study's results are in contrast to drug makers' prior assertions that bisphosphonate-related ONJ risk is only noticeable with intravenous use of the drugs, not oral usage, Sedghizadeh said. "We've been told that the risk with oral bisphosphonates is negligible, but four percent is not negligible," he said.

"We've been told that the risk with
oral bisphosphonates is negligible,
but four percent is not negligible,"

Most doctors who have prescribed bisphosphonates have not told patients about any oral health risks associated with the use of the drugs, despite even short-term usage posing a risk due to the drug's tenacious 10-year half life in bone tissue. Lydia Macwilliams of Los Angeles said no one told her about the risk posed by her three years of Fosamax usage until she became a patient of Sedghizadeh at the School of Dentistry. "I was surprised," she said. "My doctor who prescribed the Fosamax didn't tell me about any possible problems with my teeth."

Macwilliams was especially at risk for complications because she was to have three teeth extracted. The infection is a biofilm bacterial process, meaning that the bacteria infecting the mouth and jaw tissues reside within a slimy matrix that protects the bacteria from many conventional antibiotic treatments, and bisphosphonate use may make the infection more aggressive in adhering to the jaw, Sedghizadeh said. The danger is especially pronounced with procedures that directly expose the jaw bone, such as tooth extractions and other oral surgery. After her extractions, two of the three extraction sites had difficulty healing due to infection, Macwilliams said. Luckily, with treatment as well as the rigorous oral hygiene regimen USC dentists developed especially for patients with a history of bisphosphonate usage, the remaining sites slowly but fully healed. "It took about a year to heal," she said, "but it's doing just fine now."

Sedghizadeh hopes to have other researchers confirm his findings and thus encourage more doctors and dentists to talk with patients about the oral health risks associated with the widely used drugs. The results confirm the suspicions of many in the oral health field, he said. "Here at the School of Dentistry we're getting two or three new patients a week that have bisphosphonate-related ONJ," he said, "and I know we're not the only ones seeing it."

Reference
Oral Bisphosphonate Use and the Prevalence of Osteonecrosis of the Jaw: An Institutional Inquiry. Journal of the American Dental Association, Jan 1, 2009. Adapted from materials provided by University of Southern California, via EurekAlert!, a service of AAAS.

October 2, 2008
Researchers Discover Brain Pathway Responsible For Obesity: Too Many Calories Send Brain Off Kilter

University of Wisconsin - An overload of calories throws critical portions of the brain out of whack, according to a new study in the October 3rd issue of the journal Cell. That response in the brain's hypothalamus—the "headquarters" for maintaining energy balance—can happen even in the absence of any weight gain, according to the new studies in mice..

The brain response involves a molecular player, called IKKß/NF-κB, which is known to drive metabolic inflammation in other body tissues. The discovery suggests that treatments designed to block this pathway in the brain might fight the ever-increasing spread of obesity and related diseases, including diabetes and heart disease.

"This pathway is usually present but inactive in the brain," said Dongsheng Cai of the University of Wisconsin-Madison. Cai said he isn't sure exactly why IKKß/NF-κB is there and ready to spring into action in the brain. He speculates it may have been an important element for innate immunity, the body's first line of defense against pathogenic invaders, at some time in the distant past.

"In today's society, this pathway is mobilized by a different environmental challenge – overnutrition," he said. Once activated, "the pathway leads to a number of dysfunctions, including resistance to insulin and leptin," both important metabolic hormones.

"While chronic inflammation is generally
considered a consequence of obesity,
the new results suggest the inflammatory
reaction might also be a cause of the
imbalance that leads to obesity and associated
diseases, including diabetes."

Earlier studies showed that overnutrition can spark inflammatory responses in the peripheral metabolic tissues, including the muscles and liver, and therefore cause various metabolic defects in those tissues that underlie type 2 diabetes. As a result, scientists identified IKKß as a target for an anti-inflammatory therapy that was effective against obesity-associated diabetes.

Yet whether metabolic inflammation and its mediators played a role in the central nervous system remained uncertain. Now, the researchers show that a chronic high-fat diet doubles the activity of this inflammatory pathway in the brains of mice. Its activity is also much higher in the brains of mice who are genetically predisposed to obesity, they found.

The researchers report that that increased activity of the IKKß/NF-κB pathway can be divorced from obesity itself – infusions of either glucose or fat into the brains of mice alone led to this inflammatory brain reaction.

Further studies revealed that this activity in the brain leads to insulin and leptin resistance. Insulin lowers blood sugar by causing cells of the body to take it up from the bloodstream. Leptin is a fat hormone important for appetite control. Moreover, the researchers found that treatments preventing the activity of IKKß/NF-κB in the animals' brains protected them from obesity.

While chronic inflammation is generally considered a consequence of obesity, the new results suggest the inflammatory reaction might also be a cause of the imbalance that leads to obesity and associated diseases, including diabetes. As Cai says, it appears that inflammation and obesity are "quite intertwined." An abundance of calories itself promotes inflammation, while obesity also feeds back to the neurons to further promote inflammation in a kind of vicious cycle.
The findings could lead to treatments that might stop this cycle before it gets started.

Source: UW-Madison, Oct. 2 2008

October 2, 2008
Long-term Bouts with Hay Fever Worsen Ability to Breath Through Nose

New evidence for the first time suggests that people suffering from hay fever (allergic rhinitis) will over time experience a progressive worsening of their nasal passage functioning, depending on how long they have the disorder, according to a study published in the June 2008 edition of Otolaryngology – Head and Neck Surgery.

The study, authored by researchers in Italy, discovered that in 100 patients (50 with short-term rhinitis, and 50 with long-term), those who experienced longer bouts with the disorder (on average, nine years) had significantly lower airflow in their nasal passages. Furthermore, 72 percent of the patients with long-term rhinitis had "severe" nasal obstruction.

Allergic rhinitis, commonly referred to as hay fever, occurs when the body's immune system over-responds to specific, non-infectious particles such as plant pollens, molds, dust mites, and animal hair, among others.

This causes skin redness and swollen membranes in the nasal passages, combined with sneezing and congestion. It is estimated that between 10 and 20 percent of the American population suffers from hay fever, and accounts for approximately 2 percent of all visits to a doctor's office.

Source: Adapted from materials provided by American Academy of Otolaryngology, Head and Neck Surgery.

October 2, 2008
Research Reveals Possible Role for Calcium Imbalance in Alzheimer's

A new study in mice finds that plaques associated with Alzheimer’s wreak havoc on calcium’s role in cell signaling. While Alzheimer’s disease is associated with the characteristic plaques in patients’ brains, scientists have been uncertain whether these plaques actually cause the memory impairment typical of the disease. New research on mice now suggests that calcium could link the plaques to nerve-cell dysfunction.

“It’s the first evidence that calcium can be affected by [plaques] in areas that are important for synapse formation and learning and memory,” comments Alzheimer’s disease expert Kim Green of the University of California, Irvine, who cowrote a review article published with the new research in the July 31 Neuron.

“Apparently the calcium is playing a very, very important role,” comments Bharat Aggarwal, an expert in cell signaling and inflammation at the University of Texas M.D. Anderson Cancer Center in Houston. The research “provides us more targets for finding treatments for the disease.”

Calcium ions, positively charged calcium atoms, relay signals that control many functions within cells and between neighboring cells. Previous research suggested that calcium might be involved in Alzheimer’s disease, but scientists didn’t have any evidence from living animals.

In the new experiments, Brian Bacskai and his colleagues at Massachusetts General Hospital in Charlestown, Mass. compared two kinds of mice having Alzheimer’s-like conditions to healthy mice. Calcium in the brains of healthy mice was tightly controlled, but plaques in diseased mice elevated the levels of calcium in nerve cells, Bacskai’s team found. Nerve cells closest to the plaques were the most affected.

The researchers also looked at the effects of this calcium imbalance on the cells’ functioning. High calcium levels caused the “wires” between neurons to become malformed, the scientists report.

“The neuron is still alive, it’s just not communicating effectively, which could lead to the cognitive impairment,” Green says.

Abnormal calcium levels might also disrupt the creation of synapses, the tiny gaps across which neuron wires communicate. Forming new synapses is one way that scientists think neurons store new memories.

"There’s little doubt that calcium can change what synapses can do,” comments George Augustine, an expert on calcium signaling in neurons at Duke University Medical Center in Durham, N.C.

However, the new research does not show how the plaques raise calcium levels in the nearby neurons. And scientists don't yet know whether this calcium link in mouse brains also exists in people with the disease.

Source: Calcium’s Possible Role in Alzheimer’s (Science News, July 30, 2008).

October 2, 2008
New Study Shows Increased Heart Risks from Calcium Supplements

Older women taking calcium supplements to maintain bone strength may be putting themselves at increased risk of heart attack, researchers in New Zealand report. The researchers cautioned that they do not consider their findings the definitive word on the subject, but said the higher heart attack risk they saw merits further study.

"This effect could outweigh any benefits on bone from calcium supplements," researchers led by Ian Reid of the University of Auckland wrote in the British Medical Journal (BMJ). Many women take calcium supplements to try to prevent osteoporosis, a condition in which bones become weak and brittle, leading to fractures.

The study involved 1,471 healthy post-menopausal women, average age 74, who already had participated in a study on the effects of calcium on bone density and fracture rates. Of them, 732 were given a daily calcium supplement and 739 were given a placebo. They were followed for five years.

Heart attacks were more common in the women taking the calcium supplements, with 31 women who took supplements experiencing a heart attack compared to 21 women who got a placebo, the researchers said.

The researchers noted that previous research had suggested that taking calcium supplements might protect against vascular disease by lowering levels of bad cholesterol in the blood. They said that because calcium supplements raise blood calcium levels, this possibly accelerates the formation of deposits in the arteries that could lead to heart attack.

The new results "are not conclusive but suggest that high calcium intakes might have an adverse effect on vascular health," the researchers wrote. "In the meantime this potentially detrimental effect should be balanced against the likely benefits of calcium on bone, particularly in elderly women," they wrote.

Source: Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial BMJ, doi:10.1136/bmj.39440.525752.

October 2, 2008
Chocolate May Increase Risk of Osteoporosis

There's increasing evidence that chocolate is good for the heart, but new research suggests it may not be so great for the bones.

Older women who ate chocolate every day had weaker, thinner bones than their peers, who indulged less frequently, and the difference didn't appear to be due to overall dietary habits, said Dr. Jonathan M. Hodgson and colleagues of the University of Western Australia School of Medicine and Pharmacology in Perth.

"This is the first study to investigate the relation between chocolate intake and bone structural measurements and raises concerns that frequent chocolate consumption may increase the risk of osteoporosis and fracture," Hodgson and his team write in the American Journal of Clinical Nutrition.

Chocolates are rich in flavonoids, which some studies suggest can be good for the bones, the researchers say. However, they add, chocolate also contains oxalate, which blocks the absorption of calcium, and sugar, which can boost calcium excretion.

To investigate chocolate's effect on the bones, the researchers looked at 1,001 women aged 70 to 85 who were participating in a study of calcium supplementation and fracture risk.

Women who were daily chocolate consumers had a 3.1 percent lower bone density, on average, than those who ate chocolate less than once a week, as well as weaker bones in the heel and tibia, or shin bone.

Frequent chocolate eaters ate the same amount of fresh fruits and vegetables as those who ate chocolate less often. They also consumed no more saturated fats, carbohydrates or sugar, and less protein, starch, fiber, and potassium.

Women who ate chocolate every day weighed less and, on average, had lower a body mass index (BMI), the ratio of height to weight, a formula frequently used to determine if an individual is fat or thin. The chocolate eaters also consumed more calories and had a higher socioeconomic status.

The relationship between heavy chocolate consumption and lower bone density remained even after the researchers took these factors into account. They suggest: "the effect may be associated with a constituent of chocolate rather than an associated lifestyle or dietary factor."

They call for further studies to confirm or disprove the relationship, and conclude that "confirmation could have important implications for the prevention of osteoporosis and fracture."

Source:American Journal of Clinical Nutrition, January 2008

October 2, 2008
Incontinence Drugs Cause Memory Problems in New Study

Commonly used incontinence drugs may cause memory problems in some older people, a study has found. "Our message is to be careful when using these medicines," said Dr. Jack Tsao, a U.S. Navy neurologist who led the study. "It may be better to use diapers and be able to think clearly than the other way around."

Urinary incontinence sometimes can be resolved with non-drug treatments, he added, so patients should ask about alternatives. Exercises, biofeedback and keeping to a schedule of bathroom breaks work for many.

U.S. sales of prescription drugs to treat urinary problems topped $3 billion in 2007, according to IMS Health, which tracks drug sales. Bladder control trouble affects about 1 in 10 people age 65 and older, according to the National Institute on Aging, which helped fund the study. Women are more likely to be affected than men. Causes include nerve damage, loss of muscle tone or, in men, enlarged prostate.

The research began after Tsao met a 73-year-old patient. Shortly after starting an incontinence drug, she began hallucinating conversations with dead relatives and having memory problems. Her thinking improved when she stopped the drug for several months.

Tsao and his colleagues knew of similar reports. They decided to look at a large group of people to see if they could measure an effect of these and other medications that affect acetylcholine, a chemical messenger that shuttles signals through the brain and the rest of the nervous system. The drugs block some nerve impulses, such as spasms of the bladder.

The findings, released at the April 17, 2008 meeting of the American Academy of Neurology, come from an analysis of the medication use and cognitive test scores of 870 older Catholic priests, nuns and brothers who participated in the Religious Orders Study at Chicago's Rush University Medical Center. The average age was 75.

Researchers tracked them for nearly eight years, testing yearly for cognitive decline. They asked them to recite strings of numbers backward and forward, to name as many different kinds of fruit as they could in one minute and to complete other challenges during the annual testing.

Nearly 80 percent of the study participants took one or more of a class of drugs called anticholinergics, including drugs for high blood pressure, asthma, Parkinson's disease and incontinence drugs such as Detrol and Ditropan.

The people who took the drugs had a 50 percent faster rate of cognitive decline compared with those who didn't take any. The researchers considered other risk factors for memory loss, such as age, and still found the link. The researchers found no increased risk for the memory-robbing disorder Alzheimer's in people taking the drugs.

The incontinence drugs were among the most potent and were the most frequently taken of all the anticholinergics in the study. That's why the researchers believe they are driving the memory problems, Tsao said.

Some experts said the research supports previous observations and is helpful because it measures the size of the effect. "This paper adds important new data to the picture," said Dr. Elaine Perry of Newcastle University in England, who has done similar research but was not involved in the new study.

More research is needed on the effects of anticholinergic drugs on memory, Tsao said. Doctors should do baseline cognitive testing on patients before prescribing the drugs, he recommended.

A representative of Pfizer Inc., maker of the top-selling Detrol, said patients should always talk to their doctors about problems while taking medication. "Detrol has been on the market since 1998. It has been prescribed more than 100 million times worldwide," said Ponni Subbiah, Pfizer's vice president of medical affairs, in an e-mail response to questions.

October 2, 2008
Glucosamine and Chondroitin no Better Than Placebo in Osteoarthritis Study

Two popular supplements used to fight arthritis and joint pain, glucosamine and chondroitin sulphate, do not seem to work any better than placebo to slow the loss of knee cartilage in osteoarthritis. However, the researchers behind the work say they had trouble interpreting their results because they had previously found that patients who took placebos had a "clinically important reduction" in loss of cartilage.

The study, funded by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, confirms other findings showing the supplements have few or no effects. Allen Sawitzke of the University of Utah School of Medicine, who helped lead the study, said that none of the treatments studied showed any clinically important effect on osteoarthritis.

The earlier results of the study, announced in 2006, found that the supplements did not reduce the pain of knee arthritis, except among a small group of patients with moderate to severe pain. The researchers continued to watch 572 volunteers for another 18 months and found the supplements did not appear to slow the loss of cartilage, taken either alone or together.

They said arthritis worsened in 24% of participants taking both supplements, a similar level to those taking placebo.

"Research continues to reveal that osteoarthritis, the most common form of arthritis, appears to be the result of an array of factors including age, gender, genetics, obesity, and joint injuries," says Stephen Katz, director of the NIH's National Institute of Arthritis and Musculoskeletal and Skin Diseases.

"Because osteoarthritis affects nearly 21 million Americans, we are seeking ways to not only treat pain, but also address the structural effects of the condition," he says.

Source: Journal reference: Arthritis & Rheumatism (DOI: 10.1002/art.23973)

Inadequate Sleep May Speed Cellular Aging in Elderly

Researchers at the University of Pennsylvania School of Medicine have shown that the unfolded protein response (UPR), which is a reaction to stress induced by sleep deprivation, is impaired in the brains of old mice.

The findings suggest that inadequate sleep in the elderly, who normally experience sleep disturbances, could exacerbate an already-impaired protective response to protein misfolding that happens in aging cells. "Protein misfolding and aggregation is associated with many diseases like Alzheimer's and Parkinson's," notes first author Nirinjini Naidoo, PhD, Assistant Professor in the Division of Sleep Medicine. The study appears in the June issue of the Journal of Neuroscience.

The unfolded protein response (UPR) is one part of the quality control system for monitoring protein synthesis in the endoplasmic reticulum, the cellular compartment where some proteins are made. In this study, researchers found that the UPR was activated in 10-week old, sleep-deprived mice, so that misfolded proteins did not accumulate in the endoplasmic reticulum of brain cells in the cerebral cortex. However, in two-year-old, sleep-deprived mice, the UPR failed to do its job and misfolded proteins clogged the endoplasmic reticulum. Old mice that were not stressed by sleep deprivation were shown to already have an impaired UPR.

Sleep in mice is characterized by short periods of inactivity throughout the day and night. On average, mice sleep approximately one hour for every two they are awake. In order to deprive mice of sleep, researchers constantly monitored and gently stroked the mice with a brush to disturb periods of inactivity.

At 3, 6, 9, or 12 hours of sleep deprivation, proteins were examined from the mouse brains. By six hours of sleep deprivation, young mice demonstrated that the UPR system was in place because protein synthesis was shut off by a chaperone protein called BiP/GRP78. In contrast, there was no BiP/GRP78 in old mice so protein synthesis continued.

Old mice also had less of the proteins that refold abnormal proteins than young mice, and old mice had more of the proteins that cause cell death than young mice. Thus, several processes are upset in old mouse brains by sleep deprivation, and the overall result is a further accumulation of misfolded proteins.

"We could speculate that sleep disturbance in older humans places an additional burden on an already-stressed protein folding and degradation system," says Naidoo. Future studies will examine whether augmenting key protective proteins delays the effects of aging and reduces sleep disturbances

The study appears in the June issue of the Journal of Neuroscience. Study co-authors are Megan Ferber, Monali Master, Yan Zhu and Allan Pack, all of Penn. The study was funded by the National Institute on Aging.

Source: University of Pennsylvania School of Medicine.

October 2, 2008
Night Shift Sleep Problems: Keeping the "Grave" out of "Graveyard"

When Debbie Toms first started working nights as a respiratory therapist, co-workers teased her that the graveyard shift would "take 10 years off your life," she said. It never occurred to her that there might be some truth to the statement.

While Toms has managed to stay healthy in the 30 years that she's worked off and on night shifts, most recently at Kaiser Permanente's Regional Center for Sleep Medicine in San Jose, the graveyard shift has been associated with everything from ulcers and depression to heart disease and cancer. There's even a formal diagnosis called shift work disorder, which applies to people who suffer insomnia and excessive sleepiness from working nights.

"It's not surprising," said Dr. Louis Ptacek, a UCSF neurologist studying genes and sleep behaviors. "We evolved on a planet that is rotating every 24 hours. Our internal clock is more than just when we sleep and wake. It's related to cell division and it regulates our immune systems. When we battle our internal clock, that has complications."

Most researchers - and night-shift employees - agree that a fatigue factor undoubtedly goes along with working the graveyard shift. It's more difficult to get a good night's, or rather day's, sleep, and it can be a challenge to force the mind and body to be at their best in the middle of the night.

Roughly 15 million people, or 15 percent of American workers, regularly work a shift that's outside the typical daytime schedule, according to the U.S. Department of Labor. Studies have shown that between 10 and 20 percent of shift workers have trouble with insomnia when they're trying to sleep and feeling sleepy on the job when they're trying to stay awake.

That leads to the obvious connection between sleepiness and the risk of accident - either on the job or driving to and from work. People who are sleep-deprived can succumb to "microsleeps," where they fall asleep for just a few seconds and don't even realize it, said Dr. Clete Kushida, director of the Stanford University Center for Human Sleep Research.

"Probably the most obvious problems with (night) shift work are cognitive functions, so people have difficulty focusing. They might have problems with irritability and mood fluctuations," Kushida said. "And then there is excessive sleepiness, which can lead to motor vehicle accidents and industrial accidents."

Not everyone agrees that shift work is much of a health concern.

The data here is not extremely firm," said Dr. Allan Pont, vice president of medical affairs at California Pacific Medical Center, who ran the hospital's residency training program for 20 years. Pont, who has worked many night shifts himself, said he's skeptical of the idea that many health problems are related to work schedule.

"Obviously it's difficult when people change from a day shift to a night shift," he said. "There are those who can adapt to it and those who don't. Those who adapt probably do just fine, and the others quit."

Still, there are dozens of studies that have demonstrated risks associated with the night shift, and the U.S. Centers for Disease Control and Prevention a decade ago released a report to help workers protect themselves.

Last December, the International Agency for Research on Cancer, part of the World Health Organization, listed the graveyard shift as a "probable" cause of cancer. The agency's conclusion followed several studies that have shown higher rates of cancer - breast cancer in particular - among people who work nights.

It doesn't mean the graveyard shift causes cancer, researchers said, but there seems to be an association. One of the possible explanations is that shift work could interrupt the production of the hormone melatonin, which is typically made at night while the body rests. Melatonin can suppress tumor development and growth.

Cancer aside, most of the risks associated with night work are related to a simple lack of sleep and not being able to keep up steady, healthy behaviors - such as eating right and getting exercise. That could explain some studies that show higher rates of cardiac disease and metabolic syndromes in night-shift workers.

According to the CDC report, digestive problems can also arise, either because of poor eating habits or because the digestive organs aren't used to working hard in the middle of the night.

Graveyard workers also tend to be more stressed out from fatigue and from not getting to spend enough time with friends or family, doctors say. That stress could play a role in higher rates of ulcers and high blood pressure.

"A reasonable percentage of Americans work a night shift, and a majority of them have health issues related to it," said Dr. Sunil Rama, medical director of the Kaiser sleep lab. "It's been linked to arteriosclerosis, headaches, insomnia, excessive sleepiness. You ask anyone who's worked nights, and they're usually a wreck the next day."

Focus on Internal Clock

The focus of much research on shift work disorder is on the circadian rhythm - the body's internal clock that keeps everyone on roughly a 24-hour schedule. It's possible, doctors say, for people to alter their circadian rhythm so that they are perfectly healthy and comfortable working a night shift regularly.

The problem is that humans are accustomed - both by societal pressures and centuries of evolution - to sleeping at night and being active during the day. Very few people want to live on a permanent schedule that has them sleeping away the daylight hours. Instead, most people who work a regular night shift end up throwing their clock off every weekend when they try to adjust to the rest of society.

"If you can get the person to stay on the schedule seven days a week, they're usually OK. But who wants to live their life at night on their days off? What about their vacations?" said Rama.

Toms said that after 30 years of off-and-on graveyard duty, she's adjusted pretty well to her overnight shifts. The key to staying healthy, she said, is to prioritize.

Sleep is crucial. To make sure she gets enough sleep, Toms has bedtime rituals that help her unwind. She typically gets off a night shift at around 6:30 a.m. and drives home wearing dark glasses - bright light generally stimulates the body to stay awake despite the exhaustion.

At home, Toms takes care of any potential disturbances - she feeds the cats, turns off the phone, closes dark blinds in her bedroom. Sometimes she'll have a small snack, but usually it's just some tea.

She usually sleeps until about 3 p.m., then has breakfast. She'll get some light exercise like yoga - she saves the active workouts for days she doesn't work. Lunch is at 9 p.m., dinner at 3 a.m.

"You have to really be aware of your health - am I eating well, am I sleeping enough, am I exercising?" Toms said. "It just takes planning. You have to realize this is your lifestyle and be ready for it."

Tips for staying healthy

• Those who work five nights a week should stick close to the same schedule on days off.
• Try to go to bed as soon as possible after getting off work.
• Set up a bedtime routine - something to signal to the body that it's time to sleep. That could mean making a cup of tea or taking a hot bath or shower.
• Wear dark sunglasses when leaving work in the morning.
• Use window coverings that block out all light. Sleeping masks also can help.
• Get rid of noisy distractions.
• Make time for exercise.

Source: San Francisco Chronicle

Breaking Research
Potential Role of Common Curry Spice in Weight Loss and Diabetes

Dr. Tortoriello, working with pediatric resident Stuart Weisberg, MD, Ph.D., and Rudolph Leibel, MD, fellow endocrinologist and the co-director of the Naomi Berrie Diabetes Center, discovered that turmeric-treated mice were less susceptible to developing Type 2 diabetes, based on their blood glucose levels, and glucose and insulin tolerance tests. They also discovered that turmeric-fed obese mice showed significantly reduced inflammation in fat tissue and liver compared to controls. They speculate that curcumin, the anti-inflammatory, antioxidant ingredient in turmeric, lessens insulin resistance and prevents Type 2 diabetes in these mouse models by dampening the inflammatory response provoked by obesity.

Their findings were presented at ENDO 2008, the Endocrine Society's annual meeting in San Francisco this week.

The researchers tested high-doses of a dietary curcumin in two distinct mouse models of obesity and Type 2 diabetes: high-fat-diet-fed male mice and leptin-deficient obese female mice, with lean wild-type mice that were fed low-fat diets used as controls.

The link between inflammation and obesity was previously shown to be due in part to the presence of immune cells called macrophages in fat tissues throughout the body. According to researchers in the Naomi Berrie Diabetes Center these cells produce "cytokine" molecules that can cause inflammation in organs such as the heart, and islets of the pancreas, while also increasing insulin resistance in muscle and liver.

Researchers hypothesized that by suppressing the number and activity of these cells, with turmeric or an agent with similar actions, it could be possible to reduce some of the adverse consequences of obesity.

Curcumin administration was also associated with a small but significant decline in body weight and fat content, despite level or higher calorie consumption, suggesting that curcumin beneficially influences body composition.

"It's too early to tell whether increasing dietary curcumin intake in obese people with diabetes will show a similar benefit," Dr. Tortoriello said. "Although the daily intake of curcumin one might have to consume as a primary diabetes treatment is likely impractical, it is entirely possible that lower dosages of curcumin could nicely complement our traditional therapies as a natural and safe treatment."

For now, the conclusion that Dr. Tortoriello and his colleagues have reached is that turmeric – and its active antioxidant ingredient, curcumin – reverses many of the inflammatory and metabolic problems associated with obesity and improves blood-sugar control in mouse models of Type 2 diabetes.

In addition to exploring novel methods of curcumin administration to increase its absorption, they are also interested in identifying novel anti-inflammatory processes invoked by curcumin and in adapting those processes in the development of more potent curcumin analogues.

Funding for the study comes in part from the National Institutes of Health's Child Health and Human Development branch and the Naomi Berrie Diabetes Center at Columbia University Medical Center.

Source: http://www.scientificblogging.com)

For patients with type 2 diabetes, cardiovascular disease is the leading cause of death and the major cause of illness. In fact, people with diabetes are twice as likely to have heart disease or experience a stroke as those without diabetes. Diabetics also tend to develop heart disease or have strokes at an earlier age than their peers. Additionally, heart attacks in diabetics generally cause more damage and are more likely to result in death.

Since patients with type 2 diabetes face a higher risk of cardiovascular disease, diabetes specialists and their patients were shocked when a study published in the May 21, 2007 issue of the New England Journal of Medicine (NEJM) revealed that the leading diabetes drug, Avandia, is associated with a 43% increase in heart attacks and possibly a 64% increase in cardiovascular death.

Experts say the new study findings are especially alarming because two-thirds of the people with type 2 diabetes die of heart problems. In a May 21, 2007 letter to GlaxoSmithKline, the manufacturer of Avandia, US Senators Max Baucus (Chairman of the Senate Committee on Finance) and Chuck Grassley (Ranking Member of the Senate Committee on Finance) wrote:

"It is troubling, to say the least, that by taking Avandia,
diabetics may be increasing their risk of the very
adverse event that they hope to prevent
by controlling their blood sugar."

Even more worrisome, medical experts point out that the studies analyzed in the NEJM report – some lasting only 24 weeks long – were not designed to look for heart risks and it may be that higher risks will appear after a longer term of use. Dr David Nathan, chief of diabetes care at Massachusetts General Hospital, who reviewed the paper for the NEJM, told the Associated Press, "This analysis is just scratching the surface of what may be there."

Major Failure of Drug Approval Process
Avandia (rosiglitazone) was approved by the FDA in 1999 for the treatment of type 2 diabetes, a disease that affects between 18 to 20 million Americans. Following regulatory approval Avandia was promoted as being safer than Rezulin, a diabetes drug removed from the market in 2000 after serious cases of liver damage developed in patients taking the drug.

Avandia is currently the top selling diabetes drug with total US sales of $2.2 billion in 2006, according to IMS Health, a healthcare tracking information firm. A one-month supply sells for between $90 and $170, the Associated Press reported on May 23, 2007.

In an editorial accompanying the NEJM study, Dr. Bruce Psaty of the University of Washington and Dr Furberg of Wake Forest University wrote that the drug "represents a major failure of the drug-use and drug-approval processes in the United States." They also state, "the rationale for prescribing rosiglitazone at this time is unclear," because when the drug was approved its benefits were "at best mixed."

Risk Warnings Ignored for Years
Documents dating back 7 years show the FDA knew about the risks associated with Avandia and did nothing to protect consumers. The day after the new study appeared online, on May 23, 2007, Dr. Sidney Wolfe, director of Public Citizen, a non-profit health research group, sent a letter to FDA Commissioner Andrew von Eschenbach, which described a July 16, 2002 FDA memo that showed FDA scientists had recommended that the label for Avandia be amended to include post-marketing reports of heart failure among patients taking the drug.

"The failure of the FDA to act on the recommendations made almost five years ago by its Division of Drug Risk Evaluation is yet another case in which the conclusions of scientists who are engaged in post-market drug safety review are not taken seriously enough or addressed soon enough," Dr. Wolfe said in a press release.

"As a result," he stated further, "millions of people – to the detriment of their health – are prescribed drugs whose risks are dangerously understated, instead of being prescribed safer, equally or more effective alternative drugs."

Source: Rosiglitazone Evaluated for Cardiovascular Outcomes — An Interim Analysis

Feeling Fat? It Might not be Your Fault, According to Obesity Expert

According to a paper published in Nature Clinical Practice: Endocrinology and Metabolism, the current obesity epidemic is caused by a “poisoned” food supply that is altering people’s biochemistry and driving them to eat more and move less. It is unfair and unhelpful to blame personal behaviors, especially a lack of self-control, for the country’s rising obesity rates, says Dr. Robert Lustig, a UCSF doctor and nationally renowned obesity expert who culled results from thousands of studies on obesity.

The processed food that is most readily available to Americans – from potato chips and cookies to yogurt and white bread – is loaded with sugars that cause the body to believe that it is hungry, which makes people feel compelled to consume more calories and conserve energy, he said. Sugar makes the body produce more insulin, which blocks hormones that would normally tell the brain to stop eating, he said.

Breaking the pattern of sugar consumption – a pattern that Lustig compares to nicotine addiction – is more than just a matter of willpower. It will take a grassroots effort of doctors, community leaders and consumers to force the government and the food industry to get those sugary foods out of mainstream American diets, he said.

“Everyone’s assuming you have a choice, but when your brain is starving, you don’t have a choice,” Lustig said. “When you look at it that way, all of a sudden Big Food looks like the perpetrator, and the patient becomes the victim. Congress says you can’t sue McDonald’s for obesity because it’s your fault. Except the thing is, when you don’t have a choice, it’s not your fault.”

Doctors have long assumed that there is a connection between increasing sugar consumption and the country’s out-of-control obesity epidemic. A study published in the American Journal of Clinical Nutrition earlier this week suggested that a single can of soda a day can add 15 pounds a year.

And increasingly, physicians are becoming frustrated with patients who are obese or in danger of becoming obese and seem incapable of making the lifestyle changes that are necessary to lose weight. If Lustig’s hypothesis is correct, then it’s no wonder physicians are frustrated: Their patients are driven to eat more and exercise less, in much the same way they’re driven to drink when they’re thirsty.

“Your body is telling you to eat more. Our bodies don’t do well fighting biochemical drive,” Lustig said. “Try to not drink something after you’ve eaten a pizza, when you’re thirsty.”

According to Lustig’s hypothesis, sugar in large quantities drives up insulin secretion. This insulin floods the brain, and in particular the hypothalamus, which regulates energy use in the body. As a result, leptin, a hormone that tells the brain when the body needs more or less energy, can’t get its signal to the hypothalamus because the insulin is blocking the way.

The result is that the body is thrown into starvation mode – the brain thinks it isn’t getting enough energy, so it needs more calories and it needs to save energy, he said. People end up feeling the symptoms of starvation, including malaise, depression, a lack of motivation and, of course, hunger.
Source: Nat Clin Pract Endocrinol Metab. 2006 Aug;2(8):447-58.

The list of serious health problems caused by high blood sugar levels continues to grow. In the last few issues we've written about the connection between elevated blood glucose and increased incidence of Metabolic Syndrome, obesity and Type II diabetes. Now a team of medical researchers have discovered that elevated blood glucose levels and obesity contribute to the onset of BPH (Benign Prostatic Hyrpertrophy).

BPH is a common condition in older men that causes difficulty in urinating and forces men to get up three or four times during the night to urinate. BPH occurs when the prostate begins to hypertrophy, or increase in size. Other symptoms of BPH include hesitancy, reduced force of urinary stream, and occasional bleeding or infection. This condition may even proceed to the point of complete urinary obstruction.

In the new study published in the July issue of the Journal of Clinical Endocrinology & Metabolism the researchers from the University of California, San Diego, report that men are at greater risk of developing BPH if they are overweight and have elevated blood sugar levels. The research team, led by Dr. J. Kellogg Parsons, used MRI scans to determine prostate volumes of 422 men aged 27 to 84 years. They discovered that 91 men (22%) had enlarged prostates.

When they examined the men for additional risk factors, such as obesity, blood glucose concentration and diabetes, they found that overweight men were 3.5-times more likely to develop BHP than their normal-weight counterparts.

Blood glucose levels were also shown to increase the risk of developing BPH. Subjects with elevated glucose levels were 3-times more likely to have an enlarged prostate as compared to men with normal blood sugar levels. Overall diabetics were more than twice as likely to have prostate enlargement compared with men without diabetes, the researchers note.

Natural Prevention for BPH

The most common therapeutic options for BPH have been limited to either surgery or Proscar®, a prescription drug that inhibits 5-alpha reductase. Use of Proscar results in a 20 percent decrease in prostate size in 50 percent of the men who are treated. Unfortunately, Proscar is fairly expensive and has the significant side effect of causing sexual dysfunction (impotence and loss of libido). Fortunately the new research linking BPH and elevated glucose levels suggests that controlling blood sugar and weight may offer a more natural approach to preventing BPH without the cost, pain and adverse effects of current therapies.

MetaPhase™ has been shown to promote healthy blood sugar levels while reversing metabolic and chemical disturbances caused by long-term exposure to elevated insulin and blood glucose. In addition to providing a sustained reduction in blood sugar levels MetaPhase aids in restoring pancreatic function while enhancing peripheral insulin sensitivity to normalize insulin production. And by reducing carbohydrate cravings, MetaPhase can also support efforts at healthy weight reduction without the side effects of stimulants.

Maintaining a Strong Immune System
to Prevent Summer Colds

Though considered a winter malady, anyone who’s had their vacation ruined by a summer cold knows that colds follow a seasonal cycle and can strike at any time. Colds are caused by over 200 different viral agents, including respiratory syncytial viruses, rhinoviruses, echo-viruses, adenoviruses and influenza type C viruses. Over time, these viruses have adapted to thrive in different environmental conditions. As a result most Spring and Summer colds are caused by one of over 100 different forms of rhinovirus that are adapted to warmer conditions. Conversely, most colds caught in the Fall and Winter are caused by variants of both parainfluenza and respiratory syncytial virus strains.

Summer vacations often involve travel to new places and contact with new people, both factors that can dramatically increase exposure to new versions of common viruses which are unfamiliar to your immune system. And just the simple act of boarding a plane dramatically increases the chances of infection, as recycled cabin air concentrates and spreads airborne viral particles that easily penetrate the mucous membranes lining the nose, eyes and mouth.

ImmunoPhase™ is an advanced, all-natural herbal formula that supports the immune system to aid the body in defending against colds and flu by repelling viruses before they have a chance to spread. And when taken at the first signs of infection, ImmunoPhase’s powerful blend of immuo-supportive herbs – including Ilex, Isatis and Forsythia – support rapid recovery from nasal congestion, headaches and stuffy head symptoms. At the first sign of a cold or flu, adults take two capsules every 2-3 hours. Children age 6-12 take one capsule every 3 hours at the first sign of a cold or flu. Continue taking the supplement at this rate even if you do catch a full cold or flu to help your immune system reduce symptoms, fight off the virus and shorten the duration of the illness. Most people experience an immediate effect and clear reduction of symptoms within 2 hours of taking ImmunoPhase the very first time. Continued use can stop a cold or flu quickly and reduce symptoms, as well as confer protective benefits with daily long-term use.

Majority of Patients with High
Blood Pressure have Metabolic Syndrome
In a new study published in the April issue of the American Journal of Medicine a team of Spanish researchers report that up to two-thirds of patients with high blood pressure also suffer from undiagnosed Metabolic Syndrome, placing them at high risk of developing diabetes.

The researchers examined 420 non-diabetic patients recruited from 16 hypertension clinics throughout Spain. After measuring both fasting and 2-hour plasma glucose and insulin levels they discovered that a stunning 68% of patients suffered from abnormal glucose metabolism (Metabolic Syndrome).

Additionally, a vast majority of patients (65%) were also found to have at least 2 or more previously undiagnosed cardiovascular risk factors, placing them at substantially increased risk of developing heart disease.

Most surprising was the finding that out of the 420 patients, only 27 patients (6.4%) were taking steps to adequately control their risk factors.

Brain Scans Reveal Link Between
Alzheimer's and Metabolic Syndrome
Researchers in California have measured physical and metabolic changes in the brain that may predict dementia or cognitive decline in normal adults. Furthermore, the location of these changes suggests alterations to brain tissues usually only seen in early Alzheimer's.

For the study, designed to determine if brain imaging could aid in identifying early signs of dementia, the researchers followed 60 individuals, aged 60 to 100 years, for an average of 4 years. Each subject was examined with two imaging techniques -- positron emission tomography imaging (PET) and magnetic resonance imaging (MRI). At the end of the study six subjects (10%) were found to have developed serious cognitive impairment or dementia.

According to Dr. William Jagust of the University of California at Berkeley, there was a –high positive correlation” between rapid declines in cognitive function and lower glucose metabolism in key areas of the brain.

"The pattern of glucose metabolism, together with the location of brain regions that are predictive of Alzheimerês suggests that these findings are due to the detection of pre-symptomatic Alzheimerês disease,” the researchers concluded.

Controlling Glucose Metabolism
May Preserve Mental Function
In a related study researchers are putting forth a provocative new theory suggesting that diabetes is a primary cause of Alzheimerês disease. This theory is about to be tested in thousands of Alzheimerês patients receiving diabetes drugs in hopes of slowing brain decay.

Alzheimerês is already expected to skyrocket in the aging baby-boomer population, rising from 4.5 million sufferers today to a staggering 14 million by 2050. And if the new theory is right, the nationês current obesity-fueled epidemic of Type 2 diabetes could worsen that toll.

Diabetes has long been listed as a risk factor for Alzheimerês later in life because it damages blood vessels that supply the brain. The new research suggests a more insidious connection: that Alzheimerês can be silently triggered when brain cells canêt properly use their main fuel, sugar ã just as Type 2 diabetes is triggered when insulin gradually loses its ability to process sugar body-wide.

No one knows what causes the creeping brain degeneration seen in Alzheimerês, and current therapies only temporarily help symptoms. Now, researchers are searching for new drugs designed to target the diseaseês hallmark, a sticky gunk called beta-amyloid that clogs up, and probably kills, neurons.

In the new theory, brain cells become damaged as mitochondria, the intracellular power plants that provide energy for cells, lose their ability to metabolize sugar. Eventually the brain cells are impaired, leading to a buildup of beta-amyloid. Additionally, in its early stages this type of mitochondrial damage starves the brain neurons of the resources required to build additional links with adjacent cells (synapses) in youth and middle age, leading to a lack of –cognitive reserves” once the neurons begin to die off.

–When theyêre in an insulin-resistant state, it does not just affect the body, it affects the brain as well,” explains Suzanne Craft of the Veterans Affairs Puget Sound Health Care System, who led the initial research.

Among the evidence being cited by the researchers behind the new theory are findings that decades before dementia symptoms appear, PET scans of people who carry an Alzheimerês-linked gene show their brain cells underuse sugar (see study above).

Additional evidence:

« Researchers who tracked 140,000 diabetic veterans found those who received insulin-resensitizing drugs were less likely to be diagnosed with Alzheimerês years later.

« Mice engineered to develop Alzheimerês-like disease experience the metabolism changes before beta-amyloid plaques appear ã and insulin-sensitizing drugs enhance their brainsê sugar use.

« In a preliminary study involving the diabetes drug, rosiglitazone, Alzheimerês patients showed modest improvement in cognitive function in most cases.

Proponents of the new theory also see potential good news: If diabetic-like changes in the way brain cells use sugar to generate energy truly trigger Alzheimerês then maybe new therapies can be designed to intervene early and slow down tissue degeneration.

A preliminary experiment involving 511 Alzheimerês patients found evidence that insulin-resensitizing drugs might help. Those results, combined with other evidence that the diabetes pathway is important, have drug makers poised to open three Phase III clinical trials this summer to test whether the diabetes drug rosiglitazone might protect certain patientsê brains.

The diabetes hypothesis study was published in the April 2006 issue of the medical journal Alzheimerês & Dementia.

Bone Drugs Linked to Alarming Destruction of Jaw Bone
According to an article in the April 6 LA Times, more than 2,400 patients taking Fosamax and other bone-building medications like it have reported bone death in their jaws since 2001, mostly after a minor trauma such as getting a tooth extracted. Most were taking especially potent, intravenously delivered versions of these drugs, which are known as bisphosphonates.

An additional 120 people who were taking bisphosphonates in pill form to prevent bone thinning have been stricken with such incapacitating bone, joint or muscle pain that some were bedridden and others required walkers, crutches or wheelchairs.

The incidence of both these complications is minuscule in comparison with the millions of people taking these medications. More than 36 million prescriptions for oral bisphosphonates, such as Actonel, Fosamax and Boniva, were dispensed in 2005, according to IMS Health, a pharmaceutical information and consulting company. Nearly 3 million cancer patients have been treated with intravenous versions of the medications.

But because at least 90% of drug side effects aren't reported to the Food and Drug Administration, the real number of people stricken with jaw necrosis and other side effects could be higher.

"We've uncovered about 1,000 patients [with jaw necrosis] in the past six to nine months alone, so the magnitude of the problem is just starting to be recognized," says Kenneth M. Hargreaves, chair of the endodontics department at the University of Texas Health Science Center in San Antonio.

The rare side effect, called osteonecrosis of the jaw, causes severe infections, swelling and the loosening of teeth. Patients often require long-term antibiotic therapy or surgery to remove the dying bone tissue.

With concern growing over the possible side effect, the American Assn. of Endodontists has released a position statement on the problem. "Until further information is available, it would appear prudent to consider all patients taking bisphosphonates to be at some risk," the group said.

Source: The Medical Journal of Australia

Pet Clinics 'Adopting' AllerPhase and ImmunoPhase for Healthier Cats and Dogs

Dear Tango,

Have any of your products, such as AllerPhase or ImmunoPhase, ever been used on animals? And what dose would you use? The reason I ask is a lot of people are asking me if it would help their pets, as they get people illnesses too.

Thanks,
Dennis

Dear Dennis,

Several veterinarians have recently sent us reports of their success in using AllerPhase and ImmunoPhase in their pet clinics. This makes a lot of sense, as dogs and cats suffer from a wide variety of infections and animal doctors are often limited in their treatment options. And while the viruses and bacteria that infect our pets may be different from the ones that infect us, they cause similar symptoms – cough, runny nose, fatigue, lack of appetite and fever. In vulnerable pets, particularly those that are young and old, even common infections can be deadly.

One of our vets reports excellent results for two very difficult infections – parvovirus, which infects dogs, and feline infectious peritonitis, a dangerous cat inflammation. Both disorders can be fatal for the infected pet.

The good doctor diagnosed parvovirus for a dog that had been sick for ten days and had a temperature over 104 degrees. He gave the owner antibiotics and ImmunoPhase with the instructions to give his dog the herbal remedy every three hours. In a follow-up call at the end of the day, the dog had returned to drinking water, a good sign of improvement. The next morning the owner reported the dog was back to normal with healthy appetite and activity.

Our vet also treated a case of feline infectious peritonitis [FIP] with ImmunoPhase. FIP is caused by a coronavirus and is difficult to diagnose and to treat. It is probably the most common cause of unexplained fevers in cats. The illness can cause lethargy, weight loss, eye disease, and swelling of the abdomen or fluid in the chest. Most cats with FIP will die within 2 to 11 months from the damage caused by the virus, the immune system and secondary problems such as kidney or liver failure.

The cat treated by the vet with ImmunoPhase had been ill for 20 days. Nothing had worked to lessen or stop the illness and they were waiting for the pet to die. As a last resort, they gave the cat ImmunoPhase and she quickly recovered her health within a few days.

Since ImmunoPhase worked so well in these and other cases of pet infections it would be helpful to have the remedy on hand to use at the first sign of illness.

Since dogs and cats are much smaller than humans, they should be given smaller doses of the remedy. Mid-sized and larger dogs can be provided with one capsule of ImmunoPhase from 3-5 times per day. Smaller dogs and cats can take 1/2 capsule 3-5 times per day. The best way to give your pet the formula is to open the capsule and stir it in with wet pet food. The main precaution in giving the formula to your animal is to watch out for diarrhea as your pet’s digestive system may be weakened by its illness. Discontinue the remedy if this occurs. And, as with humans, be sure to consult with your veterinarian as needed for the health of your pet.

Other remedies from Tango are also proving valuable for pets, including AllerPhase for skin itching and Vital Cell for long-term cardiovascular and immune system health. Both formulas come in capsules that can be opened for convenient mixing with wet pet foods for your favorite friends.

John Steinke, L.Ac.