Crenezumab, from Genentech, a unit of Roche Holding AG, ROG.VX +0.26% targets a sticky protein in the brain called amyloid that is thought to contribute to Alzheimer's when it clumps together. The trial also will seek to understand whether the amount of amyloid in one's brain could help predict later cognitive decline—a so-called biological marker. If it works, future trials could potentially use amyloid levels to determine whether a treatment is working rather than waiting to see if patients' memory worsens.

The DHA-deprived rats also developed signs of resistance to insulin, a hormone that controls blood sugar and regulates synaptic function in the brain. A closer look at the rats' brain tissue suggested that insulin had lost much of its power to influence the brain cells.

"Because insulin can penetrate the blood–brain barrier, the hormone may signal neurons to trigger reactions that disrupt learning and cause memory loss," Gomez-Pinilla said.

He suspects that fructose is the culprit behind the DHA-deficient rats' brain dysfunction. Eating too much fructose could block insulin's ability to regulate how cells use and store sugar for the energy required for processing thoughts and emotions.

"Insulin is important in the body for controlling blood sugar, but it may play a different role in the brain, where insulin appears to disturb memory and learning," he said. "Our study shows that a high-fructose diet harms the brain as well as the body. This is something new."

Gomez-Pinilla, a native of Chile and an exercise enthusiast who practices what he preaches, advises people to keep fructose intake to a minimum and swap sugary desserts for fresh berries and Greek yogurt, which he keeps within arm's reach in a small refrigerator in his office. An occasional bar of dark chocolate that hasn't been processed with a lot of extra sweetener is fine too, he said.

Still planning to throw caution to the wind and indulge in a hot-fudge sundae? Then also eat foods rich in omega-3 fatty acids, like salmon, walnuts and flaxseeds, or take a daily DHA capsule. Gomez-Pinilla recommends one gram of DHA per day.

"Our findings suggest that consuming DHA regularly protects the brain against fructose's harmful effects," said Gomez-Pinilla. "It's like saving money in the bank. You want to build a reserve for your brain to tap when it requires extra fuel to fight off future diseases."

The UCLA study was funded by the National Institute of Neurological Disorders and Stroke. Gomez-Pinilla's lab will next examine the role of diet in recovery from brain trauma.

Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest. 2006 Jul;116(7):1793-801. Review. Erratum in: J Clin Invest. 2006 Aug;116(8):2308.
Fleischman A, Shoelson SE, Bernier R, Goldfine AB. Salsalate Improves Glycemia and Inflammatory Parameters in Obese Young Adults. Diabetes Care. 2007 Oct 24; [Epub ahead of print]
Goldfine AB, Silver S, Aldhahi W, Cai D, Tatro E, Lee J, Shoelson SE. Use of Salsalate to Target Inflammation in the Treatment of Insulin Resistance and Type 2 Diabetes, Clinical and Translational Science, 2008 May;1(1):36-43
Goldfine AB, Fonseca V, Jablonski KA, Pyle L, Staten MA, Shoelson SE; for the TINSAL-T2D (Targeting Inflammation Using Salsalate in Type 2 Diabetes) Study Team. The Effects of Salsalate on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Trial. Ann Intern Med. 2010 Mar 16;152(6):346-357.

Experts who were not involved in the multi-center trial agreed larger trials were needed, and said the impact of the drug on blood glucose levels[—.5% reduction in A1c over three months at the highest tested dose of 4g daily—]was moderate. But they said the findings were exciting because they suggested Type 2 diabetes could be treated by targeting the underlying inflammation....
Since atherosclerosis is also considered an inflammatory state, this approach may also potentially reduce the risk of cardiovascular complications associated with diabetes...
Salsalate sells for less than a quarter a pill, and does not present the opportunity for profit that would attract large pharmaceutical companies to do the research...
The patients continued with their regular Type 2 diabetes treatment regimen throughout the study.

"Then we realized that there were other salicylates, chemically similar to aspirin, that don’t carry the same risk of bleeding.” The drug they’re studying now, salsalate, was widely used not too long ago to treat arthritis, but it got “back-shelved” when other drugs were developed for the treatment of pain and arthritis.
The researchers’ first salsalate studies showed that blood glucose control and glucose metabolism improved in people with diabetes; salsalate also lowered inflammation markers and improved levels of cholesterol and triglycerides in the blood. The second round of studies, investigating whether the drugs could have a beneficial impact on overweight people who do not have diabetes but are at risk for developing it, found that blood glucose levels improved, as did inflammatory markers and other risk factors for disease.

Each percentage point decrease in A1C lowers the risk of long-term diabetes complications by 37%.
Diabetes is more common and often more severe in African Americans. To determine if people in this population could lower their A1C levels by talking regularly with others who had successfully controlled their blood glucose levels, researchers recruited 118 African Americans at the Philadelphia Veterans Affairs Medical Center who hadn’t been successful at lowering their A1C[:]
Those in the usual care group were provided with specific goals for A1C.
Participants in the financial incentive group were given $100 for lowering their A1C by one point (for example, from 7.9% to 6.9%) and $200 for lowering their A1C by two points or for hitting an A1C level of 6.5% or lower.
Those in the peer-mentoring group were connected with someone with diabetes who had once had poor blood glucose control but who had brought it to target levels (an average of 6.7%). The mentors were paid $20 and told to meet with their “mentees” at least once per week for the duration of the six-month study.
Mentors and mentees spoke an average of four times during the first month of the study and twice a month thereafter. The researchers were not sure whether this decrease in contact was due to reduced motivation or to a perceived lack of need for more frequent communication.
[Peer-mentoring participants] achieved the greatest reduction in A1C levels: Among those in the usual care group, A1C was reduced, on average, from 9.9% to 9.8%; among those in the financial incentive group, A1C was reduced from 9.5% to 9.1%; and among those in the peer-mentoring group, A1C was reduced from 9.8% to 8.7%.
“Perhaps the most obvious attraction of this type of peer mentoring is that it is virtually free, almost certainly enhancing its cost-effectiveness relative to more expensive interventions, such as nurse care management, telemedicine, and group medical appointments"...
The researchers note that all participants in the study were veterans, so the sense of camaraderie among them may not translate to other groups of people with diabetes, and they call for future studies that look into whether the blood glucose effects seen in this trial are sustainable....
{T]o find a diabetes mentor, check out the article “Peer Support, Education, and Mentoring,” [link] by certified diabetes educator Martha Mitchell Funnell.

To the unaided eye, the most striking feature of the human brain is its squiggly pattern of bumps and grooves. But within those curves is a latticework of nerve fibers that cross each other at roughly right angles (above), according to a study published March 30 in Science.
The researchers used a recently-developed method called diffusion spectrum imaging to infer the position of nerve fibers in the living human brain from the way water flows through and around them. These scans revealed an orderly weave of fibers — a much simpler organization than many scientists would have suspected.
Scans in four monkey species found a similar pattern. The researchers suggest that this grid-like organization may be advantageous during brain development, providing the equivalent of highway lane markers to help growing nerve fibers find their way to the appropriate destination.

[A study published in the November 23/30, 2011, issue of The Journal of the American Medical Association] detailed the results of a blinded crossover trial in which 75 subjects ate either canned soup or homemade soup for five days. Half ate canned soup, followed by a two-day washout period and then homemade soup. The other half ate homemade soup first, followed by a washout period, then canned soup. Aside from the soup, they could eat whatever they liked.
When subjects ate the nationally distributed canned soup, their urinary levels of BPA were 20 times higher than when they ate a similar homemade soup, averaging 1.1 mcg/L when they ate homemade soup for five days and soaring to 20.8 mcg/L when they ate the canned soup for the same amount of time. This wasn’t all soup all the time, people: It was one serving of soup per day at lunch. Just think of all the food and drink we consume out of cans. All day long. (Not to mention the water we drink that comes to us through plastic water pipes.)

Eating foods at breakfast that have a low glycemic index may help prevent a spike in blood sugar throughout the morning and after the next meal of the day...
These breakfast foods also can increase feelings of satiety and fullness and may make people less likely to overeat throughout the day...
The glycemic index ranks foods on the [rate at] which they raise blood sugar levels after eating. Foods with a high index are rapidly digested and result in high fluctuations in blood sugar levels. Foods with a low glycemic index produce gradual rises in blood sugar and insulin levels and are considered healthier, especially for people with diabetes.
Mattes’ research specifically focused on the advantages of having almonds, a low glycemic index food, with the morning meal. In his study, published last year in the Journal of Nutrition and Metabolism, participants who ate a breakfast containing whole almonds experienced longer feelings of fullness and had lower blood glucose concentrations after breakfast and lunch, compared to those who did not have a low-glycemic breakfast.
When a low glycemic food is added to the diet, people spontaneously choose to eat less at other times throughout the day. Mattes added that while the calories need to be taken into consideration as part of a person’s overall diet, almonds can be incorporated in moderate amounts without an effect on body weight.
Both Mattes and Shelke stressed the importance of eating a healthy, low-glycemic breakfast in maintaining a healthy weight and blood sugar levels. A 2009 study found that about 30 percent of people skip breakfast one to three times per week. Among those who eat breakfast, cold cereal is the most popular (83 percent), followed by eggs (71 percent).

People sleeping less than six hours a night were twice as likely to have a stroke or heart attack and 1.6 times as likely to have congestive heart failure. And those sleeping more than eight hours each night were two times as likely to have angina and 1.1 times more likely to have coronary artery disease.

An emerging body of research suggests that Alzheimer's disease may be linked to insulin resistance, constituting a third type of diabetes.  This model is based on several observations including an increased risk of developing Alzheimer's disease for diabetic patients, and reduced insulin levels in the brain tissue of Alzheimer's disease patients. Though intriguing, the existing evidence does not reveal if defective insulin signaling is causative of Alzheimer's or how insulin resistance impacts cognitive function.
Type 2 diabetes is known to increase the risk for Alzheimer's disease. Recent research has found that insulin resistance also develops in the brains of patients with Alzheimer's, which scientists sometimes call "brain diabetes." This brain insulin signaling deficit results in learning and memory disability and could potentially be known as Type 3 Diabetes.
There is much that still remains unknown about the cause of Alzheimer's disease (AD), a form of dementia that affects memory, thinking, and behavior. Two brain changes have long been known to form in the brains of patients with dementia – neurofibrillary tangles and beta-amyloid plaques. Tangles are twisted fibers of tau protein that builds up inside the cells. Plaques are accumulations of protein fragments that build up in the spaces between nerve cells. The two abnormal structures combine to block communication between nerve cells and disrupt the processes needed for them to survive.
But now, a third brain change is emerging as a likely suspect contributing to cognitive deficits in patients with Alzheimer's disease. Brain levels of insulin and insulin receptor (IR) are lower in AD and insulin signaling impairments have been documented in human postmortem analysis and in animal models....
The University of Pennsylvania team examined insulin signaling in human brain tissue postmortem, and concluded that the activation state of many insulin signaling molecules were highly related to memory and cognitive function. They further suggest that insulin resistance is a common and early feature of Alzheimer's disease.
The De Felice group further observed impaired insulin signaling in Alzheimer's brain tissue in rodent and non-human primate model systems as well as from tissue from human patients. They went on to show in a mouse model system of Alzheimer's disease that treatment with a new anti-diabetic drug normalized insulin signaling and remarkably improved cognitive function. Cumulatively, these two new studies strongly support a connection between insulin resistance and Alzheimer's disease and provide hope for new therapeutics in Alzheimer's disease treatment.

BACKGROUND:
It is commonly assumed that there are clear lines of demarcation between anxiety and depressive disorders on the one hand and psychosis on the other. Recent evidence, however, suggests that this principle may be in need of updating.
METHODS:
Depressive and/or anxiety disorders, with no previous history of psychotic disorder, were examined for the presence of psychotic symptoms in a representative community sample of adolescents and young adults (Early Developmental Stages of Psychopathology study; n = 3021). Associations and consequences of psychotic symptomatology in the course of these disorders were examined in terms of demographic distribution, illness severity, onset of service use, and risk factors.
RESULTS:
Around 27% of those with disorders of anxiety and depression displayed one or more psychotic symptoms, vs 14% in those without these disorders (OR 2.23, 95% CI 1.89-2.66, P < .001). Presence as compared with nonpresence of psychotic symptomatology was associated with younger age (P < .0001), male sex (P < .0058), and poorer illness course (P < .0002). In addition, there was greater persistence of schizotypal (P < .0001) and negative symptoms (P < .0170), more observable illness behavior (P < .0001), greater likelihood of service use (P < .0069), as well as more evidence of familial liability for mental illness (P < .0100), exposure to trauma (P < .0150), recent and more distant life events (P < .0006-.0244), cannabis use (P < .0009), and any drug use (P < .0008).
CONCLUSION:
Copresence of psychotic symptomatology in disorders of anxiety and depression is common and a functionally and etiologically highly relevant feature, reinforcing the view that psychopathology is represented by a network or overlapping and reciprocally impacting dimensional liabilities.

Rich evidence has shown that cannabis products exert a broad gamut of effects on emotional regulation. The main psychoactive ingredient of hemp, Δ9-tetrahydrocannabinol (THC), and its synthetic cannabinoid analogs have been reported to either attenuate or exacerbate anxiety and fear-related behaviors in humans and experimental animals.
The heterogeneity of cannabis-induced psychological outcomes reflects a complex network of molecular interactions...The high degree of interindividual variability in the responses to cannabis is contributed by a wide spectrum of factors, including genetic and environmental determinants, as well as differences in the relative concentrations of THC and other alkaloids (such as cannabidiol) within the plant itself.
The present article reviews the currently available knowledge on the herbal, synthetic and endogenous cannabinoids with respect to the modulation of anxiety responses, and highlights the challenges that should be overcome to harness the therapeutic potential of some of these compounds, all the while limiting the [adverse] effects associated with cannabis consumption. In addition the article presents some promising patents on cannabinoid-related agents.

Cannabis has long been known to produce cognitive and emotional effects. Research has shown that cannabinoid drugs produce these effects by driving the brain's endogenous cannabinoid system and that this system plays a modulatory role in many cognitive and emotional processes.
This review focuses on the effects of endocannabinoid system modulation in animal models of cognition (learning and memory) and emotion (anxiety and depression). We review studies in which natural or synthetic cannabinoid agonists were administered to directly stimulate cannabinoid receptors or, conversely, where cannabinoid antagonists were administered to inhibit the activity of cannabinoid receptors. In addition, studies are reviewed that involved genetic disruption of cannabinoid receptors or genetic or pharmacological manipulation of the endocannabinoid-degrading enzyme, fatty acid amide hydrolase (FAAH).
Endocannabinoids affect the function of many neurotransmitter systems, some of which play opposing roles. The diversity of cannabinoid roles and the complexity of task-dependent activation of neuronal circuits may lead to the effects of endocannabinoid system modulation being strongly dependent on environmental conditions. Recent findings are reviewed that raise the possibility that endocannabinoid signaling may change the impact of environmental influences on emotional and cognitive behavior rather than selectively affecting any specific behavior.

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The co-ingestion of mulberry extract with 75 g sucrose significantly reduced the increase in blood glucose observed over the initial 120 min of testing in control and type 2 diabetic subjects (Fig. 1). Blood glucose declines at the tail end of the study were less with extract. Thus, peak-to-trough fluctuations in blood glucose were markedly reduced by mulberry ingestion.

The mulberry-induced reduction in blood glucose presumably reflects the ability of mulberry to inhibit intestinal sucrase (9). The increased H2 observed with mulberry indicates that this supplement induced sucrose malabsorption.

The reduction of blood glucose at early time points but higher values at later time points with mulberry would yield relatively minor alterations in A1C. However, factors other than A1C concentrations may play a role in the microvascular complications of diabetes (10,11). Brownlee (12) proposed that generation of reactive oxygen species is the common pathway responsible for diabetes complications, and glucose fluctuations are associated with increased markers of oxidative injury (13). Thus, reductions in blood glucose fluctuation with mulberry extract might reduce diabetes complications despite minor reduction of A1C.

All the participants were allowed to eat as much as they wanted during the study. Those in the sleep-deprived group slept one hour and 20 minutes less each night than those in the control group, and consumed an average of 549 additional calories per day.
Both groups burned about the same amount of energy for activity...
Lack of sleep was associated with increased levels of leptin and decreased levels of ghrelin, both of which are appetite-associated hormones. [Study authors say these] changes were more likely a result of overeating, rather than the cause of overeating....
"Sleep deprivation is a growing problem, with 28% of adults now reporting...six or fewer hours of sleep per night."
Although this study suggests sleep deprivation may be an important and preventable cause of weight gain and obesity, it was a small study and does not prove a cause-and-effect relationship...

The participants kept track using either a paper diary, a personal digital assistant (PDA) without feedback, or a PDA with a program that provided personalized dietary and exercise feedback messages.

The participants who received the feedback messages (one per day on diet and one every other day on exercise) were more successful in attending group sessions, meeting daily calorie goals, meeting daily fat-intake goals, reaching weekly exercise goals and monitoring their eating and exercise.

After six months, people in the group that received feedback messages saw weight loss of more than 5 percent. After 24 months, however, weight loss was similar in all three groups....

"Over time, participants' adherence declined, particularly in the later phase as contact frequency declined and subsequently ended...Adherence in the paper-diary group declined more than in the device groups."

Diabetes patients receiving their usual care were notified of their starting levels and recommended goals for HbA1c. Those in the mentor group were assigned mentors who previously had poor glycemic control but now had good control. Mentors participated in hour-long one-on-one training, including motivational interviewing techniques, and were informed that they would receive $20 per month if the diabetes patient confirmed that they had talked at least once a week. Those in the financial incentive group were told they would earn $100 if their HbA1c dropped by one point and $200 if it dropped by two points or to a level of 6.5%.
In the six-month study, intervention by the peer mentors had a statistically significant effect in improving glucose control. On average, diabetes patients in the mentor group saw their HbA1c drop by approximately one percent (from 9.8 to 8.7). HbA1c levels in the financial incentive group dropped from 9.5 to 9.1, while the control group saw the smallest change (from 9.9 to 9.8).
The authors of the study note that several factors may have contributed to the success of the peer mentor intervention. First, those in the mentor group may have benefited from a culture of camaraderie among the veteran participants. Second, social altruism may be a powerful motivator if patients are provided with a mechanism to help each other. Third, a history of mistreatment and distrust in the health care system may make peer support particularly effective for minorities. Finally, mentors were given $20 to talk to the patients at least four times per month. This financial incentive may have motivated mentors to call more frequently.
Previous studies have shown that social support can improve diabetes self-management behaviors, such as adhering to medication, diet, exercise, and blood glucose monitoring. However, these studies generally involved nurse phone calls or home visits from community health workers, which require expensive professional or semi-professional staff members. In addition, support from families and friends is often not a viable alternative because many high-risk patients are socially isolated, while others may not want to engage relatives or friends in discussions about their medical problems. Finding family members and friends who are able to assume caretaker roles is also often a challenge for many patients.
"Our study raises the possibility that a more informal, flexible means of providing one-on-one peer support through peer coaches or mentors could potentially provide larger benefits at low cost."

A recent post on the New York Times blog Well looked at what both human and animal studies have found out about the connection between statins and muscle damage. The most recent study, published last year in the Journal of Applied Physiology, found that rats who were given a very high dose of atorvastatin for two weeks had 60% more oxidative stress (an indicator of possible cell damage) than those not given any of the drug. Some of the rats from each group were also made to run on treadmills for as long as possible. Not only did the rats on atorvastatin run a shorter distance than their non-drugged counterparts, but their post-workout oxidative stress was also 226% higher.

Human studies have yielded similar, if less dramatic, results. One study cited in the Well post — published in 2005 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology — found that among healthy people who took atorvastatin for four weeks, 56 genes were expressed differently in leg muscle cells eight hours after vigorous exercise, compared with participants who took a placebo (inactive pill). In particular, genes known to affect muscle building and repair had a lower level of expression in the atorvastatin group. There is also plenty of evidence from patient and doctor reports that statins can lead to muscle fatigue and damage. According to Well, at least 10% of people who take statins will experience some fatigue or weakness, and this number rises to 25% among those who exercise regularly.

[Researchers analysed the results of four studies on white rice consumption and diabetes risk: two in China and Japan and two in the USA and Australia]. All participants were diabetes free at study baseline.
White rice is the predominant type of rice eaten worldwide and has [a high glycemic index]. High GI diets are associated with an increased risk of developing type 2 diabetes. [Chinese eat an average of four portions a day while Westerners eat fewer] than five portions a week.
A significant trend was found in both Asian and Western countries with a stronger association found amongst women than men. [The] authors estimate that the risk of type 2 diabetes is increased by 10% with each increased serving of white rice (assuming 158g per serving).
White rice has a lower content of nutrients than brown rice including fibre, magnesium and vitamins, some of which are associated with a lower risk of type 2 diabetes. [Low intake of these nutrients may increase risk in addition to the high glycemic index and glycemic load.]

[H. pylori correlation with elevated A1c was even stronger among overweight subjects (BMI ≥ 25). The increase in A1C associated with combined higher body-mass index and H. pylori was greater than the summed effect] of the two circumstances occurring individually....

[T]he bacteria may affect the levels of two hormones in the stomach that help regulate blood glucose levels, and suggest that eliminating H. pylori using antibiotics in some older, obese individuals may have health benefits. They also note that further studies are needed to determine the effects of the bacteria—and of the removal of the bacteria—in different age groups and in people with varying body-mass indices.

In people with type 1 diabetes, target blood sugar levels can range from about 72mg/dL.(4mmol/L) to 180mg/dL.(10mmol/L)....
When participants did aerobic exercise first, blood sugar dropped closer to [the safety threshold of 80mg/dL (4.5mmol/L)] and remained lower for the duration of the workout than when they lifted weights first and ran second. Lifting weights first was also associated with less severe drops in blood sugar hours after exercise, and post-exercise drops that did occur tended to last a shorter period of time.
The current study echoes previous research showing that aerobic exercise causes a more rapid decrease in blood sugar than weightlifting...
[Researchers] did not account for levels of a number of hormones that could also lead to changes in blood glucose during exercise. Nor did they have control over participants' food and activity choices prior to exercise—the authors wanted the study to reflect real-life conditions faced by people with type 1 diabetes. Because study participants were young, active people with type 1 diabetes, it's not clear whether the findings would apply to less fit people with type 1 diabetes or people with type 2 diabetes.
Still, the authors conclude, those people with type 1 diabetes who tend to develop low blood sugar during exercise "should consider performing their resistance exercise first."

Consistent with previously published research, parent BMI change was the only significant predictor of child’s weight loss.

During single sittings, [some] over-eaters consume large servings of high-caloric foods. Sufferers contend with weight gain[, depression, and elevated risk for] heart disease and diabetes. A new clinical trial, called Regulation of Food Cues...aims to treat binge eating by helping participants to identify real hunger and to practice resistance if the stomach is full.

“Most weight-loss treatments for obese adults focus very little on the reduction of binge eating...With this study we use a variety of techniques to train the brain to identify and respond to hunger and cravings and to learn resistance to highly craved foods.”
[Thirty subjects will undergo weekly 60–90 minute sessions for] 12 weeks. Participants will learn how food cravings originate, how to detect and monitor true hunger, how [emotion influences eating, and how to manage cravings and impulses].  

“Binge eaters often consume food in response to their environment, even when they are not hungry. This could be a response to watching TV, long commutes, sitting on the couch, time of day, even loneliness...The goal is to reduce cravings to overeat by up to 50 percent.”

Teaching obese people to recognize hunger signals is based upon the principles of behavioral psychology, which has proven effective in treating conditions such as anxiety and bulimia....Exposure-based treatments help eaters improve their sensitivity to hunger and fullness and reduce their sensitivity to the sight and smell of food.

Similar programs aimed at overweight youths have yielded promising results and an ability to maintain reductions in binge eating at six and 12 months after treatment.

[Subjects] will be asked to complete interviews and surveys before and after treatment groups[, and will complete food logs monitoring] levels of hunger and fullness as well as cravings.

The Vancouver system, recommended by the Council of Science Editors (CSE), is used in medical and scientific papers and research.
In one major variant, that used by the American Society of Mechanical Engineers (ASME), citation numbers are included in the text in square brackets rather than as superscripts. All bibliographical information is exclusively included in the list of references at the end of the document, next to the respective citation number.
The International Committee of Medical Journal Editors (ICMJE) is reportedly the original kernel of this biomedical style which evolved from the Vancouver 1978 editors' meeting.[18] The MEDLINE/PubMed database uses this citation style and the National Library of Medicine provides "ICMJE Uniform Requirements for Manuscripts Submitted to Biomedical Journals -- Sample References".[19]

A healthy lifestyle maintained throughout young adulthood and middle age [correlates] with low cardiovascular disease risk in middle age. [Investigators claim this is the first study to have shown this.]
The majority of people who maintained five healthy lifestyle factors from young adulthood (including a lean body mass index (BMI), no excess alcohol intake, no smoking, a healthy diet and regular physical activity) were able to remain in this low-risk category in their middle-aged years.
In the first year of the study, when the participants’ average age was 24 years old, nearly 44% had a low cardiovascular disease risk profile. Twenty years later, overall, only 24.5% fell into the category of a low cardiovascular disease risk profile.
Sixty percent of those who maintained all five healthy lifestyles reached middle age with the low cardiovascular risk profile, compared with fewer than 5% who followed none of the healthy lifestyles.
Researchers used data collected over 20 years from the Coronary Artery Risk Development in (Young) Adults (CARDIA) study. It began in 1985 and 1986 with several thousand 18 to 30 year-olds and has since followed the same group of participants.
For this study, the researchers analyzed data such as blood pressure, cholesterol, blood sugar, BMI, alcohol intake, tobacco use, diet and exercise from more than 3,000 of the CARDIA participants to define a low cardiovascular disease risk profile and healthy lifestyle factors.
“Many studies suggest that people who have low cardiovascular risk in middle age will have a better quality of life, will live longer and will have lower Medicare costs in their older age"...

[Women who are sedentary for most of the day [appear to be at greater risk of] exhibiting the early metabolic defects that act as a precursor to developing type 2 diabetes....
[Women in a study] who spent the longest time sitting had higher levels of insulin, as well as higher amounts of C-reactive protein and chemicals released by fatty tissue in the abdomen, leptin, and interleukin6, and which indicate problematic inflammation...
[T]he link between sitting time and diabetes risk was much stronger in women than men....
"[W]omen who meet the national recommendations of 30 minutes of exercise a day may still be compromising their health if they are seated for the rest of the day.

The trial participants consumed dark chocolate bars and a beverage with a total epicatechin content of approximately 100 mg per day for three months. Biopsies of skeletal muscle were conducted before and after treatment. After the three-month treatment, the researchers looked at changes in mitochondria volume and the abundance of cristae, which are internal compartments of mitochondria that are necessary for efficient function of the mitochondria, and measurable by electron microscopy.
“The cristae had been severely damaged and decreased in quantity in these patients...After three months, we saw recovery – cristae numbers back toward normal levels, and increases in several molecular indicators involved in new mitochondria production.”
The results, which mimicked earlier studies showing improvement in skeletal and heart muscle function in animal models after treatment with epicatechin, were promising enough to prompt [a] larger study.

J Thorac Cardiovasc Surg. 2001 Dec;122(6):1094-100.
An artificial lung reduces pulmonary impedance and improves right ventricular efficiency in pulmonary hypertension.
Haft JW, Montoya P, Alnajjar O, Posner SR, Bull JL, Iannettoni MD, Bartlett RH, Hirschl RB.
Source
Department of Surgery, University of Michigan, and Michigan Critical Care Consultants, Ann Arbor, Mich, USA.
Abstract
OBJECTIVE:
Artificial lungs may have a role in supporting patients with end-stage lung disease as a bridge or alternative to lung transplantation. This investigation was performed to determine the effect of an artificial lung, perfused by the right ventricle in parallel with the pulmonary circulation, on indices of right ventricular load in a model of pulmonary hypertension.
METHODS:
Seven adult male sheep were connected to a low-resistance membrane oxygenator through conduits anastomosed end to side to the pulmonary artery and left atrium. Banding of the distal pulmonary artery generated acute pulmonary hypertension. Data were obtained with and without flow through the device conduits. Outcome measures of right ventricular load included hemodynamic parameters, as well as analysis of impedance, power consumption, wave reflections, cardiac efficiency, and the tension-time index.
RESULTS:
The model of pulmonary hypertension increased all indices of right ventricular load and decreased ventricular efficiency. Allowing flow through the artificial lung significantly reduced mean pulmonary artery pressure, zero harmonic impedance, right ventricular power consumption, amplitude of reflected waves, and the tension-time index. Cardiac efficiency was significantly increased.
CONCLUSIONS:
An artificial lung perfused by the right ventricle and applied in parallel with the pulmonary circulation reduces ventricular load and improves cardiac efficiency in the setting of pulmonary hypertension. These data suggest that an artificial lung in this configuration may benefit patients with end-stage lung disease and pulmonary hypertension with right ventricular strain.

Some studies have suggested that consumption of diet soft drinks may be associated with Type 2 diabetes and development of the condition known as metabolic syndrome — high blood pressure, abdominal obesity and other risk factors. Now a 10-year epidemiological study has found a link between diet soft drinks and cardiovascular disease.

[Among] 2,564 adults over 40 living in Manhattan,] diet and regular soft drink consumption were both associated with a number of risk factors for cardiovascular disease.

Even after controlling for many of those risks, including diabetes, the researchers found that daily consumption of diet soda was still independently associated with an increased risk for stroke, heart attack and death.

Among those with type 1 diabetes, patients with the highest quartile of TNFR2 values were three times more likely to have renal decline than those in the other quartiles, and the risk associated with high TNFR1 values was slightly less than that seen in those with elevated TNFR2.
These studies found that levels of circulating tumor necrosis factor receptor 1 and 2 (TNFR1 and TNFR2) predict kidney disease in both type 1 and type 2 diabetes.

Even minuscule amounts of BPA (used in everything from pesticides to water bottles) can scramble hormone signals, and trick fat cells into taking in more fat or mislead the pancreas into secreting excess insulin. Among the most ubiquitous and scrutinized of these...endocrine disruptors is bisphenol, better known as BPA. The chemical is a common ingredient in plastics and food-can linings.
Angel Nadal, a BPA expert at the Miguel Hernandez University in Spain stated that, "When you eat something with BPA, it's like telling your organs that you are eating more than you are really eating"[—]the chemical triggers the release of almost double the insulin actually needed to break down food. High insulin levels can desensitize the body to the hormone over time, which in some people may then lead to weight gain and Type 2 diabetes....
BPA fools a receptor into thinking it is the natural hormone estrogen, an insulin regulator. [Even the tiniest amounts of BPA—a quarter of a billionth of a gram—do] the trick. The effect disappeared when the researchers stripped the specific receptors from the study mice, evidence that they had in fact pinpointed BPA's chemical mechanism, which had previously eluded scientists. In laboratory tests of human cells, the response was even more pronounced....
An estimated 90% of people in developed countries have BPA circulating in their blood at levels often [sic] higher than the threshold for causing hormone disruption used in Nadal's study. This high incidence is due not only to exposures from leaching food packages but also BPA-infused cash register receipts, dental sealants and toilet paper.
Frederick vom Saal, another expert in endocrine disruptors at the University of Missouri-Columbia stated that, "People are seeing effects of BPA down to 1000-fold below [Nadal's threshold]." "It takes so little of this chemical to cause harm."

Participants with diabetes were stratified by insulin therapy at baseline: group A treated with insulin only; group B treated with insulin and oral hypoglycemic agent; and group C receiving no insulin treatment.
During a mean follow-up of 3.9 years, the researchers found that 4.6% of the cohort without diabetes died, compared with 15, 12.5, and 7.3% of groups A, B, and C, respectively. The hazard ratios (HRs) for all-cause mortality were 4.3, 4.2, and 2.0 for groups A, B, and C, compared with individuals without diabetes. The leading cause of death in groups A, B, and C were ESRD, ESRD and CAD, and CAD, respectively. The HRs for these conditions were at least twice as high as the HRs for all-cause mortality, extending to 17.3, 17.9, and 5.1 in groups A, B, and C, respectively, for ESRD.
"Excess mortality persists among people with young-onset diabetes of long duration, with ESRD and CAD as the leading contributors to mortality," the authors write.

[Excuse me? Don't the numbers, if correctly reported, suggest that insulin-and-drug therapy increases mortality by over two-thirds, and insulin-only therapy more than doubles mortality?—DMM]

Children and adolescents participating in moderate to vigorous physical activity have a lower cardiometabolic risk profile. [Physical activity correlated with better waist circumference, blood pressure, triglycerides, HDL cholesterol, and insulin in study subjects] regardless of the amount of time they spend sedentary.
[Based on the findings,] children should be encouraged to increase their participation in physical activity] rather than decrease the amount of time they spend sedentary, "as this appears more important in relation to cardiometabolic health."
[In pooled data from 14 studies (1998-2009) connected to the International Children's Accelerometry Database.] the time spent in moderate to vigorous physical activity has a weak to moderate association with the amount of time children spend sedentary, and this had suggested that both variables might be independently associated with cardiometabolic risk.
[A]ctivities ingrained early in life set the stage for what individuals do in their later and older years. "We're living in an age right now where it's so easy to do no physical activity at all...kids can basically go through an entirely normal childhood existence where, unless they're forced or choose to play sports, they don't have to do anything. This study shows that the more activity that you do, even if it's outside the context of typical exercise, really does make a difference."
In the ICAD analysis, 20,871 children and adolescents from Australia, Brazil, Europe, and the US had [physical-activity levels] monitored for an average of 5.2 days using the accelerometer, and the mean daily time spent engaged in moderate to vigorous physical activity was 30 minutes. The mean daily time spent sedentary was 354 minutes.
Kids in the [most active] tertile spent more than 35 minutes per day engaged in moderate to vigorous physical activity, whereas those in the bottom tertile were moderately or vigorously active just 18 minutes per day. The mean difference in waist circumference between the most active and least active kids with the most sedentary time was 5.6 cm [and 3.6 cm] in those with less sedentary time. Similarly, the difference in systolic blood pressure between the most active and least active kids with the most sedentary time was 0.7 mm Hg[, while there was a 2.6-mm-Hg difference] between the most active and least active kids who reported less sedentary time. The variations in HDL cholesterol, insulin, and triglyceride levels were similar when analyzed by physical-activity levels and sedentary time.
Overall, the results showed that higher levels of physical activity were associated with better cardiometabolic risk factors across the tertiles of sedentary time. In contrast, sedentary time was not associated with any of metabolic outcomes independent of the time engaged in moderate and vigorous activities. The researchers note that they did not qualify what specific activities the children were engaged in while being sedentary. For this reason, reducing television viewing time is still considered an important goal of parents and public-health policy because TV watching is also associated with other unhealthy behaviors, such as snacking and drinking soda.

[Some Type 1 diabetics show differences in] HLA genes that normally help the immune system to work. In addition, there are probably at least 16 other areas of DNA where differences can increase your risk of getting Type 1 diabetes....
In most cases, you need more than one DNA difference to get Type 2 diabetes. [At least 12 genes are implicated] in Type 2 diabetes, and there are probably more that scientists know nothing about yet.
In most cases, having DNA differences isn't enough to make you diabetic—it can only increase your chance. To actually get diabetes, something else has to happen....
Early diet may be important.
Type 1 diabetes may be less common in people who were breastfed. Additionally, certain infections or even cold weather might be able to trigger Type 1 diabetes in some people.
You can decrease your chances for Type 2 diabetes by exercising and eating right.
Type 2 diabetes is more common in overweight people or people who don't get enough exercise....
A classic example of all of this is the Pima Indians of Arizona. A Pima Indian with diabetes was virtually unheard of for 2000 years or so.
Recently, many of them have adopted a more typical American lifestyle—little exercise and unhealthy food. Almost overnight, around half of the Pima Indians in Arizona ended up with Type 2 diabetes.
Obviously their DNA didn't change so quickly. The DNA differences for increased Type 2 diabetes risk were always there.
But, with their old life style, it didn't matter. In other words, the DNA wasn't enough to cause the diabetes. Their environment had to change before they developed the disease....
Identical twins share the exact same DNA. So if some trait is completely due to DNA, then both identical twins would always share that trait....
If your identical twin has Type 1 diabetes, you have less than a 50% chance of getting it too. And if your identical twin has Type 2 diabetes, you have about a 75% chance of getting it. So DNA alone doesn't make you diabetic—environment is also important....
DNA, weight, physical activity, diet, and age all affect a person's risk of diabetes. No one thing alone can predict whether or not a person will get diabetes.

Awareness Day Social Media February 2012

In general, the risk of diabetes for a sibling of a patient with type 2 diabetes is about the same as that in the general population. However, there are some exceptions to this general statement. If the patient developed diabetes despite being lean, then the sibling’s risk is about twice the general population risk. Or, if the patient has a parent with type 2 diabetes, the sibling’s risk is almost three times the general population risk. If both parents have type 2 diabetes, the sibling has a fourfold risk, or nearly a 50% chance of developing diabetes.
The genetics of type 2 diabetes is complex. While type 2 diabetes may have a strong genetic basis in some patients (something less than a third of them), the development of diabetes in most patients is dependent upon the effects of environmental and behavioral factors (obesity and sedentary lifestyle) on an underlying susceptibility that is poorly understood....
Joslin researchers and others have identified about six genes that produce MODY[—maturity-onset diabetes of the young, a rarer form of type 2—but they only account for the diabetes in about one-third of affected] families....Similar patterns can be found in studies of families with the more common form of type 2 diabetes, only the age of onset differs.
The susceptibility to certain diabetes complications also seems to be linked in some ways with genetics. For patients with susceptibility genes for complications, good blood glucose control is still an important mitigating factor.

Scientists randomized 144 obese people, ages 20 to 65, to two low-carbohydrate diets providing 1,400 daily calories for women and 1,600 for men. The diets were identical except that one included a high-carbohydrate, protein-enriched breakfast with a choice of cookies, chocolate, cake or ice cream for dessert.
Throughout the study, which appears in the March 10 issue of the journal Steroids, participants were tested periodically for blood levels of insulin, glucose, lipid and ghrelin, a hormone that stimulates appetite.
During an initial 16-week period, the average weight loss in each group was identical — about 32 pounds. But over a 16-week follow-up, people on the dessert-with-breakfast diet lost an additional 13 pounds on average, while the others gained back all but 3.5 of the pounds they had lost.
Those on the dessert regimen maintained lower levels of ghrelin and reported significantly higher levels of fullness. “Most people simply regain weight, no matter what diet they are on...But if you eat what you like, you decrease cravings. The cake — a small piece — is important.”

Almonds are low in saturated fatty acids, rich in unsaturated fatty acids, and contain fiber, phytosterols and plant protein. In a scientific review, Berryman et al. (2011) showed that consuming a breakfast containing almonds aids in stabilizing blood glucose levels for most of the day and provides a lasting feeling of fullness. Pistachios are also considered a part of a heart-healthy diet and may also lower cholesterol. In addition some research has shown that walnuts may have been linked to benefits related to brain health and cancer.
Beans, also called legumes, also play an important role in diet. They contribute complex carbohydrates, vitamins, fiber, minerals and antioxidants that may help lower the odds of cognitive deficits or the risk of Alzheimer’s disease. Pulses like dry peas, lentils, and chickpeas are also members of the legume family and contain both fiber, protein, as well as seven of the eight essential amino acids needed in the body.
Chia seeds, sunflower seeds, and hemp seeds also contribute a myriad of essential minerals and amino acids to the human diet. Chia seeds can be mixed with liquids to create sports drinks for athletes with omega-3s to address inflammation and protein to help with muscle recovery.

NAFLD affects one in three Americans...and is marked by fatty build-up in the liver, with or without inflammation. In its advanced form, known as non-alcoholic steatohepatitis, the disease causes cell death, irreversible scarring and liver failure.
Physicians do not know why some patients develop the more severe forms of the disease fairly quickly while others remain relatively healthy, but nutrition, body weight, genes and environment are all believed to play a role in disease progression. Recent research shows that more children and adults are developing fatty livers, likely due to growing obesity rates...
In the current study, [none of the patients met the daily recommended choline] intake, but only those eating less than half the recommended doses were deemed choline-deficient.
Controlling for other risk factors, like body weight and alcohol consumption, menopausal women who consumed less than half the recommended daily choline had greater degrees of liver scarring, the researchers found. Advanced liver scarring was found in nearly half of the 63 postmenopausal women in the group with choline-deficient diets, compared with 30% of the 131 post-menopausal women with non-deficient diets. Differences were far less pronounced among men, children and women of child-bearing age. Advanced liver scarring was found in 18% of choline-deficient women of childbearing age and in 10% of those with non-deficient diets.
Eighteen percent of choline-deficient males 14 years of age and older had advanced liver scarring compared with 16% among their non-deficient counterparts. Advanced liver fibrosis was seen in 10% of choline deficient children ages 9 through 13, while 17% of non-deficient ones had the same degree of liver scarring.
[Why is there no comment or emphasis on the (correctly?) reported counterintuitive results in children and teens, or on the possibility that intake recommendations may be inflated across the board, and dangerously so for kids?—DMM]

According to the World Health Organization, depression is the leading cause of disability and the fourth leading contributor to the global burden of disease, projected to reach second place by 2020. There is also strong evidence that it is an independent risk factor for heart disease, and several studies show that prolonged depression is associated with selective and possibly permanent damage to the hippocampus, a region of the brain critical to memory and learning.
Add the fact that 2 percent to 12 percent of depressed people eventually commit suicide, and the [supposed evolutionary] “advantages” of depression suddenly don’t look so good....
What is natural, the thinking goes, is best. If we are designed to suffer depression in response to life’s ills, there must be a good reason for it, and we should allow it to take its painful and natural course.
But unlike ordinary sadness, the natural course of depression can be devastating and lethal. And while sadness is useful, clinical depression signals a failure to adapt to stress or loss, because it impairs a person’s ability to solve the very dilemmas that triggered it.
Even if depression is “natural” and evolved from an emotional state that might once have given us some advantage, that doesn’t make it any more desirable than other maladies. Nature offers us cancer, infections and heart disease, which we happily avoid and do our best to treat. Depression is no different.

Individuals who maintained or improved their fitness levels had a 26% and 28% lower risk of developing hypertension, a 42% and 52% lower risk of developing metabolic syndrome, and a 26% and 30% lower risk of developing elevated levels of LDL cholesterol, respectively....
[Subjects who got fatter in follow-up, as measured by percentage of body fat,] had a 26%, 71%, and 48% higher risk of developing hypertension, metabolic syndrome, and hypercholesterolemia, respectively...compared with individuals who lost weight. Similar results were observed when BMI was used as the criterion for fatness levels.
Every 1-MET improvement in fitness was associated with a 7%, 22%, and 12% lower risk of developing hypertension, metabolic syndrome, and hypercholesterolemia, respectively, while every unit increase in percentage of body fat was associated with a 4%, 10%, and 5% increased risk of developing the cardiovascular risk factors...
"In the real world, people change their fitness levels or fatness over time...Fitness and fatness, not the baseline levels, but the changes over time, are both independently important to reduce cardiovascular disease risk factors."
[Patients who had stable or increasing amounts of fatness in combination with loss of fitness had significantly higher rates of cardiovascular risk factors when compared with] individuals who gained fitness over time and lost fat. They did observe that losing fitness regardless of fat changes and getting fatter irrespective of the change in fitness levels were associated with a higher risk of developing metabolic syndrome. The adverse effects of getting fatter were attenuated slightly if fitness was maintained or improved, while declines in fitness could be offset by reductions in body-fat percentage.
"Maintaining or improving fitness levels and preventing fat gain are both important, independent of the changes of each other...[T]he ideal combination is to improve fitness and prevent fat gain, but as long as individuals maintain fitness and fatness, they are not likely to be at higher risk of cardiovascular disease risk factors. Losing weight and gaining fitness is very challenging to the general population, but maintaining fitness and fatness are less so and more doable."

Individuals who are genetically predisposed to have low levels of high-density lipoprotein (HDL[, "good"]) cholesterol or high levels of triglycerides have an increased risk of developing type 2 diabetes....
[Using data from 2,447 patients with type 2 diabetes from the Nurses' Health Study and 3,052 control subjects free of diabetes from the Health Professionals Follow-up Study, researchers analyzed genotype scores for low-density lipoprotein (LDL) cholesterol, HDL cholesterol, and triglycerides. Only] HDL cholesterol and triglycerides scores were linearly associated with an increased risk of type 2 diabetes. For each point of the HDL cholesterol genotype score, there was a 3 percent increase in the risk of developing type 2 diabetes, and for each point on the triglyceride genotype score, the increase was 2 percent. Comparing the highest and lowest quartiles of genotype scores, the odds ratios for type 2 diabetes were 1.39 for HDL cholesterol and 1.19 for triglycerides.
"In conclusion, genetic predisposition to low HDL cholesterol or high triglycerides is related to elevated type 2 diabetes risk."

[A new study] suggests that hyperglycemia (high blood sugar) injures the heart, even in patients without a history of heart disease or diabetes...[E]levated levels of glycated hemoglobin (HbA1c), a marker for chronic hyperglycemia and diabetes, were associated with minute levels of the protein troponin T (cTnT), a blood marker for heart damage. The high-sensitivity test they used detected levels of cTnT tenfold lower than those found in patients diagnosed with a heart attack....[H]yperglycemia may be related to cardiac damage independent of atherosclerosis....
Higher levels of HbA1c were associated in a graded fashion with elevated levels of high-sensitivity cTnT. This relationship was present at HbA1c levels even below the threshold used to diagnose diabetes. Using conventional tests, troponin T can be detected in 0.7% of the population and is associated with heart attacks and death. With the high-sensitivity cTnT test, low levels of troponin were found in 66% of the study population....
"[G]lucose might not only be related to increased atherosclerosis, but potentially elevated glucose levels may directly damage cardiac muscle"...

We sleep more deeply (non-REM sleep) in the early part of the night. As morning approaches, we move more into REM (dreaming) sleep. Both are important, but the earlier sleep may be more restful....
Frequent trips to the bathroom can be sleep killers. Nocturia (urinating at night more than once) can be due to bladder or prostate problems, which should be checked. But people often wake up and decide their bladders must have woken them, when something else is really the cause....
Since sleeping on the back promotes OSA, sleeping on a side or having the head elevated might stop it....There are also dental appliances that help keep the throat open, and CPAP (continuous positive airway pressure) machines that keep the airway open by pushing air through. There are also medicines to reduce swelling and stuffiness in the nose. It’s worth trying any of these approaches, if you have a problem with OSA....
[I]t’s important to know how to get back to sleep. Don’t start thinking! Concentrate on your breathing until you can nod off again....Adding daytime sleep to your schedule [may make up for the normal, age-related decay in the quality of nighttime sleep. Naps may “improve learning, memory, and creative thinking. Researchers] advise keeping naps short (20–30 minutes,) finding a “dark, quiet, cool place,” scheduling naps instead of waiting until you’re exhausted, and not feeling guilty about it....
We have to get over thinking that sleep is a waste of time, or that life will pass us by if we sleep too much. Sleep is good for us, which means it’s good for the people in our lives. It may also be the number one remedy for fatigue...

In obese versus lean individuals, brain glucose metabolism was significantly higher in the brain's striatal regions, which are involved in processing of rewards. Moreover, obese individual’s reward system responded more vigorously to food pictures, whereas responses in the frontal cortical regions involved in cognitive control were dampened.
"The results suggest that obese individuals’ brains might constantly generate signals that promote eating even when the body would not require additional energy uptake"....
The participants were morbidly obese individuals and lean, healthy controls. Their brain glucose metabolism was measured with positron emission tomography [while] the body was satiated in terms of insulin signalling. Brain responses to pictures of foods were measured with functional magnetic resonance imaging.

RT @JPBarlow: Study shows marijuana doesn't threaten lung health. Not that this will matter...

Dr. Money forced the twins to rehearse sexual acts involving "thrusting movements" with David playing the bottom role. As a child, David Reimer painfully recalled having to get "down on all fours" with his brother, Brian Reimer, "up behind his butt" with "his crotch against" his "buttocks". In another sexual position, Dr. Money forced David to have his "legs spread" with Brian on top. Dr. Money also forced the children to take their "clothes off" and engage in "genital inspections". On at "least one occasion", Dr. Money took a "photograph" of the two children doing these activities. Dr. Money's rationale for these various treatments was his belief that "childhood 'sexual rehearsal play'" was important for a "healthy adult gender identity".
For several years, Money reported on Reimer's progress as the "John/Joan case", describing apparently successful female gender development, and using this case to support the feasibility of sex reassignment and surgical reconstruction even in non-intersex cases. Money wrote: "The child's behavior is so clearly that of an active little girl and so different from the boyish ways of her twin brother." Notes by a former student at Money's lab state that during the followup visits, which occurred only once a year, Reimer's parents routinely lied to lab staff about the success of the procedure. The twin brother, Brian, later proved to be schizophrenic.
Reimer had experienced the visits to Baltimore as traumatic rather than therapeutic, and when Dr. Money started pressuring the family to bring him in for surgery during which a vagina would be constructed, the family discontinued the follow-up visits. From 22 months into his teenaged years Reimer urinated through a hole surgeons had placed in the abdomen. Estrogen was given during adolescence to induce breast development. Having no contact with the family once the visits were discontinued, John Money published nothing further about the case to suggest that the reassignment had not been successful.
Reimer's account, written with John Colapinto two decades later, described how - contrary to Money's reports - when living as Brenda, Reimer did not identify as a girl. He was ostracized and bullied by peers, and neither frilly dresses (which he was forced to wear during frigid Winnipeg winters) nor female hormones made him feel female. By the age of 13, Reimer was experiencing suicidal depression, and told his parents he would commit suicide if they made him see John Money again. In 1980, Reimer's parents told him the truth about his gender reassignment, following advice from Reimer's endocrinologist and psychiatrist. At 14, Reimer decided to assume a male gender identity, calling himself David.

David Reimer was born an identical (non-intersex) twin boy in 1965. At the age of 8 months, David and his brother each had a minor medical problem involving his penis, and a doctor decided to treat the problem with circumcision. The doctor botched the circumcision on David, using an inappropriate method and accidentally burning off virtually all of David’s penis. At the advice of psychologist John Money at Johns Hopkins University, David’s parents agreed to have him “sex reassigned” and made into a girl via surgical, hormonal, and psychological treatments—i.e., via the system Money advocated for intersex children.

For many years, John Money claimed that David (known in the interim as “Brenda”) turned out to be a “real” girl with a female gender identity. Money used this case to bolster his approach to intersex —the approach that is still used throughout much of the U.S. and developed world—one that relies on the assumption that gender identity is all about nurture (upbringing), not nature (inborn traits), and that gender assignment is the key to treating all children with atypical sex anatomies.

As it turns out, Money was lying. He knew Brenda was never happy as a girl, and he knew that as soon as David found out what happened to him, David reassumed the social identity of a boy.

The case of David Reimer has been used by the proponents of the “gender is inborn” (nature) theory as proof that they are right. We like to point out that what the story of David Reimer teaches us most clearly is how much people are harmed by being lied to and treated in inhumane ways. We don’t think we can ever predict, with absolute certainty, what gender identity a person will grow up to have. What we can predict with a good degree of certainty is that children who are treated with shame, secrecy, and lies will suffer at the hands of medical providers who may think they have the best of intentions and the best of theories.

There are 300 recipes for macaroni and cheese on the Food Network’s Web site. I’m using mac-n-cheese here as a symbol for all of those starch- and fat-laden comfort foods we love and like to occasionally indulge in.
Mac and cheese with two cheeses. Three cheeses. Four cheeses. SEVEN cheeses! Mac and cheese with ham…with bacon…with corned beef. With heavy cream (four cups in at least one recipe). With Tater Tots.
The recipes were from such celebrity chefs as Ina Garten (the Barefoot Contessa), Alton Brown, Giada De Laurentiis, Guy Fieri, and Emeril Lagasse (who once had an episode called “Pork Fat Rules.” BAM!). And, oh yeah, Paula Deen. Who, admittedly, deep-fries mac-n-cheese.
But people are only complaining about Paula Deen cooking starch- and fat-laden foods. Why? Unless you live in a cave, you probably heard last week that Deen was diagnosed with Type 2 diabetes. Three years ago. Therefore, she should have stopped cooking those decadent foods. Immediately! Fessed up. Admitted her sins.
And her critics are crawling out of the woodwork: “5 Paula Deen recipes that could give you diabetes” proclaims one headline. (Psst! Food does NOT give you diabetes!)

Federal regulators have warned Johnson & Johnson that it could face fines and other sanctions for selling faulty insulin pumps and delaying disclosures of serious injuries to diabetics who were using its OneTouch Ping and 2020 pumps. The FDA ordered the Animas Corp. unit of J&J to explain why it kept selling pumps known to fail and also to submit a plan to rectify a failure to promptly report cases in which its device might have caused or contributed to death or serious injury....
In the issue with the Animas insulin pumps, some pump keypads for controlling how much insulin is injected were deteriorating prematurely, leading to failures. "We decided to go with a new keypad because it's more durable," [spokesperson Caoline] Pavis said.
But while Animas was lining up the new keypad supplier, it was still selling the older ones. The FDA demanded documents about the company's decision to do that.

[After increasing] intake of low-glycemic-index foods, participants as a group lowered their weight, body mass index, waist circumference and [hemoglobin A1c reading]....
[Miller's claim—“I think we have enough data to say that consuming a low-glycemic-index diet has beneficial outcomes for people with diabetes"—is significant] because no guidelines currently exist for consumption of low-glycemic-index foods...[Miller believes a focus on the glycemic index in foods rather than carbohydrates and sugars is not too complicated for patients with diabetes to follow, as long as they receive adequate nutrition education—]another finding of hers in a study published in 2009.
The glycemic index is represented by a scale from 1 to 100. Foods that tend to slow the speed of digestion and prevent rapid increases in blood sugar include many vegetables, whole grains, dairy foods, nuts and seeds, beans and fruits. They are considered low-glycemic-index foods if they have an index of 55 or fewer points. Foods with a point value of 100 are the equivalent of pure glucose....
“What we found is that those who felt more committed to [their respective] goal felt the goal was less difficult. And those who had a higher level of self-efficacy[—agency—]felt that the goal was less difficult"....
It wasn’t until the trial was completed that researchers learned that many participants entered the study already eating about six servings per day of foods with a low glycemic index.
“We learned that we should set the goal for low-glycemic-index foods higher. We also learned that we need to set an individualized goal. We know that people can increase their consumption by almost two servings a day if that specific goal is set"...
Research on goal-setting also emphasizes that people should plan to take action rather than stop doing something. They also can set a substitution goal...a low-glycemic-index food for a high-glycemic-index food.
“One way to build self-efficacy is by helping people set a specific goal that is moderately difficult, action-oriented, and achievable in small successive steps"...

“Previous studies have demonstrated that those who get less sleep are more likely to also be obese, have diabetes or cardiovascular disease, and are more likely to die sooner, but this new analysis has revealed that other sleep problems, such as difficulty falling asleep, staying asleep, or even too much sleep, are also associated with cardiovascular and metabolic health issues"...
The researchers examined associations between sleep disturbances and other health conditions, focusing on perceived sleep quality, rather than just sleep duration. After adjusting for demographic, socioeconomic and health risk factors, patients with sleep disturbances at least three nights per week on average were 35% more likely to be obese, 54% more likely to have diabetes, 98% more likely to have coronary artery disease, 80% more likely to have had a heart attack, and 102% more likely to have had a stroke.
Grandner and colleagues analyzed data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) of 138,201 patients[—]the world’s largest telephone survey, designed to monitor health-related behaviors in the general population.
“This study is one of the largest ever to link sleep problems with important cardiovascular and metabolic diseases. It joins other studies that show that sleep is an important part of health, just like diet and physical activity"...

There was no evidence of any adverse effect of low systolic blood pressure on any cardiovascular outcome, except for cardiovascular mortality, which was significantly increased in patients with a baseline systolic blood pressure below 130 mm Hg who had the greatest systolic blood pressure reduction.

When in-treatment systolic blood pressure was examined by decile, there was a progressive reduction in the incidence of stroke down to 115 mm Hg systolic blood pressure, whereas there was a J-curve relationship for the other outcomes. For cardiovascular death, the nadir of the J-curve was around 135.6 mm Hg for diabetic patients and 133.1 mm Hg for nondiabetic patients.

For diastolic blood pressure, the primary outcome was most common in patients with the lowest or highest in-trial diastolic blood pressure (for both diabetic and nondiabetic patients), regardless of the systolic blood pressure.

What are the therapeutic implications of these findings? "In both diabetic and nondiabetic patients, progressively greater systolic BP reductions were accompanied by reduced risk for the primary outcome only if baseline systolic BP levels ranged from 143 to 155 mm Hg," the authors say.

They continue, "Around or below an initial systolic blood pressure of 130 mm Hg, antihypertensive treatment should be implemented with caution because of the possibility of untoward cardiac effects that could counterbalance the beneficial consequences of aggressive blood pressure reduction for stroke. This might also apply to diastolic blood pressure values of 67 mm Hg or less."

"Clearly," they add, "more evidence from prospective trials is necessary to learn whether high-risk diabetic patients with blood pressure levels between 130 and 140 mm Hg should be treated to lower blood pressure levels."