Four healthy lifestyle factorsnever smoking, maintaining a healthy weight, exercising regularly and following a healthy diettogether appear to be associated with as much as an 80 percent reduction in the risk of developing the most common and deadly chronic diseases, according to a report in the August 10/24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Cardiovascular disease, cancer and diabeteschronic diseases that together account for most deathsare largely preventable, according to background information in the article. “An impressive body of research has implicated modifiable lifestyle factors such as smoking, physical activity, diet and body weight in the causes of these diseases,” the authors write.

To further describe the reduction in risk associated with these factors, Earl S. Ford, M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues assessed data from 23,513 German adults age 35 to 65. At the beginning of the European Prospective Investigation Into Cancer and NutritionPotsdam (EPICPotsdam) studybetween 1994 and 1998participants completed an assessment of their body weight and height, a personal interview that included questions about diseases, a questionnaire on sociodemographic and lifestyle characteristics and a food frequency questionnaire.

Their responses were assessed for adherence to four healthy lifestyle factors never smoking, having a body mass index lower than 30, exercising for at least three and a half hours per week and following healthy dietary principles (for example, having a diet with high consumption of fruits and vegetables while limiting meat consumption). Followup questionnaires were administered every two to three years.

Most participants had one to three of these health factors, fewer than 4 percent had zero healthy factors and 9 percent had all four factors. Over an average of 7.8 years of followup, 2,006 participants developed new cases of diabetes (3.7 percent), heart attack (0.9 percent), stroke (0.8 percent) or cancer (3.8 percent).

After adjusting for age, sex, education level and occupation, individuals with more healthy lifestyle factors were less likely to develop chronic diseases. Participants who had all four factors at the beginning of the study had a 78 percent lower risk of developing any of the chronic diseases during the followup period than those who had none of the healthy factors. The four factors were associated with a 93 percent reduced risk of diabetes, 81 percent reduced risk of heart attack, 50 percent reduced risk of stroke and 36 percent reduced risk of cancer.

The largest reduction in risk was associated with having a BMI lower than 30, followed by never smoking, at least 3.5 hours of physical activity and then adhering to good dietary principles.

“Our results reinforce current public health recommendations to avoid smoking, to maintain a healthy weight, to engage in physical activity appropriately and to eat adequate amounts of fruits and vegetables and foods containing whole grains and to partake of red meat prudently,” the authors write. “Because the roots of these factors often originate during the formative stages of life, it is especially important to start early in teaching the important lessons concerning healthy living.”

Arch Intern Med. 2009;169[15]13551362

Source
Archives of Internal Medicine

Levels of debt have been associated with an increased risk of being fat. Researchers writing in the open access journal BMC Public Health blame the trend on the high price of healthy food, and a tendency for people worried by debt to comfort eat.

Eva Münster, from the University of Mainz, Germany, worked with a team of researchers to study more than 9000 people, finding that 25% of the 949 people in debt were medically obese, compared to only 11% of the remaining 8318 participants. She said, “The recent credit crunch will have health implications for private households. While income, education and occupational status are frequently used in definitions of socioeconomic status, levels of debt are not usually considered. Weve shown that debt can be associated with the probability of being overweight or obese, independent of these factors”.

The researchers explain that debt can affect a series of risk factors for chronic diseases, for example by limiting leisure time activities and participation in social events. The quality of an individuals diet can also be negatively affected. According to Münster, “A persons ability to pick and choose the food they eat often depends on the financial resources they have available. Energydense foods such as sweets or fatty snacks are often less expensive compared to food with lower energy density such as fruit or vegetables”.

Notes
Overindebtedness as a marker of socioeconomic status and its association with obesity a crosssectional study
Eva Munster, Heiko Ruger, Elke Ochsmann, Stephan Letzel and Andre M Toschke
BMC Public Health (in press)
biomedcentral.com/bmcpublichealth/

Source
Graeme Baldwin

The incidence of obesity among US blacks is higher than among Hispanics and nonHispanic whites, reports the Centers for Disease Control and Development (CDC).

The report was prepared by Dr Liping Pan from the CDCs Division of Nutrition, Physical Activity, and Obesity, and colleagues and appears in the July 17 issue of the CDCs Morbidity and Mortality Weekly Report (MMWR).

The proportion of the American population that is now obese is twice what it was 30 years ago, said the CDC, and when you look inside that alarming trend you find that certain ethnic and racial groups have been disproportionately affected.

Using data from an ongoing telephone survey of US adults called the Behavioral Risk Factor Surveillance System (BRFSS), the CDC found that from 2006 to 2008, the rate of obesity among adult nonHispanic blacks was 35.7 per cent. The next highest group was Hispanic adults, at 28.7 per cent, and nonHispanic whites was 23.7 per cent.

The overall rate of obesity was estimated at 25.6 per cent and found to be consistently higher in women than in men.

These figures are somewhat under the prevalence rates showin in the 20032004 National Health and Nutrition Examination Survey (NHANES) which showed that among nonHispanic blacks obesity prevalence was 45 per cent, followed by 36.8 per cent among MexicanAmericans and 30.6 per cent among nonHispaic whites.

An editorial comment by the CDC on the new report suggests that the BRFSS derived figures are probably an underestimate because they are based on selfreports done by phone, whereas the NHANES data comes from height and weight measurements taken by survey staff. However, while within the groups the prevalance rates may differ between the two datasets, they point out the same disparity among the groups nonHispanic blacks have the greatest prevalence of obesity, followed by Hispanics and nonHispanic whites.

The report also found large regional disparities. Among the four US census regions, the South had the greatest prevalence of obesity among nonHispanic blacks (36.9 per cent), followed by the Midwest (36.3 per cent), the West (33.1 per cent) and the Northeast (31.7 per cent).

For whites, the greatest prevalence of obesity was in the Midwest (25.4 per cent), followed by the South (24.4 per cent), then the Northeast (22.6 per cent) and lastly the West (21.0 per cent).

For Hispanics, the highest prevalence was in the Midwest (29.6 per cent), followed by the South (29.2 per cent), then the West (29.0 per cent) and lastly the Northeast (26.6 per cent).

The state with the lowest obesity rate among nonHispanic blacks was New Hampshire (23. 0 per cent). However, there were 5 states with 40 per cent or more obesity rates among nonHispanic blacks Alabama, Maine, Mississippi, Ohio, and Oregon.

The state with the lowest obesity rate among Hispanics was Maryland (21.0 per cent), while Tennessee had the highest (36.7 per cent).

And the state with the lowest obesity rate among nonHispanic whites was DC (9.0 per cent), while the highest was West Virginia (30.2 per cent). However, there were also 5 states with obesity rates under 20 per cent for this group California, Colorado, Connecticut, Hawaii, and New Mexico.

The CDC says that while the reasons for the diparity among the ethnic/racial groups are complex and unclear, it proposes, three, for which some research evidence existsFirstly, racial/ethnic groups have different lifestyle behaviours that affect weight gain.
For instance, blacks and Hispanics are less likely to exercise in their leisure time than Hispanics and nonHispanic whites.
Secondly, these groups also differ in their attitude to body weight they have different cultural norms.
For example, one study suggests that nonHispanic black women and Hispanic women are happier with their body size than nonHispanic white women (people who are less satisfied with their body size are more likely to try and lose weight).
And thirdly, there are socioeconomic disparities for instance in terms of access to healthy food and safe places to exercise.
There is evidence that neighbourhoods with large minority populations, and especially where these are on low income, have fewer shops where the healthy foods are the same price or cheaper than the energy dense foods.
There is also evidence to support the idea that minority and low income groups live in neighbourhoods where there is less access to exercise locations, and where traffic and fear for personal safety stops also them taking up walking.The editorial pointed out that the report also excluded people without a landline phone, which could lead to over or under estimates. Some research suggests that that adults living in wirelessonly homes tend to be younger, have lower incomes, and be members of minority groups.

While citing a number of initiatives that are already in place, the CDC recommends that

“To reduce disparities among populations in the prevalence of obesity, an effective public health response is needed that includes surveillance, policies, programs, and supportive environments achieved through the efforts of government, communities, workplaces, schools, families, and individuals.”

“Differences in Prevalence of Obesity Among Black, White, and Hispanic Adults United States, 20062008.”
L Pan, DA Galuska, B Sherry, AS Hunter, GE Rutledge, WH Dietz, Div of Nutrition, Physical Activity, and Obesity; LS Balluz, Div of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.
MMWR, 58(27);740744, 17 July 2009.

Source CDC.

Written by Catharine Paddock, PhD

In an effort to help families and school administrators fight the epidemic of obesity among children, a Yaleled team of researchers has developed a practical coding system to evaluate school wellness policies, which are required of all schools participating in the National School Lunch Program. This coding system was introduced in the July 2009 issue of the Journal of the American Dietetic Association.

The Child Nutrition and Women, Infants and Children Reauthorization Act of 2004 required all local education agencies nationwide participating in the National School Lunch Program to create a school wellness policy by the 20062007 school year. Early assessments suggest these policies range from strong and specific to weak and vague, but until now no quantitative method existed to measure their effectiveness.

“School wellness policies can offer a valuable framework for school districts seeking to make health, nutrition and physical activity a priority, as long as they are comprehensive and strong in the guidelines they set out,” said lead author Marlene Schwartz, PhD, deputy director of the Rudd Center for Food Policy and Obesity at Yale University. “This coding system is a reliable and valid measure of the quality of wellness policies.”

The Yale teams coding system is based on a 96category tool developed to evaluate seven goal areas nutrition education, standards for USDA child nutrition programs and school meals, nutrition standards for competitive and other foods and beverages, physical education, physical activity, communications and promotion and evaluation.

“The school wellness coding system will have a huge impact on public policy and the ability to move healthier school policies forward,” said Lucy Nolan of End Hunger Connecticut! She added, “Weve too often had to move policy on faith, and this will show that there is a means to an end.”

Schools will be evaluated on, among other things, whether goals for nutrition education are designed to promote student wellness; nutrition curriculum is provided for each grade level; the school coordinates nutrition education with the larger community; nutrition education extends beyond the school environment; and whether nutrition is integrated into other subjects beyond health education.

Other authors are Anne E. Lund, R.D., M.P.H. and H. Mollie Grow, M.D., M.P.H., of the University of Washington, Elaine McDonnell, M.S., R.D. and Claudia Probart, Ph.D., R.D., of Penn State University, and Anne Samuelson, M.P.H. and Leslie Lytle, Ph.D., R.D., of the University of Minnesota.

Adult obesity rates increased in 23 states and did not decrease in a single state in the past year, according to F as in Fat How Obesity Policies Are Failing in America 2009, a report released today by the Trust for Americas Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). In addition, the percentage of obese or overweight children is at or above 30 percent in 30 states.

“Our health care costs have grown along with our waist lines,” said Jeff Levi, Ph.D., executive director of TFAH. “The obesity epidemic is a big contributor to the skyrocketing health care costs in the United States. How are we going to compete with the rest of the world if our economy and workforce are weighed down by bad health?”

Mississippi had the highest rate of adult obesity at 32.5 percent, making it the fifth year in a row that the state topped the list. Four states now have rates above 30 percent, including Mississippi, West Virginia (31.2 percent), Alabama (31.1 percent) and Tennessee (30.2 percent). Eight of the 10 states with the highest percentage of obese adults are in the South. Colorado continued to have the lowest percentage of obese adults at 18.9 percent.

Adult obesity rates now exceed 25 percent in 31 states and exceed 20 percent in 49 states and Washington, D.C. Twothirds of American adults are either obese or overweight. In 1991, no state had an obesity rate above 20 percent. In 1980, the national average for adult obesity was 15 percent. Sixteen states experienced an increase for the second year in a row, and 11 states experienced an increase for the third straight year.

Mississippi also had the highest rate of obese and overweight children (ages 10 to 17) at 44.4 percent. Minnesota and Utah had the lowest rate at 23.1 percent. Eight of the 10 states with the highest rates of obese and overweight children are in the South. Childhood obesity rates have more than tripled since 1980.

“Reversing the childhood obesity epidemic is a critical ingredient for delivering a healthier population and making health reform work,” said Risa LavizzoMourey, M.D., M.B.A., RWJF president and CEO. “If we can prevent the current generation of young people from developing the serious and costly chronic conditions related to obesity, we can not only improve health and quality of life, but we can also save billions of dollars and make our health care systems more efficient and sustainable.”

The F as in Fat report contains rankings of state obesity rates and a review of federal and state government policies aimed at reducing or preventing obesity. Some additional key findings from F as in Fat 2009 include

The current economic crisis could exacerbate the obesity epidemic. Food prices, particularly for more nutritious foods, are expected to rise, making it more difficult for families to eat healthy foods. At the same time, safetynet programs and services are becoming increasingly overextended as the numbers of unemployed, uninsured and underinsured continue to grow. In addition, due to the strain of the recession, rates of depression, anxiety and stress, which are linked to obesity for many individuals, also are increasing.

Nineteen states now have nutritional standards for school lunches, breakfasts and snacks that are stricter than current USDA requirements. Five years ago, only four states had legislation requiring stricter standards.

Twentyseven states have nutritional standards for competitive foods sold a la carte, in vending machines, in school stores or in school bake sales. Five years ago, only six states had nutritional standards for competitive foods.

Twenty states have passed requirements for body mass index (BMI) screenings of children and adolescents or have passed legislation requiring other forms of weightrelated assessments in schools. Five years ago, only four states had passed screening requirements.

A recent analysis commissioned by TFAH found that the Baby Boomer generation has a higher rate of obesity compared with previous generations. As the Baby Boomer generation ages, obesityrelated costs to Medicare and Medicaid are likely to grow significantly because of the large number of people in this population and its high rate of obesity. And, as Baby Boomers become Medicareeligible, the percentage of obese adults age 65 and older could increase significantly. Estimates of the increase in percentage of obese adults range from 5.2 percent in New York to 16.3 percent in Alabama.

Key report recommendations for addressing obesity within health reform include

Ensuring every adult and child has access to coverage for preventive medical services, including nutrition and obesity counseling and screening for obesityrelated diseases, such as type 2 diabetes;

Increasing the number of programs available in communities, schools, and childcare settings that help make nutritious foods more affordable and accessible and provide safe and healthy places for people to engage in physical activity; and

Reducing Medicare expenditures by promoting proven programs that improve nutrition and increase physical activity among adults ages 55 to 64.

The report also calls for a National Strategy to Combat Obesity that would define roles and responsibilities for federal, state and local governments and promote collaboration among businesses, communities, schools and families. It would seek to advance policies that

Provide healthy foods and beverages to students at schools;

Increase the availability of affordable healthy foods in all communities;

Increase the frequency, intensity, and duration of physical activity at school;

Improve access to safe and healthy places to live, work, learn, and play;

Limit screen time; and

Encourage employers to provide workplace wellness programs.

StatebyState Adult Obesity Rankings

Note 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity. Rankings are based on combining three years of data (20062008) from the U.S. Centers for Disease Control and Preventions Behavioral Risk Factor Surveillance System to “stabilize” data for comparison purposes. This methodology, recommended by the CDC, compensates for any potential anomalies or usual changes due to the specific sample in any given year in any given state. States with a statistically significant (p

New data show that surgeons can use USGI Medical Inc.s (USGI) Incisionless Operating Platform(TM) (IOP) to durably reduce the size of the stomach pouch and stoma in RouxenY Gastric Bypass (RYGB) patients who are regaining weight because this portion of their anatomy has stretched since their original surgery.

On Friday, June 26 at the American Society of Metabolic and Bariatric Surgeons (ASMBS) Annual Meeting near Dallas, University of California, San Diego (UCSD) Medical Center surgeon Santiago Horgan, M.D. presented outcomes from 116 patients who underwent this incisionless procedure to reduce the size of their pouch and stoma.

“We believe this is the first data to confirm 12month durability for gastric folds created without incisions,” said Dr. Horgan, director of UCSDs Center for the Future of Surgery and Center for the Treatment of Obesity. “Invasive procedures to restore the anatomy to the original postsurgery proportions are too complicated for many patients. Surgeons have tried to perform restorative procedures through the mouth using other types of endoscopic instruments, however GI tissue is extremely resistant to change and its been difficult to show longterm durability of procedures utilizing endoscopic sutures or staples. USGIs Expandable Tissue Anchors have allowed us to achieve a desired amount of durable reduction in the pouch and stoma size without any significant adverse events, filling a significant unmet medical need in this patient population.”

To perform a Restorative Obesity Surgery, Endolumenally (ROSE), surgeons used USGIs IOP to grasp tissue and deploy Expandable Tissue Anchors to create multiple, circumferential tissue folds around the stoma and inside the pouch. The procedure is performed entirely through the patients mouth. An endoscope provides visualization.

Surgeons were able to place tissue folds in 112 of 116 (97%) patients. On average, surgeons placed six Expandable Tissue Anchor pairs in each of these 112 patients and reduced their mean stoma diameter by 50% and pouch length by 44%.

Dr. Horgan reported that twelvemonth postop endoscopies performed on 19 patients to date confirmed the durability of the procedure the tissue anchors remained and durable tissue folds were present. There were no significant complications associated with the procedure and most patients reported no or minimal pain.

About Incisionless Surgery

Incisionless Surgery is the next wave in minimally invasive surgery and is rapidly becoming an option demanded by patients, and healthcare providers for its potential to minimize pain, shorten hospital stays, lower treatment costs and eliminate visible external scars. Incisionless Surgery, which encompasses Natural Orifice Translumenal Endoscopic Surgery (NOTES), endolumenal and singleport techniques, can be applied to bariatric surgery, cholecystectomy, appendectomy, GERD (Gastroesophageal Reflux Disease), gastrointestinal cancer and urological and gynecological procedures.

About the USGI Incisionless Operating Platform(TM) (IOP)

USGI Medical designed the Incisionless Operating Platform(TM) (IOP) to enable Incisionless Surgery. Combining the flexibility of endoscopy with the therapeutic benefit of laparoscopy, the IOP offers a stable operating platform, access for multiple, robust, flexible surgical tools and durable tissue anchors to predictably approximate and permanently affix tissue important requirements for Incisionless Surgery that traditional endoscopes and endoscopic instruments do not provide. The IOP incorporates the TransPort(TM) Operating Platform and instruments for cutting, suturing and grasping tissue. The surgeon advances the TransPort into the body in its flexible state to conform to the patients anatomy, the surgeon uses an endscope and various tools though the TransPorts four operating channels to steer the end of the device to visualize a site, and perform surgery with control and efficiency.

UA scientists looking at the link between BMI over a lifetime and the risk of developing pancreatic cancer found that overweight and obese young adults are more likely to develop the disease, and also that older adults with pancreatic cancer who are obese have a lower overall survival rate.

The study was the work of first author Dr Donghui Li, of the University of Texas MD Anderson Cancer Center in Houston, and colleagues and is published in the 24 June issue of the Journal of the American Medical Association, JAMA.

Cancer of the pancreas is the fourth leading cause of death from cancer for American men and women, and since obesity began to rise steeply in the US in the last 20 years, there is increasing evidence that carrying too much weight is a risk factor for this disease.

But despite this trend, as the authors pointed out in their background information, we dont know very much about the link between excess body weight and risk of pancreatic cancer over a lifetime, nor do we know much about at which stages in that lifetime the key changes in weight occur that could affect the link.

So Li and colleagues investigated this further by looking at two groups of people one group was 841 patients with pancreatic cancer and the other was a group of 754 healthy people matched to the first group by age, race and sex.

For these groups, height, body weight and other medical histories had already been collected in personal interviews that started at ages 14 to 19 years and then at 10year intervals thereafter until 12 months before enrolling on the study.

Li and colleagues then explored the links between body mass index (BMI) over a lifetime and three things the risk of pancreatic cancer, the age the cancer started, and overall patient survival.

A Body Mass Index (the ratio of a persons weight in kilos to the square of their height in metres) of 25 to 29.9 is classed as overweight and a BMI of 30 or more is classed as obese.

Their results showed thatParticipants who were overweight from age 14 to 39 or obese from age 20 to 49 were at higher risk of pancreatic cancer regardless of whether they developed diabetes or not.
The link between average BMI (for every increase of 5 units) and risk of pancreatic cancer was stronger in men that in women.
The link was statistically significant for each age group from age 14 to 69 in men but only from 14 to 39 in women.
Ever smokers had a slightly stronger link between average BMI (for every 5 unit increase) and pancreatic cancer risk than never smokers.
Among never smokers the chances of pancreatic cancer being linked to being overweight or obese at an early age before diagnosis was estimated at 10.3 per cent.
Among ever smokers this figure rose to 21.3 per cent.
Pancreatic cancer was diagnosed some 2 to 6 years earlier in participants who were overweight or obese from 20 to 49 years of age.
The median (midpoint of the range) age when cancer was diagnosed was 64 for normal weight participants, 61 for for those who were overweight and 59 for those who were obese.
Participants who were overweight or obese from age 30 to 79 or up to a year before being enrolled in the study had an overall reduced survival rate for pancreatic cancer, regardless of the stage of the disease and whether the tumor had been operated on.The authors concluded that

“Overweight or obesity during early adulthood was associated with a greater risk of pancreatic cancer and a younger age of disease onset. Obesity at an older age was associated with a lower overall survival in patients with pancreatic cancer.”

“While our observations require confirmation, they provide support for a role of excess body weight in the development and progression of pancreatic cancer,” they added.

“Body Mass Index and Risk, Age of Onset, and Survival in Patients With Pancreatic Cancer.”
Donghui Li; Jeffrey S. Morris; Jun Liu; Manal M. Hassan; R. Sue Day; Melissa L. Bondy; James L. Abbruzzese.
JAMA. 2009;301(24)25532562.
Vol. 301 No. 24, June 24, 2009

Written by Catharine Paddock, PhD

Obesity is now acknowledged as a chronic disease with a number of related complications, and its prevalence has reached alarming epidemic proportions. While bariatric surgery is effective at treating the disease, access to this procedure is still too limited in Canada. The latest article published by Dr. Nicolas Christou, of the McGill University Health Centre (MUHC), in the June issue of the Canadian Journal of Surgery assesses the waiting times for this procedure.

According to the study, the average waiting time for bariatric surgery in Canada is 5 years, a timeframe that is long compared with the 8week average for cancer surgery or the 18month average for cosmetic surgery. Yet many studies have shown that this type of procedure reduces the risk of death over 5 years from 40% to 85% bariatric surgery can therefore save lives.

“Waiting times for bariatric surgery in Canada are much too long,” Dr. Christou stated. “However, the provincial governments recent announcement of additional money for our speciality is a positive and beneficial step. This funding will help us address our main obstacle, a lack of resources, and therefore represents real hope for our patients.”

This investment should also have positive spinoffs in the mediumterm for the health care system. Another article recently published by Dr. Christou in the World Journal of Surgery showed that bariatric surgery is the only treatment that ensures major and lasting weight loss. It can also significantly improve the longterm health of these patients by reducing their risk of developing obesityrelated complications, such as diabetes, cancer, or heart and respiratory diseases. The costs to the health care system to treat these related pathologies would therefore decrease, and the initial investment would lead to savings within 3 years.

Notes

The Research Institute of the MUHC is supported in part by the Fonds de la recherche en santé du Québec.

Dr. Nicolas Christou

Dr. Nicolas Christou is Director of Bariatric surgery at the MUHC and a researcher in the Infection and Immunity Axis of the Research Institute of the MUHC. He is also Professor of Surgery at the Faculty of Medicine of McGill University.

Partners

This article was coauthored by Dr. Nicolas Christou, MUHC, and Dr. Evangelos Efthimiou, MUHC.

Source
Isabelle Kling

The Foundation for Digestive Health and Nutrition has announced the 2009 American Gastroenterological Association (AGA) Foundation Research Scholars. The grants have been awarded to five outstanding young gastroenterologists who promise to make significant strides in the field of gastrointestinal research.

“With the current economic times, research funding remains elusive for all scientists, especially those young scientists just beginning their career, despite their tremendous promise,” said Sidney Cohen, MD, AGAF, chairman of the Foundation for Digestive Health and Nutrition. “The AGA Foundation for Digestive Health and Nutrition remains committed to continuing to help fund these gifted scholars, enabling them to continue their research programs. The pace of discovery must be sustained, and it is up to those of us in the profession to make it happen. The 75 grants we give out to gifted researchers each year boldly represents our commitment to progress.”

The 2009 AGA Research Scholars are Gregory Austin, MD, MPH, University of Colorado, Denver The effect of macronutrients on gastrointestinal hormones and gastric emptying in obesity

Michele Battle, PhD, Medical College of Wisconsin, Milwaukee Determining the role that GATAs play in intestinal development and function

Rohit Loomba, MD, MHSc, University of California, San Diego (Designated RSA in Geriatric Gastroenterology funded by Sucampo Pharmaceuticals, Inc.) Sexspecific effect of alcohol and obesity and adipocytokines in geriatric fatty liver disease in a prospective populationbased cohort Rancho Bernardo Study

Iryna Pinchuk, PhD, University of Texas Medical Branch, Galveston Colonic CD90+ myofibroblasts/fibroblasts implication in the enhanced expansion of CD$+ CD25 high FoxP3+ regulatory T cells during colorectal cancer progression

Andrew Tai, MD, PhD, University of Michigan, Ann Arbor Functional characterization of a novel role for a phosphatidylinositol 4kinase in hepatitis C virus replication The prestigious Research Scholar Awards offer each scientist a total of $225,000 to help support his or her research over a threeyear period. The goal of the Research Scholar Awards is to guarantee the perpetuation of strong science through the encouragement of young physician investigators and ultimately to improve patient care through digestive diseases research.

These extremely competitive awards ensure that bright, young physicians and scientists devote their careers to advancing the field of digestive health through research. Awards are based on the qualifications of the candidate, the quality of the candidates research proposal and the commitment of the candidates institution to protect 70 percent of his or her time for research.

The Research Scholar Awards program was launched in 1984 to provide crucial early support to investigators who show promise in academic gastroenterological research. The programs premise recognized that resources awarded early on could provide a stable platform from which future research funding would be derived. During and after their time as an AGA Research Scholar, recipients have made important contributions to the field of gastroenterology and many former award recipients have gone on to hold distinguished appointments in major medical institutions in the U.S. and Canada.

Since 1984, the AGA and its Foundation has awarded more than $20 million to fund 150 Research Scholars and has provided a total of $38 million in grant funding. The 2009 Scholars were chosen by a distinguished 30person national advisory committee chaired by David Brenner, MD, Dean and Vice Chancellor for Health Sciences at University of California, San Diego. Members of the committee include leading gastroenterologists from the Harvard University Medical School, Mayo Clinic, Stanford University School of Medicine, University of Chicago, University of North Carolina, Chapel Hill, University of Texas Southwestern Medical Center, and Washington University, St. Louis.

The AGA Research Scholar Awards program addresses the critical problem of a lack of funding for entrylevel researchers in gastroenterology. At a time of unparalleled scientific and clinical opportunity, the field of gastroenterology faces a significant decline in the number of gastroenterologists entering academic research careers. Although the National Institutes of Health (NIH) funds a significant amount of gastroenterology research, it rarely funds young investigators working independently without a research track record. Additionally, NIH gastroenterology research funding is proportionately much smaller than for diseases with less or similar health impact (such as HIV/AIDS or breast cancer).

Source
Alissa J. Cruz

The ghrelin hormone not only stimulates the brain giving rise to an increase in appetite, but also favours the accumulation of lipids in visceral fatty tissue, located in the abdominal zone and considered to be the most harmful. This is the conclusion of research undertaken at Metabolic Research Laboratory of the University Hospital of Navarra, published recently in the International Journal of Obesity.

Ghrelin is a hormone produced in the stomach and the function of which is to tell the brain that the body has to be fed. Thus, the level of this secretion increases before eating and decreases after. It is known to be important in the development of obesity, given that, on stimulating the appetite, it favours an increase in body weight, explained Ms Amaia Rodríguez MuruetaGoyena, doctor in biology and main researcher of the study.

However, researchers at the University Hospital of Navarra have discovered that, besides stimulating the hypothalamus to generate appetite, ghrelin also acts on the tabula rasa cortex. They observed how this hormone favoured the accumulation of lipids in visceral fatty tissue. In effect, it causes the overexpression of the fatty genes that take part in the retention of lipids, explained Ms Rodríguez.

It is precisely this accumulated fat in the region of the abdomen that is deemed to be most harmful, as it is accompanied by comorbilities, visceral obesity being related to higher blood pressure or type 2 diabetes. Moreover, being located in the abdominal zone and in direct contact with the liver, this type of fatty tissue favours the formation of liver fat and increases the risk of developing resistance to insulin. It is associated with hypertension, high levels of triglycerides, resistance to insulin and hypercholesterolemia visceral fat favours the metabolic syndrome, the researcher pointed out.

Ghrelin can show itself in acylated or deacylated form, the difference being in the octanoic acid present in the composition of the former, according to Ms Rodriguez. Previously it was thought that only the acylated form was active in the process of weight increase, but many studies point to both hormones being biologically functional.

Future development of pharmaceutical drugs

This discovery of the twin action of ghrelin on the organism opens the door to future treatment for obesity and which, for the time being, is limited to in vitro studies in cell and animal models, the University Hospital researcher pointed out. This inclusive perspective of the functioning of a hormone is necessary in order to design effective pharmaceutical drugs. There are many hormones that intervene in the control of appetite in the hypothalamus and, at the same time, can act on other organs, such as the liver, the muscles or fat, for example. Thus, the medication developed should block the action of ghrelin both on the hypothalamus and on the accumulation of abdominal fat.

At the same time, stated Ms Rodríguez, it has to be taken into account that this hormone also acts on the liver and favours the capturing of glucose in the muscle. They observed that the concentration of acylatedform ghreline in the blood increases amongst obese persons and particularly when these, moreover, suffer from diabetes. Thus, obese persons with diabetes have greater tendency to accumulate visceral fat than normoglycemic obese persons. This is a littlestudied field which has to be investigated in order to develop pharmaceutical drugs which annul this action of ghrelin.

Blood analysis and stimulation of adipocytes

The research undertaken at the Metabolic Research Laboratory of the University Hospital of Navarra principally involved the analysis of the blood of 80 patients, both obese and thin, and in the stimulation with ghrelin of the fatty cells from surgical operations. First they analysed the ghrelin levels in the blood. Then, based on the biopsies of visceral fat obtained from 24 patients subjected to various operations, the adipocytes or fatty cells were separated and subsequently stimulated with hormone, which enabled the researchers to evaluate the changes generated in the genes that favoured the lipid accumulation in these isolated adipocytes, explained the researcher.

Source
Oihane Lakar