Singapore - Regional study to be done on economic, health and social impact of haze in 2015

SINGAPORE - The haze episode in 2015 went down in history as the worst on record, surpassing even the 1997 and 2013 crises. In a bid to assess the implications for South-east Asia, a regional study on its economic, health and social impacts will be conducted.

This will allow affected countries to better understand the impact of transboundary haze and supplement existing estimates on the cost of the 2015 haze.

Details of the type of data that will be included in the study are still being worked out, Mr Masagos Zulkifli, Singapore's Minister for the Environment and Water Resources, told the media on Wednesday morning (May 4).

This is because different countries collect different types of data depending on their economies. Singapore, for instance, collects data on affected tourism while Indonesia collects data related to agriculture.

Mr Masagos noted that while there is no timeline yet for when the study will be completed, he hopes there will be some results in a year.

He was speaking during the press conference for the 18th Meeting of the Sub-regional Ministerial Steering Committee (MSC) on Transboundary Haze Pollution, which was held in the Marina Mandarin Hotel in Singapore on Wednesday morning.

Hosted by Singapore, the meeting was attended by environment ministry representatives from Malaysia, Thailand, Brunei Darussalam and Indonesia. Indonesia was represented by Mr Arief Yuwono, senior adviser to the Minister for Energy.

Smoke-belching forest and peatland fires that burn in Indonesia are the main cause of the haze experienced by Singapore and the region during the traditional dry season between June and October every year.

In 2015, the fires burned harder and for longer due mainly to the El Niño weather phenomenon, which is linked to prolonged hot and dry weather in this region. It resulted in prolonged haze that clouded the skies of Indonesia and its neighbours - causing illness and death, grounding flights and closing schools.

During Wednesday's meeting, the ministers noted that the effects of El Nino are expected to subside by the middle 2016, when the dry season typically begins. They also noted that La Nina conditions, a weather phenomenon associated with more rain this region, is expected to kick in by the third quarter of 2016.

While this could bring more rain to the parched, fire-prone landscape in Indonesia amid the dry season, Mr Masagos noted there could still be periods of dry spells in between bouts of rain. But the hope is that haze of last year's scale will not affect Singapore when June comes around.

straitstimes

Singapore - Brief bursts of intense exercise give same health benefits as long duration activity

The excuse of not having time to exercise just got deleted permanently under a study showing all it needs is a single minute of intense activity to obtain benefits of longer regimen. Climbing the stairs at work after lunch could be an ideal and quick workout.

Researchers at McMaster University have shown that a workout totaling 10 minutes of intense exercise in brief bursts equals the outcomes from 45 minutes of continuous cycling in terms of cardio-respiratory fitness and insulin sensitivity.

"This is a very time-efficient workout strategy," says Martin Gibala, a professor of kinesiology at McMaster and lead author on the study. "Brief bursts of intense exercise are remarkably effective."

The sprint interval training (SIT) compared remarkably similar to moderate-intensity continuous training (MICT), as recommended in public health guidelines. The MICT protocol involved five times as much exercise and a five-fold greater time commitment.

The SIT protocol, which involved three 20-second 'all-out' cycle sprints, included a 2-minute warm-up and 3-minute cool down, and two minutes of easy cycling for recovery between the hard sprints. The MIT group performed 45 minutes of continuous cycling at a moderate pace, plus the same warm-up and cool down. After 12 weeks of training, the results were remarkably similar in the two groups of 27 sedentary men.

Gibala, who has studied interval training for more than a decade has experimented with different protocols in an effort to identify the most time-efficient exercise strategies.

The findings are published online in the journal PLOS ONE.

A study published in 2015 in the Journal of the American College of Cardiology found that running as little as five minutes a day gives the same benefits of running or walking for longer periods. Another study in the Clinical Journal of the American Society of Nephrology (CJASN) proved that the health hazards of sitting for long periods can be offset by two minutes of walking every hour, in combination with 2.5 hours of moderate exercise each week

The WHO and the US government recommend 75 minutes per week of vigorous-intensity activity, such as running.

By Jayalakshmi K

ibtimes

Australia - Can Yoga Help Overcome Stress? Australian Study To Find Out.

Researchers in Australia are conducting a study to better understand if, and how, yoga can be used as a therapy for stress.

Can yoga really help people to overcome stress? That’s the question being posed by new Australian research, which is hoping to better understand if, and how, yoga can be used as a therapy for stress – and who can benefit most from it.

The study is being conducted by University of Adelaide Psychology Ph.D. student Kaitlin Harkess who has been a yoga instructor for the past seven years.

“Anecdotally there’s a lot of evidence to suggest that yoga can have benefits for people experiencing stress; I’ve seen that from my yoga students over the years. But it’s one thing just to accept this as fact, it’s quite another to put it to the test scientifically, which is what we’re doing with this new study,” Harkess says.

Yoga is growing in popularity in Western countries, but so are stress levels in our everyday lives, said Harkess.

“Severe forms of stress can be extremely debilitating for people – they can suffer physical as well as psychological and emotional impacts from stress. Anxiety, burn-out, depression, these are all of interest from a clinical psychology point of view. But stress can also result in real problems with people’s immune systems and cardiovascular health, for example.”

Harkess explains that yoga involves controlled movement of the body, breathing and relaxation techniques, and these might be broadly applicable to helping people overcome stress in their lives.

South Australian women aged 35-65 are needed for the study, and they must be new to yoga, says Harkess. By participating, women will learn a basic form of yoga and attend a free yoga class twice a week for two months.

Women who participate in the study will fill out a standard psychology questionnaire to help determine their level of stress. Those taking part in the study can give blood so that biochemical markers for stress can be tracked.

“There have been small studies in the past suggesting that yoga is beneficial in overcoming stress, but we’re looking for 90 women to participate, which will be the biggest study of its kind so far,” Harkess says.

Source: University of Adelaide; 

Health & Medicine

http://www.asianscientist.com 

Australia - BMI And Life Expectancy Not Linked, Says Study

A new study says that there is little adverse association between being overweight and living longer, aside from financial costs for the community.

Although the medical cost to the community rises as more and more people become obese, a new study says there is little adverse association between being overweight and living longer.

The increasing rates of obesity and associated disability and illness mean greater financial costs for the community. This expenditure is partly why obesity may have some effect on life expectancy in the aged.

A study led by Australian and Taiwanese researchers examined over 110,000 people for the effect of BMI (Body Mass Index, regarded as a measure of obesity) on life expectancy and the repercussions for health-care systems. The 12-year study included men and women across all age groups.

The results of the research were recently published in the Asia Pacific Journal of Clinical Nutrition, where the lead author is also the editor-in-chief. The study also included researchers from the National Health Research Institutes, Taiwan and the National Defense Medical Center, Taiwan.

“We found that especially in the elderly, medical expenditure continues to rise with increasing BMI, but there was little relationship with how long a person lived,” said Emeritus Professor Mark Wahlqvist from Monash University’s Department of Epidemiology and Preventive Medicine and the Monash Asia Institute.

One reason for this greater expenditure is that, with age, excess weight is increasingly accompanied by loss of muscle (sarcopenia) and bone (osteopenia or osteoporosis), with their own health consequences.

“The study showed that to maintain a favorable life expectancy for those who fall outside the desirable BMI range, more money is being spent,” Wahlqvist said.

BMI indicates a relationship between weight and height. The findings show that, if medical expenditure is to be reduced, people must maintain their BMI in the lower end of the desirable range between 18.5 and 24.

“To reduce the health burden, and the associated medical expenditure by both individuals and governments, it is important that people are encouraged to maintain a desirable BMI – and to do so by inexpensive exercise as well as diet,” he said. “It also means greater government effort for the well-being of ageing communities is needed.”

Wahlqvist said that the economic impact for both individuals and society was a consequence not only of the health costs of obesity but also of the effects it had on independent living, workforce participation, and livelihoods.

“Another difficulty to be actively addressed is that the socio-economically disadvantaged are at greater risk of obesity in the first place,” Wahlqvist said.

“In times of international financial crisis, vulnerability in the health system becomes more apparent. This can be seen in those countries in the euro-zone with demanding terms for debt alleviation, including cut-backs to health system funding.”

The article can be found at: Wahlqvist ML et al. (2012) Paradoxes with weight disorders for health systems.

Source: Monash University;

Health & Medicine

http://www.asianscientist.com

UK - Olympians Live Longer Than The Rest Of Us, Study

Olympians live longer than the general population, according to new research published in the British Medical Journal.

Olympians live longer than the general population, according to new research published in the British Medical Journal.

The study found Olympic medalists live an average of 2.8 years longer than the general population, regardless of country of origin, color of medal won, or type of sport played.

Researchers compared life expectancy among 15,174 Olympic athletes who won medals between 1896 and 2010 with general population groups matched by country, sex, and age.

All medalists lived an average of 2.8 years longer – a significant survival advantage over the general population in eight out of the nine countries studied.

Gold, silver and bronze medalists enjoyed roughly the same survival advantage, as did medalists in both endurance and mixed sports. Medalists in power sports such as gymnastics and tennis had a smaller, but still significant, advantage over the general population.

“There are many possible explanations including genetic factors, physical activity, healthy lifestyle, and the wealth and status that come from international sporting glory,” said lead author Professor Philip Clarke from the University of Melbourne, who added that their study was not designed to determine why Olympic athletes live longer.

“Perhaps the one thing those of us who do not make the Olympic team can do to increase our life expectancy is to undertake regular exercise. This has been shown to decrease the risk of big killers like type 2 diabetes,” he said.

In an accompanying editorial, two public health experts write that people who do at least 150 minutes a week of moderate to vigorous intensity physical activity also have a survival advantage compared with the inactive general population. Estimates range from just under a year to several years.

But they argue that, compared with the successes that have been achieved in tobacco control, “our inability to improve physical activity is a public health failure, and it is not yet taken seriously enough by many in government and in the medical establishment.”

The article can be found at: Clarke PM et al. (2012) Survival of the fittest: retrospective cohort study of the longevity of Olympic medallists in the modern era.

Source: BMJ;

Health & Medicine

http://www.asianscientist.com

USA - Many stroke survivors think about suicide

One in 12 stroke survivors thought about suicide or that they would be better off dead, a troubling federal survey reveals.

That's more than those with other health problems such as heart attacks or cancer, and it suggests that depression after stroke is more serious than many had realized.

"It was surprising" and shows a need for more treatment, said the study's leader, Dr. Amytis Towfighi of the University of Southern California in Los Angeles. "When patients have their depression treated they're more motivated to take their medication, do therapy and live a full life."

The study was discussed Thursday at an American Stroke Association conference in Honolulu.

More than 6 million Americans have had a stroke; about 800,000 occur each year in the U.S. Studies suggest that up to a third of stroke survivors develop depression, but few have looked at suicidal thoughts — one sign of how serious it is.

"It's not necessarily active suicidal thoughts with a plan, but perhaps wishing you hadn't survived the event," Towfighi explained.

She used the National Health and Nutrition Surveys, a government project that gives checkups and questionnaires to a representative sample of adults. More than 17,000 people were surveyed from 2005 through 2010.

They included 678 who had suffered a stroke; 758 who had had a heart attack; 1,242 with cancer, and 1,991 with diabetes. Researchers don't know how long ago these problems occurred of if people were still being treated for them.

They were asked a question that many studies use to gauge suicidal thinking: "Over the last two weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself?"

About 8 percent of stroke survivors reported such thoughts, compared to 6 percent of heart attack survivors, 5 percent of those with diabetes and 4 percent with cancer.

Suicidal thoughts were more likely in people who scored high on depression tests, were younger, overweight, less educated, poor, female or unmarried.

Depression may develop partly because strokes damage the very thing that controls mood — the brain, said a neurologist with no role in the study, Dr. Brian Silver of Brown University and Rhode Island Hospital.

"It's not necessarily the reaction to the disease ... it's also the disease itself that is causing the depression," by releasing harmful chemicals that can trigger it, he said.

Suicidal thinking is a well-known problem, but this study "puts a number on it" and shows the need to watch for and treat it, Silver said.

MARILYNN MARCHION

Stroke conference: www.strokeassociation.org

http://www.biosciencetechnology.com

Singapore - L'Oreal opens S'pore lab to study Asian skin

SINGAPORE - French cosmetics giant L'Oreal Group has opened a research laboratory in Singapore to study Asian skin.

It wants to bank skin samples from Asian donors for research and will study their skin physiology as well as new ways to tackle ageing and pigmentation.

The lab is part of the company's plan to make its research more international and its scientists will collaborate with Singapore research groups.

These include the Agency for Science, Technology and Research (A*Star) and the Mechanobiology Institute at the National University of Singapore.

The lab's director, Mr Charbel Bouez, said Singapore is a good fit for the firm because of its vibrant scientific community and ethnically diverse population.

"These complement L'Oreal's interest in understanding human skin diversity and in developing new products for our Asian customers' needs," he added.

The lab will get $3 million a year from its parent company and employ 17 scientists by June next year.

It currently has 10 scientists, six of whom are Singaporeans, and is housed at A*Star's Institute of Medical Biology (IMB) in Buona Vista.

L'Oreal had previously worked with the institute to find out how to reconstruct Asian skin from cultured cells.

IMB executive director Birgitte Lane said the local research community can also benefit from the new lab.

"It will allow us to tap each other's strengths to better understand Asian skin, which will bring about many applications, from personal care to health-care solutions," she said.

Market researcher Euromonitor said the Asian-Pacific beauty and personal care industry was worth US$114.3 billion (S$139 billion) last year, up from US$73 billion in 2008.

The Asian industry is expected to be worth US$140 billion by 2016.

Feng Zengkun

The Straits Times

USA - Can exercise detoxify the body? Health experts are skeptical

NEW YORK - The word "detoxification" is flung around the fitness community as frequently as kettlebells are swung.

Yoga teachers regularly speak of detoxifying twists, aerobics instructors of detoxifying sweat, dieters of detoxifying fasts. But health professionals are sceptical.

"If you start talking about exercising to detoxify, there's no scientific data," said Dr. Elizabeth Matzkin, chief of women's sports medicine at Harvard Medical School. "The human body is designed to get rid of what we don't need."

The same applies to fasting.

"No good scientific data supports any of those cleanses, where you drink juice, or (only) water for a week," she said.

Exercise is important, Matzkin added, because it enables our body to do what it is made to do, but the kidneys and colon get rid of waste. The role of exercise in that process is unclear.

"In general exercise helps our lungs; kidneys get rid of things that can cause us onset of disease," she said.

A healthy lifestyle - eating healthy, drinking plenty of water and exercising - is important to detoxifying because it enables our body to do what is intended to do.

"As for specific yoga moves, I'm not so sure," she said.

Yoga instructor and fitness expert Shirley Archer, an author and spokeswoman for the American Council on Exercise (ACE) said the theory behind the effectiveness of detoxifying twists in yoga is that they squeeze the organs, which push the blood out so fresh blood can rush in.

"Better circulation equals better health," said Archer, who is based in Florida. "If detox means to eliminate from the body what it no longer needs, then certain yogic practices can help."

She said yogic deep breathing with strong exhalations can empty the lungs of unneeded carbon dioxide and allow for a fresh breath of more oxygenated air. "This nourishes all of our cells," she said. "It is also a method of cleansing because better circulation equals better health."

Meditative movement practices, such as yoga and tai chi, she added, can detox your attitude because they require staying in the present moment and discourage dwelling on the past.

Last summer, celebrity trainer Tracy Anderson began taking groups of 40-odd women on what she calls Detox Weeks, which involve at least three hours of workouts each day, as well as lectures on fitness and nutrition aimed mainly at encouraging lifestyle changes.

Similar weeks in other cities are planned for 2013.

"Women work out and think 'Why can't my love handles, muffin tops go away'?" said Anderson, creator of the Tracy Anderson Method and a co-owner, with actress Gwyneth Paltrow, of fitness centers in Los Angeles and New York. "The most important thing is if you can become a consistent exerciser."

"A good workout is not five to 10 yoga poses," she explained. "You have to learn to scale up your endurance. If you can only jump for five minutes straight, we'll go to 10 minutes, then 20 minutes."

Anderson said she uses the term detoxification broadly to include everything from working up a good sweat to clearing the mind of destructive thoughts.

"Detoxification is a big topic," she said.

Nancy Clark, a registered dietitian in Boston, Massachusetts and a member of the American College of Sports Medicine, said the body generally does a fine job of detoxifying itself through the liver and kidneys. Sweating has nothing to do with it.

"When you sweat you really don't detoxify anything," she explained. "If someone goes on a crash diet, then maybe toxins are released but then the body would take care of them. When you sweat you lose sodium."

Reuters

China - Pigs In China’s Guangdong Province Infected With Avian Flu

Scientists have made a startling discovery that pigs in China’s Guangdong province are infected with avian influenza viruses.

Scientists have made a startling discovery that pigs in China’s Guangdong province are infected with three strains of avian influenza viruses.

Led by Dr. Zhang Guihong, a team of scientists from the College of Veterinary Medicine, South China Agricultural University in Guangzhou published their findings recently in the Journal of Clinical Microbiology.

In the period from 2010 to 2012, the scientists examined serum from pigs for both the avian and swine types of influenza virus. In total, 1,080 21- to 25-week-old pigs were tested for the H3, H4, H5, and H6 subtypes of avian influenza virus, and the H1 and H3 subtypes of swine influenza virus.

Looking first at the avian influenza A virus, 0.93 percent of pigs were positive for the H3 subtype, 1.6 percent were positive for the H4 subtype, and 1.8 percent were positive for the H6 subtype.

Of the swine flu virus, 35 percent of pigs were positive for H1N1, and 19.7 percent were positive for H3N2.

None of samples were positive for the avian H5 virus, which meant that the pigs had most likely been sporadically infected with the H3, H4, and H6 subtypes.

Importantly, no serum samples collected in 2001 were positive for any of the avian viruses, indicating that transmission into swine was recent.

Influenza A virus is responsible both for pandemics that have killed millions worldwide, and for the much less severe annual outbreaks of influenza. Because pigs can be infected with both human and avian influenza viruses, they are thought to serve as “mixing vessels” for genetic reassortment that could lead to pandemics.

In the lab, pigs have been infected experimentally by all avian H1-H13 subtypes. However, natural transmission of avian influenza to pigs has been documented only rarely.

“We recommend strongly that the pork industry worldwide should monitor the prevalence of influenza in pigs, considering their important role in transmitting this virus to humans,” said Dr. Zhang.

The article can be found at: Su S et al. (2012) Seroepidemiological evidence of avian influenza A virus transmission in pigs in southern China.

Source: American Society for Microbiology

http://www.asianscientist.com

USA - Power nap relieves physician fatigue

Protected sleep time could be a viable alternative to shorter duty hours

Getting some Z's through the "power nap" can help physicians fight fatigue, according to a study in theJournal of the American Medical Association, published yesterday.

Amid regulatory mandates that cut resident duty hours, researchers examined a way to protect physician sleep time without having to sacrifice the number of resident work hours--which critics have said increases handoffs and therefore risks patient safety.

Researchers from the University of Pennsylvania looked at more than 100 first-year residents from the Hospital of the University of Pennsylvania and the Philadelphia VA Medical Center. The intervention group consisted of interns who worked a 30-hour shift. They had protected sleep periods between 12:30 a.m. and 5:30 a.m., in which they received an average of two to three hours of sleep. During that time, the interns had to give their cell phone to another awake resident to ensure proper coverage of patients.

The residents who had the power nap reported feeling less fatigued after on-call nights and increased their sleep time by half.

Researchers also noted that with the protected time, resident adherence to sleep was "remarkably high," with about 98 percent of interns signing out their cell phones to a designated covering resident.

"This study provides the first evidence that contrary to long held cultural beliefs within the medical community, young doctors are embracing the importance of sleep and looking for ways to increase their own performance to better treat their patients," David Dinges, professor in the Department of Psychiatry at U Penn, said in a research announcement Tuesday.

The subject of resident sleep has been in the national spotlight since the 2009 Institute of Medicine report, which recommended protected sleep time for residents who continuously work 30 hours. Starting in July 2011, the Accreditation Council for Graduate Medical Education (ACGME) ordered that first-year residents cannot work for more than 16 hours at a time.

And last year, The Joint Commission issued a Sentinel Event Alert, declaring thatworker fatigue is linked to adverse events. The accrediting agency suggested hospitals implement a fatigue management plan, among other guidelines.

However, critics of the mandatory ACGME change have questioned the inadvertent effects on patient safety and, more recently, a potential workforce deficit with patient volume under health reform.

"While these restrictions were put into place to help battle fatigue and improve patient care, the one-size-fits-all model has left many wondering whether or not other viable options could be implemented too," Kevin Volpp, staff physician at the Philadelphia VA Medical Center, said in the statement.

Although the study didn't look at the effects on patient outcomes, it found that "strategic napping" could be an alternative to shorter duty hours.

Karen Cheung-Larivee

For more information:
- see the research announcement and watch the video
- here's the study 

http://www.fiercehealthcare.com

USA - Crowded emergency departments linked to more deaths, costs

Patients admitted during high ED crowding have 5% greater risk of dying

High emergency department crowding is associated with increased inpatient mortality, as well as moderate rises in length of stay and costs, concludes a new study in the Annals of Emergency Medicine.

Patients admitted to the hospital during high ED crowding times had 5 percent greater risk of inpatient death than similar patients admitted to the same hospital when the ED was less crowded. 

The researchers looked at almost 1 million ED visits resulting in admission to 187 hospitals and used daily ambulance diversion to measure ED crowding, according to a research announcement today.

They found that on days with a median of seven ambulance diversion hours, admitted patients had a 0.8 percent longer hospital length of stay and 1 percent higher costs.

Moreover, high ED crowding was associated with 300 excess inpatient deaths, 6,200 hospital days and $17 million in costs, the study noted.

Such findings are even more worrisome, given that half of health leaders say their ERs are overcrowded as is. Overcrowding is growing twice as fast as ER visits.

Hospitals looking to make their EDs less crowded should target Medicare patients, as almost 60 percent of their ER visits were "potentially preventable."  

However, contrary to popular belief, nonurgent, Medicaid patients aren't clogging up the ED.

Most Medicaid ED patients go because they have to, seeking emergent care for serious medical problems. Instead, most crowding stems from ED boarding, in which emergency patients admitted to the hospital are waiting for an inpatient bed, FierceHealthcare previously reported.

Researchers say the new study reinforces calls to end ED boarding. "Prolonged boarding times may delay definitive testing and increase short-term mortality, length of stay, and associated costs," the study states.

Alicia Caramenico

For more:
- read the study (.pdf)
- here's the ACEP announcement

http://www.fiercehealthcare.com

USA - Deception can be perfected

With a little practice, one could learn to tell a lie that may be indistinguishable from the truth.

New Northwestern University research shows that lying is more malleable than previously thought, and with a certain amount of training and instruction, the art of deception can be perfected.

People generally take longer and make more mistakes when telling lies than telling the truth, because they are holding two conflicting answers in mind and suppressing the honest response, previous research has shown. Consequently, researchers in the present study investigated whether lying can be trained to be more automatic and less task demanding.

This research could have implications for law enforcement and the administering of lie detector tests to better handle deceptions in more realistic scenarios.

Researchers found that instruction alone significantly reduced reaction times associated with participants' deceptive responses.

They used a control group—an instruction group in which participants were told to speed up their lies and make fewer errors, but were not given time to prepare their lies—and a training group, which received training in how to speed up their deceptive responses and were given time to prepare their lies. In the training group that practiced their lies, the differences between deceptive and truthful responses were completely eliminated.

"We found that lying is more malleable and can be changed upon intentional practice," said Xiaoqing Hu, lead author of the study and a doctoral candidate in the department of psychology at Northwestern.

Hu said they were surprised that even in the instruction group, members who were not given time to prepare their lies and told only to try to speed up their responses and make fewer errors were able to significantly reduce their deceptive response reaction time.

"This was really unexpected because it suggests that people can be really flexible, and after they know what is expected from them, they want to avoid being detected," Hu said, noting the findings could help in crime fighting.

"In real life, there's usually a time delay between the crime and interrogation," said Hu. "Most people would have time to prepare and practice their lies prior to the interrogation." However, previous research in deception usually gave participants very little time to prepare their lies.

Lie detector tests most often rely on physiological responses. Therefore, Hu said further research warrants looking at whether additional training could result in physiological changes in addition to inducing behavior changes as observed in their study.

More information: "A Repeated Lie Becomes a Truth? The Effect of Intentional Control and Training on Deception" was recently published in Frontiers in Cognitive Science. www.frontiersin.or… 488/abstract

Provided by Northwestern University

"Deception can be perfected." December 6th, 2012. http://medicalxpress.com/news/2012-12-deception.html

Canada - Could high insulin make you fat? Mouse study says yes

When we eat too much, obesity may develop as a result of chronically high insulin levels, not the other way around. That's according to new evidence in mice reported in the December 4th Cell Metabolism, a Cell Press publication, which challenges the widespread view that rising insulin is a secondary consequence of obesity and insulin resistance.

The new study helps to solve this chicken-or-the-egg dilemma by showing that animals with persistently lower insulin stay trim even as they indulge themselves on a high-fat, all-you-can-eat buffet. The findings come as some of the first direct evidence in mammals that circulating insulin itself drives obesity, the researchers say.

The results are also consistent with clinical studies showing that long-term insulin use by people with diabetes tends to come with weight gain, says James Johnson of the University of British Columbia.

"We are very inclined to think of insulin as either good or bad, but it's neither," Johnson said. "This doesn't mean anyone should stop taking insulin; there are nuances and ranges at which insulin levels are optimal."

Johnson and his colleagues took advantage of a genetic quirk in mice: that they have two insulin genes. Insulin1 shows up primarily in the pancreas and insulin2 in the brain, in addition to the pancreas. By eliminating insulin2 altogether and varying the number of good copies of insulin1, the researchers produced mice that varied only in their fasting blood insulin levels. When presented with high-fat food, those with one copy and lower fasting insulin were completely protected from obesity even without any loss of appetite. They also enjoyed lower levels of inflammation and less fat in their livers, too.

Those differences traced to a "reprogramming" of the animals' fat tissue to burn and waste more energy in the form of heat. In other words, the mice had white fat that looked and acted more like the coveted, calorie-burning brown fat most familiar for keeping babies warm.

Johnson says it isn't clear what the findings might mean in the clinic just yet, noting that drugs designed to block insulin have been shown to come with unwanted side effects. But, he added, "there are ways to eat and diets that keep insulin levels lower or that allow insulin levels to return to a healthy baseline each day."

Unfortunately, constant snacking is probably not the answer.

More information: Mehran et al.: "Hyperinsulinemia drives diet-induced obesity independently of brain insulin production." Cell Metabolism, DOI: 10.1016/j.cmet.2012.10.019

Journal reference: Current Biology and Cell Metabolism

Provided by Cell Press

http://medicalxpress.com

Europe - Moderate coffee consumption may reduce risk of diabetes by up to 25 percent

Drinking three to four cups of coffee per day may help to prevent type 2 diabetes according to research highlighted in a session report published by the Institute for Scientific Information on Coffee (ISIC), a not-for-profit organisation devoted to the study and disclosure of science related to coffee and health.

Recent scientific evidence has consistently linked regular, moderate coffee consumption with a possible reduced risk of developing type 2 diabetes. An update of this research and key findings presented during a session at the 2012 World Congress on Prevention of Diabetes and Its Complications (WCPD) is summarised in the report.

The report outlines the epidemiological evidence linking coffee consumption to diabetes prevention, highlighting research that shows three to four cups of coffee per day is associated with an approximate 25 per cent lower risk of developing type 2 diabetes, compared to consuming none or less than two cups per day1. Another study also found an inverse dose dependent response effect with each additional cup of coffee reducing the relative risk by 7-8 per cent.

Whilst these epidemiological studies suggest an association between moderate coffee consumption and reduced risk of developing diabetes, they are unable to infer a causal effect. As such, clinical intervention trails are required to study the effect in a controlled setting. One prospective randomized controlled trial3, tested glucose and insulin after an oral glucose tolerance test with 12g decaffeinated coffee, 1g chlorogenic acid, 500 mg trigonelline, or placebo. This study demonstrated that chlorogenic acid, and trigonelline reduced early glucose and insulin responses, and contribute to the putative beneficial effect of coffee.

The report notes that the association between coffee consumption a reduced risk of type 2 diabetes could be seen as counter intuitive, as drinking coffee is often linked to unhealthier habits, such as smoking and low levels of physical activity. Furthermore, studies have illustrated that moderate coffee consumption is not associated with an increased risk of hypertension, stroke or coronary heart disease. Research with patients with CVD has also shown that moderate coffee consumption is inversely associated with risk of heart failure, with a J-shaped relationship.

Finally, the report puts forward some of the key mechanistic theories that underlie the possible relationship between coffee consumption and the reduced risk of diabetes. These included the 'Energy Expenditure Hypothesis', which suggests that the caffeine in coffee stimulates metabolism and increases energy expenditure and the 'Carbohydrate Metabolic Hypothesis', whereby it is thought that coffee components play a key role by influencing the glucose balance within the body. There is also a subset of theories that suggest coffee contains components that may improve insulin sensitivity though mechanisms such as modulating inflammatory pathways, mediating the oxidative stress of cells, hormonal effects or by reducing iron stores.

Dr. Pilar Riobó Serván, Associate Chief of Endocrinology and Nutrition, Jiménez Díaz-Capio Hospital of Madrid and a speaker at the WCPD session concludes the report, commenting: "A dose-dependent inverse association between coffee drinking and total mortality has been demonstrated in general population and it persists among diabetics. Although more research on the effect of coffee in health is yet needed, current information suggests that coffee is not as bad as previously considered!"

Provided by European Science Foundation

http://medicalxpress.com

USA - Drinking too much alcohol tied to early-life strokes

Younger adults who suffered a stroke were often smokers or had abused drugs or alcohol, in a new study from Ohio and Kentucky.

Although strokes are often thought of as a condition of the elderly, researchers said long-term changes in the heart, arteries and blood as a result of drug abuse or heavy drinking may put users at higher-than-average risk earlier in life.

It's also possible that some drugs, particularly cocaine and methamphetamines, may trigger a stroke more immediately, according to Dr. S. Andrew Josephson, a neurologist from the University of California, San Francisco, who has studied drug use and stroke.

Because substance use is common in older adults as well, he said doctors should ask anyone who's had a stroke about drugs and alcohol.

But, "we know that even with vascular risk factors that are prevalent - smoking, high blood pressure… most people still don't have a stroke until they're older," Josephson, who was not involved in the new study.

"When a young person has a stroke, it is probably much more likely that the cause of their stroke is something other than traditional risk factors."

According to the Centers for Disease Control and Prevention, close to 800,000 people in the United States have a stroke every year, and strokes are the most common cause of serious long-term disability.

One study of 2007 data found that almost five per cent of people who had a stroke that year were between ages 18 and 44.

The current study included people from Greater Cincinnati and Northern Kentucky who'd had a stroke before they hit 55.

Dr. Brett Kissela from the University of Cincinnati and his colleagues reviewed medical charts for blood or urine test results or other records of substance abuse for close to 1,200 stroke patients.

In 2005, the most recent year covered, just over half of younger adults who suffered a stroke were smokers at the time, and one in five used illicit drugs, including marijuana and cocaine.

Thirteen per cent of people had used drugs or alcohol within 24 hours of their stroke, according to findings published in the American Heart Association journal Stroke.

"The rate of substance abuse, particularly illicit drug abuse, is almost certainly an underestimate because toxicology screens were not obtained on all patients," said Dr. Steven Kittner, a professor of neurology at the University of Maryland School of Medicine in Baltimore who also wasn't part of the research team.

"It's certainly underreported," he told Reuters Health.

The rate of smoking, drug use and alcohol abuse - defined as three or more drinks per day - seemed to increase among stroke patients between the mid-1990s and the mid-2000s.

But Kissela and his team said they can't be sure whether more people were actually using those substances or doctors were just getting better at testing for and recording drug abuse.

The study also can't prove that patients' drug or alcohol use directly contributed to their strokes. It's possible, for example, that people who abuse drugs also see their doctors less often or engage in other risky behaviours that increase their chance of stroke, Josephson explained.

He said the study emphasizes the importance of learning and quickly recognising the signs of a stroke - such as weakness on one side of the body and dizziness - even for young people. Some treatments can only be used during a short "window of opportunity" after the stroke.

"We see patients all the time who have symptoms that are classic for a stroke… and those symptoms are not recognised as being stroke symptoms because of the idea that, 'Well, that's something that happens only to older people,'" he said.

Reuters

Australia – New Zealand – USA - Swimming Makes Kids Smart, Study

Children who learn how to swim at a young age have better visual-motor skills and mathematical abilities, says a new study.

Children who learn how to swim at a young age have better visual-motor skills and mathematical abilities, says a new study.

Researchers from the Griffith Institute for Educational Research surveyed parents of 7,000 under-fives from Australia, New Zealand, and the U.S. over three years. The study is a joint project between Griffith University, Kids Alive Swim Program, and Swim Australia.

Lead researcher Professor Robyn Jorgensen says the study shows young children who participate in early-years swimming achieve a wide range of skills earlier than the normal population.

“Many of these skills are those that help young children into the transition into formal learning contexts such as pre-school or school,” said Jorgensen.

The researchers found significant differences between the swimming cohort and non-swimmers regardless of socio-economic background. While the two higher socio-economic groups performed better than the lower two in testing, the four swimming groups all performed better than the normal population.

The researchers also found there were no gender differences between the research cohort and the normal population.

As well as achieving physical milestones faster, children also scored significantly better in visual-motor skills such as cutting paper, coloring in, and drawing lines and shapes, and many mathematically-related tasks. Their oral expression was also better as well as in the general areas of literacy and numeracy.

“Many of these skills are highly valuable in other learning environments and will be of considerable benefit for young children as they transition into pre-schools and school,” he said.

A further 180 children aged 3, 4, and 5 years have been involved in intensive testing, making it the world’s most comprehensive study into early-years swimming.

Source: Griffith University.

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