Muscle strength improvements shown in adults undergoing long-term growth hormone treatment

It is widely understood that adults who have a growth hormone deficiency, a condition that affects an estimated 10,000,000 people annually worldwide, tend to have excess body fat and less strength in their muscles. However, little has been known about how prolonged growth hormone therapy can impact muscle strength – until now. Dr. Galina Gotherstrom and colleagues at Goteborg University studied how 10 years of growth hormone treatment affected 109 people with adult-onset growth hormone deficiency. Study participants were an average age of 50. The investigators looked specifically at muscle strength and neuromuscular function.

They discovered that long-term treatment with growth hormones of at least 10 years improves muscle strength in people with adult-onset growth hormone deficiency. Specifically, the team learned that the first five years of treatment restored muscle strength, while during the second five years, growth hormone therapy was responsible for slowing normal age-related loss of strength. In a Journal of Clinical Endocrinology and Metabolism report, the researchers noted that “growth hormone replacement induced a sustained increase in lean mass and isometric knee flexor strength during the first five years and increases in upper leg and handgrip strength.”

Muscle strength decreased during the second five years, returning to previous levels and in some cases, lower levels. But when the age and gender of each participant was taken into account, Gotherstrom’s team found that “there were sustained and even progressive increases in the measures of muscle strength through seven years of follow-up.” They concluded that the net result was that leg and hand strength returned to normal levels after 10 years of growth hormone replacement therapy.

News Release: Growth hormone slows age-related loss of strength www.reuters.com April 9, 2009

New studies show garlic’s powerful ability to reduce free radical damage

Scientists at the University of Kuwait conducted a study to determine if garlic could reduce damage from free radicals, which has been known to lead to vascular disease in people with diabetes and high blood pressure. Measurements of total serum antioxidants were taken from diabetic and hypertensive rates before and after having been treated with garlic. The researchers found that the serum levels of antioxidants had increased significantly in both groups of rats just three weeks after treatment. The diabetic rats also experienced a decrease in serum glucose, while the hypertensive rats had lower systolic blood pressures. The results suggested that garlic is able to increase total antioxidant status.

New studies have also shown that garlic is able to block cancer. A Republic of Korea study identifies diallyl disulfide (DADS) “as the most prevalent oil-soluble sulfur compound in garlic, inhibiting cell proliferation in many cell lines.” The ability of garlic to decrease genetic mutations and reduce the number of small and large lung tumors was demonstrated in another recent study published in the March issue of Mutation Research. In a third study, scientists in the Republic of China found that garlic oil was able to enhance the production of cancer-killing cytokines, as well as to increase the proliferation rate of lymphocytes, which are responsible for the body’s immune response.

The compound responsible for garlic’s healing powers is called Allicin, which has both antibiotic and anti-fungal properties. Allicin is only produced when a whole garlic clove is crushed or chopped, and it begins to degrade quickly. With its high sulfur content, garlic has been used in skin and hair products to improve skin tone and hair shine. Garlic can also be taken as a supplement in the form of garlic extract, which has been found to exhibit many of the same cancer blocking actions and ability to boost antioxidant levels as raw garlic.

News Release: Garlic boosts overall antioxidant levels and blocks cancer   www.naturalnews.com  March 11, 2009

Sensing the presence of sugar – not the sugar itself – contributes to aging

As part of a study published in the journal PLoS Genetics, Professor Luis Rokeach and his student Antoine Roux from the Université de Montréal Biochemistry made a startling discovery. They found that if a gene for a glucose sensor were removed from yeast cells, those cells survived for as long as cells fed a glucose-restricted diet. Yeast cells were used as the model organism, because they are not only easy to study, but at a basic level, they also age much like human cells. The results of the study suggest that cells don’t age based on what they consume, but on “what they think they are eating.”

This contradicts long-held scientific beliefs that the by-products of broken down sugars are responsible for aging. In the study, Rokeach and Roux found that yeast cells lived longer when the amount of glucose was decreased from their diet. They then asked two key questions: Was the increased lifespan a result of a decreased ability of the cells to produce energy? Or was it due to a decrease in the signal to cells from the glucose sensor? While the researchers found that those cells that could not consume glucose as an energy source were sensitive to the aging effects of sugar, removing the sensor that measures levels of glucose significantly increased lifespan. “Thanks to this study, the link between the rise in age-related diseases and the over-consumption of sugar in today’s diet is clearer. Our research opens a door to new therapeutic strategies for fighting age-related diseases,” says Professor Rokeach.

News Release: Not so sweet: Over-consumption of sugar linked to aging   www.sciencedaily.com  March 9, 2009

Vitamin B And Folic Acid May Reduce Risk Of Age-Related Vision Loss

Taking a combination of vitamins B6 and B12 and folic acid appears to decrease the risk of age-related macular degeneration in women, according to a report in the February 23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. Age-related macular degeneration (AMD) is a leading cause of vision loss in older Americans, according to background information in the article. Treatment options exist for those with severe cases of the disease, but the only known prevention method is to avoid smoking. Recent studies have drawn a connection between AMD and blood levels of homocysteine, an amino acid. High levels of homocysteine are associated with dysfunction of the blood vessel lining, whereas treatment with vitamin B6, vitamin B12 and folic acid appears to reduce homocysteine levels and may reverse this blood vessel dysfunction. William G. Christen, Sc.D., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues conducted a randomized, double-blind clinical trial involving 5,442 women age 40 and older who already had heart disease or at least three risk factors. Of these, 5,205 did not have AMD at the beginning of the study. In April 1998, these women were randomly assigned to take a placebo or a combination of folic acid (2.5 milligrams per day), pyridoxine hydrochloride (vitamin B6, 50 milligrams per day) and cyanocobalamin (vitamin B12, 1 milligram per day). Participants continued the therapy through July 2005 and were tracked for the development of AMD through November 2005. Over an average of 7.3 years of treatment and follow-up, 137 new cases of AMD were documented, including 70 cases that were visually significant (resulting in a visual acuity of 20/30 or worse). Of these, 55 AMD cases, 26 visually significant, occurred in the 2,607 women in the active treatment group, whereas 82 of the 2,598 women in the placebo group developed AMD, 44 cases of which were visually significant. Women taking the supplements had a 34 percent lower risk of any AMD and a 41 percent lower risk of visually significant AMD. “The beneficial effect of treatment began to emerge at approximately two years of follow-up and persisted throughout the trial,” the authors write. “The trial findings reported herein are the strongest evidence to date in support of a possible beneficial effect of folic acid and B vitamin supplements in AMD prevention,” the authors write. Because they apply to the early stages of disease development, they appear to represent the first identified way-other than not smoking-to reduce the risk of AMD in individuals at an average risk. “From a public health perspective, this is particularly important because persons with early AMD are at increased risk of developing advanced AMD, the leading cause of severe, irreversible vision loss in older Americans.” Beyond lowering homocysteine levels, potential mechanisms for the effectiveness of B vitamins and folic acid in preventing AMD include antioxidant effects and improved function of blood vessels in the eye, they note. Arch Intern Med. 2009;169[4]:335-341.

Taking aspirin may reduce cancer of the middle and lower stomach

In a British Journal of Cancer study of 311,115 people followed for seven years, researchers founds that people who take aspirin or another non-steroidal anti-inflammatory drugs (NSAID) are far less likely to develop cancer of the middle or lower stomach. Use of the painkillers was analyzed in the 12 months prior to the start of the study. In total, 73% used aspirin, while 56% reported using another NSAID at least once in those 12 months. Approximately 25% reported using aspirin daily, while 10% reported daily use of another NSAID. The rate of non-cardia stomach cancer was seven per 100,000 person-years for those who used aspirin, compared to 11 per 100,000 person years for non-users. There was also a 32 per cent reduction for the same type of stomach cancer in people who used other types of NSAIDs. In contrast to results of previous studies, this study showed that aspirin does not have the same protection benefits against esophageal or cardia gastric cancer at the top of the stomach. Lead Researcher Dr. Christian Abnet of the National Cancer Institute in America, says: “We found that the risk of non-cardia stomach cancer was lower in people who had taken aspirin, and this risk lowered the more regularly they took it. Interestingly, our results didn’t show a significant cut in the risk of esophageal or cardia stomach cancer, so it’s important that we continue to review data that suggests otherwise.” Further research needs to be conducted in order to evaluate the protective benefits of aspirin and other NSAIDs as compared to the risk of side effects, which can include bleeding in the abdomen. As Dr. Lesley Walker, Director of Cancer Information at Cancer Research UK, notes, “It’s far too early to recommend that people take aspirin to protect themselves from these cancers. In cancers where survival is low, understanding how to prevent the disease is crucial, but more research is needed to discover how side effects can be balanced with the benefits. Cancer Research UK would urge people to speak to their doctor before taking aspirin regularly.” News Release: Aspirin cuts stomach cancer risk www.news.bbc.co.uk February 6, 2009

Mediterranean Diet Linked To Lower Risk Of Cognitive Impairment

Mediterranean Diet Linked To Lower Risk Of Cognitive Impairment

Researchers in the US found that people whose diet is closer to a Mediterranean diet are at lower risk of developing MCI or Mild Cognitive Impairment (a stage between normal aging and dementia) and also have a reduced risk of MCI turning into Alzheimer’s disease.

The study was the work of Dr Nikolaos Scarmeas and colleagues at Columbia University Medical Center, New York and is published in the February issue of Archives of Neurology, one of the JAMA/Archives journals.

Previous studies have found that sticking to a Mediterranean diet may protect people from Alzheimer’s disease, but not much is known about its possible ties with MCI.

A Mediterranean diet is high in fish, vegetables, legumes (beans and lentils), fruits, cereals and unsaturated fatty acids, and low in dairy products, meat and saturated fats, plus moderate amounts of alcohol.

For the study, the researchers asked 1,875 people to fill in questionnaires about their food consumption between 1992 and 1999. From the responses, the researchers then calculated a score for the extent to which each person’s food intake most closely resembled a Mediterranean diet.

At the start of the study, 1,393 of the participants had no cognitive problems and 482 of them had MCI, and they were all examined, interviewed and screened for MCI.

The results showed that:

• Over an average follow up period of 4.5 years, 275 of the 1,393 participants without MCI developed the condition.
• Comparing the one third with the lowest scores for Mediterranean diet adherence with the one third that had the highest scores, showed that having a high score was linked to a 28 per cent lower risk of developing MCI.
• The middle third had a 17 per cent lower risk.
• Among the 482 participants who had MCI at the start, 106 developed Alzheimer’s over an average follow up of 4.3 years.
• Among these participants, sticking to a Mediterranean diet was linked with a lower risk of MCI converting to Alzheimer’s.
• In this group, the one third of participants with the highest scores for Mediterranean diet adherence had a 48 per cent lower risk of developing Alzheimer’s compared to the one third with the lowest scores.
• The middle third had a 45 per cent lower risk.

The authors concluded that:

” Higher adherence to the MeDi [Mediterranean diet] is associated with a trend for reduced risk of developing MCI and with reduced risk of MCI conversion to AD [Alzheimer's disease].”

They also wrote that more studies were needed to confirm these findings.

Speculating on their findings, they suggested that the Mediterranean diet may improve levels of cholesterol and blood sugar, as well as keep blood vessels healthier. It may also reduce inflammation. All these factors have been linked to MCI. They said that individual foods in the Mediterranean diet are also linked to lower risk of MCI. Examples of such foods include:

“Alcohol, fish, polyunsaturated fatty acids (also for age-related cognitive decline) and lower levels of saturated fatty acids,” they wrote.

Alzheimer’s is the most common form of dementia, which is a general term for loss of memory and other intellectual skills that impair quality of life. Alzheimer’s is a progressive and fatal brain disease that destroys brain cells, resulting in decline of memory, thinking and behaviour that eventually stops people from being able to work and have an independent life; their quality of life gradually diminishes as the disease progresses.

According to the Alzheimer’s Assocation (US), the disease is the sixth leading cause of death among Americans.

“Mediterranean Diet and Mild Cognitive Impairment.
Nikolaos Scarmeas; Yaakov Stern; Richard Mayeux; Jennifer J. Manly; Nicole Schupf; Jose A. Luchsinger.
Arch Neurol. Vol. 66 No. 2, pp 216-225, February 2009.

High-fat pregnancy diet causes obesity-promoting changes in fetal brain

New research suggests that eating a high-fat diet during pregnancy may cause changes in the fetal brain that promote the development of obesity.

Dr Sarah Leibowitz and colleagues at Rockefeller University compared the offspring of rats fed a high-fat diet with those fed a normal diet containing moderate amounts of fat. Results showed that the offspring of rats fed a high-fat diet ate more, weighed more throughout their lives, and began puberty earlier than the offspring of rats fed a normal diet.

Furthermore, the rats born to mothers who ate a high-fat diet also had higher levels of triglycerides and orexigenic, or appetite-promoting, peptides at birth and as adults. Further examination revealed that feeding the mother rats a high-fat diet caused changes in the brain of their fetal offspring which left the unborn rats with a significantly higher than normal number of orexigenic peptide-producing neurons. In comparison, the offspring of rats fed a normal diet had far less of the specialized neurons, and they did not appear until after the rats had been born.

“We’ve shown that short-term exposure to a high-fat diet in utero produces permanent neurons in the fetal brain that later increase the appetite for fat. This work provides the first evidence for a fetal program that links high levels of fats circulating in the mother’s blood during pregnancy to the overeating and increased weight gain of offspring after weaning,” said Dr Leibowitz in a news release. “We believe the high levels of triglycerides that the fetuses are exposed to during pregnancy cause the growth of the neurons earlier and much more than is normal. We’re programming our children to be fat.”

Chang GQ, Gaysinskaya V, Karatayev O, Leibowitz SF. Maternal High-Fat Diet and Fetal Programming: Increased Proliferation of Hypothalamic Peptide-Producing Neurons That Increase Risk for Overeating and Obesity. The Journal of Neuroscience. 2008;28:12107-12119. doi:10.1523/JNEUROSCI.2642-08.2008

News release: Fatty diet during pregnancy produces new neurons in fetal brain. Rockefeller University. November 10th 2008.

Abdominal fat dramatically increases risk of death

Abdominal fat significantly increases a person’s risk of premature death, even if their overall weight is within normal limits, say researchers.

Researchers examined the association between BMI, waist circumference, and the risk of death using data collected from 359,387 participants enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

Results showed that there was a significant association between BMI and risk of death, with higher risks of death observed in the lower and upper BMI categories than in the middle categories – the lowest risk of death was observed in men with a BMI of 25.3 and women with a BMI of 24.3.

The results also showed that waist circumference and waist-to-hip ratio were a “powerful indicator” of risk of death, regardless of BMI. Men with waists exceeding 47″ (119cm) were twice as likely to die early compared with those with waists of less than 31.5″ (80 cm), in women, those with waists over 39″ (99 cm) had double the risk of premature death compared to those of less than 25.5″ (64.7 cm). For people with the same BMI each extra 2″ (5 cm) raised the risk of early death by 17% for men and 13% for women.

The researchers concluded: “The current results underscore the importance of assessing the distribution of body fat even among persons of normal weight and challenge the use of cutoff points to define abdominal obesity, at least when they are used to predict the risk of death. Our finding of a positive association between waist circumference and the risk of death among participants of normal weight may also explain why studies have been unable to show a linear relationship between BMI and the risk of death across the entire range of BMI values.

Pischon T, Boeing H, Hoffman K, et al. General and Abdominal Adiposity and Risk of Death in Europe. NEJM 2008;359:2105-2120.

Resveratrol, Red Wine Compound Linked To Health, Also Found In Dark Chocolate And Cocoa

Hershey’s Center for Health and Nutrition announced the publication of a study that shows resveratrol, the compound often associated with the health benefits of red wine, is also found in cocoa and dark chocolate products. In the September 24 edition of the Journal of Agricultural and Food Chemistry, scientists report that cocoa powder, baking chocolate and dark chocolate all have significant levels of resveratrol, a naturally occurring antioxidant.

“This study shows that the levels of resveratrol found in cocoa and chocolate products is second to red wine among known sources of resveratrol and forms yet another important link between the antioxidants found in cocoa and dark chocolate to other foods,” says David Stuart, PhD, Director of Natural Product Science at The Hershey Company who partnered with Planta Analytica to conduct this study.

In the study, top selling retail products from six categories were tested for the level of resveratrol and its sister compound, piceid. The six product categories included cocoa powder, baking chocolate, dark chocolate, semi-sweet baking chips, milk chocolate and chocolate syrup. Gram for gram, cocoa powder had the highest average amount of resveratrol and piceid, followed by baking chocolates, dark chocolates, semi-sweet chips, milk chocolate and then chocolate syrup. In the products studied, the level of piceid was 3 to 6 times the level of resveratrol.

When the cocoa and chocolate levels were compared to published values for a serving of red wine, roasted peanuts and peanut butter, resveratrol levels of cocoa powders, baking chocolates and dark chocolate all exceeded the levels for roasted peanuts and peanut butter per serving, but were less than California red wine.

“Resveratrol gained widespread attention in the early 1990s when it was identified in relatively high amounts in red wine, which is associated with the French Paradox,” says Debra Miller, PhD, Director of Nutrition for The Hershey Company. “Despite eating a diet equally high in saturated fat as the typical American diet, the French were shown to have about one-third the level of cardiovascular disease. Continued research indicates that moderate consumption of red wine, along with fruits, vegetables, nuts and lower amounts of red meat, may contribute to this lower risk of heart of disease.”

According to a review article published this month in Nutrition Reviews, resveratrol, a naturally occurring antioxidant, was shown to improve insulin sensitivity, blood cholesterol levels and have neuroprotective actions in animal studies. Further, the article states, studies in mice indicate that diets high in resveratrol were associated with increased longevity..

“Cocoa is a highly complex natural food which contains in excess of seven hundred naturally occurring compounds, with many more yet to be discovered,” explains Jeff Hurst, the lead chemist on the project. “For years, flavanols, a different class of compounds in chocolate, received most of the attention, but these are quite different than resveratrol. It is exciting to see additional antioxidants identified in cocoa and chocolate.”

The results of the survey show that cocoa powder, baking chocolate and dark chocolate contain on average 14.1 to 18.5 micrograms of resveratrol per serving while the level found in the average California red wine is 832 micrograms per glass. Roasted peanuts have an average of 1.5 micrograms and peanut butter13.6 micrograms of resveratrol per serving, demonstrating that cocoa and dark chocolates are meaningful sources of resveratrol in the US diet.

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Article adapted by Medical News Today from original press release.
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Surgeons Discover That Vitamin C And Other Antioxidants Reduce Infections, Pulmonary Failure, And Abdominal Wall Complications In Trauma Patients

Despite continuing improvements in overall delivery of care to critically injured patients, many trauma victims who survive their initial injury will often die of multiple-organ failure following an operation. In a study presented at the 2008 Clinical Congress of the American College of Surgeons (ACS), Bryan A. Cotton, MD, FACS, reported that “implementation of high-dose antioxidant protocol (vitamins C, E, and selenium) resulted in a reduction of pulmonary complications, in general, as well as infectious complications, including central line and catheter-related infections.”

Dr. Cotton, who is assistant professor of surgery at Vanderbilt University Medical Center, Nashville, TN, also observed a remarkable decrease in abdominal wall complications including abdominal compartment syndrome and surgical site infections. When an abdominal wound opens up, the result is not just an infection to be treated with antibiotics, he explained. The wounds need packing and some of them open up to the point where they have to be reconstructed with expensive agents.

“This is a high mortality, high morbidity, may-never-return-to-work-again problem in a young healthy patient,” he said. “Abdominal wall complications are enormous, yet we noted a reduction in some of these complications with implementation of antioxidants. Importantly, the biggest difference was in those patients who had a predicted mortality exceeding 50 percent.”

Immediately prior to completing this study, Dr. Cotton and his colleagues at Vanderbilt demonstrated that this same high-dose antioxidant protocol resulted in a stunning 28 percent reduction in mortality in acutely injured patients. In addition, patients’ length-of-stay in both the hospital and intensive care unit (ICU) were reduced. After the team observed the reduction in mortality after initiating the protocol, they wanted to learn exactly how antioxidants might work. It is all related to addressing the overwhelming oxidative stress, Dr. Cotton said.

He explained that any time a patient has an acute injury, an operation, or some kind of infection, it places a huge stress on the body. This stress can result in injured oxygen molecules called free radicals being released in the body. These molecules roam around, causing considerable damage at the cellular level. This damage is called oxidative stress.

Dr. Cotton said that past research by some renowned scientists in this field has shown a depletion in the store of antioxidants in critically stressed, critically injured patients. Essentially, it appears that antioxidants work as a team in mopping up some of the oxidative stress waste byproducts, reducing the stressors that cause harm.

As Dr. Cotton explains it, antioxidants are like an army of molecular warriors that rush to the site of an injury to fight infection. In the course of doing battle on the front lines, however, most troops are lost early on. When infectious insurgents rise up later on, patients are highly vulnerable to infections. Depletion of antioxidants is one of the mechanisms that explains why we are vulnerable. Antioxidant therapy replenishes those troops to help keep us safe.

“Antioxidant therapy is so simple and that’s what throws people off,” Dr. Cotton said, confessing that he had some doubts about it at first as well. Then he saw an impressive randomized prospective trial conducted by Avery B. Nathens, MD, MPH, which showed that some inflammatory states and responses were remarkably improved in patients who had received antioxidants versus those who did not. Dr. Nathens’ trial did not have enough patients in each arm of the study, though, so they were limited in their mortality conclusions.

“Based on these results, we were inspired to initiate a study with vitamins C and E. When we looked at the literature, however, there were some concurrent studies showing that selenium had an impact too, especially on sepsis and other infectious complications. So we combined all the existing research and did a cost analysis. When we learned it would cost only $11 a patient for a seven-day course of antioxidants, we decided to give it a try.”

This retrospective study followed a total of 4,279 patients admitted to the Vanderbilt University Medical Center trauma unit during the study period. High-dose antioxidant protocol was administered to all acutely injured patients (2,258 individuals) admitted to the center between October 1, 2005, and September 30, 2006. This treatment included 1,000 mg. vitamin C (ascorbic acid) and 1,000 IU vitamin E (DL – tocopherol acetate), each routinely given every eight hours by mouth, if the patient could take it that way. In addition, 200 mcg. selenium was given once daily intravenously. Patients received these supplements upon arrival, and they were continued for seven days or until discharge, whichever happened first. Patients who were pregnant or had serum creatinine levels >2.5mg/dL did not receive antioxidants.

A comparison cohort was made up of all patients (2,021 individuals) admitted to the trauma center between October 1, 2004, and September 30, 2005 prior to implementation of the antioxidant protocol. While pneumonia and renal failure were similar between the groups, the incidence of abdominal compartment syndrome was significantly less (90 versus 31), as were catheter-related infections (75 versus 50) and surgical site infections (101 versus 44). Pulmonary failure meaning the patient could not get off the ventilator was less as well (721 versus 528).

Dr. Cotton is now prescribing high-dose antioxidants only to the most seriously ill patients in the ICU, as they seem to derive the greatest benefit. He and his colleagues will now focus on dose adjustments and length of administration to see if the doses and duration they are currently using are optimal. They have been approached by several groups that are interested in collaborating and investigating these agents as part of multiinstitutional trials and expanding their use to critically ill nontrauma patients.

“While we are all looking for that magic bullet to cure some of the horrible things that can happen after someone is injured or has an operation, we have something at our disposal,” Dr. Cotton said. “It might not be that magic bullet, but it is a very inexpensive and safe way to reduce complications and mortality in the sickest patients.”

Assisting Dr. Cotton with this study were Aviram Giladi, BS; Bryan R. Collier, DO, FACS; Lesly A. Dossett, MD; and Sloan B. Fleming, PharmD, all from Vanderbilt. He received no funding for this research.

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