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Metabolic Syndrome Threatens Mental Functioning

It used to be called syndrome of hyperinsulinism or syndrome X, but in the meantime the term Metabolic Syndrome stands for a derailment of the metabolism, which manifests itself in excessive weight, type 2 diabetes, high blood pressure and inflammatory processes in the body. The condition, which is largely preventable by healthy lifestyle choices, also paves the way for heart disease, stroke, arthritis and some cancers.
A study from the University of California at San Francisco by Dr. Kristine Yaffe points to yet another health problem that results from the metabolic syndrome and which mars the" golden years" of a large number of seniors: lack of cognitive function, short term memory loss, and forms of dementia.
The study was based on 2632 participants with an average age of 74 years. The likelihood to develop cognitive impairment was 20% higher in those participants of the study who had metabolic syndrome. Things were getting worse, if patients had metabolic syndrome and laboratory tests showed high inflammation with elevated blood levels of interleukin 6 and the C- reactive protein test: the likelihood to develop cognitive impairment rose to 66%.
So much for the bad news. The good news, however, is that lifestyle can be a powerful armor in the prevention of disability and disease.

The Medical Post, January 25,2005, page 45

Sleep More For Healthy Body Weight

Sleep deprivation is a common problem in a society governed by stress and hurry. Less hours of sleep may give us the illusion of being more effective, but it seems to be at the expense of our health. Lack of sleep affects our brain metabolism in various ways, and researchers at Columbia University recently examined data on 6115 people, ages 32 to 59 from a U.S. National Health and Nutrition Examination Survey. The findings were presented at a recent meeting of the North American Association for the Study of Obesity.

Increase of obesity risk due to sleep deprivation

Of those who slept less than four hours per night 73% were more likely to be obese. Those who slept six hours per night were 23% more likely to be obese. The findings further suggested that in people who sleep less than eight hours per night (about three quarter of the 1024 participants), body mass index was inversely proportional to sleep duration.
The researchers also reported the reasons for that. Sleep deprivation lowers leptin, a blood protein that suppresses appetite and sends the signal, when the body had enough food. Lack of sleep also raises ghrelin levels, a polypeptide hormone from the stomach wall, which makes people want to eat. Laboratory tests of one study showed that making do with only four hours of sleep resulted in an 18% reduction of the leptin (the "appetite stopper") and a 28% increase of the ghrelin (the "appetite animator"). Translated into plain text, it means that the breaks were removed and the signal given to eat by 46% more than in persons with a sufficient dose of sleep. In addition sleep deprived healthy persons in their 20's also craved more sweets and starchy foods than well-rested individuals and these added calories are stored as body fat. These hormonal changes are the biochemical evidence pointing to the connection of a sleep-deprived lifestyle with obesity and the associated health problems like diabetes and cardiovascular illness.
Drastic diets don't seem to hold the answer. Part of the entire picture may be as simple as sleeping more and as a result weighing less.

The Medical Post, February 1, 2005,page 17

Asian Diet To Manage Menopause

Hormone Replacement Therapy (HRT) has not only benefits. The potential side effects have become evident, and as a result, doctors have cautioned their patients, that HRT may not be the answer for every menopausal woman. However, lately natural hormone replacement therapy has become popular as an alternative.
According to statistics only 20% of Asian women are plagued by hot flashes during menopause as compared to 80% of Westerners. A lifestyle intervention trial from Australia taught 120 women to adapt Japanese diet and lifestyle habits. The participants of the trial also started an exercise program for women, drank lots of water, increased calcium intake and increased the intake of plant-estrogens. Researchers had chosen this model, as Japanese women average five more years of healthy living than their sisters in the West.
The spotlight of the research continues to focus on plant-based estrogens. Isoflavone precursors are found in soy (which is widely consumed in Asia), but it is also present in fruits, vegetables, legumes and seeds such as flax. We do not know too much about the long-term effect of manufactured or isolated soy products, and so it is best to stay with the natural soy foods such as edamame (soy beans), tofu, tempeh and miso. Beside soy foods, lots of vegetables, beans and fruit are beneficial, and ground flax seed has also shown to decrease menopausal symptoms. Research in Chinese women has shown a modest association between post-menopausal soy intake and increased bone density. Compared to this, the "typical" North American diet isn't an accessory to good health; being high in white flour, sugar, trans fat and providing saturated fat of meat and dairy products this is also bad news for menopause. In addition there is a correlation between an increased body mass index and one to five alcoholic drinks per week with increased hot flashes in peri-menopausal women.
Research from Simmons College at the Harvard School of Public Health has shown that Western food habits of red meat and processed meats (hot dogs, bacon) put especially women's health at risk.

Diabetes Risk Increased With Western Diet Over 14 Years (modified from Archives of Internal Medicine)

A prospective study on 69,554 women with no history of cancer, diabetes or heart disease at the beginning of the study showed after a 14 year follow-up an almost 50% increase of type 2

diabetes in women, who followed the typical North American diet. Statisticallly speaking, each additional daily serving of red meat increased the risk for diabetes by 26%. For the intake of hot dogs the risk jumped to 49 %, and bacon had the worst consequences: for every daily serving of bacon the risk of developing diabetes went up to 73%!
Some experts say that the health of Asian women is more robust due to their life-long soy intake, in which case it would make sense to not even wait for all the dreaded symptoms of menopause to appear, but make way for healthy diet choices early. Soy products have become immensely popular and are readily available in today's market, and so it will be interesting to see if the next generation of women has an easier time going through menopause.

The Medical Post January 25, 2005, page 17
The Medical Post, February 1, 2005, page 17

Depression is a psychiatric condition, which is experienced by a lot of people. It is more than just a transient feeling of the "blues". Depression can be a chronic and disabling disease, and in severe cases there is the risk of suicide. Great advances have been made from removing the social stigma from psychiatric illness, and cognitive therapy and effective medications can help most the patients to lead full and productive lives.
For a few patients however, depression can be drug-resistant and as a result, effective therapy will be much more difficult.
According to research by Dr. Gary Hasey at Mc Master University in Hamilton, Canada, magnets may have a future role in the treatment of mood disorders. TMS (standing for transcranial magnetic stimulation) has shown promising results in the treatment of some types of depression. A so far unpublished study found that 27% of 50 patients with drug -resistant depression achieved full response with TMS.

Simulated treatment in a control group did not produce this result in any of the patients. MRI scans have shown that depressed people have below-average brain activity in the frontal cortex of the brain. A magnetic field, which is created by passing an electric current through a hand-held magnetic coil, is aimed at the patient's pre-frontal cortex, which stimulates the brain activity in this area. This treatment is vastly different from the well-known electro-shock treatment (ECT), where the patient needs sedation and close observation in a hospital setting. Contrary to this, TMS can be done without sedation. The patient is conscious and can resume his normal activities after the treatment. The therapy was first discovered in the 1980's, but a lot of research had been necessary before treatment could be made available. Other trials are also running in Great Britain, and promising results have been published in the medical paper "The Lancet". Dr. Hasey cautions that there are still some details that have to be worked out. In the meantime Health Canada has approved TMS as treatment for drug-resistant depression.

The Medical Post, February 1,2005, page 28

Liver Cirrhosis Threatens Overweight Children

Generally the condition of liver cirrhosis has been associated with excessive alcohol intake, and the victims have been adults.
A similar condition is the fatty infiltration of the liver, where the function becomes impaired through the growth of fatty tissue, which replaces healthy tissue. In its worst form this non-alcoholic fatty liver disease can advance to cirrhosis and end-stage liver disease. So far this devastating course of illness has been seen in adults, but it is not confined to the adult population. The most important risk factor for this disease is obesity, and with one in three children in Canada now overweight, the previous adult-only disease is now affecting kids. Non-alcoholic fatty liver disease is now the most common cause of abnormal liver tests.

Dr. Ariel Feldstein, a pediatric gastroenterologist from the Mayo Clinic in Rochester reports that the average age of children with these symptoms is about 12, which is an alarmingly low age for this picture. There is also a warning, that children do not even have to sport a sky-high body-mass index (BMI). The risk is already significant with a high BMI.The most direct approach to prevent type 2 diabetes and fatty-liver disease in children has to start within the family. Instead of singling out the child it is important to work together as a family to become healthier. The terms"fat", "chubby", "exercise" and "diet" are less conducive to improvement than "physical activity" and "better nutrition". Consistent minor changes are also more important than crash diets that come and go. Eating more vegetables and fruit, not eating and snacking mindlessly in front of the TV, eating together as a family and preparing healthy snacks instead of tossing a cookie bar or a bag of chips into the lunch bag are all ways that benefit the entire family.
A study from Dr. Robert Berkowitz at the Children's' Hospital of Philadelphia affirms even more, that prevention has to start with the parents: children born to overweight mothers have a higher risk of following the pattern of having a high body mass index than those whose parents were normal weight.

The Medical Post, February 15, 2005, page 21

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