Article Content



[check mark] Buckle up, big guy


[check mark] Cholesterol breakthrough


[check mark] New insight into metabolic syndrome


Obesity Linked to Decreased Seatbelt Use

According to a research from Vanderbilt University, obese people are less likely to use their seatbelts than the rest of the population do, adding to the public health risks associated with this large and rapidly growing problem. The researchers examined the 2002 data from the Behavioral Risk Factor Surveillance Survey conducted by the US Centers for Disease Control, a telephone survey was used to collect data on risky behaviors and health decisions associated with death.


The study found that approximately 30% of individuals with a body mass index (BMI) that qualified them as overweight, obese, or extremely obese reported not using a seatbelt, compared to approximately 20% of the average population. Furthermore, seatbelt use declined as BMI increased, with approximately 55% of extremely obese individuals reporting that they did not use a seatbelt. The connection between increased BMI and decreased seatbelt use held even when controlling for other factors such as sex, race, and seatbelt laws in the respondent's state.


The public health problem posed by the lack of seatbelt use is magnified by increases in obesity; nearly 60% of the survey respondents fell into the categories of overweight, obese, or extremely obese.


The authors suggest that a reason why people with a high BMI do not use seatbelts is because doing so is uncomfortable. Seatbelt use reduces automobile crash-related deaths and injuries by at least 50%. Therefore, urge those big guys to buckle up!


Source: Obesity, November 2007


Hospitalizations for Gastroesophageal Reflux Disease Up by 103%

In patients with gastroesophageal reflux disease (GERD), stomach acid backs up into the esophagus, causing extreme, chronic heartburn. If untreated, GERD can cause esophageal disorders such as bleeding, trouble swallowing, Barrett esophagus, a precancerous condition, and, in extreme cases, cancer of the esophagus.


Hospitalizations for treating disorders caused by GERD increased by 103% between 1998 and 2005, according to the latest News and Numbers from the Department of Heath and Human Services Agency for Healthcare Research and Quality. During the same period, hospitalizations of patients who, in addition to the ailment for which they were admitted, had milder forms of GERD rose by 216%.


The Agency for Healthcare Research and Quality also found the following:


* Hospitalizations specifically for GERD increased roughly by 5% as a whole during the period between 1998 and 2005-from roughly 91,000 to 95,000. Among these, admissions of patients who had severe symptoms such as anemia, vomiting, and weight loss increased by 39%. Hospitalizations for patients with less serious symptoms such as hoarseness and chronic coughing, bloating, or belching rose by 43%.


* Hospitalizations for GERD in children and young adults aged 2 to 17 years rose by 84% and by 42% for infants younger than 2 years during the period.



For more information, see "Gastroesophageal reflux disease (GERD) hospitalizations in 1998 and 2005" (


Source: Agency for Healthcare Research and Quality, January 2008


Chewing Gum and Weight Loss?

In a recent study from the British Medical Journal, physicians reported 2 patients who had excess intakes of a widely used sweetener, sorbitol, in "sugar-free" products such as chewing gum and sweets, with laxative effects.


Sorbitol's laxative properties are due to its poor absorption by the small intestine.


The 2 patients had chronic diarrhea, abdominal pain, and severe weight loss. After extensive investigations, both patients admitted consuming substantial amounts of sugar-free gum and sweets.


The first patient (a 21-year-old woman) chewed large amounts of sugar-free gum, accounting for a total daily dose of 18 to 20 g sorbitol (1 stick of chewing gum contains about 1.25 g sorbitol). The second patient (a 46-year-old man) reported chewing 20 sticks of sugar-free gum and eating up to 200 g of sweets each day, which together contained around 30 g sorbitol.


After both patients started a sorbitol-free diet, diarrhea subsided, normal bowel movements resumed, and weight gain was achieved.


Source: British Medical Journal, 2008;336:96-97


Anti-inflammatory Drug May Prevent Type 2 Diabetes

Researchers at the Joslin Diabetes Center report that an inexpensive anti-inflammatory drug that is similar to aspirin, salsalate, may prevent type 2 diabetes by lowering blood glucose and reducing inflammation.


The study is only a small, proof-of-principal clinical trial but is promising enough to spur 3 more trials to see if salsalate can also treat diabetes by lowering blood glucose, slow the progression of coronary artery disease in those with metabolic syndrome, and perhaps prevent diabetes in those at high risk.


It has long been known that high doses of aspirin could reduce blood glucose levels, but the risk of stomach bleeding is too high to allow for this treatment to be used. It has also been known for several years that inflammatory markers and proteins are elevated in people with diabetes, and aspirin can reduce inflammation.


In experimental animals, aspirin is effective, but because it cannot be safely used in human beings at high doses, the researchers tried salsalate, a nonsteroidal, anti-inflammatory medication which is similar to aspirin but does not cause bleeding in patients at risk for diabetes. The inexpensive drug has been used for decades to treat arthritis.


The double-masked, placebo-controlled study of 20 obese young adults found that salsalate substantially reduced blood glucose levels as well as inflammation and, as a result, may have cut their risk of developing type 2 diabetes, although this is not yet proven. They found that those who took 4 g of salsalate per day for 1 month reduced their fasting glucose levels by 13% and levels of C-reactive protein, a marker for inflammation, by 34%. Earlier studies have implicated inflammation in the development of type 2 diabetes and heart disease. Researchers concluded that salsalate reduces glycemia and may improve inflammatory cardiovascular risk indices in the obese.


Source: Diabetes Care, January 2008


Study Identifies Key Factor That Links Metabolic Syndrome

A new study has identified insulin resistance in the liver as a key factor in the cause of metabolic syndrome and its associated atherosclerosis, disorders that put tens of millions of Americans at high risk of cardiovascular disease. Metabolic syndrome is a collection of medical problems related to insulin resistance, including obesity, glucose intolerance, hypertension, lowered high-density lipoprotein ("good") cholesterol, and elevated triglycerides in the blood, which together are associated with an increased risk of atherosclerosis.


Many of the most important features of the metabolic syndrome seem to have a common cause. If this is the case, this challenges a joint position statement issued by the American Diabetes Association and the European Association for the Study of Diabetes several years ago that questioned the very existence of the metabolic syndrome. The study sought to understand whether insulin resistance-a condition where the pancreas makes insulin but the body does not respond to it-could increase the risk of atherosclerosis. To try to find out, the researchers engineered mice by "knocking out"-that is, genetically eliminating-insulin receptors in the liver. From this 1 site of insulin resistance alone, the mice developed many of the lipid abnormalities associated with metabolic syndrome. Furthermore, when fed a high-fat diet, the mice developed extremely high cholesterol, more than 4 times the levels found in normal mice fed the same diet. More importantly, all of the "knockout" mice developed atherosclerosis, whereas none of the normal mice did.


The researchers conclude that "by pinpointing the liver, it gives researchers a target for developing potential clinical treatments, such as finding a way to overcome insulin resistance in the liver or to change the way the liver responds to insulin resistance." Now the question is if men behave like the mice or not.


Source: Cell Metabolism, January 2008


Researchers Report Breakthrough in Lowering Cholesterol and Fatty Acids

Researchers have found a way to reduce the amount of "bad" (low-density lipoprotein [LDL]) blood cholesterol and fatty acids. They successfully decreased the level of LDL-the so-called bad cholesterol-and triglycerides in the blood of mice and hamsters by manipulating a particular enzyme. While it is well known that eating too much fat and sugar (and calories) and too little exercise will make you fat and obesity often leads to diabetes and heart disease, the group studied the mechanisms behind this. Drugs called statins are used to lower LDL levels in patients but do not treat obesity. These researchers found a way to inhibit LDL and triglycerides, which are another form of fat in the blood and a leading risk in obesity-related type 2 diabetes as well as heart disease. It remains to be seen if similar effects can be obtained in human beings.


Source: Journal of Lipid Research (December 2007); Journal of Biological Chemistry (November 2007, March 2007)