Food Trends and Your Heart

The Nutrition Facts label is seen on a box of Pop Tarts at a store in New York

Cambridge- The type and amount of fat, carbohydrate, sugar, and salt in our food supply has changed over the years — for better and for worse.

Remember when packaged foods emblazoned with the words “fat free” seemed to be everywhere? Then came labels boasting “zero grams of trans fat.” “Sugar free” and “low sodium” claims soon joined the chorus. These days, gluten-free foods are all the rage.

For the most part, these food industry trends echoed the nutritional mantras of the time and were designed to improve our health — especially cardiovascular health. Not only is heart disease the nation’s leading killer, there’s overwhelming evidence that better dietary choices could prevent many heart attacks and strokes. But just how successful have these efforts been?

“It’s a mixed picture, but over all, I think we’re going in a good direction,” says Dr. Walter Willett, professor in nutrition and epidemiology at the Harvard T.H. Chan School of Public Health. The biggest change — and greatest success story — is removal of trans fats from processed foods, he says.

The trouble with trans fats

The main source of these harmful fats is partially hydrogenated oil, a longtime food industry favorite because it’s cheap, it’s easy to use, and it has a long shelf life. For decades, deep-fried fast foods, baked goods, crackers, chips, and margarine were made with partially hydrogenated oils.

But in the 1990s, researchers at Harvard and elsewhere began sounding the alarm on the adverse health effects of trans fats. Trans fats raise undesirable LDL cholesterol, make blood more likely to clot, and ramp up inflammation in the body — all of which raise heart disease risk. In 2003, the FDA began requiring manufacturers to list trans fat on the Nutrition Facts label to boost consumer awareness. As a result, many companies chose to stop using trans fats in their products.

In 2007, New York City pioneered a ban on trans fat in foods sold in public eateries, and the health benefits were apparent within just a few years. One recent study found lower rates of heart attacks and strokes in the urban counties that implemented the trans fat ban compared with other urban counties in the state that did not ban trans fats.

This healthful trend should be spreading throughout the country, thanks to a long-awaited FDA ruling to ban trans fats entirely from our food supply by June 2018. “At this point, about 85% of the trans fat has been removed from our food supply,” says Dr. Willett. For the most part, healthier unsaturated fats (such as those found in olive, corn, canola, sunflower, and safflower oils) have replaced trans fats. Some products now contain small amounts of less-desirable saturated fat from coconut and palm oils. However, many reformulated products cut back on trans fat without increasing saturated fat, according to a survey of 83 major-brand grocery store products and restaurant dishes.

These changes jibe with the overall improvement in fat quality in the United States, Dr. Willett notes. This trend helps explain why people who eat higher-fat diets (especially those that include more unsaturated fats) are better off than those who eat low-fat diets, as a major study by Dr. Willett and colleagues found last year.

The carb calamity

The low-fat craze that took hold in the 1980s turned out to have unintended — and very unhealthy — consequences. Following the nutrition dogma of the day, food manufacturers cut fat from their products. But they often replaced it with refined carbohydrates, such as white flour and sugar. Americans also began eating more carbs (think pasta, white potatoes, white bread, and sugary desserts). Eating less fat, however, doesn’t necessarily help you lose weight. And diets high in refined carbohydrates may contribute to weight gain and promote type 2 diabetes and heart disease.

Just as is true for fats, some carbohydrates are far healthier than others. The best choices include unprocessed or minimally processed whole grains, such as whole-wheat or rye bread, brown rice, bulgur wheat, oatmeal, popcorn, and corn tortillas. Recent diet surveys suggest a slow but steady increase in whole grains in American diets. They’re great sources of heart-protecting nutrients such as fiber, vitamins, and minerals.

Going against the grain?

But some grains — including wheat, barley, and rye — also contain gluten, a protein that’s been getting lots of attention in recent years. “Gluten-free diets have been a big trend lately, but there is no good evidence to support these diets for most people,” says Dr. Willett. Exceptions include people with celiac disease, which affects about 1% of the population. In people with the disorder, gluten triggers the body’s immune system to attack the small intestine, leading to gut inflammation, pain and other debilitating symptoms. Another small group of people who report feeling better when they eliminate gluten may have “gluten sensitivity,” but this condition isn’t well documented.

According to a survey by the Consumer Reports National Research Center, 63% of Americans believe that a gluten-free diet could improve their mental or physical health. And up to a third of are cutting back on it in the hope that it will improve their health or prevent disease.

In fact, the opposite might be true. A recent Harvard study found that people who avoid gluten may eat fewer whole-grain foods. Also, gluten-free packaged foods may have more sugar, fat, and salt than their gluten-containing counterparts. Gluten-free diets aren’t inherently bad, but the way they’ve been translated into the average diet isn’t necessarily healthy, says Dr. Willett. People who need or want to avoid wheat should be sure to eat gluten-free whole grains such as brown rice, oats, buckwheat, and quinoa.

Sugar: Good news, bad news

The carbohydrates that pose the greatest threat to heart health are the simple, refined ones — especially sugar. High-sugar diets have been linked to a higher risk of heart disease, even in people who aren’t overweight. Sugar-sweetened beverages such as sodas, energy drinks, and sports drinks contribute most of the added sugar in the average American’s diet. But recent data show that consumption of sugary drinks has dropped by about 25% in the United States over the past decade, thanks in part to education campaigns and bans on soda sales in schools. This encouraging trend also seems to be slowing the growing epidemic of type 2 diabetes, which is closely linked to heart disease, says Dr. Willett.

Unfortunately, other sugar-awareness efforts are on hold. In 2016, the FDA approved a revamp of the Nutrition Facts label that would require food manufacturers to list added sugars in their products, among other changes. The rule was originally slated to take effect in July 2018, but the agency announced earlier this year that it will postpone its implementation indefinitely.

One anticipated benefit of the label change was that companies would scale back the sugar in their products, similar to what happened with trans fats. In fact, some yogurt and beverage companies have already done so. It’s too early to know if this strategy will prove successful, however. Some food companies that tried removing some sodium from certain products (such as soups and vegetable juices) have now reintroduced it, says Dr. Willett. “Their competitors didn’t make the change, and the low-sodium products tasted different. We really need to create a level playing field,” he says.

Salt: Still too high

In 2016, the FDA proposed voluntary guidelines for the food industry to slash the amount of sodium in our food supply. Excess sodium (which pairs with chloride to form salt) is linked to high blood pressure, heart attacks, and stroke. The average American eats about 50% more sodium than nutrition experts recommend, and much of is already in their food before it reaches the table.

Time will tell if the FDA guidelines will make a difference. But a recent study suggests that we’ve been moving in the right direction: the average amount of sodium that households acquired from packaged foods and beverages decreased by 400 milligrams per capita between 2000 and 2014. In the meantime, see “Choosing the healthiest supermarket products” for tips on reading labels and ingredient lists while you shop.

Choosing the healthiest grocery products

When shopping for processed foods — anything bagged, packaged, canned, or bottled — check the Nutrition Facts label. Note that the Daily Value (DV) is the recommended level of a given nutrient for a person eating 2,000 calories per day.

For saturated fat, look for a % DV of 5% or less.

The same goes for sodium: % DV 5% or less.

For sugar, there is no % DV, but experts recommend that women consume no more than 24 grams daily; men should limit intake to 36 grams per day.

When selecting breads, cereals, and grain-based foods, check the list of ingredients. The first ingredient should be a whole grain, such as whole wheat (not enriched wheat). “Multigrain” just means the product includes more than one grain — and they’re not necessarily whole grains.

(Harvard Heart Letter)

Oxford University to Test Universal Flu Vaccine in World First

A nurse vaccinates a patient as part of the start of the seasonal influenza vaccination campaign in Nice

A seasonal flu vaccine that would be the first in the world to fight all types of the virus is to be tested in a two-year clinical trial involving more than 2,000 patients by researchers in Oxford.

The so-called universal vaccine was developed by Oxford University’s Jenner Institute and Vaccitech, a spin-out biotech company founded by Jenner scientists.

Current flu vaccines have to be changed each year to match strains of virus circulating at the time and they do not always protect people that well, especially older patients with weak immune systems.

The new vaccine works by using proteins found in the core of the virus rather than those on its surface. Surface proteins stick out like pins from the virus and change all the time, while those in the core are stable.

Significantly, the new vaccine works by stimulating the immune system to boost virus-killing T-cells, instead of antibodies. Previous research has shown such T-cells can help fight more than one type of flu virus.

Researchers hope the new vaccine will provide better and longer-lasting protection when used alongside the regular seasonal flu shot.

“We’re hoping it will last two to three years – maybe even four years – but we really don’t know until we do the trials,” Vaccitech Chief Executive Tom Evans told Reuters.

The new vaccine has already been tested for safety in earlier trials. Now it is advancing into mid-stage Phase IIb testing, which will see the recruitment of at least 500 British subjects this season. The remainder will be recruited during the 2018/9 flu season.

It is the first time a universal flu vaccine has progressed beyond Phase I clinical testing.

Assuming it is successful in Phase IIb, the new shot will still have to go into much bigger and expensive final-stage testing and Evans said the plan would be to bring in a partner at this stage of development.

“We would look for a better-capitalized company to take this into final Phase III tests,” he said.

Leading manufacturers of seasonal flu vaccines include Sanofi, GlaxoSmithKline and CSL’s Seqirus, which includes the old Novartis flu vaccine business.

New Camera Sees Through Human Body By Detecting Light

The camera has been designed to help doctors track medical tools known as endoscopes within the body

London- Scientists have developed a camera that can see through the human body.

The device has been designed to help doctors track medical tools, known as endoscopes, during internal examinations.

Until now, medics have had to rely on expensive scans, such as X-rays, to trace their progress.
The new camera works by detecting light sources inside the body, such as the illuminated tip of the endoscope’s long flexible tube.

Prof Kev Dhaliwal, of the University of Edinburgh, said: “It has immense potential for diverse applications, such as the one described in this work.

“The ability to see a device’s location is crucial for many applications in healthcare, as we move forwards with minimally invasive approaches to treating disease.”

‘Tissues and organs’

Early tests have shown the prototype device can track a point light source through 20cm of tissue under normal conditions.

Beams from the endoscope can pass through the body, but usually scatter or bounce off tissues and organs rather than traveling straight through.

That makes it problematic to get a clear picture of where the tool is.

The new camera can detect individual particles, called photons, and is so sensitive it can catch tiny traces of light passing through tissue.

It can also record the time taken for light to pass through the body, meaning the device is able to work out exactly where the endoscope is.

Researchers have developed the new camera so it can be used at the patient’s bedside.

The project – led by the University of Edinburgh and Heriot-Watt University – is part of the Proteus Interdisciplinary Research Collaboration, which is developing a range of new technologies for diagnosing and treating lung diseases.

Dr. Michael Tanner, of Heriot-Watt University, said: “My favorite element of this work was the ability to work with clinicians to understand a practical healthcare challenge, then tailor advanced technologies and principles that would not normally make it out of a physics lab to solve real problems.

“I hope we can continue this interdisciplinary approach to make a real difference in healthcare technology.”

Counting on Fewer Calories

Calories

Can curbing your usual daily calorie intake by 10% improve health and longevity?
There is a saying: “The less you eat, the longer you live.” The rising rates of obesity have shown that Americans consume more than necessary, and cutting back on calories may be a smart move.

“People naturally gain about a pound a year, on average, beginning in middle age, so healthy weight needs to be a goal for older men,” says Vasanti Malik, a research scientist in the Department of Nutrition at Harvard’s T.H. Chan School of Public Health. “That is why being mindful of how many calories you really need — and perhaps cutting back some, an approach called calorie restriction — may help some men stay healthy and maybe even live longer.”

Less can be more

Federal guidelines suggest older men consume between 2,000 and 2,800 calories a day depending on their activity level. (See “Daily calorie levels for men ages 51 and older.”)

Calorie restriction can be a loose term, but generally it involves consuming about 10% to 15% fewer calories than your regular intake, but without reducing key nutrients, according to Malik. “This may help men lose excess weight by being smarter about food choices and portions.”

Ground-floor animal studies have shown that calorie restriction may help increase life span by slowing metabolism and increasing muscle mass. However, these findings have not yet translated to human studies. Still, calorie restriction may help with longevity in other ways.

A 2015 study published in The Journal of Gerontology: Medical Sciences looked at a two-year trial on calorie restriction called CALERIE. Researchers recruited 220 middle-aged adults, most of whom were moderately overweight, and divided them into two groups. One group was given goals of 15.5% weight loss in the first year, followed by weight stability over the second year. The approach was to reduce their calories to 25% below their regular daily intake.

This was an ambitious target, and the group only achieved a more realistic 12% calorie restriction. Still, the participants lost an average of 10% of their body weight in the first year, and best of all, maintained that weight over the second year.

In terms of specific benefits tied to longevity, the researchers found the group’s average blood pressure dropped by 4% and total cholesterol by 6% compared with the control group. There was also a 47% reduction in levels of C-reactive protein, an inflammatory factor linked to cardiovascular disease.

Levels of the thyroid hormone triiodothyronine (T3) dropped by more than 20% in the calorie restriction group. Some studies have suggested that lower thyroid activity may help the body age at a slower rate.

Beyond weight loss

It makes sense that calorie restriction helped overweight people lose weight, but it also may benefit normalweight individuals.

A study in the February 2016 Aging Cell also used information from the two-year CALERIE trial to explore how a -calorie-restriction diet may affect people with a body mass index of 25 (which is on the border between normal and overweight).

After two years, this group had lost, on average, about 11% of their body weight, and 71% of this was in the form of fat loss. The researchers also found that in these people, concentrations of insulin-like growth factor–binding proteins (IGFBP1) increased by more than 21% to 25%. Low levels of IGFBP-1 have been associated with aging.

Calorie restriction is about food sources as well as numbers. “It is not about cutting out food, but about monitoring your intake and ensuring you eat the right foods and in the right amounts, without depriving your body of key nutrients you need, like vitamin D, calcium, and iron,” says Malik.

Counting calories can be confusing and tiresome. Instead, be mindful of portion sizes and choose high-quality foods, such as whole fruits and vegetables as well as protein sources like fish, eggs, and poultry. In addition, limit or avoid refined grains and processed foods, suggests Malik.

For portion control, measure the single portion on the nutritional panel on the food’s label to get a visual image of a proper serving. “For example, seeing what a cup of cooked pasta looks like on your plate can give you a clearer idea of how much more you usually eat,” says Malik. “Often you can feel nourished and satisfied with less, when given the chance.”

Make sure you consult with your doctor before making any changes to your regular diet. Older men who have difficulty getting sufficient calories, and thus proper nutrients, and won’t benefit from unnecessary weight loss.

Daily calorie levels for men ages 51 and older

2,000 to 2,200 calories: Sedentary (only performs activities associated with typical day-to-day life)

2,200 to 2,400 calories: Moderately active (walks the equivalent of 1.5 to 3 miles a day at 3 to 4 mph)

2,400 to 2,800 calories: Active (walks the equivalent of more than 3 miles a day at 3 to 4 mph)

Source: National Institutes of Health.

Harvard Men’s Health Watch

Big Data Shows Big Promise in Medicine

In handling some kinds of life-or-death medical judgments, computers have already have surpassed the abilities of doctors. We’re looking at something like promise of self-driving cars, according to Zak Kohane, a doctor and researcher at Harvard Medical School. On the roads, replacing drivers with computers could save thousands of lives that would otherwise be lost to human error. In medicine, replacing intuition with machine intelligence might save patients from deadly drug side effects or otherwise incurable cancers.

Consider precision medicine, which involves tailoring drugs to individual patients. And to understand its promise, look to Shirley Pepke, a physicist by training who migrated into computational biology. When she developed a deadly cancer, she responded like a scientist and fought it using big data. And she is winning. She shared her story at a recent conference organized by Kohane.

In 2013, Pepke was diagnosed with advanced ovarian cancer. She was 46, and her kids were 9 and 3. It was just two months after her annual gynecological exam. She had symptoms, which the doctors brushed off, until her bloating got so bad she insisted on an ultrasound. She was carrying six liters of fluid caused by the cancer, which had metastasized. Her doctor, she remembers, said, “I guess you weren’t making this up.”

She did what most people do in her position. She agreed to a course of chemotherapy that doctors thought would extend her life and offered a very slim chance of curing her. It was a harsh mixture pumped directly into her abdomen.

She also did something most people wouldn’t know how to do — she started looking for useful data. After all, tumors are full of data. They carry DNA with various abnormalities, some of which make them malignant or resistant to certain drugs. Armed with that information, doctors design more effective, individualized treatments. Already, breast cancers are treated differently depending on whether they have a mutation in a gene called HER2. So far, scientists have found no such genetic divisions for ovarian cancers.

But there was some data. Years earlier, scientists had started a data bank called the Cancer Genome Atlas. There were genetic sequences on about 400 ovarian tumors. To help her extract useful information from the data, she turned to Greg ver Steeg, a professor at the University of Southern California, who was working on an automated pattern-recognition technique called correlation explanation, or CorEx. It had not been used to evaluate cancer, but she and ver Steeg thought it might work. She also got genetic sequencing done on her tumor.

In the meantime, she found out she was not one of the lucky patients cured by chemotherapy. The cancer came back after a short remission. A doctor told her that she would only feel worse every day for the short remainder of her life.

But CorEx had turned up a clue. Her tumor had something on common with those of the luckier women who responded to the chemotherapy — an off-the-charts signal for an immune system product called cytokines. She reasoned that in those luckier patients, the immune system was helping kill the cancer, but in her case, there was something blocking it.

Eventually she concluded that her one shot at survival would be to take a drug called a checkpoint inhibitor, which is geared to break down cancer cells’ defenses against the immune system.

At the time, checkpoint inhibitors were only approved for melanoma. Doctors could still prescribe such drugs for other uses, though insurance companies wouldn’t necessarily cover them. She ended up paying thousands of dollars out of pocket. At the same time, she went in for another round of chemotherapy. The checkpoint inhibitor destroyed her thyroid gland, she said, and the chemotherapy was damaging her kidneys. She stopped, not knowing whether her cancer was still there or not. To the surprise of her doctors, she started to get better. Her cancer became undetectable. Still healthy today, she works on ways to allow other cancer patients to benefit from big data the way she did.

Kohane, the Harvard Medical School researcher, said similar data-driven efforts might help find side effects of approved drugs. Clinical trials are often not big enough or long-running enough to pick up even deadly side effects that show up when a drug is released to millions of people. Thousands died from heart attacks associated with the painkiller Vioxx before it was taken off the market.

Last month, an analysis by another health site suggested a connection between the rheumatoid arthritis drug Actemra and heart attack deaths, though the drug had been sold to doctors and their patients without warning of any added risk of death. Kohane suspects there could be many other unnecessary deaths from drugs whose side effects didn’t show up in testing.

So what’s holding this technology back? Others are putting big money into big data with the aim of selling us things and influencing our votes. Why not use it to save lives?

Bloomberg View

School Students Develop Portable System to Diagnose Eye Diseases

London- High School students have invented a device that can detect signs of degenerative eye disease, especially for patients with diabetes.

The Eyeagnosis system uses a 3D-printed lens and an AI-enabled smartphone app to diagnose diabetic retinopathy.

Kavya Kopparapu and her team—including her brother, Neeyanth, and her high school classmate Justin Zhang developed this system because her grandfather, who lives in a small city on India’s eastern coast, began exhibiting symptoms of diabetic retinopathy in his eye.

The system is expensive and according to “TechCrunch” the “A 3-D-printed mount and lens lets retinal scans be taken with the phone, and a machine learning system using readily available services and trained on thousands of such images does the diagnosis.”

The work was presented at an O’Reilly Artificial Intelligence Conference, and was considered by experts as the first of its kind to be fully equipped and cheap.

Some scientists believe that of 415 million diabetics worldwide, one-third will develop retinopathy, while fifty percent will be undiagnosed.

Weight-Loss Devices: How They Work

A man crosses a main road as pedestrians carrying food walk along the footpath in central Sydney, Australia

Stomach balloons and other devices may help people eat (or absorb) less food. But does the weight loss last?

For the millions of Americans who have obesity, the burden of excess weight is much more than meets the eye. This chronic, debilitating condition leaves people prone to many serious illnesses, including heart disease. But for many, diet and exercise often prove frustratingly futile (see “What’s a healthy weight?”)

What’s a healthy weight?

The body mass index (BMI) estimates whether a person has a healthy (normal) or unhealthy amount of body fat (overweight or obesity). Calculate yours at www.health.harvard.edu/bmi. Weight-loss devices are approved for people who fall into the obesity category.

Surgically removing a particular part of the stomach, known as sleeve gastrectomy, spurs substantial weight loss. It also leads to dramatic improvements in type 2 diabetes and other problems closely linked to heart disease, such as high cholesterol and high blood pressure. Yet only about 1% to 2% of people who qualify for this and other forms of weight-loss (bariatric) surgery undergo it. Although one big issue is the high cost (at least $20,000) and variable insurance coverage, other concerns may be just as pressing.

“People are not just worried about having major surgery. They’re also scared by the thought of making a permanent change to their gastrointestinal anatomy,” says Dr. Ali Tavakkoli, co-director of the Center for Weight Management and Metabolic Surgery at Harvard-affiliated Brigham and Women’s Hospital. That’s why a less risky, nonpermanent intervention to aid weight loss appeals to some people, he says.

FDA-approved devices

Research in this realm is not new: the first gastric balloon — an inflatable sphere placed in the stomach to fill space — was approved in 1985. (It didn’t last long; some people developed intestinal blockages and other serious complications.) Since then, design advances have led to several safer, more effective gastric balloon systems.

These and two other FDA-approved devices (see “Weight-loss devices”) are intended to be used in tandem with healthy eating and exercise habits. The problem is that these devices don’t come close to the effectiveness of bariatric surgery, which usually helps people lose about 25 to 40% of their total body weight, says Dr. Lee Kaplan, who directs the Obesity, Metabolism, and Nutrition Institute at Harvard-affiliated Massachusetts General Hospital.

In clinical studies testing these devices, people in the comparison groups (diet and exercise alone) typically lose about 3% to 4% of their total body weight. The vagus nerve block adds only about 1% to that total, which makes this high-cost procedure hard to justify. Gastric balloons are slightly better, helping people lose another 4% to 5% of their original weight. But the balloons must be removed after six months, after which weight regain is common.

The stomach drain, which can be left in the body as long as needed, has the best results: an additional loss of about 8% to 9% of original body weight. As a result, it’s potentially the most promising of these devices, says Dr. Kaplan. “The downside is what many people call the ‘yuck factor,’ since it involves draining partly digested food from the stomach into a toilet,” he says.

His advice to people considering a device is to first try anti-obesity medications in consultation with a physician familiar with all the different drug options. On average, these drugs are as effective as gastric balloons, and doctors know much more about their safety and long-term effectiveness.

Weight-loss devices

These devices are FDA-approved.

Gastric balloons ( ReShape , Orbera , Obalon )

These balloons are placed through a flexible tube (endoscope) passed through the mouth into the stomach (Reshape and Obera) or by swallowing a capsule attached to a tiny catheter (Obalon). Once inflated with gas or fluid, the balloons leave less room in the stomach, so the person often feels full sooner and eats less.

Vagus nerve block (Maestro)

This device, which is surgically placed in the abdomen, periodically blocks nerve signals between the brain and the stomach. This apparently helps regulate hunger and fullness, although the exact mechanism isn’t clear.

External stomach drain device (Aspire Assist)

A surgically placed tube can drain part of the stomach contents outside of the abdomen, usually into a toilet. Doing so about 20 minutes after each meal allows people to eliminate up to 30% of the calories they consume.

(Harvard Heart Letter)

Stop Diabetes Before It Begins

Diabetes educator Cornelia Cristofor teaches how to perform a blood sugar test at the Nicolae Paulescu National Institute for Diabetes, Nutrition and Metabolic Diseases in Bucharest, November 13, 2012.

Millions have prediabetes and don’t know it. Here is why it’s important to find out and act to lower your diabetes risk. An estimated one out of three American adults is prediabetic, which means blood sugar levels are higher than normal but below the threshold for type 2 diabetes. Yet 90% of these people do not realize they are in this dangerous gray zone.

“You are not going to have symptoms for prediabetes,” says Dr. David Nathan, director of the Harvard-affiliated Massachusetts General Hospital Diabetes Center. “Instead, you or your doctor should determine if you have any of the common risk factors, get your blood sugar levels checked to determine if you have prediabetes, and then make the necessary lifestyle changes you need to stop type 2 diabetes from occurring.”

Who is at risk?

The term prediabetes can be somewhat misleading. It does not mean you will get diabetes, but only that you are at high risk. Without taking action, 15% to 30% of those with prediabetes will develop type 2 diabetes within five years, according to the Centers for Disease Control and Prevention (CDC). Type 2 diabetes makes you more vulnerable to heart disease, stroke, blindness, and kidney disease.

Some risk factors for prediabetes you cannot control — for instance, a family history of diabetes and certain ethnic backgrounds, like being African American, Latino, American Indian, Asian American, or Pacific Islander. Also, as you age, insulin secretion — which helps control blood sugar levels — naturally falls, as does your body’s ability to respond to insulin. After age 60, you have about 20% to 35% odds of being prediabetic compared with about 10% for adults younger than 60.

Steps for prevention

While you cannot control your family history, ethnicity, or age, you are not helpless to prevent diabetes if you are prediabetic. The Diabetes Prevention Program — the largest and longest prevention study — recommends that people who are prediabetic can lower their risk by following two guidelines: get more exercise and lose excess weight.

Get moving. There is no special exercise that can lower your risk, but research suggests that you don’t need long and hard workouts to see results.

In fact, a brisk walking program might be enough. A study published online July 15, 2016, by the journal Diabetologia found that among people diagnosed as prediabetic, those who followed a low-quantity, moderate-intensity exercise program — equal to about nine miles of brisk walking per week — lowered their blood sugar levels more than those who did more frequent and vigorous exercise.

“Any type of physical activity contributes to lowering weight and glucose levels, so find something that you enjoy doing on a regular basis,” says Dr. Nathan.

Watch your weight. Excess weight also contributes to lower insulin secretion and response. A study published online Feb. 6, 2017, by BMC Health looked at the relationship between weight and diabetes risk among more than 15,000 men. It found that those with a body mass index (BMI) of 25 to 29.9, which is classified as overweight, were twice as likely to get diabetes compared with normal-weight men. Obese men — those with a BMI of 30 or higher — were five times as likely.

You have a much lower risk of getting diabetes if you maintain a normal, healthy weight — a BMI of 18.5 to 24.9. In fact, losing 5% to 7% of your body weight, which would be 10 to 14 pounds for a 200-pound man, can help delay or prevent type 2 diabetes, according to the CDC. “The lower your BMI, the better,” says Dr. Nathan. “Even a healthy BMI of 22 will lower your risk more than a BMI of 24.”

While exercise can help you lose weight, a healthy diet is also key. There is no single type of diet that uniquely lowers your diabetes risk, adds Dr. Nathan. “The standard advice to eat a healthy, balanced diet remains sound, and the best weight-loss diets are those that you can maintain over time, so that the weight you lose stays off,” he says. Consult with your doctor to review your diet. He or she also can refer you to a dietitian to help create a diet plan you can follow.

Get tested for prediabetes

Everyone over age 45 should be tested for prediabetes, experts say. The simple blood test for glycosylated hemoglobin, or HbA1c, shows what your average blood sugar levels have been over the past three months.

Normal: HbA1c below 5.7%

Prediabetes: 5.7% to 6.4%

Diabetes: 6.5% or higher

(Harvard Men’s Health Watch)

Yoga as Good for Low Back Pain as Physical Therapy

yoga

London – Chronic lower back pain is equally likely to improve with yoga classes as with physical therapy, according to a new study.

Twelve weeks of yoga lessened pain and improved function in people with low back pain as much as physical therapy sessions over the same period.

“Both yoga and physical therapy are excellent non-drug approaches for low back pain,” said lead author Dr. Robert Saper, of Boston Medical Center.

About 10 percent of U.S. adults experience low back pain, but not many are happy with the available treatments, Saper and colleagues write in the Annals of Internal Medicine.

The American College of Physicians advised in February that most people with low back pain should try non-drug treatments like superficial heat or massage before reaching for medications.

Physical therapy is the most common non-drug treatment for low back pain prescribed by doctors, according to Saper and colleagues. Yoga is also backed by some guidelines and studies as a treatment option, but until now no research has compared the two.

For the new study, the researchers recruited 320 adults with chronic low back pain. The participants were racially diverse and tended to have low incomes.

The participants were randomly assigned to one of three groups. One group took part in a 12-week yoga program designed for people with low back pain. Another took part in a physical therapy program over the same amount of time. People in the third group received a book with comprehensive information about low back pain and follow-up information every few weeks.

At the start of the study, participants reported – on average – moderate to severe functional impairment and pain. More than two-thirds were using pain medications.

To track participants function and pain during the study, the researchers surveyed them at six, 12, 26, 40 and 52 weeks using the Roland Morris Disability Questionnaire (RMDQ).

Scores on the RMDQ measure for function declined – meaning function was improving – by 3.8 points over the 12 weeks in the yoga group, compared to 3.5 points in the physical therapy group. Participants who received education had an average RMDQ score decline of 2.5.

The improvements among the people in yoga and physical therapy groups lasted throughout the year, the researchers found.

“If they remain the same after one year, it’s a good bet that their improvement will continue on,” Saper told Reuters Health.

Drug That Creates a ‘Real Sun-tan’

sun

London – Scientists have developed a drug that mimics sunlight to make the skin tan, with no damaging UV radiation involved.

The drug tricks the skin into producing the brown form of the pigment melanin in tests on skin samples and mice.

Evidence suggests it will work even on redheads, who normally just burn in the sun.

The team at Massachusetts General Hospital hope their discovery could prevent skin cancer and even slow the appearance of ageing.
Potent tan

UV light makes the skin tan by causing damage.

This kicks off a chain of chemical reactions in the skin that ultimately leads to dark melanin – the body’s natural sunblock – being made.

The drug is rubbed into the skin to skip the damage and kick-start the process of making melanin.

Dr David Fisher, one of the researchers, told the BBC News website: “It has a potent darkening effect.

“Under the microscope it’s the real melanin, it really is activating the production of pigment in a UV-independent fashion.”

It is a markedly different approach to fake tan, which “paints” the skin without the protection from melanin, sun beds, which expose the skin to UV light or pills that claim to boost melanin production but still need UV light.

But the team is not motivated by making a new cosmetic.

Dr Fisher said the lack of progress in skin cancer – the most common type of cancer – was a “very significant frustration”.

He added: “Our real goal is a novel strategy for protecting skin from UV radiation and cancer.

Tests, detailed in the journal Cell Reports, have shown the melanin produced by the drug was able to block harmful UV rays.