Tuesday, January 30, 2007

Stress 'harms brain in the womb'


Image of a baby
Infants were anxious and fearful
Children whose mothers were stressed out during pregnancy are vulnerable to mental and behavioural problems like ADHD, mounting evidence suggests.

Latest UK research by Professor Vivette Glover of Imperial College London found stress caused by rows with or violence by a partner was particularly damaging.

Experts blame high levels of the stress hormone cortisol crossing the placenta.

Professor Glover found high cortisol in the amniotic fluid bathing the baby in the womb tallied with the damage.

The babies exposed to the highest levels of cortisol during their development had lower IQs at 18 months.

The same infants were also more likely to be anxious and fearful, she told a conference of the Royal College of Psychiatrists.

About a million children in the UK have neurodevelopmental problems - ADHD, cognitive delay, anxiety and so on.

About 15% of this might be due to antenatal stress.

Professor Glover

Professor Glover said: "We looked at what stresses were most harmful.

"We found that if the woman had a partner who was being emotionally cruel to them while they were pregnant it had a really significant effect on their baby's future development.

"It really shows that the partner has a big role to play."


Read more . . .

Depression amid Chronic Disease

By: Psych Central News Editor
on Monday, Jan, 29, 2007

Reviewed by: John M. Grohol, Psy.D.
on Monday, Jan, 29, 2007


Receiving the diagnosis of a chronic disease or cancer is a traumatic, life-changing event. Unfortunately, the mental health effect of the incident is often obscured by attention to the physical disorder and the inability to determine “appropriate sadness” from clinical depression.

Researchers have developed a new tool to detect depression that will improve patients’ ability to come to terms with their disease.

Depression affects 25 percent of patients with advanced cancer – the stage at which the disease has begun to spread from its original tumor. At this stage, depression is difficult to diagnose as symptoms can be confused with a patient displaying ‘appropriate sadness’ – feelings which commonly result from suffering a terminal illness.

Accordingly, a University of Liverpool research team has created a method of testing for depression so clinicians can introduce additional treatment to enable patients to cope with the cancer more effectively. The tool could also be applied to sufferers of other serious illnesses such as Parkinson’s Disease and chronic heart disease.

Based on a screening system originally developed for sufferers of post-natal depression, the new tool - known as the ‘Brief Edinburgh Depression Scale’ (BEDS) - includes a six-step scale that assesses a cancer patient’s mental condition. The test includes questions on worthlessness, guilt and suicidal thoughts.

Read more . . .

Wednesday, January 24, 2007

Seek Help if “SAD”

By: Psych Central News Editor
on Wednesday, Jan, 24, 2007

Reviewed by: John M. Grohol, Psy.D.
on Wednesday, Jan, 24, 2007


Many believe feeling down or gloomy during the winter months is just a part of life. In fact, a decline in sunlight has been linked to development of seasonal affective disorders (SAD). In a new study, some researchers now believe developing SAD can be a subtype of major depression and should be treated as such.

Lead author Stephen Lurie, M.D., Ph.D., an assistant professor of Family Medicine at the University of Rochester Medical Center, also noted that SAD is sometimes missed in the typical doctor’s office setting.

“Like major depression, Seasonal Affective Disorder probably is under-diagnosed in primary care offices,” Lurie said. “But with personalized and detailed attention to symptoms, most patients can be helped a great deal.”

New, preliminary studies link SAD to alcoholism or Attention Deficit Hyperactivity Disorder (ADHD). However, not all people with SAD will have ADHD, according to the review article for the American Academy of Family Physicians.

Read more . . .

Interesting. . . SAD and ADHD are linked.

Weird Episode

Just had a very weird episode. Not the first, maybe the 6th in about as many months, one yesterday. I feel really, really bad. Instead of beating, my heart feels like it is "squishing" and I feel like it's hard to breath. . like there is water in my lungs. There are various muscular pains in my back and chest and I get nauseated and dizzy.

This time I leaned back in my chair and when I stretched to give my lungs more room to get air, there was a good deal popping and there was a bit of easing of the pain. In some ways the symptoms are similar to what women who have survived heart attacks say they endured . . otoh, stretching and breathing seems to alleviate the pain. I still feel like someone is pressing a finger into my back about heart level and to the left of my spine. And the stress has caused all the muscles in my mid-section, which I had gotten to relax more lately, to tense up.

Interesting. We'll have to see if anything comes of this.

Tuesday, January 23, 2007

Withdrawal Update

I keep forgetting to mention all the problems I'm having going off the Cymbalta, as I usually put it in my private blog as "emotional" problems. Here is a list was the problems I'm experiencing:
  • insomnia
  • tinnitis
  • dizziness
  • "twitches" in brain and eyes
  • mood swings (could be impending menopause as well . LOL)
I also have . . . .not binges, but it's about being really hungry not about emotionally needing food for comfort. I did not walk this morning, but I did yesterday. I was just too tired. Couldn't get to sleep until after midnight and slept poorly. I really really wish I could figure a way to keep a log that I will stick with, as I'm pretty sure I could identify the triggers to poor sleep.

Increased Bone Risk Associated With Anti-Depressants

A study published Monday demonstrated a significantly increased risk of broken bones in adults 50 years and older who were taking a type of popular antidepressant, called selective serotonin reuptake inhibitors or SSRIs. Zoloft and Prozac are two popular brands of antidepressants studied. People aged 50 and older who took the antidepressants faced double the risk of broken bones during five years of follow-up, compared with those who didn’t use the drugs, the study, which appeared in today’s Archives of Internal Medicine, found.

Antidepressants have also been linked with low blood pressure and dizziness leading to falls, which can increase risks for broken bones, but the researchers said they found fracture risks independent of those factors.

The study tracked 5,008 Canadians aged 50 years old and older for five years. They included 137 people who reported using SSRI antidepressants daily. In this smaller group, 18 people or 13.5 percent had bone fractures during the follow-up, compared with 317 people with fractures or 6.5 percent among the 4,871 who didn’t take the pills. Broken forearms, ankles, feet, hips and ribs were the most common fractures.

read more > > >

Wednesday, January 17, 2007

Does High-Fructose Corn Syrup Have to Be in Everything?

In her recent article on cholesterol, Karen De Coster provided information that should be beneficial to anyone interested in staying healthy. In this piece I want to address a similar issue. The title says it all. Why, in the name of health, do so many foods marketed to the U.S. public include high fructose corn syrup? Even the most cursory search of the many health sites on the Internet yield a veritable cornucopia of negative information about this stuff.

The Usual Suspect – Again

Of course the culprit for the presence of high fructose corn syrup (HFCS) in all sweetened foods in the U.S. is the state. The mechanism is the incredibly high tariff on sugar produced in other countries. The U.S. government would rather force manufacturers to use inferior and hazardous high fructose corn syrup, which can be created from corn – a crop grown in the U.S. – than allow them to use more natural sugar from places that seem rather obvious. I don’t know about you, but when I think of sugar, I think of sugar cane in South America, but when the USDA thinks of sugar, apparently they think of cornfields in Nebraska!

But Really, Who Cares?

What if corn sweetener is just as good as sugar from cane in South America? Wouldn’t it make sense to support our "local" producers? Well, no, not with legislation. If corn sweetener were really better than cane sugar, legislation artificially inflating our price for cane sugar would not be needed. Read that sentence again, because that is about the size of it. Whenever the state gets involved to force the market to take a particular path it is only because the path chosen by the state would not otherwise be taken by anyone intelligent enough to decide on his own. Period.

On the other hand, what if corn sweetener is not just as good as sugar from cane? Well, Houston, then we have a problem! According to experts such as Mehmet Oz and Michael Roisen, high-fructose corn syrup is a horrible sweetener. In their landmark book, "You: The Owner’s Manual…," they state:

"One of the biggest evil influences on our diet is the presence of high-fructose corn syrup (HFCS), a sugar substitute that itself is a sugar found in soft drinks and many other sweet, processed foods. The problem is that HCFS inhibits leptin secretion, so you never get the message that you’re full. And it never shuts off gherin, so, even though you have food in your stomach, you constantly get the message that you’re hungry." (See page 192.)

With apologies to the Church Lady, "Well, isn’t that special?" So the state forces us to consume a sweetener that’s obviously not as good for us, just so their constituents can sell more, make more money, and vote en bloc for the legislator who visits this evil on the rest of us. Sounds like yet another example of misplaced incentives.

Other Sweeteners – Same Problem

Those of us who are "into" health know all about stevia. This is a very powerful natural sweetener, extracted from South American plants much as sugar is extracted from cane. One can find stevia in health food stores, but it is not allowed as an ingredient in processed foods. Why not? The typical statist would say "because it is not shown to be proven safe and effective" which is FDA-speak for "because we didn’t say you could use it." Call me a conspiracy realist, but I doubt that "safe and effective" had much to do with the FDA deciding to ban stevia. Nothing drives this point home better than this little tidbit: the FDA initially labeled stevia as an "unsafe food additive" after an anonymous complaint. (Yes, an anonymous complaint!) You simply cannot make this stuff up.

But stevia has been used by other cultures for thousands of years with no ill effects. Yes, thousands of years. If it’s so dangerous, why are we in the U.S. alone on Earth in recognizing the danger? In Japan the government will not allow artificial sweeteners in soft drinks, so they use stevia instead. In fact, it accounts for 40% of the Japanese sweetener market. In the U.S. the government won’t allow stevia, but we get a heaping helping of Aspartame, Sucralose, and all manner of other chemical junk. Where is the logic? (Maybe I should just follow the money.) Interestingly, many of the sweetening chemicals we're allowed to have as additives come with warning labels, by the way, so the government considers it established that there are health problems with those.

Conclusion

The decisions we each make about what we eat are some of the most basic ones we'll ever encounter. But in the case of HFCS – just as one example – we in the U.S. aren’t given that choice. The FDA claims to "protect" us from snake-oil salesmen of every stripe, yet when it comes to being able to choose an item of food that is among the most basic and prevalent in any diet, economic considerations trump safety. From my standpoint, while this about par for the course, it is still darned unsettling.

Source

Spouse's Personality May Be Hazardous To Your Health

Gwenny: They needed a study to learn this? Just more proof that being intelligent doesn't make you smart.

Science Daily To the long list of things to consider when choosing a mate, there is now evidence suggesting that your spouse's personality can have a major influence on your own ability to recover from - and perhaps even survive - a major challenge to your health.It is a finding drawn from a study by a team of researchers including John M. Ruiz, an assistant professor of psychology at Washington State University, as well as Karen A. Matthews and Richard Schulz, at the University of Pittsburgh, and Michael F. Scheier with Carnegie Mellon University.

The study involved 111 coronary artery bypass patients and their spouses. The researchers assessed aspects of personality, symptoms of depression, and the marital satisfaction of each patient and his spouse prior to, and 18 months following, surgery.

The main finding was that within couples, the personality of one person predicted the depression level of their partner 18 months later. The results were published in the most recent issue of the Journal of Personality and Social Psychology.

"We've known for some time that a patient's personality and mood before surgery influence their own mental and physical recovery following surgery," Ruiz said. "We also know that a partner's personality and mood can affect us in the short term. What this work shows is that a partner's personality traits are also important determinants of our own long-term emotional and physical recovery from a major health challenge."

The research demonstrated that a patient married to a generally neurotic and anxious spouse was more likely to report symptoms of depression 18 months after surgery.

"In other words, the spouse's personality - quite independent of the patient's own personality - exhibited a major influence on how well the patient was feeling and progressing towards recovery," he said.

Depression is an important consideration in the treatment of cardiac patients as it is increasingly recognized as a significant risk factor in heart attacks and death.

"Our study suggests that there's a distinct possibility that the spouse's personality can increase depression which may then lead to these negative physical outcomes. It's an issue we will be looking at as we continue to follow these patients and as part of new studies here at WSU."

The study also focused on how the spouses of patients coped over the course of the study.

"Spouses are often times a major source of daily care and take on many of the roles that the couple may have previously shared," Ruiz said. "We found that the same effects seen for patients also applied to spouses. Those spouses who cared for a person who was generally neurotic and anxious were more likely to report symptoms of depression as well as high levels of caregiving burden and strain a year and a half later."

"We don't really understand what it is that a spouse with these negative personality traits is doing to cause this depression in their partner," he said. "Are they creating more stress, being less helpful, or burdening a person who is already having a difficult time with their own needs? It's a question that needs more study."

Ruiz notes that not all of the findings were negative. Optimism in one spouse appeared to have beneficial effects for the partner.

"Spouses caring for an optimistic, as opposed to a pessimistic, patient reported fewer depressive symptoms and significantly less burden and strain over time."

But Ruiz points out that we are hardly helpless when it comes to our spouse's personality and how it affects us. He said there is a "silver lining" in the findings, which suggests that a person's degree of satisfaction with their marriage is a key influence.

"Being married to a neurotic, anxious person was only harmful for those who were unhappy in their marriage," Ruiz said. "For those happy in their marriage, spouse neuroticism appeared to have little influence. Hence, the findings highlight the importance of personality in marriage and health, but also support the notion that 'love conquers all."

Tuesday, January 16, 2007

The Big Fat Fix

Obesity is a problem that is chronic, stigmatised, costly to treat and rarely curable. Why? Because we are looking in the wrong places for a solution.

Open a newspaper and on any given day you can usually find a story about the growing number of overweight and obese people throughout the UK, and indeed the world. Obesity is now officially an ‘epidemic’. GPs are ‘alarmed’. The Department of Health is ‘concerned’. And dozens of local authorities are gearing up to ‘do something about it’.

The figures are shocking. Globally the prevalence of overweight and obesity has increased steadily since 1970. In August of this year, it was reported that the number of overweight people in the world has topped one billion, considerably outnumbering the 800 million who are undernourished.

It’s not just an aesthetic problem. Obesity is a health risk associated with higher rates of diabetes, heart disease and cancer. In the UK, 43 per cent of men and 34 per cent of women are overweight and one in four adults, and one in 10 children under 15, are obese. The direct cost to the NHS is £480 million. The indirect costs are estimated to be in
the region of £2.5 billion per year, including costs to the NHS and costs to industry through sickness and absence. In the US, medical expenses for overweight and obesity accounted for 9.1 percent of total US medical expenditures in 1998, costing around $78.5 billion (equivalent to $92 billion today).

Most reports in the media trot out the same causes – the gluttony and sloth of modern society – and the same old solutions – eat less and exercise more. And yet if weight loss was simply a matter of cutting calories and being more active then our population should be in pretty good shape. At any given time as much as 50 per cent of the population in the UK is on a diet and/or exercise regime.

But one recent report contained a signpost to a truth about obesity that was nonetheless missed by almost everyone who read it. In September of this year a ‘fat map’ of Britain was published by Dr Foster Intelligence, an independent health research organisation that works closely with the NHS, and Experian, a market research company.

The analysis was a complex synthesis of data from two surveys – the Health Survey for England and the British Market Research Bureau’s quarterly survey of 25,000 Britons – that provided details of lifestyle, body mass index (BMI, an indication of how overweight a person is) and geographical location. Its conclusion was that people living in northern industrial towns were fatter than those living in London and more rural areas of the UK.

Across the board the reportage was unremarkable. The results, after all, echoed those of a survey produced by Experian two years ago. Having heard it all before, the newspapers avoided original analysis and focused instead on the marvels of modern technology that allow us to pinpoint, down to a street, the places where the fattest people live.

A rent-a-quote from Dr Foster Intelligence about the threat of obesity, and the benefits of surveys like this one, made all the papers: “We need to reduce levels of obesity, and detailed health maps like these show where the risks of obesity are highest,” commented the organisation’s marketing development manager, Dr Marc Farr. “This will enable
health authorities to target weight-loss drives in areas where this is a problem. Until now they have not had access to this accurate database; this should make a difference.”

At first it may be difficult to see how knowing where people are fattest will make a dramatic difference to the problem of obesity. Surely the real question that needs answering is why are we so fat? On this point, Farr fell back on mainstream thinking to conclude: “The reasons for obesity [in these northern towns] are not uncommon and shared by many areas: availability of cheap, high sugar food products, unemployment, age-related failure to engage in physical activity, understanding the nature and dangers of obesity and changes to more sedentary forms of employment.”

This oft-repeated explanation, of course, has some merit but misses the vital point; that the where and the why of being overweight are intricately linked.

Urban Fatties

The reductionist explanation for the increase in overweight and obese individuals is a simple equation: calories in/calories out. A more global view, however, would acknowledge the multifaceted effect of urbanisation and industrialisation, which have had a devastating impact on what we eat, when we eat, how much we eat, how often we eat
and the quality of the food we eat, as well as on our levels of daily physical exertion.

In the West these simple ‘whys’ of obesity are rarely questioned anymore and have become largely obscured by the solution-oriented focus of quick weight-loss schemes. But in developing nations the startling parallel between the rise in obesity and the rapid acceptance of urban/industrial lifestyles and diets is all too apparent.

Speaking in September at the International Congress on Obesity in Sydney Dr. Philip James, the British chairman of the International Obesity Task Force (IOTF), noted that in China the rate of obesity has risen from almost zero in the 1980s to about 10 percent of the population in 2006, and that the rise can be pinned down to the growing problems of urbanisation and the infiltration of a generally nutritionally poor Western diet, which favours high-fat, high-energy products over basic fruits and vegetables. Similar increases have been noted among more affluent urban dwellers in India.

Diet failures

And so we diet to fight the flab. Yet over and over again surveys show that the majority of people who lose weight on a given diet will subsequently regain that lost weight, and more besides. There is even evidence to suggest that dietary regimes that severely restrict calories as well as types of foods (fats, carbohydrates etc) in the short-term, actually encourage rebound weight gain over the long-term.

This rebound effect, which is well known to dieters and well documented in the medical literature, may have deep roots in human evolution. In our hunter-gatherer stage, when the next meal was not predictable, we became programmed to overeat when food was
available. In times of food deprivation (including when we diet), our hard-wiring changes. Our bodies develop mechanisms, largely driven by hormones, to store calories by over-riding signals of satiety and increasing hunger signals, even when food becomes plentiful again. In essence, the body is storing up calories in anticipation of the next period of food deprivation, even if it never comes.

According to the data, this effect is more dramatic when food and drink is freely available, when the foods available are calorie dense – such as crisps, sodas, Big Macs etc – and energy expenditure is low due to reduced physical activity.

Medical science has determined a biological basis for this storage effect. When we lose weight, our basal metabolic rate (BMR) – the minimum amount of energy the body requires at rest, to keep itself alive and to maintain weight at a constant ‘set point’ – decreases. BMR is related to the actual amount of body tissue so it naturally decreases when the amount of body tissue is reduced through dieting. Constant yo-yoing of weight through dieting and bingeing plays havoc with the body’s BMR and set point, in some cases wiping it out altogether, leaving the body with no blueprint for maintaining a healthy weight.

A more complex equation

In spite of the failure of conventional diets, the comforting equation of calories in/calories out still informs most weightloss initiatives, possibly because it makes the job of ‘doing something about it’ so effortless. Weight management programmes centred on this simple equation are easy to devise – anyone with a calculator, a calorie reference guide and an exercise manual can do it – and they shift the responsibility for the success or failure of the regime squarely onto the individual.

It’s an all too familiar scenario when faced with difficult cultural problems, where challenging the status quo could raise uncomfortable questions. Consider the way that individuals are encouraged to switch off standby electronics and change to energy efficient lightbulbs in order to ‘do something about’ climate change, or to recycle to end waste. Focusing on individual efforts – and failures – in this way deflects attention that away from bigger, and arguably more powerful influences, such as the government subsidies that keep polluting airlines and industries in business.

Nevertheless, the ongoing failure of ‘gold standard’ solutions like calorie counting has motivated some scientists to suggest that we must be missing something, and to look beyond the usual explanations. This year, a paper in the International Journal Of Obesity, for instance, attempted to explore the ‘roads less travelled’ in obesity research and suggested at least 10 additional causes of obesity that have nothing to do with gluttony and sloth.

The authors, made up of a panel of doctors from across the US, concluded that medical science had a tendency to “focus overwhelmingly on food-marketing practices and technology and on institution-driven reductions in physical activity (the ‘Big Two’), eschewing the importance of other influences.”

The panel went on to say that the influence of the Big Two on the global obesity epidemic is “largely circumstantial”, relying as it does on broad surveys – not unlike the recent Dr Foster report – rather than epidemiological data focused on individuals, or large randomised studies.

They further noted that the acceptance of the idea that too much food and too little exercise is the sole cause of obesity “…has created a hegemony whereby the importance of the Big Two is accepted as established and other putative factors are not seriously explored. The results may be well-intentioned, but ill-founded proposals for reducing obesity.”

In an effort to broaden the debate the authors recommended that other influential aspects of modern life (see box opposite) are influential. Among these and of particular relevance to the results of the Dr Foster survey, was exposure to hormone-disrupting pollutants – the kind you might find in excess in any industrial town in the North of the UK, where once there were mines, refineries, factories and tall chimneys belching out smoke and where now there are chemical factories, incinerators and waste transfer facilities regularly releasing toxins into the air, water and soil.

Hormone havoc

Hormones play a major role in determining and maintaining metabolism and the body’s set point. When levels of these hormones (produced by the thyroid, sympathetic nervous system and reproductive organs) deviate from the norm, problems with weight can ensue.

Thus in January 2004, at a conference titled Obesity: Developmental Origins and Environmental Influences, the US National Institutes of Health made an urgent call for more research on the link between hormone-disrupting chemicals and obesity, noting that exposure during adulthood and, crucially, in the womb, can permanently disrupt the body’s weight control mechanisms.

But, according to at least one scientist, if you look hard enough, the research is already out there. In 2002 Dr Paula Baillie-Hamilton, a visiting Fellow at the Occupational and Environmental Health Research Group, Stirling University, published a paper in which she proposed that chemical toxins were to blame for the global obesity epidemic.

Baillie-Hamilton’s hypothesis, the culmination of many years of forensic investigation into the way that pollution is changing us from the inside out, had its roots in an article she stumbled upon that explained how toxic chemicals in the environment were affecting the fertility of wildlife.

“I couldn’t understand how someone like myself, an academic with a load of scientific qualifications and papers behind me, had never heard of all these different chemicals that were out there. Yet if these chemicals were affecting the fertility of wildlife they must be affecting hormones significantly. And of course, hormones control a number of other functions in the body, including weight control.

“I spent a couple of years intensively identifying each major category of chemical and then working out how each individual substance affected the body’s weight control system. I looked at all the mechanisms involved, from the nerves and hormones to metabolism, and the levels of nutrients in the body, and found that the same chemicals that at high doses can cause weight loss, seemed to cause a fattening effect at very low levels – the same low levels that we are exposed to in everyday life.”

It was an arduous task made more difficult by the fact that weight gain is not always documented in trials of toxic chemicals. “For many years this data has been ignored or suppressed in the conclusions of scientific papers because there was no way to explain why it happened. And of course it wasn’t accepted at the time that weight gain in animals exposed to substances like DDT could be anything other than positive,” continues Baillie-Hamilton. “If weight gain was mentioned, it would be buried in the text of the paper, rather than the conclusion. Essentially what this meant was starting from scratch and reading through every single paper to find some mention of these effects.”

What else makes you fat?

Being overweight or obese is a modern problem and, as the results of a recent investigation in the International Journal Of Obesity show, many of the putative contributors to the problem have their roots in modern life. The authors suggest that even if some of these causes have only a small effect, they may interact with each other and with other factors in ways that greatly magnify their individual effects.

Sleep debt: Too many of us are getting too little sleep and the resulting ‘sleep debt’ can alter hormone levels and trigger an increase in body weight. Sleep debt is also associated with insulin resistance and diabetes, and with increased hunger and appetite.

Pollution: Hormones control body weight and many of today’s pollutants drastically alter levels of key hormones.

Air conditioning: We burn more calories when the environment is too hot or too cold for comfort. But more people than ever live and work in temperature-controlled homes and offices.

Decreased smoking: Smoking, because of its effects on circulation and the nervous system, reduces weight. In many developed countries people are smoking much less than they used to.

Prescription medications: Many different drugs – including contraceptives, steroid hormones, diabetes drugs, some antidepressants, and blood pressure drugs – can cause weight gain. Use of these drugs has risen exponentially in recent decades.

Population age and ethnicity: Middle-aged people and those of African and Hispanic origin have a tendency to be more obese than younger people of European descent. Throughout the world the population is getting older and more ethnically diverse.

Older mothers: There’s some evidence that the older a woman is when she gives birth, the higher her child’s risk of obesity. The average age at which a women has her first child is rising.

Ancestry and environment: Some health problems are passed down through the generations. A tendency towards gestational diabetes will produce a child prone to obesity (who are in turn more likely to produce obese children). Very high-fat diets during pregnancy have been shown, in animals, to skew the metabolism of offspring two generations down the line.

Obesity linked to fertility: Some evidence suggests that overweight and obese people are more fertile than lean ones. If obesity has a genetic component that makes it a dominant characteristic, the percentage of obese people in the population is likely to increase.

Unions of obese spouses: Obese women tend to marry obese men. If there are fewer thin people around – and if obesity is a dominant genetic characteristic – then these couples will produce obese children, who will then go on to produce more obese children.

A Chemical Cosh

Industrial chemicals – and specifically those that act like hormone disrupters – profoundly alter several aspects of human metabolism and appetite control. Research at the University of Laval in Quebec has added greatly to the understanding of just how wide-ranging the effects of an overpolluted body can be.

In the late 1990s Professor Angelo Tremblay and his team began to study, first in animals and then in people, the metabolic effects of organochlorines. Their interest was sparked by earlier Italian research which showed that overweight people who underwent gastric bypasses, to encourage weight loss, experienced dramatic increases in levels of the pesticide DDT and one of its breakdown products, DDE, in their blood as their bodyweight declined. The Laval studies of humans undergoing an average weight-loss programme also showed that concentrations of these chemicals rose as the pounds were shed.

Once in the body organochlorines and other industrial pollutants are generally stored in human fat cells. During weight loss the fat cells shrink and release these chemicals back into the bloodstream. The scientists at Laval found that as levels of these now freely circulating pollutants rose in dieters, levels of essential thyroid hormones – necessary for maintaining an efficient metabolism – fell dramatically.

A drop in basal metabolic rate (BMR) – the rate at which the body burns calories – is not uncommon in dieters. Studies into dieting show that as metabolism slows down during weight loss, levels of thyroid hormones also drop naturally. This slowdown is referred to as ‘adaptive thermogenesis’.

The worrying discovery of the Laval scientists was that higher levels of organochlorine compounds were associated with much lower levels of thyroid hormones than would be produced by weight loss alone. In dieters with these newly liberated toxins circulating throughout the body, BMR also slowed more dramatically, as did energy expenditure and levels of skeletal muscle oxidative enzymes (which determine how efficiently the muscles use energy – when levels are not optimum, energy gets stored as fat).

“If I were to put this in journalistic terms,” says Tremblay “I might say that the organochlorines essentially shut down the metabolic furnace that helps the body burn fat.”

Professor Tremblay’s research has focused on organochlorine compounds, for instance the pesticides DDT (and its breakdown product DDE), chlordane, aldrin, dieldrin and heptachlor, as well as PCBs, dioxins and chlorophenols. But the list of chemicals that can cause weight gain and promote obesity extends well beyond these to include a wide variety of everyday chemicals associated with manufacturing and a polluted environment (see Chemical calories, page 42).

A key effect, says Dr Baillie-Hamilton, is the way industrial pollutants interact with the sympathetic nervous system. This system releases hormones like adrenaline and noradrenaline that suppress our appetite, particularly for fat. These hormones also increase the ability and desire to exercise, as well as increasing body temperature, so that while you are exercising you are also burning calories more efficiently.

“Chemicals like organochlorines act directly on the sympathetic nervous system attacking each and every part of the way it works,” she explains. “It’s like a chemical cosh. They reduce levels of important hormones necessary for weight balance and also block and even destroy the hormone receptors in fat cells. This means the hormones can’t communicate with the fat cell and the cell becomes less sensitive to those metabolism-regulating hormones that are in circulation.”

Adapt and survive

Research at Laval continues to confirm that high circulating levels of organochlorines alter metabolism and may be one of the most important contributors to adaptive thermogenesis and the rebound weight gain so depressingly familiar to dieters.

But once liberated by weight loss these chemicals are also free to attack vital organs such as the brain, liver and kidneys, and this threat triggers an even more intriguing response. As chemicals build up beyond a level with which the body’s detoxification pathways can cope, the body begins to ‘dilute’ the amount of circulating toxins – the majority of which are fat soluble – by making new fat cells to store them in.

Recent evidence even suggests that the presence of some industrial pollutants such as bisphenol-A and organotins can signal dormant ‘baby’ fat cells, known as preadipocytes, to grow into fully mature fat cells, or adipocytes. As the number of fat cells increases it can become harder to keep weight down. In addition, with increasing weight the body detoxification system, which would normally facilitate the excretion of toxins, appears to shut down in preference to simply storing any toxins in available fat.

Professor Tremblay admits there is still much that is unknown about the way these chemicals interfere with metabolism. But, apart from triggering hormonal changes, the presence of organochlorines and other toxins can also act as inflammatory triggers.

Intelligent fat

Some physicians such as Dr. Leo Galland, author and internationally recognised expert in nutrition, believe industrial pollutants can also trigger allergies and allergic responses that can cause, or worsen, the problem of chronic systemic inflammation.

For Dr. Galland, it is the problem of chronic inflammation that is most relevant to rising levels of obesity. Inflammation, he argues, causes the body to release a range of chemicals that make the system resistant to the relatively recently discovered hormone, leptin. Professor Tremblay agrees that this is “entirely possible”.

The discovery of leptin 12 years ago in New York at the Rockefeller Institute changed the whole map of our understanding of obesity.

“Prior to that,” says Galland, “the way that everyone thought about fat was that it was just a bag of unused calories that was totally inert. The key thing about leptin is not just that it is a hormone that affects appetite, metabolism and fat stores. It’s that leptin is produced
by fat cells exclusively. So all of a sudden fat became an active player in the body. Really, fat is an organ and its function is just as intricate as any other organ in the body in that it interacts with the immune system, with the nervous system and with other systems
and can produce changes that can be very complex.”

Galland admits that the science is difficult, and yet some understanding of it is crucial if we are to get to grips with the problems of hard to shift overweight and obesity.

“Whenever there is inflammation, the cells respond by producing anti-inflammatory chemicals known as SOCS – suppressors of cytokine signalling. Two of these, SOCS1 and SOCS3, interfere with leptin by blocking the signal in the cells. The mechanism is very similar to the development of insulin resistance, which is also due to inflammation. In fact, inflammation also causes production of the fight or flight hormone cortisol from the adrenal glands. Cortisol blocks leptin and it also raises blood sugar, which in turn decreases the response to any given amount of insulin.”

The bigger picture of what these scientists are saying is staggering. Inflammation is fundamentally a protective process necessary, for instance, for wound healing as well as for curing infection. If inflammation arises in a polluted body it’s highly likely that it is a protective response to the presence of toxins.

Body fat also has a protective effect. For example, studies show that animals that are exposed to environmental toxins while at the same time encouraged to gain weight through a high calorie diet will survive better than exposed animals that are not allowed to gain weight. In other words, body fat, because it is a repository of these toxins, also becomes a survival mechanism. Thus it is possible that the obesity epidemic, as Tremblay postulated as far back as 2000, is in reality an adaptive response by the body to a chemically toxic environment.

The bigger picture

Viewed in this way, obesity could be seen as the response of an intelligent body trying to cope and maintain balance in an overwhelmingly polluted world. Sadly, in an environment where we are overwhelmed with pollutants, this intelligent adaptation is proving lethal and continued advice to simply decrease calorie intake dramatically in order to speed weight loss may even be making the problem worse.

Clinical practice has been frustratingly slow to catch up with the conceptual changes prompted by the link between environmental pollutants and obesity.

Says Dr Baillie-Hamilton, “There is still no academic textbook that brings it all together and it takes time to get through to people’s consciousness. If you are talking to an obesity specialist, whose professional life has been spent telling people that if they eat too much
and don’t exercise they are going to gain weight, he may not have a clue about the link between industrial pollutants and weight gain. And until the professionals do get a clue their conclusions, and the solutions they propose, will continue to be very limited.”

Dr Galland agrees. “There is a worldwide epidemic and it is definitely associated with industrialisation and pollution. And yes, of course, there may be confounding factors because industrialisation and pollution are also associated with dietary changes and changes in activity patterns. But the reality is that the results of most weight loss treatments are lousy and creative new approaches are urgently needed.”

To an intelligent health service the ‘fat map’ of Britain would be seen as a wakeup call, an opportunity to get to grips with a difficult and challenging problem. Instead, NHS and government advice remains stubbornly allied to the calories in/calories out equation. For example, the latest Department of Health (DoH) patient leaflet ‘Your Weight, Your Health’ makes clear that excess weight is due to ‘energy imbalance’, explains the number of calories needed per day, suggests ways to reduce the calories you take in each day and lists the benefits of being active.

Another booklet from the DoH, The Obesity Care Pathway, for health professionals advises much the same thing and suggests that a sensitive, empathetic, non-judgemental approach should underpin all obesity-related interventions – advice that is intended to complement the National Institute of Clinical Excellence (NICE) guidelines on the prevention, identification, assessment, treatment and weight management of overweight and obesity in adults and children due to be published this month (November).

Certainly, not blaming the victims when conventional diets fail would be a good first step. Given the available data on the environmental complexity of obesity this is rather like blaming the poverty striken of the world for being lazy and feckless, the victims of starvation for not having had the foresight to stock up on food, and the people murdered in the twin towers for going to work that day.

There also needs to be a much more comprehensive and honest focus on the double bind in which some of the nation’s poorest people find themselves in relation to good health. People in lower income brackets may already be subsisting on poor quality food that is high in sugar and fat and low in nutrition. Their general level of health will already be
compromised. Add the chemical cosh of industrial pollution to the mix and the metabolic and detoxification pathways that should be protecting the body may break down entirely.

Uncomfortable questions

There is also a need to address the obvious question of why the people in polluted cities like London and New York remain slimmer than those in industrial towns and cities. Given what is already known about polluted bodies, it is a fair bet that such research might show that being thin is not the only, or even the best indicator, of a healthy population. That the particulate pollution from traffic and lighter forms of industry in and around major capitals like these behaves in a distinct way in the body and causes its own kind of chemical chaos. New Yorkers and Londoners may be thinner, but are they also, for example, more infertile or more prone to allergies and asthma and generally more immune compromised?

What stands in the way of recognising the need for such solutions, says Professor Tremblay, is simply that the concept of industrial pollutants altering body chemistry invites far too many uncomfortable questions about the world in which we live. Most of these pertain to the economic consequences of acknowledging this issue.

“There is a global context here,” says Tremblay. “You see it with George W Bush’s position regarding the Kyoto agreement. He says it is out of the question to move towards any solution that might lead to what he sees as economic vulnerability. It’s the same with
obesity. The response is always framed by the politics and economics of addressing the reality, not by the potential health problems of exposure to substances like organochlorines.”

But just as the US President should be worried about global warming, he should also be worried about the fact that the ‘fat map’ of Britain was not unique to the UK. A just-published survey by the Trust for America’s Health found that the 10 fattest states in the US – Mississippi, Alabama, West Virginia, Louisiana, Kentucky, Tennessee, Arkansas, Indiana, South Carolina and Texas – were in located in the industrial South of the nation. The report failed to mention any aspect of environment, yet the Mississippi River, which runs through several of these states, is officially the most polluted river in the US. Likewise, West Virginia, Texas, Indiana, Alabama, Louisiana and Georgia are home to some of the top 20 mercury polluting power plants in the US. Fish and wildlife in some southern states like Alabama, Arkansas and Tennessee are regularly found contaminated by organochlorines like DDT and PCBs – due to the former production of these chemicals in these areas.

Instead of falling over ourselves to promote a lot of PC nonsense about not being judgemental about overweight and obesity, perhaps it would be more productive to acknowledge that the most pressing human problems, the biggest human disasters, don’t just apparate out of thin air. They evolve in the industrial, environmental and politcial milieu of modern life – and modern life can be a much dirtier business in certain parts of the country.

The health problems associated with polluted bodies are usually unseen. Some, like cancer or Alzheimer’s disease, can take decades to develop. The problems of overweight and of obesity offer us a rare and very visible cue that tells us that pollution is killing us, inch by everexpanding inch.

The recognition that chemical pollutants could have such a direct effect on our bodies is possibly one of the most important new ideas in public health; one which demands a difficult but necessary shift in our conceptual understanding of the dynamics of weight control. Allied to this there is an urgent need to acknowledge the way that our actions shape our environment and our environment, in turn, shapes our lives.

In July of this year members of the Women’s Institute in the UK took the initiative and dumped carloads of unnecessary food packaging back on the doorstep of supermarkets countrywide, with the message ‘you created this problem, now you clean it up’. The time has come to dump the problem of overweight and obesity back on the doorstep of industry and government with the same unflinching message.

Chemical Calories

In addition to organochlorines, a range of other industrial and everyday chemicals are known to encourage weight gain. These include:

ORGANOPHOSPHATES
Organophosphate pesticides, such as malathion, dursban, diazanon and carbonates, constitute 40 per cent of all pesticides used. These chemicals are mainly used inside buildings as opposed to in agriculture. They are neurotoxins and hormone disrupters.

CARBAMATES
Including aldicarb, bendiocarb, carbaryl, propoxur and thiophanate methyl, are used extensively in agriculture, forestry and gardening, and are suspected hormone disrupters.

ORGANOTINS
These chemicals, which include tributyltin (TBT) and the mono and dibutyltins (MBT, DBT), have many applications, including stabilisers in PVC and catalysts in chemical reactions. They are also found in glass coatings, agricultural pesticides, biocides in marine antifoulant paints and wood treatments and preservatives. They are damaging
to the thyroid and immune system and potential hormone disrupters.

BISPHENOL
A Estrogen mimic used to make clear, hard, reusable plastic products; also used in the manufacture of polymers, fungicides, antioxidants, dyes, polyester resins, flame retardants and rubber chemicals and some dental resins.

PHTHALATES
Hormone disrupting chemicals, produced in large volumes, and commonly detected in groundwater, rivers and drinking water as well as in meat and dairy products. Around 95 per cent of phthalate production over the last few decades is tied to the PVC industry. Can be found in many plastics and consumer products – everything from hair spray and nail varnish to plastic water bottles and tshirts.

POLYBROMINATED FLAMERETARDANTS
Added to many products, including computers, TVs and household textiles to reduce fire risk. Also found in baby mattresses, foam mattresses, car seats and PVC products. Office workers who use computers, hospital cleaners and workers in electronics-dismantling plants are at particular risk from these chemicals. Polybrominated flame-retardants are oestrogen mimics and can also affect the thyroid.

BENZO[A]PYRENE
A common food pollutant that belongs to a family of chemicals known as polycyclic aromatic hydrocarbons (PAHs). It is derived from coal tar and enters the atmosphere as a result of incomplete combustion of fossil fuels. In animals it has been shown to cause weight gain in the absence of any detectable change in food intake. It is possible that other PAHs may have a similar effect.

SOLVENTS
Neurotoxic chemicals that include xylene, dichlorobenzene, ethylphenol, styrene, toluene, acetone and trichloroethane are commonly found in human blood samples. Necessary for a wide range of industrial processes and found widely in adhesives, glues, cleaning fluids, paint and felt-tip pens, perfumes, paints, varnishes, pesticides, petrol, and household cleaners and waxes.

CADMIUM
Principally used as a protective plating for steel, in electrode material in nickel-cadmium batteries and as a component of various alloys. It is also present in phosphate fertilisers, fungicides and pesticides. Cadmium in the soil is taken up through the roots of plants and distributed to edible leaves, fruits and seeds, and eventually passed on to humans and other animals, where it can build up in milk and fatty tissues. Neurotoxic and a potential hormone disrupter.

LEAD
Professions that put their employees at risk of exposure to this neurotoxin include lead-smelting, -refining and -manufacturing industries, brass/bronze foundries, the rubber and plastics industries, steel-welding and -cutting operations, and battery manufacturing plants. Construction workers and people who work in municipal waste incinerators, in the pottery and ceramics industries, radiator-repair shops and other industries that use lead solder may also be among the high-exposure groups.

Better than Prozac

Treating depression with common food components might be as effective as using traditional drugs.

If you walked into your therapist's office and he told you to stop taking Prozac and start eating more fish, you'd probably think he was crazy. But a study has found that a combination of common food components might be as effective in treating depression as traditional drugs.

Scientists at Harvard-affiliated McLean Hospital looked at how uridine and omega-3 fatty acids could prevent depressive-like symptoms in laboratory rats. They found that each substance has antidepressant-like effects but together they are more effective than either is alone. It's a case of one plus one equals three.

Despite their powerful therapeutic effects, both uridine and omega-3 fatty acids are naturally occurring ingredients found in ordinary foods. Cold-water fish such as salmon and sardines are rich in omega-3 fatty acids, as are walnuts. Molasses and sugarbeets are good sources of uridine.

Researchers tested the two agents on rats that were forced to swim, a situation from which it was impossible to escape. It creates severe stress that induces a depression-like state of inaction and immobility. The stress, mediated by hormones, activates genes in key brain regions known to influence activity levels and mood.

When fed alone to rats, uridine had an immediate effect in relieving depression,; the rats became less immobile in the forced swim test. Omega-3 fatty acids also reduced indicators of immobility, but it took a solid month of steady consumption of dietary supplements containing omega-3 fatty acids for the animals to show signs of improved mood.

Researchers then performed another experiment in which they fed the rats normally ineffective amounts of uridine with supplements containing omega-3 fatty acids. After ten days of treatment, rats showed signs of reduced immobility, increased swimming and increased climbing.

No one is sure why the combination of uridine and omega-3 fatty acids is so effective at relieving depression, but the researchers have some theories. Uridine affects the synthesis of nerve cell membranes and their fluidity, which in turn has an impact on all transactions that must take place.

In addition, uridine influences the levels of neurotransmitters such as dopamine and norphinephrine. Both are important brain chemicals that effect mood, moobility and general arousal.

Omega-3 fatty acids are also known to affect the fluidity of nerve cell membranes. They may be affecting the ability of serotonin to dock at the cell membrane, the first step before it unloads its cargo. Serotonin is a neurotransmitter which plays an important role in depression, bipolar disorder and anxiety.

Indeed, it is possible that uridine and omega-3 fatty acids act like a good song and dance act. Uridine may rev up membrane synthesis and then the omega-3s are on hand to slip smoothly into the nerve cell membranes. There they can facilitate a whole range of processes, including improving the action of serotonin.

Membrane fluidity may be especially important for mitochondria, the little energy factories found inside all cells of the body, including nerve cells. Omega-3 acids seem to boost the flexibility of mitochondrial membranes while uridine delivers raw material for the mitochondrial furnace.

Monday, January 08, 2007

Starting over in 2007

Some cool stuff from my local paper

Instead of New Year's resolutions, which most of us aren't all that great at keeping, why not look for some areas in your life where you'd like to begin anew?

Here are some tools to make starting over a little easier and your new year a little more emotionally fit.


  • Starting over is not the same as recouping from a failure. It is a new beginning. This mindset is helpful because it keeps you from wasting your time being too hard on yourself.

  • Moving through life is like climbing stairs. You go up a step and then you level off. Nothing is ever a straight shot. Have some patience with yourself and with your newfound direction.

  • A new year is also a new decade and may be a new life if you approach it in the right way. Sometimes little ideas can turn into big things. Try writing that letter to the editor or, if you need to, make the choice to drink a little less alcohol.

  • Endings are not necessarily bad things. Even if the past year was your best so far, the one ahead might just leave it in the dust. This is also true if it's been your worst year so far, and you've suddenly found yourself unemployed or unattached.

  • Starting over may feel scary, but it's really a cause for celebration. Think of it as exciting, and many of your anxious feelings will begin to fade.

  • Remember that your future is not governed by your past. No matter what has happened in your life, you can find a way to make things a little better for yourself, and for those around you as well.

  • Having to start over is different from choosing to start over. For those whose lives are still in chaos because of manmade and natural disasters, starting over is not a choice. Giving support to those in need and being able to accept it when necessary are great qualities.

  • Healthy alternatives to negative lifestyle patterns abound. Take baby steps if you don't feel comfortable making all your changes at once. If you can't stop a bad habit, start by cutting back. It's okay to give yourself a little time to moderate or stop something that's hurting you.

  • It's not all about joining a gym to get fit. What about taking a dance class to get in shape and have fun at the same time? Starting over can mean chasing your dreams. We're happiest when we're moving toward a goal.

  • Starting over is about giving yourself a chance at real happiness. You will have to be brave and get good at learning new things, but how bad can that be? At the very worst, you will acquire the skills you need to start on the next project.


The new year is a great time to start over. Remember that once you honestly commit to the changes, you have already begun the process.

Dealing with change

Healthy behavior change, when it does happen, doesn't happen overnight, experts know. They have urged doctors to help patients understand this so they won't become discouraged so quickly and think they've failed.

On its Web site, the American Academy of Family Physicians (AAFP) posts a 2000 journal article describing a classic model of the steps involved in undergoing personal change. The "Stages of Change" model was developed by James O. Prochaska, co-author of "Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward" (Collins).

Here is an excerpt from the article posted on the AAFP site. The full text is available at http://www.aafp.org/afp/20000301/1409.html.

The Stages of Change model shows that, for most people, a change in behavior occurs gradually, with the patient moving from being uninterested, unaware or unwilling to make a change (precontemplation), to considering a change (contemplation), to deciding and preparing to make a change.

Genuine, determined action is then taken and, over time, attempts to maintain the new behavior occur. Relapses are almost inevitable and become part of the process of working toward lifelong change.

Precontemplation Stage. During this stage, patients do not even consider changing. Smokers who are "in denial" may not see that the advice applies to them personally. Patients with high cholesterol levels may feel "immune" to the health problems that strike others. Obese patients may have tried unsuccessfully so many times to lose weight that they have simply given up.

Contemplation Stage. During this stage, patients are ambivalent about changing. Giving up an enjoyed behavior causes them to feel a sense of loss despite the perceived gain. Patients assess barriers (for example, time, expense, hassle, fear, "I know I need to, doc, but ... ") as well as the benefits of change.

Preparation Stage. During this stage, patients prepare to make a specific change. They may experiment with small changes as their determination to change increases. For example, sampling low-fat foods may be an experimentation with or a move toward greater dietary modification. Switching to a different brand of cigarettes or decreasing the consumption of alcohol can signal a decision that a change is needed.

Action Stage. This stage is the one that most physicians are eager to see their patients reach. Many failed New Year's resolutions provide evidence that if the prior stages have been glossed over, action itself is often not enough. Any action taken by patients should be praised because it demonstrates the desire for lifestyle change.

Maintenance and Relapse Prevention. These steps involve incorporating the new behavior "over the long haul." Discouragement over occasional "slips" may halt the change process and result in the patient giving up. However, most patients find themselves "recycling" through the stages of change several times before the change becomes truly established.

Source