This same team of research workers recently demonstrated that inhibiting this nerve tract acted to block pain affiliated with gouty arthritis, an inflammatory case affecting the joints.

Inflaming also plays a scaled role in diabetes mellitus.

The writers of this research, released online December 21 in Nature Immunology, commenced their exploration with the NLRP3 inflammasome, which has been associated with dissimilar inflammatory disorders. Inflammasomes are clusterings of proteins that reason inflammation and play a function in the body’s innate immune reaction, excused Dr. Norma Kenyon, prof at the diabetes mellitus study establishment of the University of Miami Miller medical school. She is acquainted with the fresh discoveries.

“The inflammasome sense situations that are grievous to our body,” summed up research senior generator Jurg Tschopp, a prof at the University of Lausanne in Epalinges, Switzerland. “This admits pathogens (bacterium, viruses), but as well endogenous ‘risk situations,’ like uric acid crystals discovered in gout, high circling sugar discovered in diabetes mellitus or beta-amyloid discovered in Alzheimer’s disease.”

Until now, men of science were ineffectual to figure how out the NLRP3 inflammasome is activated. With that data now in hand, investigators might have additional assuring route to developing therapies for type 2 diabetes mellitus.

The chain of cases appears to begin with a protein addressed TXNIP, which, when exposed to oxidative tension, binds to NLRP3 and conduces the output of interleukin-1 beta or IL-1b, a resistant system formula.

Have lipid-lowering medicines substituted aspirin as the fresh wonder medication?Experts are apportioned. Heart surgeon Melissa Walton-Shirley, who controls a forum says she’s tickled about the amplified apply. “Any attempt towards bar is admirable. With Crestor, perhaps folks with excitement, referred to promote coronary artery disease, never have to build up artery plaque at all.” Food and Drug Administration consultative panel member Charles Mouton, nevertheless, voted against the label switch as, he assures me, he was concerned that the medication might be advertized to the wrong humans: younger folks at very low chance of building up heart disorder in the near future.

Then there’s that pecking chance of diabetes mellitus. The Jupiter research on which the expected label switch is grounded found that 2.8 percent of folks in the Crestor category developed diabetes mellitus equated with 2.3 percent of those who asked placebos. (That would portion to more than 30,000 fresh cases of diabetes mellitus if an another 6.5 million humans began taking lipid-lowering medicines.) The folks in the Jupiter test had the right cholesterol rates but high rates of C-reactive protein, an inflammation marking assessed via a blood examination.

Experts still cannot explicate why Crestor would multiply the likelihood of diabetes mellitus, but other study advises that the full class of lipid-lowering medicines seems to have this downside. An October research in diabetes mellitus care that examined tests using diverse kinds of lipid-lowering medications discovered a 13 percent multiplied chance in diabetes mellitus in the statin drug users. “What do you do if you’ve a medication that could be inducing a small deal of excess conditions of diabetes mellitus but is pointed in the same population to guard them from cardiovascular disorder and death rate?” states Allison B. Goldfine.

The pill, which contains the active ingredient rimonabant was approved last year in Europe where it sells under the brand name Accomplia. If approved in the US it will be marketed as Zimulti.

Rimonabant is a cannabinoid receptor antagonist; that is it blocks the cannabinoid type 1 (CB1) receptors in the brain that control hunger. So taking the drug reduces hunger and suppresses appetite. The drug may also help to control the urge to smoke, but approval is not being sought for this use.

As with all drug safety and efficacy reviews, the purpose of the panel meeting is to weigh up the benefits against the risks. On the benefits side there is now evidence that the 20 milligram a day version of Zimulti helped people to lose weight and reduce levels blood sugar, cholesterol, and fats.

On the risks side, the manufacturer has submitted results of clinical trials that showed an elevated risk of suicide and suicidal thoughts in patients who took Zimulti compared to those who took a placebo.In a recent shareholder meeting, the drug manufacturer emphasized that Zimulti/Accomplia is not a “cosmetic” for those seeking to lose a little weight to improve their shape or look slimmer. However, market experts are predicting that most of the consumers will be in this category.

In Europe the drug was approved for use under prescription only as part of a diet and exercise regimen for adult patients who are:

* Obese, that is with a body mass index (BMI) greater than or equal to 30 kg per square metre, or
* Overweight, that is with a BMI greater than equal to 25 kg per square metre and who also have one other risk factor, such as type 2 diabetes or abnormal levels of fat in their blood (dyslipidaemia).

For example, a person who is 5 feet 10 inches (1.78 m) tall and weighs 250 pounds (113 kg) is classed as obese and would qualify to receive the drug as part of an exercise and diet programme to lose weight. A person who is 5 feet 5 inches (1.65 m) tall and weighs 170 pounds (77 kg) is classed as overweight but not obese, so they would only qualify to receive the drug if they also had another risk factor, for instance if they had type 2 diabetes.

According to the Centers for Disease Control and Prevention (CDC), the prevalence for overweight and obesity among American adults and children has risen sharply since the 1970s. Among adults this figure has risen from 15 per cent of the populaton in the late 1970s to 33 per cent in the last few years. That means one in three adult Americans is overweight or obese.

Zimulti has been tested in four trials of 6,600 overweight and obese patients weighing on average between 94 and 104 kg ((207 to 229 pounds). The results of these trials were the basis for the European approval.

All four studies compared the effect of the drug on weight loss with that of a placebo for 12 to 24 months. One study looked in particular at the drug’s impact on blood fat and another on type 2 diabetes. A third study looked at how the weight loss could be maintained in the second year.

After one year, all patients on Zimulti lost more weight than the ones who took the placebo. They lost on average 4.9 kg (10.8 pounds) more than the placebo patients, except for the diabetic study where the weight loss compared with placebo was 3.9 kg (8.6 pounds). The drug also showed ability to reduce risk of putting weight back on.

Another set of trials have also been carried out in 7,000 patients to test the ability of the drug to help smokers quit. The durations ranged between 10 weeks and one year, and the outcome measures included cessation and relapses in the second year. However, the results from these trials were inconsistent and the company withdrew its European application for the drug to be considered as an aid for smoking cessation.

The manufacturer is continuing with post-market monitoring of the drug, which is being used in South America as well as Europe. Nearly 110,000 people have been prescribed the drug since the start of March this year.

Part of the submission to the FDA panel includes a risk management plan to which excludes the drug from being prescribed to patients with a psychiatric illness. People who suffer from epilepsy may also need to be careful.

When the FDA receives the panel’s decision it does not have to follow it, although in most cases it does. According to the manufacturer, the FDA will give its decision by the end of July.

However, experts following this story closely are suggesting that the FDA panel may ask for further data on the drug’s safety and this would delay the decision even further.

“Approximately 85 percent of women are affected by cellulite,” said John Kitzmiller, MD, ASPS Member Surgeon and study co-author. “Cellulite is not specific to overweight people, but excess weight may worsen the condition. We found that weight loss in overweight patients improved the appearance of cellulite, but for a few, it actually worsened the condition.”

The study examined 29 women who enrolled in medically supervised weight loss programs including low-fat meals, liquid diets, medication, and bariatric surgery. Seventeen patients experienced an improvement in the appearance of their cellulite, while 9 worsened. The average weight loss was 30.5 pounds (range 2.3 – 102 pounds).Patients who lost larger amounts of weight and lowered their percentage of thigh fat experienced the greatest improvement in cellulite. These patients had a significantly higher starting body mass index (BMI) and had more severe cellulite on average.

Patients whose cellulite worsened started with a significantly lower BMI, lost smaller amounts of weight, and had no change in percentage of thigh fat.

Skin elasticity after weight loss also played an important role in improving the appearance of cellulite. Cellulite worsened in those whose skin became significantly looser after weight loss.

“There is no answer for completely eliminating cellulite, however, it appears the more weight one loses, the better its appearance,” said Dr. Kitzmiller. “Although the appearance of cellulite diminished for the majority of patients, weight loss did not totally eradicate the condition. The dimples appear to be permanent features that lessen in depth as the pounds come off.”

For referrals to ASPS Member Surgeons certified by the American Board of Plastic Surgery, visit  plasticsurgery.org where you can also learn more about cosmetic and reconstructive plastic surgery.

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

The 12-week pilot study, led by Dr. Ken Fujioka, monitored weight and metabolic factors, such as insulin secretion, of the 100 men and women who participated in the Scripps Clinic ‘Grapefruit Diet’ study.

On average, participants who ate half a grapefruit with each meal lost 3.6 pounds, while those who drank a serving of grapefruit juice three times a day lost 3.3 pounds. However, many patients in the study lost more than 10 pounds.

‘For years people have talked about the grapefruit diet, and some even swear by it, but now, we have data that grapefruit helps weight loss,’ said Dr. Fujioka, principal researcher at the Nutrition and Metabolic Research Center at Scripps Clinic.

‘Our study participants maintained their daily eating habits and slightly enhanced their exercise routine; the only dietary change was the intake of Florida grapefruit and grapefruit juice.’Additionally, the research indicates a physiological link between grapefruit and insulin, as it relates to weight management. The researchers speculate that the chemical properties of grapefruit reduce insulin levels and encourage weight loss.

The importance of this link lies with the hormone’s weight management function. While not its primary function, insulin assists with the regulation of fat metabolism.

Therefore, the smaller the insulin spike after a meal, the more efficiently the body processes food for use as energy and the less it’s stored as fat in the body. Grapefruit may possess unique chemical properties that reduce insulin levels which promotes weight loss.

Obesity continues to plague the American public and the health system.

According to the National Center for Health Statistics, 64 percent of U.S. adults are considered overweight or obese. Overweight or obese people stand a greater likelihood of developing life-altering and/or life-threatening illnesses such as heart disease, cancer, diabetes, high blood pressure, high cholesterol, sleep apnea, arthritis, liver problems, and many others.

‘Our study shows grapefruit can play a vital role in overall health and wellness, and in battling America’s ever-growing obesity epidemic,’ stated Dr. Fujioka.

‘Whether it’s the properties of grapefruit or its ability to satiate appetites, grapefruit appeared to help with weight loss and decreased insulin levels leading to better health. It’s good the ‘Grapefruit Diet’ never lost its popularity among the public.’

The study linking grapefruit and grapefruit juice consumption to weight loss continues to broaden the health benefits associated with this citrus product.

Founded in 1924, Scripps Clinic is a multi-specialty, outpatient care facility caring for patients at multiple locations throughout San Diego County, California including Torrey Pines, Del Mar, Encinitas, La Jolla, Rancho Bernardo, Rancho San Diego, San Diego, and Santee.

Scripps Clinic and its physicians are world-renown for research-driven care and medical specialty expertise and is an operating unit of Scripps Health, a not-for-profit, community-based health care delivery network that includes more than 2,600 affiliated physicians, five acute-care hospitals, home health care and associated support services.

Scripps Health is one of the largest health care organizations in San Diego County, drawing from the expertise of more than 10,000 health care professionals.

“With the rapid increase in obesity rates in the U.S. and, subsequently, more people losing large amounts of weight, we are seeing more patients who want body contouring following massive weight loss,” said J. Peter Rubin, MD, Chair of the ASPS Post-Bariatric Task Force and co-author of the studies. “Because of this, the need to examine various demographics for differences in how these patients tolerate surgery is ever important to guarantee appropriate patient selection, safety and optimal results.”

The first study looked at 449 patients to see if having body contouring surgery while still obese and prior to reaching goal BMI would affect complication rates. The study found being obese did increase surgery complication rates for single body contouring procedures.

“As patient safety advocates, plastic surgeons should counsel their patients to wait for body contouring surgery until they reach their goal BMI,” said Dr. Rubin. “Body contouring yields excellent results in the appropriate patient. If waiting a little longer means ensuring safe surgery, then it’s worth it.”A second study examined 435 women and 48 men to assess whether gender impacted complication rates following body contouring. According to the study, men were at an increased risk for bleeding after surgery (hematoma) 12.5 percent and fluid collection (seroma) 25 percent, as opposed to 4.1 percent and 14.3 percent, respectively, of all patients.

“Hematoma and seroma are complications that can range in severity. Patients should know that plastic surgery is real surgery,” said Dr. Rubin. “We don’t know why men have slightly higher complication rates, so more research is necessary. However, this information is important to keep in mind when examining prospective patients.”

Finally, the authors examined whether there were complication differences in patients who lost weight (more than 50 pounds) via gastric bypass surgery (449 patients) as opposed to those who exclusively lost weight through diet and exercise (29 patients). The study found the differences in overall complication rates in these two groups were not statistically significant.

“The findings were not what I expected,” said Dr. Rubin. “Most plastic surgeons, including myself, would assume since nutritional status might be better in diet and exercise patients, they would have fewer complications than those who lost weight through gastric bypass. It shows how important it is to ask all massive weight loss patients, pre-operatively, about their nutritional status, lifestyle, participation in exercise programs and medical health.”

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Article adapted by Medical News Today from original press release.
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Nearly 67,000 body contouring procedures after massive weight loss were performed in 2007, according to the ASPS. More than 8,000 thigh lifts; 9,300 upper arm lifts; 19,500 lower body lifts and 30,000 breast lift/reductions were performed in 2007. Seventy-six percent of all thigh and upper arm lifts were performed following massive weight loss in 2007.

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 6,700 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 90 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

Source: ASPS Public Relations

In the course of the 12 week study, the 27 refractory weight loss patients underwent a single treatment: avoidance of foods that were shown to be immune reactive according to blood testing through a system known as the ALCAT test. The study participants showed an average weight loss of approximately 37 pounds plus an average drop of six points of BMI (body mass index) and an average decrease of 30% of body fat.

Dr. Fred Pescatore, former Medical Director of the famed Atkins Center and a pioneer in the study of the hormonal and immune system effects of foods, reviewed the findings and said, “I’m not surprised by these results, dramatic as they may appear. I’ve used the ALCAT test with my difficult patients time and time again, and it always works.”Other studies based on the elimination of food sensitivities had previously been reported. In a Baylor Medical College study 98% of subjects also displayed significant improved body composition and/or scale weight following an ALCAT test-based food elimination diet within four weeks. A matched control group that followed calorie restriction alone actually became fatter.

“When I first began to lecture to health professionals about how avoidance of food sensitivities helped the weight loss process, people looked at me like I had two heads,” says Roger Deutsch, co-author of the book, Your Hidden Food Allergies are Making You Fat. “Now we know that chronic inflammation, caused primarily by exposure to incompatible foods, is at the root of metabolic problems like diabetes, cardiovascular disease and obesity. The immune system chemicals block insulin receptors; so, guess what happens to the sugars we eat? – they get stored as fat. Cut the inflammation, cut the fat storage.”

Along with avoidance of food sensitivities, Deutsch and other experts also recommend paying attention to the quality of food eaten, getting adequate rest, exercise, and a healthy lifestyle.

About Cell Science Systems

Cell Science Systems (CSS) is a life sciences company and the worldwide market leader in food sensitivity testing as the maker of The ALCAT Test. ALCAT identifies cellular reactions to over 300 foods and chemicals. These inflammatory reactions are linked to chronic health problems like obesity and diabetes, as well as skin, heart, joint, and digestive disorders. Located in Deerfield Beach, Florida, CSS is a FDA-inspected and registered, cGMP medical device manufacturer and operates a CLIA-certified laboratory.

Source: Cell Science Systems

- Reversal of Type 2 diabetes “Because obesity is the primary risk factor for Type 2 diabetes, weight-loss surgery can have a profound impact on the condition,” says Dr. Nicholson. Published in the March 2009 issue of The American Journal of Medicine, a study revealed that 82 percent of patients who had weight-loss surgery reversed their diabetes in less than two years, and 62 percent remained diabetes free two years following surgery.

- Improved fertility Although most obese women are not infertile, according to the American Society for Reproductive Medicine, ovulatory functions and pregnancy rates frequently improve significantly after weight loss in obese women.- Improvement or elimination of hypertension A study published in the Journal of the American Medical Association in 2004 stated that hypertension was eliminated in 61.7 percent of weight-loss surgery patients and significantly improved in 78.5 percent of patients.

- Easing of joint pain Weight-loss surgery can ease the pain caused by the stress of extra weight on joints; a 2004 study showed the number of painful joints and other painful areas reported by the obese adults in the study was cut in half six to 12 months after weight-loss surgery. Plus, researchers in Austria have found that weight-loss surgery can help resolve the chronic inflammation associated with rheumatoid arthritis.

- Increased longevity Studies at the University of Alabama in Birmingham and at the Erasmus Medical Center in the Netherlands conclude that obesity can cut a person’s life span by up to 20 years. Researchers with the Pennington Biomedical Research Center have found that weight-loss surgery for severely obese patients appears to decrease overall mortality.

“Partnered with improved quality of life, the medical benefits of weight-loss surgery can’t be taken lightly; the surgery can truly lead to greater physical and emotional health and wellness,” adds Dr. Nicholson.

Source: Baylor Health Care System

Rates of obesity in the general population are skyrocketing, while in vegetarians, obesity prevalence ranges from 0 percent to 6 percent, note study authors Susan E. Berkow, Ph.D., C.N.S., and Neal D. Barnard, M.D., of the Physicians Committee for Responsible Medicine (PCRM).

The authors found that the body weight of both male and female vegetarians is, on average, 3 percent to 20 percent lower than that of meat-eaters. Vegetarian and vegan diets have also been put to the test in clinical studies, as the review notes. The best of these clinical studies isolated the effects of diet by keeping exercise constant. The researchers found that a low-fat vegan diet leads to weight loss of about 1 pound per week, even without additional exercise or limits on portion sizes, calories, or carbohydrates.“Our research reveals that people can enjoy unlimited portions of high-fiber foods such as fruits, vegetables, and whole grains to achieve or maintain a healthy body weight without feeling hungry,” says Dr. Berkow, the lead author.

“There is evidence that a vegan diet causes an increased calorie burn after meals, meaning plant-based foods are being used more efficiently as fuel for the body, as opposed to being stored as fat,” says Dr. Barnard. Insulin sensitivity is increased by a vegan diet, allowing nutrients to more rapidly enter the cells of the body to be converted to heat rather than to fat.

Earlier this month, a team of researchers led by Tim Key of Oxford University found that meat-eaters who switched to a plant-based diet gained less weight over a period of five years. Papers reviewed by Drs. Berkow and Barnard include several published by Dr. Key and his colleagues, as well as a recent study of more than 55,000 Swedish women showing that meat-eaters are more likely to be overweight than vegetarians and vegans.

Founded in 1985, the Physicians Committee for Responsible Medicine is a nonprofit health organization that promotes preventive medicine, especially good nutrition. PCRM also conducts clinical research studies, opposes unethical human experimentation, and promotes alternatives to animal research.

Brent Neuschwander-Tetri, M.D., a hepatologist at Saint Louis University Liver Center and study researcher said, “It’s a helpful study because we can now give patients a benchmark, a line they need to cross to see improvement.”The study looked at patients with NASH, which is a type of liver disease characterized by excessive fat, causing inflammation and damage in the liver. Researchers set out to see if orlistat, which limits fat absorption, along with calorie restriction would lead to weight loss and improve liver disease in overweight patients with NASH, which was determined by a liver biopsy.

Fifty patients participated in the study, with all instructed to consume a 1,400 calorie diet and vitamin E, and half also receiving orlistat for 36 weeks, at which time liver biopsies were repeated.

While orlistat itself was not linked directly to improved liver health, weight loss was, and, further, researchers were able to pin-point the percentage of weight loss needed to improve liver damage.

Patients who lost 5 percent or more of body weight over nine months showed improvement in insulin resistance and steatosis (fat accumulation in the liver), and those who lost at least 9 percent showed reversal of their liver damage.

The data about the drug orlistat was less clear. Those in the orlistat group lost 8.3 percent body weight and those in the other group lost 6 percent body weight, not a statistically significant difference. As for liver disease, orlistat did not itself improve liver enzymes, measures of insulin resistance or reverse liver damage.

“The bottom line is that weight loss can help improve fatty liver disease,” said Neuschwander-Tetri, who is a professor of internal medicine at Saint Louis University. “Now we know how much weight loss is needed for improvement, and we can give patients specific goals as they work to improve their health.”

Published in the January edition of Hepatology, the study was conducted at Saint Louis University and Brooke Army Medical Center and was funded by Roche Pharmaceuticals, the maker of orlistat.

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease
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