Archive for the ‘diabetes type 2’ Category

Oh, it's phytonutrients, not Fidonutrients

Sunday, May 26th, 2013

We got a new dog almost three weeks ago, another Tibetan terrier, but this time a retired show dog. So I'm been intetested in what he eats (dry dog food, but a specific brand and for senior canines). I guess it was logical that when I saw an article on phytonutrients in The New York Times this morning, that my first thought was of "Fido nutrients." Of course that wasn't at all what the writer meant.

a healthy salad is one place to start

a healthy salad is one place to start

I found a background piece specifically on phytonutrients in WebMD; I already knew that the word "Phyto" referred to plants, but was somewhat surprised to read there are over 25,000 of these natural chemicals found in fruits and vegetables as well as in whole grains, tea, beans and nuts. From the plant's point of view, the phytonutrients help defend against its natural enemies (e.g., bugs & germs).

From our point of view, however, they may help prevent disease, visual problems, diabetes, cancer, dementia and heart disease. None of those are as clearcut as I'd like, but I've become a believer in their value. Yet eight out of ten Americans have a "phytonutrient gap," they get less in their diets than they should for optimal health.

I need to emphasize the "may help" part of my comment above; I don't find many large, double-blind, prospective clinical trials that conclude there is an absolute benefit.

What can these chemicals do for us? The National Cancer Institute mentions one significant advantage; they help protect us from free radicals, atoms or groups of atoms that have an odd number of electrons, those tiny negatively charged particles that circle the nucleus of an atom. They are formed when oxygen interacts with certain chemicals and react with cells, especially with their DNA.

Antioxidants are believed to have a role in slowing the aging process and in animal studies have helped prevent the free radical damage that is associated with cancer. Human studies have been inconclusive thus far.

There seems to me, at the current state of knowledge, to be no logic behind taking supplements to increase your intake of antioxidants. But eating more fruits and vegetables and picking which ones you eat is an entirely different story.

2010 article in e! Science News highlighted the concept that trying different fruits and veggies could help us increase our daily intake of phytonutrients. To start with, even those of us who follow the current guidelines to consume less red meat and eat a lot more fruits and veggies tend to eat more sweet varieties than is optimal. We need, as I just did, to occasionally eat some rhubarb or other less sweet fruit and add more herbs in our cooking.

By and large, the concept "Eat Your Colors," as I found in a University of Minnesota advisory piece online, is the clue to getting a significant amount of of the various phytochemicals in your diet. There are five different fruit and vegetable hue groups: red, yellow/orange, purple/blue, green and white/tan.

there are lots of kinds of potatoes

there are lots of kinds of potatoes

When we traveled to South America eight years ago we were amazed at the variety of vegetables available in a local market in Peru. One kind of potato was purple and, according to an article I read today in The New York Times, that variety has twenty-eight times as much of a particular useful chemical as russet potatoes do. That chemical is believed to help fight cancer, but some studies say it doesn't get into the body in an active form when the plant it's found in is eaten.

The NYT article was titled "Breeding the Nutrition Out of Our Food," and was written by an investigative journalist, Jo Robinson, who has a book about to be published, Eating on the Wild Side: The Missing Link to Optimum Health. She's been writing in the field of nutrition for years.

Robinson mentions that wild dandelions, formerly eaten by Native Americans, have much higher levels of these chemicals than spinach and one kind of apple (she doen't specify which) has 100 times the levels of phytonutrients as its Golden Delicious competitors. I gave up on that rather blah-tasting apple and its Red Delicious sibling  years ago and now look for Rome, Galas, Fuji, Granny Smith and Braeburn varieties.

Her basic premise is that humans have been picking sweeter fruits and vegetables for thousands of years; most of these are low fiber, high sugar (and starch and oil) varieties. Sweet corn is a key example where we've trended over the years to a vegetable that's lower in some helpful chemicals than blue, black or red corn.

I've been very intrigued as I read five articles on the subject today. I agree there's no definitive data that tells me to eat my colors and eschew the most common choices availble at supermarkets. I do know that the tomatoes we've gotten from a local CSA are much more flavorful than those I see on the shelves in the store.

The other way of looking at the concept, even if you don't accept that phytonutrients are the answer to many of our health issues, is to say when you concentrate on fruits and veggies and fill well over half your plate (preferably three-quarters), you have less room for meat. And when you choose fruits and vegetables with unusual colors, you serve a more attractive plateful of food.

That's a reasonable start.

 

 

Heart attacks Part 2: Prevention: risk factors & our kids

Wednesday, May 23rd, 2012

Here's a risk factor you can eliminate

This post pings off the April 17, 2012 article in The Wall Street Journal, "The Guide to Beating a Heart Attack." I initially wrote about surviving a heart attack (myocardial infarction {MI} is the medical term). Next I wanted to turn toward the prevention side.

I first found the Interheart study's article from 2004, "Nine modifiable risk factors predict 90% of acute MI." The study followed 29,000 people from 262 sites in 52 countries and concluded that the common belief that half of heart attacks can be predicted was clearly an underestimate.

The research group found the same impact of the nine variables everywhere in the world: abnormal blood lipids (fats, like cholesterol) and smoking were at the top of their list. Then came diabetes, high blood pressure, abdominal obesity, stress & depression, exercise, diet and alcohol intake.

I was used to measuring cholesterol and its HDL (so-called good cholesterol)  and LDL (bad cholesterol) components. This study actually used a more sophisticated lipid approach.

They measured the ratios of  the proteins that bind to and carry fats, apolipoproteins A and B. APOA is associated with HDL lipids while APOB is said to unlock the door to cells and in doing so acts as an unwelcome delivery van for cholesterol. When present in high levels, APOB can lead to plaque formation in blood vessels and an increased risk of coronary heart disease (CHD).

They also found some good news: as expected, eating fruits and vegetables daily, exercising and perhaps moderate alcohol intake were associated with lower risks of CHD. Again this was true everywhere in the world.

The WSJ article mentioned that hospital admissions for heart attacks had actually decreased among the elderly; these nine factors were better predictors in younger groups. What can be done to stop the looming specter of CHD among our younger population?

The CDC examined the parameters in a recent online article titled "A Growing Problem." One issue was "screen time." Our kids eight to eighteen average four an a half hours a day watching TV and three more on cell phones, movies, computers and video games. I even read an article about a two-year-old whose parents think learns a lot from their iPad. Maybe so, but how much exercise does that kid (and his older compatriots) get?

The CDC feels there is a dearth of quality physical activity in our schools; as of 2009 only a third of them provided daily PE for our kids. And after they leave school or when they're on vacation, many don't have safe access to biking, hiking, running, playing areas and trails.

Somerville chose healthier food in their schools

One Massachusetts community, Somerville, has gotten attention for their anti-obesity integrated program, "Shape Up Sommerville"  (You can watch the thirteen minute PBS special on their community-wide progress). The Robert Wood Johnson Foundation is attempting to help similar programs get started across the country, especially focusing on childhood obesity.

Recently I heard a NPR comment that caught my attention. If we don't do something to stop the epidemic of childhood obesity, we'll soon be seeing CHD rates soar in people in their 20s and 30s and maybe even younger.

A French researcher said, "Mankind is doing a good job of killing himself."

We need to try new approaches to help our kids. The Somerville plan sound like a good place to start.

 

 

 

Adults, obese and otherwise

Sunday, February 12th, 2012

PIck well and cut back your waste/waist

In my last post I explained the concept and the math behind the body mass index (BMI) approach to evaluating if your weight was normal or not (your BMI is very  well in synch with the most scientific methods of determining body fat percentages). Now I want to expand on that a bit  with some recent statistics and some thoughts on how we can lose weight if we need to. Unfortunately, some of us have lots of extra pounds we should shed if we want to have our best shot at leading long, healthy lives.

The Feb 1, 2012 issue of JAMA had a number of interesting articles on obesity. I've previously mentioned several on childhood and adolescent obesity; today I'd like to zero in on two whose focus is American adults.

Four CDC staffers, led by Katherine Flegal, PhD, published the most recent statistics from a recurring national survey with the daunting acronym NHANES. This national health and nutrition survey (the E stands for examination) started in 1971, but from 1999 on has been released results in two-year cycles. The current article from the National Center for Health Statistics, looking at the 2009-2010 NHANES data had a little good news and lots of bad news.

After 1980, until the turn of the 21st century, the prevalence (scientific term for percentage) of obesity in our population kept zooming up. Now it appears to have leveled off. I guess that's something we should be happy about, except now over 35% of adults in this country are obese. Men and women have about equally high rates of obesity and men have caught up to women in this regard over the last twelve years. Some subsets, by sex and racial groups, are even more likely to be obese or very obese.

The worst news from this article was that no group--men, women, non-Hispanic whites, Hispanics or non-Hispanic blacks--had a decrease in the prevalence of obesity in this most recent data set.

So which exercise and diet should we try?

getting enough exercise is difficult when your joints hurt

Many adults report "No Leisure-Time Physical activity." Overall, more of us are exercising, but the data vary from state to state. Those who have arthritis, fifty million in the US, need special attention or are even more likely to get no exercise. The CDC has worked with the Arthritis Foundation to develop ideas for this huge group. Going back to my review of articles on youngsters, I think for the rest of us, we could begin with simple steps, parking at the far end of the parking lot and substituting some walking for part of our screen time as two examples.

Harvard Medical School's free online HEALTHbeat publication had a review of pros and cons of various diets in its Feb 7, 2012 edition. The bottom line still is if you want to lose weight, you must cut down on your calories. The Mediterranean-style emphasis on fruits and vegetables, unrefined carbohydrates, nuts, seeds and fish may be the most effective in reducing cardiovascular and diabetic risks.

My New Year's Resolution is to keep my weight under 150 pounds. I have to work at it as I like to eat, but most of the time I've stayed away from splurges.

How about you?

 

JAMA

 

 

What Sweeteners Do You Use? Part 2

Monday, January 16th, 2012

Sugarcane grows in the tropics

In my last post I said I'd dig more fully into the background and safety record of the artificial sweeteners. Then I got diverted; one question was what kind of sugars were there before the artificial sort? I ended up at a website called Lab Cat which, in a brief verbal and visual format, described the sugars we commonly might ingest. Table sugar usually comes from either sugarcane or beets; it's a combination of two other sugars, glucose and fructose, the former found, typically in grapes and corn; the latter in honey, fruits and vegetables.

When a physician measures your blood sugar level; he or she is checking for glucose. The WebMD site has a nice discussion of blood sugar, mainly focused on those who have too much of it, namely diabetics. Another brief discussion, this one by a Harvard Medical School professor, can be found in an abcNEWS piece online. Normal fasting blood sugar levels are in the 70 to 99 milligrams per deciliter (mg/dl) range.  A deciliter is one-tenth of a liter, a little over three and a third ounces or six and two-thirds tablespoons. A liter is 1.05 quarts and a liter of water has 33.81 ounces of water. Even after eating, a non-diabetic person doesn't usually  have a blood sugar level over 135 to 140 mg/dl.

Diabetics may have considerably higher blood sugar levels, enough so their urine contains sugar. Up to levels of 180-200 mg/dl your kidneys can reabsorb sugar; above those levels a urine dipstick test will be positive (briefly immersing a plastic strip into the urine; the chemicals on the strip will cause a color change if glucose is present in the urine).

If your blood sugar is low, below the low 70 mg/dl level, either from missing meals or overdosing with insulin or oral drugs used for diabetes (there are a host of other causes), you usually will feel shaky, hungry and perhaps have other symptoms. Most of us who are otherwise healthy  are unlikely to have our blood sugar level fall to really low levels, but those can be extremely dangerous.

If you get an IV with sugar, it's really glucose under its pseudonym, dextrose. A common IV solution is D5W; that means the composition of the fluid is 5% dextrose (glucose) dissolved in water. another is D5NS, meaning the sugar is dissolved in a salt solution. That is usually given to patients who are dehydrated and need volume; the sugar, in the form of dextrose, is added to make the sterile intravenous fluid "isotonic," An isotonic solution has the same salt concentration as the normal cells of the body and the blood.(using only salt enough to approximately match what your normal blood level of sodium should be and not adding the dextrose would result in a fluid too dilute for safety).

Fructose can be added to foods, drinks, or, eventually, your waistline

When I read what I had written thus far I realized I wasn't sure anymore what exactly happens to the fructose part of table sugar, or for that matter the high-fructose corn syrup added to so many processed foods. That turns out to be more complicated than I remembered so I'll save that discussion for my next post.

 

 

 

Slim down those truckers

Wednesday, November 23rd, 2011

some truckers are relatively slender

I have two series of posts going, but couldn't resist the article I found in the New York Times while riding a recumbent bike in the gym. The title alone, "A Hard Turn: Better Health on the Highway," was enough to grab my attention.

The first story was typical, a trucker driving long hours every day, eating all the wrong foods, getting no exercise, gaining huge amounts of weight. I found the online abstract of a 2007 Journal of the American Dietetic Association article cited: long-haul truckers of necessity eat at truck stops and of 92 such truckers stopping at a Mid-eastern US truck stop nearly 86% were overweight and 56.5% were obese.

One of our family members used to be a truck driver and I've heard his stories of long days spent behind the wheel, eating greasy foods when he stopped. He's slimmer now and in better shape as his current employment allows him more exercise time and a choice of where and what to eat.

Now that insurance costs are rising sharply, the trucking firms are getting involved and the truckers themselves, there's over three million of them in the US, are coming to grips with the issue out of necessity. One group ran a blood-pressure screening clinic for 2,000 truckers at a truck show. Twenty-one were immediately sent to a nearby emergency room; one had a heart attack before reaching the hospital.

drive carefully around trucks like this

Trucks are involved in 400,000 accidents a year and 5,000 fatalities. I just watched a nearly eighteen minute video on how we, as drivers of passenger vehicles, contribute to those accidents; 70% are caused by the drivers of other vehicles (see link below). Yet many of the ones caused by trucker driver error occur because the trucker has a health problem or falls asleep.

http://www.sharetheroadsafely.org/cardrivers/Unsafe-Driving-Acts.asp

Some truckers are taking steps to decrease their weight and its accompanying risks for themselves and those who share the roads with them. A number of companies are helping (and perhaps finding a lucrative new client group). I just looked at a website for "Rolling Strong," and found a gym in my area that offers fitness programs for truckers. Others are joining Weight Watchers, a solid organization that my slender wife has belonged to for many years (she says she was "chunky" in high school) or creating their own programs for fitness: one carries a fold-up bike in his 18-wheeler and uses it whenever he stops for a break. Many are cooking in their trucks or even hiring a trainer.

Others joined the Healthy Truckers Association of America, paying $7.50 a month to belong to an organization that is rapidly growing (see link below to Chicago tribune article). That group now offers truckers a prescription drug card enabling its members to save ~60% on meds.

http://healthytruck.org/node/101

I applaud all these moves; if I'm on the road with a large truck or a series of them, I'd like their drivers to be in shape and wide awake.

Do our kids have a bleak future?

Saturday, November 19th, 2011

As close to a salad as he'll get

I'm taking a break today from my series of posts on greenhouse gases, alternative energy source, volcanoes and global warming. All of those will affect the generations to come and those now growing up, but I want to re-examine another side of their issues. This morning I read two articles and one newspaper report on the heart health prospects for our American kids (and, by extension, kids elsewhere in the developed/rapidly developing world). The initial article came from a section of the Wall Street Journal I hadn't gotten around to reading yesterday and was about to recycle. Then I saw a title that caught my eye, "Kids' Hearth Health Is Faulted."

I found a CDC website with an explanation of the National Health and Nutrition Examination Survey, NHANES. This is a continuation of a US Public Health Service effort started 40 years ago and is updated annually. Medically-trained interviewers may well come to your town and even to your front door someday. The data they obtain is used in many ways (I'll paste in a website that leads you to some comments on NHANES as well as to a link to a video).

Now a portion of the survey/study looked at 5,450 kids between 12 and 19, finding they were a long ways from matching the American Heart Association's (AHA) seven criteria for idea cardiovascular health (see 2nd link below to Harvard's Beth Israel Deaconess Medical Center's article on the subject). The adult health measures, known as Life's Simple 7, are: 1). Never smoked or quit more than a year ago; 2). Body Mass Index (a measure of height versus weight) <25; 3). Physical activity on a weekly basis for 75 minutes (vigorously) or 150 minutes (moderate intensity).; 4). a healthy diet (four or more components meeting AHA guidelines); 5). total cholesterol <200 mg/dL; 6). blood pressure (BP) <120/80; and fasting blood glucose (AKA blood sugar) <100 mg/dL. The original article was published in the journal Circulation January 20, 2010 and is available free online. The metrics are slightly different for kids.

So where do our kids stack up? If you exclude eating a healthy diet, only 16.4% of boys and 11.3% of girls meet the standards for the other six criteria; if you include diet, none of them do. They don't eat four to five servings of fruits and vegetables a day; they also don't get enough whole-grains or fish and they consume far to much salt and sugar-sweetened drinks. Only one fifth of them even eat "fairly well."

drop that hamburger and run for an hour

Many of then also don't exercise on a daily basis for at least sixty minutes (50% of the boys do and 40% of the girls). More than a third are overweight or obese.

There's some hope: a just-published article in the New England Journal of Medicine, examining the data from four studies following 6328 kids, found that those who do manage to lose weight had lower risk for type 2 diabetes, hypertension, abnormal lipids and carotid artery disease.

So I'm heading to the health club and will read the 2010 Circulation tome on an exercise bike.

Thus far my one biologic grandson, about to be 12,  is physically active and slender. I'll encourage him to stay that way and the non-biologic grandkids to follow his example.

More on this subject to come.

Check out these articles:

Survey Results and Products from the National Health and Nutrition Examination Survey

AHA Defines "Ideal" Cardiovascular Health

 

Early cholesterol testing now recommended

Saturday, November 12th, 2011

We're seeing more obese kids

With our sweeping epidemic of childhood obesity ( current estimates say over one-sixth of American kids are obese, three times the prevalence rate seen thirty years ago), it's time to take some additional steps. On Friday 11, 2011, sweeping new guidelines for childhood lipid testing were espoused by both the NIH's Nation Heart Lung and Blood Institute and The American Academy of Pediatrics. I found these, of all places, not on the websites of the two august bodies, but on the front page of the Wall Street Journal, an NPR article and in the Los Angeles Times.

The actual article in the journal Pediatrics, won't be out for two more days and should find a fair amount of opposition. Previous position papers by the AAP and the US Preventive Services Task Force have either suggested lipid studies be done in focused groups (eg. family history of heart disease or lipid disorders) or, if universally, no earlier than age 20. The CDC (actually the acronym has changed since it's now the Centers for Disease Control and Prevention), in a 2010 report, commented that a single elevated LDL cholesterol reading in a child may be found to be normal in subsequent testing.

The current recommendation panel, headed by Dr. Stephen R. Daniels, an MD, PhD who is Chairman of Pediatrics at the University of Colorado School of Medicine, is quick to avoid any suggestion of widespread statin use for children found to have high levels of "bad cholesterol," LDLs over 190 milligrams per deciliter. Another panel member, Dr. Elaine M. Urbana, director of preventive cardiology at the Cincinnati Children's Hospital Medical Center, was quoted as saying, "This documents on the fact that this generation may be the first to have a shorter life expectancy than their parents."

So go back to the facts: one-third of US kids are overweight and about 12.5 million of them are actually obese. Even here in Colorado, the thinnest state in the nation, I see some of those kids every day. We're not just talking about high schoolers; some of these fat kids are as young as two.

What's missing is a balanced diet with emphasis on fruits and vegetables and a reasonable amount of daily exercise.

earlier blood tests may let them live longer

Daniels comments, "...the atherosclerosis process really begins early in life." he also said, "Heart disease is the number one killer in our society...people who are able to maintain a low risk through childhood and early adulthood have a lower risk (of dying from coronary artery disease)."

From my perspective, it's our responsibility as parents and grandparents, to help prevent childhood obesity, the accompanying risk of later type 2 diabetes and the huge risk of early heart disease. I filled out a health history form yesterday and noted my mother had a heart attack at age 74 (she lived 'till 90), but ignored my father's need for an artery unclogging procedure shortly before his 90th birthday. That may be something I can put off by eating well and exercising, but that's not the focus here.

I never want to see a child or grandchild die of a heart attack in their 50s or 40s or 30s or 20s.

So blood tests between ages 9 and 11 and again between 17 and 21 make sense.

 

 

Should the kids be in the middle? It may depend on the kid's middle

Tuesday, November 1st, 2011

This is not the example you should set

Wall Street Journal headline caught my eye, "Obesity Fuels Custody Fights." It noted that childhood obesity is frequently being used by one parent or the other as grounds for custody changes with accusations concerning poor diets and lack of exercise flying back and forth.

That led me to a July 13, 201 article in The Journal of the American Medical Association (henceforth JAMA), "State Intervention in Life-Threatening Childhood Obesity."

We're not talking about mildly overweight kids here; in 2009 a 555-pound fourteen-yer-old boy, living in one of the southeastern states, was taken  by court order from his mother and placed into foster care. She in turn was charged with criminal neglect as the Department of Social Services for that state felt they must intervene or the boy would be at considerable risk for major obesity-related problems, especially diabetes type 2. I found a photo online of the boy and my jaw dropped.

The JAMA article notes "even relatively mild parenting deficiencies" can contribute to a child's weight problems: having junk food in the home, frequently taking the kids to fast food restaurants, failing to model an active lifestyle.The CDC estimates `17% of America's kids and teens are obese (we're not just talking mildly overweight); that's 12.5 million kids at risk. The two Boston authors who wrote in JAMA quote a study showing 2 million of those obese kids are grossly obese with a BMI at or beyond the 99th percentile for their age (a very small percentage of those grossly obese kids, it turns out, may have a genetic abnormality; in those rare cases, the parents aren't to blame).

What can we do about this horrendous problem? Well, there are a variety of "bariatric" operations available in pediatric surgery programs; in dire cases state legal action may be

this makes more sense

necessary. But I liked what I saw the other day walking Yoda, our nine-year-old Tibetan terrier, on his morning constitutional (he gets an evening walk as well, which means either my wife or I or both get some extra exercise).

We came near the elementary school near us and there was a long line of kids, punctuated by an occasional teacher, running past. We stopped to watch, realized these were kindergarden and/or first grade kids, and finally had an opportunity to ask one of the teachers what was going on.

"It's a new program we've started in the Poudre School District," she said. "We keep the kids moving for thirty minutes. They can run and most do, or twirl around and walk the field next to the school, but they've got to keep moving."

The conclusion in the JAMA article was stark, but offered a road to resolution. The authors noted, "An increasing proportion of US children are so severely obese as to be at immediate risk for life-threatening complication including type 2 diabetes." They mentioned the pediatric weight loss surgical programs and state protective services, but finished with our need to decrease the need for those options through beefing up the social infrastructure and policies to improve both kids' diets and guide them toward more physical activity.

Those solutions may work.

More on the heatwave and its consequences.

Thursday, September 1st, 2011

Here's one way to cool off

This morning I read in the New York Times Breaking News that comes to my Kindle that NYC has recently seen an unprecedented number of heat-related deaths. The age range of the victims varied considerably; youngsters, a 45-year-old  woman and some elderly folk all were struck down. Today I'd like to concentrate on older adults.

You may or may not believe in global warming (I certainly do) and, if you do, whether humans are making a significant contribution to it. But in the meantime we seem to be experiencing a hot patch and we have to cope with that.

I got up fairly early, took Yoda, my Tibetan terrier, to Whole Foods to buy a sack of his dog food and then took him for a walk. All in 72 to 75 degrees on a day that will later see a 95+ degree peak temperature. And this is in Colorado at 5,200 feet elevation. I checked out temp predictions for Denver and for the mountains; the former will be just under 100 degrees later on today whereas those areas at considerably higher elevation will stay in the 70s.

But agewise, I'm also in my 70s, as of April, and therefore read with interest the National Institute on Aging's paper titled "NIH tips for older adults to combat heat-related illnesses." The basic concepts are threefold: we lose some of our ability to adapt to heat as we get older; we are in a group that frequently has underlying diseases/conditions that fare poorly in hot weather; the meds our physicians use to treat those diseases sometimes limit our ability cope with the  heat.

I'll add a link to the article below, but will paraphrase some of their points and add my own spin.

Firstly some of the physiologic changes we experience as we age limit our ability to respond to elevated temperatures. Those include our cooling via sweating or , in some cases, our limited mobility and, in other cases, our mental responses or lack thereof. Additionally, our ability to vasodilate small blood vessels may be compromised.

Then we're experiencing, as a nation, an epidemic of obesity and concurrently those who exceed their weight goal by a large amount experience more heat-connected problems. I searched medical websites for the rationale and, if I were a teenager, would have said, "Duh!" The layer of adipose tissue the obese accumulate is the equivalent of wearing an insulted suit, something you wouldn't want to do in the heat of a summer day.

And then there are all those medications we take as we age. One article I found said older people take 2 to 6 prescribed drugs while also taking a number of OTC medications. Those drugs can directly alter our response to heat while potentially causing increased body temperature in a number of other ways, e.g., hypersensitivity reactions or the pharmacological action of the drug itself.

That helps

So if you're an older adult, avoid the heat of the day, get enough fluids and, if necessary, contact the Low Income Home Energy Assistance Program (through HHS) for help with home cooling.

http://www.nia.nih.gov/NewsAndEvents/PressReleases/PR20110718hyperthermia.htm

Will this work and is it safe?

Tuesday, July 5th, 2011

The ultrasound said 9 pounds

I'm still digesting Taubes's work with mixed feelings, but his concept that insulin is central in the obesity epidemic took on a new meaning today. I was reading the "Health & Wellness" section of The Wall Street Journal and came across an article titled "Programming a Fetus for a Healthier Life." I was intrigued and read further, finding the U.K. government is backing a research effort in the realm of "fetal programming," changing the uterine environment during pregnancy in an attempt to better a child's health for the better in later years.

This is new turf for me and normally not an area I would have written about; in this case, however, the experiment, thus far only in its early stages, hopes to prevent obesity.

The underlying concept is the work of Dr. David J. P. Barker, who published a theory in 1997 termed the "thrifty phenotype," saying that in poor nutritional conditions, a pregnant woman can modify the development of her unborn child such that it will be prepared to survive in a resource-limited environment. The extension of this says reduced fetal growth is associated with a number of later-life chronic conditions.

Barker is now both Professor of Epidemiology at an English university and Professor in the Department of Cardiovascular Medicine at the Oregon Health and Science University. In 1995 his theory was renamed as the Barker hypothesis by the British Medical Journal. Now it's being applied in a very different setting.

a model of human insulin

The study is attempting to enroll obese pregnant women, 400 of them, in a trial of an oral agent called Metformin, normally utilized to treat type-2 diabetes, to lower their blood sugars, which tend to run higher than normal. The thought is that glucose is passed on to babies in utero and they then end up larger than normal birth weights and elevated insulin levels, setting the stage for lifelong obesity.

Dr. Jane Norman, a maternal-fetal health specialist at the University of Edinburgh is a lead investigator. A prominent US specialist, on the board of the 2,000-member Maternal-Fetal Medicine Society and not involved in the study, says he'd have no qualms about his patients joining the Metformin-taking moms-to-be.

I searched the literature and found the following

"Does metformin cause birth defects? Is it safe to take it during the first trimester?

Most studies suggest that metformin is not associated with an increased risk of birth defects. Some early trials suggested that the use of metformin during the first trimester was associated with an increased risk of birth defects. However, it is not clear whether these were caused by metformin or poor control of the mothers’ diabetes. More recent trials studying the safety of metformin during pregnancy, mostly when used to treat insulin resistance in women with PCOS (polycystic ovary syndrome), did not show an increased rate of birth defects or complications at birth."

So the concept appears to be a reasonable test of whether the uterine environment can be safely altered with a drug to prevent obesity.

Wow!