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The number of deaths from coronary heart disease among Japanese men is less than half that of American men. Whether this effect is due to genetic, dietary or other factors has not been confirmed. In the first international study of its kind, published in the August 5, 2008, issue of Journal of the American College of Cardiology, University of Pittsburgh Graduate School of Public Health assistant professor of epidemiology Akira Sekikawa, MD, PhD, and colleagues evaluated data from 868 men aged 40 to 49 enrolled in the ERA JUMP (Electron-Beam Tomography, Risk Factor Assessment Among Japanese and U.S. Men in the Post-World War II Birth Cohort) Study. Two hundred eight-one of the current study’s subjects were from Japan; 306 were Caucasian men from Pennsylvania; and 281 were Japanese-American men living in Hawaii. Blood tests measured total fatty acids and the omega-3 fatty acids eicosapentaenoic, docosahexaenoic and docosapentaenoic acids which are commonly obtained by consuming fish. Ultrasound examination assessed carotid artery intima-medial thickness (IMT), which is used to evaluate atherosclerosis. Coronary artery calcification (CAC) in the heart’s arteries, which also identifies heart disease, was assessed via electron-beam CT scanner.

Dr Sekikawa’s team found that although total fatty acid levels were similar among all subjects, the percentage of fish-based omega-3 fatty acids was twice as high among Japanese men compared with Americans of both European and Japanese descent. Japanese men had significantly less atherosclerosis, as indicated by lower average intima-media thickness and coronary artery calcification. Among Japanese men, intima-media thickness values declined with rising omega-3 fatty acid levels, a phenomenon that was not observed in either American group.

“The death rate from coronary heart disease in Japan has always been puzzlingly low,” Dr Sekikawa observed. “Our study suggests that the very low rates of coronary heart disease among Japanese living in Japan may be due to their lifelong high consumption of fish. Our study clearly demonstrated that whites and Japanese-Americans have similar levels of atherosclerosis, which are much higher than in the Japanese in Japan. This indicates that much lower death rates from coronary heart disease in the Japanese in Japan is very unlikely due to genetic factors.”

“Our study suggests that very high levels of omega-3 fatty acids have strong properties that may help prevent the buildup of cholesterol in the arteries,” Dr Sekikawa stated. “Increasing fish intake to two times a week for healthy people is currently recommended in the U.S. Our study shows much higher intake of fish observed in the Japanese [approximately 3 ounces daily] may have strong anti-atherogenic effect.”

“While we don’t recommend Americans change their diets to eat fish at these quantities because of concerns about mercury levels in some fish, increasing intake of omega-3 fatty acids in the U.S. could have a very substantial impact on heart disease,” he added.

 A new study from the University of Colorado Denver’s School of Pharmacy has found that a simple educational intervention provided by a pharmacist can make a significant impact in the amount of vitamin D intake in geriatric outpatients, resulting in increased serum, or blood levels of this key nutrient. Surprisingly, the study also found that the overall increase in serum levels in the patients who received the intervention were still not in the target range, indicating that current national recommendations for vitamin D intake may be insufficient. The study is published this month in the July/August issue of the Journal of the American Pharmaceutical Association.“The educational intervention was simple to administer and can be reproduced by pharmacists in a variety of settings, including a community pharmacy or a clinical practice site,” said Joseph Vande Griend, PharmD, assistant professor in the Department of Clinical Pharmacy at the UC Denver School of Pharmacy and lead author of the paper. “Geriatric patients are at risk of medical complications from vitamin D insufficiency, including osteoporosis, and pharmacists, physicians, and other point-of-contact health care representatives can make a difference by recognizing vitamin deficiencies in their patients and taking the time to talk about the importance of key nutrients like vitamin D.”The Pharmacist’s Findings and an Educational Intervention Vitamin D concentrations were studied in older adults, ages 65 to 89 years, during clinic visits to the University of Colorado Hospital from December 2005 to January 2006. Eighty patients completed the study and 59 of them, 74 percent, were found to have vitamin D insufficiency. The majority of patients who were vitamin D insufficient consumed more than the recommended 400 to 600 IU per day of vitamin D.

The UC Denver pharmacists practicing in geriatric medicine then created a vitamin D informational sheet that was given to those geriatric outpatients who had insufficient vitamin D intake. A pharmacist reviewed the sheet with the participant during a 15-minute, one-on-one educational session about vitamin D, in which it was recommended the participant consume a total of 1,200 IU per day of vitamin D. A recommendation of 1,200 IU was chosen because the amount was estimated to increase patient serum levels to the study-defined sufficient vitamin D concentration of 32 ng/mL. The 1200 IU per day of vitamin D is also easy to obtain from over-the-counter resources; it is higher than the current Institute of Medicine recommendation (400 IU/day under age 70 and 600 IU/day over age 70) but below the upper daily intake limit (2,000 IU/day).

The handout covered the importance of vitamin D in maintaining good health, provided a listing of food sources with vitamin D, and a listing of over-the-counter supplements containing vitamin D3 along with their general cost. The handout is available online at http://www.japha.org/ .

At the conclusion of the educational session, the clinical pharmacist helped the participant choose which foods and/or supplements to use to increase daily vitamin D intake and provided the participant with a written, personalized plan to consume 1,200 IU per day of vitamin D. No supplements were provided to the study participants.

Two weeks after the educational session, the pharmacist followed-up with participants via telephone. During the call, the importance of vitamin D in maintaining optimal health and the details of the personalized vitamin D plan were reiterated. Participants were then asked whether they had obtained the agreed upon vitamin D product(s) and whether they were actually using the products. If not, the recommendation was reviewed and the participant was encouraged to obtain the product(s) and try to increase vitamin D intake.

The Outcome of the Educational Intervention After 12 weeks, a higher proportion of participants in the educational intervention group (55 percent) achieved the desired vitamin D blood level concentration of 32 ng/mL compared with the nonintervention group (24 percent). The change in dietary and over-the-counter vitamin D intake was also evaluated. Self-reported total vitamin D intake increased by a mean of 647 IU/day in educational intervention participants and 67 IU/day in the nonintervention group. Participants in the educational intervention group reported consuming an average of more than 1,400 IU/day vitamin D.

NEW YORK, July 18, 2008 /PRNewswire via COMTEX/ — Drinking four to five cups of tea a day may help maintain a healthy mind and body, according to new research published in a supplement to the August issue of the Journal of Nutrition. One study’s results suggest that four to five cups of tea a day may improve attention and focus. This and other studies on tea polyphenols, including research on neurological health, genetic susceptibility to cancer, and insulin sensitivity are included in the Proceedings of the Fourth International Scientific Symposium on Tea and Human Health. The supplement also provides an update on the evidence in support of tea’s role in cardiovascular health, and the bioavailability of its beneficial flavonoids.

“This supplement highlights many of the new frontiers being investigated regarding black and green tea’s potential public health benefits,” said Tea Symposium co-chair, Jeffrey Blumberg, Ph.D., Professor, Friedman School of Nutrition Science and Policy and Director, Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston. Lenore Arab, Ph.D., Professor of Internal Medicine at the University of California, Los Angeles and Blumberg’s partner as Tea Symposium co-chair adds that, “There are tremendous advancements to better understand the mechanisms by which tea may reduce risk for heart disease, certain cancers, type II diabetes, and help maintain neurological function.”

Theanine in Tea Increases Attention and Focus

The results of a new human, placebo-controlled, trial published in the Proceedings of the Fourth International Scientific Symposium on Tea and Human Health found that theanine, an amino acid present almost exclusively in the tea plant, including black, green, and oolong varieties, actively alters the attention networks of the brain. “Our results show that after having theanine, individuals had significant improvements in tests for attention, and that activity in cortical regions responsible for attention functions was enhanced,” said author John Foxe, Ph.D., Professor of Neuroscience, Biology and Psychology at City College of the City University of New York. “What’s more, we have seen that just 20 minutes after consuming theanine, the blood concentrations increase and the brain’s alpha waves are impacted. It lasts about three to four hours, which we have speculated may be why people tend to drink a cup of tea every three-to-four hours during the day,” added Dr. Foxe.

The new research from Dr. Foxe and his team used electrophysiological measures to monitor brain activity after individuals drank solutions containing a placebo, 50 mg caffeine, an amount of theanine equivalent to five to six cups of tea, or a combined treatment. The subjects were asked to complete a variety of attention-related computerized tasks.

The results from Dr. Foxe’s laboratory, the Cognitive Neurophysiology Laboratory at the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, New York, supported by the Lipton Institute of Tea, suggest that the effects of theanine in combination with caffeine are even greater than with either one alone in improving attention. Theanine may work synergistically with caffeine to help induce a more calming, relaxed state, but one that allows the mind to focus and concentrate better at tasks Theanine is known to be absorbed by the small intestine and cross the blood-brain barrier where it affects the brain’s neurotransmitters, and increases alpha brain-wave activity. This alpha brain rhythm is known to induce a calmer, yet more alert, state of mind. A cup of brewed tea typically contains between 10 and 20 mg of theanine.

Tea May Protect Aging Brains from Alzheimer’s and Parkinson’s Diseases

Newly published study by Sylvia Mandel, Ph.D., of the Eve Topf Center for Neurodegenerative Diseases in Israel, show that the active flavonoids in tea may have multiple mechanisms of action on a cellular level on maintaining neurological health. Mandel, who has been studying the effects of tea on brain functions in laboratory and animal models for over a decade, looked at animal models of neurological diseases such as Parkinson’s and Alzheimer’s. An amount of purified EGCG equal to about two to four cups of green tea per day was provided to animals with induced Parkinsonism as part of their diet to evaluate how their symptoms improved or progressed. They found that when the animals are fed green tea EGCG, the polyphenol appeared to prevent brain cells from dying, and showed improvements in reducing compounds that lead to lesions in the brains of animals with Alzheimer’s disease.

“In the past, it was thought that once brain cells were damaged, there was no way to repair them. Not only may the EGCG help prevent brain cells from dying, it appears that the polyphenol may even rescue the neurons, once they have been damaged, to help them repair,” says Dr. Mandel.

While numerous studies have concluded that diets rich in fruits and vegetables support the body in fighting neurological decline through antioxidant mechanisms associated with their high flavonoid content, the importance of tea’s polyphenolic flavonoids in supporting healthy brain cells appears to go beyond the simple oxygen species scavenging, involving pleiotropic effects on numerous biological pathways to help keep human brain cells from dying and even help repair them when they are subjected to insults that damage the cells’ DNA.

Human epidemiological and new animal data from around the world suggests that drinking tea — especially those rich in flavonoids named catechins — may help support the brain as we age. Recent publications from earlier this year also contribute to the growing body of research on the potential neuroprotective benefits of tea polyphenols. Tan et al found an inverse association between black tea and Parkinson’s disease, based on a 12 year prospective study of over 63,000 men and women, that was due to black tea ingredients separate from its caffeine content. A retrospective study, by Kandinov et al, of nearly 300 patients with Parkinson’s disease found that drinking three or more cups of tea per day delayed motor symptoms by 7.7 years. In addition to epidemiological data, results from recent animal studies showed that tea polyphenols may improve memory in Alzheimer’s disease (Rezai-Zadeh et al), and be neuroprotective against oxidative stress (Hague et al).

Tea May Alter Cancer Genetics

Results from a tea intervention on the role of green tea on the prevention of cancer provided insights into the cutting-edge field of nutri-genomics, or how gene susceptibility toward chronic diseases can be altered through dietary interventions. Iman Hakim, M.D., Ph.D., M.P.H., Professor and Dean of the Mel and Enid Zuckerman College of Public Health and Professor at the Arizona Cancer Center, University of Arizona, has conducted several human clinical trials over the past decade on the role both green and black tea may play in certain cancers. Her latest human clinical trial suggests that bioactive compounds in tea have a significant effect on genes that impact cancer susceptibility and repair from environmental insults.

“The good news is that we are seeing that green tea is impacting genes that play a role in cancer, but we cannot pinpoint who will be responders versus non-responders at this time,” noted Dr. Hakim. “In addition, our recent preliminary data show a beneficial effect of green tea on lipid profile among smokers and former smokers. Since there are no known negative effects of consuming tea, and it may be beneficial, there’s no reason not to recommend drinking it.” Dr. Hakim recommends at least four cups per day.

Growing Body of Evidence

The Proceedings of the Fourth International Scientific Symposium on Tea and Human Health provides the latest scientific update from key research scientists from top medical institutions in North America, Europe, the Middle East and Asia, based on their clinical, laboratory, and epidemiological studies related to the role of tea in promoting healthfulness and reducing the risk of disease. The ongoing scientific exploration of the health benefits of drinking tea has led to a growing body of research that points to tea as an important contributor to overall health. The Proceedings extends the base of credible, published data supporting the health benefits of tea, encouraging the scientific community to continue exploring this exciting area.

USA TODAY

07-14-08

The chiseled body of 41-year-old Olympic swimmer Dara Torres was all the talk of people watching the U.S. Olympic trials.

And it prompted some middle-aged people to think about their own physical condition and wonder whether mere mortals can achieve that high level of fitness and end up looking like Torres.

“Many people in their 40s could look like her, but they’d have to train a ridiculous number of hours, and most people in the U.S. would have to lose a lot of weight,” says Timothy Church, director of preventive medicine research at the Pennington Biomedical Research Center in Baton Rouge and co-author of the exercise book Move Yourself.

“It would have to be your mission in life. You’d have to do a minimum of two hours of hard, hard training a day, but probably more like four hours a day. And you’d have to really reduce how much you’d eat. You can build muscle, but if it’s covered in fat, you can’t see it.”

That would be hard for people who juggle a job, family and other responsibilities, he says.

Genetics and age play a big role in how difficult it would be to achieve a high level of fitness, he says. It’s much easier to attain if you have great genes, are in your 20s, naturally have a lot of muscle and have never gained extra weight.

That’s true, says Miriam Nelson, director of the John Hancock Center for Physical Activity and Nutrition at Tufts University in Boston and co-author of Strong Women Stay Young.

If you want to be a competitive athlete, you’ll be training most of the day, she says. And you have to make sure you are doing it correctly so you don’t hurt yourself.

Torres, who has a 2-year-old daughter, does one intense swim workout a day. She also does weight training and dry-land workouts. She has been fit for years, and she has a team that includes two “stretchers” who travel with her, a strength coach and a massage therapist.

Her head coach, Michael Lohberg, says most people may not be able to look like her, “but I really do think with proper nutrition and proper training, people can look very, very fit.”

Americans should be inspired by Torres to increase their strength, aerobic fitness and flexibility, says orthopedic surgeon Angela D. Smith, former president of the American College of Sports Medicine and a National Masters Figure Skating medalist.

Everyone, especially people who have never been very active, must give their bodies time to adapt to a fitness program, she says. “Bones, muscles, ligaments, tendons have to be strengthened gradually by slowly increasing the length and intensity of the workouts.”

People can work with what they have and improve how they look and feel, Smith says. Researchers believe muscle mass plateaus in your mid-40s and then slowly declines unless you do something to preserve it.

Studies show that men ages 50 to 70 who are doing some weight training don’t lose any strength or muscle, Nelson says. And there is research that shows women 50 to 70 can gain muscle if they start lifting weights.

“We don’t have the full picture yet, but data are emerging that suggest that you can preserve much of your strength and fitness well into your 60s and beyond if you work hard enough at it,” Nelson says.

Church used to train more than 20 hours a week for Ironman triathlons, which involve swimming 2.4 miles, biking 112 miles and running a marathon of 26.2 miles in one day.

“When you are super-fit, you just feel invincible. There is no way I could train like that now with a family, and quite frankly I really no longer want to,” says Church, who has two young children.

These days he jogs 30 to 35 minutes two to three days a week. On weekends, he and his wife put their children in a jogger and go out for a fast walk/jog for an hour or more.

If you don’t have the time or inclination to achieve a high fitness level, remember there are great health benefits with moderate amounts of activity, he says. “Thirty minutes a day of walking promotes healthier, happier aging.”

The majority of men with androgen deficiency may not be receiving treatment despite having sufficient access to care, according to a report in the May 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals (see also JAMA and Archives Journals).

Androgen deficiency in men means the body has lower than normal amounts of male hormones, including testosterone, according to background information in the article. Although prescriptions for testosterone therapy for aging men have increased in recent years, treatment patterns for androgen deficiency are not clearly understood in community-dwelling U.S. males.

Susan A. Hall, Ph.D., of New England Research Institutes, Watertown, Mass., and colleagues examined data collected from 1,486 Boston-area men (average age 46.4) from April 2002 to June 2005 to estimate the number of men receiving treatment for androgen deficiency, to explain how treated and untreated men varied in seeking care and to understand potential barriers to health care. Specific symptoms of androgen deficiency include low libido, erectile dysfunction and osteoporosis and less-specific symptoms include sleep disturbance, depressed mood and tiredness.

A total of 97 men met the criteria for having androgen deficiency. Eighty-six men were symptomatic and untreated, and 11 were prescribed testosterone treatment. “Men were using the following: testosterone gel (n=1), testosterone patch (n=3), testosterone cream (n=1), testosterone cypionate [an injectable form of testosterone] (n=1) or unspecified formulations of testosterone (n=5),” the authors write. “All of the unspecified forms of testosterone used were self-reported as administered in intervals defined in weeks, which suggests that these were injectable formulations.”

“Men with untreated androgen deficiency were the most likely of the three groups to have low socioeconomic status, to have no health insurance and to receive primary care in an emergency department or hospital outpatient clinic,” the authors write. However, all men with treated and untreated androgen deficiency were more likely to report receiving regular care than those without the condition and reported visiting their doctor more often throughout the year (with averages of 15.1 visits for those with untreated androgen deficiency, 6.7 visits for those without the condition and 12 visits for those with treated androgen deficiency).

“Under our assumptions, a large majority (87.8 percent) of 97 men in our groups with androgen deficiency were not receiving treatment despite adequate access to care,” the authors conclude. “The reasons for this are unknown but could be due to unrecognized androgen deficiency or unwillingness to prescribe testosterone therapy.”

Jun. 18–It’s hard to miss all the buzz about omega-3 fatty acids. In the grocery store the other day, I noticed that omega-3 fatty acids have been added to some brands of orange juice. Consumers now also have the choice of buying eggs and peanut butter fortified with omega-3 fatty acids.

In general, fats are described based on the predominant fatty acid present. Fatty acids are of two basic types: saturated (such as in butter) or unsaturated (such as in liquid vegetable oils). Unsaturated fatty acids, in turn, are classified as monounsaturated or polyunsaturated. Omega-3s are a type of polyunsaturated fatty acid.

The most common omega-3 fatty acids are eicosapentaenoic (EPA), docosahexaenoic (DHA) and alpha-linolenic (ALA) acids. At this time, the national dietary standards known as the Dietary Reference Intakes do not include recommended intakes for all omega-3 fatty acids. But an adequate intake has been set for ALA at 1.6 and 1.1 grams per day for men and women, respectively.

ALA is found in plant oils, including flax, canola and soybean. DHA and EPA are found in the tissues of cold-water fish such as salmon, mackerel, tuna, herring, sardines and even oysters. Cod liver also is a rich source of these omega-3s. My mother may have been right in forcing us to choke down that spoonful of cod liver oil each day.

Strong evidence exists that consumption of fish oil reduces serum lipid levels and reduces inflammation, which are both associated with cardiovascular disease risk.

In fact, many health problems are linked to chronic inflammation: cardiovascular disease, asthma, at least some types of cancer, type 2 diabetes and obesity. The anti-inflammatory effects of omega-3s are mediated by changes in the production of bioactive substances called cytokines by our white blood cells.

Evidence also suggests that consuming omega-3s may improve the body’s sensitivity to its own insulin, thus helping to maintain a healthy body weight and reducing risk for type 2 diabetes. Recent studies conducted by French researchers found that consuming 1.8 grams of EPA/DHA per day resulted in a significant loss of body fat after just two months.

While DRIs have not been established for all of the omega-3s, several expert groups have recommended increases in the amounts and types of omega-3s in the diet. Recommendations have varied from 0.5 to 1.6 grams per day (combined EPA/DHA), to 1 percent to 2 percent of total calories a day (for total omega-3’s). For a person consuming a 2,000-calorie-a-day diet, this would translate to 20 to 40 calories or 2 to 4 grams of omega-3s each day. This level of omega-3 intake can be achieved using fish oil supplements. Since a single 1-gram capsule of fish oil contains about 30 percent EPA/DHA, this would require consuming two to six capsules each day.

Another approach is to include plant sources of ALA in your diet. One of the richest sources of ALA is flax — grown right here in North Dakota. Flax oil is about half ALA. Other edible seed oils contain lesser amounts of ALA. For example, canola (also grown in North Dakota) oil has about 12 percent ALA, and soybean (again, produced here) oil contains about 7 percent.

ALA can be converted to EPA by our tissues, but that conversion provides only small amounts of EPA. One study indicated that one would need to consume 7 grams of ALA to get the same effect as 1 gram of EPA/DHA. This means one would have to consume 14 grams (1 tablespoon) of flax oil (50 percent ALA) to get the same effect.

Unlike fish oil, flax and flax oil can be incorporated into many foods without great effects on flavor, texture and other characteristics. For this reason, consumers are being presented choices of foods fortified with omega-3s from plant oils. This trend is bound to continue as more evidence emerges about the health benefits of ALA.

Each month, scientists at the Grand Forks Human Nutrition Research Center write a column about their work and how their work affects people’s lives on a daily basis. This month’s column is written by Wesley Canfield, research medical officer, who received his medical degree from the State University of New York Health Sciences Center at Upstate.

The June 23, 2008 issue of the American Medical Association journal Archives of Internal Medicine published the discovery of Austrian and German researchers that men and women with higher serum levels of vitamin D have a reduced risk of dying from all causes as well as specifically from cardiovascular disease over a seven year period, compared with individuals whose blood levels are low.

Harald Dobnig, MD, of Medical University of Graz, Austria, and colleagues evaluated data from 3,258 participants scheduled for coronary angiography who enrolled in the Ludwigshafen Risk and Cardiovascular Health Study between 1997 and 2000. Serum levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamn D, which is converted from 25-hydroxyvitamin D in the body, were measured in blood samples collected prior to the angiographic procedure.

Over an average 7.7 years of follow-up, 737 deaths occurred, of which 62.8 percent were from cardiovascular causes. Approximately two-thirds of the patients were found to have low serum 25-hydroxyvitamin D levels of under 20 nanograms per milliliter. Cardiovascular risk markers, including C-reactive protein levels and interleukin 6 levels (which evaluate inflammation), oxidative burden, and cell adhesion markers, were greater among individuals with lower serum 25-hydroxyvitamin D levels than in those whose levels were higher. Participants whose serum 25-hydroxyvitamin D levels were among the lowest one-fourth of participants, at a median of 7.6 nanograms per milliliter, had an adjusted risk of dying from all causes or cardiovascular disease that was twice that of subjects whose levels were among the highest fourth at 28.4 ng/mL. When 1,25-dihydroxyvitamin D levels were evaluated, similar associations were found.

“This prospective cohort study demonstrates for the first time, to our knowledge, that low 25-hydroxyvitamin D and 1,25-dihyroxyvitamin D levels are associated with increased risk in all-cause and cardiovascular mortality compared with patients with higher serum vitamin D levels,” the authors write. “Apart from the proved effects that vitamin D has on bone metabolism and neuromuscular function, appropriate serum levels (that may also be higher than in the present investigation) are associated with a decrease in mortality. Although not proved, it seems possible that at least part of this effect may be due to lowering of a risk profile promoting atherosclerosis and preventing cardiovascular end points.”

“Based on the findings of this study, a serum 25-hydroxyvitamin D level of 20 nanograms per milliliter or higher may be advised for maintaining general health,” they conclude.

07-08-08

Dieters who write down everything they eat each day lose twice as much weight as those who don’t, according to one of the largest weight-loss studies ever conducted.

This confirms the importance of keeping a food diary — advice that nutritionists and weight-loss programs have pushed for years.

Scientists at four clinical research centers recruited 1,685 overweight or obese adults who weighed an average 212 pounds. Forty-four percent were African Americans.

The participants were offered 20 weekly group sessions led by nutritionists and behavior counselors and encouraged to try to lose at least 9 pounds in six months. They were told to consume about 500 fewer calories a day, eat plenty of fruits and vegetables, do about 180 minutes of moderate-intensity physical activity a week, and keep daily food and exercise records.

The findings reported in the August issue of the American Journal of Preventive Medicine:

*Dieters who kept their food diary six or more days a week lost an average of about 18 pounds in six months, compared with about 9 pounds for those who didn’t keep food diaries.

*The biggest losers also attended most of the group meetings and did more exercise. Some did 300 minutes or more of physical activity a week, but the average participant in the study did about 117 minutes a week.

*69% of the participants lost 9 pounds or more, which is enough to improve some health measures such as blood pressure, joint pain and pre-diabetes.

*69% of black men and 59% of black women lost at least 9 pounds.

“There is a misconception that nobody can lose weight, but in this study, two-thirds of them lost enough weight to make a difference to their health,” says Victor Stevens, senior investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. The National Heart, Lung, and Blood Institute sponsored the study.

These weight-loss techniques work well with everybody, including African Americans, who are often underrepresented in studies and yet suffer from a high rate of obesity and weight-related illnesses, he says.

Food diaries are a “powerful self-management technique. They help you figure out where the extra calories are coming from,” he says. It works best if someone else looks over your food record. “When you put yourself in a position where you are accountable for your behavior, it changes behavior.”

Many people are getting lots of extra calories by eating large portions at restaurants, Stevens says. He is currently working with a client who was consuming 1,500 calories of fast food at lunch. The dieter is now bringing a 500-calorie lunch to work, saving 1,000 calories a day.

Dawn Jackson Blatner, a registered dietitian in Chicago, tells people that a food diary “is the best way to monitor every crumb, morsel, nibble, sip, swallow and bite you take.”

To significantly reduce disease, we must slow the aging process, according to a team of experts who published their conclusion online in the British Medical Journal on July 8. In an article entitled, “New model of health promotion and disease prevention for the 21st century,” Professor S. Jay Olshansky of the University of Illinois at Chicago and his associates suggest that the current focus on preventing and curing individual diseases will become outmoded as people in developed countries live longer and develop the multiple chronic illnesses that come with aging.

“The change in strategy we are calling for requires a systematic attack on aging itself,” they write. “Evidence in models ranging from invertebrates to mammals suggests that all living things, including humans, possess biochemical mechanisms that influence how quickly we age and that they are adjustable.”

Due to a greater life expectancy in developed countries, the increased incidence of diseases related to aging has resulted in a dramatic rise in health care costs. Dr Olshansky and colleagues note that if an extended life span is combined with health, it could result in a number of economic, social, and other benefits, which they call “the longevity dividend.” They propose increased funding for studies that will increase our knowledge concerning the relationship of aging to such diseases as type 2 diabetes, Parkinson’s disease, and most cancers, in addition to research into the processes that control aging itself.

In an accompanying analysis entitled, “Has the time come to take on time itself?” associate professor Colin Farrelly of the department of political science at Canada’s University of Waterloo notes that the Alliance for Aging Research has called on Congress to invest three billion dollars annually into research that would increase our understanding of the biology of aging. “To those who ask, ‘Can we afford to invest more in such research?’” he writes, “We can reply: ‘Can we really afford not to tackle aging?’ That is the really important question. And the answer clearly is no.”

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