January 27, 2012
NIH Podcast Episode #0151
Balintfy: Welcome to the 151st episode of NIH Research Radio. NIH Research Radio bringing you news and information about the ongoing medical research at the National Institutes of Health – NIH . . . Turning Discovery Into Health®. I'm your host Joe Balintfy, and coming up in this edition a lot about diets: news about a link between animal fat and a kind of diabetes, we’ll get details on some top-ranked eating plans, hear how an app, and coaching, can help with weight control, and a story about sleep. But first, this news update. Here’s Craig Fritz.
Fritz: Since the discovery of the microscope, scientists have tried to visualize smaller and smaller structures to provide insights into the inner workings of human cells, bacteria and viruses. More recently, cryo-electron microscopy has helped scientists see very small particles. This method has been useful in helping researchers understand how vaccines work. But it has had limitations. Now, researchers at the NIH have developed a new way to see more clearly inside viruses. The investigators call this technique bubblegram imaging. Ideally, this technique will allow a better understanding of the inner workings of viruses, providing more opportunities for developing novel therapies. One exciting prospect lies in using this approach to visualize differences in cancer vs. non-cancer cells. Researchers say this new procedure makes previously invisible proteins visible and, thus, will provide new understanding of cell biology.
For this news update, I’m Craig Fritz.
Balintfy: News updates are compiled from information at www.nih.gov/news. Coming up on NIH Research Radio: a sleep story and a series of reports about nutrition, diets, and weight control tips, that’s next.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
High animal fat diet increases gestational diabetes risk
Balintfy: In this first report, researchers using information from more than 13-thousand women participating in the Nurses’ Health Study II have found an important link between diet and having a healthy pregnancy.
Zhang: Higher animal fat and cholesterol intake were associated with an increased risk of gestational diabetes.
Balintfy: Dr. Cuilin Zhang at the NIH is the senior author of a recent paper published in the American Journal of Clinical Nutrition.
Zhang: Gestational diabetes is a common pregnancy complication. And it affects both women themselves and also their babies.
Balintfy: Gestational diabetes is a form of diabetes seen during pregnancy that increases the risk for certain pregnancy complications and health problems in the newborn.
Bowers: One of the major risk factors is obesity.
Balintfy: Dr. Katherine Bowers at the NIH is the lead author of the paper.
Bowers: I think one of the important points of this paper though is that it’s not just obesity, but the independent and the specific dietary factors themselves. For example the specific fats, animal fat – the source of the fat – and cholesterol.
Balintfy: Women whose diets were high in total fat or other kinds of fats – but not in animal fat or cholesterol – did not have an increased risk. Moreover, the increased risk for gestational diabetes seen with animal fat and cholesterol did not appear connected to other dietary and non-dietary risk factors. For example, exercise is known to reduce the risk of gestational diabetes. But women in the study who exercised and consumed higher amounts of animal fat and cholesterol had the higher risk. Dr. Zhang says these findings have important implications.
Zhang: For women who are planning for pregnancy, they should also work on their diet.
Balintfy: The researchers conclude that changing the source of 5 percent of dietary calories from animal fat to plant-derived sources could decrease a woman’s risk for gestational diabetes by 7 percent.
Zhang: Given that gestational diabetes is such a common pregnancy complication, and its prevalence is increasing, and also considering the potential adverse impact of gestational diabetes on the baby’s outcome, it’s really important to identify modifiable factors to help women to prevent the development of this disorder during pregnancy.
Balintfy: The researchers add that additional studies may lead to better understanding of how a mother’s diet before and during pregnancy influences her metabolism during pregnancy, which may have implications for the baby’s health at birth, and later in life. They also point out that this type of study requires confirmation by a clinical trial. For more information on the study visit www.nichd.nih.gov. For details on gestational diabetes, visit the website ndep.nih.gov.
Top-ranked eating plans from NIH
Balintfy: Are you one of the many people that has made – and perhaps already abandoned – a New Year’s resolution to better manage you weight? Experts say stick with it.
de Jesus: Weight maintenance is very important.
Balintfy: NIH nutritionist Janet de Jesus says weight affects heart disease risk factors, high blood cholesterol and hypertension, or high blood pressure.
de Jesus: It’s important for people to lose weight if their overweight or obese, and hopefully sustain that throughout the year.
Balintfy: But the question is often which diet to start? de Jesus points out that U.S. News & World Report recently evaluated 25 of the most popular diets and identified the best.
de Jesus: And they ranked very highly the DASH Eating Plan and the TLC which is the Therapeutic Lifestyle Changes.
Balintfy: Ranked number one and two respectively, both diets are NIH-supported and research-based. But de Jesus adds that they can be thought of as eating plans, rather than diets.
de Jesus: I like “eating plan” better than “diet” because really this is a change for life. It’s how you eat. “Diets” is that cliché that comes up. It’s usually taken negatively. So we want to say positively, healthy eating is good for you and not just the negative diet that comes around in January or when someone gets bad news from their doctor.
Balintfy: Bad news from a doctor can be a diagnosis of hypertension. de Jesus says that the top-ranked DASH eating plan focuses on that.
de Jesus: DASH stands for Dietary Approaches to Stop Hypertension. And this eating plan was created as a result of two major clinical trials. So the eating plan mirrors very closely -- what was fed to the participants, so it was a feeding trial. And what they found is that even independent of sodium reduction or weight loss that the DASH eating plan was able to lower blood pressure in participants compared to a controlled diet.
Balintfy: de Jesus adds that hypertension is a risk factor for heart disease and stroke. Another heart disease risk factor is high blood cholesterol, which is the target of the number 2-ranked TLC.
de Jesus: TLC stands for Therapeutic Lifestyle Changes and that comes out of the National Cholesterol Program and the aim is to lower your high blood cholesterol. So this diet, the main emphasis is on lowering saturated fat, trans fat and cholesterol.
Balintfy: US News says to be top rated in their ranking, a diet has to be nutritious, safe and effective. de Jesus adds that for any diet, try to make it meaningful and realistic.
de Jesus: I would just say you want to start with small steps. You don’t want to change everything at once. You know pick something that you want to work on. So for example, if you want to lower your saturated fat intake, look at the foods that you’re eating and see what’s high in saturated fat. So for example, high fat dairy products, fatty cuts of meat, skin on poultry. If you are eating those, look to replace those with something healthier. Don’t do everything at once. Once you’ve mastered that then you could probably switch to another nutrient.
Balintfy: She also recommends getting family and friends involved because support is important. Also working with a physician and a registered dietician to start or change an eating plan can be very helpful.
de Jesus: Changing the way you eat and also increasing your physical activity is really worth it for your health. It’s better for you. It’s good for your family as well, so give it a try and keep it up and don’t get too frustrated. We all stumble but just keep it up throughout the year.
Balintfy: For more information on both the DASH and TLC eating plans, visit www.nhlbi.nih.gov.
Body Mass Index app helps measure health risk
Balintfy: So you have a couple eating plan options, but now maybe you’re looking for a convenient way to stay informed about your weight and possibly the health risks associated with being overweight or obese? Well how about a BMI app for that:
Donato: The app is a way for you to calculate your weight in relation to your height, and then it will give you the corresponding BMI number as well as the categories of weight where your body mass index lies.
Balintfy: Karen Donato is the coordinator of overweight and obesity research applications at the NIH’s National Heart, Lung and Blood Institute. She explains that BMI stands for Body Mass Index.
Donato: It's a useful and practical measure of overweight and obesity. It actually is a number that's calculated from your weight and height and is a very good estimate of total body fat in most people.
Balintfy: For example, a BMI of about 19 to 24 is normal, where a BMI of 30 or more is a sign of obesity. Donato says that having a BMI calculator app makes getting this information easy.
Donato: I think the app is just an easy way for people to calculate your body mass index if you're curious about whether or not you fall within the normal or overweight category as well as in the obese category. It's available on most mobile devices and is readily available.
Balintfy: The BMI calculator can also be used on line, but Donato adds that knowing your BMI is just one part of your health picture.
Donato: Although BMI can be used for most men and women, it does have some limits in that it can overestimate body fat in athletes or others who have a lot of muscle, or it can also underestimate body fat in older persons and others who have lost muscle.
Balintfy: Donato says that in addition to BMI, it is important to measure your waist circumference since where the fat is located is also important to determining corresponding health risks.
Donato: In addition to BMI, measuring waist circumference is important since if most of your fat is around your waist rather than at your hips, you're at a higher risk for heart disease and type 2 diabetes. The risk goes up with a waist size greater than 35 inches for women or greater than 40 inches for men. Also, body mass index, the higher your body mass index and the higher your waist circumference, the higher your risk for obesity-related diseases such as heart disease, high blood pressure, type 2 diabetes, certain cancers, gallstones, and breathing problems.
Balintfy: The BMI calculator and app also help direct you to what to do next depending on your BMI.
Donato: For example, if your BMI is around 27, you're considered overweight and you'll be directed to a page that provides some tips for weight loss success. If you fall in a normal weight category, you will be directed to a page to help you maintain that healthy weight.
Balintfy: The app is available for free from the BMI calculator page on the NHLBI website as well as from the iTunes store. To download the app or find more information about BMI and the importance of a maintaining a healthy weight, visit www.nhlbi.nih.gov.
NIH studies find long-term weight loss methods for clinical practice
Balintfy: Of course a million dollar question in weight maintenance is how to not only get it started, but keep it going to make an impact. Wally Akinso reports that research is showing that weight loss coaching by phone, Web, and e-mail contact, as well as support from primary care providers, can help.
Akinso: Obese adults who received weight loss coaching over the phone, web, email contacts and support from their primary care providers lost a significant amount of weight for about two years according to a five year two part NIH study. Dr. Barbara Wells is the program director of the POWER Trials.
Wells: POWER is an acronym. It actually stands for Practice-based Opportunities for Weight Reduction.
Akinso: She says results from two POWER studies are appearing separately in the New England Journal of Medicine.
Wells: These were separate randomized, control trials funded by the NIH to identify effective weight loss treatments that can be used in ordinary, real world, primary care practices to help obese patients.
Akinso: The first POWER trial was conducted by John Hopkins University School of Medicine. POWER Hopkins recruited 415 participants from six primary care practices in the Baltimore area and assigned them at random to one of three groups.
Wells: One was a control or self directed group. The second group, which we called the remote group, received phone internet and email support from trained weight loss coaches with no face to face contacts. The third group received the same phone, internet, and email support plus individual group sessions with office based coaches. The latter two groups also received support from their primary care providers at the regularly scheduled medical visits.
Akinso: The control group received weight loss information in printed materials and a website link. Dr. Wells explains what researchers found when comparing the groups.
Wells: They found that both treatment approaches achieves substantial weight loss, with or without in person coaching sessions. The average weight loss regardless of whether it was in person or remote was over 10 pounds.
Akinso: The second study, known as, POWER-UP, was conducted by the University of Pennsylvania. There were 390 participants from six primary care practices in the Penn Medicine system and also assigned them at random to one of three groups.
Wells: The control or usual care group received printed educational materials. The second group was offered a brief lifestyle counseling approach of 25 coaching sessions that relied upon auxiliary health care providers such as medical assistance. And the third group, the enhance brief lifestyle was also offered these 25 coaching sessions plus they had the additional option to use meal replacements such as liquid shakes or meal bars or take prescription weight loss medication. And all groups met with their primary health care provider four times a year this trial.
Akinso: Dr. Wells points out that the POWER-UP study findings were different.
Wells: What they found was that the enhanced brief lifestyle counseling was more effective than the usual care group. Weight loss for the brief lifestyle counseling group did not differ significantly from the usual care group.
Akinso: Dr. Wells adds that these studies will help bring proven weight loss interventions to the front lines of clinical practice. For more information, visit www.nhlbi.nih.gov.
Balintfy: That’s Wally Akinso reporting. We’ll have another report from Wally about protecting sleep health. That’s next on NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Updated NIH Sleep Disorders Research Plan seeks to promote and protect sleep health
Balintfy: Building on scientific advances that link sleep problems to health and safety risks, the NIH seeks to spur new approaches to the prevention and treatment of sleep disorders. Here again is Wally Akinso.
Akinso: An estimated 50–70 million adults in the United States have chronic sleep or wakefulness disorders. Sleep deficiency and disorders are associated with a growing number of long-term health problems including a greater risk of heart disease, stroke, diabetes, obesity, and other diseases.
Twery: Sleep is a part of everyone's life. Whether you're young or old, everyone is affected by not getting enough sleep.
Akinso: Dr. Michael Twery is the director of the National Center on Sleep Disorders Research at the NIH.
Twery: We think that, that as many as 70 percent of adolescents are not obtaining enough sleep according to survey data by the Center for Disease Control and perhaps as many as 36 percent or more of U.S. adults are not getting enough sleep.
Akinso: Drowsy driving, one of the most lethal consequences of inadequate sleep, has been responsible for an estimated 1,500 fatalities and 40,000 nonfatal injuries annually. In addition, research has shown that sleep disturbances can contribute to a person's risk of developing mental illnesses, particularly in adolescents. Sleep-related issues can affect a person's quality of life, and can contribute to a host of medical, social, and economic conditions.
Twery: In point of fact, this research indicates that this is the biggest threat to health. That not setting aside enough time to satisfy the need for sleep or staying awake too long seems to be the most common problem.
Akinso: To help solve the problems, Dr. Twery explains that the NIH has updated a plan to chart a course for future sleep research.
Twery: One is basic sleep research. We need better understand how sleep is regulated. A second area is clinical sleep research. We need to better understand how not getting enough sleep begins to affect our health and our ability to think clearly and how that affects our mood and behaviors. A third are was sleep disorders medicine. Another area that is very important for the NIH is translation and dissemination research. This is where we want to take all the advances, whether it's in basic research or clinical research and then apply those to actually improve public health. There's a fifth area and that is research training.
Akinso: Dr. Twery says there is a significant opportunity to inform public health research, given the prevalence of sleep and circadian problems nationwide. He adds that the goals outlined in the plan will help bring attention to important questions that still remain about the effects of sleep disturbances as well as the appropriate therapeutic approaches for them.
Twery: It's always going to be important for individuals who feel that excessive sleepiness is a burden to their daily activities to bring those symptoms to the attention of a physician, who can then evaluate whether further study or treatment is necessary. There is no blood test for a sleep problem. And the physician isn't going to see the problem when you're visiting him or her in the office. In fact the diagnosis of sleep disorders and sleep problems hinges on the patient discussing those symptoms with their physician.
Akinso: The 2011 NIH Sleep Disorders Research Plan provides an opportunity for future research to continue to define the role of sleep as a fundamental requirement of daily life and learn why a wide range of health, performance, and safety problems emerge when sleep and circadian rhythms are disrupted. For more information, visit www.nhlbi.nih.gov.
Balintfy: Again, thanks to Wally Akinso for that report. And that’s it for this episode of NIH Research Radio. Please join us again on Friday, February 10 when our next edition will be available.
“As we celebrate Black History Month and American Heart Month this February, let’s also take some time to learn how to lower our risk for heart disease”
That story and more next time. If you have any questions or comments about this program, or have story suggestions for a future episode, please let me know. Send an email to NIHRadio@mail.nih.gov. Also, please consider following NIH Radio via Twitter, or on Facebook. Until next time, I'm your host, Joe Balintfy. Thanks for listening.
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