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Studies: Weight-loss surgery dramatically improves diabetes

Posted: March 27, 2012 at 12:21 pm

Date: Tuesday Mar. 27, 2012 6:10 AM ET

CHICAGO New research gives clear proof that weight-loss surgery can reverse and possibly cure diabetes, and doctors say the operation should be offered sooner to more people with the disease -- not just as a last resort.

The two studies, released on Monday, are the first to compare stomach-reducing operations to medicines alone for "diabesity" -- Type 2 diabetes brought on by obesity. Millions of Americans have this and can't make enough insulin or use what they do make to process sugar from food.

Both studies found that surgery helped far more patients achieve normal blood-sugar levels than medicines alone did.

The results were dramatic: Some people were able to stop taking insulin as soon as three days after their operations. Cholesterol and other heart risk factors also greatly improved.

Doctors don't like to say "cure" because they can't promise a disease will never come back. But in one study, most surgery patients were able to stop all diabetes drugs and have their disease stay in remission for at least two years. None of those treated with medicines alone could do that.

"It is a major advance," said Dr. John Buse of the University of North Carolina at Chapel Hill, a leading diabetes expert who had no role in the studies. Buse said he often recommends surgery to patients who are obese and can't control their blood-sugar through medications, but many are leery of it. "This evidence will help convince them that this really is an important therapy to at least consider," he said.

There were signs that the surgery itself -- not just weight loss -- helps reverse diabetes. Food makes the gut produce hormones to spur insulin, so trimming away part of it surgically may affect those hormones, doctors believe.

Weight-loss surgery "has proven to be a very appropriate and excellent treatment for diabetes," said one study co-leader, Dr. Francesco Rubino, chief of diabetes surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center. "The most proper name for the surgery would be diabetes surgery."

The studies were published online by the New England Journal of Medicine, and the larger one was presented Monday at an American College of Cardiology conference in Chicago.

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Studies: Weight-loss surgery dramatically improves diabetes

Weight-loss surgery can reverse diabetes and may cure it, study finds

Posted: March 27, 2012 at 10:07 am

CHICAGO -- New research gives clear proof that weight-loss surgery can reverse and possibly cure diabetes, and doctors say the operation should be offered sooner to more people with the disease -- not just as a last resort.

The two studies, released on Monday, are the first to compare stomach-reducing operations to medicines alone for "diabesity" -- Type 2 diabetes brought on by obesity. Millions of Americans have this and can't make enough insulin or use what they do make to process sugar from food.

Both studies found that surgery helped far more patients achieve normal blood-sugar levels than medicines alone did.

The results were dramatic: Some people were able to stop taking insulin as soon as three days after their

In this March 23, 2012 photo, Tamikka McCray, 39, holds photos showing her before a weigh-loss surgery, during an interview at Weill Cornell Medical Center in New York. McCray no longer needed to take diabetes medication and insulin after her weigh-loss surgery. (AP Photo/Bebeto Matthews)

Doctors don't like to say "cure" because they can't promise a disease will never come back. But in one study, most surgery patients were able to stop all diabetes drugs and have their disease stay in remission for at least two years. None of those treated with medicines alone could do that.

"It is a major advance," said Dr. John Buse of the University of North Carolina at Chapel Hill, a leading diabetes expert who had no role in the studies. Buse said he often recommends surgery to patients who are obese and can't control their blood-sugar through medications, but many are leery of it. "This evidence will help convince them that this really is an important therapy to at least consider," he said.

There were signs that the surgery itself -- not just weight loss -- helps reverse diabetes. Food makes the gut produce hormones to spur insulin, so trimming away part of it surgically may affect those hormones, doctors believe.

Weight-loss surgery "has proven to be a very appropriate and excellent treatment for diabetes," said one study co-leader, Dr. Francesco Rubino, chief of diabetes surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center. "The most proper name for the surgery would be diabetes surgery."

The studies were published online by the New England Journal of Medicine, and the larger one was presented Monday at an American College of Cardiology conference in Chicago.

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Weight-loss surgery can reverse diabetes and may cure it, study finds

Weight-loss surgery effective against diabetes, studies show

Posted: March 27, 2012 at 10:07 am

In findings that promise radical changes in the care of the 20 million U.S. patients with Type 2 diabetes, two new clinical trials have shown that weight-loss surgery brings about dramatically greater improvement of blood sugar control in obese diabetics than standard diabetes care.

In both studies, even rigorously supervised regimens of diet, exercise and medications failed to bring blood sugar under good control after a year or more. In contrast, two teams of researchers one in Italy, the other in the United States reported that surgical procedures to reduce the size and sometimes the placement of the stomach often allowed subjects to discontinue diabetes medications within weeks.

Both studies were published online Monday in the New England Journal of Medicine. One of them, by researchers at the Cleveland Clinic and Harvard University, was presented Monday at the American College of Cardiology's annual meeting in Chicago.

In an accompanying editorial in the journal, diabetes specialists Paul Zimmet and K. George M.M. Alberti wrote that although surgical weight-loss procedures were "not yet" a panacea for the worldwide epidemic of Type 2 diabetes, the new research "suggests they should not be seen as a last resort."

"Such procedures might well be considered earlier in the treatment of obese patients with Type 2 diabetes," Zimmet and Alberti wrote. Zimmet is a specialist at the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, and Alberti is at King's College in London.

"Now we know that treating diabetes can and should be a primary reason for doing this surgery," said Dr. Lee M. Kaplan, director of the Massachusetts General Hospital Weight Center. Such surgery should not be the first line of treatment, Kaplan said, but it should become a fallback for patients whose blood sugar control remains poor despite medications and lifestyle changes.

"We ought to be using it more," he said.

Both studies examined patients who had undergone one of three bariatric surgery procedures: biliopancreatic diversion, Roux-en-Y gastric bypass or sleeve gastrectomy. In addition to improved blood sugar control, all experienced significantly greater weight loss than those on standard drug treatment.

Both studies also reported that subjects who had surgery saw more improvement in some, though not all, cholesterol measures than those on standard diabetes therapy.

In general, the studies found that the scale of improvements in patients' metabolic function and weight loss tracked the degree to which the surgical procedures reshaped the gastrointestinal system. Biliopancreatic diversion, the most radical of the operations, appeared to produce the most radical improvements, followed by Roux-en-Y bypass and sleeve gastrectomy.

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Weight-loss surgery effective against diabetes, studies show

Weight loss surgery eliminates diabetes symptoms

Posted: March 27, 2012 at 10:07 am

A new study in the New England Journal of Medicine demonstrates that patients with severe, out-of-control diabetes who received either gastric banding surgery or gastric bypass, had lower blood sugar -- long before they lost weight. NBC's Robert Bazell reports.

By Robert Bazell, Chief Science and Health Correspondent

A "sensational" new finding could be the beginning of a cure for type 2 diabetes, a disease described in an editorial accompanying the research in the New England Journal of Medicine as one of the fastest growing epidemics in human history.

Two studies find that weight loss surgery can eliminate the symptoms of type 2 diabetes in a large proportion of volunteers. That might not seem surprising, since obesity is the major risk factor for the disease. But in these studies, published in the New England Journal of Medicine and presented Monday at the annual meeting of the American College of Cardiology, many of the patients got better within weeks, days, sometimes even hours after the surgery -- long before they lost any weight.

Its pretty amazing, said Dr. Phil Schauer of the Cleveland Clinic, the lead author on one of the studies. Schauaers study divided 150 patients with out-of-control diabetes into three groups. One-third got the best drug therapy, the next gastric-banding surgery, and last gastric bypass. The goal was to get the patients blood sugar (measured by the A1C test familiar to diabetics) below the normal level of 6 percent. Forty-two percent of the bypass patients reached the goal after one year compared to 37 percent of the banding patients and only 12 percent on medical therapy.

But those numbers dont even begin to show how successful this was," according to Dr. Steve Nissen, another author of the paper from the Cleveland Clinic. He points out that at the beginning of the study most of the patients were taking three or more medications to control their diabetes. But after a year almost none of the gastric-bypass patients needed medication. Forty-four percent required daily insulin injections before surgery and none did after. Diabetes is a major risk factor for heart disease. Most of the surgery patients saw their HDL, the good cholesterol, shoot way up and their artery clogging triglycerides drop sharply.

This is sensational, Nissen told me.

The second study from the Catholic University of Rome and Weill Cornell Medical College followed sixty patients for two years and produced even stronger results. In that experiment one third of the volunteers got drug therapy, one third bypass surgery, and the last group underwent bilopancreatic diversion, an even more severe weight-loss operation where surgeons block part of the small intestine.

After two years none of the patients on drug therapy reached the goal of normal blood sugar levels while 75 percent of those who underwent bypass did and as did fully 95 percent of those undergoing the bilopancreatic diversion. The authors of the study say these patients have achieved complete diabetes remission. Though the doctors have followed them for only two years, there is no indication that the diabetes is returning in any of them.

Why, in some patients, do the positive effects take place long before they lose weight? Marla Evans, 56, one of the volunteers who got gastric banding in the Cleveland study put it this way, I was a diabetic, and then after the surgery, within a few days, the diabetes was much better, and within a month or two therewas no diabetes in my blood at all.

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Weight loss surgery eliminates diabetes symptoms

Eating fatty foods makes the brain GROW – but the new cells seem to tell the body to put on even more weight

Posted: March 27, 2012 at 12:21 am

Mice on high-fat diet grow four times as many cells in one part of the brain Change occurs in weeks Mice with new cells put on more weight than others - even if both are on high-fat diet Growth of 'tanycyte' cells - also found in humans

By Rob Waugh

PUBLISHED: 09:52 EST, 26 March 2012 | UPDATED: 09:52 EST, 26 March 2012

Cream tea? High-fat diets pile on weight around the midriff - but in mice at least, they seem to cause 'growth' inside the brain

High-fat diets pile on weight around the midriff - but in mice at least, they also seem to cause 'growth' inside the brain.

Sadly, a diet of cheeseburgers won't make you more intelligent - the new cells trigger weight gain.

Mice with the new cells packed on weight far faster than other mice - even when both were on the same high-fat diet.

The finding could offer an insight into how the brain controls weight gain through eating and hunger.

It could even open new avenues into understanding the factors that trigger obesity.

It's not clear whether the same process is at work in humans - but if so, the finding could also offer an avenue for anti-obesity treatments.

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Eating fatty foods makes the brain GROW - but the new cells seem to tell the body to put on even more weight

Socca to me: The next food trend?

Posted: March 27, 2012 at 12:21 am

Chickpea crepes, coming soon to a kitchen near you. iPhone photo by Rebekah Denn

I know it's early to be making trend lists for 2012, but it seems everywhere I look lately I'm seeing socca, a French chickpea crepe.

You can find socca on the menu at Bastille, but I'm not seeing it show up at restaurants so much as in the kitchens of friends. It's popular among those who need to eat gluten-free meals, and with the increasing numbers of people I see on anti-inflammatory diets. Expat and dessert chef extraordinaire David Lebovitz might have planted the seeds a few years back with his post on making socca at home, where he sold us by saying that the street food from Nice "is meant to be in rough shards, eaten with your fingers, and is especially good after a long day on a sun-saturated beach when your skin is tingling with sand and you can lick your lips and taste the sand of the Mediterranean."

My friends haven't waxed quite so eloquent, but they've been relieved to find a simple food that supports their diets, from a crackery crunch in the thinner versions to a thicker soft crepe.

I gave it a try with this tomato-onion topped version from Yotam Ottolenghi's book "Plenty," which is winning raves of its own nationwide. (With the eggs and dairy, it doesn't work with all my friends' diets, but it worked for mine.) I used garbanzo bean flour from Bob's Red Mill, which is widely available at supermarkets, and it was a piece of -- well, not cake, but at least crepe.

Socca

Serves 4

2 cups cherry tomatoes, halved 5 1/2 tablespoons olive oil, plus more for drizzling 1 3/4 pounds white onions, cut into thin rings 2 tablespoons thyme leaves salt and black pepper 1/2 teaspoon white wine vinegar 1 3/4 cups chickpea flour 2 cups water 2 egg whites creme fraiche to serve

Preheat oven to 275 degrees. Spread the tomatoes cut-side up on a small baking pan and sprinkle them with some salt and pepper and a drizzle of olive oil. Roast for 25 minutes or until semi-cooked. They are not supposed to dry out completely. (Note: After 25 minutes we turned up the heat to 300, as ours didn't seem cooked enough.)

Meanwhile, heat 4 tablespoons olive oil in a large frying pan. Add the onions, thyme, and some salt and pepper, and cook on high heat, stirring for about a minute. Reduce the heat to low and continue cooking for 20 minutes, stirring occasionally. You want the onions completely soft, sweet and golden brown but not very dark. At the end, stir in the vinegar, then taste and adjust the seasoning.

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Socca to me: The next food trend?

Should 7-year-olds be put on strict diets? Vogue article sparks debate

Posted: March 27, 2012 at 12:21 am

(CBS News) Dara-Lynn Weiss' daughter, Bea, had become a statistic. At 4-foot, 4 inches and 93 pounds, the 7-year-old had become obese. So, the Vogue columnist did what she knew best: She put Bea on a strict diet.

"One day Bea came home from school in tears, confessing that a boy at school had called her fat. The incident crushed me, but it was a wake-up call. Being overweight is not a private struggle. Everyone can see it," Weiss wrote in the April 2012 issue of Vogue.

VIDEO: 12-year-old teaches town to lose weight Bullied boy loses 85 lbs., inspires others to lose

Weiss wrote she decided to enroll her daughter into a "Red Light, Green Light" diet program. The mother detailed her struggle to keep Bea fit and how she turned to such tactics as making her go without dinner after she celebrated French heritage day at school, banning her from participating in "pizza Fridays" and publicly admonishing her cravings in front of others. In the end Bea lost 16 pounds in one year, but it has left many wondering whether the harsh and berating treatment worth the weight loss.

While Bea's weight loss was impressive, some experts say that Weiss went about it all in the wrong way. Dr. Joanna Dolgoff, who runs the Red Light, Green Light, Eat Right program that Bea enrolled in, confirmed to HealthPop that Bea's weight made her considered obese, and said she respected and understood why Weiss was so strict because of the difficulty of the situation.

But, Dolgoff insisted that Weiss' methods were not the intention of her program. The traffic light-based diet system revolves around teaching kids healthy eating habits, so they can be in charge of their diet plans.

"We want to empower these kids," Dolgoff said. "Studies show that if you treat overweight kids in a sensitive manner, you do decrease emotional problems."

Dolgoff said that the Weiss stopped going to the counseling sessions halfway through the program and Bea and her mother didn't get the emotional support they needed. The Red Light program ultimately allows the child to make the decisions, and even if the kid slips up and eats something that is unhealthy, parents are advised to let them do it.

"Their emotional health is extremely important, and that's what we talk a lot about in the visit," Dolgoff said. "We don't want them thinking they've been bad. We explain it's hard to be healthy in our society when they put supersized everything in front of you."

Childhood obesity is a society problem in the U.S. According to the Center of Disease Control, between 1980 and 2008 the percentage of children aged 6 to 11 who were obese has risen 14 percent, and for those 12 to 19 years it has gone up 13 percent. More than one third of children and adolescents are overweight or obese.

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Should 7-year-olds be put on strict diets? Vogue article sparks debate

Dukan Diet doctor faces ethics charge

Posted: March 27, 2012 at 12:21 am

Dr Dukan, 70, whose high-protein regime was used by Carole Middleton and is said to have been used by her daughter the Duchess, is accused of offering potentially dangerous advice that could breach the French medical ethics code.

Dr Dukan faces disciplinary action or being struck off the medical register if found guilty and has a month to respond to the complaints.

Yesterday, his lawyer said he would happily provide his observations to the ethics council, arguing that his proposals were part of a doctors right to freedom of expression.

The fact that his work doesnt leave the public indifferent is proof that it highlights a major public health issue, said Isabelle Lucas-Baloup, adding that a summons does not amount to a conviction.

Dr Dukan, who has sold eight million copies of his diet book worldwide, made his ideal weight exam option proposal in his book An Open Letter to the Future President.

At its launch, he said: There is nothing unhealthy about educating youngsters about nutrition.

My idea would change nothing for those who have no need to get thinner. But for those who do, it would only motivate them to lose weight.

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Dukan Diet doctor faces ethics charge

Hold the Butylated Hydroxyanisole: GenoVive Survey Reveals Adults Prefer Diet Food Without a Side Order of Preservatives

Posted: March 27, 2012 at 12:21 am

NEW ORLEANS, LA--(Marketwire -03/26/12)- Americans looking to lose weight want diet food companies to hold the preservatives according to a recent survey conducted by Harris Interactive on behalf of GenoVive, a new weight management program that uses genetic analysis as the foundation of customized weight loss programs. The January survey of more than 2,500 adults ages 18 and older found that two out of three people surveyed (67%) would prefer that their diet foods include only all-natural ingredients without preservatives and not processed foods with other potentially harmful chemicals and additives.

"Additives such as preservatives, antibiotics, hormones, and a variety of new-to-nature components appear to negatively impact the quality of our food and potentially negatively impact our bodies," said Dr. Ruth DeBusk, PhD, RD, who is a geneticist, molecular biologist and clinical dietitian in practice in Tallahassee, Florida, and a member of GenoVive's Scientific Advisory Board.

The survey also showed that women are significantly more likely than men to prefer diet foods with all natural ingredients, with 71% of women making this choice over 63% of men.

"With women making many of the critical decisions about food in American households, it comes as no surprise that women in particular are demanding better ingredients for their diet needs and overall food choices for their families," said Dr. DeBusk. "Diet foods that are laden with additives actually work against us by disrupting the body's natural tendencies. They make the challenge of losing weight and keeping it off even more difficult."

Beverly Swango, nutritionist and director of product development at GenoVive, cautions against the proliferation of food additives in the foods we eat that exceed reasonable amounts each day.

"It's unfortunate, but today, most diet foods as well as a startling number of food items found in our supermarkets contain additives and chemicals that trigger unwanted reactions in our cells and in our genes," said Swango.

According to Swango, most consumers realize that the BPA found in water bottles is harmful yet some of the most-unsuspecting foods also contain additives. "Tortilla wraps contain anti-microbials while nutrient bars for diabetics include titanium dioxide. While some additives are considered safe in trace amounts, over time there can be cumulative effect that can have significant negative impact on consumer health. At GenoVive, we only use 'real food' that the body was designed to metabolize."

About GenoVive LLC

Founded in 2008, GenoVive, a division of Genvis Bio Group, LLC, based in New Orleans, LA, represents a new approach to weight loss and sustained healthy eating. GenoVive's geneticists and food scientists developed customized, all-natural meal and exercise programs, featuring ideal combinations of macronutrients based on individual DNA. GenoVive is sold directly to the consumer at GenoVive.com and by phone with convenient home delivery. Follow GenoVive on Twitter @myGenovive, Facebook at http://www.facebook.com/GenoVive, and YouTube at http://www.youtube.com/GenoVivednadiet.

Survey Methodology

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Hold the Butylated Hydroxyanisole: GenoVive Survey Reveals Adults Prefer Diet Food Without a Side Order of Preservatives

Mother’s strict diet for 7-year-old raises controversy, criticism

Posted: March 27, 2012 at 12:21 am

In a controversial article appearing in the April issue of Vogue magazine, author Dara-Lynn Weiss writes about the strict diet she imposed upon her daughter after a pediatrician suggested she was clinically obese.

Bea, who stood 4-feet, 4-inches tall, weighed 93 pounds was not necessarily obese, but fat, according to Weiss, who admits to having issues with food for the past 30 years.

- Dara-Lynn Weiss, writing for Vogue Magazine

Growing up in an affluent, achievement-driven suburb, I had suffered through my own issues with food, eating and weight, Weiss wrote. Though the rest of my family had a seemingly healthy relationship to food, I was constantly battling weight gain and asking my mother to lock-up the peanut butter jar. Whether I weighed 105 pounds or 145 pounds hardly mattered. I hated how my body looked and devoted an inordinate amount of time to trying to change it.

Weiss added that she once even begged a doctor to write her a prescription for appetite suppressant fen-phen, even after it was found to cause heart valve defects and pulmonary hypertension.

Weiss article talks about the increase in childhood obesity in todays society and cites a survey that revealed parents are more comfortable talking to their kids about sex than weight.

The author admitted she wasnt very consistent with how she served Bea food sometimes Beas after school snack was a slice of pizza or a chicken gyro from a street vendor. Other days I forced her to choose low-fat soup or a single hard-boiled egg. Occasionally, Id give in to her pleas for a square of coffee cake, mainly because I wanted to eat half of it.

Starting the diet

When a kid at school called Bea fat and made her cry, Weiss took matters into her own hands, scheduling an appointment with child-obesity specialist Dr. Joanna Dolgoff, who assigns a red light to bad foods and green light to good foods. Weiss said she joined her daughter in dieting, and the two embarked upon a low-fat, low-cal, and reduced-portion diet.

Bea had to start exercising too she joined karate and in the summer, swam once a week.

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Mother’s strict diet for 7-year-old raises controversy, criticism


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