Diabetes and Exercise – what’s the big deal???

Due to the large percentage of the population currently with the condition known as diabetes (it is estimated as of a 2007 study that 7.8% of the population currently HAS diabetes, and another 25.9% of adults age 20 and over has pre-diabetes), many people are talking about prevention and exercise.  I’ll touch on the prevention a little bit, and then delve deeper into the exercise portion.

Many of you may have been told that prevention should include not eating anything that contains sugar, exercise (there is that nasty word again), eating at certain times of the day, losing weight, etc.  Most of this is true, of course.  Here are 5 tips on prevention from the Mayo clinic:

  1. Get more physical activity (there’s the whole exercise thing again)
  2. Get plenty of fiber
  3. Go for whole grains
  4. Lose extra weight
  5. Skip fad diets and make healthier choices

So, for now I’ll continue to skip over the nasty exercise word, and concentrate on the other 4 steps.

First, the fiber.  Why on earth would you want to eat fiber?  Well, for one, it can make you feel fuller, which can help you lose weight.  It also tends to slow down things going through your intestines, and slows the absorption of sugar, allowing you to have better control over your blood sugar after a meal.

Now, for the whole grains.  Scientists aren’t quite sure why whole grains help, but they do tend to help maintain blood sugar levels.  Currently, recommendations are to get half of your grains from whole grains – look for the word “whole” on the package and among the first few ingredients listed.

Losing excess weight – often even as much as 5 to 10 percent of initial body weight – and exercise regularly can reduce the risk of developing diabetes by as much as 58% over 3 years.  Fat releases hormones that promote diabetes; decreasing the amount of total body fat that you have will decrease levels of those hormones, and reduce your risk.

Fad diets – dieting is about lifestyle change, and making healthy choices.  Eliminating one entire food group can set you up for nutritional deficiencies.  And the weight you lose in the beginning is mostly water and a substance called glycogen, which is stored in the liver to help regulate blood sugar levels.  Glycogen can store up to 3 times its weight in water, and can be used up rapidly – this is the source of losing massive amounts of weight (well, one of the sources at least – you do have other sources of glycogen and water in your body, especially in your muscles) while on severely limiting diets (not mentioning any, of course *cough*Atkins*cough*).

Now, for the exercise portion. People who exercise for 2 1/2 hours at least per week cut their risk (the 58% mentioned above).  Does this mean that you have to purchase a gym membership and work your butt off?  Of course not – moderate exercise is the key.  About half of that needs to be aerobic – meaning, it works out your heart and your vascular systems (blood vessels).  The other half should be in resistance-exercises (weight lifting, using bands, etc).

The effects of exercise on blood glucose levels lasts about 3 days, so don’t do your 2 1/2 hours in one day, and expect that to be the end.  About 30 minutes each day is the perfect amount, for 5 days a week.  Now, who can’t fit THAT in???  Other exercises that could be done for the prevention of diabetes include:

  • Gardening
  • Walking
  • Biking
  • Hiking
  • Walking up/down stairs
  • Lifting bottles/jugs of water
  • Chasing the kids around
  • etc…

So, nearly anything you can think of that will raise your heart rate can count as your exercise.

Please note:  if you already HAVE diabetes, it would be best if you talked to your doctor before starting ANY exercise program.  People who have been diagnosed with diabetes are at an increased risk for (among other things) heart disease, so make sure your ticker is in good condition before you start!  Stay healthy!!!


Osteoporosis Medications – miracle cure, or cruel myth?

There are quite a few women (and sometimes men) out there with the dreaded condition known as osteoporosis.  First of all, what the heck does that even mean?  I’m sure that most of you have heard of it, but what is it?  Secondly, I’m also sure that some of you have seen the commercials on TV telling you to talk to your doctor about drug X – it’s supposed to reverse osteoporosis!  Is this possible – are there drugs that can reverse this process?  How do they work?  How might I improve the action of the drug?  These are a few of the things we will look at in today’s article.

What Osteoporosis looks like in bone So, what is osteoporosisOsteoporosis simply means “porous bones.”  The condition causes bones to become weak and “brittle” (kind of like glass is brittle, it will shatter if you hit it).  This condition can worsen to the point that a fall, or some mild stresses like bending over or coughing/sneezing can cause a fracture.  The most common fractures that can happen are in the spine, hips, ribs, and wrists (although, since the entire skeleton is affected, fractures can happen anywhere).

Unfortunately, there are really no symptoms of this condition until fractures occur.  It can be present for decades, in fact.  Also, a bone might fracture, but might not do so with pain; in other words, it might not be a complete fracture.  So, the condition can go on, until the patient experiences a painful fracture.

How can this be prevented?  Can I “catch” osteoporosis???  OK, you cannot “catch” osteoporosis – it is an internal condition, and not caused by some type of “bug.”  The best prevention starts before age 30 – yes, you heard me right, before you’re 30.  After 30, your bone density begins to go downhill, unless you take preventative steps.  The national osteoporosis foundation has 5 steps for the prevention of osteoporosis (you need all 5, one or two will not help enough):

  • Get your daily recommended amounts of calcium and vitamin D
  • Engage in regular weight-bearing exercise
  • Avoid smoking and excessive alcohol
  • Talk to your healthcare provider about bone health
  • When appropriate, have a bone density test and take medication

I will touch on ONE point above – weight-bearing exercise.  Does this mean that you need to become a power-lifter?  Of course not – but it does mean that you need to do some sort of resistance exercise, like lifting weights.  Don’t have weights?  Lift food cans! ;)

OK I lied, I’ll touch on two points – the amounts of calcium and vitamin D.  Vitamin D you can get from the sun, as well as fortified milk and other foods, so I’ll just touch on the calcium.  There are generally two forms of calcium – calcium carbonate and calcium citrate.  There are pros and cons to both.

Calcium carbonate is generally much less expensive, and you don’t need to take nearly as many pills to get your daily dose.  If you have a condition where you don’t have as much stomach acid, you’ll have trouble absorbing it, and it may also be constipating (you’ll have trouble going number 2).

Calcium citrate is much more expensive, and you’ll have to take more of it to get your dose.  But, it doesn’t need any acid, so if you are taking antacid medications, or have had bypass surgery, this is the way to go for you.

Also, don’t take more than 500mg of calcium at one time – you won’t be able to absorb it, and you’ll be throwing your money away.  Here is a table of intake based on your age:

  • 0 to 6 months – 210 mg
  • 7 to 12 months – 270 mg
  • 1 to 3 yrs – 500 mg
  • 4 to 8 yrs – 800 mg
  • 9 to 18 yrs – 1300 mg
  • 19 to 50 yrs – 1000 mg
  • 51+ yrs – 1200 mg

Don’t take more than 2500 mg/day – too much of a good thing CAN in fact be a bad thing.

Alright, enough about calcium, prevention, and definitions – what about those of you who already may HAVE this condition.  Is there anything you can do about it?

First of all, talk to your doctor, and get a bone density test.  This will show whether you have the condition in the first place.

Secondly, begin (or continue) to have some form of light exercise, especially weight-bearing exercise.  Be careful about this, and talk to your doctor first if you already have osteoporosis, as this can cause stress fractures.

OK, so the last of the 5 steps was medications.  By now, I’m sure all of you have heard of these – they promise to “reverse osteoporosis.”  So, what are the medications, and do any of them actually follow through on their claims?

Here are the current medications (that I know of) for the Prescription Drugstreatment of osteoporosis:

  • Fosamax (alendronate Sodium)
  • Actonel (Risendronate Sodium)
  • Parathar (Teriparatide)
  • Evista (Raloxifene)
  • Zometa (Zoledronic acid)
  • Boniva (Ibandronate Sodium)
  • Calcimar, Miacalcin (Calcitonin)
  • Vitamin D3 (Cholecalciferol)

Whew – what a list!  And yes – there may be others out there that would be prescribed for osteoporosis; this is a short list.  If you know of any more, and want questions on them answered, please leave a comment below!  So, do any of them work?  Well take that on right now:

FOSAMAX (alendronate sodium):  basically, the group that this particular drug belongs to binds certain cells in bones.  They attempt to slow down the rate at which they break down.  Basically, the drug does this by stopping the processes in the cells that break down calcium (called osteoclasts), which prevent your body from getting calcium from the bone.  This has two effects – your bone density stops degrading, but your blood calcium levels can fluctuate.  Other things that depend on calcium – your heart, for example – may be affected, so it is extremely important that you are supplementing with calcium.  Side-effects can include GI bleeding (gastrointestinal) and diarrhea, arthralgia (joint pain), and nonspecific chest pain.

ACTONEL (Risendronate Sodium): has the same basic action as FOSAMAX, but is about 1,000 times more powerful.  In some studies, Actonel acts much faster than FOSAMAX, but there have not been any clinical trials to prove this.

PARATHAR (Teriparatide):  This is an interesting drug.  It is actually a synthetic hormone (parathyroid hormone).  Given continuously, it can actually result in bone loss, as it causes more calcium to go into the bloodstream.  But, it is given once a day; this intermittent dose actually results in net bone formation, which is good for patients with osteoporosis. Side effects include hypercalcemia (too much calcium in the blood) and hypercalciurea (too much calcium in the urine, is the most common cause of calcium kidney stones).  Sometimes, side effects can include dizziness, depression, pain, headache, and leg cramps.

EVISTA (Raloxifene):  This is interesting, as it affects two different things.  It is an estrogen receptor modulator (it affects estrogen receptors), and works like estrogen does on the bone.  It acts as an “anti-estrogen” in other parts, especially breast tissue and the uterus.  This results in the prevention and treatment of osteoporosis by slowing bone thinning.  It can cause “some” increase in bone thickness, but this to my understanding is minimal.  It also greatly lowers (by 66-76%) the risk of breast cancer.  Side effects include hot flashes, vaginal dryness, leg cramps, blood clots in deep veins, uterine cancer (very rare), muscle and joint pains, weight gain, and a rash.

ZOMETA (Zoledronic acid):  I won’t spend much time on this one, it has about the same method of action as FOSAMAX and ACTONEL, and has the same strength as ACTONEL.  This is an IV drug, so you’ll have to visit your doctor’s office when you need a dose.  As far as I can tell, this is mostly used in cases of cancer.

BONIVA (Ibandronate sodium):  And here we have BONIVA, and so many people have heard of this miracle drug, I’m surprised I’m having to explain it at all… ;)   But, here it is anyway.  BONIVA is in the same class of drugs that FOSAMAX is – meaning that ACTONEL and ZOMETA are more powerful.  So, it has the same side effects, and the same effects as those other drugs.  BONIVA is a monthly drug (or a every 3-month injection); FOSAMAX and ACTONEL are once-weekly by mouth.  BONIVA was the slowest to show a reduction in fractures, with patients needing to take it for at least 2 years to show real benefit.  It is important to note that BONIVA is only approved for fracture reduction in the spine; ACTONEL has approval for spine and non-spine, and FOSAMAX has approval to treat for fracture reduction at the spine and hip.  So, even though all of them act though the same mechanism, they are approved for different things.

CALCIMAR, MIACALCIN (Calcitonin):  is a naturally occurring hormone that regulates calcium levels in the blood.  Basically, it makes the cells that make bone take calcium from the blood and deposit it into the bone.  These drugs have been shown to slow the rate of bone thinning, however, have not been shown to be as effective as ACTONEL, FOSAMAX, or BONIVA.  This might be used, however, if patients have bad reactions to those other drugs.  It also can be used to reduce pain (takes up to 2 weeks) from a vertebral fracture and collapse.

VITAMIN D3 (Cholecalciferol):  Mainly used with calcium, vitamin D raises the amount of calcium that can be absorbed by the body.  It can be used to treat other bone diseases, but we’re focusing on osteoporosis here.

So, there are a bunch of drugs on the market, and some of them even seem to build bone back up.  It is important to note, however, that no long-term studies on any of these has been done (FOSAMAX is the oldest), so they can’t say for sure what the long-term effects of these drugs really is.  The best thing to do is prevention – get your calcium and vitamin D, and do weight-bearing exercise.  But, if it’s already too late, and you think you might have osteoporosis, talk to your doctor.  You will have to take most of the drugs for a very long time to build bone back up, but many of them do seem to work, as far as clinical trials have shown.

Finally, how might you improve the actions of these drugs?  Almost universally, they help absorb calcium from the blood into the bone.  So, if you don’t have enough calcium, they can’t do their jobs effectively.  If you are taking one of these medications, you will need to take a calcium supplement, as well as Vitamin D in order to get the most out of it.

Please comment with any questions, or if you find any information contained in this article that you think might be incorrect.  Thanks!

Nuclear waste – are there green solutions to the problem?

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The Scream - by Edvard MuchCountries like France get up to 80% of their power from nuclear power plants.  The US gets about 20% from nuclear power – but we produce more waste products than the French do.  Is there a solution?  Will be be buried under a mountain of nuclear waste?  Read on!

In my last post on nuclear power, I talked about how nuclear power works, and whether the technology is safe and/or green.  I had some good feedback from that, and decided that the topic of nuclear waste would be a good second post on the subject.  So, how is nuclear waste generated?  What is it exactly?  And are the any solutions?

As you probably already know, nuclear waste is the byproduct of a nuclear fission process.  Fission is where the atoms in a radioactive material (usually Uranium) split, making other elements and giving off heat.  The products of a uranium fission are usually iodine, caesium, strontium, xenon, and barium, all of which are usually radioactive immediately after the process ends.  Another product of uranium fission is Plutonium.  And yes, in case you are wondering, one of the nuclear power plants in the Manhattan Project was producing plutonium for the atomic bomb (it was the Hanford site).

So what’s so dangerous about nuclear waste?  They’re just elements, right?  Maybe so, but these elements by themselves are radioactive, because the contain extra parts in their atoms.  This makes them unstable, and so handling them can make you very sick, cause burns, or kill you.  Let’s take a quick look at the generation of nuclear waste, and how some countries handle it.

These pellets (which contain uranium) are placed in this metal rod (the fuel rod)Upon fission in a nuclear reactor, the above elements might be generated, along with another uranium isotope.  An isotope is simply a fancy word for elements that contain different amounts of a substance in their atoms, namely neutrons (don’t hold any type of a charge, positive OR negative).  All of these products are fairly radioactive.  The United States does not reprocess this waste – it is stored only.  This is due to the fact that the reprocessing of nuclear waste products three things – uranium that can be used for power production (a very good thing), high-level radioactive waste (a very BAD thing), and plutonium.  The concern is that the plutonium, if enough was stocked, could be used to build a weapon.  Other countries (namely the UK, France, Russia, and India) do reprocess this fuel, and use both the uranium and plutonium produced as fuel in their reactors.

The remaining high-level radioactive waste is largely solidified, and stored.  There isn’t currently a very good way to get rid of nuclear waste, which is why it’s such a controversy (OK, only ONE of the reasons).  France keeps high-level waste on-site (at the reactor) for a few years, then sends it off to be solidified, and stored for several decades.  They are currently working on many options, including geologic disposal (sealing the waste deep in the earth).  Some other options include reprocessing the waste into glass, and burying the glass deep underground, long-term storage facilities (which would be above ground), and transmutation (changing it into something else).

So, as you can see, most solutions to the waste problem attempt to deal with it by burying it in geologic formations that have lasted many thousands of years.  This is why Yucca mountain in Nevada was looked at (possibly more on Yucca mountain later).  But currently, most nuclear waste is stored on-site underwater, until a better solution can be found.  So, will we be buried under a mountain of radioactive waste?  Probably not, but a solution needs to be found for the long term, because no matter what your view is on the matter, nuclear power production is here to stay for the foreseeable future.

References

World Nuclear Association (2007) – http://www.world-nuclear.org/info/inf29.html

French Office of Civilian Radioactive Waste Management (2001) – http://www.ocrwm.doe.gov/factsheets/doeymp0411.shtml

Teenage “night owl syndrome” possibly caused by lack of morning sunlight???

insomnia 3am 200 Teenage “night owl syndrome” possibly caused by lack of morning sunlight???How many of us have dealt with teenagers who can seemingly stay up endless hours?  Partying, playing video games, or just “hanging around?”  Well, some researchers decided that it couldn’t possibly be natural – so they looked into the causes.  And here’s what they found:

When teenagers spend more time indoors, they miss out on morning light, which kind of “resets” the body’s natural sleep/wake cycle.  These researchers did a study on 11 eighth grade students, who wore special glasses, preventing them from having a certain type of light (short wavelength light, or blue light) reach their eyes.  By the end of a 5 day study, they experienced a 30-minute delay in sleep at the end of the day.  They think that this is due to the decrease of melatonin, a hormone that regulates sleep patterns, with removal of the blue light.  The study showed that melatonin was released about 6 minutes later each night they students were deprived of the blue light.  About 2 hours after melatonin is released, sleep typically occurs.  These findings were published in Neuroendocronology Letters.

Whew, that was a mouthful.  I would again like to give a shout out to Inditop.com for the findings of this study.  And now, the explanation – for the rest of us.

First of all, the “study” results.  I found them VERY interesting – until I got to the size of the “study.”  There are several types of studies, some are called case studies, some are randomized controlled studies, and there are still others, but I’ll leave that for another time.  Case studies involve a few people, and an observation about these people.  What seems to happen.  These can be very biased, meaning that there are factors that affect the outcome of the study that the researcher doesn’t intend.  For example, I could do a case study on the number of cases of diabetes in the American population.  I choose 20 people for my study, and I get a whopping 95% of those ended up having diabetes.  Does this mean that 95% of the population will have diabetes?  Of course not – the 20 people that I chose were all severely overweight, did not exercise, and ate fast food all the time.  That introduces bias, and so the results cannot be trusted.

A randomized controlled study is a type of study where the participants are chosen at random, from a similar population.  There are a couple of different types of these studies, but they all involve larger groups of people, so the information can be more trusted.

This study is a type of case study.  It cannot prove that lack of morning light turns teenagers into night owls.  It can say there might be a link, however, which is what is interesting about this study.  More needs to be done in order to make a decision as to whether we need more morning light in order to get to bed on time.

Finally, a little bit about the hormone melatonin.  Melatonin (in the case that we are talking about) is produced by the pineal gland, a small gland in your brain.  It releases hormone in reaction to light levels, with the highest levels being released during the night.  It was once thought that this hormone actually controlled sleep; it is now known that although melatonin promotes sleep, it doesn’t actually send you to sleep – your higher brain functions do that on their own.  Some people who are having trouble sleeping can wear blue-blocking glasses a few hours before bedtime – this raises melatonin levels and helps promote sleep.

This being said, does lack of MORNING light hold back melatonin production at NIGHT?  Like I said before, further study is needed – especially since it would make sense (to me) that artifical light at night (especially fluorescent daylight lighting, as it contains a higher amount of blue light) would be more important than simply not having enough light when you wake up.  What are your thoughts on this?  Any questions?

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Stem cells – should they be used? What is ethically and morally right – you decide.

Before I dive into the meat of this topic, I just want to give a shout out to Method:  The Best Science Blogs for syndicating this blog.  If you have a chance, check them out – their address is http://science.blogdig.net.  And now, on with the show…

So I was thinking about other topics to write about, and since it is a hotly contested topic (for several years now), I thought I would write on stem cell research.    In this article, I will explore exactly what the different types of stem cells are, how they might be used, and why there is so much controversy.

So, what is a stem cell?  The phrase “stem cell” has become somewhat of a buzz word among the general populace, as well as among doctors and research scientists, but it doesn’t describe very well how many different TYPES of stem cells there are.  I’m going to float around a couple of different “sciency” terms here, but I’ll provide descriptions after them – just skip to those if you’re unfamiliar with the terms.  There are two general categories of stem cells – totipotent and pluripotent.  Some of you will argue this, but I’ll go into subcategories in a moment.  Totipotent stem cells have total potential – they can become any cell in the body, or can become extra-embryonic cells (ok, that was a big one, just think of the placenta, amniotic sac, etc).  Pluripotent stem cells come from the totipotent ones – they can become all cells EXCEPT for the extra-embryonic ones.

One of the problems with stem cell research is that they only take the pluripotent cells, which means that the embryo has begun to form.  I do say begun here – the embryo is in the 8 or 16 cell stage.

A subcategory are called multipotent cells.  These cells can only become certain things – for instance, some cells make all the white and red blood cells in your body, but they cannot regenerate skin.  You have a different type of stem cell for that purpose.

Most multipotent cells are also called somatic stem cells, or adult stem cells, since they only regenerate body tissue and cannot regenerate multiple parts of the body.

One other type of cell has recently surfaced – induced pluripotent stem cells.  These cells have been taken from an adult, and have been chemically induced (made) to take on a pluripotent role.  This type of cell has high hopes in research, as there is much less controversy surrounding them.

So why are we so excited about stem cells?  For starters, they can be used to regenerate any tissue in your body – if your heart is wearing out, they can regenerate you a new one.  Have a spinal cord injury?  Without stem cells, your options for walking again might be limited, but stem cells can regenerate the nerve tissue that might allow you to walk again.

But these cells can go beyond this as well.  Cell based therapies range from injuries to cancer, and everything in between.  Some think that this might be a way to introduce genetic treatments as well, since cells tend to “talk” to others around themselves with chemical messengers.

Finally, the controversy.  Embryonic stem cells are taken from human embryos.  To a large percentage of the population, this is killing the embryo, since it has already been conceived.  It all depends on your point of view – where do you view the creation and beginning of a new life?  Is it at conception?  When they can start thinking?  Birth?  These are the questions that ethical philosophers and research scientist have been trying to answer for years.  Ultimately, stem cell research could be the way to treat a number of different injuries and disease processes, but the ethical and moral dilemma will probably always be a barrier against this type of research.  This is why things like induced pluripotent stem cells are so interesting – they completely bypass the ethical and moral dilemma of working with embryonic stem cells.  So what is the future – embryonic stem cell research, or doing research on adult or “somatic” stem cells to make them able to take on new roles in the body?