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- Thyroxine (T4) and tri-iodothyronine (T3) determinations: techniques and value in the assessment of thyroid function
Hormonal production of the thyroid gland is constituted of thyroxine or T4 (80%) and triiodothyronine or T3 (20%). In the circulation, whole T4 originates from thyroid secretion but most of T3 (80%) is produced extrathyroidally from T4 deiodination. - Role of thyrotropin in triiodothyronine generation in hypothyroidism
T3 is the main active thyroid hormone and TSH is the major modulator of its synthesis and release by the thyroid gland - TSH may not be a good marker for adequate thyroid hormone replacement therapy
TSH levels used to monitor substitution, mostly regulated by intracellular T3 in the pituitary, may not be such a good indicator of adequate thyroid hormone action in all tissues. The co-administration of T3 may prove more effective in this respect, provided novel suitable preparations are developed - Low triiodothyronine (T3) syndrome
As first described in serious systemic illnesses isolated decreased T3 plasma concentration was related to impaired peripheral conversion of T4, to T3 with preferential production of reverse T3 (rT3). A "low T3 syndrome" was seen in 47 out of 109 patients with extra-thyroidal diseases. Metabolic state, TSH and TSH responses to TRH were normal despite of low T3 concentration. Euthyroidism seems mainly due to T4 itself in these patients. - Thyroid hormone metabolism in obesity
Serum thyroid hormone concentrations and their metabolic fate are within the normal range limits in obese subjects. Also serum TSH concentrations and its response to TRH are normal, suggesting that tissue availability of thyroid hormones is normally preserved in these subjects. In contrast, during caloric restriction serum T3 concentrations decrease as a consequence of its reduced production rate from peripheral deiodination of T4. Opposite, serum rT3 concentrations markedly increase as a result of its decreased metabolic clearance rate. - Diagnosing and treating hypothyroidism
The prevalence of both overt and subclinical hypothyroidism increases with age, affecting 5% to 10% of women over age 50 and 1.25% of men over age 60, with an increasing incidence in women ages 40 to 50. Typical symptoms are consistent with declining metabolic functions and range from vague complaints of fatigue in subclinical deficiency to overt clinical symptoms involving changes in mentation and memory, lethargy, weight gain, cold intolerance, constipation, and goitrous enlargement of the thyroid gland. - Fasting--wrong in obesity?
Fasting has been advocated as an effective way to reduce body weight. However, few data support any long-term effect of this therapy. On the contrary, evidence is accumulating that the repeated weight loss and concomitant weight gain, typical of fasting in many individuals, will lead to a subsequently higher body weight. Each weight cycle seems to increase the risk of a higher waist/hip ratio, greater metabolic efficiency and a food preference towards fat. All these trends result in further problems associated with weight loss and a vicious circle is established.
Koolhydraatverslaving
- Brain serotonin, carbohydrate-craving, obesity and depression.
Carbohydrate consumption--acting via insulin secretion and the "plasma tryptophan ratio"--increases serotonin release; protein intake lacks this effect. Hence many patients learn to overeat carbohydrates (particularly snack foods, like potato chips or pastries, which are rich in carbohydrates and fats) to make themselves feel better. This tendency to use certain foods as though they were drugs is a frequent cause of weight gain, and can also be seen in patients who become fat when exposed to stress, or in women with premenstrual syndrome, or in patients with "winter depression," or in people who are attempting to give up smoking - Does carbohydrate-rich, protein-poor food prevent a deterioration of mood and cognitive performance of stress-prone subjects when subjected to a stressful task?
During the CR/PP diet only the HS subjects did not show the stress-induced rise in depression, decline in vigour and cortisol elevation that they showed after the PR/CP diet. With respect to cognitive performance, significant dietary effects were found on reaction time. It is suggested that CR/PP food in HS subjects may increase personal control, probably under the influence of higher levels of brain tryptophan and serotonin. - Carbohydrate cravings: a disorder of food intake and mood.
Current findings on the relationship between excessive appetite for carbohydrate-rich foods and mood disorders may explain repetitive weight gain or the inability to lose weight among some obese individuals. Obese individuals who crave carbohydrates, exhibit positive changes in mood after carbohydrate intake Brain serotonin may be involved in these disorders of affect and appetite; thus therapies that mimic the effect of carbohydrate intake on the synthesis and release of this neurotransmitter may be useful in treating obesity arising from these causes - Depression and weight gain: the serotonin connection
Many individuals who fail to maintain a normal weight may be susceptible to daily, monthly or seasonal perturbations in mood which result in an excessive intake of carbohydrate-rich foods and resistance to engaging in physical activity. Brain serotonin appears to be involved in these disturbances of mood and appetite; - Glycemic index, glycemic load, and risk of type 2 diabetes
The possibility that high, long-term intake of carbohydrates that are rapidly absorbed as glucose may increase the risk of type 2 diabetes has been a long-standing controversy. Two main mechanisms have been hypothesized, one mediated by increases in insulin resistance and the other by pancreatic exhaustion as a result of the increased demand for insulin. During the past decade, several lines of evidence have collectively provided strong support for a relation between such diets and diabetes incidence. - The involvement of brain serotonin in excessive carbohydrate snacking by obese carbohydrate cravers
Evidence is presented that carbohydrate snacking seems to be related to a "need" to increase the level of brain serotonin; - Hypothalamic serotonin in control of eating behavior, meal size, and body weight
Serotonin (5-HT) has been implicated in the control of eating behavior and body weight. Stimulants of this monoamine reduce food intake and weight gain and increase energy expenditure, both in animals and in humans. - Menstrual cycle and appetite control: implications for weight regulation
Hormonal fluctuations associated with the menstrual cycle influence appetite control and eating behaviour. Energy intake varies during the reproductive cycle in humans and animals, with a periovulatory nadir and a luteal phase peak. Patterns of macronutrient selection show less consistency but a number of studies report carbohydrate cravings in the premenstrual phase, particularly in women with premenstrual syndrome. - Effect of nutrient intake on premenstrual depression.
Consumption of a carbohydrate-rich, protein-poor evening test meal during the late luteal phase of the menstrual cycle improved depression, tension, anger, confusion, sadness, fatigue, alertness, and calmness scores (p less than 0.01) among patients with premenstrual syndrome. Because synthesis of brain serotonin, which is known to be involved in mood and appetite, increases after carbohydrate intake, premenstrual syndrome subjects may overconsume carbohydrates in an attempt to improve their dysphoric mood state. - Carbohydrate craving, mood changes, and obesity.
Carbohydrate craving can cause weight gain in affected people and is present in women with premenstrual syndrome (PMS) and persons with seasonal affective disorder (SAD). - Serotonin, carbohydrates, and atypical depression
At least three categories of atypical depression have been described. The hysteroid dysphoria is characterized by repeated episodes of depressed mood in response to feeling rejected, and a craving for sweets and chocolate. Two other issues are characterized by a cyclical occurrence of changes of mood and appetite, i.e., the late luteal phase dysphoric disorder (DSM-III-R, appendix), or "the premenstrual syndrome" (PMS), and the major depression with seasonal pattern (DSM-III-R), or seasonal affective disorder (SAD). - Comparison of Hypericum extract WS 5570 and Paroxetine in ongoing treatment after recovery from an episode of moderate to severe depression: results from a randomized multicenter study
This study showed that WS 5570 and Paroxetine were similarly effective in preventing relapse in a continuation treatment after recovery from an episode of moderate to severe depression and point therefore to an important alternative treatment option for long-term relapse-prevention. - Acute treatment of moderate to severe depression with Hypericum extract WS 5570 (St John's wort): randomised controlled double blind non-inferiority trial versus Paroxetine
In the treatment of moderate to severe major depression, Hypericum extract WS 5570 is at least as effective as Paroxetine and is better tolerated. - Efficacy of St. John's wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial.
H. perforatum extract WS 5570 was found to be safe and more effective than placebo for the treatment of mild to moderate depression. - Superior efficacy of St John's wort extract WS 5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial
Hypericum perforatum extract WS 5570 at doses of 600 mg/day (once daily) and 1200 mg/day (600 mg twice daily) were found to be safe and more effective than placebo, with comparable efficacy of the WS 5570 groups for the treatment of mild to moderate major depression. - Safety and efficacy of St. John's wort (Hypericum) during pregnancy and lactation.
Caution is warranted with the use of St John's wort during pregnancy until further high quality human research is conducted to determine its safety. St John's wort use during lactation appears to be of minimal risk, but may cause side effects. Caution is warranted when using medications along with St John's wort. - The emerging recognition of herb-drug interactions with a focus on St. John's wort (Hypericum perforatum).
The herbal antidepressant St. John's wort (Hypericum perforatum) is one of the most commonly utilized herbal agents. Examples of conventional medications which may undergo significant CYP 3A4 induction by St. John's wort include cyclosporine, indinavir, and oral contraceptives. - Effect of grapefruit juice in relation to human pharmacokinetic study
Grapefruit juice (GFJ) interacts with a number of drugs, and can alter pharmacokinetics parameters of the drugs. As for these interactions, most reports have focused on the elevation of drug bioavailability by GFJ, but a few recent reports have indicated that GFJ reduced the absorption of drugs not metabolized by cytochrome P450 (CYP) - Safety of St. John's Wort extract compared to synthetic antidepressants
Risks to the patient are not caused by SWE but by drugs with a narrow therapeutic range. Consequently, SWE preparations should not be taken concurrently with other antidepressants, with coumarin-type anticoagulants, the immunosuppressants cyclosporine and tacrolimus, protease and reverse transcriptase inhibitors used in anti-HIV treatment or with certain antineoplastic agents. However, such cases are extremely rare and, with medical supervision, easily avoided. In conclusion, the safety of SWE must be considered more favourable than that of synthetic antidepressants. - Bioefficacy of a novel calcium-potassium salt of (-)-hydroxycitric acid.
(-)-Hydroxycitric acid (HCA), a natural plant extract from the dried fruit rind of Garcinia cambogia, has been reported to promote body fat loss in humans without stimulating the central nervous system.. HCA-SX has been shown to increase serotonin availability, reduce appetite, increase fat oxidation, improve blood lipid levels, reduce body weight, and modulate a number of obesity regulatory genes without affecting the mitochondrial and nuclear proteins required for normal biochemical and physiological functions. - Transcriptome of primary adipocytes from obese women in response to a novel hydroxycitric acid-based dietary supplement.
The dried fruit rind of Garcinia cambogia, also known as Malabar tamarind, is a unique source of (-)-hydroxycitric acid (HCA), which exhibits a distinct sour taste and has been safely used for centuries in Southeastern Asia to make meals more filling. Recently it has been demonstrated that when taken orally, a novel, highly soluble calcium/potassium salt of HCA (HCA-SX) is safe and bioavailable in the human plasma. - Efficacy of a novel calcium/potassium salt of (-)-hydroxycitric acid in weight control.
Eighty-two subjects completed the study. At the end of 8 weeks, in group A, both body weight and BMI decreased by 5.4%, low-density lipoprotein and triglycerides levels were reduced by 12.9% and 6.9%, respectively, while high-density lipoprotein levels increased by 8.9%, serum leptin levels decreased by 38%, serotonin levels increased by 44.5% and urinary excretion of fat metabolites increased by 32-109%. Group B demonstrated similar beneficial changes, but generally to a greater extent. No significant adverse effects were observed. The combined results confirm that HCA-SX and, to a greater degree, the combination of HCA-SX plus NBC and GSE reduce body weight and BMI, suppress appetite, improve blood lipid profiles, increase serum leptin and serotonin levels and increase fat oxidation more than placebo. - An overview of the safety and efficacy of a novel, natural(-)-hydroxycitric acid extract (HCA-SX) for weight management.
At the end of 8 weeks, body weight and BMI decreased by 5.4% and 5.2%, respectively. Food intake, total cholesterol, LDL, triglycerides and serum leptin levels were significantly reduced, while HDL and serotonin levels, and excretion of urinary fat metabolites (a biomarker of fat oxidation) significantly increased. No significant adverse effects were reported. These results demonstrate the safety, bioavailability and efficacy of HCA-SX in weight management. No remarkable toxicity results were detected, demonstrating the safety of HCA-SX. - Short-term (-)-hydroxycitrate ingestion increases fat oxidation during exercise in athletes.
These results suggest that a short-term administration of HCA enhances endurance performance with increasing fat oxidation, which spares glycogen utilization during moderate intensity exercise in athletes. - Effects of (-)-hydroxycitrate on net fat synthesis as de novo lipogenesis.
(-)-Hydroxycitrate (HCA) might promote weight maintenance by limiting the capacity for de novo lipogenesis (DNL). We conclude that an experimental condition resulting in DNL in humans was created and that treatment with HCA during overfeeding with carbohydrates may reduce DNL. (De novo lipogenesis is the metabolic route by which mammals convert excessive dietary carbohydrates into fat.) - Dexfenfluramine, fluoxetine, and weight loss among female carbohydrate cravers
These results suggest that weight loss following treatment with serotoninergic drugs may relate to a selective decrease in CHO appetite - Serotoninergic manipulation, meal-induced satiety and eating pattern: effect of Fluoxetinein obese female subjects
Mean daily energy intake, calculated from food diary records, was 1881 kcal when subjects were taking the placebo compared to 1460 kcal when taking Fluoxetine(a reduction of 22.4%). Fluoxetinetreatment produced a significant weight loss of 1.97 kg over the two weeks of treatment compared to a weight loss of only 0.04 kg on placebo - Central nervous appetite regulation: mechanisms and significance for the development of obesity
The involvement of brain serotonin neurons in appetite control is most attractive, since serotonin synthesis and release is readily affected by either precursor loading (i.e., 1-tryptophan) or pharmacological manipulation (e.g., drugs such as fenfluramine or fluoxetine). - Fluoxetineincreases resting energy expenditure and basal body temperature in humans
We propose that serotonin reuptake inhibition increases energy expenditure by increasing basal body temperature - Metabolic effects of Fluoxetinein obese menopausal women
The conclusion was that our data give support to thermogenic actions of FL after acute administration, suggesting also that chronic FL treatment may restrain to some degree the metabolic adaptation expected during weight loss in obese subjects. At variance with what observed with other drugs, such as dexfenfluramine, an increased thermic effect of oral glucose does not seem to be involved in the thermogenetic action of FL - A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving
The results of this study suggest that the main effect of chromium was on carbohydrate craving and appetite regulation in depressed patients and that 600 mug of elemental chromium may be beneficial for patients with atypical depression who also have severe carbohydrate craving - Effects of chromium picolinate on food intake and satiety
Study 1 demonstrated that CrPic, as compared to placebo, reduced food intake (P < 0.0001), hunger levels (P < 0.05), and fat cravings (P < 0.0001) and tended to decrease body weight (P = 0.08). - Dietary chromium intake. Freely chosen diets, institutional diet, and individual foods
Even well-balanced diets may contain suboptimal levels of dietary chromium - Chromium intake, absorption and excretion of subjects consuming self-selected diets
These data demonstrate that the average daily intake of chromium from self-selected diets is well below the minimum suggested safe and adequate intake and that Cr absorption, at levels found in typical US diets, is inversely related to dietary intake - Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes
This study demonstrates that CrPic supplementation in subjects with type 2 diabetes who are taking sulfonylurea agents significantly improves insulin sensitivity and glucose control. Further, CrPic supplementation significantly attenuated body weight gain and visceral fat accumulation compared with the placebo g - Chromium in the prevention and control of diabetes
Within the past five years, chromium has been shown to improve glucose and related variables in subjects with glucose intolerance and type 1, type 2, gestational and steroid-induced diabetes - FluoxetineSandoz 20 bijsluiter
FluoxetineSandoz 20 bijsluiter - Does St. John's wort interfere with the antiandrogenic effect of oral contraceptive pills?
There were no statistically significant differences in androgen levels after the addition of SJW in women using Loestrin 1/20trade mark. However, there were decreases in total testosterone and fT levels (10.7% and 15.8%, respectively) along with a small increase in SHBG levels (7.0%). CONCLUSIONS: In women using OCPs and SJW simultaneously, it appears that SJW does not interfere with the antiandrogenic properties of OCPs - Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding
Treatment with St. John's Wort was associated with a significant 13-15% reduction in the dose exposure from the contraceptive. Breakthrough bleeding increased in the treatment cycles, as did evidence of follicle growth and probable ovulation. CONCLUSION: St. John's Wort is associated with increased metabolism of norethindrone and ethinyl estradiol, breakthrough bleeding, follicle growth and ovulation. Women using OCs should be cautioned that St. John's Wort might interfere with contraceptive effectiveness - The interaction between St John's wort and an oral contraceptive.
St John's wort causes an induction of ethinyl estradiol-norethindrone metabolism consistent with increased CYP3A activity. Women taking oral contraceptive pills should be counseled to expect breakthrough bleeding and should consider adding a barrier method of contraception when consuming St Johns wor - Hypericin--the facts about a controversial agent
In other contemporary studies, screening hypericin for inhibitory effects on various pharmaceutically important enzymes such as MAO (monoaminoxidase), Recent studies report antidepressive, antineoplastic, antitumor and antiviral (human immunodeficiency and hepatitis C virus) activities of hypericin - A randomized, double-blind trial comparing sertraline and Fluoxetine6-month treatment in obese patients with Binge Eating Disorder
These results were maintained by responders (weigh loss of at least 5% of baseline weight) over 24 weeks. The results suggest that a 6-month treatment with SSRI may be an effective option to treat patients with BED - Fluoxetineimproves insulin sensitivity in obese patients with non-insulin-dependent diabetes mellitus independently of weight loss
Fluoxetine improves insulin-mediated glucose disposal in obese patients with NIDDM independently of weight loss - St John's wort for major depression
The available evidence suggests that the Hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants. The association of country of origin and precision with effects sizes complicates the interpretation - Zwangerschap en kind>Vanaf 1 jaar>Gezond gewicht>Introductie
Wel is tot 18 jaar de beoordeling van de BMI anders dan bij volwassenen. Bij kinderen hangen lengte en gewicht namelijk sterk af van de leeftijd omdat ze nog in de groei zijn. Internationaal is bepaald bij welke BMI-waarden kinderen een gezond gewicht, overgewicht en obesitas hebben - Zwangerschap en kind>Vanaf 1 jaar>Gezond gewicht>Bmi jongens
De Body Mass Index bij jongens. Deze tabel geeft een beoordeling van de Body Mass Index - Zwangerschap en kind>Vanaf 1 jaar>Gezond gewicht>Bmi meisjes
De Body Mass Index bij meisjes. Deze tabel geeft een beoordeling van de Body Mass Index - Hyperiplant als eerste geneesmiddel op basis van St.Janskruid geregistreerd
Hyperiplant® is als eerste kruidengeneesmiddel op basis van een extract van Hypericum perforatum (Sint Janskruid), door het CBG geregistreerd voor gebruik bij milde tot matige depressieve klachten - Use of antidepressants in treatment of comorbid diabetes mellitus and depression as well as in diabetic neuropathy
There have been six studies of fluoxetine, a selective serotonin reuptake inhibitor (SSRI), at a dose of 60 mg/day pursued up to 12 months that have demonstrated that medication's usefulness in diabetic patients, with reductions in weight (to 9.3 kg), in FPG (to 45 mg%), and in HbA1c (to 2.5%). In comorbid diabetes mellitus and depression, most evidence supports the use of fluoxetine in control of glucose handling
Hyperinsulinemie
- Insulin resistance and hyperinsulinemia: is hyperinsulinemia the cart or the horse?
The condition exists when insulin levels are higher than expected relative to the level of glucose. Thus, insulin resistance is by definition tethered to hyperinsulinemia - Hyperinsulinism. Causes and mechanisms
A high plasma insulin concentration in the presence of a normal or high plasma glucose level appears to be a common feature of glucose intolerance, obesity, and hypertension - Dietary carbohydrate's effects on lipogenesis and the relationship of lipogenesis to blood insulin and glucose concentrations
The process by which dietary carbohydrate is transformed into fat in the human body is termed de novo lipogenesis - Lipogenesis
Lipogenesis is the process by which simple sugars such as glucose are converted to fatty acids. Insulin stimulates lipogenesis in three main ways - The role of skeletal muscle insulin resistance in the pathogenesis of the metabolic syndrome
In contrast, hepatic de novo lipogenesis and hepatic triglyceride synthesis were both increased by >2-fold in the insulin-resistant subjects - Postprandial de novo lipogenesis and metabolic changes induced by a high-carbohydrate, low-fat meal in lean and overweight men
After intake of the high-carbohydrate meal, the overweight men had hyperinsulinemia and higher fatty acid and triacylglycerol concentrations than did the lean men. De novo lipogenesis was significantly higher before and after meal intake in the overweight men and was positively associated with fasting serum glucose and insulin concentrations - Hyperinsulinism syndromes caused by insulin resistance
Resistance to insulin consists in a decrease in insulin's biologic action and is manifested mainly by hyperinsulinism - Genetic determinants of the metabolic syndrome
Complex interactions between inherited factors and the environment determine an individual's susceptibility to type 2 diabetes mellitus and related syndromes. Insulin resistance, obesity, hypertension, and hyperlipidemia frequently precede the development of frank diabetes and aggregate in families - The metabolic syndrome: a crossroad for genotype-phenotype associations in atherosclerosis
The metabolic syndrome comprises a set of metabolic and physiologic risk factors associated with elevated cardiovascular disease risk. The expression of each one of its major factors (hypertriglyceridemia, low high-density lipoprotein cholesterol levels, hypertension, abdominal obesity, and insulin resistance) has been found to be the result of complex interactions between genetic and environmental factors - Archaeology of NIDDM. Excavation of the "thrifty" genotype
It also is hypothesized that this thrifty genotype in these Indians may contribute to NIDDM when a sedentary life-style is adopted and food sources are constant. Because insulin resistance in muscle is a major feature of NIDDM, it is possible that insulin resistance per se is the phenotypic expression of the thrifty genotype - Type-2 diabetes: a cocktail of genetic discovery
T2DM is a complex genetic disease comprised of many metabolic disorders with a common phenotype of glucose intolerance. Patients with T2DM would have inherited a variety of different genetic factors that together with environmental factors combine as the primary cause - Glycemic index and obesity
Many high-carbohydrate, low-fat diets may be counterproductive to weight control because they markedly increase postprandial hyperglycemia and hyperinsulinemia. Many high-carbohydrate foods common to Western diets produce a high glycemic response [high-glycemic-index (GI) foods], promoting postprandial carbohydrate oxidation at the expense of fat oxidation, thus altering fuel partitioning in a way that may be conducive to body fat gain - Diet composition and insulin action in animal models
Substantial evidence has now accumulated for a major role of dietary fat subtypes in insulin action. Intake of saturated fats is strongly linked to development of obesity and insulin resistance, while that of polyunsaturated fats (PUFAs) is not - Does dietary fat influence insulin action?
Epidemiological evidence linking particularly high saturated fat intake with hyperinsulinemia and increased risk of diabetes - Trans fatty acids, insulin resistance, and type 2 diabetes
High intakes of saturated fats may promote insulin resistance. It is therefore reasonable to hypothesize that high intakes of TFAs would have similar, or stronger, effects - Saturated, but not n-6 polyunsaturated, fatty acids induce insulin resistance: role of intramuscular accumulation of lipid metabolites
These results indicate that increasing dietary Sat induces insulin resistance with concomitant increases in muscle DAG. Diets rich in n-6 PUFA appear to prevent insulin resistance by directing fat into TAG, rather than other lipid metabolites - Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment
Increasing intakes of refined carbohydrate (corn syrup) concomitant with decreasing intakes of fiber paralleled the upward trend in the prevalence of type 2 diabetes observed in the United States during the 20th century - Magnesium transport induced ex vivo by a pharmacological dose of insulin is impaired in non-insulin-dependent diabetes mellitus
These data suggest that insulin resistance and magnesium depletion may result in a vicious cycle of worsening insulin resistance and decrease in intracellular Mg(2+) which may limit the role of magnesium in vital cellular processes - Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets
These data demonstrate that consumption of diets in the lowest 25% of normal chromium intake lead to detrimental effects on glucose tolerance, insulin, and glucagon in subjects with mildly impaired glucose tolerance - Physical inactivity rapidly induces insulin resistance and microvascular dysfunction in healthy volunteers
Physical inactivity was associated with the development of insulin resistance, dyslipidemia, increased blood pressure, and impaired microvascular function in healthy volunteers - Cigarette smoking and insulin resistance in patients with noninsulin-dependent diabetes mellitus
In conclusion, chronic cigarette smoking seems to markedly aggravate insulin resistance in patients with NIDDM - Long-term use of nicotine gum is associated with hyperinsulinemia and insulin resistance
These findings suggest that nicotine is the major constituent in cigarette smoke that leads to insulin resistance, metabolic abnormalities associated with the insulin resistance syndrome, and increased cardiovascular morbidity - Psychosocial stress and the insulin resistance syndrome
In 90 middle-aged male volunteers, psychosocial stress-related variables, defined as feelings of excessive tiredness and as personality and behavioral factors reflecting a stress-inducing life-style (type A behavior, hostility, and anger), were significantly correlated with the hyperinsulinemia, hyperglycemia, dyslipidemia, hypertension, increased abdominal obesity, and increased plasminogen activator inhibitor-1 (PAI-1) antigen comprising the IRS - Obesity: a major component of the metabolic syndrome
Approximately 60% of people with metabolic syndrome have obesity as a contributing factor - The effect of antidepressants on glucose homeostasis and insulin sensitivity: synthesis and mechanisms
Some serotonergic antidepressants (e.g., fluoxetine) reduce hyperglycaemia, normalise glucose homeostasis and increase insulin sensitivity, whereas some noradrenergic antidepressants (e.g., desipramine) exert opposite effects. Dual-mechanism antidepressants (e.g., duloxetine and venlafaxine) do not appear to disrupt glucose homeostatic dynamics, whereas nonselective hydrazine monoamine oxidase inhibitors (e.g., phenelzine) are associated with hypoglycaemia and an increased glucose disposal rate - Antidepressants induce cellular insulin resistance by activation of IRS-1 kinases
These results implicate selected SSRIs (paroxetine and sertraline) as inhibitors of insulin signaling and as potential inducers of cellular insulin resistance - Comparisons of glucose-insulin homeostasis following maprotiline and Fluoxetinetreatment in depressed males
Following maprotiline treatment, the body weight and BMI were significantly increased (P=0.02). Our findings imply that norepinephrine reuptake inhibitor (NRI) antidepressants might attenuate insulin sensitivity - Metabolic syndrome: relevance to antidepressant treatment
Some drugs, such as tricyclic antidepressants, can cause insulin resistance and can increase serum lipids independent of their affect on weight - Alterations of glucose metabolism during treatment with clozapine or amisulpride: results from a prospective 16-week study
Body mass index (BMI), fasting serum insulin levels and the Homeostasis Model Assessment (HOMA) index for insulin resistance increased significantly in patients treated with clozapine - Antihypertensive agents, insulin sensitivity, and new-onset diabetes
In general, thiazide diuretics and conventional beta blockers decrease insulin sensitivity and increase new-onset diabetes, whereas angiotensin-converting enzyme inhibitors, calcium channel blockers, and angiotensin II receptor blockers have neutral or beneficial effects on these parameters - Menopause and the metabolic syndrome: the Study of Women's Health Across the Nation
Cross-sectional studies suggest that prevalence of the metabolic syndrome (MetS) increases from premenopause to postmenopause in women, independent of age - Metabolic syndrome in the elderly
The prevalence of metabolic syndrome is increasing worldwide, especially among the elderly. Due to multiple age-related physiologic mechanisms, the elderly are at increased risk of developing intra-abdominal obesity and the metabolic syndrome - Hyperinsulinemia--how innocent a bystander?
Epidemiological data support a key role for hyperinsulinemia in these disorders but it is far from conclusive except for the fact that hyperinsulinemia and insulin resistance may be present many years before the onset of impaired glucose tolerance and NIDDM, and clearly play a role in their etiology - Insulin resistance and polycystic ovary syndrome
Most women with PCOS also exhibit features of the metabolic syndrome, including insulin resistance, obesity and dyslipidaemia - Obstructive sleep apnea and metabolic syndrome: alterations in glucose metabolism and inflammation
In summary, OSA may represent a novel risk factor for MS and diabetes, and thus clinicians should be encouraged to systematically evaluate the presence of metabolic abnormalities in OSA and vice versa - Current perspectives on hypertension and metabolic syndrome
Finally, metabolic syndrome, consisting of obesity, low HDL-C, and elevated BP, triglycerides, and fasting glucose, affects 47 million people and increases diabetes and CVD r - Growth hormone in obesity
Growth hormone (GH) secretion, either spontaneous or evoked by provocative stimuli, is markedly blunted in obesity - Dehydroepiandrosterone: the "missing link" between hyperinsulinemia and atherosclerosis?
Recent evidence indicates that the adrenal steroid dehydroepiandrosterone (DHEA) exerts multiple antiatherogenic effects and also suggests that hyperinsulinemia may reduce serum DHEA and DHEA-sulfate levels by decreasing production and enhancing metabolic clearance - High-sensitivity C-reactive protein and the hypertriglyceridemic waist in patients with type 2 diabetes and metabolic syndrome
High-sensitivity C-reactive protein is an important biomarker of systemic inflammation. The hypertriglyceridemic waist contributes to the metabolic syndrome and most likely is an important factor increasing high-sensitivity C-reactive protein levels and consequently, relative coronary risk in patients with type 2 diabetes of any sex and age. - Laboratoriumbepalingen SHL
Laboratoriumbepalingen SHL - Fasting serum insulin and the homeostasis model of insulin resistance (HOMA-IR) in the monitoring of lifestyle interventions in obese persons
HOMA-IR index (homeostasis model of insulin resistance) was calculated as [fasting serum glucose*fasting serum insulin/22.5], with lower values indicating a higher degree of insulin sensitivity. Individual changes in the carbohydrate metabolism achieved by a lifestyle intervention program were displayed by fasting serum insulin concentrations and the HOMA-IR but not by fasting glucose measurement alone - Laboratorial evaluation and diagnosis of insulin resistance
HOMA is a mathematical model that predicts IS simply by measuring insulinemia and fasting blood glucose and shows good correlation with hyperinsulinemic-euglycemic clamp method, considered a gold standard in the measurement of IS - Dehydroepiandrosterone, obesity and cardiovascular disease risk: a review of human studies
The age-related decline in serum dehydroepiandrosterone (DHEA) and its sulfated ester (DHEA-S) has suggested that a relative deficiency of these steroids may be causally related to the development of chronic diseases generally associated with aging, including insulin resistance, obesity, cardiovascular disease, cancer, reductions of the immune defense, depression and a general deterioration in the sensation of well-being - The relationship between testosterone and dehydroepiandrosterone sulfate concentrations, insulin resistance and visceral obesity in elderly men
DHEA-S and testosterone deficiency were independently associated with higher insulin resistance and obesity - The relationship between androgens concentrations (testosterone and dehydroepiandrosterone sulfate) and metabolic syndrome in non-obese elderly men
The DHEA-S and testosterone deficiency was a significant and independent risk factor of the metabolic syndrome in non-obese elderly men - DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial
DHEA replacement could play a role in prevention and treatment of the metabolic syndrome associated with abdominal obesity - Dehydroepiandrosterone supplementation improves endothelial function and insulin sensitivity in men
The low dose DHEA supplementation improves vascular endothelial function and insulin sensitivity and decreases the plasminogen activator inhibitor type 1 concentration. These beneficial changes have the potential to attenuate the development of age-related disorders such as cardiovascular disease - The relationship between testosterone and dehydroepiandrosterone sulfate concentrations, insulin resistance and visceral obesity in elderly men
DHEA-S and testosterone deficiency were independently associated with higher insulin resistance and obesity - The relationship between androgens concentrations (testosterone and dehydroepiandrosterone sulfate) and metabolic syndrome in non-obese elderly men
The DHEA-S and testosterone deficiency was a significant and independent risk factor of the metabolic syndrome in non-obese elderly men - A relationship between dehydroepiandrosterone sulphate and insulin resistance in obese men and women
Significant negative correlation between DHEAS and HOMA-IR was found in the group of obese type 2 diabetic women but not in obese non-diabetic women suggesting that low DHEAS level might be connected to the development of insulin resistance and type 2 diabetes mellitus in obese wo - Uitslag bloedsuikertest
Bloedglucose waarde. De officiële afspraken voor bloed gemeten met een vingerprik: nuchter geprikt boven de 6 mmol/l: diabetes, nuchter geprikt tussen de 5,6 en 6 mmol/l: voorfase van diabetes, niet-nuchter geprikt: boven de 11 mmol/l: diabetes - Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial
DHEA replacement could play a role in prevention and treatment of the metabolic syndrome associated with abdominal obesity - A relationship between dehydroepiandrosterone sulphate and insulin resistance in obese men and women
Significant negative correlation between DHEAS and HOMA-IR was found in the group of obese type 2 diabetic women but not in obese non-diabetic women suggesting that low DHEAS level might be connected to the development of insulin resistance and type 2 diabetes mellitus in obese women - The effects of testosterone treatment on body composition and metabolism in middle-aged obese men
Testosterone treatment was followed by a decrease of visceral fat mass, measured by computerized tomography, without a change in body mass, subcutaneous fat mass or lean body mass. Insulin resistance, measured by the euglycemic/hyperinsulinemic glucose clamp method, improved and blood glucose, diastolic blood pressure and serum cholesterol decreased with testosterone treatment.
Schildklierproblemen
- Hypothyroidism: common complaints, perplexing diagnosis
The disease affects every major organ system and metabolic process. The diagnosis of primary hypothyroidism can be perplexing to the clinician because of its insidious onset and wide array of nonspecific manifestations. Complaints of fatigue, muscle weakness, lethargy, and weight gain are often at first attributed to emotional or other health problems. Additionally, patients may not seek medical care because they are unaware that they are ill - Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample
Thyroid function (as assessed by serum TSH concentration) within the reference range is associated with body weight in both sexes. Our findings raise the possibility that modest increases in serum TSH concentrations within the reference range may be associated with weight gain - Hypothyroidism: a comprehensive review
Hypothyroidism is a common clinical entity encountered frequently in most adult primary care settings. The reported prevalence in the general population is approximately 3% in men, but as high as 10% in women - Hypothyroidism in the elderly: pathophysiology, diagnosis and treatment
Some degree of hypothyroidism is common in the elderly. It affects 5-20% of women and 3-8% of men - Hypothyroidism in the pregnant woman
Around another 2.5% of pregnant women have subclinical ('compensated') hypothyroidism, which is defined as a raised plasma TSH concentration with a normal free T4 concentrat - Screening for thyroid disease in pregnancy
Although gestational hyperthyroidism is uncommon (0.2%), hypothyroidism (autoimmune disease or suboptimal iodine intake) occurs in 2.5% of women and is predictive of reduced neonatal and child neuropsychological development and maternal obstetric complications. T4 supply is crucial to fetal nervous system maturation; currently, the recommended daily iodine intake is 200 microg, and this is not always achieved, even in the UK - Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample
Thyroid function (as assessed by serum TSH concentration) within the reference range is associated with body weight in both sexes. Our findings raise the possibility that modest increases in serum TSH concentrations within the reference range may be associated with weight gain - Sub-laboratory hypothyroidism and the empirical use of Armour thyroid
Evidence is presented that many people have hypothyroidism undetected by conventional laboratory thyroid-function tests, and cases are reported to support the empirical use of Armour thyroid. Clinical evaluation can identify individuals with sub-laboratory hypothyroidism who are likely to benefit from thyroid-replacement therapy. In a significant proportion of cases, treatment with thyroid hormone has resulted in marked improvement in chronic symptoms that had failed to respond to a wide array of conventional and alternative treatments - Measurement of serum free thyroid hormone concentrations: an essential tool for the diagnosis of thyroid dysfunction
When hypothyroidism is suspected, the most reliable test appears to be FT4 (together with TSH), because FT3 may still be normal in patients with subclinical or mild thyroid failure - Selenium, zinc, and thyroid hormones in healthy subjects: low T3/T4 ratio in the elderly is related to impaired selenium status
Iodothyronine 5' deiodinase, which is mainly responsible for peripheral T3 production, has recently been demonstrated to be a selenium (Se)-containing enzyme. A highly significant linear correlation between the T3/T4 ratio and indices of Se status was observed in the older group of subjects - Selenium deficiency and thyroid hormone metabolism and function
If Se is deficient, the deiodinase activity would be inhibited, the level of circulation T4 will be elevated, and the concentration T3 in peripheral tissues will be decreased. Se deficiency will also accelerate the iodine depletion of thyroid and may even exacerbate some detrimental effects of iodine deficiency. Possibly Se deficiency is involved in the occurrence and development of iodine deficient disorders. Keshan disease, with Se deficiency as the major cause, was also observed a change of thyroid hormone metabolism - Effects of the combined deficiency of selenium and iodine on thyroid function
In fact, although the major role of selenium is related to the glutathione peroxidase system, which protects cellular structures from oxidative damages, selenium plays also an important role in thyroid hormone metabolism as an essential component of the three deiodinase - Zinc supplementation alters thyroid hormone metabolism in disabled patients with zinc deficiency
Zn may play a role in thyroid hormone metabolism in low T3 patients and may in part contribute to conversion of T4 to T3 in humans - Are there functional consequences of a reduction in selenium intake in UK subjects?
Dietary Se levels in the UK have fallen over the last 20 years and recent surveys indicate that average Se intakes are 30-40 microg/d, which is well below the current UK reference nutrient intake for adult men (75 microg/d) or women (60 microg/d). - Use of national food balance data to estimate the adequacy of zinc in national food supplies: methodology and regional estimates
The mean per capita absorbable zinc content of national food supplies ranged from 2.98-3.01 mg day(-1) in Western Europe and USA & Canada to 2.09 mg day(-1) in Southeast Asia. The estimated percentage of individuals at risk of inadequate zinc intake ranged from 9.3-9.5% in the regions of North Africa & Eastern Mediterranean and USA & Canada to 33.1% in Southeast Asia. Overall, approximately 20.5% of the world's population is estimated to be at risk of inadequate zinc intake. Data on the absorbable zinc content of national food supplies can be used to determine whether further assessments of population zinc status and development of intervention - Thyroid disease in pregnancy and childhood
The presence of TPO antibodies in about 10% of pregnant women in early gestation is a predictor of an increased incidence of subclinical hypothyroidism during pregnancy and also of postpartum thyroid dysfunction. The latter condition occurs in 5-9% of women and 25-30% progress to permanent hypothyroidism - Syndrome of resistance to thyroid hormone: insights into thyroid hormone action
Resistance to thyroid hormone (RTH) is a rare disorder caused by mutations in the TR beta gene. Biochemically, the syndrome is defined by elevated circulating levels of free thyroid hormones due to reduced target tissue responsiveness and normal, or elevated, levels of thyroid-stimulating hormone (TSH). This "inappropriate" TSH elevation contrasts with the situation in hyperthyroidism, where the pituitary secretion of TSH is suppressed - Thyroid hormone resistance without mutations in thyroid hormone receptor beta
Resistance to thyroid hormone (RTH) is a rare autosomal dominant disorder that leads to elevated free thyroid hormone levels in the presence of normal or increased serum thyroid-stimulating hormone (TSH) concentrations if it is generalized because both the pituitary and peripheral tissues are then partially resistant. In approximately 85% of patients with RTH, mutations in the thyroid hormone receptor beta (TR beta) gene can be identified - Dominant inheritance of resistance to thyroid hormone not linked to defects in the thyroid hormone receptor alpha or beta genes may be due to a defective cofactor
Resistance to thyroid hormone (RTH) is an inherited syndrome of reduced tissue responsiveness to thyroid hormone. However, affected family members manifest a severe form of RTH, with reduced responses of thyrotrophs and peripheral tissues requiring 8- to 10-fold the normal replacement doses of L-T4 and L-T3 - Thyroid hormone resistance: the role of mutational analysis
The finding of increased thyroxine (T4) and tri-iodothyronine (T3) levels in a patient with normal or increased thyroid-stimulating hormone is unexpected and presents a differential diagnosis between a thyroid-stimulating hormone-secreting pituitary adenoma, generalized resistance to thyroid hormone (RTH) and laboratory artefact. Without careful clinical and biochemical evaluation, errors may occur in patient diagnosis and treatment. In the case of RTH, mutation of the thyroid hormone receptor beta gene results in generalized tissue resistance to thyroid hormone. Mutational analysis also enables family screening and may help to avoid potential misdiagnosis and inappropriate treatment - Thyroid Hormone Resistance in children
Thyroid Hormone Resistance (RTH) is characterized by the diminished response of thyroid hormone-responsive tissues in varying degrees in association with elevated serum levels of total and free T4 and T3 and inappropriately normal or elevated TSH levels. In almost all cases it is due to different mutations in only one allele of the thyroid hormone receptor beta gene which blocks the action of normal allele thus producing dominantly inherited RTH. Patients with hypothyroid and hyperthyroid symptoms may require treatment with thyroid hormone and with agents such as beta blockers, antithyroid drugs and thyroid hormone analogues - Hypopituitarism
Hypopituitarism is the partial or complete insufficiency of anterior pituitary hormone secretion and may result from pituitary or hypothalamic disease. Secondary hypothyroidism is a rare disease. The biochemical diagnosis is suggested by low serum FT4 levels and inappropriately normal or low basal TSH levels that do not rise normally after TRH - Central hypothyroidism
Central hypothyroidism (CH) is a rare cause of hypothyroidism due to an insufficient stimulation of an otherwise normal thyroid gland and it is caused by either pituitary (secondary hypothyroidism) or hypothalamic (tertiary hypothyroidism) defects. The diagnosis of CH is usually suggested by the finding of lowered thyroid hormone concentrations, associated with inappropriately low/ normal TSH levels. Restoration and maintenance of euthyroidism represent the therapeutic goals in all forms of CH. On these basis, the vast majority of patients with CH is treated with standard levo-thyroxine (L-T4) therapy which is tailored according to FT4 circulating levels that should be maintained in the normal range - Autoimmune thyroid disease--clinical symptoms of associated autoimmunity
The initial report of this autoimmune thyroid disease (AITD) dates back to Hakira Hashimoto (1912). In HT, as an organ-specific autoimmune disease, massive infiltration of lymphoid cells and parenchyma destruction are a consistent feature. The infiltration appears to be immune-mediated, primarily lymphocytic (T helper, T suppressor cells), NK cells and B cells - Genetic susceptibility in thyroid autoimmunity
Genetic susceptibility in combination with external factors (e.g. dietary iodine) are believed to initiate the autoimmune response to thyroid antigens in AITD. Indeed, there is solid epidemiological data to support a strong genetic influence on the etiology of AITD including family and twin s - Autoimmune thyroid disease and associated diseases
Chronic autoimmune thyroidism (Thyreoiditis lymphocytaria Hashimoto, HT), as well as immunogenic hyperthyroidism (Morbus Graves Basedow, MGB) are frequently associated with autoimmune diseases of other organs, such as: chronic insufficiency of salivary glands (Sy Sjögren), autoimmune hemolytic anemia, megalocytic pernicious anemia, thrombocytopenia, Rheumatoid arthritis, Diabetes mellitus (more often type 2, but also type 1), Morbus Addison, Coeliakia, and other autoimmune diseases such as systemic diseases of connecting tissue (Lupus erythematosus-SLE, Sclerodermia, Vasculitis superficialis). - Risk factors of primary thyroid dysfunction in early infants born to mothers with autoimmune thyroid disease
Maternal autoimmune thyroid disease during pregnancy will affect infant thyroid function. Therefore, appropriate management of maternal autoimmune thyroid disease throughout pregnancy is essential in the prevention of undesirable neonatal outcomes - Risk factors for and prevalence of thyroid disorders in a cross-sectional study among healthy female relatives of patients with autoimmune thyroid disease
The positive correlation between TPO antibody titres and TSH levels in euthyroid subjects suggests that TPO antibodies are indeed a marker of future thyroid failure - Lithium: a review of its metabolic adverse effects
Treatment with lithium has long been recognized to be associated with metabolic adverse effects notably hypothyroidism, hyperparathyroidism, weight gain and nephrogenic diabetes insipidus - The effects of amiodarone on the thyroid
In 14-18% of amiodarone-treated patients, there is overt thyroid dysfunction, either amiodarone-induced thyrotoxicosis (AIT) or amiodarone-induced hypothyroidism (AIH). - The effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto's thyroiditis
In conclusion, 78.3% of patients with hypothyroidism due to Hashimoto's thyroiditis regained an euthyroid state iodine restriction alone. Both a low initial serum TSH and a high initial urinary iodine concentration can be predictable factors for a recovery from hypothyroidism due to Hashimoto's thyroiditis after restricting their iodine intake - Potential uses of T3 in the treatment of human disease
Thyroxine (T4) monotherapy is currently the standard of care, but may leave some hypothyroid symptoms unaddressed. Triiodothyronine (T3), formed by the monodeiodination of T4, is the biologically active form of thyroid hormone based upon its ability to regulate gene expression at the nuclear level. A variety of human and animal studies have raised the question of whether T4 monotherapy is sufficient to restore tissue and organ intracellular T3 levels to normal. Furthermore, some evidence, albeit controversial, suggests that the addition of T3 (Cytomel) to T4 replacement therapy may improve patients' quality of life, psychometric performance and mood - Effects of Thyroxine as Compared with Thyroxine plus Triiodothyronine in Patients with Hypothyroidism
The patients had lower serum free and total thyroxine concentrations and higher serum total triiodothyronine concentrations after treatment with thyroxine plus triiodothyronine than after thyroxine alone, whereas the serum thyrotropin concentrations were similar after both treatments. Among 17 scores on tests of cognitive performance and assessments of mood, 6 were better or closer to normal after treatment with thyroxine plus triiodothyronine. Similarly, among 15 visual-analogue scales used to indicate mood and physical status, the results for 10 were significantly better after treatment with thyroxine plus triiodothyronine - Thyroid function during pregnancy
Assessment of thyroid function during pregnancy should be done with a careful clinical evaluation of the patient's symptoms as well as measurement of TSH and free, not total, thyroid hormones. Measurement of thyroid autoantibodies may also be useful in selected cases to detect maternal Graves disease or Hashimoto thyroiditis and to assess risk of fetal or neonatal consequences of maternal thyroid dysfunction - Vitamin B12 deficiency common in primary hypothyroidism
There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms, although a placebo effect cannot be excluded, as a number of patients without B12 deficiency also appeared to respond to B12, administration - Effect of iodine intake on thyroid diseases in China
Iodine is an essential component of thyroid hormones; either low or high intake may lead to thyroid disease. We observed an increase in the prevalence of overt hypothyroidism, subclinical hypothyroidism, and autoimmune thyroiditis with increasing iodine intake in China. More than adequate Selenium, zinc, and thyroid hormones in healthy subjects or excessive iodine intake may lead to hypothyroidism and autoimmune thyroiditis - Adequacy of the iodine supply in The Netherlands
The iodine supply is below cut-off points in 4-20% of the adult population. It is possible to decrease the prevalence of low iodine intakes without a clear risk of exceeding the maximum acceptable daily iodine intake by increasing the iodine content of baker's salt and/or by adding iodine to other foods - Iodine intake and urinary excretion among adults in the Netherlands
The prevalence of low iodine supply, based on intake <100 microg/d (mean of three days) and intake or excretion parameters per creatinin excretion or per kg body weight, varied from 4-14% among adult women and from 5-17% among adult men - The argument for increasing selenium intake
Se appears to be a key nutrient in counteracting certain viral infections; thus, in a Se-deficient host the benign coxsackie virus becomes virulent, causing heart damage, the influenza virus causes more serious lung pathology and HIV infection progresses more rapidly to AIDS. Long recognised as essential for successful animal reproduction, Se is required for human sperm maturation and sperm motility and may reduce the risk of miscarriage. Deficiency has been linked to adverse mood states. Findings have been equivocal in linking Se to cardiovascular disease risk, although other conditions involving oxidative stress and inflammation have shown some association with Se status. There is growing evidence that higher Se intakes are associated with reduced cancer risk - Low selenium status in the elderly influences thyroid hormones
Iodothyronine 5'-deiodinase, which is mainly responsible for peripheral triiodothyronine (T3) production, has recently been demonstrated to be a selenium-containing enzyme. In the elderly, reduced peripheral conversion of thyroxine (T4) to T3 and overt hypothyroidism are frequently observed - Sodium selenite therapy and thyroid-hormone status in cystic fibrosis and congenital hypothyroidism
Apart from an improvement of the antioxidant status a stimulation of thyroid-hormone efficacy owing to increased T4--T3 conversion is also noteworthy in sodium selenite medication - Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations
In areas with severe selenium deficiency there is a higher incidence of thyroiditis due to a decreased activity of selenium-dependent glutathione peroxidase activity within thyroid cells. Selenium-dependent enzymes also have several modifying effects on the immune system. Therefore, even mild selenium deficiency may contribute to the development and maintenance of autoimmune thyroid diseases - Effects of a six month treatment with selenomethionine in patients with autoimmune thyroiditis
Selenomethionine is proven to be rapidly absorbed by the gastrointestinal tract. It appears to be useful as adjunctive therapy with LT(4) in the treatment of AIT. The exact mechanism(s) is not very well determined, it might enhance the activity of detoxifying enzymes and enforce the defense against oxidative stress - Hashimoto's thyroiditis and the role of selenium. Current concepts
Recent clinical studies have documented the suppressive effect of selenium treatment on serum anti-thyroid peroxidase concentrations in patients with HT. Recent clinical studies have documented the suppressive effect of selenium treatment on serum anti-thyroid peroxidase concentrations in patients with HT - The influence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies
Se supplementation during pregnancy and in the postpartum period reduced thyroid inflammatory activity and the incidence of hypothyroidism - Safe range of iodine intake levels: a comparative study of thyroid diseases in three women population cohorts with slightly different iodine intake levels
Iodine excess may lead to thyroid diseases. Our previous 5-year prospective survey showed that the prevalence and incidence of hypothyroidism or autoimmune thyroiditis increased with iodine intake - Voedingscentrum Zink
Zink is een onderdeel van vele enzymen in het lichaam - Treatment of hypothyroidism
The therapeutic goal is to achieve a TSH level between 0.5-1.5 mIU/l. Most patients will then have thyroxine values in the upper 1/3 of the reference range, some will have elevated thyroxine values. If necessary, the thyroxine dose can be increased to give a TSH level between 0.2 and 1.0 mIU/l - Thyroid disease in pregnancy and childhood
Women receiving thyroxine therapy for hypothyroidism or as suppressive therapy should have their dose increased by up to 50% during pregnancy. There are now substantial data to show deleterious effects on child IQ resulting from low maternal T4 (or high TSH) during gestation - Dominant inheritance of resistance to thyroid hormone not linked to defects in the thyroid hormone receptor alpha or beta genes may be due to a defective cofactor
Resistance to thyroid hormone (RTH) is an inherited syndrome of reduced tissue responsiveness to thyroid hormone. However, affected family members manifest a severe form of RTH, with reduced responses of thyrotrophs and peripheral tissues requiring 8- to 10-fold the normal replacement doses of L-T4 and L-T3 - Postpartum thyroiditis: long-term follow-up
The probability of developing PH after a PPT with hypothyroidism episode is 56%. PPT screening in all women permits us to establish levothyroxine treatment, if necessary, before a new pregnancy - Thyroid hormone replacement for subclinical hypothyroidism
Subclinical hypothyroidism is defined as an elevated serum thyroid-stimulating hormone (TSH) level with normal free thyroid hormones values. The prevalence of subclinical hypothyroidism is 4% to 8% in the general population, and up to 15% to 18% in women who are over 60 years of age. - Hypothyroidism
Once suspected it can be easily diagnosed by a simple blood test measuring serum thyroxine (T4) and thyroid stimulating hormone (TSH) levels - Subclinical hypothyroidism
Subclinical hypothyroidism, defined by elevated serum levels of thyroid stimulating hormone (TSH) with normal levels of free thyroid hormones, belongs to the most common disorders encountered in an endocrine office practice. Thyroxine therapy should be given if the serum TSH level is higher than 10 mIU/L but for lower TSH values, the decision for therapy should be individualized - Rapid progression from subclinical to symptomatic overt hypothyroidism
Most patients with subclinical hypothyroidism have progression to overt hypothyroidism at a slow rate - Thyroxine (T4) and tri-iodothyronine (T3) determinations: techniques and value in the assessment of thyroid function
Hormonal production of the thyroid gland is constituted of thyroxine or T4 (80%) and triiodothyronine or T3 (20%). In the circulation, whole T4 originates from thyroid secretion but most of T3 (80%) is produced extrathyroidally from T4 deiodination - Role of thyrotropin in triiodothyronine generation in hypothyroidism
T3 is the main active thyroid hormone and TSH is the major modulator of its synthesis and release by the thyroid gland - Low triiodothyronine (T3) syndrome
As first described in serious systemic illnesses isolated decreased T3 plasma concentration was related to impaired peripheral conversion of T4, to T3 with preferential production of reverse T3 (rT3). A "low T3 syndrome" was seen in 47 out of 109 patients with extra-thyroidal diseases. Metabolic state, TSH and TSH responses to TRH were normal despite of low T3 concentration. Euthyroidism seems mainly due to T4 itself in these patients - Thyroid hormone metabolism in obesity
Serum thyroid hormone concentrations and their metabolic fate are within the normal range limits in obese subjects. Also serum TSH concentrations and its response to TRH are normal, suggesting that tissue availability of thyroid hormones is normally preserved in these subjects. In contrast, during caloric restriction serum T3 concentrations decrease as a consequence of its reduced production rate from peripheral deiodination of T4. Opposite, serum rT3 concentrations markedly increase as a result of its decreased metabolic clearance rate
Verbeter verzadigingsgevoel
- Protein in Leptin Resistance and Obesity
Obesity is one of the risk factors in various chronic diseases and malignancy. It may result from excess accumulation of body fat. This condition may be caused by dysfunction of appetite-regulating pathways and energy balance due to leptin resistance - Gastrointestinal hormones and regulation of food intake
Several peptides synthesised in the gastrointestinal tract which affect food intake have been identified including ghrelin, cholecystokinin (CCK), glucagon-like peptide-1 (7-36) amide (GLP-1), oxyntomodulin, peptide YY (PYY) and pancreatic polypeptide (PP). - Leptin signaling in the hypothalamus: emphasis on energy homeostasis and leptin resistance
Leptin, the long-sought factor of adipocytes origin, has emerged as one of the major signals that relay the status of fat stores to the hypothalamus and plays a significant role in energy homeostasis. It is now established that central leptin resistance contributes to the development of diet-induced obesity and ageing associated obesity - Elevated leptin: consequence or cause of obesity?
Chronic overexpression of central leptin induces a leptin resistance that mimics many of the characteristics associated with diet-induced or adult-onset obesity including reduced leptin receptors, diminished signaling, and impaired responsiveness to exogenous leptin. Once leptin resistance takes hold, each subsequent exposure to high-density food faces diminished counter-regulatory responses, leading to exacerbated weight gain - Peptides regulating food intake and body weight
So, adipocytes synthesize and express leptin, the product of Ob gene, a regulator of long-term food intake, in amounts proportional to the fat amount - Gut peptides and the regulation of appetite
In the last 10 years, discoveries of new hormones such as leptin and ghrelin, together with greater understanding of previously described hormones such as cholecystokinin (CCK), pancreatic polypeptide (PP), peptide YY (PYY) and glucagon-like peptide 1 (GLP-1), have led to a rapid increase in our knowledge of the regulation of energy balance. Among the most important factors, controlling appetite and satiety are peptide hormones released from the gut. - Gastrointestinal hormones regulating appetite
Many gut peptides have been shown to influence energy intake. The most well studied in this regard are cholecystokinin (CCK), pancreatic polypeptide, peptide YY, glucagon-like peptide-1 (GLP-1), oxyntomodulin and ghrelin. With the exception of ghrelin, these hormones act to increase satiety and decrease food intake. Local effects such as the inhibition of gastric emptying might contribute to the decrease in energy intake. Circulating gut hormones have also been shown to act directly on neurons in hypothalamic and brainstem centres of appetite control. In this way, hormonal signals from the gut may be translated into the subjective sensation of satiety - Influence of ghrelin on food intake and energy homeostasis
Ghrelin is an endogenous orexigenic peptide recently discovered in the stomach. Ghrelin is involved in short-term regulation of food intake since its plasma levels increase before meals and decrease strongly postprandially - Human plasma ghrelin levels increase during a one-year exercise program
Weight loss resulting from decreased caloric intake raises levels of the orexigenic hormone, ghrelin. In summary, ghrelin levels increase with weight loss achieved without reduced food intake, consistent with a role for ghrelin in the adaptive response constraining weight loss and, thus, in long-term body weight regulation - Circulating ghrelin is sensitive to changes in body weight during a diet and exercise program in normal-weight young women
Body fat, body weight, and resting metabolic rate significantly decreased in the weight-loss group before the increase in ghrelin. These findings suggest that ghrelin responds in a compensatory manner to changes in energy homeostasis in healthy young women, and that ghrelin exhibits particular sensitivity to changes in body weight - Influence of weight loss on plasma ghrelin responses to high-fat and high-carbohydrate test meals in obese women
Weight loss is associated with an improved postprandial plasma ghrelin response to a carbohydrate meal, whereas the response to a fat meal is not modified - Appetite regulation and energy balance
Thirty minutes after the start of eating, satiety signals arise from the intestinal tract and, in between meals, from the adipose tissue and liver. Satiety signals are sedative and arrest the processing of food in the intestine, hence leading to termination of ea - Eating slowly led to decreases in energy intake within meals in healthy women
Ad libitum energy intake was lower when the meal was eaten slowly, and satiety was higher at meal completion. Although more study is needed, these data suggest that eating slowly may help to maximize satiation and reduce energy intake within meals - Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets
Our analysis showed that whenever and wherever it was ecologically possible, hunter-gatherers consumed high amounts (45-65% of energy) of animal food. Most (73%) of the worldwide hunter-gatherer societies derived >50% (> or =56-65% of energy) of their subsistence from animal foods, whereas only 14% of these societies derived >50% (> or =56-65% of energy) of their subsistence from gathered plant foods - Acute appetite reduction associated with an increased frequency of eating in obese males
Obese males fed an isoenergetic pre-load sub-divided into a multi-meal plan consumed 27% less at a subsequent ad libitum test meal than did the same men when given the pre-load as a single meal. Prolonged but attenuated increases in serum insulin concentration on the multi-meal programme may facilitate this acute reduction in appetite - Greater appetite control associated with an increased frequency of eating in lean males
These data suggest that when the nutrient load was spread into equal amounts and consumed evenly through the day in lean healthy males, there was an enhanced control of appetite. This greater control of satiety when consuming smaller multiple meals may possibly be linked to an attenuation in insulin response although clearly both other physical (gastric stretch) and physiological (release of gastric hormones) factors may also be affected by the periodicity of eating - Relationships between physical activity, obesity and meal frequency in adolescents
The data indicate that increased meal frequency may have a beneficial effect on a reduced BMI. Physical activity and breakfast skipping may be candidate targets for prevention programmes aimed at reducing overweight/obesity among adolescents - Highlighting the positive impact of increasing feeding frequency on metabolism and weight management
Research on feeding frequency started more than 20 years ago and some studies have shown evidence of nutritional benefits, especially on metabolism and body weight management. The experts agreed that, as long as we do not consume more energy than we use up and we only eat when we are hungry, it may be useful to split our total energy intake into as many meals as our social pattern allows - Meal frequency and childhood obesity
The prevalence of obesity decreased by number of daily meals: three or fewer meals, 4.2% [95% confidence interval (CI), 2.8 to 6.1]; four meals, 2.8% (95% CI, 2.1 to 3.7); and 5 or more meals, 1.7% (95% CI, 1.2 to 2.4). These effects could not be explained by confounding due to a wide range of constitutional, sociodemographic, and lifestyle factors. A protective effect of an increased daily meal frequency on obesity in children was observed and appeared to be independent of other risk factors for childhood obesity. A modulation of the response of hormones such as insulin might be instrumental - Development of food preferences
Using a developmental systems perspective, this review focuses on how genetic predispositions interact with aspects of the eating environment to produce phenotypic food preferences. Predispositions include the unlearned, reflexive reactions to basic tastes: the preference for sweet and salty tastes, and the rejection of sour and bitter tastes. Other predispositions are (a) the neophobic reaction to new foods and (b) the ability to learn food preferences based on associations with the contexts and consequences of eating various foods - Effect of altering the variety of sensorially distinct foods, of the same macronutrient content, on food intake and body weight in men
These data suggest that increasing the variety of sensorially distinct foods that are virtually identical in composition can increase food and energy intake and in the short to medium term can alter energy balance - High protein intake sustains weight maintenance after body weight loss in humans
A 20% higher protein intake, that is, 18% of energy vs 15% of energy during weight maintenance after weight loss, resulted in a 50% lower body weight regain, only consisting of fat-free mass, and related to increased satiety and decreased energy efficiency - The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review
There is convincing evidence that a higher protein intake increases thermogenesis and satiety compared to diets of lower protein content. The weight of evidence also suggests that high protein meals lead to a reduced subsequent energy intake - The significance of protein in food intake and body weight regulation
Protein is more satiating than carbohydrate and fat in the short term, over 24 h and in the long term. Thermogenesis plays a role in this satiety effect, but the role of satiety hormones still needs to be elucidated. On the short-term 'fast' proteins are more satiating than 'slow' proteins, and animal protein induces a higher thermogenesis than vegetable protein - Effects of a moderate dietary fibre supplement on hunger rating, energy input and faecal energy output in young, healthy volunteers. A randomized, double-blind, cross-over trial
This study demonstrated that moderate dietary fibre supplementation in normal man increases faecal energy excretion with simultaneously decreased hunger feeling. These beneficial effects may have therapeutic value in the management of obesity - Overweight treated with energy restriction and a dietary fibre supplement: a 6-month randomized, double-blind, placebo-controlled trial
After treatment the weight reduction in the fibre-treated group, 5.5 +/- 0.7 kg, was significantly higher than that of the placebo group, 3.0 +/- 0.5 kg (P = 0.005). Hunger feelings using visual analogue scales (VAS) were significantly reduced from 139.8 +/- 8.2 cm to 118.3 +/- 7.0 cm in the fibre-treated group, whereas a significant increase from 129.5 +/- 6.9 cm to 146.9 +/- 8.8 cm (P less than 0.02) was seen in the placebo group - Effect of a high-protein breakfast on the postprandial ghrelin response
The HP breakfast decreased postprandial ghrelin concentrations more strongly over time than did the HC breakfast. The HP breakfast also reduced gastric emptying, probably through increased secretion of cholecystokinin and glucagon-like peptide 1 - Ghrelin and glucagon-like peptide 1 concentrations, 24-h satiety, and energy and substrate metabolism during a high-protein diet and measured in a respiration chamber
An HP diet, compared with an AP diet, fed at energy balance for 4 d increased 24-h satiety, thermogenesis, sleeping metabolic rate, protein balance, and fat oxidation. Satiety was related to protein intake, and incidentally to ghrelin and GLP-1 concentrations, only during the HP diet - The appetizing effect of an apéritif in overweight and normal-weight humans
Twenty-four-hour energy intake was higher on a day that an apéritif was consumed than after water or no preload. CONCLUSION: Twenty-four-hour energy intake was elevated with a 1-MJ apéritif but not with a 1-MJ liquid carbohydrate, fat, or protein appetizer - Paleolithic vs. modern diets--selected pathophysiological implications
Our genome can have changed little since the beginnings of agriculture, so, genetically, humans remain Stone Agers--adapted for a Paleolithic dietary regimen - Origins and evolution of the Western diet: health implications for the 21st century
There is growing awareness that the profound changes in the environment (eg, in diet and other lifestyle conditions) that began with the introduction of agriculture and animal husbandry 10000 y ago occurred too recently on an evolutionary time scale for the human genome to adjust. - Implications of fiber in different pathologies
Three decades ago, the observations of Trowell and Burkitt gave rise to the "fibre theory", in which it was contended that there was a link between the consumption of a diet rich in fibre and non-processed carbohydrates and the level of protection against many of the "first world diseases" such as constipation, diverticulosis, cancer of the colon, diabetes, obesity and cardiovascular disease. A high fibre intake (> 25-30 g/day) based on a variety of food sources (fruit, vegetable, legumes, cereals) is the only way to avoid many of the disorders mentioned - Position of the American Dietetic Association: health implications of dietary fiber
Dietary fiber consists of the structural and storage polysaccharides and lignin in plants that are not digested in the human stomach and small intestine. A wealth of information supports the American Dietetic Association position that the public should consume adequate amounts of dietary fiber from a variety of plant foods. Recommended intakes, 20-35 g/day for healthy adults and age plus 5 g/day for children, are not being met, because intakes of good sources of dietary fiber, fruits, vegetables, whole and high-fiber grain products, and legumes are low - Importance of dietary fiber in childhood
Currently, children consume amounts of dietary fiber that appear to be inadequate for optimal health promotion and disease prevention. It is prudent to recommend that children older than 2 years of age increase dietary fiber intake to an amount equal to or greater than their age + 5 g/day. According to the "age + 5" rule dietary fiber intake would increase from 8 g/day at age 3 years to 25 g/day by age 20 years - Dietary fiber and weight regulation
Under conditions of fixed energy intake, the majority of studies indicate that an increase in either soluble or insoluble fiber intake increases postmeal satiety and decreases subsequent hunger. When energy intake is ad libitum, mean values for published studies indicate that consumption of an additional 14 g/day fiber for >2 days is associated with a 10% decrease in energy intake and body weight loss of 1.9 kg over 3.8 months - Nutriceuticals in cardiovascular disease: psyllium
In recent years, there has been a growing interest in the use of dietary fiber in health maintenance and disease prevention. A deficiency of fiber in the Western diet may be contributing to the current epidemics of diabetes mellitus, coronary artery disease (CAD), and colonic cancer - Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia
Treatment with 5.1 g psyllium twice daily produces significant net reductions in serum total and LDL-cholesterol concentrations in men and women with primary hypercholesterolemia. Psyllium therapy is an effective adjunct to diet therapy and may provide an alternative to drug therapy for some patients - Guar gum in insulin-dependent diabetes: effects on glycemic control and serum lipoproteins
In conclusion, guar gum can improve glycemic control and decrease serum LDL-cholesterol concentrations in mildly hypercholesterolemic insulin-dependent diabetic patients and thus reduce risk factors for both micro- and macroangiopathic complications - Pre-meal water consumption reduces meal energy intake in older but not younger subjects
Under acute test meal conditions, pre-meal water consumption reduces meal energy intake in older but not younger adults. Because older adults are at increased risk for overweight and obesity, intervention studies are needed to determine whether pre-meal water consumption is an effective long-term weight management strategy for the aging populati - Water consumption reduces energy intake at a breakfast meal in obese older adults
Meal energy intake was significantly less in the water preload condition as compared with the no-preload condition (500+/-32 vs 574+/-38, respectively; P=0.004), representing an approximate 13% reduction in meal energy intake - Effect of psyllium on gastric emptying, hunger feeling and food intake in normal volunteers: a double blind study
Psyllium reduces hunger feelings and energy intake in normal volunteers at reasonable dose and without requiring mixing with the meal. It does not act by slowing down the gastric emptying of hydrosoluble nutrients, but by increase in the time allowed for intestinal absorption, as suggested by the flattening of the postprandial serum glucose, insulin and triglycerides curves - Correlation between echographic gastric emptying and appetite: influence of psyllium
The correlation between echographic gastric emptying and sensations of hunger and satiety was excellent (p < 0.001) after the intake of either psyllium or placebo. Psyllium significantly delayed gastric emptying from the third hour after a meal. It increased the sensation of satiety and decreased hunger at the sixth hour after the me - Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non-insulin-dependent diabetes
For meals eaten immediately after psyllium ingestion, maximum postprandial glucose elevation was reduced by 14% at breakfast and 20% at dinner relative to placebo. Postprandial serum insulin concentrations measured after breakfast were reduced by 12% relative to placebo. Second-meal effects after lunch showed a 31% reduction in postprandial glucose elevation relative to placebo - Glucomannan and obesity: a critical review
At doses of 2-4 g per day, GM was well-tolerated and resulted in significant weight loss in overweight and obese individuals. There is some evidence that GM exerts its beneficial effects by promoting satiety and fecal energy loss. Additionally, GM has been shown to improve lipid and lipoprotein parameters and glycemic status - Effect of glucomannan on obese patients: a clinical study
Results showed a significant mean weight loss (5.5 lbs) using glucomannan over an eight-week period. Serum cholesterol and low-density lipoprotein cholesterol were significantly reduced (21.7 and 15.0 mg/dl respectively) in the glucomannan treated group. No adverse reactions to glucomannan were reported - Chronic use of glucomannan in the dietary treatment of severe obesity
The comparative analysis of the results obtained in both groups showed that the diet + glucomannan group had a more significant weight loss in relation to the fatty mass alone, an overall improvement in lipid status and carbohydrate tolerance, and a greater adherence to the diet in the absence of any relevant side effects. Due to the marked ability to satiate patients and the positive metabolic effects, glucomannan diet supplements have been found to be particularly efficacious and well tolerated even in the long-term treatment of severe obesity - Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial
A diet rich in high-viscosity KJM improves glycemic control and lipid profile, suggesting a therapeutic potential in the treatment of the insulin resistance syndrome - Konjac-mannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. A randomized controlled metabolic trial
KJM fiber added to conventional treatment may ameliorate glycemic control, blood lipid profile, and sBP in high-risk diabetic individuals, possibly improving the effectiveness of conventional treatment in type 2 diabetes - Effect of hydrolyzed guar fiber on fasting and postprandial satiety and satiety hormones: a double-blind, placebo-controlled trial during controlled weight loss
The results indicated that a hydrolyzed guar gum fiber supplement produced a heightened postprandial CCK response, but did not alter other satiety hormones or increase satiety ratings, in either the fasting or the postprandial state - Effect of guar gum on body-weight, hunger ratings and metabolism in obese subjects
Body-weight was significantly reduced during guar-gum treatment even though the patients were asked to maintain their normal dietary habits. Daily hunger ratings recorded for up to 10 weeks showed that guar gum reduced hunger significantly better than commercially available bran taken in the same way. Thus, guar gum seemed to influence carbohydrate and lipid metabolism in a beneficial way in obese subjects. The reduction in hunger would offer an additional benefit to these patients - Guar gum: a miracle therapy for hypercholesterolemia, hyperglycemia and obesity
The demand for guar gum is still growing rapidly because in addition to its indispensable role in lowering serum cholesterol and glucose levels, it is also considered helpful in weight loss programs. The main thrust of therapeutic and medicinal properties lies in the soluble dietary fiber content of guar gum to improve the serum biochemical profile of human and non-human primates, reducing total serum cholesterol, triglycerides, increasing the high density lipoprotein cholesterol level, and the management of glycemic indices and obes - Guar attenuates fall in postprandial blood pressure and slows gastric emptying of oral glucose in type 2 diabetes.
The magnitude of the fall in blood pressure was less (P < 0.05) and gastric emptying slower (P < 0.05) after guar. Blood glucose (P < 0.05) and serum insulin (P < 0.01) concentrations were lower after guar - The role of viscous soluble fiber in the metabolic control of diabetes. A review with special emphasis on cereals rich in beta-glucan
This high viscosity delays absorption. A 50% reduction in glycemic peak can be achieved with a concentration of 10% beta-glucan in a cereal food. A significant lowering of plasma LDL cholesterol concentrations can also be anticipated with the daily consumption of > or = 3 g of beta-glucan - Post-prandial responses to cereal products enriched with barley beta-glucan
Products prepared from barley flour enriched with beta-glucan exhibit favourable responses on glucose metabolism, and particularly on insulinemic responses - Modulation of glucagon-like peptide 1 and energy metabolism by inulin and oligofructose: experimental data
In most cases, the beneficial effects of OFS are linked to an increase of glucagon-like peptide-1 (GLP-1) level in the portal vein and of GLP-1 and proglucagon mRNA, its precursor, in the proximal colon. Several studies in humans already support interest in OFS in the control of satiety, triglyceridemia, or steatohepatitis - Impact of inulin and oligofructose on gastrointestinal peptides
Based on these results it appears justified to test, in human subjects, the hypothesis that dietary inulin-type fructans could play a role in the management of obesity and diabetes through their capacity to promote secretion of endogenous gastrointestinal peptides involved in appetite regulation - Oligofructose promotes satiety in healthy human: a pilot study
Oligofructose treatment increases satiety following breakfast and dinner, reduces hunger and prospective food consumption following dinner. This pilot study presents a rationale to propose oligofructose supplements in the management of food intake in overweight and obese patients - Improvement of glucose tolerance and hepatic insulin sensitivity by oligofructose requires a functional glucagon-like peptide 1 receptor
In summary, our data show that the antidiabetic actions of OFS require a functional GLP-1 receptor. These findings highlight the therapeutic potential of enhancing endogenous GLP-1 secretion for the treatment of type 2 diabet - A small dose of soluble alginate-fiber affects postprandial glycemia and gastric emptying in humans with diabetes
Sodium alginate also induced significantly lower postprandial rises in blood glucose, serum insulin and plasma C-peptide. The diminished glucose response after the addition of sodium alginate could be correlated to the delayed gastric emptying rate induced by the fiber (rs = 0.92, P less than 0.01) - In vivo imaging of intragastric gelation and its effect on satiety in humans
Compared with the control meal, the strong-gelling alginate (P = 0.031) and guar (P = 0.041) meals increased fullness at 115 min, and the strong-gelling alginate decreased hunger by the 115-min (P = 0.041) and 240-min (P = 0.041) time points. Agents that gel on contact with acid may be useful additions to weight-reducing diets - The many lives of leptin
Obesity in humans and many animals is associated with a leptin resistant state rather than a leptin deficiency. Consideration of the BBB data would favor the view that ancestral levels of leptin were much lower than those currently considered normal and are consistent with leptin acting as a metabolic switch, informing the brain when fat reserves are adequate to direct energy expenditures towards activities other than seeking calories - The blood-brain barrier as a regulatory interface in the gut-brain axes
Leptin transport is also inhibited in starvation and by hypertriglyceridemia. Since hypertriglyceridemia occurs in both starvation and obesity, we have postulated that the peripheral resistance induced by hypertriglyceridemia may have evolved as an adaptive mechanism in response to starvation - The blood-brain barrier as a cause of obesity.
We postulate that hypertriglyceridemia evolved as a starvation signal to the brain that acts in part to inhibit the transport of the leptin across the BBB. The hypertriglyceridemia of obesity invokes this aspect of the starvation response, inducing leptin resistance at the BBB - Overweight and obesity-related metabolic disorders in hospital employees
The risks attributable to obesity (baseline BMI >or= 25 kg/m2) were 23.0% for hypertension, 70.8% for diabetes, 27.9% for hypertriglyceridemia, and 24.1% for hyperuricemia - Triglycerides induce leptin resistance at the blood-brain barrier
Here, we show that milk, for which fats are 98% triglycerides, immediately inhibited leptin transport as assessed with in vivo, in vitro, and in situ models of the BBB. Fat-free milk and intralipid, a source of vegetable triglycerides, were without effect. We conclude that triglycerides are an important cause of leptin resistance as mediated by impaired transport across the BBB and suggest that triglyceride-mediated leptin resistance may have evolved as an anti-anorectic mechanism during starvation - Leptin sensitivity in skeletal muscle is modulated by diet and exercise
Recent data indicate that obesity-causing high-fat diets lead to leptin resistance in muscle, whereas supplementation with dietary fish oil and aerobic training can partially reverse this resistance - Effects of docosahexaenoic acid on serum lipoproteins in patients with combined hyperlipidemia: a randomized, double-blind, placebo-controlled trial.
These preliminary findings suggest that dietary supplementation with 1.25 g DHA/day, provided in a triglyceride form, may be an effective tool to aid in the management of hypertriglyceridemia - Docosahexaenoic acid supplementation improves fasting and postprandial lipid profiles in hypertriglyceridemic men
DHA supplementation may improve cardiovascular health by lowering concentrations of triacylglycerols and small, dense LDL particles - Evaluation of the effects of Neptune Krill Oil on the clinical course of hyperlipidemia
The results of the present study demonstrate within high levels of confidence that krill oil is effective for the management of hyperlipidemia by significantly reducing total cholesterol, LDL, and triglycerides, and increasing HDL levels. At lower and equal doses, krill oil was significantly more effective than fish oil for the reduction of glucose, triglycerides - Identifying patients at risk for coronary heart disease: implications from trials of lipid-lowering drug therapy
Abnormal lipid levels contribute significantly to the risk of coronary heart disease (CHD), which is increased further in the presence of other risk factors. Thus, although prevention trials to date have primarily assessed the impact of LDL lowering on CHD events, the initial assessment of CHD risk should consider a more detailed atherogenic profile including HDL and triglyceride levels - Psyllium fibre and the metabolic control of obese children and adolescents
The reviewed evidence seems to show that psyllium improves glucose homeostasis and the lipid and lipoprotein profile; however, more well controlled trials and further studies are needed to clarify it's effects and the mechanisms involved - Endurance training partially reverses dietary-induced leptin resistance in rodent skeletal muscle.
Endurance training was generally effective in preventing the development of leptin resistance, although this did not appear to require a decrease in SOCS3 expression - Dietary and lifestyle factors in relation to plasma leptin concentrations among normal weight and overweight men
These data suggest that physical activity may be a significant determinant of plasma leptin concentrations in men. Increasing physical activity is associated with lower plasma leptin concentrations even after adjusting for BMI. Physical activity may lower leptin concentrations not only due to decreased body fat mass, but potentially through an increase in leptin sensitivity - The effect of Korean pine nut oil on in vitro CCK release, on appetite sensations and on gut hormones in post-menopausal overweight women
This study suggests that Korean pine nut may work as an appetite suppressant through an increasing effect on satiety hormones and a reduced prospective food intake. Subjects received capsules with 3 g Korean pine (Pinus koraiensis) nut FFA, 3 g pine nut TG or 3 g placebo (olive oil). CCK-8 was higher 30 min after pine nut FFA and 60 min after pine nut TG when compared to placebo (p < 0.01). GLP-1 was higher 60 min after pine nut FFA compared to placebo (p < 0.01). Over a period of 4 hours the total amount of plasma CCK-8 was 60% higher after pine nut FFA and 22% higher after pine nut TG than after placebo (p < 0.01). For GLP-1 this difference was 25% after pine nut FFA (P < 0.05). Ghrelin and PYY levels were not different between groups. The appetite sensation "prospective food intake" was 36% lower after pine nut FFA relative to placebo (P < 0.05). - The effect of Korean pine nut oil (PinnoThin) on food intake, feeding behaviour and appetite: a double-blind placebo-controlled trial
Certain free fatty acids have been shown to have potent effects on food intake and self-reported changes in appetite; effects associated with increases in the release of endogenous cholecystokinin (CCK) and glucagon like peptide-1 (GLP-1). Collectively, these data suggest that PinnoThin may exert satiating effects consistent with its known action on CCK and GLP-1 release, and previously observed effects on self-reported appetite ratings. 2 g FFA PinnoThin™, given 30 minutes prior to an ad-libitum buffet test lunch, significantly reduced food intake (gram) by 9% (F(4,164) = 2.637, p = 0.036) compared to olive oil control. - Stone agers in the fast lane: chronic degenerative diseases in evolutionary perspective
From a genetic standpoint, humans living today are Stone Age hunter-gatherers displaced through time to a world that differs from that for which our genetic constitution was selected. Although our genes have hardly changed, our culture has been transformed almost beyond recognition during the past 10,000 years, especially since the Industrial Revolution. There is increasing evidence that the resulting mismatch fosters "diseases of civilization" that together cause 75 percent of all deaths in Western nations - Effects of a medical food containing an herbal alpha-glucosidase inhibitor on postprandial glycemia and insulinemia in healthy adults
Compared with the control, the 1,000-mg S oblonga extract dose reduced the plasma glucose and serum insulin incremental areas under the curve (0 to 120 minutes postprandial) by 23% ( P =.32) and 29% ( P =.01), respectively. The other doses of S oblonga extract did not impact glycemia or insulinemia. The presence of S oblonga extract tended to lower postprandial glycemia and significantly reduced the postprandial insulin response - Effects of a nutritional supplement containing Salacia oblonga extract and insulinogenic amino acids on postprandial glycemia, insulinemia, and breath hydrogen responses in healthy adults
Salacia oblonga extract is a promising nutraceutical ingredient that decreased glycemia in this study. Supplementation with amino acids had no significant additional effect on glycemia - Extract of Salacia oblonga lowers acute glycemia in patients with type 2 diabetes
Both doses of the Salacia extract significantly lowered the postprandial positive area under the glucose curve (14% for the 240 mg extract and 22% for the 480 mg extract) and the adjusted peak glucose response (19% for the lower dose and 27% for the higher dose of extract) to the control meal. In addition, both doses of the herbal extract significantly decreased the postprandial insulin response, lowering both the positive area under the insulin curve and the adjusted peak insulin response (14% and 9%, respectively, for the 240 mg extract; 19% and 12%, respectively, for the 480 mg extract) in comparison with the control meal - Salacia oblonga root improves postprandial hyperlipidemia and hepatic steatosis in Zucker diabetic fatty rats: activation of PPAR-alpha
Here, we demonstrate that chronic oral administration of the water extract from the root of SO to Zucker diabetic fatty (ZDF) rats, a genetic model of type 2 diabetes and obesity, lowered plasma triglyceride and total cholesterol (TC) levels, increased plasma high-density lipoprotein levels and reduced the liver contents of triglyceride, non-esterified fatty acids (NEFA) and the ratio of fatty droplets to total ti - Salacia oblonga root improves cardiac lipid metabolism in Zucker diabetic fatty rats: modulation of cardiac PPAR-alpha-mediated transcription of fatty acid metabolic genes
Excess cardiac triglyceride accumulation in diabetes and obesity induces lipotoxicity, which predisposes the myocytes to death. On the other hand, increased cardiac fatty acid (FA) oxidation plays a role in the development of myocardial dysfunction in diabetes. Here we demonstrate that chronic oral administration of SOE reduces cardiac triglyceride and FA contents and decreases the Oil red O-stained area in the myocardium of ZDF rats, which parallels the effects on plasma triglyceride and FA levels - Toxicological and cytogenetic assessment of a Salacia oblonga extract in a rat subchronic study
The present study results indicate that SOE was negative for the induction of chromosomal aberrations in cultured rat peripheral blood lymphocytes after 90 consecutive days of treatment with SOE. The no observable adverse effect level (NOAEL) was determined to be 2,500 mg/kg/day following daily subchronic oral gavage administrations to rats - Safety evaluation of an extract from Salacia oblonga
We conclude that salacinol extract, in a medical food consumed for 2 weeks in amounts estimated at 10-fold greater than proposed for human intake, did not result in clinical chemistry or histopathologic indications of toxic effects in male Sprague-Dawley rats - Leptin and reproduction: a review
Leptin may act as the critical link between adipose tissue and the reproductive system, indicating whether adequate energy reserves are present for normal reproductive function. Future interventional studies involving leptin administration are expected to further clarify this role of leptin and may provide new therapeutic options for the reproductive dysfunction associated with states of relative leptin deficiency or resistance - The role of the leptin in reproduction
Numerous pieces of evidence have accumulated showing that leptin potentially plays an important role in the control of the reproductive function. Moreover, understanding the role of leptin might be useful for new treatments in reproductive pathologies - Dietary fructose reduces circulating insulin and leptin, attenuates postprandial suppression of ghrelin, and increases triglycerides in women
Numerous pieces of evidence have accumulated showing that leptin potentially plays an important role in the control of the reproductive function. Moreover, understanding the role of leptin might be useful for new treatments in reproductive pathologies - Fructose, weight gain, and the insulin resistance syndrome
Because leptin production is regulated by insulin responses to meals, fructose consumption also reduces circulating leptin concentrations. The combined effects of lowered circulating leptin and insulin in individuals who consume diets that are high in dietary fructose could therefore increase the likelihood of weight gain and its associated metabolic sequelae - The hypothalamus, hormones, and hunger: alterations in human obesity and illness
While obese subjects have appropriate reductions in orexigenic ghrelin, other gut-hormone disturbances may contribute to obesity such as reduced anorexigenic PYY and PP - Gut hormones as peripheral anti obesity targets
Obese subjects have lower basal fasting PYY levels and have a smaller post prandial rise - Basal and postprandial plasma levels of PYY, ghrelin, cholecystokinin, gastrin and insulin in women with moderate and morbid obesity and metabolic syndrome
In MOB-MS women the fasting PYY(3-36) levels were lower compared to lean controls and OB-MS, whilst postprandially in both OB-MS and MOB-MS, it was much lower than in lean women - Interactions between the "cognitive" and "metabolic" brain in the control of food intake
It is hypothesized that this naturally occurring leptin resistance allowed temporary neutralization of satiety mechanisms and evolved as a response to survive subsequent periods of famine - Adipokines that link obesity and diabetes to the hypothalamus
The reduction in leptin levels during fasting stimulates appetite, decreases thermogenesis, thyroid and reproductive hormones, and increases glucocorticoids - The blood-brain barrier as a cause of obesity
Triglycerides are elevated in both starvation and obesity - Role of prescription omega-3 fatty acids in the treatment of hypertriglyceridemia
A prescription form of omega-3 fatty acids has been approved by the United States Food and Drug Administration as an adjunct to diet for the treatment of very high triglyceride levels. The active ingredients of omega-3 fatty acids are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are responsible for the triglyceride lowering - The triglyceride-lowering effects of a modest dose of docosahexaenoic acid alone versus in combination with low dose eicosapentaenoic acid in patients with coronary artery disease and elevated triglycerides
Our results indicate that the American Heart Association recommended cardioprotective dose of omega-3 fatty acids can also significantly lower triglycerides in patients with CAD. There do not appear to be significant differences in triglyceride-lowering between DHA only and DHA + EPA combination products when dosing is based on DHA - Endurance training partially reverses dietary-induced leptin resistance in rodent skeletal muscle
Leptin acutely stimulates skeletal muscle fatty acid (FA) metabolism in lean rodents and humans. This stimulatory effect is eliminated following the feeding of high-fat diets in rodents as well as in obese humans. Endurance training was generally effective in preventing the development of leptin resistance, although this did not appear to require a decrease in SOCS3 expression - Acute effect of exercise on plasma leptin level and insulin resistance in obese women with stable caloric intake
Our study suggests that acute exercise decreases insulin resistance at the first exercise session with no effect on leptin levels. Significant leptin decrement was evident at the first week and lasted during the entire four weeks exercise session - Leptin and adiponectin responses in overweight inactive elderly following resistance training and detraining are intensity related
Resistance training and detraining may alter leptin and adiponectin responses in an intensity-dependent manner. Leptin and adiponectin changes were strongly associated with RMR and anthropometric changes - Effects of exercise on metabolic risk variables in overweight postmenopausal women: a randomized clinical trial
Regular moderate-intensity exercise can be used to improve metabolic risk variables such as insulin and leptin in overweight/obese postmenopausal women. These results are promising for health care providers providing advice to postmenopausal women for lifestyle changes to reduce risk of insulin resistance, coronary heart disease, and diabetes - Changes in serum leptin concentrations in overweight Japanese men after exercise
The present study indicated exercise significantly lowers serum leptin concentrations, and thus it may improve the leptin resistance observed in overweight Japanese men - Dietary and lifestyle factors in relation to plasma leptin concentrations among normal weight and overweight men
These data suggest that physical activity may be a significant determinant of plasma leptin concentrations in men. Increasing physical activity is associated with lower plasma leptin concentrations even after adjusting for BMI. Physical activity may lower leptin concentrations not only due to decreased body fat mass, but potentially through an increase in leptin sensitivity - Brain regulation of food intake and expenditure energy: molecular action of insulin, leptin and physical exercise
The physical activity is an important component on long-term weight control. The exercise markedly increased phosphorylation activity of several proteins involved in leptin and insulin signal transduction in the hypothalamus. Recently our laboratory showed that physical activity increase in sensitivity to leptin- and insulin-induced anorexia after enhances interleukin-6 production. These findings provide support for the hypothesis that the appetite-suppressive actions of exercise may be mediated by the hypothalamus - Impaired cholecystokinin secretion and disturbed appetite regulation in women with polycystic ovary syndrome
We conclude that women with PCOS have reduced postprandial CCK secretion and deranged appetite regulation associated with increased levels of testosterone. Impaired CCK secretion may play a role in the greater frequency of binge eating and overweight in women with PCOS - Ghrelin and measures of satiety are altered in polycystic ovary syndrome but not differentially affected by diet composition
Subjects with PCOS were less satiated (P = 0.001) and more hungry (P = 0.007) after a test meal at wk 0 and 16 than subjects without PCOS. Appetite regulation, as measured by subjective short-term hunger and satiety and ghrelin homeostasis, may be impaired in PCOS - Obesity and the polycystic ovary syndrome
The polycystic ovary syndrome (PCOS) is a mostly hyperandrogenic disorder and is possibly the most common endocrinopathy of premenopausal women. The prevalence of obesity in PCOS patients is increased when compared to the general female population and, conversely, the prevalence of PCOS is increased in overweight and obese women when compared to their lean counterparts - Stone agers in the fast lane: chronic degenerative diseases in evolutionary perspective
From a genetic standpoint, humans living today are Stone Age hunter-gatherers displaced through time to a world that differs from that for which our genetic constitution was selected. Although our genes have hardly changed, our culture has been transformed almost beyond recognition during the past 10,000 years, especially since the Industrial Revolution. There is increasing evidence that the resulting mismatch fosters "diseases of civilization" that together cause 75 percent of all deaths in Western nations - High-density lipoprotein cholesterol changes after continuous egg consumption in healthy adults
In the majority of healthy adults, an addition of one egg per day to a normal fat diet could raise HDL-c levels and decreased the ratio of TC toHDL-c. Therefore, egg consumption might benefit blood cholesterol - Eggs modulate the inflammatory response to carbohydrate restricted diets in overweight men
A CRD with daily intake of eggs decreased plasma CRP and increased plasma adiponectin compared to a CRD without eggs. These findings indicate that eggs make a significant contribution to the anti-inflammatory effects of CRD, possibly due to the presence of cholesterol, which increases HDL-C and to the antioxidant lutein which modulates certain inflammatory responses - Dietary cholesterol from eggs increases plasma HDL cholesterol in overweight men consuming a carbohydrate-restricted diet
These results suggest that including eggs in a CRD results in increased HDL-C while decreasing the risk factors associated with MetS - A prospective study of egg consumption and risk of cardiovascular disease in men and women
These findings suggest that consumption of up to 1 egg per day is unlikely to have substantial overall impact on the risk of CHD or stroke among healthy men and women. The apparent increased risk of CHD associated with higher egg consumption among diabetic participants warrants further research - Safety evaluation of oligofructose: 13 week rat study and in vitro mutagenicity
There were no consistent differences in gross pathology or histopathology related to dietary OF. OF did not induce a positive response in the Ames test or chromosomal aberration test with CHO cells. These results demonstrate no adverse effects of OF - Adverse effects of laxatives
Bulking agents and nonabsorbable compounds such as lactulose can cause bloating but have very few serious adverse effects except for the allergic reaction to psyllium preparations - Psyllium-associated anaphylaxis and death: a case report and review of the literature
Psyllium hypersensitivity has been well described in health care workers and pharmaceutical plant employees. Clinical manifestations of allergy range from upper respiratory tract symptoms on inhalation to anaphylaxis on ingestion - Effect of short-term ingestion of konjac glucomannan on serum cholesterol in healthy men
The effects of the soluble fiber konjac glucomannan (GM) on serum cholesterol concentrations were investigated in 63 healthy men in a double-blind crossover, placebo-controlled study. After a 2-wk baseline period, the subjects were given 3.9 g GM or placebo daily for 4 wk. After a washout period of 2 wk, crossover took place, followed by another 4 wk of treatment. No adverse effects were observed. - Fiber (glucomannan) is beneficial in the treatment of childhood constipation
No significant side effects were reported during each 4-week treatment period. Significantly fewer children complained of abdominal pain and more children were successfully treated while on fiber (45%) as compared with placebo treatment (13%). Parents rated significantly more children (68%) as being better on fiber versus 13% as being better on placebo - Glucomannan and obesity: a critical review
At doses of 2-4 g per day, GM was well-tolerated and resulted in significant weight loss in overweight and obese individuals - Guar gum. A review of its pharmacological properties, and use as a dietary adjunct in hypercholesterolaemia
Gastrointestinal effects, notably flatulence, occur relatively frequently and may be considered unacceptable by some patients
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- Human plasma ghrelin levels increase during a one-year exercise program
Weight loss resulting from decreased caloric intake raises levels of the orexigenic hormone, ghrelin. In summary, ghrelin levels increase with weight loss achieved without reduced food intake, consistent with a role for ghrelin in the adaptive response constraining weight loss and, thus, in long-term body weight regulation - Circulating ghrelin is sensitive to changes in body weight during a diet and exercise program in normal-weight young women
Body fat, body weight, and resting metabolic rate significantly decreased in the weight-loss group before the increase in ghrelin. These findings suggest that ghrelin responds in a compensatory manner to changes in energy homeostasis in healthy young women, and that ghrelin exhibits particular sensitivity to changes in body weigh - Influence of weight loss on plasma ghrelin responses to high-fat and high-carbohydrate test meals in obese women
Diet-induced weight loss is associated with an increase in fasting ghrelin. Weight loss is associated with an improved postprandial plasma ghrelin response to a carbohydrate meal, whereas the response to a fat meal is not modified - Fasting--wrong in obesity?
Fasting has been advocated as an effective way to reduce body weight. However, few data support any long-term effect of this therapy. On the contrary, evidence is accumulating that the repeated weight loss and concomitant weight gain, typical of fasting in many individuals, will lead to a subsequently higher body weight. Each weight cycle seems to increase the risk of a higher waist/hip ratio, greater metabolic efficiency and a food preference towards fat. All these trends result in further problems associated with weight loss and a vicious circle is established - The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss.
The foremost objective of a weight-loss trial has to be the reduction in body fat leading to a decrease in risk factors for metabolic syndrome. However, a concomitant decline in lean tissue can frequently be observed. Given that fat-free mass (FFM) represents a key determinant of the magnitude of resting metabolic rate (RMR), it follows that a decrease in lean tissue could hinder the progress of weight loss. The advantages of strength training may have greater implications than initially proposed with respect to decreasing percentage body fat and sustaining FFM - Overweight and obesity-related metabolic disorders in hospital employees
The risks attributable to obesity (baseline BMI >or= 25 kg/m2) were 23.0% for hypertension, 70.8% for diabetes, 27.9% for hypertriglyceridemia, and 24.1% for hyperuricemia - Peptides regulating food intake and body weight
So, adipocytes synthesize and express leptin, the product of Ob gene, a regulator of long-term food intake, in amounts proportional to the fat amount - The blood-brain barrier as a regulatory interface in the gut-brain axes
Leptin transport is also inhibited in starvation and by hypertriglyceridemia. Since hypertriglyceridemia occurs in both starvation and obesity, we have postulated that the peripheral resistance induced by hypertriglyceridemia may have evolved as an adaptive mechanism in response to starvation - Elevated leptin: consequence or cause of obesity?
Once leptin resistance takes hold, each subsequent exposure to high-density food faces diminished counter-regulatory responses, leading to exacerbated weight gain - Adipokines that link obesity and diabetes to the hypothalamus
The reduction in leptin levels during fasting stimulates appetite, decreases thermogenesis, thyroid and reproductive hormones, and increases glucocorticoids. Leptin also stimulates fatty acid oxidation, insulin release, and peripheral insulin action
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- Low resting metabolic rate as a risk factor for weight gain: role of the sympathetic nervous system
Resting metabolic rate (RMR) comprises 50-80% of daily energy expenditure, and is highly variable between subjects even after adjusting for body weight and body composition. RMR is believed to be genetically determined. Individuals with a low RMR for a given body size are at higher risk of significant weight gain, relative to those with a high RMR - Effects of dieting and exercise on resting metabolic rate and implications for weight management
Resting metabolic rate accounts for 60–75% of total energy expenditure in sedentary people. Therefore, it is a major determinant of energy balance and changes in weight. Factors which decrease resting metabolic rate would be associated with difficulty maintaining weight or weight loss, or frank weight gain. On the contrary, anything that increases resting metabolic rate would facilitate weight loss and maintenance of weight loss. Caloric restriction is known to produce a short-term reduction in resting metabolic rate.
Verhoog uw verbranding door beweging
- The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss
The foremost objective of a weight-loss trial has to be the reduction in body fat leading to a decrease in risk factors for metabolic syndrome. However, a concomitant decline in lean tissue can frequently be observed. Given that fat-free mass (FFM) represents a key determinant of the magnitude of resting metabolic rate (RMR), it follows that a decrease in lean tissue could hinder the progress of weight loss. Therefore, with respect to long-term effectiveness of weight-loss programmes, the loss of fat mass while maintaining FFM and RMR seems desirable - Exercise as treatment for obesity
Thus, during diet-induced weight loss, added exercise seems to accelerate fat loss and maintain lean body mass, a condition which may prevent a decline in RMR - Effects of habitual physical activity on the resting metabolic rates and body compositions of women aged 35 to 50 years
This research supports and emphasizes the benefits of habitual physical activity in maintaining RMR and lower body fat levels in middle-aged women - Optimizing fat oxidation through exercise and diet
Fat oxidation rates increase from low to moderate intensities and then decrease when the intensity becomes high. Maximal rates of fat oxidation have been shown to be reached at intensities between 59% and 64% of maximum oxygen consumption in trained individuals and between 47% and 52% of maximum oxygen consumption in a large sample of the general population. The mode of exercise can also affect fat oxidation, with fat oxidation being higher during running than cycling. Endurance training induces a multitude of adaptations that result in increased fat oxidation - Substrate utilization during exercise in active people
When people walk at low intensity after fasting, the energy needed is provided mostly by oxidation of plasma fatty acids. As exercise intensity increases (eg, to moderate running), plasma fatty acid turnover does not increase and the additional energy is obtained by utilization of muscle glycogen, blood glucose, and intramuscular triglyceride. Further increases in exercise intensity are fueled mostly by increases in muscle glycogen utilization with some additional increase in blood glucose oxidation - Optimizing fat oxidation through exercise and diet
Ingestion of carbohydrate in the hours before or on commencement of exercise reduces the rate of fat oxidation significantly compared with fasted conditions, whereas fasting longer than 6 h optimizes fat oxidation. Fat oxidation rates have been shown to decrease after ingestion of high-fat diets, partly as a result of decreased glycogen stores and partly because of adaptations at the muscle level - Effects of acute and chronic exercise on fat metabolism
Fatty acids are an important source of energy for skeletal muscle contraction, particularly during exercise of mild-moderate intensity, prolonged duration, and in the fasting state - Physical activity and resting metabolic rate
Resting metabolic rate (RMR) is the largest component of the daily energy budget in most human societies and, therefore, any increases in RMR in response to exercise interventions are potentially of great importance. Long-term effects of training include increases in RMR due to increases in lean muscle mass. Many studies of human subjects indicate a short-term elevation in RMR in response to single exercise events (generally termed the excess post-exercise O2 consumption; EPOC). This EPOC appears to have two phases, one lasting < 2 h and a smaller much more prolonged effect lasting up to 48 h - New approach for weight reduction by a combination of diet, light resistance exercise and the timing of ingesting a protein supplement
The fat-free mass significantly decreased in C, whereas its decrease in S was not significant. The RMR and post-meal total energy output significantly increased in Protein Supplement group (S), while these variables did not change in Control Group ©. In addition, the urinary nitrogen excretion tended to increase in C but not in S. These results suggest that the RMR increase observed in S might be associated with an increase in body protein synthesis - The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss
The advantages of strength training may have greater implications than initially proposed with respect to decreasing percentage body fat and sustaining FFM. Research to date suggests that the addition of exercise programmes to dietary restriction can promote more favourable changes in body composition than diet or physical activity on its own - The effects of a 20-week exercise training program on resting metabolic rate in previously sedentary, moderately obese women
Resistance training (RT) can potentiate an increase in RMR through an increase in fat-free mass - Influence of exercise training on physiological and performance changes with weight loss in men
These data indicate that a weight-loss dietary regimen in conjunction with aerobic and resistance exercise prevents the normal decline in fat-free mass and muscular power and augments body composition, maximal strength, and maximum oxygen consumption compared with weight-loss induced by diet alone - Selection of appropriate exercise regimens for weight reduction during VLCD and mainten
We conclude that exercise with VLCD is beneficial particularly isotonic resistance training, in improving muscular efficiency and RMR/lean - Lower extremity muscle size and strength and aerobic capacity decrease with caloric restriction but not with exercise-induced weight loss
Caloric restriction (CR) results in fat loss; however, it may also result in loss of muscle and thereby reduce strength and aerobic capacity (VO2 max). These effects may not occur with exercise-induced weight loss (EX) because of the anabolic effects of exercise on heart and skeletal muscle. These data provide evidence that muscle mass and absolute physical work capacity decrease in response to 12 mo of CR but not in response to a similar weight loss induced by exercise. These findings suggest that, during EX, the body adapts to maintain or even enhance physical performance capacity - Optimal load for increasing muscle power during explosive resistance training in older adult
Peak muscle power may be improved similarly using light, moderate, or heavy resistances, whereas there is a dose-response relationship between training intensity and muscle strength and endurance changes. Therefore, using heavy loads during explosive resistance training may be the most effective strategy to achieve simultaneous improvements in muscle strength, power, and endurance in older - Hormonal responses and adaptations to resistance exercise and training
Resistance exercise has been shown to elicit a significant acute hormonal response. It appears that this acute response is more critical to tissue growth and remodelling than chronic changes in resting hormonal concentrations, as many studies have not shown a significant change during resistance training despite increases in muscle strength and hypertrophy. Anabolic hormones such as testosterone and the superfamily of growth hormones (GH) have been shown to be elevated during 15-30 minutes of post-resistance exercise providing an adequate stimulus is present. Protocols high in volume, moderate to high in intensity, using short rest intervals and stressing a large muscle mass, tend to produce the greatest acute hormonal elevations (e.g. testosterone, GH and the catabolic hormone cortisol) compared with low-volume, high-intensity protocols using long rest intervals - Acute hormonal responses to submaximal and maximal heavy resistance and explosive exercises in men and women
A significant increase (p < 0.05) in serum growth hormone (GH) was observed after HRE both in men and women, but the increase was greater (p < 0.05) in men than in women. Serum testosterone (T) increased significantly (p < 0.05) only during HRE in men. Since GH and T are anabolic hormones, the acute exercise-induced response during HRE may play an important role in the long-term anabolic adaptation processes related to muscle hypertrophy and maximal strength development - New approach for weight reduction by a combination of diet, light resistance exercise and the timing of ingesting a protein supplement
The RMR and post-meal total energy output significantly increased in Protein Supplement group (S), while these variables did not change in Control Group ©. In addition, the urinary nitrogen excretion tended to increase in C but not in S. These results suggest that the RMR increase observed in S might be associated with an increase in body protein synthesis - The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss
Moreover, recent research indicates that the macronutrient content of the energy-restricted diet may influence body compositional alterations following exercise regimens. Protein emerges as an important factor for the maintenance of or increase in FFM induced by exercise training - Protein nutrition, exercise and aging
Aging is associated with remarkable changes in body composition. Loss of skeletal muscle, a process called sarcopenia, is a prominent feature of these changes. In addition, gains in total body fat and visceral fat content continue into late life. The cause of sarcopenia is likely a result of a number of changes that also occur with aging. These include reduced levels of physical activity, changing endocrine function (reduced testosterone, growth hormone, and estrogen levels), insulin resistance, and increased dietary protein needs - Increased resting energy expenditure after 40 minutes of aerobic but not resistance exercise
Resting energy expenditure (REE) is increased 24 hours after high-intensity aerobic exercise lasting 60 minutes, whereas results have been inconsistent after resistance training and aerobic exercise of shorter duration. Consistent with findings on longer duration AT, these results show that 40 minutes of AT elevates REE for 19 hours in trained black and white women. This elevation did not occur with 40 minutes of RT. Results suggest that differences are, in part, due to increased sympathetic tone - Regulation of mitochondrial biogenesis in muscle by endurance exercise
An understanding of the molecular and cellular mechanisms that govern the increases in mitochondrial volume with repeated bouts of exercise can provide insights into possible therapeutic interventions to care for those with mitochondrially-based diseases, and those unable to withstand regular physical activity - The role of AMP-activated protein kinase in mitochondrial biogenesis
While it has been known for more than 75 years that physical activity is associated with increased mitochondrial content in muscle, the molecular mechanism for this adaptive process has only recently been elucidated. This brief review examines existing studies that have identified AMPK-activated protein kinase (AMPK) and several other key regulators of mitochondrial biogenesis - The exercise-induced growth hormone response in athletes
Human growth hormone (hGH) is secreted in a pulsatile fashion, generally following a circadian rhythm. A number of physiological stimuli can initiate hGH secretion, the most powerful, non-pharmacological of which are sleep and exercise. hGH has many varied roles throughout life, from growth itself, including the turnover of muscle, bone and collagen, to the regulation of selective aspects of metabolic function including increased fat metabolism and the maintenance of a healthier body composition in later life. Resistance training results in a significant exercise-induced growth hormone response (EIGR). The EIGR to endurance exercise is associated with the intensity, duration, frequency and mode of endurance exercise. A number of studies have suggested an intensity 'threshold' exists for EIGR. An exercise intensity above lactate threshold and for a minimum of 10 minutes appears to elicit the greatest stimulus to the secretion of hGH - Effects of growth hormone on body composition in adults
GH replacement therapy in GH-deficient adults has recently been shown to increase (normalize) muscle volume and decrease adipose tissue volume as measured by means of CT scan and skinfold thickness. Also in adults with acquired GH deficiency in adulthood, GH replacement has been shown to significantly influence body composition with an increase in lean body mass and a reduction in skinfold thickness. Preliminary results from an open long-term trial indicate that 12 months of GH substitution result in a further normalization of the muscle/fat ratio. The fluid-retaining effect, with a significant increase in extracellular-fluid volume demonstrated during GH administration to normal subjects, seems to be of little clinical importance if a replacement dose around 2 IU/m2/day is chosen for young GH-deficient adults - Testosterone replacement therapy and the risk of prostate cancer. Is there a link?
Substantial evidence supports the value of testosterone replacement therapy (TRT) in improving quality of life in men with proven aging male syndrome (AMS). Benefits of TRT include improved bone mineral density, reduced fracture risk, increased muscle mass, and improved mood, sense of well being, and libido, among others
Verhoog uw verbranding met behulp van voeding en voedingssupplementen
- Protein, weight management, and satiety.
Potential beneficial outcomes associated with protein ingestion include the following: 1) increased satiety--protein generally increases satiety to a greater extent than carbohydrate or fat and may facilitate a reduction in energy consumption under ad libitum dietary conditions; 2) increased thermogenesis--higher-protein diets are associated with increased thermogenesis, which also influences satiety and augments energy expenditure (in the longer term, increased thermogenesis contributes to the relatively low-energy efficiency of protein) and 3) maintenance or accretion of fat-free mass--in some individuals, a moderately higher protein diet may provide a stimulatory effect on muscle protein anabolism, favoring the retention of lean muscle mass while improving metabolic profile. - Ghrelin and glucagon-like peptide 1 concentrations, 24-h satiety, and energy and substrate metabolism during a high-protein diet and measured in a respiration chamber
An HP diet, compared with an AP diet, fed at energy balance for 4 d increased 24-h satiety, thermogenesis, sleeping metabolic rate, protein balance, and fat oxidation. Satiety was related to protein intake, and incidentally to ghrelin and GLP-1 concentrations, only during the HP diet - Protein intake and energy balance
Recent findings suggest that an elevated protein intake plays a key role herein, through (i) increased satiety related to increased diet-induced thermogenesis, (ii) its effect on thermogenesis, (iii) body composition, and (iv) decreased energy-efficiency, all of which are related to protein metabolism. Supported by these mechanisms, relatively larger weight loss and subsequent stronger body-weight maintenance have been observed. Therefore 'high protein negative energy balance diets' aim to keep the grams of proteins ingested at the same level as consumed at energy balance, despite lower energy intakes
Hydroxycitroenzuur
- Bioefficacy of a novel calcium-potassium salt of (-)-hydroxycitric acid
(-)-Hydroxycitric acid (HCA), a natural plant extract from the dried fruit rind of Garcinia cambogia, has been reported to promote body fat loss in humans without stimulating the central nervous system. Typically, HCA used in dietary weight loss supplement is bound to calcium, which results in a poorly soluble (<50%) and less bioavailable form. Conversely, the structural characteristics of a novel Ca2+/K+ bound (-)-HCA salt (HCA-SX or Super CitriMax) make it completely water soluble as well as bioavailable. HCA-SX has been shown to increase serotonin availability, reduce appetite, increase fat oxidation, improve blood lipid levels, reduce body weight, and modulate a number of obesity regulatory genes without affecting the mitochondrial and nuclear proteins required for normal biochemical and physiological functions - Comparison of the effects of three different (-)-hydroxycitric acid preparations on food intake in rats
Regulator and Citrin K significantly reduced food intake in both experimental setups, while Super CitriMax HCA-600-SXS was less effective. When administered for 4 subsequent days Regulator and Citrin K diminished body weight gain. The striking differences in efficacy between these 3 preparations indicate that low doses of a relatively low-effective HCA preparation may have contributed to the lack of efficacy as found in several human studies - Effects of a natural extract of (-)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight loss
At the end of 8 weeks, body weight and BMI decreased by 5-6% in both groups A and B. Food intake, total cholesterol, low-density lipoproteins, triglycerides and serum leptin levels were significantly reduced in both groups, while high-density lipoprotein levels and excretion of urinary fat metabolites increased in both groups. A marginal or non-significant effect was observed in all parameters in group C. The present study shows that optimal doses of HCA-SX and, to a greater degree, the combination of HCA-SX, NBC and GSE can serve as an effective and safe weight-loss formula that can facilitate a reduction in excess body weight and BMI, while promoting healthy blood lipid levels - The effect of (-)-hydroxycitrate on energy intake and satiety in overweight humans
Twenty-four-hour EI was decreased by 15-30% (P<0.05) with HCA treatment compared to placebo, without changes in the appetite profile, dietary restraint, mood, taste perception and hedonics, while body weight tended to decrease (P=0.1).CONCLUSION: HCA treatment reduced 24 h EI in humans while satiety was sustained - Short-term (-)-hydroxycitrate ingestion increases fat oxidation during exercise in athletes
These results suggest that a short-term administration of HCA enhances endurance performance with increasing fat oxidation, which spares glycogen utilization during moderate intensity exercise in athletes - Efficacy of a novel calcium/potassium salt of (-)-hydroxycitric acid in weight control
The combined results confirm that HCA-SX and, to a greater degree, the combination of HCA-SX plus NBC and GSE reduce body weight and BMI, suppress appetite, improve blood lipid profiles, increase serum leptin and serotonin levels and increase fat oxidation more than placebo. We conclude that dosage levels, timing of administration, subject compliance and bioavailability of HCA-SX significantly affect results and that when taken as directed, HCA-SX is a highly effective adjunct to healthy weight control - Transcriptome of primary adipocytes from obese women in response to a novel hydroxycitric acid-based dietary supplement
Obesity is a global public health problem. Traditional herbal medicines may have some potential in managing obesity. The dried fruit rind of Garcinia cambogia, also known as Malabar tamarind, is a unique source of (-)-hydroxycitric acid (HCA), which exhibits a distinct sour taste and has been safely used for centuries in Southeastern Asia to make meals more filling. Taken together, the net effects support the antilipolytic and antiadipogenic effects of HCA-SX. Further human studies are warranted - An overview of the safety and efficacy of a novel, natural(-)-hydroxycitric acid extract (HCA-SX) for weight management.
Garcinia cambogia-derived (-)-hydroxycitric acid (HCA) is a safe, natural supplement for weight management. HCA is a competitive inhibitor of ATP citrate lyase, a key enzyme which facilitates the synthesis of fatty acids, cholesterol and triglycerides. HCA-SX was also shown to exhibit concentration-dependent release of serotonin in isolated rat brain cortex, which may explain its appetite suppressive action. At the end of 8 weeks, body weight and BMI decreased by 5.4% and 5.2%, respectively. Food intake, total cholesterol, LDL, triglycerides and serum leptin levels were significantly reduced, while HDL and serotonin levels, and excretion of urinary fat metabolites (a biomarker of fat oxidation) significantly increased. No significant adverse effects were reported. These results demonstrate the safety, bioavailability and efficacy of HCA-SX in weight management - Effects of (-)-hydroxycitrate on net fat synthesis as de novo lipogenesis.
(-)-Hydroxycitrate (HCA) might promote weight maintenance by limiting the capacity for de novo lipogenesis (DNL). During overfeeding, they ingested 3 x 500 mg/day HCA or placebo (PLA).. We conclude that an experimental condition resulting in DNL in humans was created and that treatment with HCA during overfeeding with carbohydrates may reduce DNL.
Groene thee
- Recent findings of green tea extract AR25 (Exolise) and its activity for the treatment of obesity
The green tea extract AR25 is an 80% ethanolic dry extract standardized at 25% catechins expressed as epigallocatechin gallate (EGCG). In vitro, green tea extract AR25 exerts a direct inhibition of gastric and pancreatic lipases and a stimulation of thermogenesis. In an open study, the effects of extract AR25 were evaluated in moderately obese patients. After 3 months, body weight was decreased by 4.6% and waist circumference by 4.48%. These results suggest the green tea extract AR25 to be a natural product for the treatment of obesity - Obesity and thermogenesis related to the consumption of caffeine, ephedrine, capsaicin, and green tea
Tools for obesity management, including caffeine, ephedrine, capsaicin, and green tea have been proposed as strategies for weight loss and weight maintenance, since they may increase energy expenditure and have been proposed to counteract the decrease in metabolic rate that is present during weight loss. Also positive effects on body-weight management have been shown using green tea mixtures. Green tea, by containing both tea catechins and caffeine, may act through inhibition of catechol O-methyl-transferase, and inhibition of phosphodiesterase. Here, the mechanisms may also operate synergistically. In addition, tea catechins have antiangiogenic properties that may prevent development of overweight and obesity. Furthermore, the sympathetic nervous system is involved in the regulation of lipolysis, and the sympathetic innervation of white adipose tissue may play an important role in the regulation of total body fat in general - Epigallocatechin gallate attenuates diet-induced obesity in mice by decreasing energy absorption and increasing fat oxidation
OBJECTIVE: To examine the antiobesity effect of epigallocatechin gallate (EGCG), a green tea bioactive polyphenol in a mouse model of diet-induced obesity. METHODS: Obesity was induced in male New Zealand black mice by feeding of a high-fat diet. EGCG purified from green tea (TEAVIGO) was supplemented in the diet RESULTS: Dietary supplementation of EGCG resulted in a dose-dependent attenuation of body fat accumulation. Food intake was not affected but faeces energy content was slightly increased by EGCG, indicating a reduced food digestibility and thus reduced long-term energy absorption CONCLUSIONS: Dietary EGCG attenuated diet-induced body fat accretion in mice. EGCG apparently promoted fat oxidation, but its fat-reducing effect could be entirely explained by its effect in reducing diet digestibility - Anti-obesity effects of green tea: from bedside to bench
Green tea, green tea catechins, and epigallocatechin gallate (EGCG) have been demonstrated in cell culture and animal models of obesity to reduce adipocyte differentiation and proliferation, lipogenesis, fat mass, body weight, fat absorption, plasma levels of triglycerides, free fatty acids, cholesterol, glucose, insulin and leptin, as well as to increase beta-oxidation and thermogenesis. Studies conducted with human subjects report reduced body weight and body fat, as well as increased fat oxidation and thermogenesis and thereby confirm findings in cell culture systems and animal models of obesity - Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans
The green tea extract may play a role in the control of body composition via sympathetic activation of thermogenesis, fat oxidation, or both - Green tea extract thermogenesis-induced weight loss by epigallocatechin gallate inhibition of catechol-O-methyltransferase
Epidemiological studies have shown that intake of tea catechins is associated with a lower risk of cardiovascular disease. Reports have shown that green tea extract intake is associated with increased weight loss due to diet-induced thermogenesis, which is generally attributed to the catechin epigallocatechin gallate. That catechin-polyphenols are known to be capable of inhibiting catechol-O-methyltransferase (the enzyme that degrades norepinephrine) is a possible explanation for why the green tea extract is effective in stimulating thermogenesis by epigallocatechin gallate to augment and prolong sympathetic stimulation of thermogenesis - Proposed mechanisms of (-)-epigallocatechin-3-gallate for anti-obesity
Green tea catechins (GTCs) are polyphenolic flavonoids formerly called vitamin P. GTCs, especially (-)-epigallocatechin-3-gallate (EGCG), lower the incidence of cancers, collagen-induced arthritis, oxidative stress-induced neurodegenerative diseases, and streptozotocin-induced diabetes. Also, inhibition of adipogenesis by green tea and green tea extract has been demonstrated in cell lines, animal models, and humans. The obesity-preventive effects of green tea and its main constituent EGCG are widely supported by results from epidemiological, cell culture, animal, and clinical studies in the last decade. In addition, it was shown that dietary supplementation with EGCG could potentially contribute to nutritional strategies for the prevention and treatment of type 2 diabetes mellitus - Tea polyphenols, their biological effects and potential molecular targets
The results of several investigations indicate that green tea consumption may be of modest benefit in reducing the plasma concentration of cholesterol and preventing atherosclerosis. Additionally, the cancer-preventive effects of green tea are widely supported by results from epidemiological, cell culture, animal and clinical studies. In vitro cell culture studies show that tea polyphenols potently induce apoptotic cell death and cell cycle arrest in tumor cells but not in their normal cell counterparts - EGCG on cardiovascular and metabolic health
The anti-cancer effects of green tea and EGCG were the focus of early research, and encouraging data from in vitro, animal model, and human studies have emerged. Dose-response relationships observed in several epidemiological studies have indicated that pronounced cardiovascular and metabolic health benefits can be obtained by regular consumption of 5-6 or more cups of green tea per day. Furthermore, intervention studies using similar amounts of green tea, containing 200-300 mg of EGCG, have demonstrated its usefulness for maintaining cardiovascular and metabolic health. Additionally, there are numerous in vivo studies demonstrating that green tea and EGCG exert cardiovascular and metabolic benefits in these model systems. - Safety studies on epigallocatechin gallate (EGCG) preparations. Part 1: genotoxicity
From these studies, it is concluded that Teavigo (EGCG) is not genotoxic - Safety studies on epigallocatechin gallate (EGCG) preparations. Part 2: dermal, acute and short-term toxicity studies
From these studies a no-observed adverse effect level of 500 mg EGCG preparation/kg/day was established - Safety studies on epigallocatechin gallate (EGCG) preparations. Part 3: teratogenicity and reproductive toxicity studies in rats
there was no evidence of any direct embryo-fetal toxicity, although some maternal toxicity was seen. In the main teratogenicity study, feeding pregnant rats diets supplemented at 1400, 4200 or 14,000 ppm during organogenesis was non-toxic to dams or fetuses. A two-generation study in rats fed 1200, 3600 or 12,000 ppm EGCG preparation showed no adverse effects on reproduction or fertility. The highest dose reduced the growth rate of offspring, and there was a slight increase in pup loss. A growth effect among pups was also seen at 3600 ppm, but in the second generation only. The lowest dose was considered the overall no-observed adverse effect level (NOAEL). As dams consumed twice the amount of feed during the crucial lactation period, the NOAEL was equivalent to 200 mg/kg/day EGCG preparation - Green tea and stroke prevention: emerging evidence
CONCLUSION: Green tea is a safe and cheap beverage. Its consumption should be encouraged because it could potentially serve as a practical method for stroke prevention - Clinical relevance of the inhibitory effect of green tea catechins (GtCs) on prostate cancer progression in combination with molecular profiling of catechin-resistant tumors: an integrated view
Green Tea Catechins (GTCs) were proven effective at inhibiting cancer growth in several laboratory studies. We recently performed a pilot clinical trial in HG-PIN subjects showing that only 1/30 tumour was diagnosed in subjects treated for 1 year with 600 mg/die GTCs, while 9/30 cancers were found in placebo-treated men - Acute EGCG supplementation reverses endothelial dysfunction in patients with coronary artery disease
prior to treatment with EGCG or placebo, two hours after an initial dose of EGCG (300 mg) or placebo, and after two weeks of treatment with EGCG (150 mg twice daily) or placebo. The order of treatments (EGCG or placebo) was randomized and there was a one-week washout period between treatments. RESULTS: A total of 42 subjects completed the study, and brachial artery flow-mediated dilation improved from 7.1 +/- 4.1 to 8.6 +/- 4.7% two hours after the first dose of 300 mg of EGCG (P = 0.01), but was similar to baseline (7.8 +/- 4.2%, P = 0.12) after two weeks of treatment with the final measurements made approximately 14 hours after the last dose CONCLUSION: EGCG acutely improves endothelial function in humans with coronary artery disease, and may account for a portion of the beneficial effects of flavonoid-rich food on endothelial function - A green tea extract high in catechins reduces body fat and cardiovascular risks in humans
a 12-week double-blind parallel multicenter trial was performed, in which the subjects ingested green tea containing 583 mg of catechins (catechin group) or 96 mg of catechins (control group) per day. Decreases in body weight, body mass index, body fat ratio, body fat mass, waist circumference, hip circumference, visceral fat area, and subcutaneous fat area were found to be greater in the catechin group than in the control group. A greater decrease in systolic blood pressure (SBP) was found in the catechin group compared with the control group for subjects whose initial SBP was 130 mm Hg or higher. Low-density lipoprotein (LDL) cholesterol was also decreased to a greater extent in the catechin group. No adverse effect was found - Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction
Warfarin was the most common cardiovascular drug involved. It was found to interact with boldo, curbicin, fenugreek, garlic, danshen, devil's claw, don quai, ginkgo, papaya, lycium, mango, PC-SPES (resulting in over-anticoagulation) and with ginseng, green tea, soy and St. John's wort (causing decreased anticoagulant effect Interaction between herbal medicine and cardiovascular drugs is a potentially important safety issue. Patients taking anticoagulants are at the highest risk
7-oxo DHEA
- Significance of dehydroepiandrosterone and dehydroepiandrosterone sulfate in different diseases
The levels of dehydroepiandrosterone and dehydroepiandrosterone-sulfate are maximal between the ages of 20 and 30 years, then start a decline of 2% per year, leaving a residual of 10-20% of the peak production by the eight decade of life - Steroids and thermogenesis
Recent studies demonstrate that 7-oxo-dehydroepiandrosterone, one of its 7-oxygenated metabolites, is even more effective than dehydroepiandrosterone. Recent findings of various actions of these steroids support the view that they may also participate in modulating thermogenic effects - A randomized, double-blind, placebo-controlled study of 3-acetyl-7-oxo-dehydroepiandrosterone in healthy overweight adults
Group 1 lost a significant amount of body weight compared with Group 2, placebo group (?2.88 kg vs ?0.97 kg; P = 0.01) over the 8 weeks. Group 1 also achieved a significant reduction in body fat compared with Group 2 (?1.8% vs ?0.57%; P = 0.02). The results of the study suggest that 7-oxo-DHEA combined with moderate exercise and a reduced-calorie diet significantly reduces body weight and body fat compared with exercise and a reduced-calorie diet alone. In addition, 7-oxo-DHEA significantly elevated T3 levels but did not affect TSH or T4 levels, indicating that it does not adversely affect thyroid function in the short term - Ergosteroids: induction of thermogenic enzymes in liver of rats treated with steroids derived from dehydroepiandrosterone
Dehydroepiandrosterone (DHEA), an intermediate in the biosynthesis of testosterone and estrogens, exerts several physiological effects not involving the sex hormones. We report here that these 7-oxygenated derivatives are active inducers of these thermogenic enzymes in rats and that the 7-oxo derivatives are more active than the parent steroids - HUM5007, a novel combination of thermogenic compounds, and 3-acetyl-7-oxo-dehydroepiandrosterone: each increases the resting metabolic rate of overweight adults
In this study, the administration of HUM5007 or 7-Keto reversed the decrease in RMR normally associated with dieting. HUM5007 and 7-Keto increased RMR above basal levels and may benefit obese individuals with impaired energy expenditure. HUM5007 and 7-Keto were generally well tolerated and no serious adverse events were reported - Hydroxydehydroepiandrosterone--a natural antiglucocorticoid and a candidate for steroid replacement therapy?
-7/Hydroxylated metabolites of dehydroepiandrosterone (DHEA) are believed to be responsible for at least some immunomodulatory and antiglucocorticoid effects of DHEA and hence are considered candidates for hormone replacement therapy - Effects of 7-oxo-DHEA treatment on the immunoreactivity of BALB/c mice subjected to chronic mild stress
CONCLUSION: 7-oxo-DHEA can improve the depressive symptoms and hypoimmunity of BALB/c mice induced by chronic mild stress as its parent DHEA - Dehydroepiandrosterone, obesity and cardiovascular disease risk: a review of human studies
The age-related decline in serum dehydroepiandrosterone (DHEA) and its sulfated ester (DHEA-S) has suggested that a relative deficiency of these steroids may be causally related to the development of chronic diseases generally associated with aging, including insulin resistance, obesity, cardiovascular disease, cancer, reductions of the immune defense, depression and a general deterioration in the sensation of well-being - Effects of transdermal application of 7-oxo-DHEA on the levels of steroid hormones, gonadotropins and lipids in healthy men
The single dose contained 25 mg 7-oxo-DHEA. After the treatment, we noted the following significant changes: a decline of testosterone and estradiol levels, increase of LH, HDL-cholesterol and apolipoprotein A-I levels. The decrease of total cholesterol levels was of the borderline significance.The most expressive was the fall of the atherogenic index. We suggest that the gel containing 7-oxo-DHEA might be a suitable drug for improving the composition of the steroid and lipid parameters in elderly men - 7-oxo-DHEA and Raynaud’s phenomenon
We suggest that an ergogenic (thermogenic) steroid, 7-oxo-DHEA (3-acetoxyandrost-5-ene-7,17-dione), which is available without prescription as the trademarked 7-keto DHEA, may be very helpful in prevention of primary Raynaud's attacks by increasing the basal metabolic rate and inhibiting vasospasm - Safety and pharmacokinetic study with escalating doses of 3-acetyl-7-oxo-dehydroepiandrosterone in healthy male volunteers
CONCLUSION: These results indicate that 3beta-acetyl-7-oxo-DHEA is safe and well tolerated in normal healthy men at doses up to 200 mg/d for 4 weeks - An acute oral gavage study of 3beta-acetoxyandrost- 5-ene-7,17-dione (7-oxo-DHEA-acetate) in rats
This study demonstrated that the no-observable adverse effect level for a single oral dose of 7-ODA in male and female rats was 2,000 mg/kg - Dehydroepiandrosterone metabolites and their interactions in humans
Dehydroepiandrosterone (DHEA) is 7alpha-hydroxylated by the cytochrome P4507B1 in the liver, skin and brain, which are targets for glucocorticoids. 7alpha-Hydroxy-DHEA produced anti-glucocorticoid effects in vivo but the interference between the glucocorticoid hormone binding with its receptor could not be determined.. Both the production of 7alpha-hydroxysteroids and their interference with the activation of cortisone into cortisol are basic to the concept of native anti-glucocorticoids - How short-term transdermal treatment of men with 7-oxo-dehydroepiandrosterone influence thyroid function
Dehydroepiandrosterone may influence thyroid function. Its metabolite, 7-oxo-dehydroepiandrosterone, a precursor of immunomodulatory 7-hydroxylated metabolites and thermogenic agent, belongs to candidates of steroid replacement therapy It was concluded that treatment of 7-oxo-dehydroepiandrosterone affects the thyroid parameters only temporarily and that it provides a considerable persistent amount of 7beta-hydroxy-dehydroepiandrosterone - 7-Keto DHEA The Fat-Burning Metabolite of DHEA
Scientists have known for some time that DHEA supplementation can decrease blood cholesterol levels.15 The question then became which DHEA metabolite or metabolites are responsible for this action. A study at the Institute of Endocrinology in Prague, Czech Republic, revealed that 7-Keto contributes to this cholesterol-lowering activity.16 Ten volunteers aged 27 to 72 years applied a gel containing 25 mg of 7-Keto to their abdominal skin for five consecutive days - DHEA(S): the fountain of youth
The decline of DHEAS concentrations with aging has led to the suggestion that DHEAS could play a role in itself and be implicated in longevity. Moreover, the epidemiological evidence has shown that adult men with high plasma DHEAS levels are less likely to die of cardiovascular disease. DHEA has also been shown to increase the body's ability to transform food into energy and burn off excess fat. Another recent finding involves the anti-inflammatory properties of DHEA. It has been known that DHEA can lower the levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha). It should be pointed out that chronic inflammation is known to play a critical role in the development of the killer diseases of aging: heart disease, Alzheimer's disease and certain types of cancer - How short-term transdermal treatment of men with 7-oxo-dehydroepiandrosterone influence thyroid function
Dehydroepiandrosterone may influence thyroid function. Its metabolite, 7-oxo-dehydroepiandrosterone, a precursor of immunomodulatory 7-hydroxylated metabolites and thermogenic agent, belongs to candidates of steroid replacement therapy - The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss
The foremost objective of a weight-loss trial has to be the reduction in body fat leading to a decrease in risk factors for metabolic syndrome. However, a concomitant decline in lean tissue can frequently be observed. Given that fat-free mass (FFM) represents a key determinant of the magnitude of resting metabolic rate (RMR), it follows that a decrease in lean tissue could hinder the progress of weight loss. Therefore, with respect to long-term effectiveness of weight-loss programmes, the loss of fat mass while maintaining FFM and RMR seems desirable
Pyruvaat
- Effect of pyruvate and dihydroxyacetone on metabolism and aerobic endurance capacity
When chronically fed to animals as part of their diet, pyruvate plus dihydroxyacetone reduce the rate of weight gain and body fat content during growth. These alterations in growth pattern appear to be the result of an increased loss of calories as heat at the expense of storage of lipid. Pyruvate-dihydroxyacetone supplementation has also been found to improve the insulin sensitivity of insulin resistant rats and reduce plasma cholesterol levels induced by a high cholesterol diet as well as lower blood pressure and heart rate in obese individuals. The mechanism of action is unclear, but available data suggest that the increase in performance following pyruvate-dihydroxyacetone supplementation may be a result of an increased reliance on blood glucose, thus sparing muscle glycogen - Supplemental products used for weight loss
OBJECTIVE: To review the scientific literature on several dietary supplements and herbal products commonly promoted for weight loss.. Pyruvate has consistently shown positive weight loss effects - Inhibition of regain in body weight and fat with addition of 3-carbon compounds to the diet with hyperenergetic refeeding after weight reduction
OBJECTIVE: To investigate the efficacy of the 3-carbon compounds pyruvate and dihydroxyacetone (PD) in inhibiting reaccumulation of body weight and fat with refeeding after weight loss. We conclude that 3-carbon compounds decrease weight gain and reaccumulation of body fat, without decreasing body protein gain, in obese subjects with hyperenergetic refeeding subsequent to weight loss - The effects of pyruvate supplementation on body composition in overweight individuals
Furthermore, Profile of Mood States fatigue and vigor scores improved significantly for the pyruvate group (P<0.05) at 6 wk (vigor) and 4 and 6 wk (fatigue). There was no significant change in total lean body mass in the pyruvate group. The placebo group demonstrated a significant increase (P<0.05) for POMS vigor at 2 and 4 wk with no changes occurring in any of the remaining parameters measured. Thus, the ingestion of 6 g of pyruvate for 6 wk, in conjunction with mild physical activity, resulted in a significant decrease in body weight and fat mass - Pyruvate supplementation of a low-cholesterol, low-fat diet: effects on plasma lipid concentrations and body composition in hyperlipidemic patients
The effects of the three-carbon compound pyruvate on plasma lipid concentrations and body composition were evaluated in hyperlipidemic patients consuming a low-cholesterol (165-180 mg), low-fat (22-24% of energy; 18-20% of energy as saturated fatty acid) diet (0.091-0.099 MJ.kg body wt-1 x d-1). After consuming the above diet for 4 wk, during which time plasma lipid concentrations decreased, 34 subjects were randomly assigned to receive either 22-44 g pyruvate (n = 17) or 18-35 g polyglucose (placebo, Polycose, n = 17), iso-energetically substituted for a portion of carbohydrate energy for 6 wk. Despite greater weight and fat losses with pyruvate (P < 0.05), plasma concentrations of cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride were not different between the two groups of subjects. We conclude that subsequent to diet-induced reduction in plasma lipid concentrations, pyruvate supplementation of a low-cholesterol, low-fat diet providing 6.7-7.6 MJ/d for 6 wk has no effect on plasma lipid concentrations but enhances body weight and fat losses - The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss
The foremost objective of a weight-loss trial has to be the reduction in body fat leading to a decrease in risk factors for metabolic syndrome. However, a concomitant decline in lean tissue can frequently be observed. Given that fat-free mass (FFM) represents a key determinant of the magnitude of resting metabolic rate (RMR), it follows that a decrease in lean tissue could hinder the progress of weight loss - Correlation between the rate of weight loss and changes in body composition in obese postmenopausal women after 5 weeks: a pilot study
Approximately 25% of weight lost during restrictive diets (without exercise) is lean body mass (LBM). No study has yet investigated the impact of the rate of weight loss (RWL) on LBM and fat mass (FM). The purpose of this study was to investigate the relationships between the RWL and body composition in older obese women. Current guidelines, which recommend RWL up to 0.91 kg.week(-1), might not be optimal to prevent decreases in LBM in postmenopausal women when no exercise is added.
Chroom
- Daily dietary chromium intake in Belgium, using duplicate portion sampling
Daily dietary chromium intake in Belgium has been evaluated by sampling duplicate portions of food, heating them at an acidic pH in a microwave oven and then quantifying the chromium by atomic absorption spectrometry. The mean intake value (53 +/- 31 micrograms/day) is similar to levels found for most other countries and is situated at the lower end of the recommended range for a safe and adequate daily dietary intake - Chromium intake, absorption and excretion of subjects consuming self-selected diets
These data demonstrate that the average daily intake of chromium from self-selected diets is well below the minimum suggested safe and adequate intake and that Cr absorption, at levels found in typical US diets, is inversely related to dietary intake - Chromium content of foods and diets
whereas in certain developed countries, such as Finland, Sweden, Switzerland, and the US, the intake is 50 micrograms/d or lower and, consequently, at or below the estimated safe and adequate daily dietary intake range of 50-200 micrograms/d established by the US National Academy of Sciences - Chromium and insulin resistance
Since as early as the 50s of the last century, it has been known that chromium is essential for normal glucose metabolism. Too little chromium in the diet may lead to insulin resistance. In a double-blind randomised placebo-controlled trial in a Chinese population with type-2 diabetes mellitus, supplementation with 1000 micrograms of chromium led to a fall in the glycosylated haemoglobin level (HbA1c) by 2%. Toxic effects of chromium are seldom seen - Effect of chromium chloride supplementation on glucose tolerance and serum lipids including high-density lipoprotein of adult men
The data are thus consistent with the hypothesis that Cr supplementation raises high-density lipoprotein cholesterol and improves insulin sensitivity in those with evidence of insulin resistance but normal glucose tolerance - Chromium in the prevention and control of diabetes.
Suboptimal dietary intake of chromium is associated with increased risk factors associated with diabetes and cardiovascular diseases. Chromium increases insulin binding to cells, insulin receptor number and activates insulin receptor kinase leading to increased insulin sensitivity - Chromium May Reduce Risk of Diabetes
Insulin is the master metabolic hormone in our body and regulates blood sugar; chromium is an essential trace mineral required by humans in order for insulin to work properly. They received either a placebo or 1,000 micrograms (1 mg) of chromium daily. After four months, insulin resistance was reduced by a statistically significant 40%, and this improvement was maintained at the end of eight months - A scientific review: the role of chromium in insulin resistance
Chromium is an essential mineral that appears to have a beneficial role in the regulation of insulin action and its effects on carbohydrate, protein and lipid metabolism - Vitamin and mineral deficiencies which may predispose to glucose intolerance of pregnancy
Gestational diabetes is associated with excessive nutrient losses due to glycosuria. Specific nutrient deficiencies of chromium, magnesium, potassium and pyridoxine may potentiate the tendency towards hyperglycemia in gestational diabetic women because each of these four deficiencies causes impairment of pancreatic insulin production - Effects of chromium picolinate on food intake and satiety
Study 1 demonstrated that CrPic, as compared to placebo, reduced food intake (P < 0.0001), hunger levels (P < 0.05), and fat cravings (P < 0.0001) and tended to decrease body weight (P = 0.08). These data suggest CrPic has a role in food intake regulation, which may be mediated by a direct effect on the brain - The safety and efficacy of high-dose chromium
Previous claims of mutagenic effects of chromium are of questionable relevance. While studies have found DNA fragmentation (clastogenic effects) by chromium picolinate, anecdotal reports of high-dose chromium picolinate toxicity are few and ambiguous. Chromium supplementation does result in tissue retention, especially in the kidney, although no pathogenic effect has been demonstrated despite considerable study - Chromium picolinate does not produce chromosome damage
In the current study CrPic did not induce chromosomal damage in bone marrow cells at single doses of 33, 250 and 2000 mg/kg of body weight and thus there was no indication of any toxicity of CrPic - The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes
Chromium supplementation gives better control of glucose and lipid variables while decreasing drug dosage in type 2 diabetes patients.
Magnesium
- Dietary intake and bioavailability of trace elements
The results indicate that the intake of potassium, magnesium, zinc, copper, and selenium is low when compared with the present recommended dietary allowance (RDA) values - Environmental magnesium deficiency as a cardiovascular risk factor
Magnesium is abundant in nature and the major routes of intake are through food and water. Through changes in the treatment of foodstuffs and altered diets, as well as increased use of surface water with low magnesium content, magnesium deficiency is present in modern society - Magnesium content of the food supply in the modern-day world
A large-scale US survey has shown that the dietary magnesium intake tends to be lower than recommended. The suboptimal intake prevalent among US adults is consistent with the pattern observed in other North American and European surveys - Low serum magnesium levels and metabolic syndrome
There was a strong independent relationship between low serum magnesium levels and MS (odds ratio (OR)=6.8, CI(95%) 4.2-10.9). This study reveals a strong relationship between decreased serum magnesium and MS - Magnesium physiology and pathogenic mechanisms that contribute to the development of the metabolic syndrome
Recently, there has been burgeoning experimental, clinical, and epidemiological data that provides strong evidence that dietary magnesium intake and supplementation are inversely associated with the risk for MetS and its components - Magnesium deficiency is associated with insulin resistance in obese children
The association between magnesium deficiency and IR is present during childhood. Serum magnesium deficiency in obese children may be secondary to decreased dietary magnesium intake. Magnesium supplementation or increased intake of magnesium-rich foods may be an important tool in the prevention of type 2 diabetes in obese children - A review of magnesium intake in the elderly. A cause for concern?
Elderly people in the United States represent an emerging high risk group for nutritional deficiencies. A magnesium deficit in the elderly can occur due to inadequate nutrient intakes, multiple drug use, or altered gastrointestinal function. It is not known to what extent suboptimal intakes may affect the aging process; however, magnesium-deficient conditions have been associated with neuromuscular and cardiovascular disorders, endocrine disturbances, insulin resistance and Alzheimer's disease - Vitamin and mineral deficiencies which may predispose to glucose intolerance of pregnancy
Gestational diabetes is associated with excessive nutrient losses due to glycosuria. Specific nutrient deficiencies of chromium, magnesium, potassium and pyridoxine may potentiate the tendency towards hyperglycemia in gestational diabetic women because each of these four deficiencies causes impairment of pancreatic insulin production - Oral magnesium supplementation improves insulin sensitivity in non-diabetic subjects with insulin resistance. A double-blind placebo-controlled randomized trial
Oral magnesium supplementation improves insulin sensitivity in hypomagnesemic non-diabetic subjects. Clinical implications of this finding have to be established/LI> - Magnesium, the metabolic syndrome, insulin resistance, and type 2 diabetes mellitus
Magnesium is an essential mineral and has been established as a cofactor for over 300 metabolic reactions in the body. Some research has indicated that lower intakes of magnesium and lower serum magnesium concentrations may lead to and are associated with the metabolic syndrome, insulin resistance, and/or type 2 diabetes mellitus - Is low magnesium concentration a risk factor for coronary heart disease?
BACKGROUND: Hypomagnesemia has been hypothesized to play a role in coronary heart disease (CHD),These findings suggest that low magnesium concentration may contribute to the pathogenesis of coronary atherosclerosis or acute thrombosis - Magnesium intake and plasma concentrations of markers of systemic inflammation and endothelial dysfunction in women
Magnesium intake from diet is modestly and inversely associated with some but not all markers of systematic inflammation and endothelial dysfunction in apparently healthy women - A prospective study of nutritional factors and hypertension among US men
These results support hypotheses that an increased intake of fiber and magnesium may contribute to the prevention of hypertension - Possible roles of magnesium on the immune system
During the last few years, magnesium (Mg) has been subject of research due to its functionality in the organism. It is one of the most important micronutrients, and therefore its role in biological systems has been extensively investigated. Particularly, Mg has a strong relation with the immune system, in both nonspecific and specific immune response, also known as innate and acquired immune response - Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects
Greater magnesium intake was significantly related to higher bone mineral density (BMD) in white women and men. The lack of association observed in black women and men may be related to differences in Ca regulation or in nutrient reporting - Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized, double-blind, placebo
This study does not unequivocally determine whether oral magnesium oxide is or is not superior to placebo in preventing frequent migrainous headache in children, but treatment with the active agent did lead to a significant reduction in headache days. Larger trials involving this safe, appealing complementary therapy are needed
CLA waarschuwing
- Conjugated linoleic acid reduces body fat mass in overweight and obese humans
The data suggest that conjugated linoleic acid may reduce BFM in humans and that no additional effect on BFM is achieved with doses > 3.4 g CLA/d - The role of conjugated linoleic acid in reducing body fat and preventing holiday weight gain
Randomized, double-blind, placebo-controlled study of 3.2 g/day CLA for 6 months. CLA supplementation among overweight adults significantly reduced body fat over 6 months and prevented weight gain during the holiday season. Although no adverse effects were seen, additional studies should evaluate the effect of prolonged use of CLA - Effects of cis-9,trans-11 conjugated linoleic acid supplementation on insulin sensitivity, lipid peroxidation, and proinflammatory markers in obese men
A CLA preparation containing the purified c9,t11 CLA isomer increased insulin resistance and lipid peroxidation compared with placebo in obese men. Because c9,t11 CLA occurs in commercial supplements as well as in the diet, the present results should be confirmed in larger studies that also include women - Supplementation with trans10cis12-conjugated linoleic acid induces hyperproinsulinaemia in obese men: close association with impaired insulin sensitivity
In obese men, t10c12CLA induces hyperproinsulinaemia that is related to impaired insulin sensitivity, independently of changes in insulin concentrations. These results are of clinical interest, as hyperproinsulinaemia predicts diabetes and cardiovascular disease. The use of weight-loss supplements containing this fatty acid is worrying - Conjugated linoleic acid impairs endothelial function
A CLA isomeric mixture had at most modest effects on adiposity and worsened endothelial function. On the basis of these results, the use of the isomeric mixture of CLA as an aid to weight loss cannot be recommended - CLA, een nieuw gezond vetzuur ?
Uit dierstudies blijkt bovendien dat te hoge innames van CLA kunnen leiden tot onder meer leververvetting, insulineresistentie en verhoogde vetoxidatie. Momenteel zijn er reeds verschillende CLA-supplementen voorhanden. Zij bevatten in het algemeen relatief hoge concentraties van het t10,c12-isomeer. In afwachting van meer onderzoek raden voedingsdeskundigen het gebruik ervan in het algemeen echter nog af
Carnitinedeficiëntie
- The carnitine system and body composition
Carnitine is a trimethylamine molecule that plays a unique role in cell energy metabolism. Mitochondrial betaoxidation of long-chain fatty acids, the major process by which fatty acids are oxidized, is ubiquitously dependent on carnitine.In skeletal muscle, the importance of the function of the carnitine system in the control and regulation of fuel partitioning not only relates to the metabolism of fatty acids and the capacity for fatty acid utilization, but also to systemic fat balance and insulin resistance. The carnitine system is shown to be determinant in insulin regulation of fat and glucose metabolic rate in skeletal muscle, this being critical in determining body composition and relevant raised levels of risk factors for cardiovascular disease, obesity, hypertension, and type 2 diabetes - New insights concerning the role of carnitine in the regulation of fuel metabolism in skeletal muscle
However, recent research has shed new light on the importance of carnitine as a regulator of muscle fuel selection. It has been established that muscle free carnitine availability may be limiting to fat oxidation during high intensity submaximal exercise. Furthermore, increasing muscle total carnitine content in resting healthy humans (via insulin-mediated stimulation of muscle carnitine transport) reduces muscle glycolysis, increases glycogen storage and is accompanied by an apparent increase in fat oxidation - Disorders of carnitine transport and the carnitine cycle
Carnitine plays an essential role in the transfer of long-chain fatty acids across the inner mitochondrial membrane - The role of the carnitine system in human metabolism
Metabolism cycles daily between the fed and fasted states. The pathways of energy production are reversible and distinct. In the anabolic (fed) state, the liver stores glucose as glycogen, and fatty acid/triglyceride synthesis is active. In the catabolic (fasted) state, the liver becomes a glucose producer, lipogenesis is slowed, and fatty acid oxidation/ketogenesis is activated. The rate-limiting step for the latter is vested in the carnitine/carnitine palmitoyltransferase (CPT) system, and the off/on regulator of this is malonyl CoA. Activation of fatty acid oxidation has considerable clinical promise for the treatment of obesity, type 2 diabetes, steatohepatitis, and lipotoxic damage to the heart - Levocarnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigue
Administration of levocarnitine to healthy elderly subjects resulted in a reduction of total fat mass, an increase of total muscle mass, and appeared to exert a favourable effect on fatigue and serum lipids - L-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trial
Our study indicates that oral administration of levocarnitine produces a reduction of total fat mass, increases total muscular mass, and facilitates an increased capacity for physical and cognitive activity by reducing fatigue and improving cognitive functions. - Effects of L-carnitine on obesity, diabetes, and as an ergogenic aid
Also, both exercise training and supplementation of carnitine and antioxidants improved lipid profiles and carnitine metabolism in humans, suggesting that carnitine and antioxidant supplementation may improve exercise performance. - Supplementation of L-carnitine in athletes: does it make sense?
As reported in the majority of studies, an increase in maximal oxygen consumption and a lowering of the respiratory quotient indicate that dietary carnitine has the potential to stimulate lipid metabolism. Thus there is evidence for a beneficial effect of L-carnitine supplementation in training, competition, and recovery from strenuous exercise and in regenerative athletics - L-Carnitine: therapeutic applications of a conditionally-essential amino acid
Conditions which seem to benefit from exogenous supplementation of L-carnitine include anorexia, chronic fatigue, coronary vascular disease, diphtheria, hypoglycemia, male infertility, muscular myopathies, and Rett syndrome. In addition, preterm infants, dialysis patients, and HIV+ individuals seem to be prone to a deficiency of L-carnitine, and benefit from supplementation. Although available data on L-carnitine as an ergogenic aid is not compelling, under some experimental conditions pretreatment has favored aerobic processes and resulted in improved endurance performance - Obesity, inflammation, and the potential application of pharmaconutrition
Obesity creates a low-grade systemic inflammatory response syndrome (SIRS) that is similar (but on a much smaller scale) to gram-negative sepsis. Specialized nutrition therapy for such patients currently consists of a hypocaloric, high-protein diet. However, this approach does not address the putative pathophysiologic mechanisms of inflammation and altered metabolism associated with obesity. A number of dietary agents such as arginine, fish oil, and carnitine may correct these problems at the molecular level. Pharmaconutrition formulas may provide exciting innovations for the nutrition therapy of the obese patient - Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial
In the randomized, double-blind, placebo-controlled 6-month trial reported here, we assessed whether 2 or 4 g/d oral L-carnitine... In both the A and B groups, the two doses of carnitine were similarly effective. In conclusion, L-carnitine is effective in both reversing and preventing symptoms of hyperthyroidism and has a beneficial effect on bone mineralization. Because hyperthyroidism depletes the body deposits of carnitine and since carnitine has no toxicity, teratogenicity, contraindications and interactions with drugs, carnitine can be of clinical use - Effects of carnitine on thyroid hormone action
By experiments on cells (neurons, hepatocytes, and fibroblasts) that are targets for thyroid hormones and a randomized clinical trial on iatrogenic hyperthyroidism, we validated the concept that L-carnitine is a peripheral antagonist of thyroid hormone action. In particular, L-carnitine inhibits both triiodothyronine (T3) and thyroxine (T4) entry into the cell nuclei. This is relevant because thyroid hormone action is mainly mediated by specific nuclear receptors - Risk assessment for carnitine
Regarding safety, systematic evaluation of the research designs and data do not provide a basis for risk assessment and the usual safe upper level of intake (UL) derived from it unless the newer methods described as the observed safe level (OSL) or highest observed intake (HOI) are utilized. The OSL risk assessment method indicates that the evidence of safety is strong at intakes up to 2000mg/day l-carnitine equivalents for chronic supplementation, and this level is identified as the OSL. Although much higher levels have been tested without adverse effects and may be safe, the data for intakes above 2000mg/day are not sufficient for a confident conclusion of long-term safety - Interaction of food supplement L-carnitine with oral anticoagulant acenocoumarol
According to further findings it may be justified to press manufacturers of products containing carnitine to place an appropriate warning in their package inserts, as well as to spread the information among medical practitioners caring for patients on anticoagulant therapy - Carnitine-acylcarnitine translocase deficiency, clinical, biochemical and genetic aspects
The carnitine-acylcarnitine translocase (CACT) is one of the components of the carnitine cycle. The carnitine cycle is necessary to shuttle long-chain fatty acids from the cytosol into the intramitochondrial space where mitochondrial beta-oxidation of fatty acids takes place
Hormonale stoornissen
De menopauze
- Premature menopause: multiple disruptions between the woman's biological body experience and her lived body
Menopause involves hormonal changes that result, on average (for Australian women), in the cessation of menstruation around 51 years of age - Metabolic syndrome after menopause and the role of hormones
MBS may occur in 40% of PM women and is largely determined by overweight status and obesity. Weight gain, particularly an increase in central fat mass increases in PM women, beginning a few years prior to menopause - Increased visceral fat and decreased energy expenditure during the menopausal transition
Body fat and weight increased significantly over time only in those women who became postmenopausal by year 4 (n=51). The postmenopausal group also exhibited a significant decrease in serum estradiol. Physical activity decreased significantly 2 years before menopause and remained low. Dietary energy, protein, carbohydrate and fiber intake were significantly higher 3-4 years before the onset of menopause compared with menopause onset. Twenty-four hour EE and sleeping EE decreased significantly with age; however, the decrease in sleeping EE was 1.5-fold greater in women who became postmenopausal compared with premenopausal controls (-7.9 vs -5.3%). Fat oxidation decreased by 32% in women who became postmenopausal (P<0.05), but did not change in those who remained premenopausal - Revisiting the duration of vasomotor symptoms of menopause: a meta-analysis
The percentage of women experiencing symptoms increased sharply in the 2 years before final menstrual period, peaked 1 year after final menstrual period, and did not return to premenopausal levels until about 8 years after final menstrual period. Nearly 50% of all women reported vasomotor symptoms 4 years after final menstrual period, and 10% of all women reported symptoms as far as 12 years after final menstrual period - Modulation of appetite by gonadal steroid hormones
A variety of peripheral feedback controls of eating, including ghrelin, cholecystokinin (CCK), glucagon, hepatic fatty acid oxidation, insulin and leptin, has been shown to be estradiol-sensitive under at least some conditions and may mediate the estrogenic inhibition of eating. Orchiectomy decreases food intake by decreasing meal frequency and ovariectomy increases food intake by increasing meal size. These changes are reversed by testosterone and estradiol treatment, respectively - The effect of estrogen on appetite
Accumulating evidence indicates that estradiol may decrease meal size by increasing the potency of the satiating actions of some gut peptides, especially cholecystokinin - Traversing the menopause: changes in energy expenditure and body composition
Thus, it appears that the loss of ovarian function induces a reduction in resting metabolic rate, physical activity energy expenditure, fat-free mass, and an increase in fat mass and abdominal adipose tissue accumulation - Protein nutrition, exercise and aging
Aging is associated with remarkable changes in body composition. Loss of skeletal muscle, a process called sarcopenia, is a prominent feature of these changes. In addition, gains in total body fat and visceral fat content continue into late life. The cause of sarcopenia is likely a result of a number of changes that also occur with aging. These include reduced levels of physical activity, changing endocrine function (reduced testosterone, growth hormone, and estrogen levels), insulin resistance, and increased dietary protein needs - Body fat distribution, the menopause transition, and hormone replacement therapy
Loss of estrogen has been associated with the development of cardiovascular disease. Central distribution and accumulation of adipose tissue, and the concomitant insulin resistant dyslipidemic state have emerged as important components of a cluster of metabolic abnormalities that are strongly related to coronary heart disease. Available longitudinal data also support an increase in central body fatness occurring with menopause. Most intervention trials on hormone replacement therapy and body fat distribution showed that the treatment prevented the increase in central adiposity that was noted in postmenopausal women receiving no treatment or placebo - Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial
The primary outcome was coronary heart disease (CHD) (nonfatal myocardial infarction and CHD death), with invasive breast cancer as the primary adverse outcome. A global index summarizing the balance of risks and benefits included the 2 primary outcomes plus stroke, pulmonary embolism (PE), endometrial cancer, colorectal cancer, hip fracture, and death due to other causes. RESULTS: On May 31, 2002, after a mean of 5.2 years of follow-up, the data and safety monitoring board recommended stopping the trial of estrogen plus progestin vs placebo because the test statistic for invasive breast cancer exceeded the stopping boundary for this adverse effect and the global index statistic supported risks exceeding benefits - Endometrial cancer and hormone-replacement therapy in the Million Women Study
previous hysterectomy were recruited into the Million Women Study in 1996-2001, Oestrogens and tibolone increase the risk of endometrial cancer. Progestagens counteract the adverse effect of oestrogens on the endometrium, the effect being greater the more days every month that they are added to oestrogen and the more obese that women are. However, combined oestrogen-progestagen HRT causes a greater increase in breast cancer than the other therapies do. Thus, when endometrial and breast cancers are added together, there is a greater increase in total cancer incidence with use of combined HRT, both continuous and cyclic, than with use of the other therapies - Is dehydroepiandrosterone a hormone?
Dehydroepiandrosterone (DHEA) is not a hormone but it is a very important prohormone secreted in large amounts by the adrenals in humans. In women, after menopause, all estrogens and almost all androgens are made locally in peripheral tissues from DHEA which indirectly exerts effects, among others, on bone formation, adiposity, muscle, insulin and glucose metabolism, skin, libido and well-being. The new field of intracrinology or local formation of sex steroids from DHEA in target tissues has permitted major advances in the treatment of the two most frequent cancers, namely breast and prostate cancer, while its potential use as a physiological HRT could well provide a physiological balance of androgens and estrogens, thus offering exciting possibilities for women's health at menopause - Might DHEA be considered a beneficial replacement therapy in the elderly
Menopause is the event in a woman's life that induces a dramatic change in the steroid milieu, and use of DHEA as 'replacement treatment' has been reported to restore both the androgenic and estrogenic environment and reduce most of the symptoms of this change. Furthermore, DHEA is perceived differently around the world, being considered only a 'dietary supplement' in the US, while in many European countries it is considered a 'true hormone' that has not been approved for use as a hormonal treatment by the European health authorities - Significance of dehydroepiandrosterone and dehydroepiandrosterone sulfate in different diseases
The age-associated decrease may lead to osteoporosis, deterioration of lipid-metabolism, cardiovascular diseases and second type of diabetes mellitus. Administration of dehydroepiandrosterone resulted in a reduction of postmenopausal osteoporosis - Hormoontherapie van klachten in het climacterium en de postmenopauze.
Hormoontherapie dient zo laag mogelijk gedoseerd te worden. De duur van hormoontherapie dient individueel vastgesteld te worden en jaarlijkse evaluatie moet voorkomen dat de behandeling onnodig lang wordt voortgezet
De andropauze
- Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study
Each age trend was satisfactorily described by a constant percent change per yr between ages 39-70 yr. Free testosterone declined by 1.2%/yr, and albumin-bound testosterone by 1.0%/yr. Sex hormone-binding globulin (SHBG), the major serum carrier of testosterone, increased by 1.2%/yr, with the net effect that total serum testosterone declined more slowly (0.4%/yr) than the free or albumin-bound pools alone - Therapy of the "aging male
Serum testosterone levels decline in men with increasing age. Late-onset hypogonadism with its characteristic symptoms can occur in men as they age. Typical symptoms of late-onset hypogonadism are decreased libido and sexual function, osteoporosis, altered distribution of body fat, overall reduction in physical strength, and alterations in general mood - The Testosterone replacement therapy and prostate cancer: a word of caution testosterone
Symptoms of hypogonadism include erectile dysfunction, diminished libido, sarcopenia, increased adiposity, osteopenia and osteoporosis, impaired cognition, and depression. Testosterone levels have been shown to modulate prostate cancer risk and progression - Oestrogen-androgen crosstalk in the pathophysiology of erectile dysfunction
Ageing in man is associated with a decline in testosterone following changes in the hypothalamo-pituitary-testicular axis. This may offset the physiologic equilibrium between oestrogen and androgen and at some point when the ratio of free testosterone to oestradiol reaches a critical level, the oestrogenic gonadotropin suppressive effect predominates with decreased release of FSH and LH - Estradiol in elderly men
In males, testosterone is the major source of plasma estradiol, the main biologically active estrogen, only 20% of which is secreted by the testes. Estradiol levels are highly significantly positively related to body fat mass and more specifically to subcutaneous abdominal fat, but not to visceral (omental) fat. Indeed, aromatase activity in omental fat is only one-tenth of the activity in gluteal fat. Estrogens in males play an important role in the regulation of the gonadotropin feedback, several brain functions, bone maturation, regulation of bone resorption and in lipid metabolism. Moreover, they affect skin metabolism and are an important factor determining sex interest in man - The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction
estradiol inhibition of gonadotropin release, both of which result in decreased testosterone production. As testosterone levels decrease and estradiol levels increase, the ratio of free testosterone to estradiol reaches a critical point and the estrogenic gonadotropin suppressive effects predominate - Differential regulation of gonadotropin secretion by testosterone in the human male: absence of a negative feedback effect of testosterone on follicle-stimulating hormone secretion
From these data we conclude that in terms of sex steroid feedback, E(2) is the predominant regulator of FSH secretion in the human male - Aromatase inhibition in the human male reveals a hypothalamic site of estrogen feedback
From these data, we conclude that in the human male, estrogen has dual sites of negative feedback, acting at the hypothalamus to decrease GnRH pulse frequency and at the pituitary to decrease responsiveness to GnRH - Clinical utility of sex hormone-binding globulin measurement
The high-affinity binding of the sex hormone-binding globulin (SHBG) for testosterone and to a lesser extent for estradiol influences the circulating levels of these sex steroid hormones, their biodisposal to target cells as well as their mutual balance - Sex Steroid Hormones, Upper Body Obesity, and Insulin Resistance
We conclude that in normogonadal nondiabetic males, variability of plasma bio-available testosterone concentrations is predictive of the variability of fat deposition in the sc adipose tissue compartments of both the truncal and peripheral areas. In these circumstances, low plasma levels of bioavailable testosterone do not independently predict insulin resistance, ß-cell dysfunction, or excessive hepatic glucose output. However, through its effect on body composition and fat distribution, it is conceivable that testosterone may play a role in the pathogenesis of insulin resistance and development of the metabolic syndrome and type 2 diabetes - Obesity in men: the hypogonadal-estrogen receptor relationship and its effect on glucose homeostasis
The increased estradiol concentrations influence both of the estrogen receptors, but specifically intensify the metabolic effects of ER beta because of its released suppression, a consequence of diminished testosterone concentrations. These dual actions then combine to amplify the mechanisms that lead to disordered glucose homeostasis and insulin resistance under these conditions - Fat tissue: a steroid reservoir and site of steroid metabolism
We conclude that fat tissue is an important steroid hormone reservoir, that it is the site of active aromatase and 17 beta-hydroxysteroid dehydrogenase, and that tissue DHEA(S) may have a modulating effect on tissue estrogen production - Laboratoriumbepalingen
SHL, Man <15 jaar 0.1 – 50 pmol/l, 15 - 25 jaar 15 – 100 pmol/l, 25 - 60 jaar 20 – 70 pmol/l >60 jaar 15 - 50 pmol/l - Effect of aromatase inhibition on bone metabolism in elderly hypogonadal men
Anastrozole is an oral aromatase inhibitor that decreases estrogen production and increases androgen production in men. Currently, anastrozole is being investigated as a potential agent for the treatment of hypogonadism in aging men - Aromatase inhibitors and musculoskeletal pain in patients with breast cancer
Aromatase inhibitors are recommended for use by postmenopausal women who have estrogen receptor-positive early-stage breast cancer. They reduce local and distant recurrence more effectively than tamoxifen. Anastrozole (Arimidex, AstraZeneca Pharmaceuticals LP), letrozole (Femara, Novartis Pharmaceuticals Corporation), and exemestane (Aromasin, Pfizer Inc.) inhibit aromatase activity, thus significantly decreasing estrogen production in tissues such as liver, muscle, and fat - Effects of aromatase inhibition in elderly men with low or borderline-low serum testosterone levels
These data demonstrate that aromatase inhibition increases serum bioavailable and total testosterone levels to the youthful normal range in older men with mild hypogonadism. Serum estradiol levels decrease modestly but remain within the normal male range - Dietary flavonoids: effects on xenobiotic and carcinogen metabolism
Flavones (chrysin, baicalein, and galangin), flavanones (naringenin) and isoflavones (genistein, biochanin A) inhibit the activity of aromatase (CYP19), thus decreasing estrogen biosynthesis and producing antiestrogenic effects, important in breast and prostate cancers - Inhibition of aromatase activity by flavonoids
Over 50% of the flavonoids significantly inhibited aromatase activity, with greatest activity being demonstrated with apigenin (IC50: 0.9 microg/mL), chrysin (IC50: 1.1 microg/mL), and hesperetin (IC50: 1.0 microg/mL). - Flavonoid inhibition of aromatase enzyme activity in human preadipocytes
Eleven flavonoid compounds were compared with aminoglutethimide (AG), a pharmaceutical aromatase inhibitor, for their abilities to inhibit aromatase enzyme activity in a human preadipocyte cell culture system. Chrysin, the most potent of the naturally-occurring flavonoids, was similar in potency and effectiveness to AG, a pharmaceutical aromatase inhibitor used clinically in cases of estrogen-dependent carcinoma - Interactions affecting the bioavailability of dietary polyphenols in vivo
The absorption of flavanols, notably green tea catechins, is affected by epimerization reactions occurring during processing, the presence of lipid and carbohydrate, and is improved by the presence of piperine and tartaric acid - Black pepper and its pungent principle-piperine: a review of diverse physiological effects
Piperine has been documented to enhance the bioavailability of a number of therapeutic drugs as well as phytochemicals by this very property. Piperine's bioavailability enhancing property is also partly attributed to increased absorption as a result of its effect on the ultrastructure of intestinal brush border - Piperine modulates permeability characteristics of intestine by inducing alterations in membrane dynamics: influence on brush border membrane fluidity
ultrastructure and enzyme kinetics., Piperine (1-Piperoyl piperidine) is a major alkaloid of Piper nigrum Linn. and Piper longum Linn. It is shown to possess bioavailability-enhancing activity with various structurally and therapeutically diverse drugs - A Word about Testosterone and Prostate Disease
Estrogen (measured as estradiol) should be kept at 30 picograms per milliliter (pg/mL) or lower. If a man’s estrogen level is more than 30 pg/mL, it should be reduced by using aromatase-inhibiting drugs or nutrients - Testosterone deficiency: a common, unrecognized syndrome
Testosterone deficiency syndrome (TDS) refers to the clinical signs and symptoms that result from an abnormally low testosterone level. Men with 'classic' hypogonadism can have unequivocally low testosterone levels and typical symptoms and signs. By contrast, the age-related decline of testosterone levels can be responsible for ambiguous clinical pictures, which can potentially be misinterpreted as part of the aging process or depression. Nevertheless, this decline can have detrimental effects on quality of life and on the function of multiple organ systems. TDS is underdiagnosed-its overall prevalence varies from 6% to 9.5% in community-dwelling men aged 40-70 years, and rises to 15-30% in diabetic or obese men-and undertreated; less than 10% of men with TDS receive treatment - Male hypogonadism : an update on diagnosis and treatment
However, once-daily transdermal therapies have become increasingly popular and now include both patch and gel systems - Testosterone therapy--what, when and to whom?
Thus, the new application modes--hydroalcoholic gel (for example, Testogel, Schering AG, Germany) and intramuscular testosterone undecanoate (Nebido, Schering AG, Germany)--appear to be the methods of choice in the near future, one being very suitable for hormone therapy in elderly men, the other for long-term substitution in classical forms of hypogonadism. Doses of 50-100 mg gel applied once daily on the skin deliver sufficient amounts of testosterone to restore normal hormonal values and correct the signs and symptoms of hypogonadism - Effects of some micronutrients on partial androgen deficiency in the aging male
Partial androgen deficiency in the aging male (PADAM) is a kind of syndrome which affects the aging male s health. At present, testosterone supplementation therapy is mostly used to improve the symptoms of PADAM, but it may bring some adverse effects, such as erythrocytosis and hyperplasia and carcinoma of the prostate. Some studies have shown that quite a few nutrients, especially vitamin A, vitamin E, zinc and selenium are favorably related to androgen deficiency and sperm production - Selenium--its biological perspectives
Se content of testes increases considerably during pubertal maturation and, during Se deficiency, the supply to the testes has priority over the other tissues. The element is localized in the mitochondrial capsule protein (MCP) and is involved in biosynthesis of testosterone - Androgen replacement therapy and prostate safety
It is well established that hypogonadal men receiving adequate androgen therapy develop a prostate with a volume similar to what would be expected from their eugonadal counterparts. Androgen therapy results in modest elevations in the PSA and minor changes in flow parameters. Although there is no evidence that normal levels of testosterone promote the development of cancer of the prostate, it is clear that the administration of testosterone enhances a pre-existing prostatic malignancy - Testosterone therapy for men at risk for or with history of prostate cancer
Since the early 1940s when Huggins showed that severe reductions in serum testosterone by castration or estrogen therapy caused regression of prostate cancer (PCa), it has been assumed that higher testosterone levels cause enhanced growth of PCa. For this reason, it has been considered taboo to offer testosterone replacement therapy (TRT) to any man with a prior history of PCa, even if all objective evidence suggests he has been cured. The fear has been that higher testosterone levels would "awaken" dormant cells and cause a recurrence. there is a varied and extensive literature indicating that TRT does not pose any increased risk of PCa growth in men with or without prior treatment. For instance, the cancer rate in TRT trials is only approximately 1%, similar to detection rates in screening programs, yet biopsy-detectable PCa is found in one of seven hypogonadal men. Moreover, PCa is almost never seen in the peak testosterone years of the early 20s, despite autopsy evidence that men in this age group already harbor microfoci of PCa in substantial numbers - Testosterone replacement therapy in hypogonadal men at high risk for prostate cancer: results of 1 year of treatment in men with prostatic intraepithelial neoplasia
We evaluated prostatic changes in hypogonadal men with and without high grade prostatic intraepithelial neoplasia (PIN), which is considered a prostatic precancerous lesion, after 1 year of TRT. After 1 year of TRT men with PIN do not have a greater increase in PSA or a significantly increased risk of cancer than men without PIN. These results indicate that TRT is not contraindicated in men with a history of PIN - Testosterone and the prostate
PSA value and prostate volume do not show significant changes under testosterone substitution therapy. Even if there are no long-term studies in men under substitution due to decreased testosterone, the therapy seems to be safe under regular control of the prostate with PSA and sonography, and the risk for prostate carcinoma is not increased - Prostate cancer risk in testosterone-treated men
A study on a large prospective cohort of 10,049 men, contributes to the gathering evidence that the long standing "androgen hypothesis" of increasing risk with increasing androgen levels can be rejected, suggesting instead that high levels within the reference range of androgens, estrogens and adrenal androgens decrease aggressive prostate cancer risk. Indeed, high-grade prostate cancer has been associated with low plasma level of testosterone - Testosterone treatment in hypogonadal men: prostate-specific antigen level and risk of prostate cancer
PSA levels increased in response to all types of testosterone replacement, regardless of whether the testosterone level was raised endogenously or exogenously. PSA levels are inappropriately low in hypogonadal men and may mask an underlying cancer. Determining PSA levels before and after testosterone treatment is recommended. Elevated PSA levels before or after testosterone therapy should prompt performance of a urologic evaluation for possible prostate biopsy - Testosterone replacement therapy and the risk of prostate cancer. Is there a link?
Substantial evidence supports the value of testosterone replacement therapy (TRT) in improving quality of life in men with proven aging male syndrome (AMS). Benefits of TRT include improved bone mineral density, reduced fracture risk, increased muscle mass, and improved mood, sense of well being, and libido, among others - The effects of testosterone treatment on body composition and metabolism in middle-aged obese men
Testosterone treatment was followed by a decrease of visceral fat mass, measured by computerized tomography, without a change in body mass, subcutaneous fat mass or lean body mass. Insulin resistance, measured by the euglycemic/hyperinsulinemic glucose clamp method, improved and blood glucose, diastolic blood pressure and serum cholesterol decreased with testosterone treatment - Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency
Oral TU treatment of type 2 diabetic men with androgen deficiency improves glucose homeostasis and body composition (decrease in visceral obesity), and improves symptoms of androgen deficiency (including erectile dysfunction). In these men, the benefit of testosterone supplementation therapy exceeds the correction of symptoms of androgen deficiency and also includes glucose homeostasis and metabolic control - Long-Term Testosterone Gel (AndroGel) Treatment Maintains Beneficial Effects on Sexual Function and Mood, Lean and Fat Mass, and Bone Mineral Density in Hypogonadal Men
Sexual function and mood parameters improved rapidly and were maintained throughout T treatment. Lean body mass increased (P = 0.0001) and fat mass decreased (P = 0.0001), and these changes were maintained with treatment but were not accompanied by significant increases in muscle strength. Increases in serum bone markers suggestive of increased bone formation were followed by gradual and progressive increases in bone mineral density more in the spine (P = 0.0001) than the hip (P = 0.0004).
DHEA deficiëntie
- Steroids and thermogenesis
Apart from hormonal steroids, dehydroepiandrosterone, an important precursor in the metabolic pathway leading to hormonal steroids which possess many, mostly beneficial effects on human health, modulates metabolic pathways which may lead to increased heat production. Recent studies demonstrate that 7-oxo-dehydroepiandrosterone, one of its 7-oxygenated metabolites, is even more effective than dehydroepiandrosterone. Recent findings of various actions of these steroids support the view that they may also participate in modulating thermogenic effects - Dehydroepiandrosterone, dehydroepiandrosterone sulfate and related steroids: their role in inflammatory, allergic and immunological disorders
immunological effects both in vitro and in vivo in experimental animals and humans - Dehydroepiandrosterone administration in humans: evidence based?
These hormones are thought to affect mood and well-being, have neurosteroid effects and may influence the immune system. Animal experiments suggest that DHEA has many other effects, including anticancer, immune-enhancing, neurotropic and general antiageing effects, but information based on studies in humans is limited. In female patients with adrenal insufficiency, treatment with DHEA replacement doses of 20 to 50 mg results in improvements in mood, quality of life and libido. some studies suggest a beneficial immunomodulatory effect of DHEA in patients with autoimmune diseases - Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial
DHEA replacement could play a role in prevention and treatment of the metabolic syndrome associated with abdominal obesity - A relationship between dehydroepiandrosterone sulphate and insulin resistance in obese men and women
Significant negative correlation between DHEAS and HOMA-IR was found in the group of obese type 2 diabetic women but not in obese non-diabetic women suggesting that low DHEAS level might be connected to the development of insulin resistance and type 2 diabetes mellitus in obese women - Might DHEA be considered a beneficial replacement therapy in the elderly?
Furthermore, DHEA is perceived differently around the world, being considered only a 'dietary supplement' in the US, while in many European countries it is considered a 'true hormone' that has not been approved for use as a hormonal treatment by the European health authorities - DHEA: why, when, and how much--DHEA replacement in adrenal insufficiency
Replacement consists of a single oral dose of 25-50 mg DHEA in the morning - The Dehydroepiandrosterone And WellNess (DAWN) study: research design and methods
Levels of dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEAS), the major secretory products of the adrenal gland, decline dramatically with age, concurrent with the onset of degenerative changes and chronic diseases associated with aging. Epidemiological evidences in humans and animal studies suggest that DHEA(S) may have cardioprotective, antiobesity, antidiabetic, and immuno-enhancing properties. These observations led to the proposal that restoration of DHEA to young adult levels may have beneficial effects on age-related conditions - DHEA enhances effects of weight training on muscle mass and strength in elderly women and men
The plasma levels of dehydroepiandrosterone (DHEA) and its sulfated form (DHEAS) decline approximately 80% between the ages of 25 and 75 yr. Muscle mass and strength also decrease with aging. This study provides evidence that DHEA replacement has the beneficial effect of enhancing the increases in muscle mass and strength induced by heavy resistance exercise in elderly individuals
Medicijngebruik
Antidepressiva
- Dexfenfluramine, fluoxetine, and weight loss among female carbohydrate cravers
These results suggest that weight loss following treatment with serotoninergic drugs may relate to a selective decrease in CHO appetite - Serotoninergic manipulation, meal-induced satiety and eating pattern: effect of Fluoxetinein obese female subjects
Mean daily energy intake, calculated from food diary records, was 1881 kcal when subjects were taking the placebo compared to 1460 kcal when taking Fluoxetine(a reduction of 22.4%). Fluoxetinetreatment produced a significant weight loss of 1.97 kg over the two weeks of treatment compared to a weight loss of only 0.04 kg on placebo - A randomized, double-blind study of Fluoxetineand maprotiline in the treatment of major depression
In fact, the only statistically significant difference found was in weight change: weight loss in the Fluoxetinegroup and weight gain in the maprotiline group - Comparison of Hypericum extract WS 5570 and Paroxetine in ongoing treatment after recovery from an episode of moderate to severe depression: results from a randomized multicenter study
This study showed that WS 5570 and Paroxetine were similarly effective in preventing relapse in a continuation treatment after recovery from an episode of moderate to severe depression and point therefore to an important alternative treatment option for long-term relapse-prevention - Acute treatment of moderate to severe depression with Hypericum extract WS 5570 (St John's wort): randomised controlled double blind non-inferiority trial versus Paroxetine
In the treatment of moderate to severe major depression, Hypericum extract WS 5570 is at least as effective as Paroxetine and is better tolerated - Lithium: a review of its metabolic adverse effects
Treatment with lithium has long been recognized to be associated with metabolic adverse effects notably hypothyroidism, hyperparathyroidism, weight gain and nephrogenic diabetes insipidus - Effects of antidepressants on sleep
Sleep continuity is improved by the rise of synaptic level of serotonin. Among tricyclic antidepressants trimipramine and amitriptyline are the best to improve sleep. Mirtazapine is the first-line sleep promoter among atypical antidepressants, however, its effect on increasing appetite markedly limits its application> - Hypericin--the facts about a controversial agent
In other contemporary studies, screening hypericin for inhibitory effects on various pharmaceutically important enzymes such as MAO (monoaminoxidase), Recent studies report antidepressive, antineoplastic, antitumor and antiviral (human immunodeficiency and hepatitis C virus) activities of hypericin - St John's wort for major depression
The available evidence suggests that the Hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants. The association of country of origin and precision with effects sizes complicates the interpretation
Anticonceptie
- Anticonceptiepil vergroot risico van zwangerschapsdiabetes
Een studie heeft aangetoond dat het gebruik van bepaalde anticonceptiepillen in de vijf jaren voorafgaand aan een zwangerschap, mogelijk het risico van zwangerschapsdiabetes vergroten - Benefits and risks of oral contraceptive use
Progestins, especially norgestrel, increase the risk of coronary artery disease. Other side effects include acne and weight gai - Oral contraceptives and venous thromboembolism: an epidemiological review
New epidemiological studies have demonstrated a higher risk of venous thromboembolism among users of oral contraceptives (OCs) with third-generation progestogens desogestrel or gestodene compared with users of OCs with second-generation progestogens levonorgestrel or norgestrel - A case-control study of oral contraceptive use and incident breast cancer
These results suggest that OC use is associated with an increased risk of breast cancer diagnosed in recent years
Prednison of prednisolon
- Population-based assessment of adverse events associated with long-term glucocorticoid use
Weight gain was the most common self-reported AE (70% of the individuals), cataracts (15%) and fractures (12%) were among the most serious The prevalence of 8 commonly attributed self-reported glucocorticoid-associated AEs was significantly associated with cumulative and average glucocorticoid dose in a dose-dependent fashion. Physicians should be vigilant for glucocorticoid-related AEs and should counsel patients about possible risks, even among low-dose long-term users - Het SCDiet
Het bewijzen van de effectiviteit van het Specifieke Koolhydraten Dieet bij mensen met darmontstekingen is nagenoeg onmogelijk, omdat aan dergelijke studies zeer hoge eisen gesteld worden. Meer hierover. We kunnen echter wel de theorie achter het SCDiet zeer aannemelijk maken door te verwijzen naar verschillende wetenschappelijke studies die in verschillende medische journals gepubliceerd zijn. Het betreft hier studies over het elementaire dieet. Het elementaire dieet is een kunstmatig dieet dat voorverteerde voedingsstoffen bevat. De gelijkenis van het elementaire dieet met het SCDiet is zeer groot. Zie hieronder hoe aannemelijk is te maken dat het SCDiet in bepaalde gevallen werkt
Bčtablokkers
- Effects of nutrient intake on sympathoadrenal activity and thermogenic mechanisms
Inhibition of facultative thermogenesis by beta-blockers such as propranolol, diminishes the daily energy expenditure and promotes weight gain and obesity. Although thermogenesis mediated by the sympathoadrenal system accounts for only a small part of the daily energy expenditure, it is sufficient to explain the positive energy balance - Effect of antihypertensive agents on the development of type 2 diabetes mellitus
People with hypertension have a high prevalence of insulin resistance and are at relatively high risk of developing type 2 diabetes mellitus. It is becoming increasingly evident that antihypertensive agents have disparate metabolic effects.. Therefore, the risk of new-onset diabetes-associated cardiovascular risks should be factored into future treatment recommendations for patients who require antihypertensive therapy. This will become even more important as the number of insulin-resistant patients with hypertension increases in parallel with the steady growth in the number of sedentary, obese, and aged persons in our population - New treatment strategies for patients with hypertension and insulin resistance
However, older antihypertensive agents such as thiazide diuretics and beta-blockers have potentially adverse effects on glucose and lipid metabolism and may even the exacerbate the metabolic syndrome and increase risk of type 2 diabetes. Recent clinical trials have suggested that antihypertensive agents that inhibit the renin-angiotensin system may reduce risk for new-onset type 2 diabetes - Should beta blockers remain first choice in the treatment of primary hypertension? A meta-analysis
In comparison with other antihypertensive drugs, the effect of beta blockers is less than optimum, with a raised risk of stroke. Hence, we believe that beta blockers should not remain first choice in the treatment of primary hypertension and should not be used as reference drugs in future randomised controlled trials of hypertension - Hypokalemia: a practical approach to diagnosis and its genetic basis
Hypokalemia is a common and important finding in hospitalized patients because it may provoke cardiac arrhythmias and/or respiratory arrest - Potassium disorders--clinical spectrum and emergency management
Potassium disorders are common and may precipitate cardiac arrhythmias or cardiopulmonary arrest. They are an anticipated complication in patients with renal failure, but may also occur in patients with no previous history of renal disease - Effect of longer-term modest salt reduction on blood pressure
Our meta-analysis demonstrates that a modest reduction in salt intake for a duration of 4 or more weeks has a significant and, from a population viewpoint, important effect on blood pressure in both individuals with normal and elevated blood pressure. These results support other evidence suggesting that a modest and long-term reduction in population salt intake could reduce strokes, heart attacks, and heart failure. Furthermore, our meta-analysis demonstrates a correlation between the magnitude of salt reduction and the magnitude of blood pressure reduction. Within the daily intake range of 3 to 12 g/day, the lower the salt intake achieved, the lower the blood pressure - Potassium, magnesium
Despite advances in the prevention and treatment of hypertension over the past decade, hypertension remains an important public health challenge. Recent efforts to reduce the prevalence of hypertension have focused on nonpharmacologic means, specifically diet. An increased intake of minerals such as potassium, magnesium, and calcium by dietary means has been shown in some but not all studies to reduce blood pressure in patients with hypertension - Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension
The mean reduction in systolic blood pressure of the CoQ-treated group was 17.8 +/- 7.3 mm Hg (mean +/- SEM). None of the patients exhibited orthostatic blood pressure changes. CONCLUSIONS: Our results suggest CoQ may be safely offered to hypertensive patients as an alternative treatment option - Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease
These findings indicate that treatment with coenzyme Q10 decreases blood pressure possibly by decreasing oxidative stress and insulin response in patients with known hypertension receiving conventional antihypertensive drugs.
Amiodarone
- The effects of amiodarone on the thyroid
Amiodarone is a benzofuranic-derivative iodine-rich drug widely used for the treatment of tachyarrhythmias and, to a lesser extent, of ischemic heart disease. It often causes changes in thyroid function tests (typically an increase in serum T(4) and rT(3), and a decrease in serum T(3), concentrations), mainly related to the inhibition of 5'-deiodinase activity, resulting in a decrease in the generation of T(3) from T(4) and a decrease in the clearance of rT(3). In 14-18% of amiodarone-treated patients, there is overt thyroid dysfunction, either amiodarone-induced thyrotoxicosis (AIT) or amiodarone-induced hypothyroidism (AIH). Both AIT and AIH may develop either in apparently normal thyroid glands or in glands with preexisting, clinically silent abnormalities. Preexisting Hashimoto's thyroiditis is a definite risk factor for the occurrence of AIH - Amiodarone-related pneumonitis
Amiodarone-related pneumonitis is a potentially limiting factor for amiodarone usage. Clinicians must remain alert to detect amiodarone-related pneumonitis even under low dosage and short duration of amiodarone usage. Immediate withdrawal of amiodarone and prompt steroid therapy will ensure full recovery - Optic Neuropathy in Patients Using Amiodarone
Amiodarone optic neuropathy was first reported in 1987. Additional detailed descriptions of this entity have appeared in several case reports and small case series. The clinical picture that has emerged is quite variable, including cases with both unilateral and bilateral optic nerve involvement. While most reported cases have been associated with mild optic nerve dysfunction, which may be reversible, others have experienced significant permanent visual loss - Severe ataxia caused by amiodarone
Neurologic toxicity is an infrequently reported and under-recognized consequence of amiodarone, symptoms of which may include tremor, peripheral sensorimotor neuropathy, proximal weakness, and ataxia - Amiodarone treatment and visual prognosis
An insidious visual loss can occur with amiodarone treatment. A swelling of the optic disc without visual deterioration can occur as the first sign of a defect of the optic nerve. An abnormal blue colour vision can also be detected. After discontinuation of amiodarone either a visual improvement or a permanent deterioration may result. We recommend that every patient being treated with amiodarone should be observed by opthalmoscopy and colour vision examination at regular intervals (approximately every 3 months). Treatment with amiodarone should be discontinued after exclusion of life-threatening situations by a cardiologist, as soon as the first changes of the optic disc occur
Voedingstekorten
- Voedingscentrum
Bepaalde groepen zoals kleine kinderen, zwangere vrouwen en ouderen hebben een grotere behoefte aan bepaalde vitamines. Anderen krijgen voldoende vitamines en andere nuttige stoffen binnen door gezond en gevarieerd te eten met voldoende groente en fruit - Gezondheidsraad 30 september 2008
Naar een toereikende inname van vitamine D. Een onvoldoende vitamine D-status komt onder alle lagen van de Nederlandse bevolking voor. Het percentage is daarbij hoger aan het einde van de winter dan aan het einde van de zomer (tabel 1). - Vitamin D and living in northern latitudes--an endemic risk area for vitamin D deficiency
Active metabolites of vitamin D play an important role in calcium and phosphate homeostasis. Deficiency of vitamin D results in diminished bone mineralization and an increased risk of fractures. In addition, vitamin D is connected to a variety of other diseases that include different cancer types, muscular weakness, hypertension, autoimmune diseases, multiple sclerosis, type 1 diabetes, schizophrenia and depression - Vitamin D status and the metabolic syndrome
The identification of vitamin D receptor expression in different tissues suggests a widespread role for vitamin D action beyond its classical function in bone and mineral metabolism. Recently, the importance of vitamin D status as a risk factor in the development of metabolic syndrome has been the focus of several studies - Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction
The data show a positive correlation of 25(OH)D concentration with insulin sensitivity and a negative effect of hypovitaminosis D on beta cell function. Subjects with hypovitaminosis D are at higher risk of insulin resistance and the metabolic syndrome. Further studies are required to explore the underlying mechanisms - Role of vitamin D in the pathogenesis of type 2 diabetes mellitus
Vitamin D deficiency has been shown to alter insulin synthesis and secretion in both humans and animal models. It has been reported that vitamin D deficiency may predispose to glucose intolerance, altered insulin secretion and type 2 diabetes mellitus - Vitamin D deficiency is the cause of common obesity
Common obesity and the metabolic syndrome may therefore result from an anomalous adaptive winter response. The stimulus for the winter response is proposed to be a fall in vitamin D. The synthesis of vitamin D is dependent upon the absorption of radiation in the ultraviolet-B range of sunlight - Vitamin D and diabetes
Vitamin D deficiency predisposes individuals to type 1 and type 2 diabetes, and receptors for its activated form-1alpha,25-dihydroxyvitamin D3-have been identified in both beta cells and immune cells. Vitamin D deficiency has been shown to impair insulin synthesis and secretion in humans and in animal models of diabetes, suggesting a role in the development of type 2 diabetes - Iron intake and iron status among adults in the Netherlands
Average iron intake was higher than the recommended daily allowance for the Netherlands in all sex-age groups except women aged 20-49, in which group average iron intake was 23% below the recommendation. Women aged 20-49 are the adult sex-age group with the greatest risk of developing (an early stage of) iron depletion. The most important dietary factors influencing the iron status are the type of iron (haem/non-haem) and factors affecting the bioavailability of iron - Vitamine weg uit onze groenten
De kwaliteit van onze andijvie, bloemkool en wortelen holt achteruit. In de afgelopen twintig jaar is de aanwezigheid van vitaminen en mineralen in de zogeheten vollegrondsgroente fors teruggelopen, soms met meer dan vijftig procent. Uit onderzoek van de Consumentenbond blijkt dat onze groente nauwelijks nog een nuttige stof als selenium bevat. (Mineralen worden door groente uit de grond gehaald. Vitamines worden aangemaakt uit mineralen.) Het is in elk geval zo laag dat het niet meer te meten is. Dat komt omdat de bodem in feite dood is - Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety
To ensure that serum 25(OH)D concentrations exceed 100 nmol/L, a total vitamin D supply of 100 µg (4000 IU)/d is required. Except in those with conditions causing hypersensitivity, there is no evidence of adverse effects with serum 25(OH)D concentrations <140 nmol/L, which require a total vitamin D supply of 250 µg (10000 IU)/d to attain.Because vitamin D is potentially toxic, intake of >25 µg (1000 IU)/d has been avoided even though the weight of evidence shows that the currently accepted, no observed adverse effect limit of 50 µg (2000 IU)/d is too low by at least 5-fold.
Chronische stress
- Psychological stress and cardiovascular disease
Studies of chronic stressors are discussed in terms of job stress, marital unhappiness, and burden of caregiving. From all of these studies there are extensive data concerning stressors' contributions to diverse pathophysiological changes including sudden death, myocardial infarction, myocardial ischemia, and wall motion abnormalities, as well as to alterations in cardiac regulation as indexed by changes in sympathetic nervous system activity and hemostasis. There is nonetheless overwhelming evidence both for the deleterious effects of stress on the heart and for the fact that vulnerability and resilience factors play a role in amplifying or dampening those effects. Numerous approaches are available for stress management that can decrease patients' suffering and enhance their quality of life - Pathophysiologic cardiovascular changes in stress and depression
The sympathetic nervous system plays an important role in stress-associated changes in cardiovascular regulation and contributes to cardiovascular morbidity and mortality by inducing vasoconstriction and tachycardia, as well as arrhythmia. As endothelial dysfunction is an early manifestation of atherosclerosis, the impact of mental stress on endothelial function is also important - Cardiovascular disease and modifiable cardiometabolic risk factors
Cardiovascular disease (CVD) is the leading cause of death in the United States and many parts of the world. In addition, the growing prevalence of obesity and type 2 diabetes mellitus (DM) threatens to undermine the improvements in CVD that have been achieved. In the United States, approximately two thirds of adults are overweight or obese, and even modest excess body weight is associated with a significantly increased risk of CVD-related mortality - Global public health problem of sudden cardiac death
Cardiovascular disease is a leading cause of global mortality, accounting for almost 17 million deaths annually or 30% of all global mortality. In developing countries, it causes twice as many deaths as HIV, malaria and TB combined. Prevention of cardiovascular disease by increasing awareness of risk factors such as lack of exercise, inappropriate diet and smoking has reduced cardiovascular mortality in the US over the past few decades. However, there is still a huge cardiovascular disease burden globally as well as in the US - Abdominal obesity: the cholesterol of the 21st century?
Cardiovascular disease (CVD) is a leading cause of morbidity and death in many countries worldwide. Body fat distribution, especially visceral adipose tissue accumulation, has been found to be a major correlate of a cluster of diabetogenic and atherogenic abnormalities that has been described as the metabolic syndrome. The importance of abdominal obesity in association with the development of CVD and type 2 diabetes has been recognized in several studies, beyond the contribution of overall obesity - Successful management of the obese patient
Because stress is a primary predictor of relapse and overeating,11 teaching patients various methods for reducing stress and tension is crucial. Tension reduction techniques (e.g., diaphragmatic breathing, progressive muscle relaxation and meditation) are designed to reduce tension and associated sympathetic nervous system arousal, thereby providing a distraction from stressful events. These strategies are highly effective for numerous health-related problems, including obesity - Maintenance and relapse after weight loss in women: behavioral aspects
Most maintainers (90%) and control subjects (82%) exercised regularly, were conscious of their behaviors, used available social support (70% and 80%, respectively), confronted problems directly (95% and 60%, respectively), and used personally developed strategies to help themselves. Few relapsers exercised (34%), most ate unconsciously in response to emotions (70%), few used available social support (38%), and few confronted problems directly (10%). In the present study, weight regain (relapse) was frequently attributed to negative emotional states and unexpected or unpredictable stressful life events - Chronic stress and insulin resistance-related indices of cardiovascular disease risk, part 2: a potential role for mind-body therapies
The increasing global prevalence of CVD reflects in part the concurrent rise in insulin resistance, obesity, dyslipidemia, and other atherogenic changes associated with insulin resistance syndrome (IRS). Evidence suggests that chronic stress and related psychosocial factors also play an important role in the development and progression of IRS-related states and ultimately, in the pathogenesis of CVD. Designed to address these interrelated psychological and physiological components of health, yoga and other traditional mind-body therapies may offer particular promise in both the primary and secondary prevention of CVD - Stress and Diabetes: A Review of the Links
Three approaches to stress management go hand in hand, albeit with some overlap: 1) when possible, removing or minimizing the source of stress, 2) changing the response to the stressful situation, and 3) modifying the longer-term effects of stress. In summary, research has indicated that stressful experiences have an impact on diabetes. Stress may play a role in the onset of diabetes, it can have a deleterious effect on glycemic control and can affect lifestyle. Emerging evidence strongly suggests, however, that interventions that help individuals prevent or cope with stress can have an important positive effect on quality of life and glycemic control - Mindfulness-based stress reduction: a literature review and clinician's guide
PURPOSE: To provide nurse practitioners (NPs) with clinical research about Mindfulness-Based Stress Reduction (MBSR) and demonstrate its usefulness for reducing stress in a variety of populations. MBSR is an effective treatment for reducing stress and anxiety that accompanies daily life and chronic illness. No negative side effects from MBSR have been documented. MBSR is a safe, effective, integrative approach for reducing stress. Patients and healthcare providers experiencing stress or stress-related symptoms benefit from MBSR programs. NPs can safely and effectively use this intervention in a variety of patient populations - A pilot study comparing the effects of mindfulness-based and cognitive-behavioral stress reduction
OBJECTIVES: The objective of this pilot study was to compare the effects of two mind-body interventions: mindfulness-based stress reduction (MBSR) and cognitive-behavioral stress reduction (CBSR). MBSR was an 8-week course using meditation, gentle yoga, and body scanning exercises to increase mindfulness. CBSR was an 8-week course using cognitive and behavioral techniques to change thinking and reduce distress. MBSR subjects improved on all eight outcomes, with all of the differences being significant. CBSR subjects improved on six of eight outcomes, with significant improvements on well-being, perceived stress, and depression. Multivariate analyses showed that the MBSR subjects had better outcomes across all variables, when compared with the CBSR subjects. Univariate analyses showed that MBSR subjects had better outcomes with regard to mindfulness, energy, pain, and a trend for binge eating. CONCLUSIONS: While MBSR and CBSR may both be effective in reducing perceived stress and depression, MBSR may be more effective in increasing mindfulness and energy and reducing pain - The protective role of exercise on stress system dysregulation and comorbidities
ndeed, accumulating evidence documents the beneficial effects of regular exercise in preventing or ameliorating the metabolic and psychological comorbidities induced by chronic stress. These benefits are thought to derive from a central effect of exercise to reduce the sensitivity to stress and also peripheral actions influencing metabolic functions and, in particular, insulin sensitivity and the partitioning of fuels toward oxidation rather than storage - Physical training in the treatment of psychological disorders
Numerous studies in healthy volunteers have demonstrated positive psychological effects of regular aerobic exercise, such as reduction of anxiety or depressive symptoms, in crease of self-esteem and improved stress management - Stress response and binge eating disorder
In clinical practice, obese patients report stress as a primary trigger for binge eating. This paper presents, a theoretical overview of how cortisol secretion, a major component of the stress response, could play a role in binge eating, given that exogenous glucocorticoids can lead to obesity by increasing food intake. I will review recent findings demonstrating a greater cortisol response to stress in obese women with BED compared to non-BED - Relationship between stress, eating behavior, and obesity
Stress appears to alter overall food intake in two ways, resulting in under- or overeating, which may be influenced by stressor severity. Chronic life stress seems to be associated with a greater preference for energy- and nutrient-dense foods, namely those that are high in sugar and fat. Evidence from longitudinal studies suggests that chronic life stress may be causally linked to weight gain, with a greater effect seen in men. Stress-induced eating may be one factor contributing to the development of obesity
SITE MAP
- Candida: Candida infectie - CVS/ME: Chronische vermoeidheid Syndroom - Diabetische complicaties: Behandeling diabetische complicaties - Neuropathie - Retinopathie - Nefropathie - Bloeduiker stabilisatie - Hart en vaatziekten: Cardiomyopathie en Hartfalen - Cardiomyopathy and Heart Failure - Hoge bloeddruk - Cholesterol verlaging - Aderverkalking (atherosclerose) - Levensverlenging: Levensverlenging - DHEA - Melatonine - 65+ - Kanker: - Ondersteuningstherapie bij kanker - Artrose en artritis: - Artrose - Artritis - Fibromyalgie: - Fibromyalgie - Urinewegen: - Prostaatklachten - Blaasontsteking - Voeding: Voeding wat is er mis mee - Melk - Suiker - Aanvulling onvolwaardige voeding - Vitamine supplementen: Voedingssupplementen - Overgewicht: - Overgewicht - SLIM - Andere artikelen: - HPU - Astma - Multiple Sclerose - Psoriasis - Staar - Depressie - Behandelingsforum - Orthomoleculaire Geneeskunde
- Candida: Candida infectie - CVS/ME: Chronische vermoeidheid Syndroom - Diabetische complicaties: Behandeling diabetische complicaties - Neuropathie - Retinopathie - Nefropathie - Bloeduiker stabilisatie - Hart en vaatziekten: Cardiomyopathie en Hartfalen - Cardiomyopathy and Heart Failure - Hoge bloeddruk - Cholesterol verlaging - Aderverkalking (atherosclerose) - Levensverlenging: Levensverlenging - DHEA - Melatonine - 65+ - Kanker: - Ondersteuningstherapie bij kanker - Artrose en artritis: - Artrose - Artritis - Fibromyalgie: - Fibromyalgie - Urinewegen: - Prostaatklachten - Blaasontsteking - Voeding: Voeding wat is er mis mee - Melk - Suiker - Aanvulling onvolwaardige voeding - Vitamine supplementen: Voedingssupplementen - Overgewicht: - Overgewicht - SLIM - Andere artikelen: - HPU - Astma - Multiple Sclerose - Psoriasis - Staar - Depressie - Behandelingsforum - Orthomoleculaire Geneeskunde
