Diabetes And Low Testosterone

Diabetes And Low Testosterone
The Two Go Hand In Hand, With Possibly Serious Consequences
Dec. 1, 2004

Diabetes

Symptoms, treatments, and how to prevent it.

(WebMD) A third of men with type 2 diabetes have low testosterone levels, a new study suggests.

Testosterone helps men reduce body fat and improves the way their bodies handle insulin. So low testosterone levels may have serious consequences for men with diabetes, suggests Sandeep Dhindsa, MD, of State University of New York at Buffalo.

"We are describing a new complication of type 2 diabetes. We are saying that the largest group of people who have [low testosterone] are diabetics," Dhindsa tells WebMD. "It means your pituitary gland, which controls all the other hormones in your body, is not working very well. We are talking about one-third of men with diabetes being at risk of high fat mass, low muscle mass, low bone density, depression, and erectile dysfunction."


Total Testosterone Vs. Free Testosterone

Previous studies have found that men with diabetes are more likely to have low testosterone than are men without diabetes, notes Glenn R. Cunningham, MD, professor of molecular and cellular biology and vice chairman for research at Baylor College of Medicine.

"People have looked at testosterone levels in diabetics a lot. A number of studies show a fairly significant percentage of diabetics have low testosterone," Cunningham tells WebMD.

But most of these studies, Dhindsa says, relied on measures of total testosterone. Total testosterone levels depend on the amount of a testosterone-binding substance in the blood (sex hormone binding globulin, or SHBG). Since men with diabetes have low SHBG levels, it was hard to know what these earlier findings meant.

Dhindsa and colleagues, however, used much more sophisticated tests that measure free testosterone in the blood of 103 men with type 2 diabetes.

"That gives more validity to this study than to some of the others," Cunningham says. "They did find somewhat higher prevalence of low testosterone than previously reported."


Low Testosterone In Diabetes: More Than Obesity

A man's testosterone levels drop as he ages. If he's obese, his testosterone levels drop even more. Diabetes accentuates these effects.

Indeed, the older and more obese men in the Dhindsa study did tend to have low testosterone levels. But many of the younger, leaner men had low testosterone, too.

The researchers found nothing wrong with the men's testes. Instead, they found evidence that the men's pituitary glands weren't making enough luteinizing hormone. That's the hormone that tells the testes to make testosterone.

Why is this a problem? Low testosterone levels are, of course, linked to erectile dysfunction. Low testosterone is linked to higher fat mass, particularly abdominal fat, which is particularly dangerous for people with diabetes because of its risk for heart disease. Low testosterone is also linked to low bone density, low lean muscle mass, depression, mood disorders, and cognitive problems. And low testosterone is linked to insulin resistance.


Advice To Men With Diabetes: Get Testosterone Test

Cunningham advises men with diabetes to get a testosterone test — free testosterone, not total testosterone — if they have any symptoms of sexual dysfunction.

Dhindsa advises men with diabetes not to wait for symptoms, but to get a testosterone test as part of their basic medical care.

"We are screening all diabetic men for low testosterone because the symptoms are very nonspecific," he says. "Anyone can have erectile dysfunction or a mood problem. And most diabetes patients with low testosterone do not have any symptoms. They are surprised to find they have low testosterone."

Testosterone replacement therapy is available. Will it help people with diabetes? That remains to be seen. Dhindsa and colleagues are giving the treatment to men with diabetes and low testosterone, but it's too soon to tell whether it's the right thing to do.

"The data are not sufficient to recommend testosterone replacement for men with diabetes," Cunningham says. "One of the things that could be important is when you treat a man with male sex hormone, it increases lean body mass and causes some decrease in fat mass. There is some issue whether testosterone might improve diabetic men's insulin sensitivity. The studies we have are not definitive."

Sources: Dhindsa, S. The Journal of Clinical Endocrinology & Metabolism, November 2004; vol 89: pp 5462-5468. Sandeep Dhindsa, MD, assistant professor of medicine, State University of New York, Buffalo. Glenn R. Cunningham, MD, professor of molecular and cellular biology and vice chairman for research, Baylor College of Medicine; associate chief of staff, Research Service, VA Medical Center, Houston.


By Daniel J. DeNoon
Reviewed by Brunilda Nazario, MD
© 2004, WebMD Inc. All rights reserved.

REAL Health Breakthroughs

REAL Health Breakthroughs
From William Campbell Douglass II,M.D.

Visit us at www.DouglassReport.com Learn more about William Campbell Douglass II, M.D.

The Great Cholesterol Myth Busted!

The controversy has been raging for years about the importance (or lack of importance) of cholesterol in the diet. Radicals like me have been saying all along that the more cholesterol you eat the better. Back in the 70s when the cardiologists were telling their patients to limit eggs to one a week, I was telling my patients to eat 10 a day if they liked

Over the last 50 years, the "high cholesterol/heart disease" theory has been disproved many times over, but mainstream medicine still pretends not to know it. In fact, in 2004 the Journal of the American College of Nutrition printed a study by Dr. David R. Pendergast of the State University of New York that proves my point perfectly. Dr. Pendergast and his colleagues placed 11 healthy adults on a very low-fat diet with only 19 percent of calories பிரோம் fat—something only a dedicated carrot cruncher could tolerate. The volunteers' good cholesterol, HDL, dropped significantly. Then Pendergast had them switch to a high-fat plan. After three weeks on this diet, which provided 50 percent of calories from fat, participants' HDL levels went up considerably. And, by the way, the high-fat diet did not raise LDL (bad) cholesterol beyond the levels participants had on their regular diets.

"While saturated fat is blamed for raising 'bad' LDL cholesterol levels, Pendergast said, it may in fact be the combination of lots of fat and too many calories that makes for unhealthy cholesterol profiles."

Saturated fat does NOT raise cholesterol levels. That was proven 80 years ago by the famous arctic explorer Vilhjalmur Stefansson, who lived on whale and seal blubber for a year and came out of it wiser but no fatter. In fact, he was in great shape. One of the greatest nutritionists of the century, George Mann, M.D., the co-director of the Framingham Heart Study, said, "The diet-heart idea [the notion that saturated fats and cholesterol cause heart disease] is the greatest scientific deception of our times. This idea has been repeatedly

shown to be wrong, and yet, for complicated reasons of pride, profit and prejudice, the hypothesis continues to be exploited by scientists, fund-raising enterprises, food companies and even governmental agencies. The public is being deceived by the greatest health scam of the century."

The REAL scoop on heart disease

So if the problem isn't saturated fat and cholesterol, what is it? It's an amino acid called homocysteine. Normally, homocysteine is used to build and maintain tissues. Your body forms homocysteine when you eat food containing an amino acid called methionine, which is present in all animal and vegetable protein. But too much in your bloodstream literally shreds your arteries from the inside out, allowing fat and cholesterol to stick...eventually leading to total blockage, followed by a heart attack or stroke. Thirty years of intensive research has revealed that excess homocysteine disables a mechanism in your arterial cells called contact inhibition, which regulates the growth of the smooth muscle cells just below the inner wall of the artery.

As a result, the smooth muscle cells multiply out of control. This creates a bulge that pushes other cells apart and protrudes into the artery. This is what makes arteriosclerosis possible: The inner wall becomes uneven and rough, then the build up of plaque begins…and the rest, as they say, is scientific.

Studies published in many prominent medical journals have linked elevated homocysteine levels with cardiac problems.

An article in the June 1996 issue of Medical Tribune News stated the

following: "High levels of homocysteine, a substance involved in protein production, are associated with artery thickening, a precursor to both stroke and heart disease." A team of cardiologists in Norway conducted a study in which they followed 587 heart patients for five years. The results, published in the New England Journal of Medicine, showed that 24 percent of the patients with high levels of homocysteine in their blood were dead within five years. The five-year mortality rate among the patients with normal homocysteine levels was only 3 percent. A 1992 Harvard study of 15,000 physicians showed that those physicians with the highest 5 percent of homocysteine readings had a threefold-plus increase in heart-attack risk (JAMA, vol. 268, pp. 877-81)

Homocysteine also interferes with your blood vessels' natural ability to relax and makes your blood stickier. The good news is that there's a simple secret to controlling homocysteine overload: Your body requires a steady supply of three particular "helper nutrients" to process, convert, and excrete excess homocysteine.

The three Bs for better vascular health

Vitamins B6 and B12 and folic acid (which is also a B vitamin) are the keys to maintaining normal homocysteine levels. These three nutrients play a crucial role in converting the potential villain homocysteine into cystathione and methionine, which are harmless and occur naturally. Folic acid is the most important of these B vitamins in attacking and neutralizing homocysteine.

There are now numerous studies reported in peer-reviewed international medical and research journals that demonstrate the benefits of folic acid in combating high homocysteine levels. The best sources of folic acid are animal protein, animal fat, and dairy products. The leader in folate nutrition—by far—is liver. A small serving of beef liver—3 oz., for instance—contains 174
micrograms of folic acid. When is the last time a nutritionist or doctor advised you to eat some variety of liver a least once a week? Probably never. Chicken liver is the tastiest and, with the proper sauce, is an outstanding dish. BUT, don't overcook it. It should be a little red or at least pink. But even with a healthy diet containing plenty of folate-rich animal food, you should still டேக் a supplement just to be absolutely certain you're getting enough of this nutrient. Take at least 800 micrograms a day. Keep in mind that doses up to 5,000 micrograms—and more—are safe and will do you even more good. I take 5,000 to 15,000 micrograms a day.

You should consider supplementing with vitamins B6 and B12 as well. These two nutrients are often destroyed by heating, dehydration, and other types of food processing, and our soil is depleted of much of its nutrient value, so it's virtually impossible to get enough B6 and B12 to normalize homocysteine levels from food sources alone. I suggest at least 25 milligrams of B6, and ௫௦௦ micrograms of B12 daily.

For more about cholesterol and hundreds of other real health topics, go to Dr. Douglass' website at www.DouglassReport.com .

Visit us at www.DouglassReport.com Learn more about William Campbell Douglass II,M.D.

©Copyright 2007 The Douglass Report 819 N. Charles St., Baltimore, MD 21201. All rights reserved. No part of this report may be reproduced பி
any means or for any reason without the consent of the publisher.

This information is provided as information only and may not be construed as medical advice or instruction. No action should be taken based solely
on the contents of this publication. Readers should consult appropriate health professionals on any matter relating to their health and well-being. த Theinformation and opinions provided in this publication are believed to be accurate and sound, based on the best judgment available to the authors, but
readers who fail to consult appropriate health authorities assume the risk of any injuries. The publisher is not responsible for errors or omissions.

The Danger of Too Many Tests By Dr. Ranit Mishori

The Danger of Too Many Tests By Dr. Ranit Mishori

http://www.parade.com/articles/editions/2008/edition_07-06-2008/3Too_Many_Tests

If you’re like most Americans, your health bills are soaring. One reason is the “diagnostic imaging” industry, which includes X-rays, CT scans, and MRIs—the tests that let doctors “see” our bones, blood vessels, nerves, muscles, and organs. According to the American College of Radiology, imaging is one of the fastest-growing services in medicine, with costs reaching approximately $100 billion annually.

The detail revealed by these tests can be astounding, the information lifesaving. But are we overdoing it? Are all those tests really necessary? And is harm potentially being done?

Some researchers worry about overexposure to radiation. While noting that many lives are saved by imaging, Dr. David Brenner, director of the Center for Radiological Research at Columbia University Medical Center in New York City, estimates that “1% to 2% more cases of cancer may result from the increased use of imaging in the future.” Of special concern: Some 5 million CT scans are performed annually on children, who are 10 times more sensitive to radiation than adults.

Further, imaging may result in “false-positive” results (finding a problem that does not in fact exist) or “incidental findings” (seeing an abnormality that may be clinically harmless), notes Dr. Stephen Baker, chair of the Department of Radiology at the UMDNJ-New Jersey Medical School. Both results often lead to even more imaging and risky invasive procedures, including surgery.

Not every ache and pain calls for a scan or an X-ray. It’s best to know where and how imaging tends to be overused.

CT Scans
Computed Tomography (CT) scans, also known as CAT scans, are the “doughnut holes” patients can find themselves in. CT scans are particularly good for looking at organs, bone, soft tissue, and blood vessels. However, their radiation levels can be quite high—“typically the equivalent of about 100 conventional X-rays,” says Dr. Brenner. CTs are routinely ordered for headaches, heart imaging, and full-body scans, but there are reasons to question their use for each.

Headaches. CT scans are requested for many of the 45 million patients who suffer from headaches to rule out their greatest fear: a brain tumor.

Numerous studies suggest, however, that this is overkill. Most headaches are not indicators of something serious—a tumor or brain bleed. Furthermore, these more-serious problems almost always are accompanied by other, visible symptoms, such as seizures and neurological impairment. For example, Sen.Ted Kennedy’s recent brain tumor diagnosis involved clear seizure activity. In the absence of such red flags, a scan probably is not worth the risk of increased radiation exposure. This view has been endorsed by a panel of experts, including the American Academy of Neurology.

Heart imaging. Coronary CT angiography is a relatively new procedure that gives a detailed view of the heart and the arteries that supply it with blood. It allows doctors to see calcium deposits and blocked arteries without inserting tubes or needles. This test has become quite popular, but it also raises concerns because of the frequency of false-positive and false-negative results. Furthermore, in addition to radiation exposure, there is the risk from the contrast dye used, which can lead to allergic reactions and kidney damage.

At present, there are no clear guidelines for when a coronary CT is clinically appropriate. It appears that the test can benefit those who have symptoms that suggest heart disease or who are at high risk for heart disease. But healthy individuals should not rush to request this test.

Full-body scans. CT scans of the entire body—a virtual physical, where every inch of your body is scrutinized from the inside—have been marketed in recent years to perfectly healthy individuals. But experts—including those at the American Cancer Society, Food and Drug Administration (FDA), and American College of Radiology—agree that these scans are not a good idea for healthy people without any symptoms. The scans often find irregularities that are entirely harmless but nevertheless lead to many expensive, unneeded, and invasive procedures.

X-rays
This classic imaging tool is useful for looking at bones and the chest.

Chest X-rays. Doctors often order chest X-rays for routine evaluation before surgery. While it certainly makes sense to do so in certain cases—for those whose surgery involves the heart or lungs, for example—there is increasing evidence that general testing is not advantageous. A recent extensive review in the United Kingdom found that chest X-rays may lead to false-positive results and expose patients to unnecessary radiation.

Back pain. Despite the discomfort associated with lower back pain, the vast majority of patients (90%) recover within 6-8 weeks, and most do not need X-rays, MRIs, or CT scans of their lower back. Imaging should be reserved for those cases where a serious underlying condition is suspected.

Magnetic Resonance Imaging
Magnetic Resonance Imaging (MRI) provides excellent views of the soft tissues of the body, so it is very useful in brain and cancer imaging. Unlike CTs or X-rays, MRIs do not emit radiation—they use a magnetic field to create images—but they are much more expensive than simple X-rays.

Achy knees. These days, MRIs frequently are ordered for patients with knee pain due to arthritis, because they provide a detailed view of the knees, bones, cartilage, and ligaments. But MRIs may not be necessary to diagnose a common condition such as osteoarthritis. A study presented this year at the American Academy of Orthopaedic Surgeons’ annual meeting suggested that, in most cases, X-rays are sufficient to determine who needs knee-replacement surgery. The cost difference translates into millions of dollars: MRIs are billed anywhere from $1200 to $2500 per session, whereas knee X-ray billing falls under $200.

Why Is My Doctor Ordering It?
There are several reasons behind the trend of excessive imaging. Together with your doctor, you, the patient, can play a part in finding the right balance for their use.

Short appointment times. With less time available to spend with patients, some doctors may order images as a shortcut—a way to get quick answers.

Malpractice fears. Excessive litigation forces doctors to practice defensive medicine. Even if there is little chance of a serious disease or condition, a physician may order a test to reduce the risk of being sued later for missing something important.

Where the money is. A growing number of physicians own diagnostic facilities or equipment. Some may have an incentive to order tests, because the fee goes to their own bottom line.

Patient expectations. Many patients want what they consider “the best”—sophisticated technologies like CT scans or MRIs—and doctors are quick to comply even if they don’t really see the need.

Patient reassurance. Sometimes, all evidence aside, it is easier to lower a patient’s anxiety by pointing to an actual CT image and saying, “See, there is no tumor there.” In some cases, a picture may be worth 1000 words (or dollars).

Do You Really Need It?
Learn about the various tests and what each is best for. Then talk with your doctor about the risks involved, such as radiation and false-positive results. Ask:

• Why is a specific imaging test necessary?

• How certain are you about the diagnosis without the scan? A medical history and physical may be enough for a diagnosis and treatment plan.

• How will test results affect treatment decisions?

• Does another, safer test exist that would give me the same information?

Be sure to request a copy (a CD-ROM or a written report) of any CT scan or other imaging study you have done. That will save you the trouble (and radiation) of having the same exam twice if you go to another hospital, move to another town, or change doctors.

Green tea 'prevents heart disease

Green tea 'prevents heart disease'

London (PTI): Tea time? Go for the green, for a study has revealed that sipping a cup of the beverage everyday could help prevent heart disease.

Green tea is already popular worldwide because of its immensely powerful health benefits. Now a Greek team has found that a cup of the bru daily helps in expanding arteries, which in turn improves blood flow thereby keeping the heart healthy.

According to researchers, the flavonoids in green tea relax the cells, called the endothelium, which is a thin layer on the inside of the blood vessels, that smooths the flow of blood allowing a more efficient circulation.

"Tea consumption has been associated with reduced cardiovascular morbidity and mortality in several studies. Green tea is consumed less in the Western world than black tea, but it could be more beneficial because of the way it seems to improve endothelial function.

"In this same context, recent studies have also shown potent anticarcinogenic effects of green tea attributed to its antioxidant properties," lead researcher Nikolaos Alexopoulos was quoted by the British media as saying.

In their study, the researchers at Athens Medical School tested a small group of volunteers who consumed green tea, 125 mg of caffeine and 450 ml of hot water on three separate occasions.

The team measured the diameter of the brachial artery in each participant 30, 90 and 120 minutes after they consumed each beverage. Dilation of the artery peaked at an increase of 3.9 per cent at the 30-minute test time.

They found that the caffeine and hot water did not have the same effect on the brachial artery that the green tea did -- in fact, drinking six grams of the drink caused the participants' brachial arteries (in the upper arm) to expand by almost four per cent.

"These findings have important clinical implications," Dr Alexopoulos said.
The findings of the study have been published in the latest edition of the 'European Journal of Cardiovascular Prevention and Rehabilitation'.

Watch out for the wrong kind of sugar

Watch out for the wrong kind of sugar
We know about good and bad fats. Now suspicion is growing that not all sugars are created equal either. Overweight adults who consume large amounts of fructose have been found to experience alarming changes in body fat and insulin sensitivity that do not occur after eating glucose.

Pure fructose is found in fresh fruit, fruit juice and preserves. But much of it sneaks into our diets though high-fructose corn syrup (HFCS) in soft drinks - which gets broken down into 55 per cent fructose and 45 per cent glucose in the body - or via sucrose (ordinary sugar), which is broken down into the same two sugars.

Fears that fructose and HFCS are fuelling the obesity epidemic and triggering insulin resistance and diabetes have been circulating for years (New Scientist, 1 September 2001, p 26), but there have been few direct investigations in humans.
So Peter Havel at the University of California, Davis, persuaded 33 overweight and obese adults to go on a diet that was 30 per cent fat, 55 per cent complex carbohydrates and 15 per cent protein for two weeks. For a further 10 weeks, they switched to a diet in which 25 per cent of their energy came from either fructose or glucose.

In those given fructose there was an increase in the amount of intra-abdominal fat, which wraps around internal organs, causes a pot belly and has been linked to an increased risk of diabetes and cardiovascular disease. This did not happen with the group who consumed glucose instead, even though both gained an average 1.5 kilograms in weight.

Those who consumed fructose also had raised levels of fatty triglycerides, which get deposited as intra-abdominal fat, and cholesterol. Their insulin sensitivity also fell by 20 per cent. Glucose appeared to have no effect on these measures. Havel presented the results at a meeting of the Endocrine Society in San Francisco last week.

Because Havel's test looked only at pure fructose, not HFCS or sucrose, it is not yet clear whether these substances are to blame for obesity and diabetes. "The question is, what is the amount of HFCS or normal sugar you need to consume to get these effects?" says Havel, who is planning a long-term study to find out. But he says it's not too soon for people with metabolic syndrome - the blend of conditions including belly fat and insulin resistance that raise the risk of diabetes and cardiovascular disease - to avoid drinking too many fructose-containing beverages.

PepsiCo, which sponsored Havel's research, disagrees. "This is a very interesting and important study," says a spokeswoman. "But it does not reflect a real-world situation nor is it applicable to PepsiCo since pure fructose is not an ingredient in any of our food and beverage products."

In a separate study, Havel's team compared the immediate effects of consuming a meal in which 25 per cent of the energy came from one of HFCS, sucrose, fructose or glucose. Blood triglyceride levels were all elevated to a similar level 24 hours after consuming fructose, sucrose or HFCS, but not glucose (The American Journal of Clinical Nutrition, vol 87, p 1194), suggesting that all three substances may have similar, negative health impacts. Longer-term studies are needed to confirm whether the triglycerides produced by sucrose or HFCS have similar effects to fructose on abdominal fat and insulin resistance.
"It adds to what we have known for a long time," says Francine Kaufman at the Keck School of Medicine in Los Angeles. "It's probably not a good idea to consume too much sugar."

The 10 Most Common Toxins

The 10 Most Common Toxins

The following toxins are among the most prevalent in our air, water and/or food supply. This list is by no means all-inclusive, as thousands of other toxins are also circulating in our environment. Keep reading to find out tips to avoid these toxins and others as much as possible.

PCBs (polychlorinated biphenyls): This industrial chemical has been banned in the United States for decades, yet is a persistent organic pollutant that's still present in our environment.
Risks: Cancer, impaired fetal brain development
Major Source: Farm-raised salmon . Most farm-raised salmon, which accounts for most of the supply in the United States are fed meals of ground-up fish that have absorbed PCBs in the environment and for this reason should be avoided.

Pesticides: According to the Environmental Protection Agency (EPA), 60 percent of herbicides, 90 percent of fungicides and 30 percent of insecticides are known to be carcinogenic. Alarmingly, pesticide residues have been detected in 50 percent to 95 percent of U.S. foods.
Risks: Cancer, Parkinson's disease, miscarriage, nerve damage, birth defects, blocking the absorption of food nutrients
Major Sources: Food (fruits, vegetables and commercially raised meats), bug sprays

Mold and other Fungal Toxins: One in three people have had an allergic reaction to mold. Mycotoxins (fungal toxins) can cause a range of health problems with exposure to only a small amount.
Risks: Cancer, heart disease, asthma, multiple sclerosis, diabetes
Major Sources: Contaminated buildings, food like peanuts, wheat, corn and alcoholic beverages

Phthalates: These chemicals are used to lengthen the life of fragrances and soften plastics.
Risks: Endocrine system damage (phthalates chemically mimic hormones and are particularly dangerous to children )
Major Sources: Plastic wrap, plastic bottles, plastic food storage containers. All of these can leach phthalates into our food.

VOCs (Volatile Organic Compounds): VOCs are a major contributing factor to ozone, an air pollutant. According to the EPA, VOCs tend to be even higher (two to five times) in indoor air than outdoor air, likely because they are present in so many household products.
Risks: Cancer, eye and respiratory tract irritation, headaches, dizziness, visual disorders, and memory impairment
Major Sources: Drinking water, carpet, paints, deodorants, cleaning fluids, varnishes, cosmetics, dry cleaned clothing, moth repellants, air fresheners.

Dioxins: Chemical compounds formed as a result of combustion processes such as commercial or municipal waste incineration and from burning fuels (like wood, coal or oil).
Risks: Cancer, reproductive and developmental disorders, chloracne (a severe skin disease with acne-like lesions), skin rashes, skin discoloration, excessive body hair, mild liver damage
Major Sources: Animal fats: Over 95 percent of exposure comes from eating commercial animal fats.

Asbestos: This insulating material was widely used from the 1950s to 1970s. Problems arise when the material becomes old and crumbly, releasing fibers into the air.
Risks: Cancer, scarring of the lung tissue, mesothelioma (a rare form of cancer)
Major Sources: Insulation on floors, ceilings, water pipes and healing ducts from the 1950s to 1970s.

Heavy Metals : Metals like arsenic, mercury, lead, aluminum and cadmium, which are prevalent in many areas of our environment, can accumulate in soft tissues of the body.
Risks: Cancer, neurological disorders, Alzheimer's disease, foggy head, fatigue, nausea and vomiting, decreased production of red and white blood cells, abnormal heart rhythm, damage to blood vessels
Major Sources: Drinking water, fish, vaccines, pesticides, preserved wood, antiperspirant, building materials, dental amalgams , chlorine plants

Chloroform: This colorless liquid has a pleasant, nonirritating odor and a slightly sweet taste, and is used to make other chemicals. It's also formed when chlorine is added to water.
Risks: Cancer, potential reproductive damage, birth defects, dizziness, fatigue, headache, liver and kidney damage.
Major Sources: Air, drinking water and food can contain chloroform.

Chlorine: This highly toxic, yellow-green gas is one of the most heavily used chemical agents.
Risks: Sore throat, coughing, eye and skin irritation, rapid breathing, narrowing of the bronchi, wheezing, blue coloring of the skin, accumulation of fluid in the lungs, pain in the lung region, severe eye and skin burns, lung collapse, reactive airways dysfunction syndrome (RADS) (a type of asthma)
Major Sources: Household cleaners, drinking water (in small amounts), air when living near an industry (such as a paper plant) that uses chlorine in industrial processes.

Study: Low-carb diet best for weight, cholesterol

Study: Low-carb diet best for weight, cholesterol
By MIKE STOBBE, AP Medical Writer Thu Jul 17, 7:23 AM ET

ATLANTA - The Atkins diet may have proved itself after all: A low-carb diet and a Mediterranean-style regimen helped people lose more weight than a traditional low-fat diet in one of the longest and largest studies to compare the dueling weight-loss techniques.

A bigger surprise: The low-carb diet improved cholesterol more than the other two. Some critics had predicted the opposite.

"It is a vindication," said Abby Bloch of the Dr. Robert C. and Veronica Atkins Foundation, a philanthropy group that honors the Atkins' diet's creator and was the study's main funder.

However, all three approaches ˜ the low-carb diet, a low-fat diet and a so-called Mediterranean diet ˜ achieved weight loss and improved cholesterol.

The study is remarkable not only because it lasted two years, much longer than most, but also because of the huge proportion of people who stuck with the diets ˜ 85 percent.

Researchers approached the Atkins Foundation with the idea for the study. But the foundation played no role in the study's design or reporting of the results, said the lead author, Iris Shai of Ben-Gurion University of the Negev.

Other experts said the study ˜ being published Thursday in the New England Journal of Medicine ˜ was highly credible.

"This is a very good group of researchers," said Kelly Brownell, director of Yale University's Rudd Center for Food Policy and Obesity.

The research was done in a controlled environment ˜ an isolated nuclear research facility in Israel. The 322 participants got their main meal of the day, lunch, at a central cafeteria.

"The workers can't easily just go out to lunch at a nearby Subway or McDonald's," said Dr. Meir Stampfer, the study's senior author and a professor of epidemiology and nutrition at the Harvard School of Public Health.

In the cafeteria, the appropriate foods for each diet were identified with colored dots, using red for low-fat, green for Mediterranean and blue for low-carb.

As for breakfast and dinner, the dieters were counseled on how to stick to their eating plans and were asked to fill out questionnaires on what they ate, Stampfer said.

The low-fat diet ˜ no more than 30 percent of calories from fat ˜ restricted calories and cholesterol and focused on low-fat grains, vegetables and fruits as options. The Mediterranean diet had similar calorie, fat and cholesterol restrictions, emphasizing poultry, fish, olive oil and nuts.

The low-carb diet set limits for carbohydrates, but none for calories or fat. It urged dieters to choose vegetarian sources of fat and protein.

"So not a lot of butter and eggs and cream," said Madelyn Fernstrom, a University of Pittsburgh Medical Center weight management expert who reviewed the study but was not involved in it.

Most of the participants were men; all men and women in the study got roughly equal amounts of exercise, the study's authors said.

Average weight loss for those in the low-carb group was 10.3 pounds after two years. Those in the Mediterranean diet lost 10 pounds, and those on the low-fat regimen dropped 6.5.

More surprising were the measures of cholesterol. Critics have long acknowledged that an Atkins-style diet could help people lose weight but feared that over the long term, it may drive up cholesterol because it allows more fat.

But the low-carb approach seemed to trigger the most improvement in several cholesterol measures, including the ratio of total cholesterol to HDL, the "good" cholesterol. For example, someone with total cholesterol of 200 and an HDL of 50 would have a ratio of 4 to 1. The optimum ratio is 3.5 to 1, according to the American Heart Association.

Doctors see that ratio as a sign of a patient's risk for hardening of the arteries. "You want that low," Stampfer said.

The ratio declined by 20 percent in people on the low-carb diet, compared to 16 percent in those on the Mediterranean and 12 percent in low-fat dieters.

The study is not the first to offer a favorable comparison of an Atkins-like diet. Research published in the Journal of the American Medical Association last year found overweight women on the Atkins plan had slightly better blood pressure and cholesterol readings than those on the low-carb Zone diet, the low-fat Ornish diet and a low-fat diet that followed U.S. government guidelines.

The heart association has long recommended low-fat diets to reduce heart risks, but some of its leaders have noted the Mediterranean diet has also proven safe and effective.

The heart association recommends a low-fat diet even more restrictive than the one in the study, said Dr. Robert Eckel, the association's past president who is a professor of medicine at the University of Colorado-Denver.

It does not recommend the Atkins diet. However, a low-carb approach is consistent with heart association guidelines so long as there are limitations on the kinds of saturated fats often consumed by people on the Atkins diet, Eckel said.

The new study's results favored the Atkins-like approach less when subgroups such as diabetics and women were examined.

Among the 36 diabetics, only those on the Mediterranean diet lowered blood sugar levels. Among the 45 women, those on the Mediterranean diet lost the most weight.

"I think these data suggest that men may be much more responsive to a diet in which there are clear limits on what foods can be consumed," such as an Atkins-like diet, said Dr. William Dietz, of the Centers for Disease Control and Prevention.

"It suggests that because women have had more experience dieting or losing weight, they're more capable of implementing a more complicated diet," said Dietz, who heads CDC's nutrition unit.