December 11, 2009
NIH Podcast Episode #0099
Balintfy: Welcome to the 99th episode of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health—the nation's medical research agency. I'm your host Joe Balintfy. Coming up in this episode can you imagine a doctorís visit, without actually going to the doctorís office? Also, a new source for heart-healthy recipes just in time for the holidays, plus details on averting holiday weight gain. But first news about Alzheimerís Disease risk: scientists have identified two new gene variations. That's next on NIH Research Radio, right after this break.
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[PSA: Happy Holidays from the NIH Research Radio podcast! A couple holiday and anniversary notes for you: Weíre skipping a week for Christmas. Episode 99 stays on schedule, but after that the next edition will be available for download on Friday, January 1st, not December 25th. January 1, 2010 marks the 100th anniversary when weíll re-launch with new features, and continue every two weeks from then. Be sure to keep tuning in. Thanks for listening and Happy Holidays again from NIH Research Radio!]
Scientists Identify Two Gene Variants Associated with Alzheimer's Risk
Balintfy: A genome-wide association study is a research approach that involves rapidly scanning complete sets of DNA, or genomes, of many people. Researchers try to find genetic variations associated with a particular disease. Once new genetic associations are identified, researchers can use that information to develop better strategies to detect, treat and prevent the disease. Recently, the largest genome-wide association study reported to date involving Alzheimer's disease was completed. From the study, scientists have identified two new possible genetic risk factors for late-onset Alzheimer's, the most common form of the disease. Wally Akinso has this report.
Akinso: Scientists have identified two new possible genetic risk factors for late-onset Alzheimer's, the most common form of the disease.
Snyder: Like other diseases Alzheimerís disease is now believed to be rather complex disorder for which there are multiple genes that contribute to it.
Akinso: Dr. Steve Snyder is the deputy director of the National Institute on Agingís Division of Neuroscience.
Snyder: Weíre seeing multiple genes each with a minor effect summing to contribute to what maybe Alzheimerís disease but weíre still at the very earliest stages of working with that.
Akinso: In the largest genome-wide association study reported to date involving Alzheimerís disease, scientists pooled DNA samples from a number of European and U.S. groups. Dr. Snyder explains that increased risk for Alzheimerís disease was associated with variations in the sequence of two genes.
Snyder: One gene was the clusterin gene (CLU). It belongs to a family that weíre familiar with. And itís an apolipoprotein J. It helps get molecules into and out of the bloodstream and across barriers and into cells. Thatís one of the genes. The other gene was PICALM and what it is involved in is trafficking and moving molecules around within the cell.
Akinso: Dr. Snyder says another 13 gene variants were found that merit further investigation, adding that identifying gene variants advances understanding of Alzheimerís.
Snyder: If these findings are indeed validated it does put you a much better position to sort of find therapeutics, to find out what it is we can do to slow down or eliminate the disease.
Akinso: This study involved more than 16,000 DNA samples and the findings presented in a recent online issue of Nature Genetics. For more information in the study and Alzheimerís disease research, visit www.nia.nih.gov. This is Wally Akinso at the National Institutes of Health, Bethesda, Maryland.
The Future of Telemedicine
Balintfy: Telemedicine uses a range of technologies to provide medical care remotely. That technology includes standard telephone service plus high-speed, digital connections with computers, and other sophisticated equipment and software. Connecting like this has real benefits. But Kristine Crane reports that uses for telemedicine wouldnít just be a convenience.
Crane: Telemedicine provides healthcare for people from a distance. Currently, telemedicine connections exist in all fifty states, primarily remote areas.
Shannon: The priorities are the people who live at great distances from healthcare facilities in the larger urban areas.
Crane: Gary Shannon is a professor of Geography at the University of Kentucky who has been studying telemedicine for the past thirty years.
Shannon: Telemedicine can prevent people, especially the chronic elderly, from having to be re-admitted to hospitals so many times and having so many tests. Because they can be monitored in their home, so they donít have to go to the hospital.
Crane: Professor Shannon says that telemedicine saves money for both patients and healthcare providers.
Shannon: It certainly reduces costs for the patients in terms of having to travel and out of pocket costs and opportunity costs. But it also I think reduces the loads on the specialists and on the hospitals, and that they no longer are seeing people who really donít need to be seen, and so they have free time to really devote to people who really need to be seen.
Crane: Professor Shannon feels everyone could benefit from telemedicine, especially if it is used in preventative medicine.
Shannon: There are a number of studies in pediatric endocrinology using telemedicine to educate people in rural areas, to educate parents of obese children in how they should change their eating habits.
Crane: For people living in remote areas of the country who donít have access to healthcare, Professor Shannon says telemedicine can deliver quality medical care. He spoke at the National Library of Medicine as part of the History of Medicine Division Seminar. For more information on telemedicine, visit www.nlm.nih.gov. This is Kristine Crane at the National Institutes of Health, Bethesda, Maryland.
NHLBI Publishes New Heart Healthy Cookbook
Balintfy: The health of your heart is connected to what you eat. To help busy people and families shop for, prepare, and serve healthy meals, the National Heart, Lung, and Blood Institute created and published Keep the Beat Recipes: Deliciously Healthy Dinners. This isnít just a holiday gift idea: A healthy diet is a major factor in reducing the risk of heart disease. Janet de Jesus, Nutrition Education Specialist at the National Heart Lung and Blood Institute says studies show that heart health has a lot to do with food.
De Jesus: Heart disease is the number one killer and overweight is one of the risk factors; and we hope that by teaching people how to eat heart-healthy, that they can improve their heart health. So a nutritious diet combined with regular physical activity can help improve oneís heart health.
Balintfy: Some risk factors for heart disease cannot be changed, like age, gender and genes or race. But good nutrition is important to heart-health and can help control other risk factors. Controllable risk factors for heart disease include high cholesterol, high blood pressure and overweight. De Jesus says many studies, including the Framingham Heart Study, have shown how a poor diet increases heart disease risk, which is why the NHLBI developed a new cookbook, containing 75 heart-healthy recipes.
De Jesus: The recipes all follow heart-healthy guidelines so they're low in saturated fat, trans-fat, cholesterol, they're moderate in sodium, so they include fruits vegetables, whole grains, so all of these foods can help you keep your cholesterol levels, your blood pressure, your weight, in check; weíre hoping that people do this along with regular physical activity that it will help them improve their heart health.
Balintfy: De Jesus says the new cookbook, called Keep the Beat Recipes: Deliciously Healthy Dinners is designed for everyone.
De Jesus: Itís for anyone who wants to cook heart healthy and looking for tasty heart-healthy recipes. The dishes variety in flavor and cuisine and theyíre influenced by Asian, Latino, Mediterranean and American. And they really provide a satisfying portion while helping people stay within their calorie limits.
Balintfy: She adds that main dish meals take no more than 40 minutes to prepare and cook, and side dishes are made in 30 minutes or less. For more information on heart disease risk, healthy eating and the new cookbook, visit www.nhlbi.nih.gov. So you get the cookbook, have healthy recipes, but want more tips on keeping holiday weight gain down? Stay tuned, weíll have some expert input after this break.
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Healthy Eating for the Holiday
Balintfy: Have you heard that the average American gains about a pound during the holiday season? Not so bad, but studies show this additional weight accumulates through the years and could possibly lead to obesity later on Ė that pound doesnít tend to come off. To get more details on holiday weight gain, and tips to prevent it, we talked to a couple experts. One is Dr. Susan Yanovski, Executive Director of National Institute of Diabetes and Digestive and Kidney Diseasesí National Task Force on the Treatment and Prevention of Obesity. Jilliene Mitchell reviews holiday eating and a study on the topic in this interview.
Mitchell: Dr. Yanovski, why did you decide to conduct this study?
Dr. Yanovski: We had heard all of the stories that the average American gains five pounds, seven pounds over the holidays, but we really couldnít find any research to back it up. So, about five years ago, my husband and I decided we were actually going to see if this was true. We did a study, and we recruited about 200 folks, most of them within the NIH community, and had them come in and get weighed, four times over the course of the holiday season. They came in in the fall, then again before Thanksgiving, after the New Year, again in the spring, and we even brought some of them back the following year to look at one-year weight gain.
Mitchell: How were you able to ensure that the study subjects wouldnít alter their eating habits during the course of your experiment?
Dr. Yanovski: We fooled them a little bit, in that we didnít tell them we were studying weight gain; we told them we were just studying how changes in vital signs occur over the year. And what we found was the average person does not gain five pounds over the holidays, in fact, in the period between Thanksgiving and New Yearís, they gain a little bit less than a pound. Now, we always say this is a good news/bad news story, the good news is the average person gains only about a pound, the bad news is, they donít take that pound off again. In fact, over the course of a year, they gain even a little bit more, and so itís the kind of thing where you might not really notice a weight gain of a pound or so, but over time, thatís going to add up and probably contribute to the 20 or 30 pounds people gain over adulthood.
Mitchell: Thank you Dr. Yanovski. So the key is to keep that pound off, not just during the holidays, but year round, and thereís a campaign for that Ė it focuses on kids, but has useful tips for everyone. Dr. Karen Donato, Coordinator of the Obesity Education Initiative at the National Heart, Lung, and Blood Institute, can you explain, what is the WE CAN! campaign?
Dr. Donato: WE CAN! stands for Ways to Enhance Childrenís Activity and Nutrition. Itís a national education program from NIH, and its main focus is on helping parents and families maintain a healthy weight. So, we have an array of resources and products that are flexible, are science-based, and can be used in a variety of different settings.
Mitchell: Dr. Donato, what types of resources do you have available to parents who want to promote healthy lifestyles in their homes?
Dr. Donato: Well, because the focus of WE CAN! is on the importance of maintaining healthy weight, we have a handbook for parents, we have programs for parents, and the essence of those programs is teaching them about energy balance. Energy balance by maintaining an equal amount of calories in with the calories you burn up, you should be able to maintain a healthy weight.
Mitchell: But during the holidays, if I am going to eat dinner at a friendís house, how can I reduce the amount of calories I take in? I want to keep from feeling hungry.
Dr. Donato: That means, you know, starting off with those foods that might fill you up, but not provide you with lots of calories. For example, if you have a soup and a salad, prior to your main meal, youíre more apt to be full. If you have vegetables instead of second helping of mashed potatoes and gravy, youíre going to have fewer calories. And so, within the WE CAN! parent handbook, we provide parents with some of these tips that they can use at the holidays. In addition, another tip is the beverages that one consumes over the holidays are pretty high in calories, often. Sodas, alcohol, we encourage that people be mindful of the calories that they may be consuming in their beverages, and to choose water or unsweetened beverages, even low-fat or skim milk is a good option for children, rather than some of the sweetened beverages.
Mitchell: Dr. Donato, are there other things that people should think about prior to eating that holiday meal?
Dr. Donato: Another thing to be mindful of is the portion size. At the holidays, we have heaps and mounds of foods that are offered to us, either at home or when we go to parties, but to make sure that youíre mindful that one portion might be the size of a fist, and if you must have dessert, you might have a sliver of dessert. A small piece, a taste, rather than eating large portions or second portions of foods.
Dr. Yanovski: Itís okay to have the carrot cake or the turkey dinner, itís just—everythingís moderation. Iím not saying anything people donít really know in their heart of hearts, itís fine to have a slice of carrot cake, itís not fine to have the whole carrot cake.
Mitchell: So Dr. Yanovski, You can have a sip off eggnog, but not the whole carton.
Dr. Yanovski: Yeah, and you know, at any holiday dinner, there are going to be things that are just very ordinary and things that are very special, and I think one of the keys is, donít eat the cheese cubes, you know, 500 calories worth of cheese cubes, when you can get those at any time, but if thereís a very special, pumpkin pie or stuffing or something that you really enjoy, have that. Work it into your diet.
Mitchell: Going back to your study, Dr. Yanovski, were there other discoveries that you made through your research?
Dr. Yanovski: One of the things we looked at over the course of our study was who gained more weight, and also, how did people really prevent that weight gain? We found a couple of things. One is that people that who were already overweight or obese to start with, they were more likely to gain that five pounds over the holidays; so we need to recognize that if youíre already overweight, youíre at risk, and you need to be a little bit more careful than the average person. The other thing we found that was very interesting was, it wasnít how many parties you went to or, you know, how many calories you said you were taking in, but we found that people who said they were more active than usual over the holiday season, not only didnít they gain weight, they actually ended up losing a little bit of weight. So, it sounds as if, if you make a real effort to increase your physical activities over the holidays, that may be one way to prevent that excess weight gain.
Mitchell: Dr. Donato, are there topics covered in the WE CAN! parentís handbook and the youth curriculum that can help prevent excess weight gain?
Dr. Donato: The WE CAN! parents handbook and the WE CAN! youth curriculum focus on three behaviors. One is healthy eating, one is increasing physical activity, and the third is to decreasing screen time. And by screen time, we mean that we want to decrease the amount of time that children and youths spend in front of the television or computer screen doing video games, and that limitation is no more than two hours per day.
Mitchell: Dr. Yanovski, do you have anything else to add?
Dr. Yanovski: Youíll enjoy your foods more and your time with family more if youíre not feeling overstuffed.
Balintfy: Thank you Jilliene. And thatís it for this episode of NIH Research Radio. Again please note, weíre skipping a week: The next edition—our 100th anniversary episode—will be available for download on Friday, January 1st. Weíll be introducing a slightly new format, and new theme music, plus a new naming convention for our mp3 files. But from January 1st on, weíll continue every two weeks as usual with more episodes of NIH Research Radio. I'm your host, Joe Balintfy. Thanks for listening and Happy New Year from all of us at NIH Research Radio.
NIH Research Radio is a presentation of the NIH Radio News Service, part of the News Media Branch, Office of Communications and Public Liaison in the Office of the Director at the National Institutes of Health in Bethesda, Maryland, an agency of the US Department of Health and Human Services.