By Addition Treatment Magazine

Smoking is responsible for elevating multiple health risks, including heart disease and several types of cancer. For diabetics, however, the stakes are especially high. A new study has revealed that nicotine is responsible for blood sugar levels remaining high over an extended period of time in those who have diabetes and smoke.

The study was presented at the 241st National Meeting and Exposition of the American Chemical Society. The lead author, Xiao-Chuan Liu, PhD, is a researcher at California State Polytechnic University in Pomona California and presented the study’s results at the meeting. Liu stressed the importance of the findings, indicating that the results are the first to establish a clear link between nicotine and complications for diabetics.

Full story at Addiction Treatment Magazine

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By Emily Deans, M.D

Back in the day we ate a lot of brains. Stands to reason. All animals come with one, after all. And we certainly wouldn’t leave behind such a great source of important fat. You don’t think we just took the skinless boneless chicken breast and left the rest behind, did you?  In fact, anthropologic data suggests that the opposite is true – we preferentially grabbed the fatty bits (marrow, organ meats, fatty meat), and that we would also seek to hunt for particular animals in season when they were fattiest.  In fact if you were fastidious and ate only the lean meat, you might succumb to so-called “rabbit starvation,” where you have plenty of protein but suffer from malnutrition and hunger. Humans cannot live on protein alone.

Have you seen the movie Zombieland? I highly recommend it if you are into a bit of gore and fun, and while the dietary advice isn’t necessarily paleo, the exercise discussions take a functional fitness turn… (that last link is not entirely “safe for work,” as they say, due to some foul language).

Zombies might be lacking in variety with their chosen food, but they certainly wouldn’t be lacking in micronutrients and omega 3s! Brains are also an especially rich source of phospholipids, one of which, phosphatidylserine, was mentioned by a commenter on my other blog. She seems to have had luck with it helping her joint pain and fatigue. Terrific! But why?

Well, phospholipids are found in many foods, but the highest concentrations are in brains, seafood, and some organ meats. When one looks back at different hunter-gatherers roaming the world, they would tend to eat a lot of seafood, or they ate a lot of large land-roving mammals, or both. It would make sense that today we might have a lot less phospholipid intake compared to our evolutionary past. In fact, today’s foods contain about 1/3 the amount of phospholipids they did even at the beginning of the 20th century (1).

Research in phospholipids was heating up in the 80s and 90s, but then a little illness came along called mad cow disease, and since the major source of phospholipids for supplements was cow brain, things slowed down for a while until an alternative soy source was found. Not surprisingly, the soy sourced supplement is somewhat different than the animal sourced one, but looks like from perusing pubmed that almost all the latest research was done with the soy version. If you are not fond of soy, krill oil combines omega 3 and phospholipids, and since krill (or the algae they eat) are the food for marine animals from which many ancient humans got their phospholipids, it would certainly be a more evolutionarily pedigreed source than soy. Not keen on krill or pills in general? Eggs and chicken and beef heart have tons of choline, the precursor of the phospholipid phosphatidylcholine.

Phospholipids are necessary to form cell membranes and to form the particles that carry cholesterol around in the blood stream.  Who cares?  Well, if we don’t have enough of the precursors to make the phospholipids, the fat will get stuck in our livers, leading to the aptly named fatty liver.  Lack of choline, for example, has been associated with both fatty liver and the development of diabetes.  You might be interested to know that women eating the standard American diet have insufficient choline intake, and that the small percentage eating enough choline get it from eating an unusually high number of eggs.

But what does the research show about our brains and muscles? Do we suffer as human beings because we’ve greatly reduced our phospholipid intake, especially in the last century? Well, in sports performance studies, phospholipids can help reduce pain and speed up recovery. And supplementation can result in a statistically significant improvement in your golf shot (2). A study of memory and cognition in the elderly didn’t show any improvement using the soy-derived versions (3), though other earlier studies showed positive effects. But the most intriguing part of the research is when you find out that ingestion of phospholipids has been found to reduce increases in ACTH and cortisol in response to stress(4).  That is remarkable – it would imply that having plenty of phospholipids on board would diminish our total hormonal stress response, and decrease the damaging effects of chronic stress along the way.  Effects that would include an increased vulnerability to depression, anxiety, diabetes, and heart disease.

I’ve always wondered why we modern humans are considered so “stressed.” I mean, sure, we are probably way more stressed than the majority of our ancestors who worked obtaining food 17 hours a week and otherwise hung out and told stories and played games. But the most accepted pathophysiologic model for major depressive disorder and other mental illness is the stress diathesis model. Meaning stress combined with genetic vulnerability changes your brain and causes your symptoms. There’s a lot of research support for this model and it makes a great deal of sense. BUT. Mental illness has been increasing over the 20th and 21st centuries, especially depression. Maurizio Fava MD said in a lecture it is increasing on the order of 10% in each generation since the 1950s. That is HUGE. We know this (in America at least) from epidemiological catchment studies (5) done since the beginning of the 20th century.

But are we really more and more stressed? In the first 50 years of the 20th century, there were two world wars. Millions of people died from flu epidemics, and when my mother was a child, there was still constant fear of polio. By the 60s we were worried about global nuclear annihilation. Sure, now I have to remember 40 different passwords and traffic is pretty rotten, and we worry about terrorism and natural disasters and relatives with chronic illness, and men and women are still fighting wars, but is that more stressful than what families faced in the last century? Ot the centuries before, also ridden with war, plague, and famine?

I don’t think stress has changed so much, at least in recent history. Agricultural humans have always been unhealthy and stressed, and I don’t see how increases in cardiovascular disease and mental illness over the past 100 years could be explained *strictly* by a stress (cortisol) model.

I contend (as many do) that the MAJOR change in the last 100 years has been our industrialized diets. Agriculture is one thing, and not good for human health (though it did beef up human fertility). But industrialization of the food supply, I believe, is the primary causative factor in our modern physical diseases and our modern decline in mental health.

And here we have a bit of evidence that may bring diet and stress together at last. Phospholipid supplementation, in a few studies, decreases our stress response, especially to emotional stress. Imagine day after day of munching on mammal brains or atlantic herring, rich in phospholipids, and thus (if one believes the research) having a blunted hormonal response to emotional and physical stressors, compared to our relatively phospholipid deficient diets of today. Modern disease pathology is all about the cortisol, as much as it is all about the insulin.

We are built for eating brains and/or seafood (or eggs).  Ancestral migration patterns would seem to suggest that is the case. The farther we stray from achieving the micronutrient richness of our ancestral diets, the more we seem to suffer.

Source Psychology Today

Risk for Alcoholism Linked to Risk for Obesity


The researchers noted that the association between a family history of alcoholism and obesity risk has become more pronounced in recent years. Both men and women with such a family history were more likely to be obese in 2002 than members of that same high-risk group had been in 1992.

“In addiction research, we often look at what we call cross-heritability, which addresses the question of whether the predisposition to one condition also might contribute to other conditions,” says first author Richard A. Grucza, PhD. “For example, alcoholism and drug abuse are cross-heritable. This new study demonstrates a cross-heritability between alcoholism and obesity, but it also says — and this is very important — that some of the risks must be a function of the environment. The environment is what changed between the 1990s and the 2000s. It wasn’t people’s genes.”

Obesity in the United States has doubled in recent decades from 15 percent of the population in the late 1970s to 33 percent in 2004. Obese people — those with a body mass index (BMI) of 30 or more — have an elevated risk for high blood pressure, diabetes, heart disease, stroke and certain cancers.

Reporting in the Archives of General Psychiatry, Grucza and his team say individuals with a family history of alcoholism, particularly women, have an elevated obesity risk. In addition, that risk seems to be growing. He speculates that may result from changes in the food we eat and the availability of more foods that interact with the same brain areas as addictive drugs.

“Much of what we eat nowadays contains more calories than the food we ate in the 1970s and 1980s, but it also contains the sorts of calories — particularly a combination of sugar, salt and fat — that appeal to what are commonly called the reward centers in the brain,” says Grucza, an assistant professor of psychiatry. “Alcohol and drugs affect those same parts of the brain, and our thinking was that because the same brain structures are being stimulated, overconsumption of those foods might be greater in people with a predisposition to addiction.”

Grucza hypothesized that as Americans consumed more high-calorie, hyper-palatable foods, those with a genetic risk for addiction would face an elevated risk from because of the effects of those foods on the reward centers in the brain. His team analyzed data from two large alcoholism surveys from the last two decades.

The National Longitudinal Alcohol Epidemiologic Survey was conducted in 1991 and 1992. The National Epidemiologic Survey on Alcohol and Related Conditions was conducted in 2001 and 2002. Almost 80,000 people took part in the two surveys.

“We looked particularly at family history of alcoholism as a marker of risk,” Grucza explains. “And we found that in 2001 and 2002, women with that history were 49 percent more likely to be obese than those without a family history of alcoholism. We also noticed a relationship in men, but it was not as striking in men as in women.”

Grucza says a possible explanation for obesity in those with a family history of alcoholism is that some individuals may substitute one addiction for another. After seeing a close relative deal with alcohol problems, a person may shy away from drinking, but high-calorie, hyper-palatable foods also can stimulate the reward centers in their brains and give them effects similar to what they might experience from alcohol.

“Ironically, people with alcoholism tend not to be obese,” Grucza says. “They tend to be malnourished, or at least under-nourished because many replace their food intake with alcohol. One might think that the excess calories associated with alcohol consumption could, in theory, contribute to obesity, but that’s not what we saw in these individuals.”

Grucza says other variables, from smoking, to alcohol intake, to demographic factors like age and education levels don’t seem to explain the association between alcoholism risk and obesity.

“It really does appear to be a change in the environment,” he says. “I would speculate, although I can’t really prove this, that a change in the food environment brought this association about. There is a whole slew of literature out there suggesting these hyper-palatable foods appeal to people with addictive tendencies, and I would guess that’s what we’re seeing in our study.”

The results, he says, suggest there should be more cross-talk between alcohol and addiction researchers and those who study obesity. He says there may be some people for whom treating one of those disorders also might aid the other.

This work was supported by grants from the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse of the National Institutes of Health.

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Washington University School of Medicine.

A National Institute of Depression?

by Jonathan Rottenberg, Ph.D

I am reading Siddharta Murkherjee’s, wonderful, Emperor of All Maladies: A Biography of Cancer. One of the stories it tells is about the formation of the National Cancer Insitute in 1937. Here is the current mission statement of the NCI:

* Supports and coordinates research projects conducted by universities, hospitals, research foundations, and businesses throughout this country and abroad through research grants and cooperative agreements.
* Conducts research in its own laboratories and clinics.
* Supports education and training in fundamental sciences and clinical disciplines for participation in basic and clinical research programs and treatment programs relating to cancer through career awards, training grants, and fellowships.
* Supports research projects in cancer control.
* Supports a national network of cancer centers.
* Collaborates with voluntary organizations and other national and foreign institutions engaged in cancer research and training activities.
* Encourages and coordinates cancer research by industrial concerns where such concerns evidence a particular capability for programmatic research.
* Collects and disseminates information on cancer.
* Supports construction of laboratories, clinics, and related facilities necessary for cancer research through the award of construction grants.
which over time became a major institute within the National Institutes of Health.

In other words, the NCI is a national coordinating body for research and training to reduce the menace of cancer.

If we look across the National Insitutes of Health we see that many conditions have an institute. Alcohol has an institute. Drug Abuse does. Diabetes is covered. Stroke. Allergies. Check, check.

But not depression.

Depression is soon to become the emperor of all maladies. Serious depression affects nearly a fifth of the population and it is booming, especially in the young. If you need a call to action, look at the graph below from the National Comorbidity Study Replication, a comprehensive national survey of mental health in the United States. It shows that young people aged 18 to 29 have already experienced as much depression as people aged 60+, even though they have lived for less than half as long on planet earth.

Although it is hard to quantify the suffering caused by depression, it is straightforward to make sound estimates of its overall burden — for example the financial costs of lost work time and increased use of health care dollars. When you do the math, depression already ranks up there with the most burdensome disorders. The World Health Organization projects that in less than 10 years, depression will be the 2nd most burdensome condition. That’s greater, by the way, than cancer.

A National Institute on Depression makes sense not only because there is an urgent public health need but because there is so much about depression that we still don’t know. In my last post, I pointed out one striking example:  A recent search revealed only one well-designed  prospective study of the depressive prodrome (i.e., warning symptoms that herald depression). And much of our knowledge about depression isn’t well coordinated. We don’t do a good job of even knowing what we already know.

Poor integration of existing knowledge is one of the major limitations of the current national approach to depression. Thus, in addition to giving a new NID the broad mission along the lines of the NCI, it would be important for the NID to allow room for many approaches, not only the exclusive focus on genes and brains that has yielded relatively modest results so far but cognitive, sociological, and anthropological perspectives as well.

In our times of fiscal retrenchment, it’s easy to shoot down any new initiatives. But at the same time, wouldn’t keeping our current approach to depression be far riskier to the public health? and more costly in the long run? The time is right to make a modest investment to expand federal research on depression and bring together the work that’s currently done in several NIH insitutes (Mental Health, Aging, Child Health and Development) into a stand-alone National Insitute of Depression. If not now, when?

Sugar May Lessen Aggression

By RICK NAUERT PHD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on December 1, 2010

Have you ever wanted to calm someone down? Researchers say a spoonful of sugar may do the trick — at least for a short time, and if the friend is not a diabetic.

Investigators discovered people who drank a glass of lemonade sweetened with sugar acted less aggressively toward a stranger a few minutes later than did people who consumed lemonade with a sugar substitute.

Researchers believe it all has to do with the glucose, a simple sugar that provides energy.

“Avoiding aggressive impulses takes self-control, and self-control takes a lot of energy. Glucose provides that energy in the brain,” said Brad Bushman, Ph.D., an Ohio State University professor and a co-author of the study.

“Drinking sweetened lemonade helped provide the short-term energy needed to avoid lashing out at others.”

The finding is more than just a medical curiosity, Bushman said.

In two published papers, he and his colleagues did several studies showing that people who have trouble metabolizing, or using, glucose in their bodies show more evidence of aggression and less willingness to forgive others.

The problem is that the number of people who have trouble metabolizing glucose — mainly those with diabetes — is rising rapidly to put it mildly. From 1980 through 2008, the number of Americans with diabetes has more than tripled (from 5.6 million to 18.1 million).

“Diabetes may not only harm yourself — it is bad for society,” Bushman said.

“The healthy metabolism of glucose may contribute to a more peaceful society by providing people with a higher level of energy for self-control.”

Bushman conducted the lemonade study with C. Nathan DeWall and Timothy Deckman of the University of Kentucky and Matthew Gailllot of SUNY-Albany. It appears online in the journal Aggressive Behavior and will be published in a future print edition.

In the study, 62 college students fasted for three hours to reduce glucose instability. They were told they were going to participate in a taste-test study, and then have their reaction times evaluated in a computerized test against an opponent.

Half of the participants were given lemonade sweetened with sugar, while the others were given lemonade with a sugar substitute.

After waiting eight minutes to allow the glucose to be absorbed in their bloodstream, the participants took part in the reaction test.

The reaction test has been used and verified in other studies as a way to measure aggression. Participants were told they and an unseen partner would press a button as fast as possible in 25 trials, and whoever was slower would receive a blast of white noise through their headphones.

At the beginning of each trial, participants set the level of noise their partner would receive if they were slower. The noise was rated on a scale of 1 to 10 — from 60 decibels to 105 decibels (about the same volume as a smoke alarm).

Each participant randomly won 12 of the 25 trials.

Aggression was measured by the noise intensity participants chose on the first trial — before they were provoked by their partner.

Results showed that participants who drank the lemonade sweetened with sugar behaved less aggressively than those who drank lemonade with a sugar substitute.

Those who drank the sugar-sweetened beverage chose a noise level averaging 4.8 out of 10, while those with the sugar substitute averaged 6.06.

“To our knowledge, this is the first study to find that boosting glucose levels can reduce actual aggressive behavior,” Bushman said.

“To be sure, consuming sugar should not be considered a panacea for curbing aggression. But the results do suggest that people who reportedly ‘snap’ with aggression may need some way to boost their mental energy, so they can override their aggressive impulses.”

In two other studies in the same paper, the researchers showed how problems metabolizing glucose may translate to problems on a societal level. Using 2001 data, the researchers found that the diabetes rates for each of the 50 states were linked to violent crime rates.

Those states with higher diabetes rates also tended to have higher rates of murder, assault, rape and robbery, even after controlling for poverty rates in each state.

“This suggests that diabetes did not predict violent crime simply because poverty contributes to both diabetes and violent crime,” he said. “There is a real correlation between diabetes and violence.”

In a separate analysis, the researchers tested whether another medical problem related to glucose metabolism was linked to violence worldwide.

They examined the prevalence, in the populations of 122 countries around the world, of a deficiency in an enzyme called glucose-6-phosphate dehydrogenase. This enzyme is related to glucose metabolism. It is the most common enzyme deficiency in the world, afflicting more than 400 million people.

Countries with higher levels of the disorder also had more violent killings, even outside of war.

“Taken together, these studies offer different types of evidence linking low glucose and other problems metabolizing glucose with aggression and violence,” Bushman said.

The findings were further corroborated in another series of studies, published recently in the journal Personality and Individual Differences.

In that paper, Bushman and DeWall, along with University of Kentucky researcher Richard Pond, had participants complete a commonly used and well-accepted checklist that measures the number and severity of Type 2 diabetes symptoms, such as numbness in the feet, shortness of breath at night, and overall sense of fatigue. In three separate studies, the same participants completed different measures of their willingness to forgive others.

On all three measures, people with higher levels of diabetic symptoms were less likely to forgive others for their transgressions.

In a fourth study, participants took part in a prisoner’s dilemma game, which is often used to understand how people deal with conflict. In this version, participants had to choose whether to cooperate or compete against an unseen partner in a computer game.

“We were especially interested in how participants responded when their partner behaved in an uncooperative, antagonizing manner when the game began,” Bushman said. “Would they forgive their partner or would they refuse to cooperate?”

Results showed that those who scored higher on diabetic symptoms were less likely to forgive an initially uncooperative partner, when compared to those who scored lower on diabetic symptoms.

“These studies are more evidence that diabetic symptoms may cause difficulty in how people relate to each other on a day-to-day basis,” Bushman said.

“It’s not an excuse, diabetes does not mean people have to act aggressively, but it may shed some light on why these behaviors occur.”

“With the rate of diabetes increasing worldwide, it is something that should concern all of us.”

Source: Ohio State University