Overlooked "Brown Fat" Tied to Obesity

Scientists have thought that adults lack a type of fat called brown fat. New research shows that not only do adults have it, but it may play an important role in weight control.


A scanning electron micrograph of fat tissue. Image by David Gregory & Debbie Marshall. All rights reserved by Wellcome Images.
There are a least 2 different types of fat. Our bodies store energy primarily as white fat. When you consume too many calories, your body turns the excess into white fat. To lose weight, you generally have to use more energy than you take in, which makes your body tap into its stores and break down the white fat for energy.

Brown fat helps to maintain body temperature by burning up chemical energy to create heat. It’s found in small mammals like rodents throughout their lives. Human infants have it when they’re born, but we lose brown fat as we age. By adulthood, researchers thought, our brown fat was essentially nonexistent. However, it’s been difficult to actually measure brown fat.

A team of scientists at several institutions in Boston set out to measure brown fat directly. They detected uptake of a labeled sugar molecule in whole-body scans that used an imaging system called positron-emission tomography and computed tomography (PET–CT). Cells that take up the sugar are metabolically active. In fat tissue, that indicates the presence of brown fat. The team, led by Dr. C. Ronald Kahn at the Joslin Diabetes Center, was partly supported by NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

The researchers analyzed almost 2,000 patients for the presence of regions of brown fat that were at least 4 mm in diameter. In the April 9, 2009, edition of the New England Journal of Medicine, they reported that they detected brown fat in 76 of 1,013 women (7.5%) and 30 of 959 men (3.1%). Women also had more brown fat tissue and higher levels of sugar uptake. The most common area in which brown fat was detected was a region of the neck.
Notably, the less brown fat tissue the researchers detected, the higher the body mass index (a ratio of weight to height) tended to be, especially in older people. That suggests a potential role of brown fat in adult human metabolism.

Two companion papers published in the same journal issue complemented these findings. In one, a research team in the Netherlands reported detecting brown fat tissue activity in 23 of 24 men during cold exposure, but not at room temperature. The activity was significantly lower in the overweight and obese men than in the lean subjects. These results imply a role for brown fat in keeping the body warm.

In the other study, a team from Sweden found that labeled sugar uptake increased by a factor of 15 in the cold. Suspecting the presence of brown fat, the researchers took tissue biopsies and demonstrated the presence of active brown fat.

"Taken together, these studies show that a significant percentage of adults have active brown fat, and that it likely plays a role in regulating body temperature," says NIDDK researcher Dr. Francesco S. Celi, who wrote an accompanying editorial in the journal. "Stimulating this tissue to burn more energy may be a promising novel strategy for treating or preventing obesity."

—Harrison Wein, Ph.D.

Related Links:
Weight-control Information Network:
http://win.niddk.nih.gov
Aim for a Healthy Weight:
http://www.nhlbi.nih.gov/health/public/heart/obesity/aim_hwt.htm

OBESITY

The Pavlovian power of palatable food: lessons for weight-loss adherence from a new rodent model of cue-induced overeating

M M Boggiano1,1, J R Dorsey1, J M Thomas1 and D L Murdaugh1

1Behavioral Neuroscience Division, Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA

Correspondence: Dr MM Boggiano, Department of Psychology, University of Alabama at Birmingham, 415 Campbell Hall, 1300 University Blvd., Birmingham, AL 35394-1170, USA. E-mail: boggiano@uab.edu

1Former name MM Hagan.

Received 5 January 2009; Revised 6 March 2009; Accepted 7 March 2009; Published online 7 April 2009.


Abstract
Objective: Relapsing to overeating is a stubborn problem in obesity treatment. We tested the hypothesis that context cues surrounding palatable food (PF) intake have the power to disrupt caloric regulation even of less PF. Context cues are non-food cues that are in the environment where PF is habitually eaten.
Design: Rats were conditioned to associate intake of Oreo cookies as the PF to cages with distinct context cues that differed from cues in cages where they were only given chow. PF naturally stimulated greater caloric intake. The rats were then tested in the PF cage with only chow available to determine whether the PF-paired cues, alone, could elicit overeating of plain chow.
Subjects: Non-food-deprived female Sprague–Dawley rats.
Measurements: Intake of plain chow under PF-paired cues vs chow-paired cues was compared. This was also measured in tests that included a morsel of PF as a priming stimulus. We also controlled for any effect of binge-prone vs binge-resistant status to predict cued-overeating.
Results: Rats consumed significantly more chow when exposed to context cues paired earlier with PF than with chow (P<0.01). This effect occurred using various cues (for example, different types of bedding or wallpaper). The effect was strengthened by priming with a morsel of PF (P<0.001) and was unaffected by baseline differences in propensity to binge on PF.
Conclusion: Context-cues associated with PF intake can drive overeating even of a less PF and abolish the ability of rats to compensate for the calories of a PF primer. Just as drug-associated context cues can reinstate drug-addiction relapse, PF-paired cues may trigger overeating relapses linked to weight regain and obesity. This model should help identify the reflex-like biology that sabotages attempts to adhere to healthy reduced calorie regimens and call greater attention to the cue-factor in the treatment of binge eating and obesity.
Keywords: binge eating, craving, junk food, external cues, animal model

Grape Seed Extract May Help Neurodegenerative Diseases

Tauopathies—a group of neurodegenerative conditions such as Alzheimer's disease—have been linked to the build-up of "misfolded" tau proteins in the brain. (Tau proteins are associated with microtubules, which help to regulate important cellular processes.) In light of previous studies indicating that grape-derived polyphenols may inhibit protein misfolding, an NCCAM-funded research center at the Mount Sinai School of Medicine recently examined the potential role of a particular grape seed polyphenol extract (GSPE) in preventing and treating tau-associated neurodegenerative disorders.

The results of their in vitro study showed that GSPE is capable of interfering with the generation of tau protein aggregates and also disassociating preformed aggregates, suggesting that GSPE may affect processes critical to the onset and progression of neurodegeneration and cognitive dysfunctions in tauopathies.

An earlier study by the Mount Sinai researchers found that this GSPE reduced Alzheimer's-type neuropathology and cognitive decline in a mouse model of Alzheimer's disease and inhibited an Alzheimer's-linked process called cerebral amyloid deposition. In another recent study, the researchers used a variety of analytical techniques to further clarify how the GSPE affects Alzheimer's-related processes; an important finding was the extract's protective effects against cellular toxicity.

The researchers concluded that their laboratory findings, together with indications that this GSPE is likely to be safe and well-tolerated in people, support its development and testing as a therapy for Alzheimer's disease.

Electroacupuncture Relieves Cancer Pain in Laboratory Rats

Pain resulting from the spread of cancer to skeletal bone is the most common physical symptom in cancer patients and can severely disrupt their quality of life. Standard opioid treatments used to ease the pain can often cause serious side effects. Electroacupuncture (acupuncture combined with electrical stimulation) has been used to treat cancer pain; however, the existing data on its efficacy and how it works are unclear. In a recent study, NCCAM-funded researchers at the University of Maryland investigated the effects of electroacupuncture on cancer pain in rats and also looked at the underlying biomechanisms.

The researchers injected prostate cancer cells into the tibia (shinbone) of rats to induce cancer in the bone, gave them either electroacupuncture or sham electroacupuncture, and then subjected them to various pain tests. The results showed that compared with the sham control, electroacupuncture significantly reduced cancer-induced bone pain.

The researchers also examined the rats spinal cords to see whether electroacupuncture affected chemical processes thought to play a role in pain. They found that compared with the sham control, electroacupuncture inhibited up-regulation of two substances involved in these processes: spinal cord preprodynorphin mRNA and dynorphin. In a separate experiment, they found that injection of an antiserum against dynorphin also inhibited cancer-induced pain in the rats.

The researchers concluded that electroacupuncture eases cancer pain in rats, at least in part by inhibiting spinal dynorphin. They note that their findings support the clinical use of electroacupuncture in the treatment of cancer pain.

Reference
Zhang RX, Li A, Liu B, et al. Electroacupuncture attenuates bone cancer-induced hyperalgesia and inhibits spinal preprodynorphin expression in a rat model. European Journal of Pain. 2008;12(7):870–878.
Additional Resource
More information from NCCAM on acupuncture
Pain Control: Support for People with Cancer (National Cancer Insitute)

Acupuncture and Pregnancy

Acupuncture Shows Promise in
Improving Rates of Pregnancy Following IVF

A review of seven clinical trials of acupuncture given with embryo transfer in women undergoing in vitro fertilization (IVF) suggests that acupuncture may improve rates of pregnancy. An estimated 10 to 15 percent of couples experience reproductive difficulty and seek specialist fertility treatments, such as IVF. IVF, which involves retrieving a woman's egg, fertilizing it in the laboratory, and then transferring the embryo back into the woman's womb is an expensive, lengthy, and stressful process. Identifying a complementary approach that can improve success would be welcome to patients and providers.

According to Eric Manheimer of the University of Maryland School of Medicine's Center for Integrative Medicine and colleagues who conducted the systematic review, acupuncture has been used in China for centuries to regulate the female reproductive system. With this in mind, the reviewers analyzed results from seven clinical trials of acupuncture in women who underwent IVF to see if rates of pregnancy were improved with acupuncture. The studies encompassed data on over 1366 women and compared acupuncture, given within one day of embryo transfer, with sham acupuncture, or no additional treatment.

The reviewers found that acupuncture given as a complement to IVF increased the odds of achieving pregnancy. According to the researchers, the results indicate that 10 women undergoing IVF would need to be treated with acupuncture to bring about one additional pregnancy. The results, considered preliminary, point to a potential complementary treatment that may improve the success of IVF and the need to conduct additional clinical trials to confirm these findings.

References
Manheimer E, Zhang G, Udoff L, et al. Effect of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systematic review and meta-analysis. British Medical Journal. Published online February 2008.

Liberation Medicine Empowers Students, Patients in Developing Countries

It is difficult for most Americans to imagine the health challenges that people in developing countries routinely endure. With the myriad of diseases that surround them, one observer described daily life in underdeveloped parts of the world as "a game of Russian Roulette with five bullets in the chamber."



Bastyr student Jennifer Kaltunas defines
"liberation medicine" as "the conscious and conscientious use of health care to promote
human dignity and social justice."

Fortunately, groups like Doctors of Global Health, Doctors Without Borders and Natural Doctors International (NDI) have made it their mission to provide free health care to underserved populations around the globe. NDI, headquartered in Portland, Oregon, is an international medical volunteer organization for naturopathic physicians, chiropractors, acupuncturists, midwives, herbalists, students and other allied health professionals. The group brings natural medicine to global health in five main areas: clinical care, education, cross border collaboration, research and international policy.

Recently, a group of 10 naturopathic students from Bastyr University traveled to Nicaragua with NDI to study international health care in general, and the economic and political influences affecting Nicaraguans in particular. The students learned about "liberation medicine," which empowers patients to transform their environments in ways that promote health and sustainability. They set out to help improve working conditions, decrease the use of pesticides in crops, implement trash-reduction programs and schedule social activities to promote community cohesion.

One of the founders of NDI, Dr. Tabatha Parker, who now lives in Nicaragua permanently, began working with the students upon their arrival. Parker founded NDI in 2003 with two colleagues, Dr. Michael Owen and Dr. Laurent Chaix, to bring naturopathic medicine to underserved populations around the world. NDI provides free health care services by offering medical rotations and global health courses for licensed naturopathic physicians, chiropractors, acupuncturists, midwives, herbalists and medical students of all backgrounds.

The Bastyr students included brigade leader Jenny Nelson, Jamie Henrichsen, Jennifer Kaltunas, Aaron Morris, Kristin Neibling, Carrie Runde, Sheetal Shah, Eva Shen Kozura, Kate Short, and Suzanne Smokevitch. Of the 10, Jennifer Kaltunas and Eva Shen Kozura participated through the school's venture grant program, which is carried out through the student council. Grants of up to $1,000 per student are available to assist with travel costs – so long as the destinations provide an educational experience (academic or clinical) that will benefit them and the University. Once the students return from their travels, they are required to share their experiences with fellow students and faculty members.

Prior to their departure, the student brigade conducted several fundraisers and sought donations from naturalproducts companies. These efforts enabled them to bring $7,000 worth of tinctures and supplements with them, along with an EKG machine (the only one on the island where they worked). Both Shen and Kaltunas received $800 in venture grant funds to help defray their travel costs. Fellow student Jill Meyer also assisted in the fundraising efforts.

Bringing Medicine and Hope to Ometepe

On the Nicaraguan island of Ometepe, the student brigade worked for 10 days with Tabatha Parker, ND; Tania Neubauer, ND; Jum Nguyen, ND; and Ben Woodard, an herbalist, to treat patients in the Moyogalpa Center for Health, "the closest thing to a hospital" on the island. They set up a permanent office and a dispensary stocked with the 500 pounds of donated supplies they brought with them. The students worked alongside the doctors as they created treatment plans for 170, mostly elderly or very young patients. The team used physical medicine, along with fungal and parasite creams, herbal tinctures and ear drops, to treat a wide range of conditions, including pneumonia, muscle and joint problems, ear infections, heart disease, respiratory ailments and diabetes.

When they weren't working at the clinic, the students harvested organic tumeric and coffee to experience "a day in the life of an island farm worker." They attended classes to help them better understand cultural practices, local medicine and the political factors that created the region's poorly funded health care system. NDI is working with the Nicaraguan government to obtain United Nations status as a non-governmental organization (NGO), which would then provide international recognition for naturopathic health care.

"The goal is to work for change on a systemic level," Jennifer Kaltunas says. "For example, many of the patients have parasites and other illnesses related to the poor water quality and extensive use of pesticides on crops. NDI educates the people about these dangers while also working with the government and corporations to change the policies that lead to poor health."

Kaltunas defines "liberation medicine" as "the conscious and conscientious use of health care to promote human dignity and social justice." Practitioners focus their efforts on underserved populations that have limited access to health care. They identify the societal factors that contribute to poor health and empower patients by teaching them how to better care for themselves. They also work with political leaders to get to the root of what's going on and find ways to make things better.

Dr. Parker, who permanently resides in Nicaragua, recently married there and is now expecting her first child. "This is part of the liberation medicine piece," Kaltunas says. In order to truly help the people around her, she has completely assimilated into the culture to fully understand their circumstances.

Dr. Parker clearly understands that sustainability is a key component of liberation medicine. Many wellintentioned Westerners have brought programs to developing countries that cause more harm than good, once the organizers leave. Free trade (i.e., NAFTA and CAFTA) has not been good for Nicaraguans.

"Overall, American influence here has been negative," Kaltunas says. "It's caused a downward spiral for schools, jobs and health care. There's a lot of corruption as money is the primary motivating factor. Therefore, priority is given to whatever is going to be economically beneficial. Unfortunately, health care doesn't fall into that category."

Apricot Thumbprint Cookies

These delicious and fun-to-make cookies are perfect with afternoon tea. Variations in flavor can be made by substituting different nuts and juices as shown in the Orange Hazelnut adaptation below.

2 cups whole wheat pastry flour
1 cup almonds (ground into 1½ cup meal)
2 teaspoons baking powder
¼ teaspoon sea salt
1/3 cup cold-pressed vegetable oil or melted, unsalted butter
1/3 cup apricot juice (or apple)
1/3 cup maple syrup or concentrated fruit sweetener
1 teaspoon almond extract
½ teaspoon vanilla
Apricot preserves (fruit-sweetened)
Preheat oven to 350° F. Combine flour, almonds, baking powder, and salt in a mixing bowl; set aside. In a separate bowl, mix oil, juice, syrup, extracts together. Add wet ingredients to dry and mix well, kneading a little. Form dough into balls and flatten to make circles. Place on lightly oiled cookie sheet. Indent each cookie with your thumb or your child's thumb and put ½ teaspoon preserves in the imprint. Bake 15 minutes, until edges turn golden.

Preparation time: 30 minutes
Makes 24 cookies

Orange Hazelnut Thumbprint Cookies
Replace almonds with hazelnuts. Replace apricot juice with orange juice. Add ½ teaspoon orange zest to dry ingredients.

Effect of Yoga Training Package On Heart Patients

Yogacharya Vishwas Mandlik, Dr. Jayant Sohoni and Dr. Ramesh Varkhede
Yoga Vidya Dham, Kaivalya Nagari, Nashik (INDIA).

Background
Yoga, being the process of normalization, is studied since thousands of years. The daily practice of Yoga brings the various unbalanced systems of the body to normal state. Hence we planned to study the effect of Yoga Training Package on heart patients in this experiment.

Aim
This paper aims to study the effect of six months of regular practice of a package of selected yogic practices viz. Asanas, Pranayama, Meditation, Yoga Nidra and Omkar Chanting. ( one and half hours per day) on heart patients.

Subjects
We are teaching Yoga in our institution for the last 22 years including sick persons.

Out of these we have selected 23 Heart Patients for this experiment.

Design
We designed a special course for these heart patients which consisted of simple body movements in yogic style, some stretching Asanas, some types of Pranayamic breathing exercises and initial types of Meditation. We had included the daily practice of Yoga Nidra specially designed for heart patients and Omkar chanting in a particular fashion. The practice was continued for six months daily. The patients were thoroughly checked medically before and after the training and the results were compared.

Results and Discussions
It is observed that the blood pressure and blood cholesterol reduced considerably. It is also observed that the exercise time on stress test increased and number of METS reduced significantly. The patients ecperienced an overall relief of about 90%.

Key words : Heart disease, Yoga, exercise stress test, cholesterol, blood pressure.

Heart cells grow back, finds Indian doctor

3 Apr 2009, 0335 hrs IST, Vithal C Nadkarni, TNN

MUMBAI: A broken heart can mend itself, literally. In a discovery that opens up possibilities of helping people with serious cardiac ailments, an

international team of researchers that included a Canadian-born Indian neurosurgeon has found that the heart can regenerate itself.

Scientists hitherto believed that the heart never regenerates. "We have shown for the first time that the heart is capable of regeneration," Dr Ratan Bhardwaj - who gave primary inputs for the research under lab supervision of Jonas Frisen at Stockholm's Nobel Medical Research Institute - told TOI just after the research paper was published in the prestigious journal, Science. Bhardwaj, now at the University of Toronto, said the cells that regenerate, called cardiomyocytes, comprise 20% of the total heart tissue. They are also responsible for the crucial pumping action.

Calling the finding a "myth breaker and a paradigm shifter in science", Bhardwaj said it opens doors to future stem cell therapeutics and regenerative strategies. "It would be great if researchers could understand this mechanism better and possibly devise a pill to boost the regeneration of the organ especially after a heart attack or chronic heart failure," he said.

The 35-year-old doctor said, "You are actually having your own body heal itself. It's akin to the skin healing after a cut or the bones joining after a fracture. So wouldn't it be great to find a way to heal your heart when it literally breaks, or fails? That's the beauty of this experiment."

The research used carbon dating to track DNA molecules within heart cells to show that new cells were being produced.

"For the first time, we were able to see and show that the heart actually is continuously making and replenishing new heart cells."

Radio carbon dating is a technique used to determine the age of anything from the bust of the Mohenjodaro Priest to that of Queen Nefertiti. "But the body uses During the Cold War, the rash of nuke-testing released huge amounts of radioactive C-14 in the atmosphere. This got mixed up with carbon dioxide in the atmosphere that plants used up in photosynthesis. "Humans and animals ate the plants; so the C-14 went into our system. Now could this somehow be tracked, we wondered. With that leap of logic, we zeroed in on the DNA molecule which ought to be fixed from the time when the cell was made, barring very negligible amounts of turnover, so if one could carbon date the DNA from a specific set of cells, one could find out how old that cell was," Bhardwaj said.

"In terms of actually doing it, however, it was a long shot, very expensive. Not a lot of groups are able to do this: start with a whole human heart, separate the heart cells - the crucial 20% - from the rest; purify the DNA; send to lab to measure the C 14 content. One speck of dust in the sample can totally wreck the data. So we were not too worried about competing with many other labs," he said.

The beating heart that's responsible for pumping blood is made up of cardiomyocytes which comprise about 20% of the cells. The rest are largely support cells of the matrix. Bhardwaj said, "Now, as we grow in age and size, this amazing cell has long been known to 'hypertrophy', that is, get bigger with function. We were able to show that it grows in number as well."