A lot is known about diabetes. But a discovery that could change how this disease is treated shows just how much more there is to learn. A team of Harvard Medical School researchers has discovered a hormone called betatrophin made by liver and fat cells that signals the body to make more insulin-producing beta cells. A report of their work appears in this month’s issue of the prestigious scientific journal Cell. In mice with diabetes, experimentally turning on the production of betatrophin inside liver and fat cells caused an increase in beta cells and a dramatic improvement in blood sugar. It will, of course, take much more research in mice—and then in humans—to determine if this newly discovered hormone can serve as a treatment for diabetes. So it’s too soon to get excited that the discovery of betatrophin will translate directly into a new treatment for diabetes. But it is another example of the human body’s power to naturally repair itself.
My twice-daily walks with my border collie, Clair DeNoon, are the highlights of my day. A new report from the American Heart Association will put an extra spring in my steps on these walks. A panel of experts from the American Heart Association has weighed all the available evidence on pet ownership and cardiovascular disease. The verdict: Having a pet—a dog in particular—likely lowers the risk of heart disease. Some of the connection can be attributed to the extra walks dog owners take. Companionship also contributes. If dog ownership is heart healthy, should everyone who cares about heart health have a dog? No. According to the heart association panel, “the primary purpose of adopting, rescuing, or purchasing a pet should not be to achieve a reduction in cardiovascular risk.”
With the unofficial start of summer just a few days away, many people will soon be stocking up on sunscreen. The products they’ll be seeing in stores look different than they have in the past. That’s because new rules for sunscreen labels are now in effect. The changes are good ones for consumers. The new rules, mandated by the FDA, are making sunscreen more informative with less misleading information. For example, the term “sunblock” is banned because none of these products can block all of the sun’s ultraviolet rays. “Waterproof” is also banned, replaced by “water-resistant”—which must be accompanied by a set time for reapplication. Another big change has to do with SPF, or sun protection factor. The best protection comes from a sunscreen that provides broad spectrum protection, meaning it filters out much of the UVA and UVB. Under the new FDA rules, if a label says “broad spectrum,” the product must pass tests proving that it truly protects against both UVA and UVB rays. Sunscreen products that don’t meet an SPF of 15 or higher for both UVA and UVB must now carry a warning.
Beginning in March, 2013, reports started to come out of Eastern China that a new “bird flu” virus was loose and causing infections in humans. The new virus is called H7N9. Should we in the U.S. be worried? Neither I nor anyone I know can give a confident answer to that question. So far the news is reassuring. A report from the U.S. Centers for Disease Control and Prevention (CDC), and another from a team from China in this week’s New England Journal of Medicine, indicate that so far the new H7N9 virus has not clearly spread from one person to another, and has not spread outside of Eastern China. Even so, every public health agency around the world is keeping a close eye on China. That’s because a virus that cannot spread easily from one person to another can change or swap genes—and suddenly be capable of spreading easily.
• Fast-food restaurants deliver filling, inexpensive meals and snacks. But there’s usually a hidden added cost: a wallop of salt (sodium) that isn’t good for cardiovascular health. Even with the current clamor for reducing sodium in the American diet, and industry promising to do just that, the amount of sodium in prepared foods hasn’t changed much since 2005, according to a report published in the latest issue of JAMA Internal Medicine. The average sodium in chain restaurant items increased 2.6% between 2005 and 2011. In packaged foods, it fell on average 3.5%. While some are calling for tighter government regulation on the sodium content in processed and restaurant foods, you can take action now.
Angelina Jolie revealed yesterday in a New York Times op-ed article that she underwent a double mastectomy even though she doesn’t have breast cancer. She did that because she carries a gene (BRCA1) that substantially increases her chances of developing the disease. Her mother’s 10-year losing battle with ovarian cancer helped guide her decision. Women who carry BRCA1, BRCA2, or who have at least two close relatives—a mother, sister, or daughter—who have had breast or ovarian cancer are candidates for prophylactic mastectomy. Some women who develop cancer in one breast often have both breasts removed to avoid a recurrence of the disease. Taking time to make the decision, and talking it over with a trusted and knowledgeable expert, is an important part of the decision-making process. Having as much information as possible before choosing prophylactic mastectomy is as empowering as making the decision itself.
In the past decade, a remarkable series of experiments from laboratories all over the world has begun to show what causes aging—and how to slow it. In the latest example of such aging research, two of my Harvard Medical School colleagues, cardiologist Richard T. Lee (co-editor in chief of the Harvard Heart Letter) and stem cell biologist Amy Wagers and their teams have found a substance that rejuvenates aging hearts in mice. The researchers joined the circulation of an old mouse with a thick, stiffened heart to that of a young mouse. After four weeks, the heart muscle of the old mouse became dramatically thinner and more flexible. The team then identified a substance called growth differentiation factor 11 (GDF11) as the probable “anti-aging” substance. It’s too soon to tell if this discovery will ever help humans with heart failure. But it reveals that there are substances naturally present in all living things that cause aging and that retard it. By understanding them, we may someday be able to slow aging.
As wait times to see a doctor for simple problems like sinusitis and urinary tract infection lengthen, more and more Americans are turning to retail health clinics—walk-in medical facilities located in pharmacies, grocery stores, and retailers such as Wal-Mart and Target. The number of visits to such clinics quadrupled from 1.48 million in 2007 to 5.97 million in 2009, according to a study published in the journal Health Affairs, and topped 10 million last year. Convenience is driving this migration to retail health clinics, since you can walk into a retail health clinic without an appointment, and many are open nights and weekends. Although most retail clinics focus on immunizations and common ailments such as strep throat and sinus infections, some are beginning to manage chronic conditions such as high blood pressure, diabetes, high cholesterol, and asthma.
Most reputable companies that provide services tell you what you’ll get for your money. Hospitals are an exception. They haven’t traditionally made public the cost of operations and other procedures. This secrecy has let hospitals set widely different prices for the same procedure. It’s also made it impossible to do any comparison shopping. Yesterday’s release to the public of a once very private database shows just how big the differences can be from hospital to hospital. The database, released by the Centers for Medicare and Medicaid Services, details what 3,300 hospitals charged for the 100 most common treatments and procedures in 2011. It data reinforce the big differences in charges from one part of the U.S. to another. What’s new and surprising are the huge differences sometimes seen between hospitals in the same city, or even the same neighborhood.
New Jersey Governor Chris Christie’s revelation yesterday that he had secretly undergone weight-loss surgery back in February shouldn’t come as a big surprise. He has been publicly (and privately) struggling with his weight for years and fits the profile of a good candidate for this kind of operation. In general, weight-loss surgery is appropriate for people with a body mass index (BMI) of 40 or higher, as well as for those with a BMI of 35 to 39.9 and a severe, treatment-resistant medical condition such as diabetes, heart disease, and sleep apnea, who had tried to lose weight other ways. Christie had a BMI of at least 41. He also acknowledged trying to lose weight many times, using different weight loss programs. He underwent laparoscopic gastric banding, also known as lap banding. There are also two other types of weight-loss surgery, gastric bypass and the gastric sleeve procedure.