Hydrogenated Fats Kill 30,000 Americans A Year

In a new review of research studies conducted over the last decade, Harvard scientists confirm that trans fats in our diets kill almost as many Americans each year as automobile accidents. Trans fatty acids, which are created when vegetable oils are partially hydrogenated, increase the risk of coronary heart disease (CHD) and cause 30,000 of the 500,000 deaths caused by blood vessel damage each year. Researchers at the Harvard School of Public Health and the Wageningen Centre for Food Sciences in the Netherlands published their research review in the June 24 New England Journal of Medicine.

The Harvard research covered more than 25 studies that show among other things that trans fats increase low-density lipoprotein cholesterol (LDL--"bad cholesterol") and decrease high-density lipoprotein cholesterol (HDL--"good cholesterol"). The research tracked the link between people's eating habits and the occurrence of CHD later in their lives. These studies found a link between the intake of trans fats and CHD that was higher than expected, suggesting that all the ways that trans fats increase the risk of CHD may not be yet understood.

Trans fats are solid at room temperature and are stable for long periods of time on the shelf. Polyunsaturated fatty acids have a turn or twist in their structure, but always in one direction, which helps keep them fluid at room temperature. In the hydrogenation process, they are heated to remove some of the double bonds that keep them fluid. However, when this heating occurs, many of the fats are bent in the wrong or trans direction. Human enzymes do not break down these abnormal structures. Today, hydrogenated oils are used for deep fat frying in most restaurants, they make up most margarines, and are also used in many commercially baked goods.

Researchers have been aware of this danger for many years, but the public is less aware of the danger of trans fats, and many consumers think that if a label says a product is low in cholesterol and saturated fat, it is heart healthy. But these same products often contain dangerous levels of trans fats. The Food and Drug Administration is considering new regulations for nutrition labels requiring manufacturers to report the amount of trans fatty acids.

In the review Alberto Ascherio, associate professor of nutrition and epidemiology at the Harvard School of Public Health, urges the food industry to replace partially hydrogenated fats with fats that are not hydrogenated to reduce the risk of CHD.

Overtime And Stress Greatly Increase Risk Of Type 2 Diabetes

The results of an eight year study in an electrical company in Japan (Independent Health, 1999 Apr; 37(2): 174-86) shows that Japanese men who work more than 50 hours a week are 3.7 times more likely to develop Type 2 diabetes than men who work fewer hours. The study also found that men who work with new technology have a 2.4 times higher risk of Type 2 than other workers.

The goal of the study was to determine the effects of overtime and psychosocial job conditions on the occurrence of Type 2 diabetes. To do this, 2597 men in an electrical company were followed for eight years. The men had no diabetes or other chronic disease when chosen. Data from an annual screening program on 84% of the men was assessed based on the WHO criteria for Type 2 diabetes. The study concludes that longer work hours and new technology are significant risk factors for Type 2 diabetes in Japanese men.

Another paper published in March, 1999 issue of Diabetes Care reviews research studies over the past 15 years on psychosocial job stress and its effect on health in Japan. Job stressor scales have been translated into Japanese, and their psychometric properties tested and extensively used in recent epidemiologic studies. While the impact of overtime and quantitative job overload on mental health seems moderate, long working hours were associated with a higher risk of myocardial infarction, diabetes mellitus and hypertension. Clotting, blood sugar levels, immune function, and number of health care visits were also affected by job stress.

Germany Shows Widespread Intensified Treatment Has Benefits

The German Diabetes Association formed a working group (Arbeitsgemeinschaft Strukturierte Diabetestherapie [ASD]) of 57 general internal medicine departments in city and country hospitals throughout the country. Participating institutions performed a structured program of intensive treatment and education for all type 1 diabetes patients who were referred to them on a routine basis. The program included either multiple daily insulin injections or continuous subcutaneous insulin infusion, frequent blood sugar testing and self-adjustment of insulin dosages and other treatment by the patients, plus liberalization of diets.

After the member institutions collected outcome data for more than a year, the 1997 evaluation of 1,103 type 1 diabetic patients, showed significant decreases in HbA1c levels, a halving of severe hypoglycemia from 0.35 to 0.16 cases per patient-year, and an even greater drop in ketoacidosis from 0.08 to 0.02 cases per patient-year. Our only question is why isn't this being done in the United States?

Obesity Is A Leading Cause Of Premature Death In The US

The results of a study of over a million people published in the New England Journal of Medicine confirms that being overweight is associated with a shorter life span.

Obesity is one of the most prevalent public health problems in the United States and is a serious, growing epidemic, not only in the United States but throughout the world. The epidemic is fed by unhealthy nutrition habits and inadequate physical activity. In the United States, approximately 300,000 deaths a year are attributed to obesity, making it second only to smoking as a cause of death.

To emphasize the importance of this, the American Association of Clinical Endocrinologists have established an AACE Obesity Task Force which has developed the ``AACE/ACE Position Statement on the Prevention, Diagnosis and Treatment of Obesity.''

The AACE outlines the management of obesity in the objectives of its position statement. Physicians and the health care community need to:

• Become aware that obesity is a disease
• Increase knowledge of the prevention, diagnosis, consequences, and treatment of obesity
• Promote obesity prevention and treatment programs and their long-term effectiveness
• Develop and direct physician-led, multi-disciplinary teams to care for the obese patient
• Encourage the the availability of and payment for the services needed by obese patients
• Reduce the prevalence of obesity.

Even Slight Weight Reduction Improves Health

Overweight individuals make up more than 50% of the adult population, but most people are not taking it very seriously. Part of the problem seems to be that people think they have to drastically reduce their body weight to improve their health. Since this is a long term, difficult proposition, many people simply aren't hopeful about improving their health by losing weight.

But a study published in the October issue of the American Journal of Public Health shows that losing even a small amount of weight, say 10%, produces significant health benefits.

The investigators found that a weight loss of only 10% reduced heart disease risk significantly from 50 to 38 cases per every 1,000 individuals. Individuals who lose 10% and keep it off can expect to save $5,200 in medical costs over their lifetime because they are not treating as much hypertension, diabetes, or heart disease. In addition, life expectancy increases anywhere from 2 to 7 months in men, and 2 to 5 months in women.

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