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How we can stop stress from making us obese

Contact: Dr. Branwen Morgan
b.morgan@garvan.org.au
61-043-407-1326
Research Australia

Professor Herbert Herzog, Director of the Neuroscience Research Program at the Garvan Institute of Medical Research, together with scientists from the US and Slovakia, have shown that neuropeptide Y (NPY), a molecule the body releases when stressed, can ‘unlock’ Y2 receptors in the body’s fat cells, stimulating the cells to grow in size and number. By blocking those receptors, it may be possible to prevent fat growth, or make fat cells die.

“We have known for over a decade that there is a connection between chronic stress and obesity,” said Professor Herzog. “We also know that NPY plays a major role in other chronic stress-induced conditions, such as susceptibility to infection. Now we have identified the exact pathway, or chain of molecular events, that links chronic stress with obesity.”

“There is not much we can do about the increased levels of NPY caused by stress, but we can do something about the damage it causes. If we can interfere before it causes fat to amass, it could have a major impact on cardiovascular disease, diabetes, and cancer (which all have links with obesity).”

“Basically, when we have a stress reaction, NPY levels rise in our bodies, causing our heart rate and blood pressure to go up, among other things. Stress reactions are normal, unavoidable, and generally serve a useful purpose in life. It’s when stress is chronic that its effects become damaging.”

Scientists at Georgetown University (Washington D.C), part of this collaborative study, have found a direct connection between stress, a high calorie diet and unexpectedly high weight gain. Stressed and unstressed mice were fed normal diets and high calorie (high fat and high sugar, or so called ‘comfort food’) diets. The mice on normal diets did not become obese. However, stressed mice on high calorie diets gained twice as much fat as unstressed mice on the same diet. The novel and unexpected finding was that when stressed and non-stressed animals ate the same high calorie foods, the stressed animals utilised and stored fat differently.

“Our findings suggest that we may be able to reverse or prevent obesity caused by stress and diet, including the worst kind of obesity; the apple-shaped type, which makes people more susceptible to heart disease and diabetes,” says senior author of the Nature Medicine paper, Professor Zofia Zukowska of Georgetown University. “Using animal models, in which we have either blocked the Y2 receptor, or selectively removed the gene from the abdominal fat cells, we have shown that stressed mice on high calorie diets do not become obese. “Even more surprisingly, in addition to having flatter bellies, adverse metabolic changes linked to stress and diet, which include glucose intolerance and fatty liver, became markedly reduced. We do not know yet exactly how that happens, but the effect was remarkable,” she said.

Professor Herzog believes that these research findings will have a profound effect on the way society will deal with the obesity epidemic. “There are millions of people around the world who have lived with high levels of stress for so long their bodies think it’s ‘normal’. If these people also eat a high fat and high sugar diet, which is what many do as a way to reduce their stress, they will become obese.”

“Until now, the pharmaceutical industry has focused on appetite suppressants with only moderate success. Our hope is that in the near future pharmaceutical companies, using the results of our research, will develop antagonists against the Y2 receptor that will bring about a reduction in fat cells.”

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Notes to editors:

Stress-activated adipogenic pathway in fat tissue exaggerates diet-induced obesity and metabolic syndrome.
Kuo, L.E., Kitlinska, J.B., Tilan, J.U., Li, L., Baker, S.B., Johnson, M.D., Lee, E.W., Burnett, M.S., Fricke, S.T., Kvetnansky, R.K., Herzog, H. & Zukowska, Z.
Nature Medicine advance online publication, 1 July 2007

The study was co-funded by the National Institutes of Health, the American Heart Association, and the Slovak Research and Development Agency.

ABOUT GARVAN

The Garvan Institute of Medical Research was founded in 1963. Initially a research department of St Vincent’s Hospital in Sydney, it is now one of Australia’s largest medical research institutions with approximately 400 scientists, students and support staff. Garvan’s main research programs are: Cancer, Diabetes & Obesity, Arthritis & Immunology, Osteoporosis, and Neuroscience. The Garvan’s mission is to make significant contributions to medical science that will change the directions of science and medicine and have major impacts on human health. The outcome of Garvan’s discoveries is the development of better methods of diagnosis, treatment, and ultimately, prevention of disease.

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July 2, 2007 Posted by | Alberta, Baltimore, Calgary, Cancer, Cardiovascular Disease, Chronic, Chronic Stress, Chronic Stress and Obesity, Complex Chronic Conditions, Diabetes, Garvan Institute of Medical Research, Global, Global Health Vision, Global News, Heart Disease, Iraq, Irvine, Neuropeptide Y, News, News Australia, News Canada, News Israel, News Jerusalem, News UK, News US, News USA, Obesity, Osaka, Research, Research Australia, Slovakia, Spain, Virginia, WASHINGTON, Washington DC, World News | Leave a comment

Online education program better source of information for patients

Contact: Karen Astle
karen.astle@heart.org
214-706-1392
American Heart Association

American Heart Association meeting report

WASHINGTON, May 11 – Patients who used the American Heart Association’s online heart disease education program were more aware of treatment options than other patients, researchers reported at the American Heart Association’s 8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

Those who used Heart ProfilersTM — the American Heart Association’s Internet-based education program developed with Thomson Healthcare — also were more likely to ask their doctors about their care, according to survey results. Researchers examined the association between use of the Heart Profilers program and patient knowledge and behavior. Patients with coronary artery disease (CAD), atrial fibrillation (AF), heart failure (HF), high cholesterol or hypertension who registered to use Heart Profilers were invited to answer an Internet questionnaire. Their responses were compared with a randomly selected control group who had not used the Heart Profilers.

“Patients who used the Heart Profilers, particularly those with HF and AF, reported a greater understanding of their heart medications than other heart patients who used other Internet sources,” said Ileana Piña, M.D., professor of medicine at Case Western Reserve University and senior author on the study.

“Patient education and empowerment are key pathways in reducing complications of cardiovascular disease,” she said.

“The Heart Profilers tool empowers patients to take control and manage their condition by providing personalized information in lay language so patients have a complete picture of their condition and treatments relevant to their diagnosis profile.”

Chronic disease is an ever-growing problem among patients with heart disease. Patient education is critical for improving compliance and for patients to partner with their health care providers in managing their own cardiovascular issues. The Heart Profilers provide accurate information in lay language in the safe setting of the home.

Upon registration with Heart Profilers, patients are asked to complete a questionnaire to receive a free, confidential, personalized treatment options report. Users receive information, based on peer-reviewed, scientifically based literature, regarding success rates of various treatment options, potential medication side effects and questions to ask their healthcare providers. Patients also have access to medical journal abstracts and research studies written in an easy-to-understand format.

“Again, this format takes the patient to accurate and up-to-date information,” Piña said. “Other Internet sites may be replete with misinformation. It may be difficult for the average patient to separate accurate education from false information. The trust in the American Heart Association allows them to be confident in what education they receive and access for themselves.”

Researchers divided respondents into three groups: those who completed the Heart Profiler questionnaire (users), those who registered but did not complete it (registrants) and a control sample of non-users with one of the five heart conditions, who were identified via a nationally representative telephone survey, (controls). There were 1,039 users, 389 registrants and 1,564 controls.

Users and registrants were younger (average age 53.9 and 55.9 years) versus controls (average age 64.4). Nearly half of users and registrants held a four-year college degree, compared to one-third of controls. Users took 2.8 heart medications, registrants took 3.0 and controls 2.3. However, they had a similar number of heart conditions.

Consistent with their greater understanding of medications, HF and AF patients reported a greater tendency to use their medications as prescribed by their doctor, researchers said.

“It’s beneficial for patients to be educated in this way,” Piña said. “When patients understand the different treatment options available to them, they can become more active participants in their healthcare decision-making by asking appropriate questions and understanding what their doctor is telling them.

“In essence, when there is a two-way dialogue between patient and doctor (referred to as ‘shared decision-making’), there is a greater chance that patients believe treatment decisions made with the doctor are the best for them personally. When patients believe the treatment is the right one, they will be more likely to stick with it,” she added.

“This is the same logic for having better knowledge about medications — if you believe in the necessity and importance of the medication, you will be more likely to take it as prescribed,” Piña said.

According to researchers, users were 1.58 times more likely than controls to be aware of four or more AF treatments. And they were 1.56 times more likely to ask their doctors about medications or treatments that they had heard about outside the doctor’s office.

Heart Profilers seemed to benefit patients with HF and AF more than others, possibly because “HF and AF are more chronic conditions, so they have a greater impact on overall health and functioning and patients may be more symptomatic,” Piña said. “Patients literally feel these conditions more, whereas you don’t feel high cholesterol. Therefore, when patients with HF and AF access the Heart Profilers, they may be ready to make more active use of the information provided than other patients. Physicians are increasingly expected to provide education for patients with chronic cardiovascular diseases. Heart Profilers can serve as a powerful adjunct for physicians to recommend to their patients, as well.”

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Co-authors are lead author Kathleen A. Foley, Ph.D.; Gayle R. Whitman R.N., Ph.D. and Karen Robb. Disclosure: Thomson Healthcare, co-developer of the Heart Profilers, is the leading provider of decision support solutions that help organizations across the healthcare industry improve clinical and business performance. Thomson Healthcare products and services help clinicians, hospitals, employers, health plans, government agencies and pharmaceutical companies manage the cost and improve the quality of healthcare. Thomson Healthcare is a part of The Thomson Corporation.

Editor’s Note: Patient and Professional Heart Profilers® have been developed for the following topics: Coronary Artery Disease (CAD), Heart Failure, Atrial Fibrillation, Cholesterol and High Blood Pressure (HBP). These tools can be accessed on the American Heart Association main Web site at americanheart.org/heartprofilers.

Statements and conclusions of abstract authors that are presented at American Heart Association/American Stroke Association scientific meetings are solely those of the abstract authors and do not necessarily reflect association policy or position. The associations make no representation or warranty as to their accuracy or reliability.

Note: Presentation time is 9:30–11 a.m. EDT, May 11, 2007.

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May 11, 2007 Posted by | American Heart Association, Cardiovascular Disease, Global, Global Health Vision, Global News, News, Stroke, WASHINGTON, Washington DC | 1 Comment