In An Unregulated World, Dogs Take Over

Paleontologist Tim Heaton holds a plastic cast of a human lower jaw at the site of a cave dig on Prince of Wales Island.

Natives’ DNA may match cave man’s

ADN.COM, by George Bryson — Tlingit, Haida and Tsimshian Indians gathering in Juneau today will get a chance to prove they’re directly related to one of the very first Alaskans — a 10,300-year-old mariner whose bear-chewed bones were discovered a decade ago in a cave on Prince of Wales Island.

In return, molecular anthropologists collecting the participants’ DNA hope to add to their knowledge about how the earliest Americans spread across the western hemisphere — possibly along a coastal sea route — in spite of the ice-choked plains.

First, however, they’ll have to gather a little saliva, about a single milliliter per customer, by inducing potential relatives of the ancient Alaskan to spit into a laboratory test tube.

The fact that Southeast Native elders approve of the experiment — just as they earlier endorsed requests to examine the human remains — contrasts sharply with the protests and pitched legal battles Indian leaders in Washington state waged over the fate of “Kennewick Man,” the 9,000-year-old Columbia River skeleton.

Tlingit elder Rosita Worl, president of the Sealaska Heritage Institute — the Southeast Alaska Native nonprofit group that’s helping stage the study — partially credits the institute’s Council of Traditional Scholars.

“When this 10,300-year-old person was found on Prince of Wales, the way it was interpreted was that we had one of our ancestors offering himself to give us knowledge,” Worl said. “They were also saying that if our culture is going to survive and flourish, then we have to be receptive to science.”

It was a former Alaska scientist named Tim Heaton, a paleontologist, who discovered the ancient bones in 1996. He’d been conducting an archaeological survey on the northern tip of Prince of Wales Island — about 140 miles south of Juneau — in a place called On Your Knees Cave.

The bones themselves were few and superficially unimpressive: a molar-filled jaw recovered in two pieces, the partial remains of a pelvis, three ribs, some vertebrae, a scattering of teeth.

Lead archaeologist E. James Dixon initially dated the bones at more than 9,000 years old, making them the oldest human remains ever discovered in Alaska or Canada. And with Heaton’s help, he began to piece together the cave man’s story.

The teeth indicated he died in his prime, possibly early to mid-20s. The content of his bones revealed that his primary food came from the sea. The nearby stone tools — consisting of materials not found on the island — suggested a long-distance traveler. And his final resting place filled with bear bones (including the femur of a 35,000-year-old grizzly), coupled with signs that his own bones had been chewed on by a large carnivore, spoke of dying a violent death.

Most importantly, however, the evidence indicated that On Your Knees Cave man was a prime example of a relatively new theory about how the first people may have spread across the Americas, even before the last ice age ended.


Scientists used to think migrating groups simply walked across the 1,000-mile-wide Bering Land Bridge and bided their time around present-day Fairbanks — at least until about 12,000 years ago, when the glaciers that blocked the center of the continent finally began to melt, opening an ice-free corridor south.

But that long-accepted migration theory has grown problematic of late, as scientists keep discovering evidence of earlier Americans living south of Alaska — including humans in Monte Verde, Chile, 12,500 years ago, and on an island off California 13,000 years ago, and inside a coastal Oregon cave 14,300 years ago.

They could have got there, some scientists believe, simply by paddling the coast. One who thinks so is Washington State molecular anthropologist Brian Kemp, who spent two years as a graduate student trying to tease DNA from On Your Knees Cave man’s bones. Eventually he succeeded, using a tooth — specifically dated at 10,300 years old — which yielded the oldest DNA sample in the western hemisphere.

Examining it for mitochondria DNA — the genetic marker passed down through millennia only by mothers– Kemp determined that the Prince of Wales man was a member of Haplogroup D, one of five genetic groups that comprise all Native Americans.

But only about 15 out of every 100 Native Americans who’ve been sampled are Ds. Among them are very few Native Alaskans. There no known Tlingits, Haidas, Athabascans or Inupiats, though about two-thirds of sampled Aleuts are Ds and, so far, one Yupik.

Kemp, however, took his DNA study one step further by classifying On Your Knees Cave man into a narrower genetic subgroup known as D3H4 — which represents less than 2 percent of all Native Americans. Then he located all members of the subgroup on a map, drawing upon prior genetic studies of both living and deceased Native Americans.

What emerged was the image of nearly all of On Your Knees Cave man’s closest genetic relatives clinging to the West Coast from California to the tip of Argentina — perhaps mirroring an ancient pathway south.

“I thought that was fantastic,” said Kemp, whose study was published last year in the American Journal of Physical Anthropology. “It was evidence of a coastal migration.”


Kemp himself was scheduled to travel the coast this week — to Juneau, where he hopes to gather more DNA. According to Worl, the scientists should have pretty good luck.

The Sealaska Heritage Institute has been actively promoting the research as part of its biennial Celebration 2008 festivities, which began Thursday and conclude on Saturday. More than 5,000 Native Alaskans are expected to attend the celebration.

Chances that any of them who participate in the DNA study will turn out to be directly related to On Your Knees Cave Man are relatively slim, Kemp said, partly because populations move around so much (the Tlingit and Haida people, for example, are closely related linguistically to Interior Athabascans and may have moved to Alaska a few thousand years ago from a home farther south).

According to Kemp’s research, part of what happened in the Americas is this:

Some of the caveman’s relatives decided to head south from Alaska. Members of his specific genetic lineage have been found among the Chumash people of Southern California, the Cayapa of Ecuador and the Yaghan of Tierra del Fuego.

The fact that most of them landed at seaside destinations lends a lot more credence to scientists who believe the Lower 48 states and South America were populated first by coastal mariners — Ice Age migrants from Asia who skirted around land-blocking glaciers in Alaska as early as 20,000 years ago

“It may be that we’re not going to find the same DNA in the present population,” said Worl, a Harvard-trained anthropologist. “I’m totally aware of that.”

But that doesn’t mean that the Tlingit, Haida and Tsimshian people of Southeast Alaska aren’t related to On Your Knees Cave man, she said. He’s at least a cousin, and maybe more than that.

Said Worl: “As far as we’re concerned, he’s still our ancestor.”

Last year, the Forest Service conveyed custody of On Your Knees Cave man’s bones to the Tlingit tribes in Klawock and Craig, marking the first time a federal agency has transferred human remains that old to a Native American tribe. This fall the tribes plan to rebury the remains on Prince of Wales Island.


FORBES.COM, March 2, 2009, by Robert Langreth — In a wistful and defiant speech, Genentech Chief Executive Arthur Levinson spent the morning in front of analysts here at the Mandarin Oriental Hotel in New York trying to drive up the price of Roche’s hostile bid for the 44% of Genentech shares it does not already own.

Levinson repeated the company’s contention that Roche’s $86.50 tender offer is far too low. He insisted the company was “largely immune” from patent expirations ravaging drug companies like Merck and Pfizer and argued that any government health care reform “will have limited or no impact” on the company’s commercial performance.

He argued that the company could grow its earnings per share 16% a year from 2010 to 2015. “We stand behind these forecasts and would welcome to debate them anywhere, anytime with anyone,” he said.

The speech sounded a bit like one at a memorial service, with Levinson proudly discussing some of the company’s greatest hits, including Herceptin for breast cancer and Rituxan for lymphoma. Herceptin “is almost a miracle drug,” said Levinson, citing data showing the drug vastly improves survival rates in both advanced and early stage disease for a subset of patients with a certain gene mutation. In early trading Monday, Genentech shares declined 2.9% to $83.

Genentech has always taken pride in being more focused on science than stodgy, marketing-driven East Coast drug firms. True to form, executives spent much time playing up the company’s basic science prowess, noting that its scientific biology papers are more often cited than those from any other university, including Harvard.

Genentech also highlighted the company’s new theory of what causes Alzheimer’s disease. This early finding, published last month in the journal Nature, suggests that Alzheimer’s is caused by a cellular pruning process run amok and that drugs that block this process could help slow the disease. But it is years from yielding a drug that could enter human trials, but Genentech research chief Richard Scheller argues that “this is the most important discovery made in Alzheimer’s disease in the last 20 years, maybe ever.”

Genentech said it has 25 new drugs in human testing, including five that could yield important trial results this year. However, the outcome of the Roche hostile bid could very well come down to trial results for its existing colon cancer drug, Avastin, due next month. Avastin is already approved for advanced colorectal cancer. The new study aims to see if Avastin can also prevent recurrence in earlier stage colon patients who have had their tumors surgically removed.

If it works, it means hundreds of millions in additional sales for Avastin. By all accounts, the study is going down to the wire. Memorial Sloan-Kettering Cancer Center oncologist Leonard Saltz says, “The study is neither a clear unequivocal zero nor a home run at this time.” If the colon trial unambiguously succeeds, it would put pressure on Roche to raise its bid by a large amount. But if it fails, Roche might be able to snag the rest of Genentech without such a big bump-up.

Overall, Genentech said that if all ongoing major Avastin trials somehow succeed, the drug’s annual sales could grow to over $10 billion by 2015 from $2.6 billion last year.

Levinson said Roche’s bid to buy the rest of his company didn’t come as a surprise to him. “When [Roche head] Franz Humer called me last July to tell me of his intent, I said I wasn’t angry, I understood. I was sad and I was disappointed,” he says.

Even though Roche has owned a majority of Genentech for years, Genentech has operated with surprising independence. Levinson pointed out that Genentech-developed products accounted for 66% of Roche’s top selling drugs in 2008.


GoogleNews.com, February 27, 2009 — By now, most people have read stories about how to “grow your own organs” using stem cells is just a breakthrough away. Despite the hype, this breakthrough has been elusive.

A new report brings bioengineered organs a step closer, as scientists from Stanford and New York University Langone Medical Center describe how they were able to use a “scaffolding” material extracted from the groin area of mice on which stem cells from blood, fat, and bone marrow grew. This advance clears two major hurdles to bioengineered replacement organs, namely a matrix on which stem cells can form a 3-dimensional organ and transplant rejection.

“The ability to provide stem cells with a scaffold to grow and differentiate into mature cells could revolutionize the field of organ transplantation,” said Geoffrey Gurtner, M.D., Associate Professor of Surgery at Stanford University and a senior researcher involved in the work.

To make this advance, Gurtner and colleagues first had to demonstrate that expendable pieces of tissue (called “free flaps”) could be sustained in the laboratory. To do this, they harvested a piece of tissue containing blood vessels, fat, and skin from the groin area of rats and used a bioreactor to provide nutrients and oxygen to keep it alive. Then, they seeded the extracted tissue with stem cells before it was implanted back into the animal.

Once the tissue was back in the mice, the stem cells continued to grow on their own and the implant was not rejected. This suggests that if the stem cells had been coaxed into becoming an organ, the organ would have “taken hold” in the animal’s body. In addition to engineering the stem cells to form a specific organ around the extracted tissue, they also could be engineered to express specific proteins which allows for even greater potential uses of this technology.

“Myth has its lures, but so does modern science. The notion of using one tissue as the scaffold for another is as old as the Birth of Venus to the Book of Genesis,” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. “Eve may or may not have been formed from Adam’s rib, but these experiments show exactly how stem cell techniques can be used to turn one’s own tissue into newly-formed, architecturally-sound organs.”

Federation of American Societies for Experimental Biology (2009, February 26). From Stem Cells To New Organs: Scientists Cross Threshold In Regenerative Medicine


StemCells.com, by Sandra Richardson — Scientists have achieved a success in finding a new treatment to fight against AIDS. They have claimed that stem cell treatment can be helpful to protect from AIDS by protecting the immune system from HIV.

They have mentioned that pioneering technique involves separating three genes which control the spread of HIV inside the body.

Daily telegraph has mentioned the saying of David DiGiusto of City of Hope Medical Centre in California. It quoted “What we are doing is genetically modifying a fraction of the patient’s stem cells with genes that target three different aspects of HIV that allow it to get in the immune cells and replicate.

“When those stem cells are transplanted into patients, they create mature immune cells that circulate in the patient and protect against HIV”.

In the research, scientists transplanted anti-HIV stem cells into five AIDS patients. Scientist have done bone- marrow replacement as part of treatment for a form of cancer known as lymphoma.

Initial results of this research show that transplanted stem cells in small quantities produce new white blood cells which results in an improvement in patient condition.

Further research is going on to identify that whether this treatment is helpful in relieving the patient from HIV infection.

FRANKLIN LAKES, N.J., Feb. 26 /PRNewswire-FirstCall/ — With more powerful, expensive and potentially dangerous medicines reaching the market on a daily basis, the time has come to leverage genetic tests that provide physicians with the confidence that they have prescribed the precise drug and dose tailored to their patient’s unique genetic code, a leading authority on personalized medicine at Medco Health Solutions, Inc. (NYSE: MHS) today told industry leaders.

“We are at the precipice of a revolution in personalized medicine,” said Felix Frueh, Medco vice president of personalized medicine research and development. “With greater frequency genetic testing is recommended in the medication label. Making such tests the standard of care can significantly reduce waste, improve patient care and raise the safety profile for powerful new medications.”

Genetic tests associated with prescription medications represent an additional up-front cost in the early treatment of a condition. However, a building body of evidence is showing that genetic screenings can lead to greater savings over time from fewer hospital admissions and less waste, Frueh said. He predicts that the use of pharmacogenomic testing will become increasingly popular over the next several years as clinicians, patients and payors seek more opportunities to improve safety and efficacy in pharmacy care.

Pharmacogenomics is the science of capturing a patient’s genetic information to help predict how a person is likely to respond to a wide variety of drugs, including commonly used medications such as pain relievers, blood thinners and cancer drugs. This information has a bearing on what drug is selected and may help optimize doses for particular drugs.

Addressing attendees of an audio conference hosted by magazine publisher Atlantic Information Services, Inc., Frueh – who prior to leading Medco’s pharmacogenomic research efforts led a core genomics review team at the U.S. Food and Drug Administration (FDA) and chaired the first FDA-wide, interdisciplinary pharmacogenomics review group – said health care payors were an “overlooked constituency” in the emerging field of personalized medicine, but the improved outcomes and potential savings make it extremely pertinent to their interests.

Frueh cited several examples where gene tests can reduce the costs of care, including cancer therapies, which can cost tens of thousands of dollars a month. For instance, a $500 test for the HER-2 gene could determine whether spending $50,000 a year for a specific breast cancer drug makes sense, since the drug does not work on two-thirds of patients who are Her-2 negative.

Cost savings aside, the clinical need for testing is paramount. For example, a genetic screening can help prevent the occurrence of potentially fatal hypersensitivity reactions, which can result from the use of a certain HIV medication (abacavir) and seizure medication (carbamazepine) in patients with a genetic pre-disposition.

Frueh identified 11 drugs that likely will be paired with genetic tests if and when they reach the market between now and mid-2010. These compounds include treatments for cancer, heart failure, HIV, COPD/asthma, Huntington’s disease, Alzheimer’s disease, and high cholesterol.

Medco and Personalized Medicine

Medco has existing research collaborations with Mayo Clinic studying genetic consideration in the use of warfarin, and with LabCorp for breast cancer patients using tamoxifen. Medco anticipates having the results of these studies available within the next year. The company also has a research partnership with the Food and Drug Administration aimed at improving patient health and the quality of the delivery of care via pharmacogenomics, and it anticipates additional development partnerships with other health care entities.

In addition, the Medco Personalized Medicine Program offers solutions for payors to help enable them to leverage the potential advantages of personalized medicine by analyzing claims histories to identify patients who could benefit from genetic testing, communicating with physicians about testing options and results and engaging patients to educate them about genetic tests.

About Medco

Medco Health Solutions, Inc. (NYSE: MHS) is a leading health care company, serving the needs of more than 60 million people. Medco, the world’s most advanced pharmacy(R), provides clinically driven pharmacy services designed to improve the quality of care and lower total health care costs for private and public employers, health plans, labor unions and government agencies of all sizes, and for individuals served by Medicare Part D Prescription Drug Plans. Through its unique Medco Therapeutic Resource Centers(R) and the Accredo Health Group, Medco’s Specialty Pharmacy, the company is creating innovative models for the care of patients with chronic and complex conditions. Medco is a leader in the emerging field of personalized medicine and in applying evidence-based protocols to elevate the practice of pharmacy – a key element in reforming America’s health care system. Medco is ranked number 51 on the Fortune 500 list, with 2008 revenues of more than $51 billion. For more information about Medco, go to http://www.medcohealth.com.

This press release contains “forward-looking statements” as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks and uncertainties that may cause results to differ materially from those set forth in the statements. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the risks and uncertainties that affect our business, particularly those mentioned in the Risk Factors section of the Company’s Annual Report on Form 10-K and Quarterly Reports on Form 10-Q filed with the Securities and Exchange Commission.

News Author: Laurie Barclay, MD
CME Author: Hien T. Nghiem, MD

Medscape.com, March 2, 2009 — Calcium intake may protect against cancer, particularly gastrointestinal tract cancer, according to the results of a prospective study reported in the February 23 issue of the Archives of Internal Medicine.

“Dairy food and calcium intakes have been hypothesized to play roles that differ among individual cancer sites, but the evidence has been limited and inconsistent,” write Yikyung Park, ScD, from the National Cancer Institute in Bethesda, Maryland, and colleagues. “Moreover, their effect on cancer in total is unclear.”

In the National Institutes of Health-AARP (formerly known as the American Association of Retired Persons) Diet and Health Study, the investigators evaluated the association of dairy food and calcium intakes with incidence of total cancer and cancer at individual sites. A food frequency questionnaire was used to determine intakes of dairy food and calcium from foods and supplements.

Linkage with state cancer registries allowed identification of incident cancer cases. Relative risks and 2-sided 95% confidence intervals (CIs) were determined with a Cox proportional hazard model.

During follow-up (average, 7 years), 36,965 cancer cases were identified in men and 16,605 in women. In men, calcium intake was not associated with total cancer. However, calcium intake was nonlinearly associated with total cancer in women, with the risk decreasing up to approximately 1300 mg/day but with no further risk reduction above those levels.

Dairy food and calcium intakes were inversely associated with cancers of the digestive system in both men and women. Multivariate relative risk for the highest quintile of total calcium vs the lowest was 0.84 in men (95% CI, 0.77 – 0.92) and 0.77 in women (95% CI, 0.69 – 0.91). This reduction in the risk for gastrointestinal tract cancer was especially prominent for colorectal cancer, and supplemental calcium intake was also inversely associated with the risk for colorectal cancer.

“Our study suggests that calcium intake is associated with a lower risk of total cancer and cancers of the digestive system, especially colorectal cancer,” the study authors write.

Limitations of this study include failure to examine whether associations with intakes of dairy food and calcium differed by tumor subtype or tumor aggressiveness of site-specific cancers, possible residual confounding by unknown or unmeasured risk factors, limited statistical power to examine an association for some low-incidence cancers, and diet evaluated only once at baseline.

“Nevertheless, our study is one of the first cohort studies to examine dairy food and calcium intakes in relation to total cancer as well as low-incidence cancers,” the study authors concluded. “Moreover, our prospective design avoids the recall and selection biases that can affect results from case-control studies.”

The Intramural Research Program of the National Cancer Institute, National Institutes of Health, supported this study. The study authors have disclosed no relevant financial relationships.

Arch Intern Med. 2009;169:391-401.

Clinical Context

Because of the known effects of calcium on bone health, currently dietary guidelines recommend intakes of both calcium and dairy food. The Institute of Medicine recommends 1200 mg/day of calcium for adults 50 years and older, and the 2005 dietary guidelines for Americans recommend 3 cups per day of fat-free or low-fat dairy food. In addition, dairy food and calcium intakes have been hypothesized to play roles that differ among individual cancer sites, but the evidence has been limited and inconsistent. Moreover, their effect on cancer in total has been difficult to assess.

The aim of this study was to examine whether intakes of dairy food and calcium were associated with the risk for total cancer as well as cancer at multiple individual sites.


· In this large prospective cohort study, dairy food and calcium intakes in relationship to total cancer as well as cancer at individual sites were examined in the National Institutes of Health-AARP Diet and Health Study.

· In 1995 and 1996, intakes of dairy food and calcium from foods and supplements were assessed with a baseline food frequency questionnaire.

· Demographic characteristics were also assessed with the baseline questionnaire. Compared with participants in the lowest quintile of dairy food or total calcium intake, participants in the highest quintile were more likely to be white, non-Hispanic; college educated; physically active; current menopausal hormone therapy users if female, and to have a lower body mass index, but they were less likely to smoke cigarettes and to drink alcohol,

· During follow-up from 1995 to 2003, incident cancer cases were identified through linkage with state cancer registries.

· A Cox proportional hazard model was used to estimate relative risks and 2-sided 95% CIs.

· During an average of 7 years of follow-up, 36,965 and 16,605 cancer cases were identified in men and women, respectively.

· Results demonstrated that total calcium intake was not related to total cancer in men but was nonlinearly associated with total cancer in women: the risk decreased with total calcium intake up to approximately 1300 mg/day, above which no further risk reduction was observed.

· In addition, dairy food and dietary, supplemental, and total calcium intakes were not associated with total cancer mortality rates in both men and women.

· In both men and women, dairy food and calcium intakes were inversely associated with cancers of the digestive system (multivariate relative risk for the highest quintile of total calcium vs the lowest, 0.84; 95% CI, 0.77 – 0.92 in men and 0.77; 95% CI, 0.69 – 0.91 in women), especially with colorectal cancer.

· Supplemental calcium intake was also inversely associated with colorectal cancer risk.

· Calcium intake was not related to breast, endometrial, ovarian, or prostate cancer.

· Limitations to this study were that there was lack of evaluation for associations with intakes of dairy food and calcium on tumor subtype or tumor aggressiveness of site-specific cancers; residual confounding by unknown or unmeasured risk factors may exist for some cancers; in the analysis of low-incidence cancers, there was limited statistical power to examine an association; and because the diet was only assessed at baseline, it may not account for long-term usual intake as accurately as repeated measurements of diet during follow-up.


· Current dietary guidelines recommend 1200 mg/day of calcium for adults 50 years and older and 3 cups per day of fat-free or low-fat dairy food according to the Institute of Medicine and the 2005 dietary guidelines for Americans, respectively.

· Calcium intake is associated with a lower risk for total cancer in women and cancers of the digestive system, especially colorectal cancer, in both men and women.

WebMD.com, March 2, 2009 (Boston, Massachusetts) — It may be one of the most commonsense observations ever to be validated in a diet study: people lose weight if they eat fewer calories, regardless of where those calories come from [1]. That’s the upshot of a two-year study by Dr Frank Sacks (Harvard School of Public Health, Boston, MA) and colleagues, published in the February 26, 2009 issue of the New England Journal of Medicine.

After two years, 811 overweight adults randomized to one of four heart-healthy diets, each emphasizing different levels of fat, protein, and carbohydrates, showed similar degrees of weight loss. On average, patients lost 6 kg in six months, but gradually began to regain weight after 12 months, regardless of diet group.

According to Sacks, the research should help quell some of the debate–fostered by decades of research and fad diets–over what types of foods should be emphasized to produce weight loss.

If people can maintain a calorie deficit no matter what type of diet they were on, they’re going to lose weight.

“Research has looked at whether carbohydrate is more satiating than fat, or whether protein is more satiating than carbohydrates, or whether overeating fat puts more fat in the belly than overeating carbohydrates, etc,” Sacks explained. “So what’s concerned colleagues of mine on the nutrition guideline panels in the past is the possibility that if we say that a 40% fat diet is okay, that maybe that would lead to weight gain. But where this study is going to be helpful is in saying 40% fat, 20% fat, it doesn’t matter. If people can maintain a calorie deficit no matter what type of diet they were on, they’re going to lose weight.”

Sacks, who is incoming chair of the AHA’s Nutrition Committee, acknowledged that nutrition advice in the past has worried too much about fat in the diet. “I’m very concerned that we maintain the focus on calories and keep the focus off percent calories from fat,” he said.

Another important, if unsurprising, finding from the study was that people who regularly attended counseling sessions over the two-year study were significantly more likely to lose weight.

The findings should remind physicians to hammer home the importance of losing weight. “Physicians really should, visit after visit, keep encouraging patients to eat a heart-healthy diet that they can stick with, that will help them lose weight, and try to get them involved in some kind of support group or to see a dietician,” Sacks said.

Commenting on the study for heartwire, Dr Robert Eckel (University of Colorado Health Sciences Center, Denver) said he wasn’t surprised by the study findings. “I think you can lose weight in a number of different ways, and this study simply affirms that people who are successful are the people who adhere to a program. . . . Ownership, by the patient, of the weight-loss program is what proves successful, not the type of diet you chose.”

Diet Details

The diets tested in the study included the same types of foods, but in different proportions, and were tailored to patients such that overall calorie consumption was reduced by approximately 750 calories per day, with each diet including a different macronutrient composition:

· High-fat, average protein: 40% fat, 15% protein, 45% carbohydrate.

· High-fat, high-protein: 40% fat, 25% protein, 35% carbohydrate.

· Low-fat, average protein: 20% fat, 15% protein, 65% carbohydrate.

· Low-fat, high-protein: 20% fat, 25% protein, 55% carbohydrate.

Participants were advised to exercise for at least 90 minutes per week, at a moderate level, and were offered counseling sessions every eight weeks, with group sessions held weekly or biweekly over the course of the study.

In all, 80% of subjects completed the trial, and 14% to 15% of subjects managed to lose at least 10% of their initial body weight. Subjects randomized to different groups reported similar degrees of satisfaction, hunger, and satiety. All the diets reduced risk factors for diabetes and cardiovascular disease at six months and two-year follow-up. At the two-year mark, the low-fat diets and the highest carbohydrate diet fared better than the high-fat diets and low-carb diet in terms of reducing LDL cholesterol. By contrast, the lowest carbohydrate diet improved HDL-cholesterol levels more than the highest carbohydrate diet. All of the diets produced slight improvements in blood pressure and decreased the number of patients with metabolic syndrome. All, with the exception of the highest carbohydrate diet, decreased fasting serum insulin levels.

External and Internal Motivators

An editorial accompanying Sacks et al’s study applauds the duration of the study and the low dropout rate but takes a dimmer view of the weight loss achieved in the study and the ability of dieters to adhere to their diets over time [2]. “Even these highly motivated, intelligent participants who were coached by expert professionals could not achieve the weight losses needed to reverse the obesity epidemic,” Dr Martijn B Katan (VU University, Amsterdam, the Netherlands) writes. “The results would probably have been worse among poor, uneducated subjects. Evidently, individual treatment is powerless against an environment that offers so many high-calorie foods and labor-saving devices.”

Sacks, speaking with heartwire, defended what he insisted was “clinically meaningful” weight loss in his study, emphasizing that many people achieved far greater losses than the average figure. Eckel, by contrast, was less sanguine, pointing out that an average weight loss of 3.5 kg at two years represents the best-case scenario, since real-life interventions rarely live up to the research setting.

Katan, however, argues that “like cholera, obesity may be a problem that cannot be solved by individual persons but that requires community action.” He cites a French study that profoundly reduced obesity rates in children by having everyone in the town commit to getting children to eat less and move more, building sporting facilities and playgrounds, giving cooking workshops to families, creating walking itineraries, etc.

“It is an approach that deserves serious investigation, because the only effective alternative that we have at present for halting the obesity epidemic is large-scale gastric surgery,” he writes.

In response, Sacks said simply that communitywide changes won’t absolve individual responsibility. “It’s two factors. There’s what each person puts into his or her mouth, and there’s what’s out there for people to choose to put in their mouths.”

Sacks and Katan disclosed having no conflicts of interest; disclosures for other study authors are listed in the paper.

1. Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 2009; 360:859-873.

2. Katan MB. Weight-loss diets for the prevention and treatment of obesity. N Engl J Med 2009; 360:923-924.


FORBES.COM, (Tokyo Dispatch) March 2, 2009, by Tim Kelly — No one may hear you scream in space, but they might smell your cheesy feet. Overlooked in the technological wonder that makes space travel possible is the less often mentioned reality that astronauts, particularly those aboard the International Space Station, have to make do with some rather low-tech appurtenances.

Astronauts on the ISS wear the same clothes for days on end, even after workouts or strenuous space walks. A shower fitted in the station’s living quarters doesn’t work, and mechanical problems last year temporarily put its toilet out of order. The three astronauts that normally inhabit the outpost have to make do with wet wipes to keep their odors at bay and have an emergency supply of bags in case their restroom goes on the blink again.

It’s therefore good fortune that rather than aspiring to boldly go, Japan’s space program has instead started fussing over the mundane practicalities of living in outer space. Slated to head out into orbit on the next shuttle flight in March is veteran Japanese space adventurer Koichi Wakata. His main mission during the three months he will circle the earth is to measure the stress of weightlessness on the human body and to dose himself with drugs concocted to counter the calcium-sapping effect that zero gravity will have on his bones.

That’s not, however, groundbreaking research. Boffins have for decades been using astronauts as guinea pigs in similar experiments. What’s new is that as he exercises to keep his skeleton from getting brittle he will be wearing garments made of an experimental light-activated deodorizing material developed at the Japan Women’s University in Tokyo. Should mankind ever undertake the long-haul voyages through the vast emptiness of space in search of alien life, having smell-free clothes might avert any embarrassing contacts with extraterrestrials who have noses.

Unlike its flag-waving neighbor China, Japan has so far shown little ambition to plant the rising sun on the lunar surface or any other celestial body. Having spent most of its space budget so far building heavy-lift rockets to supply the ISS and compete in the commercial satellite launch market, they have had little left over to splurge on the costly development of human spaceflight. That means Japan will have to rely either on the American shuttle or Russian Soyuz program to get its people aloft for the foreseeable future.

Among them will be Japan’s first two astronaut cadets in a decade, announced last week in Tokyo, men who will be trained to man the Japanese-built Kibo experiment module recently bolted onto the expanding space station. One of the two, Kimiya Yui, 39, is a lieutenant colonel in the nation’s air force. The other, Takuya Ohnishi, 33, is a commercial pilot for local airline All Nippon Airways.

The Chinese may get to the moon before Ohnishi or his colleagues do, but if Wakata’s odor-eating wear works, the Japanese at least should smell rosier when they eventually touch down.

Billionaires In Space

FORBES.COM, by Elizabeth Woyke — In the world of gamers, Richard Garriott answers to the name “Lord British.” But what about in space?

Call him a “space tourist,” and Garriott will grimace. Instead the lanky, 46-year-old computer gaming tycoon thinks of himself as a “private astronaut”–and he’s hoping that hundreds of other people will want to earn the same title, too.

On Oct. 12, Garriott plans to be the sixth private citizen to head into space. He will be joining an elite group of astronauts, including several billionaires and fellow millionaires such as telecom entrepreneur Anousheh Ansari and former Microsoft executive Charles Simonyi.

In Pictures: Billionaires In Space

Space travel is getting trendier at the speed of light.Virgin Galactic, a company started by Richard Branson, plans to jet tourists into suborbital space as early as 2009. Tickets will cost $200,000 apiece. So far, 200 people have signed up for flights, including physicist Stephen Hawking and actress Sigourney Weaver. Then there’s Google, which recently announced the first 10 teams of competitors in its $30-million Lunar X Prize contest to send a spacecraft back to the moon. (See “Google Shoots For The Moon.”)

But Garriott’s ambitions stretch beyond merely reaching space. He wants to reinvent the way Americans view and, eventually, experience space travel. “I grew up listening to criticisms of space exploration,” says Garriott. “My mission is to show that this is a useful, profitable activity.”

Garriott isn’t exaggerating when he says he grew up hearing about space: His father, Owen Garriott, is a former NASA astronaut who completed two space missions in 1973 and 1983. Richard opted for more of a virtual profession, however, and started designing videogames including the best selling “Ultima” computer game series in the 1980s. His windfall came in 1992 when gaming giant Electronic Arts acquired Origin Systems, a videogame publisher he co-founded in 1983. He still actively designs games for developer Destination Games, which he helped launch in 2000. Last year, he released Tabula Rasa, a “near future” sci-fi game that takes players on a romp through the cosmos.

So why not go for real?

Garriott says he began funding space tourism research in the 1990s, hoping to be the first private citizen in orbit. In 2000, he teamed up with Virginia-based Space Adventures after meeting Chief Executive Eric Anderson at an Explorers Club gala. Currently a Space Adventures board member, he’s also a trustee of the X Prize, a nonprofit organization that awards big prizes to inventors in hopes of spurring innovation. Other X Prize trustees include Google co-founder, Larry Page. “There’s an astonishing overlap between high-tech entrepreneurs and people interested in privatization of space,” Garriott says. “Branson, Bezos, Elon Musk, the Google guys–we all know each other.”

The collapse of the dot-com bubble drained Garriott’s fortune–enough, he says, that he didn’t feel comfortable paying out $20 million, the going price in 2000 for a spaceflight. Space Adventures sold Garriott’s spot on its waiting list to multimillionaire Dennis Tito, who became the first space tourist in April 2001.

After rebuilding his wealth with his gaming business and clearing his schedule, Garriott last year signed on again for another flight. Assuming all goes according to plan, he is slated to lift off from Kazakhstan aboard the Russian spacecraft Soyuz TMA-13 on Oct. 12. Garriott is scheduled to spend 10 to 14 days on the International Space Station with four other people, including second-generation Russian cosmonaut Sergey Volkov and NASA astronaut, Michael Fincke.

Tickets aren’t cheap, now at $30 million apiece. Garriott says that he will pay some portion out of his own pocket and is seeking corporate sponsorship to cover the rest of the bill. One company that will help him out: Huntsville, Ala.-based ExtremoZyme, which develops enzymes for research and industrial application. Owen Garriott was one of ExtremoZyme’s founders; Richard is an investor.

To prepare for the flight, Garriott is logging time in Russia’s Star City cosmonaut training center and at NASA’s Johnson Space Center, which houses a mockup of the space station. There will also be a stint in the Black Sea for survival training. He’s already completed “centrifuge runs” at Brooks Air Force in San Antonio, Texas, to simulate the body’s reaction to re-entering the earth’s atmosphere.

Once in space, Garriott’s itinerary will be busy. To show that space travel isn’t just a lark, he’s promoting in-flight commercial activities. For sponsor ExtremoZyme, he will take protein molecules into space and document their crystallization in zero gravity. The data, he says, could be used to develop drugs and therapies for various ailments.

Garriott also plans to devote time to photographing the earth, in a nod to the 60 days his father spent in 1973 making observations from space station Skylab 3. Snapping pictures of urban areas, glaciers, deserts, forests and volcanoes will show how earth has changed “within a lifetime,” he says. He also wants to communicate with schools–possibly by streaming video–to promote awareness of space travel.

Despite a lifetime of preparation, discussing the prospect of space travel still makes him giddy. “The total time from the beginning of re-entry to being on the ground is six minutes,” he marvels. “It’s phenomenal.”

He’s equally excited about an increasingly accessible future for space travel. Space Adventures is currently negotiating with cosmonauts to take guests to the moon and back. Garriott likens it to chartering a pilot: “You’d get two seats at a time, with input into how long you stay, where you fly and where to dock.” He is also keen on the plans under way at Las Vegas-based start-up, Bigelow Aerospace, to develop a commercial space operation for low-earth orbit by 2012.

“If you look at my creations, homes, collections and vacations, it’s one big continuum,” he notes. Case in point: His Austin, Texas, estate–named Britannia Manor in a nod to his English roots–boasts an observatory, secret passageways and dungeons. An avid amateur magician, Garriott also collects oddities including scientific instruments and favors extreme adventures such as safaris, exploring hydrothermal vents in Antarctica and salvaging deep ocean wrecks.

It all feeds his overarching goal of making space travel commercially viable. “The fundamental reason for going is just that I want to go. Participating as a follower or viewer would be enough,” says Garriott. “But the great joy of going is to be productive. There’s so much value all around you up there.”