Jewish World Review April 1, 2002 / 20 Nisan, 5762

Pre-diabetes: a newly defined category of health risk

By Robert A. Wascher, M.D., F.A.C.S.

http://www.NewsAndOpinion.com | The Department of Health & Human Services, in conjunction with the American Diabetes Association, has initiated a new public information campaign to warn Americans about the health risks associated with a condition previously known as "impaired glucose tolerance."

This condition has now been anointed "pre-diabetes." Pre-diabetes is a precursor of overt diabetes, and occurs when the insulin receptors in the body's cells begin to lose their sensitivity to insulin. In healthy people, the pancreas secretes insulin after we eat a meal. Insulin then binds to insulin receptors on cells throughout the body, causing the cells to take in the sugar that has been absorbed into the bloodstream following a meal. In pre-diabetes, the cells begin to lose their sensitivity to insulin, allowing blood sugar levels to rise after meals containing sugars or carbohydrates (which are converted into sugars by the body).

Pre-diabetes is thought to affect about 16 million Americans, and has been linked to a 50% increase in the risk of developing coronary heart disease. Pre-diabetes also significantly increases the risk of developing diabetes, which results in dangerously elevated blood sugar levels without treatment. The majority of people with pre-diabetes will develop diabetes within 10 years, unless they take steps to reverse the factors that ultimately give rise to these two conditions: excessive calorie intake and inadequate physical activity (both of which can lead to obesity, which is also strongly linked to diabetes).

The new recommendations include the routine screening of overweight people over the age of 45 for pre-diabetes with one of several glucose tolerance tests. Patients who are younger than 45, but who are significantly obese, should also be screened if they have at least one of the following additional risk factors: a family history of diabetes, low blood HDL cholesterol levels, high blood triglyceride levels, high blood pressure, history of high blood sugar during pregnancy, and non-white ethnic group.

Even moderate exercise, such as walking for 30 minutes at a time, five days a week, can cut the risk of developing diabetes by more than half when combined with sensible dieting!

TEEN TELEVISION VIEWING AND SUBSEQUENT AGGRESSIVE BEHAVIOR

From the journal Science comes an intriguing-and worrisome-study that links even relatively modest television viewing among teens with an increased risk of aggressive or violent behavior during adulthood. A total of 707 teens and young adults were evaluated for their frequency of television viewing. Over a subsequent period of 17 years, incidents of aggressive or violent behavior towards others were also documented in this group.

Even after adjusting for tendencies towards aggressive behavior during childhood, childhood neglect, socioeconomic status, parents' educational level, level of neighborhood violence, and history of psychiatric disorders, the study's authors found a compelling link between television viewing habits and the onset of aggressive or violent behavior later in life.

Although this is not the first study to link television viewing with subsequent antisocial behavior, this study found that as little as 1 hour of TV viewing per day by teens and young adults was linked with a significantly increased risk of aggressive or violent behavior later in adulthood....

THE BENEFITS OF STRENGTH TRAINING IN THE ELDERLY

As we age, our bodies gradually lose muscle mass (unfortunately, our bodies also gain additional fat as well). There have been several previous studies that have shown improved levels of physical functioning in older men and women who engage in resistance strength training, including a reduced incidence of falls and bone fractures. This month's Archives of Internal Medicine features a new study that looks at the relationship between strength training and the capacity to become aerobically fit in elderly men and women.

A total of 62 volunteers, aged 60 to 83 years, engaged in 6 months of resistance strength training. These elderly weight-lifting volunteers were then tested on a treadmill to evaluate their aerobic exercise capabilities. The authors found that both low and high intensity weight training increased the aerobic exercise capabilities of these elderly volunteers by 20 to 26%! Older Americans wishing to begin a strength training and exercise program should find the results of this new study particularly interesting.

Remember, however, to check with your physician before beginning a new exercise program!

BRIEFLY....

... The Archives of Internal Medicine also reports that while the prolonged consumption of coffee does seem to temporarily raise one's blood pressure, this habit appears to play a minimal role, if any, on the development of chronic high blood pressure.

The journal Lancet reports that the use of oral contraceptives for 10 or more years may be linked to an increased risk of cancer of the cervix. Almost all cases of cervical cancer are thought to be caused by a virus known as the human papilloma virus (HPV). It is not yet clear why oral contraceptives (OCs) should increase the risk of cervical cancer, although OCs are actually composed of synthetic female sex hormones. This finding is additive to previous studies showing an increased risk of cervical cancer in women with a history of multiple sex partners, and among women with 7 or more children. Fortunately, most cervical cancers can be detected early through annual Pap smears.

The journal Cancer Research reports that the common antibiotic doxycycline, a member of the tetracycline family, may have important anticancer activities. The drug appears to inhibit the growth of breast cancer cells in mice, and may reduce the ability of breast cancer cells to successfully spread to the bones (a common site of breast cancer metastasis). Further studies in humans will be necessary to confirm these findings, but it is nonetheless a very interesting finding.

JWR contributor Dr. Robert A. Wascher is a senior research fellow in molecular & surgical oncology at the John Wayne Cancer Institute in Santa Monica, CA. Comment by clicking here.