MUSC Pilot study shows weight loss leads to great gainsTweet
By Mikie Hayes
As part of the research study, Michael Hunter gets his blood drawn post-challenge by registered nurse Kyra Hasslock. Photo provided
A dynamic fitness commando takes the stage and tells everyone — in no uncertain terms – that their bodies are already in a state of chronic disease. For most that is terrifying news they really hadn’t contemplated in those terms. They knew they had weight to lose; maybe they’d dealt with high blood pressure, possibly elevated sugar. But chronic disease?
She had their attention.
“However,” she continued, “each and every one of you can make modifications in your lives that will not only help you live longer but add quality to those years.”
No, it wasn’t a Denise Austin infomercial at 3 a.m. that people were watching: It was Janis Newton, director of the Healthy Charleston Challenge, addressing 75 new participants at the start of the spring 2014 program.
A 12–week weight–loss, lifestyle–intervention program, the HCC was designed to increase physical activity and provide skills, professional guidance and accountability for developing healthy habits as well as to provide opportunities for partnerships between the Wellness Center and MUSC researchers.
Whether participants had 25 pounds or 225 pounds to lose, Newton explained to them on that evening in January, that being overweight or obese was wreaking havoc on their cells, organs, bones, and joints. Further, that just by being part of the challenge, they would get healthier, have more energy, feel more confident, and literally change the very state of their mitochondria: the all-important powerstations of the cell.
She knew from anecdotal information shared by past participants going back as far as the program’s beginning in 2008, that people were experiencing amazing results from the challenge.
Physicians had reduced or taken many completely off their medications for blood pressure, cholesterol and diabetes. Participants, too, had been able to return to sports they once enjoyed and many thanked her as they experienced a marked reduction of pain in their joints. And, over the years, physicians praised her efforts because of the stellar results they’d seen in their patients.
But soon there would be definitive numbers: scientific proof that the HCC was indeed making a difference in people’s health. Newton announced a pilot study being conducted by two MUSC researchers, David Turner, Ph.D., assistant professor in the Department of Pathology and Laboratory Medicine in Hollings Cancer Center and Mathew Gregoski, Ph.D., assistant professor in the College of Nursing. This biomarker study would combine forces with the HCC and 20 participants would have an opportunity to take part in it.
The goal of the study was to determine if regular exercise and changes in eating habits would, over the course of the challenge, help to decrease in participants certain disease biomarkers such as advanced glycemic end–products, better known as AGEs. It did, and at rates even higher than Turner and Gregoski expected.
AGEs are a complex group of compounds that form when sugar reacts with amino acids. This is a process that occurs in the body in addition to the fact that AGEs exist in everyday foods like meat, butter and vegetables.
Turner explains it as such: “As our bodies use the sugars that we consume for energy, they generate waste products, or metabolites, including molecules called advanced glycation end-products or AGEs. AGEs naturally accumulate in our tissue, and as we grow older, the body becomes less efficient at clearing these metabolites from our bodies. They have also been implicated in diseases associated with aging such as diabetes, heart disease, and Alzheimer’s disease.They can also cause increased inflammation and the generation of potentially harmful chemicals known as reaction oxygen species, both of which promote cancer.” AGEs, which are intrinsic to many foods, can be increased by the process of cooking. In particular, meats that have been cooked with dry heat — barbequed, fried, roasted, or baked — are very high in AGEs.
Fats and meat products contain the most, while carbohydrates are relatively low in AGEs. Higher cooking temperatures increase AGEs and the same holds true for longer cooking times. Cooking with moist heat reduces AGEs because it cooks at a lower temperature. And processed foods contain more AGEs than natural or homemade foods. For instance, a 100 gram serving of the following foods contain various amounts of AGEs: 2 1/2 stalks of celery contain 43 AGEs and a medium baked apple, 90. A slice of thin-crust pepperoni pizza has approximately 6,825, and 5 slices of fried bacon have 91,577.
There is ample evidence that in addition to chronic diseases such as cancer and diabetes, AGEs play an important role in skin aging and aging in general, making AGEs an ironic and fitting acronym for the toll they take on the body.
Pick up a copy of Prevention, Longevity or Cosmopolitan magazine and it’s clear that the word aging causes dread in the hearts of the American public. Aging has come to represent an inevitable decline in looks, health, energy, and libido. Americans’ insatiable need to stay forever young fuels an anti-aging products and services market that was valued at nearly $262 billion in 2013, according to BCC Research, a publisher of technology market research reports based in Wellesley, Mass. And, the American Society of Plastic Surgeons stated that the number of botulinum toxin (Botox) treatments alone rose 680 percent from 2000 to 2012.
Newton and the researchers know “behavioral medicine” is a much healthier way to address aging than getting injections to deaden facial muscles. While AGEs is one of the major molecular mechanisms by which damage accrues in the body leading to aging, disease and eventually death, the good news, according to Gregoski, is that regular exercise has been shown to attenuate AGE accumulation.
“There are few chronic diseases that cannot be improved by a regular exercise program. In some ways, exercise is more important than medicine; It’s life,” Gregoski said.
And South Carolinians need some good news. “Our state ranks among the worst in the country for the prevalence of these disease states,” Gregoski said. “The higher accumulation of AGEs resulting from the typical Southern diet is a potential contributor.”
According to Newton, the Southern diet has led many an HCC participant, desperate for help, through the doors of the Wellness Center.
Michael Hunter is the perfect example. He and wife, Missy, married 19 years, joined the challenge together to lose weight, improve their health and gain energy. Hunter was tired of hearing the same lecture from his doctor “over and over and over.”
The couple had been thinking of doing something for themselves for a very long time when the challenge presented itself, and they “jumped on it.”
Hunter said, “We had completely lost focus on ourselves. We stay so busy with the kids, work, and everyone’s activities, that everything became more important than taking care of our health. We finally said, ‘That’s it.’”
After signing up for the HCC, the Hunters applied for and were selected to be part of the Biomarker research study, which was made possible through funding by the South Carolina Clinical and Translational Research Institute Research Nexus and the Lucey Mortgage Corporation. The Hunters and the other 18 study subjects received an assessment of their lipid profile before and after they completed the HCC ,as well as a DXA scan, which provides one of the most highly accurate measurements of body composition available, registering fat and lean mass distribution throughout the entire body.
The bottom line after post-test results were in? The numbers tell the story: The HCC improves health on every level.
Gregoski was pleased but not surprised when he reviewed the after-challenge numbers. Michael Hunter’s changes were dramatic. In addition to a weight loss of 35 pounds, before the HCC his glucose level was 122 and after it was 89. His A1C (hemoglobin A1C is measured in people with diabetes to provide an index of average blood glucose) before was 6.1 and after it was 5.3. His total body fat before was 27.6 percent and after it was 22.3, and he reduced his AGE level by 51 percent.
"To put his numbers in perspective,” said Gregoski, “upon entry into the program, Michael Hunter’s test results showed that he had an elevated A1C putting him in the pre-diabetic range. Without this program Michael may have continued to have further increases in his A1C until he was diagnosed as a Type 2 diabetic. Completing the program changed the trajectory of Michael's A1C levels, which now match those of a healthy adult. Type 2 diabetes may not kill you overnight but evidence suggests that having Type 2 diabetes shortens your life span by about 10 years.”
Hunter is elated about the changes he and Missy made. “Since I’ve lost the weight, nothing fits anymore. I need to buy new clothes. I donated all my big clothes to Goodwill. More importantly, Missy and I can both do things that physically we have not been able to do in the past 20 years. We enjoy running around with the kids and doing activities with them so much more now.”
In all, the study proved what Gregoski and Turner expected. Everyone lost significant fat mass, at least five percent, and all in the study who were at risk for developing Type 2 diabetes had glucose and A1C levels in the normal range post-testing. That being said, both were surprised at just how dramatically AGE levels dropped.
“While we thought AGE levels would be reduced,” Turner said, “we were quite surprised at how significantly they were reduced in the 12 weeks.”
The results indicate that increasing physical activity and eating healthily can reduce AGE accumulation levels and the HCC clearly represents an AGEs-reducing behavioral intervention.
Gregoski summed it up this way: "In terms of Advanced Glycation End–products (AGEs) the benefits of exercise are still unknown. The results from our study found that AGEs were reduced by approximately 50 percent for most of our participants. What does that mean in real-world terms? Not only can going to the gym make a bad day better, it may also decrease your risk for cancer. "
Turner agrees. “The HCC had provided the perfect platform for us to see if a physical activity and diet intervention can actually reduce AGE levels within our bodies.” Turner added, “The data obtained from this study within the HCC will now provide the basis for larger, more detailed studies investigating the physical benefit of reducing AGE levels in cancer and other diseases.”
June 6, 2014