The massive, long-term Diabetes Prevention Program study has now found (twice!) that altering one’s lifestyle in terms of diet and exercise is more effective than a common prescription drug in delaying the onset of the disease. To power this study and its recently published follow-up, dozens of medical centers conducted multiple examinations each year on thousands of patients - 3234 in the first 3-year study, and 2665 in the 10-year follow. It’s impressive - and more clinically useful - to look at the summary data accumulated from this very large population of patients. But what kind of impact does a huge study such as the DPP have on the individual participants?

With help from Margaret Matulik, the DPP program coordinator at the University of Chicago Medical Center, I connected with a couple of the study subjects to hear about the lives behind the data points. Both Katherine Seaberry, 80, and Robert Nolan, 61, are from Chicago, and enrolled in the study in the late 1990’s. Both were also motivated to join the DPP due to their respective families’ experience with diabetes - Nolan’s sister and mother suffered from the disease and died around the age of 60, and Seaberry said her “whole family” has been diagnosed with diabetes.

“It saved me,” Seaberry said of her involvement with the Diabetes Prevention Program. “It’s amazing that I’m the only one in my family that’s not diabetic. If I wasn’t in this study, I think I would be diabetic by now.”

read more

Pharmaceutical companies often make up trade names for new drugs that semi-subliminally evoke their purpose - some of my favorites are Boniva, for osteoporosis, or Ambien, the sleeping pill that sounds like it was named by Brian Eno.  It’s kind of a silly practice, motivated mostly by marketing reasons, because all of these drugs already have names - Ambien’s true name, Zolpidem, is even kind of fun to say. But the fact that these trade names are so widespread suggests they are effective at attracting consumers, so here’s my modest proposal: let’s give simple changes in diet and exercise that improve health a fancy trade name, Lifestyltrin.

This train of thought stems from a study published last week by medical journal The Lancet, in which one of the largest diabetes studies showed (again) that changes in lifestyle are more effective than a leading medication in preventing the disease. Originally published in 2001, the Diabetes Prevention Program (DPP) followed more than 3000 people at risk for diabetes at hospitals across the United States as they underwent either a lifestyle intervention, treatment with anti-diabetic drug metformin, or a placebo treatment. After nearly 3 years of study, the authors reported that lifestyle changes (meaning diet and exercise to reduce weight) reduced diabetes incidence by almost 60%. Metformin also reduced the disease, but only by about 31% - results so strong that the authors stopped the study and began offering both treatments to everyone in their study.

But the study didn’t end, and the medical centers involved continued to monitor as many patients as were willing to stay in contact. All told, 2766 of the original 3234 participants continued to be monitored, allowing the publication last week of a followup study examining how many of these at-risk patients had developed diabetes 10 years after the original study began. What they found was somewhat status quo - after 10 years, the lifestyle group still showed twice the decrease of new diabetes cases than the drug group, 34% vs 18% lower compared to placebo. But that also means there was no difference in the number of new diabetes cases between lifestyle and drug groups in the 7 years between the original study’s end and the followup study’s end, which authors attributed to the mixture of treatments - the group receiving lifestyle interventions was now allowed access to metformin, and vice versa.

read more

Dr. Funmi Olopade and Dr. Mary Ann Malloy at the Harold Washington Public Library in Chicago, September 22, 2009 (photo by Rob Mitchum)

On Monday we previewed Dr. Funmi Olopade’s public lecture at the Harold Washington Public Library in Chicago titled “Nature, Nurture and Breast Cancer.” For that post, I talked about some recent work from Olopade’s research group that compared the types of breast tumors found in West African women with the tumors seen most often in black and white American women. That research indicated that there likely is a genetic difference between women of African origin and Caucasian, North American women that leads to fewer breast cancer cases but a  higher rate of aggressive, harder-to-treat tumors in black women here and abroad. But the patients from Senegal and Nigeria which Olopade’s group studied also showed different proportions of tumors when compared to African-American women, suggesting a strong role for environmental factors in causing breast cancer as well.

In her library appearance Tuesday evening with NBC reporter Dr. Mary Ann Malloy, Olopade expanded upon those mysterious “environmental factors” that likely contribute to the higher breast cancer numbers in North America. To a rapt audience, Olopade listed off the most well-known and common risk factors for breast cancer: age, family history and “the most important risk factor,” being a woman.

(Chicago Public Radio’s Chicago Amplified is supposed to post audio from Tuesday night’s event, but it’s not up yet. I’ll add a link when it’s available.)

But even to a crowd that, judging from their questions, was very well informed about breast cancer medicine and science, Olopade inspired gasps of surprise by rattling off some less-publicized environmental factors: breastfeeding, age at childbirth, even height. Many of these factors, in combination with more mundane things like lack of moderation in diet, exercise and alcohol intake, are behaviors more commonly seen in rich countries where women have achieved a more equal status in their work and private lives.

“I think what we’re still struggling with is, as we get more affluent and as people live the good life, then you see the rising incidence of breast cancer,” Olopade said. “We want people to have the good life, but what is it about the good life that is predisposing us to breast cancer?”

read more

A three-dimensional image of a "BK" cellular ion channel (Yale University/Futurity)

I apologize for the lack of a Linkage post last Friday - instead of blogging, your editors were learning about Chicago’s downtown architecture as we floated along the green if not Green Chicago River on one of summer’s final days. But like the reversed flow of that waterway, the science never stops, and last week saw the official launch of a new source for science news: Futurity.

Disclosure alert: the University of Chicago is one of the contributors to Futurity’s content, and our esteemed paleontologist Paul Sereno’s new “punk-size” T-Rex spent much of last week as the site’s featured story. But as both producers and consumers of science writing, we’re genuinely excited about the site, which will aggregate articles from an initial pool of 39 universities in an attempt to the gap left by shrinking science and medicine staffs at newspapers and television stations. With reduced space and time for science stories in the mainstream media, the news offices of these universities have taken it upon themselves to bring their science to the public directly, sometimes by employing refugees from those very same shrinking science staffs.

Yes, that largely means publishing press releases, though it must be said that many press releases are now themselves written and laid out like a news article, with an eye-catching lead, quotes from researchers and outside sources, historical perspective and photo or graphic art. Sites like ScienceDaily and Eurekalert are well-known depositories for these releases, but can be sensory overload for the casual reader with hundreds of new releases posted to the site each day. Futurity looks like it will filter out some of the noise and present the most exciting research in an aesthetically pleasing manner, with the hope that general audience readers, not just other science journalists and news office personnel, will find it entertaining and informative.

The site had a soft launch in the spring and went full-on live last Tuesday, so there’s already been a bit of attention paid to it by sites such as Inside Higher Ed, the San Jose Mercury News, and the Columbia Journalism Review. Skeptics note, appropriately, that there is a certain preaching-to-the-niche quality, where only people actively seeking out science news will be exposed to science news. But through deals with wider-audience news aggregators like Google and Yahoo!, the hope is that a casual reader will be distracted by interesting science news on their way to sports scores or celebrity gossip, just like they used to do in a newspaper.

Here are a few of the Futurity stories that caught our eye in the website’s opening week:

• Scientists cure color blindness in monkeys with a human gene (University of Washington)
• Using Legos to model nanobiology (Johns Hopkins)
• Thin, overeating friends can inspire unhealthy eating behavior (Duke; with a slick YouTube video that makes us very envious)
• Using trees to generate electricity (University of Washington)
• An “open-source” camera with a brilliant name: Frankencamera (Stanford)

The committee members who make up the shortlist for the  Nobel Prize in Physiology or Medicine each year might want to start listing an unlikely trio of medical researchers: The Brothers Gibb, otherwise known as The Bee Gees.

Last fall, David Matlock, a medical resident with the University of Illinois School of Medicine presented a study at the American College of Emergency Physicians meeting that found listening to the Bee Gees’ “Stayin’ Alive” during a CPR refresher course helped doctors and medical students perform the lifesaving method accurately. Retesting the same subjects five weeks later, with the subjects instructed to replay the song in their heads, the doctors and students continued to show excellent CPR technique. Though Matlock’s proof appeared to be the first scientific study of Bee Gee-related emergency medicine, inside medical sources (i.e. my wife), say that the song has been an instructional CPR tool for some time. [Conveniently, the song is also a health threat in its own right. - ed.]

Since it’s already stuck in your head by now…

The song’s medical benefits had little to do with the soothing sound of falsetto harmonies or fond memories of John Travolta, but rather with the pace: “Stayin’ Alive” struts along at 103 beats per minute, very near the 100 compressions per minute recommended for CPR. As such, any 100bpm song would do, but the uplifting message of the Bee Gees chorus makes for an irresistible and memorable lesson.

That tempo was harnessed for the powers of health again recently, this time as a guide for  aerobic activity. Earlier this week, the website of the Department of Health and Human Services spotlighted a May paper in the American Journal of Preventive Medicine that found “Stayin’ Alive” sets the internal metronome for a healthy walking pace. Researcher Simon Marshall of San Diego State University determined that 100 steps per minute was the ideal rate for “moderate intensity walking,” which public health guidelines recommend adults do for at least 150 minutes each week. Therefore, humming the tune and making like Travolta is a low-budget solution for those unwilling to purchase a pedometer to track their feet.

“The tempo of it is such that – as with most disco music from the ‘70s – the beat is fairly consistent throughout the whole song, and most people find it hard to sit still to,” the pro-disco Marshall told HHS.

Of course, an anti-disco attitude can also help you burn off some calories, but may result in legal charges. If you’re planning on performing CPR or walking at a moderate intensity pace and can’t stand the Bee Gees (or just prefer “Night Fever”), here’s a list of songs that are exactly 100 beats per minute, so you’ll be even more accurate. Perhaps Ricky Martin’s “Shake Your Bon-Bon” suits you better? I won’t judge.