Exercise Proven Treatment for Fatty Liver in Diabetics

I found this article and thought it would be of interest to the Cushing's community, since so many suffer from fatty liver and diabetes. My new diet is in response to the way I've been feeling lately, as well as the 225 blood sugar reading I got 2 hours after dinner one day last week. I'm not diagnosed diabetic, but it runs rampant on my maternal side of the family. I figure I need to try to head it off at the pass.

"http://ihealthbulletin.com/blog/2008/09/19/exercise-proven-treatment-for-fatty-liver-in-diabetics/"

Weekly bouts of moderate aerobic exercise on a bike or treadmill, or a brisk walk, combined with some weightlifting, may cut down levels of fat in the liver by up to 40 percent in people with type 2 diabetes, a study by physical fitness experts at Johns Hopkins shows.

According to researchers, who present their findings on September 18, 2008 at the annual meeting of the American Association of Cardiovascular and Pulmonary Rehabilitation, high liver fat levels are common among people with type 2 diabetes and contribute to heart disease risk.

The NIH-funded study’s lead investigator, exercise physiologist Kerry Stewart, Ed.D., says the rise in the number of people with nonalcoholic fatty liver, mostly due to obesity, signals “a dark trend” because the disease, also called hepatic steatosis, may lead to cirrhosis and subsequent liver failure and transplantation, even cancer, as well as increased risk of diabetes-related heart disease.

“People with type 2 diabetes have added reason to be active and to exercise, not just because it is good for their overall health, but also because our study results pinpoint a key benefit to trimming the fatty liver that complicates their illness and which could accelerate heart disease and liver failure,” says Stewart, a professor of medicine and director of clinical and research exercise physiology at the Johns Hopkins University School of Medicine and its Heart and Vascular Institute.

A majority of the quarter-million people who die each year from all kinds of diabetes do so as a result of some form of heart disease or stroke. And excess body fat is known to increase the likelihood of potentially life-threatening illness because the fat leads to more inflammation in the artery walls, high blood pressure and elevated blood cholesterol levels.

Stewart says the team’s study is believed to be the first to specifically demonstrate the beneficial role played by exercise in controlling hepatic fat levels in people with diabetes.

In the study, 77 diabetic men and women in Baltimore, Md., were divided into two groups.

For a six-month period, half of the study participants were put through a moderate program of sustained aerobic exercise consisting of 45-minute sessions three times a week. They could bicycle, run on a treadmill or take brisk walks. In addition, they lifted stacked weights for about 20 minutes, also three times a week, and not at a heavy-duty pace. The other half of the participants were asked to avoid any formal aerobic fitness or gym classes.

Special magnetic resonance imaging scans performed at the start and end of the study showed much lower levels of liver fat in the active group, while levels remained the same in the nonexercising group (at 5.6 percent and 8.5 percent, respectively). Physical fitness exams were also done.

Among the team’s other findings were better measures in general fitness and fatness among exercisers when compared to the nonexercising group. Averages for peak oxygen uptake levels during treadmill testing, or V02 levels, were greater by 13 percent (25.1 milliliters per kilogram per minute, compared to 22.2 milliliters per kilogram per minute), muscles were stronger by 7 percent (lifting 216.7 pounds, as opposed to 202.8 pounds for seven exercises tested), while percentages of body fat and body weight were each lower by 6 percent (35.5 percent versus 33.2 percent, and 98.5 pounds versus 92.2 pounds, respectively). Even waistlines shrunk on average by 2 inches (39 inches, compared to 41 inches).

“The benefits in improved fitness and fatness are clear, and physicians should really have all people with type 2 diabetes actively engaged in an exercise program,” says Stewart, who plans to further promote moderate exercise through direct talks with referring physicians and through his monthly health blog to the public while he amasses more evidence about the benefits of exercise in people with the disease. An estimated 14 million Americans have been diagnosed with this most common form of diabetes, in which the body cannot use its own life-sustaining insulin and eventually stops producing it.

Stewart says his team’s next steps are to analyze the long-term effect of moderate exercise on diabetes and heart disease, including any improvements in heart and blood vessel structure and function, insulin resistance and arterial inflammation.

The Hopkins study’s exercise program followed current physical fitness guidelines from the American College of Sports Medicine. Their latest research follows another study published in 2005 by the Johns Hopkins scientists, which showed that moderate exercise reduced by more than 20 percent the number of people who develop metabolic syndrome, a clustering of three or more risk factors for developing heart disease, diabetes and stroke. Risk factors include high blood pressure, elevated blood glucose levels, excess abdominal fat and abnormal cholesterol (Newswise).

Time for a Change - In My Diet

I've been away for awhile again. I lost my internet connection for 2 weeks and that was interesting - I lived through it with very little withdrawal, which was a surprise for me. But I did miss all my online friends. I'm on my 4th or 5th data card. Everytime Windows does a service pack, my connection bites the dust.

I'm struggling lately with weight loss. At first, right after my pituitary surgery, the weight came off quickly and easily. So of course there are questions. Am I really cured, or in remission from Cushing's, or whatever you want to call it? Who knows? I just can't sit around and worry about it, and I also can't actively test and investigate since my husband and I both lost our long-time jobs and good health insurance. We now have very expensive insurance that doesn't cover squat on pre-existing conditions for 6 months, and then there's a rather high deductible. So I'm sort of stuck for now and am not going to dwell on it as long as my life is half-way normal. And it is.
For now, anyway!

So my immediate plan is to stay on a low carb diet and see if that helps get the weight loss going again. If it doesn't, it will indicate that I'm dealing with another endocrine issue, whether pituitary or thyroid or whatever. So look for low carb blogs in my bloglist. Tonight I have added
"http://www.weightoftheevidence.wordpress.com/",
so check it out. There's a lot of good information there.

So I've been low carbing for about 5 or 6 days now and have seen some changes. I lost 2 pounds in the first couple of days. But the biggest change that I've seen so far is that my stomach isn't upset all the time. It's early on in the diet, though, so I will keep you posted

A New Neighbor - and He Scares Me!

I haven't been around much lately, mainly because I am working on a project and just haven't had time. I hate writing here so sporadically, but it's that or nothing for me these days!

Many of you know that I live in a beautiful woodland. This is our dream location, we both love everything about the woods. (Except I am not fond of snakes!)If you notice the photo on my homepage, you can see what I am talking about. That is the lane that winds up to our driveway. It is just gorgeous here in northern Michigan.

But there are critters in those woods. We see deer and turkey and squirrels and chipmunks and flying squirrels and raccoons, and I'm pretty sure I saw a bear a few months back. DH heard coyotes a while back, and there are fox everywhere! It's part of the charm of the place. We are communing with nature! So here's the bug I found outside a few days ago. Anybody ever seen anything like it? It is sort of freaking me out, to be honest. Do we have some alien bug culture here, or what?!




I hope you can see it, that's as big as I could get the picture. So I am asking for your help. What is this fascinating new inhabitant of our peaceful woods?

EVEN HAPPY EXPERIENCES CAN'T REDUCE STRESS, NEW RESEARCH SHOWS

This study caught my attention. It is, in itself, quite interesting. But the thing that got me was that they did this and measured these subjects' cortisol levels several times throughout the course of the interview, once beforehand, and then at 30 minute intervals. And it occurred to me: Why do sick people have to beg to get cortisol tests to check for Cushing's?!

COLUMBUS, Ohio -- Researchers here have made a surprising new discovery: They've spent the last decade examining how stressful situations can alter the levels of certain hormones in the blood, weakening the immune system and increasing a person's vulnerability to disease.

But for some people in situations typically considered stress-free -- perhaps even pleasant -- the levels of one hormone, cortisol, may even rise. Scientists have long believed that cortisol levels increase in times of stress and decrease as the stress is eased. The new finding is puzzling researchers but also pointing them to an entirely new area for future research.

The work was described August 4 by Janice Kiecolt-Glaser, professor of psychiatry and psychology at Ohio State University, at the annual meeting of the American Psychological Association in Washington, D.C.

The new work stems from a series of experiments done more than a decade ago and intended to look for physiologic changes
caused by stressful situations. A group of about 90 newlywed couples took part in the study at Ohio State's Clinical Research Center. The couples completed questionnaires and then were asked to discuss several areas of disagreement regarding their marriage.

Blood samples were taken from each subject at the beginning of the session and at 30-minute intervals until they were discharged. When researchers analyzed the data, they found changes in hormones and other bloodstream components that could indicate a weakening of the immune status.

Today's findings, however, arise from a new analysis of data from blood samples taken immediately after those "conflict" discussions. Following a short "transition" period, the newlyweds had been asked to discuss the history of their relationships - how they met, what attracted them to each other, how did they decide to marry.

"For most people, not surprisingly," explained Kiecolt-Glaser, "this was a pretty positive interaction. And they were coming down off the earlier discussion which was usually seen as a negative emotional experience."

When Kiecolt-Glaser and colleagues Ronald Glaser, professor of molecular virology, immunology and medical genetics, and William Malarkey, professor of internal medicine, looked at the levels of cortisol in the blood however, they were surprised.

"In 75 percent of the subjects, the hormone levels had fallen just as we expected - 26 percent on average for the men and 35 percent for the women," Kiecolt-Glaser said. "But in 25 percent of them, cortisol levels stayed relatively the same or, in some cases, actually went up."

Normally, levels of cortisol drop after we wake in the morning. The experiments were done in midmornings and the newlyweds were "coming down" off the negative discussion, which should have forced cortisol levels lower.

But in one of every four people in the study, the cortisol levels failed to drop. In some people, the levels even rose. The findings were especially interesting when coupled with information from follow-up surveys of the participants. The researchers had tracked down each person to check their current marital status and to find out if the newlyweds were still together.

They found that the women whose cortisol levels rose during the discussions of their relationship history were twice as likely to have been divorced from their husbands. No similar relationship appeared among men whose levels had risen.

The study also looked at the exact word choice the couples used in describing their relationship. They used an instrument called the Linguistic Inquiry and Word Count program which lists both "positive" and "negative" words - 261 which describe optimism, energy and positive feelings and 345 words suggesting anxiety, fear, sadness, depression and anger.

Cortisol levels for three-fourths of the men in the study dropped - on average 26 percent. They used significantly more words considered "positive" than did their counterparts whose cortisol remained steady or even rose. There was no similar trend in positive word choice among women whose cortisol had dropped.

Women whose cortisol levels failed to drop, or even rose, however tended to use more negative words as they discussed their relationship history. "What I think is happening here is that in some ways, cortisol levels may serve as a bellwether of what's going to happen," whether women's marriages would survive, Kiecolt-Glaser said.

The most important finding, she says however, is that this proves that "positive" interactions, along with their health implications, deserve as much study as "negative" interactions have garnered.

The National Institutes of Health supported the study.