No, no elephants here. Sorry. This is about human trunks - that is, your upper torso. "Upper trunk fat" refers to fatty deposits that form on the chest and upper back area. According to the latest research, upper trunk fat is associated with increased risk for insulin resistance. And insulin resistance, in case ya didn't know, is an early symptom of type 2 diabetes.

It was already known that visceral fat, the fatty deposits that form around and between the internal organs, contributes to insulin resistance.

This study, linking upper trunk fat to insulin resistance, was conducted by researchers based at the San Francisco VA Medical Center. The connection was actually established in the course of a study of fat redistribution and metabolic change in HIV-infected patients. Both HIV-positive patients on antiretroviral therapy and non-HIV-infected control participants were involved in the study.

A surprise finding was this fact that upper trunk fat contributes to insulin resistance just as much as does visceral fat. Also of note: this occurs regardless of whether or not the other type of fat is present. The researchers also note that all study participants were equally at risk. Says lead researcher Dr. Carl Grunfeld, "Strikingly, there was very little difference between HIV-infected people and controls. If you have fat up top, it's bad for you."

A full report has been published in the online version of the Journal of Acquired Immune Deficiency Syndromes.

It's common knowledge that diabetes and heart disease are linked. If you have diabetes, you are much more prone to heart disease than are your non-diabetic counterparts. I've sometimes wondered: why should that be? And here comes the answer, courtesy of a recent Netscape health article.

Scientists at Washington University School of Medicine in St. Louis have been examining the issue. Their conclusion? It all comes down to how the body metabolizes fat. The heart cells of diabetics lose a lipid (cardiolipin) designed to provide the heart with energy to function properly. Says Dr. Richard Gross, "Diabetic hearts run mostly on fats for fuel because glucose isn't readily available to them." Problem is, the absence of cardiolipin screws up the heart's cell membranes, both in terms of structure and function.

It's all downhill after the cardiolipin disappears. For one thing, the heart muscle cells begin to be starved of energy. Second, harmful substances form in the cells. Both these factors contribute to heart problems down the road. Observes Dr. Gross, "The pieces of the puzzle of diabetic heart disease are now rapidly falling into place. We hope that these kinds of studies will enable physicians to diagnose diabetic cardiovascular disease sooner and treat it earlier."

Gastric bypass or banding surgery has become known as an effective measure for treating type 2 diabetes. What has put it in the news, of late, is the fact that gastric bypass is incredibly successful. Many recipients who've gone under the knife respond not only with extreme weight loss (of course - that's what the surgery is designed to do!), but also a normalization of blood sugar levels. Sometimes the reaction is so positive that patients can stop taking blood sugar controlling meds.

Case in point: Marlene Zytcer (57) and her daughter Aimee (31) of Phoenix, Arizona. Marlene and Aimee recently both had gastric banding surgery at the University of California, San Diego Medical Center. Prior to the surgery, both mom and daughter were doing poorly health-wise. They were both obese and fighting heart disease and type 2 diabetes. They say they both have a genetic predisposition to those conditions.

Hot on the heels of my previous cat-related post comes yet more kitty news from the UK. This time it's about the extent to which diabetes is affecting British cats, and the news isn't good. A study conducted at Edinburgh University reports that one in 230 pet cats in the UK is diabetic. Neutered, overweight male cats are most at risk, apparently. Hmm, at least our hefty male friends don't have to contend with the one of those risk factors! Like humans, however, the more sedentary the cat, the greater the risk.

Overall, being overweight ups the risk of diabetes in felines by three times. There are now around five times more diabetic cats in the UK than there were back in the 1970s. Says Professor Danielle Gunn-Moore of the veterinary program at Edinburgh University, "The lifestyle of cats, just like their owners, is changing. Unfortunately, just like people, cats will overeat if they are offered too much tasty food, particularly if they are bored. While cats would naturally exercise outside, many cats are now housebound, so they have little to do all day but eat, sleep, and gain weight."

Yikes, this describes our own chunky kitty Kato to a T. He is getting older, is sedentary, and weighs in at around 19 pounds last time I checked. Like many people, I'm reluctant to let my cats out in case they get lost, hit by a car, stolen, trapped and impounded...the list goes on and on. Then there's the killing of backyard birds to consider. So: what's a cat lover to do?

Fat. Never a good thing, right? At least not in the US, where food is super-abundant. Instead of being rightly grateful for all that food, we blame it for our weight woes. Yes, there's a growing sense that food is the enemy. Food leads to weight gain, which leads to obesity, which leads to heart disease, type 2 diabetes, and on and on. (Read Michael Pollan's The Omnivore's Dilemma for more on what he terms "our national eating disorder.")

But apparently there's a silver lining in all that fat. Says journalist Natalie Angier for The New York Times, "to castigate fat for getting too big and to blame it for high blood pressure or a wheezing heart is like a heavy drinker blaming the liver for turning cirrhotic." That is, if the body couldn't convert energy to fat cells in an efficient manner we'd really be up the proverbial creek. In fact, evolutionary biologists have even speculated that humans' ability to store good-sized quantities of fat has aided the survival of the species and made it possible for our big brains to grow so big and, um, brainy. The fat, you see, helps us through hard times. Food for thought, huh?

I really don't get this, but here goes: according to a report summarized on the website DiabetesHealth, weight gain reduces the severity of heart disease in type 1 diabetics. Huh? How can that be possible, I'm wondering? After all, we live in a world where weight gain is considered a great evil, a threat to individual health, a drain on our healthcare resources etc. etc. And now this!?

The findings come from the Pittsburgh Epidemiology of Diabetes Complications Study, which was conducted over a period of sixteen years and involved the participation of 225 type 1 diabetes patients. The Pittsburgh people agree more fat on the bones adds up to one heck of a big risk factor for heart disease. However, they also say that if you're type 1 and do get heart disease, carrying extra weight makes the heart disease less severe. They also report that this effect is especially true for women. So, the big question: why? The researchers think it's because heavier people may have better insulin control. But don't run for the local Burger Barn; weight gain is not desirable as it does more harm than good in the long run.

Ever noticed that people tend to be around the same weight as spouses and friends? Well, it's not your imagination. A study just out in the New England Journal of Medicine reports that obesity, a major risk factor for type 2 diabetes, acts somewhat like a contagious disease - so when one person puts on weight, others around them follow suit. This, the researchers say, helps explain why Americans have gotten so fat in recent decades.

The study, a summary and discussion of which is featured in The New York Times, involved the analysis of a social network of 12,067 people over a period of thirty-two years (from 1971 to 2003). Researchers tracked not only the health and weight loss/gain of these people, but also who knew whom, who was friends with whom, and who was related to whom. Over time, it became clear that those whose friends became obese were much more likely to grow obese themselves. The likelihood, in fact, tripled in the case of close friends. Interestingly, friendship mattered more as a determining factor than did being related or being neighbors with someone.

It works like this: people tend to share the lifestyle habits of their family and friends. Folks who consider salads delightful and who enjoy frequent jogs around the park generally surround themselves with similarly-minded folks, and it shows in their trim physiques. Likewise, fast-food munchers who enjoy lots of TV tend to hang out with a similar crowd...and their thighs - not to mention waistlines, hearts, blood sugar levels etc. - suffer the consequences. Another factor, says researcher Nicholas Christakis, is the perception of the self in relation to others: "You change your idea of what is an acceptable body type by looking at the people around you."

It used to be that fat was just fat. Not anymore. Turns out that even fat is, upon close examination, more complicated than we ever realized. Did you know, for instance, that accumulations of deep belly fat are particularly harmful? Such accumulations are a risk factor for Type 2 diabetes because they are associated with increased insulin resistance, not to mention increased risk of heart attack.

One problem with deep belly fat, however, is that you can't necessarily detect it with a tape measure or by eyeballing someone's waistline. That is, you can't tell by just looking at a person how much of the fat surrounding their abdomen is deep belly fat versus the subcutaneous fat that lies just under the skin's surface. However, a new study reports that a simple blood test could solve this problem by measuring quantities of the retinol-binding protein 4, also known as RBP4, in the bloodstream. RBP4 is present in much higher levels in the bodies of those with greater amounts of deep belly fat. Not only does this mean that testing for high levels of RBP4 could be useful in assessing risk for conditions such as Type 2 diabetes or heart disease, it also opens up the possibility of treating such conditions by somehow manipulating RBP4 levels.

The study in question was conducted by scientist Barbara Kahn and colleagues from Harvard Medical School, Beth Israel Deaconess Medical Center, and the University of Leipzig, Germany. The results have been published in the journal Cell Metabolism (July, 2007). Kahn is particularly well known in the area of diabetes-related research for her work on insulin resistance in mice.

What is the purpose of body fat? We all have it, some of us a little more than others. As we grow older, some of our diets fall out of balance with our energy needs causing our white fat cells to become swollen.

White fat cells secrete leptin, adiponectin and resistin. Leptin and adiponectin work together in suppressing appetite. Resistin is the newest discovered - and has been found to participate in the inflammatory response and resistence to insulin. It also triggers an immune response to irritation, so it may be the fat cells attempt to shut your piehole because we're not gonna take it. As the white fat cells take on excessive calories they begin swelling, resulting in an inflammatory response.

Inflammation, by definition, is a protective attempt to remove the injurious stimuli (excess calories) and initiate the healing process. As the fat cells dispatch hormones signaling inflammation - one could hypothesize that Type 2 diabetes is a response to an imbalanced diet - calories in versus calories out. So what do our white fat cells do for us? They are designed to store energy for use in times of need. When your body is sending out DEFCON signals of inflammation - I'd say that is a time of need, indeed. Would inducing ketosis till the swelling goes down help?

Yes, whole foods are good for your health. But maybe even better than you imagined. A Swedish study has concluded that a "Stone Age" diet is great for the health and could even prevent Type 2 diabetes. So what did people eat in the dark depths of prehistory? Well, a variety of foods, but nearly all of it was high in fiber, low in fat, fresh, and nearly unprocessed.

Scientists took a small group of fourteen glucose intolerant heart patients and put them on the diet of a lifetime: lean meat, fish, fruits, vegetables and nuts. This, it is assumed, is the sort of diet consumed by our Stone Age ancestors - hunter gatherers who lived around 70,000 years ago, long before the emergence of agriculture. Meanwhile, another group of patients with similar health issues were put on a supposedly healthy "Mediterranean diet" rich in whole grains, dairy, fruits and vegies, and unsaturated fats. Well, you guessed it. After twelve weeks, the researchers found those on the Stone Age diet had much more stable blood sugar levels and were better able to process carbohydrates without such major blood sugar fluctuations. In fact, all the Stone Age patients had normal blood glucose levels by the end of the study and also dropped a few pounds too. Those on the Mediterranean diet, however, experienced hardly any changes at all.

Admittedly, this is a very small-scale study. But the results are interesting nevertheless, and, I'd wager, not a huge shock to well-informed diabetics who understand the importance of curbing carb intake for better health. On the other hand, I was interested to note that the author of the study, Dr. Staffan Lindeberg, played down the "carb as culprit" angle, and instead emphasized the following simple rule for better health: avoid modern, processed foods.

Shrek, Cocoa Krispies, Frosted Flakes. You don't have to be a health nut to find the breakfast cereal and snack treat aisles at your local supermarket a bit disturbing. Sugar, sugar and more sugar: seems that's the main ingredient in most of the cereals pitched at children. And the appalling effect of all that consumption on the nation's children is evident in record (and rising) levels of childhood obesity and Type 2 diabetes. But it seems the food industry is beginning to respond to these concerns.

The New York Times reports that the Kellogg Company plans to quit advertising some of its least nutritious products to children younger than twelve. Those products are the ones packed with so-called "empty-energy" calories derived from sugar and fat, and also containing high levels of sodium. Kellogg also promised to end the use of licensed characters and toys to sell those products. In addition, Kellogg's President and CEO, David Mackay, is quoted as saying that the most sugar-soaked products may be reformulated to make them a tad healthier if it can be done "without negatively impacting the taste of the product."

Kellogg is doing this voluntarily, and expects to complete the changes over the course of the next year and a half. The marketing switch will affect marketing of about half of Kellogg's products. Needless to say, it is what you might call a preemptive move. By making this concession, the company will be able to counter accusations from food industry critics that its execs don't care about the health of our children. Oh, and there's the small matter of a lawsuit which, if it had proceeded, would have brought some horrible bad publicity to Kelloggs. The Center for Science in the Public Interest and the Campaign for a Commercial Free Childhood, along with two Massachusetts parents, says The Times, were threatening to bring a suit against Kellogg and Nickelodeon for their tactics in pitching products to young children. These groups now say they will not pursue their case against Kellogg in light of the changes it has made.

And now for the best headline of the week, courtesy of The Australian: STATE OF MAN: FAT AND DEPRESSED. Ouch. I see the the stereotypical image of Australian men starting to crumble. In the 80s we had Mel Gibson in his heyday. In the 90s we got Russell Crowe. And now, this??

Yes, according to a new study, the "disease burden" in Australia is behind the decline of the Australian man. The study found that half of Aussie men aged between thirty-five and eighty years of age have officially tipped the scales into that dreaded category called Overweight. A further thirty percent are even worse off - in the Obese category. That leaves just a minority, twenty percent, of a normal weight. Yikes, that is bad!

The culprit, as is so often the case here in the US, is the unhealthy lifestyle led by so many. Lack of exercise and poor eating habits lead to weight gain and further inactivity. Not to mention diabetes. Sixteen percent of the Australian men in this study have Type 2 diabetes. Other big problems are depression, anxiety, and asthma. All evidence of a trend that researcher Gary Wittert characterizes as "alarming" and links to social causes like lack of social standing, low earning potential and relationship dissatisfaction.

Mel, you're having problems, that's true. But take heart! Looks like you have plenty of company...or would if you would only return to your homeland. (Just a suggestion...)

Despite claims by zinc supplement manufacturers that the pills can help prevent type 2 diabetes, clinical trials do not support this hypothesis.

Laboratory research suggests that zinc helps promote the production and action of insulin. A four-week study of 56 obese women found that zinc did not have an effect on factors associated with the development of diabetes. This study was an example of one trial that treated 56 people with either zinc or a placebo for four weeks and found no effect. This single trial is too small and too short to tell us anything about the effectiveness of zinc in preventing the development of type 2 diabetes.

Research does support that zinc plays a key role in the regulation of insulin production and glucose utilization. Diabetics have shown a zinc deficiency, which impairs their ability to use glucose. However this fact does not confirm zinc as a supplement to prevent the development of diabetes. I apologize it's a nonevent insofar as news. But look at it this way – it's one trial. Nobody says you have to cross it off your list because 56 obese women didn't see a change in their risk factors for developing diabetes. One study is not gospel.

Here's a question for you to ponder: we know that obesity/overeating is harmful to the body, right? It leads to Type 2 diabetes, among a myriad of other harmful effects. So why do we continue to eat the way we do? Author and academic (at the University of California, Berkeley) Michael Pollan has taken a valiant stab at answering that question. Pollan is the author of the well-received book The Omnivore's Dilemma: A Natural History of Four Meals. I have not read the book (though I'm adding it to my list of books to read in 2007), but I did read Pollan's fab article "Unhappy Meals" in this weekend's New York Times. Our obesity problem, says Pollan, is all tied up with a national hangup about eating and nutrition.

The "elephant in the room," writes Pollan, is the Western way of eating. To be healthier and to avoid diseases like Type 2 diabetes, we should cut consumption of meat and carbs, avoid processed foods, and eat lots more fruits and vegetables. In the case of Type 2 diabetes, the nation needs to stop, in the word's of a scientist quoted by Pollan, "mainlining glucose." And yet...it doesn't happen. Instead, Americans subscribe to fad diets, they invest in expensive exercise equipment and gym memberships. Moreover, says Pollan, Americans are beset by "nutritionism." That is, we try to prevent obesity and diet-related diseases like diabetes by identifying and eliminating the harmful substances in our foods - like salt, fat or carbs - when what we need is to totally modify our diets. He (politely) places a lot of the blame for this on scientists and the media for supplying us with a constant stream of nutrition-related advice that's so confusing and contradictory and seemingly-important that we keep forgetting about that big old "elephant" - the Western diet as a whole. This focus, he says, "has diminished our pleasure in eating it while doing little or nothing to improve our health." It's a conundrum alright.

Scientists have found that mice lacking a protein known as SH2B1 throughout their body are obese and ultimately develop diabetes. Researchers replaced SH2B1 in the brain of obese mice and it seemed to deter the onset of obesity. The study reveals that targeting SH2B1 in the brain might be a new avenue of treatments for obesity and type 2 diabetes.

SH2B1 is expressed in tissues related to obesity, including the brain, liver, pancreas, and fat tissue. Replacing SH2B1 in the brain of mice lacking SH2B1 prevented the mice from becoming obese. It also prevented the mice from developing obesity after being fed a high-fat diet, indicating that SH2B1 in the brain is required to regulate body weight and fat content.

This study implies that SH2B1 in the brain is a practical target for the development of new drugs to treat obesity and type 2 diabetes.