More than just genetics: Lifestyle choices impact GI health

Breakfast habits, environmental factors positively affect metabolism, decrease risk of IBD

LOS ANGELES (May 22, 2006) – Lifestyle factors, such as daily breakfast choices and childhood home environments, have a significant impact on the gastrointestinal system, affecting your metabolism, body mass index and the likelihood of developing GI-related conditions, according to new research presented today at Digestive Disease Week® 2006 (DDW). DDW is the largest international gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

"While some lifestyle factors may be difficult for patients to change, other simple adjustments such as eating a healthy breakfast can result in a striking improvement in GI health," said Lee Kaplan, M.D., Ph.D., associate professor of medicine, Harvard Medical School and director of the Massachusetts General Hospital Weight Center. "These changes should not be underestimated and doctors and patients should work together to improve health and quality of life."

Effect of Breakfasts with Different Glycemic Index and Glycemic Load on Metabolic and Hormonal Responses to the Breakfast and to the Following Meal [Abstract T2071]

Previous research has shown that breakfast patterns can affect a person's weight and energy level, as those who skip breakfast or eat a breakfast rich in protein and fat may experience weight gain and altered energy balance. Researchers from the Universities of Verona and Parma in Italy further examined the link between breakfast and metabolism and found that patients experienced a different metabolic response depending on what type of breakfast they consumed.

A total of 16 healthy volunteers were followed over a three-day period, receiving each of three types of breakfasts: one high in both glycemic index and glycemic load (HGI-HGL); one high in glycemic index and low in glycemic load (HGI-LGL); and one low in both glycemic index and glycemic load (LGI-LGL). Glycemic index refers to how quickly a carbohydrate is processed into the blood stream, raising blood sugar levels. Foods that are lower in glycemic index take somewhat longer to raise blood sugar levels. Glycemic load multiplies the glycemic index of a food by the amount of carbohydrates (in grams) per standard serving size.

Researchers found that LGI-LGL breakfast is associated with keeping the metabolic response active at a higher rate for a longer period of time than other breakfast options with less of an increase in glucose or insulin levels. The LGI-LGL breakfast increased levels of the hormone peptide YY on the morning after the breakfast. Peptide YY, which is produced in the stomach as a response to food, promotes satiety and tends to decrease food intake. Surprisingly, participants who consumed the HGI-HGL breakfast experienced more satiety and fullness compared to those who consumed the other breakfast options. However, this breakfast also caused higher levels of glucose and insulin during the morning. Of the three options, the HGI-LGL breakfast produced the highest insulin levels somewhat later, after lunchtime.

"Consuming foods with low glycemic levels and glycemic load may be a helpful way to naturally stimulate metabolic response," said Luigi Benini, M.D., University of Verona and lead author of the study. "More research must be done to further investigate the potential long-term impact of dietary manipulations on metabolism."

Six Months Supplementation with Conjugated Linoleic Acid Decreases Fat Mass Region-specifically in Overweight and Obese [Abstract 360]

Previous studies have found that conjugated linoleic acid (CLA), a fatty acid typically found in animal food sources such as dairy products or meat, may have some benefit in improving the health of patients suffering from diabetes, clogged arteries and osteoporosis. Researchers from the Scandinavian Clinical Research AS in Norway examined the fat loss effects of CLA and found that overweight or obese patients taking CLA supplements experienced significantly more fat loss than control patients.

The researchers administered either 3.4 grams (g)/day (d) of ClarinolTM CLA or a placebo of olive oil to 118 overweight or obese patients. After six months, results showed that in patients receiving CLA, body fat mass decreased by 2 kilograms (5.6 percent of their starting weight) more than the placebo group. Results were significant as early as three months after starting the CLA, with men losing more fat from their abdomens and women losing more fat from their abdomens and legs.

"With the significant increase in obesity, it is important to find healthy ways to decrease body fat," said Sandra Einerhand, Ph.D., Director Nutrition & Toxicology at Lipid Nutrition in the Netherlands and lead study author. "CLA has proven to be both safe and effective in helping overweight and obese people in reducing body weight, waist/hip ratio and BMI and may be a viable supplement option in conjunction with a healthy diet and exercise."

Environmental Factors Associated with Ulcerative Colitis: A Large Population-Based Case-Control Study [Abstract 902]

Environmental factors have long been associated with disease development and prevention. Investigators from the Christchurch School of Medicine and Hospital in New Zealand evaluated potential environmental factors that may affect the development of inflammatory bowel disease (IBD), specifically ulcerative colitis (UC) and Crohn's disease. They found several factors that exerted possible protective effects against the diseases, including breast-feeding, number of home occupants early in life, and the presence of a home vegetable garden.

Researchers distributed a questionnaire to 668 UC patients, 715 Crohn's disease patients and 599 control patients, receiving 95.2 percent, 94.4 percent and 84 percent response rates, respectively. The questionnaire investigated more than 70 possible environmental risk factors including a family history of IBD, smoking status, previous appendectomy, breastfeeding as an infant, antibiotic use in adolescence, socioeconomic status, household crowding, and the presence of a vegetable garden.

The study found that patients with a family history of IBD, those who were ex-smokers at the time of diagnosis and those who used more than four courses of antibiotics per year as adolescents were between 1.7 and 6.8 times more likely to develop UC. Conversely, patients who were breastfed for more than three months during infancy or had a household vegetable garden during childhood were 30 percent and 40 percent less likely to develop UC than the control group, respectively. In addition, patients residing in homes that were considered "crowded" (defined as more people than bedrooms) in childhood also had a reduced risk of developing UC.

"This study illustrates that there are a variety of factors unrelated to genetics that play a major role in our long-term digestive health," said Richard Gearry, MBChB, Christchurch Hospital Gastroenterologist and lead study author. "While some of these environmental factors may be beyond our control, researchers should continue to think about the variety of social and environmental factors that may come into play to prevent the disease."

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Digestive Disease Week® (DDW) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT), DDW takes place May 20-25, 2006 in Los Angeles, California. The meeting showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.


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