The Simeons Therapy Diet Fad

The New York Times published an article this week on the latest diet fad; a daily food intake of just 500 calories a day combined with daily injections of human chorionic gonadotropin (hCG). It’s known as the Simeons therapy, and it’s been around since 1964.

Frankly, the New York Times article stirs up an old “controversy” that shouldn’t still exist. Anyone who can stick to a 500 calorie-per-day diet will lose weight. Weight loss accomplished on the Simeons therapy diet has nothing to do with the added hCG, according to a well-documented review written in 1995.

The FDA has warned that non-injectable “homeopathic” forms of hCG available over the counter cannot be labelled as having have weight-loss properties. But there’s a long-standing tradition of allowing physicians to decide what is best for each patient (in consultation with the patient, of course). Therefore, physicians can legally prescribe injectable hCG as part of a diet plan if they wish, whether or not it works. And of course, they are free to charge whatever they like for the consultation/evaluation prior to writing the prescription.

Acquaint yourself with the facts, and then don’t waste your money on this diet.

Canada Declares BPA Plastic to be Toxic

Canada recently declared a plastic called BPA (bisphenol A) to be a toxic substance. BPA is commonly used in the manufacture of refillable polycarbonate water bottles and in the linings of metal food and beverage cans.

BPA falls into a category of substances known as endocrine disruptors. As a group, endocrine disruptors either mimic or block the action of hormones, thereby disrupting the body’s functions. In laboratory animals, high concentrations of BPA have been shown to mimic the female hormone estrogen. Several studies reported by The Endocrine Society, a well-known scientific group, suggest that endocrine disruptors such as BPA may have adverse health affects that include infertility and cancer.

Canada and about half a dozen states in the U.S. have already banned the use of BPA in children’s products. Canada’s recent action paves the way for future bans on the use of BPA in food and beverage containers for adults as well, and for increased control over manufacturing processes involving BPA.

So far the U.S. government has taken no action, saying there is not enough evidence that the substance harms humans. But research is underway, and time will tell.

It's Official: She Can Compete

It took more than 10 months for a committee of the IAAF, international track and field’s governing body, to decide that Caster Semenya could compete in track and field events as a woman. As you may recall, Ms. Semenya’s gender was called into question after she completely dominated the 800-meter event in the world championships last August in Berlin (see this blog, Sept. 7, 2009.) A statement released yesterday by the IAFF on their Web site (www.IAAF.org) reads in full:

Caster Semenya May Compete. “The process initiated in 2009 in the case of Caster Semenya (RSA) has been completed. The IAFF accepts the panel of medical experts that she can compete with immediate effect. Please note that the medical details of the case remain confidential and the IAAF will make no further comment on the matter.” (IAFF statement)

Remember the old “Where’s the beef?” commercials for Wendy’s chain of restaurants? One might ask, “Where’s the proof?” Out of fairness to all athletes in sports, sports governing bodies should develop understandable policies, guidelines, or criteria for gender assignment in sports. But it won’t be easy (gender IS ambiguous, sometimes), so I’m betting the IAAF won’t even attempt it.

The Wendy’s commercial ended with the remark, “(I don’t think there’s anybody back there…)” IAAF, are you listening?

Inflammation and Type 2 Diabetes

Scientists have long suspected that inflammatory processes play a role in certain chronic diseases, such as Type 2 diabetes and atherosclerosis, and now there’s preliminary evidence. In a clinical trial involving 104 patients, an anti-inflammatory drug related to aspirin called salsalate lowered blood levels of hemoglobin A1c levels and triglycerides slightly in Type 2 diabetics. (Hemoglobin A1c levels are the “gold standard” for monitoring long-term effectiveness of glucose control in diabetic patients.)

Scientists caution that no one should start taking salsalate just yet to try to prevent or treat diabetes or atherosclerosis. Larger clinical studies involving many more patients will be needed before salsalate is becomes a standard treatment for these diseases. Nevertheless, these preliminary findings bring us just a little bit closer to an understanding of the link between obesity and inflammation, and whether (and if so, how) inflammation contributes to chronic diseases such as Type 2 diabetes.

Athlete Caught Doping with Growth Hormone

British rugby player Terry Newton has the distinction of being the first athlete ever caught doping with growth hormone to boost muscle mass. He’s been banned from rugby competition for two years.

Until recently athletes had assumed that human growth hormone doping was undetectable, because the synthetic form of growth hormone looks exactly like natural growth hormone. But then scientists discovered that the body actually produces several different forms of the hormone, and that by examining the ratio of these different forms in blood they could tell if the pure synthetic form had been administered. Anti-doping agencies also began requiring random blood tests rather than just tests after athletic events, because the hormone disappears from the blood just days after administration. It was a random test that caught Mr. Newton.

The U.S. National Football League and Major League Baseball have shown interest in the test but so far it has not been instituted, in part because it requires a blood sample.

Glucose Monitoring Devices are Inaccurate

Most diabetic patients measure their blood glucose level on a regular basis, as part of a daily regimen to try to maintain their blood glucose within normal limits. Many diabetics rely on home glucose monitors that are relatively cheap and easy to use - trouble is, they’re not very accurate. For example, one study reported that five different popular home glucose monitors gave readings that were different by as much as 30%.

Consumers probably are not aware that the devices can be this inaccurate. The Food and Drug Administration (FDA) is understandably concerned, and it’s pressuring the international organization that sets standards for the devices to tighten up the standards - or else the FDA may do it for them.

But this raises an interesting dilemma. Re-engineering and manufacturing the devices would make them more accurate, but it could also increase their price – at least, that’s the manufacturer’s arguments against new standards for accuracy. And if an increase in price caused some people to stop using them altogether, have we really gained anything? There’s always a trade-off; always a choice to be made…..

Is She a Woman?

After 18-yr-old South African Caster Semenya turned in the fastest time of the year in a women’s 800-meter event in 2009, track and track and field’s governing body ordered an investigation into her gender. They're demanding “proof” that she’s actually a female, so they’ve assembled a committee tell them. Let's see, now, a geneticist, an endocrinologist, a gynecologist, and a psychologist are getting together to determine the sex of…

It sounds like the beginning of a bad joke, but it’s not. Legitimate physiological and anatomical “gender confusion” can be caused by sex hormone imbalances, tissue unresponsiveness to sex hormones, genes that don’t turn on properly during fetal development, or even sex-determining genes located on the wrong chromosome (in rare cases, an XY male can develop the characteristics of a female).

Sports federations should develop rules that allow gender determination (for the purposes of sports competition) before an athletic event, not afterwards, in the public eye. One can only wonder about the emotional damage about to be done to young Caster Semenya.

Inhaled Insulin (Who Cares?)

Eli Lilly & Company announced that it was halting development of its inhaled insulin product because it no longer believes that the product has sufficient market potential. The company recorded a three-month loss of $90–120 million to shut down the failed project. The announcement comes just five months after the first inhaled insulin product, Pfizer’s Exubera, was pulled from the market because of weak sales.

What happened? For decades, scientists and drug marketers dreamed of blockbuster profits from the first inhalable insulin product that would eliminate the need for injections in the treatment of diabetes. It turns out that no one cared. Patients didn’t like the cumbersome device used to administer the powdered insulin, and doctors found that the powders had a slight tendency to impair lung function.

It seemed like such a good idea.

Hormone Replacement Therapy Revisited

Back in the 1990s the federal government launched the Women’s Health Initiative to investigate the health of older women. One of its goals was to determine the risks and benefits of hormone replacement therapy (HRT) in post-menopausal women. The HRT study was stopped early (in 2002) when it was discovered that HRT led to an increased risk of breast cancer, heart attacks, and strokes.

What about the women who were on HRT during the study - do they remain at higher risk even after discontinuing HRT? The good news is that apparently most of the increased risk goes away with time. The first follow-up study indicates that three years after HRT is discontinued, the increased risk of heart attacks disappears, and the increased risk of cancer declines significantly. Future reports will show whether any increased risk of cancer remains as time passes.

Current recommendations for HRT remain unchanged; women should consider HRT only if they have moderate to severe post-menopausal symptoms, and for the shortest time and lowest dose that is effective.

Reference: Heiss, Gerardo, et al. Health Risks and Benefits 3 Years After Stopping Randomized Treatment With Estrogen and Progestin. JAMA 299:1036-1045, Mar. 5, 2008.