New marker provides insights into the development of type 2 diabetes

Small chemical changes in the DNA building blocks, which may be influenceable by lifestyle factors, can reduce the amount of IGFBP2. A DIfE / DZD research team has now reported in the journal Diabetes that these epigenetic changes increase the risk of type 2 diabetes. Moreover, people with high blood levels of the binding protein IGFBP2 are less likely to develop this metabolic disorder. The changes in the blood are already detectable a few years prior to the onset of the disease.

According to the German Diabetes Health Report 2018, more than 5.7 million people in Germany suffer from type 2 diabetes. The affected individuals react inadequately to the hormone insulin, which leads to elevated blood glucose levels. This in turn can lead to strokes, heart attacks, retinal damage, kidney damage and nerve disorders. Since the metabolic disease develops gradually, initial damage has usually already occurred at the time of diagnosis. “In the future, our findings may help to identify risk potentials for type 2 diabetes even earlier and help to counteract the disease with preventive measures,” said Professor Annette Schürmann, head of the Department of Experimental Diabetology at the German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) and speaker of the German Center for Diabetes Research (DZD).

Uncovering the molecular mechanisms

In addition to insulin, insulin-like growth factor 1 (IGF-1) is also involved in the metabolism of sugar and fat. The effect of this growth factor is weakened by binding to the IGF-binding protein 2 (IGFBP2). If the liver does not release enough IGFBP2 into the blood, the balance of the glucose and lipid metabolism may be disrupted. The research team led by Schürmann and Professor Matthias Schulze, head of the Department of Molecular Epidemiology at DIfE, therefore investigated how the diminished effect of the IGFBP2 gene could influence the development of type 2 diabetes.

Human studies show that people suffering from fatty liver produce and release less IGFBP2. Schürmann’s team observed similar effects in earlier mouse experiments, which showed that IGFBP2 levels were already reduced prior to the liver disease. This is due to the transfer of methyl groups at certain sites of the IGFBP2 DNA sequence, which inhibited the gene in the liver. These so-called epigenetic changes are caused, among other things, by lifestyle factors. Such modifications of the DNA in the IGFBP2 gene were also previously detected in blood cells of overweight people with impaired glucose tolerance.

Translational research from mouse to human studies

The interdisciplinary research team led by Schürmann and Schulze used findings from the clinic and laboratory to evaluate blood samples and data from the EPIC Potsdam Study. “This study is a good example of how translational research works: A clinical finding is taken up, analyzed mechanistically in the laboratory and finally examined in a population-wide study,” said Schürmann.

Recent analyses by the researchers indicate that inhibition of the IGFBP2 gene promotes type 2 diabetes. In addition, the team of scientists observed that leaner study participants and study participants with lower liver fat levels had higher concentrations of the protective binding protein in the blood. Higher plasma concentrations of IGFBP2 were associated with a lower risk of developing type 2 diabetes in subsequent years. “Our study confirms the hypothesis that the IGF-1 signaling pathway also plays an important role in the development of type 2 diabetes in humans,” added Dr. Clemens Wittenbecher, research associate in the Department of Molecular Epidemiology at DIfE and first author of the study.

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Sitting is NOT the new smoking, contrary to popular myth

No, sitting is not the new smoking, despite what countless newspaper articles have peddled in recent years.

That’s the consensus from an international team of researchers who have laid to rest misleading claims comparing the health dangers of sitting for long periods with smoking cigarettes.

In the latest issue of the American Journal of Public Health, researchers from Canada, the US and Australia say that while research does suggest excessive sitting (roughly more than eight hours a day) increases the risk of premature death and some chronic diseases by 10-20%, this pales in comparison to the risks associated with smoking.

Smoking increases the risk of premature death from any cause by approximately 180 per cent, the researchers say.

University of South Australia epidemiologist Dr Terry Boyle, one of nine researchers involved in the evaluation, says media stories comparing sitting with smoking increased 12-fold from 2012 to 2016, and some respected academic and clinical institutions have also spread the myth.

“The simple fact is, smoking is one of the greatest public health disasters of the past century. Sitting is not, and you can’t really compare the two,” Dr Boyle says.

“First, the risks of chronic disease and premature death associated with smoking are substantially higher than for sitting. While people who sit a lot have around a 10-20 per cent increased risk of some cancers and cardiovascular disease, smokers have more than double the risk of dying from cancer and cardiovascular disease, and a more than 1000 per cent increased risk of lung cancer.

“Second, the economic impact and number of deaths caused by smoking-attributable diseases far outweighs those of sitting. For example, the annual global cost of smoking-attributable diseases was estimated at US$467 billion in 2012 and smoking is expected to cause at least one billion deaths in the 21st century.

“Finally, unlike smoking, sitting is neither an addiction nor a danger to others.

“Equating the risk of sitting with smoking is clearly unwarranted and misleading, and only serves to trivialize the risks associated with smoking,” Dr Boyle says.

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For older adults, does eating enough protein help delay disability?

To live successfully and independently, older adults need to be able to manage two different levels of life skills: basic daily care and basic housekeeping activities.

Basic daily care includes feeding yourself, bathing, dressing, and going to the toilet on your own.

You also need to handle basic housekeeping activities, such as managing your finances and having the mobility to shop and participate in social activities.

If you or someone you care for has trouble performing these two types of life skills, this may bring on problems that can reduce quality of life and independence. People 85-years-old and older form the fastest-growing age group in our society and are at higher risk for becoming less able to perform these life skills. For this reason, researchers are seeking ways to help older adults stay independent for longer. Recently, a research team focused their attention on learning whether eating more protein could contribute to helping people maintain independence. Their study was published in the Journal of the American Geriatrics Society.

Protein is known to slow the loss of muscle mass. Having enough muscle mass can help preserve the ability to perform daily activities and prevent disability. Older adults tend to have a lower protein intake than younger adults due to poorer health, reduced physical activity, and changes in the mouth and teeth.

To learn more about protein intake and disability in older adults, the research team used data from the Newcastle 85+ Study conducted in the United Kingdom (UK). This study’s researchers approached all people turning 85 in 2006 in two cities in the UK for participation. At the beginning of the study in 2006-2007, there were 722 participants, 60 percent of whom were women. The participants provided researchers with information about what they ate every day, their body weight and height measurements, their overall health assessment (including any level of disability), and their medical records.

The researchers learned that more than one-quarter (28 percent) of very old adults in North-East England had protein intakes below the recommended dietary allowance. The researchers noted that older adults who have more chronic health conditions may also have different protein requirements. To learn more about the health benefits of adequate protein intake in older adults, the researchers examined the impact of protein intake on the increase of disability over five years.

The researchers’ theory was that eating more protein would be associated with slower disability development in very old adults, depending on their muscle mass and muscle strength.

As it turned out, they were correct. Participants who ate more protein at the beginning of the study were less likely to become disabled when compared to people who ate less protein.

Dr. Nuno Mendonca, the principal author of the study, said: “Our findings support current thinking about increasing the recommended daily intake of protein to maintain active and healthy aging.”

Find your recommended daily protein intake — and other important nutritional needs — by using this calculator: https://fnic.nal.usda.gov/fnic/dri-calculator/

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