Dr. Blackburn recently prestented at the annual conference for the American Association of Clinical Endocrinologists.

His topic was "Managing Obesity and Severe Insulin Resistance Comorbidities".

George L. Blackburn, MD, PhD (Harvard Medical School, Boston, MA) gave a talk describing how physicians can work with patients who are obese and have significant insulin resistance. The American diet has changed for the worse in the past 30 years: there has been a 400 kcal/day increase between 1970 and 2009. Nearly half (47.5%) of the American food dollar is now spent on food away from home. A great deal of this is fast food. Additional weight gain of 11-18 pounds increases the risk of developing type 2 diabetes by 200%. To address obesity behaviorally, he advocated a low-calorie, high-fiber diet developed by the Joslin Diabetes Center in Boston, MA. (Although this sounds great, we doubt it will be easy to persuade everyone at risk of obesity or already overweight or obese to move to this diet.) Other behavioral changes he recommended were adequate sleep, small portions, slow eating (again, these are difficult changes to implement). On the exercise front, he characterized resistance training as an important element in weight loss. A troubling study by Vanhecke et al (2009, Clinical Cardiology) showed that morbidly obese patients are generally sedentary for all but ~9 minutes per day. This both demonstrates the enormous challenge of obesity and the great improvement that could be seen with even a small change.

Here's an update from the symposia:

The second day of AACE had less diabetes-related presentation but we enjoyed a great opening plenary session from the likes of Dr. Alan Garber (Baylor College of Medicine, Houston, TX), Dr. Yehuda Handelsman (Metabolic Institute of America, Tarzana, CA) and Dr. Francesco Rubino (Weill Cornell Medical College, New York, NY). In his compelling opening remarks, Dr. Daniel Einhorn, (University of California, San Diego, CA) called for participation at all levels as we go through monumental changes in our healthcare environment. He thanked attendees for braving a troubling economy, H1N1 (swine flu) alarms, and increased scrutiny of physician/industry relationships, in order to make it to this year’s conference. Among today’s most interesting discussions were fascinating talks around what may ultimately be transformative change in the field, namely, the evolution of bariatric surgery to metabolic surgery. This surgery that has also today been referred to as diabetes surgery. Dr. Rubino made the distinction that bariatric surgery focused on weight loss, while by contrast, metabolic surgery focuses on physiologic change, as does diabetes surgery. At this stage, we would like to see more long-term data before declaring “metabolic surgery” and “diabetes surgery” as cures. Today’s discussions had a lot of focus on prediabetes and off-label pharmacotherapy use (mostly TZDs).

It would appear as those the FDA will take their regulations to another level. Beyond monitoring the health effects of the supplement industry, the government's premier health agency will take a harsher stand against food labels claiming health benefits on American staple food items.

WASHINGTON (AP) — Federal regulators are scolding the maker of Cheerios, saying it made inappropriate claims about the popular cereal's ability to lower cholesterol and treat heart disease.

The Food and Drug Administration says in a warning letter to General Mills that language on the Cheerios box suggests the cereal is designed to prevent or treat heart disease. Regulators say that only FDA-approved drugs are allowed to make such claims.

Among other claims, the labeling states: "you can lower your cholesterol 4 percent in six weeks."

General Mills said the health claims on Cheerios have been approved for 12 years and the FDA's complaints deal with how the language appears on the box. The company said in a statement that the science was not in question.

Copyright © 2009 The Associated Press. All rights reserved.

Read Madelyn Ferstrom's Blog post

http://madelynfernstrom.ivillage.com/2009/05/fda-warning-stop-taking-hydrox.html

FDA Warning: Stop Taking Hydroxycut for Weight Loss

Billions of dollars are spent yearly by Americans seeking quick and easy weight loss with unregulated dietary supplements. Why regulate, you might ask? These are "natural compounds" and are not "drugs", so what could be bad? The problem is that these products, while they do originate from a plant source, can do more harm than good. Natural doesn't mean safe - arsenic is natural! Many of these products DO have active ingredients - particularly stimulants - and there is no monitoring of safety, purity, or dosage. It's a major health gamble you don't want to risk. The odds are not in your favor.

The latest in this "discovery" of the health damaging effects of unregulated weight loss dietary supplements is for a family of products called Hydroxycut, associated with liver function problems. Hydroxycut products have been promoted for weight loss as fat burners and energy enhancers, The FDA's statement was quite clear: discontinue use of Hydroxycut products in order to avoid any undue risk. The company has recalled 14 different types of dietary supplements from store shelves (although 2 products still remain).

Unregulated dietary supplements for weight loss sound too good to be true, and they are. At the very least, they're a waste of money. At the worst, they can cause illness, and even death. And, this is not a new problem. You may also recall the FDA-mandated removal of "ephedra" (ma huang), from weight loss supplements because of illness and deaths.

But there is some good news.The FDA has approved the fat-blocking prescription medication, Orlistat, for over-the-counter use in a lower (but effective)dose, called Alli. In fact, all weight loss products need to be reviewed for safety, as well as efficacy.

National efforts are ongoing to bring continued attention to this area. The Reality Coalition, a national group of health experts and organizations, has been working for the past few years on both education and improved health legislation to monitor and regulate the weight loss supplement industry.

Should you risk your health for the promise of quick and easy weight loss? I believe the answer is a resounding no. When it comes to losing weight, there is no quick fix, and slow and steady wins the race.

As you may know, Beth Israel Deaconess and our CEO Paul Levy have been featured heavily for taking a lead in minimizing job cuts during this tough ecomony.

Here is some noteable press coverage:

'Briefing Room' on NECN

'Nightly News' on NBC

'A Head with a Heart' in The Boston Globe

President and CEO of Beth Israel Deaconess Medical Center Paul Levy may have found an alternative to layoffs.

It was the kind of meeting that is taking place in restaurant kitchens, small offices, retail storerooms, and large auditoriums all over this city, all over this state, all over this country.

Paul Levy, the guy who runs Beth Israel Deaconess Medical Center, was standing in Sherman Auditorium the other day, before some of the very people to whom he might soon be sending pink slips.

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