Experts Matter. Find Yours.
Connect for media, speaking, professional opportunities & more.
GP guidance: Diet and weight loss to achieve type 2 diabetes remission
• Research finds diet and weight loss key to remission of type 2 diabetes • Experts conducted a critical narrative review of over 90 research papers including international clinical trials • Researchers advise on reducing blood sugar levels to manage negative effects of type 2 diabetes and reduce risk of complications Achieving ‘remission’ for people with type 2 diabetes through dietary approaches and weight loss should be the primary treatment goal of GPs and healthcare practitioners, concludes a large-scale review of clinical evidence led by researchers at UCL and Aston University. Type 2 diabetes (T2DM) is a serious condition caused when the body resists the insulin produced in the pancreas, and not enough insulin is made. This leads to high levels of sugar (glucose) in the blood and is associated with multiple health problems including increased risk of heart disease, blindness, and amputation. In the UK T2DM affects around 3.9 million people and 179 million globally. Care and treatment of T2DM costs the NHS around £10 billion a year. Corresponding author, Dr Duane Mellor, Aston University said: “Accounting for all the evidence, our review suggests remission should be discussed as a primary treatment goal with people living with type 2 diabetes. There are multiple dietary approaches that have been shown to bring about T2DM remission though at present meal replacements offer the best quality evidence. Low carbohydrate diets have been shown to be highly effective and should also be considered as a dietary approach for remission.” Lead author, Dr Adrian Brown, UCL Division of Medicine said: “Traditionally T2DM has focussed on managing a person’s blood glucose with medication, however the approach doesn’t address the underlying causes of T2DM. There is now a growing body of research that shows losing significant weight, 10-15kg, either through weight loss surgery or dietary approaches, can bring about type 2 diabetes remission (non-diabetic blood sugar levels).” For the study, published in the Journal of Human Nutrition & Dietetics, specialist dietitians and obesity experts conducted a critical narrative review of over 90 research papers covering international clinical trials and clinical practice data of dietary methods used to treat T2DM. The study found that meal-replacement diets helped around one in three (36%) people successfully achieve remission, while low carbohydrate diets were able to help around one in five (17.6 %) people achieve and maintain remission for at least two years. People who lost the most weight and kept the weight off using both of these dietary approaches were able to stay in remission. Calorie restricted and Mediterranean diets were also able to help people achieve remission – but at much lower rates. Only around 5% of people on calorie restricted diets stayed in remission after one year, while only 15% of people on a Mediterranean diet stayed in remission after a year. In reaching their findings, the research team had to account for the fact there is no single definition of remission; it is typically defined as a return to non-diabetic blood sugar levels (glycated haemoglobin less than 48mmol/mol), without the use of diabetes drugs. Other definitions however say weight (especially fat around the midsection) must be lost to achieve remission, and others that medications can continue to be used. In addition, some reports suggest low-carbohydrate diets can normalise blood sugar levels even without weight loss. This happens as when carbohydrates are eaten, they are broken down into sugars which cause our blood sugar levels to rise. A low-carbohydrate diet means less blood sugar appears in the bloodstream, leading to improved blood sugar control. However, if weight loss is not achieved but individuals are able to achieve non-diabetic blood glucose, the authors are suggesting this should instead be called mitigation, as the underlying mechanisms of T2DM are not being addressed. Dr Brown said: “The evidence is clear that the main driver of remission remains the degree of weight loss a person achieved. Therefore, for those not achieving weight loss but achieving a non-diabetic blood glucose we are suggesting this isn’t remission per se, but rather “mitigation” of their diabetes.” The research concludes that while weight loss appears to be the best predictor of remission success, it assumes fat loss from the pancreas and liver. They note, that it will be important for future studies to compare how these diets work for different ethnic groups, as T2DM can happen at lower body weights in different ethnic groups, who may have less weight to lose. Dr Mellor added: “Not everyone will be able to achieve remission, but people who are younger (less than 50), male, have had type 2 diabetes for less than six years and lose more weight are more likely to be successful. “This could be because these people are able to address the causes of their diabetes, therefore recovering more of the pancreas’s ability to make insulin and the liver’s ability to use it. But this doesn’t mean others won’t be successful if they improve their diet and lifestyle and lose weight. “Whether or not a person achieves remission, reducing blood sugar levels is important in managing the negative effects of type 2 diabetes and reducing risk of complications. But when it comes to choosing a diet, the most important thing is to pick one that suits you – one that you’re likely to stick to long term.” The initial meeting which led to the writing of this paper was supported by the British Dietetic Association and Diabetes UK.
UMW entomologist can explain why it should be ‘lights out’ for the spotted lanternfly
The call for a cull has been made. Spotted lanternflies are popping up across the East Coast, and scientists are worried this invasive insect could wreak havoc on more than 70 tree and plant species, including many agricultural crops like apples, grapes, stone fruits and hop plants. Indigenous to Asia, spotted lanternflies have been latching on to anything that moves. Residents of several states are being asked to check their vehicles as these resilient bugs are crafty enough to travel by car – quite literally hitchhiking across America. Though harmless to humans and animals, the fast-breeding insect spews out a honey-like substance that covers plants and prevents photosynthesis, leading to an ultimate death of the plant. Experts are advising only one remedy so far – kill them on site. Extreme measures are warranted until scientists can come up with a better plan. There’s a lot to know about invasive species and the spotted lanternfly – and if you are a reporter covering this pressing topic, then let our experts help. Dr. Josephine Antwi is an entomologist whose research focuses on the effects that insect pests have on crops of economic importance. Dr. Antwi is available to speak with media, simply click on her icon to arrange an interview today.
Aston University researchers based in the College of Health and Life Sciences have been awarded a Knowledge Transfer Partnership (KTP) project by Innovate UK, to bring its academic and scientific expertise to assist Catalent in the development of its Zydis® technology, the leading orally disintegrating tablet (ODT). The Zydis ODT fast-dissolve formulation is a unique, freeze-dried oral solid dosage form that disperses almost instantly in the mouth with no water required. It helps delivering treatments to patients and consumers who have difficulty swallowing conventional pills, or where rapid onset of action is desirable. The aim of the KTP partnership is to develop and prove an accurate predictive decision-making tool to pre-determine accurate levels of absorption enhancer for each Zydis product, potentially facilitating faster pharmaceutical development, improving efficiency, and reducing time to market. A Knowledge Transfer Partnership (KTP) is a three-way collaboration between a business, an academic partner and a KTP Associate. The UK-wide programme helps businesses to improve their competitiveness and productivity through the better use of knowledge, technology and skills. Aston University is the leading KTP provider within the Midlands. Academic lead on the project is Professor Afzal Mohammed, who is also chair in Pharmacy in the College of Health & Life Sciences (HLS) and a member of the Aston Pharmaceutics Group (APG) at Aston University. Afzal said: “This is a great opportunity for us to share and translate our academic experience in cell based models, excipient and formulation characterisation to develop an evidence based predictive tool that has the potential to expedite product development at Catalent.” Ralph Gosden, head of Zydis product development at Catalan, added: "We are excited to be working with Aston University on this project. Their expertise in drug transportation, cell biology, data analysis and model cell line design, coupled with its world-class facilities means that together, we will be able to achieve significant improvements in efficiency, and accelerate new product development.” Professor Mohammed will be supported by other colleagues from the Aston Pharmaceutics Group, including, Dr Dan Kirby, who has experience in drug delivery and improving patient acceptability of dosage forms gained through original research; Dr Affiong Iyire who has research expertise in the formulation of drugs for pre-gastric absorption and innovative cell models; and Dr Raj Badhan, who is a pharmacokinetics expert with vast knowledge of in silico methods. The outcomes of the project will be integrated into Aston University’s curriculum through teaching case studies, thereby developing well equipped graduates.
As Pfizer gets full FDA approval – Georgia Southern’s experts are in the media and getting coverage
With a fourth wave of COVID sweeping America and beyond – the Pfizer vaccine receiving full FDA approval couldn’t come at a better time according to most health experts. And as news swept across the country, Georgia Southern University’s Isaac Chun-Hai Fung, Ph.D., associate professor of epidemiology, was front and center for media and reporters, helping to explain the importance and significance of this landmark announcement. The green light from the U.S. Food and Drug Administration to move Pfizer’s vaccine from emergency use to full approval Monday is a milestone in the national pandemic response, and one that comes as Georgia and much of the country battles another surge in infections and hospitalizations due to the delta variant. More than 60% of Americans have received at least one dose of the vaccine, and experts have long pointed to data that shows the shots are safe and effective. Still, the official thumbs-up is a significant piece of evidence to bolster that fact, said Isaac Chun-Hai Fung, Ph.D., associate professor of epidemiology at the Jiann-Ping Hsu College of Public Health at Georgia Southern University. “With this new formal approval from the FDA, the public should have the same confidence as they do with existing vaccines that we have used for years against other diseases,” Fung said. August 24, Georgia Recorder As the COVID story progresses and advances, there will be a lot of questions that need answers and stories for journalists to tell. And if you are covering – then let us help. Fung is available to speak with media regarding this topic — simply reach out to Georgia Southern Director of Communications Jennifer Wise at jwise@georgiasouthern.edu to arrange an interview today.
Why a diet consisting mainly of fruit is bad for you
Plant-based diets have become increasingly popular in recent years, both for health and ethical reasons. One extreme form of plant-based diet is “fruitarianism”, a diet based largely on consumption of raw fruit. At first glance, this may sound healthy, but what effect will this type of restrictive diet have on the body? And is it a healthy diet choice? There is solid evidence that plant-based diets are good for the body. Plant-based diets may reduce the risk of heart disease by 40% and stroke by 29%. Plant-based diets have also been shown to be a useful strategy for helping people lose weight. While plant-based diets have clear benefits for health and environmental sustainability, fruitarianism is one of the most restrictive diet choices available and has almost no evidence to support health benefits. There is no definitive description of what a fruitarian diet should consist of, although one commonly cited “rule” is that between 55% and 75% of the diet should comprise raw fruit. Beyond this, there is some variability; some fruitarians eat grains, some also eat nuts and oils. Apple co-founder, Steve Jobs, experimented with a fruitarian diet, supplementing it with nuts, seeds and grains. Some adherents of fruitarianism stick to an 80-10-10 rule: 80% of calories coming from fresh fruit and vegetables, 10% coming from protein and 10% from fat. This rule is mistakenly based on the belief that humans are not omnivores, but “frugivores” – animals that prefer to eat raw fruit. Proponents of this belief state that the human digestive system is physiologically designed to digest fruit and raw vegetables. While this may have once been true, the human body has evolved. Some fruitarians claim that “going raw” has had marked benefits including curing cancer and eliminating bloating and body odour. There is no robust evidence to back up these claims. The idea of consuming a fruit-only (or fruit-heavy) diet might appear a healthy option at first glance, but there are potentially many problems with this form of restrictive eating. There are clear and significant physical health issues to consider when the human body is provided with a largely fruit-based diet. Following this eating pattern excludes essential food groups and nutrients that the body needs to maintain normal health. While most fruit is considered to be healthy and nutritious, a diet that almost solely relies on fruits will be deficient in nutrients, including protein, iron, calcium, vitamin B (including vitamin B12) and D, zinc and omega-3 fatty acids. Deficiency in these nutrients can have significant health implications including rickets and osteomalacia (a softening of the bones), anaemia and issues with bones, muscles and skin. Put simply, fruit does not contain all the nutrients the body needs. In addition to what is missing in a fruitarian diet, the high levels of fructose have to be considered. Fructose is a simple sugar, like glucose, but the human body processes it very differently. Fructose is metabolised solely in the liver. Excess fructose consumption can cause fat buildup in the liver, leading to insulin resistance in the liver and non-alcoholic fatty liver disease. While there is controversy as to whether fructose from fruit is as bad as fructose syrup, which is added to foods to sweeten them, experiments in rats fed a high fructose diet showed similarities to human fatty liver disease. Serious harm Beyond the potential physical effects of fruitarianism, restrictive diets are also often associated with an eating disorder known as orthorexia nervosa, or an unhealthy obsession with eating “pure” food only. This means that what can start off as a healthy move towards eating more fruit and vegetables and less junk food can lead to an eating disorder, depression and anxiety. Worryingly, isolated cases of death or significant disease have been reported when a fruitarian style diet has been followed. Examples include a nine-month-old girl dying after being fed a fruit-only diet. The girl died vastly underweight and malnourished. Additionally, a 49-year-old man was recently reported to have developed reversible dementia after subsisting on a fruit-only diet. With little evidence of the benefits of such a restrictive diet, it is clear that people who follow this restrictive diet are potentially putting their health at serious risk. Supplementation with foods that provide the missing nutrients may help, but may be rejected by some with orthodox views on fruitarianism. Before changing a diet, especially if the change is going to be extreme, it is always wise to speak to your doctor first. Incorporating more fruit and vegetables as part of a balanced diet is a far safer, healthier way to approach fruit consumption.
It’s World Water Week – Have you lined up an expert for your stories and coverage this week?
It’s World Water Week, and as issues with pollution in our oceans, safe drinking water in cities and droughts impacting public safety, public health and key industries across the west dominate the headlines – water is a topic that can’t be overlooked or its importance to society taken for granted. There are a host of angles, aspects and storylines that touch on just about every economic, political and social aspects of modern life, and if you are a reporter looking to cover World Water Week - then let our experts help! Asli Aslan, Ph.D., is a water microbiologist, and her research program bridges ecosystem and human health. She has ongoing funded projects on microbial source tracking, health risk assessment of water resources, and the ecology of pathogens in the aquatic environment. She is available to speak with reporters – simply click her icon to arrange an interview today.
The Olympics have come and gone. As the world watched top athletes from across the globe compete, one key takeaway was not a new world record or a perfect 10 on the floor – but that Black female athletes faced unfair scrutiny and an obvious double standard when it came to issues of stress and mental health, policies and protocol, uniforms and hair, and more. UMW Assistant Professor of Communication Emily Deering Crosby's previous research has focused on how the media has portrayed Black female Olympians like Lolo Jones and Gabby Douglas. Here's what she had to say: There were numerous instances this summer of world class women athletes being sexualized, penalized, mocked and dismissed for a variety of issues from uniforms to motherhood to naturally occurring testosterone levels to mental health to archaic policy. This was particularly salient for Black women athletes, which is worth highlighting, since racism and sexism often function in tandem ways that many people misunderstand as “normal” or “insignificant” since it can be pervasive. My work aims to root out, point out and amplify why these practices are wrong, why they keep women from being appropriately valued, and how sports culture can be better and thus enhance communication scholarship and everyday practices by media, fans and athletes themselves. The silver lining in the most recent Games is how digital culture, particularly social media, gives athletes themselves a voice. Further, fans and athletes alike are becoming more knowledgeable of these problematic policies and are bravely and creatively calling them out. Thus, athletes such as Simone Biles, Naomi Osaka, Sha’Carri Richardson, Allyson Felix, Norway’s women’s beach handball team, etc. are key case studies to understand these communication and structural phenomena more deeply and ultimately bring more critical awareness and justice to women’s sports.” If you’re a journalist looking to know more about this important topic – then let our experts help with your questions and coverage. Assistant Professor of Communication Emily Deering Crosby is a rhetorical critic of popular culture with research concentrations in feminist criticism – and she’s a go-to expert on this topic for national media. Dr. Crosby is available, simply click on her icon now to arrange an interview today.
Sugar: why some people experience side-effects when they quit
It might surprise you to learn that sugar consumption has actually been steadily decreasing since 2008. This could be happening for any number of reasons, including a shift in tastes and lifestyles, with the popularity of low-carbohydrate diets, like keto, increasing in the past decade. A greater understanding of the dangers of eating excess sugar on our health may also be driving this drop. Reducing sugar intake has clear health benefits, including reduced calorie intake, which can help with weight loss, and improved dental health. But people sometimes report side-effects when they try eating less sugar – including headaches, fatigue or mood changes, which are usually temporary. The reason for these side-effects is poorly understood. But it’s likely these symptoms relate to how the brain reacts when exposed to sugary foods – and the biology of “reward”. Carbohydrates come in several forms – including as sugars, which can naturally occur in many foods, such as fructose in fruits and lactose in milk. Table sugar – known as sucrose – is found in sugar cane and sugar beet, maple syrup and even honey. As mass production of food has become the norm, sucrose and other sugars are now added to foods to make them more palatable. Beyond the improved taste and “mouthfeel” of foods with high sugar content, sugar has profound biological effects in the brain. These effects are so significant it’s even led to a debate as to whether you can be “addicted” to sugar – though this is still being studied. Sucrose activates sweet taste receptors in the mouth which ultimately leads to the release of a chemical called dopamine in the brain. Dopamine is a neurotransmitter, meaning it’s a chemical that passes messages between nerves in the brain. When we’re exposed to a rewarding stimulus, the brain responds by releasing dopamine – which is why it’s often called the “reward” chemical. The rewarding effects of dopamine are largely seen in the part of the brain involved in pleasure and reward. Reward governs our behaviour – meaning we’re driven to repeat the behaviours which caused dopamine to be released in the first place. Dopamine can drive us to seek food (such as junk food). Experiments in both animals and people have shown how profoundly sugar activates these reward pathways. Intense sweetness surpasses even cocaine in terms of the internal reward it triggers. Interestingly, sugar is able to activate these reward pathways in the brain whether it’s tasted in the mouth or injected into the bloodstream, as shown in studies on mice. This means its effects are independent of the sweet taste. In rats, there’s strong evidence to suggest that sucrose consumption can actually change the structures in the brain that dopamine activates as well as altering emotional processing and modifying behaviour in both animals and humans. Quitting sugar It’s obvious that sugar can have a powerful effect on us. So that’s why it’s not surprising to see negative effects when we eat less sugar or remove it from our diet completely. It’s during this early “sugar withdrawal” stage that both mental and physical symptoms have been reported – including depression, anxiety, brain fog and cravings, alongside headaches, fatigue and dizziness. This means giving up sugar can feel unpleasant, both mentally and physically, which may make it difficult for some to stick with the diet change. The basis for these symptoms has not been extensively studied, but it’s likely they’re also linked to the reward pathways in the brain. Although the idea of “sugar addiction” is controversial, evidence in rats has shown that like other addictive substances, sugar is able to induce bingeing, craving and withdrawal anxiety. Other research in animals has demonstrated that the effects of sugar addiction, withdrawal and relapse are similar to those of drugs. But most of the research that exists in this area is on animals, so it’s currently difficult to say whether it’s the same for humans. The reward pathways in the human brain have remained unchanged by evolution – and it’s likely many other organisms have similar reward pathways in their brains. This means that the biological impacts of sugar withdrawal seen in animals are likely to occur to some degree in humans too because our brains have similar reward pathways. A change in the brain’s chemical balance is almost certainly behind the symptoms reported in humans who remove or reduce dietary sugar. As well as being involved in reward, dopamine also regulates hormonal control, nausea and vomiting and anxiety. As sugar is removed from the diet, the rapid reduction in dopamine’s effects in the brain would likely interfere in the normal function of many different brain pathways, explaining why people report these symptoms. Although research on sugar withdrawal in humans is limited, one study has provided evidence of withdrawal symptoms and increased sugar cravings after sugar was removed from the diets of overweight and obese adolescents. As with any dietary change, sticking to it is key. So if you want to reduce sugar from your diet long term, being able to get through the first few difficult weeks is crucial. It’s important to acknowledge, however, that sugar isn’t “bad” per se – but that it should be eaten in moderation alongside a healthy diet and exercise
Clinical trials to combat short sightedness in children underway at Aston University
Clinical trials to treat myopia - or short sightedness - in children are now underway. They are being conducted by researchers from Aston University in partnership with industry and in collaboration with the Universities of Queens, Ulster, Glasgow Caledonian, Anglia Ruskin, Waterloo and TU Dublin, with one of the trials funded by the National Institute for Health Research (NIHR). The myopia research team in the College of Health and Life Sciences at Aston University is recruiting children between the ages of six to 15 years old, to take part in the clinical studies, which involve a range of different interventions that aim to slow the progression of myopia in children. The interventions under trial include low dose atropine eye drops, contact lenses and spectacle lenses. Myopia is an eye condition where distant objects appear blurry. It typically occurs in childhood and progresses through the teenage years. It can lead to eye disease in later life, as the eye grows longer with myopia, it causes stretching in parts of the eye. Myopia is becoming increasingly prevalent throughout the world and it has been predicted to affect approximately 50 per cent of the world's population by 2050, based on trending myopia prevalence figures. Myopia is an overlooked but leading cause of blindness, particularly among the working age population. At present, different designs of soft contact lenses, orthokeratology contact lenses (lenses worn overnight to correct the myopia), novel spectacle lenses and eye drops are all being used to slow eye growth and myopia progression in children. The aim in this trial is to manage myopia with an intervention at a young age in order to maximise the impact on slowing down the progression of myopia. Lead researcher professor, Nicola Logan, said: “Myopia is often considered benign because the blurred vision is easily corrected with glasses, contact lenses or refractive surgery. Higher levels of myopia are associated with increased risk of pathological complications, but it is important to note that there is no safe level of myopia. Even low levels of myopia increase the risk of sight-threatening eye conditions. “We are at an exciting time whereby we now have interventions based on research evidence that can be used in clinical practice that will help to slow down the rate of progression of myopia. “In these trials we want to find out the impact of different interventions on myopia progression in UK children, as well as look at why myopia develops and how it progresses in children, to see if we can enhance the current interventions. New information may be used to make the myopia control interventions more effective.” The researchers are aiming to recruit around 200 children aged between six and 15 years old across the three trials by 2021. If you are a parent or guardian of children who have myopia and feel this may be suitable for your children, then you can contact the research team at myopia@aston.ac.uk or (+44)121 204 4100 for further information.
Homelessness expert on eviction moratoriums
Marybeth Shinn, Cornelius Vanderbilt Chair, Department of Human and Organizational Development, is available for commentary on eviction moratoriums and how they work. An expert on the topic of homelessness and affordable housing, Shinn is also the author of a recently published book, "In the Midst of Plenty: Homelessness and What to Do About It." Shinn can speak to: How an eviction moratorium works and consequences for it ending, including accumulated rents being due The health hazard that evictions and potential homelessness or congregate housing cause, especially as we continue to endure COVID Her view that we know what causes homelessness (lack of affordable housing, rising inequality, etc.) and have the resources to end it, but lack the political will Suggested government assistance to end the crisis and how affordable housing is the first step to getting people back on their feet (everything else, such as employment, comes second)
