Hormone imbalance may explain higher diabetes rates in sleep-deprived men

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Studies have found an association between insufficient sleep and the development of insulin resistance, one of the factors that cause type 2 diabetes, and now researchers have discovered a biological reason for this relationship, at least in men: an imbalance between their testosterone and cortisol hormones. The study results will be presented Sunday at ENDO 2018, the Endocrine Society’s 100th annual meeting in Chicago, Ill.

“Our highly controlled sleep study showed that even one night of restricted sleep can cause insulin resistance and that we can dampen this effect by controlling levels of these two important hormones,” said senior investigator Peter Y. Liu, M.B.B.S., Ph.D., a professor of medicine with the Los Angeles Biomedical (LA BioMed) Research Institute at Harbor-UCLA Medical Center, Torrance, Calif.

Insulin resistance occurs when the body does not properly use the hormone insulin. Testosterone is the main anabolic, or muscle-building, hormone, whereas cortisol—often called the “stress hormone”—helps catabolism, or breaking down energy and fat stores for use, Liu explained. Past research shows that sleep loss reduces a man’s testosterone levels and increases cortisol levels.

Liu and his fellow researchers conducted five nights of sleep studies in 34 healthy men with an average age of 33. They controlled what the subjects ate and how much they slept, giving them 10 hours of sleep the first night and restricting them to four hours of sleep the remaining nights. The study received funding from the National Institutes of Health and the Clinical and Translational Research Center at LA BioMed.

In this “crossover” study, the men served as their own controls. In one series of sleep studies, they received three medications: ketoconazole, which switches off the body’s production of testosterone and cortisol; testosterone gel; and oral hydrocortisone, a synthetic form of cortisol. The doses of testosterone and hydrocortisone were in the midrange of levels that the body normally produces, according to Liu. This arm of the study was called a dual “clamp” because it stopped the body’s production of these two hormones and then gave them a fixed amount of the hormones, thus clamping levels in a normal hormonal balance, he said.

In another set of experiments, the men received inactive placebos that matched the medications. The order of when they received the clamp and the placebo was random, with a two-week interval between the study conditions. The morning after the first and last nights of each part of the study, all men took the oral glucose tolerance test, in which they gave blood samples while fasting and again after drinking a sugary drink. This test result allowed the researchers to calculate each man’s insulin resistance using standard measures, including the Matsuda Index.

After sleep restriction, this index reportedly showed greater insulin resistance with both the clamp and the placebo. However, Liu said this increase was significantly dampened, or less severe, with the dual-clamp, demonstrating that testosterone and cortisol reduced the negative effects of sustained sleep restriction on insulin resistance.

“Maintaining hormonal balance could prevent metabolic ill health occurring in individuals who do not get enough sleep,” he said. “Understanding these hormonal mechanisms could lead to new treatments or strategies to prevent insulin resistance due to insufficient sleep.”

Article Source: https://medicalxpress.com/news/2018-03-hormone-imbalance-higher-diabetes-sleep-deprived.html

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Low sperm count not just a problem for fertility

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A man’s semen count is a marker of his general health, according to the largest study to date evaluating semen quality, reproductive function and metabolic risk in men referred for fertility evaluation. The study results, in 5,177 male partners of infertile couples from Italy, will be presented Sunday at ENDO 2018, the Endocrine Society’s 100th annual meeting in Chicago, Ill.

“Our study clearly shows that low sperm count by itself is associated with metabolic alterations, cardiovascular risk and low bone mass,” said the study’s lead investigator, Alberto Ferlin, M.D., Ph.D. He recently moved as associate professor of endocrinology to Italy’s University of Brescia from the University of Padova, where the study took place in collaboration with professor Carlo Foresta, M.D.

“Infertile men are likely to have important co-existing health problems or risk factors that can impair quality of life and shorten their lives,” said Ferlin, who is also president of the Italian Society of Andrology and Sexual Medicine. “Fertility evaluation gives men the unique opportunity for health assessment and disease prevention.”

Specifically, Ferlin and his colleagues found that about half the men had low sperm counts and were 1.2 times more likely than those with normal sperm counts to have greater body fat (bigger waistline and higher body mass index, or BMI); higher blood pressure (systolic, or top reading), “bad” (LDL) cholesterol and triglycerides; and lower “good” (HDL) cholesterol. They also had a higher frequency of metabolic syndrome, a cluster of these and other metabolic risk factors that increase the chance of developing diabetes, heart disease and stroke, the investigators reported. A measure of insulin resistance, another problem that can lead to diabetes, also was higher in men with low sperm counts.

Low sperm count was defined as less than 39 million per ejaculate, a value also used in the U.S. All the men in the study had a sperm analysis as part of a comprehensive health evaluation in the university’s fertility clinic, which included measurement of their reproductive hormones and metabolic parameters.

The researchers found a 12-fold increased risk of hypogonadism, or low testosterone levels, in men with low sperm counts. Half the men with low testosterone had osteoporosis or low bone mass, a possible precursor to osteoporosis, as found on a bone density scan.

These study findings, according to Ferlin, suggest that low sperm count of itself is associated with poorer measures of cardiometabolic health but that hypogonadism is mainly involved in this association. He cautioned that their study does not prove that low sperm counts cause metabolic derangements, but rather that sperm quality is a mirror of the general male health.

The bottom line, Ferlin stressed, is that treatment of male infertility should not focus only on having a child when diagnostic testing finds other health risks, such as overweight, high cholesterol or high blood pressure.

“Men of couples having difficulties achieving pregnancy should be correctly diagnosed and followed up by their fertility specialists and primary care doctor because they could have an increased chance of morbidity and mortality,” he said.

Article Source: https://www.eurekalert.org/pub_releases/2018-03/tes-lsc031418.php

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These two economists used ‘meta rules’ to drop 120 pounds

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“Meta-rules” are a small but powerful way to change your eating habits and keep off unwanted pounds, according to former obese economists Christopher Payne and Robert Barnett. The friends, who once worked together at Bloomberg, used the philosophy to drop a combined 120 pounds.

Payne and Barnett have written a book about their weight loss journey: “The Economists’ Diet.” They say their philosophy, which they adopted from behavioral economist Dan Ariely, applies their knowledge about economics to mindful eating.

“There’s a glut of food, we’re eating too much,” Payne tells NBC News BETTER. “This is how we have to impose eating austerity in order to get our bodies back.”

“META-RULES” ARE SMALL RULES YOU ESTABLISH THAT DICTATE HOW YOU EAT

Whether you make it a rule to only eat dessert once a week, or to ban sugary drinks, “meta-rules” help you lose weight because they reduce decision making about what goes in your stomach, Payne and Barnett say.

“It’s almost like an oath to yourself to take decision and choice out of it,” Payne says. “But in another sense, what we’re talking about is just habits.”

The men give the following tips in addition to applying “meta-rules” to weight loss.

  • Weigh yourself every morning. This will force you to be conscious of how your eating habits are affecting your weight.
  • Never waste calories on food you don’t love.
  • Have two light meals and one square meal per day.
  • If you know you’re going to eat a large meal later, skip a meal earlier in the day.
  • Become calorie conscious. You may even want to keep a food ledger and count your calories.

LOSING WEIGHT TAKES TIME

Payne and Barnett insist “meta-rules” are not a fad diet: they won’t help you lose weight quickly.

“It’s a long-term process about changing behavior for the good,” Payne says.

You do something quick, and then you almost toss it out and go back to your old ways.

You do something quick, and then you almost toss it out and go back to your old ways.

Payne says it took him 18 months to lose 45 pounds, or about 2.5 pounds a month. Barnett says it took him over a year to lose 75 pounds.

“We would generally caution against [losing weight quickly] because we don’t think it gives you enough time to instill the habits you’re going to need to [keep the weight off] for the rest of your life,” says Barnett. “You do something quick, and then you almost toss it out and go back to your old ways.”

DEVELOPING MINDFUL EATING HABITS IS MORE EFFECTIVE THAN EXERCISE

You might think that exercise is enough to maintain a healthy weight, the authors say, but developing positive eating habits through “meta-rules” outperforms the gym.

“For many of us, [exercise] is not something we’re going to keep up forever,” Payne says. “You need to be able to keep up the sustainable habits.”

“META-RULES” ARE ABOUT CHANGING YOUR BEHAVIOR FOR THE LONG-HAUL

Both men say “meta-rules” helped them lose weight and keep it off.

“There’s plenty enough to worry about in life, and it just so happens for me the one thing I don’t have to worry about is my weight,” says Payne. “But it’s not that I have some perfect physique — far from it — it’s just good enough, and that’s great.”

Barnett says his blood pressure has gone down and he no longer takes medication.

“I think whenever you can sort of naturally control something like that as opposed to needing a pill, that’s great,” says Barnett. “So hopefully I’ll be around for my children for more years and that kind of thing because of losing weight.”

HOW TO CHANGE YOUR EATING HABITS WITH “META-RULES”

  • Make some rules: Creating “meta-rules” for mindful eating will help reduce decision making about what you’re going to eat. For example, you might make a rule that you’re only going to drink your coffee black, or that you will only eat out twice a month.
  • Practice patience: “Meta-rules” are not a fad diet. Losing weight is a slow process. Remember: it’s not about being thin, but rather, changing your behavior, which will help keep the weight off.
  • Eat well first, exercise second: While exercise is great, it probably won’t help you stay in shape if you’re not also watching what goes in your mouth. “Meta-rules” help keep the weight off even when you can’t make it to the gym.
  • You have to be in it to win it: Whether you’re tired of being overweight or just want to be healthier, “meta-rules” will help you develop healthier habits for the rest of your life.

Article Source: https://www.nbcnews.com/better/pop-culture/these-two-economists-used-meta-rules-drop-120-pounds-ncna855206

by Julie Compton / 

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Is testosterone replacement therapy the right thing for aging males?

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Testosterone (T) is a naturally occurring hormone in men, and most of it is produced in the testicles.

At puberty, T production escalates, bringing about masculinizing changes in muscle mass.  also promotes sex drive, sperm and red blood cell production, bone mass and determines how men store body fat.

It can impact quality of life issues as well, like mood, energy and motivation.

Beginning at about age 30, T production begins to decline on average by about 1 percent per year, plummeting late in life. This causes all sorts of problems, including lack of sex drive, inability to sleep, loss of muscle and bone mass, increased belly fat, the list goes on. Reversing these symptoms and improving the quality of life is the reason T replacement therapy (TRT) clinics supervised by physicians have sprung up around the country.

Although it is considered a male hormone, women also produce a modest amount of T in the ovaries. After menopause, estrogen production declines, which alters the ratio of estrogen to T, explaining why women begin taking on some male characteristics, like storing more fat around the midsection, rather than on the hips, thighs and buttocks as occurs earlier in life.

TESTOSTERONE REPLACEMENT THERAPY

Is TRT a good thing? It can be when managed responsibly. If you are older, and your T level is very low and falls below the normal range, it makes sense to address it with TRT because it can negatively impact health, increasing risks associated with diabetes, obesity and osteoporosis. Low T also may shorten life, but this is controversial because when TRT raises T levels it has not been shown to extend life.

More is not always better, and many TRT clinics are viewed with suspicion because they advertise that it’s possible to feel like you are 25 years old again, even though you are decades older. Perhaps this is possible, but at what price, and if you are taking huge doses of T, could you be damaging your health?

Research studies in 2013 and 2014 indicated that TRT increased the risk of heart disease in men 65 and older, and in younger men with a history of heart disease. However, subsequent studies refute these findings and some show a deceased risk of heart disease. Another area of concern is an increased risk of prostate cancer, but this, too, is controversial. There does appear to be solid evidence that TRT can increase the risk of blood clots and stroke, plus sleep apnea, acne and breast enlargement.

All in all, some experts believe the benefits outweigh the risks, while others are more cautious because TRT hasn’t been around long enough or impacted enough men to draw meaningful conclusions. Time will tell. In the meantime, like most things in life, moderation is the best approach.

ANABOLIC STEROIDS

Anabolic steroids (AS) are synthetic steroid hormones that resemble T. AS require a doctor’s prescription and were developed to promote muscle mass in postsurgical patients, particularly older patients. Unfortunately, AS use spilled over to strength athletes who wanted the advantages associated with increased muscle mass, and AS delivered as promised. This, in turn, inspired gross overdosing with AS as a means to producing freaky muscular proportions and super human strength.

AS can cause a long list of negative side effects, the most serious being growth of tumors in the liver and acceleration of atherosclerosis (clogging of the arteries). AS suppress HDL (good cholesterol) production, which leads to a ratio of bad to good cholesterol that is out of whack, promoting clogged arteries and ultimately leading to a heart attack. Worse, because a doctor’s prescription is required, AS often are obtained illegally from foreign countries through the mail, with no sense of the quality of the product or the dangers involved.

When I was young, I was an enthusiastic weight lifter, working out hours every day. Some of my friends went the AS route and developed amazing physiques. Recently, I have endeavored to track them down to see how they are doing, and I was saddened to learn that too many have died prematurely, in their fifties and sixties, some even earlier. The most likely cause was a heart attack.

THE BOTTOM LINE

TRT has a place and can be beneficial if managed prudently. Just be careful of extreme approaches and promises that seem too good to be true. As for AS, there is no justifiable reason for athletes to be taking them. Ever!

Article Source: https://www.courier-journal.com/story/life/wellness/health/2017/09/07/testosterone-replacement-therapy-aging-males/569708001/?cookies=&from=global

Written BY: Bryant Stamford

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Men’s Sperm Counts Are Dropping, and Scientists Don’t Know Why

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The topic of overpopulation has been much discussed over the past few decades, but what if the real issue is a severe decline in population?

It sounds like something straight out of a dystopian nightmare, but new research shows sperm counts are drastically dropping across the Western world.

Researchers from Hebrew University-Hadassah Braun School of Public Health and Community Medicine in Jerusalem announced this week that sperm count in men residing in developed countries has dropped by a whopping 50 percent over the past 40 years. They claim this alarming trend could potentially result in a decline in male health, fertility and possibly even extinction if the trend doesn’t turn around.

“This study is an urgent wake-up call for researchers and health authorities around the world to investigate the causes of the sharp ongoing drop in sperm count,” explained study co-author Hagai Levine.

After data was collected from 185 studies looking at sperm count and concentration in men from North America, Europe, Australia and New Zealand from 1973 to 2011, researchers found that total sperm count declined by 59.3 percent and sperm concentration declined by 52.4 percent.

Data from men in South America, Asia and Africa were also examined, however, no serious decline was detected. Researchers did note that not as many studies have been conducted in these regions.

Researchers didn’t look into reasons why the drop in sperm count occurred, but noted that the phenomenon has been previously linked to factors ranging from exposure to chemicals and pesticides to lifestyle choices, including smoking, obesity and stress. They are worried that if things keep heading in this direction, the human race could be doomed.

Daniel Brison, an embryology and stem cell biology specialist at Manchester University who was asked to comment on the findings, told Reuters the study had “major implications not just for fertility, but for male health and wider public health.”

“An unanswered question is whether the impact of whatever is causing declining sperm counts will be seen in future generations of children via epigenetic (gene modifications) or other mechanisms operating in sperm,” Brison said.

The next step is obviously to pinpoint what is causing the sperm count to decrease so dramatically. “Given that we still do not know what lifestyle, dietary or chemical exposures might have caused this decrease, research efforts to identify (them) need to be redoubled and to be nonpresumptive as to cause,” added Edinburgh University’s Richard Sharpe.

In the meantime, if you are concerned about your own declining sperm count you should consider modifying your diet. Here are some foods that can help make your sperm more active, healthy and abundant.

Article Source: https://www.yahoo.com/amphtml/lifestyle/men-apos-sperm-counts-dropping-074720787.html?__twitter_impression=true

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Study: Long-term testosterone therapy improves urinary, sexual function and quality of life

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A new study shows a significant improvement in both sexual and urinary function as well as quality of life for hypogonadal men who undergo long-term testosterone replacement therapy.

These findings appear in the Journal of Urology.

Testosterone is a steroid hormone involved in the regulation of sexual function, urinary health and metabolism as well as a number of other critical functions. For most men, testosterone concentration declines slowly with age and may not cause immediate major symptoms. However, some men may experience a host of signs and sumptoms constituting a clinical condition called Testosterone Deficiency (TD), or male hypogonadism, which is attributed to insufficient levels of testosterone. As a result, they experience symptoms as varied as erectile dysfunction, low energy, fatique, depressed mood and an increased risk of diabetes.

Researchers from the Boston University School of Medicine (BUSM) and Public Health (BUSPH) collaborated with a group of urologists in Germany to investigate the effects of long-term testosterone replacement therapy on urinary health and sexual function as well as quality of life in men with diagnosed, symptomatic testosterone deficiency. More than 650 men in their 50s and 60s enrolled in the study, some with unexplained testosterone deficiency and others with known genetic and auto-immune causes for their hypogonadism.

“It is thought that testosterone treatment in men may increase prostate size and worsen lower urinary tract symptoms,” said Abdulmaged Traish, PhD, professor of urology at BUSM.

However, he and Gheorghe Doros, PhD, professor of biostatistics at BUSPH, discovered that despite increased prostate size in the group that received testosterone therapy, there were fewer urinary symptoms such as frequent urination, incomplete bladder emptying, weak urinary stream and waking up at night to urinate.

In addition to these subjective improvements, the researchers conducted objective testing that showed that those men treated with testosterone emptied their bladders more fully. Finally, testosterone treatment also increased the scores patients received on assessments of their erectile/sexual health and general quality of life.

The findings of this study are of great significance to men suffering with symptomatic testosterone deficiency. Traish emphasized the value of this treatment option, stating that, “[Testosterone therapy] is well-tolerated with progressive and sustained improvement in urinary and sexual function and overall improvement in quality of life.”

Article Source: https://www.eurekalert.org/pub_releases/2017-08/bumc-slt081517.php

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One hidden culprit behind weight gain: fruit juice

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Fruit juice isn’t doing any favors for your waistline, a new study reports.

People who drink a small glass of fruit juice daily can expect to steadily gain a bit of weight over the years, according to data from a long-term study of women’s health.

It’s about the same weight gain you’d expect if someone drank a similar amount of sugary soda every day, the study authors noted.

On the other hand, someone who increases consumption of whole fruit by one serving a day can expect to lose about a pound over three years, the researchers found.

A single 6-ounce daily serving of 100-percent fruit juice every day prompted an average weight gain of about half a pound over three years, said lead researcher Dr. Brandon Auerbach, a doctor at Virginia Mason Medical Center in Seattle.

“The numbers might not seem like they’re that large, but this is in the context of an average American gaining about one pound every year,” Auerbach said. “In terms of weight gain, there’s a striking difference between fruit juice and whole fruit.”

The large load of sugar contained in fruit juice is contributing to the United States’ obesity epidemic, the researchers concluded.

A 6-ounce serving of pure fruit juice contains between 15 and 30 grams of sugar, and 60 to 120 calories, the study authors noted.

Whole fruit also contains sugar, but that sugar is stored within the pulp and fiber of the fruit, Auerbach said. Even high-pulp 100-percent orange juice is not a significant source of fiber.

Without that added fiber, the sugar in fruit juice hits your bloodstream much faster, inducing an insulin jolt that alters your metabolism, Auerbach said.

“Fruit juice does have the same vitamins and minerals as whole fruit does, but it has hardly any fiber,” he said. “The sugar in fruit juice gets absorbed very quickly, and we think that’s why it acts differently in the body.”

This new report relied on data from more than 49,000 post-menopausal American women who were part of the Women’s Health Initiative, a national health study, between 1993 and 1998.

On average, participants gained a little more than 3 pounds during three years of follow-up, the researchers reported.

After controlling for other factors in weight gain—for example, exercise, total calories consumed a day, education and income—the researchers found that women who frequently drank fruit juice were more likely to  .

Sugary fruit juice is a contributing factor to obesity, said Dr. Reshmi Srinath, but “it’s hard to pinpoint as a single culprit” responsible for weight gain.

“Generally, the association is with the pattern of healthy eating and healthy lifestyle,” said Srinath, an assistant professor of endocrinology, diabetes and bone disease with Mount Sinai’s Icahn School of Medicine in New York City.

“Those who eat more fresh fruit are generally having a healthier or more active lifestyle than those who are drinking juice,” Srinath added. She wasn’t involved in the study.

Srinath noted that, on average, women in the study drank less than one serving a day of pure fruit juice from the beginning, “which makes it even harder to find a significant difference, and makes it a more challenging study to interpret.”

Both Srinath and Auerbach agreed that moms should limit kids’ fruit juice, and instead pop a piece of whole fruit in their lunches.

“I would say to limit juice, especially through childhood, because those patterns can continue into adulthood,” Srinath said.

The study was published online recently in the journal Preventive Medicine.

More information: Brandon Auerbach, M.D., MPH, doctor, Virginia Mason Medical Center, Seattle; Reshmi Srinath, M.D., assistant professor, endocrinology, diabetes and bone disease, Icahn School of Medicine at Mount Sinai, New York City; Jan. 9, 2018, Preventive Medicine, online.

Article Source: https://medicalxpress.com/news/2018-02-hidden-culprit-weight-gain-fruit.html

February 14, 2018 by Dennis Thompson, Healthday Reporter

 

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