Metreleptin improved metabolic parameters in children with lipodystrophy.

Positive results from an NIH-supported analysis indicate an investigational recombinant analogue of human leptin has potential as a therapy for pediatric lipodystrophy, according to data presented at the 2013 Pediatric Academic Societies Annual Meeting.

The literature has established that lipodystrophy is known to cause metabolic abnormalities (ie, hypertriglyceridemia, insulin resistance, diabetes andsteatohepatitis), which tend to become severe through childhood and adolescence, and may be resistant to current treatment options.

Rebecca Brown, MD, assistant clinical investigator of the diabetes, endocrinology and obesity branch at the National Institute of Diabetes and Digestive and Kidney Diseases, and colleagues included pediatric patients in an ongoing, open-label study at the NIH (2000 to present).

According to abstract data, patients included in the study (n=39; nine male and 30 female; mean age, 11.9 years) had four subtypes of the disease: congenital generalized lipodystrophy (n=26, 67%), acquired generalized lipodystrophy (n=9, 23%), familial partial lipodystrophy (n=2, 5%), and acquired partial lipodystrophy (n=2, 5%).

On average, the researchers administered metreleptin 4.4 mg (Bristol-Myers Squibb and AstraZeneca) subcutaneously once or twice daily for a mean duration of 3.9 years.

Data indicate that baseline HbA1c (9.8%) decreased significantly to 7.7% after 12 months (–2.3; 95% CI, –3.2 to –1.4) in adolescent patients aged 12 to 18 years.

Triglycerides were notably high in the same group at baseline (1,378 mg/dL), but improved significantly to 385 mg/dL after 12 months (–44; 95% CI, –73 to –15), according to data.

Both age groups displayed significantly elevated mean alanine aminotransferase (ALT; ≤12 years: 193 U/L; adolescents: 105 U/L) and aspartate aminotransferase (AST; ≤12 years: 119 U/L; adolescents: 87 U/L) at baseline. However, ALT (≤12 years: 155 U/L; adolescents: 59 U/L) and AST (≤12 years: 90 U/L; adolescents: 57 U/L) decreased after metreleptin therapy, according to data.

“Metabolic disorders resulting from lipodystrophy can develop in childhood and adolescence and are exacerbated over time,” Brown said in a press release. “This new analysis supports the continued study of investigational metreleptin as a potential treatment option for pediatric patients with lipodystrophy.”

Overall, metreleptin was well tolerated, and the most common adverse events reported were decreased weight (n=3, 7.7%) and hypoglycemia (n=3, 7.7%), followed by fatigue (n=2, 5.1%) and nausea (n=2, 5.1%), the researchers wrote.

According to the press release, metreleptin has acquired orphan designation from the FDA, and the European Medicines Agency is evaluating the agent.

For more information:

Brown R. #3490.3. Presented at: Pediatric Academic Societies Annual Meeting; May 4-7, 2013; Washington.

Source: Endocrine today




Empagliflozin provided sustained glycemic control, weight loss in type 2 diabetes.

  • The novel investigational sodium-glucose cotransporter 2 inhibitor empagliflozin demonstrated 90 weeks of sustained glycemic control and weight loss in patients with type 2 diabetes. Study researcher Thomas Hach, MD, a senior medical director at Boehringer Ingelheim, spoke withEndocrine Today about the data presented during a late-breaking session here.

“We feel there is an important obligation for us to understand patient benefits: to look at benefit-risks and to really understand which patients will benefit most or where there could possibly be limitations,” Hach said.

In active-control studies, Hach told Endocrine Today that he and colleagues saw comparable efficacy. They conducted a randomized, open-label, 78-week extension study on empagliflozin (Boehringer Ingelheim/Eli Lilly and Company).

They investigated empagliflozin 10 mg (n=81), 25 mg (n=82) or metformin (n=80) as monotherapy, or empagliflozin 10 mg (n=71), 25 mg (n=70) or sitagliptin (n=71; Januvia, Merck) as add-on to metformin in patients with type 2 diabetes who also completed one of two 12-week randomized control trials.

According to 90-week data, adjusted mean changes in HbA1c from baseline were: –0.51% (empagliflozin 10 mg), –0.60% (empagliflozin 25 mg) and –0.64% (metformin); and –0.61% (empagliflozin 10 mg), –0.74% (empagliflozin 25 mg) and –0.45% (sitagliptin).

Further data indicate adjusted mean changes in fasting plasma glucose were: –32.4 mg/dL (empagliflozin 10 mg), –28.1 mg/dL (empagliflozin 25 mg), and –25.9 mg/dL (metformin); –23.3 mg/dL (empagliflozin 10 mg), –31.8 mg/dL (empagliflozin 25 mg), and –11.7 mg/dL (sitagliptin).

Moreover, changes in weight were reported as: –2.1 kg (empagliflozin 10 mg), –1.9 kg (empagliflozin 25 mg), and –0.9 kg (metformin); –2.9 kg (empagliflozin 10 mg), –3.8 k (empagliflozin 25 mg), and –0.6 kg (sitagliptin).

“If I was still in clinical practice, I would look forward to having something new in my armamentarium. Unfortunately, there’s still a huge unmet need in diabetes,” Hach said.

The medication was well tolerated, and the most common adverse events associated with empagliflozin include urinary tract and genital infections. Hach said clinicians should use caution with elderly patients or those with renal impairment because those patients are more susceptible to adverse events.

In March, a new drug application for empagliflozin was submitted to the FDA. Further data will be presented at the American Diabetes Association Scientific Sessions in Chicago next month, Hach said. – by Samantha Costa

For more information:

Ferrannini E. Abstract #1102. Presented at: the AACE Annual Scientific and Clinical Congress; May 1-5, 2013; Phoenix.

Source: Endocrine today


Obesity treatment paradigms should target those at risk for diabetes.

Lifestyle modifications, weight-loss medications and bariatric surgery are the three major modalities that will have clinical implications on the prevention and treatment of obesity, according to data presented here.

“With effective options in all of these three treatment modalities, we can now evolve rational data-driven models of care that treat obesity as a medical illness,” W. TimothyGarvey, MD, professor and chair in the department of nutrition sciences at the University of Alabama at Birmingham, and senior scientist at the Nutrition Obesity Research Center, told Endocrine Today.

W. Timothy Garvey

Emerging therapies

During a presentation on emerging obesity therapies, Garvey reported recent data on phentermine-topiramate (Qsymia, Vivus) and lorcaserin (Belviq, Eisai), both of which gained approval in adults with an initial BMI of at least 30 or in those with a BMI of at least 27 and at least one weight-related condition, such as hypertension, type 2 diabetes or dyslipidemia.

“We’re in an exciting phase of drug development for obesity, with two drugs approved in the summer of 2012 that appear to be safe and effective for the treatment of obesity,” Garvey said.

“In addition, we have two other drugs that have finished or will soon finish phase 3 trials.”

One of these is bupropion/naltrexone (Contrave, Orexigen), an experimental agent now finished with phase 3 clinical trials. According to Garvey, a cardiovascular outcomes study is currently ongoing as requested by the FDA before approval. “The BP did not increase with the drug, but it didn’t go down to the extent that you’d predict with the weight loss achieved,” he said. “This will be the first cardiovascular outcomes study with a weight-loss drug where the data will be available in, perhaps, 2014.”

About an 8% weight loss was demonstrated and sustained during 1 year compared with 2% with placebo, Garvey said.

Furthermore, he referenced recent data from a 56-week, double blind, phase 3a clinical trial investigating higher-dose liraglutide (Victoza, Novo Nordisk) as a potential treatment for maintained weight loss in overweight or obese patients with type 2 diabetes. The manufacturer recently released the second phase 3a trial results from the clinical development program for liraglutide 3 mg as an obesity treatment.

“About 4 kg were lost on lifestyle intervention alone, and up to 9 kg were lost with high-dose liraglutide. There are 2-year data indicating that its efficacy for sustaining this weight loss is evident,” Garvey said.

Bariatric surgery

However, Garvey said medical and surgical interventions provide the best outcomes in obese patients with complications, and optimal benefit–risk occurs when weight loss is used as a tool to treat these complications of obesity.

As an adjunct to lifestyle modification, the aforementioned new medical therapies can result in a 10% loss of body weight, but if a patient begins with a BMI of 38, he will likely be obese when therapies are complete, Garvey said.

“However, that 10% loss of body weight is sufficient to improve insulin sensitivity, glucose homeostasis, lipid levels, BP, diabetes prevention, CVD risk factors and better control of both glucose and BP in patients with type 2 diabetes. We’re achieving an amount of weight loss here that’s in fact beneficial in terms of cardiometabolic disease,” he said.

Moving forward

Garvey concluded with the economic burden of diabetes and obesity on the United States health care system. He told Endocrine Today that for the clinical research community to address the diabetes and obesity epidemics, the progression from prediabetes to diabetes should first be considered.

“A rational and effective obesity treatment paradigm that targets resources to patients who are at highest risk will be cost-effective in preventing diabetes,” he said. “The numbers vary, but it costs much more per year to take care of a patient with diabetes than it does to take care of a patient without diabetes.”

Source: Endocrine today


Dual-therapeutic reporter genes fusion for enhanced cancer gene therapy and imaging.

Two of the successful gene-directed enzyme prodrug therapies include herpes simplex virus–thymidine kinase (HSV1TK) enzyme-ganciclovir prodrug and the Escherichia coli nitroreductase (NTR) enzyme-CB1954 prodrug strategies; these enzyme-prodrug combinations produce activated cytotoxic metabolites of the prodrugs capable of tumor cell death by inhibiting DNA synthesis and killing quiescent cells, respectively. Both these strategies also affect significant bystander cell killing of neighboring tumor cells that do not express these enzymes. We have developed a dual-combination gene strategy, where we identified HSV1-TK and NTR fused in a particular orientation can effectively kill tumor cells when the tumor cells are treated with a fusion HSV1-TK–NTR gene– along with a prodrug combination of GCV and CB1954. In order to determine whether the dual-system demonstrate superior therapeutic efficacy than either HSV1-TK or NTR systems alone, we conducted both in vitro and in vivo tumor xenograft studies using triple negative SUM159 breast cancer cells, by evaluating the efficacy of cell death by apoptosis and necrosis upon treatment with the dual HSV1-TK genes-GCV-CB1954 prodrugs system, and compared the efficiency to HSV1-TK–GCV and NTR-CB1954. Our cell-based studies, tumor regression studies in xenograft mice, histological analyses of treated tumors and bystander studies indicate that the dual HSV1-TK–NTR–prodrug system is two times more efficient even with half the doses of both prodrugs than the respective single gene-prodrug system, as evidenced by enhanced apoptosis and necrosis of tumor cells in vitro in culture and xenograft of tumor tissues in animals.





A nanomedicine to treat ocular surface inflammation: performance on an experimental dry eye murine model.

MUC5AC is a glycoprotein with gel-forming properties, whose altered expression has been implicated in the pathogenesis of dry eye disease. The aim of our study was to achieve an efficient in vivo transfection of MUC5AC, restore its normal levels in an inflamed ocular surface and determine whether restored MUC5AC levels improve ocular surface inflammation. Cationized gelatin-based nanoparticles (NPs) loaded with a plasmid coding a modified MUC5AC protein (pMUC5AC) were instilled in healthy and experimental dry eye (EDE) mice. MUC5AC expression, clinical signs, corneal fluorescein staining and tear production were evaluated. Ocular specimens were processed for histopathologic evaluation, including goblet cell count and CD4 immunostaining. Neither ocular discomfort nor irritation was observed in vivo after NP treatment. Expression of modified MUC5AC was significantly higher in ocular surface tissue of pMUC5AC-NP-treated animals than that of controls. In healthy mice, pMUC5AC-NPs had no effect on fluorescein staining or tear production. In EDE mice, both parameters significantly improved after pMUC5AC-NP treatment. Anterior eye segment of treated mice showed normal architecture and morphology with lack of remarkable inflammatory changes, and a decrease in CD4+ T-cell infiltration. Thus, pMUC5AC-NPs were well tolerated and able to induce the expression of modified MUC5A in ocular surface tissue, leading to reduction of the inflammation and, consequently improving the associated clinical parameters, such as tear production and fluorescein staining. These results identify a potential application of pMUC5AC-NPs as a new therapeutic modality for the treatment of dry eye disease.




NASA to Mark 40th Anniversary of Skylab and Life Off Earth .



NASA will commemorate the 40th anniversary of America‘s first space station Monday, May 13, with a televised roundtable discussion featuring Skylab astronauts, a current astronaut and agency managers planning future space missions.
The discussion, open to NASA employees and the public, will begin at 2:30 p.m. EDT in the James Webb Auditorium of NASA Headquarters at 300 E St. SW in Washington. The event will air live on NASA Television and the agency’s website.

Participants will include:
Owen Garriott, science pilot, Skylab 3
Gerald Carr, commander, Skylab 4
— Kevin Ford, commander, International Space Station (ISS) Expedition 34
— D. Marshall Porterfield, director, Space Life and Physical Sciences Research and Applications Division, NASA Headquarters
— Jason Crusan, director, Advanced Exploration Systems, NASA Headquarters

Media representatives who want to attend must call 202-358-1100 no later than noon May 13. Anyone unable to attend the event in-person may ask questions during the program via Twitter or Google+ using the hashtag #asknasa.

NASA launched Skylab on May 14, 1973. It was the nation’s first foray into significant scientific research in microgravity. The three Skylab crews proved humans could live and work effectively for long durations in space. The knowledge gathered during Skylab helped inform development and construction of the International Space Station, just as the research and technology demonstrations being conducted aboard the ISS will help shape a new set of missions that will take Americans farther into the solar system.




Japanese Doctor Confirms Health Benefits of Working Out Less, But More Intensely.

Story at-a-glance

  • High-intensity interval training (HIIT) gives a natural boost to human growth hormone (HGH) production, which is essential for optimal health, strength and vigor. HIIT has also been shown to significantly improve insulin sensitivity, boost fat loss, and increase muscle growth
  • According to Japanese research, a mere four minutes of exercise performed at extreme intensity, four times a week, can improve your anaerobic capacity by 28 percent, and your VO2 max and maximal aerobic power by 15 percent in as little as six weeks
  • Study participants who performed an hour of steady cardiovascular exercise on a stationary bike five times a week only improved VO2 max by 10 percent, and their regimen had no effect on their anaerobic capacity after six weeks
  • Previous research showed that just three minutes of HIIT per week for four weeks improved participants’ insulin sensitivity by an average of 24 percent

A little over three years ago, I was introduced to high intensity interval training, commonly referred to as HIIT, when I met Phil Campbell at a fitness camp in Mexico. I refer to it as Peak Fitness Training.

Since then, researchers have repeatedly confirmed the superior health benefits of HIIT compared to traditional and typically performed aerobic workouts.

For example, high-intensity interval-type training gives a natural boost to human growth hormone (HGH) production—which is essential for optimal health, strength and vigor—and has been shown to significantly improve insulin sensitivity, boost fat loss, and increase muscle growth.

Anaerobic HIIT can be performed on a recumbent bike or an elliptical machine, or sprinting outdoors (with proper guidelines to avoid injury).

While there are a large number of variations, the HIIT routine I recommend involves going all out for 30 seconds and then resting for 90 seconds between sprints. Total workout is typically 8 repetitions. In all, you’ll be done in about 20 minutes, and you only need to perform HIIT two or three times a week.

But researchers such as Dr. Izumi Tabata have shown that even shorter workouts can work, as long as the intensity is high enough.1

The video above shows a modified high intensity workout from the DVD Mash Up Conditioning. It demonstrates 30 seconds of high intensity followed by 30 seconds of recovery with repeated intervals. There are 3 different levels demonstrated at the same time in the video.

Personal Modifications

I personally modified the Peak 8 to a Peak 6 this year as it was sometimes just too strenuous for me to do all 8. So by listening to my body and cutting it back to 6 reps, I can now easily tolerate the workout and go full out and I no longer dread doing them.

Another tweak is to incorporate Butyenko breathing into the workout and do most of the workout by only breathing through my nose. This raises the challenge to another level. I will discuss more of the benefits of this in a future article but I do believe it has many benefits.

I then finish my Peak 6 workout with Power Plate stretches, 10 pull ups, 10 dips and 20 inverted pushups, and call it a day. I personally have never tried the Tabata protocol as it seems too intimidating and I’m not sure I could do it, but it is yet another option that people can use.

Can You Get Fit in Just Four Minutes, Four Times a Week?

After monitoring the Japanese speed skating team in the early 90’s, Dr. Tabata noticed that extremely hard but intermittent exercise appeared to be at least as effective as standard workouts that require several hours a week. The training protocol he came up with as a result requires a mere four minutes, four times a week. The caveat? Extreme intensity.

Dr. Tabata’s HIIT protocol calls for just 20 seconds of all-out drop-dead effort, followed by a mere 10 seconds of rest. This intense cycle is repeated eight times. According to Dr. Tabata:2

“All-out effort at 170 percent of your VO2 max is the criterion of the protocol. If you feel OK afterwards you’ve not done it properly. The first three repetitions will feel easy but the last two will feel impossibly hard. In the original plan the aim was to get to eight, but some only lasted six or seven.”

When performed four times per week for six weeks, participants in one experiment increased their anaerobic capacity by 28 percent, and their VO2 max (an indicator of cardiovascular health) and maximal aerobic power by 15 percent. This is in contrast to the control group, who performed an hour of steady cardiovascular exercise on a stationary bike five times a week. These participants improved their VO2 max by just 10 percent, and their regimen had no effect on their anaerobic capacity.

Dr. Tabata also has forthcoming research findings showing that his protocol reduces your risk of diabetes, which other HIIT studies have already suggested. And, according to the featured article:3

“Another soon-to-be-published finding, which Tabata describes as ‘rather significant,’ shows that the Tabata protocol burns an extra 150 calories in the 12 hours after exercise, even at rest, due to the effect of excess post-exercise oxygen consumption. So while it is used by most people to get fit – or by fit people to get even fitter – it also burns fat.”

As Little as Three Minutes of HIIT Per Week Can Improve Your Health, Previous Study Suggests

Dr. Tabata’s claims may sound crazy, but previous research has also found that performing high intensity exercises for just minutes per week can significantly improve important health indices. One such study found that just three minutes of HIIT per week for four weeks improved participants’ insulin sensitivity an average of 24 percent. This truly is amazing, and while aerobic fitness is indeed important, improving and maintaining good insulin sensitivity is perhaps one of the most important aspects of optimal health.

Other research has also demonstrated that 20 minutes of high intensity training, two to three times a week, can yieldgreater results than slow and steady conventional aerobics done five times a week. But the fact that you can improve your insulin sensitivity by nearly 25 percent with a time investment of less than ONE HOUR A MONTH really shows that you can significantly improve your health without having to eliminate hours of other commitments from your calendar.

As I mentioned previously I have not even attempted this protocol as I know how hard Peak Fitness is with a 90 second recovery. I shudder to think how painful the Tabata protocol is with only 10 seconds to recover. That said, I believe that while it’s theoretically possible to reap valuable results with as little as three minutes once a week, it might be more beneficial to do these exercises two or three times a week for a total of four minutes of intense exertion, especially if you are not doing strength training.

You do not need to do them more often than that however. In fact, doing HIIT more frequently than two or three times a week can be counterproductive, as your body needs to recover between these intense sessions. If you feel the urge to do more, make sure you’re really pushing yourself as hard as you can during those two or three weekly sessions, rather than increasing the frequency. Remember, intensity is KEY for reaping all the benefits interval training can offer. To perform it correctly, you’ll want to raise your heart rate to your anaerobic threshold, and to do that, you have to give it your all for those 20 to 30 seconds. Phil Campbell suggests that it needs to be even higher than your maximum calculated heart rate, which is about 220 minus your age.

Why High Intensity Interval Training May Be Ideal for Most

Contrary to popular belief, extended extreme cardio actually sets in motion inflammatory mechanisms that damage your heart. So while your heart is indeed designed to work very hard, and will be strengthened from doing so, it’s only designed to do sointermittently, and for short periods—not for an hour or more at a time. This is the natural body mechanics you tap into when you perform HIIT.

Repeatedly and consistently overwhelming your heart by long distance marathon running, for example, can actually prematurely age your heart and make you more vulnerable to irregular heart rhythm. This is why you sometimes hear of seasoned endurance athletes dropping dead from cardiac arrest during a race.

Compelling and ever-mounting research shows that the ideal form of exercise is short bursts of high intensity exercise. Not only does it beat conventional cardio as the most effective and efficient form of exercise, it also provides health benefits you simply cannot get from regular aerobics, such as a tremendous boost in human growth hormone (HGH), aka the “fitness hormone.”

What Makes HIIT so Effective?

Your body has three types of muscle fibers: slow, fast, and super-fast twitch muscles. Slow twitch muscles are the red muscles, which are activated by traditional strength training and cardio exercises. The latter two (fast and super-fast) are white muscle fibers, and these are only activated during high intensity interval exercises or sprints.

According to fitness expert Phil Campbell, author of Ready, Set, Go, getting cardiovascular benefits requires working all three types of muscle fibers and their associated energy systems — and this cannot be done with traditional cardio, which onlyactivates your red, slow twitch muscles. If your fitness routine doesn’t work your white muscle, you aren’t really working your heart in the most beneficial way. The reason for this is because your heart has two different metabolic processes:

  • The aerobic, which requires oxygen for fuel, and
  • The anaerobic, which does not require any oxygen

Traditional strength training and cardio exercises work primarily the aerobic process, while high intensity interval exercises work both your aerobic AND your anaerobic processes, which is what you need for optimal cardiovascular benefit. This is why you may not see the results you desire even when you’re spending an hour on the treadmill several times a week. Interestingly enough, when it comes to high intensity exercises, less really is more. You can get all the benefits you need in just a 20-minute session, start to finish, performed two or a max of three times per week.

How to Properly Perform Peak Fitness Exercises

If you are using exercise equipment, I recommend using a recumbent bicycle or an elliptical machine for your high-intensity interval training, although you certainly can use a treadmill, or sprint anywhere outdoors. Just beware that if you sprint outside, you must be very careful about stretching prior to sprinting.

I personally prefer and recommend the Peak Fitness approach of 30 seconds of maximum effort followed by 90 seconds of recuperation, opposed to Dr. Tabata’s more intense routine of 20 seconds of exertion and only 10 seconds of recovery. But some might like his strategy more. His approach may be better suited to fitter athletes who want to kick it up another notch, but may be too intense for most people. For a demonstration using an elliptical machine, please see the following video. Here are the core principles:

  • Warm up for three minutes
  • Exercise as hard and fast as you can for 30 seconds. You should be gasping for breath and feel like you couldn’t possibly go on another few seconds. It is better to use lower resistance and higher repetitions to increase your heart rate
  • Recover for 90 seconds, still moving, but at slower pace and decreased resistance
  • Repeat the high-intensity exercise and recovery 7 more times. (When you’re first starting out, depending on your level of fitness, you may only be able to do two or three repetitions of the high-intensity intervals. As you get fitter, just keep adding repetitions until you’re doing eight during your 20-minute session)
  • Cool down for a few minutes afterward by cutting down your intensity by 50-80 percent





The Most Effective Strategies for Eliminating Cellulite.

Cellulite, those pockets of fat that tend to collect on buttocks, thighs and upper arms, are a cause of embarrassment for many. The dimpling, “orange peel” effect occurs when fat cells push against the surrounding subcutaneous connective tissue in your skin. If your lymph circulation becomes sluggish, toxins accumulate in these fat cells.

Liposuction, creams and wraps only temporarily reduce the appearance of cellulite. Without continual treatment, cellulite just reappears…So what, if anything, might actually work to reduce cellulite?

The featured article in The Guardian1 suggests body brushing. Simply give yourself a vigorous scrub-down with a dry body brush before you get into the shower, and then apply a good moisturizer afterward. (I recommend plain coconut oil opposed to chemical-laden creams). According to the writer, this simple technique “really did, honest-to-God, make a remarkable difference in just a few weeks.”

There’s certainly nothing wrong with this strategy; body brushing can help improve circulation and lymph flow, which are important elements for cellulite elimination. The downside is having to manually scrub yourself in areas that can be hard or uncomfortable to reach. Three strategies that I believe might be far more effective, in order of importance, are as follows, and in the following sections I’ll explain why:

  1. Intermittent fasting
  2. Whole body vibration training, a.k.a. Acceleration Training
  3. Rebound exercise

Intermittent Fasting Shifts Your Body from Burning Sugar to Burning Fat

In a nutshell, the answer to eliminating cellulite is to shift your body from burning sugar to efficiently burning fat for fuel, in order to get rid of excess fat deposits. Intermittent fasting is one of the most powerful interventions I know of to move your body into fat burning mode.

One of the mechanisms that makes fasting so effective for fat loss is the fact that it provokes the secretion of human growth hormone (HGH), which is a fat-burning hormone. Fasting also increases catecholamines, which increases resting energy expenditure while decreasing insulin levels, which allows stored fat to be burned for fuel.

Together, these and other factors will turn you into an effective fat-burning machine.

The type of fast you choose appears to be less important, so pick whichever one fits your lifestyle, schedule, and temperament the best. For variations, see this previous article on intermittent fasting. I have been experimenting with different types of scheduled eating in my own life for the past three years, and my preference is to simply skip breakfast and restrict my eating to a 6-7 hour window each day.

For this version of intermittent fasting to be effective, you need to restrict your eating to a window of maximum eight hours each day. This means eating only between the hours of 11am until 7pm, as an example. Essentially, this equates to simply skipping breakfast and making lunch your first meal of the day instead.

This is doable and convenient for most people, but you can restrict it even further — down to six, four, or even two hours, if you want, but you can still reap many of these rewards by limiting your eating to a window of about eight hours.

In the 6-8 hours that you do eat, you want to have healthy protein, minimize your carbs like pasta and bread and potatoes and exchange them for healthful fats like butter, eggs, avocado, coconut oil, olive oil and nuts. (The type of fats the media and “experts” tell you to avoid.)

This will help shift your body from sugar-burning mode to fat-burning mode. Remember it takes a few weeks to make the transition. You have to do it gradually, but once you succeed and switch to fat burning mode, you will easily be able to fast for 18 hours and not feel hungry. Your cravings for sugar will magically disappear and it will be much easier to achieve your ideal weight.

How Acceleration Training Can Help Beat Cellulite

Next, reconsider how you exercise. One form of exercise that provides many of the same health benefits as intermittent fasting is high intensity interval training (HIIT). Doing these kinds of Peak Fitness exercises while fasted (i.e. exercise before you break your fast) will further boost the effects. One of the ways HIIT can be particularly helpful for combating cellulite is that it significantly boosts your levels of human growth hormone (HGH) which, as mentioned earlier, is a fat-burning hormone.

But another form of exercise that is particularly useful for combating cellulite in particular is Acceleration Training, in which you perform exercises on a vibrating platform such as the Power Plate.

Acceleration Training improves your lymph circulation, helping break down cellulite from the inside out. The vibrations cause thousands of muscle contractions that pump your lymphatic fluid out of problem areas, reducing fluid congestion in your tissues. This helps to flush out toxins and ease the load on your immune system. This mechanism has been scientifically shown to actually help rid your body of excess pounds and unsightly cellulite.

In a 2004 German study,2 Acceleration Training alone reduced cellulite on subjects’ thighs and buttocks by nearly 26 percent. When cardio exercises were added to Vibration Training, cellulite dropped even more; just over 32 percent. Other research confirms its benefits for sustained fat loss. For example, one animal study3 showed that Acceleration training caused a drop in the creation of new fat cells, and a 2010 study4 on humans found that:

  • Those using Acceleration Training in addition to a low calorie diet lost twice as much visceral fat after six months compared to those who followed a low calorie diet with cardio and weight training.
  • The decrease in visceral fat remained at the same level in the vibration group after 12 months, while the diet and fitness groups returned to their normal baseline values after 12 months. The researchers suggested that the maintenance of visceral fat loss in the Acceleration Training group might be related to hormonal changes—specifically, increased production of human growth hormone (HGH).

As You Get Older, Growth Hormone Levels Can Affect Your Fat Deposits

Many tend to gain weight as they approach middle age, and if you don’t stay physically active, you also start losing muscle mass around age 40. Overall, you start burning fewer calories as your body shifts from building muscle to storing more fat. This is in part caused by what’s known as “somatopause” — the decline of your body’s hormone production as you age, which includes dwindling production of human growth hormone (HGH). HGH actually starts declining rapidly after age 21, so by the time you hit your 40’s, your levels can be quite low, contributing to these stubborn fat deposits.

The amount of HGH you secrete depends on how much lean body mass and belly fat you have. The more belly fat you have, the less HGH your body produces. Some resort to HGH injections to maintain youthful levels. According to,5 HGH injections are now also considered a “revolutionary” way to reduce cellulite. But there are significant drawbacks to HGH injections, both biological and financial.

As discussed above, there are at least three different ways you can elevate your HGH levels naturally, either alone or in combination. Each of these can very effectively boost HGH production, and when combined I have no doubt it can rival or even surpass injections, but without any of the associated health risks or cost:

  1. Intermittent fasting
  2. High intensity interval training (HIIT)
  3. Acceleration Training

Even a Mini Trampoline—or Rebounding—Can Help Improve Cellulite

Acceleration training works by increasing the acceleration or the force of gravity on your body. To a lesser degree, a mini trampoline will also increase the G forces on your body and provide similar, yet less extreme, benefits. A mini trampoline or rebounder subjects your body to gravitational pulls ranging from zero at the top of each bounce to 2 to 3 times the force of gravity at the bottom, depending on how high you jump. And, unlike jogging on hard surfaces which stresses your ankles and knees, rebounding helps protect against this stress so it’s easy on the joints.

Some of the benefits rebounding offers include circulating oxygen and nutrients to tissues and organs, and promoting increased muscle strength. It’s an option you can use if the cost of a vibration platform such as the Power Plate is prohibitive. Acceleration Training on a high-quality machine will definitely offer more powerful benefits though, and some gyms do have them, so it’s worth checking around.

Tying it All Together…

Foods high in sugars and carbs, damaged fats (think trans fats) and processed salt are all dietary contributors to cellulite, so addressing your diet should be your first step. My optimized Nutrition Plan can help you do that with the least amount of fuss as it takes you step by step through the changes, from beginners to advanced.

It’s important to realize that dietary carbohydrates, especially fructose, are the primary source of a substance called glycerol-3-phosphate (g-3-p), which actually causes fat to become fixed in fat tissue. High carb intake also raises your insulin levels, which prevents fat from being released, so sugars and grains are really at the root of stubborn fat deposits.

In short, you’ll want to avoid processed foods, as they are loaded with fructose and highly processed fats and salt. Keep in mind that for every gram of excess sodium chloride your body has to neutralize, it uses up 23 grams of cellular water. Hence, eating too much common processed salt will cause fluid to accumulate in your tissues, which can also contribute to unsightly cellulite.

Instead, focus your diet on whole, ideally organic and locally grown foods, healthful fats such as butter, eggs, avocado, coconut oil, olive oil and nuts, and grass-fed or pastured animal protein. If you want to add salt, make sure to use unprocessed natural salt, such as Himalayan salt, which contains about 86 different essential minerals and will not cause the same detrimental health effects as processed salt—especially if you’re eating a diet high in vegetables, as this will ensure a healthy sodium to potassium ratio.

Eating this way will help you transition from being a sugar burner to burning fat as your primary fuel, which is key for lasting weight loss and optimal health. However, do not attempt fasting if your diet still consists mainly of processed foods as proper nutritionbecomes even more important at that stage. Next, revise your exercise regimen to include some high intensity interval exercises, and consider Acceleration Training to further boost results—especially if you want to tackle cellulite.


NASA Scientist Reveals How You Can Improve Your Health by Moving Correctly.

Story at-a-glance

  • Sitting for extended periods of time is an independent risk factor for poor health and premature death.
  • An analysis of 18 studies found that people who sat for the longest periods of time were twice as likely to have diabetes or heart disease, compared to those who sat the least
  • Research by a former NASA scientist shows your body needs perpetual motion to function optimally. The good news is that there are virtually unlimited opportunities for movement throughout the day, from doing housework or gardening, to cooking and even just standing up every 10 to 15 minutes
  • To compensate for long hours spent sitting down at work, you could incorporate Foundation Training exercises; powerful simple structural movements that help strengthen and realign your body posture
  • Grounding, by walking barefoot outside, is another grossly neglected foundational practice for optimal health that you can easily correct

Most people, including me, spend a large portion of each day in a seated position. It’s hard to avoid these days, as computer work predominates, and most also spend many precious hours each week commuting to and from work.

Interestingly, a growing body of evidence suggests that sitting in and of itself is an independent risk factor for poor health and premature death—even if you exercise regularly.

An increasingly sedentary lifestyle has led to a steady increase in a number of health problems, including:

While these disorders were historically associated with advancing age, they now affect increasing numbers of people well before middle-age. Even children are falling victim.

In the video above, Dr. Joan Vernikos,1 former director of NASA’s Life Sciences Division and author of Sitting Kills, Moving Heals, presents a scientific explanation for why sitting has such a dramatic impact on your health, and what you can do about it.

In another words, she was one of the primary doctors assigned to keep the astronauts from deteriorating in space, and what she found has profound implications for each and every one of us.

You might think, like I did, that if you had a phenomenal exercise program that you wouldn’t have to worry about prolonged sitting. But nothing could be further from the truth.

In order to figure out why regular exercise does not appear to compensate for the negative effects of prolonged sitting, some of her research focused on finding out what type of movement is withdrawn by sitting.

The Gravity of the Situation…

What she discovered was nothing short of astounding. “Standing was more effective than walking,” she says. And, it wasn’t how long you were standing, but how many times you stood up that made the difference. In conclusion, she discovered that it is the change in posture that is the most powerful, in terms of having a beneficial impact on your health.

In a nutshell, your body needs perpetual motion to function optimally. As Dr. Vernikos states, the good news is that there are virtually unlimited opportunities for movement throughout the day.

“The key to lifelong health is more than just traditional gym exercise once a day, three to five times a week,” she says. “The answer is to rediscover a lifestyle of constant, natural low-intensity non-exercise movement that uses the gravity vector throughout the day.”

Some of the examples she lists include housecleaning, stirring a pot of pasta sauce, rolling dough, gardening, hanging clothes to dry, dancing… the list is endless, because it covers the entire spectrum of movements you engage in during daily life. Interestingly, recent research23 has also found that those who engage in community gardening projects have considerably lower body mass index (BMI) than non-gardeners. Overall, female community gardeners were 46 percent less likely to be overweight or obese than the average woman in their neighborhood, and men who gardened were 62 percent less likely to be overweight or obese than their non-gardening neighbors.

The problem is that our modern society and our reliance on technology has reduced or eliminated many of these opportunities for low-intensity movement and replaced it with sitting. Instead of walking across the street to talk to your best friend, you send them a text while slumped on the couch. Some people even text other family members inside the same house instead of getting up and walking into the next room! All of this sloth-like inactivity adds up.

The answer then, as Dr. Vernikos states, is to reintroduce these opportunities for movement. Part of the mechanism that makes non-strenuous, posture-shifting movement so effective is that it engages what she refers to as the gravity vector. The less you move, the less you use gravity, and gravity, it turns out, is your lifeline

’ve previously written about the health benefits of Acceleration Training, or Whole Body Vibration Training, in which you perform exercises on a vibrating platform such as the Power Plate. Acceleration Training works by increasing the force of gravity on your body—which is at the heart of issue, according to Dr. Vernikos.

To a lesser degree, a mini trampoline will also increase the G forces on your body and provide similar, yet less extreme, benefits. A mini trampoline or rebounder subjects your body to gravitational pulls ranging from zero at the top of each bounce to 2 to 3 times the force of gravity at the bottom, depending on how high you jump. Some of the benefits rebounding offers include circulating oxygen and nutrients to tissues and organs, and promoting increased muscle strength.

Mounting Evidence Indicts Sitting as Independent Risk Factor for Poor Health

In recent years, researchers have taken a serious look at the effects of inactivity, and have repeatedly found that not moving or engaging in very limited-range movements for extended periods of time has a profoundly negative impact on health and longevity. For example, one study, published last year in the British Journal of Sports Medicine,4 concluded that adults who spend an average of six hours a day in front of the TV will reduce their life expectancy by just under 5 years, compared to someone who does not watch TV.

Again, it’s a matter of allowing technology to severely limit your opportunity for regular movement. If you weren’t watching TV, what would you do? Unless you’re sitting down reading, chances are you’d be doing something that requires you to move your body.

Another recent analysis5 of 18 studies (which in total included nearly 800,000 people), found that those who sat for the longest periods of time were twice as likely to have diabetes or heart disease, compared to those who sat the least. And, while prolonged sitting was linked to an overall greater mortality risk from any cause, the strongest link was to death due to diabetes. According to lead researcher Thomas Yates, MD:6

“Even for people who are otherwise active, sitting for long stretches seems to be an independent risk factor for conditions like diabetes, cardiovascular disease, and kidney disease.”

A 2009 study7 highlighted much of the recent evidence linking sitting with biomarkers of poor metabolic health, showing how total sitting time correlates with an increased risk of type 2 diabetes, heart disease and other prevalent chronic health problems—even if you exercise regularly. According to the authors:

“Even if people meet the current recommendation of 30 minutes of physical activity on most days each week, there may be significant adverse metabolic and health effects from prolonged sitting — the activity that dominates most people’s remaining ‘non-exercise’ waking hours.”

In other words, even if you’re fairly physically active, riding your bike to work or hitting the gym four or five days a week — you may still succumb to the effects of too much sitting if the majority of your day is spent behind a desk or on the couch.

Counteracting the Ill Effects of Sitting, Using Foundation Training

While sitting down is not the only thing that can cause trouble (adopting any particular posture for long periods of time can slow down your circulatory system), sitting is one of the most pervasive postures in modern civilizations. So how can you increase your activity levels if you have a fulltime “desk job,” as so many of us do these days?

One of the things I do to compensate for the time I spend sitting each day is to regularly do Foundation exercises developed by a brilliant chiropractor, Eric Goodman. These exercises also address the root cause of most low back pain, which is related to weakness and imbalance among your posterior chain of muscles. It is easily argued that these imbalances are primarily related to sitting. I recently interviewed Dr. Goodman about his techniques, so to learn more, you can check out that interview.

Below are two video demonstrations: “The Founder,” which helps reinforce proper movement while strengthening the entire back of your body, and “Adductor Assisted Back Extension,” which will teach you how to properly extend your spine.

Besides “disengaging from the gravity vector,” when you sit, your head and shoulders drop forward, and your hip flexors and abdomen shorten. This misalignment is a major cause of chronic pains. Every exercise included in Foundation Training lengthens the front of your body, which is over-tightened, and strengthens the back of your body, which will help you stand tall and move with strength and flexibility. I do these exercises daily and it is a great tool to build a stronger and more stable low back. As explained by Dr. Goodman:

“The place to start is learning how to hinge effectively. Learn how your hamstrings, lower back, and glutes are designed to work and stretch together. Once that part is in place, you can then advance to all the exercises that build upon that foundation, that build upon The Founder exercise.”


How Long Will Your Dog Be with You? It Depends Heavily on This….


Story at-a-glance

  • When it comes to species of mammals, generally speaking, bigger animals live longer than smaller ones. But within species, this isn’t always true – for example, in the case of mice, horses, and especially dogs — the bigger the body, the shorter the lifespan.
  • According to a new study, big dogs die younger than smaller breeds mainly because they age quickly. The average lifespan of a Great Dane is about 7 years; a Yorkshire Terrier, from 13 to 16 years.
  • The study concludes that large breeds seem to age at faster rates than smaller breeds, and the speed at which the risk of death increases with age is also greater with big dogs. Bigger dogs more often get cancer, which makes sense since cancer is the result of abnormal cell growth.
  • There are many things breeders and owners of big dogs can do to help these pets live better and longer — including proper nutrition; regular maintenance of the musculoskeletal system and organs; fostering a strong, balanced immune system; and following responsible, health-focused breeding practices.

When you evaluate species of mammals, it quickly becomes obvious that as a general rule, the bigger the creature, the longer it lives. Elephants in the wild can live well into their 60’s, whereas squirrels only live about six years.

But when you look closer at individual species, this general rule doesn’t always hold true, and dogs are a good example. As any canine enthusiast knows, big dogs have much shorter lifespans than small dogs. The same holds true for mice, horses, and possibly even humans.

Large Breeds Age Quickly and Die Younger

According to a study published in the April issue of the journal American Naturalist1, big dogs die younger primarily because they age quickly. Study authors believe these new findings can help scientists understand the biological links between growth and mortality.

Dogs seem to be a perfect subject for the study, because humans have bred them throughout history to be wildly variable in size. According to LiveScience, the heaviest dog on record was probably an English Mastiff that weighed 343 pounds, while the smallest was a terrier weighing in at under a quarter-pound. There is no other species of mammal with such tremendous size disparity.

Giant breeds live the most abbreviated lives of all dogs. For example the Great Dane has an average life span of about seven years, while a Yorkie can be expected to live 13 to 16 years.

A Big Dog’s Life ‘Unwinds in Fast Motion’

The American Naturalist study took a look at ages of death in 74 breeds and over 56,000 dogs that visited veterinary teaching hospitals.

Researchers learned that large breeds seem to age at faster rates than smaller breeds, and the speed at which the risk of death increases with age is also greater with big dogs. According to study authors, “… large dogs age at an accelerated pace, suggesting that their adult life unwinds in fast motion.” For a dog, every 4.4 pounds of body mass takes about a month off his life.

The researchers next want to look at the growth and health histories of dogs to narrow down the leading causes of death for large breeds. For example, bigger dogs more often acquire cancer, which makes sense when you consider they grow more than small dogs, and cancer is the result of abnormal cell growth. It’s possible that humans have inadvertently selected for characteristics – like rapid growth – that predispose large dogs to cancer.

Other large animals like elephants that have many more cells than smaller creatures, and should therefore also be at greater risk for cancer, have undoubtedly evolved special defense mechanisms against disease. These mechanisms probably developed through natural selection over a very long period of time, whereas most dog breeds have evolved through selection by humans, and over a much shorter period of time.

Evolutionarily speaking, dogs have evolved in the blink of an eye, and protective mechanisms against cancer and other diseases haven’t had time to catch up.

Extending the Lives of Large and Giant Breed Dogs

If you own a large or giant breed dog or are thinking about getting one of the big guys, I hope you’ll watch my interview with Dr. Jeff Bergin.

Dr. Bergin and his partner, Christine, raise and breed Newfoundlands, and in my opinion, they do things the right way. In fact, it’s not unusual for their giant breed dogs to live into their late teens. In the world of Newfies, a 17-year lifespan is almost unheard of.

Some of the wonderful practices Dr. Bergin follows with his Newfies include:

  • Feeding exclusively raw diets.
  • Breeding for health, first and foremost. Dr. Bergin breeds his dogs only once or twice during the course of their lives, with at least six years between litters. He does not breed dogs with congenital defects, and so far only one of his dogs has had a genetic health issue, a heart problem. (Heart problems, osteosarcoma and hip dysplasia are the most common health challenges for this breed.)
  • Performing regular chiropractic adjustments. With large and giant breed dogs, it’s very important to take care of the frame. Dr. Bergin happens to be both a licensed animal chiropractor as well as a human chiropractor. He performs regular manual orthopedic manipulation on all his dogs, from the moment they first stand on their own through the remainder of their lives. This practice is one of the keys to keeping a big dog’s musculoskeletal system from degenerating with age. Dr. Bergin’s dogs are typically fully mobile even at the end of their lives.
  • Limiting vaccines and other assaults on the immune system. Dr. Bergin only vaccinates his dogs against rabies, because the law requires it. By strictly limiting the number of vaccines they receive, he helps keep his dogs’ immune systems strong and resilient.
  • Insuring Newfie litters go to the right families. Dr. Bergin and Christine perform a mandatory home visit to families interested in their dogs. They won’t release a dog without seeing the new home. They conduct in-depth interviews with prospective owners to insure the puppy will be well taken care of. They also insist on a commitment from prospective owners to feed raw.

For most pet owners, it’s the quality of their dog’s life that is most important. You may have your precious pup with you for eight years or twice that long. By focusing on the three pillars of health – nutrition, maintenance of the frame, and a strong, resilient immune system — you can insure you’re providing her with everything she needs for an excellent quality of life, however long her life may be.