A 56-year-old female presented with type 2 diabetes (DMII), obesity, hypertension, elevated cholesterol, and sleep apnea. She was taking atorvastatin (Lipitor ^® ), glyburide (Micronase ^® ), metformin (Glucophage ^® ), metoprolol, amlodipine, benazepril (Lotrel ^® ), aspirin, and one-a-day multivitamin, and mineral supplement. Lab tests to identify underlying imbalances and to direct treatment were ordered. Treatment included dietary, nutritional, and mind-body support. After nine months of therapy, laboratory data continued to reflect improvement, including a 30-pound weight loss, improvement in blood pressure and fasting blood sugar. A1C normalized as well as liver enzymes, lipids, Vitamins D and B, and mitochondrial markers. The patient's sleep apnea resolved, and she was able to reduce her metformin and eliminate the glyburide and metoprolol. She also began regular exercises. The mentioned comprehensive lifestyle management offered with detailed knowledge and professional skills attenuated DMII mellitus and its co-morbid conditions in this patient. The case report aptly illustrates and emphasis that today's medical fraternity often unduly depends on pharmacological therapy neglecting the nonpharmacological intervention for noncommunicable diseases.

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Background: Iodine deficiency can cause brain damage and/or cognitive impairment in children. It is preventable and of public health concern. After sixteen years of universal salt iodization in Nigeria, we undertook this study in north-western Nigeria to determine: prevalence of iodine deficiency in school children, any relationship between iodine deficiency, goiter and intelligence quotient and iodine content of table salt from their households. Methodology: A cross-sectional study of school children aged 6-12 years. Data was collected using structured questionnaire. Enrolled children had physical examination and anthropometric measurements. Presence of goiter was clinically assessed using criteria jointly recommended by WHO, UNICEF and ICCIDD. Intelligence quotient was assessed using the "Draw-A-Man" test. Specimen of urine was obtained from each child and table salt specimen from their homes. Atomic absorption spectrophotometry was used to analyze urinary iodine in μg/L. Iodine content of salt was semi-quantitatively analyzed. Results: A total of 544 children were studied. Their mean age (±1SD) was 9.5 ± 2.0 years. Median urinary iodine excretion (UIE) level was 148 μg/L. Forty-seven (8.6%) children had goiter. Three hundred and seventy- six (69.1%) children had normal body build. Of 118 (21.7%) children with adequate iodine status, 18 (15.3%) were stunted; a similar proportion in iodine deficient children. One hundred and thirty-four (57.0%) of 235 iodine-deficient children and 67 (56.8%) of 118 iodine-sufficient children had normal Intelligence Quotient. All household table salts contained iodine. Conclusion: There was no relationship between nutritional status and Iodine status; iodine status and intelligence quotient in study children.

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Introduction: In adults, central adiposity is known to be an indicator of intra-abdominal fat and correlates directly with cardiovascular disease risk. However, it is unclear whether central adiposity predicts similar risks among adolescents. Objective: The objective was to study the clinical validity of central adiposity indicators for predicting the risk of high blood pressure (BP) among Indian adolescents. Subjects and Methods: Children from 5 ^th to 10 ^th standard covering age group of 9-15 years (boys = 490 and girls = 468) were included in the study. Anthropometric measurements such as weight, height, body fat %; the skin fold thickness at four sites and waist circumference were measured by trained investigators using standard procedures. BP was measured using sphygmomanometer by a qualified pediatrician. Results: Overall adiposity and central adiposity correlated significantly with systolic blood pressure (SBP) and diastolic blood pressure (DBP). Mean SBP and DBP was remarkably higher among overweight subjects. Similarly, the prevalence of high BP was higher among overweight subjects. Prevalence of high BP showed an increasing trend from lower to higher tertile of waist circumference and subscapular skinfold. Sub-scapular skin folds (for boys) and waist circumference (for girls) showed significant odds ratio even in the middle tertile indicating early prediction for high SBP. Conclusion: The data suggest that subscapular skinfolds and waist circumference was a better and early indicator for identifying the risk of high BP in boys and girls, respectively. The above study thus needs to be tested on a larger sample.

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Objective: The objective was to investigate the effects of a 6 month diet-induced weight loss (DIWL) on glucose homeostasis, cardiometabolic variables, and high density lipoproteins (HDL) associated functionality paraoxonase1 (PON1) enzyme in overweight/obese African American (AA) and White American (WA) women, with prediabetes. Methods: We recruited 108 obese women (67 AA and 41 WA) with prediabetes hemoglobin A ₁ C (HbA ₁ C; 5.7-6.4%). Metabolic studies, fasting cardiometabolic markers (lipids/lipoproteins, inflammatory markers), and PON1 were performed at 0, 3, and 6 months. Insulin sensitivity (Si), glucose effectiveness (Sg), acute insulin response to glucose (AIRg), and disposition index (DI) were obtained (Bergman's Minmod). The DIWL program consists of approximately 1200 kcal/day for 6 months. Results: The mean body mass index was greater in AA than WA (38 ± 8 vs. 34 ± 8 kg/m ² ). DIWL resulted in a mean 7.5% and 10.3% (8kg vs. 10.3 kg) weight loss in AA versus WA. Mean fasting and 2 h serum glucose, insulin, and c-peptide levels decreased significantly during 3 and 6 versus 0 month. The mean Si, Sg, AIRg, and DI did not improve in either AA or WA. DIWL had no significant effect on the cardiometabolic markers or PON1 in the present study. Conclusions: We found ethnic differences in the magnitude of the weight loss. However, modest weight loss had no impact on the glucose homeostasis, cardiovascular markers, and HDL functionality in prediabetic AA and WA women.

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Menopausal transition (MT), a state of hormonal turbulence, is fraught with a possibility of weight gain, visceral obesity, and development of metabolic syndrome (MS). Though the weight gain in postmenopausal women seems to be an age-related phenomenon, a change in body composition with the resultant android type of obesity (visceral obesity) from premenopausal gynecoid phenotype is attributed to MT. Several studies including from India have conclusively shown that there is significantly higher prevalence of MS among postmenopausal women as compared to premenopausal women. MS is a forerunner of type 2 diabetes mellitus (DM) and cardiovascular diseases (CVD). Obesity particularly central adiposity, MS, DM, and CVD are all considered as low-grade chronic inflammatory diseases. Can administration of anti-inflammatory dietary substances attenuate menopausal MS? The issue of protection from inflammation can be examined from two perspectives: Using a reductionist approach by examining the effects of individual nutrients and by using a more holistic perspective by examining foods and diets in toto. Here we review both the approaches vis-ΰ-vis their anti-inflammatory actions.

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The prevalence of obesity and vitamin D deficiency has increased in the last decade, becoming pandemics. In obesity, macrophage accumulation occurs in the adipose tissue. This is associated with a low-grade chronic inflammation and leads to the release of inflammatory cytokines. Vitamin D was found to have anti-adipogenic activity and may exert immunoregulatory effects as well as reduce the adipose tissue inflammation. Recent studies suggest that vitamin D and vitamin D receptor (VDR) play an important role in adipose tissue whereas the expression of genes of the 25-hydroxyvitamin D 1α-hydroxylase (CYP27B1) and VDR were demonstrated in human adipocytes. Growing evidence suggests vitamin D also plays a role in the type of preadipocytes, and the proneness to the inflammatory process.

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