Brain image study: Fructose may spur overeating

This is your brain on sugar — for real. Scientists have used imaging tests to show for the first time that fructose, a sugar that saturates the American diet, can trigger brain changes that may lead to overeating.

After drinking a fructose beverage, the brain doesn't register the feeling of being full as it does when simple glucose is consumed, researchers found.

It's a small study and does not prove that fructose or its relative, high-fructose corn syrup, can cause obesity, but experts say it adds evidence they may play a role. These sugars often are added to processed foods and beverages, and consumption has risen dramatically since the 1970s along with obesity. A third of U.S. children and teens and more than two-thirds of adults are obese or overweight.

All sugars are not equal — even though they contain the same amount of calories — because they are metabolized differently in the body. Table sugar is sucrose, which is half fructose, half glucose. High-fructose corn syrup is 55 percent fructose and 45 percent glucose. Some nutrition experts say this sweetener may pose special risks, but others and the industry reject that claim. And doctors say we eat too much sugar in all forms.

For the study, scientists used magnetic resonance imaging, or MRI, scans to track blood flow in the brain in 20 young, normal-weight people before and after they had drinks containing glucose or fructose in two sessions several weeks apart.

Scans showed that drinking glucose "turns off or suppresses the activity of areas of the brain that are critical for reward and desire for food," said one study leader, Yale University endocrinologist Dr. Robert Sherwin. With fructose, "we don't see those changes," he said. "As a result, the desire to eat continues — it isn't turned off."

What's convincing, said Dr. Jonathan Purnell, an endocrinologist at Oregon Health & Science University, is that the imaging results mirrored how hungry the people said they felt, as well as what earlier studies found in animals.

"It implies that fructose, at least with regards to promoting food intake and weight gain, is a bad actor compared to glucose," said Purnell. He wrote a commentary that appears with the federally funded study in Wednesday's Journal of the American Medical Association.

Researchers now are testing obese people to see if they react the same way to fructose and glucose as the normal-weight people in this study did.

What to do? Cook more at home and limit processed foods containing fructose and high-fructose corn syrup, Purnell suggested. "Try to avoid the sugar-sweetened beverages. It doesn't mean you can't ever have them," but control their size and how often they are consumed, he said.

A second study in the journal suggests that only severe obesity carries a high death risk — and that a few extra pounds might even provide a survival advantage. However, independent experts say the methods are too flawed to make those claims.

The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly higher risk of death than those who were overweight. Many experts criticized that work, saying the researcher — Katherine Flegal of the Centers for Disease Control and Prevention — painted a misleading picture by including smokers and people with health problems ranging from cancer to heart disease. Those people tend to weigh less and therefore make pudgy people look healthy by comparison.

Flegal's new analysis bolsters her original one, by assessing nearly 100 other studies covering almost 2.9 million people around the world. She again concludes that very obese people had the highest risk of death but that overweight people had a 6 percent lower mortality rate than thinner people. She also concludes that mildly obese people had a death risk similar to that of normal-weight people.

Critics again have focused on her methods. This time, she included people too thin to fit what some consider to be normal weight, which could have taken in people emaciated by cancer or other diseases, as well as smokers with elevated risks of heart disease and cancer.

"Some portion of those thin people are actually sick, and sick people tend to die sooner," said Donald Berry, a biostatistician at the University of Texas MD Anderson Cancer Center in Houston.

The problems created by the study's inclusion of smokers and people with pre-existing illness "cannot be ignored," said Susan Gapstur, vice president of epidemiology for the American Cancer Society.

A third critic, Dr. Walter Willett of the Harvard School of Public Health, was blunter: "This is an even greater pile of rubbish" than the 2005 study, he said. Willett and others have done research since the 2005 study that found higher death risks from being overweight or obese.

Flegal defended her work. She noted that she used standard categories for weight classes. She said statistical adjustments were made for smokers, who were included to give a more real-world sample. She also said study participants were not in hospitals or hospices, making it unlikely that large numbers of sick people skewed the results.

"We still have to learn about obesity, including how best to measure it," Flegal's boss, CDC Director Dr. Thomas Frieden, said in a written statement. "However, it's clear that being obese is not healthy - it increases the risk of diabetes, heart disease, cancer, and many other health problems. Small, sustainable increases in physical activity and improvements in nutrition can lead to significant health improvements."

___

Online:

Obesity info: http://www.cdc.gov/obesity/data/trends.html

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Mike Stobbe can be followed at http://twitter.com/MikeStobbe

Read More..

Photographer following Justin Bieber Ferrari killed

Los Angeles police said the driver who hit a photographer after the paparazzo took photos of Justin Bieber's Ferrari is not likely to face charges.

The photographer died at Ronald Reagan UCLA Medical Center. A friend of the photographer told KCAL-TV Channel 9 that he was not a professional.

The incident took place on Sepulveda Boulevard near Getty Center Drive shortly before 6 p.m. Tuesday. A friend of Bieber was driving the sports
car when it was pulled over on the 405 Freeway by the California Highway Patrol for a traffic stop, according to LAPD Sgt. Rudy Lopez.

A CHP officer directed the driver of Bieber's car off the freeway and onto Sepulveda.

The photographer arrived at the scene, got out of his car and crossed
Sepulveda to take photos. He was hit by a car as he went back across
the street to his own car, the sources said.

The sources said the photographer was not crossing in a crosswalk and the driver was fully cooperating with authorities.

The paparazzi have tracked the driving habits of Bieber, 18, and the
Los Angeles city attorney's office has been unsuccessful in its attempt
to use a novel state law to limit their pursuits.

Judge Thomas Rubinson ruled in November the state law did not
pass constitutional muster in a case against Paul Raef, a photographer
who sped on the 101 Freeway last year to capture Bieber receiving a
traffic citation.

Passed in 2010, the law punishes paparazzi driving dangerously to
obtain images they intend to sell. But Rubinson said the law violated
1st Amendment protections, potentially affecting wedding photographers
or those speeding to events where celebrities are present.

ALSO:

Son of Clippers owner Donald Sterling found dead in Malibu

'Feud' behind man's body found encased in concrete, police say

Read More..

Kim Jong-un, North Korean Leader, Makes Overture to South

SEOUL, South Korea — The North Korean leader, Kim Jong-un, called for an end to the “confrontation” with rival South Korea on Tuesday in what appeared to be an overture to the incoming South Korean president as she was cobbling together South Korea’s new policy on the North.

North Korea issued a major policy statement on New Year’s Day, following a tradition set by Mr. Kim’s grandfather, the North Korean founder Kim Il-sung, and continued by his father, Kim Jong-il, who died in December 2011, bequeathing the dynastic rule to Mr. Kim.

Although Mr. Kim inherited the central policies of his father, outside analysts see him as trying to distance himself in a variety of ways from his father’s ruling style. Kim Jong-il was more feared than respected among his people, and his rule was marked by a major famine.

The most significant feature of Kim Jong-un’s speech was its marked departure of tone regarding South Korea.

“A key to ending the divide of the nation and achieving reunification is to end the situation of confrontation between the North and the South,” Mr. Kim said. “A basic precondition to improving North-South relations and advancing national reunification is to honor and implement North-South joint declarations.”

He was referring to two inter-Korean agreements, signed in 2000 and 2007, when two South Korean presidents, Kim Dae-jung and Roh Moo-hyun, were pursuing a “Sunshine Policy” of reconciliation and economic cooperation with North Korea and met Mr. Kim’s father in the North Korean capital, Pyongyang.

As a result of those agreements, billions of dollars of South Korean investment, aid and trade flowed into the North. Billions more were promised in investments in shipyards and factory parks, as the South Korean leaders believed that economic good will was the best way of encouraging North Korea to shed its isolation and hostility while reducing the economic gap between the Koreas and the cost of reunification in the future.

But that warming of ties ended when conservatives came to power in South Korea with the inauguration of President Lee Myung-bak in 2008. Mr. Lee suspended any large aid or investment because of the lack of progress toward dismantling the North’s nuclear weapons programs, and inter-Korean relations spiraled down, further aggravated by the North’s shelling of a South Korean island in 2010.Mr. Kim’s speech on Tuesday, which was broadcast through the North’s state-run television and radio stations, was another sign that the young leader was trying to emulate his grandfather, who was considered a more people-friendly leader and is still widely revered among North Koreans.

Mr. Kim returned to the tradition of Kim Il-sung, issuing the statement in a personal speech. During the rule of Kim Jong-il, the statement — which laid out policy guidelines for the new year and was studied by all branches of the party, state and military — was issued as a joint editorial of the country’s main official media.

In his speech, Kim Jong-un, echoed themes of previous New Year’s messages, emphasizing that improving the living standards of North Koreans and rejuvenating the agricultural and light industries were among the country’s main priorities.

But he revealed no details of any planned economic policy changes. He mentioned only a need to “improve economic leadership and management” and “spread useful experiences created in various work units.”

Since July, reports from various media suggest that Mr. Kim’s government has begun carrying out cautious economic incentives aimed at bolstering productivity at farms and factories. Some reports said the state was considering letting farmers keep at least 30 percent of their yield; currently, it is believed, they are allowed to sell only a surplus beyond a government-set quota that is rarely met.

Mr. Kim also vowed to strengthen his country’s military, calling for the development of more advanced weapons. But he made no mention of relations with the United States or the international efforts to halt North Korea’s nuclear weapons program. He simply reiterated that his government was willing to “expand and improve upon friendly and cooperative relationships with all countries friendly to us.”

Mr. Kim’s speech followed the successful launching of a satellite aboard a long-range rocket in December. North Korea’s propagandists have since been busy billing the launch as a symbol of what they called the North’s soaring technological might and Mr. Kim’s peerless leadership. Washington considered it a test of long-range ballistic-missile technology and a violation of United Nations Security Council resolutions banning such tests, and is seeking more sanctions to impose on the isolated country.

The incoming leader of South Korea, Park Geun-hye, who was the presidential candidate of Mr. Lee’s conservative governing party, did not immediate respond to the speech. Ms. Park is the daughter of Park Chung-hee, the former military strongman under whose rule from 1961 until 1979 a staunchly anti-Communist, pro-American political establishment took root in South Korea.

North Korea had engineered a couple of assassination attempts on Ms. Park’s father, one of which resulted in her mother’s death in 1974. But Ms. Park also traveled to Pyongyang in 2002 and discussed inter-Korean reconciliation with Kim Jong-il.

During her campaign for president, she said that if elected, she would decouple humanitarian aid from politics and try to hold a summit meeting with Kim Jong-un. She was in part reacting to widespread criticism in South Korea that Mr. Lee’s hard-line policy did little to change the North’s behavior.

During the campaign, however, Ms. Park stuck to Mr. Lee’s stance on the most contentious issue of large-scale investment, which the North considers crucial. Ms. Park, like the current president, insisted that any large-scale economic investments be preceded by the “building of trust” through progress in curbing North Korea’s nuclear weapons program.

Peace bought with “shoveling” of unrestrained aid under the Sunshine Policy was “a fake,” she said, citing the North’s long history of using military threats to win economic concessions.

Earlier, North Korea called her a “confrontational maniac” and “fascist.” But since her election, it has refrained from attacking her.

Read More..

Jessica Simpson and Kendall & Kylie Jenner Make Readers Smile - and Frown

01/01/2013 at 07:00 PM EST

Splash News Online; Michael Simon/Startraks

What's on the minds of PEOPLE readers this week? We love getting your feedback, and as always, you weighed in – even while celebrating during the holidays – with plenty of reactions to all of our stories.

From Kelly Osbourne's dramatic weight loss to Jessica Simpson's happy baby news to the tragic death of hero surfer Dylan Smith in Puerto Rico, readers responded to what made them happy, what made them laugh out loud and what made them sad this week.

Check out the articles with the top reactions on the site this week, and keep clicking on the emoticons at the bottom of every story to tell us what you think!

Kelly Osbourne says loving herself was the key to her 60-lb. weight loss. She had to get to a place where she respected herself enough to take care of her health – and she emerged a fierce style star who is not afraid to rock a bikini.

Jessica Simpson became a new mom just 8 months ago – so the news that she's expecting baby No. 2 with fiancé Eric Johnson made readers say, "Wow!"

Reality stars Kendall and Kylie Jenner showed off expensive Christmas gifts on Instagram, and their pricey public display turned many readers off. From a pair of Louboutin spike heels to Balenciaga boots with a more than $1,000 price tag, the teens cleaned up with lavish presents that most could only dream about.

Dylan Smith captured our hearts with his heroic efforts during Superstorm Sandy, saving six people on his surfboard. But the Queens, N.Y., lifeguard, 23, who was named one of PEOPLE's Heroes of the Year, drowned on Dec. 24 in a surfing accident off Puerto Rico.

Does the idea of Tom Cruise dating a new woman make you laugh? Maybe. A story that falsely linked the actor romantically to a 26-year-old restaurant manager, had readers clicking LOL. Or maybe the funny part was this quote from a source, who told told PEOPLE: "He's single and will be talking to women – all of whom he won't be instantly dating."

Check back next week for another must-read roundup, and see what readers are reacting to every day here.

Read More..

Brain image study: Fructose may spur overeating

This is your brain on sugar — for real. Scientists have used imaging tests to show for the first time that fructose, a sugar that saturates the American diet, can trigger brain changes that may lead to overeating.

After drinking a fructose beverage, the brain doesn't register the feeling of being full as it does when simple glucose is consumed, researchers found.

It's a small study and does not prove that fructose or its relative, high-fructose corn syrup, can cause obesity, but experts say it adds evidence they may play a role. These sugars often are added to processed foods and beverages, and consumption has risen dramatically since the 1970s along with obesity. A third of U.S. children and teens and more than two-thirds of adults are obese or overweight.

All sugars are not equal — even though they contain the same amount of calories — because they are metabolized differently in the body. Table sugar is sucrose, which is half fructose, half glucose. High-fructose corn syrup is 55 percent fructose and 45 percent glucose. Some nutrition experts say this sweetener may pose special risks, but others and the industry reject that claim. And doctors say we eat too much sugar in all forms.

For the study, scientists used magnetic resonance imaging, or MRI, scans to track blood flow in the brain in 20 young, normal-weight people before and after they had drinks containing glucose or fructose in two sessions several weeks apart.

Scans showed that drinking glucose "turns off or suppresses the activity of areas of the brain that are critical for reward and desire for food," said one study leader, Yale University endocrinologist Dr. Robert Sherwin. With fructose, "we don't see those changes," he said. "As a result, the desire to eat continues — it isn't turned off."

What's convincing, said Dr. Jonathan Purnell, an endocrinologist at Oregon Health & Science University, is that the imaging results mirrored how hungry the people said they felt, as well as what earlier studies found in animals.

"It implies that fructose, at least with regards to promoting food intake and weight gain, is a bad actor compared to glucose," said Purnell. He wrote a commentary that appears with the federally funded study in Wednesday's Journal of the American Medical Association.

Researchers now are testing obese people to see if they react the same way to fructose and glucose as the normal-weight people in this study did.

What to do? Cook more at home and limit processed foods containing fructose and high-fructose corn syrup, Purnell suggested. "Try to avoid the sugar-sweetened beverages. It doesn't mean you can't ever have them," but control their size and how often they are consumed, he said.

A second study in the journal suggests that only severe obesity carries a high death risk — and that a few extra pounds might even provide a survival advantage. However, independent experts say the methods are too flawed to make those claims.

The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly higher risk of death than those who were overweight. Many experts criticized that work, saying the researcher — Katherine Flegal of the Centers for Disease Control and Prevention — painted a misleading picture by including smokers and people with health problems ranging from cancer to heart disease. Those people tend to weigh less and therefore make pudgy people look healthy by comparison.

Flegal's new analysis bolsters her original one, by assessing nearly 100 other studies covering almost 2.9 million people around the world. She again concludes that very obese people had the highest risk of death but that overweight people had a 6 percent lower mortality rate than thinner people. She also concludes that mildly obese people had a death risk similar to that of normal-weight people.

Critics again have focused on her methods. This time, she included people too thin to fit what some consider to be normal weight, which could have taken in people emaciated by cancer or other diseases, as well as smokers with elevated risks of heart disease and cancer.

"Some portion of those thin people are actually sick, and sick people tend to die sooner," said Donald Berry, a biostatistician at the University of Texas MD Anderson Cancer Center in Houston.

The problems created by the study's inclusion of smokers and people with pre-existing illness "cannot be ignored," said Susan Gapstur, vice president of epidemiology for the American Cancer Society.

A third critic, Dr. Walter Willett of the Harvard School of Public Health, was blunter: "This is an even greater pile of rubbish" than the 2005 study, he said. Willett and others have done research since the 2005 study that found higher death risks from being overweight or obese.

Flegal defended her work. She noted that she used standard categories for weight classes. She said statistical adjustments were made for smokers, who were included to give a more real-world sample. She also said study participants were not in hospitals or hospices, making it unlikely that large numbers of sick people skewed the results.

"We still have to learn about obesity, including how best to measure it," Flegal's boss, CDC Director Dr. Thomas Frieden, said in a written statement. "However, it's clear that being obese is not healthy - it increases the risk of diabetes, heart disease, cancer, and many other health problems. Small, sustainable increases in physical activity and improvements in nutrition can lead to significant health improvements."

___

Online:

Obesity info: http://www.cdc.gov/obesity/data/trends.html

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Mike Stobbe can be followed at http://twitter.com/MikeStobbe

Read More..

Ruling over bumper-car injury supports amusement park

SAN FRANCISCO — The California Supreme Court, protecting providers of risky recreational activities from lawsuits, decided Monday that bumper car riders may not sue amusement parks over injuries stemming from the inherent nature of the attraction.

The 6-1 decision may be cited to curb liability for a wide variety of activities — such as jet skiing, ice skating and even participating in a fitness class, lawyers in the case said.

"This is a victory for anyone who likes fun and risk activities," said Jeffrey M. Lenkov, an attorney for Great America, which won the case.

But Mark D. Rosenberg, who represented a woman injured in a bumper car at the Bay Area amusement park, said the decision was bad for consumers.

"Patrons are less safe today than they were yesterday," Rosenberg said.

The ruling came in a lawsuit by Smriti Nalwa, who fractured her wrist in 2005 while riding in a bumper car with her 9-year-old son and being involved in a head-on collision. Rosenberg said Great America had told ride operators not to allow head-on collisions, but failed to ask patrons to avoid them.

The court said Nalwa's injury was caused by a collision with another bumper car, a normal part of the ride. To reduce all risk of injury, the ride would have to be scrapped or completely reconfigured, the court said.

"A small degree of risk inevitably accompanies the thrill of speeding through curves and loops, defying gravity or, in bumper cars, engaging in the mock violence of low-speed collisions," Justice Kathryn Mickle Werdegar wrote for the majority. "Those who voluntarily join in these activities also voluntarily take on their minor inherent risks."

Monday's decision extended a legal doctrine that has limited liability for risky sports, such as football, to now include recreational activities.

"Where the doctrine applies to a recreational activity," Werdegar wrote, "operators, instructors and participants …owe other participants only the duty not to act so as to increase the risk of injury over that inherent in the activity."

Amusement parks will continue to be required to use the utmost care on thrill rides such as roller coasters, where riders surrender control to the operator. But on attractions where riders have some control, the parks can be held liable only if their conduct unreasonably raised the dangers.

"Low-speed collisions between the padded, independently operated cars are inherent in — are the whole point of — a bumper car ride," Werdegar wrote.

Parks that fail to provide routine safety measures such as seat belts, adequate bumpers and speed controls might be held liable for an injury, but operators should not be expected to restrict where a bumper car is bumped, the court said.

The justices noted that the state inspected the Great America rides annually, and the maintenance and safety staff checked on the bumper cars the day Nalwa broke her wrist. The ride was functioning normally.

Reports showed that bumper car riders at the park suffered 55 injuries — including bruises, cuts, scrapes and strains — in 2004 and 2005, but Nalwa's injury was the only fracture. Nalwa said her wrist snapped when she tried to brace herself by putting her hand on the dashboard.

Rosenberg said the injury stemmed from the head-on collision. He said the company had configured bumper rides in other parks to avoid such collisions and made the Santa Clara ride uni-directional after the lawsuit was filed.

Justice Joyce L. Kennard dissented, complaining that the decision would saddle trial judges "with the unenviable task of determining the risks of harm that are inherent in a particular recreational activity."

"Whether the plaintiff knowingly assumed the risk of injury no longer matters," Kennard said.

maura.dolan@latimes.com

Read More..

Rape Incites Women to Fight Culture in India

Andrew Caballero-Reynolds/Agence France-Presse — Getty Images

A candlelight gathering after the cremation on Sunday blocked a road in New Delhi, the city where the Dec. 16 rape occurred.

NEW DELHI — Neha Kaul Mehra says she was only 7 years old the first time she was sexually harassed. She was walking to a dance class in an affluent neighborhood of New Delhi when a man confronted her and began openly masturbating.

That episode was far from the last. Years of verbal and physical sexual affronts left Ms. Mehra, now 29, filled with what she described as “impotent rage.”

Last week, she and thousands of Indian women like her poured that anger into public demonstrations, reacting to news of the gang rape of another young woman who had moved to the city from a small village, with a new life in front of her.

That woman, a 23-year-old physiotherapy student, died Saturday from internal injuries inflicted with a metal rod during the rape, which took place on a bus two weeks ago.

In her story and its brutal ending, many women in the world’s largest democracy say they see themselves.

“That girl could have been any one of us,” said Sangeetha Saini, 44, who took her two teenage daughters to a candle-filled demonstration on Sunday in Delhi. Women in India “face harassment in public spaces, streets, on buses,” she said. “We can only tackle this by becoming Durga,” she added, referring to the female Hindu god who slays a demon.

Indian women have made impressive gains in recent years: maternal mortality rates have dropped, literacy rates and education levels have risen, and millions of women have joined the professional classes. But the women at the heart of the protest movement say it was born of their outraged realization that no matter how accomplished they become, or how hard they work, women here will never fully take part in the promise of a new and more prosperous India unless something fundamental about the culture changes.

Indeed, many women in India say they are still subject to regular harassment and assault during the day and are fearful of leaving their homes alone after dark. Now they are demanding that the government, and a police force that they say offers women little or no protection, do something about it.

Ankita Cheerakathil, 20, a student at St. Stephen’s College who attended a protest on Thursday, remembered dreading the daily bus ride when she was in high school in the southern state of Kerala. Before she stepped outside her house, she recalled, she would scrutinize herself in a mirror, checking to see whether her blouse was too tight. At the bus stop, inevitably, men would zero in on the schoolgirls in their uniforms, some as young as 10, to leer and make cracks filled with sexual innuendo.

“This is not an isolated incident,” Ms. Cheerakathil said of the death of the New Delhi rape victim. “This is the story of every Indian woman.”

While the Dec. 16 attack was extreme in its savagery, gang rapes of women have been happening with frightening regularity in recent months, particularly in northern India. Critics say the response from a mostly male police force is often inadequate at best.

Last week, an 18-year-old woman in Punjab State committed suicide by drinking poison after being raped by two men and then humiliated by male police officers, who made her describe her attack in detail several times, then tried to encourage her to marry one of her rapists. Dozens more gang rapes have been reported in the states of Haryana, Bihar and Uttar Pradesh in recent months.

The government does not keep statistics on gang rape, but over all, rapes increased 25 percent from 2006 to 2011. More than 600 rapes were reported in New Delhi alone in 2012. So far, only one attack has resulted in a conviction.

Sociologists and crime experts say the attacks are the result of deeply entrenched misogynistic attitudes and the rising visibility of women, underpinned by long-term demographic trends in India.

After years of aborting female fetuses, a practice that is still on the rise in some areas because of a cultural preference for male children, India has about 15 million “extra” men between the ages of 15 and 35, the range when men are most likely to commit crimes. By 2020, those “extra” men will have doubled to 30 million.

“There is a strong correlation between masculinized sex ratios and higher rates of violent crime against women,” said Valerie M. Hudson, a co-author of “Bare Branches: The Security Implications of Asia’s Surplus Male Population.” Men who do not have wives and families often gather in packs, Ms. Hudson argues, and then commit more gruesome and violent crimes than they would on their own.

Reporting was contributed by Malavika Vyawahare, Anjani Trivedi, Niharika Mandhana and Saritha Rai.

Read More..

Kim Kardashian: From Divorce Drama to Baby Mama in 5 Clicks

Follow her odyssey from her messy split with Kris Humphries to her great expectation with Kanye West

Credit: INF

Updated: Monday Dec 31, 2012 | 11:45 AM EST

Subscribe Now

Read More..

AP IMPACT: Big Pharma cashes in on HGH abuse

A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.

The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.

But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.

From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.

___

EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

___

Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.

The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.

Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.

Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.

Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.

Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.

Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.

HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.

Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.

Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.

The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.

On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.

Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.

Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.

While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.

Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition

Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request.

"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.

And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.

First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.

Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.

FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.

Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.

Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.

These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.

The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort. The operations insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.

A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.

For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)

These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.

"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."

___

Associated Press Writer David B. Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.

___

AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh

___

The AP National Investigative Team can be reached at investigate(at)ap.org

EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

Read More..

'Overwhelmed' mother admits drowning her autistic son

A 37-year-old San Diego woman, sobbing uncontrollably, pleaded guilty Thursday to 2nd-degree murder for drowning her 4-year-old autistic son in the bathtub of the family home.

Patricia Corby was so overwhelmed by the task of caring for her son that she decided to kill him and then commit suicide, prosecutors said. Her attempt to drown herself in the tub failed.

After drowning the child on March 31, Corby drove to a neighborhood police station and admitted to police what she had done. The body of Daniel Corby, wrapped in a wet blanket, was found in the family's sport-utility vehicle.

Corby faces a mandatory minimum sentence of 15 years in prison when sentenced Jan. 28 in San Diego County Superior Court. The victim's father, Duane Corby, was in the court when his wife pleaded guilty.

ALSO:

L.A. city official hands new victory to Chinatown Wal-Mart

Flowers, candles honor homeless woman set on fire in Van Nuys

Warning: Celebratory gunfire for New Year's could land you in prison

--Tony Perry in San Diego

Photo: Patricia Corby in court. Credit: Fox-5 San Diego

Read More..