1. Calcium and Vitamin D Prevents Bone Loss
2. Chronic Fatigue Syndrome and Morning Cortisol Response
3. Why High-Protein, Low-Fat, and Low-Carbohydrate Diets Suppress Hunger
4. Call for Nominations: The Endocrine Society Award for Excellence in Science and Medical Journalism
5. New Hormone Foundation Bilingual Patient Fact Sheet on Turner Syndrome

1. Calcium and Vitamin D Prevents Bone Loss
The combination of calcium and vitamin D is more effective than calcium alone in preventing bone loss in elderly women, according to a new study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM).

Previous studies have shown that high calcium intake can help prevent bone loss. This latest study, however, demonstrated that calcium therapy, although initially successful at preventing bone loss, was no different from placebo after three or five years.

“In the long term, calcium alone loses its effectiveness in preventing bone loss. But there is good news,” said Dr. Richard Prince, professor at the University of Western Australia in Perth, Australia. “Our five-year study has shown that a combination of calcium and vitamin D prevented bone loss for the duration of the study.”

Prince and fellow researchers evaluated the relative benefits of five years of calcium supplementation with or without vitamin D2 compared to placebo on hip bone mineral density (BMD) and bone related biochemistry in ambulatory elderly women aged 70–80 years.

The combination of 1200 mg of calcium a day and vitamin D 1000 IU maintained hip BMD constant for five years, while calcium alone after three or five years was no different than placebo.

The beneficial effect of calcium and vitamin D is considered to be related to reducing bone turnover, the process of old bone constantly being reabsorbed and replaced with new bone, and suppressing parathyroid hormone (PTH) concentrations in individuals with relatively high PTH levels. PTH is a hormone that regulates calcium levels by taking calcium from bones and releasing it into the blood.

Based on the results of this study, Prince suggests that older women increase dietary calcium to 2 grams per day as well as replace vitamin D that would normally be activated by sunlight, especially if there is evidence of vitamin D deficiency.

Other researchers working on the study include Kun Zhu, Ian M. Dick, and Scott G. Wilson of the University of Western Australia in Perth, Australia; and Amanda Devine of Edith Cowan University in Perth, Australia.

A rapid release version of this paper has been published on-line and will appear in the March 2008 issue of JCEM, a publication of The Endocrine Society.

2. Chronic Fatigue Syndrome and Morning Cortisol Response
People who suffer from chronic fatigue syndrome (CFS) often endure months of persistent fatigue, muscle pain, and impaired memory and concentration. Understanding the physiological changes that accompany CFS, however, has been difficult, but a new study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM) reveals that abnormally low morning concentrations of the hormone cortisol may be correlated with more severe fatigue in CFS patients, especially in women.

“We’re learning more and more about the complexities of the illness that is chronic fatigue syndrome,” said William C. Reeves, M.D., with the Centers for Disease Control and Prevention in Atlanta, Ga., and lead author of the study. “This research helps us draw a clearer picture in regards to how CFS affects people, which ultimately will lead to more effective management of patients with CFS.”

For their study, the researchers screened 19,381 residents of Georgia, selecting 292 people who had CFS, 268 who were considered chronically unwell, and 163 who were considered well to participate. The researchers then measured free cortisol concentrations in saliva, which was collected on regular workdays, immediately upon awaking and 30 minutes and 60 minutes after awakening. The data indicated different profiles of cortisol concentrations over time among the groups, with the CFS group showing an attenuated morning cortisol profile.

Study participants were purposely screened and enrolled from the community, rather than from volunteers identified at a specialty referral clinic. The purpose of this study design was to provide results that would be more generalizable to the population suffering from CFS. In this study, women with CFS exhibited significantly attenuated morning cortisol profiles compared with well women. In contrast, men with and without CFS showed no difference in cortisol levels. This could explain why women are predominately more likely to suffer from CFS.

This study confirms previous research indicating that CFS is related to an imbalance in the normal interactions among the various systems of the body that work together to manage stress. “People with CFS have reduced overall cortisol output within the first hour after they wake up in the morning, which is actually one of the most stressful times for the body,” Dr. Reeves said. “We need further studies to better understand the relationship between morning cortisol levels and functional status of a patient suffering from CFS.”

Other researchers involved in this study include Drs. Urs M. Nater, Elizabeth Maloney, Roumiana S. Boneva, Brian M. Gurbaxani, Jin-Man Lin, and James F. Jones with the Centers of Disease Control and Prevention; and Dr. Christine Heim with the Emory School of Medicine in Atlanta.

A rapid release version of this paper has been published on-line and will appear in the March 2008 issue of JCEM, a publication of The Endocrine Society.

3. Why High-Protein, Low-Fat, and Low-Carbohydrate Diets Suppress Hunger
Many popular diet plans are based on changing the proportion of carbohydrates, proteins, and fats one ingests as a method to promote weight loss. There has been some controversy regarding the effectiveness of these diets, but a new study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM) could shed light on potential mechanisms by which various diets promote weight loss.

This study examined the relative ability of different nutrient types to suppress ghrelin, which is secreted by the stomach and is the only known appetite-stimulating hormone. Circulating ghrelin levels increase shortly before meals and then decrease promptly after ingestion of food.

“We found that when fat is consumed, levels of ghrelin remain relatively high, which could in turn stimulate hunger,” said Dr. Karen Foster-Schubert of the University of Washington School of Medicine in Seattle, Washington. “Protein consumption resulted in the greatest suppression of ghrelin over a long period and, interestingly, consumption of carbohydrates resulted in a strong ghrelin suppression initially, although subsequent ghrelin levels rebounded well above baseline.”

In this study, subjects were given three beverages with widely varying compositions of macronutrients (carbohydrates, fats, and proteins). Blood samples were taken before the first beverage was ingested and every 20 minutes for six hours thereafter. Researchers then measured the ghrelin levels in each sample.

“These findings open the door to future research on the effectiveness of varying methods of dieting,” said Foster-Schubert. “Improving our understanding of the regulation of ghrelin by ingested macronutrients could facilitate rational design of weight-reducing diets.”

Other researchers involved in this study include Joost Overduin, Holly Callahan, and David Cummings of the University of Washington School of Medicine in Seattle, Washington; and Jianhua Liu, Bruce Gaylinn, Michael Thorner, and Catherine Prudom of the University of Virginia in Charlottesville, Virginia.

A rapid release version of this paper has been published on-line and will appear in the April 2008 issue of JCEM, a publication of The Endocrine Society.

4. Call for Nominations: The Endocrine Society Award for Excellence in Science and Medical Journalism
The Endocrine Society is calling for nominations for its first annual Award for Excellence in Science and Medical Journalism. The award recognizes outstanding reporting that enhances public understanding of health issues pertaining to the field of endocrinology.

The award is open to all credentialed journalists in print (both “hard” and electronic) or broadcast. Candidates can self-nominate or be nominated by someone else. Only one nomination is permitted for each nominee. Submissions can include any work first published between January 1, 2007, and February 29, 2008.

Weight will be given to entries that demonstrate thorough research, accurate reporting, and originality, and contribute to the public understanding of endocrinology.

The award consists of a presentation piece and $2,000 honorarium, to be presented at the Society’s annual meeting in San Francisco, Calif. The award recipient will also receive travel expenses to attend the annual meeting for presentation of the award.

Nomination forms and eligibility and submission requirements can be found at http://www.endo-society.org/media/Journalism-Award.cfm. To apply, submit the completed nomination form and three copies of the work, whether published or recorded, to:

Aaron Lohr
The Endocrine Society
8401 Connecticut Ave., Ste. 900
Chevy Chase, MD 20815

Submissions must be received by March 3, 2008.

5. New Hormone Foundation Bilingual Patient Fact Sheet on Turner Syndrome
The Hormone Foundation has published a bilingual (English/Spanish) fact sheet on Turner syndrome. This publication describes the possible features, as well as the risks associated with the condition. It also provides detailed information about how the condition is diagnosed and treated. To download free copies and other useful health resources for patients, visit the Foundation's Web site (www.hormone.org).

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Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Md. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.