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Dr Peraglie 407-922 3424,
Flo Ballengee 863-899-3463,


MGB Almost Twice as Powerful as Lapband

MGB Twice as Powerful as Lapband:
Five hundred and twenty severely obese patients with body mass index (BMI) ≥35 were recruited. Among them, 149 and 371 subjects received laparoscopic adjustable gastric banding (LAGB) and laparoscopic * mini-gastric bypass* (LMGB), respectively.

Obese patients had LESS decrease in BMI after LAGB (-7.5 vs. -6) compared to patients after LMGB, (-12.5 vs. -10.0)

Amplify’d from
Obes Surg. 2011 Jul 1. [Epub ahead of print]

ESR1, FTO, and UCP2 Genes Interact with Bariatric Surgery Affecting Weight Loss and Glycemic Control in Severely Obese Patients.


Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.



Significant variability in weight loss and glycemic control has been observed in obese patients receiving bariatric surgery. Genetic factors may play a role in the different outcomes.


Five hundred and twenty severely obese patients with body mass index (BMI) ≥35 were recruited. Among them, 149 and 371 subjects received laparoscopic adjustable gastric banding (LAGB) and laparoscopic mini-gastric bypass (LMGB), respectively. All individuals were genotyped for five obesity-related single nucleotide polymorphisms on ESR1, FTO, PPARγ, and UCP2 genes to explore how these genes affect weight loss and glycemic control after bariatric surgery at the 6th month.


Obese patients with risk genotypes on rs660339-UCP2 had greater decrease in BMI after LAGB compared to patients with non-risk genotypes (-7.5 vs. -6 U, p = 0.02). In contrast, after LMGB, obese patients with risk genotypes on either rs712221-ESR1 or rs9939609-FTO had significant decreases in BMI (risk vs. non-risk genotype, -12.5 vs. -10.0 U on rs712221, p = 0.02 and -12.1 vs. -10.6 U on rs9939609, p = 0.04) and a significant amelioration in HbA1c levels (p = 0.038 for rs712221 and p < 0.0001 for rs9939609). The synergic effect of ESR1 and FTO genes on HbA1c amelioration was greater (-1.54%, p for trend <0.001) than any of these genes alone in obese patients receiving LMGB.


The genetic variants in the ESR, FTO, and UCP2 genes may be considered as a screening tool prior to bariatric surgery to help clinicians predict weight loss or glycemic control outcomes for severely obese patients.



The 6 Surprising Money Savers Hiding in My Home

The 6 Surprising Money Savers Hiding in My Home

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First Person: The 6 Surprising Money Savers Hiding in My Home

On Friday July 1, 2011, 5:00 pm EDT
*Note: This was written by a Yahoo! contributor. Do you have a personal finance story that you’d like to share?

Household spending is a complicated aspect of nearly every budget. If only there were a way to use products already in the pantry to help alleviate this monthly strain. Well, good news: There is! Many items you currently have in your home can serve more than their original purpose. The following are a few I use regularly.

Paper towels are ridiculously expensive. Many people have moved to cleaning with old washcloths or a sponge, and that is certainly a great alternative. However, I am one of those people who prefer to throw away things I have used to wipe the toilet. If you are like me, try using cheap coffee filters. They clean better than paper towels (especially mirrors), and are way cheaper.

Speaking of cleaning, “going green” is in these days, so why not hop on that bandwagon for some of your kitchen and bathroom cleansers? Simple ingredients like baking soda splashed with vinegar are terrific for cleaning showers and toilets, and they’re especially great at opening drains. If your bathtub drains are clogged with hair, replace the Drano with a few shakes of baking soda, a splash or three of vinegar, and a kettleful of boiling water. These products are generally in the pantry already, and when combined they make amazing cleaning agents.

It’s surprising how many things you already own that can serve multiple purposes. Try these, and venture into the realm of repurposing. As you find even more new uses for old objects, share your knowledge with all of your friends.



The Best and Worst Products at Trader Joe's

The Best and Worst Products at Trader Joe’s

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The Best and Worst Products at Trader Joe’s

Russ Shelly of the review site What’s Good At Trader
Joe’s weighs in on 25 products

What’s good at Trader Joe’s? What’s not?
These are questions that
fans and detractors of the store are very passionate
. Last August, Nathan Rodgers, his wife Sonia,
and their friend Russ Shelly and his wife Sandy decided to
systematically review every product to find out.

The team reviewed 75 products on their site, What’s Good at Trader
. They
then rated them for The Daily Meal
in five categories
(drinks, desserts, sauces and soups, international entrées, and
snacks), setting off a firestorm of comments from both
“TJ’s” fans and “Traitor Joe’s” haters.
“The frozen chocolate croissants from TJ’s are
amazing,” noted one. “I hate TJ’s produce,” said
another. “It tastes like science.”

The last laugh is on haters. Several confused readers wrote
requesting stores be built in Wilkes-Barre, Penn.; Memphis; Kansas
City; Dallas-Fort Worth; and the Pacific Northwest. And some of
these wishes may be fulfilled. According to Trader
, stores are planned for Kansas City; Chicago
(South Loop); Leawood, Kan. Louisville; Mt. Pleasant, S.C.;
Pittsburgh; Spokane, Wash.; State College, Penn.; and Staten

10 Chain Restaurants Worth

With 2011’s midpoint nearing, it’s time to check in again
with the trio to get an update on the best and worst products. You
have to wonder, given the time they’ve spent in the store and
all the products they’ve considered, is there anything the
What’s Good at Trader Joe’s folks are scared to try?
“We don’t really have a top five list for what Nathan and I
are scared to try, but I can tell you our top scary items,”
Russ confided.

“The Blueberry Vanilla Chèvre kinda scares me a little,”
Nathan admitted. “I’m down with goat cheese on salads and
sandwiches, but I’ve never thought of it as a dessert

“We’ve had fans swear by it, though,” said Russ.
“For me, the thought of trying any Trader Joe-brand sushi is a
kneeknocker. I’ve heard horror stories from sushi aficionados, and
the one time I’ve had sushi in my life, at a pretty respectable
restaurant, I wasn’t much of a fan. I can’t imagine the Trader
Joe’s sushi being worthwhile or remotely enjoyable.”

And with that, it’s time for some best-ofs. Below are Russ
Shelly’s picks in five new categories with his brief reviews
and ratings on a scale of 1 to 10 (10 being the best), including a
category likely to stir things up: “Worst. Stuff.

Top 5 Vegetarian
1. Veggie Sausage Patties (9
I’m a meatatarian by nature and nurture, and sausage is by far one
of my favorites. These veggie patties come extremely close to
matching the real thing. If meat grew on a tree this is how it
would taste.

2. Trader Jose’s Mildly Spiced Vegetable
(8.5 points)
I was amazed at how good these were. I love meat, and I love spicy,
but there’s something about these that make them surprisingly and
undeniably good. The burritos definitely have more of a kick than
expected, too.

3. Paneer Tikka Masala (8 points)
One of my wife’s favorites, and it’s up there for me too. The
masala sauce is intoxicating, and it ties together a very good,
somewhat off the beaten track microwave lunch.

4. Lentil Soup with Ancient Grains (8
This stuff seems straight from another time from another part of
the world. It’s thick and chunky and extremely filling. This ain’t
no canned soup. We make a beeline for it when shopping.

5. Apocryphal Pita and Roasted Garlic
(8 points)
Pitas and hummus make a classic vegetarian pairing, and this combo
should not be missed.

What Else is Good at Trader Joe’s

Top 5 Breakfast
1. Organic Mango Passion Granola (10
Finally, a breakfast cereal worth waking up for. It actually puts a
smile on my face early in the morning and keeps me full until
lunch. The Mango Passion Granola truly has my respect.

2. Breakfast Scramble (8.5
Quick ‘n easy potatoes, onions and eggs, and shockingly good out of
a microwave. Tough to beat for a hot meal on a busy morning without
a drive-thru involved.

3. Frosted Maple and Brown Sugar Shredded Bite Size
(8.5 points)
A tasty twist on a cereal classic. The maple and brown sugar flavor
make for an easy morning for the taste buds and the biscuits are
crispy crunchy to the last spoonful.

4. Organic Lowfat Yogurt Wildberry Probiotic
(8.5 points)
Quick and portable for a quick grab. They could be a little bigger,
especially if you wake with the hunger of a bear coming out of
hibernation, but for what they are, they’re pretty darn good.

5. Heart Healthy Whole Grain Blueberry Instant
(7.5 points)
Some mornings only oatmeal will do. Sorry Wilfred Brimley, this
stuff is tough to beat.

Trader Joe’s: The Good, the Bad, and the Dearly

Top 5

1. Heat &
Eat Falafel
: (9.5 points)
Ridiculously easy. Ridiculously satisfying. And ridiculously good
paired with some TJ’s hummus. They’re spicy, homey, and have
instant comfort. They’re restaurant quality for a fraction of the

2. Thai Joe’s Coconut Curry Chicken
(8 points)
The stix are good enough to rival spring rolls at many Thai
restaurants. For being a one-trick pony, Thai Joe did pretty well
for himself here.

3. Parmesan Pastry Pups (7.5
Not a lot of Parmesan, but good pastry, and thankfully, no pups
involved. A good twist on the classic pig in a blanket, especially
since the mini-dogs are beef.

4. Scallop Bites (7 points)
More delishy than fishy. These certainly make a decent seafood
snack, and would be sure to please a crowd.

5. Mini Chicken Tacos (7 points)
A little plain, and not for those who are weirded out by miniature
foods. Still, a pretty good facsimile, however smaller, of a pretty
decent taco.

What Else is Good at Trader Joe’s?

Top 5 Biggest Winner Versus Expectation

1. Baker Josef’s Chocolate Cake and Frosting
(10 points)
Nathan and Sonia’s biggest pleasant surprise was the Baker
Josef’s Chocolate Cake and Frosting Mixes. Neither one of them
is really a “chocolate cake person,” but they might be if
all chocolate cakes tasted like this one.

2. Green Plant Green Food Beverage (6
Okay, it’s not highly rated, but it was definitely one of the
biggest pleasant surprises for me. It looked disgusting and I had
to swallow hard before trying it, but the green beverage actually
turned out to be fairly good overall. I definitely thought I’d
score it much lower.

3. Heart of Darkness Mango Passion Fruit
(8 points)
After the very unsuccessful Organic Mango Nectar, we were a little
hesitant to try this one, but it’s really tasty. A bit oddly
inspired, to be sure.

4. Chicken & Cheese Tamales (8
Frozen microwavable tamales that actually taste good? That’s
possible? In a word, yes.

5. Omega Orange Carrot Juice (7.5
One of the most uniquely delicious tasting juices we’ve ever tried.
It’s so good, it doesn’t taste healthy.

Trader Joe’s: The Good, the Bad, and the Dearly

Bottom 5: Worst.
Stuff. Ever.

1. Turkey “Meatloaf Muffins” (0
Easily one of the worst things I’ve ever put in my mouth since
being old enough to know better. And that says a lot. To date,
still the only 0 we’ve ever granted. My wife Sandy was smart enough
to never even try them. I wish I was as wise.

2. Fat Free Spicy Black Bean Dip (2.5
If you like hummus-fied dark super vinegary matter, you’ll like
this. Not spicy at all and we cannot verify if there are really
black beans or anything other than vinegar in it.

3. Satay Peanut Sauce (3 points)
Tastes fishy. Literally. That’s not even close to what satay peanut
sauce is supposed to taste like.

4. Chile Spiced Mango (3 points)
Way too much chile and not enough mango. Flavor combinations can’t
be this one sided.

5. Trader Joe-San’s Green Beans (3
A little too out there texture-wise, and very inconsistent from one
bite to the next. Pretty bland as well.

These rankings set off
comments from fans and haters alike
who weighed in
with their own picks. Favorites include nut mixes, dips and chips,
chocolate nut candies, soups, smoked fish, olives, pre-cooked
grains, and frozen food. Things that didn’t fare so well? Asian
food, cheese, and fish.
See the full list – and join the debate – at The Daily
Arthur Bovino,
The Daily Meal

More from the Daily Meal:



Diet Drinks Lead to 70% Greater Waist Size

Consumers of diet soft drinks experienced a 70% greater increase in waist circumference than nonconsumers. Further, among elderly drinkers of 2 or more diet soft drinks per day, mean increases in waist circumference were 5 times greater than those recorded for nonconsumers.

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Even Diet Soda Induces Weight Gain in the Elderly

Neil Canavan

June 24, 2011 (San Diego, California) — The perception that diet soft drinks are a benign alternative to highly sweetened beverages might be dangerously wrong, according to the results of the San Antonio Longitudinal Study of Aging, which were reported here at the American Diabetes Association 71st Scientific Sessions.

Diet soft drinks have long been thought to be a healthier alternative to their sugary counterparts; however, past reports have linked increased incidence of obesity, metabolic syndrome, and diabetes to the frequent intake of diet soft drinks.

In the study presented, Sharon P. Fowler, MPH, from the University of Texas Health Science Center at San Antonio, and colleagues examined the effect of the long-term consumption of diet soft drinks by a population of individuals 65 to 74 years of age (n = 474).

At baseline, measures of height, weight, and waist circumference were recorded, as was diet soft drink intake. Three additional exams of the study subjects were conducted over an average follow-up of just over 3.5 years (the study was conducted over a 9-year period).

When the results of these observations were compared with those from subjects who did not drink diet soft drinks, the differences were striking. Overall, consumers of diet soft drinks experienced a 70% greater increase in waist circumference than nonconsumers. Further, among elderly drinkers of 2 or more diet soft drinks per day, mean increases in waist circumference were 5 times greater than those recorded for nonconsumers.

“These results suggest that — amidst the national drive to reduce consumption of sugar-sweetened drinks — policies that promote the consumption of diet soft drinks may have unintended deleterious effects,” state the study investigators.



Sitting is Deadly

Time spent sitting was associated with 34% and 17% increased risk of death among women and men.

When sitting was considered in the context of the level of physical activity, the risk of death increased to a 94% higher likelihood for women and 48% higher likelihood for men, respectively, compared with their less sedentary counterparts.

Amplify’d from
ACSM’S Health & Fitness Journal:
January/February 2011 – Volume 15 – Issue 1 – pp 41-43
doi: 10.1249/FIT.0b013e318201d199

The Problem With Too Much Sitting: A Workplace Conundrum

Pronk, Nico Ph.D., FACSM, FAWHP

Free Access

Article Outline
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Author Information

Nico Pronk, Ph.D., FACSM, FAWHP, is vice president for Health Management and health science officer for JourneyWell at HealthPartners in Minneapolis, MN, where he also is a senior research investigator at the HealthPartners Research Foundation. Dr. Pronk holds a faculty position in the Department of Society, Human Development, and Health at the Harvard University School of Public Health, where he teaches and conducts research in worksite health. He is the current president for the International Association for Worksite Health Promotion, an ACSM affiliate society, the editor of ACSM’s Worksite Health Handbook, 2nd Edition, and an associate editor for ACSM’s Health & Fitness Journal®.

Recently, stories abound in the popular press on the health risks associated with too much sitting. News anchors talk up the impact of sitting on premature death, story lines read “Sitting kills” and “Get off that deadly chair,” whereas e-news stories and streaming video zip along the information highway informing listeners and viewers on the deadly effects of prolonged sitting. So, is this truly news or is it merely a reinvention of an age-old message?

Figure. No caption a...

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Not so long ago, in 1953, Jeremy Morris and colleagues observed that bus conductors who climbed the stairs of double-deck buses in London as part of their regular workday experienced half the number of myocardial infarction cases when compared with their colleagues driving the bus who spent 90% of their work hours sitting (2). A little while before that, in 1713, Bernardino Ramazzini, the Italian physician widely considered the father of industrial medicine, noted that tailors and cobblers who sat at their work and were therefore called “chair-workers,” experience general ill health (6). Note that both these examples of early observations on the ill-health effects of prolonged sitting involve workers. Hence, the connection between the workplace setting and the negative impact of prolonged sitting is not new. However, because of the more recent changes in the work environment brought about by emerging technologies and automation, sedentary and sitting tasks have become a usual circumstance for many employees, and the message is highly relevant today.

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Sedentary behaviors include sitting in a variety of settings, for example, television viewing at home, sitting while commuting, and screen time during computer use at work are all examples of behaviors with very low energy expenditure across a variety of settings that may occur throughout the course of a single day. During the course of an entire day, repeated throughout weeks and months, accumulated sitting time may have negative consequences for health. Recent evidence reports associations between television time and poor metabolic health, indicating that overall sitting time is related to increased health risk caused by higher waist circumferences, body mass index, systolic blood pressure, triglycerides, plasma glucose, and fasting insulin, as well as lower high-density lipoprotein. Furthermore, leisure time spent sitting (≥6 hours day−1 vs. ❤ hours day−1) was associated with 34% and 17% increased risk of death among women and men, respectively, after 14 years of follow-up in the American Cancer Society’s Cancer Prevention Study II (4). When sitting was considered in the context of the level of physical activity (≥6 hours day−1 of sitting and being less physically active), the risk of death increased to a 94% higher likelihood for women and 48% higher likelihood for men, respectively, compared with their less sedentary counterparts. In one study, each 1-hour increment in television viewing time was found to be associated with an 11% and an 18% increased risk for all-cause and cardiovascular disease mortality rates, respectively (3). In a recent study from the Cooper’s Institute, cardiovascular mortality outcomes related to sedentary behaviors of men after 21 years of follow-up showed an 82% greater risk of dying among men who reported spending more than 10 hours per week sitting in automobiles compared with men sitting in automobiles less than 4 hours per week (7).

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Too much sitting may be hazardous to overall health and well-being, but does it apply when guidelines for physical activity are met? The current guidelines for health-enhancing physical activity include the accumulation of 150 minutes per week of moderate-intensity activity, or 75 minutes per week of vigorous intensity activity, or a combination of the two where vigorous activity counts double compared with moderate-intensity activity (5). A 30-minute run three times per week or a daily 25-minute walk will exceed the minimum criteria for meeting the physical activity guidelines for health. However, if this same person sits in front of the computer at work for 8 to 9 hours each day or spends 4 hours per day or more in front of the television, this person might be considered an “active couch potato” and has a higher likelihood for metabolic abnormalities. It is questionable whether the time spent in activity is sufficient to offset the deleterious effects of so much sedentary time. Breaking up sitting time appears to be beneficial for health.

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Healy and colleagues from Australia have presented research indicating a beneficial association between breaks in sedentary time and metabolic biomarkers (1). The difference between sedentary time and nonsedentary time was akin to moving from a sitting to a standing position or from standing still to beginning to walk. The higher the number of “breaks” in sedentary time, the lower the risk associated with waist circumference, body mass index, triglycerides, and 2-hour plasma glucose. In fact, there was a 6-cm difference in waist circumference among those with prolonged sitting behavior compared with those who engaged in frequent “breaks” in sedentary time throughout the day.

Based on a review of the sedentary behavior literature, Patel’s team identified research gaps related to interventions studies where sedentary time is broken up or reduced with specific emphasis on the workplace setting (4). However, this does not mean that nothing is known about increasing work breaks or reducing prolonged sitting time in the workplace. In fact, some good examples of introducing physically active work breaks already exist in the literature. Table 1 outlines several examples. However, more research is needed to increase our understanding of what works in reducing the ill effects of prolonged sitting time as the result of planned interventions.

Table 1

Table 1
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Perhaps even more important of an area for research than the impact of prolonged sitting on health is its deleterious effects on productivity and sick leave, especially when it is considered from an employer’s point of view. Obviously, a successful intervention that improves productivity as the central outcome provides immediate rationale for a company to invest in such a resource. From this perspective, a close examination of what is available in the area of occupational health and ergonomics makes good sense. Here, the integration of worker health protection (occupational health and safety) and worksite health promotion is an intuitive fit. An excellent resource to consider is the NIOSH WorkLife program (see

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When workers are exposed to prolonged sedentary time, a program or intervention that provides opportunity for a break from sitting may benefit the health and productivity of employees. Such breaks would include periodic or more frequent standing up (but not prolonged standing that may have its own health-related issues), stretch breaks, and walking breaks, among others. In many cases, the potential to move from a sitting to a standing position (and vice versa) does not necessarily impede with the work routine. For example, conference calls, data entry, and call center work tasks are all examples of work that may be conducted in either sitting or standing positions. On the other hand, stretch breaks or other activity-specific breaks are likely to affect the flow of work tasks in which an employee is involved. For such breaks to fit in the work routine, adaptations may need to be made. Table 2 presents several ideas from public access resources for interventions that may help prompt or provide support for breaking up the prolonged sitting times among employees.

Table 2

Table 2
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Comprehensive, multicomponent, and multilevel programs have been shown to be effective for employee health improvement, reduction in productivity loss, and generating a positive return on investment. Integrating a focused effort to reduce prolonged sitting time as a component of a comprehensive health promotion program is a good idea. It supports the overall program objectives and is consistent with the larger vision of improving employee health. Furthermore, insofar as prolonged sitting may affect only a portion of the workforce, the overall comprehensive program will present other employees with access to programs more appropriate for their jobs. Given that physical activity remains a mainstay of worksite health promotion programs, a variety of interventions that reduce sedentary behavior from a multitude of perspectives represents a long-term approach to improving and maintaining the health of employees.



High Vit D = > Lower Risk Diabetes

“The implications of this study relate to the importance of performing a randomized placebo-controlled trial of vitamin D for the prevention of type 2 diabetes in those at high risk,” he told Medscape Medical News. “In the interim, clinicians should at least focus on maintaining vitamin D levels in high-risk individuals at or around 20 ng/mL,” he added.

Amplify’d from

From Medscape Medical News

Higher Vitamin D Levels Linked to Lower Diabetes Risk

Emma Hitt, PhD

Physician Rating:  3.5 stars  
Rate This Article:


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June 25, 2011 (San Diego, California) — Higher levels of vitamin D in the blood appear to be associated with a reduced risk for incident diabetes among people at high risk for the disease, according to a new report.

Anastassios G. Pittas, MD, from the division of endocrinology, diabetes, and metabolism at the Tufts New England Medical Center in Boston, Massachusetts, and colleagues presented the findings here at the American Diabetes Association 71st Scientific Sessions.

According to Dr. Pittas, vitamin D might play a role in diabetes by improving insulin secretion and insulin sensitivity. “Most of the evidence focuses on a favorable effect in pancreatic beta cells,” he told Medscape Medical News.

To determine the relation between vitamin D status and risk for incident diabetes, the researchers analyzed data from the Diabetes Prevention Program (DPP), a 3-group trial comparing intensive lifestyle modification or metformin with placebo for the prevention of diabetes in patients with prediabetes.

The mean follow-up of the 2039-person cohort was 3.2 years. Plasma vitamin D levels were measured at yearly intervals, and subjects were assessed for incident diabetes. For this analysis, only participants in the intensive lifestyle and placebo groups of the DPP were considered.

Participants with vitamin D levels in the highest tertile (median concentration, 30.1 ng/mL) had a hazard ratio of 0.74 (95% confidence interval [CI], 0.59 to 0.93) for developing diabetes, compared with those with vitamin D levels in the lowest tertile (median concentration, 12.8 ng/mL).

The findings also suggest a dose-dependent effect for vitamin D levels; the hazard ratio for incident diabetes was lowest (0.46; 95% CI, 0.23 to 0.90) in the people with the highest vitamin D levels (50 ng/mL or higher), compared with those with the lowest levels (below 12 ng/mL).

In a subgroup analysis by tertiles of vitamin D, the association was similar in the placebo group (0.72; 95% CI, 0.53 to 0.96) and the lifestyle group (0.80; 95% CI, 0.54 to 1.14).

According to Dr. Pittas, “this study offers several methodological advantages over previous studies.” Vitamin D status was assessed multiple times during follow-up, not just once at baseline, which might not reflect long-term vitamin D status.

“Our study also includes a large clinically relevant population at high risk for diabetes, with a substantial proportion of nonwhite participants, which improves the external validity of the results,” he said. However, he added, “this is an observational study and therefore confounding cannot be excluded. It would be premature to recommend vitamin D specifically for prevention of diabetes.”

“This prospective study confirms that there is an association between levels of vitamin D and risk of diabetes, even when correcting for body weight, with no absolute threshold of serum 25-hydroxy vitamin D,” said independent commentator Clifford Rosen, MD, from the Jackson Laboratory in Bar Harbor, Maine. Dr. Rosen is a vitamin D researcher and member of the Institute of Medicine Committee that reviewed the evidence on calcium and vitamin D.

“The implications of this study relate to the importance of performing a randomized placebo-controlled trial of vitamin D for the prevention of type 2 diabetes in those at high risk,” he told Medscape Medical News. “In the interim, clinicians should at least focus on maintaining vitamin D levels in high-risk individuals at or around 20 ng/mL,” he added.