Milk, the white ladykiller

You can’t have missed it, it’s all over the news media: the epidemiological study that researchers at Uppsala University in Sweden published recently in the BMJ. The study shows that every glass of milk you drink daily increases your chance of an early death and of broken bones. The culprit is thought to be the sugar galactose.

Study
The Swedes have followed a group of over sixty thousand women since the late 1980s and a group of almost fifty thousand men since the mid 1990s. The researchers got their subjects to complete questionnaires on their dairy consumption. They also recorded any broken bones and fatalities that occurred.

Results
Milk had little effect on the men. Every glass of milk they drank each day increased their chance of dying by one percent and their chance of breaking a bone by about the same amount.

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Among the women the situation was different. For every glass of milk they drank each day, their chance of dying increased by 15 percent, and their chance of breaking a bone increased by 2 percent.

Women who drank three glasses of milk a day were twice as likely to die compared with women who drank less than one glass of milk a day. Milk increased the chance of developing fatal cardiovascular diseases in particular, but also increased the likelihood of developing a fatal form of cancer.

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Explanation
The Swedes suspect that the simple carbohydrate galactose found in milk is the cause of the problems. Milk contains lactose, a double carbohydrate consisting of one glucose molecule and one galactose molecule.

Results
Galactose is a dextro isomer of glucose. In the human body enzymes convert lactose into galactose and glucose, and then they convert galactose into glucose.

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Animal studies have shown that galactose speeds up the aging process. [J Neurosci Res. 2006 Aug 15;84(3):647-54.] In 2006 Chinese researchers published the results of an experiment in which they injected mice daily for seven weeks with 100 mg galactose per kg bodyweight, and discovered that this caused the animals’ brain cells to age faster. Galactose probably boosts free radical activity.

The Chinese were actually able to reduce the harmful effects of galactose by administering R-alpha-lipoic acid. In another Chinese animal study, ECGC, a flavonoid in green tea, protected mice against galactose-induced premature aging. [Biol Pharm Bull. 2009 Jan;32(1):55-60.]

The dose that the Chinese used was not high, the Swedes say. “This is equivalent to 6-10 g in humans, corresponding to 1-2 glasses of milk. Based on a concentration of lactose in cow’s milk of approximately 5%, one glass of milk comprises about 5 g of D-galactose.”

The researchers tried to test the theory and measured the concentration of the inflammatory protein Interleukine-6 in the blood and of the inflammatory marker 8-iso-PGF2alpha in the urine. The more milk the study participants drank, the higher the levels of these were.

Cheese, soured milk and yoghurt
“Particularly noteworthy is that intake of fermented milk products such as yogurt and soured milk and cheese were associated with lower rates of fracture and mortality”, the Swedes write.

Conclusion
“Our results may question the validity of recommendations to consume high amounts of milk to prevent fragility fractures”, the researchers write. “The results should, however, be interpreted cautiously given the observational design of our study. The findings merit independent replication before they can be used for dietary recommendations.”

Effects of Three Different Medications on Metabolic Parameters and Testicular Volume in Patients With Hypogonadotropic Hypogonadism

Abstract

Introduction The aim of this study was to demonstrate the influences of three different treatment strategies on biochemical parameters and testicular volume (TV) in patients with idiopathic hypogonadotropic hypogonadism (IHH).

Subjects design and methods Seventy-seven never-treated patients with IHH and age and body mass index (BMI)-matched 42 healthy controls were analysed in a retrospective design. Twenty-eight patients were treated with testosterone esters (TE), 25 patients were treated with human chorionic gonadotropin (hCG) and 24 patients were treated with testosterone gel (TG). Biochemical parameters, tanner stages (TS) and TV were evaluated before and after 6 months of treatment.

Results Pretreatment TV, TS and biochemical test results were similar among the three treatment subgroup. In the TE-treated group, BMI, haemoglobin, haematocrit, creatinine, triglyceride, total testosterone (TT), TS and TV increased, but HDL-cholesterol (C) and urea level decreased significantly. In the hCG-treated group, triglyceride level decreased, and luteinizing hormone level, TS and TV increased significantly. BMI, TT, TS and TV increased, and leucocyte count, total-C, HDL-C levels decreased significantly in the TG-treated patients. No treatment type resulted in any changes in insulin resistance markers.

Conclusion

hCG treatment resulted in favourable effects particularly on Testicular Volume and lipid parameters. When TV improvement is considered less important, TG treatment may be a better option for older patients with IHH because of its easy use, neutral effects on triglyceride, haemoglobin and haematocrit, and its beneficial effects on total cholesterol level.

Note: Dosing of hCG, injectable testosterone and testosterone gel were not “standard” as shown:

25 patients treated with hCG (Pregnyl® Organon hCG 5000 IU; Organon USA Inc., Roseland, NJ, USA) 5000 IU twice weekly, 28 patients treated with IM injections of oil-based blend of four esterized testosterone (TE) compounds (Sustanon® 250 mg Organon; Organon Schering-Plough Corporation, Istanbul, Turkey; 30 mg testosterone propionate, 60 mg testosterone phenylpropionate, 60 mg testosterone isocaproate and 100 mg testosterone decanoate) once every 3 weeks, and 24 patients treated with daily transdermal testosterone gel (TG; Testogel® Testosterone 50 mg/5 g-Schering, Schering Health Care Ltd, Burgess Hill, West Sussex) were enrolled.

This graph shows the changes in HDL, triglycerides, testosterone, and testicular volume. It is surprising that 5000 IU of hCG twice per week hardly increased T levels. hCG looks good in all other parameters.

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This graph shows the same parameters before and after each treatment option. You can see how all patients were undertreated (total T levels did not increase beyond 300 ng/dL)

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The authors admit that their dosing regimen was not the best:

“Successful testosterone replacement treatment is guided by the hormone levels remaining above the lower limit of normal range just before the next application of drug.[16] In this respect, we found only TG treatment achieved the target and hCG was the least effective. Similar to our result, IHH was previously found poorly responsive to hCG therapy in terms of normalization of serum testosterone.[17]However, some other studies showed that serum testosterone increased to normal ranges after hCG treatment at a dose of 5000 IU.[18, 19] Our subjects received 5000 IU hCG twice weekly. This regimen resulted in a significant increase in tanner scores, but the magnitude of change was lesser in comparison with the other two options. It is likely that serum testosterone increased to an effective level after hCG treatment, but this period remained relatively short, and testosterone level turned nearly to baseline values before the next injection time. Although some improvements were evident in tanner scores in this study, this treatment regimen may not optimal for obtaining basal testosterone level, also suggesting that smaller doses with shorter intervals may be more favourable. After injection of the commonly administered dose of 200 or 250 mg, TE has the disadvantage that it produces supraphysiological serum testosterone levels during the days immediately following administration, with a slow decline to the lower limit of normal within the following 10–14 days. Patients frequently dislike these swings in serum testosterone levels, which they experience as ups and downs in vigour, mood and sexual activity.[20] Our study showed that serum testosterone falls to the levels lower than the normal just before the next injection. As a result, also for TE treatment, smaller doses with narrow intervals may be tried to reach physiological testosterone levels.”  
  

 

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