A study of 90,000 people has uncovered new genetic variants that influence fat mass, weight and risk of obesity. The variants act in addition to the recently described variants of the FTO gene: adults carrying variants in both genes are, on average, 3.8 kg (or 8.5 lb) heavier.

The variants map close to a gene called MC4R: mutations in this gene are the most common genetic cause of severe familial obesity. The study highlights the power of large collections of volunteer samples to uncover common variants that influence health.

“By working together with many international groups we have been able to assemble a sample collection which was large enough to allow this finding to be made,” explains Dr Ruth Loos, leading author from the Medical Research Council Epidemiology Unit. “Several groups had shown that rare, highly disruptive variants in the MC4R gene were responsible for very severe, genetic forms of obesity: this collaboration has uncovered more common variants that affect more people.”

The study, published in Nature Genetics, is led by investigators from the Cambridge GEM consortium (Genetics of Energy Metabolism) and Oxford University and is a collaboration between 77 institutions from the UK, USA, France, Germany, Italy, Finland and Sweden.

The team studied more than 77,000 adults and found that two copies of genetic variants resulted in an average increase in weight of about 1.5 kg.

This is the second set of common variants that are associated with weight and obesity, following the study, involving many of the same team, published in April 2007 that uncovered a role for the FTO gene. People who carry two copies of an FTO variant are about 2-3 kg heavier than those who have no copies of the variant.

Importantly, the effects of the new gene add to those of FTO; people who carried both the FTO variant and new variants were on average 3.8 kg (8.5 lb) heavier.

“This is a great example of how cooperation can bring about new findings that can be missed when researchers work in isolation,” explains Dr In??s Barroso, Investigator at the Wellcome Trust Sanger Institute and one of the senior authors on the study. “The precise role in obesity of genetic variants in FTO and near MC4R remains to be discovered, but we can now begin to understand the biological consequences of these variants. This is where this research will make a difference.”

MC4R protein plays a pivotal role in many aspects of physiology, including regulation of appetite and energy expenditure. The severe form of MC4R-related obesity is a consequence of alterations in the gene sequence, resulting in an inactive or less active MC4R protein.

By contrast, the new variants lie some distance from the MC4R gene. The team suspect that the sequence variant changes activity of the MC4R gene, perhaps by disrupting DNA regions required for normal activity of MC4R.

“Through this new and powerful genetic approach we are increasingly finding that the genes known to play a role in severe – but rare – diseases are also implicated in much more common disease,” explains Professor Mark McCarthy, Robert Turner Professor of Diabetes at the University of Oxford, UK. “The common variants we are uncovering do not have such a dramatic effect on the normal functioning of the gene as do the rare mutations in MC4R that can cause rare examples of very serious, early onset obesity.”

Dramatically, in a study of almost 6000 children, they found that the effects were almost double those seen in adults. Between the ages of four and seven, this additional increase in weight was the result, almost exclusively, of gain of fat tissue, and not due to gain in muscle or other solid tissues.

This more dramatic effect in young children reflects the more extreme consequences seen with rare variants of MC4R that severely disrupt its activity, suggesting that the novel variants do indeed exert their effect through action on MC4R.

“Our work to understand common disease, such as obesity, depends on the participation of thousands of people – members of the public who provide samples,” explains Professor Nick Wareham, Director of the MRC Epidemiology Unit. “Without their willing participation, we could never achieve the power in our research to make striking findings like this.

“For each discovery, our efforts and the contribution of the participants will lead to improved healthcare for the population at large.”

The team will now look to uncover how the DNA variants affect activity of the MC4R protein, which is a key player in orchestrating information from the body to control appetite and energy expenditure to keep body weight in balance. The team propose that altered activity of MC4R, imposed by the variants, might reduce its ability to carry out this important role.

The team emphasize that, although gene variants can affect weight, body mass index and obesity, they are only part of the story: lifestyle actions such as good diet and regular exercise are vital to control of weight.

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Publications details

Loos RJF et al. (2008) Association studies involving over 90,000 people demonstrate that common variants near to MC4R influence fat mass, weight and risk of obesity. Nature Genetics Published online on Sunday 4 May 2008 doi: dx.doi/10.1038/ng.140

Participating groups

A full list of participating groups can be found at the Nature website.

The Cambridge Genetics of Energy Metabolism (GEM) consortium includes researchers from the Wellcome Trust Sanger Institute, MRC Epidemiology Unit and University of Cambridge Department of Clinical Biochemistry and brings together teams with diverse skills to tackle the task of understanding the genetics of both common polygenic forms and also rare monogenic forms of diabetes and obesity.

Funding

This research programme was supported by the Medical Research Council, the Wellcome Trust, Diabetes UK, Cancer Research United Kingdom, BDA Research, UK National Health Service Research and Development, the European Commission, the Academy of Finland, the British Heart Foundation, the National Institutes of Health, the Novartis Institutes for BioMedical Research, GlaxoSmithKline, and the German National Genome Research Net.

Additional support was provided to individuals by the US National Institute of Diabetes and Digestive and Kidney Diseases, the Throne-Holst Foundation, the Vandervell Foundation, American Diabetes Association, Unilever Corporate Research and the British Heart foundation.

The Wellcome Trust Sanger Institute, which receives the majority of its funding from the Wellcome Trust, was founded in 1992 as the focus for UK sequencing efforts. The Institute is responsible for the completion of the sequence of approximately one-third of the human genome as well as genomes of model organisms such as mouse and zebrafish, and more than 90 pathogen genomes. In October 2005, new funding was awarded by the Wellcome Trust to enable the Institute to build on its world-class scientific achievements and exploit the wealth of genome data now available to answer important questions about health and disease. These programmes are built around a Faculty of more than 30 senior researchers. The Wellcome Trust Sanger Institute is based in Hinxton, Cambridge, UK. sanger.ac/

Oxford University’s Medical Sciences Division is one of the largest biomedical research centres in Europe and Oxford is ranked third in the world for biomedicine. The Medical Sciences Division represents almost one third of Oxford University’s income and expenditure and two thirds of Oxford University’s external research income. Work ranges from basic science including leading molecular research to studies in humans, with vaccines in field trials for HIV, TB and malaria. ox.ac/

The Medical Research Council supports the best scientific research to improve human health. Its work ranges from molecular level science to public health medicine and has led to pioneering discoveries in our understanding of the human body and the diseases which affect us all. mrc.ac/

GlaxoSmithKline – one of the world’s leading research-based pharmaceutical and healthcare companies – is committed to improving the quality of human life by enabling people to do more, feel better and live longer. For company information, visit GlaxoSmithKline at gsk/.

GlaxoSmithKline sponsored, in part, the CoLaus Study in Lausanne, Switzerland. This study is one of a large panel of academic-industry collaborations that GlaxoSmithKline has set up to decipher the genetic basis of common diseases. Scientists from GlaxoSmithKline and from Lausanne University Hospital collaborated closely with the MRC and Sanger scientists and were involved in the collection and the analysis of the data which led to the present publication.

The Wellcome Trust is the largest charity in the UK. It funds innovative biomedical research, in the UK and internationally, spending around ??650 million each year to support the brightest scientists with the best ideas. The Wellcome Trust supports public debate about biomedical research and its impact on health and wellbeing. wellcome.ac/

Source: Don Powell

Wellcome Trust Sanger Institute Continue reading →

The Finnish Meteorological Institute in Helsinki, Finland, will host the first annual meeting of the European Integrated Project on Aerosol Cloud Climate and Air Quality Interactions, EUCAARI, headed by Academy Professor Markku Kulmala, on 19-22 November 2007. The purpose of EUCAARI is to significantly improve current knowledge of the impact of fine particles in the atmosphere on climate and air quality. The first year of the project was dedicated to developing state-of-the-art aerosol measuring equipment, establishing a global network of measuring stations, and planning. The measuring period, beginning next spring, will collect data on European air through both ground-based and airborne measurements simultaneously.

During the past year, this EU-wide research project has developed an extremely sensitive measuring device for aerosols, allowing for reliable measurements of particles less than 3 nanometres across. Such a development in measuring technology will play a key role when solving the physical and chemical questions of aerosol generation and formation, and has already enabled significant, recently-published new observations on the quantity of particles less than 3 nm in size.

The past few months have also seen the establishment of a global measuring station network for EUCAARI. Stations have been established in Brazil, South Africa, China, and India. They cover measurement areas that are geographically important for the monitoring of air pollution. For example, the Brazilian station is located in the rainforest region, and the South African station in the savannah area. The stations will start operating from the beginning of 2008. In addition to the University of Helsinki, the Finnish Meteorological Institute plays a key role in running the observation stations and planning the infrastructure.

Next May, a new, month-long measuring period will begin. During that time, the atmosphere above Europe will be observed simultaneously from both ground-based and aircraft-borne equipment. The data-gathering flights will move across Europe in various directions. This will provide measuring data on, for example, the development of aerosol quantities at various altitudes in the atmosphere, and trace the long-range migration of air masses and various kinds of pollution. The month-long measurement period is part of a wider 15-month (1 March 2008-31 May 2009) intensive EUCAARI ground-based measurement campaign involving measuring stations in and outside Europe. The University of Helsinki’s Hyyti?¤l?¤ Forestry Field Station will contribute to this intensive period by providing ground-based measurements.

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The four-year long EUCAARI was launched in January 2007, and will end in December 2010. The total budget of EUCAARI, currently the largest aerosol project in Europe, is ?‚¬15 million, 10 million of which is covered by the European Union. The project employs researchers from 25 different countries.

For further information, please contact Markku Kulmala, University of Helsinki.

Source: Markku Kulmala

University of Helsinki Continue reading →

A unique pattern of gene expression observed in rats may be linked to a conditioned desire for food and excessive food intake, an article published in BMC Biology suggests.

It’s well known that food-associated cues, such as advertising, can influence food intake. But the underlying neurobiology is far from clear. Craig A. Schiltz and colleagues from the University of Wisconsin Madison School of Medicine and Public Health, USA, created an experimental set up that allowed them to study patterns of gene expression linked to this motivational state – rats conditioned to expect a chocolate-flavoured treat in a particular environment, were subsequently denied their reward.

The research, conducted in the laboratory of Ann E. Kelly showed that expression of a handful of immediate early genes was increased in cortical, striatal, thalamic and hypothalamic brain regions. Food-related cues triggered dramatic changes in the functional connectivity of circuits involved in adaptive behaviour. For example, increased connectivity was seen between the cortex and two other regions – the amygdala and the striatum. Within the latter, there was a shift in activity from the outer shell to the inner core of the nucleus accumbens and an increased expression of the opioid-encoding proenkephalin gene.

Taken together, these results suggest that food-associated cues have a powerful influence on neuronal activity and gene expression in brain areas mediating complicated functions such as cognition and emotion, and more basic abilities such as arousal and energy balance. The pattern of activation differs from that elicited by neutral cues, and may well contribute to a conditioned motivational state that can lead to excessive food intake.

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Article:
Food-associated cues alter forebrain functional connectivity as assessed with immediate early gene and proenkephalin expression
Craig A Schiltz, Quentin Z Bremer, Charles F Landry and Ann E Kelley
BMC Biology (In press)

Contact: Martyn Thomas

BioMed Central Continue reading →

Wake Forest University’s Center for Nanotechnology and Molecular Materials will host a gathering of scientists, engineers and medical researchers at a workshop that will explore both the science and the emerging business of nanomaterials used in medicine.

“Nanomaterials and Hyperthermia: Nanotechnology Approaches to Medicine” will be held April 6-9 at the Historic Brookstown Inn in Winston-Salem. “Hyperthermia” in this context refers to the use of heat to trigger the release of drugs being transported inside nanomaterials.

The proceedings are open to the public, but advance registration is required. Registration information is available at nanomedicineworkshop/.

Speakers from Wake Forest University School of Medicine and research institutions as far away as New Zealand will attend the workshop. Presentations will cover such topics as the pharmacology of nanomaterials, heat transduction in nanoparticles, combining hyperthermia and mild hyperthermia with chemotherapies and extending hyperthermic therapies to noncancerous diseases.

“Unlike typical scientific forums, we will seek to understand the interplay between the needs of startup drug companies in the field of nanotechnology and the solutions that traditional drug developers have found for their own products,” David Carroll, professor of physics and director of the Center for Nanotechnology and Molecular Materials, said. “In this way, we plan to create a forum that strikes the fine balance between technical innovations and developing regulatory approaches that will work for those innovations. To our knowledge, this will be the first workshop nationwide that is designed to understand the integration of therapeutic development and scientific innovation for an entire class of nanotherapeutics.”

The conference is co-sponsored by the North Carolina Biotechnology Center, Wake Forest University and the Translational Science Institute of Wake Forest University Health Sciences.

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Source: Eric Frazier

Wake Forest University Continue reading →

The human brain is composed of billions of cells, each a separate entity that communicates with others. The chemical interaction of those cells determines personality, controls behavior and encodes memory; but much remains to be understood.

Researchers at the University of Illinois at Urbana-Champaign have developed tools for studying the chemistry of the brain, neuron by neuron. The analytical techniques can probe the spatial and temporal distribution of biologically important molecules, such as vitamin E, and explore the chemical messengers behind thought, memory and emotion.

“In most organ tissues of the body, adjacent cells do not have significant differences in their chemical contents,” said Jonathan Sweedler, a William H. and Janet Lycan Professor of Chemistry and director of the Biotechnology Center at the U. of I. “In the brain, however, chemical differences between neurons are critical for their operation, and the connections between cells are crucial for encoding information or controlling functions.”

By dismantling a slice of brain tissue into millions of single cell-size pieces, each of which can be interrogated by mass spectrometric imaging techniques, Sweedler’s research group can perform cellular profiling, examine intercellular signaling, map the distribution of new neuropeptides, and follow the release of chemicals in an activity-dependent manner.

Sweedler will describe the techniques and present new results at the 230th American Chemical Society national meeting in Washington, D.C. Using these techniques, Sweedler’s group has already discovered multiple novel neuropeptides in a range of neuronal models from mollusks to mammals.

“We work with sea slugs, whose simple brains contain 10,000 neurons; we work with insects possessing one million neurons; and we work with mice having 100 million neurons,” said Sweedler, who also is a researcher at the Beckman Institute for Advanced Science and Technology. “Working with these model organisms allows us to examine the functioning of such basic operations as the neuronal control of behavior and long-term memory.”

Sweedler’s group also developed an approach for looking at the distribution of smaller molecules in brain cells. In a paper accepted for publication in the Journal of the American Chemical Society, and posted on its Web site, they report the subcellular imaging of vitamin E in the sea slug Aplysia californica.

The researchers utilized novel sampling protocols and single cell time-of-flight secondary ion mass spectrometry to identify and map the presence of vitamin E in the membranes of isolated neurons.

“To our surprise, we found that vitamin E was not distributed uniformly in the neuronal membrane,” Sweedler said. “Instead, vitamin E was concentrated in the neuron right where it extends to connect with other neurons.”

The subcellular localization of vitamin E, which had been impossible to obtain in the past, supports other work that suggested vitamin E performed an active role in transport mechanisms and cellular signaling of neurons.

“Our technique doesn’t tell us how or why vitamin E is distributed this way, but suggests that it is under active control and tight regulation,” Sweedler said. “Understanding the chemistry that takes place within and between neurons, including small molecules like vitamin E, will no doubt lead to a better understanding of brain function in healthy and diseased brains.”

Co-authors of the paper are Sweedler, research scientists Jinju Lee and Stanislav Rubakhin, postdoctoral research associate John Jurchen and graduate student Eric Monroe. The U.S. Department of Energy and the National Institute on Drug Abuse funded the work.

James E. Kloeppel, Physical Sciences Editor
kloeppeluiuc.edu
217-244-1073
University of Illinois at Urbana-Champaign
uiuc.edu Continue reading →

A new study from the Perelman School of Medicine at the University of Pennsylvania indicates that post-menopausal women with coronary artery disease and other risk factors are at an increased risk for sudden cardiac death (SCD).

“Until now, there has been very little data about SCD risk in women with existing cardiovascular conditions. Our research has revealed an important subset of women who are at an increased risk for SCD,” said Rajat Deo, MD, assistant professor of Medicine, Cardiovascular Division, at the Perelman School of Medicine, and the study’s lead author. “We have identified a series of clinical risk factors that may eventually help clinicians better counsel women on how to manage their overall health to avoid SCD.”

Over 250,000 people in the U.S. die each year from SCD, an unexpected death due to cardiac causes occurring in a short time period (generally within 1 hour of symptom onset). Most SCD cases occur in the general population or among individuals without advanced cardiovascular disease, so it is often very difficult to predict who is at-risk.

In the current study, researchers from the Perelman School of Medicine and University of California, San Francisco, analyzed data from the Heart and Estrogen/Progestin Replacement Study (HERS), which originally evaluated the effects of hormone replacement therapy on cardiovascular events among 2,763 postmenopausal women with coronary artery disease (CAD). The new analysis revealed that sudden cardiac death made up 54 percent of the cardiac-related deaths in these patients and over a quarter of all deaths in the entire study.

“Coronary artery disease is common among both men and women in the United States. The finding that SCD comprised the majority of cardiovascular deaths and over a quarter of all deaths in this group of women with CAD is remarkable and higher than we would have expected,” said Dr. Deo. “In addition, most of these women would not have been identified as high risk using current methods for SCD risk stratification.”

Currently, the only established predictor for SCD is to evaluate the heart’s pumping capacity in the left ventricle by measuring what’s called the “ejection fraction.” This refers to the percentage of blood that’s pumped out of the left ventricle with each heartbeat. However, recent studies have shown that less than one-third of people who experience SCD would have been identified by this clinical test.

Dr. Deo and colleagues also analyzed a series of baseline characteristics in the HERS cohort to evaluate potential risk factors for SCD. They determined that previous heart attack, heart failure, atrial fibrillation, physical inactivity, diabetes, and reduced kidney function were all closely associated with the SCD deaths in the HERS cohort. Women with at least three of the risk factors were at a ten-fold greater risk of SCD than women with none of the risk factors.

“Our findings show that a simple assessment of clinical risk factors has a better predictive value for SCD than currently available clinical measurements alone,” said Dr. Deo. “Using the two methods together provided the most complete picture of SCD in the patients we studied.”

The researchers conclude that taken together, the results of their current research may help clinicians better counsel their patients on the modifiable risk factors, such as controlling diabetes and participating in regular exercise. They suggest that future research is needed in a larger cohort of patients to validate the use of the risk factors and help understand how they can best be used in clinical practice.

The study is published in this week’s online-first edition of the Archives of Internal Medicine. The research was supported, in part, by grants from the National Institutes of Health and a Kynett-FOCUS Junior Faculty Investigator Award for Research in Women’s Cardiovascular Health funded by the Edna G. Kynett Memorial Foundation at the Perelman School of Medicine at the University of Pennsylvania.

Source: Perelman School of Medicine Continue reading →

The Honourable Leona Aglukkaq, Member of Parliament for Nunavut, Regional Minister for the North and Minister of Health, on behalf of the Honourable John Duncan, Minister of Indian Affairs and Northern Development and Federal Interlocutor for M?©tis and Non-Status Indians, joined Elizabeth Copland, Chair of the Nutrition North Canada Advisory Board, to emphasize the Board’s commitment to represent the views of Northerners.

“The Nutrition North Canada Advisory Board was brought together to provide Northerners with a strong voice in the implementation of this new northern retail subsidy program,” said Minister Aglukkaq. “We have listened to Northerners and have made adjustments to the Nutrition North Canada program based on their feedback. We will continue to do so as we move forward with the program.”

Nutrition North Canada’s new retail subsidy model will begin on April 1, 2011. An expanded list of food and non-food items eligible for subsidy will give retailers and shoppers more time to adjust to the new program. This expanded list will remain until October 1, 2012. The program is designed to be flexible, as demonstrated by the announcement last week of a revised eligibility list.

The purpose of implementing the Nutrition North Canada External Advisory Board was to foster engagement with Northerners, enhance the transparency of the new program, and to provide information and advice to help guide the management of Nutrition North Canada.

“This Advisory Board will continue to play an integral role in this program,” said Minister Duncan. “The Board’s input will help ensure that Nutrition North Canada focuses on access to fresh, healthy and affordable food in the North and that the voices of Northerners continue to be heard.”

“On behalf on the Advisory Board, I would like to reiterate that our role is to focus on monitoring program performance and accountability after Nutrition North Canada is implemented on April 1, 2011,” said Ms. Copland “This program is an opportunity to improve the well-being of Northerners.

The members of the Board, who are from communities across the North, were selected by Minister Duncan in consultation with Minister Aglukkaq and were appointed to a three-year term. Board members were chosen based on their overall experience and their ability to expand public awareness.

Nutrition North Canada benefits people living in eligible communities in Yukon, the Northwest Territories, Nunavut, Saskatchewan, Manitoba, Ontario, Quebec, and Newfoundland and Labrador.

Source:

Health Canada Continue reading →

Scientists have shown for the first time why a feeling of control helps us reduce pain. The research, carried out at the Wellcome Trust Centre for Neuroimaging at UCL, London, has implications for how patients with persistent pain can cope with what is often a debilitating condition.

Using fMRI scanners, which allow scientists to examine how the brain operates, the research, led by Dr Katja Wiech and Dr Raffael Kalisch, showed that when people feel that they can control their pain, an area of their prefrontal cortex associated with a feeling of security is activated. The findings are published in the Journal of Neuroscience today and have been welcomed by the Expert Patients Programme.

More significantly, the team went on to show that when faced with pain beyond their control, people who tend to feel more in control of their own lives show a lower response in the prefrontal cortex, indicating that they are less effective in coping with pain than those who don’t expect to have control.

“Patients with persistent pain report that often it is not the pain itself that makes their situation unbearable, but the fact that there is nothing they can do against it which makes them feel helpless,” explains Dr Wiech. “Unfortunately, this feeling of uncontrollability in turn tends to worsen the pain. On the other hand, teaching persistent pain patients psychological coping strategies to handle their pain usually does help reduce its effects.”

Dr Wiech and her team set up an experiment to investigate how people cope with pain. In the first stage, volunteers were given an electric stimulus to the backs of their hands and told that they could stop the pain at any point. In the second stage, they were told that the decision to stop the pain was out of their control and could only be stopped by a person or computer outside the room.

Using one of the centre’s fMRI scanners, the researchers were able to show that a number of areas of the brain were activated according to whether the volunteer felt in control of the pain. Most important was the anterolateral prefrontal cortex, which is associated with successful coping with feelings of anxiety.

The findings may have implications for future therapeutics, believes Dr Wiech.

“If we were able to stimulate the prefrontal cortex through psychological intervention, medication or some other stimulus, we could help reduce the pain felt by a patient,” she says. “However, we are still some way of this.”

The team also analysed the subjects’ outlook on life, examining whether they felt in control of their own lives. They found that whilst the subjects’ outlook did not affect the anterolateral prefrontal cortex when they controlled the stimulus, when they were not able to stop the painful stimulation subjects with no control expectations were better at activating this brain region than those with a strong control belief.

The findings support the practice of “acceptance-based therapy” whereby doctors focus on training patients to cope with the pain rather than attempting to make the pain go away.

“Throughout our lives, we are taught that we should aim to take control of our lives, to get the best job, find the best partner,” says Dr Wiech. “But sometimes we should accept what we have and make the most of it. Rather than constantly battling pain, our research supports the view that it is better to provide a patient with the tools to cope with his or her persistent pain.”

The findings are welcomed by Pete Moore, lead trainer in pain management for the Expert Patients Programme Community Interest Company.

“This is interesting work by UCL. We have found that many people with pain are over achievers and tend to do more than they have to. This is why when people with persistent pain attend an Expert Patients Programme they are provided with a toolbox of self-management skills to support them to manage their day-to-day pain.”

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The Wellcome Trust Centre for Neuroimaging at UCL – formerly the Functional Imaging Laboratory – has recently been awarded a Strategic Award of 6.74 million pounds funding over five years by the Wellcome Trust. The award will further bolster the reputation of a laboratory already renowned for its research into the neural basis of human cognition, work which is extending our understanding of common neurological and psychiatric diseases, such as schizophrenia and dementia.

Contact: Craig Brierley

Wellcome Trust Continue reading →

Addiction affects people from all walks of life-presidents struggling to stop smoking, doctors dependent on pain pills, elderly widows who gamble too much, and teenagers abusing stimulant drugs. Nearly a quarter of Americans have a nicotine addiction at one point or another, and more than one in seven grapple with a drug or alcohol use disorder. Overcoming Addiction: Paths toward recovery, a new report from Harvard Medical School, offers guidance for breaking unwanted addictive habits and starting fresh for 2009.

For many years, experts believed that addiction was possible only to powerful drugs or alcohol. More recently, they have recognized that excessive behaviors such as gambling, shopping, and sex also can lead to addiction. What’s common to all addictions is the brain’s response to pleasurable experiences, no matter what their source. Genetic research has uncovered that some people are predisposed to addiction in general, but not to a specific type. In other words, addiction is a disorder that manifests itself in many different ways.

A number of effective treatments can help people recover from addiction, including self-help strategies, psychotherapy, medications, rehabilitation programs, or a combination of these elements. All are described in this report, along with advice about coping with a loved one’s addiction.

Action steps for change

If you’re trying to overcome an addiction at the dawn of the new year, the following steps offer the greatest chance of success.

1. Seek help. Although people can recover from addiction on their own, others need advice and support from professionals, peers, or both. Your own doctor, a community mental health center, or a local substance abuse treatment center are good places to start.

2. Set a quit date. It might be helpful to choose a meaningful date like a special event, birthday, or anniversary.

3. Change your environment. Remove any reminders of your addiction from your home and workplace. For example, separate from those who would encourage you to be involved with the substance or behavior. If you are trying to quit drinking, get rid of any alcohol, bottle openers, wine glasses, and corkscrews. If you’re trying to quit gambling, remove reminders of your gambling, such as playing cards, scratch tickets, or poker chips. Also, don’t let other people use or bring reminders of the substance or behavior into your home.

4. Learn new skills and activities. Instead of giving in to an urge to use, come up with alternative activities, such as going for a walk, to keep you busy until the urge passes. Be prepared to deal with things that trigger your cravings, such as being in an environment where others are using.

5. Review your past attempts at quitting. Think about what worked and what did not. Think of what might have contributed to relapse and change accordingly.

6. Create a support network. Talk to your family, friends, and co-workers and ask for their encouragement and support. Also, consider talking to your health care provider about the method of quitting that is best for you. There may be medications that can ease the process for you, and increase your chances of success.

Overcoming Addiction: Paths toward recovery is available for $18 from Harvard Health Publications, the publishing division of Harvard Medical School. Order it online at health.harvard.edu/ADD.

Harvard Medical School Continue reading →

The House on Thursday voted 396-31 to approve the $512.9 billion fiscal year 2007 defense authorization bill, which does not include most of a proposal from President Bush to increase TRICARE fees, CQ Today reports (Donnelly, CQ Today, 5/11). The proposal, developed by the Joint Chiefs of Staff, would have increased TRICARE copayments and enrollment fees by 115% for military retirees younger than age 65 (Kaiser Daily Health Policy Report, 4/25). However, the bill would increase retail pharmacy prescription fees for military retirees to encourage the use of mail-order services (Kaiser Daily Health Policy Report, 5/11). The legislation also would extend TRICARE benefits to almost all National Guard members and reservists, regardless of whether they were mobilized after Sept. 11, 2001 (CQ Today, 5/11). The FY 2005 defense authorization law extended TRICARE benefits to National Guard members and reservists mobilized after Sept. 11, 2001 — regardless of whether they were no longer on active duty — provided that they pay 28% of the premium (Kaiser Daily Health Policy Report, 4/25). Prior to the vote, the Bush administration said in a statement that the elimination of the proposed TRICARE fee increases would cost $700 million in FY 2007 and $11.2 billion over five years (Scully, CongressDaily, 5/11). After the vote, the Bush administration expressed “disappointment” that the bill did not include the proposed TRICARE fee increases and said that the proposed TRICARE expansion — which would cost $400 million in FY 2007 and $3.6 billion over five years — “dramatically worsens the fiscal situation” of the program (CQ Today, 5/11).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →