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Scientists May Be Able to Make Grapefruits Compatible With Medications They Currently Interfere With

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Scientists May Be Able to Make Grapefruits Compatible With Medications They Currently Interfere With

You may be among the millions of people who have seen a surprisingly specific warning like this on the labels of drugs you take:

Avoid eating grapefruit or drinking grapefruit juice while using this medication.

Such warnings are issued for dozens of substances, including docetaxel, a cancer drug; erythromycin, an antibiotic; and some statins, the cholesterol-lowering drugs prescribed to more than a third of American adults over 40.

The problem is a set of molecules, furanocoumarins. High levels of furanocoumarins interfere with human liver enzymes, among other processes. In their presence, medications can build up to unhealthy levels in the body. And grapefruits and some related citrus fruits are full of them.

But there is no such warning for other kinds of citrus, such as mandarins and other oranges. Citrus researchers at the Volcani Center in Israel reported Wednesday in the journal The New Phytologist that, by crossing mandarins and grapefruit, they’ve uncovered genes that produce furanocoumarins in some citrus fruits. It’s a finding that opens the possibility of creating grapefruit that doesn’t require a warning label.

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Scientists had worked out the compounds’ structures and pieced together a basic flowchart of how they are made years ago, said Yoram Eyal, a professor at the Volcani Center. But the precise identities of enzymes catalyzing the process — the proteins that snip off a branch here, or add a piece there — remained mysterious. He and his colleagues knew that one way to identify them was to breed citrus high in furanocoumarins with those without. If the offspring of such a cross had varying levels of the substances, it should be possible, by digging into their genetics, to pinpoint the genes for the proteins.

“We were afraid to approach it, because it’s very time-consuming and it takes many years,” he said, noting how involved it can be to grow new trees from seeds and assess their genetics. “But finally, we decided we have to dive in.”

When they examined the offspring of a mandarin and a grapefruit, the researchers saw something remarkable. Fifty percent of the young plants had high levels of furanocourmains, and 50 percent had none. That particular signature meant something very specific, in terms of how the ability to make these substances is inherited.

“We saw there was only one gene that could have controlled it,” said Livnat Goldenberg, a Volcani Center researcher who is the lead author of the new study.

The researchers soon identified the gene controlling the production of furanocoumarins in leaves and fruit, which produces an enzyme called 2-oxoglutarate-dependent dioxygenase, or 2OGD for short. Mandarins, it turns out, have a mutated form of this gene that keeps the enzyme from functioning properly. This version cropped up in all the mandarin and orange varieties the researchers checked, explaining why they do not cause the same problems as grapefruit in people taking prescription medications. In these plants, furanocoumarin production is paused.

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With gene editing technology, it should be possible to alter the gene in grapefruit as well, Dr. Eyal suggests. The team at the Volcani Center is now exploring that project.

Looking at how widespread this mutated version is in mandarins and some other citrus, the scientists speculate that some gene nearby on the genome must play an important role in a highly prized trait. A long-ago citrus breeder, selecting for some unknown quality, must have unwittingly spread this furanocoumarin-busting version of the gene to an ancestor of modern varieties of mandarins and oranges.

All these years later, that person’s work is coming to light, under the gaze of geneticists, who may, someday, put grapefruit back on the menu.

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BMI is wrong way to measure obesity, researchers say — here’s what they recommend instead

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BMI is wrong way to measure obesity, researchers say — here’s what they recommend instead

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A group of 58 researchers is calling for a new, better way to measure obesity.

The global team’s recommendations were published in The Lancet Diabetes & Endocrinology on Jan. 14.

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Body mass index (BMI) has been the international standard for measuring obesity since the 1980s, according to many sources, though some experts have questioned its validity. 

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A person’s BMI is calculated by dividing his or her weight by the square of his or her height in feet.

Body mass index (BMI) has been the international standard for measuring obesity since the 1980s, according to many sources, though some experts have questioned its validity.  (iStock)

“Obesity is a complex problem and has different significance at the individual level,” the report’s lead author Francesco Rubino, chair of bariatric and metabolic surgery at King’s College London, United Kingdom, told Fox News Digital.

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Obesity is a “spectrum,” he said, rather than a “single, distinct clinical entity.”

Rubino went on, “It is impossible to say if obesity is a disease or not, as disease status cannot coincide with body size or mere excess body fat.” 

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The Commission on Clinical Obesity has proposed a “reframing” of obesity that distinguishes between people who have a disease here and now, and those who may have a risk for future disease, Rubino said.

Instead of relying solely on BMI, the researchers recommend also measuring adiposity, which is the amount of excess body fat.

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Chart of BMI equation

A person’s BMI is calculated by dividing his or her weight by the square of his or her height in feet. (iStock)

Adiposity can be determined by measuring a person’s waist circumference or taking body scans to measure fat mass, according to the researchers.

The group of experts recommends using two levels of obesity: preclinical and clinical.

With preclinical obesity, the person has excess body fat that has not affected the function of their tissues and organs.

“People with clinical obesity suffer from a chronic illness and should be treated in the same way as people who suffer from any other chronic disease.”

The person may have, however, an increased risk of developing clinical obesity, type 2 diabetes, heart disease and some types of cancer, the researchers noted. 

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Clinical obesity is defined as “a chronic, systemic illness characterized by alterations in the function of tissues, organs, the entire individual or a combination thereof, due to excess adiposity.”

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With clinical obesity, the person may experience “severe end-organ damage, causing life-altering and potentially life-threatening complications,” the researchers wrote.

Potential effects of clinical obesity may include heart attack, stroke and kidney failure. 

“As these categories of obesity are entirely new, we can’t measure their relative prevalence in the population,” Rubino noted. “Doctors have not yet had the possibility to make such a diagnosis, because many of the organ dysfunctions that characterize clinical obesity have not been routinely assessed so far.” 

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When excess body fat is confirmed, clinicians should assess individuals to determine whether obesity may have caused any organ dysfunction, the study researcher said. (iStock)

The researchers call for future studies into these diagnoses. 

“We recommend that clinicians thoroughly assess people with obesity in the clinic and use other measures of body size — waist circumference or others — to understand if an increased BMI level is due to excess body fat or other reasons, like increased muscle mass,” Rubino told Fox News Digital.

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When excess body fat — meaning obesity — is confirmed, clinicians should assess individuals to determine whether obesity may have caused any organ dysfunction, the researcher said.

“People with clinical obesity suffer from a chronic illness and should be treated in the same way as people who suffer from any other chronic disease,” Rubino said. 

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People with preclinical obesity should undergo “evidence-based health counseling, monitoring of their health status over time, and, when applicable, appropriate intervention to reduce risk of developing clinical obesity,” they wrote.

Between August 2021 and August 2023, approximately 40% of U.S. adults had obesity, according to the Centers for Disease Control and Prevention (CDC). Around 9.4% of those adults had severe obesity.

‘Outdated measure’

Dr. Brett Osborn, a neurosurgeon, longevity expert and fitness competitor based in Florida, agrees that BMI is an “outdated measure” for diagnosing obesity.

“It is clear that obesity should no longer be defined solely by physical appearance or weight.”

“As medicine evolves, it is clear that obesity should no longer be defined solely by physical appearance or weight — or weight relative to height, as in BMI calculations,” the doctor, who was not involved in this new research, told Fox News Digital. 

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“Instead, the condition must be understood through the lens of metabolic dysfunction.”

      

Obesity isn’t just a disease of excess weight, Osborn said, but a “systemic metabolic disorder requiring nuanced and individualized care.”

The condition is better measured by looking at factors like inflammation, insulin resistance and glucose tolerance, according to the doctor.

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In some cases, using BMI can result in “muscular athletes” being labeled as obese, he noted, and people with “normal” BMI can sometimes have “harmful” levels of visceral (abdominal) fat.

Osborn noted that in his own clinic, he and his team do not use BMI, relying instead on visceral fat scores, skeletal muscle mass and body fat percentage. 

Muscle mass

In some cases, using BMI can result in “muscular athletes” being labeled as obese, one doctor noted. (iStock)

Skeletal muscle mass (the muscles that connect to the bones) is critical to physical strength and metabolic efficiency, Osborn said.

For optimal health, he recommends that males aim for 50% skeletal muscle mass relative to total body weight and females target 45% — although other factors, like age and fitness levels, come into play.

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“Remember, your resilience — your ability to ward off disease — resides in your muscle,” Osborn added.

“By integrating body composition metrics, metabolic markers and personalized assessments, we can more accurately diagnose obesity and tailor interventions to each individual.”

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Water for Weight Loss? How Much You Should Drink to Shed More Weight

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Water for Weight Loss? How Much You Should Drink to Shed More Weight


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