Keep up with your weight loss goals with daily weighing

According to research presented in the American Heart Association’s 2018 scientific meeting, daily weighing may help with weight loss goals. People who don’t weigh themselves at all or rarely were less likely to lose weight than those who weighed themselves often,

Researchers examined the self-weighing patterns of 1,042 adults (78 percent male, 90 percent white, average age 47) and whether there were differences in weight change by these self-weighing patterns over 12 months. They analyzed remotely transmitted self-weighing data from Health eHeart, an ongoing prospective e-cohort study. The participants weighed themselves at home as they normally would, without interventions, guidance or weight-loss incentives from researchers.

Researchers identified several categories of self-weighing adults, from those that weighed themselves daily or almost daily to adults who never used at-home scales.

They found that people who never weighed themselves or only weighed once a week did not lose weight in the following year. Those that weighed themselves six to seven times a week had a significant weight loss (1.7 percent) in 12 months.

Citation: Daily weighing may be key to losing weight
American Heart Association Meeting  Poster Presentation Sa2394 – Session: NR.APS.01
Yaguang Zheng, Ph.D., M.S.N., R.N., University of Pittsburgh School of Nursing, Pittsburgh, PA

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Study finds effectiveness of fasting diet (5:2 diet) in clearing fat

Researchers from the University of Surrey examined the effectiveness of the 5:2 diet vs. daily calorie restriction diet. They found that 5:2 diet clears triglycerides from blood quicker after eating meals. Their findings are published in British Journal of Nutrition reports.

The study divided overweight people into two groups. One group was assigned 5:2 diet another group was assigned daily calorie restriction diet. They measured days required for 5% weight loss, ability to clear fat and glucose from the blood. The 5:2 diet involved eating regularly for five days and restricting remaining 2 days to 600 calories per day.

Results of the study showed that subjects assigned to 5:2 diet lost 5% weight in 59 days compared other group which took 73 days. Researchers also found improved ability to clear triglycerides in this group. The study also found 9% reduction in systolic blood pressure by in 5:2 group.

Dr. Rona Antoni, Research Fellow in Nutritional Metabolism at the University of Surrey, said:

As seen in this study, some of our participants struggled to tolerate the 5:2 diet, which suggests that this approach is not suited to everybody; ultimately the key to dieting success is finding an approach you can sustain long term.

“But for those who do well and are able stick to the 5:2 diet, it could potentially have a beneficial impact on some important risk markers for cardiovascular disease, in some cases more so than daily dieting. However, we need further studies to confirm our findings, to understand the underlying mechanisms and to improve the tolerability of the 5:2 diet.”

Citation:  Antoni, Rona, Kelly L. Johnston, Adam L. Collins, and M. Denise Robertson. “Intermittent v. Continuous Energy Restriction: Differential Effects on Postprandial Glucose and Lipid Metabolism following Matched Weight Loss in Overweight/obese Participants.” British Journal of Nutrition 119, no. 05 (2018): 507-16. doi:10.1017/s0007114517003890.

Adapted from press release by the University of Surrey.

Amino acids link gut microbiome to obesity

Researchers at Lund University in Sweden have discovered a new link between gut bacteria and obesity. They found that certain amino acids in our blood can be connected to both obesity and the composition of the gut microbiome.

Increasing number of research studies indicate that our gut microbiome does play an important role in our health. It affects our metabolism and can be linked to obesity, cardiovascular disease and type 2 diabetes.

Previous studies have shown that people with these diseases have varying occurrence of different metabolites, i.e. small molecules or metabolic residues, in the bloodstream. The aim of the new study was therefore to identify metabolites in the blood that can be linked to obesity (high body mass index, BMI) and to investigate whether these obesity-related metabolites affect the composition of the bacterial flora in stool samples.

The researchers analysed blood plasma and stool samples from 674 participants in the Malmö Offspring Study. They found 19 different metabolites that could be linked to the person’s BMI; glutamate and so-called BCAA (branched-chain and aromatic amino acids) had the strongest connection to obesity. They also found that the obesity-related metabolites were linked to four different intestinal bacteria (Blautia, Dorea and Ruminococcus in the Lachnospiraceae family, and SHA98).

“The differences in BMI were largely explained by the differences in the levels of glutamate and branched-chain and aromatic amino acids. This indicates that the metabolites and gut bacteria interact, rather than being independent of each other”, says Marju Orho-Melander, professor of genetic epidemiology at Lund University.

By far the strongest risk factor for obesity in the study, glutamate, has been associated with obesity in previous studies, and BCAA has been used to predict the future onset of type 2 diabetes and cardiovascular disease.

“This means that future studies should focus more on how the composition of gut bacteria can be modified to reduce the risk of obesity and associated metabolic diseases and cardiovascular disease”, says Marju Orho-Melander. “To get there, we first need to understand what a healthy normal gut flora looks like, and what factors impact the bacterial composition. This requires large population studies, like the Malmö Offspring Study, as well as intervention studies”, she concludes.

Citation: Ottosson, Filip, Louise Brunkwall, Ulrika Ericson, Peter M. Nilsson, Peter Almgren, Céline Fernandez, Olle Melander, and Marju Orho-Melander. “Connection between BMI related plasma metabolite profile and gut microbiota.” The Journal of Clinical Endocrinology & Metabolism, 2018. doi:10.1210/jc.2017-02114.

Adapted from press release by the Lund University.

Metformin influences gut microbiome

A recent study at Sahlgrenska Academy and University of Girona indicates thatcontrol of blood glucose by metformin is achieved partly through modulation of the gut microbiota. Results of the study are published in journal Nature Medicine.

Fredrik Bäckhed’s research group at Sahlgrenska Academy has previously shown that the gut microbiota is altered in patients with type 2 diabetes and after bariatric surgery. By conducting a clinical study in patients with new onset diabetes, the group could clarify how the gut microbiomeis affected by metformin.

Sequencing of the microbiome of 22 patients before and after treatment compared with a placebo treated group of patients showed that the gut microbiome was altered dramatically within two months of treatment. Through experiments in the laboratory, the researchers demonstrated that metformin increases the growth of several bacterial species that are linked to improved metabolism.

Citation: Wu, Hao, Eduardo Esteve, Valentina Tremaroli, Muhammad Tanweer Khan, Robert Caesar, Louise Mannerås-Holm, Marcus Ståhlman, Lisa M. Olsson, Matteo Serino, Mercè Planas-Fèlix, Gemma Xifra, Josep M. Mercader, David Torrents, Rémy Burcelin, Wifredo Ricart, Rosie Perkins, José Manuel Fernàndez-Real, and Fredrik Bäckhed. “Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug.” Nature Medicine, 2017.
doi:10.1038/nm.4345.
Adapted from press release by  the University of Gothenburg.

Gut microbiome shown to protect against type 2 diabetes

New study form the University of Eastern Finland showed that a high concentration of indolepropionic acid in the serum protects against type 2 diabetes. Indolepropionic acid is a metabolite produced by intestinal bacteria, and its production is boosted by a whole grain products and fibre-rich diet. According to the researchers, the discovery provides additional insight into the role of intestinal bacteria in the interplay between diet, metabolism and health.

The findings were published in Scientific Reports. The study was carried out in the LC-MS Metabolomics Centre of the University of Eastern Finland together with a large number of partners from Finnish and Swedish research institutes.

The study compared two groups participating in the Finnish Diabetes Prevention Study, DPS. At the onset of the study, all participants were overweight and had impaired glucose tolerance. The researchers investigated the serum metabolite profile of 200 participants with impaired glucose tolerance, who either developed type 2 diabetes within the first 5 years, or did not convert to type 2 diabetes within a 15-year follow-up. The differences between the groups were analysed by non-targeted metabolomics analysis. The greatest differences in the metabolic profiles of those who developed type 2 diabetes and those who didn’t were observed in the concentrations of indolepropionic acid and certain lipid metabolites. A higher concentration of indolepropionic acid seemed to promote insulin secretion by pancreatic beta cells, which might explain the protective effect.

In addition to the DPS data, the association of indolepropionic acid with the risk of diabetes was also studied in two other population-based datasets: in the Finnish Metabolic Syndrome In Men Study, METSIM, and in the Swedish Västerbotten Intervention Project, VIP. In these datasets too, indolepropionic acid was discovered to protect against diabetes.

The study also identified several new lipid metabolites whose high concentrations were associated with improved insulin resistance and reduced risk of diabetes. The concentrations of these metabolites were also associated with dietary fat: the lower the amount of saturated fat in the diet, the higher the concentrations of these metabolites. Similarly to indolepropionic acid, high concentrations of these lipid metabolites also seemed to protect against low-grade inflammation.

The Finnish Diabetes Prevention Study was the first randomised, controlled lifestyle intervention study to show that in persons with impaired glucose tolerance, type 2 diabetes can be prevented by lifestyle changes. The most important lifestyle changes included weight loss, more exercise and dietary adjustments to include more whole grain products, fruits and vegetables.

Citation: Mello, Vanessa D. De, Jussi Paananen, Jaana Lindström, Maria A. Lankinen, Lin Shi, Johanna Kuusisto, Jussi Pihlajamäki, Seppo Auriola, Marko Lehtonen, Olov Rolandsson, Ingvar A. Bergdahl, Elise Nordin, Pirjo Ilanne-Parikka, Sirkka Keinänen-Kiukaanniemi, Rikard Landberg, Johan G. Eriksson, Jaakko Tuomilehto, Kati Hanhineva, and Matti Uusitupa. “Indolepropionic acid and novel lipid metabolites are associated with a lower risk of type 2 diabetes in the Finnish Diabetes Prevention Study.” Scientific Reports 7 (2017): 46337.
doi:10.1038/srep46337.
Adapted from press release by University of Eastern Finland.

Research on Allulose, a rare naturally occuring sugar show promise as healthy alternative to Sucrose

Animal research have shown that low calorie natural sugars like allulose could help regulate glucose levels. Researchers are now trying to find out how it works, and their findings are reported in Journal of Agricultural and Food Chemistry.

Sucrose is the natural sweetener what everyone refer to when sugar is on the ingredient list. Allulose, which is 70 percent as sweet as sucrose, and other rare sugars also can be found in fruits and vegetables in very small amounts. Recently researchers discovered an industrial way to produce allulose in large quantities from high-fructose corn syrup. Past studies have suggested that allulose can help control weight gain and control glucose levels. Tomoya Shintani and colleagues wanted to confirm these results and understand how it works.

To find out researchers gave three groups of rats plain water, water with high-fructose corn syrup and water with rare-sugar syrup containing glucose, fructose, allulose and other rare sugars for 10 weeks. The rats drinking rare-sugar syrup infused water gained less weight, had less abdominal fat, and had lower blood glucose and insulin levels compared to the high-fructose corn syrup group. The research showed that rats fed with rare-sugar syrup infused water had increased levels of glucokinase in liver cells. Glucokinase is an enzyme that reduces blood-sugar levels by helping convert glucose to its stored form, glycogen.

Although more research is needed, the scientists say, the findings suggest that rare sugars could be a good alternative sweetener.

Citation: Shintani, Tomoya, Takako Yamada, Noriko Hayashi, Tetsuo Iida, Yasuo Nagata, Nobuaki Ozaki, and Yukiyasu Toyoda. “Rare Sugar Syrup Containing d-Allulose but Not High-Fructose Corn Syrup Maintains Glucose Tolerance and Insulin Sensitivity Partly via Hepatic Glucokinase Translocation in Wistar Rats.” Journal of Agricultural and Food Chemistry, 2017. doi:10.1021/acs.jafc.6b05627.
Adapted from press release by American Chemical Society.

Obesity genes: role of foraging gene in fruit fly

A University of Toronto study on fruit flies has uncovered a gene that could play a key role in obesity in humans. The paper published online this month in Genetics examines a “foraging gene” humans share in common with the flies, which plays multiple roles and is found in similar places, such as the nervous system, in the muscle and in fat.

“What our study does is nails the gene for being very important for the traits of moving, feeding and fat storage,” says University Professor Marla Sokolowski of the Department of Ecology & Evolutionary Biology in U of T’s Faculty of Arts & Science.

In nature, fruit flies called “Rovers” with high amounts of the gene tend to move a lot, eat very little and stay lean, while flies with low amounts of for called “Sitters” are the opposite. The same could apply to obesity in humans.

“So you could imagine if you are a fly, preferences for sugar, the tendency to store a lot of fat and the tendency to move less could all be contributing to the likelihood of being more obese if you have low levels of this gene, or to be leaner if you have higher levels.”

Such similarities between species are known as orthologs, meaning they are genes that evolved from a common ancestor eons ago.

The study involved a technique called recombineering to manipulate DNA at the molecular level, so as to remove and then reinsert the gene in various doses to see the effects on behavior and metabolism.

“To be able to take a gene of this large size and complexity and put it back in the fly so that it works is almost at the edge of what is possible,” Sokolowski says it’s particularly interesting that one gene should have multiple roles in feeding and obesity in the body, a characteristic known as pleiotropy.

The next question would be how exactly it plays multiple roles. “Lots of genes have multiple roles, but the idea here is that this gene may be involved in the coordination of roles in traits important for feeding and obesity.”

 “We don’t know much about pleiotropy, or how it happens, or how it’s regulated at the level of the molecules. So this sets the groundwork to be able to look at that in detail.”

Citation: Allen, Aaron M., Ina Anreiter, Megan C. Neville, and Marla B. Sokolowski. “Feeding-Related Traits Are Affected by Dosage of the foraging Gene in Drosophila melanogaster.” Genetics 205, no. 2 (2016): 761-73.
doi:10.1534/genetics.116.197939.
Research funding: Natural Sciences and Engineering Council of Canada, Canadian Institutes for Health Research.
Adapted from press release by the University of Toronto.

Benefits of continuously monitoring blood glucose in Diabetic patients

Researchers have found that significantly decreased blood sugar levels over time  and increased well-being are just some of the results of a long-term study at Sahlgrenska Academy of continuous glucose monitoring in persons with type 1 diabetes.

“This is one of few new treatments in recent decades which significantly reduces blood sugar levels for persons with type 1 diabetes, who are dependent on insulin injections,” notes Marcus Lind, Associate Professor of Diabetology at the department of molecular and clinical medicine, and Chief Physician in Uddevalla.

A total of 161 people took part in the study, from Härnösand in the north to Malmö in the south, each one in need of insulin injections several times per day in order to keep their blood sugar levels in check.

They were randomly selected in different rounds to either use traditional equipment, and prick their finger at least four times per day in order to measure the sugar levels, or use a device which measures the blood sugar continually via a thin filament under the skin on the stomach. A separate unit kept in the pocket would beep or vibrate when the sugar level was to high or too low.

The study lasted 16 months and the patients used each method over a 6-month period, with a four-month “washout period” without assisted treatment between each round.

The blood sugar value, measured using the marker HbA1c, which gives a mean value over a three-month period, dropped by five millimole per mole; a leap which can be considered justification for giving wider access to the treatment.

Previous studies of the technology have been more focused on the verification, over shorter periods, of blood sugar values produced by continual measurement. The fact that the mean sugar levels have been shown to actually decrease is something that can protect the patient group.

The study also shows an increase in treatment satisfaction and well-being. Factors that are important in themselves and which also improve the chances of the treatment working in the long term.

“It’s important how the patients experience the treatment in their everyday lives in terms of their willingness to continue; it mustn’t get too complicated. Quality of life and well-being are also becoming increasingly emphasized in guidelines for diabetes care,” says Marcus Lind.

Citation: Lind, Marcus, William Polonsky, Irl B. Hirsch, Tim Heise, Jan Bolinder, Sofia Dahlqvist, Erik Schwarz et al. “Continuous Glucose Monitoring vs Conventional Therapy for Glycemic Control in Adults With Type 1 Diabetes Treated With Multiple Daily Insulin Injections: The GOLD Randomized Clinical Trial.” Jama 317, no. 4 (2017): 379-387.
DOI: 10.1001/jama.2016.19976
Adapted from press release by the University of Gothenburg, Sahlgrenska Academy.

Obesity related Epigenetic changes in DNA

Obesity has been linked to “letter” changes at many different sites in the genome, yet these differences do not fully explain the variation in people’s body mass index (BMI) or why some overweight people develop health complications while others don’t. A large study from Boston Children’s Hospital, the University of Edinburgh, the Harvard School of Public Health, the Framingham Heart Study and the National Heart, Lung, and Blood Institute (NHLBI) provides more insight, linking obesity with epigenetic modifications to DNA that in turn are tied to an increased risk of weight-related health problems such as coronary artery disease.

The study is one of the largest to date to examine the link between BMI, obesity-related disease and DNA methylation  a type of epigenetic modification that influences whether genes are turned on or off. Findings were published in PLoS Medicine.

“Even though we’ve genetically sequenced more and more people at greater and greater breadth and depth, we haven’t completely explained who develops obesity and why,” says Michael Mendelson, MD, ScM, a pediatric cardiologist with the Preventive Cardiology Program at Boston Children’s Hospital, who shared first authorship on the paper with Riccardo Marioni of the University of Edinburgh. “We found that obesity is related to widespread changes in DNA methylation. Unlike your DNA sequence, these regulatory modifications change over time and can influence your risk of disease in later life.”

The researchers studied blood samples from 7,800 adults from the Framingham Heart Study, the Lothian Birth Cohort and three other population studies. They systematically looked for markers of DNA methylation at more than 400,000 sites in the genome. They then looked to see if these markers differed according to BMI in a predictable pattern.

Their analysis identified strong associations between BMI and DNA methylation at 83 locations in 62 different genes. Methylation at these sites was, in turn, associated with differences in the expression of genes involved in energy balance and lipid metabolism.

When Mendelson and colleagues scored people in the study for how many methylation changes they had, they found that the more changes, the greater their BMI. The methylation score captured 18 percent of the variation in BMI when tested in a separate population. For each standard deviation increase in the score, the odds ratio for obesity was 2.8 times higher.

The researchers then applied a statistical technique called Mendelian randomization, which provides supportive evidence that a detected association is causal. They concluded that 16 of the 83 identified sites in the genome were differently methylated as a result of obesity, a finding that held true across people of different ethnicities.

Difference in methylation at one gene, SREBF1, appeared to be causative of obesity and was clearly linked with unhealthy blood lipid profiles, glycemic traits (a risk factor for diabetes) and coronary artery disease. It encodes a known regulator of lipid metabolism and could be a target for a drug treatment, the researchers say.

“Taken together, these results suggest that epigenetic modifications may help identify therapeutic targets to prevent or treat obesity-related disease in the population,” says Mendelson, who is also a research fellow in the Population Sciences Branch of the NHLBI. “The next step is to understand how we can modify epigenetic modifications to prevent the development of cardiometabolic disease.”
Since the study was done in blood cells, it also suggests that with further study, methylation markers could be easily accessible biomarkers to guide therapy bringing a “precision medicine” approach to preventive cardiology, says Mendelson.

“We’ve known for a long time that people who are overweight or obese are more likely to develop metabolic risk factors like diabetes, lipid abnormalities and hypertension,” adds study coauthor Daniel Levy, MD. He is director of the Framingham Heart Study, which is supported by the NHLBI. “This study may help us understand the molecular mechanism linking obesity to metabolic risk, and that knowledge may pave the way for new approaches to prevent even more dire complications such as cardiovascular disease.”

Citation: Michael M. Mendelson, Riccardo E. Marioni, Roby Joehanes, Chunyu Liu, Åsa K. Hedman, Stella Aslibekyan, Ellen W. Demerath, Weihua Guan, Degui Zhi, Chen Yao, Tianxiao Huan, Christine Willinger, Brian Chen, Paul Courchesne, Michael Multhaup, Marguerite R. Irvin, Ariella Cohain, Eric E. Schadt, Megan L. Grove, Jan Bressler, Kari North, Johan Sundström, Stefan Gustafsson, Sonia Shah, Allan F. McRae, Sarah E. Harris, Jude Gibson, Paul Redmond, Janie Corley, Lee Murphy, John M. Starr, Erica Kleinbrink, Leonard Lipovich, Peter M. Visscher, Naomi R. Wray, Ronald M. Krauss, Daniele Fallin, Andrew Feinberg, Devin M. Absher, Myriam Fornage, James S. Pankow, Lars Lind, Caroline Fox, Erik Ingelsson, Donna K. Arnett, Eric Boerwinkle, Liming Liang, Daniel Levy and Ian J. Deary. “Association of Body Mass Index with DNA Methylation and Gene Expression in Blood Cells and Relations to Cardio metabolic Disease: A Mendelian Randomization Approach.”
DOI: 10.1371/journal.pmed.1002215

Research funding: National Heart, Lung, and Blood Institute of the NIH, Tommy Kaplan Fund (Department of Cardiology, Boston Children’s Hospital), UK Biotechnology and Biological Sciences Research Council, UK Royal Society, Chief Scientist Office of the Scottish Government, Age UK, Wellcome Trust Institutional Strategic Support Fund, UK Economic and Social Research Council, UK Medical Research Council, Australian National Health and Medical Research Council.

Adapted from press release by Boston Children’s Hospital.

Vitamin E requirements increased in people suffering from metabolic syndrome

New research has shown that people with metabolic syndrome need significantly more vitamin E – which could be a serious public health concern, in light of the millions of people who have this condition that’s often related to obesity. A study published in the American Journal of Clinical Nutrition also made it clear that conventional tests to measure vitamin E levels in the blood may have limited accuracy compared to tests made in research laboratories, to the point that conventional tests can actually mask an underlying problem.

Vitamin E supplements. Credit: John Liu / Oregon State University.

Vitamin E – one of the more difficult micronutrients to obtain by dietary means – is an antioxidant important for cell protection. It also affects gene expression, immune function, aids in the repair of wounds and the damage of atherosclerosis, is important for vision and neurologic function, and largely prevents fat from going rancid.

Nutrition surveys have estimated that 92 percent of men and 96 percent of women in the United States fail to get an adequate daily intake of vitamin E in their diet. It is found at high levels in almonds, wheat germ, various seeds and oils, and at much lower levels in some vegetables and salad greens, such as spinach and kale.

This study was done by researchers at the Linus Pauling Institute at Oregon State University and the Human Nutrition Program at The Ohio State University, as a double-blind, crossover clinical trial focusing on vitamin E levels in people with metabolic syndrome. “The research showed that people with metabolic syndrome need about 30-50 percent more vitamin E than those who are generally healthy,” said Maret Traber, a professor in the OSU College of Public Health and Human Sciences, and Ava Helen Pauling Professor in the Linus Pauling Institute.

“In previous work, we showed that people with metabolic syndrome had a lower bioavailability of vitamin E. Our current work uses a novel approach to measure how much vitamin E the body needs. This study clearly demonstrates that people with metabolic syndrome need a higher intake of this vitamin.”

More than 30 percent of the American public are obese, and more than 25 percent of the adults in the United States meet the criteria for metabolic syndrome, putting them at significantly increased the risk for cardiovascular disease and type-2 diabetes primary causes of death in the developed world.

That syndrome is defined by diagnosis of three or more of several conditions, including abdominal obesity, elevated lipids, high blood pressure, pro-inflammatory state, a pro-thrombotic state and insulin resistance or impaired glucose tolerance. This research, for the first time, also clearly outlined a flaw with conventional approaches to measuring vitamin E.

By “labeling” vitamin E with deuterium, a stable isotope of hydrogen, scientists were able to measure the amount of the micronutrient that was eliminated by the body, compared to the intake. The advanced research laboratory tests, which are not available to the general public, showed that people with metabolic syndrome retained 30-50 percent more vitamin E than healthy people – showing that they needed it. When the body doesn’t need vitamin E, the excess is excreted.

But in the group with metabolic syndrome, even as their tissues were taking up and retaining the needed vitamin E, their blood levels by conventional measurement appeared about the same as those of a normal, healthy person.

“We’ve discovered that vitamin E levels often look normal in the blood, because this micronutrient is attracted to high cholesterol and fat,” Traber said. “So vitamin E can stay at higher levels in the circulatory system and give the illusion of adequate levels, even as tissues are deficient.

“This basically means that conventional vitamin E blood tests as they are now being done are useless.”

The findings support the conclusion that people with metabolic syndrome have higher levels of oxidative and inflammatory stress, scientists said in their conclusion, and require more antioxidants such as vitamins E as a result.

Citation: Maret G Traber, Eunice Mah, Scott W Leonard, Gerd Bobe, and Richard S Bruno. “Metabolic syndrome increases dietary α-tocopherol requirements as assessed using urinary and plasma vitamin E catabolites: a double-blind, crossover clinical trial.” The American Journal of Clinical Nutrition 2017 pp: ajcn138495
DOI: 10.3945/ajcn.116.138495
Research funding: National Institutes of Health, National Dairy Council, and DSM Nutrition.
Adapted from press release by Oregon State University.