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Can Exercise Come in a Pill?

By Martha Rosenberg, AlterNet. Posted August 14, 2008.


A new drug works at the genetic level to change metabolism. But how effective is it? And is it safe?
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The timing couldn't have been better.

Salk Institute molecular biologist Ronald Evans debuted the results of a metabolic wonder drug that could mimic exercise, increase endurance and double fat-burning muscle just in time for the Olympics.

Exercisers could lose their treadmills, predicted health reporters, couch potatoes could lose their guilt -- and Olympic athletes could, well, cheat.

In an article in the journal Cell titled AMPK and PPAR Agonists Are Exercise Mimetics, Evans, a professor at the Howard Hughes Medical Institute, and 12 colleagues write that they have identified the "muscle endurance gene signature" and "molecular crosstalk" of two drugs that can actually reprogram muscle, in some cases, without exercise.

One drug, GW1516, developed but abandoned by GlaxoSmithKline because of toxic side effects, improved the endurance of mice that exercised by 77 percent and increased fat-burning "slow twitch" muscle fibers by 38 percent.

The other drug, AICAR, similar to the body's food energy nucleotide, adenosine monophosphate (AMP), and licensed by Schering-Plough Corp. for prevention of a surgical complication (at least until this month's stock bounce anticipating new "uses"), improved endurance in mice that did not exercise by 44 percent.

The changes seen in the lab were not "cosmetic," like the muscle building of steroids.

Rather, both drugs alter metabolism at the genetic level by acting upon PPAR-delta, a gene-controlling protein that produces the slow-twitch, fat-burning muscle fibers associated with endurance athletes, versus fast-twitch, sugar-burning fibers.

"This is not just a free lunch," Evans told the New York Times. "It's pushing your genome toward a more enhanced genetic tone that impacts metabolism and muscle function. So instead of inheriting a great set-point, you are using a drug to move your own genetics to a more activated metabolic state."

Happy Abs Forever?

While the promise of an Ectomorph Nation filled with lean, muscular bodies always opens Wall Street ears and wallets, the 46-year-old La Jolla, Calif.-based Salk Institute for Biological Sciences is not as enamored with lab-to-commercialization "technology transfer" as many pharma-supported institutions are.

Two-thirds of its approximately $90 million annual budget comes from federal funds -- the study published in Cell was supported by the Howard Hughes Medical Institute, the Hillblom Foundation and the National Institutes of Health -- and it penned its first partnership with a for-profit company, Paris-based Ipsen, only this year.

Nor is Evans likely a pharma favorite after publishing the results of a Salk mice study in Nature Medicine last year that found that long-term use of GlaxoSmithKline's Avandia in the treatment of type 2 diabetes "may cause osteoporosis due to both increased bone resorption and decreased bone formation." Oops.


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See more stories tagged with: exercise pill, diet drugs, gw1516, aicar

Martha Rosenberg is a columnist and cartoonist who frequently writes about the impact of the pharmaceutical, food and gun industries on public health. A former medical copywriter, her work has appeared in the Boston Globe, San Francisco Chronicle, Los Angeles Times, Chicago Tribune, on the BBC and in the original National Lampoon.

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Discipline In a Pill
Posted by: pdxjoe on Aug 14, 2008 12:33 AM   
Current rating: 5    [1 = poor; 5 = excellent]
If the value of exercise were reducible to chemical excitation, I wonder whether that includes the discipline that accompanies even modest exercise. My guess is that it cannot, and to that extent there is a vital component missing from this notion of exercise. I think this especially as exercise is widely understood to have emotional and cognitive benefits: these benefits in particular cannot be reached without the investment of time and energy in activity.

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» RE: Discipline In a Pill Posted by: weathered
» RE: Discipline In a Pill Posted by: nicksjain
Exercise is not just about reducing obesity
Posted by: akai ringo on Aug 14, 2008 4:20 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
I agree entirely with the previous comment about the cognitive and emotional benefits of exercise. If after working at my computer for a few hours, I find myself faced with a particularly tricky translation problem and my brain refuses to supply the solution, a brisk 30-minute walk along the nearby river bank, or even a short cycle ride to the supermarket to do some shopping works wonders in clearing away the fog from my brain and putting me in a mook in which I can once again get down to work. I do take 2 pills a day to counteract chronic high blood pressure, but have always eschewed medicines as far as at all possible, preferring to rely on exercise and a healthy diet, and with a stable BMI of 23 and good physical and mental health at nearly 70, I think the results speak for themselves.

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» I would try it Posted by: bookie
The Final Frontier
Posted by: 6399 on Aug 14, 2008 5:26 AM   
Current rating: 4    [1 = poor; 5 = excellent]
You had to know this was coming. The ultimate solution to America's greasy lifestyles. Now you can have your saturated fat-laden cake and burgers and ice cream . . . and eat it too.

This will get fast tracked over at the FDA because, like the article mentions, Wall Street is clamoring for it. A few years will elapse before the actual side-effects become apparent, but by that time, millions of overworked, lazy and superficially socialized Americans will have been ensnared by Big Pharma's warm, psychotropic embrace.

Various forms of cancer, metabolic disorders like adrenal insufficiency and heart problems will begin manifesting themselves in young and old guinea pigs, er, patients alike with older patients in particular experiencing increased incidence of aortic dissection, valvular disease, etc.

There will be commercials featuring seniors flying kites among gently rustling waves of grain and a sexy young couple picnicking along the banks of a babbling brook, their cute little Labrador puppy playfully ambling amid a forest of sunflowers. It will be perfect.

It has already been foretold. The die is cast and all that is left is for millions of gullible people to be sent to an early grave by yet another assemblage of greedy, hand-rubbing big pharma cronies trying to pass themselves off as humanitarians who just want to "see Americans thrive" and "get back out there". I can almost hear the tag line now: "Attaining an ideal body weight is tough, but Plaxissus can help".

Remember our last go round with, admittedly, dissimilar drugs that touted the same results? Fen-phen, Ephedra? How about Olestra? I can't wait to see what the long-term side effect of the OTC product Alli are.

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The Problem of Breaking Things Into Components...
Posted by: grumble-bum on Aug 14, 2008 5:39 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
It seems like it has become an obsession in our culture to find quick, effortless fixes for our problems. & almost always, this approach involves fragmenting an existing process (that might require commitment or, as the poster above notes, discipline) into component parts, targeting the specific end result & discarding the associated work.

As we are becoming aware, this can cause serious problems, whether we are talking about our out of control drug industry that pushes magic pills to an eager market without fully exploring side effects, or food science. In the latter case, we are seeing that our focus on defining & highlighting the nutritional aspects of originally whole foods has led to a dangerous myopia.

Sure, humans can stay alive by eating certain broken-down & recombinant food products, but key, sometimes mysterious physically & mentally beneficial interactions are lost or distorted, causing health problems that need to be further "targeted".

As human animals, it seems that the best approach to health is consuming whole foods & engaging in "whole" activities. Exercise can be temporarily painful & sometimes monotonous, but even in moderate doses it has lasting, pronounced effect on our physical & mental health. I avoided routine exercise for most of my life since childhood, other than the strains of jobs that required constant standing & lifting, only to begin a regimen in my early 30's. In two years, the positive aspects have been huge; regaining a natural weight for my body type, improved mental clarity & attitude, & increased self-esteem. Perhaps the biggest benefit is that my body is happy because it is doing what it is built to do, & there is a real feeling of accomplishment in the discipline of making & sticking to a routine.

I doubt that any super-pill would provide this combination. Rather, I suspect it would simply draw us further into a cycle of narcissistic chasing of the "ideal", with potential negative health effects, to boot.

Why can't we learn to keep it simple?

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Combine it!
Posted by: Intellect on Aug 14, 2008 5:53 AM   
Current rating: 5    [1 = poor; 5 = excellent]
They need to combine it with Viagra!

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» RE: Combine it! Posted by: mnstra
They need to combine it with VIAGRA ?!
Posted by: kww355 on Aug 14, 2008 7:03 AM   
Current rating: 5    [1 = poor; 5 = excellent]
Oh, Hell, NO. Then this poor tired middle aged broad would have to take it in self defense to be able to get anything else done around my house...lmao.

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Alternative for people who can't exercise well.
Posted by: reelectnoone on Aug 14, 2008 7:30 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
I have a bad hip but can't afford a new one. One of the side effects is that I can't exercise very well and have gained weight. The extra weight places more strain on the hip.

Something like this could go a long way to helping someone in my situation reduce weight, taking more pressure off the joint.

I don't think it is a good idea to avoid exercise if you are fully capable but where there is some physical barrier to good exercise, this could be a good thing.

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American as ever....
Posted by: Spiritgirl on Aug 14, 2008 7:30 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Why am I not surprised! Americans always want to take the short-cut. It's not as though someone tied them to the table and force fed them. No, I don't believe that everyone should be thin, but we need to realize Americans are the FATTEST PEOPLE ON THE PLANET!

Now there will be pills, yet no one has said what are the side effects! Because there will certainly be some. Yes let us continue to stuff ourselves as we sit on that couch, because all we need do is pop a pill and voila no weight gain! No, people we need to get off of our collective a--es and start moving! This is just another symptom of how sick a society that we are in. No, everyone doesn't have thyroid issues, slow metabolisms, or any of the hundreds of other excuses that we use to delude ourselves.

I know no one wants to think about it, but when you ride past those chain eateries(Macaroni Grill, Red Lobster, Outback, etc.) just look at the lines of people, then really look at the line, do you see yourself. This isn't hate, this is about your health or lack thereof. This is about letting your kids sit in front of the t.v. all day snacking. This is about children that are contracting type 2 diabetes at rates that haven't been seen before! This is about the choices that we make.

No, this pill shouldn't be fast-tracked. Let the obese walk!

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Missing the point
Posted by: drmflorida on Aug 14, 2008 7:32 AM   
Current rating: 5    [1 = poor; 5 = excellent]
It strikes me that this drug is potentially tapping into a real medical issue that the author and commenters are glossing over: why do some people who eat right and exercise moderately either maintain their weight or even gain weight, while others who eat poorly and do not exercise have no weight problems whatsoever.

I look at my parents as an excellent example of this. My father and mother both exercise the exact same amount, and eat mostly the same foods. My father goes for seconds and desert, my mother does not. My father hasn't gained a pound since college, my mother is constantly battling her weight.

My brothers both took after my father, and just my luck, I took after my mother.

People like me are not looking for "exercise in a bottle". I am not an athlete, but I also do not live an entirely sedentary life. I ride my bike, take walks, do yoga and tai chi. My diet is very good, rich in green vegetables. Overall, I feel very healthy, but unless I am leading some sort of regimental lifestyle, my weight keeps pushing upwards. I don't want to be a couch potato. I just want life to be "normal".

The current solution is for me to ramp up the exercise to excessive levels. But does anyone wonder if spending an hour a day on the treadmill or on the tennis court causes long term physical damage? Has anyone ever done a study on how healthy former professional football players are into their geriatric years?

The idea that I should be content to be overweight while my brothers are skinny just because that is how the genetic cards were dealt strikes me as regressive, and something I would expect from religious fanatics more than enlightened liberals.

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Ah Yes, The Old American Laziness
Posted by: Godfather89 on Aug 14, 2008 8:01 AM   
Current rating: 1    [1 = poor; 5 = excellent]
Yet another to avoid pain and work in this country. Theres no need to run, to workout, to swim unless you want to. Yes, this preferential society in hand with science is making life so much more easier! But isnt the whole idea of losing weight and staying fit supposed to be to work for it. Their are very few cases that I can think of for using such a pill:
- Morbidly Obese
- Paralyzed from Waist Down
- Type A Personality where you are busy with other things

This "pill" is a real temptation on this already fat consumer society.

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I'm gonna run with this one...
Posted by: elidude420 on Aug 14, 2008 8:06 AM   
Current rating: 1    [1 = poor; 5 = excellent]
Side effects may include shortness of breath, headache, backache, dizziness, and nausea. Some users may experience soft tissue inflammation. Do not use this product if you drink three or more alcoholic beverages each day, as this may cause an unsafe loss of coordination.

Before long, people will be crushing these pills and snorting them for the euphoric "runner's high." The original formulation will be banned. Its replacement will a small amount of the original drug mixed with 325 mg of soot and gravel to prevent abuse.

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Sure, a lot of fat lazy people in this country!
Posted by: g on Aug 14, 2008 8:41 AM   
Current rating: 5    [1 = poor; 5 = excellent]
Then again, we also have cancer patients, people with MS or other conditions who cannot exercise. Most of these posters seem to think that the ones who may *need* the pill for health reasons should do without it. Why? Well, because these posters don't want the fat lazy ones to have access to an easy way out of their problem. First of all, if you have 100 pounds to loose, this pill by itself won't help much. Secondly, this is pure, unadulterated hate speech. Sure, the pharmaceutical industry will try to push this as the 'get skinny fast!' remedy. And even if it was, so what? What's your problem, people? Do you hate fat people so much that you'd rather see sick people waste away than see the fatties slim down without effort? I wouldn't be surprised to see this attitude in a right wing rag, but I expected better from Alternet readers. Oh well.

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Excercise Is Beneficial-Pills Are Not
Posted by: BushBashinBabyAngel on Aug 14, 2008 8:49 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
While we seem to believe that when you take a pill there is no need to help it along by excercising, we are very wrong. You take a calcium pill, but you must still drink milk and have other dairy products to get the maximum amount of calcium possible, correct? So why should we be able to take this "excercise pill" and not have the need to still excercise? Excercise is not just about not being overweight, or wanting to increase your body's muscular structures, but also about being healthy and maintaining healthy lifestyles. I may be young, but I have my fair share of problems when it comes to my body structure, so its a struggle for myself as well too excercise all the time, but it doesn't stop me from excercising whenever I feel it's possible. I have spina bifida Occulta, and my back gets really sore along with my right leg once I have done too much physical activity, and I have Oz Good Slatters, a disease which is eating away at the cartilage in my knees. I cannot run on pavement or jump rope or do anything that puts lots of pressure on my knees because of it, and I should not be doing anything that requires tackling because of my back. But I can run on grass, I can run on a track, and I can still use a treadmill and other excercise equipment. So, even if I were to take that pill, I would not be able to just suddenly stop all my excercising! So why should others be able to? There are people that have far worse problems that are suddenly taking this pill and are no longer excercising, but what they do not realize is once they stop excercising and continue to take this excercise pill, their muscular structure will dissipate and will slowly grow weaker and weaker and within the course of a minimum of one year and a maximum of four will be unable to do just about anything where they woukd need to use their muscles. People will still be able to smile, they will still be able to walk, but they will need assistance from a cane or a walker. There was a recent test that was said to have genetically and scientifically quickened whatever the effects of this new pill would be on a human being and those were the results. Many people will be physically impaired and will come to regret this choice of medication. Good luck to you all, and I sincerely hope you will cease to use this pill for your own health and continue to excercise normally.
---All the best,
Brittany Rollin

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NO and you can stop allowing BIG GOVERNMENT from funding Big Agri/Pharma !
Posted by: jwverez on Aug 14, 2008 10:18 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
If history has taught us anything about "industrializing" food such as the hostile take over of grass-fed meat and diary with petroleum-manufactured-corn-fed shit, the same can and will apply to substituting exercise with phony exercise pills. They don't work. Now, get your asses off the couch and stop supporting BIG GOVERNMENT's arming of Big Agri/Pharma. 50 years of poisoning you all to DEATH should be a WAKE UP CALL !

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Work
Posted by: PaulK on Aug 14, 2008 11:08 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Work is something that humans once did. They planted and harvested food. Sometimes they hunted or snared animals for meat.

The human body is genetically crafted for work. Work improves muscle tone and cardiovascular strength. Work improves balance and keeps the mind active. Work also puts food on the table and keeps people under roofs. Does this new pill put food on the table too?

Without work, the body and mind gets sick and malformed in many, many ways.

With certain kinds of work, certain muscles are strengthened and certain bones are stressed. For example, typing strengthens the fingers and can cause carpal tunnel syndrome.

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Muscle Growth vs. Muscle Use
Posted by: pdxjoe on Aug 14, 2008 1:11 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
That's the other question that comes to my mind. It is one thing if the drug is used to create fat-burning musculature, but how is that musculature to be maintained?

If it encourages the growth of slow-twitch muscles, then low-intensity/high-frequency exercise is still needed to maintain it. What's more is that, since muscles normally develop in response to their use, which is a question of how the muscle is used and not simply how much, without using this kind of muscle in the way that naturally encourages it to grow or persist, using these sorts of drugs may not encourage muscles to grow how they should.

In other words, this drug doesn't sound like it could be anything more than an enhancement to actual exercise and not anything like a substitute for it. This still means it can help those for whom exercise alone isn't enough, but not those who cannot or otherwise do not exercise at all.

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Hype
Posted by: fanny666 on Aug 14, 2008 2:02 PM   
Current rating: 5    [1 = poor; 5 = excellent]
So, we're talking about one drug that's not even made anymore and one drug that people are "anticipating new uses" ... The hype here is not coming from the science, it's coming from non-scientist reporters and pundits.

The purpose of this research is not to make "exercise come in a pill". Those are the words of sensationalist headlines. The purpose of the research is to figure out what goes wrong in metabolic disorders, and how exactly exercise helps.

As much as everybody likes to point out how fat and lazy our fellow Americans are, there are reasons that some people cannot move their muscles. How about advanced muscular dystrophy? Are those people just being lazy? It is a bad thing to figure out a way to mimic exercise, and try to bring their limbs back to life?

I can bet that not a single one of the authors on the original scientific paper are even hoping that their research is used in a way that makes people think exercise can be stopped, and replaced with a pill. Without ever having met a single one of these scientists, I will confidently say that they are trying to help sick people, not trying to help fat people to be lazy. That's just "mad scientist" bullshit.

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» RE: Hype Posted by: BigElectricCat
» RE: Hype Posted by: g
A Miracle Industry Gone Completely Awry
Posted by: drricklippin on Aug 14, 2008 4:17 PM   
Current rating: 3    [1 = poor; 5 = excellent]
Big PhRMA has hit bottom. This is yet another example of the insanity of this industry.Imagine scientists having the hubris that they could substitute a pill for exercise.

Yet a significant percentage the American public still believes this hype.

I won't be happy until some of these CEOs do jail time.Fines and lawsuit financial settlements are not enough.

Dr. Rick Lippin
Southampton,Pa
ralippin@aol.com

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WHEN YOU WATCH THE OLD COWBOY MOVIES, DO YOU DOUBT THAT 19TH CENTURY MEDICINE MAN
Posted by: Raymond Emerson on Aug 17, 2008 11:31 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
with fancy wagon is a fake and a snake oil artist? The more things change the more they remain the same.

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hah hah.. so you'll be skinnier but age quicker
Posted by: cyr3n on Aug 17, 2008 7:30 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
this is just hilarious! So fatties will take a pill to increase their metabolism.. not realizing that increased metabolism equals increased caloric intake equals a yummy side effect of accelerated aging. Unless those toxins are kept in check, you're going to have some haggard looking 21 yr olds hitting the bars!

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Negative on animal experiments
Posted by: Tricia on Aug 17, 2008 11:20 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
This observation was the last one made, but I'm glad the author bothered to point out both the cruelty as well as the ineffectiveness of animal experiments as applied to humans.

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High protein, low starchy carbohydrate diet is what USA needs
Posted by: marxistsocialist on Aug 21, 2008 7:34 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
USA is overweight from many things, and mainly from too many starchy-carbohydrates. USA needs a diet high in protein, moderate in carbohydrates but where most of the carbohydrates would come from low G.I fruits and green vegetables and moderate in fats, along with a change in lifestyle, from an indoor anti-social lifestyle to a more outdoor and socialized lifestyle

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