Exercise in a Pill?

August 29, 2008

Before we get into a new drug’s seemingly miraculous ability to provide the same benefits as strenuous exertion, here’s why it is so potentially important. When I saw this headline in Google news, I had to do a double-take to make sure that it wasn’t from The Onion, the satirical Web site whose faux-journalistic parodies occasionally are plagiarized by reporters in other countries and run as actual news. But no, this story is from Reuters, and apparently it’s dead serious:   

ALL U.S. ADULTS COULD BE OVERWEIGHT IN 40 YEARS   

Ouch. The study in question, published in the latest issue of the scientific journal Obesity, uses data gathered over the past four decades to project the expansion of American waistlines into the future. And it’s not a pretty picture. By 2030, if present trends continue, 86.3 percent of American adults will be overweight, with a body mass index of 25 or greater, and 51.1 percent will be obese, with BMIs above 30. If the pattern persists through 2048, all American adults will be carrying a significant excess of pounds, something scientists would not have believed to be possible.

"Genetically and physiologically, it should be impossible" for all U.S. adults to become overweight, said Dr. Lan Liang of the federal government's Agency for Healthcare Research and Quality, one of the researchers on the study.

However, she told Reuters Health, the data suggest that if the trends of the past 30 years persist, "that is the direction we're going."

I’m avoiding the temptation to make a gratuitous Jabba the Hutt joke here, because the trend described by this study is a potential health catastrophe of staggering proportions. Indeed, the researchers predict that the cost of treating health problems associated with excess weight could double each decade, so that by 2030 we could be spending nearly a trillion dollars a year, or nearly a fifth of total U.S. healthcare expenditures, to cope with what essentially is a preventable condition.

So what’s an increasingly corpulent nation to do? Giving up cheese fries and venti lattes will help, but cutting caloric intake drastically only works up to a point, because our bodies kick into starvation-fighting mode and become super-efficient at preserving those stores of fat, often at the expense of consuming muscle. A less-drastic balanced diet, combined with plenty of exercise, is the conventional wisdom. The problem with that solution: A lot of people don’t particularly care for getting all breathless and sweaty.

But what if you could get the benefits of exercise simply from taking a pill?

Amazingly, this may soon be possible. In a recently published article in the scientific journal Cell, researchers describe how a drug called AICAR can mimic the effects of exercise, increasing endurance and the body’s ability to burn fat for energy.

As Scientific American explains:

Researchers say that AICAR — which is in clinical trials to treat some heart ailments — in essence works by reprogramming muscle, switching it from sugar-burning, fast twitch muscle — which is better for speed and power — into fat-burning, slow-twitch muscle that does not tire as easily.

The key to this transformation is a protein called PPARdelta, which Evan's team previously showed could create so-called high-endurance "marathon mice" if the animals were genetically engineered to make a lot of it. But, another experimental drug that targeted only PPARdelta had some metabolic benefits, including lowering fatty acids and blood sugar, but it only boosted endurance in mice that were running regularly.

Enter AICAR, which targets a protein called adenosine monophosphate-activated protein kinase) (AMPK). AMPK is produced when cells need more energy — as they do when we're exercising — and triggers increased levels of PPARdelta. As a result, researchers thought that AICAR could kick off the process in lieu of exercise.

And it did. Sedentary lab mice that were given AICAR actually were able to run on a treadmill almost 1.5 times farther than other rodents who didn’t get the drug. Essentially, "it's tricking the muscle into 'believing' it's been exercised daily," one of the study’s co-authors, developmental biologist Ronald Evans of the Salk Institute for Biological Studies, told Scientific American. "It proves you can have a pharmacologic equivalent to exercise."

If these results are borne out in human subjects, AICAR could be a huge breakthrough in the treatment of degenerative diseases such as muscular dystrophy as well as diabetes, because it also seems to help the body use and remove sugar from the blood more effectively. As Dallas Morning News technology blogger Andrew Smith implores, "Please God, let this work in humans."

Obviously, exercise-in-a-pill could have tremendous benefits. In addition to promoting weight loss or maintenance, you’ll finally be able to reclaim the square footage in your apartment now taken up by that dust-covered elliptical trainer that you’re too embarrassed to put on Craigslist. You’ll be able to sleep in an hour later in the morning, instead of dragging yourself out of bed to go for a run or to the gym. You’ll be free to make fun of infomercials by Tony “You can do it!” Little with impunity.

But there are significant downsides, as well. While AICAR might improve muscular endurance and weight loss, I don’t see anything in the scientific literature that indicates it would improve cardiovascular fitness the way that conventional exercise would. And if you want flexibility, balance, coordination and/or explosive power, forget it. No amount of AICAR — or any other drug, for that matter — is likely to enable a couch potato to do the sort of moves demonstrated by my kung fu instructor, Sifu Robert Thompson, in this video.

So, what do you think? Is exercise-in-a-pill the way of the future? Or should we stick to old-fashioned grunting and perspiration? Express your opinion below.

Photo: AP

Comments

[Natural Man]

Love that Bim Sherman song in the video!

[Caffeine Driven Stress Magnet]

Wow, what a great invention! I would love to get some of these pills.

[Astroboy]

I like it better when you write about blowing things up!!!!

[Joyce]

I could see this medication as a help to those with metabolic and wasting diseases, but I think it is unnecessary for healthy people, especially athletes, to use it. It is possible to become extremely fit without using a substance that may possibly have serious side effects over long periods. Natural is better!

[Daniel Klaisner]

I agree with Joyce. Our race is getting to dependant on artificial things that make our life unnessasarily easier. I say run a mile you lazy people!

[I hate jogging!]

I think this is a great idea. Nobody has to spend $100 on a pair of fancy running shoes anymore or dodge the bicyclists on running paths.

[Willie povell]

I think the part about treating diabetes and other diseses is ok, but I don't know about just to lose weight. It isn't natural.

[Mickey]

Isn't there also a genetic treatment that will grow a lot of muscles? If you combined that with this exercise pill, you could be in fantastic shape without lifting a finger. Sounds great to me.

[James]

That guy in the Under Armor ad in the corner is scaring me.

[Marci]

I won't be surprised if this pill turns out to have serious side effects. It sounds too good to be true, so it probably is.

[Stephan Burgess]

Who's that guy in the video? That double side kick is pretty amazing.

[Cain]

The jumping spinning crescent kicks were pretty nasty, too. What style of kung fu does he do? It looks like some sort of Northern style, like Shaolin.

[Rudy T.]

I don't think athletes should take this pill, but it might be a good thing for people who hate to exercise. There are a lot of people in America who just won't get up off the couch! At least they'll be healthier with this pill.

[Patrick]

It's actually Bungo Fu, a Jamaican hybrid of kung fu and the dancelike techniques of African foot fighting. The kung fu aspect, which is based upon a personal style developed and taught by a Mongol general, is definitely more Northern, with a lot of high kicks and aerial manuevers. You can see more of it at http://www.youtube.com/watch?v=UTmQLgZqEdY

[Acomplia Online]

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[Arnie]

Acomplia isn't FDA approved and causes nausea and vomiting in 19 percent of trial subjects, but other than that it's really great, right? Go peddle your drugs somewhere else.

[Acomplia online]

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[Arnie]

http://www.diet-blog.com/archives/2006/02/07/acomplia_side_effects_the_story_you_must_read.php

...Carol (not her real name) knows about the risk - and it is anything but acceptable. I recently corresponded with Carol, who participated in a Rimonabant drug trial.

With a long history of dieting, Carol began the trial at a weight of 13 stone 1 pound (183 pounds). With a daily dosage of 20mg, Carol noticed two immediate reactions; She was less hungry, and she became very tearful and depressed. She began to lose a pound or two per week (without being on a diet or exercise program).

However things went from bad to worse. "I also felt nauseous quite often and in a period of 3 months vomited 6 times. As the trial progressed I became more and more depressed. I felt suicidal most of the time." In her desperation to lose weight, Carol stayed on the drug, but slowly descended into psychosis "I couldn’t sleep and when I did I had terrible nightmares". Carol experienced more graphic symptoms of psychosis (such as self-inflicted violence). She has since been on anti-psychotic medication for over a year, and has gradually improved.
"I lost my health and happiness because of these pills and experienced the most wretched time of my life". Carol also added "My relationship with my partner never recovered from him having to care for me and we split up at the end of last year."

To add insult to injury, the 20 pounds that Carol lost in the trial came back on within 3 months. Carol reports that her appetite "came back with a vengeance".