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May 29, 2009

Think D for dementia

Think D for dementiaIn the May, 2009 issue of the Journal of Alzheimer's Disease, William B. Grant, PhD of the Sunlight, Nutrition, and Health Research Center suggests that reduced serum vitamin D levels could be implicated in the development of Alzheimer's disease and vascular dementia.

Dr Grant lists a number of conditions associated with low serum levels of 25-hydroxyvitamin D that are risk factors for or precede dementia, including cardiovascular disease, diabetes, depression, osteoporosis, dental caries and periodontal disease. Both dental caries and periodontal disease cause tooth loss, which has been associated with cognitive impairment, Alzheimer’s disease and vascular dementia.

Laboratory studies indicate that vitamin D reduces inflammation and helps protect the brain, in addition to its involvement in brain function and development.

Dr Grant recommends the initiation of studies that evaluate the effect of serum vitamin D levels or vitamin D supplementation on dementia incidence. He suggests that men and women over the age of 60 have their serum 25-hydroxyvitamin D levels tested, and that 1000 to 2000 international units vitamin D3 per day should be supplemented if serum levels are lower than 40 nanograms per milliliter.

"There are established criteria for causality in a biological system,” Dr Grant writes. “The important criteria include strength of association, consistency of findings, determination of the dose-response relation, an understanding of the mechanisms, and experimental verification. To date, the evidence includes observational studies supporting a beneficial role of vitamin D in reducing the risk of diseases linked to dementia such as vascular and metabolic diseases, as well as an understanding of the role of vitamin D in reducing the risk of several mechanisms that lead to dementia."

—D Dye

May 27, 2009

Healthy lifestyle practitioners an endangered species

Healthy lifestyle practitioners an endangered speciesAn article published in the June 2009 issue of The American Journal of Medicine revealed that, while the benefits of practicing healthy lifestyle habits have been widely publicized, those who engage in such behaviors are few and are actually declining in number.

Dana E. King, MD, MS and colleagues from the Medical University of South Carolina compared data from 7,340 participants in the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 7,811 subjects enrolled in NHANES 2001-2006. The current research was limited to subjects aged 40 to 74 because this is the primary age during which cardiovascular disease or its risk factors are diagnosed. The five healthy habits examined included consuming a diet high in vegetables and fruit, maintaining proper weight, using alcohol in moderation, engaging in physical activity at least 12 times per month, and not smoking

While only 15 percent of the NHANES 1988-1994 population met all five lifestyle goals, the percentage dropped to 8 percent among those in NHANES 2001-2006. In just 18 years, those whose body mass index was greater than 30 increased from 28 to 36 percent while physical activity 12 times or more per month declined from 53 to 43 percent. Those who consumed five or more vegetables or fruits decreased from 42 to 26 percent. The percentage of smokers remained unchanged, and moderate alcohol intake increased.

"Regular physical activity and a prudent diet can reduce the risk of premature death and disability from a variety of conditions including coronary heart disease, and are strongly related to the incidence of obesity,” the authors write. “In the US, medical costs due to physical inactivity and its consequences are estimated at $76 billion in 2000 dollars. Research indicates that individuals are capable of adopting healthy habits in middle age, and making an impact on cardiovascular risk."

—D Dye

May 22, 2009

Vitamin K supplementation slows coronary artery calcification

Vitamin K supplementation slows coronary artery calcificationIn the June, 2009 issue of the American Journal of Clinical Nutrition, researchers at the US Department of Agriculture’s Human Nutrition Research Center on Aging at Tufts University, along with scientists at the National, Heart, Lung and Blood Institute, Massachusetts General Hospital, and the University of California, San Diego, report their discovery that supplementing with phylloquinone (vitamin K1) helps retard the progression of coronary artery calcium (CAC) in individuals with pre-existing disease. Increased coronary artery calcium has been demonstrated to independent predicts cardiovascular disease and cardiovascular mortality.

In a double-blinded, randomized trial, 229 men and women aged 60 to 80 received 500 micrograms vitamin K1 and 223 subjects received a multivitamin that did not contain vitamin K for three years. Coronary artery calcium was assessed by computed tomography (CT), and blood samples were analyzed for vitamin K1, matrix Gla protein (MGP), inflammatory markers and other factors, at the beginning and end of the treatment period.

While there did not appear to be a difference in coronary artery calcium progression between the two groups, when the 295 participants whose adherence to their supplement regimen was at least 85 percent were separately examined, a protective effect for vitamin K1 against CAC progression was observed. When the analysis was restricted to adherent participants who had mild or greater CAC at the beginning of the study, those who received vitamin K experienced 6 percent less progression than those who did not receive the vitamin.

The decrease in coronary artery calcium progression observed in the vitamin K group was independent of changes in serum MGP levels or markers of inflammation, leading the researchers to conclude that the mechanisms by which vitamin K conferred a protective role in this study are still uncertain. Larger studies in other populations are recommended.

—D Dye

May 20, 2009

Vitamin D may slow asthma progression

Vitamin D may slow asthma progressionIn a presentation on May 20, 2009 at the American Thoracic Society's 105th International Conference held in San Diego, Gautam Damera, PhD of the University of Pennsylvania reported that supplementation with a form of vitamin D could retard the decline in the ability to breathe that occurs with asthma and chronic obstructive pulmonary disease (COPD).

Dr Damera and colleagues compared the effects of calcitriol, the type of vitamin D that is synthesized in the body, and dexamethasone, an anti-inflammatory steroid used to treat asthma, on airway muscle cells derived from 12 asthmatic and nonasthmatic subjects. Human airway smooth muscle cells proliferate in asthma in a process known as airway remodeling, which reduces lung function.

The team discovered that calcitriol decreased growth-factor-induced human airway smooth muscle cell proliferation in a dose-dependent manner in cells derived from both asthmatics and nonasthmatics, while dexamethasone had little effect. In another experiment, the researchers found that calcitriol helped reduce proinflammatory cytokine secrections and may also retard airway remodeling in chronic obstructive pulmonary disease.

Dr Damera believes that calcitriol’s mechanism may be that of inhibiting the activation of proteins responsible for cell-cycle progression. "Calcitriol has recently earned prominence for its anti-inflammatory effects, but our study is the first to reveal the potent role of calcitriol in inhibiting airway smooth muscle proliferation," Dr Damera announced.

The researchers plan to conduct a randomized trial of calcitriol in patients with severe asthma as part of the University of Pennsylvania's Airway Biology Initiative. “Calcitriol may offer a unique therapeutic approach in the management of diseases characterized by increased airway smooth muscle mass that include asthma and COPD,” the researchers conclude.

—D Dye

May 18, 2009

Glutamine helps heal stomach ulcers

Glutamine helps heal stomach ulcersIn the May, 2009 of the Journal of Nutrition, researchers from Beth Israel Deaconess Medical Center and the Massachusetts Institute of Technology report that the amino acid glutamine could help heal the damage caused by H. pylori, the bacteria that causes stomach ulcers and many cases of stomach cancer.

In earlier research, Susan Hagen, PhD and her colleagues discovered that glutamine prevented the death of cultured stomach cells from H. pylori-produced ammonia. For the current experiment, they divided 105 mice to receive standard diets or diets in which L-glutamine replaced 5 percent of total calories. After two weeks, some of the mice in each group were infected with H. pylori. The animals were followed for 20 weeks, during which blood samples were analyzed for antibodies to immune cells that mediate the body’s response to H. Pylori. Additionally, tissue samples were obtained from the stomach and examined for damage, cancer progression and inflammation.

At the end of the 20 week period, infected animals that received L-glutamine had less inflammation than those that received the control diet. "Because many of the stomach pathologies during H. pylori infection are linked to high levels of inflammation, this result provides us with preliminary evidence that glutamine supplementation may be an alternative therapy for reducing the severity of infection," Dr Hagen explained.

"H. pylori bacteria infect more than half of the world's population and were recently identified as a Group 1 carcinogen by the World Health Organization," Dr Hagen added. "Approximately 5.5 percent of the entire global cancer burden is attributed to H. pylori infection and, worldwide, over 900,000 new cases of gastric cancer develop each year. The possibility that an inexpensive, easy-to-use treatment could be used to modify the damaging effects of H. pylori infection warrants further study in clinical trials."

—D Dye

May 15, 2009

Ginger helps relieve chemotherapy-induced nausea

Ginger helps relieve chemotherapy-induced nauseaThe American Society of Clinical Oncology meeting held in Orlando was the site of a presentation by University of Rochester Medical Center assistant professor of Dermatology and Oncology Julie L. Ryan, PhD, MPH concerning the benefits of ginger (Zingiber Officinale) in combating nausea in patients undergoing chemotherapy. Although chemotherapy patients are commonly provided with antiemetic drugs such as Zofran®, nausea and vomiting are still experienced by up to 70 percent of patients.

The double-blinded trial included 644 patients being treated with chemotherapy for breast, alimentary, lung and other cancers who reported nausea during a chemotherapy cycle. Participants were randomized to receive 0.5 grams, 1.0 grams or 1.5 grams ginger, or a placebo for 6 days beginning three days prior to their next two chemotherapy cycles. Treatments were provided in divided doses. Participants continued to received anti-nausea drugs on the first day of their chemotherapy cycles.

Nausea severity was rated by the subjects during the first four days of each cycle. All groups who received ginger experienced a reduction in nausea on day one, which declined over 24 hours. The two lowest doses of ginger were associated with the greatest decrease in nausea, with those in the 0.5 gram and 1.0 gram groups experiencing a 40 percent reduction.

The trial is the largest randomized study to reveal a benefit for ginger against nausea experienced by patients treated with chemotherapeutic drugs. “By taking the ginger prior to chemotherapy treatment, the National Cancer Institute-funded study suggests its earlier absorption into the body may have anti-inflammatory properties," Dr Ryan stated.

"There are effective drugs to control vomiting, but the nausea is often worse because it lingers," Dr Ryan noted. "Nausea is a major problem for people who undergo chemotherapy and it's been a challenge for scientists and doctors to understand how to control it.”

—D Dye

May 13, 2009

Folic acid supplements prior to conception associated with reduced infant prematurity

Folic acid supplements prior to conception associated with reduced infant prematurityAn article published online on May 11, 2009 in the journal PLoS Medicine reports that women who consumed folic acid supplements for a year or more before conceiving experienced a significantly lower risk of giving birth prematurely. Births that take place prior to 37 weeks of gestation have been associated with developmental disabilities as well as decreased survival, yet no method of preventing premature delivery is currently known.

Radek Bukowski of the University of Texas Medical Branch Department of Obstetrics and Gynecology and colleagues evaluated data from 34,480 pregnant women for the current study. Twenty percent reported using folic acid supplements for one year or more prior to conception, 36 percent reported using folic acid for less than one year before conceiving, and 44 percent did not use the supplements. One thousand six hundred fifty-eight spontaneous births occurred prior to the 37th week of gestation, and 160 occurred before the 32nd week.

Longer duration of folic acid supplementation was associated with a declining risk of spontaneous preterm delivery. Women who supplemented for at least one year prior to conception experienced a 70 percent lower risk of premature delivery between the 20th and 28th week of gestation than women who did not supplement, and a 50 percent decrease between the 28th and 32nd week.

In an accompanying editorial, Nicholas Fisk from the University of Brisbane, Australia and his associates commented, "Methodologically, the study has several strengths... It is based on a huge dataset, with prospective recording of dietary supplements and potential confounders, and gestational age determined accurately on first trimester ultrasound."

“These findings, despite their limitations, provide a basis for further inquiry into preconceptional folate supplementation for prevention of spontaneous preterm birth in clinical trials,” the authors conclude.

—D Dye

May 11, 2009

Iceland’s dramatic decline in coronary heart disease mortality attributed to risk factor reduction

Iceland’s dramatic decline in coronary heart disease mortality attributed to risk factor reductionAt the EuroPRevent 2009 conference, held May 6-9 in Stockholm, Sweden, Dr Thor Aspelund reported the results of a study which revealed that the 80 percent reduction in coronary heart disease mortality that occurred over a 25 year period for men and women aged 25 to 74 living in Iceland can be attributed to a reduction in risk factors among three quarters of the population.

Dr Aspelund and colleagues from the Icelandic Heart Association and the University of Iceland applied a coronary heart disease analysis model to Icelandic death statistics, published trials and meta-analyses, national quality registers and population surveys. They determined that the decrease in heart disease deaths observed between 1981 and 2006 was largely the result of cholesterol reduction, smoking cessation, reductions in systolic blood pressure, and greater physical activity. One fourth of the decrease in coronary heart disease deaths was due to individual treatment, with 7 percent attributable to treatment or surgery following a coronary event, 6 percent to heart failure treatment, 5 percent to initial treatments for acute coronary syndrome, and 1 percent to hypertension therapy. The decline in heart disease deaths occurred despite a 5 percent increase in the incidence of diabetes and a 4 percent increase in obesity, which are both heart disease risk factors.

"Approximately three-quarters of the large coronary heart disease mortality decrease in Iceland between 1981 and 2006 was attributable to reductions in major cardiovascular risk factors in the population," Dr Aspelund remarked. "These were mainly in total serum cholesterol, smoking and blood pressure levels. The findings emphasize the value of a comprehensive strategy that promotes tobacco control and a healthier diet. It also highlights the potential importance of effective, evidence-based medical treatments."

—D Dye

May 08, 2009

Glycerol feeding as effective as calorie restriction to extend yeast life span

Glycerol feeding as effective as calorie restriction to extend yeast life spanIn an article published online on May 8, 2009 in PLoS Genetics, researchers from the University of Southern California in Los Angeles report that feeding glycerol to yeast results in the same extension of life span as the well known technique of calorie restriction. Although glycerol has the same amount of calories as table sugar, it is metabolized differently.

Senior author Valter Longo of USC’s Andrus Gerontology Center and his colleagues initially discovered that yeast cells genetically modified to live five times as long as normal yeast have high levels amounts of glycerol-producing genes, and convert glucose and ethanol into glycerol. Additionally, they are more resistant to cellular damage. The current research included an experiment comparing the effects of calorie restriction to the administration of a 0.1 percent and 1.0 percent glycerol solution to yeast cultures, which found that both glycerol solutions were associated with a slightly greater number of yeast surviving to 30 days compared with the calorie restricted yeast.

The study is the first to propose that dietary substitution could replace calorie restriction to enhance life span. "If you add glycerol, or restrict caloric intake, you obtain the same effect," Dr Longo remarked. "It's as good as calorie restriction, yet cells can take it up and utilize it to generate energy or for the synthesis of cellular components."

"This is a fundamental observation in a very simple system, that at least introduces the possibility that you don't have to be calorie-restricted to achieve some of the remarkable protective effects of the hypocaloric diet observed in many organisms, including humans,” he added. “It may be sufficient to substitute the carbon source and possibly other macronutrients with nutrients that do not promote the ‘pro-aging’ changes induced by sugars."

—D Dye

May 06, 2009

Greater intake of several nutrients combined with low glycemic foods linked to reduced risk of macular degeneration

Greater intake of several nutrients combined with low glycemic foods linked to reduced risk of macular degenerationThe May, 2009 issue of the journal Opthalmology published the finding of researchers at Tufts University in Boston of a protective effect of several nutrients combined with a low glycemic index diet against age-related macular degeneration. Macular degeneration is a major cause of blindness among older adults in western nations, and is characterized by the accumulation of drusen in the eye’s macula, which can lead to a loss of central vision.

For the current research Chung-Jung Chiu, PhD of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University and colleagues analyzed data from 4,003 participants in the Age-Related Eye Disease Study (AREDS). Dietary questionnaires completed by the subjects were scored for the intake of nutrients tested in AREDS: vitamin C, vitamin E, and zinc, and AREDS2: lutein/zeaxanthin, and the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Glycemic index, which measures how fast a particular food raises blood glucose, was calculated for consumed food items. Fundus photographs of the macula of the eye taken upon enrollment were graded for severity of drusen or type of macular degeneration.

Participants whose compound diet scores of both groups of nutrients as well as low glycemic index foods were higher were determined to have the lowest risk of early as well as advanced macular degeneration, compared to the risk experienced by those with lower scores. When single nutrients were analyzed separately, only vitamin E emerged as significantly protective against the disease.

The study is the first to analyze the combination of the two nutrient groups and a low glycemic index diet. “Although the compound score may be a useful new tool for assessing nutrients in relation to AMD, specific dietary recommendations should be made only after our results are confirmed by clinical trials or prospective studies,” Dr. Chiu stated.

—D Dye

May 04, 2009

Deficient vitamin D levels prevalent in ICU patients

Deficient vitamin D levels prevalent in ICU patientsIn a letter published in the April 30, 2009 issue of the New England Journal of Medicine, endocrinologists from Sydney, Australia documented a high rate of vitamin D deficiency in critically ill patients.

Dr Paul Lee, Professor John Eisman and Associate Professor Jackie Center of the Garvan Institute of Medical Research, evaluated the vitamin D levels of 42 intensive care unit (ICU) patients, and found that 45 percent were deficient. Disease severity was found to increase as vitamin D levels declined. The three deaths that occurred were in those who had undetectable levels of the vitamin.

"Until now, the medical community has thought of Vitamin D deficiency as a chronic condition," Dr Lee stated. "Little is known about its acute complications. Last year, we published several cases showing that vitamin D deficiency can cause acute complications in the intensive care unit."

"Recently, Vitamin D has been recognized for its many roles beyond the musculoskeletal system,” he observed. “It has been implicated in diabetes, in the immune system, in cancers, in heart disease and in metabolic syndrome. Vitamin D appears to have roles in controlling sugar, calcium, heart function, gut integrity, immunity and defense against infection. Patients in ICU suffer from different degrees of inflammation, infection, heart dysfunction, diarrhea and metabolic dysregulation – so vitamin D deficiency may play a role in each of these common ICU conditions."

“Vitamin D is very safe,” Dr Lee added. “It's inexpensive and has a very large safety window, making toxicity unlikely, unless there are underlying diseases causing high calcium. Giving vitamin D to severely deficient patients is very unlikely to cause harm. In addition, ICU patients are lying in bed for a long time, and are at risk of bone loss and osteoporosis. So if nothing else, Vitamin D will help protect their bones."

—D Dye

May 01, 2009

Wine drinkers live longer

Wine drinkers live longerA report published ahead of print on April 29, 2009 in the Journal of Epidemiology and Community Health revealed the finding of Dutch researchers of an association between drinking wine and improved life expectancy.

Dr M. T. Streppel and colleagues evaluated data from 1,373 participants in the Zutphen Study of middle-aged men residing in Zutphen, Netherlands. Periodic interviews conducted from 1960 through June, 2000 obtained information on food and alcohol intake, weight, smoking status, and disease incidence. Over the follow-up period 1,130 deaths were confirmed, of which more than half were attributable to cardiovascular disease.

The percentage of men who consumed alcohol increased from 45 percent in 1960 to 86 percent in 2000, with wine drinkers increasing from 2 percent to about 44 percent. Long-term intake of up to 20 grams per day of alcohol was associated with a 67 percent reduction in the risk of dying from cerebrovascular disease, a 70 percent reduction in cardiovascular disease mortality risk, and a 25 percent reduction in mortality from all causes over the course of follow-up compared to no alcohol consumption.

Life expectancy at age 50 was found to be increased by approximately 2 years among those who reported light alcohol intake compared with subjects who reported no alcohol consumption. The increase in life expectancy was slightly less among participants who consumed more than 20 grams per day. When those who reported drinking only wine in moderation were analyzed, they were found to have an increase in life expectancy that was 2.5 years greater than those who drank other alcoholic beverages and 5 years greater than nondrinkers.

“To our knowledge, we are the first to study the effects of absolute alcohol intake and type of alcoholic beverage on life expectancy,” the authors write. “More studies are needed to verify our results.”

—D Dye

 

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