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Nutrient combo reduces inflammation and oxidative stress
An article published online on February 24, 2010 in the American Journal of Clinical Nutrition reports a positive outcome for a combination of nutrients in reducing inflammation and oxidative stress and improving metabolism in overweight human subjects. Increased inflammation is believed to be involved in the greater incidence of disease observed in overweight individuals.
In a double-blinded, crossover study, Dutch researchers gave a placebo or an anti-inflammatory dietary mix of nutrients known to affect inflammation to 36 overweight men whose mildly elevated plasma C-reactive protein levels indicated a state of inflammation. The mix included 6.3 milligrams resveratrol, 94.5 milligrams green tea extract, 90.7 milligrams alpha-tocopherol (vitamin E), 125 milligrams vitamin C, omega-3 fatty acids from fish oil, and tomato extract. Subjects received the anti-inflammatory dietary mix or placebo capsules during four 5-week periods, after which plasma and urine samples were analyzed for markers of inflammation and oxidative stress defense. In addition, 120 plasma proteins, 274 plasma metabolites and the transcriptomes (part of the genomes) of peripheral blood mononuclear cells and adipose tissue were evaluated.
While C-reactive protein levels remained unchanged, a number of other factors improved following 5 weeks of the anti-inflammatory dietary mix, including a 7 percent increase in plasma adiponectin, an anti-inflammatory adipokine secreted by fat cells. Changes in other measurements indicated improvements in adipose tissue inflammation, endothelial function and oxidative stress levels, and increased liver fatty acid oxidation.
“The changes in concentrations of genes, proteins, and metabolites induced by the anti-inflammatory dietary mix appeared to be consistent,” the authors write. “In contrast with the accepted biomarkers, the application of nutrigenomics techniques for large-scale profiling of genes, proteins, and metabolites showed that the anti-inflammatory dietary mix was able to influence processes of inflammation, oxidative stress, and metabolism in humans.”
Niacin may help improve brain function following stroke
The International Stroke Conference, held February 23-26, 2010 in San Antonio, was the site of a presentation by Henry Ford Neuroscience Institute scientific director Michael Chopp, PhD concerning his discovery of a protective effect conferred by vitamin B3, or niacin, on neurologic function following a stroke.
Niacin is commonly recommended for people with high serum cholesterol, which is associated with cardiovascular disease. The ability of niacin to increase high density lipoprotein (HDL), a protective form of cholesterol, helps lower the risk of heart attack and stroke.
Dr Chopp and his colleagues tested the effect of extended-release niacin in a rat model of stroke. The animals were given 40 milligrams/kilogram niacin daily for two weeks, beginning 24 hours after a two hour period of middle cerebral artery occlusion. A control group of animals did not receive the vitamin. When the animals’ brains were examined, the researchers found new blood vessels and nerve cell sprouting in the rats that received niacin, indicating improved neurological outcome.
Earlier research conducted at Henry Ford Hospital revealed low levels of HDL cholesterol in stroke patients at the time of admission. Dr Chopp determined that elevation of HDL by niacin increases the brain’s growth of axons and dendrites. "Niacin essentially re-wires the brain which has very exciting potential for use in humans," Dr Chopp stated. "The results of this study may also open doors in other areas of neurological medicine, including brain injury."
Henry Ford Hospital is currently the only site in the U.S. that is evaluating the effect of niacin in human stroke patients. "If this proves to also work well in our human trials, we'll then have the benefit of a low-cost, easily-tolerable treatment for one of the most neurologically devastating conditions," Dr Chopp said.
Progesterone shows promise for traumatic brain injury
During a panel discussion on the topic of brain injury that took place at the American Association for the Advancement of Science (AAAS) Annual Meeting in San Diego on February 19, 2010, David Wright, MD of Emory University reported the progress being made using progesterone in traumatic brain injury (TBI) patients.
Progesterone is present in the brains of both males and females, and human brain tissue contains numerous progesterone receptors. Research suggests that progesterone is needed for the normal neuron development, and helps protect against brain injury.
A new double-blind Phase III clinical trial known as ProTECT III (Progesterone for Traumatic brain injury – Experimental Clinical Treatment) will follow the three-year ProTECT I trial of 100 brain trauma patients which concluded that progesterone was safe and could reduce the risk of long-term disability and death. Brain trauma patients treated with progesterone in the ProTECT I trial were half as likely to die of their injuries compared to those who did not receive the hormone.
The current trial will enroll 1,140 patients over a 3 to 6 year period beginning in March of this year. Grady Memorial Hospital in Atlanta will serve as the lead center among 17 medical centers throughout the US that are taking part.
"No new treatment for severe TBI has been approved in over 30 years," stated Dr Wright, who is an associate professor of emergency medicine at Emory University School of Medicine. "With such promising success in laboratory testing and in our previous clinical trial, we hope to conclude in this national trial that progesterone–along with standard medical trauma care–works better than standard medical care alone in reducing brain damage caused from a TBI."
Meta-analysis confirms correlation of high vitamin D levels with a lower incidence of diabetes and heart disease
A meta-analysis appearing in the March, 2010 issue of the journal Maturitas associates high vitamin D levels with a reduction in the risk of cardiometabolic disorders among a large number of middle aged and older men and women.
In the introduction to their article, the authors note that cardiometabolic disorders, including cardiovascular disease, type 2 diabetes and metabolic syndrome are major causes of illness and death and that vitamin D deficiency is also highly prevalent worldwide.
Nineteen cross-sectional, 3 case–control, and 9 cohort studies, including a total of 99,745 participants, were selected for the review. Fourteen studies took place in the United States and the rest were conducted in Europe, Iran, Australasia and India.
Pooled analysis of the data revealed that having a high level of serum 25-hydroxyvitamin D was associated with a 43 reduction in the risk of cardiometabolic disorders compared to low levels. The association was significant across all study types. When cardiovascular disease, metabolic syndrome and diabetes were individually evaluated, high vitamin D levels were linked to 33, 51 and 55 percent lower risks.
“To our knowledge, this is the first meta-analysis on this topic that provides a complete picture of the potentially beneficial role that high levels of 25-hydroxyvitamin D may provide on cardiometabolic health,” the authors announce.
“We found that high levels of vitamin D among middle age and elderly populations are associated with a substantial decrease in cardiovascular disease, type 2 diabetes and metabolic syndrome,” concluded lead researcher Dr Oscar H. Franco, of the University of Warwick Medical School’s Health Sciences Research Institute in Coventry, England. “Targeting vitamin D deficiency in adult populations could potentially slow the current epidemics of cardiometabolic disorders.”
Glucosamine plus walking improves arthritis symptoms
The results of a clinical trial published online on February 12, 2010 in the journal Arthritis Research & Therapy suggest that supplementing with glucosamine and engaging in a program of walking could improve pain, physical function and activity levels in adults with arthritis.
Dr Kristiann Heesch and colleagues at the University of Queensland in Australia randomized 36 men and women with mild to moderate hip or knee osteoarthritis to a 3 or 5 day per week walking program. Participants received 1500 milligrams glucosamine sulphate daily, 6 weeks prior to and during the 12-week walking program. With the aid of a pedometer, subjects were asked to increase their walking from 1500 to 3000 steps per day over the first 6 weeks in addition to any walking currently engaged in. They were then asked to increase their steps to 6000 per day over the subsequent 6 weeks. Physical activity levels and physical function were assessed and arthritis symptoms were rated upon enrollment and at 6, 12, 18 and 24 weeks.
After 6 weeks of glucosamine supplementation, physical activity, stiffness and function improved. Between the beginning of the walking program and the 24 week follow-up visit, significant improvements in physical activity and function as well as pain occurred, and there was a trend for improvement in stiffness. No significant differences were observed between participants who participated in the 3 and 5 day per week programs. "These findings are not surprising given that the three-day and five-day walking groups did not differ significantly in the mean number of days actually walked per week, the mean number of daily steps walked, nor their weekly minutes of physical activity," Dr Heesch noted. "They provide preliminary evidence that osteoarthritis sufferers can benefit from a combination of glucosamine sulphate and walking 3000 steps per day for exercise, in bouts of at least 1500 steps each, on at least three days per week".
White blood cell count, C-reactive protein levels predict death in oldest individuals
In an article published online on January 27, 2010 in The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, researchers at Leiden University Medical Center in the Netherlands report that high white blood cell counts and C-reactive protein levels independently predict men and women’s risk of dying within a period of up to 10 years following their 85th birthday. Elevations in both white blood cells and C-reactive protein (CRP) are markers of inflammation, which is associated with vascular events and other health concerns.
The study included 599 individuals enrolled between 1997 and 1999 in the Leiden 85-plus Study of Leiden residents born between 1912 and 1914. Participants were followed until their deaths, or until February, 2008. Blood samples obtained upon recruitment were analyzed for white blood cells, C-reactive protein levels, and other factors.
Over a mean 5.4 year follow-up period, 169 subjects died of vascular causes and 277 of nonvascular causes. There were 6 deaths from unknown causes. Higher white blood cell counts increased the risk of dying as did higher C-reactive protein levels. After adjusting the data, the authors concluded that “both WBC count and CRP level are independent predictors of mortality at old age.”
“To our knowledge, the comparison of these predictors, white blood count and CRP levels, in the relation with an increased mortality has not been described before,” they write. “Additional studies are needed to determine whether interventions to decrease these markers can reduce the increased mortality risk. In clinical practice, it is necessary to pay more attention to the potential of white blood cell count as a predictor for mortality in the oldest old.”
Chocolate consumption linked with lower stroke risk
The results of a Canadian analysis scheduled for presentation at the American Academy of Neurology's 62nd Annual Meeting to be held in Toronto April 10 to April 17, 2010 indicate an association between consuming chocolate and a lower risk of stroke and stroke mortality. Chocolate contains cocoa flavonoids to which the lower risk of cardiovascular disease observed among individuals who include chocolate in their diet has been attributed. However, the impact of chocolate consumption on stroke risk has not been well explored.
Sarah Sahib, BScCA, of McMaster University in Hamilton, Ontario, along with Gustavo Saposnik, MD, MSc, of St Michael's Hospital and the University of Toronto evaluated 88 studies concerning the effects of flavonoids on stroke and mortality, from which 3 studies were selected. While one study found only an insignificant association between flavonoid intake and a reduced risk of stroke or mortality when 3 percent of catechin intake was derived from chocolate, another study revealed a 22 percent reduction in the risk of stroke in 44,489 subjects who consumed chocolate weekly compared to the risk associated with no weekly intake. In the third study, a 46 percent decrease in the risk of dying from stroke was associated with 50 grams of weekly chocolate consumption among 1,169 subjects.
Dr Sahib concluded that “Higher flavonoid intake from chocolate sources may be associated with lower incident risk of stroke and stroke-related mortality.”
"More research is needed to determine whether chocolate truly lowers stroke risk, or whether healthier people are simply more likely to eat chocolate than others," she noted.
Increased antioxidant vitamin intake linked with lower cervical cancer risk
An article published in the latest issue of Nutrition and Cancer reports an association between the intake of beta-carotene, and vitamins A, C and E and a lower risk of cervical cancer in Korean women.
Mi Kyung Kim of the Republic of Korea’s National Cancer Center and colleagues age-matched 144 women diagnosed with cervical cancer with 288 control subjects with no history of the disease. Sociodemographic information was collected upon enrollment and dietary questionnaire responses were analyzed for nutrient intake.
The researchers uncovered associations between higher intakes of vitamins A, C, and E from diet and supplements with a significantly lower risk of cervical cancer. Participants in the top 25 percent of vitamin E intake had a 47 percent lower risk of cervical cancer than those in the lowest fourth, and those in the top one-fourth of vitamins A and C intake had a 65 percent lower risk. When intake from diet alone was examined, participants whose vitamin A, beta-carotene, and vitamin C were in the top quarter of subjects experienced a 64, 52 and 64 percent lower risk than those in the lowest fourth.
“The present study is the first to explore the association between antioxidant vitamin intakes and the risk of cervical cancer in a Korean population, taking total nutrient intakes (food and supplements) into consideration,” the authors announce. In their discussion of a possible mechanism, they note that antioxidants induce cell differentiation and growth inhibition in animal and human cancer cells.
“The findings support a role for increased antioxidant vitamin intake in decreasing the risk of cervical cancer,” they conclude. “These associations need to be assessed in large prospective studies with long-term follow-up.”
Potassium supplements benefit heart, bone
An article published ahead of print on January 18, 2010 in the American Heart Association journal Hypertension reports the benefit of potassium supplements on risk factors for bone loss and cardiovascular disease.
In a double-blind, placebo-controlled crossover trial, 42 men and women with mildly elevated blood pressure received potassium chloride for 4 weeks, potassium bicarbonate for 4 weeks, or a placebo for 4 weeks in random order over a 12 week period. Blood pressure was measured and blood and urine samples were analyzed at the beginning of the study and at the end of each 4 week period. Endothelial function, a key factor in cardiovascular health, was assessed at each time point by brachial artery flow-mediated dilatation.
Both types of potassium elevated urinary potassium and were associated with significant improvements in endothelial function and left ventricular diastolic function, as well as with decreased left ventricular mass compared to the placebo. While potassium chloride supplementation was associated with a small improvement in 24 hour and daytime systolic blood pressure and a reduction in 24-hour urinary albumin (which, when elevated, is a risk factor for the development and progression of renal and cardiovascular disease), potassium bicarbonate reduced 24-hour urinary calcium, calcium to creatinine ratio, and plasma C-terminal cross-linking telopeptide of type 1 collagen, which are markers of bone turnover.
“The potassium intake achieved in our study is very similar to the adequate intake for adults recommended by the US Institute of Medicine (120 millimoles per day),” the authors write. “The current potassium intake in most populations is approximately 60 to 70 millimoles per day. Increasing potassium intake could play an important role in the prevention of cardiovascular disease and osteoporosis in the long term.”
Lifestyle should be given same priority as medication following acute coronary syndrome
An article published online on February 1, 2010 in the American Heart Association journal Circulation reveals the importance of lifestyle changes in preventing recurrent cardiovascular events in individuals with acute coronary syndrome.
Researchers led by Clara K Chow of Hamilton General Hospital in Hamilton, Ontario evaluated data from 18,809 subjects enrolled in the Organization to Assess Strategies in Acute Ischemic Syndromes (OASIS) 5 randomized clinical trial. Patients were eligible for the enrollment if they were aged 60 and older, had an elevated level of troponin or creatine kinase-MB isoenzyme, or electrocardiogram changes indicative of ischemia. Demographic and other data were collected at the beginning of the study, and questions concerning smoking status and adherence to recommended exercise programs and dietary modifications were answered by the participants during follow-up visits at 1, 3 and 6 months. Heart attack, stroke, cardiovascular death and mortality from all causes were documented.
Among those who survived to 30 days after presenting with acute coronary syndrome, 481 deaths and 575 cardiovascular events occurred by the end of the 6 month follow-up period. Thirty percent of the participants reported having adhered to both diet and exercise recommendations at the 30 day follow-up while 28.5 percent adhered to neither. Nearly two-thirds were able to stop smoking. Compliance with both diet and exercise recommendations was associated with a risk of heart attack that was half that of those who did not comply. For those who failed to stop smoking as well as to comply with diet and exercise recommendations, there was a 3.8-fold increase in the risk of cardiovascular events or death compared with those who never smoked and who modified their diet and exercise habits.
“Adherence to behavioral advice after acute coronary syndrome was associated with a substantially lower risk of recurrent cardiovascular events,” the authors conclude. “These findings suggest that behavioral modification should be given priority similar to other preventive medications immediately after acute coronary syndrome.”
Exercise your right to healthier aging
Reports published in the January 25, 2010 issue of the Archives of Internal Medicine confirm the association between physical activity and better health and cognitive function in older individuals.
In an analysis of 13,535 women over the age of 70 who participated in the Nurses’ Health Study, researchers at Harvard University School of Public Health and Brigham and Women’s Hospital and Harvard Medical School in Boston determined that those who regularly engaged in physical activity during midlife had fewer chronic diseases or physical or mental impairment.
A Canadian study reported in the journal compared 155 women aged 65 to 75 assigned to once or twice-weekly resistance training to 49 control subjects assigned to weekly balance and tone training for one year. The investigators found that resistance training improves women’s muscle function as well as attention and conflict resolution skills.
In another report, 3903 older participants in a prospective cohort study in Germany were followed for two years. Moderate or high physical activity levels were found to be associated with a reduction in the development of cognitive impairment over follow-up.
An additional German study reported in the journal found that women aged 65 or older who participated in a high-intensity exercise program for 18 months had increased bone density and a reduced risk of falling when compared to those who were assigned to low frequency, low intensity exercise.
"Since the American population is aging rapidly and nearly a quarter of Americans do not engage in any leisure-time activity, our findings appear to support federal guidelines regarding physical activity to promote health among older people and further emphasize the potential of activity to enhance overall health and well-being with aging," write Jeff Williamson, MD, MHS, and Marco Pahor, MD in an accompanying editorial. "The notion that physical activity can promote successful survival rather than simply extend the lifespan may provide particularly strong motivation for initiating activity."
Omega-3 fatty acids could be protective against psychiatric disorders
In the February, 2010 of the American Medical Association journal Archives of General Psychiatry, researchers from Austria, Switzerland and Australia report that daily fish oil capsules containing long-chain omega-3 polyunsaturated fatty acids (PUFAs) help prevent psychotic disorders in high risk individuals.
The current research included 81 young adults with mild psychotic symptoms, transient psychosis, or a family history of psychosis plus decreased functioning . In a randomized, double-blinded trial, G. Paul Amminger, MD of Medical University of Vienna and his colleagues gave 81 participants daily fish oil capsules providing 1.2 grams omega-3 fatty acids or a placebo for 12 weeks, followed by a 40 week monitoring period.
At the end of the study, 27.5 percent of the participants who received a placebo had progressed to a psychotic disorder, compared with 4.9 percent of those who received fish oil. Subjects who received fish oil also reported fewer symptoms and better functioning compared with the placebo group.
The authors remark that dysfunctional fatty acid metabolism could be involved in the development of schizophrenia, and that trials of omega-3 fatty acids have demonstrated benefits in this population. Omega-3 fatty acids may exert their protective benefits via their incorporation into cell membranes which affects membrane fluidity and receptor responses, by interaction with dopaminergic and serotonergic systems, or by increasing glutathione in the brain, which helps protect neurons.
“To our knowledge, this is the first randomized, placebo-controlled trial in a help-seeking group at ultra-high risk of psychosis to test the efficacy of omega-3 PUFAs in a preventive role,” the authors announce. “The present trial strongly suggests that omega-3 PUFAs may offer a viable prevention and treatment strategy with minimal associated risk in young people at ultra-high risk of psychosis, which should be further explored.”