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Oral steroid use can result in vitamin D deficiency
Researchers from the Albert Einstein College of Medicine of Yeshiva University report online on September 28, 2011 in The Journal of Clinical Endocrinology and Metabolism that the use of oral corticosteroid drugs is associated with double the risk of having severely deficient levels of vitamin D compared to non-use of the drugs.
Einstein College assistant professor of pediatrics Amy Skversky, MD, MS and her associates analyzed data from 22,650 children, adolescents and adults who participated in the National Health and Nutrition Examination Survey (NHANES) 2001-2006. One hundred eighty-one subjects reported oral steroid use over the thirty days prior to being questioned. Among steroid users, 11 percent had serum 25-hydroxyvitamin D levels of less than 10 nanograms per milliliter, which is considered severely deficient, compared to 5 percent of the remainder of the study population. For oral steroid users under the age of 18, severe vitamin D deficiency was fourteen times as likely to occur compared with nonsteroid users in the same age group.
The finding is concerning due to the increased risk of conditions such as osteomalacia, myopathy and rickets that are associated with vitamin D deficiency. Other research has revealed decreased levels of vitamin D in children with asthma and those with Crohn’s disease who are often prescribed steroid drugs. The drugs may lower vitamin D levels by increasing the level of an enzyme that inactivates the vitamin.
"When doctors write that prescription for steroids and they're sending the patients for lab tests, they should also get the vitamin D level measured," Dr Skversky recommended.
Zinc aids in regulating brain cell communication
A report published online on September 21, 2011 in the journal Neuron reveals an important role for the mineral zinc in the regulation of brain cell communication. The finding is the first instance of proof that an element, as opposed to a chemical compound, is used by the nervous system as a neurotransmitter.
In research conducted over half a century ago, high concentrations of zinc were found in nerve cell compartments known as vesicles that package neurotransmitters—the chemicals that facilitate the transmission of impulses between neurons. Neurons in the brain’s hippocampus, which is the center of learning and memory, were discovered to have the highest levels of zinc. However, it remained unknown whether the zinc that was found in the cells’ vesicles actually played a role in nerve cell communication.
For the current investigation, researchers at Duke University and the Massachusetts Institute of Technology utilized a novel zinc chelator to help bind and remove zinc from hippocampal brain samples derived from mice. "We discovered that zinc is essential to control the efficiency of communication between two critical populations of nerve cells in the hippocampus," senior author James McNamara, MD, of Duke University reported. "This addresses a longstanding controversy in the field."
Although having adequate zinc is essential for nerve cell communication, excessive enhancement of this communication has been observed in animals with epilepsy. "Carefully controlling zinc's regulation of communication between these nerve cells is critical to both formation of memories and perhaps to occurrence of epileptic seizures," Dr McNamara stated.
He noted that zinc supplements are widely available and are often used to treat depression and other brain disorders, however, it isn’t known whether supplementing with the mineral changes the brain’s zinc content or modifies the communication between its nerve cells.
Soy protein slows the progression of atherosclerosis in postmenopausal women
Researchers from the University of Southern California report the outcome of a double-blinded trial of postmenopausal women which found a protective effect for soy protein supplementation against the progression of atherosclerosis if initiated within five years of menopause. The findings appeared online on September 8, 2011 in the American Heart Association journal Stroke.
Howard N. Hodis, MD of USC’s Keck School of Medicine and his associates randomized 350 postmenopausal women aged 45 to 92 who did not have cardiovascular disease or diabetes to receive 25 grams isolated soy protein per day or a placebo for 2.7 years, during which carotid artery intima-media thickness was monitored. Although carotid artery intima-media thickness progression averaged 16 percent less in women who received soy protein compared to those who received a placebo, the effect was not considered significant. However, when the participants were analyzed by age group, a significant protective effect was observed among those who were within five years of menopause, with those who received soy protein having an average rate of progression that was 68 percent lower than those who received a placebo.
This trial is the largest and longest randomized controlled human study so far to evaluate isolated soy protein’s effect on atherosclerosis progression. In addition to retarding atherosclerosis, the researchers also observed a significant increase in high density lipoprotein (HDL) cholesterol among women who received soy protein, which is associated with a protective effect on the cardiovascular system.
"These results are consistent with what we have learned through research conducted over the past decade," Dr Hodis stated. "The literature demonstrates that there is a 'window of opportunity' of a potential beneficial effect on coronary heart disease for products that bind to the estrogen receptor including hormone-replacement therapy, soybean isoflavones or selective estrogen receptor modulators (SERMs) when initiated in women within 5-6 years of menopause."
Reduced vitamin D levels correlated with greater asthma severity in children
An article published on September 8, 2011 in the American Journal of Respiratory and Critical Care Medicine reports a link between reduced vitamin D status and severe therapy-resistant asthma (STRA) among asthmatic children. Severe therapy-resistant asthma occurs in 5 to 10 percent of asthmatic children and necessitates greater utilization of healthcare services due to increased asthma episodes and related illnesses.
Atul Gupta, MD of Royal Brompton Hospital in London and colleagues compared serum 25-hydroxyvitamin D levels of 24 children without asthma, 26 children with moderate asthma and 36 with severe therapy-resistant asthma. The team found that boys and girls with STRA had significantly lower levels of vitamin D, more frequent attacks, greater usage of asthma medications, increased airway muscle tissue mass and worse lung function in comparison with the other groups.
The study is the first to evaluate the impact of vitamin D status in children with STRA. "Little is known about vitamin D status and its effect on asthma pathophysiology in these patients," Dr. Gupta noted. "For our study, we hypothesized that children with STRA would have lower levels of vitamin D than moderate asthmatics, and that lower levels of vitamin D would be associated with worse lung function and changes in the airway muscle tissue."
"Our results suggest that detecting vitamin D deficiency in children with STRA, and then treating that deficiency, may help prevent or reduce the structural changes that occur in the airway smooth muscle, which in turn may help reduce asthma-related symptoms and improve overall lung function," he added. “The determination of the exact mechanism between low vitamin D and airway changes that occur in STRA will require intervention studies. Hopefully, the results of this and future studies will help determine a new course of therapy that will be effective in treating these children."
Soy peptide aids in blocking metastasis
An article published online on September 10, 2011 in the journal Cancer Letters describes the discovery of Elvira Gonzalez de Mejia and Vermont P. Dia of the University of Illinois in Urbana of a benefit for lunasin, a peptide that occurs in soy, in preventing the spread of colon cancer to the liver, the predominant site of metastasis for this type of cancer. "When lunasin was used in combination with the chemotherapy drug oxaliplatin, we saw a sixfold reduction in the number of new tumor sites," revealed Dr de Mejia, who is an associate professor of food chemistry and food toxicology at UI.
The current study utilized mice bred to develop colon cancer that metastasizes to the liver. The researchers divided the animals to receive daily injections of lunasin, lunasin plus the chemotherapy drug oxaliplatin, oxaliplatin alone or neither compound. "The group that received lunasin alone had 50 percent fewer metastatic sites,” reported Dr de Mejia. “But an even more exciting result was seen in the group that received both lunasin and the chemotherapy drug—only 5 new cancer sites when compared with 28 in the control group.”
"This huge reduction in metastasis was achieved with the amount of lunasin in only 25 daily grams of soy protein, the amount recommended in the FDA health claim," noted Dr Dia, who is a University of Illinois postdoctoral fellow. "In this study, we have learned that lunasin can penetrate the cancer cell, cause cell death, and interact with at least one type of receptor in a cell that is ready to metastasize."
"Two glasses of soy milk a day generally provide half the amount of lunasin used in our study," Dr de Mejia remarked. "It certainly seems feasible to create a lunasin-enriched product that people could consume in a preventive way."
Spice up that boring broccoli for greater benefit
If you’ve ever thought that the piece of broccoli on your plate needed a little extra “something,” chances are you’re right, according to a report published on September 13, 2011 in the British Journal of Nutrition.
Broccoli contains glucoraphanin, which converts in the body to a compound known as sulforaphane. Sulforaphane is an isothiocyanate that is responsible for broccoli’s cancer-preventive benefit. While the gut’s flora enable the release of sulforaphane in the lower intestine, it is necessary for glucoraphanin to be hydrolyzed by the enzyme myrosinase in order for sulforaphane to be released in the upper intestine. Myrosinase is found in broccoli sprouts, mustard, horseradish and other foods, but is deficient in some powdered broccoli supplements.
Researchers at the University of Illinois at Urbana-Champaign evaluated the absorption of a glucoraphanin-rich broccoli powder alone and in combination with fresh broccoli sprouts. Four men were assigned to consume four meals enhanced with broccoli powder, broccoli sprouts, broccoli powder and sprouts, or neither, after which sulforaphane metabolites were measured in blood and urine.
Plasma isothiocyanate levels were higher one-half hour after meals containing broccoli sprouts alone or in combination with broccoli powder. Isothiocyanates peaked in blood plasma after the consumption of broccoli with sprouts in half the time as that determined for broccoli or sprouts alone, and levels were higher than those measured after the other meals. The highest urinary sulforaphane metabolite levels were observed following the consumption of both broccoli and broccoli sprouts.
"Here's another benefit of protecting and enhancing the myrosinase in your foods," stated coauthor Elizabeth H. Jeffrey. "If myrosinase is present, sulforaphane is released in the ileum, the first part of your digestive system. Absorption happens well and quickly there, which is why we saw bioactivity in 30 minutes."
"To get this effect, spice up your broccoli with broccoli sprouts, mustard, horseradish, or wasabi,” she recommended. “The spicier, the better; that means it's being effective."
White fruit/vegetable consumption associated with lower risk of stroke
While the value of a rainbow diet that emphasizes richly pigmented plant foods has been recently touted for its health benefits, researchers from the Netherlands report online in Stroke: Journal of the American Heart Association the finding of a reduced risk of stroke among those who consume high amounts of fruit and vegetables with white flesh. The study is the first to evaluate the association of fruit and vegetable colors with stroke risk.
Linda M. Oude Griep, MSc and her colleagues evaluated dietary questionnaire responses of 20,069 adults with an average age of 41 to obtain information on the color of fruit and vegetables consumed. Color was classified as green, orange/yellow, red/purple or white.
Over a ten year follow-up, 233 strokes occurred. For those who had a high intake of white fruit and vegetables, such as apples, pears and cauliflower, the risk of stroke was 52 percent lower than those whose intake was low. Each 25 gram per day increase in white fruit and vegetable intake was associated with a 9 percent lower risk.
"To prevent stroke, it may be useful to consume considerable amounts of white fruits and vegetables," suggested Dr Griep, who is a postdoctoral fellow in human nutrition at Wageningen University. "For example, eating one apple a day is an easy way to increase white fruits and vegetable intake. However, other fruits and vegetable color groups may protect against other chronic diseases. Therefore, it remains of importance to consume a lot of fruits and vegetables."
"It may be too early for physicians to advise patients to change their dietary habits based on these initial findings," she added.
Lifestyle improvements and heart disease treatment may be better than drugs for ED
The results of a review published online on September 12, 2011 in the Archives of Internal Medicine reveal that engaging in beneficial lifestyle practices and obtaining treatment for cardiovascular disease risk factors significantly improve erectile dysfunction (ED) in middle aged men. The meta-analysis is the first, to the author’s knowledge, to evaluate the effect of lifestyle interventions and cardiovascular risk factor reductions on the condition.
Researchers at the Mayo Clinic in Rochester, Minnesota selected six randomized clinical trials that included a total of 740 men with an average age of 55.4 years for their analysis. The trials evaluated the effects of exercise and lifestyle change, a Mediterranean diet, an interval exercise program, weight loss and treatment with the drug atorvastatin on cardiovascular risk factors. Erectile dysfunction was evaluated via questionnaire responses.
The analysis affirmed that improvements in cardiovascular risk factors were associated with a reduction in erectile dysfunction. Separate analyses of lifestyle and drug treatment were also both associated with a significant benefit.
“Therapies currently used for the treatment of ED include oral therapy with phosphodiesterase type 5 (PDE-5) inhibitors, which are highly effective in the treatment of ED,” the authors write. “However, we demonstrate that cardiovascular risk factor reduction improves ED even in men who are not responsive to PDE-5 inhibitors.”
“Our findings suggest that cardiovascular risk factor reduction provides incremental benefits in ED well beyond that achieved with the use of PDE-5 inhibitors,” they add. “Adoption of lifestyle modifications and cardiovascular risk factor reduction will provide incremental benefit regardless of PDE-5 inhibitor use.”
Alpha-lipoic acid slows neuropathy progression
The results of a trial published in the journal Diabetes Care suggest that supplementing with alpha-lipoic acid (ALA) could help retard the progression of diabetic distal symmetric sensorimotor polyneuropathy (DSPN), a condition that affects an estimated one-third of those with diabetes.
The Neurological Assessment of Thioctic Acid in Diabetic Neuropathy (NATHAN) 1 trial was a multicenter, randomized, double-blinded trial which compared the effects of four years of daily supplementation with 600 milligrams alpha-lipoic acid to a placebo on the progression of DSPN. The desired end point of the trial was a change in the combined scores for the Neuropathy Impairment Score (NIS), NIS-Lower Limbs and seven neurophysiologic tests.
At the end of the treatment period, the combined scores of the group that received alpha-lipoic acid improved and combined scores for the placebo group worsened, but the difference was not considered significant. However, when individual test scores were compared, the Neuropathy Impairment Score significantly improved among the participants that received lipoic acid and worsened for subjects who received the placebo, while the differences reached borderline significance for the NIS Lower Limbs. A greater number of those who received lipoic acid showed clinically meaningful improvement compared to those in the placebo group.
“The lack of improvement in the composite score was predominantly due to the fact that nerve conduction deficits in the placebo-treated group did not progress,” the authors remark. “Thus, secondary prevention of progression of the composite end point by treatment with ALA was not readily achievable.”
“In conclusion, four-year treatment with ALA in mild-to-moderate diabetic distal symmetric sensorimotor polyneuropathy was well tolerated and was associated with improvement of neuropathic impairments but not nerve conduction attributes,” they write.
Asthma benefit for vitamin C
An article published on August 25, 2011 in Clinical and Translational Allergy reports a positive effect for vitamin C supplementation in asthmatic children.
In a cross-over trial, 60 children between the ages of 7 and 10 with asthma were given 200 milligrams vitamin C, zinc, omega-3 fatty acids, a combination of the three supplements or a placebo daily for six weeks. After a two week period during which no supplements were given, the participants were switched to a new regimen, until all children had received each treatment. Questionnaires assessed asthma severity at the beginning of the study and at the end of each phase of treatment, and pulmonary function was tested via spirometry. Additionally, the parents were questioned on the presence of mold or dampness in the children’s bedrooms.
While supplementation with vitamin C was associated with an average increase of 29 percent in forced expiratory volume per one second (FEV1), which is a measure of pulmonary function, there was significant difference among the participants according to age and level of mold exposure. Children aged 7 to 8.2 years who had no exposure to dampness or mold experienced a 37 percent increase FEV1, while this measure increased by just 21 percent in those between the ages of 8.3 and 10 years whose parents reported mold and dampness in their children’s rooms. When symptom questionnaire responses were analyzed, children aged 7 to 8.2 years with mild asthma symptoms were found to have experienced the greatest benefit from the vitamin, while older subjects whose symptoms were severe benefitted least.
“It would seem important to carry out further research to confirm our findings and more accurately identify the groups of children who would receive the greatest benefit from vitamin C supplementation,” the authors write.