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  • Berries, cocoa, red wine could lower risk of early mortality in Parkinson’s disease
  • Vitamin D and fish oil supplementation associated with lower autoimmune disease risk
  • Food as medicine
  • Fish oil users have lower risk of liver cancer
  • Digestion aided by coffee
  • T cells need magnesium
  • Ginger supplementation associated with lower BP, blood glucose
  • Modified citrus pectin associated with halt in prostate cancer progression
  • Higher serum magnesium associated with greater brain volume, lower risk of cerebrovascular disease
  • Greater olive oil intake associated with reduced risk of death from major diseases
  • Benefit-risk ratio may be best basis for aspirin prescribing
  • Reactive oxygen species influence Alzheimer progression in research models
  • Trial affirms arginine benefit in ED


    Berries, cocoa, red wine could lower risk of early mortality in Parkinson’s disease

    Berries, cocoa, red wine could lower risk of early mortality in Parkinson’s disease January 31 2022. On January 26, 2022, Neurology® reported the finding of a lower risk of premature mortality among Parkinson disease patients who consumed higher amounts of plant compounds known as flavonoids, such as anthocyanins that occur in red wine, compared to Parkinson patients with a lesser intake.

    The study included 599 women enrolled in the Nurses’ Health Study and 652 men who participated in the Health Professionals Follow-up Study who were diagnosed with Parkinson disease during the studies’ follow-up periods. Dietary questionnaires completed upon enrollment and every four years thereafter were evaluated for the intake of total flavonoids and flavonoid-rich foods, including apples, berries, oranges, red wine and tea.

    When men and women who were among the top 25% of flavonoid consumers were compared to those whose intake was among the lowest 25%, they were found to have a 30% lower risk of mortality during follow-up. The effect was stronger among men.

    Those who had the highest intake of anthocyanin, flavone and flavan-3-ol flavonoid subclasses prior to being diagnosed with Parkinson disease had 34%, 22% and 31% lower respective risks of mortality compared to participants whose intake of these flavonoids was among the lowest 25%. When individual foods were examined, more than three servings per week of berries was associated with a 23% lower risk of mortality compared to less than one serving per month, and more than three servings per week of red wine was associated with a 32% lower risk.

    “Flavonoids are antioxidants, so it’s possible they could be lowering chronic neuroinflammation levels,” first author Xinyuan Zhang stated. “It’s also possible they may interact with enzyme activities and slow neuron loss and could protect against cognitive decline and depression, which are both associated with higher mortality risk.”


    —D Dye


    Vitamin D and fish oil supplementation associated with lower autoimmune disease risk

    Vitamin D and fish oil January 28 2022. A trial reported on January 26, 2022 in the BMJ found that daily supplementation with vitamin D with or without fish oil is associated with a lower risk of developing autoimmune diseases, which occur when the immune system mistakenly attacks normal cells, among older men and women. Common autoimmune diseases include rheumatoid arthritis, psoriasis and some thyroid diseases.

    The study included 25,871 participants in the Vitamin D and Omega-3 Trial whose age averaged 67 years. Daily treatment regimens consisted of 2,000 IU vitamin D plus 1,000 mg omega-3 fatty acids from fish oil, vitamin D and a placebo, omega-3 and a placebo, or a placebo alone. Confirmed and probable cases of autoimmune diseases were documented during a 5.3-year average follow-up.

    Participants in the vitamin D group had a 22% lower risk of being diagnosed with an autoimmune disease than the placebo group. Although a statistically insignificant 15% reduction in risk occurred among the group that received omega-3, inclusion of probable cases in the analysis resulted in a significant 18% reduction. When autoimmune diseases diagnosed after two years of trial participation were evaluated, participants who received vitamin D had a 39% lower risk and those who received omega-3 had a 10% lower risk than the placebo. Consuming both was associated with a 30% reduction.

    “Now, when my patients, colleagues, or friends ask me which vitamins or supplements I’d recommend they take to reduce risk of autoimmune disease, I have new evidence-based recommendations for women age 55 years and older and men 50 years and older,” stated senior author Karen Costenbader, MD, MPH.

    “We are continuing to follow participants for two years in an extension study to test the time course of this autoimmune disease reduction effect,” the authors noted.


    —D Dye


    Food as medicine

    Food as medicine January 26 2022. The oft-heard adage “Let food be thy medicine” appears to be valid advice according to the results of a first of its kind study published on January 26, 2022 in the Journal of Nutrition.

    “Based on the outcomes seen in our study, using this type of food as medicine approach expands the options for medical professionals and patients,” first author Stephen Kopecky, MD, FACC, of the Mayo Clinic commented. “Many patients who are unwilling or unable to take statin drugs may be able to help manage their high cholesterol, or hyperlipidemia with a realistic food-based intervention.”

    The crossover study included 54 men and women with elevated low-density lipoprotein (LDL) cholesterol levels, which are associated with an increased risk of cardiovascular disease. For the first four-week phase, participants substituted some foods with whole food-based snacks made from ingredients associated with healthy lipids or similar grocery store brand control snacks considered to be nutritious. A subsequent period during which no study snacks were given was followed by another four-week phase in which each group of participants was provided with the type of food items they did not receive during the initial phase. Lipid levels and other factors were measured before and after each treatment period.

    In comparison with the control snacks, total cholesterol was lowered by an average of 5.08% and LDL cholesterol was reduced by an average of 8.8% in association with the whole food snacks.

    “Nutrition contributes to 5 of the 7 modifiable risk factors for heart disease, but getting patients to change diet is incredibly challenging,” noted coauthor Elizabeth Klodas MD, FACC. “This study underscores what’s possible when we succeed. The implications of attaining such a significant cholesterol impact from a small food-based intervention are profound. We could change the health of our country in 30 days.”


    —D Dye


    Fish oil users have lower risk of liver cancer

    Fish oil users have lower risk of liver cancer January 24 2022. Findings from a study published on December 31, 2021 in Frontiers in Nutrition revealed a significantly lower risk of liver cancer among people who supplemented with fish oil compared to nonusers.

    The study included 434,584 middle-aged and older men and women enrolled in the UK Biobank who were free of cancer upon enrollment. Participants were queried concerning fish oil use in questionnaires completed at the beginning of the study. Cancer registry data reported cases diagnosed during a median follow-up period of 7.8 years.

    Two hundred sixty-two cases of liver cancer were diagnosed, including 127 cases of hepatocellular carcinoma (the most common liver cancer) and 110 cases of intrahepatic cholangiocarcinoma. Compared to those who did not use fish oil, fish oil users had a 44% lower risk of liver cancer, a 52% lower risk of hepatocellular carcinoma  and a 40% lower risk of intrahepatic cholangiocarcinoma.

    When the intake of oily fish was examined, participants who consumed two or more servings per week had a 54% lower risk of hepatocellular carcinoma than those who consumed less than one serving per week.

    “To the best of our knowledge, no previous studies have evaluated the relationship between fish oil supplements and risk of liver cancer,” authors Wei Jiang and colleagues wrote. “In a large population-based prospective study of UK men and women, habitual use of fish oil supplements reported at baseline was associated lower risk of liver cancer and its major histological subtypes including hepatocellular carcinoma and intrahepatic cholangiocarcinoma after approximately 8 years.”

    “Additional studies of fish oil supplements, such as randomized controlled trials conducted among high-risk patients (e.g., liver fibrosis/cirrhosis), may help elucidate the clinical relevance of fish oil supplements in the treatments of risk factors and the primary prevention of liver cancer.”


    —D Dye


    Digestion aided by coffee

    Digestion aided by coffee January 21 2022. If you need yet another reason to enjoy a cup of coffee, a review that appeared on January 18, 2022 in the journal Nutrients reported that the beverage stimulates digestive processes, helps protect against gallstones and is associated with a lower risk of liver diseases, including the most common type of liver cancer.

    The review was conducted by Astrid Nehlig, PhD, Emeritus Research Director at the French National Institute of Health and Medical Research (INSERM).

    Coffee stimulates the secretion of gastric acid in the stomach as well as gallbladder and pancreatic secretions involved in digestion. Coffee also improves the composition of intestinal microbiota, including Bacteroides, Prevotella and Bifidobacteria that can impact digestion. It additionally stimulates colon motility (which moves food through the intestine) and may be associated with less chronic constipation.

    Individual studies and meta-analyses have revealed a lower risk of gallstone disease among coffee drinkers. When liver diseases were examined, a large study revealed a link between coffee consumption and a lower risk of viral hepatitis, alcohol-associated liver disease or cirrhosis, and nonalcoholic fatty liver disease. Hepatocellular carcinoma, which is the most prevalent form of liver cancer, was shown in several analyses to have a lower incidence among coffee drinkers.

    The review concluded there are no harmful effects on digestive tract organs in association with drinking coffee.

    “Contrary to some assumptions, coffee consumption is not overall linked to bowel or digestive problems,” Dr Nehlig observed. “In some instances, coffee has a protective effect against common digestive complaints such as constipation. Emerging data also indicate there may be an association with improved levels of gut bacterial groups such as Bifidobacteria which have recognized beneficial effects. Although additional data will be needed to understand coffee’s effects throughout the digestive tract, this is an extremely encouraging place to begin.”


    —D Dye


    T cells need magnesium

    T cells need magnesium January 19 2022. Researchers at the University of Basel reported the discovery that T cells, which are a variety of immune system cells that fight pathogens and cancer cells, function efficiently only in an environment that contains sufficient magnesium. The finding was published on January 11, 2022 in the journal Cell.

    In animal studies, deficient levels of magnesium have been associated with infections and cancer. Professor Christoph Hess, of the University of Basel’s Department of Biomedicine and colleagues found that magnesium is needed by a surface protein on T cells known as LFA-1, which acts as a docking site to activate T cells so that they can eliminate abnormal or infected cells efficiently. “In the inactive state this docking site is in a bent conformation and thus cannot efficiently bind to infected or abnormal cells,” Dr Hess explained. “This is where magnesium comes into play. If magnesium is present in sufficient quantities in the vicinity of the T cells, it binds to LFA-1 and ensures that it remains in an extended – and therefore active – position.”

    The discovery could be important for immunotherapies that stimulate the immune system to battle cancer cells. The research team demonstrated that T cell response against cancer cells was increased in association with a boost in tumor magnesium content. “In order to verify this observation clinically, we’re now looking for ways to increase the concentration of magnesium in tumors in a targeted manner,” Dr Hess stated.

    Further investigation using data from studies of cancer patients revealed that immunotherapies were less effective among those who had insufficient blood magnesium compared to patients with higher levels.

    “As a next step, we’re planning prospective studies to test the clinical effect of magnesium as a catalyst for the immune system,” Dr Hess added.


    —D Dye


    Ginger supplementation associated with lower BP, blood glucose

    Modified citrus pectin associated with halt in prostate cancer progression January 17 2022. Results from a systematic review and meta-analysis reported on January 11, 2022 in Complementary Therapies in Medicine revealed lower blood pressure, fasting glucose and hemoglobin A1c (HbA1c, a marker of long-term glucose control) in association with ginger supplementation.

    “Ginger is considered as a safe and complementary therapy with reductive effect on inflammation, which is the crucial risk factor of several diseases, in healthy individuals and in patients, in particular those with chronic diseases and gastrointestinal disorders,” Armin Ebrahimzadehof Kashan University of Medical Sciences and colleagues noted.

    For their meta-analysis, the authors selected 10 randomized controlled trials that investigated the effects of ginger on blood glucose, HbA1c, blood pressure and lipids among type 2 diabetes patients. Supplements included ginger root, capsules or tablets, in doses that ranged from 1,200 to 3,000 mg per day for durations of 8 to 13 weeks.

    The meta-analysis indicated a reduction in fasting blood glucose and HbA1c among participants who received ginger supplements compared to the control groups. Systolic and diastolic blood pressure were also reduced. No differences in lipids were found between participants who received ginger and the control groups. However, a significant reduction in triglycerides was determined among studies with less than 60 participants, and reductions in total and LDL cholesterol were found in studies with durations of more than 11 weeks and less than 11 weeks, respectively.

    “To the best of our knowledge, this is the first comprehensive meta-analysis investigating effects of ginger supplementation on metabolic profiles in patients with type 2 diabetes mellitus,” the authors announced. “Our study indicated that ginger supplementation reduced fasting blood sugar, HbA1C and BP in patients with type two diabetes mellitus, with no significant changes in lipid profiles.”


    —D Dye


    Modified citrus pectin associated with halt in prostate cancer progression

    Modified citrus pectin associated with halt in prostate cancer progression January 14 2022. A prospective phase II study reported on November 28, 2021 in Nutrients found that supplementing with modified citrus pectin was associated with a reduction in markers of prostate cancer progression.

    The study included 59 men with nonmetastatic biochemically relapsed prostate cancer, which is characterized by a rising prostate-specific antigen (PSA) level after treatment with surgery or radiotherapy. Participants received 4.8 grams modified citrus pectin three times per day for six months. Blood samples collected at the beginning of the study and at monthly follow-up assessments were analyzed for serum PSA and other factors.

    Fifty-eight percent of the participants had a decreased or stable PSA by the end of the six-month treatment period. PSA doubling time, another marker of progression, improved among 75% of the men compared to values obtained at the beginning of the study. Twenty-seven percent of the men improved their category of risk (poor, intermediate or high) as determined by PSA doubling time values. Positron emission tomography-prostate-specific membrane antigen (PET-PSMA) scans conducted at this time identified cancerous lesions in 5%.

    Participants with negative scans, stable PSA or improved PSA doubling time entered a second, 12-month treatment phase. At six months, PSA progression had occurred among 17% and PSA progression plus progression as determined by PET-PSMA scans in 5%.

    “The present study suggests that modified citrus pectin in biochemically relapsed prostate cancer has a potential benefit and is safe, as evident by changes in PSA doubling time, lower than expected rates of disease progression compared to historical data, and no significant toxicity,” authors Daniel Keizman and colleagues wrote. “This compound may be particularly interesting for delaying disease progression in a group of patients with relatively low disease burden states, such as in nonmetastatic biochemically relapsed prostate cancer.”


    —D Dye


    Higher serum magnesium associated with greater brain volume, lower risk of cerebrovascular disease

    Higher serum magnesium associated with greater brain volume, lower risk of cerebrovascular disease January 12 2022. On December 16, 2022, Nutrients published the finding of an association between higher serum magnesium levels and greater brain volume as well as a lower incidence of subclinical cerebrovascular disease, associated with stroke.

    The study included 1,466 participants in the Atherosclerosis Risk in Communities Neurocognitive Study with no history of stroke who had serum magnesium measurements and MRI scan results obtained during 2011-2013. The subjects’ age averaged 76.2 years. Researchers Aniqa B. Alam of the Department of Epidemiology at Emory University School of Public Health and colleagues assessed differences in brain lobe, deep grey matter, total brain and white matter hyperintensity volumes and the prevalence of infarcts indicative of cerebrovascular disease.

    Compared to men and women whose magnesium levels were among the lowest one-fifth of participants, those among the highest fifth had greater total brain volumes as well as frontal, temporal and parietal lobe volumes. Serum magnesium among the top fifth was associated with a 56% lower risk of subcortical infarcts, indicating less cerebrovascular disease.

    “We found elevated serum magnesium to be associated with greater brain volumes and lower odds of subclinical cerebrovascular disease compared to those with low circulating magnesium, potentially implicating protection against neuronal degeneration and cerebrovascular disease as mechanisms responsible for the lower risk of dementia in those with higher circulating magnesium,” the authors wrote. “These findings should be confirmed in well-designed prospective analyses, with particular focus on evaluating the potential of interventions aimed at increasing circulating magnesium for the prevention of neurodegeneration and cerebrovascular disease. Given the established effect of oral magnesium supplementation on circulating magnesium concentrations, these interventions have the potential to make a significant impact on the prevention of dementia, a major contributor to the burden
    of disease in the population.”


    —D Dye


    Greater olive oil intake associated with reduced risk of death from major diseases

    Greater olive oil intake associated with reduced risk of death from major diseases January 10 2022. Consuming over half a tablespoon of olive oil per day is associated with a lower risk of dying from cancer as well as cardiovascular, neurodegenerative and respiratory diseases, according to a study reported on January 10, 2022 in the Journal of the American College of Cardiology.

    The investigation included 60,582 women enrolled in the Nurses’ Health Study and 31,801 men who participated in the Health Professionals Follow-up Study. All subjects were free of cardiovascular disease and cancer at the beginning of the study. Information concerning olive oil intake was obtained from dietary questionnaires administered every four years during a 28-year follow-up period.

    During follow-up, 22,768 participants in the Nurses’ Health Study and 14,076 participants in the Health Professionals Follow-up Study died. Compared to men and women who rarely or never consumed olive oil, those whose intake was highest at over 7 grams per day (over one-half tablespoon) had a 17% lower risk of cancer mortality, 19% lower risk of cardiovascular mortality, 29% lower risk of neurodegenerative disease mortality and 18% lower risk of dying from respiratory illnesses. Substituting 10 grams per day of fats other than vegetable oil with olive oil was also associated with a lower risk of total and cause-specific mortality.

    “Our findings support current dietary recommendations to increase the intake of olive oil and other unsaturated vegetable oils,” stated lead author Marta Guasch-Ferré, PhD, of Harvard T.H. Chan School of Public Health. “Clinicians should be counseling patients to replace certain fats, such as margarine and butter, with olive oil to improve their health. Our study helps make more specific recommendations that will be easier for patients to understand and hopefully implement into their diets.”


    —D Dye


    Benefit-risk ratio may be best basis for aspirin prescribing

    Benefit-risk ratio may be best basis for aspirin prescribing January 7 2022.The US Preventive Services Task Force’s most recent guideline recommends that the use of aspirin for the primary prevention of cardiovascular disease (CVD) be restricted to individuals younger than 60 years. However, a Perspective published in the November 2021 issue of Family Medicine and Community Health recommends evaluation of potential benefits and risks of aspirin for the prevention of CVD rather than patient age as the basis for prescribing the drug.

    Sarah K. Wood and colleagues observed that the most comprehensive meta-analysis of trials that evaluated aspirin in the prevention of CVD found a 12% reduction in risk. “The absolute benefits generally outweighed the absolute risks when the 10-year risk of a first CVD event was greater than 10%,” they noted. “The benefits of aspirin on CVD in patients over 60 or 70 years were not significantly decreased.”

    By updating the meta-analysis with the addition of four recent trials, a 13% reduction in risk was observed with similar benefits at older ages.

    “Guidelines and guidance based on age are intrinsically contradictory because aspirin is recommended, on the one hand, only for higher risk primary prevention subjects, but on the other, not over age 60 or 70 where the absolute risks of cardiovascular disease are much higher than at younger or middle ages,” Dr Wood and colleagues wrote.

    They remarked that poor patient adherence may have contributed to the failure to detect a significant benefit for aspirin that was reported for older adults in some trials.

    “Any judgments about prescribing long-term aspirin therapy for apparently healthy individuals should be based on individual clinical judgments between the health care provider and each of his or her patients that weighs the absolute benefit on clotting against the absolute risk of bleeding,” Dr Wood recommended.


    —D Dye


    Reactive oxygen species influence Alzheimer progression in research models

    Reactive oxygen species influence Alzheimer progression in research models January 5 2022. The December 28, 2021 issue of the Proceedings of the National Academy of Sciences reported the discovery of how a genetic variation disrupts a mechanism in the brain that protects against neurodegeneration, and how reactive oxygen species (ROS), a type of free radical that causes damaging oxidative stress, accelerate the process.

    “Two brain cell types, neurons and glia, work together to protect against neurodegeneration,” explained first author Matthew Moulton. “We worked with fruit fly and mammal models to investigate whether known genetic risk factors for Alzheimer’s disease were associated with disturbing the protective mechanism.”

    When neurons are exposed to high levels of ROS, such as occur during aging, they produce an increased amount of lipids (fats), which interact with ROS to form damaging peroxidated lipids. Neurons have a protective mechanism through which apolipoproteins transport peroxidated lipids to glia cells, where they are stored.

    Having a variant of the gene APOE, which directs the formation of the protein apolipoprotein E, results in a form of apolipoprotein that has a poor ability to transfer these lipids, which explains some of the greater risk of Alzheimer disease associated with the variant, known as APOE4. However, the research team determined that another gene restored this lipid transport ability.

    Other investigation found that ROS increased the effects of amyloid-beta, the substance that forms plaques in the brain of in Alzheimer disease patients. “We observed that ROS and amyloid-beta together increased neuronal death in fruit flies and resulted in larger and more numerous amyloid-beta-rich plaques in a mouse model, suggesting that, indeed, ROS and amyloid-beta can interact and potentially influence disease progression,” Dr Moulton reported.

    “Our findings support further investigations into feasible means to reduce the levels of ROS in the brain as a strategy to minimize ROS’s key contribution to neurodegeneration,” senior author Hugo Bellen concluded.


    —D Dye


    Trial affirms arginine benefit in ED

    Trial affirms arginine benefit in ED January 3 2022. A trial reported January 1, 2022 in the Journal of Endocrinological Investigation added evidence to a benefit for supplementation with the amino acid L-arginine among men with erectile dysfunction (ED). The findings suggest that L-arginine could serve as an alternative to PDE5 inhibitor drugs used to treat ED which are not always effective or can be associated with side effects.

    The trial included 98 men aged 20 to 73 years with vasculogenic ED, which occurs when arteries or veins that deliver blood to and from the penis malfunction due to narrowing, blockage or other causes. Fifty-one men received two grams L-arginine three times per day and 47 received a placebo for three months. Questionnaires administered at the beginning and end of the study provided scores that categorized erectile function as absent, mild, mild-moderate, moderate or severe. Ultrasonographic examinations of the penis conducted at these time points obtained measurements of penile cavernous arteries peak systolic flow velocity (PSV), which was categorized as mild-moderate or severe.

    At the end of the trial, men who received arginine had significant improvement in their questionnaire scores while scores among the placebo group were unchanged. ED category improved among 74% of treated participants and 24% achieved scores indicating an absence of the condition.

    Arginine supplementation was associated with significantly improved PSV in mild-moderate, but not severe ED, while PSV was unchanged in the placebo group at the end of the trial.

    “Taking into account the concept that nutraceuticals are considered safer and are generally less costly than PDE5 inhibitors, these agents might represent a valid therapeutic alternative in the treatment of ED, particularly for the treatment of non-severe or at least mild ED, or ED unresponsive to PDE5 inhibitors, or in case of intolerance to PDE5 inhibitors,” the authors concluded.


    —D Dye


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