Research Highlights - January

Nutrition Reviews

• Low zinc status may be a risk factor for pneumonia in the elderly. The magnitude of the problem of pneumonia (its prevalence, morbidity, and mortality) in the elderly, pneumonia's etiology, and the dysregulation of the immune system associated with increasing age is growing. Recent evidence demonstrates that low zinc status (commonly reported in the elderly) impairs immune function, decreases resistance to pathogens, and is associated with increased incidence and duration of pneumonia, increased use and duration of antimicrobial treatment, and increased overall mortality in the elderly. Inadequate stores of zinc might, therefore, be a risk factor for pneumonia in the elderly.

American Journal Clinical Nutrition

• Two reports, which are based largely on National Health and Nutrition Examination Survey (NHANES) data for the 2003–2006 time period, show how the Food and Drug Administration (FDA) models of exposure, which preceded the 1996 mandate that enriched flour be fortified with 140 µg folic acid per 100 g flour to prevent neural tube defect births, got the folic acid dose right. This mandate increased folic acid exposure in women of childbearing age without excessive exposure to those beneficiaries and others in the population. The documentation in these 2 articles of the remarkable predictive value of those models over a decade ago is testimony to the value of prefortification modeling and, at once, a resounding argument for the benefit of such national health and dietary surveys such as NHANES on which the models and their validation is based.

• Trans Fat intake should be reduced as much as possible because of its adverse effects on lipids and lipoproteins. The replacement of Trans Fat with Stearic Acid compared with other saturated fatty acids in foods that require solid fats beneficially affects LDL cholesterol, the primary target for CVD risk reduction; unsaturated fats are preferred for liquid fat applications. Research is needed to evaluate the effects of Stearic Acid on emerging CVD risk markers such as fibrinogen and to understand the responses in different populations. Steve - stearic acid is often use as a stabilizer in dietary supplements.

• Multiple micronutrient supplementation may be associated with a marginal increase in fluid intelligence and academic performance in healthy schoolchildren but not with crystallized intelligence. More research is required, however, before public health recommendations can be given.

Journal Nutrition

• Acute intake of a omega-3 fatty acids shifted the balance between plasma PAI-1 and t-PA, which might indicate a lower capacity for fibrinolysis.

• Higher vitamin B-6 intakes were linked to protection against inflammation and the vitamin B-6 intake associated with maximum protection against vitamin B-6 inadequacy was increased in the presence compared to absence of inflammation.

Journal of the American Dietetic Association

• The use of digital images for assessing accuracy of portion size for some food forms, digital images of mounds or household measures are as accurate as images of food and, therefore, are a cost-effective alternative to photographs of foods.

Food and Chemical Toxicology

• Pesticide residues have been found in various fruits and vegetables; both raw and processed. One of the most common routes of pesticide exposure in consumers is via food consumption. Most foods are consumed after passing through various culinary and processing treatments. A few literature reviews have indicated the general trend of reduction or concentration of pesticide residues by certain methods of food processing for a particular active ingredient. In this study, reduction of residue levels was indicated by blanching, boiling, canning, frying, juicing, peeling and washing of fruits and vegetables with an average response ratio ranging from 0.10 to 0.82. Baking, boiling, canning and juicing indicated both reduction and increases for the 95% and 99.5% confidence intervals.

Use of Dietary Supplements in Elderly People

Investigators in a Journal American Geriatric Society study found that 82.5% of patients used at least 1 dietary supplement, and 54.5% used 3 or more. The average number of prescription medications used per patient was 3.5; the average number of supplements was 3.4. The majority (83%) of prescription medication users also used supplements. No difference was found in supplement or prescription use with respect to sex or age. A weak correlation between the number of prescription medications used and number of supplements used was identified. Classes of prescription drugs most frequently coadministered with supplements were nonsteroidal anti-inflammatory drugs, thyroid medications, and estrogens.

Bonnie - this study stresses the importance of working with a licensed professional to determine potential contraindications between supplements and medications.

What it also tells you is that most elderly are taking supplements.

Chlorophyll Effective Against Aflatoxin

A new study has found that chlorophyll and its derivative chlorophyllin are effective in limiting the absorption of aflatoxin in humans. Aflatoxin is produced by a fungus that is a contaminant of grains including corn, peanuts and soybeans; it is known to cause liver cancer -- and can work in concert with other health concerns, such as hepatitis and anaphylaxis. Results of the study were just published in the journal Cancer Prevention Research.

Bonnie - this could be an exciting discovery with more data in clinical trials.

No Benefit of Ginkgo Biloba for Age-Related Cognitive Decline

Results of a randomized trial show no effect of ginkgo biloba supplements on the rate of cognitive decline in adults with either normal cognition or mild cognitive impairment. The Ginkgo Evaluation of Memory (GEM) study, a large randomized trial, showed that use of the popular herbal supplement in a dose of 120 mg twice daily was no different than placebo in terms of cognitive outcomes during a median follow-up of 6 years. "There were changes of normal aging in the general testing and in all 4 cognitive domains, but there was no separation between the 2 curves; they were virtually completely superimposable," said senior author Steven T. DeKosky, MD, from the University of Pittsburgh, Pennsylvania. The study is published in the Journal of the American Medical Association.

Steve - this is not a surprise. Many other studies prior to this one has shown the same results. We have not recommended this supplement for cognitive decline for many years.

Tai Chi reduces knee pain

Researchers from Tufts University School of Medicine have determined that patients over 65 years of age with knee osteoarthritis (OA) who engage in regular Tai Chi exercise improve physical function and experience less pain. Tai Chi (Chuan) is a traditional style of Chinese martial arts that features slow, rhythmic movements to induce mental relaxation and enhance balance, strength, flexibility, and self-efficacy. according to a study in Arthritis Care & Research.

40 patients with confirmed knee OA, mean age of participants was 65 years with a mean body mass index of 30, were randomly selected and 20 were asked to participate in 60-minute Yang style Tai Chi sessions twice weekly for 12 weeks. The remaining 20 participants assigned to the control group attended two 60-minute class sessions per week for 12 weeks. Each control session included 40 minutes of instruction covering OA as a disease, diet and nutrition, therapies to treat OA, or physical and mental health education. The final 20 minutes consisted of stretching exercises involving the upper body, trunk, and lower body, with each stretch being held for 10–15 seconds.

At the end of the 12-week period, patients practicing Tai Chi exhibited a significant decrease in knee pain compared with those in the control group.

Running at any age is great exercise

One of the fastest ways to get fit is to start running. It can be daunting if you’ve never run before. Especially if you have friends, colleagues or family members who talk casually about how they run 7 miles each morning before breakfast. There are some important advantages of running as a fitness strategy:

• It boosts cardiovascular fitness.

• It tones your whole body because so many muscle groups are involved when you run.

• Weight-bearing exercise, such as running, is especially good in promoting bone density and protecting against osteoporosis, which affects men as well as women.

• Running is a natural movement.

• The body is designed to be able to run.
  
  
• As one of the most vigorous exercises out there, running is an efficient way to burn calories and drop pounds.
  

Here are some tips that will help you develop running:

1. Buy good shoes
It’s worth going to a specialty shop to buy a pair of running shoes. Make sure that the salesperson looks at the shape and arch of your foot to figure out the best shoes for you. The reason good shoes are important is because it will soften the impact and protect your joints.

2. Take it slow
When you start running, it doesn’t matter how slow you go. Remember that your body needs to get used to new movement.

3. Ease into running with interval training.
The best way to get fit fast is through interval training. This means short burst of high intensity exercise alternating with recovery periods. According to the American College of Sports Medicine, more calories are burned in short, high intensity exercise. Try alternating 5 minutes of walking and one minute of running for twenty minutes. As you get fitter, you can lengthen the periods of running. Once you get used to running, you can alternate slow jogging with fast sprints.

4. Warm up first
It’s important to warm up your body before running. Otherwise running will feel very hard and your body will moan and groan. Walking is a great way to warm up the body. Stride out and pump your arms. Start with a medium paced walk and then speed up until you start to sweat. Once your body is warm, you are ready to run.

5. Use correct running technique
Beginners like me find it difficult to relax while running. Keep your head up and your lower arms in hip height, and run without bouncing. It all helps to work your body more efficiently. Check out this video about correct running technique.

6. Run with others
A great way to keep up your motivation is to run with others. See if a colleague or a friend is willing to come running with you. Set an interval schedule for your run and stick to it.

7. Keep an exercise diary
Keep a record of your new exercise routine. Write down each day what kind of exercise you have done. A great way to track your growing fitness is by measuring your resting pulse before you get up in the morning. As you get fitter, your resting pulse will get lower.

8. Add strength exercises to the mix
Building strength in your legs will help you to run. A simple way to build your leg muscles is by doing squats. Stand with feet a little more than shoulder width apart. As you squat, keep your feet on the ground and swing your arms to the front in order to keep your balance. Start with 3 sets of 10 squats but don’t get carried away. If you do too many at one time, you might have difficulty walking the next day! As you get fitter, you can add more sets to your squat routine.

9. Add a cool-down period after exercise
It’s important for the body to cool down after running. The best way is to walk at a medium pace until your heart-rate returns to normal.

10. Stretch after running
It’s a good practice to stretch after running because it keeps your body flexible.

Junk food turns rats into addicts

Junk food elicits addictive behavior in rats similar to the behaviors of rats addicted to heroin. Pleasure centers in the brains of rats addicted to high-fat, high-calorie diets became less responsive as the binging wore on, making the rats consume more and more food. The results, presented at the Society for Neuroscience’s annual meeting, may help explain the changes in the brain that lead people to overeat. “This is the most complete evidence to date that suggests obesity and drug addiction have common neurobiological underpinnings,” says study coauthor Paul Johnson of the Scripps Research Institute in Jupiter, Fla.

To see how junk food affects the brain’s natural reward system — the network of nerve cells that release feel-good chemicals — Johnson started at the grocery store. He loaded up on typical Western fare, including Ho Hos, sausage, pound cake, bacon and cheesecake. Johnson fed rats either a standard diet of high-nutrient, low-calorie chow, or unlimited amounts of the palatable junk food.

Rats that ate the junk food soon developed compulsive eating habits and became obese. “They’re taking in twice the amount of calories as the control rats,” says Johnson’s coauthor Paul Kenny, also of Scripps. Johnson and Kenny wanted to know if this overeating affected the pleasure centers of the rats’ brains, the regions responsible for drug addiction. The researchers used electrical stimulations to activate these reward centers and induce pleasure. Rats could control the amount of feel-good stimulation by running on a wheel — the more they ran, the more stimulation they got. The rats fed junk food ran more, indicating that they needed more brain stimulation to feel good.

After just five days on the junk food diet, rats showed “profound reductions” in the sensitivity of their brains’ pleasure centers, suggesting that the animals quickly became habituated to the food. As a result, the rats ate more food to get the same amount of pleasure. Just as heroin addicts require more and more of the drug to feel good, rats needed more and more of the junk food. “They lose control,” Kenny says. “This is the hallmark of addiction.”

To see how strong the drive to eat junk food was, the researchers exposed the rats to a foot shock when they ate the high-fat food. Rats that had not been constantly exposed to the junk food quickly stopped eating. But the foot shock didn’t faze rats accustomed to the junk food — they continued to eat, even though they knew the shock was coming. “What we have are these core features of addiction, and these animals are hitting each one of these features,” Kenny says. These reward pathway deficits persisted for weeks after the rats stopped eating the junk food, the researchers found. “It’s almost as if you break these things, it’s very, very hard to go back to the way things were before,” Kenny says.

When the junk food was taken away and the rats had access only to nutritious chow (what Kenny calls the “salad option”), the obese rats refused to eat. “They starve themselves for two weeks afterward,” Kenny says. “Their dietary preferences are dramatically shifted.” Scientists are interested in determining the long-term effect of altering the reward system. “We might not see it when we look at the animal,” says obesity expert Ralph DiLeone of Yale University School of Medicine. “They might be a normal weight, but how they respond to food in the future may be permanently altered.”

Steve - Big Food is well aware of these "pleasure centers" in humans and cater to them early and often!

FDA to study safety of drugs taken during pregnancy

U.S. health officials plan to study the safety of medications taken during pregnancy with an eye toward using the data in future regulations and medical practice, the U.S. Food and Drug Administration.Citing a lack of clinical trials to determine how medications affect mothers and unborn children, the FDA said it will collaborate with other researchers in the new study, called the Medication Exposure in Pregnancy Risk Evaluation Program. The agency said data shows that about two-thirds of women who deliver a baby have taken at least one prescription medication during pregnancy. "Results of these studies will provide valuable information for patients and physicians when making decisions about medication during pregnancy," Gerald Dal Pan, a director at the FDA's Center for Drug Evaluation and Research, said in a statement. The program will work off of data from 11 health plan-affiliated research sites that have healthcare information for about 1 million births over a seven-year period started in 2001. The FDA did not give a timeline for when the program will complete the safety study.

Bonnie - how lovely that they are doing this now. For so many women and their children, this comes way too late.

Med diet reduces risk of stomach cancer

Greater adherence to a Mediterranean diet is associated with a significantly lower risk for incident gastric adenocarcinoma, according to the results of study reported in the American Journal of Clinical Nutrition.

The study cohort consisted of 485,044 participants from 10 European countries who provided dietary and lifestyle information at recruitment into EPIC. Age range was 35 to 70 years, and 144,577 subjects were men. An 18-unit relative Mediterranean diet score, which included information regarding 9 key components of the Mediterranean diet, allowed estimation of relative Mediterranean diet adherence. During mean follow-up of 8.9 years, there were 449 validated cases of incident gastric adenocarcinoma that could be analyzed. Compared with low relative Mediterranean diet adherence, high adherence was associated with a significant decrease in gastric adenocarcinoma risk. For every 1-unit increase in relative Mediterranean diet score, the risk for gastric adenocarcinoma decreased by 5% to 7%.

Green tea may have antiviral properties

The research division of Japanese tea manufacturer Ito En says its most recent study has demonstrated that green tea catechins have the ability to reduce infections from flu, including H1N1. Ito En's Central Research Institute and Takashi Suzuki, a professor in the University of Shuzuoka's School of Pharmaceutical Sciences, jointly conducted the study. They based the current research on previous work indicating that epigallocatechin gallate (EGCG), a catechin found in green tea, has antiviral properties. The researchers mixed EGCG with solutions containing three types of viruses, including the H1N1 virus – the so-called "swine flu" virus spread into a global pandemic in 2009. The researchers then infected cultured cells with the mixture and allowed them to incubate. After fixed amounts of time, they measured the growth of the infection and the concentration of EGCG at which infection was cut in half (compared to cells with no EGCG). The tests showed that EGCG could halve infections caused by three types of viruses, including H1N1, at much lower concentrations than Amantadine (a flu treatment drug). In a statement, the Central Research Institute concluded that "EGCG contained in green tea has potential to inhibit flu infection regardless of its type."

Steve - keep in mind that the researchers represent special interest, a tea manufacturer. With that in mind, this data does add to growing evidence about tea's antiviral benefits.

Study shows no link between phytoestrogens and cancer

Phytoestrogen intake was not associated with breast cancer among women or colorectal cancer among men in a recent University of Cambridge study that appeared in American Journal Clinical Nutrition. Dietary phytoestrogen intakes were evaluated in about 25,000 cancer-free, 40- to 79-years-old British patients who participated in the European Prospective Investigation into Cancer and Nutrition - Norfolk (EPIC-Norfolk) between 1993 and 1997.

Within 12 months of study, 244 breast cancers, 221 colorectal cancers and 204 prostate cancers were reported. The diets and other relevant information from those who developed cancer were compared to information from participants who did not develop cancer. Researchers concluded they found no association between phytoestrogen intake and breast cancer in women or between phytoestrogen intake and colorectal cancer in men.

Vilsack espouses Health Initiative program

U.S. Agricultural Secretary Tom Vilsack says Americans have “serious challenges” with sodium and sugar and a U.S.D.A. pilot project in the new year will try to find a way to steer shoppers to more nutritious food. It’s called the NuVal system. Coffee creamer, for example, gets the lowest score of one, while unsweetened shredded wheat in the cereal aisle gets an 83 out of 100.

Vilsack joked a bit about the nutritional labels on the food sold in grocery stores. “You know, if you take a look at a label — unless you’re a dietician or a chemist or a doctor — it’s really hard to determine between two products which is the best product for you and your family,” Vilsack said. According to the ag secretary, that’s why the NuVal system the Hy-Vee grocery store chain is using is so intriguing. While the system reviews all the things are that are printed on the label, it comes up with a single number to signify the product’s nutritional value.

Steve - while this initiative has good intentions, I fear that it will be rife with tampering from Big Food, aside from the fact that I do not trust the USDA to rate what is deemed healthy food.

In 2010, the U.S.D.A. will launch the “Health Initiatives Program.” States will be able to apply for $20 million in U.S.D.A. grants to test projects that get consumers to buy more fruits and vegetables.

Steve - this is something I can get excited about, as long as the money is allocated properly.

Whole Foods goes on a diet

Steve - this article seems awkward, but as we have posted several times in the last few years, Whole Foods has gradually been getting away from its original mission.

Whole Foods is returning to its health-food roots.

"There have been these two dominant values driving our products over the years," CEO John Mackey said in an interview at the company's headquarters. "One is food as health and the other one is food as indulgence. Those have battled, you might say, for the soul of Whole Foods."

The chain spent the first half of its existence focused on food as the key to health. Then it shifted to food as indulgence, seizing on a gourmet revolution that put imported sea salts and truffle oil in many American pantries.The cycle has shifted back, and Mackey says the timing couldn't be better. Whole Foods is spending this year preparing for the transition, which it will roll out in 2010.It plans to increasingly push healthy eating and education — adding teams of employees, classes, books, DVDs and supper clubs dedicated to it.

The company isn't ditching its foodie fans, and its products won't change overnight. But gradually they will evolve, letting health become the dominant theme.

Antibody testing for celiac improves diagnosis

The advent of antibody testing to diagnose celiac disease has led to a substantial increase in the number of cases detected among children, according to a study in the December issue of Pediatrics. These tests have allowed more and more people who have "atypical" celiac symptoms to be referred for definitive testing with an intestinal biopsy -- where a small piece of tissue is removed from the small intestine to check for damage to the villi.

The study's researchers say that blood testing for celiac disease should be performed when a child has chronic gastrointestinal symptoms of any kind that do not improve on their own or respond to treatment. Testing might also be appropriate for children with a family history or celiac-associated medical conditions. He also stressed that the antibody blood tests are only a screening procedure and do not provide a definitive diagnosis. A positive test result, needs to be followed up by an intestinal biopsy. This is important, Butzner explained, because the treatment for celiac disease is to go on a lifelong gluten-free diet. While effective at easing symptoms and healing and preventing intestinal damage, the diet can also be expensive and challenging to follow.

Bonnie - unfortunately, the researchers left out what is still considered the gold standard for assessing whether gluten causes digestive or other health problems: a two month removal even if celiac. If gluten makes you feel bad, avoid it! and reintroduction challenge.

Low thyroid may equal hard labor

Too little of the hormone thyroxine is already known to complicate pregnancy, increasing the risk of miscarriage, premature birth and pre-eclampsia. Now a Dutch team has found even "low to normal" levels of thyroxine may cause babies to be positioned wrongly, making labor more difficult. According to journal Clinical Endocrinology, the babies tended to face the wrong way - towards their mother's back rather than stomach. Not only are these labors generally longer and harder, they are also more likely to end in an assisted delivery with forceps, ventouse or a Caesarean.Because the researchers believe the hormone problem affects about one in 10 pregnancies - a blood test for it should become a routine part of the antenatal check.

Niacin helps restore HDL levels in diabetics

HDL lowers heart risks because it clears low-density lipoprotein, or LDL cholesterol, away from arteries and back to the liver, where it is passed out of the body. Several recent studies also suggest HDL protects arteries by promoting cell healing and repair. But in people with diabetes, HDL may be less protective, researchers at the University Hospital Zurich and the Medical School of Hannover in Germany reported in the journal Circulation.

All of the type 2 diabetic subjects were taking statins to lower their bad cholesterol. Researchers found that the protective benefits on blood vessels were "substantially impaired" in HDL taken from the diabetic patients compared with that taken from healthy people. When they divided up the diabetics and gave half a placebo and treated half with extended-release niacin, after three months, patients who got the niacin had increased HDL levels, and markedly improved protective functions of HDL in laboratory testing as well as improved vascular function. Because it was a small study, the team said more research is needed.

Dr. Oz on epigenetics

This is a quote taken from an interview between Dr. Oz and a reporter at The Cleveland Plain Dealer about his pregnancy book.

Is there anything about pregnancy you didn't know before?

There are probably 10 things per page that we didn't know. We didn't know a lot about amniotic fluid. For both Mehmet and I, it was the most fascinating thing. All of the stuff on epigenetics,* we were not aware of how powerful it was. What you're eating now, earlier and later influences not only your kids, but your kids' kids' kids . . . whether you end up diabetic or not, intelligent or just average -- a lot of that is determined by what you and your ancestors and descendants do to influence those specific genes.

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Neti Pot, Nasal Rinse Warning

Steve - nasal irrigation using "neti pots" or rinse bottles are often used to clear the sinuses, soothe cold and allergy symptoms, and decrease sinus infections. But now preliminary research suggests that chronic use might actually increase the risk for sinus infections. Researchers suspect that chronic irrigation might alter normal nasal secretions and wash away protective immune mediators. Some experts (we are in this camp) think that contaminated neti pots and rinse bottles might be the contributing factor to increasing infections. Here are some tips going forward:

1. Use boiled, bottled, or distilled water in the neti pot for irrigating.
2. Wash neti pots with hot soapy water after every use and never to share them with other people.
   
3. Those using rinse bottles should switch to a new bottle monthly.
4. Those of you who continue to get frequent nasal infections, consider a trial off irrigation to see if that helps.
   
5. Limit nasal irrigation to once or twice daily to minimize irritation or on an as needed basis.

Stem Cells Gets a Boost From Vitamin C

Vitamin C is often recommended to help fight the common cold and heal wounds, but the antioxidant might have another benefit: it appears to help adult cells generate embryonic-like stem cells, according to the journal Cell Stem Cell, adding to previous research that showed how adult cells can be reprogrammed.

The problem, researchers explained, is that the process doesn't work very well. "The low efficiency of the reprogramming process has hampered progress with this technology and is indicative of how little we understand it. Further, this process is most challenging in human cells," senior study author Duanqing Pei, of the South China Institute for Stem Cell Biology and Regenerative Medicine at the Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, said.

The researchers found that vitamin C boosted the process in both human and mouse cells. "It is also of interest that a vitamin with long-suspected anti-aging effects has such a potent influence on reprogramming, which can be considered a reversal of the aging process at the cellular level. It is likely that our work may stimulate further research in this area as well," Pei added.

Bonnie - obviously, this is a very exciting discovery and we will be following this data further.