This Week in Science for Holistic Health
Welcome to This Week in Science for Holistic Health!
I scour the science news for interesting and relevant research for a holistic approach to health to keep you up-to-date!
Foods, Diets & Eating – Children need enough energy and protein to grow when on an elimination diet
Supplements & Nutrients – Too much vitamin D can be toxic (hypercalcemia)
Anatomy & Physiology – Autoimmune thyroid disease should be screened for B12 deficiency
Foods, Diets & Eating
The impact of the elimination diet on growth and nutrient intake in children with food protein induced gastrointestinal allergies.
Non immunoglobulin E (IgE) mediated allergies affecting the gastrointestinal tract require an elimination diet to aid diagnosis. The elimination diet may entail multiple food eliminations that contribute significantly to macro- and micro-nutrient intake which are essential for normal growth and development. Previous studies have indicated growth faltering in children with IgE-mediated allergy, but limited data is available on those with delayed type allergies. We therefore performed a study to establish the impact on growth before and after commencing an elimination diets in children with food protein induced non-IgE mediated gastrointestinal allergies.
We recruited 130 children: 89 (68.5 %) boys and a median age of 23.3 months [IQR 9.4-69.2]. Almost all children (94.8 %) in this study eliminated cow’s milk from their diet and average contribution of energy in the form of protein was 13.8 % (SD 3.9), 51.2 % (SD 7.5) from carbohydrates and 35 % (SD 7.5) from fat. In our cohort 9 and 2.8 % were stunted and wasted respectively. There was a statistically significant improvement in weight-for-age (Wtage) after the 4 week elimination diet. The elimination diet itself did not improve any of the growth parameters, but achieving energy and protein intake improved Wtage and WtHt respectively, vitamin and/or mineral supplements and hypoallergenic formulas were positively associated with WtHt and Wtage.
With appropriate dietary advice, including optimal energy and protein intake, hypoallergenic formulas and vitamins and mineral supplementation, growth parameters increased from before to after dietary elimination. These factors were positively associated with growth, irrespective of the type of elimination diet and the numbers of foods eliminated.
Supplements & Nutrients
ANNALS EXPRESS: Self-administration of Vitamin D supplements in the general public can result in high to toxic 25-hydroxyvitamin D levels.
Our open access vitamin D testing service enables members of the public to assess their vitamin D status. We have investigated vitamin D supplement regimes being used by members of the public, causing them to have high to toxic levels of 25-hydroxyvitamin D.
This study reports on 372 members of the public that had used our direct access vitamin D testing service and found to have total 25-hydroxyvitamin D levels >220nmol/L. Of 14,806 direct access samples received, 372 (2.5%) were from users with 25-hydroxyvitamin D concentrations ranging from 221-1235nmol/L. Only 0.06% of GP patients had results above 220nmol/L over the same time frame. The high direct access levels were a result of regular vitamin D supplementation in 361 people, with supplementation ranging from 1000-120,000 IU/day. Two users achieved high levels as a result of taking bolus doses of 300,000 and 900,000 IU. Only 23 users taking supplements (6.4%) were under medical supervision. Of 28 users whose results were >500nmol/L, just one was under medical supervision. The majority obtained their supplements from the internet (74%) with 55 different brands named.
A high proportion of the direct access vitamin D testing service had a high to toxic level of vitamin D. Many people were taking more than the Institute of Medicine’s NOAEL of 10,000 IU/day yet only a very small proportion were being medically supervised. Clinicians should be aware that patients may be self-administering very high levels of vitamin D over long periods of time, especially when investigating unexplained hypercalcaemia.
No current list of potentially life-threatening, hepatotoxic herbs and dietary supplements based on PubMed case studies exists in a summarized tabular form.
Over the past 50 years, approximately 19 herbs (minus germander and usnic acid that are no longer sold) and 13 dietary supplements(minus the six no longer sold and vitamin A & niacin due to excess) posed a possible risk for liver injures in certain individuals. The top three herbs with the most number of reported publications (but not cases studies) in descending order, were germander, black cohosh, kava extract, and green tea extract.
These online tables will contribute to continued Phase IV post marketing surveillance to detect possible liver toxicity cases and serve to forewarn consumers, clinicians, and corporations.
Conventional foods, followed by dietary supplements and fortified foods, are the key sources of vitamin D, vitamin B6, and selenium intake in Dutch participants of the NU-AGE study.
With aging, energy needs decrease, necessitating a more nutrient-dense diet to meet nutritional needs. To bridge this gap, the use of nutrient-dense foods, fortified foods, and dietary supplements can be important. This observational study aims to describe current micronutrient intakes of Dutch elderly and to identify the contribution of nutrient-dense foods, fortified foods, and dietary supplements to the intake of micronutrients that are often inadequately consumed in Dutch elderly.
The percentages of participants not meeting their average requirement were high for vitamin D (99%), selenium (41%), and vitamin B6 (54%) based on conventional foods and also when taking into account fortified foods (98%, 41%, and 27%, respectively) and vitamin and mineral supplements (87%, 36%, and 20%, respectively). Conventional foods were the main source of vitamin D, vitamin B6, and selenium intake (42%, 45%, and 82%, respectively), followed by vitamin and mineral supplements (41%, 44%, and 18%) and fortified foods (17%, 11%, and 1%). Foods with the highest nutrient density contributed most to total vitamin B6 intake only.
To optimize nutrient intakes of elderly, combinations of natural food sources, fortified foods, and dietary supplements should be considered.
Effect of ginger powder supplementation on nitric oxide and C-reactive protein in elderly knee osteoarthritis patients: A 12-week double-blind randomized placebo-controlled clinical trial.
There is limited evidence that ginger ( shēng jiāng) powder consumption can relieve pain and inflammation because of its special phytochemical properties. This study is aimed at investigating the effect of ginger powder supplementation on some inflammatory markers in patients suffering from knee osteoarthritis. This is a double-blind randomized placebo-controlled clinical trial with a follow-up period of 3 months that was conducted on 120 outpatients with moderately painful knee osteoarthritis. Patients were randomly divided up into two groups: ginger group (GG) or placebo group (PG). Both groups received two identical capsules on a daily basis for 3 months. Each ginger capsule contained 500 mg of ginger powder; the placebo capsules had 500 mg of starch in them. Serum samples were collected prior to and after the intervention and were stored at -70 °C until the end of the study. Serum concentration of nitric oxide (NO) and hs-C reactive protein (hs-CRP) were measured using enzyme-linked immunosorbent assay kits. There was no significant difference between the two groups in terms of inflammatory markers (i.e., NO and hs-CRP) prior to the intervention. However, after 3 months of supplementation, serum concentration of NO and hs-CRP decreased in the GG. After 12 weeks, the concentration of these markers declined more in the GG than in the PG. Ginger powder supplementation at a dose of 1 g/d can reduce inflammatory markers in patients with knee osteoarthritis, and it thus can be recommended as a suitable supplement for these patients.
Nutrients are commonly consumed in foods or dietary supplements. It is clear that nutrients could play an important role and influence colorectal cancer outcomes. The relationship between nutrients and colorectal risk is complex. Vitamins, folic acid, calcium, selenium and dietary fiber have been proposed as potential agents to prevent colorectal cancer. However, some studies found that these nutrients did not reduce the incidence of colorectal cancer.
The supplementary dose of nutrients, the length of time required to observe the effects and confounding factors during the study might influence the role of nutrients in the prevention of colorectal cancer. Therefore, more evidence from ongoing clinical trials with different population groups and longer follow-up periods is critical to determine the relationship between nutrients and colorectal cancer.
Herbal Medicines for Treating Metabolic Syndrome: A Systematic Review of Randomized Controlled Trials.
Objective. The aim of this systematic review is to evaluate the efficacy and safety of herbal medicines in the management of metabolic syndrome.
Results. From 1,098 articles, 12 RCTs were included in this review: five trials studied herbal medicines versus a placebo or no treatment, and seven trials studied herbal medicines versus western medicines. Herbal medicines were effective on decreasing waist circumference, blood glucose, blood lipids, and blood pressure.
Conclusion. This study suggests the possibility that herbal medicines can be complementary and alternative medicines for metabolic syndrome.
Between 40% and 50% of women in Western countries use complementary therapies to manage menopausal symptoms.
To determine the association of plant-based therapies with menopausal symptoms, including hot flashes, night sweats, and vaginal dryness.
CONCLUSIONS AND RELEVANCE:
This meta-analysis of clinical trials suggests that composite and specific phytoestrogen supplementations were associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats. However, because of general suboptimal quality and the heterogeneous nature of the current evidence, further rigorous studies are needed to determine the association of plant-based and natural therapies with menopausal health.
NOTE from Leesa: If you have experienced an adverse event related to your use of any supplement or medication, AND you’re in Canada or the USA, you can report them directly to the health authorities at the links below. Health Canada’s MedEffect link is reference (3), and the FDA’s MedWatch link is reference (4).
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Anatomy & Physiology
Due to the non-specificity of symptoms and possibly severe consequences of untreated vitamin B-12 deficiency, screening is important for at-risk patients to ensure the prompt delivery of treatment.
In this review, studies assessing the prevalence of vitamin B-12 deficiency in thyroid dysfunction are evaluated to determine whether regular vitamin B-12 screening is necessary.
From a total of 7091 manuscripts generated, 6 were included in this review. The prevalence of vitamin B-12 deficiency in hypothyroidism was reported as 10, 18.6, and 40.5% in three separate studies. The prevalence of deficiency in autoimmune thyroid disease was reported as 6.3, 28, and 55.5% in three studies. The prevalence of vitamin B-12 deficiency in hypothyroidism and autoimmune thyroid disease are reflective of the nutrition status of the population. Autoimmune thyroid disease is also associated with the autoimmune disorders pernicious anemia and atrophic gastritis which may lead to malabsorption of vitamin B-12.
Vitamin B-12 screening is recommended upon initial diagnosis with autoimmune thyroid disease and then periodically thereafter. There is not enough evidence to recommend regular screening for patients with hypothyroidism unless the underlying cause is autoimmune thyroid disease.
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Inclusion Criteria for This Week in Science for Holistic Health posts:
- Studies must be published in a peer-reviewed medical journal or highly credible website (e.g. Cochrane.org) within the last few weeks,
- Articles must be relevant to a holistic approach to health (specifically nutrition & lifestyle factors),
- Studies were done on people unless noted otherwise (animal and tissue studies have unknown relevance to people),
- I also include new science-based books that look interesting (’cause I LOVE reading!).
- None of the above applies if it’s a response to something in the media. 😉
- P.S. – The titles are hyperlinked to the actual studies, so feel free to “geek out”. 🙂
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Leesa Klich is a science-based holistic nutritionist living at the intersection of science and holistic health (it’s really, really interesting here!) 🙂
At Nutrition Interactions she empowers women to optimize their bone health using foods, supplements and lifestyle upgrades. She also helps holistic-minded people taking medications maximize the benefits of good nutrition; as well as holistic health professionals find and understand science-based health information.
She has a MSc in Toxicology and Nutritional Science, over a decade experience in drug/supplement safety, and is also a Registered Holistic Nutritionist. For a list of free health resources, click here.
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How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease by Michael Greger, MD
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