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!
Food & Eating – How the heck do they create dietary guidelines?
Supplements & Nutrients – Why you don’t need to be overly concerned with green tea extracts
Disease Prevention – IF you eat breakfast, it should have protein and fiber
Anatomy & Physiology – Nutrition for heart and bone health
Food & Eating
Dietary guidelines provide evidence-based statements on food choices to meet nutritional requirements and reduce the risk of prevailing chronic disease. They involve a substantial amount of research translation, and their implementation has important health consequences. Foods, however, are complex combinations of nutrients and other compounds that act synergistically within the food and across food combinations. In addition, the evidence base underpinning dietary guidelines accesses research that reflects different study designs, with inherent strengths and limitations. We propose a systematic approach for the review of evidence that begins with research on dietary patterns. This research will identify the combinations of foods that best protect, or appear deleterious to, health. Next, we suggest that evidence be sought from research that focuses on the effects of individual foods. Finally, nutrient-based research should be considered to explain the mechanisms by which these foods and dietary patterns exert their effects, take into account the effects of ingredients added to the food supply, and enable assessments of dietary sufficiency. The consideration of individual nutrients and food components (e.g., upper limits for saturated fat, added sugar, and sodium) provides important benchmarks for evaluating overall diet quality. The concepts of core and discretionary foods (nutrient-rich and nutrient-poor foods, respectively) enable distinctions between foods, and this has implications for the relation between food policy and food manufacturing. In summary, evidence supporting healthy dietary patterns provides the foundation for the development of dietary guidelines. Further reference to individual foods and nutrients follows from the foundation of healthy dietary patterns.
PURPOSE: This study aimed to provide an overview of available literature on interventions aiming to improve dietary intake among university students.
CONCLUSIONS: Nutrition education, enhancing self-regulation components towards dietary intake (often facilitated by the worldwide web or other media devices), and point-of-purchase messaging strategies may improve university or college students’ dietary intake. Future high quality randomised controlled trials should evaluate sustainability of intervention effects, as well as further investigate the effectiveness of realistic and low-cost environmental (preferably combined with intrapersonal) interventions which can easily and instantly reach a great part of the university population.
Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data.
The present systematic review critically examines the available scientific literature on risk factors for malnutrition in the older population (aged ≥65 y).
A total of 6 longitudinal studies met the inclusion criteria and were included in the systematic review. These studies reported the following significant risk factors for malnutrition: age (OR: 1.038; P = 0.045), frailty in institutionalized persons (β: 0.22; P = 0.036), excessive polypharmacy (β: -0.62; P = 0.001), general health decline including physical function (OR: 1.793; P = 0.008), Parkinson disease (OR: 2.450; P = 0.047), constipation (OR: 2.490; P = 0.015), poor (OR: 3.30; P value not given) or moderate (β: -0.27; P = 0.016) self-reported health status, cognitive decline (OR: 1.844; P = 0.001), dementia (OR: 2.139; P = 0.001), eating dependencies (OR: 2.257; P = 0.001), loss of interest in life (β: -0.58; P = 0.017), poor appetite (β: -1.52; P = 0.000), basal oral dysphagia (OR: 2.72; P = 0.010), signs of impaired efficacy of swallowing (OR: 2.73; P = 0.015), and institutionalization (β: -1.89; P < 0.001). These risk factors for malnutrition in older adults may be considered by health care professionals when developing new integrated assessment instruments to identify older adults’ risk of malnutrition and to support the development of preventive and treatment strategies.
A few studies have assessed the effects of fat intake in the induction of dyspeptic symptoms. So, the aim of this study was to review the articles regarding the dietary fat intake and FD.
Anecdotally, specific food items or food groups, particularly fatty foods have been related to dyspepsia. Laboratory studies have shown that the addition of fat to a meal resulted in more symptoms of fullness, bloating, and nausea in dyspeptic patients. Studies have reported that hypersensitivity of the stomach to postprandial distension is an essential factor in the generation of dyspeptic symptoms. Small intestinal infusions of nutrients, particularly fat, exacerbate this hypersensitivity. Moreover, evidence showed that perception of gastric distension increased by lipids but not by glucose. Long chain triglycerides appear to be more potent than medium chain triglycerides in inducing symptoms of fullness, nausea, and suppression of hunger. Thus, Fatty foods may exacerbate dyspeptic symptoms. Therefore, it seems that a reduction in intake of fatty foods may useful, although this requires more evaluations.
Mothers’ own milk is the best source of nutrition for nearly all infants. Beyond somatic growth, breast milk as a biologic fluid has a variety of other benefits, including modulation of postnatal intestinal function, immune ontogeny, and brain development. Although breastfeeding is highly recommended, breastfeeding may not always be possible, suitable or solely adequate. Infant formula is an industrially produced substitute for infant consumption. Infant formula attempts to mimic the nutritional composition of breast milk as closely as possible, and is based on cow’s milk or soymilk. A number of alternatives to cow’s milk-based formula also exist. In this article, we review the nutritional information of breast milk and infant formulas for better understanding of the importance of breastfeeding and the uses of infant formula from birth to 12 months of age when a substitute form of nutrition is required.
Breast milk is the best nutrition for infant growth and development, and is also rich in antibodies that provide the first source of adaptive immunity in a newborn’s intestinal tract. In preterm or low birth weight newborns, a mother’s own milk is the first choice for preterm infants; when it is unavailable, donor breast milk is considered as the next best choice. For healthy newborns whose mothers are unable to provide sufficient breast milk, the current option of choice is infant formula.
Energy Contribution and Nutrient Composition of Breakfast and Their Relations to Overweight in Free-living Individuals: A Systematic Review.
Previous systematic reviews on the relation between overweight or obesity and breakfast focused on the frequency of consumption and only partially accounted for breakfast nutritional profiles. Given the central role of these factors, we conducted a systematic review of the literature on this putative relation, with a specific focus on breakfast energy intake and/or breakfast composition.
Of the 16 studies that evaluated the amount of energy intake at breakfast, 4 found that a lower energy intake at breakfast was significantly associated with obesity in children, adolescents, and adults, whereas 2 partially overlapping studies found that a higher energy intake was significantly associated with a higher body mass index in children. Of the 8 studies investigating breakfast composition, 3 suggested that a breakfast characterized by a higher amount of carbohydrates and a lower amount of fat is significantly related to normal weight in adults, whereas the others reported mixed results. In conclusion, there is some evidence that a lower energy intake at breakfast is related to obesity, although the studies are few and heterogeneous. Studies on the nutrient composition of breakfast have shown inconsistent results.
Kefir is a complex fermented dairy product created through the symbiotic fermentation of milk by lactic acid bacteria and yeasts contained within an exopolysaccharide and protein complex called a kefir grain. As with other fermented dairy products, kefir has been associated with a range of health benefits such as cholesterol metabolism and angiotensin-converting enzyme (ACE) inhibition, antimicrobial activity, tumor suppression, increased speed of wound healing, and modulation of the immune system including the alleviation of allergy and asthma. These reports have led to increased interest in kefir as a focus of research and as a potential probiotic-containing product. Here, we review those studies with a particular emphasis on the microbial composition and the health benefits of the product, as well as discussing the further development of kefir as an important probiotic product.
…Whole kefir, as well as specific fractions and individual organisms isolated from kefir, provide a multitude of positive effects when consumed. These range from improved cholesterol metabolism and wound healing, to the modulation of the immune system and microbiome, and even the potential alleviation of allergies and cancers. Further studies into the mechanisms behind these effects will allow scientists to better understand exactly how kefir and other fermented dairy products confer these benefits as well as how to harness these traits outside of kefir itself.
The need for further research does not only apply to the mechanisms by which kefir consumption exerts these effects but also which organisms or parts of kefir are responsible for each benefit. By determining which organisms and metabolites are essential for each process, the possibility arises for the commercial manufacturing of kefir that is specifically designed to create the most profound effect in those that consume it. As it stands currently, the highly variable nature of the organisms and metabolites present in traditional kefir requires health claims to be verified individually in each grain and kefir beverage. The ability to combine the best possible strains of the best organisms from multiple sources of kefir would create the potential for greater benefits than have been previously observed, with a measure of control over these effects that has not been possible in traditional kefir.
Supplements and Nutrients
Liver-related safety assessment of green tea extracts in humans: a systematic review of randomized controlled trials.
There remain liver-related safety concerns, regarding potential hepatotoxicity in humans, induced by green tea intake, despite being supposedly beneficial. Although many randomized controlled trials (RCTs) of green tea extracts have been reported in the literature, the systematic reviews published to date were only based on subjective assessment of case reports. To more objectively examine the liver-related safety of green tea intake, we conducted a systematic review of published RCTs. … 34 trials were identified. Of these, liver-related adverse events were reported in four trials; these adverse events involved seven subjects (eight events) in the green tea intervention group and one subject (one event) in the control group. The summary odds ratio, estimated using a meta-analysis method for spare event data, for intervention compared with placebo was 2.1 (95% confidence interval: 0.5-9.8). The few events reported in both groups were elevations of liver enzymes. Most were mild, and no serious liver-related adverse events were reported. Results of this review, although not conclusive, suggest that liver-related adverse events after intake of green tea extracts are expected to be rare.
A combination of omega-3 fatty acids, folic acid and B-group vitamins is superior at lowering homocysteine than omega-3 alone: A meta-analysis.
The aim of the study was to assess whether omega-3 polyunsaturated fatty acid supplementation alone or in combination with folic acid and B-group vitamins is effective in lowering homocysteine. … For the purposes of reducing homocysteine, a combination of omega-3s (0.2-6g/day), folic acid (150 – 2500μg/day) and vitamins B6 and B12 may be more effective than omega-3 supplementation alone.
Chondroitin sulfate (CS) being a natural glycosaminoglycan is found in the cartilage and extracellular matrix. It shows clinical benefits in symptomatic osteoarthritis (OA) of the finger, knee, hip joints, low back, facial joints and other diseases due to its anti-inflammatory activity. It also helps in OA by providing resistance to compression, maintaining the structural integrity, homeostasis, slows breakdown and reduces pain in sore muscles. It is most often used in combination with glucosamine to treat OA. CS is a key role player in the regulation of cell development, cell adhesion, proliferation, and differentiation. Its commercial applications have been continuously explored in the engineering of biological tissues and its combination with other biopolymers to formulate scaffolds which promote and accelerate the regeneration of damaged structure. It is approved in the USA as a dietary supplement for OA, while it is used as a symptomatic slow-acting drug (SYSADOA) in Europe and some other countries. Any significant side effects or overdoses of CS have not been reported in clinical trials suggesting its long-term safety. This review highlights the potential of CS, either alone or in combination with other drugs, to attract the scientists engaged in OA treatment and management across the world.
Effect of Flavonoids on Upper Respiratory Tract Infections and Immune Function: A Systematic Review and Meta-Analysis.
Previous research on animals indicates flavonoid compounds have immunomodulatory properties; however, human research remains inconclusive.
Overall, flavonoid supplementation decreased URTI incidence by 33% (95% CI: 31%, 36%) compared with control, with no apparent adverse effects. Sick-day count was decreased by 40% with flavonoid supplementation, although unclear. Differences in bio-immune markers (e.g., interleukin-6, tumor necrosis factor-α, interferon-γ, neutrophils) were trivial between the intervention and control groups during the intervention and after exercise when a postintervention exercise bout was included. These findings suggest that flavonoids are a viable supplement to decrease URTI incidence in an otherwise healthy population.
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Diseases/Conditions and Prevention/Treatments
Evaluating the Intervention-Based Evidence Surrounding the Causal Role of Breakfast on Markers of Weight Management, with Specific Focus on Breakfast Composition and Size.
Nutritional strategies are vitally needed to aid in the management of obesity. Cross-sectional and epidemiologic studies consistently demonstrate that breakfast consumption is strongly associated with a healthy body weight. However, the intervention-based long-term evidence supporting a causal role of breakfast consumption is quite limited and appears to be influenced by several key dietary factors, such as dietary protein, fiber, and energy content.
…there is limited evidence supporting the addition of breakfast for body weight management and daily food intake. Regarding the type of breakfast, accumulating evidence exists supporting the consumption of increased protein and fiber at breakfast, as well as consuming more energy during the morning hours. …
Historically, obese individuals were believed to have lower energy expenditure (EE) rates than nonobese individuals (normal and overweight), which, in the long term, would contribute to a positive energy balance and subsequent weight gain. The aim of this review was to critically appraise studies that compared measures of EE and its components, resting EE (REE), activity EE (AEE), and diet-induced thermogenesis (DIT), in obese and nonobese adults to elucidate whether obesity is associated with altered EE. Contrary to popular belief, research has shown that obese individuals have higher absolute REE and total EE. When body composition (namely the metabolically active component, fat-free mass) is taken into account, these differences between obese and nonobese individuals disappear, suggesting that EE in obese individuals is not altered. However, an important question is whether AEE is lower in obese individuals because of a decrease in overall physical activity or because of less energy expended while performing physical activity. AEE and DIT could be reduced in obese individuals, mostly because of unhealthy behavior (low physical activity, higher intake of fat). However, the current evidence does not support the hypothesis that obesity is sustained by lower daily EE or REE. Future studies, comparing EE between obese and nonobese and assessing potential physiologic abnormalities in obese individuals, should be able to better answer the question of whether these individuals have altered energy metabolism.
The role of geographical ecological studies in identifying diseases linked to UVB exposure and/or vitamin D.
Using a variety of approaches, researchers have studied the health effects of solar ultraviolet (UV) radiation exposure and vitamin D. This review compares the contributions from geographical ecological studies with those of observational studies and clinical trials. Health outcomes discussed were based on the author’s knowledge and include anaphylaxis/food allergy, atopic dermatitis and eczema, attention deficit hyperactivity disorder, autism, back pain, cancer, dental caries, diabetes mellitus type 1, hypertension, inflammatory bowel disease, lupus, mononucleosis, multiple sclerosis, Parkinson disease, pneumonia, rheumatoid arthritis, and sepsis. … Indications exist that for some outcomes, UVB effects may be independent of vitamin D. This paper discusses the concept of the ecological fallacy, noting that it applies to all epidemiological studies.
It is universally accepted that diets rich in fruit and vegetables lead to reduction in the risk of common forms of cancer and are useful in cancer prevention. Indeed edible vegetables and fruits contain a wide variety of phytochemicals with proven antioxidant, anti-carcinogenic, and chemopreventive activity; moreover, some of these phytochemicals also display direct antiproliferative activity towards tumor cells, with the additional advantage of high tolerability and low toxicity. The most important dietary phytochemicals are isothiocyanates, ellagitannins (ET), polyphenols, indoles, flavonoids, retinoids, tocopherols. Among this very wide panel of compounds, ET represent an important class of phytochemicals which are being increasingly investigated for their chemopreventive and anticancer activities. This article reviews the chemistry, the dietary sources, the pharmacokinetics, the evidence on chemopreventive efficacy and the anticancer activity of ET with regard to the most sensitive tumors, as well as the mechanisms underlying their clinically-valuable properties.
The increasing awareness and knowledge of the capacity of plant-derived compounds to modify cell transformation and cancer cell growth suggest that they could serve as new tools for either preventive and therapeutic interventions. Today, ET are recognized as a class of phytochemicals characterized by a strong potential for development as chemopreventive, and possibly as therapeutic, agents against various human cancers. This could have a direct clinical and translational relevance to cancer patients if consumption of ET-rich fruits and vegetables will unequivocally prove to contrast the process of carcinogenesis and tumor growth, with positive outcomes in terms of survival and quality of life of the patient. To this end, future research should be addressed to define the actual clinical potential of ET through specific studies such as the determination of the systemic bioavailability from either food sources or concentrated formulations, the optimal period of administration and dosing, the toxicity and side effects (if any), the anticancer activity. The effects of single ET and of rational combinations of different ET should also be addressed. A multidisciplinary and coordinated approach will be needed and will involve basic research investigations, epidemiological and preclinical studies including the effect of combining ET with conventional antineoplastic drugs.
Persons living with HIV (PLWH) often seek complementary treatments to improve their overall health and well-being. Reiki, an ancient healing practice, has been found to be effective in reducing symptoms of stress, anxiety, pain, and depression. The purpose of this pilot study was to evaluate the effectiveness of Reiki as a complementary treatment for PLWH. Using a two-group mixed-methods experimental design, 37 participants were randomized to either a 6-week Reiki with Music Group or a Music Only Group. Self-reported and physiologic measures were obtained at baseline, 6 weeks, and 10 weeks. Significant improvements in relief of pain and stress in those receiving RMG were found. At the 6-week assessment, semi-structured interviews were conducted with all participants. Qualitative findings indicated that Reiki and music therapy helped reduce stress, anxiety, and depression. Evidence-based data regarding the effectiveness of Reiki will help nurses help patients better manage HIV-related symptoms.
Complementary and integrative medicine for breast cancer patients – Evidence based practical recommendations.
•On average half of the breast cancer patients’ population uses complementary and integrative medicine (CIM) therapies.
•Patients often don’t feel comfortable in discussing CIM related questions with their conventional treatment team.
•Some CIM interventions have shown positive effects in breast cancer patients and might be useful in supportive cancer care.
•It is important, in the conventional setting, to inquire patients about their interest in CIM interventions.
•It is important, in the conventional setting, to give practical guidance on how to choose and find a qualified referral to a CIM treatment.
On average half of the breast cancer patients’ population uses complementary and integrative medicine (CIM) therapies and many of them would like to receive information on CIM from their conventional treatment team. However, often they don’t feel comfortable in discussing CIM related questions, with their conventional treatment team, because they think they don’t have enough expertise and available time to deal with this topic. Furthermore, information on the evidence of CIM is not easily accessible and the available information is not always reliable. The purpose of the current paper is to provide: 1) an overview about the CIM interventions that have shown positive effects in breast cancer patients and might be useful in supportive cancer care, 2) practical guidance on how to choose and find a qualified referral to a CIM treatment: 3) recommendations on how these interventions could be integrated into Breast Cancer Centers and which factors should be taken into consideration in this setting. This paper takes available CIM practice guidelines for cancer patients and previous research on CIM implementation models into account. There are CIM interventions that have shown a potential to reduce symptoms of cancer or cancer treatments in breast cancer patients and the vast majority uses a non-pharmacological approach and have a good potential for implementation. Nevertheless, further and more rigorous research is still needed.
Making sense of “alternative”, “complementary“, “unconventional” and “integrative” medicine: exploring the terms and meanings through a textual analysis.
BACKGROUND: Medical pluralism has flourished throughout the Western world in spite of efforts to legitimize Western biomedical healthcare as “conventional medicine” and thereby relegate all non-physician-related forms of healthcare to an “other” category. These “other” practitioners have been referred to as “unconventional”, “alternative” and “complementary“, among other terms throughout the past half century.
RESULTS: Five commonly-used, unconventional medicine-related terms were identified. Authors using “complementary and alternative”, “complementary“, “alternative”, or “unconventional” tended to define them by what they are not (e.g., therapies not taught/used in conventional medicine, therapy demands not met by conventional medicine, and therapies that lack research on safety, efficacy and effectiveness). Authors defined “integrated/integrative” medicine by what it is (e.g., a new model of healthcare, the combining of both conventional and unconventional therapies, accounting for the whole person, and preventative maintenance of health). Authors who defined terms by “what is not” stressed that the purpose of conducting research in this area was solely to create knowledge. Comparatively, authors who defined terms by “what is” sought to advocate for the evidence-based combination of unconventional and conventional medicines. Both author groups used scientific rhetoric to define unconventional medical practices.
CONCLUSIONS: This emergence of two groups of authors who used two different sets of terms to refer to the concept of “unconventional medicine” may explain why some journals, practitioner associations and research/practice centres may choose to use both “what is not” and “what is” terms in their discourse to attract interest from both groups. Since each of the two groups of terms (and authors who use them) has different meanings and goals, the evolution of this discourse will continue to be an interesting phenomenon to explore in the future.
Anatomy & Physiology
Bone and heart health are linked through a variety of cellular, endocrine, and metabolic mechanisms, including the bidirectional effects of mineral-regulating hormones parathyroid hormone and fibroblast growth factor 23. Nutrition plays an important role in the development of both cardiovascular and bone disease. This review describes current knowledge on the relations between the cardiovascular system and bone and the influence of key nutrients involved in mineral metabolism-calcium, vitamin D, and phosphorus-on heart and bone health, as well as the racial/ethnic differences in cardiovascular disease and osteoporosis and the influence that nutrition has on these disparities.
More than 100 trillion microbial cells that reside in the human gut heavily influence nutrition, metabolism, and immune function of the host. Gut dysbiosis, seen commonly in patients with chronic kidney disease (CKD), results from qualitative and quantitative changes in host microbiome profile and disruption of gut barrier function. Alterations in gut microbiota and a myriad of host responses have been implicated in progression of CKD, increased cardiovascular risk, uremic toxicity, and inflammation. We present a discussion of dysbiosis, various uremic toxins produced from dysbiotic gut microbiome, and their roles in CKD progression and complications. We also review the gut microbiome in renal transplant, highlighting the role of commensal microbes in alteration of immune responses to transplantation, and conclude with therapeutic interventions that aim to restore intestinal dysbiosis.
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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 NutritionInteractions she helps holistic-minded people taking medications maximize the benefits of good nutrition. She also helps 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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