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 – Mediterranean diet for pregnancy
Supplements & Nutrients – CoQ10 for heart failure
Lifestyle – Diet and activity for older adults and cancer prevention
Anatomy & Physiology – Diagnosing non-celiac gluten sensitivity
Foods, Diets & Eating
… The studies detailed above highlight the importance of emphasising healthy dietary choices in preconception counseling to optimise not only reproductive outcomes but also general maternal health. Current guidelines of preconception care emphasise that nutrition and certain lifestyle factors play an important role in pregnancy. This review finds evidence that, for European countries, the Mediterranean diet is a relatively healthy diet. Importantly, the diets with higher intake of fruits, vegetables, legumes and fish have positive pregnancy outcomes in general and this conclusive evidence should be communicated to women specifically. As a modifiable factor, diet is a key area for intervention in pregnant women, but the precise content of the intervention is yet to be elucidated.
PURPOSE: The only effective and safe treatment of celiac disease (CD) continues being strict exclusion of gluten for life, the so-called gluten-free diet (GFD). Although this treatment is highly successful, following strict GFD poses difficulties to patients in family, social and working contexts, deteriorating his/her quality of life. We aimed to review main characteristics of GFD with special emphasis on factors that may interfere with adherence to it.
METHODS: We conducted a search of various databases, such as PubMed, Google Scholar, Embase, and Scielo, with focus on key words such as “gluten-free diet”, “celiac disease”, “gluten” and “gluten-free diet adherence”. Available literature has not reached definitive conclusions on the exact amount of gluten that is harmless to celiac patients, although international agreements establish cutoff points for gluten-free products and advise the use of clinical assessment to tailor the diet according to individual needs. Following GFD must include eliminating gluten as ingredient as well as hidden component and potential cross contamination in foods. There are numerous grains to substitute wheat but composition of most gluten-free products tends to include only a small number of them, especially rice. The diet must be not only free of gluten but also healthy to avoid nutrient, vitamins and minerals deficiencies or excess. Overweight/obesity frequency has increased among celiac patients so weight gain deserves attention during follow up. Nutritional education by a trained nutritionist is of great relevance to achieve long-term satisfactory health status and good compliance.
CONCLUSIONS: A balanced GFD should be based on a combination of naturally gluten-free foods and certified processed gluten-free products. How to measure and improve adherence to GFD is still controversial and deserves further study.
Epilepsy is a disorder where recurrent seizures (fits) are caused by abnormal electrical discharges from the brain. Most seizures can be controlled by one or more antiepileptic medicines but seizures may not be helped by these medicines after a while (called drug-resistant epilepsy). For people who have drug-resistant epilepsy a special diet (called a ketogenic diet) may be considered. Ketogenic diets are high in fat and low in carbohydrate.
This review aimed to investigate the effect of a ketogenic diet on seizure control, cognition (e.g., learning, concentration and academic performance in children; learning, concentration and memory in adults) and behaviour. We also investigated the side effects of the diet and the number of participants who dropped out of the studies and the reasons for this.
We searched medical databases for randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups) of adults or children with epilepsy where a ketogenic diet was compared with other treatments. We found seven randomised controlled trials, with 427 participants. The trials were between three and six months long.
The short-term side effects of ketogenic diets included diarrhoea, constipation and vomiting. In the long term, heart heath could be affected.
All studies reported participants dropping out, due to lack of improvement in seizures and poor tolerance of the diet.
No studies reported upon the effect of ketogenic diets on cognition and behaviour.
Recently, other, more agreeable, ketogenic diets, such as the modified Atkins ketogenic diet, found similar effects on seizure control as those more restrictive ketogenic diets. However, more research is required.
Quality of the evidence
The studies included in this review were limited by small numbers of participants and they only included children; therefore, the quality of the evidence was low.
There is little research at present into the use of these diets in adults, therefore, more research is required in this area.
Supplements & Nutrients
Heart failure affects 5.1 million people in the USA annually. It accounts for a frequent cause of hospitalizations and disability. Patients with congestive heart failure have lower plasma levels of CoQ10, which is an independent predictor of mortality in this patient population. It has been hypothesized that a deficiency of CoQ10 can play a role in the development and worsening of heart failure, and that oral supplementation can possibly improve symptoms and survival in these patients. Based on previous small studies and meta-analyses, the use of CoQ10 in heart failure suggested an improvement ejection fraction, stroke volume, cardiac output, and cardiac index with CoQ10 supplementation, however most of these small studies appeared to be underpowered to result in any significant data. The results of the recent Q-SYMBIO trial demonstrated an improvement in heart failure symptoms with a significant reduction in major adverse cardiovascular events and mortality.
Nutraceuticals might exert significant lipid-lowering effects through multiple mechanisms.
This makes them potential candidates for synergizing the effects of current lipid-lowering drugs.
Nutraceuticals are mostly safe and very well tolerated.
The effect of nutraceuticals on the incidence of cardiovascular outcomes requires further investigation.
The present review provides an up-to-date summary of the findings on the lipid-lowering effects of the most important nutraceuticals and functional foods. Based on current knowledge, nutraceuticals might exert significant lipid-lowering, and their use has several advantages:
They have natural origins and are mainly extracted from natural products.
They are mostly safe and very well tolerated.
Their use is supported by the findings from randomized controlled trials and meta-analyses.
The lipid-lowering effect of most nutraceuticals is multimechanistic, which makes them potential candidates for improving the effects of current lipid-lowering drugs when used in combination.
A number of important questions remain to be addressed, including whether longer durations of therapy would result in a better response and the exact safety profile of nutraceuticals, especially at doses higher than those consumed in an average diet. Additionally, data regarding the effects of nutraceutical supplementation on the incidence of cardiovascular outcomes are lacking, and it is not clear whether additional lipid lowering by nutraceuticals can modify the residual cardiovascular risk that remains after statin therapy.
Nutraceuticals for #lipid lowering? - #heartdisease #CVD #statin #nutraceutical #supplement Click To Tweet
The effect of (L-)carnitine on weight loss in adults: a systematic review and meta-analysis of randomized controlled trials.
This study provides a systematic review and meta-analysis of randomized controlled trials, which have examined the effect of the carnitine on adult weight loss. … Results from meta-analysis of eligible trials revealed that subjects who received carnitine lost significantly more weight (MD: -1.33 kg; 95% CI: -2.09 to -0.57) and showed a decrease in body mass index (MD: -0.47 kg m-2 ; 95% CI: -0.88 to -0.05) compared with the control group. The results of meta-regression analysis of duration of consumption revealed that the magnitude of weight loss resulted by carnitine supplementation significantly decreased over time (p = 0.002). We conclude that receiving the carnitine resulted in weight loss. Using multiple-treatments meta-analysis of the drugs and non-pharmacotherapy options seem to be insightful areas for research.
A systematic review and meta-analysis of randomized controlled trials on the effects of magnesium supplementation on insulin sensitivity and glucose control.
A systematic review and meta-analysis was conducted to evaluate the effect of oral magnesium supplementation on insulin sensitivity and glucose control in both diabetic and non-diabetic individuals. … The impact of magnesium supplementation on plasma concentrations of glucose, glycated hemoglobin (HbA1c), insulin, and HOMA-IR index was assessed in 22, 14, 12 and 10 treatment arms, respectively. A significant effect of magnesium supplementation was observed on HOMA-IR index (WMD: -0.67, 95% CI: -1.20, -0.14, p=0.013) but not on plasma glucose (WMD: -0.20mmol/L, 95% CI: -0.45, 0.05, p=0.119), HbA1c (WMD: 0.018mmol/L, 95% CI: -0.10, 0.13, p=0.756), and insulin (WMD: -2.22mmol/L, 95% CI: -9.62, 5.17, p=0.556). A subgroup analysis comparing magnesium supplementation durations of <4 months versus ≥4 months, exhibited a significant difference for fasting glucose concentrations (p<0.001) and HOMA-IR (p=0.001) in favor of the latter subgroup. Magnesium supplementation for ≥4 months significantly improves the HOMA-IR index and fasting glucose, in both diabetic and non-diabetic subjects. The present findings suggest that magnesium may be a beneficial supplement in glucose metabolic disorders.
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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Exercise prescription for the older population: The interactions between physical activity, sedentary time, and adequate nutrition in maintaining musculoskeletal health.
The minimum amount of physical activity needed to promote musculoskeletal function for older adults is poorly defined.
Combining physical activity and adequate nutrition is critical for maintaining skeletal muscle mass and metabolic health.
The feasibility of reducing sedentary time to maintain musculoskeletal health in older individuals needs to be explored.
Physical activity guidelines should highlight the importance of nutrition combined with resistance-type exercise.
Regular physical activity (PA) promotes musculoskeletal health in older adults. However, the majority of older individuals do not meet current PA guidelines and are also highly sedentary. Emerging evidence indicates that large amounts of sedentary time accelerate the loss of skeletal muscle mass (i.e., sarcopenia) and physical function with advancing age. However, current PA recommendations for sedentary time are non-specific (i.e., keep sedentary time to a minimum). Research indicates that physical inactivity and large amounts of sedentary time accelerate sarcopenic muscle loss by inducing skeletal muscle ‘anabolic resistance’. These findings suggest a critical interaction between engaging in ‘sufficient’ levels of PA, minimising sedentary time, and consuming ‘adequate’ nutrition to promote optimal musculoskeletal health in older adults. However, current PA recommendations do not take into account the important role that nutrition plays in ensuring older adults can maximise the benefits from the PA in which they engage. The aim of this narrative review is: (1) to briefly summarise the evidence used to inform current public health recommendations for PA and sedentary time in older adults; and (2) to discuss the presence of ‘anabolic resistance’ in older adults, highlighting the importance of regular PA and minimising sedentary behaviour. It is imperative that the synergy between PA, minimising sedentary behaviour and adequate nutrition is integrated into future PA guidelines to promote optimal musculoskeletal health and metabolic responses in the growing ageing population.
More activity, less #sedentary time and good #nutrition for #olderadults - #physicalactivity… Click To Tweet
Adherence to Diet and Physical Activity Cancer Prevention Guidelines and Cancer Outcomes: A Systematic Review.
Many studies have reported that adherence to health promotion guidelines for diet, physical activity, and maintenance of healthy body weight may decrease cancer incidence and mortality. A systematic review was performed to examine associations between adherence to established cancer prevention guidelines for diet and physical activity and overall cancer incidence and mortality. … High versus low adherence to established nutrition and physical activity cancer prevention guidelines was consistently and significantly associated with decreases of 10% to 61% in overall cancer incidence and mortality. Consistent significant reductions were also shown for breast cancer incidence (19%-60%), endometrial cancer incidence (23%-60%), and colorectal cancer incidence in both men and women (27%-52%). Findings for lung cancer incidence were equivocal, and no significant relationships were found between adherence and ovarian or prostate cancers. Adhering to cancer prevention guidelines for diet and physical activity is consistently associated with lower risks of overall cancer incidence and mortality, including for some site-specific cancers.
Anatomy & Physiology
PURPOSE OF REVIEW: Symptoms attributed to gluten consumption are frequently reported evoking the need for differentiating nonceliac gluten sensitivity (NCGS) from other gluten-related disorders such as celiac disease and wheat allergy. This review discusses diagnostic criteria and research to date on the pathogenesis and diagnosis of NCGS.
RECENT FINDINGS: There is recent evidence to support NCGS as a distinct clinical entity. The symptoms attributed to NCGS are nonspecific, overlapping with those reported in patients with celiac disease and irritable bowel syndrome. In contrast to celiac disease and wheat allergy, the diagnosis of NCGS is more challenging because there are no specific clinical biomarkers and because the pathogenesis of NCGS is largely not well understood. The pathogenesis of NCGS may reflect alterations in innate immunity to gluten or other components of wheat, may be linked with autoimmunity, or is a result of a reaction to gluten as a fermentable carbohydrate.
SUMMARY: NCGS is a newly characterized and evolving clinical entity that requires ruling out other causes of wheat-related or gluten-related gastrointestinal symptoms, including celiac disease and wheat allergy, coupled with double-blind placebo-controlled crossover challenge with gluten.
Obesity in the Early Childhood Years: State of the Science and Implementation of Promising Solutions: Workshop Summary.
Among the many troubling aspects of the rising prevalence of obesity in the United States and elsewhere in recent years, the growth of early childhood overweight and obesity stands out. To explore what is known about effective and innovative interventions to counter obesity in young children, the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Obesity Solutions held a workshop in October 2015. The workshop brought together many of the leading researchers on obesity in young children to describe the state of the science and potential solutions based on that research. Participants explored sustainable collaborations and new insights into the implementation of interventions and policies, particularly those related to nutrition and physical activity, for the treatment and prevention of obesity in young children. Obesity in the Early Childhood Years summarizes the presentations and discussions from the workshop.
Nutrition and #physicalactivity for #obesity in #children - #nutrition #PA #earlychildhood Click To Tweet
Environmental pollution is a major cause of disease and death. Exposures in early life are especially dangerous. Patterns of exposure vary greatly across countries. In low-income and lower middle income countries (LMICs), infectious, maternal, neonatal, and nutritional diseases are still major contributors to disease burden. By contrast, in upper middle income and high-income countries noncommunicable diseases predominate. To examine patterns of environmental exposure and disease and to relate these patterns to levels of income and development, we obtained publically available data in 12 countries at different levels of development through a global network of World Health Organization Collaborating Centres in Children’s Environmental Health. Pollution exposures in early life contribute to both patterns. Chemical and pesticide pollution are increasing, especially in LMICs. Hazardous wastes, including electronic waste, are accumulating. Pollution-related chronic diseases are becoming epidemic. Future Global Burden of Disease estimates must pay increased attention to the short- and long-term consequences of environmental pollution.
Pain afflflicts over 50 million people in the US, with 30.7% US adults suffering with chronic pain. Despite advances in therapies, many patients will continue to deal with ongoing symptoms that are not fully addressed by the best conventional medicine has to offer them. The patients frequently turn to therapies outside the usual purview of conventional medicine (herbs, acupuncture, meditation, etc.) called complementary and alternative medicine (CAM). Academic and governmental groups are also starting to incorporate CAM recommendations into chronic pain management strategies. Thus, for any physician who care for patients with chronic pain, having some familiarity with these therapies-including risks and benefits-will be key to helping guide patients in making evidence-based, well informed decisions about whether or not to use such therapies. On the other hand, if a CAM therapy has evidence of both safety and efficacy then not making it available to a patient who is suffering does not meet the need of the patient. We summarize the current evidence of a wide variety of CAM modalities that have potential for helping patients with chronic pain in this article. The triad of chronic pain symptoms, ready access to information on the internet, and growing patient empowerment suggest that CAM therapies will remain a consistent part of the healthcare of patients dealing with chronic pain.
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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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