This Week in Science for Holistic Health – 07May2016

This Week in Science for Holistic Health

07May2016 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!

This issue:

  • Food & Eating – Milk – good or bad for health? Or neutral?

  • Supplements & Nutrients- Probiotics may not work in the elderly.

  • Disease Prevention – Cancer and phytochemicals, acupuncture & antineoplastons

  • Anatomy & Physiology – Gut microbes and more gut microbes.


Food & Eating

Does Milk Consumption Contribute to Cardiometabolic Health and Overall Diet Quality?

Although milk consumption is recommended in most dietary guidelines around the world, its contribution to overall diet quality remains a matter of debate in the scientific community as well as in the public domain. This article summarizes the discussion among experts in the field on the place of milk in a balanced healthy diet. The evidence to date suggests at least a neutral effect of milk intake on health outcomes. The possibility that milk intake is simply a marker of diets higher in nutritional quality cannot be ruled out. This review also identifies a number of key research gaps pertaining to the impact of milk consumption on health. These need to be addressed to better inform future dietary guidelines.

Although in principle, RCTs would be the optimal means of assessing the impact of milk consumption per se on clinical outcomes such as CVD, type 2 diabetes, or cancer, such studies are for the most part not practicable, and hence it is necessary to rely on high-quality observational cohort studies as well as on smaller-scale clinical studies of milk effects on surrogates of disease outcome such as cardiometabolic risk factors. The available body of evidence is relatively consistent in supporting a neutral effect of milk intake on multiple health outcomes (Table 3). This raises the question about the relevance of including milk (and dairy) as part of the guidelines for promoting healthy eating. However, milk consumption does contribute to the intake of several important nutrients, and this needs to be factored in when considering the place of milk in current dietary guidelines.

Milk - good or bad for health? Or neutral? #milk #dairy #dietaryguidelines #CVD #diabetes… Click To Tweet

Metabolic Inflammation-Differential Modulation by Dietary Constituents.

Obesity arises from a sustained positive energy balance which triggers a pro-inflammatory response, a key contributor to metabolic diseases such as T2D. Recent studies, focused on the emerging area of metabolic-inflammation, highlight that specific metabolites can modulate the functional nature and inflammatory phenotype of immune cells. In obesity, expanding adipose tissue attracts immune cells, creating an inflammatory environment within this fatty acid storage organ. Resident immune cells undergo both a pro-inflammatory and metabolic switch in their function. Inflammatory mediators, such as TNF-α and IL-1β, are induced by saturated fatty acids and disrupt insulin signaling. Conversely, monounsaturated and polyunsaturated fatty acids do not interrupt metabolism and inflammation to the same extent. AMPK links inflammation, metabolism and T2D, with roles to play in all and is influenced negatively by obesity. Lipid spillover results in hepatic lipotoxicity and steatosis. Also in skeletal muscle, excessive FFA can impede insulin’s action and promote inflammation. Ectopic fat can also affect pancreatic β-cell function, thereby contributing to insulin resistance. Therapeutics, lifestyle changes, supplements and dietary manipulation are all possible avenues to combat metabolic inflammation and the subsequent insulin resistant state which will be explored in the current review.

As discussed throughout this review, metabolic-inflammation in the metabolic and immune cells of adipose, liver, pancreas and skeletal muscle contributes to the development of obesity induced insulin resistance and T2D. Hypertrophic adipose tissue occurs in obesity with reduced adipogenesis and the inability to maintain insulin sensitivity. Initial immune cell infiltration is a protective mechanism, but with increasing adiposity, immune cell number and chemokine secretion proportionally increase. The immune cells undergo a phenotypic switch from M2 anti-inflammatory to M1 pro-inflammatory, with the Mme in between the two. SFA, namely PA, induce the former, with MUFA and PUFA influencing the latter phenotypes. Inflammatory mediators can inhibit insulin signaling and glucose transport and worsen the already established inflammation within the metabolic tissues. TNF-α and IL-1β are two of the major players in this event. Inflammation and diet combined can determine the metabolic pathway utilized by the cell. Inflammation undergoes metabolic reprogramming, with a switch from energy efficient oxidative phosphorylation to the less efficient glycolysis. Downstream metabolites from this can then feedback and cause further inflammation and oxidative stress. The energy sensor, AMPK, has been shown to be involved in metabolic fatty acid oxidation, while having an anti-inflammatory effect induced by OA and PO. Conversely, pAMPK is decreased in obesity and with SFA. Lipid “spillover” from the expanding adipose tissue ends up causing lipotoxicity and hepatic steatosis within the liver, which is ill equipped to deal with excess FFA. The skeletal muscles’ inability to respond effectively to insulin is a direct result of lipid accumulation within this tissue. Furthermore, PA can activate the NF-κB pathway exacerbating the situation. The pancreas is sensitive to hyperglycemia and develops glucotoxicity as a result. This can lead to β-cell dysfunction and eventual failure, with the pancreas being the instrumental organ in insulin secretion. Obesity per se is a nutritional stressor at the heart of the metabolic-inflammatory environment. Lifestyle interventions and weight loss are effective but difficult to maintain. There are many therapeutics available, however, their incomplete effects or side effects mean there is no one cure for all the symptoms of metabolic-inflammation and insulin resistance. Dietary manipulation of fat quality is an attractive option but mixed results make it hard to enforce.
Discrepancies between in vitro, animal and human studies make it difficult to ascertain the exact mechanisms at play and, more importantly, how best to treat them. Although in vitro and animal studies provide an opportunity for mechanistic examination of the pathways involved using genetic deletion, inhibition with drugs, treatments with individual dietary components and use of elaborate techniques; these are not all possible in human studies. The lack of translation between these models and humans is understandable; however, the lack of consistency and findings among human studies is harder to accept. Various factors including differences in study design, doses of nutrients and drugs utilized, combination of nutrients within a human diet, lifestyle, and many other aspects could be confounding the results from human intervention studies. The interplay between different fatty acids, inflammatory cytokines, metabolic pathways and nutrient and pathogen sensing pathways further complicate the field. Further investigation is required to decipher if dietary fatty acids affect the metabolic switch in immune cells and how metabolites can affect the immune and metabolic tissues. Metabolism and inflammation have not yet been effectively demonstrated in human studies and warrant further research. More combination studies are required as different inflammatory mediators interact and synergize with one other, the same of which is true for dietary constituents. Regression of the insulin resistant phenotype needs more attention as, realistically, this is the scenario we are attempting to address in the human setting. The complexity of all these pathways in obesity leading to adipose tissue expansion, lipotoxicity, glucotoxicity, inhibition of insulin signaling, and low-grade chronic inflammation means there are multiple sites that require targeting. Given the specificity, high cost and adverse effects of pharmaceuticals, perhaps, nutrient therapies are the better option. Nutritional interventions allow for easier combination therapies, with fewer side effects, and also allow for longer term treatment. A whole body approach is required which involves weight loss, and use of anti-inflammatories, insulin sensitizers and anti-oxidants in order to fully combat obesity-induced metabolic-inflammation and its subsequent diseases.

Roots and Tuber Crops as Functional Foods: A Review on Phytochemical Constituents and Their Potential Health Benefits.

Starchy roots and tuber crops play a pivotal role in the human diet. There are number of roots and tubers which make an extensive biodiversity even within the same geographical location. Thus, they add variety to the diet in addition to offering numerous desirable nutritional and health benefits such as antioxidative, hypoglycemic, hypocholesterolemic, antimicrobial, and immunomodulatory activities. A number of bioactive constituents such as phenolic compounds, saponins, bioactive proteins, glycoalkaloids, and phytic acids are responsible for the observed effects. Many starchy tuber crops, except the common potatoes, sweet potatoes, and cassava, are not yet fully explored for their nutritional and health benefits. In Asian countries, some edible tubers are also used as traditional medicinal. A variety of foods can be prepared using tubers and they may also be used in industrial applications. Processing may affect the bioactivities of constituent compounds. Tubers have an immense potential as functional foods and nutraceutical ingredients to be explored in disease risk reduction and wellness.

Amazing benefits of #roots and #tubers - #potatoes #sweetpotatoes #cassava #antioxidant… Click To Tweet

Effect of diet-induced weight loss on muscle strength in adults with overweight or obesity – a systematic review and meta-analysis of clinical trials.

We conducted a systematic review and meta-analysis to identify how diet-induced weight loss in adults with overweight or obesity impacts on muscle strength. Twenty-seven publications, including 33 interventions, most of which were 8-24 weeks in duration, were included. Meta-analysis of seven interventions measuring knee extensor strength by isokinetic dynamometry in 108 participants found a significant decrease following diet-induced weight loss (-9.0 [95% confidence interval: -13.8, -4.1] N/m, P < 0.001), representing a 7.5% decrease from baseline values. Meta-analysis of handgrip strength from 10 interventions in 231 participants showed a non-significant decrease (-1.7 [-3.6, 0.1] kg, P = 0.070), with significant heterogeneity (I2  = 83.9%, P < 0.001). This heterogeneity may have been due to diet type, because there was a significant decrease in handgrip strength in seven interventions in 169 participants involving moderate energy restriction (-2.4 [-4.8, -0.0] kg, P = 0.046), representing a 4.6% decrease from baseline values, but not in three interventions in 62 participants involving very-low-energy diet (-0.4 [-2.0, 1.2] kg, P = 0.610). Because of variability in methodology and muscles tested, no other data could be meta-analyzed, and qualitative assessment of the remaining interventions revealed mixed results. Despite varying methodologies, diets and small sample sizes, these findings suggest a potential adverse effect of diet-induced weight loss on muscle strength. While these findings should not act as a deterrent against weight loss, due to the known health benefits of losing excess weight, they call for strategies to combat strength loss – such as weight training and other exercises – during diet-induced weight loss.

Consider adding #strengthtraining to your #weightloss #diet to keep your #musclestrength -… Click To Tweet

The relationship between nutrition and frailty: Effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review.

BACKGROUND:  Frailty is a geriatric syndrome that predicts the onset of disability, morbidity and mortality in elderly people; it is a state of pre-disability and is reversible. The aim of this review is to assess how nutrition influences both the risk of developing frailty and its treatment.

DATA SOURCES:  We searched two databases, PubMed and Web of Science. We included epidemiologic studies and clinical trials carried out on people aged over 65 years. We included 32 studies with a total of over 50,000 participants.

RESULTS:  The prevalence of frailty is ranges from 15% among elderly people living in the community to 54% among those hospitalized. Furthermore, the prevalence of frailty is disproportionately high among elderly people who are malnourished. Malnutrition, which is very prevalent in geriatric populations, is one of the main risk factors for the onset of frailty. A good nutritional status and, wherever necessary, supplementation with macronutrients and micronutrients reduce the risk of developing frailty. Physical exercise has been shown to improve functional status, helps to prevent frailty and is an effective treatment to reverse it. Despite the relatively large number of studies included, this review has some limitations. Firstly, variability in the design of the studies and their different aims reduce their comparability. Secondly, several of the studies did not adequately define frailty.

CONCLUSIONS:  Poor nutritional status is associated with the onset of frailty. Screening and early diagnosis of malnutrition and frailty in elderly people will help to prevent the onset of disability. Effective treatment is based on correction of the macro- and micronutrient deficit and physical exercise.

Poor #nutrition is associated with #frailty in the #elderly - Make sure to get those #nutrients… Click To Tweet

Pertinence of the recent school-based nutrition interventions targeting fruit and vegetable consumption in the United States:a systematic review.

BACKGROUND:  Schools are the major locations for implementing children’s dietary behavior related educational or interventional programs. Recently, there has been an increase in school-based nutrition interventions. The objective of this systematic review was to overview the evidence for the effectiveness of school-based nutrition intervention on fruit and vegetable consumption.

METHODS:  PubMed was used to search for articles on school-based nutrition interventions that measured students’ fruit and vegetable consumption. Our search yielded 238 articles.The article was included if published in a peer-reviewed journal, written in English language,administered in the United States, and conducted among a population-based sample of children in Kindergarten through eighth grade. A total of 14 publications met the inclusion criteria.

RESULTS:  Eight articles successfully showed the positive effect on increasing fruit and or vegetable consumption while the other six did not. Several factors, including (but not limited to) intervention duration, type of theory used, style of intervention leadership, and positively affecting antecedents of fruit and vegetable consumption were compared; however, no dominant factor was found to be shared among the studies with significant findings. Given that the criteria for selection were high, the lack of consistency between interventions and positive outcomes was surprising.

CONCLUSION:  With high levels of scrutiny and budget constraints on school nutrition, it is imperative that more research be conducted to identify the effective intervention components.

Unclear if better #school #lunch programs increase #fruit & #vegetable consumption Click To Tweet


Supplements and Nutrients

Probiotics Reduce the Risk of Antibiotic-Associated Diarrhea in Adults (18-64 Years) but Not the Elderly (>65 Years): A Meta-Analysis.

BACKGROUND:  Antibiotic-associated diarrhea (AAD) is a common problem in adults and elderly patients due to the widespread use of antibiotics in this population. Multiple previous systematic reviews have demonstrated an association between specific probiotics and decrease of AAD, especially in children. As there is no specific analysis concerning the elderly patients, we decided to focus on adults, especially elderly people.

METHODS:  We performed a systematic review of the literature regarding the use of probiotics in the treatment of AAD in adults (18-64 years old) and elderly subjects (≥65 years old). We identified 436 articles that met the search criteria. Thirty randomized controlled trials met the predefined inclusion criteria and were included in the meta-analysis.

RESULTS:  There was considerable heterogeneity among the trials (P < .001); thus, subgroup analyses were performed. The meta-analysis resulted in a pooled relative risk (RR) of AAD of 0.69 (95% confidence interval [95% CI]: 0.62-0.76) in a fixed effects model and 0.58 (95% CI: 0.48-0.71) in a random effects model, as compared with placebo. The positive association between intake of probiotic and reduced risk of AAD was observed in adults (RR, 0.47; 95% CI: 0.4-0.56). In contrast, in elderly patients, there was no positive effect (RR, 0.94; 95% CI: 0.76-1.15) of probiotic use and AAD.

CONCLUSION:  In summary, the results emerging from our meta-analysis suggested that adjunct probiotic administration is associated with a reduced risk of AAD in adults but not in elderly people.

Probiotics for antibiotic-associated #diarrhea - #children #adults #elderly #probiotics… Click To Tweet

The Basis of Structure/Function Claims of Nutraceuticals.

In the United States, as in most of the world, there are large numbers of nutraceuticals that are sold and which people take to boost their immune response. There are, in addition, almost an equal number of products sold to reduce allergies. However, very few consumers, and indeed physicians, are aware of what a structure/function claim is. Structure/function claims are labeling claims that can be used to describe the potential effects of a dietary ingredient or similar substance on the structure or function of the human body. This category of claims was created by legislation contained in the Dietary Supplement Health and Education Act. The intent was to supply consumers with reasonably substantiated information that would allow them to make educated choices about their diet and health. They were not intended to have the same weight and substantiation as the claims made for conventional prescription pharmaceuticals. Rather, they were proposed to fill the gap between consumer desire for over-the-counter supplements and foods, and rigorous and generally more potent and potentially “toxic” prescription medications. The legally mandated disclaimer, stating that the U.S. Food and Drug Administration has not evaluated the structure/function claim, often leads to misinterpretation. While there should be a biologic premise underlying the claim, there is not an absolute requirement for a conventional rigorous placebo-controlled dose response trial. While this may not be the clinical standard that a typical scientific oriented society might desire, it reflects the attempts of the FDA to find common grounds and to allow consumers to use products that are generally considered as safe based on historical use and biologic comparisons. The logic of, indeed need for, structure/function claims is straightforward; however, of equal importance is that nutraceuticals should be properly labeled, have accuracy in their ingredients, be free of contamination, be safe, and have a reasonable body of data that supports their efficacy.

Supplement claims - what standards are there? #FDA #supplement #nutraceutical #claim Click To Tweet


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Diseases/Conditions and Prevention/Treatments

Dietary phytochemicals as epigenetic modifiers in cancer: Promise and challenges.

The influence of diet and environment on human health has been known since ages. Plant-derived natural bioactive compounds (phytochemicals) have acquired an important role in human diet as potent antioxidants and cancer chemopreventive agents. In past few decades, the role of epigenetic alterations such as DNA methylation, histone modifications and non-coding RNAs in the regulation of mammalian genome have been comprehensively addressed. Although the effects of dietary phytochemicals on gene expression and signaling pathways have been widely studied in cancer, the impact of these dietary compounds on mammalian epigenome is rapidly emerging. The present review outlines the role of different epigenetic mechanisms in the regulation and maintenance of mammalian genome and focuses on the role of dietary phytochemicals as epigenetic modifiers in cancer. Above all, the review focuses on summarizing the progress made thus far in cancer chemoprevention with dietary phytochemicals, the heightened interest and challenges in the future.

More evidence that eating plants prevents cancer - #phytochemical #antioxidant #plant-based… Click To Tweet

Antineoplastons PDQ Cancer Information Summaries

  • Antineoplastons are drugs composed of chemical compounds that are naturally present in the urine and blood. They are an experimental cancer therapy that is purported to provide a natural biochemical substance that is excreted and therefore lacking in people with cancer.
  • Antineoplastons were first proposed as a possible cancer treatment in 1976.
  • Antineoplastons were originally isolated from human urine but are now synthesized from readily available chemicals in the developer’s laboratory.
  • Antineoplastons are not approved by the U.S. Food and Drug Administration for the prevention or treatment of any disease.
  • No randomized controlled trials showing the effectiveness of antineoplastons have been published in the peer-reviewed scientific literature.
  • Antineoplaston side effects can include serious neurologic toxicity.
  • Nonrandomized clinical trials investigating the anticancer efficacy of antineoplastons are underway at the developer’s institute.
No published studies of antineoplastons - #morestudiesneeded #antineoplastons #cancer Click To Tweet

Acupuncture PDQ Cancer Information Summaries

Can acupuncture help cancer patients cope? - #acupuncture #cancer #nausea #vomiting Click To Tweet

Vitamin D and Autism Spectrum Disorder: A Literature Review.

Low vitamin D status in early development has been hypothesised as an environmental risk factor for Autism Spectrum Disorder (ASD), given the concurrent increase in the prevalence of these two conditions, and the association of vitamin D with many ASD-associated medical conditions. Identification of vitamin D-ASD factors may provide indications for primary and secondary prevention interventions. We systematically reviewed the literature for studies on vitamin D-ASD relationship, including potential mechanistic pathways. We identified seven specific areas, including: latitude, season of conception/birth, maternal migration/ethnicity, vitamin D status of mothers and ASD patients, and vitamin D intervention to prevent and treat ASD. Due to differences in the methodological procedures and inconsistent results, drawing conclusions from the first three areas is difficult. Using a more direct measure of vitamin D status-that is, serum 25(OH)D level during pregnancy or childhood-we found growing evidence for a relationship between vitamin D and ASD. These findings are supported by convincing evidence from experimental studies investigating the mechanistic pathways. However, with few primary and secondary prevention intervention trials, this relationship cannot be determined, unless randomised placebo-controlled trials of vitamin D as a preventive or disease-modifying measure in ASD patients are available.

Vitamin D & Autism Spectrum Disorder - Link? Or not? - #vitD #vitaminD #autism Click To Tweet


Anatomy & Physiology

The Microbiome and Mental Health: Looking Back, Moving Forward with Lessons from Allergic Diseases.

Relationships between gastrointestinal viscera and human emotions have been documented by virtually all medical traditions known to date. The focus on this relationship has waxed and waned through the centuries, with noted surges in interest driven by cultural forces. Here we explore some of this history and the emerging trends in experimental and clinical research. In particular, we pay specific attention to how the hygiene hypothesis and emerging research on traditional dietary patterns has helped re-ignite interest in the use of microbes to support mental health. At present, the application of microbes and their structural parts as a means to positively influence mental health is an area filled with promise. However, there are many limitations within this new paradigm shift in neuropsychiatry. Impediments that could block translation of encouraging experimental studies include environmental forces that work toward dysbiosis, perhaps none more important than westernized dietary patterns. On the other hand, it is likely that specific dietary choices may amplify the value of future microbial-based therapeutics. Pre-clinical and clinical research involving microbiota and allergic disorders has predated recent work in psychiatry, an early start that provides valuable lessons. The microbiome is intimately connected to diet, nutrition, and other lifestyle variables; microbial-based psychopharmacology will need to consider this contextual application, otherwise the ceiling of clinical expectations will likely need to be lowered.

What do we actually know about the role our #gutmicrobiota play in #mentalhealth - #GI… Click To Tweet

A healthy gastrointestinal microbiome is dependent on dietary diversity.

BACKGROUND:  Like all healthy ecosystems, richness of microbiota species characterizes the GI microbiome in healthy individuals. Conversely, a loss in species diversity is a common finding in several disease states. This biome is flooded with energy in the form of undigested and partially digested foods, and in some cases drugs and dietary supplements. Each microbiotic species in the biome transforms that energy into new molecules, which may signal messages to physiological systems of the host.

SCOPE OF REVIEW:  Dietary choices select substrates for species, providing a competitive advantage over other GI microbiota. The more diverse the diet, the more diverse the microbiome and the more adaptable it will be to perturbations. Unfortunately, dietary diversity has been lost during the past 50 years and dietary choices that exclude food products from animals or plants will narrow the GI microbiome further.

MAJOR CONCLUSION:  Additional research into expanding gut microbial richness by dietary diversity is likely to expand concepts in healthy nutrition, stimulate discovery of new diagnostics, and open up novel therapeutic possibilities.

A diverse diet increases diversity of gut microbes - #diet #diversity #microbes #gut #GI Click To Tweet


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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. 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”. 🙂

Enjoy! 🙂

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What Leesa is reading now:

I love the site, it’s definitely one of my “go-to’s” when it comes to nutrition and health information
How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease by Michael Greger, MD
Part 1 includes chapters for “How not to die from:” heart/lung/brain, etc. diseases with almost 3,000 scientific references; Part 2 has Dr. Greger’s favourite recipes, kitchen gadgets, brands, etc.. I’m looking forward to reading this!

Watch the trailer here:

Buy the book here:

(affiliate link image above)

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 Nutrition, 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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