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 – Alcohol’s health promoting AND health depleting effects.
Supplements & Nutrients – Supplements in pregnancy.
Disease Prevention – Tai chi for bone health? (more research needed).
Food & Eating
Epidemiological and experimental studies have consistently linked alcoholic beverage consumption with the development of several chronic disorders, such as cancer, cardiovascular diseases, diabetes mellitus and obesity. The impact of drinking is usually dose-dependent, and light to moderate drinking tends to lower risks of certain diseases, while heavy drinking tends to increase the risks. Besides, other factors such as drinking frequency, genetic susceptibility, smoking, diet, and hormone status can modify the association. The amount of ethanol in alcoholic beverages is the determining factor in most cases, and beverage types could also make an influence. This review summarizes recent studies on alcoholic beverage consumption and several chronic diseases, trying to assess the effects of different drinking patterns, beverage types, interaction with other risk factors, and provide mechanistic explanations.
Resident and physician burnout is a complex issue. Adequate nutrition and hydration play important roles in the maintenance of health and well-being of all individuals. Given the high prevalence of burnout in physicians, we believe that in addition to issues related to heavy workload, structure and length of shifts, the current status of physicians’ nutrition and hydration and their effects on their work performance and well-being should also be addressed. In this review, we summarise the current evidence on the potential effects of nutrition and hydration on physicians’ occupational well-being and performance, identify gaps and discuss opportunities to address nutrition as one of the important means of improving physicians’ well-being.
Coeliac disease and the gluten-free diet: a review of the burdens; factors associated with adherence and impact on health-related quality of life, with specific focus on adolescence.
Adherence and non-adherence to a gluten-free diet (GFD) may impact negatively on health-related quality of life (HRQoL). Understanding the factors that influence compliance could help inform management and also guide support. … A number of studies report that adolescents face stigmatisation and feel isolated in social situations and at school. Additional burdens that are highlighted are a lack of knowledge regarding CD and GFD difficulties in interpreting food labels, as well as dissatisfaction with the organoleptic properties of GF foods. Factors associated with poor adherence in adolescence include older age, an absence of immediate symptoms, difficulties eating out and poor palatability of GF foods. Conversely, better emotional support and stronger organisation skills have been associated with superior adherence. … Further research specific to adolescence is required to identify independent predictors of adherence.
Vinegar as a functional ingredient to improve postprandial glycaemic control – the human intervention findings and the molecular mechanisms.
Type 2 diabetes prevalence worldwide is increasing and the burden is particularly high in Asian countries. Identification of functional food ingredients to curb the rise of diabetes among various Asian population groups is warranted. Vinegar is widely consumed throughout Asia, where the principle bioactive component is acetic acid. This review has collated data from human intervention trials to show that vinegar consumption seems more effective in modulating glycaemic control in normal glucose tolerant individuals than in either type 2 diabetics or in those with impaired glucose tolerance. … The review also discusses why these mechanisms are more effective in non-diabetics than in diabetics.
NOTE from Leesa – This is a great article for infant feeding (free full text in link above)!
Infant dietary patterns tend to be insufficient sources of fruits, vegetables, and fiber, as well as excessive in salt, added sugars, and overall energy. Despite the serious long-term health risks associated with suboptimal fruit and vegetable intake, a large percentage of infants and toddlers in the U.S. do not consume any fruits or vegetables on a daily basis. Since not all fruits and vegetables are nutritionally similar, guidance on the optimal selection of fruits and vegetables should emphasize those with the greatest potential for nutrition and health benefits. A challenge is that the most popularly consumed fruits for this age group (i.e., apples, pears, bananas, grapes, strawberries) do not closely fit the current general recommendations since they tend to be overly sweet and/or high in sugar. Unsaturated oil-containing fruits such as avocados are nutritionally unique among fruits in that they are lower in sugar and higher in fiber and monounsaturated fatty acids than most other fruits, and they also have the proper consistency and texture for first foods with a neutral flavor spectrum. Taken together, avocados show promise for helping to meet the dietary needs of infants and toddlers, and should be considered for inclusion in future dietary recommendations for complementary and transitional feeding.
The Role of Avocados in Maternal Diets during the Periconceptional Period, Pregnancy, and Lactation.
Maternal nutrition plays a crucial role in influencing fertility, fetal development, birth outcomes, and breast milk composition. During the critical window of time from conception through the initiation of complementary feeding, the nutrition of the mother is the nutrition of the offspring-and a mother’s dietary choices can affect both the early health status and lifelong disease risk of the offspring. Most health expert recommendations and government-sponsored dietary guidelines agree that a healthy diet for children and adults (including those who are pregnant and/or lactating) should include an abundance of nutrient-rich foods such as fruits and vegetables. These foods should contain a variety of essential nutrients as well as other compounds that are associated with lower disease risk such as fiber and bioactives. However, the number and amounts of nutrients varies considerably among fruits and vegetables, and not all fruit and vegetable options are considered “nutrient-rich”. Avocados are unique among fruits and vegetables in that, by weight, they contain much higher amounts of the key nutrients folate and potassium, which are normally under-consumed in maternal diets. Avocados also contain higher amounts of several non-essential compounds, such as fiber, monounsaturated fats, and lipid-soluble antioxidants, which have all been linked to improvements in maternal health, birth outcomes and/or breast milk quality. The objective of this report is to review the evidence that avocados may be a unique nutrition source for pregnant and lactating women and, thus, should be considered for inclusion in future dietary recommendations for expecting and new mothers.
Supplements and Nutrients
What is the issue?
Miscarriage occurs frequently among pregnant women but it is often difficult to know the factors responsible. Poor diet, without enough vitamins, has been associated with an increased risk of women losing their baby in early pregnancy. Does vitamin supplementation taken by women before pregnancy and during pregnancy decrease the risk of spontaneous miscarriage? Does supplementation improve maternal, birth and infant outcomes, and are there any side effects?
Why is this important?
Vitamin supplementation is commonly recommended for pregnant women and women planning to conceive. Considering the widespread use of vitamin supplementation before and during pregnancy, it is important to study the relation between vitamin supplementation and early pregnancy outcomes, particularly since the causes of miscarriage are unknown and the nutritional status of a mother can affect her baby’s development.
What evidence did we find?
This review included 40 randomised controlled trials involving 276,820 women and 278,413 pregnancies. Supplementing women with any vitamins does not reduce the number of women who have miscarriages. However, the risk for stillbirth was reduced among women receiving multivitamins plus iron and folic acid compared with iron and folate only groups. Although total fetal loss was lower in women who were given multivitamins without folic acid and multivitamins with or without vitamin A, these findings included one trial each with small numbers of women involved. Also, they include studies where the comparison groups included women receiving either vitamin A or placebo, and thus require caution in interpretation.
What does this mean?
Taking vitamin supplements before pregnancy or in early pregnancy may be beneficial; but this review did not show sufficient evidence that taking vitamin supplements prevents miscarriage.
The recent increase in the intake of folic acid by the general public through fortified foods and supplements, has raised safety concern based on early reports of adverse health outcome in elderly with low B12 status who took high doses of folic acid. These safety concerns are contrary to the 2015 WHO statement that “high folic acid intake has not reliably been shown to be associated with negative healeffects”. In the folic acid post-fortification era, we have shown that in elderly participants in NHANES 1999-2002, high plasma folate level is associated with exacerbation of both clinical (anemia and cognitive impairment) and biochemical (high MMA and high Hcy plasma levels) signs of vitamin B12 deficiency. Adverse clinical outcomes in association with high folate intake were also seen among elderly with low plasma B12 levels from the Framingham Original Cohort and in a study from Australia which combined three elderly cohorts. Relation between high folate and adverse biochemical outcomes were also seen in the Sacramento Area Latino Study on Aging (High Hcy, high MMA and lower TC2) and at an outpatient clinic at Yale University where high folate is associated with higher MMA in the elderly but not in the young. Potential detrimental effects of high folic acid intake may not be limited to the elderly nor to those with B12 deficiency. A study from India linked maternal high RBC folate to increased insulin resistance in offspring. Our study suggested that excessive folic acid intake is associated with lower natural killer cells activity in elderly women. In a recent study we found that the risk for unilateral retinoblastoma in offspring is 4 fold higher in women that are homozygotes for the 19 bp deletion in the DHFR gene and took folic acid supplement during pregnancy. In the elderly this polymorphism is associated with lower memory and executive scores, both being significantly worse in those with high plasma folate. These and other data strongly imply that excessive intake of folic acid is not always safe in certain populations of different age and ethnical/genetic background.
Herb induced liver injury (HILI) and drug induced liver injury (DILI) share the common characteristic of chemical compounds as their causative agents, which were either produced by the plant or synthetic processes. Both, natural and synthetic chemicals are foreign products to the body and need metabolic degradation to be eliminated. During this process, hepatotoxic metabolites may be generated causing liver injury in susceptible patients. There is uncertainty, whether risk factors such as high lipophilicity or high daily and cumulative doses play a pathogenetic role for HILI, as these are under discussion for DILI. It is also often unclear, whether a HILI case has an idiosyncratic or an intrinsic background. Treatment with herbs of Western medicine or traditional Chinese medicine (TCM) rarely causes elevated liver tests (LT). However, HILI can develop to acute liver failure requiring liver transplantation in single cases. HILI is a diagnosis of exclusion, because clinical features of HILI are not specific as they are also found in many other liver diseases unrelated to herbal use. In strikingly increased liver tests signifying severe liver injury, herbal use has to be stopped. To establish HILI as the cause of liver damage, RUCAM (Roussel Uclaf Causality Assessment Method) is a useful tool. Diagnostic problems may emerge when alternative causes were not carefully excluded and the correct therapy is withheld. Future strategies should focus on RUCAM based causality assessment in suspected HILI cases and more regulatory efforts to provide all herbal medicines and herbal dietary supplements used as medicine with strict regulatory surveillance, considering them as herbal drugs and ascertaining an appropriate risk benefit balance.
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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Diseases/Conditions and Prevention/Treatments
Effects of tai chi exercise on bone health in perimenopausal and postmenopausal women: a systematic review and meta-analysis.
Tai chi exercise may have positive effects on bone health in perimenopausal and postmenopausal women. This systematic review is the first to summarize evidence to clarify the efficacy of tai chi exercise in bone health. The benefits of tai chi exercise on bone health remain unclear; further studies are needed. Emerging randomized controlled trials (RCTs) exploring the efficacy of tai chi exercise on bone health among older women, but yielded inconclusive results. Our objective is to conduct a systematic review to evaluate evidence from RCTs to clarify the efficacy of tai chi exercise on bone mineral density (BMD), and bone turnover markers (BTM) in perimenopausal and postmenopausal women. Six electronic databases were searched, and reference lists of systematic reviews and identified studies from the search strategy were also screened. We included all RCTs that investigate tai chi exercise for bone health in perimenopausal and postmenopausal women. Data selection, extraction, and evaluation of risk of bias were performed independently by two reviewers. Ten trials detailed in 11 articles were included. Six of the 11 studies reported positive outcomes on bone health. Results of our meta-analysis showed a significant effect of tai chi exercise on BMD change at the spine compared with no treatment in perimenopausal and postmenopausal women. When tai chi exercise combined with a calcium supplement was compared with the calcium supplement alone, the result of BMD change at the spine showed no significant effect. Because the measurable effect observed was minimal, and due to the low quality of methodology of the studies, we conclude that the result is of limited reliability. Tai chi exercise may have benefits on bone health in perimenopausal and postmenopausal women, but the evidence is sometimes weak, poor, and inconsistent. Consequently, only limited conclusions can be drawn regarding the efficacy of tai chi exercise on bone health. Further well designed studies with low risk of bias are needed.
NOTE from Leesa – “cis” is the opposite of “trans” (see figure 1 in the free full text article linked above)
The effects of cis-monounsaturated fatty acids (cis-MUFAs) on the risk of coronary heart disease (CHD) and on CHD mortality are not clear. Also, dietary recommendations for cis-MUFA as derived by various organizations are not in agreement. Earlier studies have mainly focused on the effects of cis-MUFA on serum lipids and lipoproteins. More recent studies, however, have also addressed effects of cis-MUFA on other non-traditional CHD risk markers such as vascular function markers, postprandial vascular function, and energy intake and metabolism. Although well-designed randomized controlled trials with CHD events as endpoints are missing, several large prospective cohort studies have recently been published on the relationship between cis-MUFA and CHD risk. The aim of this paper is to review these new studies that have been published in the last 3 years on the effects of cis-MUFA on cardiovascular risk markers and CHD.
In summary, recent studies are in line with the earlier studies showing that cis-MUFAs have a favorable effect on the serum lipoprotein profile as compared with a mixture of SFA, while effects are comparable to those of linoleic and α-linolenic acid. Effects on fasting and postprandial vascular function have not been studied extensively and no consistent differences between the various fatty acids are evident. Longer-term studies should address whether products rich in cis-MUFA affect energy intake and metabolism compared with other macronutrients. In fact, studies addressing the effects of food sources and matrices are of interest, as this may impact the results. Well-designed RCTs with CVD events as endpoints are lacking. Evidence from large prospective cohort studies regarding effects of cis-MUFA on the risk to develop CHD is limited, but several studies do suggest that replacements of SFA or high-glycemic index foods for cis-MUFA lowers CHD risk. In this respect, however, cis-MUFA is not more beneficial than linoleic acid. More research is thus required on the long-term effects of cis-MUFA as compared with other macronutrients on CHD risk markers as well as on clinical endpoints to clarify the potential role of cis-MUFAs in the primary and secondary prevention of CHD.
Use of complementary and alternative medicine in children and adolescents with autism spectrum disorder: A systematic review.
Despite limited evidence, complementary and alternative medicine treatments are popular in autism spectrum disorder. The aim of this review was to summarize the available evidence on complementary and alternative medicine use frequency in autism spectrum disorder. … Special diets or dietary supplements (including vitamins) were the most frequent complementary and alternative medicine treatments, ranking first in 75% of studies. There was some evidence for a higher prevalence of complementary and alternative medicine use in autism spectrum disorder compared to other psychiatric disorders and the general population. Approximately half of children and adolescents with autism spectrum disorder use complementary and alternative medicine. Doctors should be aware of this and should discuss complementary and alternative medicine use with patients and their carers, especially as the evidence is mixed and some complementary and alternative medicine treatments are potentially harmful.
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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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How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease by Michael Greger, MD
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