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 and Eating – Low FODMAP diets may help people with IBD.
Supplements – Calcium and Vit D supps decrease loss in bone mineral density in people with RA.
Disease Prevention – Improving gut microbiota can help metabolic syndrome.
Anatomy & Physiology – Our nervous system needs pre-formed DHA.
Food and Eating
CONCLUSIONS: The application of the domestic cooking of potatoes encompasses a variety of processes, such as boiling, frying, steaming, baking and roasting. The modifications (physics, chemical, and enzyme) during domestic cooking affect the nutritional value of the potato to different degrees. Generally, the nutrients, including minerals, vitamins, proteins and dietary fiber are well retained with the appropriate cooking methods. Despite the leaching or degradation of the intrinsic phytochemicals, higher recoveries are obtained due to the release of bound-phytochemicals during domestic cooking. Compared to boiling or mashing, some cooking methods (e.g., frying, microwaving and baking) could reduce the postprandial glycemic response significantly, and a cooling step or co-digestion with protein, lipid and vinegar were effective ways to decrease the GI of potato.
CONTEXT: Nonnutritive sweetener (NNS) consumption is increasing among children, yet its long-term health impact is unclear, particularly when exposure occurs during early life.
OBJECTIVE: To synthesize evidence from prospective studies evaluating the association of early-life NNS exposure and long-term metabolic health.
DATA EXTRACTION: The primary outcome was BMI; secondary outcomes included growth velocity, overweight/obesity, adiposity, and adverse metabolic effects. Study quality and risk of bias were evaluated using validated assessment tools.
CONCLUSIONS: There is limited and inconsistent evidence of the long-term metabolic effects of NNS exposure during gestation, infancy, and childhood. Further research is needed to inform recommendations for the use of NNSs in this sensitive population.
BACKGROUND/OBJECTIVES: Data regarding the relationships between body mass index (BMI) and brain tumors are inconsistent, especially for the commonly seen gliomas and meningiomas. Therefore, we conducted a dose-response meta-analysis to unravel the issue.
CONCLUSIONS: Excess weight was associated with increased risk of brain tumors and meningiomas but not with gliomas. Selective screening for brain tumors among obesity, especially for the females, might be more instructive.
Objectively measured sedentary behaviour and health and development in children and adolescents: systematic review and meta-analysis.
Sedentary behaviour has emerged as a unique determinant of health in adults. Studies in children and adolescents have been less consistent. We reviewed the evidence to determine if the total volume and patterns (i.e. breaks and bouts) of objectively measured sedentary behaviour were associated with adverse health outcomes in young people, independent of moderate-intensity to vigorous-intensity physical activity. … Quality evidence from studies with robust designs and methods, objective measures of sitting, examining associations for various health outcomes, is needed to better understand if the overall volume or patterns of sedentary behaviour are independent determinants of health in children and adolescents.
A systematic review and meta-analysis of energy and macronutrient intake responses to physical activity interventions in children and adolescents with obesity.
BACKGROUND: The effects of regular physical activity on energy intake in obese adolescents are unknown.
OBJECTIVE: The objective is to determine how physical activity interventions affect energy and macronutrient intake in overweight/obese youth.
CONCLUSION: Structured physical activity interventions favour decreased daily energy intake in obese adolescents.
- Probiotics may help certain people with UC, and IBD, but have not been shown to help people with Crohn’s.
- We need to learn more about the gut microbioota.
- Reducing FODMAPs may help people with IBD.
Although patients with inflammatory bowel diseases (IBD) have a strong interest in dietary modifications as part of their therapeutic management, dietary advice plays only a minor part in published guidelines. The scientific literature shows that dietary factors might influence the risk of developing IBD, that dysbiosis induced by nutrition contributes to the pathogenesis of IBD, and that diet may serve as a symptomatic treatment for irritable bowel syndrome-like symptoms in IBD. The role of nutrition in IBD is underscored by the effect of various dietary therapies. In paediatric patients with Crohn’s disease (CD) enteral nutrition (EN) reaches remission rates similar to steroids. In adult patients, however, EN is inferior to corticosteroids. EN is not effective in ulcerative colitis (UC). Total parenteral nutrition in IBD is not superior to steroids or EN. The use of specific probiotics in patients with IBD can be recommended only in special clinical situations. There is no evidence for efficacy of probiotics in CD. By contrast, studies in UC have shown a beneficial effect in selected patients. For patients with pouchitis, antibiotic treatment followed by probiotics, like VSL#3 or Lactobacillus GG, is effective. When probiotics are used, the risk of bacterial translocation and subsequent bacteremia has to be considered. More understanding of the normal intestinal microflora, and better characterization of probiotic strains at the phenotypic and genomic levels is needed as well as clarification of the mechanisms of action in different clinical settings. A FODMAP reduced diet may improve symptoms in IBD.
An eye on nutrition: The role of vitamins, essential fatty acids, and antioxidants in age-related macular degeneration, dry eye syndrome, and cataract.
Visual impairment is a global epidemic. In developing countries, nutritional deficiency and cataracts continue to be the leading cause of blindness, whereas age-related macular degeneration (AMD) and cataracts are the leading causes in developed nations. The World Health Organization has instituted VISION 2020: “The Right to Sight” as a global mission to put an end to worldwide blindness. In industrialized societies, patients, physicians, researchers, nutritionists, and biochemists have been looking toward vitamins and nutrients to prevent AMD, cataracts, and dry eye syndrome (DES). Nutrients from the AREDS2 study (lutein, zeaxanthin, vitamin C, vitamin E, zinc, copper, eicosapentanoic acid [EPA], and docosahexanoic acid [DHA]) set forth by the National Institutes of Health remain the most proven nutritional therapy for reducing the rate of advanced AMD. Omega-3 fatty acids, especially DHA, have been found to improve DES in randomized clinical trials. Conflicting results have been seen with regard to multivitamin supplementation on the prevention of cataract.
BACKGROUND: Osteoporosis is a common complication in patients with rheumatoid arthritis (RA). The change of bone mineral density (BMD) in patients with RA is slow, and little data are known about the long-term change of BMD.
OBJECTIVES: This study aimed to determine the frequency of osteoporosis and the long-term change on BMD in a cohort of Chinese patients with RA routinely receiving calcium and vitamin D supplementation.CONCLUSIONS: Osteoporosis is common in Chinese patients with RA. Routine use of calcium and vitamin D supplementation decreased the risk of BMD decrease and should be recommended for all patients with RA.
The primary purpose of this work was to gain further insight into the need for sodium supplementation for maintenance of appropriate hydration during prolonged exercise under hot conditions. Participants of a 161-km ultramarathon (ambient temperature reaching 39° C) underwent body weight measurements immediately before, during, and after the race, and completed a postrace questionnaire about supplemental sodium intake and drinking strategies during 4 race segments. … Although the use of supplemental sodium enhanced body weight maintenance, those not using sodium supplements maintained a more appropriate weight than those consistently using sodium supplements. Therefore, we conclude that the supplemental sodium is unnecessary to maintain appropriate hydration during prolonged exercise in the heat.
Does Long-Term Furosemide Therapy Cause Thiamine Deficiency in Patients with Heart Failure? A Focused Review.
Diuretic therapy is a cornerstone in the management of heart failure. Most studies assessing body thiamine status have reported variable degrees of thiamine deficiency in patients with heart failure, particularly those treated chronically with high doses of furosemide. Thiamine deficiency in heart failure patients appears to be predominantly attributable to increased urine volume and urinary flow rate. There is also evidence that furosemide may directly inhibit thiamine uptake at the cellular level. Limited data suggest that thiamine supplementation is capable of increasing left ventricular ejection fraction and improving functional capacity in patients with heart failure and a reduced left ventricular ejection fraction who were treated with diuretics (predominantly furosemide). It may therefore be reasonable to provide such patients with thiamine supplementation during heart failure exacerbations.
Folic acid supplementation in pregnancy to prevent preterm birth: a systematic review and meta-analysis of randomized controlled trials.
Folic acid (FA) may have a role in the prevention of pregnancy complications. However, the efficacy of FA supplementation in reducing the risk of preterm birth (PTB) is still unclear. The aim of this systematic review with meta-analysis was to evaluate the efficacy of folic acid supplementation during pregnancy to prevent preterm birth (PTB). The research protocol was designed a priori, defining methods for searching the literature in electronic databases, including and examining articles, and extracting and analyzing data. We included all randomized trials (RCTs) of asymptomatic singleton gestations without prior PTB who were randomized to prophylactic treatment with either FA supplementation or control (placebo or no treatment). The primary outcome was the incidence of PTB <37 weeks. … In summary, FA supplementation during pregnancy does not prevent PTB <37 weeks. Daily FA supplementation remains the most important intervention to reduce the risk of neural tube defects.
- More controversy for antioxidant supplementation. Better clinical studies are needed that specifically look at individual antioxidants, and consider each patient’s “redox state”.
CONCLUSION: Redox state homeostasis in living systems is very complex and life style factors undeniably concur in determining the impact of changes in oxidative stress response in both unhealthy and healthy subjects.
A large part of studies investigating the effectiveness of antioxidant supplementation therapy in humans raised contrasting results. This is due to many aspects among which the often-limited statistic power of the studies, the patient genetic background, the bioavailability of the molecules used, and the non-specific effects that antioxidants might have in the human body, should be taken into account.
Mainly in the elderly, the clinical trials conducted so far often suffer from an incorrect initial selection of the patients. Further investigations should be planned to improve patients selection by performing, for example, quantitative characterizations of the redox state for each individual and taking into account both the individual patient demand and genetic background.
In addition it is worth to underline that, when dealing with either natural or synthetic antioxidants, clinical trials should consider other two important aspects. First, antioxidants bearing different functional moieties can be profoundly diverse in terms of chemical structure and mode of action; therefore, it should be recommended to identify the right antioxidant to treat a specific pathological condition (Bast and Haenen, 2013). Secondly, the validity of the biomarkers used to determine the effects of antioxidants on human health are still under debate (van Ommen et al., 2009). Antioxidants, in fact, might be responsible of subtle effects specific for human health optimization and/or disease prevention, which are processes that can be very different in many aspects from disease onset and progression.
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Diseases/Conditions and Prevention/Treatments
OBJECTIVES: To systematically review the published evidence regarding the association between Mg intake and serum concentrations with MetS and, if possible, to summarize the results using a meta-analysis.
CONCLUSIONS: The present systematic review and meta-analysis found an inverse association between Mg intake and MetS. However, the inverse association for serum Mg levels was highly heterogeneous and sensitive. The link between Mg status and MetS should be confirmed by prospective cohort studies controlling the association for other nutrients related to MetS risk.
CONTEXT: Sedentary time spent with screen media is associated with obesity among children and adults. Obesity has potentially serious health consequences, such as heart disease and diabetes. This Community Guide systematic review examined the effectiveness and economic efficiency of behavioral interventions aimed at reducing recreational (i.e., neither school- nor work-related) sedentary screen time, as measured by screen time, physical activity, diet, and weight-related outcomes.
CONCLUSIONS: Among children, these interventions demonstrated reduced screen time, increased physical activity, and improved diet- and weight-related outcomes. More research is needed among adolescents and adults.
BACKGROUND: Bile acid diarrhoea results from imbalances in the homoeostasis of bile acids in the enterohepatic circulation. It can be a consequence of ileal disease/dysfunction, associated with other GI pathology or can be idiopathic.
CONCLUSION: Bile acid diarrhoea is common, and likely under-diagnosed. Bile acid diarrhoea should be considered relatively early in the differential diagnosis of chronic diarrhoea.
The gut microbiome contributes approximately 2kg of the whole body weight, and recent studies suggest that gut microbiota has a profound effect on human metabolism, potentially contributing to several features of the metabolic syndrome. Metabolic syndrome is defined by a clustering of metabolic disorders that include central adiposity with visceral fat accumulation, dyslipidemia, insulin resistance, dysglycemia and non-optimal blood pressure levels. Metabolic syndrome is associated with an increased risk of cardiovascular diseases and type 2 diabetes. It is estimated that around 20-25 percent of the world’s adult population has metabolic syndrome. In this manuscript, we have reviewed the existing data linking gut microbiome with metabolic syndrome. Existing evidence from studies both in animals and humans support a link between gut microbiome and various components of metabolic syndrome. Possible pathways include involvement with energy homeostasis and metabolic processes, modulation of inflammatory signaling pathways, interferences with the immune system, and interference with the renin-angiotensin system. Modification of gut microbiota via prebiotics, probiotics or other dietary interventions has provided evidence to support a possible beneficial effect of interventions targeting gut microbiota modulation to treat components or complications of metabolic syndrome.
CONTEXT: The “first 1,000 days”-conception through age 24 months-are critical for the development and prevention of childhood obesity. This study systematically reviews existing and ongoing interventions during this period, identifies gaps in current research, and discusses conceptual frameworks and opportunities for future interventions.
CONCLUSIONS: Obesity interventions may have the greatest preventive effect if begun early in life. Yet, few effective interventions in the first 1,000 days exist, and many target individual-level behaviors of parents and infants. Interventions that operate at systems levels and are grounded in salient conceptual frameworks hold promise for improving future models of early-life obesity prevention.
- Observational studies(1), and NOT randomized clinical trials, have shown that a higher blood levels of 25-OH vitamin D are associated with:
- lower risk of being diagnosed with or dying from colorectal cancer,
- lower risk of worsening or dying from breast cancer, and
- no associations with prostate cancer.
- More randomized, double-blind clinical trials are needed to clarify.
Over the past two decades, the question of whether vitamin D has a role in cancer incidence, progression, and mortality has been studied in detail. Colorectal, breast, and prostate cancers have been a particular area of focus; together, these three malignancies account for approximately 35% of cancer cases and 20% of cancer deaths in the United States, and as such are a major public health concern. Herein, we review and synthesize the epidemiological research regarding vitamin D, as measured by the biomarker 25-hydroxycholecalciferol [25(OH)D], and the incidence, progression, and mortality of these cancers. Overall, the results of observational studies of the relationship between 25(OH)D and colorectal cancer have revealed a consistent inverse association for incidence and mortality; while for breast cancer, results have generally demonstrated a relationship between higher 25(OH)D and lower risk for progression and mortality. In contrast, randomized, double-blind clinical trials conducted to date have generally failed to support these findings. For prostate cancer, there is no convincing evidence of an association between 25(OH)D and incidence, and inconsistent data for progression and mortality, though results of one open label clinical trial suggest that supplementation with 4000 IU/d of vitamin D3 may inhibit progression of the disease. Nonetheless, until the results of additional ongoing randomized, double-blind clinical trials are reported, it will be difficult to ascertain if vitamin D itself is related to a reduction in risk for some cancer endpoints, or whether high concentrations of the vitamin D biomarker 25(OH)D may instead serve as a marker for an overall beneficial risk factor profile.
Anatomy & Physiology
Docosahexaenoic acid (DHA) is the predominant omega-3 (n-3) polyunsaturated fatty acid (PUFA) found in the brain and can affect neurological function by modulating signal transduction pathways, neurotransmission, neurogenesis, myelination, membrane receptor function, synaptic plasticity, neuroinflammation, membrane integrity and membrane organization. DHA is rapidly accumulated in the brain during gestation and early infancy, and the availability of DHA via transfer from maternal stores impacts the degree of DHA incorporation into neural tissues. The consumption of DHA leads to many positive physiological and behavioral effects, including those on cognition. Advanced cognitive function is uniquely human, and the optimal development and aging of cognitive abilities has profound impacts on quality of life, productivity, and advancement of society in general. However, the modern diet typically lacks appreciable amounts of DHA. Therefore, in modern populations, maintaining optimal levels of DHA in the brain throughout the lifespan likely requires obtaining preformed DHA via dietary or supplemental sources. In this review, we examine the role of DHA in optimal cognition during development, adulthood, and aging with a focus on human evidence and putative mechanisms of action.
CONCLUSION: Overall, DHA appears to have the ability to influence many different signaling pathways, receptor systems, enzyme activities, membrane structures and dynamics that ultimately lead to overall better development, maintenance and aging of the CNS, resulting in optimal cognition throughout the lifespan. These benefits likely require a sustained supply of DHA across development, adolescence and adulthood to build and maintain sufficient pools and/or to replenish depleted neural stores. For those unable to obtain sufficient amounts of DHA via dietary means, supplemental DHA from fish oil or vegetarian (algal oil) sources is ideal. DHA-containing supplements are taken daily by millions of people worldwide and have been shown to be safe and well tolerated even at high doses .
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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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What I’m reading now: “How Not to Die” by Michael Greger, MD.
I will post my review in the upcoming weeks. 🙂
I love the NutritionFacts.org 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 lives 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 Master of Science degree in Toxicology and Nutrition and is currently studying to be a Registered Holistic Nutritionist. For a list of free health resources, click here.
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