Abstracts
B Vitamins Beat Depression
This month’s (August) American Journal of Clinical Nutrition presents a longitudinal study supporting the use of B vitamins in the management of mental health.
In Nutritional Therapy practice when we are faced with patients who seem to be struggling with depression and are finding recovery hard as well as trying to prevent recurrence after resolving their current symptoms we often think – B Vitamins
But what is the evidence for this apparently normal recommendation – is there anything of substance that supports the therapeutic use of these water soluble vitamins.
To date most studies have been conducted using a cross sectional approach[1],[2] (a class of research methods that involve observation of some subset of a population of items all at the same time, in which, groups can be compared at different ages with respect of independent variables) rather than the preferred prospective style investigations (an analytic study designed to determine the relationship between a condition and a characteristic shared by some members of a group). A prospective study may involve many variables or only two; it may seek to demonstrate a relationship that is an association or one that is causal. Prospective studies produce a direct measure of risk called the relative risk.
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Does Junk Food increase the risk of Allergies and IBD?
As discussed here on many occasions it is well recognised that developed countries are suffering from an epidemic rise in immunologic disorders, such as allergy-related diseases and certain auto-immunities. One of the proposed explanations and one that I feel most convinced about is the changing composition of our intestinal microflora and parasite burden. Our intestinal ecological changes appear to be altering our ability to manage appropriate immunomodulatory responses to various ingested and inhaled antigens.
The Proceedings of The National Academy of Science Journal published a paper this June 2010 exploring the differences in the microbial communities between those children on a western style diet and those from a rural African community whose diet reflected that of a the early humans – high in fibre.[1]
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Blueberries for Blood Pressure Benefits – A Medicinal Food?
In the management of patients for hypertension and weight, linked to metabolic syndrome, we will find ourselves saying – eat more fruits and vegetables without always giving them our full attention – well I do anyway!
A paper just out in the Journal of Nutrition describes the effects of consuming 50gm of freeze dried blueberry smoothie equivalent they suggest to -350g of fresh blueberries for eight weeks by 48 participants (44 women & 4 men) with an average age of 50 and BMI of 38kg/m2.[1]
This was not just a simple watch and see trial, they randomised it with a placebo, so whilst the numbers are small the methodology is sound. The controls were asked to consume 960ml of water daily – even this had an effect as I have previously described.
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Fat to Thin Quenches Inflammation!
There are numerous benefits related to maintaining a healthy body mass and apart from personal comfort and self esteem the reduction of excess fatty tissues has been proven to show a great deal of change in circulating markers of inflammation. Pro inflammatory cytokines are understood to be involved with a wide range of adverse health conditions and it is generally accepted that managing to keep these low molecular weight molecules in a state of balance will provide benefits to all tissues in the body – including the brain.
Two types of cytokine in particular are related to obesity – IL-6 and TNF-α and raised levels will undoubtedly have adverse effects and reduce capacity for a healthy life. This study out in GUT demonstrates that excessive weight loss is an effective anti-inflammatory strategy.[1]
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Dendritic Cells Aid Intestinal Homeostasis and Disease
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Inside our gastrointestinal tract live a family of specialised cells, co-dependent on bacteria and nutrients to send a calming message to the mucosal tissues. They have a number of variations in their make up but they are vital in their role as diplomats, passing sensitive information across the borders to provide a long term peaceful mission and maintain oral tolerance. Essentially they induce either protective immunity to infectious agents or tolerance to innocuous antigens, including food and commensal bacteria. This recent article out in the Journal of Clinical Investigation explores the current understanding of how these cells contribute to health and illness.[1]
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Vitamin D Halves Asthma Hospitalisation Risk
There seems no end to the illnesses this secasteroid is capable of influencing, although it should be of no real surprise that Vit D deficiency is linked to the respiratory condition asthma. The reason….mucosal tissues such as those found in the lung are rich with immune receptors that are intimately tied into the Vit D receptor family. Vitamin D up regulates a specific gene that produces over 200 anti-microbial peptides, some of which work like a broad-spectrum antibiotic.
Because of its beneficial role in respiratory tract infections and immune system modulation, it has been hypothesised that vitamin D status might affect the risks for exacerbations.[1] This paper shows show that children with initial circulating vitamin D levels of 30 ng/mL or less (vitamin D insufficiency) have a 50% greater risk for severe exacerbation over the course of a 4-year clinical trial of asthma treatment than children with circulating vitamin D levels of 30 ng/mL or greater (vitamin D sufficiency) at the start of the trial.
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Vitamin E Prevents Alzheimer’s?
A study in the Journal of Alzheimer’s Disease has raised the interesting correlation between a single nutrient with multiple components and Alzheimer’s disease (AD) reduction.recommendations I have described earlier.
The researchers hypothesised:
That all the vitamin E family members could be important in protecting against AD. If confirmed, this result has implications for both individuals and society, as 70 percent of all dementia cases in the general population occur in people over 75 years of age, and the study suggests a protective effect of vitamin E against AD in individuals aged 80+.
This study looked at the levels in the plasma of 8 different forms of vitamin E and their relationship to Alzheimer’s in an elderly population.
A total of 232 dementia free 80+ year old people were followed for 6 years to detect incidence of AD. Plasma levels of In this study we investigated the association between plasma levels of eight forms of vitamin E (α-, β-, γ, and δ-tocopherol; α-, β-, γ-, and δ-tocotrienol) were measured at baseline.
They found that subjects with plasma levels of total tocopherols, total tocotrienols, or total vitamin E in the highest tertile had a reduced risk of developing AD in comparison to persons in the lowest tertile.
When considering each vitamin E form, the risk of developing AD was reduced only in association with high plasma levels of β-tocopherol (HR: 0.62, 95% CI 0.39-0.99), whereas α-tocopherol, α- tocotrienol, and β-tocotrienol showed only a marginally significant effect in the multiadjusted
In conclusion, high plasma levels of vitamin E are associated with a reduced risk of AD in advanced age. The neuroprotective effect of vitamin E seems to be related to the combination of different forms, rather than to α-tocopherol alone, whose efficacy in interventions against AD is currently debated.
The study found that subjects with higher blood levels of all the vitamin E family forms had a reduced risk of developing AD, compared to subjects with lower levels. After adjusting for various con-founders, the risk was reduced by 45-54 percent, depending on the vitamin E component, said the researchers.
Comment
The use of single nutrient analysis is consistent with the reductionist analysis favoured by drug investigators, but also provides valid insights into the potential role of specific nutrient complexes and risk of AD. The mix of vitamin E components suggests total dietary intake may be more effective than limited single nutrient interventions, but adding a natural Vit E supplement with a complex present may well suit older patients less willing to modify their dietary choices.
References
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More Evidence to Support Vit D as an Anti Viral Compound
Last year I wrote a number of posts relating to mechanisms related to mucosal immune defences, in particular the innate immune defences and how we as Nutritional Therapists may advise our patients of evidence based strategies. This paper out in the open access journal Plos One adds further validity to the vitamin D recommendations I proposed.
Declining serum concentrations of 25-hydroxyvitamin D seen in the fall and winter as distance increases from the equator may be a factor in the seasonal increased prevalence of influenza and other viral infections.[1]
This paper in PLOS Biology describes how almost 200 adults had their serum 25-hydroxyvitamin D levels measured, without knowing what was been investigated.
One hundred ninety-eight participants, 85 men and 113 women, with an age range of 20–88, were enrolled in the study.
The researcher found that people with fair skin, lean body mass and who supplemented with vitamin D had the highest levels of 25-hydroxyvitamin D. People who achieved 38ng/ml or higher 25-hydroxyvitamin D level had a remarkable 50% reduction in the risk of developing acute respiratory tract infections and a significant reduction in the number of days ill (p<0.0001).
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A Bacteria Triggers Arthritis.
The gut microbiomes of humans and mice are broadly similar which is helpful as this paper has used the mouse model to explain how a resident bacteria in the gut can induce arthritis. In both hosts human and mouse upwards of ∼1000 different microbial species from ∼10 different divisions colonise the gastrointestinal tract, but just two bacterial divisions—the Bacteroidetes and Firmicutes—and one member of the Archaea appear to dominate, together accounting for ∼98% of the 16S rRNA sequences obtained from this site.[1] 16SrRNA is a laboratory method for analysing bacterial and provides species-specific signature sequences useful for bacterial identification but is not routinely used in diagnostic settings yet.
Their analysis revealed that despite the enormous species variation in the gut a single species of bacteria that lives here is able to trigger a cascade of immune responses that can ultimately result in the development of arthritis.[2] Gut-residing bacteria can also play a role in disorders of the immune system, especially autoimmune disorders in which the body attacks its own cells. The gut microbiota is now known to shape intestinal immune responses during health and disease with systemic effects.
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Sun or Supplements – The Vit D Controversy
Vitamin D is increasingly understood to be an essential component of many aspects of human health and although technically not a “vitamin,” vitamin D is in a class by itself. Its metabolic product, calcitriol, is actually a secosteroid (A compound derived from a steroid in which there has been a ring cleavage) hormone that binds to over 2000 gene receptors (about 10% of the human genome) in the human body. There are 3 recognised ways for adults to ensure adequate levels of vitamin D:
