News Briefs – July/August 2013Michael Downey July 1, 2013
B Vitamin Cocktail Delays Alzheimer’s
Researchers have shown that an inexpensive regimen of specific B vitamins delay the start of Alzheimer’s disease and dementia. A specific combination of vitamins B6, B12, and B9 (more commonly known as folic acid), slowed atrophy of gray matter in brain areas most affected by Alzheimer’s disease.
(Older people’s brains shrink about 0.5% a year from the age of 60, and faster in people with vitamin B12 deficiency, mild cognitive impairment or Alzheimer’s disease. Delaying the onset of dementia is a goal not yet achieved by prescription drugs. If studies confirm this finding of success with a vitamin regimen, it may help stem the surge in cases, which the W.H.O. predicted would more than triple from 36 million worldwide in 2010 to 115 million in 2050.)
Researchers tracked 156 people ages 70 and older who had mild memory loss and high levels of a protein previously linked to dementia. The study found that the amount of gray matter declined 5.2% in those taking a placebo, compared with 0.6% in those who took the vitamin cocktail, over a two-year followup. The supplements together cost about 30 cents a day in pharmacies and health-food stores, and included 0.5 milligrams of vitamin B12, along with 20 milligrams of vitamin B6 and 0.8 milligrams of folic acid. If you delay the onset of Alzheimer’s by five years, you can halve the number of people dying from it.
It is too early to put everyone on B vitamins, the researchers advised, citing the need first for more evidence on what is actually going on in the brain. One of the researchers holds three patents for certain B vitamin formulations for Alzheimer’s. This new study was funded in part by vitamin maker Meda AB. Vitamin B12 is found in liver, fish and milk, and folic acid in fruit and vegetables. Deficiency of folate and B vitamins is already linked to dementia. A 2008 U.S. study found that people who had moderate or severe Alzheimer’s didn’t benefit from these supplements.
This study was released May 20, 2013, ahead of publication in a future issue of the journal, Proceedings of the National Academy of Sciences. Find it online at https://tinyurl.com/nudbcv8
Preterm Babies Need Substantial Vitamin D
A study has found that preterm infants may need to be given 800 international units (IU) of vitamin D a day to ensure they develop strong bones. (Preemies are known to be at risk for vitamin D insufficiency, and if levels of vitamin D are too low, infants and children can get rickets, which leads to softening and weakening of the bones. Recommendations from medical organizations on how much vitamin D should be given to preterm babies range from 400 IU to 1000 IU per day. This lack of consensus prompted researchers to conduct the largest study to date on vitamin D supplementation in preterm infants.)
Subjects included 96 infants born between 28 and 34 weeks gestation who were receiving milk feeding. Blood samples were taken from the infants to determine their serum vitamin D levels. The infants then were randomly assigned to receive either 800 IU or 400 IU of oral vitamin D3. Researchers assessed whether the prevalence of vitamin D insufficiency (VDI) at full term-equivalent age, and at 3 months post-term-age (3 months after what would have been the full-term birth date), differed between the two dosage groups. Results showed that vitamin D insufficiency (VDI) was common in both groups before they received supplements. The study results also showed conclusively that, in preterm infants, supplementation with 800 IU of vitamin D3 per day, compared to 400 IU per day, reduces vitamin D insufficiency by 43% at both term-equivalent age and at 3 months post-term age. A decrease to 400 IU may be sufficient after 3 months.
This study was presented in Washington, DC, on May 5, 2013 at the Pediatric Academic Societies annual meeting.
Coq10 Helps Heart Failure Patients Survive
Researchers have reported on a breakthrough study which found that taking coenzyme Q10, or CoQ10, supplements improves overall survival in patients with moderate to severe heart failure. The two subject groups took either 100 milligrams of CoQ10 three times daily or placebo. Results at two years showed that the primary endpoint of major adverse cardiovascular event was reached by 14% in the CoQ10 group versus 25% of patients in the placebo group. Furthermore, at two years, in comparison to placebo, CoQ10-treated patients had a significantly lower cardiovascular mortality, fewer hospitalizations, and greater improvements in functionality. (This represents the first study with adequate evidence to show that CoQ10, a vitamin-like substance that is also known as ubiquinone, has an effect on survival in heart failure patients. Earlier research has been ignored by medical authorities due to weak study evidence and findings. Also, synthesis is known to be inhibited by statins, drugs commonly prescribed to heart failure patients, which are known to reduce serum levels of CoQ10 by up to 40%. These results are guideline-changing, making a strong case for CoQ10 to be considered as part of the maintenance therapy for all patients with chronic heart failure. Some experts have suggested that the ubiquinol form is better absorbed than the ubiquinone form, but ubiquinol was not used in the study.) This study was presented May 28, 2013 in Lisbon at the Heart Failure Congress 2013.
Lectin-Restricting Diet may Reverse Blood Vessel Dysfunction
An unusual diet, combined with certain antioxidant supplements, may help reverse blood vessel abnormality, reports a new study. (The blood vessel abnormality known as endothelial dysfunction occurs when cells lining the interior wall of blood vessels malfunction, a serious condition that is often one of the first signs of heart disease. Any therapy that can be verified to reverse this artery condition would, in turn, help prevent high blood pressure, diabetes and obesity.)
The study diet was unusual because it restricted foods that are rich sources of lectin, a sugar-binding protein generally regarded as a healthy nutrient. This meant restricting intake of lectin foods including grains, beans, fruit, poultry, and plants belonging to the nightshade family, which includes tomatoes. Instead, the diet focused on low-lectin foods including plenty of leafy greens, shellfish and fish, olive oil, and grass-fed animal protein. At the same time, the diet was supplemented with a polyphenol-rich combination of fish oil, grape seed extract, and vitamins. In the subjects, aged 51 to 86, endothelial function was largely restored. But the mechanism for this improvement was not clear.
This study was presented May 1, 2013 in Lake Buena Vista, Florida, at the Arteriosclerosis, Thrombosis and Vascular Biology 2013 Scientific Sessions. It has not yet been posted or published. Sessions were presented by the American Heart Association, which despite the study, still recommends a diet with plenty of fruits, whole grains, fish and vegetables, including tomatoes.
Magnesium Important for Children’s Bone Health
Scientists have just reported that, despite common belief that calcium and calcium-rich foods build strong bones, magnesium has emerged as a more important nutrient for bone health in children. In fact, the study found that, unlike magnesium, calcium had no effect on infant bones. (While it is known that magnesium is important for bone health in adults, few studies have looked at whether magnesium or calcium intakes are related to bone mineral content in young children. Another study released the same day found that substantial doses of vitamin D are required to build strong bones in preterm babies.)
While the children were hospitalized, levels of calcium and magnesium were measured using a technique that involved giving them non-radioactive forms of magnesium and calcium, called stable isotopes, intravenously and orally. Urine was collected for 72 hours. By measuring the stable isotopes in the urine, the researchers could determine how much calcium and magnesium were absorbed into the body. Bone mineral content and density were measured using total body dual-energy X-ray absorptiometry. Results showed that the amounts of magnesium consumed and absorbed were key predictors of how much bone density the children had. Dietary calcium intake, however, was not significantly associated with total bone mineral content or density. This study was presented on May 5, 2013 at the Pediatric Academic Societies annual meeting in Washington, DC.
Air Pollution Linked to Insulin Resistance, Diabetes in Children
Researchers have found an association between prominent air pollution in some growing areas and an increased risk of insulin resistance, the predecessor to diabetes type 2, among children. (Earlier research has shown associations between air pollution and other chronic issues such as heart disease and atherosclerosis. Currently, epidemiological studies that have analyzed links between long-term exposure to traffic-related air pollution and type 2 diabetes in adults have had conflicting results. Fetal exposure to air pollution has also been linked to pediatric cancers, as well as low birth weight in babies. But this is the first known study of pollution on insulin resistance in children.) A study released last month found that overall, Americans are now breathing cleaner air than a decade ago. However, many are congregated in growing and more polluted cities and are breathing in more pollutants than before. The investigators collected fasting blood samples from 397 children, all aged 10 years, and estimated personal-level exposures to traffic-related air pollution at each of their home addresses, by assessing neighborhood road traffic, population density and land use in the area. Using a model adjusted for many potential confounders such as birth weight, body-mass index, and second-hand smoke at home. They found that insulin resistance was higher in children with greater exposure to air pollution. Proximity to major roads raised insulin resistance by 7 percent per 500 meters. The finding of an association does not necessarily prove causation. This study was published in the May 2013 issue of the journal Diabetologia. The full-text version is now available at https://www.diabetologia-journal.org/files/Thiering.pdf
Certain Drugs Cause Cognitive Impairment in Elderly After 60 Days
Scientists have found that daily use, by older adults, of a drug with strong anticholinergic effects, or a combination of drugs with weak anticholinergic effects, causes memory problems in just 60-90 days. This effect is serious enough to be categorized as mild cognitive impairment (MCI). Whether this effect can be reversed will be explored in future research. (Anticholinergic drugs work by blocking acetylcholine, a nervous system neurotransmitter. Some anticholinergics are sold over the counter, and some by prescription. Older adults commonly use over-the-counter drugs with anticholinergic effects as sleep aids, for relief of bladder leakage, or simply as antihistamines. Drugs with anticholinergic effects are frequently prescribed for many chronic diseases including hypertension, cardiovascular disease and chronic obstructive pulmonary disease. Mild cognitive impairment or MCI is a cognitive decline that, unlike dementia, is not considered to have a major impact on the ability to function independently; it does not necessarily lead to dementia or Alzheimer’s.)
Drugs that are strongly anticholinergic were associated with more than double the risk of MCI. There was no increased risk of actual dementia; in fact, subjects taking anticholinergics showed a 50% reduced risk of this more serious form of decline. This study will be published in an upcoming issue of the journal, Alzheimer’s and Dementia. It can be read in full at https://tinyurl.com/cfmbx8r. (You can find out whether your drugs have an anticholinergic activity, and to what extent each adds to the overall risk burden, by visiting the Aging Brain Care website at https://tinyurl.com/dxr8ztw.)
Johns Hopkins Scientist Criticizes CDC Promotion of Flu Vaccine
A Johns Hopkins scientist has issued a blistering report on influenza vaccines, and the British Medical Journal (BMJ) published it online May 16, 2013. Peter Doshi, PhD, charges that although vaccines are being pushed on the public in unprecedented numbers, they are less effective and cause more side effects than alleged by the Centers for Disease Control and Prevention (CDC). His report also suggests that the studies that underlie CDC policy of encouraging most people to get a yearly flu shot are often low-quality studies that do not substantiate the official claims. Promoting influenza vaccines is one of the most visible and aggressive public health policies in North America. Only 20 years ago, 32 million doses of influenza vaccine were available in the U.S. on an annual basis. Today, the total has skyrocketed to 135 million doses.
The main assertion of the CDC that fuels the push for flu vaccines each year is that influenza comes with a risk of serious complications which can cause death, especially in senior citizens and those suffering from chronic illnesses. But when read carefully, the CDC acknowledges that studies finding any perceived reduction in death rates may be due to the “healthy-user effect,” which is the tendency for healthier people to be vaccinated more than less-healthy people. The only randomized trial of influenza vaccines in older people found no decrease in deaths. Randomized, controlled trials of healthy adults found that vaccinating between 33 and 100 people resulted in one less case of influenza. In addition, according to the BMJ report, no evidence exists to show that this reduction in influenza risk for a specific population extrapolates into any reduced risk of serious complications from influenza, such as hospitalizations or deaths, among seniors.
Perhaps the most surprising part of the report for some readers is the included explanation that the “flu” and influenza are not necessarily the same disease. It may seem like semantics, but even the ideal influenza vaccine, matched perfectly to circulating strains of wild influenza and capable of stopping all influenza viruses, can only deal with a small part of the “flu” problem because most flu appears to have nothing to do with influenza. Every year, hundreds of thousands of respiratory flu specimens are tested and of those, an average 16% are found to be influenza-positive. But the so-called flu vaccine is strictly for influenza forms of the flu, and not the majority of flu diseases. The report explains, “All influenza is flu, but only one in six flus are influenza. It is no wonder so many people feel that flu shots don’t work: for most flus, they can’t.”
This analysis is accessible online, at the site of the British Medical Journal, in its full-text version at https://tinyurl.com/mqsmu7p without charge.
Did You Know…?
Nearly all of the beneficial polyphenols in pistachios are released to the body during digestion, but unlike other high-fat nuts, their high-calorie fat content is not completely absorbed.
Michael Downey is a former columnist with Vitality Magazine.