Fw: Weekly Update - March 30, 2009

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Weekly Update - March 30, 2009

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Clinical Pearls Nutrition Research Updates for the Week of March 30,

2009

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Quote of the Week

Patience and perseverance have a magical effect

before which difficulties disappear and obstacles vanish.

- Quincy

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New Expert Interviews (more...) :

a.. Bone Mineral Density, Resistance Training and Antioxidants,

Isabelle J. Dionne, Ph.D., Canada

b.. Hypertension and Garlic, Kurt M Reinhart, Pharm.D., USA

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Summary# 47080

Topic: Consumption of Onions and Garlic May Lower Risk of Acute

Myocardial Infarction

Keywords: ACUTE MYOCARDIAL INFARCTION, HEART ATTACK - Allium,

Onions, Garlic, Diet

Reference: " Allium vegetable intake and risk of acute myocardial

infarction in Italy, " Galeone C, La Vecchia C, et al, Eur J Nutr, 2009;

48(2): 120-3. (Address: Dept. of Epidemiology, Istituto di Ricerche

Farmacologiche " Negri " , Via La Masa 19, 20156 Milan, Italy. E-mail:

galeone@... ).

Summary: In a case-control study involving 760 patients with a

first episode of acute myocardial infarction (AMI) and 682 controls, results

indicate that regular consumption of onions and garlic may be associated

with a reduced risk of AMI. Diet information was gathered using a validated

food frequency questionnaire. After adjusting for confounders, consumption

of at least 1 portion of onions per week was associated with a 22% reduced

risk of AMI, compared with consuming a diet with no onions. Similarly,

garlic intake was associated with a 16% reduced risk of AMI. Thus, the

authors conclude, " The current study, the first from Mediterranean

countries, suggests that a diet rich in onions may have a favorable effect

on the risk of AMI. "

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Summary# 47083

Topic: Potential Role For Zinc And Copper Supplementation in

Slowing Progression of Age-Related Macular Degeneration

Keywords: AGE-RELATED MACULAR DEGENERATION, AMD - Zinc, Copper,

Metals, Eyes

Reference: " Reduced zinc and copper in the retinal pigment

epithelium and choroid in age-related macular degeneration, " Erie JC, Pulido

JS, et al, Am J Opthalmol, 2009; 147(2): 276-82. (Address: Department of

Ophthalmology Mayo Clinic, Rochester, Minnesota, USA. E-mail:

erie.jay@... ).

Summary: In a study analyzing 88 donor eyes (44 subjects),

results indicate that reduced levels of zinc and copper in the retinal

pigment epithelium (RPE) and choroid complex were found in eyes of subjects

with age-related macular degeneration. Metal levels in both eyes were

measured and averaged (treated as one observation). Subjects with

age-related macular degeneration (AMD) showed 24% and 23% reduced levels of

zinc and copper, respectively, in RPE and choroid complex, compared to

subjects without AMD. Thus, the authors of this study conclude, " Reduced RPE

and choroid complex zinc and copper levels in AMD eyes combined with

previous information that oral supplementation of zinc plus copper reduces

the risk of progression of AMD suggests that metal homeostasis plays a role

in AMD and in retinal health. "

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Summary# 47087

Topic: Vitamin D Intake May Help Prevent Nonvertebral Fracture

Keywords: BONE HEALTH, FRACTURE, HIP FRACTURE, NONVERTEBRAL

FRACTURE, BONE BREAK - Vitamin D, 25(OH)D

Reference: " Prevention of nonvertebral fractures with oral

vitamin D and dose dependency: a meta-analysis of randomized controlled

trials, " Bischoff-Ferrari HA, Willett WC, et al, Arch Intern Med, 2009;

169(6): 551-61. (Address: Centre on Aging and Mobility, University of

Zurich, University Hospital, Switzerland. E-mail: heike.bischoff@... ).

Summary: In a meta-analysis which included results from 20

randomized, double-blind, controlled trials, vitamin D intake was found to

prevent non-vertebral fractures in a dose-dependent manner, with a 20%

reduction in fractures achieved by a higher dose (> 400 IU/d). Twelve of the

trials examined oral vitamin D and non-vertebral fractures (n=42,279) and 8

of the trials involved hip fractures and oral vitamin D (n=40,886). Results

found the pooled relative risk to be 0.86 for prevention of non-vertebral

fracture and 0.91 for prevention of hip fractures, " but with significant

heterogeneity for both end points. " A higher dose of vitamin D and higher

blood levels of 25(OH)D were found to be linked to a greater reduction in

fracture risk (RR=0.80, n=33,265 from 9 trials for non-vertebral fracture

risk and RR=0.82, n=31,872 from 5 trials for hip fracture risk). The authors

conclude, " Nonvertebral fract ure prevention with vitamin D is dose

dependent, and a higher dose should reduce fractures by at least 20% for

individuals aged 65 years or older. "

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Summary# 47092

Topic: DHEA along with Vitamin D and Calcium may Improve Spine

BMD

Keywords: BONE MINERAL DENSITY, BMD - DHEA,

Dehydroepiandrosterone

Reference: " Dehydroepiandrosterone replacement therapy in older

adults: 1- and 2-y effects on bone, " Weiss EP, Shah K, et al, Am J Clin

Nutr, 2009 March 25; [Epub ahead of print]. (Address: EP Weiss, 3437

Caroline Street, Room 3076, St Louis, MO, USA. E-mail: eweiss4@... ).

Summary: In a randomized trial involving 58 women and 55 men

between the ages of 65 and 75 years, supplementation with 50 mg/d oral DHEA

(dehyroepiandrosterone), along with vitamin D (16 mug/d) and calcium (700

mug/d) was found to improve spine BMD (bone mineral density) in women. In

the first year of the study, subjects were randomized to DHEA (50 mg/d) or

placebo. In the second year of the study, all subjects were given DHEA

(open-label). During both years, subjects received vitamin D and calcium

supplementation. Among women in the active group, spine BMD increased by

1.7% during the first year and 3.6% after 2 years of supplementation. Among

women who received placebo for the first year, spine BMD was unchanged that

first year; however, after starting DHEA supplementation in the second year,

spine BMD increased to 2.6% above baseline. No such benefits were found

among men, or for hip BMD in either sex. Levels of testosterone, estradiol,

and insulin-like growth factor 1 increased in the DHEA group alone. These

results suggest that supplementation with DHEA, when given along with

vitamin D and calcium, may improve spine BMD in women.

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Summary# 47090

Topic: Vitamin D Supplementation May Reduce Cardiovascular

Disease Risk in Overweight Persons

Keywords: CARDIOVASCULAR DISEASE, OVERWEIGHT, WEIGHT LOSS -

Vitamin D, Nutritional Status, 25(OH)D, 25-hydroxyvitamin D

Reference: " Vitamin D supplementation enhances the beneficial

effects of weight loss on cardiovascular disease risk markers, " Zittermann

A, Frisch S, et al, Am J Clin Nutr, 2009 March 25; [Epub ahead of print].

(Address: A. Zittermann, Klinik für Thorax- und Kardiovaskularchirurgie,

Herzzentrum Nordrhein-Westfalen, Georgstraße 11, 32545 Bad Oeynhausen,

Germany. E-mail: azittermann@... ).

Summary: In a placebo-controlled, double-blind study involving

200 healthy, overweight subjects with mean 25(OH)D concentrations of 30

nmol/L (12 ng/mL), supplementation with vitamin D (83 mug/d) for a period of

12 months, while undergoing a weight-reduction program, was found to reduce

several markers of cardiovascular disease. Vitamin D supplementation did not

appear to have any significant effect on weight loss (-5.7 kg loss in the

vitamin D group vs. -6.4 kg loss in the placebo group). Significant

reductions in triglycerides (-13.5% vs. +3%), tumor necrosis factor-alpha (a

marker of inflammation) (-10.2% vs. -3.2%), and parathyroid hormone (-26.5%

vs. -18.7%) were found in the vitamin D group, as compared to the placebo

group. 25(OH)D increased by 55.5 nmol/L and calcitriol concentration

increased by 40.0 pmol/L among subjects in the vitamin D group. LDL

cholesterol concentrations were also slightly raised in the vitamin D group

(+5.4%), compared with the placebo group (-2.5%). These results suggest that

overweight individuals following a weight reduction regimen may reduce risk

factors for cardiovascular disease by supplementing with 83 mug/d vitamin D.

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Summary# 47091

Topic: Multiple Micronutrient Supplementation - Multiple

Benefits

Keywords: CHILDREN'S GROWTH AND DEVELOPMENT, PREGNANCY, HIV,

AIDS, MORTALITY - Micronutrients, Nutritional Status

Reference: " Provision of Multiple Rather Than Two or Fewer

Micronutrients More Effectively Improves Growth and Other Outcomes in

Micronutrient-Deficient Children and Adults, " LH, Peerson JM, et al, J

Nutr, 2009; March 25; [Epub ahead of print]. (Address: USDA, Agricultural

Research Service Western Human Nutrition Research Center, , CA 95616,

USA).

Summary: In a review of studies comparing the effects of

multiple micronutrient supplementation versus placebo or versus

supplementation with just one or two micronutrients on children's growth,

health, and development; pregnancy outcomes; nutritional status; and

HIV/AIDS mortality and morbidity, supplementation with multiple

micronutrients was associated with small but significantly greater

improvements in height, weight, hemoglobin, serum zinc, serum retinol, and

motor development. According to a Cochrane review, multiple micronutrient

supplementation during pregnancy was effective in reducing the relative risk

of low birth weight, small-for-gestational age, and anemia - however, it was

as effective as supplementation with iron plus folic acid. The authors

discuss the research that demonstrates the effectiveness of multiple

micronutrient supplementation on CD4 counts and HIV-related morbidity and

mortality in adults. The authors conclude, " The efficacy of MMN varies

across trials, but overall there is evidence that outcomes are better than

when providing </=2 MN. "

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Summary# 47082

Topic: Dietary Supplementation with Oat Bran May be a Safe and

Effective Alternative to Laxative Use

Keywords: CONSTIPATION - Fiber, Oat Bran, Fibre, Laxative

Reference: " Use of Fiber instead of Laxative Treatment in a

Geriatric Hospital to Improve the Wellbeing of Seniors, " Sturtzel B, Elmadfa

I, et al, J Nutr Health Aging, 2009; 13(2): 136-9. (Address: I. Elmadfa,

University of Vienna, Department of Nutritional Science, Althanstrasse 14,

1090 Vienna. E-mail: ibrahim.elmadfa@... ).

Summary: In a double-blind, controlled study involving 30 frail

inhabitants of a geriatric hospital aged 57-100 years capable of oral food

intake with no swallowing troubles, and taking laxatives, results indicate

that dietary supplementation with oat-bran may be a safe and effective

alternative to laxatives. The subjects were assigned to consume their daily

regular diet supplemented with 7-8 g/d of oat-bran (n=15) or continue with

their regular diet with no fiber supplementation, for a period of 12 weeks.

By intervention end, 59% of patients in the fiber group had successfully

discontinued laxative use, compared with an 8% increase in laxative use in

the control group. Additionally, body weight was found to decrease in the

control group, while remaining constant in the fiber group. Thus, the

authors of this study conclude, " Fiber supplementation is a safe and

convenient alternative to laxatives in a geriatric hospital. "

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Summary# 47094

Topic: Calcium Supplementation Improves Insulin Sensitivity in

Patients with Type 2 Diabetes

Keywords: DIABETES TYPE 2, INSULIN SENSITIVITY, HYPERTENSION,

HIGH BLOOD PRESSURE - Calcium

Reference: " Insulin sensitivity increase after calcium

supplementation and change in intraplatelet calcium and sodium-hydrogen

exchange in hypertensive patients with Type 2 diabetes, " Pikilidou MI,

Lasaridis AN, et al, Diabet Med, 2009; 26(3): 211-9. (Address: Department of

Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital,

Thessaloniki, Greece. E-mail: m_pikilidou@... ).

Summary: In a randomized, controlled, single-blinded, parallel

group study involving 31 patients, oral supplementation with 1500 mg/d

calcium (Ca(2+)) for a period of 8 weeks was found to improve insulin

sensitivity in patients with type 2 diabetes and hypertension, as compared

to no treatment. These results suggest that supplementation with calcium may

improve insulin sensitivity in type 2 diabetics.

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Summary# 47089

Topic: Micronutrient Supplementation Improves Sleep in Infants

Keywords: INFANCY, SLEEP DISRUPTION, IRON DEFICIENCY ANEMIA -

Iron, Folic Acid, Zinc, Vitamins, Minerals, Micronutrients

Reference: " The Effects of Iron and/or Zinc Supplementation on

Maternal Reports of Sleep in Infants from Nepal and Zanzibar, " Kordas K,

Siegel EH, et al, J Dev Behav Pediatr, 2009 March 23; [Epub ahead of print].

(Address: Department of Nutritional Sciences, Pennsylvania State University,

University Park, PA, USA).

Summary: In two randomized, placebo-controlled, parallel design

trials involving 877 Pemban infants (from Zanzibar) and 567 Nepali infants,

supplementation with iron and zinc were both found to improve sleep duration

and reduce nighttime waking. Infants received iron-folic acid supplements

with or without zinc for a period of 12 months. Infant sleep duration and

waking at night was assessed by the mothers. Supplemental iron was

consistently associated with longer night and total sleep duration, and zinc

supplementation was also associated with longer sleep duration. The authors

conclude, " Micronutrient supplementation in infants at high risk for iron

deficiency and iron deficiency anemia was related to increased night sleep

duration and less night waking. "

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Summary# 47081

Topic: Vitamin D(3) Supplementation May Improve Postprandial

Insulin Sensitivity

Keywords: INSULIN RESISTANCE, DIABETES MELLITUS - Vitamin D3,

Vitamin D

Reference: " A double-blind, randomized, placebo-controlled trial

of the short-term effect of vitamin D3 supplementation on insulin

sensitivity in apparently healthy, middle-aged, centrally obese men, " Nagpal

J, Bhartia A, et al, Diabet Med, 2009; 26(1): 19-27. (Address: Sitaram

Bhartia Institute of Science and Research, New Delhi, India).

Summary: In a randomized, double-blind, placebo-controlled study

involving 71 healthy, middle-aged, centrally obese men, results indicate

that supplementation with vitamin D(3) may improve postprandial insulin

sensitivity. The subjects were randomized to three doses of 120,000 IU

vitamin D(3) or placebo, fortnightly, for a period of 6 weeks. At

intervention end, a significant increase in oral glucose insulin sensitivity

was observed in the vitamin D(3) group, compared with the placebo group.

Thus, the authors conclude, " The trial indicates that vitamin D(3)

supplementation improves postprandial insulin sensitivity (OGIS) in

apparently healthy men likely to have insulin resistance (centrally obese

but non-diabetic). "

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Summary# 47093

Topic: Benefits of Supplementation with Selenium, Vitamin E,

Beta-Carotene on Mortality

Keywords: MORALITY, CANCER, GASTRIC CANCER - Vitamins, Minerals,

Micronutrients, Nutraceuticals, Nutriceuticals, Selenium, Vitamin E,

Beta-carotene

Reference: " Total and Cancer Mortality After Supplementation

With Vitamins and Minerals: Follow-up of the Linxian General Population

Nutrition Intervention Trial, " Qiao YL, Dawsey SM, et al, J Natl Cancer

Inst, 2009 March 24; [Epub ahead of print]. (Address: Philip R. , MD,

ScD, Genetic Epidemiology Branch, Division of Cancer Epidemiology and

Genetics, National Cancer Institute, National Institutes of Health, 6120

Executive Blvd, Rm 7006, MSC 7236, Bethesda, MD 20892-7236, USA. E-mail:

ptaylor@... ).

Summary: In this study, authors conducted a 10-year follow-up of

29,584 subjects who from 1985 to 1991 participated in a randomized trial

involving the use of supplements containing selenium (50 mug), vitamin E (30

mg), and beta-carotene (15 mg), which was found to reduce mortality from all

causes, cancer overall, and gastric cancer. In this study, subjects were

followed up with 10 years post-intervention. Results found that subjects who

had received the supplement were found to have lower overall mortality

(HR=0.95) and lower gastric cancer mortality (HR=0.89), compared to subjects

who did not receive the supplement. No significant difference in death from

esophageal cancer was found overall, however, in subjects under 55 years of

age, mortality decreased by 17% among those who received the supplement

(HR=0.83), while it increased 14% among those over 55 years of age. The

authors conclude, " The beneficial effects of selenium, vitamin E, and

beta-carotene on mortality were still evident up to 10 years after the

cessation of supplementation and were consistently greater in younger

participants. "

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Summary# 47085

Topic: High Intake of Meat Linked to Increased Mortality

Keywords: MORTALITY, LONGEVITY, AGING, CANCER, CARDIOVASCULAR

DISEASE - Meat, Red Meat, Processed Meat, Vegetarian, Diet

Reference: " Meat intake and mortality: a prospective study of

over half a million people, " Sinha R, Cross AJ, et al, Arch Intern Med,

2009; 169(6): 562-71. (Address: Division of Cancer Epidemiology and

Genetics, National Cancer Institute-Nutritional Epidemiology Branch,

Rockville, MD 20852, USA. E-mail: sinhar@... ).

Summary: In a study involving data from half a million people

between the ages of 50 and 71 years of age (at baseline), intakes of red

meat and processed meats were found to be associated with modest increases

in total mortality, cancer mortality, and cardiovascular disease mortality.

Over a follow-up period of 10 years, there were 47,976 male deaths and

23,276 female deaths. Overall mortality risk was found to be higher among

men and women in the highest quintile of red meat intake (62.5 g per 1000

calories/day) (HR=1.31 and 1.36, respectively), as compared to those in the

lowest quintile of red meat intake (9.8 g per 1000 calories/day). Similarly,

subjects in the highest quintile of processed meat intake (22.6 g/d) were

found to have an increased risk of mortality (HR=1.16 and 1.25), as compared

to subjects in the lowest quintile of processed meat intake (1.6 g per 1000

calories/day). In addition, ca rdiovascular disease risk was increased in

both men and women in the highest vs. the lowest quintile of red meat intake

(HR=1.27 and 1.50, respectively) and processed meat intake (HR=1.09 and

1.38, respectively), as was cancer mortality (HR=1.22 and 1.20,

respectively, for red meat intake and 1.12 and 1.11, respectively, for

processed meat intake). Intake of white meat, on the other hand, was

modestly inversely associated with total mortality, cancer mortality, and

death from all other causes in both men and women. These results support

recommendations to reduce intake of red meats and processed meats in the

diet.

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Summary# 47088

Topic: Plant Food Nutrient Intakes May Reduce the Risk of

Prostate Cancer

Keywords: PROSTATE CANCER - Plant Food Nutrients, Vitamins,

Minerals, Antioxidants, Nutriceuticals, Nutraceuticals, Fiber, Vitamin C,

Vitamin A, Alpha-carotene, Beta-carotene, Cryptoxanthin, Folate, Genistein,

Daidzein, Fruit, Fruit Juice

Reference: " Intake of plant foods and associated nutrients in

prostate cancer risk, " JE, Soler-Vila H, et al, Nutr Cancer, 2009;

61(2): 216-24. (Address: Department of Psychiatry and Behavioral Sciences,

University of Miami School of Medicine, 1120 NW 14th Street, Miami,

FL 33136, USA).

Summary: In a study involving 478 men with prostate cancer (373

incident and 105 prevalent cases) and 382 controls, various nutrients from

plant foods were found to be associated with reduced risk of prostate

cancer. Among Caucasians, incident cases of prostate cancer were found to

have lower intakes of fiber, vitamin C, vitamin A, alpha-carotene,

beta-carotene, cryptoxanthin, folate, genistein, daidzein, and fruits and/or

fruit juices, compared with controls and compared to prevalent cases. Among

African-Americans, incident cases were found to have lower intakes of

alpha-carotene, compared to controls and prevalent cases. A reduced risk of

prostate cancer was found to be associated with the highest tertile of

cryptoxanthin (OR=0.51), fiber (OR=0.56), vitamin C (OR=0.60) and fruits

and/or fruit juices (OR=0.46). An increased risk of prostate cancer was

found to be associated with the highest tertile of protein intake (OR=1.99)

and daily servings of grains (OR=1.99). The authors conclude, " The

significantly higher consumption of protective dietary constituents among

prevalent cases compared to incident cases suggests that PC survivors may be

amenable to dietary change. "

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Summary# 47086

Topic: Omega-3 Fatty Acids May Protect Against Prostate Cancer

Keywords: PROSTATE CANCER, INFLAMMATION - Omega-3 Fatty Acids,

Fish Oil, EPA, DHA, COX-2 gene, Cyclooxygenase-2

Reference: " Dietary Omega-3 Fatty Acids, Cyclooxygenase-2

Genetic Variation, and Aggressive Prostate Cancer Risk, " Fradet V, Cheng I,

et al, Clin Cancer Res, 2009; [Epub ahead of print]. (Address: Departments

of Urology and Epidemiology and Biostatistics and Institute for Human

Genetics, University of California at San Francisco, San Francisco,

California, USA).

Summary: In a case-control study involving 446 men with

aggressive prostate cancer and 478 age- and ethnicity-matched controls,

increased intake of long-chain omega-3 polyunsaturated fatty acids was

strongly associated with a decreased risk of aggressive prostate cancer

(OR=0.37 for the highest vs. lowest quartile of omega-3 PUFA intake). This

association was modified by a specific variant (SNP rs4648310) of COX-2 (an

inflammatory gene), which has been associated with an increased risk of

prostate cancer (OR=5.49, for men with low omega-3 PUFA intake). This

increased risk was reversed by increasing intake of long-chain omega-3

PUFAs. The authors conclude, " Our findings support the hypothesis that LC

n-3 may impact prostate inflammation and carcinogenesis through the COX-2

enzymatic pathway. "

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Summary# 47084

Topic: Intravenous Supplementation With Omega-3 Fish Oil

Emulsion May Benefit Patients With Systemic Inflammatory Response Syndrome

Keywords: SYSTEMIC INFLAMMATORY RESPONSE SYNDROME, SEVERE ACUTE

PANCREATITIS - Omega-3 Fish Oil Emulsion, Intravenous, Omega-3 Fatty Acids

Reference: " Regulation of omega-3 fish oil emulsion on the SIRS

during the initial stage of severe acute pancreatitis, " Xiong J, Wang C, et

al, J Huazhong Univ Sci Technolog Med Sci, 2009; 29(1): 35-8. (Address:

Department of Pancreatic Surgery, Union Hospital, Tongji Medical College,

Huazhong University of Science and Technology, Wuhan, 430022, China. E-mail:

xiongjiongxin2005@... ).

Summary: In a prospective, randomized, controlled study

involving 60 patients with systemic inflammatory response syndrome (SIRS)

during the initial stage of severe acute pancreatitis (SAP), results

indicate that intravenous supplementation with omega-3 fish oil emulsion in

addition to conventional therapy may exert beneficial effects. The patients

were randomized to conventional therapy with or without intravenous

supplementation with omega-3 fish oil emulsion (0.2 g/kg/day). Disease

severity (APACHE-II scores) significantly decreased in the fish oil group,

compared with the control group. In the fish oil group, plasma levels of

TNF-alpha and IL-10 significantly decreased, compared with the control

group. Thus, the authors of this study conclude, " During the initial stage

of SAP, parenteral supplementation with omega-3 fish oil emulsion could

efficiently lower the magnitude and persistence time of the SIRS, markedly

retrieve the unbala nce of the pro-/anti-inflammatory cytokines, improve

severe condition of illness and may provide a new way to regulate the SIRS. "

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