French maritime pine bark supplementation associated with improvements in diabetes complications
Tabriz University of Medical Sciences (Iran), February 24 2021.
A randomized trial reported on February 18, 2021 in Complementary Therapies in Medicine resulted in improvement of several factors related to type 2 diabetes among men and women who were given supplements containing French maritime pine bark extract.
The trial included 46 diabetics between the ages of 30 and 65 years who were recruited from March 2018 to April 2019. Participants received two capsules that provided 50 milligrams each of French maritime bark extract or a placebo daily for eight weeks. Diet and medication use remained unchanged throughout the trial. Anthropometric factors, glycemic parameters, lipids and factors related to inflammation and kidney function were assessed at the beginning and end of the study.
At eight weeks, waist circumference, waist to height ratio, hemoglobin A1c, total cholesterol, vascular cell adhesion molecule 1 (VCAM-1, an inflammatory cell that contributes to atherosclerosis), and urinary albumin to creatinine ratio (an early indicator of kidney disease) were lower at the end of the study among participants who received French maritime pine bark extract in comparison with the placebo. Serum fasting blood glucose levels were also lower at the end of the study in the group that received the extract; however, the reduction was not considered significant.
“There is a growing body of evidence that suggests pine bark extract supplementation has some potentially beneficial metabolic properties such as anti-diabetic and hypoglycemic effects,” Elham Navval-Esfahlan and colleagues wrote.
“The present study indicated that daily supplementation with 100 mg of pine bark extract in patients with type 2 diabetes mellitus and microalbuminuria had favorable effects on glycemic control, serum VCAM-1, and urinary albumin to creatine ratio level, as well as total cholesterol concentrations and abdominal obesity which could be helpful in the control of diabetes complications,” they concluded.
Study finds association between supplementing with zinc and lower risk of Alzheimer's disease
University of Manchester (UK), February 22 2021.
An epidemiologic study conducted at the University of Manchester found an association between zinc supplementation and a decreased risk of Alzheimer's disease as well as a reduction in the progression of cognitive decline in Alzheimer's disease patients. It was additionally determined that zinc deficiency accelerated memory deficits in an Alzheimer's disease mouse model compared to a control group, due to increased inflammation. The findings were reported in an article appearing on February 17, 2021 in the Journal of Neuroscience.
For the epidemiologic study, Jack Rivers-Auty and his associates utilized data from the Alzheimer’s Disease Neuroimaging Initiative database, which included 1,631 men and women who were cognitively normal or diagnosed with mild cognitive impairment or early Alzheimer's disease. Subjects were evaluated upon enrollment, at six and 12 months, and yearly thereafter. Data obtained at the beginning of the study provided information concerning the use of nutritional supplements.
Among those who reported supplementing with zinc, just 6% were diagnosed with Alzheimer's disease, in contrast with 26% of those who reported no supplement use. Calcium, iron and magnesium also appeared to be protective. Zinc use was additionally associated with a less rapid rate of cognitive decline during up to ten years of follow-up.
Giving mice zinc deficient diets was associated with increased cognitive decline due to enhanced NLRP3-driven inflammation, which was reversed by giving the animals diets that contained a normal amount of zinc. “These data suggest that zinc deficiency is causally accelerating cognitive decline in Alzheimer’s disease and that these cognitive deficits are reversible,” Dr Rivers-Auty and colleagues wrote.
“This research suggests that zinc status is linked to inflammatory reactivity and may be modified in people to reduce the risk and slow the progression of Alzheimer’s disease,” they concluded.
Study finds low folate, vitamin B12 associated with worse cognitive function
University of Massachusetts, February 22, 2021
According to news reporting from Lowell, Massachusetts, research stated, “There is evidence that low plasma vitamin B-12 and folate individually, as well as an imbalance of high folic acid and low vitamin B-12 status, may be associated with lower cognitive function. We examined dietary and plasma folate and vitamin B12 status, and their interaction, in relation to cognitive function in a cohort of older Puerto Rican adults.”
The news correspondents obtained a quote from the research from the University of Massachusetts Lowell, “The design is cross-sectional, with 1408 participants from the Boston Puerto Rican Health Study (mean SD age: 57.1 +/- 7.9 y). Cognitive function was assessed with a comprehensive test battery and a global composite score was derived. Plasma folate, vitamin B12, and methylmalonic acid (MMA) were assessed in fasting blood samples. After adjusting for covariates, high plasma folate and high plasma vitamin B-12 were each positively associated with global cognitive score (beta: 0.063; 95% CI: -0.0008, 0.127; P = 0.053 and beta: 0.062; 95% CI: 0.009, 0.12; P = 0.023, respectively, for logged values, and beta: 0.002; 95% CI: 0.00005, 0.004; P-trend = 0.044 and beta: 0.00018; 95% CI: 0.00001, 0.0003; P-trend = 0.036, respectively, across tertiles). Nine percent of participants had vitamin B-12 deficiency (plasma vitamin B-12 148 pmol/L or MMA 271 nmol/L), but none were folate deficient (plasma folate < 4.53 nmol/L). Deficient compared with higher vitamin B-12 was significantly associated with lower cognitive score (beta: -0.119; 95% CI: -0.208, -0.029; P = 0.009). We could not examine the interaction for vitamin B-12 deficiency and high plasma folate, because there were too few individuals (<1% of the cohort) in this category to draw conclusions. Low plasma vitamin B-12 and low plasma folate were each associated with worse cognitive function in this population. Vitamin B-12 deficiency was prevalent and clearly associated with poorer cognitive function. More attention should be given to identification and treatment of vitamin B-12 deficiency in this population.”
According to the news reporters, the research concluded: “Additional, larger studies are needed to examine the effect of vitamin B-12 deficiency in the presence of high exposure to folic acid.”
This research has been peer-reviewed.
Structured exercise program, not testosterone therapy improved men's artery health
University of Western Australia, February 22, 2021
Twelve weeks of exercise training improved artery health and function in middle-aged and older men (ages 50-70 years) with low-to-normal testosterone levels, while testosterone therapy provided no benefits to the arteries, according to new research published today in Hypertension, an American Heart Association journal.
The natural aging process for men includes decreased testosterone and physical activity levels decline with age, leading to declines in artery health and function. Testosterone replacement therapy is often used to combat the symptoms of decreasing testosterone levels, including low energy, reduced muscle mass and reduced vigor. In the absence of any new clinical indications, testosterone sales have increased 12-fold globally in the past decades.
"The global increase in testosterone use has been very large, particularly among middle-aged and older men who might see it as a restorative hormone to increase energy and vitality," said study author Daniel J. Green, Ph.D., Winthrop Professor and cardiovascular exercise physiology researcher in the School of Human Sciences at The University of Western Australia in Perth, Australia. "However, previous studies are mixed as to whether replacement testosterone is beneficial or not, or whether it provides additional benefit over and above the effects of an exercise program."
Green and colleagues evaluated men ages 50 to 70 years old, with no history of cardiovascular disease, higher than normal waist circumferences and testosterone levels that were in the low to normal range. The researchers also excluded current smokers, men currently on testosterone treatment or men on medications that would alter testosterone concentrations. At the beginning and end of the study, researchers measured artery function using a method that increases blood flow inside an artery. This assesses whether the inner lining of the artery is healthy and can help the artery to increase in size or dilate.
The 12-week study included 78 men randomized into four groups: 21 men received topical testosterone and completed a supervised exercise program including aerobic and strength exercises two to three times a week; 18 men received testosterone with no exercise; 20 men received a placebo and no exercise; and 19 men received a placebo with exercise. The exercise training was supervised in a research gymnasium at Fiona Stanley Hospital in Perth, and the program was overseen by an Accredited Exercise Physiologist (AEP).
The researchers found:
Testosterone treatment increased the levels of the hormone to above average levels in 62% of men in the groups that received the treatment.
Exercise training also increased testosterone level; however, the levels were highest among the men in the groups who received the testosterone supplement.
Artery function and health improved in the groups who received exercise training; but no improvement was found in those who received testosterone without exercise training.
Artery function in response to testing improved by 28% in the group who received exercise without testosterone, and by 19% in the group who received a combination of testosterone and exercise.
The researchers did not see changes in other tests that stimulated muscle cells in the middle of the artery wall, following exercise training, testosterone treatment or the combination of the two.
"The results of our study suggest that if you are a healthy but relatively inactive middle-aged or older man with increased abdominal girth, and you are worried about your risk of heart attack, stroke or diabetes, then an exercise program with some support and supervision can help to improve the function and health of your arteries," Green said. "Testosterone therapy may have some benefits, for example in increasing muscle mass in the legs, however, we didn't find any benefits in terms of artery function, which is a determinant of future cardiovascular risk."
Green noted that the study's small size is a limitation, and this research lays the foundation for larger studies that could lead to health recommendations for men.
Effects of yoga-based interventions on cognitive functioning in healthy older adults: a systematic review of randomized controlled trials
Karolinska Institute (Sweden), Imperial College London, Victoria University (Australia), February 11, 2021
The world's elderly population is growing. Physical activity has positive effects on health and cognition, but is decreasing among the elderly. Interest in yoga-based exercises has increased in this population, especially as an intervention targeting balance, flexibility, strength, and well-being. Recent interest has arisen regarding yoga’s potential benefits for cognition.
To systematically review evidence from randomized controlled trials (RCTs) examining the effects of yoga-based interventions on cognitive functioning in healthy adults aged 60 + . A secondary objective was to report the intervention characteristics.
The review was conducted in accordance with PRISMA guidelines. Searches were performed from inception to June 2020 using the following electronic databases: (1) PubMed (NLM); (2) Embase (Elsevier); (3) Cochrane Central (Wiley); (4) PsycINFO (EBSCOhost); and (5) Cinahl (EbscoHost). Inclusion criteria: RCTs of yoga-based interventions assessing cognition in healthy adults ≥60 years. Risk of bias was assessed using the revised Cochrane risk of bias tool.
A total of 1466 records were initially identified; six studies (5 unique trials) were included in the review. Four of the six articles reported significant positive effects of yoga-based interventions on cognition, including gross memory functioning and executive functions. Intervention characteristics and assessment methods varied between studies, with a high overall risk of bias in all studies.
Yoga-based interventions are associated with improvements in cognition in healthy older adults. Adequately powered RCTs with robust study designs and long-term follow-ups are required. Future studies should explicitly report the intervention characteristics associated with changes in cognitive function.
Fruit and veg-rich diet linked to much lower risk of chronic lung disease
Karolinksa Institute (Sweden), February 22, 2021
A diet rich in fruit and vegetables is linked to a significantly lower risk of developing chronic lung disease (COPD) in former and current smokers, finds research published online in the journal Thorax.
Each additional daily serving was associated with a 4-8% lower risk, the findings show. COPD, short for chronic obstructive pulmonary disease, is an umbrella term for respiratory conditions that narrow the airways, which include bronchitis and emphysema.
The primary risk factor for its development is smoking, and the World Health Organization predicts that COPD is set to become the third leading cause of death worldwide. Recent evidence suggests that diet may be an important factor in the development and/or prevention of COPD.
To try and find out if fruit and vegetable intake might have a dietary role, the researchers tracked the respiratory health of more than 44,000 men aged between 45 and 79 for 13 years.
They were also quizzed about other potentially important factors, such as educational attainment, weight, height, physical activity and inactivity levels and how much, and how often, they drank alcohol. And they were asked how many daily cigarettes they smoked, on average, between the ages of 15 and 20; 21 and 30; 31 and 40; 41 and 50; and 51 and 60.
Almost two thirds of the men (nearly 63%) had smoked at some point; around one in four (24%) were current smokers; and nearly four out of 10 (38.5%) had never smoked.
During the monitoring period, 1918 new cases of COPD were diagnosed. The number of new cases in current and former smokers was estimated to be 1166 and 506/100,000 people, respectively, among those eating fewer than 2 daily portions of fruit and vegetables; but in those eating more than 5, the equivalent figures were 546 and 255.
In all, those eating 5 or more daily servings were 35% less likely to develop lung disease than those eating 2 or fewer daily servings. And when the data were stratified by smoking, current and former smokers eating 5 or more portions of fruit and vegetables every day were, respectively, 40% and 34%, less likely to develop COPD.
Each additional serving was associated with a 4% lower risk of COPD in former smokers and an 8% lower risk in current smokers.
Compared with those who had never smoked and who ate 5 or more portions of fruit and vegetables, current and former smokers eating fewer than 2 daily portions were, respectively, 13.5 times and 6 times more likely to develop COPD.
Those at the high end of the consumption scale were 7.5 times (current smokers), and more than 3.5 times (former smokers), as likely to develop COPD.
Apples or pears; green leafy vegetables; and peppers seemed to exert the strongest influence on risk, but no such associations were seen for berry fruits; bananas; citrus fruits; cruciferous and root vegetables; tomatoes; onions; garlic; or green peas.
As oxidative tissue stress and inflammation may be involved in COPD development, and smoking is a potent trigger of these processes, the antioxidants abundant in fruit and vegetables may curb their impact, suggest the researchers, who add that smoking cessation should still continue to be promoted as the mainstay of prevention.
But in a linked editorial, Drs Raphaelle Varraso and Seif Shaheen emphasise that as this is an observational study, no firm conclusions can be drawn about cause and effect; a clinical trial would be needed for that.
But they write: "it could be argued that there is nothing to be lost by acting now. We would argue that clinicians should consider the potential benefits of a healthy diet in promoting lung health, and advocate optimising intake of fruits and vegetables, especially in smokers who are unable to stop smoking."
Do gluten-free diets provide a cure-all for celiac disease?
University of Oslo (Norway), February 24, 2021
A new study provides insights into the curative effects of gluten-free diets in celiac patients. Results from the proteomics-based research suggests not.
Celiac disease is a highly prevalent disorder characterized by a harmful immune reaction to dietary gluten proteins in the upper small intestine. The disease is caused when CD4+ T-cells in a patient respond to gluten, mounting an immune reaction that causes intestinal damage.
Tracking celiac disease: intestinal biopsies
Disease diagnosis and monitoring are typically performed via expert analysis of intestinal biopsies by medical professionals. The only current effective treatment for celiac disease is complete and permanent removal of gluten from patients' diets. For the vast majority of patients, biopsies reveal that avoiding gluten in this way is very effective and that the intestine regains its normal architecture after some time.
Treated patients (those who have remained off gluten and have a healthy intestine according to biopsy analysis) are sometimes re-exposed to gluten (gluten challenge) in the clinic to confirm diagnosis or to track drug efficacy in clinical trials.
Varied response to gluten challenge
For reasons that are not completely understood, upon gluten challenge, some treated patients develop strong mucosal inflammation while others do not. This suggests that there are subtle differences between treated patients that are not easy to detect by visual inspection of intestinal biopsies alone, and that a more detailed picture of tissue status is needed to fully understand the connection between gluten exposure and disease severity.
That was the aim of the new study, led by Jorunn Stamnæs at the KG Jebsen Coeliac Disease Research Centre (JCoDiRC) at the University of Oslo.
Collaboration with NAPI
Jorunn collaborated with staff at the NAPI Proteomics Core Facility at Oslo University Hospital to perform mass spectrometry-based proteomics analysis of intestinal samples from a cohort of 19 well-treated celiac disease patients subjected to gluten challenge.
Although the 19 patients all were categorized as well treated prior to gluten challenge, they react very differently to the gluten—with strong mucosal changes in some patients and no observable changes in other patients.
The researchers used biopsies from all patients both before and after short-term gluten exposure, which allowed unbiased global analysis of the protein profiles associated with the different levels of inflammatory response.
Proteomics paints clearer picture
The proteomic approach revealed that patients with a strong inflammatory response had signs of ongoing 'basal' inflammation before re-exposure to gluten. This coincided with increased levels of gluten-specific T cells in the intestine, as well as a low-level presence of inflammatory proteins in the blood.
Although all patients in this cohort were considered well-treated by a standard gluten-free diet, gluten-related inflammation could still be ongoing at low level in the patients that responded strongly to gluten re-exposure. As these patients had a 'head start' they rapidly developed clear mucosal destruction.
Alternative approaches to categorize patients
These findings provide valuable new insights into celiac disease mechanisms, and raise the question as to whether a standard gluten-free diet is sufficient to fully 'cure' all celiac patients.
The research also suggests that, whilst manual inspection of intestinal biopsies is a valuable tool to broadly categorize disease status and response to gluten, alternative approaches such as proteomics could help to better define which patients still demonstrate low-level gluten-specific immune responses. A significant number of patients previously thought to be well-treated by a gluten-free diet may in fact require additional interventions to fully curb their gut inflammation.
Researchers at JCoDiRC are now investigating whether activated gluten-specific CD4+ T cells are present also in some celiac patients on long-term gluten free diet.