208CNO12JUN2015

CNO Report 208

Release Date 12 JUN 2015

Draft Report Compiled by

Ralph Turchiano

www.clinicalnews.org

 

In This Issue:

1.       Researchers find fructose contributes to weight gain, physical inactivity, and body fat

2.       Western diet may increase risk of death after prostate cancer diagnosis

3.       Organic agriculture more profitable to farmers

4.       Finnish-Swedish study analyzes link between psychotropic drugs and homicide risk

5.       Memory loss among the elderly is lower than what was originally thought

6.       Boosting gut bacteria defense system may lead to better treatments for bloodstream infections

7.       The Lancet: Over 95 percent of the world’s population has health problems — with over a third having more than 5 ailments

8.       Are the data underlying the US dietary guidelines flawed?

9.       Lactobacillus reuteri may have multiple benefits as a probiotic in premature infants

10.   Milk proteins may protect against cardiovascular disease

11.   High salt prevents weight gain in mice on a high-fat diet

12.   Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days

 

Public Release: 1-Jun-2015

Researchers find fructose contributes to weight gain, physical inactivity, and body fat

Beckman Institute for Advanced Science and Technology

 

In the last 40 years, fructose, a simple carbohydrate derived from fruit and vegetables, has been on the increase in American diets. Because of the addition of high-fructose corn syrup to many soft drinks and processed baked goods, fructose currently accounts for 10 percent of caloric intake for U.S. citizens. Male adolescents are the top fructose consumers, deriving between 15 to 23 percent of their calories from fructose–three to four times more than the maximum levels recommended by the American Heart Association.

A recent study at the Beckman Institute for Advanced Science and Technology at the University of Illinois found that, matched calorie for calorie with the simple sugar glucose, fructose causes significant weight gain, physical inactivity, and body fat deposition.

The paper, “Fructose decreases physical activity and increases body fat without affecting hippocampal neurogenesis and learning relative to an isocaloric glucose diet,” was published in Scientific Reports.

“The link between increases in sugar intake, particularly fructose, and the rising obesity epidemic has been debated for many years with no clear conclusions,” said Catarina Rendeiro, a postdoctoral research affiliate at the Beckman Institute for Advanced Science and Technology and lead author on the study. “The reality is that people are not only consuming more fructose through their diets, but also consuming more calories in general.

“One of the key questions is whether an increase in fructose intake contributes to obesity in the absence of excessive calorie intake.”

The researchers, under the direction of Justin Rhodes of Beckman’s NeuroTech Group and professor of psychology at Illinois, studied two groups of mice for two-and-a-half months: one group was fed a diet in which 18 percent of the calories came from fructose, mimicking the intake of adolescents in the United States, and the other was fed 18 percent from glucose.

“The important thing to note is that animals in both experimental groups had the usual intake of calories for a mouse,” said Rendeiro. “They were not eating more than they should, and both groups had exactly the same amount of calories deriving from sugar, the only difference was the type of sugar, either fructose or glucose.”

The results showed that the fructose-fed mice displayed significantly increased body weight, liver mass, and fat mass in comparison to the glucose-fed mice.

“In previous studies, the increases in fructose consumption were accompanied by increases in overall food intake, so it is difficult to know whether the animals put on weight due to the fructose itself or simply because they were eating more,” Rhodes said.

Remarkably, the researchers also found that not only were the fructose-fed mice gaining weight, they were also less active.

“We don’t know why animals move less when in the fructose diet,” said Rhodes. “However, we estimated that the reduction in physical activity could account for most of the weight gain.”

“Biochemical factors could also come into play in how the mice respond to the high fructose diet,” explained Jonathan Mun, another author on the study. “We know that contrary to glucose, fructose bypasses certain metabolic steps that result in an increase in fat formation, especially in adipose tissue and liver.”

The precise mechanisms are still being investigated, but one thing is certain: high intake of fructose by itself adds pounds.

“We designed this study based on the intake of fructose by adolescents in the United States,” said Rhodes. “Our study suggests that such levels of fructose can indeed play a role in weight gain, favor fat deposition, and also contribute to physical inactivity. Given the dramatic increase in obesity among young people and the severe negative effects that this can have on health throughout one’s life, it is important to consider what foods are providing our calories.”

Public Release: 1-Jun-2015

Western diet may increase risk of death after prostate cancer diagnosis

Harvard School of Public Health

 

Boston, MA — After a prostate cancer diagnosis, eating a diet higher in red and processed meat, high-fat dairy foods, and refined grains–known as a Western diet–may lead to a significantly higher risk of both prostate cancer-related mortality and overall mortality compared with eating a diet rich in vegetables, fruits, fish, whole grains, and healthy oils, according to a new study from Harvard T.H. Chan School of Public Health.

The study, which appears online June 1, 2015 in the journal Cancer Prevention Research, offers insight on how diet may help improve survivorship for the nearly three million men living with prostate cancer in the U.S.

“There is currently very little evidence to counsel men living with prostate cancer on how they can modify their lifestyle to improve survival. Our results suggest that a heart-healthy diet may benefit these men by specifically reducing their chances of dying of prostate cancer,” said Jorge Chavarro, assistant professor of nutrition and epidemiology at the Harvard Chan School and senior author of the study.

Researchers examined health and diet data from 926 men participating in the Physicians’ Health Study I and II who were diagnosed with prostate cancer. They followed the men for an average of 14 years after their diagnosis, grouping them into quartiles according to whether they followed a Western dietary pattern or a “prudent” (higher consumption of vegetables, fruits, fish, legumes, and whole grains) dietary pattern.

They found that men who ate mostly a Western diet (those in the highest quartile of the Western dietary pattern) had two-and-a-half times higher risk of prostate cancer-related death–and a 67% increased risk of death from any cause–than those in the lowest quartile. Men who ate mostly a “prudent” diet had a 36% lower risk of death from all causes.

“These results are encouraging and add to the scant literature on this area, but it is important to keep in mind that all study participants are physicians and most are white. Therefore it is very important that our results are replicated in other studies with more diverse socioeconomic and racial/ethnic backgrounds,” said lead author Meng Yang, research fellow at the Harvard Chan School.

Public Release: 1-Jun-2015

Organic agriculture more profitable to farmers

Large profit margins show room for growth

Washington State University

 

PULLMAN, Wash.–A comprehensive study finds organic agriculture is more profitable for farmers than conventional agriculture.

In spite of lower yields, the global study shows that the profit margins for organic agriculture were significantly greater than conventional agriculture. The results show that there’s room for organic agriculture to expand and, with its environmental benefits, to contribute a larger share in feeding the world sustainably. Organic agriculture currently accounts for only one percent of agriculture globally.

The study, published this week in the Proceedings of the National Academy of Sciences, was authored by Washington State University scientists David Crowder and John Reganold.

To be sustainable, organic agriculture must be profitable. That motivated Crowder and Reganold to analyze dozens of studies comparing the financial performance of organic and conventional farming.

“The reason we wanted to look at the economics,” said Crowder, an entomologist who studies organic systems, “is that more than anything, that is what really drives the expansion and contraction of organic farming–whether or not farmers can make money. It was kind of surprising that no one had looked at this in a broad sense.”

Organic price premiums give farmers an incentive to adopt more sustainable farming practices. The authors suggest that governmental policies could further boost the adoption of organic farming practices and help ease the transition for conventional farmers.

Room to grow

The actual premiums paid to organic farmers ranged from 29 to 32 percent above conventional prices. Even with organic crop yields as much as 18 percent lower than conventional, the breakeven point for organic agriculture was 5 to 7 percent.

“That was a big surprise to me,” said Reganold, a soil scientist and organic agriculture specialist. “It means that organic agriculture has room to grow, there’s room for premiums to go down over time. But what we’ve found is that the premiums have held pretty steady over the 40 years represented in the study.”

Out of 129 initial studies, 44 met Crowder and Reganold’s criteria for inclusion in the meta-analysis of costs, gross returns, benefit/cost ratios, and net present values – a measure that accounts for inflation. The analysis represented 55 crops in 14 countries on five continents. The published article provides the criteria used to select the studies as well as a list of studies that were rejected.

“This is the first large-scale synthesis of economic sustainability of organic farming compared to conventional that we know of,” Crowder said. The authors consulted with three agricultural economists to confirm their findings.

Unique to the analysis was the inclusion of yield and economic data for crops grown as part of a rotational system, in addition to data for single crops. The study included profit data for multiple crops grown over several seasons, a more accurate reflection how farmers profit from agriculture.

None of the comparison studies accounted for the environmental costs and benefits of farming. Environmental costs tend to be lower and benefits higher in organic agriculture. But for consumers who believe that organic farming is more environmentally friendly, organic premiums may serve as stand in for the monetary value of such costs and benefits.

Incentive to change

Organic premiums offer a strong incentive for farmers to transition from conventional to organic farming.

“Most growers that we work with, and probably in the United States in particular, do a little bit of organic and lot of conventional,” Crowder said. “If they make a little bit of money on that organic acreage they might convert more of their farm.”

But farmers converting to organic are in a vulnerable position. The transition period for organic certification exposes farmers to financial risk when their yields drop but they are not yet receiving premiums.

“The challenge facing policymakers,” the authors write, “is to develop government policies that support conventional farmers converting to organic and other sustainable systems, especially during the transition period, often the first three years.”

As long as environmental degradation, population growth and climate change remain challenges, farming practices that are profitable to farmers while offering additional benefits of sustainability are needed, they said.

Public Release: 1-Jun-2015

Finnish-Swedish study analyzes link between psychotropic drugs and homicide risk

University of Eastern Finland

 

A study analysing the Finnish homicide and prescription drug databases discovered that the use of certain drugs that affect the central nervous system are associated with an increased risk of committing a homicide. The greatest risk was associated with the use of painkillers and tranquillizing benzodiazepines, while anti-depressants were linked only to a slightly elevated risk. The study is the first one of its kind in the world.

Professor Jari Tiihonen’s research group analysed the use of prescription drugs of 959 persons convicted of a homicide.

In the recent years, there has been plenty of debate over whether psychotropic drugs can cause violent behav-iour. In particular, this debate has been fuelled by massacres committed by young persons in schools and other public places in the US and in Finland, too. “It has been repeatedly claimed that it was the anti-depressants used by the persons who committed these massacres that triggered their violent behaviour. It is possible that the massive publicity around the subject has already affected drug prescription practices,” Tiihonen says.

In order to properly study the link between drug use and the risk of committing a crime, the following criteria must be fulfilled: the sample needs to be representative, the reason for using the drug needs to be taken into consideration, and the effect needs to be controlled for. Furthermore, the effects of any other drugs and intox-icants used simultaneously also need to be considered. No other studies like the present one have been pub-lished thus far.

The newly published study analysed the pre-crime use of prescription drugs among all persons convicted of a homicide in Finland between 2003 and 2011. The registers used were the Finnish Homicide Database of the In-stitute of Criminology and Legal Policy, and the Finnish Prescription Register of the Social Insurance Institution of Finland, Kela. After confounding factors were controlled for, the results show that the use of anti-psychotics was not associated with a significantly increased risk of committing a homicide, whereas the use of anti-depressants was associated with a slightly elevated risk (+31%), and the use of benzodiazepines (drugs used to treat anxiety and insomnia) with a significantly elevated risk (+45%). The study found, rather surprisingly, that the highest increase in the risk of committing a homicide was associated with opiate painkillers (+92%) and anti-inflammatory painkillers (+206%). In persons under 26 years of age, the highest increase in the risk of commit-ting a homicide was associated with opiate painkillers (+223%) and benzodiazepines (+95%). An increase in the risk by, for example, 100% means that the risk doubles. Although the use of intoxicants was present in the ma-jority of the homicides, the differences between the drug groups could not be explained by simultaneous in-toxicant use.

In many cases, benzodiazepines had been prescribed in very high doses and for a long period of time. “Benzo-diazepines can weaken impulse control, and earlier research has found that painkillers affect emotional pro-cessing. Caution in prescribing benzodiazepines and strong painkillers to people with a history of substance abuse is advisable,” Tiihonen says.

Public Release: 5-Jun-2015

Memory loss among the elderly is lower than what was originally thought

According to a piece of research by the UPV/EHU-University of the Basque Country, the capacity to recall specific facts deteriorates with age, but other types of memory do not

University of the Basque Country

 

Alaitz Aizpurua, a lecturer at the UPV/EHU, maintains that “the highly widespread belief that memory deteriorates as one approaches old age is not completely true. Various pieces of neuro-psychological research and other studies show that cognitive loss starts at the age of 20 but that we hardly notice it because we have sufficient capacity to handle the needs of everyday life.This loss is more perceptible between 45 and 49 and, in general, after the age of 75, approximately.”

The deterioration does not tend to be either uniform or general: “It takes place in certain memory types more than in others.In old age, deterioration appears in episodic memory but not in semantic memory. This type of memory (semantic) and procedural memory are maintained (in some cases they even improve) whereas episodic memory in which detailed memories are retainedis reduced,” said Aizpurua.

“Procedural memory is the one to do with ‘skills’, the one we need to ‘do things’ (to drive, for example). In general, it is maintained during old age.Semantic memory, on the other hand, is related to language, to the meaning of concepts and to repetitive facts. Whenever we go to a restaurant, for example, we remember the sequence of steps we have to follow: wait until the waiter attends to us and tell him/how many diners there will be; whether we have booked a table, and if so, in whose name; order the dishes, etc. Finally, episodic memory preserves the facts (episodes) of the past in our personal life, and it is more specific in terms of time and space:we can remember, for example, the last time we went to a restaurant, who we sat next to, what we ate, etc.,” explained the author of the research.

Autobiographical memory –the object of the research by Aizpurua and Kootstaal– forms part of episodic memory and is essential when it comes to planning or predicting our future and well as for our emotional well-being. In the experiment conducted for the research, the participants were asked to recall three facts from their personal lives: something that happened the previous year (but not in the previous month), something that happened during the previous month, (but not in the previous week) and something that happened the previous week (but not on the previous day).

Rules of the game identical for older and younger adults

The authors of the research detected certain gaps in the autobiographical memory measurements that have been conducted until now. “Older and younger people were asked about events that had occurred at a specific moment (the same for both groups), but for the older adults the time interval that had elapsed since the event was much longer. If a young adult is asked about an event in his/her childhood, he/she will have to go back 10 to 15 years; by contrast, an older adult has to go back 40 years or more,” stressed Aizpurua.

So these researchers changed the interview pattern that had been used for studies of this type, and asked older adults and younger ones the same questions,and they drew the following conclusion: “An individual, both an adult and a young person, has the capacity to remember information relating to facts in his/her private life in detail. The main difference between older adults and younger adults is as follows: the younger ones remember more episodic details. Our research shows, however, that this difference only occurred in one of the three sections referred to, in the one involving memories of the previous year; in other words, in that of the oldest recollections. No appreciable differences were found in the recollections of the previous month and the previous week, and the older adults were just as capable as the younger adults in providing episodic details relating to the facts,” asserted Aizpurua.

Public Release: 8-Jun-2015

Boosting gut bacteria defense system may lead to better treatments for bloodstream infections

UT Southwestern Medical Center

 

DALLAS – June 8, 2015 – An upset in the body’s natural balance of gut bacteria that may lead to life-threatening bloodstream infections can be reversed by enhancing a specific immune defense response, UT Southwestern Medical Center researchers have found.

In the study, published online in Nature Medicine, scientists identified how a certain transcription factor – a protein that that turns genes on and off – works in partnership with a naturally occurring antibiotic to kill infection-causing fungi called Candida albicans.

These particular fungi, best known as a cause of yeast infections and oral thrush, can be lethal if they overgrow and invade the bloodstream from the gut. At high risk for this type of infection are stem cell transplant and leukemia patients whose immune systems are suppressed during treatment. Up to 25 percent of cancer patients develop bloodstream infections from bacteria or fungi.

“For a cancer patient with a Candida bloodstream infection, the fatality rate is about 30 percent. Candida is the No. 1 fungal pathogen,” said senior author Dr. Andrew Koh, Assistant Professor of Pediatrics and Microbiology, and a member of the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern.

Certain antibiotics do fight invasive Candida infection, but they are not always effective and antibiotic resistance increasingly has become an issue. Dr. Koh’s research team aimed to uncover how the body’s natural immune defense system might be enhanced to fight a Candida infection.

About half of the population carries Candida in the gut, where the yeast is usually harmless. When the organism overgrows, it may leave the gut and cause infection. Commensal bacteria, the resident bacteria of the gut, normally defend against disease by inhibiting growth of potentially pathogenic organisms.

By studying how mice infected with Candida responded in different scenarios, the researchers discovered how to enhance the body’s natural ability to eradicate infection, in this case Candida.

“The commensal bacteria stimulate gut tissue to make a transcription factor and a natural antibiotic, which then kills the Candida fungus,” said Dr. Koh, Director of the Pediatric Hematopoietic Stem Cell Transplantation Program at UT Southwestern and Children’s Medical Center Dallas. “When we gave the mice a pharmacologic agent called L-mimosine that stimulates the transcription factor, the agent knocked down Candida 100-fold, which translated into a 50 percent reduction in mortality from invasive Candida infection.”

Specifically, the researchers found that enhancing the transcription factor HIF-1α with L-mimosine led to increased production of the natural antibiotic peptide LL-37, which in turn killed the fungi. L-mimosine is a natural product derived from seeds of the koa haole tree that is not approved as a drug but is known to boost HIF-1α activity. The study also suggested that certain gut bacteria – Cloistridial Firmicutes and Bacteroidetes – may be important in producing short-chain fatty acids that help fight infection.

More study is needed to pinpoint the optimal method of inducing the body’s gut defense system, whether through use of an agent like L-mimosine or by administering short-chain fatty acids such as vinegar.

“Can we modulate the gut system to maintain balance so that it never gets to the point of pathogens invading the bloodstream?” asked Dr. Koh. “Boosting GI mucosal immune effectors to reduce fungal burden may be the key to tipping the balance back toward normal and preventing invasive fungal disease.”

Public Release: 8-Jun-2015

The Lancet: Over 95 percent of the world’s population has health problems — with over a third having more than 5 ailments

The Lancet

 

Just one in 20 people worldwide (4·3%) had no health problems in 2013, with a third of the world’s population (2·3 billion individuals) experiencing more than five ailments, according to a major new analysis from the Global Burden of Disease Study (GBD) 2013, published in The Lancet.

Moreover, the research shows that, worldwide, the proportion of lost years of healthy life (disability-adjusted life years; DALYS [1]) due to illness (rather than death) rose from around a fifth (21%) in 1990 to almost a third (31%) in 2013.

As the world’s population grows, and the proportion of elderly people increases, the number of people living in suboptimum health is set to rise rapidly over coming decades, warn the authors.

The findings come from the largest and most detailed analysis to quantify levels, patterns, and trends in ill health and disability around the world between 1990 and 2013.

In the past 23 years, the leading causes of health loss have hardly changed. Low back pain, depression, iron-deficiency anaemia, neck pain, and age-related hearing loss resulted in the largest overall health loss worldwide (measured in terms of YLD–Years Lived with Disability–ie, time spent in less than optimum health [2]) in both 1990 and 2013.

In 2013, musculoskeletal disorders (ie, mainly low back pain, neck pain, and arthritis) and mental and substance abuse disorders (predominantly depression, anxiety, and drug and alcohol use disorders) accounted for almost half of all health loss worldwide.

Importantly, rates of disability are declining much more slowly than death rates. For example, while increases in rates of diabetes have been substantial, rising by around 43% over the past 23 years, death rates from diabetes increased by only 9%.

“The fact that mortality is declining faster than non-fatal disease and injury prevalence is further evidence of the importance of paying attention to the rising health loss from these leading causes of disability, and not simply focusing on reducing mortality,” [3] says Theo Vos, lead author and Professor of Global Health at the Institute of Health Metrics and Evaluation, University of Washington, USA.

The GBD 2013 Disease and Injury Incidence and Prevalence Collaborators analysed 35 620 sources of information on disease and injury from 188 countries between 1990 and 2013 to reveal the substantial toll of disabling disorders and the overall burden on health systems from 301 acute and chronic diseases and injuries, as well as 2337 health consequences (sequelae) that result from one or more of these disorders.

Key findings include:

·         In 2013, low back pain and major depression ranked among the top ten greatest contributors to disability in every country, causing more health loss than diabetes, chronic obstructive pulmonary disease, and asthma combined.

·         Worldwide, the number of individuals with several illnesses rapidly increased both with age and in absolute terms between 1990 and 2013. In 2013, about a third (36%) of children aged 0-4 years in developed countries had no disorder compared with just 0·03% of adults older than 80 years. Furthermore, the number of individuals with more than ten disorders increased by 52% between 1990 and 2013.

·         Eight causes of chronic disorders–mostly non-communicable diseases–affected more than 10% of the world population in 2013: cavities in permanent teeth (2·4 billion), tension-type headaches (1·6 billion), iron-deficiency anaemia (1·2 billion), glucose-6-phosphate dehydrogenase deficiency trait (1·18 billion), age-related hearing loss (1·23 billion), genital herpes (1·12 billion), migraine (850 million), and ascariasis (800 million; giant intestinal roundworm).

·         The number of years lived with disability increased over the last 23 years due to population growth and ageing (537·6 million to 764·8 million), while the rate (age-standardised per 1000 population) barely declined between 1990 and 2013 (115 per 1000 people to 110 per 1000 people).

·         The main drivers of increases in the number of years lived with disability were musculoskeletal, mental, and substance abuse disorders, neurological disorders, and chronic respiratory conditions. HIV/AIDS was a key driver of rising numbers of years lived with disability in sub-Saharan Africa.

·         There has also been a startling increase in the health loss associated with diabetes (increase of 136%), Alzheimer’s disease (92% increase), medication overuse headache (120% increase), and osteoarthritis (75% increase).

·         In central Europe, falls cause a disproportionate amount of disability and health burden, ranking as the second leading cause of disability in 11 of 13 countries. In many Caribbean nations anxiety disorders ranked more highly, and diabetes was the third greatest contributor to disability in Mexico, Nicaragua, Panama, and Venezuela. Disability from past war and conflict was the leading contributor to health loss in Cambodia, Nicaragua, Rwanda, and ranked second in Vietnam.

According to Professor Vos, “Large, preventable causes of health loss, particularly serious musculoskeletal disorders and mental and behavioural disorders, have not received the attention that they deserve. Addressing these issues will require a shift in health priorities around the world, not just to keep people alive into old age, but also to keep them healthy.” [3]

Public Release: 9-Jun-2015

Are the data underlying the US dietary guidelines flawed?

Opposing views regarding the validity of widely-cited what we eat in America and NHANES dietary data presented in Mayo Clinic Proceedings

Elsevier Health Sciences

 

Rochester, MN, June 9, 2015 – U.S. government-issued dietary recommendations continue to evolve over time. In a special article published in Mayo Clinic Proceedings, an obesity theorist and cardiovascular health researchers claim that the main source of dietary information used by the U.S. Government’s 2015 Dietary Guidelines Advisory Committee (DGAC) is scientifically flawed because the underlying data are primarily informed by memory-based dietary assessment methods (M-BMs) (eg, interviews and surveys). In an editorial response nutrition experts suggest that the purported flaws are well-appreciated by nutritional researchers and can be mitigated by using multiple data sources, resulting in valid data.

The data under scrutiny come from the “What We Eat in America” and the National Health and Nutrition Examination Surveys (WWEIA/NHANES), a five-decade long study of American’s diet and exercise behaviors. In this case the standard M-BMs employed include asking participants to recall what they consumed during the last 24 hours (24HRs) as well as completion of food frequency questionnaires (FFQs). It is the authors’ contention that these data suffer from five major and potentially fatal flaws.

Lead author Edward Archer, PhD, of the Office of Energetics, Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, and co-authors Gregory Pavela, PhD, and Carl J. Lavie, MD, from the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School – the University of Queensland School of Medicine, New Orleans, LA, present a large body of evidence to support their conclusions:

1. The vast majority of the WWEIA/NHANES data are physiologically implausible (i.e., incompatible with life) and therefore are not valid estimates of food and beverage consumption.

2. Human memory and recall are too inaccurate and imprecise to be used as tools to collect scientific data.

3. The protocols used in WWEIA/NHANES mimic protocols known to induce false memory and recall.

4. Mental phenomena such as memories of food and beverage consumption are inadmissible as scientific evidence because they cannot be independently observed, measured, or falsified.

5. Physical activity, cardio-respiratory fitness and exercise are major determinants of health and are largely ignored or improperly measured by federally funded nutrition researchers.

According to Dr. Archer, “Our work indicates there is no scientific foundation to past or present U.S. Dietary Guidelines. This finding may explain why nutrition recommendations are continually changing and the average consumer is confused as to what constitutes a healthy diet.”

In an accompanying editorial, Brenda M. Davy, PhD, RD, and Paul A. Estabrooks, PhD, both from the Department of Human Nutrition, Foods, and Exercise, Virginia Tech University, Blacksburg, VA, provide empirical evidence that recall measures can be scientifically sound. They present a different perspective that values multiple forms of evidence to determine the scientific appropriateness of measurement instruments, including predictive validity, sensitivity to change, feasibility, and actionability.

“Attempting to develop recommendations to improve health is a complex enterprise due to the interactive nature of genetics, environmental factors, and individual behavior; however, one thing is clear–behaviors matter,” Dr. Davy and Dr. Estabrooks explain. “The body of research that contributed to these findings includes a variety of scientific approaches that range from retrospective and prospective epidemiologic studies to randomized controlled trials. One consistency across scientific inquiry and behavioral domains is that participant recall has been used as a representation of behavior.” They note that the authors of the special article and others have used participant recall to draw conclusions about other aspects of diet and exercise.

In conclusion Dr. Davy and Dr. Estabrooks maintain that “To argue that these data represent a waste of resources, while concurrently citing scientific findings where those same data collection methods were used to demonstrate the importance of diet and activity in health, is scientific doublespeak–and an impediment to scientific progress in obesity and nutrition research.”

Public Release: 9-Jun-2015

Lactobacillus reuteri may have multiple benefits as a probiotic in premature infants

Lactobacillus reuteri DSM 17938 could reduce the risk of necrotising enterocolitis and feed intolerance in premature infants

American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)

 

A new study finds that supplementing enteral nutrition with Lactobacillus reuteri (L. reuteri) DSM 17938 as a probiotic may reduce the risk of necrotizing enterocolitis (NEC) in premature infants. NEC is a condition where portions of the bowel undergo tissue death. It is the second most common cause of death among premature infants.

The study, published today in the OnlineFirst version of the Journal of Parenteral and Enteral Nutrition (JPEN), the research journal of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), is a systematic review of randomized controlled trials (RCTs) and non-RCTs of L. reuteri DSM 17938 supplementation in premature infants born at a gestational age of less than 37 weeks. Studies comparing enteral administration of any dose of L. reuteri DSM 17938 or mother strain L. reuteri ATCC 55730 within the first 10 days of life and continued for at least 7 days with placebo or control were eligible for inclusion. Studies comparing L. reuteri DSM 17938 with another probiotic were also included. In the end, 6 RCTs and 2 non-RCTs were included.

The results from the RCTs showed a statistically insignificant improvement in NEC, while the non-RCTs showed significant improvement. Overall, this systematic review suggests that L. reuteri DSM 17938 supplementation has the potential not only to reduce the risk of NEC but also to facilitate enteral nutrition in premature infants. However, larger definitive studies are needed to confirm these findings.

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A publication of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), the Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original, peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or intravenous therapies. All published JPEN articles are available online at http://pen.sagepub.com.

The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) is dedicated to improving patient care by advancing the science and practice of nutrition support therapy and metabolism. Founded in 1976, A.S.P.E.N. is an interdisciplinary organization whose members are involved in the provision of clinical nutrition therapies, including parenteral and enteral nutrition. With more than 6,000 members from around the world, A.S.P.E.N. is a community of dietitians, nurses, nurse practitioners, pharmacists, physicians, scientists, students, and other health professionals from every facet of nutrition support clinical practice, research, and education. For more information about A.S.P.E.N., please visit http://www.nutritioncare.org.

Public Release: 11-Jun-2015

Milk proteins may protect against cardiovascular disease

Naturally-fermented foods are a good source, according to new Journal of Dairy Science® study

Elsevier Health Sciences

 

Philadelphia, June 11 — The Maillard reaction is a chemical reaction between amino acids and reducing sugars that results in browned foods like seared steaks and toasted bread. When proteins and sugars are mixed together and heated, new chemical compounds are formed. Some are responsible for new flavors and some, according to a new study published in the Journal of Dairy Science®, may protect us against cardiovascular disease.

Researchers at the R&D Center, Seoul Dairy Cooperative, the College of Life Science & Biotechnology, Korea University, and the BK21 Plus Graduate Program, Department of Animal Science and Institute Agricultural Science & Technology, Chonbuk National University in South Korea, have determined that dietary compounds formed in milk-based products lowered serum total and low-density lipoprotein (LDL) cholesterol levels and triglycerides in mice. These compounds also protected against acute pulmonary thromboembolism as well as aspirin, but without the possible bleeding consequences often observed in aspirin therapy.

Whey protein concentrate and sodium caseinate were heated with lactose to form whey-protein Maillard reaction products (wMRP). Lactic acid bacteria were then used to produce fermented MRPs (f-MRP). Sodium caseinate alone was also reacted to form Maillard-reacted sodium caseinate (cMRP) and further fermented to f-cMRP.

To determine antithrombotic effects, 60 mice were divided into four treatment groups of 15. Group one received phosphate buffered saline (PBS) (negative control), group two received aspirin (positive control), group three received wMRP, and group four received f-MRP in addition to a normal diet. Assessment of antioxidant activity and cholesterol reduction effect of fermented cMRP was done with another group of 60 mice fed various diets with and without f-cMRP.

‘This is the first report describing the verification for the impacts of MRPs and their fermented product in cardiovascular risk using animal model,’ explained lead investigator Younghoon Kim, Ph.D., of the Department of Animal Science, Chonbuk National University, Republic of Korea, ‘In addition, our findings represent a real advance in the area of milk proteins and indicate that f-cMRP and cMRP could be recommended for use as potential antioxidants and cardioprotective ingredients for various functional, pharmaceutical, and dairy applications.’

Matt Lucy, Ph.D., Editor-in-Chief, Journal of Dairy Science, and Professor of Animal Science, University of Missouri, added, ‘We are beginning to understand that dairy products provide benefits to human health beyond the traditional nutrients. This study performed in laboratory animals demonstrates the potential for milk proteins found in naturally fermented foods to improve human cardiovascular health.’

Public Release: 11-Jun-2015

High salt prevents weight gain in mice on a high-fat diet

Dietary sodium suppresses digestive efficiency, limiting fat absorption

University of Iowa Health Care

 

In a study that seems to defy conventional dietary wisdom, University of Iowa scientists have found that adding high salt to a high-fat diet actually prevents weight gain in mice.

As exciting as this may sound to fast food lovers, the researchers caution that very high levels of dietary salt are associated with increased risk for cardiovascular disease in humans. Rather than suggest that a high salt diet is suddenly a good thing, the researchers say these findings really point to the profound effect non-caloric dietary nutrients can have on energy balance and weight gain.

“People focus on how much fat or sugar is in the food they eat, but [in our experiments] something that has nothing to do with caloric content – sodium – has an even bigger effect on weight gain,” say Justin Grobe, PhD, assistant professor of pharmacology at the UI Carver College of Medicine and co-senior author of the study, which was published in the journal Scientific Reports on June 11.

The UI team started the study with the hypothesis that fat and salt, both being tasty to humans, would act together to increase food consumption and promote weight gain. They tested the idea by feeding groups of mice different diets: normal chow or high-fat chow with varying levels of salt (0.25 to 4 percent). To their surprise, the mice on the high-fat diet with the lowest salt gained the most weight, about 15 grams over 16 weeks, while animals on the high-fat, highest salt diet had low weight gain that was similar to the chow-fed mice, about 5 grams.

“We found out that our ‘french fry’ hypothesis was perfectly wrong,” says Grobe, who also is a member of the Fraternal Order of Eagles Diabetes Research Center at the UI and a Fellow of the American Heart Association. “The findings also suggest that public health efforts to continue lowering sodium intake may have unexpected and unintended consequences.”

To investigate why the high salt prevented weight gain, the researchers examined four key factors that influence energy balance in animals. On the energy input side, they ruled out changes in feeding behavior – all the mice ate the same amount of calories regardless of the salt content in their diet. On the energy output side, there was no difference in resting metabolism or physical activity between the mice on different diets. In contrast, varying levels of salt had a significant effect on digestive efficiency – the amount of fat from the diet that is absorbed by the body.

“Our study shows that not all calories are created equal,” says Michael Lutter, MD, PhD, co-senior study author and UI assistant professor of psychiatry. “Our findings, in conjunction with other studies, are showing that there is a wide range of dietary efficiency, or absorption of calories, in the populations, and that may contribute to resistance or sensitivity to weight gain.”

“This suppression of weight gain with increased sodium was due entirely to a reduced efficiency of the digestive tract to extract calories from the food that was consumed,” explains Grobe.

It’s possible that this finding explains the well-known digestive ill effects of certain fast foods that are high in both fat and salt, he adds.

Through his research on hypertension, Grobe knew that salt levels affect the activity of an enzyme called renin, which is a component in the renin- angiotensin system, a hormone system commonly targeted clinically to treat various cardiovascular diseases. The new study shows that angiotensin mediates the control of digestive efficiency by dietary sodium.

The clinical usefulness of reducing digestive efficiency for treating obesity has been proven by the drug orlistat, which is sold over-the-counter as Alli. The discovery that modulating the renin-angiotensin system also reduces digestive efficiency may lead to the developments of new anti-obesity treatments.

Lutter, who also is an eating disorders specialist with UI Health Care, notes that another big implication of the findings is that we are just starting to understand complex interactions between nutrients and how they affect calorie absorption, and it is important for scientists investigating the health effects of diet to analyze diets that are more complex than those currently used in animal experiments and more accurately reflect normal eating behavior.

“Most importantly, these findings support continued and nuanced discussions of public policies regarding dietary nutrient recommendations,” Grobe adds.

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Public Release: 11-Jun-2015

Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days

Data suggest short-term use of over-the-counter drugs could negatively impact fertility

European League Against Rheumatism

 

Rome, June 11 — The results of a study presented today at the European League Against Rheumatism Annual Congress (EULAR 2015) show that diclofenac, naproxen and etoricoxib significantly inhibit ovulation in women with mild musculoskeletal pain. Of the women receiving NSAIDs, only 6.3 percent (diclofenac), 25 percent (naproxen) and 27.3 percent (etoricoxib) ovulated, compared with 100 percent of the control group.

These findings suggest that readily available non-steroidal anti-inflammatory drugs (NSAIDs) could have a harmful effect on fertility, and should be used with caution in women wishing to start a family.

‘After just ten days of treatment we saw a significant decrease in progesterone, a hormone essential for ovulation, across all treatment groups, as well as functional cysts in one third of patients,’ said study investigator Professor Sami Salman, Department of Rheumatology, University of Baghdad, Iraq. ‘These findings show that even short-term use of these popular, over-the-counter drugs could have a significant impact on a women’s ability to have children. This needs to be better communicated to patients with rheumatic diseases, who may take these drugs on a regular basis with little awareness of the impact.’

NSAIDs are among the most commonly used drugs worldwide, and are taken by more than 30 million people every day. Available without prescription, NSAIDS are largely used for the treatment of pain, inflammation and fever — all common features of rheumatic conditions.

Thirty nine women of childbearing age who suffer from back pain took part in the study, and received diclofenac (100mg once daily), naproxen (500mg twice daily) and etoricoxib (90mg once daily) or placebo. Treatment was given for 10 days from day 10 of the onset of the menstrual cycle; hormonal analysis (progesterone level) and follicle diameter were conducted via blood sample and ultra sonsography respectively. At the end of the NSAID treatment period, the dominant follicle remained unruptured in 75 percent, 25 percent and 33 percent of patients receiving diclofenac, naproxen and etoricoxib respectively. Rupturing of the dominant follicle, and subsequent release of an oocyte (unfertilised egg), is essential for ovulation to occur.

‘These findings highlight the harmful effects NSAIDs may have on fertility, and could open the door for research into a new emergency contraception with a more favourable safety profile than those currently in use,’ concluded Professor Sami Salman.