224 CNO Report 13 FEB 2016



CNO Report 224

Release Date 13 FEB 2016

Draft Report Compiled by

Ralph Turchiano






In This Issue:

1. The benefits of chocolate during pregnancy

2. Drinking coffee may reduce the risk of liver cirrhosis

3. Researchers develop concept for new sunscreen that allows body to produce vitamin D

4. Effects on HIV and Ebola

5. Impact of high fructose on health of offspring

6. Why your muscles get less sore as you stick with your gym routine

7. Bacterial molecules discovered in processed foods could unlock key to healthier diets

8. Barley can help improve blood sugar levels and reduce appetite

Public Release: 1-Feb-2016

The benefits of chocolate during pregnancy

Society for Maternal-Fetal Medicine

ATLANTA (Feb. 1, 2016)–In a study to be presented on Feb. 4 at 1:15 p.m. EST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, in Atlanta, researchers will present findings from a study titled, High-flavanol chocolate to improve placental function and to decrease the risk of preeclampsia: a double blind randomized clinical trial.

In light of previous studies showing conflicting results regarding the role of chocolate consumption during pregnancy and the risk of preeclampsia, this study set out to evaluate the impact of high-flavanol chocolate. Researchers conducted a single-center randomized controlled trial of 129 women with singleton pregnancy between 11 and 14 weeks gestation who had double-notching on uterine artery Doppler. The pregnant women selected were randomized to either high-flavanol or low-flavanol chocolate. A total of 30 grams of chocolate was consumed daily for 12 weeks and women were followed until delivery. Uterine artery Doppler pulsatility index was at baseline and 12 weeks after randomization. Preeclampsia, gestational hypertension, placenta weight, and birthweight were also evaluated.

The result was that there was no difference in preeclampsia, gestational hypertension, placental weight or birthweight in the two groups; however, the uterine artery Doppler pulsatility index (a surrogate marker of blood velocity in the uterine, placental and fetal circulations) in both groups showed marked improvement that was much greater than expected in general population.

“This study indicates that chocolate could have a positive impact on placenta and fetal growth and development and that chocolate’s effects are not solely and directly due to flavanol content,” explained Emmanuel Bujold, M.D., one of the researchers on the study who will present the findings. Dr. Bujold and Dr. Sylvie Dodin, principal investigator of the trial, are with the Université Laval Québec City, Canada.

Public Release: 1-Feb-2016

Drinking coffee may reduce the risk of liver cirrhosis

Regular consumption of coffee was linked with a reduced risk of liver cirrhosis in a review of relevant studies published before July 2015.

In patients with cirrhosis, the liver becomes scarred often as a result of long-term and persistent injury from toxins like alcohol and viruses like hepatitis C. It can be fatal because it increases the risk of liver failure and cancer.

The analysis found that an extra 2 cups of coffee per day may reduce the risk of cirrhosis by 44%, and it may nearly halve the risk of dying from cirrhosis.

“Coffee appeared to protect against cirrhosis.This could be an important finding for patients at risk of cirrhosis to help to improve their health outcomes,” said Dr. O. J. Kennedy, lead author of the Alimentary Pharmacology and Therapeutics analysis. “However, we now need robust clinical trials to investigate the wider benefits and harms of coffee so that doctors can make specific recommendations to patients.”

Public Release: 1-Feb-2016

Researchers develop concept for new sunscreen that allows body to produce vitamin D

Boston University Medical Center

(Boston)–For the first time researchers have developed a process for altering the ingredients in a sunscreen that does not impact its sun protection factor (SPF), but does allow the body to produce vitamin D. The findings, published in the peer reviewed journal PLOS ONE, has led to the production of a new sunscreen called Solar D.

Sun exposure is the major source of vitamin D for most children and adults worldwide. It is also recognized that vitamin D deficiency and insufficiency is a major health problem that afflicts approximately 40 percent of children and 60 percent of adults. However, because of concern for increased risk for skin cancer, widespread sunscreen use has been implemented. As a result, an SPF of 30 when properly applied, reduces the capacity of the skin to produce vitamin D by almost 98 percent

According to the researchers there are several chemical compounds that are typically used in a sunscreen that efficiently absorbed varying wavelengths of UVB radiation. After removing certain ingredients the researchers compared Solar D, which has an SPF of 30, to a popular commercial sunscreen with the same SPF, and found Solar D allowed for up to 50 percent more production of vitamin D in-vitro.

“Solar D was designed with compounds with differing filter compositions to maximize vitamin D production while maintaining its sun protection for reducing erythema or burning of the skin,” explained corresponding author Michael F. Holick, PhD, MD, professor of medicine, physiology and biophysics at Boston University School of Medicine and an endocrinologist at Boston Medical Center.

Solar D is currently available in Australia and will be available in the U.S. summer 2016.

Public Release: 2-Feb-2016

Effects on HIV and Ebola

Cell culture experiments reveal potent antiviral activity of Cistus incanus

Helmholtz Zentrum München – German Research Center for Environmental Health

Neuherberg, February 2, 2016. Scientists at the Helmholtz Zentrum München discover that extracts of the medicinal plant Cistus incanus (Ci) prevent human immunodeficiency viruses from infecting cells. Active antiviral ingredients in the extracts inhibit docking of viral proteins to cells. Antiviral activity of Cistus extracts also targets Ebola- and Marburg viruses. The results were published in Scientific Reports*.

Virus infections are among the ten leading causes of death worldwide and represent a major global health challenge. Their control requires the continuous development of new and potent antiviral drugs/therapeutic options. Despite the availability of numerous drugs for chronic treatment of HIV/AIDS, new drugs are needed to prevent the emergence of drug resistant viral variants. Furthermore, new antiviral drugs are required for rapid treatment of acute infections by viruses like Marburg and Ebola viruses during acute viral outbreaks. A recent study by the team of Professor Ruth Brack-Werner and Dr. Stephanie Rebensburg from the Institute for Virology (VIRO) of the Helmholtz Zentrum München demonstrates that extracts of the medicinal plant attack HIV and Ebola virus particles and prevent them from multiplying in cultured cells.

HIV: broad activity, no resistance

The Brack-Werner team found potent activity of Ci extracts acted against a broad spectrum of clinical HIV-1 and HIV-2 isolates. This also included a virus isolate resistant against most available drugs. „Antiviral ingredients of Ci extracts target viral envelope proteins on infectious particles and prevent them from contacting host cells”, Brack-Werner explains. No resistant viruses were detected during long-term treatment (24 weeks) with Ci extract, indicating that Ci extract attacks viruses without causing resistance. The Brack-Werner study suggests that commercial herbal extracts from plants like Cistus incanus*or other plants like Pelargonium sidoides** are promising material for the development of scientifically validated antiviral phytotherapeutics. „Since antiviral activity of Ci extracts differs from all clinically approved drugs, Ci-derived products could be an important complementation to current established drug regimens”, says Brack-Werner.

Antiviral activity of Cistus extracts also targets Ebola and Marburg proteins in virus particles

Ci extracts not only blocked different HIV isolates, but also virus particles carrying Marburg and Ebola viral envelope proteins. Analysis of the antiviral components of the extract revealed the presence of multiple antiviral ingredients that may act in combination. These results firmly establish broad antiviral activity of Ci extracts against various major human viral pathogens, including previously reported activity against influenza viruses.

Potential applications of Ci extract for global control of lethal virus infections

Further development of these plant extracts may advance global treatment and control of virus infections in various ways. Thus these plant extracts may be useful starting material for the development of potent herbal agents against selected virus infections. Another application could be their development into crèmes or gels (i.e. microbicides) that prevent transmission of viruses like HIV during sexual intercourse. Finally, these plant extracts represent promising collections of natural antiviral agents for the discovery of new antiviral molecules.

Future work in the Brack-Werner lab will focus on investigating the antiviral potential of these plant-derived products for applications in humans and detailed analysis of their active antiviral ingredients.

Public Release: 4-Feb-2016

Impact of high fructose on health of offspring

Society for Maternal-Fetal Medicine

ATLANTA (Feb. 4, 2016)–In a study to be presented on Feb. 5 in the oral session at 1:15 p.m. EST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, in Atlanta, researchers will present findings on the effects of antenatal exposure to a high fructose diet on the offspring’s development of metabolic syndrome-like phenotype and cardiovascular disease later in life.

The study, titled High fructose diet in pregnancy leads to fetal programming of hypertension, insulin resistance and obesity in adult offspring, randomly allocated either a fructose solution or water as the only drinking fluid for pregnant mice from first day of pregnancy through delivery. Offspring were then started on regular chow and evaluated after one year of life. Percent of visceral adipose tissue was measured along with liver fat infiltrates using computed tomography, and blood pressure using a non-invasive monitor. Glucose tolerance testing was also performed and serum concentrations of glucose, insulin, triglycerides, total cholesterol, leptin and adiponectin were measured.

Maternal weight, pup number and average weight at birth were similar between the two groups. Male and female offspring born to mothers who received the fructose solution group had higher peak glucose compared with controls. Female offspring from the fructose group were heavier and had a higher percent of visceral adipose tissue, liver fat infiltrates, fasting homeostatic model assessment scores, higher serum concentrations of leptin and lower concentrations of adiponectin.

No significant differences in these parameters were noted in male offspring. Serum concentrations of triglycerides and total cholesterol were not different between the two groups or either gender.

“While this study was done in a mouse model, it is an important indicator of the effect of the mothers’ diet during pregnancy on the health of their children later in life,” explained Antonio Saad, M.D. with UTMB Galveston and the lead researcher of the study. “Through this study, we know that consuming high fructose during pregnancy putts the child at future risk for a variety of health conditions including obesity and the many complications it causes.”

The study concluded that, while maternal intake of high fructose leads to fetal programming of adult obesity, hypertension, and metabolic dysfunction–all of which risk factors for cardiovascular disease; limiting high fructose enriched diets in pregnancy may have a significant impact on long term health.


A copy of the abstract is available at http://www.​smfmnewsroom.​org and below. For interviews please contact Vicki Bendure at Vicki@bendurepr.com 202-374-9259 (cell).

The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine. The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed. For more information visit http://www.​smfm.​org.

Abstract 67 High Fructose Diet in Pregnancy Leads to Fetal Programming of Hypertension, Insulin Resistance and Obesity in Adult Offspring

Authors: Antonio Saad1, Joshua Disckerson1, Phyllis Gamble1, Huaizhi Yin1, Talar Kechichian1, Ashley Salazar1, Igor Patrikeev2, Massoud Motamedi2, George Saade1, Maged Costantine1

1UTMB Galveston, Galveston, TX, 2UTMB Center of Biomedical Engineering, Galveston, TX

Objective: Consumption of fructose rich diets in the U.S is on the rise and thought to be associated with obesity and cardio-metabolic diseases. Our objective was to determine the effects of antenatal exposure to high fructose diet on offspring’s development of metabolic syndrome-like phenotype and other cardiovascular disease (CVD) risk factors later in life.

Study Design: Pregnant C57BL/6J dams were randomly allocated to fructose solution (FRC, 10% W/V, n=10) as only drinking fluid or water (CTR, n=10) from day 1 of pregnancy until delivery. Pups were then started on regular chow, and evaluated at 1 year of life. We measured % visceral adipose tissue (VAT) and liver fat infiltrates using computed tomography (CT), and blood pressure using CODA/ non-invasive monitor. Intraperitoneal glucose tolerance testing (IPGTT), with corresponding insulin concentrations were obtained. Serum concentrations of glucose, insulin, triglycerides (TG), total cholesterol (TC), leptin, and adiponectin were measured in duplicate using standardized assays. Fasting homeostatic model assessment (HOMA- IR) was also calculated to assess insulin resistance.

Results: Maternal weight, pup number and average weight at birth were similar between the two groups. Male and female FRC offspring had higher peak glucose and area under the IPGTT curve, compared with CTR (Figures 1A&B), and higher mean arterial pressure compared to CTR (Figure 1C). Female FRC offspring were heavier and had higher % VAT (Figure 1D), liver fat infiltrates, HOMA-IR scores, insulin area under the IPGTT curve, serum concentrations of leptin, and lower concentrations of adiponectin compared to female CTR offspring (Table). No significant differences in these parameters were noted in male offspring. Serum concentrations of TG or TC were not different between the 2 groups for either gender.

Conclusion: Maternal intake of high fructose leads to fetal programming of adult obesity, hypertension and metabolic dysfunction, all risk factors for CVD. This fetal programming is more pronounced in female offspring. Limiting intake of high fructose enriched diets in pregnancy may have significant impact on long term health.

Public Release: 8-Feb-2016

Why your muscles get less sore as you stick with your gym routine

BYU research shows unexpected immune system cells may help repair muscles

Brigham Young University

The first time back to the gym after a long break usually results in sore muscles. Fortunately, the return trip a few days later–if it happens–is generally less painful.

Scientists have studied this reduced-soreness phenomenon for decades and even have a name for it–the repeated bout effect. Despite all those years of research, they still can’t figure out exactly why people feel less sore the second time around.

What they do know is the immune system plays some role in how the muscle repairs itself and protects against additional damage. But now exercise science researchers at BYU have produced evidence that shows for the first time the surprising presence of very specific immune workers: T-cells.

“You think of T-cells as responding to infections, not repairing muscles–but we found a significant accumulation of T-cells infiltrating damaged muscle fibers,” said Robert Hyldahl, assistant professor of exercise science at BYU. “Our study is the first to show T-cells present in human muscle in response to exercise-induced damage.”

The research appears this month in Frontiers in Physiology and builds off past studies that implicate immune cells in muscle healing. One such study was a 2013 paper out of Harvard showing T-cells active in the skeletal muscles of mice (but not yet humans) after injury.

For the study, researchers, put 14 men and women through two vigorous rounds of exercise on an isokinetic dynamometer machine, 28 days apart. (“All of them got really sore,” Hyldahl said.) Before and after each bout of exercise, the team took muscle biopsies from the subjects and then used immunohistochemistry and microscopy to analyze the muscle tissue.

The BYU group found an expected increase in certain white blood cells after the second bout of exercise, but only identified the T-cells after it was suggested by Amanda Gier, one of two undergraduate coauthors on the paper, who was enrolled in an immunology course at the time.

“T-cells, up until recently, were not thought to enter healthy skeletal muscle,” said lead author and grad student Michael Deyhle. “We hadn’t planned on measuring them because there’s no evidence that T-cells play a role in infiltrating damaged muscle tissue. It’s very exciting.”

The presence of the T-cells suggests that muscles become more effective at recruiting immune cells following a second bout of exercise and that these cells may facilitate accelerated repair. In other words, the muscle seems to remember the damaging insult and reacts similarly to when the immune system responds to antigens–toxins, bacteria or viruses.

The group was also surprised to find inflammation actually increased after the second round of exercise. Hyldahl, his students and many physiologists have long thought inflammation goes down after the second bout of exercise, contributing to that “less sore” effect.

Instead, the slightly enhanced inflammatory response suggests inflammation itself probably does not worsen exercise-induced muscle damage.

“Many people think inflammation is a bad thing,” Deyhle said. “But our data suggest when inflammation is properly regulated it is a normal and healthy process the body uses to heal itself.”

Adds Hyldahl: “Some people take anti-inflammatory drugs such as Ibuprofen and Aspirin after a workout, but our study shows it may not actually be effective. The inflammation may not be directly causing the pain, since we see that muscle soreness is reduced concurrent with increases in inflammation.”


Public Release: 9-Feb-2016

Bacterial molecules discovered in processed foods could unlock key to healthier diets

University of Leicester discovery identifies harmful bacterial molecules in processed foods and how to prevent them from arising

University of Leicester

Credit: University of Leicester

· Study identifies harmful PAMP molecules in processed foods that may increase risk of diseases such as coronary artery disease and Type 2 diabetes

· PAMPs can be found in processed foods such as sausages, burgers, ready meals, cheeses, chocolate and ready-chopped vegetables

· Removal of PAMP molecules from the diet leads to weight loss and reduction in bad cholesterol

· Fresh food contains undetectable levels of PAMPs

· Researchers believe food manufacturers could use method to remove PAMPs and make food healthier without change to taste or cost

Our favourite foods could be made healthier thanks to a new technique developed by the University of Leicester which has identified harmful bacterial molecules in certain processed foods such as burgers and ready meals.

The study identifies a particular kind of contaminating molecule known as ‘pathogen-associated molecular patterns’ (PAMPs), which are released by certain types of bacteria as they grow during some food processing and refrigeration processes, and may increase our risk of developing conditions such as coronary artery disease and Type 2 diabetes.

PAMPs are undetectable in non-processed and fresh foods, suggesting that they develop during the manufacturing process.

Dr Clett Erridge from the University of Leicester’s Department of Cardiovascular Sciences who led the study explained: “It has been understood for many years that frequent consumption of highly processed foods, particularly processed meats, is associated with increased risk of developing a range of diseases, including cardiovascular disease, Type 2 diabetes and obesity. Our recent findings have uncovered a potential mechanism by which certain types of processed food increase risk of developing these diseases.

“In essence, we have discovered that contaminating molecules that arise in processed foods from the overgrowth of a specific type of bacteria during refrigeration or food processing can cause our immune systems to over-react in a manner that might be damaging to health when we eat foods containing these molecules.”

After testing volunteers on a diet low in PAMPs for one week, researchers discovered an 11 per cent reduction in white blood cell count and an 18 per cent reduction in LDL (bad) cholesterol – which if maintained would be equivalent to a greater than 40 per cent reduction in risk of developing coronary artery disease.

The volunteers also experienced a reduction in weight (on average 0.6kg) and waist circumference (average 1.5 cm). The reductions in waist circumference and white cell count are equivalent to a greater than 15 per cent reduction in risk of developing Type 2 diabetes.

When the same volunteers were fed food enriched in PAMPs, the beneficial changes were reversed, highlighting the negative effect PAMPs appear to have on the health of an individual.

This was an experimental study, which is one of the ways that we establish a relationship between cause and effect.

The researchers believe that their new method of detecting PAMPs could be used by food manufacturers to help identify where in their production process the PAMP molecules are arising in foodstuffs, such as which parts of machinery or which raw materials introduce contamination to their products.

Dr Erridge added: “Crucially, we have found that some processed foods do not contain these molecules, and our results suggest it should be possible to manufacture almost any current foodstuff in a manner that results in a low content of pro-inflammatory PAMP molecules. Our method can also be used to monitor progress in efforts to clean up the production process.

“The present work suggests that removing these molecules from common foods could provide a health benefit to consumers and suggest a potential means of making some of our favourite foods healthier without any appreciable change to taste, texture, cost or ingredients.”

Key processed foods found to frequently contain high levels of PAMPs include foods containing minced meat (including sausages and burgers), ready meals (especially lasagne, bolognese), some cheeses, chocolate and some types of ready-chopped vegetables, such as onions.

Foods containing these as ingredients, such as sauces and sandwiches, were also found to have a relatively high risk of PAMP contamination.

The study suggests that when food is absolutely fresh, including any type of meat, fruit or vegetable, it contains undetectable levels of PAMPs. However, once it has been chopped finely, especially if minced, the PAMP content rises rapidly, day on day, even when stored at refrigeration temperature.

Public Release: 9-Feb-2016

Barley can help improve blood sugar levels and reduce appetite

Lund University

A recent study from Lund University in Sweden shows that barley can rapidly improve people’s health by reducing blood sugar levels and risk for diabetes. The secret lies in the special mixture of dietary fibres found in barley, which can also help reduce people’s appetite and risk for cardiovascular disease.

“It is surprising yet promising that choosing the right blend of dietary fibres can — in a short period of time — generate such remarkable health benefits”, says Anne Nilsson, Associate Professor at the Food for Health Science Centre and one of the researchers behind the study.

The study was conducted with healthy middle-aged participants who were asked to eat bread largely made out of barley kernels (up to 85%) for three days — at breakfast, lunch and dinner. Approximately 11-14 hours after their final meal of the day participants were examined for risk indicators of diabetes and cardiovascular disease.

The researchers found that the participants’ metabolism improved for up to 14 hours, with additional benefits such as decreases in blood sugar and insulin levels, increases in insulin sensitivity and improved appetite control. The effects arise when the special mixture of dietary fibres in barley kernel reaches the gut, stimulating the increase of good bacteria and the release of important hormones.

“After eating the bread made out of barley kernel, we saw an increase in gut hormones that regulate metabolism and appetite, and an increase in a hormone that helps reduce chronic low-grade inflammation, among the participants. In time this could help prevent the occurrence of both cardiovascular disease and diabetes”, says Anne Nilsson.

In a previous related study conducted with a team from the University of Gothenburg in Sweden researchers also found that dietary fibres from barley kernel generate an increase of the gut bacteria Prevotella copri, which have a direct regulatory effect on blood sugar levels and help decrease the proportion of a type of gut bacteria that is considered unhealthy.

The effects from barley kernel are influenced by the composition of the individual’s gut microbiota, meaning people with low concentrations of the Prevotella copri bacteria experienced less effect from their intake of barley products. Eating more barley could, however, help stimulate growth of the bacteria.

The results are timely as rates of obesity and type 2 diabetes have significantly increased in the past few years. Researchers hope that more knowledge about the impact of specific dietary fibres on people’s health will result in stores keeping more food products with healthy properties such as barley kernels. The ambition is also to get more people to use barley in meals, for example in salads, soups, stews, or as an alternative to rice or potatoes.

The researchers’ advice for how to maintain a healthy blood sugar level:

· Choose bread with as much whole grains as possible. Feel free to mix with other grains, for example rye

· Avoid white flour

· Add barley kernel grains in soups and stews

· Replace for example white rice with cooked barley

· Eat beans and chickpeas with your meal as they too have a good blend of dietary fibres and like barley kernels a low glycaemic index with positive health effects.

The bread used in the study was 85% made out of barley grains, which had been boiled and mixed with wheat flour. If you want to reduce the amount of barley grains, you can replace some of it with whole grains.