Vitamin D reverses diabetic neuropathy

by Dr Linda Calabresi
15 April 2008

Vitamin D supplementation is an effective treatment of neuropathic pain in Type 2 diabetes patients, new Australian research suggests.

Previous research has found that vitamin D deficiency is common in patients with Type 2 diabetes, but its effect on neuropathic pain has not previously been tested, say study authors Drs Paul Lee and Roger Chen from Concord Repatriation General Hospital.

Their study, published in today’s Archives of Internal Medicine (168:771-772) involved 51 patients with Type 2 diabetes and typical neuropathic pain. All patients were vitamin D deficient with a mean serum 25D concentration of 18 ng/mL.

After three months, vitamin D repletion with cholecalciferol (vitamin D3) tablets resulted in a significant reduction in pain scores using two separate assessments, one suggesting the pain severity was reduced by 40% the other suggesting pain severity had been halved.

How vitamin D reduces the severity of diabetic neuropathic pain is uncertain, but the researchers suggest that vitamin D insufficiency may potentiate diabetic nerve damage and impair nociceptor function. The results could not be explained by a decrease in parathyroid hormone as testing did not show any statistically significant difference in hormone level following the vitamin D repletion, they say.

Vitamin D is known to have a role in the prevention of osteoporosis. It is also increasingly being recognised for its ability to improve glycaemic control, the endocrinologist researchers said. In addition, vitamin D repletion is free of adverse effects.

Therefore, the researchers said they would advocate a trial of vitamin supplementation in vitamin D-deficient patients with neuropathic pain.

“It is unlikely to have any harmful effects and may offer not only pain relief but also beneficial effects on bone health and glycaemic control.”

Source: www.sci.rutgers.edu/forum/showthread

Glycemic Index Education May Lead to Better Diabetes Control

Nine weeks of education about the glycemic index in foods is enough to encourage adults with type 2 diabetes to adopt better dietary habits that result in improvements to their health, suggests recent research published in Public Health Nutrition.

Participants in a clinical trial attended weekly sessions to learn about the potential benefits of low­–glycemic-index foods. After nine weeks, the participants had adopted a lower glycemic-index diet and recorded lower weight, smaller waists, and improved blood sugar levels. When they were tested again another nine weeks later—during which time they received no additional education—the participants had maintained most of those improvements.

The research addresses a controversy in the nutrition community: Some practitioners believe the principles behind maintaining a low–glycemic-index diet are too complicated for average consumers.

“We found that with education, people with diabetes were able to adopt a lower glycemic-index diet. And it had a significant improvement in their weight control and glucose control,” says Carla Miller, senior study author and an associate professor of human nutrition at Ohio State University. “A vast majority of people with diabetes don’t get sufficient education about their condition when they are diagnosed. And yet for many patients, that’s the only time they receive nutrition education. What they really need is continued education and support to help them maintain good control.”

In the study, people with diabetes were randomized to one of two groups. One group immediately participated in the nine-week intervention, and the other group waited for nine weeks before undergoing the same intervention.

The 103 participants who completed the study were between the ages of 40 and 70, had been diagnosed with type 2 diabetes for at least one year, and did not require insulin therapy for diabetes management. For the most part, participants were already doing a good job of controlling their blood glucose levels.

Each group education session lasted between 90 minutes and two hours. Session topics included self-monitoring of food intake and portion sizes, carbohydrate counting, and maintaining behavioral change. Overall, the intervention emphasized selecting lower glycemic-index foods rather than restricting overall carbohydrate intake.

“The emphasis historically has been to control how much carbohydrate people with diabetes eat rather than the type of carbohydrate they choose. And the controversy has been that the glycemic index is so complicated, it’s just another thing that we are asking people to worry about,” Miller says. “And they do have to balance many different variables to get all of these blood parameters under control. That’s another reason they need a lot more education than they receive.”

Researchers collected health measures and diet and physical activity information before and after the intervention period. During the intervention, participants tested their blood glucose levels before and after meals four days per week. To track the participants’ food choices, researchers made periodic unannounced phone calls and asked patients to recall what they had eaten in the previous 24 hours.

After nine weeks of intervention, participants in the first group lost an average of about 5.1 lbs, decreased their waist circumference by 1.1 inches, reduced their body mass index by almost 1 point, and lowered their blood glucose concentration after eating by almost 18 mg/dL. Another nine weeks later, even with no additional intervention, these participants had maintained those health benefits, with the exception of a slight average gain in waist circumference among women.

The participants who waited nine weeks for the intervention recorded similar health improvements after they attended the education sessions. But Miller notes that while they waited, this group also gained weight and recorded expansions of their waists—yet another sign that education can’t start soon enough for many patients with diabetes.

“They had a trajectory of change that was getting worse,” she says. “People with diabetes do need continued support to sustain optimal glycemic control because the disease progresses as they live longer.”

Based on self-reports of food choices, the study showed that participants’ fiber intake improved and they ate less fat. And they did not restrict carbohydrates but instead made different carbohydrate choices.

“We were not putting people on a strict diet. They consumed the same amount of carbohydrate that they normally would but selected lower glycemic-index foods within that carbohydrate allotment,” Miller says. “That addresses another controversy in nutrition. People with diabetes do not have to go on a low-carb diet, which typically is accompanied by a high intake of fat. What these participants ate was closer to [what] the dietary guidelines generally recommend for Americans, with less than 30% of calories coming from fat. The quantity of carbohydrate does matter to some extent, but the type of carbohydrate makes a big difference.”

— Source: The Ohio State University

Source: www.todaysdietitian.com

Anti Oxidant Activity of Tumeric

Turmeric (Curcuma longa) is a major culinary spice of India and other Asian countries, and has been shown to have anti-cancer, anti-coagulative, and anti-hepatotoxic properties. As an anti-oxidant, it is sometimes added (at 0.5-1.0% levels) to ground nut oils to reduce the formation of peroxides and to increase shelf-life. This study was conducted to determine the nature of the anti-oxidant principle in turmeric. From an aqueous extract of powdered turmeric tubers, a heat-stable protein with anti-oxidant properties was isolated. This turmeric anti-oxidant/protein (TAP) was found to inhibit lipid peroxidation in both of the environments in which it was incubated: in vitro in rat brain tissue, and in cod liver oil.

In previous studies, turmeric has been shown to be as effective an anti-oxidant as butylated hydroxy anisole, which is used in the preservation of foods. But whereas high concentrations of butylated hydroxy anisole have been shown to be toxic, high concentrations of turmeric have been reported to be non-toxic. These findings, therefore, are significant in areas where turmeric is consumed in the diet. The ability of TAP to protect tissues from peroxidation merits further study.

January 8. 1996

Selvam, R., Lalitha Subramanian, R. Gayathri, and N. Angayarkanni. The anti-oxidant activity of turmeric (curcuma longa) Journal of Ethnopharmacology. Vol 47, 1995:.

Source: The American Botanical Council

Celiac Disease

Disease characteristics. Celiac disease is a systemic immune disease that can be associated with gastrointestinal findings (diarrhea, weight loss, abdominal pain, anorexia, lactose intolerance, abdominal distention, and irritability) and/or highly variable non-gastrointestinal findings (iron-deficiency anemia, dermatitis herpetiformis, chronic fatigue, joint pain/inflammation, migraines, depression, attention-deficit disorder, epilepsy, osteoporosis/osteopenia, infertility and/or recurrent fetal loss, vitamin deficiencies, short stature, failure to thrive, delayed puberty, dental enamel defects, and autoimmune disorders). Classic celiac disease, characterized by mild to severe gastrointestinal symptoms, is less common than nonclassic celiac disease, characterized by absence of gastrointestinal symptoms.

Diagnosis/testing. The diagnosis of celiac disease relies on characteristic histologic findings on small-bowel biopsy and clinical and/or histologic improvement on a gluten-free diet. Most individuals with celiac disease have celiac disease-associated antibodies and specific pairs of allelic variants in two HLA genes, HLA-DQA1 and HLA-DQB1. Because 30% of the general population has one of the celiac disease-associated HLA alleles and only 3% of individuals with one or both of these alleles develop celiac disease, presence of celiac disease-associated HLA alleles is not diagnostic of celiac disease; however, their absence essentially excludes a diagnosis of celiac disease.

Management. Treatment of manifestations: lifelong adherence to a strict gluten-free diet (avoidance of wheat, rye, and barley); treatment of nutritional deficiencies (iron, zinc, calcium, fat-soluble vitamins, folic acid); standard treatment of osteoporosis. Prevention of primary manifestations: lifelong gluten-free diet. Surveillance: for symptomatic individuals responsive to a gluten-free diet, periodic physical examination and assessment of growth, nutritional status, and non-gastrointestinal disease manifestations; repeat small-bowel biopsy one to three years following diagnosis. For symptomatic individuals unresponsive to a gluten-free diet, periodic evaluation for refractory sprue, ulcerative enteritis, T-cell lymphoma, and other gastrointestinal cancers. Agents/circumstances to avoid: dietary gluten. Testing of relatives at risk: when the celiac disease-associated HLA alleles in the family are known, molecular genetic testing of first-degree relatives (including young children) to monitor those with known celiac disease-susceptibility alleles for early evidence of celiac disease in order to institute gluten-free diet early in the disease course.

Genetic counseling. Celiac disease is a multifactorial disorder resulting from the interaction of HLA-DQA1 and HLA-DQB1 gene variants known to be associated with celiac disease susceptibility, less well-recognized variants in non-HLA genes, gliadin (a subcomponent of gluten), and other environmental factors. Some empiric risk data are available for at-risk relatives.

Diagnosis

Clinical Diagnosis

The diagnosis of celiac disease is made through the combination of the following [Hill et al 2005, NIH Consensus Committee 2005, Green & Cellier 2007]:

· Small-bowel biopsy that shows characteristic histologic abnormalities

· Subsequent improvement (clinical and/or histologic) on a gluten-free diet

· Additional findings in most affected individuals:

· Clinical findings or abnormal laboratory findings (although some individuals are asymptomatic and lack laboratory abnormalities)

· Celiac disease-associated antibodies
Note: Although positive specific antibody testing is highly associated with celiac disease and greatly facilitates its diagnosis [Fasano 2001, Farrell et al 2002], small-bowel biopsy remains the gold standard in confirming the diagnosis of celiac disease.

· Celiac disease-associated human leukocyte antigen (HLA) alleles

Testing

Celiac-associated antibody testing

Note:

(1) It is important for the individual being tested to remain on a gluten-containing diet before celiac disease-associated antibody testing and small-bowel biopsy are performed because antibody levels and histologic abnormalities gradually revert to normal on a gluten-free diet.

(2) For individuals on a gluten-free diet, diagnostic celiac disease-associated antibody testing and small-bowel biopsy should follow a gluten challenge (i.e., eating gluten-containing foods [the equivalent of one to three slices of bread per day] for one to three months and sometimes longer if no symptoms are observed). However, the gluten challenge can make some individuals very ill.

· Tissue transglutaminase (tTG) IgA. Measurement of serum concentration of tissue transglutaminase (tTG) immunoglobulin A (IgA) is often recommended for initial testing because of its high sensitivity and specificity for celiac disease, relatively low cost, and ease of test performance and reliability. However, the sensitivity and specificity differ among laboratories [Abrams et al 2006]. False positive test results may occur in persons with acute coronary syndromes and in individuals with cirrhosis and chronic liver disease.

· Endomysial antibody (EMA) IgA. Serum concentration of endomysial antibody (EMA) IgA has the highest specificity (~99%), but is more expensive and more time-consuming to perform and is potentially more prone to false negative results than serum concentration of tTG IgA. Because it is determined by indirect immunofluorescence, serum concentration of EMA IgA is subject to observer variability, which affects its sensitivity [Murray 2004]. When performed in an experienced laboratory, this test has a higher specificity (approaching 100%) than tTG antibody testing and is useful in individuals with cirrhosis.

· Anti-deamidated gliadin-related peptide (a-DGP) antibodies IgA and IgG. This new test detects antibodies binding synthetic deamidated gliadin-related peptides (DGPs). In preliminary studies examining groups with a high prevalence of celiac disease, both isotypes (IgA and IgG) were shown to be highly sensitive and specific for active celiac disease. Specificity is greater than in antigliadin (AGA) testing and similar to that for tTG testing. An increase in DGP antibody levels may precede an increase in serum concentration of tTG-IgA in young children [Liu et al 2007, Niveloni et al 2007]. However, as in all antibody tests, a minority of individuals have false negative results.

· Measurement of serum concentration of total IgA to evaluate for selective IgA deficiency. The prevalence of selective IgA deficiency, a condition of unknown cause, is 1:700 in the general population. For unknown reasons the prevalence of selective IgA deficiency is higher (1:50) in individuals with celiac disease than in the general population [Wong el al 2003, Alaedini & Green 2005].
Note: Because individuals with selective IgA deficiency do not produce IgA antibodies, the celiac-associated IgA antibodies tTG IgA and EMA IgA are not present in these individuals. Therefore, in these individuals, testing for celiac-associated IgG antibodies (tTG IgG) or DGP-IGG should be performed instead.

· Antigliadin antibody (AGA) IgA and IgG. The NIH Consensus Development Conference on Celiac Disease recommended against the use of AGA in the diagnosis of celiac disease because of the low specificity of this assay and the availability of more specific and sensitive tests, including tTG and EMA IgA [Hill et al 2005].

Note: (1) The overall sensitivity of celiac disease-associated antibody testing may be slightly increased when all four tests (serum concentrations of tTG IgA, EMA IgA, total IgA, and AGA IgA and IgG) are performed. However, the use of panels that incorporate AGA markedly increase the false positive rate as a result of a lone positive AGA antibody and drop the positive predictive value to low levels except in the case of a very high pre-test prevalence. (2) Although a positive result on celiac disease-associated antibody testing is likely to be diagnostic of celiac disease, false positive results occur. (3) Conversely, normal celiac-associated antibody test results do not exclude the diagnosis of celiac disease, especially in the presence of lesser degrees of villous atrophy or in persons on a gluten-free diet prior to testing.

Small-bowel biopsy generally refers to multiple (four or more) biopsies taken endoscopically from the post-bulbar duodenum.

Characteristic histologic findings that are the gold standard for the diagnosis of celiac disease include partial or complete villous atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes (IELs). Based on the dynamic development of the pattern of the intestinal lesions and the frequency of mild lesions in celiac disease, Marsh [1992] proposed a four-stage grading classification to establish the diagnosis and to assess improvement in response to a gluten-free diet (Table 1). Although these changes are not unique to celiac disease, reversion of intestinal damage after gluten withdrawal is unique to celiac disease. The positive predictive nature of the biopsies depends on the relative prevalence of celiac disease as compared to other causes of enteropathy in the population.

Authored by:

Cara L Snyder, MS, CGC

Certified Genetic Counselor
Kimball Genetics, Inc
Denver

Danielle O Young, MS, CGC

Certified Genetic Counselor
Kimball Genetics, Inc
Denver

dyoung@kimballgenetics.com

Peter HR Green, MD

Director, Celiac Disease Center
Professor of Clinical Medicine
Columbia University
New York

pg11@columbia.edu

Annette K Taylor, MS, PhD, FACMG

President and CEO
Kimball Genetics, Inc.
Denver

aktaylor@kimballgenetics.com 03072008celiac
Initial Posting: July 3, 2008.

Source: Gene Reviews; funded by the NIH Developed at the University of Washington, Seattle 1993-2009

Monograph on Scientific and Clinical Research of Pycnogenol®

(Austin, TX) January 21, 2010. The nonprofit American Botanical Council (ABC) has just published a monograph summarizing selected scientific and clinical studies of Pycnogenol^®, a patented dietary ingredient from French maritime pine bark.

Seventeen human clinical studies of Pycnogenol are reviewed in the monograph, evaluating the extract’s potential benefits in numerous areas. These include its cardiovascular benefits, such as its ability to reduce difficulties associated with chronic venous insufficiency and problems related to thrombosis (formation or presence of blood clots in blood vessels).

Based on the review of scientific and clinical trials, the monograph notes that Pycnogenol has been shown to have a wide range of potential applications, including the ability to improve blood sugar control in patients with type 2 diabetes and improve endothelial function (the ability of blood vessels to widen through relaxation of the muscular wall of the vessels). Current clinical trial data suggest that Pycnogenol may also help decrease edema formation (swelling) in the lower legs, benefit children with attention deficit hyperactivity disorder (ADHD), be a useful adjunct therapy for patients with asthma, reduce pain associated with menstrual disorders, and improve subjective symptoms of osteoarthritis in the knee.

“Pycnogenol is an excellent example of a natural plant-based product which is the subject of extensive clinical research,” said ABC Founder and Executive Director Mark Blumenthal. “ABC acknowledges Horphag Research, the manufacturer, for its singular focus and for its commitment to funding continued clinical trials to investigate and document the beneficial role Pycnogenol might have in selfcare and healthcare.”

Horphag Research of Geneva Switzerland invests about $1.5 million annually in new scientific and clinical research on the special extract.

“The ABC monograph on Pycnogenol presents one of the most comprehensive and detailed monographs ever published on a dietary ingredient,” said Victor Ferrari, CEO of Horphag Research. “Consumers, health professionals, and industry members alike are looking for comprehensive and evidence-based information, and as such, the monograph provides an excellent detailed view of the versatility of this natural product.”

The monograph is published in three parts: The full monograph, a clinical overview (i.e., executive summary) containing condensed information from the monograph, and a consumer/patient information sheet, consisting of essential information for consumer education about the responsible use of the product. Each of these elements is accessible separately on the ABC website.

The full monograph contains an overview of Pycnogenol’s production and chemistry, uses of the product, dosage information, summaries of the product’s pharmacology and mechanisms of action, safety data, and summaries of selected clinical trials. A table includes synopses of the clinical trials profiled within the monograph’s text, plus summaries of several additional studies. The monograph also includes how Pycnogenol is regulated in 10 countries and regions around the world.

Pycnogenol’s manufacturer Horphag Research has extensively studied the extract over the past 40 years to assure the safety and efficacy of Pycnogenol as an ingredient in dietary supplements and conventional foods. More than 220 studies and review articles have been published on the extract, and Horphag Research earned the Frost & Sullivan North American Health Ingredients Excellence in Research of the Year Award for 2008.

“Horphag Research has incorporated ongoing research into its business model as a necessity to keep the pledge towards its customers and consumers to rely on scientific evidence,” said Ferrari, explaining that this research will also provide the basis for new product development, patents, and new product applications. “To date, we have not come across any other company performing the same amount of research at the same level of quality on a single ingredient. It is critical to investigate nutritional ingredients to the point that one can establish that they are of the highest quality, safe, and that the data shows supporting scientific evidence for their use.”

ABC’s 19-page monograph on Pycnogenol was written by toxicologist Heather S. Oliff, PhD, and it was formally peer reviewed by scientific and medical experts for its accuracy.

ABC emphasizes that the publication of the Pycnogenol monograph is not an endorsement or recommendation of the ingredient or the manufacturer. “ABC has had a long history of documenting the specific herbal products and ingredients that have been clinically tested,” said Blumenthal. “As part of our nonprofit educational mission, we believe it is in the public interest to identify clinically tested natural plant-based products and ingredients which the scientific literature suggests are safe and beneficial.”

ABC’s Pycnogenol monograph is the fourth in a series of product-specific monographs that the organization has initiated. Additional monographs concerning specific researched commercial products and ingredients are being developed by ABC.

About the American Botanical Council

Founded in 1988, the American Botanical Council is a leading international nonprofit organization addressing research and educational issues regarding herbs and medicinal plants. ABC’s members include academic researchers and educators; libraries; health professionals and medical institutions; government agencies; members of the herb, dietary supplement, cosmetic, and pharmaceutical industries; journalists; consumers; and others within over 70 countries. The organization occupies a historic 2.5-acre site in Austin, Texas where it publishes the quarterly journal HerbalGram, the monthly e-publication HerbalEGram, HerbClips (summaries of scientific and clinical publications), reference books, and other educational materials. ABC also hosts HerbMedPro, a powerful herbal database, covering scientific and clinical publications on more than 220 herbs. ABC also co-produces the “Herbal Insights” segment for Healing Quest, a television series on PBS. Previous product-specific monographs developed by ABC have focused on CVT-E002^® (the active ingredient in the ginseng-based formulation COLD-FX^®), POM^® Wonderful Pomegranate Juice, and the herbal combination product Sinupret^®.

ABC is tax-exempt under section 501(c) (3) of the IRS Code. Information: Contact ABC at P.O. Box 144345, Austin, TX 78714-4345, Phone: 512-926-4900. Website: http://www.herbalgram.org/.

About Horphag Research

Horphag Research Ltd., founded in 1925 and based in Geneva, Switzerland, is the exclusive worldwide supplier of Pycnogenol, extracted from French maritime pine bark (Pinus pinaster). The company leads the world in Pycnogenol research, and new applications for Pycnogenol are explored every year. Pycnogenol is available in more than 700 dietary supplements, multivitamins and health products worldwide. Pycnogenol is a registered trademark of Horphag Research Ltd and its applications are protected by US and international patents. Natural Health Science, in Hoboken, NJ, is the exclusive North American raw material supplier of Pycnogenol. More information about Pycnogenol is available at the company’s website: www.pycnogenol.com.

Vitamin D supplementation may improve HDL cholesterol levels

MedWire News: Low levels of serum 25(OH)D (vitamin D) are associated with low levels of high-density lipoprotein (HDL) cholesterol and reduced waist circumference, report researchers in the Journal of Clinical Lipidology.

Low levels of vitamin D have previously been associated with markers of cardiovascular disease (CVD) risk, explain Kevin Maki (Provident Clinical Research, Glen Ellyn, Illinois, USA) and team.

In this cross-sectional study, the investigators recruited 257 men and women to assess links between vitamin D level and selected CVD risk markers including components of the metabolic syndrome such as HDL cholesterol, triglycerides, and abdominal obesity.

They also evaluated dietary intake using food frequency and dietary supplement questionnaires.

Maki et al report that HDL cholesterol level significantly increased in a graded fashion, with levels increasing from 48.4 mg/dl to 62.3 mg/dl (1.25 to 1.61 mmol/l) among participants in the lowest and highest tertiles of serum vitamin D, respectively.

Each 10-ng/ml increment in serum vitamin D level was associated with an increase in HDL cholesterol of 3.80–4.20 mg/dl (0.10–0.11 mmol/l) following adjustment for established determinants of HDL cholesterol.

The authors point out that, if confirmed, this finding could have important implications with regard to coronary heart disease, as previous studies have shown that a 1.00 mg/dl (0.02 mmol/l) increase in HDL cholesterol is linked to a 4–6% decrease in risk for the condition.

Of note, each 1-ng/ml increment in vitamin D was associated with a significant 0.31 cm smaller waist circumference. But the researchers say this could be explained by the fact that vitamin D is fat soluble and there is therefore a “greater storage capacity for vitamin D in overweight and obese individuals, which may result in a reduced circulating concentration.”

Other factors such as triglycerides showed a graded inverse relationship with vitamin D level, and metabolic syndrome prevalence decreased significantly from the lowest to the highest tertile.

“These results suggest that clinical trials should be undertaken to assess the impact of increasing vitamin D intake on the metabolic cardiovascular risk factor profile,” concludes the team.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

© 2010 Current Medicine Group, a trading division of Springer Healthcare Limited.

Source: www.lipidsonline.com

Alpha-lipoic acid improves vascular endothelial function in patients with type 2 diabetes: a placebo-controlled randomized trial.

Heinisch BB, Francesconi M, Mittermayer F, Schaller G, Gouya G, Wolzt M,
Pleiner J.

Medical University of Vienna, Vienna, Austria.

Eur J Clin Invest 2009 Abstract Objective The aim of this study was to investigate the effect of alpha-lipoic acid (ALA) treatment on endothelium-dependent and -independent vasodilatation, assessed by forearm blood flow (FBF), in patients with type 2 diabetes mellitus.  Research design and methods A total of 30 subjects with type 2 diabetes were included in this randomized, controlled, double-blinded, parallel group study. FBF responses to intra-arterial acetylcholine (ACh) and glycerol trinitrate (GTN) were measured before and after 21 days of intravenous treatment with 600 mg alpha-lipoic acid or placebo. Results FBF responses were comparable at baseline. After treatment, FBF reactivity to ACh and GTN was unchanged in subjects receiving placebo. By contrast, ALA treatment increased endothelium-dependent vasodilatation to ACh (P < 0.05) but not to GTN compared with baseline. Conclusions Intravenous ALA treatment improves endothelium-dependent vasodilatation in patients with type 2 diabetes, in the absence of effects on forearm vasomotor function. If this salutary action  translates into vascular risk reduction remains to be established.

Six Supernutrients That Can Transform Your Health

Imagine sustained energy… a flawless memory… perfect vision and hearing… and the physical endurance of someone half your age—all as you reach fifty, sixty, seventy and beyond.

This may sound like an unreachable fantasy. But there’s no rule that says your health has to fall apart once you reach middle age—especially not when a carefully chosen combination of the right phytonutrients can provide you with comprehensive protection against all of the most common pitfalls of aging …and add years of vitality onto your life in the process.

Take turmeric, for example: This is the spice that gives curry its kick—but it’s also a clinically proven antioxidant powerhouse. Turmeric—and more specifically its primary constituent curcumin—has been tested with great success against of number of inflammation-related conditions, including psoriasis, chronic pancreatitis, inflammatory bowel and eye diseases plus rheumatoid arthritis.1

Green tea is another powerful life-extending nutrient—rich in a number of health-promoting polyphenols, including the powerful antioxidant epigallocatechin-3-gallate (EGCG). Extensive research shows that, among other benefits, green tea can help to balance blood sugar and insulin levels, fight inflammation, protect against stroke-related brain damage and increase cognitive function plus help to prevent atherosclerosis resulting from elevated LDL cholesterol.2-8

Grape seed extract is a good source of a class of phytochemicals called proanthocyanidins and has emerged as another key anti-aging staple. Studies show that this antioxidant compound can support healthy blood pressure and cholesterol levels, reduce plaque-causing lipid peroxidation, inhibit clot-forming platelet aggregation and reduce inflammation.9-11 Other notable benefits of grape seed supplementation include accelerating wound healing and supporting skin health.12-13

As the most popular staple of the “French paradox”—that is, the phenomenon of low rates of coronary artery disease paired with a diet rich in saturated fat—there seems to be no limit to the health benefits of red wine… especially where your heart is concerned. Not only is it packed with both polyphenols and stilbenes—powerful antioxidants that can raise “good” cholesterol and protect against artery damage—- it’s also rich in the anti-aging compound resveratrol. Research shows that resveratrol can mimic the beneficial effects of caloric restriction—including improved heart function and bone density, better motor function, delayed cataracts and longer lifespan—without strict dieting.14-19

Your liver is your body’s filter, responsible for pushing out damaging toxins on a daily basis—so keeping this organ in perfect shape is another crucial aspect of longevity. Luckily, numerous clinical trials offer compelling modern-day support for the historical use of milk thistle—and more specifically, its main constituent silymarin—for this very purpose. Research shows that daily silymarin supplementation can improve recovery time dramatically in patients with acute hepatitis, cirrhosis, and other forms of liver disease—while additional studies indicate that it can help to maintain healthy blood sugar and offer critical protection against damaging UV radiation.20-23

Finally, the last few decades have seen the ancient herb Ginkgo biloba emerge as a superstar in the supplement world—most notably for its clinically proven benefits to nerve and cognitive health. Extensive research shows that it can increase blood flow to the brain, reduce memory deficit in Alzheimer’s patients and boost vision.24-25

References:

1. Hsu CH, Cheng AL. Clinical studies with curcumin. Adv Exp Med Biol. 2007;595:471-480.

2. Tsuneki H, Ishizuka M, Terasawa M, Wu JB, Sasaoka T, Kimura I. Effect of green tea on blood glucose levels and serum proteomic patterns in diabetic (db/db) mice and on glucose metabolism in healthy humans. BMC Pharmacol, 2004 Aug 26;4(1):18.

3. Lee H, Bae JH, Lee SR. Protective effect of green tea polyphenol EGCG against neuronal damage and brain edema after unilateral cerebral ischemia in gerbils. J Neurosci Res, 2004 Sep 15;77(6):892-900.

4. Kim HK, Kim M, Kim S, Kim M, Chung JH. Effects of green tea polyphenol on cognitive and acetylcholinesterase activities. Biosci Biotechnol Biochem, 2004 Sep;68(9):1977-9.

5. Hussain T, Gupta S, Adhami VM, Mukhtar H. Green tea constituent epigallocatechin-3-gallate selectively inhibits COX-2 without affecting COX-1 expression in human prostate carcinoma cells. Int J Cancer, 2004 Sep 28 [Epub ahead of print].

6. Pezzato E, Sartor L, Dell’aica I, Dittadi R, Gion M, Belluco C, Lise M, Garbisa S. Prostate carcinoma and green tea: PSA-triggered basement membrane degradation and MMP-2 activation are inhibited by (-)epigallocatechin-3-gallate.Int J Cancer, 2004 Dec 10;112(5):787-92.

7. Zhang M, Lee AH, Binns CW, Xie X. Green tea consumption enhances survival of epithelial ovarian cancer. Int J Cancer, 2004 Nov 10;112(3):465.

8. Ouyang P, Peng WL, Lai WY, Xu AL. [Green tea polyphenols inhibit low-density lipoprotein-induced proliferation of rat vascular smooth muscle cells] [Article in Chinese]. Di Yi Jun Yi Da Xue Xue Bao, 2004 Sep;24(9):975-9.

9. Edirisinghe I, Burton-Freeman B, Tissa Kappagoda C. Mechanism of the endothelium-dependent relaxation evoked by a grape seed extract. Clin Sci (Lond). 2008 Feb;114(4):331-7.

10. Freedman JE, Parker C, Li L, et al. Select flavonoids and whole juice from purple grapes inhibit platelet function and enhance nitric oxide release. Circulation. 2001;103:2792-8.

11. Shafiee M, Carbonneau MA, Urban N, Descomps B, Leger CL. Grape and grape seed extract capacities at protecting LDL against oxidation generated by Cu2+, AAPH or SIN-1 and at decreasing superoxide THP-1 cell production. A comparison to other extracts or compounds. Free Radic Res. 2003 May;37(5):573-84.

12. Katiyar SK. Dietary grape seed proanthocyanidins inhibit photocarcinogenesis through prevention of UV-induced suppression of immune responses via induction of interleukin-12 in mice. Presented at the 233rd national meeting of the American Chemical Society, Chicago, March 25, 2007. Abstract: AGFD 011.

13. Hughes-Formella B, Wunderlich O, Williams R. Anti-inflammatory and skin-hydrating properties of a dietary supplement and topical formulations containing oligomeric proanthocyanidins. Skin Pharmacol Physiol. 2007;20(1):43-9. Epub 2006 Oct 11.

14. Baur JA, Pearson KJ, Price NL, et al. Resveratrol improves health and survival of mice on a high-calorie diet. Nature. 2006 Nov 16;444(7117):337-342.

15. Lagouge M, Argmann C, Gerhart-Hines Z, et al. Resveratrol improves mitochondrial function and protects against metabolic disease by activating SIRT1 and PGC-1alpha. Cell. 2006 Dec 15;127(6):1109-1122.

16. Pfluger PT, Herranz D, Velasco-Miguel S, Serrano M, Tschöp MH. Sirt1 protects against high-fat diet-induced metabolic damage. Proc Natl Acad Sci USA. 2008;105(28):9793-9798.

17. Sun C, Zhang F, Ge X, et al. SIRT1 improves insulin sensitivity under insulin-resistant conditions by repressing PTP1B. Cell Metab 2007;6:307-319.

18. Pearson KJ, Baur JA, Lewis KN, et al. Resveratrol delays age-related deterioration and mimics transcriptional aspects of dietary restriction without extending life span. Cell Metab. 2008 Aug;8(2):157-168.

19. Barger JL, Kayo T, Vann JM, et al. A low dose of dietary resveratrol partially mimics caloric restriction and retards aging parameters in mice. PLoS ONE. 2008 Jun 4;3(6):e2264.

20. El-Kamary SS, Shardell MD, Abdel-Hamid M, Ismail S, El-Ateek M, Metwally M, Mikhail N, Hashem M, Mousa A, Aboul-Fotouh A, El-Kassas M, Esmat G, Strickland GT. A randomized controlled trial to assess the safety and efficacy of silymarin on symptoms, signs and biomarkers of acute hepatitis. Phytomedicine. 2009 May;16(5):391-400.

21. Huseini HF, Larijani B, Heshmat R, Fakhrzadeh H, Radjabipour B, Toliat T, Raza M. The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytotherapy Research. Published online ahead of print on October 30, 2006.

22. Meeran SM, Katiyar S, Elmets CA, Katiyar SK. Silymarin inhibits UV radiation-induced immunosuppression through augmentation of interleukin-12 in mice. Mol Cancer Ther. 2006 Jul;5(7):1660-8.

23. Svobodova A, Zdarilova A, Maliskova J, Mikulkova H, Walterova D, Vostalova J. Attenuation of UVA-induced damage to human keratinocytes by silymarin. J Dermatol Sci. 2007 Apr;46(1):21-30. Epub 2007 Feb 7.

24. B. Hofferberth. The Efficacy of EGb 761 (Ginkgo biloba extract) in Patients with Senile Dementia of the Alzheimer Type, A double-Blind, Placebo-Controlled Study on Different Levels of Investigation. Human Psychopharmacol 1994, vol. 9, 215-222.

25. Wu ZM, Yin XX, Ji L, Gao YY, Pan YM, Lu Q, Wang JY. Ginkgo biloba extract prevents against apoptosis induced by high glucose in human lens epithelial cells. Acta Pharmacol Sin. 2008 Sep;29(9):1042-50.

News Release
Herbal Science Organization Clarifies New Ginkgo Study

(Austin, TX) December 28, 2009. New research findings published this week on a standardized Ginkgo biloba extract are very limited and the public should focus on the well-documented cognitive and cardiovascular benefits of ginkgo, said the American Botanical Council (ABC), an independent nonprofit research and education organization.

A new study of previously published data being published in this week’s issue of the Journal of the American Medical Association (JAMA) has reported that a leading ginkgo extract did not reduce the decline in cognitive impairment in older adults.1,2

“There are many significant limitations of this study”, said Mark Blumenthal, ABC founder and executive director.

First, the data being published this week are drawn from a previous clinical trial which was not designed to determine the decline in cognition.3 Second, about 40% of the subjects dropped out over the 6-year duration of the trial; the statistics reported in the study include the dropouts for which no final data are available. Further, the subjects in the study were not monitored for certain cognitive parameters until several years after the trial began, creating difficulty in determining accurately whether they experienced a decline in cognition or not. Also, the age of the subjects is quite advanced, at an average of 79 years at the beginning of the trial. This age group is not typical of the age of both healthy people and those with mild cognitive impairment who use ginkgo for improving mental performance.

Further, ABC noted that another weakness of this trial is the lack of an active control, i.e., a potential third arm of the trial (i.e., besides the patients on ginkgo or placebo) in which patients would have used a pharmaceutical medication with presumed efficacy, to determine to what extent the particular population being tested would respond. This was not possible for this trial since no conventional pharmaceutical drug has ever demonstrated the ability to prevent the onset of dementia or diminish its progression.

ABC also stated that several recent publications have demonstrated an improvement in cognitive performance in subjects using the same German gingko extract.4,5,6

The new publication, by Beth E. Snits, Ph.D., a neuropsychologist associated with the University of Pittsburgh, and other colleagues, analyzed outcomes from the Ginkgo Evaluation of Memory study (GEM, published in 2008 in JAMA) to determine if ginkgo extract slowed cognitive decline in older adults who had either normal cognition or mild cognitive impairment at the beginning of the study. 3

The GEM study previously found that ginkgo extract was not effective in reducing the incidence of Alzheimer dementia or dementia overall. This large, randomized, double-blind, placebo-controlled, multi-centered clinical trial included 3,069 community-dwelling subjects (aged 72 to 96 years) who received either a dose of 120 mg of ginkgo extract twice daily or an identical-appearing placebo. The trial was conducted at 6 academic medical centers in the United States between 2000 and 2008, with a median follow-up of 6.1 years. Change in cognitive function was evaluated by various tests and measures.

ABC emphasized that the original GEM trial was designed to determine whether taking ginkgo would prevent the onset of dementia. What this new publication has done is attempted to analyze the possible decline in levels of cognitive function – not a primary outcome measure of the GEM study.

“This trial is not conclusive nor should it in any way detract from ginkgo’s reputation as a useful dietary supplement to help support and improve cognitive function and enhance peripheral circulation – conditions for which it has been reported to be effective in numerous clinical trials,” reminded Blumenthal.

At least 16 controlled clinical trials have evaluated various ginkgo extracts for healthy, non-cognitively impaired adults. A systematic review has shown that in 11 of these trials, the ginkgo increased short-term memory, concentration and time to process mental tasks.7

“The results of this new trial must be viewed in proper perspective,” noted Blumenthal. “There is a vast body of pharmacological and clinical research supporting numerous health benefits for ginkgo extracts, particularly for improving various symptoms and conditions associated with declining cognitive performance and poor circulation.”

ABC also emphasized that this publication, and the one published in 2008 on which it is based, both underscore the relative safety of ginkgo extract: the amount of adverse events were basically the same in both the ginkgo and placebo groups, particularly no serious adverse effects, e.g. no statistically significant incidence of coronary heart disease, stroke of any type, and major bleeding.

The trial utilized EGb 761®, the world’s most clinically tested ginkgo extract, produced by W. Schwabe Pharmaceuticals in Karlsruhe, Germany.

About Ginkgo Extract

Ginkgo (Ginkgo biloba) is the world’s oldest living tree, dating back about 250 million years. Ginkgo leaves have been used in traditional Chinese medicine for about 500 years. For about the past 30 years the leaves of ginkgo have been made into a highly concentrated (50:1) extract, chemically standardized to compounds unique to ginkgo (ginkgolides and bilobalide) as well as other compounds. The leading German ginkgo extract has been subjected to a vast range of clinical trials documenting its ability to improve peripheral circulation and cognitive function, particularly in patients with early stages of mild cognitive impairment, senile dementia, Alzheimer’s disease, and memory loss. Clinical trials also support the use of ginkgo extract in assisting elderly patients in walking longer distances without leg pain (peripheral arterial occlusive disease, also known as intermittent claudication). Standardized ginkgo extracts are approved for use as medicines in Germany and numerous other countries.

About the American Botanical Council

Founded in 1988 the American Botanical Council is a leading international nonprofit organization addressing research and educational issues regarding herbs and medicinal plants. ABC’s members include academic researchers and educators, universities and libraries, health professionals and medical institutions, botanical gardens and arboreta, government agencies, members of the herb, dietary supplement, cosmetic, and pharmaceutical industries, journalists, consumers, and other interested parties from over 70 countries. The organization occupies a historic 2.5-acre site in Austin, Texas where it publishes the quarterly journal HerbalGram, the monthly e-publication HerbalEGram, HerbClips (over 4000 summaries of scientific and clinical publications), reference books, and other educational materials. ABC also hosts HerbMedPro, a powerful herbal database, covering scientific and clinical publications on more than 220 herbs.

ABC is tax-exempt under section 501© (3) of the IRS Code. Information: Contact ABC at P.O. Box 144345, Austin, TX 78714-4345, Phone: 512-926-4900. Website: http://www.herbalgram.org/.

References

1. Snitz BE, O’Meara ES, Carlson MC, Arnold A, Ives DG, Rapp SR, Saxton J, Lopez OL, Dunn LO, Sink K, DeKosky ST. Does Ginkgo biloba slow cognitive decline in older adults? JAMA Dec 23/30, 2009.

2. American Medical Association. Ginkgo Biloba Does Not Appear to Slow Rate of Cognitive Decline. [press release]. Chicago, IL: Dec. 23, 2009.

3. DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo biloba for prevention of dementia: a randomized controlled trial.[see comment]. JAMA. Nov 19 2008;300(19):2253-2262.

4. QWiG Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. IQWiG Reports – Commission No. A05-19B. Ginkgo in Alzheimer’s disease. Executive Summary. Cologne: IQWiG, 2008.

5. Kaschel R. Ginkgo biloba: specificity of neuropsychological improvement – a selective review in search of differential effects. Human Psychopharmacology: Clinical and Experimental 2009;24:345-370.

6. Kasper S, Schubert H. Ginkgo-Spezialextrakt EGb 761® in der Behandlung der Demenz: Evidenz für Wirksamkeit und Verträglichkeit. [Ginkgo biloba extract EGb 761® in the treatment of dementia: evidence of efficacy and tolerability.] Fortschritte Neurologie Psychiatrie 2009;77:494-506.

7. Crews W, Harrison DW, Griggin ML, Falwell KD, Crist T, Longest L, Hehemann L, Rey ST. The neuropsychological efficacy of ginkgo preparations in healthy and cognitively intact adults; A comprehensive review. HerbalGram 2005;67:42-62.

Source: American Botanical Council 12/30/09.