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In a study published in the Journal of Nutrition, researchers evaluated the effects of grape polyphenols in adult men classified with metabolic syndrome. Metabolic syndrome is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke, and type 2 diabetes.
Participants in this double-blind, crossover study included 24 men aged 30-70 years of age who were randomly assigned to consume either a grape polyphenol product or a placebo for 30 days. There was a 3 week wash-out period between treatments. The men maintained their normal physical activity level and normal diet. They also were told to avoid polyphenol-rich food during the trial period.
At the end of each dietary period, blood pressure was measured and several different tests were used to analyze vascular function. When compared to the placebo period, the grape polyphenol treatment period resulted in lower systolic blood pressure and an increased blood flow in the brachial (arm) arteries. An indicator of blood platelet “stickiness”, known as sICAM-1, was also reduced during the polyphenol treatment period.
The results of this study indicate that grape polyphenols may positively influence vasorelaxation, blood pressure, and lower circulating cell adhesion molecules, improving overall vascular health and function, especially in men with metabolic syndrome.
Barona J, Aristizabal JC, Blesso CN, Volek JS, Fernandez ML. Grape polyphenols reduce blood pressure and increase flow-mediated vasodilation in men with metabolic syndrome. J Nutr. 2012;142(9):1626-32.

For those with diabetes, folic acid supplementation may be beneficial in reducing the risk of stroke.


Folic acid is a derivative of folate (an essential B vitamin) and is an essential nutrient which has been linked to numerous health benefits. It is important enough that many governments require grains to be fortified with folate/folic acid to provide their citizens with regular, daily access to this important vitamin.
In countries with low access to folate, research has demonstrated an incredible reduction of incidences of neural tube defects (NTDs) in infants whose mothers had access to folic acid supplementation during pregnancy. Folic acid supplementation has proven to be a safe, inexpensive, and effective way to reduce the risk of NTDs and other birth defects in third-world countries and at-risk populations all around the world.
Folic acid supplementation has also been purported to improve heart health. The American Heart Association (AHA) published an article last year exploring the decrease in congenital heart defects associated with folic-acid supplementation and folic-acid-fortified foods. This connection between the B vitamin and heart health suggests that folic acid can work preventatively with regards to stroke and myocardial infarction, otherwise known as heart attack.
Diabetes, which is characterized by high blood glucose concentrations during and after periods of fasting, is a known risk factor for stroke. Researchers at several universities and hospitals in China hypothesized about the link between folic acid supplementation and the first stroke associated with elevated blood glucose levels. They performed a randomized double-blind study over the course of several years.
Participants in this study were men and women between the ages of 45 and 75 with hypertension, who were diagnosed as diabetic (type 2 diabetes mellitus) or normoglycemic prior to the study.
The subjects were provided with either a daily oral dose of 10mg enalapril and 0.8mg folic acid, or 10 mg enalapril only. Follow-up visits for each participant were scheduled every three months for the duration of the study (median duration = 4.5 years).
Results indicate that, for any given glucose category (hypoglycemic, normoglycemic, diabetic), risk of stroke was significantly reduced by folic acid supplementation. Those with fasting glucose blood levels indicating diabetes showed the greatest risk reduction due to folic acid supplementation.
From the results of this study, it can be inferred that folic acid supplementation may be beneficial in reducing the risk of stroke for those with diabetes. Increasing the amount of folic in the diet should be a priority for everyone; however, without regular access to folate-fortified grains, this goal can be hard to achieve. Folic acid supplements can be a great way to regularly meet the daily recommended value of this essential nutrient.
Xu RB, Kong X, Xu BP, et al. Longitudinal association between fasting blood glucose concentrations and first stroke in hypertensive adults in China: effect of folic acid intervention.
The American Journal of Clinical Nutrition. 2017;105(3):564-570. doi:10.3945/ajcn.116.145656. Folic acid fortified food linked to decrease in congenital heart defects.


Nutrient levels account for a 17% variation in memory and thinking ability, and a 37% variation in brain volume in a group of study individuals.
A study published in Neurology has found that certain nutrients work together synergistically to promote brain health. The study looked at the effects of diet and nutrient intake in seniors on memory, thinking and brain volume.
The researchers recruited 104 individuals (average age 87) and measured blood levels of certain nutrients, as well as memory and thinking in all study participants. They also analyzed MRI scans to determine the brain volume of 42 of the subjects.
Participants in the study were healthy non-smokers with relatively few chronic diseases and free of memory and thinking problems. Most had generally healthy diets, but there were some with deficiencies of certain nutrients. This created enough variation to determine that nutrient status does play a significant role in memory, thinking, and brain volume. It was determined that nutrient levels accounted for 17% of the variation found in memory and thinking, and for the 37% of the variation in brain volume.
With this data, the researchers came to three conclusions. The first conclusion is that individuals with diets high in omega-3 fatty acids, vitamins C, D, E, and B were more likely to score better on memory and thinking tests. Those with diets high in trans-fat were more likely to both score poorly on memory and thinking tests, and to have brain shrinkage. Finally, individuals with low omega-3 fatty acid intake and other nutrient intake are more likely to have lower brain volume.
Getting adequate nutrients through a balanced diet and supplements may be an important overall approach to maintaining good brain health and thinking ability as we age.
Bowman GL, Silbert LC, Howieson D, et al. Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology. 2012;78(4):241-9.
Compared to placebo, patients taking Vitamin E had slower functional decline and needed less caregiver assistance.
A study published in the Journal of the American Medical Association reports on the benefit of high dose Vitamin E in patients with mild to moderate Alzheimer’s Disease. The double-blind, placebo-controlled, randomized clinical trial involved 613 patients with mild to moderate Alzheimer’s Disease. Participants were randomized to receive 2,000 international units (IU) of vitamin E, 20 milligrams of memantine, a combination of both, or a placebo daily. Average follow-up was 2.3 years.
Patients were analyzed on their capability to perform daily living activities, memory and language, cognitive function, behavioral and psychological issues, and the time needing caregiver assistance. The data was measured and collected at the beginning of the study and every six months during the trial.
Over the years of follow-up, scores declined by 3.15 units less in the Vitamin E group compared with the placebo group. In the memantine group, the scores declined 1.98 units less than the decline in the placebo group. Compared to the placebo group, those taking Vitamin E had an average delay in clinical progression of 19% per year, or approximately 6.2 months over the follow-up period.
Patients receiving the vitamin also needed less caregiver assistance in comparison with the placebo group. There was no significant difference in all-cause mortality or safety issues reported between the placebo and Vitamin E groups.
This study showed that high dose Vitamin E appears to slow functional decline and caregiver burden in patients with mild to moderate Alzheimer’s Disease.
Dysken MW, Sano M, Asthana S, et al. Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial. JAMA. 2014;311(1):33-44.

Hydroxytyrosol is thought to be the main antioxidant compound in olive fruit, and it is believed to play a significant role in many of the health benefits attributed to olive oil. Previous research has linked the compound to cardiovascular benefits, typically reductions in LDL or “bad” cholesterol. Data has also suggested the compound may boost eye health and reduce the risk of macular degeneration.

Spanish researchers reported these results in the British Journal of Nutrition. Twenty-two healthy volunteers between 20 and 45 years of age and with a BMI between 18 and 33 kg/m2 were recruited. Volunteers were randomly assigned to receive 10 to 15 grams per day of hydroxytyrosol-enriched sunflower oil or non-enriched sunflower oil for three weeks. The former provided a daily hydroxytyrosol dose of between 45 and 50 mg. After the initial three week period, volunteers had two weeks of no intervention before crossing over to receive the other intervention.

Results showed no changes in total, LDL, or HDL-cholesterol between the groups. However, consumption of the hydroxytyrosol-enriched sunflower oil produced significant reductions in oxidized LDL from 79.8 units per liter at the start of the study to 64.1 U/l after three weeks, compared to an increase from 72.7 to 86.4 U/l during the control phase. Furthermore, the activity of arylesterase increased from 235.2 to 448.9 U/l during the hydroxytyrosol phase, compared with an increase from 204.1 to 310.3 U/l during the control phase.

The researchers reported that although hydroxytyrosol-enriched sunflower oil did not significantly reduce LDL-cholesterol or increase HDL-cholesterol, it acted as a functional food by increasing arylesterase activity and reducing oxidized LDL. Oxidized LDL is believed to be a major player in promoting atherosclerosis (the build-up of fatty plaques in arteries) and general cardiovascular disease. Based on these results, dietary sources of hydroxytyrosol appear to be capable of reducing certain risk factors associated with coronary artery disease.

Vazquez-Velasco M, et al. Effects of hydroxytyrosol-enriched sunflower oil consumption on CVD risk factors. 2010. Br J Nutr.

Although there are a few published reports regarding the effect of green tea on insulin sensitivity and glucose control in humans, the results have been inconsistent.

In a new study published in the American Journal of Clinical Nutrition, researchers aimed to more accurately quantify the effect of green tea on glucose control and insulin sensitivity.

Researchers completed a thorough literature search to find all randomized controlled trials that included information on the effects of green tea and green tea extracts on insulin sensitivity and glucose control in humans.

There were 17 trials, including a total of 1,133 subjects that met the criteria and were included in this meta-analysis. The studies were mostly of a short duration, and 7 of the studies were considered of high quality.

Overall, green tea consumption significantly reduced fasting glucose and hemoglobin A1c (a long-term measure of blood glucose control). These results were more significant in studies including subjects at risk for metabolic syndrome, and in subject with higher catechin (a compound in green tea) intakes. When only the high quality studies were included, green tea significantly reduced fasting insulin concentrations.

The results of this meta-analysis suggest that green tea intake may lower fasting glucose, insulin and HbA1c concentrations, especially in people at risk for metabolic syndrome. Researchers noted that long-term randomly controlled trials of higher quality should be conducted to further confirm these findings.

Kai Liu et al. Effect of green tea on glucose control and insulin sensitivity: a meta-analysis of 17 randomized controlled trial.

Periodontal disease is a common chronic inflammatory disease and a major risk factor for tooth loss.  A study published in the American Journal of Clinical Nutrition has demonstrated a link between low blood levels of vitamin D and the incidence of gum disease.

The study group included over 11,000 adults over the age of twenty. Eighty percent of those studied had inadequate vitamin D levels, and the lower their vitamin D serum levels, the greater the risk of tooth loss. Among subject participants age 50 and older, those with the lowest vitamin D levels had 25 to 27 percent more tooth loss than those in the highest vitamin D range.

The researchers suspect that vitamin D may cut down on the inflammatory response that leads to periodontal disease. Given the high prevalence of periodontal disease and vitamin D deficiency, these findings suggest important oral health implications related to vitamin D intake.

Dietrich T, et al. Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. Am J Clin Nutr 80(1):108-13.

Age-Related Macular Degeneration (AMD) is the most common cause of vision loss in developed countries. This degenerative eye disease causes damage to the macula (central retina) of the eye, impairing central vision. People affected by AMD have difficulty reading, driving and performing activities that require clear central vision. Many factors contribute to the development of AMD, including aging, genetics, diet, and smoking. The macula is a yellow oval-shaped pigmented area located near the center of the retina. Structures within the macula are specialized to provide high-acuity vision. Lutein and zeaxanthin are found in high concentrations here, giving the macula its yellow color. This protective layer, known as macular pigment, filters harmful high-energy blue wavelengths of light preventing damage to the retina, cones, and rods.

Numerous published studies have previously reported a link to intakes of lutein and zeaxanthin and AMD risk; however, the research has been mostly inconsistent. In this newly published prospective study, researchers used two decades of data involving more than 100,000 participants from the Nurses’ Health Study and the Health Professionals Follow-up Study. All participants were aged 50 years or older and were free of diagnosed AMD, diabetes mellitus, cardiovascular disease, and cancer (except non-melanoma skin cancer) at baseline. The researcher’s analyzed carotenoid intake based on dietary food frequency questionnaires at baseline and follow-up, and then calculated predicted plasma carotenoid scores. The results of this study found that participants with the highest average plasma lutein and zeaxanthin levels had a 40% reduced risk of developing advanced AMD compared to those with the lowest average levels. “Lutein and zeaxanthin form macular pigments that may protect against AMD by reducing oxidative stress, absorbing blue light, and stabilizing cell membranes,” the authors explain.

Dark green leafy vegetables are the primary dietary sources of lutein and zeaxanthin, but they are also found in some other colorful fruits and vegetables. Average dietary intake in the U.S. is only about 1-3 mg/day, far below the amount most studies indicate as a minimum needed to decrease risk of AMD. “Because other carotenoids may also have a protective role, a public health strategy of increasing the consumption of a wide variety of fruits and vegetables rich in carotenoids could be most beneficial and is compatible with current dietary guidelines,” the authors concluded.

JAMA Ophthalmol. 2015;133(12):1415-1424.

Osteo_SS_kneejointdamageOsteoarthritis (OA) is a degenerative joint disease that mainly affects cartilage, causing functional limitation and disability particularly in the elderly. It is estimated that over 27 million individuals over the age of 65 suffer from osteoarthritis, which most commonly affects the knee. Vitamin D plays many biological and functional roles in joint health, so vitamin D status may play a role in the progression of knee osteoarthritis.

In a new study published online in the Journal of Nutrition, researchers investigated whether serum vitamin D and parathyroid hormone (PTH) concentrations might predict the progression of knee OA. PTH is responsible for regulating the metabolism of vitamin D. The study included 418 participants enrolled in the Osteoarthritis Initiative who had at least one knee with diagnosed osteoarthritis. Serum vitamin D and PTH were measured at the 30 or 36 month visit of the study, and progression of OA was defined as an increase in the joint space narrowing (JSN) score between the 2 and 4 year study visits.

The average serum vitamin D level of the participants was 26 ng/ml, while 16% of this population had levels below 15 ng/ml. Between the beginning of the study and follow-up visits, 14% of the subjects experienced joint space narrowing (increased JSN score). Subjects with a low vitamin D level (< 15 ng/ml) had twice the risk of elevated knee OA progression than the participants with vitamin D levels > 15 ng/ml. Although a high serum PTH itself was not associated with a significant increase in JSN score, individuals with both low vitamin D and high PTH (> 73 pg/ml) had a greater than 3 fold increased risk of OA progression.

The results of the present study suggest that individuals deficient in vitamin D have greater risk of osteoarthritis progression than those with normal vitamin D levels.

Fang Fang Zhang et al. J Nutr. 2014; 144(12):2002-8. doi: 10.3945/jn.114.193227.

Child obeseSeveral B vitamins play important roles in the metabolism of carbohydrates, proteins, fats, and the health of mitochondria, which are involved in energy metabolism. Previous research has indicated that insufficient micronutrient intake can be a contributing factor in childhood obesity, but the results of research have been somewhat inconsistent.

In a new study published in the Journal of Nutrition, researchers examined the associations between serum vitamin B12 and folate concentrations, and intakes of select B vitamins with body fat. Subjects included 1,131 Mexican American children 8-15 yrs. of age who participated in the National Health and Nutrition Examination Survey (NHANES) 2001-2004. Blood samples were analyzed for serum vitamin B12 and folate levels, and dietary questionnaire responses provided information concerning B vitamin intake. Dexa scans of fat mass and total body fat mass were used along with BMI as measures of body fat.

Body mass index, trunk fat mass and total body fat mass increased with age, but children with higher serum levels of B12 and folate had lower measures of BMI, trunk fat and total body fat. Children with normal weight had higher serum B12 levels compared to overweight or obese children. Analysis of B vitamin intake showed that children with higher intakes of thiamin (B1) and riboflavin (B2) were more likely to have a healthy BMI and lower body trunk fat mass.

The results of this study showing the inverse relationship between the status of B12, folate, riboflavin and thiamin suggest that these micronutrients may play a role in the risk reduction of childhood obesity.

Inong R Gunanti et al. J Nutr. 2014 Dec; 144(12):2027-33. doi: 10.3945/jn.114.201202.

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