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In a recent study, researchers discovered a significant correlation between healthy plasma levels of coEnzyme Q10 and vitamin B-6 and a reduced risk of coronary artery disease.

Cardiovascular diseases are the leading cause of death worldwide, accounting for nearly 30% of all deaths. It is estimated that by 2030, over 23 million people will die from cardiovascular diseases annually.

In a new study published in Nutrition Research, scientists investigated the possible relationship between plasma levels of CoEnzyme Q10 and vitamin B6 and the risk of coronary artery disease (CAD). Study participants included 134 adults, 45 with at least 50% stenosis (blockage) of one major coronary artery. The control group (n=89) had normal blood biochemistry and were free of CAD. Researchers measured the plasma concentrations of CoQ10, vitamin B6 and lipid profiles of each participant.

Individuals with CAD were found to have significantly lower plasma CoQ10 and Vitamin B6 compared to the control group. Even after adjusting for other CAD risk factors, subjects with higher CoQ10 plasma concentration had a significantly lower risk of CAD. Higher plasma vitamin B6 concentration also related to a significantly lower risk of CAD, but the relationship was less significant after adjusting for other CAD risk factors.

This observational study suggests that there may be a significant correlation between the plasma levels of CoQ10 and Vitamin B6 and the risk of cardiovascular disease.  Statin drugs, which are commonly prescribed to CAD patients and those at risk, are known to lower plasma CoQ10 levels. The researchers state that further research should be conducted to examine the benefits of supplementing CoQ10 in combination with Vitamin B6 to CAD patients, especially if their CoQ10 levels are below normal levels.

Source: Bor-Jen Lee et al. Nutrition Research 32(10):751-756, October 2012.

The latest meta-analysis of clinical studies suggested that CoQ10 supplementation improves outcomes in patients with congestive heart failure (CHF).

CoQ10 (ubiquinone) is an antioxidant that plays two important biological roles.  It is an integral component of the mitochondrial respiratory chain used for ATP production; it is also a lipid-soluble antioxidant that slows lipid peroxidation in the circulation.  CoQ10 has been used to help improve functional status during CHF. Several clinical trials have examined the effects of CoQ10 on CHF, but some of the research has been inconclusive.

In a recently published paper in the American Journal of Clinical Nutrition, researchers conducted a meta-analysis to evaluate the effect of CoQ10 supplementation on ejection fraction (EF) and functional improvements of patients with CHF.

A systematic review of the research literature was performed using databases that included Medline, Embase, Cochrane Central Register of Controlled Trials, and examination of references from other selected studies. Included studies were randomized controlled trials of CoQ10 supplementation that reported EF or specific functional improvements as a primary outcome.

When all studies were pooled, supplementation with CoQ10 resulted in a net change of 3.67% in the EF and a trend in functional improvements. Cross-over studies of 12 weeks or more, daily dosages of at least 100 mg CoQ10, and patients with less severe CHF showed the most significant improvements in EF and health outcomes.

This meta-analysis of randomized controlled trials suggests that CoQ10 supplementation may improve the EF of patients with CHF.  However additional well-designed larger studies with a more diverse population are needed to exam if CoQ10 can be used as adjunct treatment with the standard therapy for CHF and its dose-response effect on stages of CHF.

Source: Fotino AD, Thompson-Paul AM, Bazzano LA. Am J Clin Nutr 2013 Feb;97(2):268-75.

Studies revealed that the majority of the pediatric population may fall short of recommended dietary intakes of omega-3 fatty acids.

According to NHMRC Nutrient Reference Values for Australia and New Zealand, the daily Adequate Intake of essential fatty acids and omega-3 fats such as DHA/EPA/DPA is 55mg/day for children aged 4-8 years of age. However estimates of actual dietary intake of these beneficial fatty acids are limited in children.

A study in the Journal of Nutrition has published direct quantification of fatty acid intakes in 41 children aged 4-8 years.  Identical portions of all food and dietary supplements consumed over 3 days were collected. Duplicate samples were analyzed for calories, macronutrients, and fatty acids, including alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA).

Based on the dietary analysis, the children averaged 1,404 kcal energy intake per day, and their fatty acid intakes were at the following levels in mg/day: alpha-linolenic acid 1,611; EPA 38.4; DPA 26.3; and DHA 54.1.

Based on the US government recommended Dietary Reference Intakes (DRI), 61% of the children met the adequate intake for ALA, and only 22% met the recommended intake for DHA + EPA. These intakes were compared with recently established Australia/New Zealand recommendations for children, where only about half the children (51%) met suggested intakes for EPA + DPA + DHA.

The result of this study indicates a significant deficit in the actual intakes of polyunsaturated fatty acids, including DHA, among Canadian and Australian children when compared to recommended intakes. This deficit gap can be readily filled with an increased consumption of fish/seafood, foods (dairy products, breads, and others) that have been enriched with various delivery forms of omega-3 EFA, and the use of supplementation where necessary.

Madden SM et al; J Nutr. 2009 Mar; 139(3):528-32.

24 March 2012

Approximately 310,000 Australians suffer from chronic heart disease and is the second largest disease burden to Australian economy.  The total direct healthcare cost attributed to cardiovascular disease is AUD$5.9 billion each year in Australia.  A latest health economic analysis by Deloitte Access Economics showed that fish oil supplementation is a cost-effective intervention to prevent future cardiovascular mortality and morbidity in Australia.

Fish oil supplements offer a number of advantages through lowering potential risk profiles. The World Health Organization (WHO), American Heart Association, National Health and Medical Research Council (NHMRC), and the National Heart Foundation of Australia recommend fish oil as a complementary treatment in addition to standard treatments following a Myocardial Infarction (MI), commonly known as heart attack. MI typically occurs when the blood supply to parts of the heart is cut off by a blocked artery, causing damage to the heart tissue, and the cells in the affected area to start to die. In the days and weeks following a cardiac incident, this area may grow, eventually leaving a large part of the heart unable to function properly and increasing the risk of further heart problems.

Epidemiological studies have shown that the consumption of fatty fish is associated with lower incidence rates of coronary heart disease (CHD), stroke and MI.  The Complementary Healthcare Council of Australia (CHC) recently commissioned Deloitte Access Economics to undertake cost benefit analysis (CBA) of fish oils and estimate the net benefit of fish oils as adjunctive treatment for prevention of heart disease among those who have experienced MI, versus no fish oils, taking into account the cost per person of the treatment and the DALYs (Disability-Adjusted Life Years) avoided. DALY is a measure of overall disease burden adopted by WHO.

The analysis by Deloitte Access Economics is based on fish oil supplementation with dosage of 510-540mg EPA/day and 345-360mg DHA/day.  The result showed an ICER (incremental cost-effectiveness ratio) of $2,041 per DALY averted, indicating that fish oils are cost effective in the secondary prevention of CHD relative to the WHO benchmark.  The maximum value of the DALY benefits from the fish oil intervention was estimated at up to $3.4 billion.

This latest report offers further evidence that fish oil supplementation not only is effective in the reduction of incidence rates for cardiovascular disease, but also offers a genuine opportunity to reduce disease burden in a cost effective manner.

CHC Report on Fish oils for the secondary prevention of Coronary Heart Disease, 17 Feb 2012


17 March 2012

Fats are a necessary part of dietary energy supply.  However the quality of dietary fats, particularly long-chain Polyunsaturated fatty acids (PUFAs), plays critical roles in physiological functions such as central nervous system (CNS) development and visual function in infants and children.  In addition, the effect of dietary fats on lipids metabolism at an earlier age may be associated with cardiovascular mobidity and mortality in later life.

In recent years, there has been growing researches in the quality of dietary fat intake in early life as a major determinant of growth and development in children as well as long-term health.  The selection of dietary fatty acid sources during the first years of life is now considered to be of critical importance.

Lipids are structural components of all tissues and are indispensable for the assembly of membranes and cell organelles. The brain, retina and other neural tissues are particularly rich in long-chain polyunsaturated fatty acids (PUFAs).  For example, docosahexaenoic acid (DHA), a type of long-chain omega-3 PUFA, is a critical component of cell membranes, especially in the brain and the retina, and plays an important role in brain and visual function, due to its high content in cerebral cortex and retinal phospholipids.  DHA is considered conditionally essential during early development in childhood.

During the first 6 months of life, dietary total fat should contribute 40–60% of total energy to cover the energy needed for growth and the fat required for tissue deposition. From age 6 months to 3 years, fat intake requirements are reduced gradually to approximately 30–35% of energy depending on the physical activity of the child.  Many health organizations recommend that daily DHA intake should be between 0.2-0.5% of total fat intake for infants.  The daily Omega-3 intake for prevention of nutrition-related chronic disease should ideally fall within 1-2% of total energy intake for children over 2-yrs of age.

Vegetarian source of fats has virtually no long-chain PUFA unless algae are included in the diet.  Fish is the major source of the two important PUFAs – DHA and EPA.  Recent scientific evidence have shown that direct supply of DHA and EPA in the diet provides many health benefits including retinal and brain development and function during early childhood, cardiovascular health, inflammatory response, and allergy.  Balanced dietary intake of beneficial fats in childhood can influence risk of Cardio Vascular Diseases (CVD) later in life.

In summary, lifelong intakes of EPA and DHA are associated with reduced risk of cardiovascular disease and metabolic syndrome, as well as optimal mental development, behaviour, and immune response. Since the dietary intakes of EPA and DHA among infants and children in many western and non-western countries are lower than desirable on a unit of body weight basis and as percent of total energy, it is prudent that parents take measures to ensure that their children obtain optimal levels of EPA and DHA through diet and supplementation where required.

R Uauy and AD. Dangour; Ann Nutr Metab 2009;55:76–96

By Jackie Khor

20 September 2011

Whatever condition and disease you study, Vitamin D keeps coming up as a major factor. Vitamin D is an essential nutrient that plays multiple roles in human health.

Vitamin D in calcium metabolism and bone health is well recognized but more recently, its role in cardiovascular health, immune function, glucose metabolism, and cell differentiation and proliferation have been defined.

It is well established that vitamin D deficiency leads to rickets in developing children but more current research has also linked vitamin D deficiency with osteoporosis, osteomalacia, impaired muscle function, infection, autoimmune disorders, diabetes, and some cancers in adults. Thus, achieving optimal vitamin D status throughout life is essential to maintaining overall health.

Vitamin D is unique among other vitamins, in that very little is obtained through a normal diet. The principal source of circulating vitamin D is endogenous production in the skin following exposure to sunlight. Thus, factors that limit sun exposure and/or endogenous vitamin D synthesis greatly reduce circulating vitamin D concentrations. Some of these factors include geographic latitude, season of the year, melanin content of the skin, use of sunblock, lack of outdoor activity, age, and more. Any of these factors, among others, can lead to chronic vitamin D deficiency.

Deficiencies of vitamin D are common. It is currently estimated that more than 1 billion people worldwide and 30-to-40% of the population between 15 and 49 years of age in the United States suffer from vitamin D deficiency. Consensus is building that adequate circulating vitamin D concentrations should be greater than 30 ng/mL and optimally above 50 ng/mL (7-10). Because relatively small amounts of vitamin D are obtained through the diet and so many lifestyle factors reduce endogenous vitamin D synthesis, supplementation becomes an important avenue for achieving and maintaining optimal vitamin D status. It has been shown that 100 IU of vitamin D per day increases circulating concentrations of vitamin D by ~1 ng/mL (7-10). Thus, supplementation with advanced doses of vitamin D (2000-4000 IU/day) depending on lifestyle, are required to reverse vitamin D deficiency, boost vitamin D levels into the optimal range, and maintain them thereafter.

There are several forms of vitamin D including D1, D2 and D3. You want to take D3 (calciferol). Vitamin D3 is converted in our bodies to the active form which is dihydroxy vitamin D. Doctors and pharmaceutical corporations keep promoting dangerous, synthetic, expensive, prescription only analogs of vitamin D. These can be patented and not sold over the counter. It is important not to take too much D3 as it is oil soluble, toxic in excess, and can result in side effects. Since you can’t get any meaningful amounts in common foods, this is not a problem at all.

Remember how popular cod liver oil has been for decades now? This is really because of the vitamin D content. People often really do get dramatic results from simply taking a spoonful of cod liver oil. This is because they are getting the vitamin D they need so badly. Of course, taking a multivitamin of inexpensive 400 IU vitamin D supplement is a much more practical and tasty way to do this.

There are many reasons we suffer from so many diseases and conditions in the richest country in the world with the highest standard of living. One important and proven reason is lack of vitamin D in most people. Study after study shows people of all ages in most countries are deficient in vitamin D by blood analysis. This is especially true of the poor and the elderly. Along with your multiple vitamin just take an extra 400 IU capsule of inexpensive vitamin D when you’re not getting out in the sun regularly. No matter how well you eat you aren’t going to get any significant amount in your diet.

The science behind this is just overwhelming. People of all ages should take it. The international published science here is endless and growing. Vitamin D deficiency is a worldwide epidemic.

A new study from Spain discusses the heart health potential of hydroxytyrosol, an olive extract possibly effective at reducing levels of oxidized LDL cholesterol.

In a recent study, supplementing with hydroxytyrosol – a polyphenolic compound extracted from olives – correlated with higher activity levels of the enzyme arylesterase, an antioxidant biomarker, and lower levels of oxidized LDL cholesterol. Oxidized LDL is believed to be a major player in promoting atherosclerosis (the build-up of fatty plaques in arteries) and general cardiovascular disease.

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 most recent 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 oxidised 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.  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. Br J Nutr; 11 May 2011; 105(10):1448-52.

Although 70% Alaskan Eskimos are overweight or obese, they did not show the same risk factors for heart disease as the US population.  They also had a lower prevalence of diabetes.  The latest study suggested that an Omega-3 rich diet may offer protection against some of the harmful effects of obesity.

It has been known that Omega-3 fatty acids are associated with favorable, and obesity with unfavorable, concentrations of chronic disease risk biomarkers.

In a cross-sectional study, the researchers analyzed data from 330 people living in the Yukon Kuskokwim Delta region of south-west Alaska, who typically consume around 20 times as much omega-3 fats from fish as the average American.  They have similar overweight and obesity levels to those in the US overall but their prevalence of type 2 diabetes is significantly lower, at 3.3% versus 7.7%.

The researchers examined whether high eicosapentaenoic (EPA) and docosahexaenoic (DHA) acid intakes, measured as percentages of total red blood cell (RBC) fatty acids, modify associations of obesity with chronic disease risk biomarkers.

The study found that those with the highest levels of the omega-3 fish oils docosahexaenoic acid and eicosapentaenoic acid had the lowest triglyceride and C-reactive protein levels.  High RBC EPA and DHA were associated with attenuated dyslipidemia and low-grade systemic inflammation among overweight and obese persons. This may help inform recommendations for Omega-3 fatty acid intakes in the reduction of obesity-related disease risk.

Z Makhoul et al; European Journal of Clinical Nutrition; advance online publication 23 March 2011; doi: 10.1038/ejcn.2011.39

Emerging scientific evidence has strongly supported the view that daily consumption of fish oils provides therapeutic benefits for people with heart disease, as well as preventive benefits for general population.  In the latest release of its position statement, National Heart Foundation of Australia for the first time made recommendations with respect to fish, fish oils and omega-3 polyunsaturated fatty acids (n-3 PUFA) to improve the cardiovascular health of all Australians.

It recommends that, to lower their risk of coronary heart disease (CHD), all Australians without existing heart conditions should consume about 500 mg per day of combined DHA and EPA through the combination of oily fish, fish oil capsules or liquid, and food and drinks enriched with marine Omega-3 PUFA.

For adult Australians with documented CHD, National Heart Foundation recommends that they consume about 1000 mg per day of combined DHA and EPA through a combination of oily fish, fish oil capsules or liquid, and food and drinks enriched with marine Omega-3 PUFA.

The position statement by Notational heart Foundation also provides cautions on the consumption of fish with high and medium methylmercury content, and advise people to follow government guidelines regarding safety issues.  Many people are unable to consume the recommended dosage requirements through fish alone and for this reason, fish oil supplements therefore provide consumers with a cost effective way of ensuring their omega 3 intake is adequate.  For further information, please visit National Heart Foundation’s website at:

Fish oil supplements and regular exercise both reduce body fat and improve cardiovascular and metabolic health.

A combination of prolonged exercise and fish oil can dramatically reduce levels of a fat that can cause hardening of the arteries, a leading cause of heart disease. Fat in the bloodstream is a primary contributor to atherosclerosis, or partial blockage of the arteries.

A recent study found that people who do prolonged aerobic exercise have muscle cells that are able to quickly break down and reduce levels of a fat called triglycerides. Taking a fish oil supplement can reduce triglyceride levels even more.

The researchers studied triglyceride levels in recreationally active men after they’d eaten high-fat meals. One group ate a fatty meal after they exercised. A second group ate a high-fat meal after taking a four-gram fish oil supplement. A third group ate a high-fat meal after exercising and taking the fish oil supplement. A control group ate a high-fat meal only.

The study found a 38 percent decline in peak triglyceride levels in the men who took a fish oil supplement before they ate a high-fat meal. Peak triglyceride levels dropped 50 percent in the men who exercised and took a fish oil supplement before they ate a high-fat meal.

Regular exercise and fish oil supplements may be beneficial for people who are concerned about maintaining a healthy triglyceride level.
Metabolism. 2004 Oct;53(10):1365-71.

In a similar, more recent study, combining fish-oil supplements with regular exercise improved both body composition and heart disease risk factors. Overweight participants with various heart disease risk factors were assigned to one of three groups: fish oil (approximately 1.9 grams/day of omega-3 fats), fish oil and exercise, or placebo (sunflower oil). The exercise group walked 3 days/week for 45 minutes. Heart disease risk factors and body composition were measured at 0, 6, and 12 weeks. The group taking fish oil had a significant reduction in triglycerides, increased HDL cholesterol, and improved arterial vasodilation (blood flow). Both fish oil and exercise independently reduced body fat.

This study showed that increasing intake of omega-3 fatty acids could be a useful addition to exercise programs aimed at improving body composition and decreasing cardiovascular disease risk.

Source: AM J Clin Nutr. 2007 May;85(5):1267-74.

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