In parallel with increasing prevalence of obesity in adolescents, it is expected that long-term morbidity in this population will increase.  A recent Australian research investigated the association between measures of adiposity (body mass index and waist circumference) and risk factors for heart disease, type 2 diabetes, fatty liver disease, and the clustering of risk factors in middle adolescence.

496 year 10 students (mean age – 15.4 years) in the Sydney metropolitan area were included in this study.  Blood samples were collected for biomarker studies including lipids (HDL and LDL cholesterol, triglycerides), insulin and glucose, liver health (ALT and GGT), high-sensitivity CRP (a marker for inflammation and risk predictor for cardiovascular disease), and blood pressure.

The study found that:

• The prevalence of overweight and obesity in adolescent boys was 27.6%, based on BMI (body mass index calculated as weight in kilograms divided by height in meters squared), and 20.0% based on waist circumference cut points. The prevalence of overweight and obesity in adolescent girls was 19.4% based on BMI and 18.0% based on waist circumference.
• Adolescent boys are more likely to have multiple risk factors than adolescent girls, particularly if they are overweight or obese.
• 95% of obese and 80% of overweight adolescent boys had at least 1 risk factor.
• Obese adolescent boys and girls were significantly more likely to have 2 or more risk factors than non-overweight adolescents.
• The cardiovascular risk factors were relatively common, with high blood pressure being the most prevalent risk factor in adolescent boys (22.1%) and girls (10.8%).
• Low HDL cholesterol levels and elevated high sensitivity-CRP levels were also relatively common, with 10.7% of adolescent boys and 3.9% of adolescent girls having low HDL cholesterol levels and 7.5% of adolescent boys and 8.6% of adolescent girls having high hs-CRP levels.
• 4.5% of adolescent boys and 6.3% of adolescent girls have abnormal LDL cholesterol level.

Analysis on the clustering of risk factors indicates that Insulin, ALT, GGT, HDL cholesterol, high-sensitivity CRP, and blood pressure were significantly associated with overweight and obesity in adolescent boys. In adolescent girls, insulin, high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were significantly associated with overweight and obesity.

Previous studies suggested that the presence of more than 1 risk factor in childhood presents an increased risk of cardiovascular disease in adulthood.  Identifying adolescents at risk for long-term morbidity and offering early intervention may improve long-term outcomes.

Source:
Elizabeth Denney-Wilson et al (2008); Arch Pediatr Adolesc Med. 162(6):566-573

Vitamin D deficiency rickets has been reemerging as a public health problem in some developed and developing countries. Persistent severe vitamin D deficiency causes rickets in children and osteomalacia in adults, whereas mild vitamin D deficiency may also be associated with hyperparathyroidism and increased bone turnover.

A cross-sectional study by researchers in Australia, China, and Malaysia investigated the influence of low-vitamin D status on bone mass, bone turnover, and muscle strength in 301 healthy Chinese adolescent girls in Beijing, China.  The researchers measured the Blood plasma 25-hydroxyvitamin D [25(OH)D], the plasma and urine biomarkers of bone turnover; and the bone mineral content (BMC) and density and bone area for the whole body and the distal and proximal forearm

Vitamin D deficiency was defined as a serum 25(OH)D concentration of <=50 nmol/L.  Severe
Deficiency was defined as <25 nmol/L.  58% of the adolescent girls were vitamin D deficient and 31% were severely deficient.

The study results showed that girls with adequate vitamin D status had higher size-adjusted BMC for the whole body, distal forearm, and proximal forearm than those with poorer vitamin D status.  Similar results were also found for handgrip muscle strength.

Girls with adequate vitamin D status had significantly lower concentrations of biomarkers for bone resorption compared with those of the vitamin D-deficient girls, suggesting that low vitamin D status is associated with greater rates of bone remodeling.

Adolescent girls with adequate vitamin D status had significantly higher bone mass and muscle strength compared with those with poor vitamin D status. This may be attributed in part to a lower rate of bone remodeling with adequate vitamin D status.

These findings suggest that adequate vitamin D status during adolescence is important for optimizing bone mass, which may lead to higher peak bone mass at maturity. Poor vitamin D status also compromises forearm muscle strength.

In conclusion, adequate vitamin D status is important in enhancing muscle strength and in attaining higher peak bone mass. This effect on bone may in part be attributed to lower rates of bone remodeling when vitamin D status is adequate.

Source:
Leng Huat Foo et al. (2009) J. Nutr. 139: 1002–1007

Studies have demonstrated inverse relationships between diet quality and the common mental disorders in adults. However, little is known about such association in adolescents. Given that three quarters of lifetime psychiatric disorders will emerge in adolescence or early adulthood, a recent prospective study investigated the temporal relationships between diet quality and mental health and the associations between change in diet quality and change in psychological symptoms.

Researchers collected diet and mental health information from 3040 Australian adolescents aged 11–18 years at baseline in 2005–6 and followed up in 2007–8.  The study found that boys had significantly higher scores on the Unhealthy diet scale than girls and were also more active; and that improvements in diet quality were mirrored by improvements in mental health over the follow-up period, while deteriorating diet quality was associated with poorer psychological functioning.

The researchers hypothesized that diet quality influences the genesis and/or progression of depressive illnesses by modulating inflammatory, oxidative and/or neurotrophic factors.

Given that adequate nutrition is essential during periods of rapid physical development, and that the majority of mental health problems first manifest in adolescence and early adulthood, further intervention studies are now urgently required to test the effectiveness of preventing the common mental disorders through dietary modification.  For the parents, the foods available and provided to adolescents need to be receiving much greater attention.  Particular attention should be paid to creating environments that promote healthy eating in supporting adolescents to maintain good nutrition during a difficult life stage.

Source:
Jacka FN et al. (2011) A Prospective Study of Diet Quality and Mental Health in Adolescents; PLoS ONE 6(9): e24805. doi:10.1371/journal.pone.0024805

Pre-eclampsia and eclampsia are common causes of serious morbidity and death. Calcium supplementation may reduce the risk of pre-eclampsia through a number of mechanisms, and may help to prevent preterm birth.

To assess the effects of calcium supplementation during pregnancy on hypertensive disorders of pregnancy and related maternal and child outcomes, a recent Cochrane meta-analysis reviewed 13 randomised controlled trials involving 15,730 women.  All trials compared at least 1 gram of daily calcium supplementation during pregnancy with placebo.

The study found that the average risk of high blood pressure and preterm birth was reduced in the calcium group. There was also a reduction in the average risk of pre-eclampsia associated with calcium group.  Calcium supplementation appears to approximately halve the risk of pre-eclampsia, to reduce the risk of preterm birth and to reduce the occurrence of the composite outcome ‘death or serious morbidity’. The effect was greatest for women with low dietary calcium intake at baseline and those selected as being at high risk.

The study authors found that calcium supplementation during pregnancy is a safe and relatively cheap means of reducing the risk of pre-eclampsia in women at increased risk, and women from communities with low dietary calcium. No adverse effects have been found but further research is needed into the ideal dosage for supplementation.

Source:
Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD001059. DOI: 10.1002/14651858.CD001059.pub3

In a recent population based study of men and women over 65 years of age, those experiencing chronic moderate to extreme pain were twice as likely to be vitamin D deficient than those not reporting pain.

Inadequate vitamin D levels are common in older adults and may result in osteoporosis, osteoma-lacia and a wide range of other non-communicable diseases that have potential effects on health outcomes. Moderate to extreme pain is also more likely to present in older adults.

A recent study published in the British Journal of Nutrition has shown that older men and women experiencing moderate to extreme chronic pain are more likely than others to have poor vitamin D status.

Researchers sought to examine the connection between chronic pain and serum vitamin D levels among a population of men and women aged 65 years or older. The study included 2,070 adults who took part in the 2005 annual Health Survey for England, which assessed health and health-related behaviors in children and adults.

The results of this study show that symptoms of chronic pain were associated with poor vitamin D status, independent of other variables. Of the 53% of participants that reported experiencing moderate or extreme pain or discomfort, 80% had chronic illnesses and 60% had been diagnosed with musculoskeletal conditions.

The odds of experiencing moderate to severe pain increased with decreasing levels of serum vitamin D.  In those reporting pain, the odds of being deficient in vitamin D (less than 25 nmol/l, or 10 ng/ml) were double that of subjects who did not report pain.

These results support previous research showing an association between increased pain and poor vitamin D status. The researchers suggest that the active form of the vitamin may be associated with a reduction in inflammation. The results of this study also support the supposition that it is important to screen older patients reporting pain for vitamin D status so that appropriate interventions can be provided.

Source:
Hirani V. British Journal of Nutrition; pp 1-5 Published online: 28 September 2011.

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases.  Recent study published in Archives of Ophthalmology investigated whether dietary nutrients can reduce the genetic risk of early age-related macular degeneration (AMD) conferred by the genetic variants CFH Y402H and LOC387715 A69S in a nested case-control study.

Researchers assessed dietary intake of 2167 individuals (>=55 years) from the population-based Rotterdam Study at risk of AMD, using a semiquantitative food frequency questionnaire and genetic variants were determined. Incident early AMD was determined at 3 follow-up visits (median follow-up, 8.6 years). The synergy index was used to evaluate biological interaction between risk factors; hazard ratios were calculated to estimate risk of early AMD in strata of nutrient intake and genotypes.

Five hundred seventeen participants developed early AMD. Significant synergy indices supported the possibility of biological interaction between CFH Y402H and zinc, β-carotene, lutein/zeaxanthin, and eicosapentaenoic/docosahexaenoic acid (EPA/DHA) and between LOC387715 A69S and zinc and EPA/DHA. Dietary intakes of zinc in the highest tertile, as well as high dietary intakes of β-carotene, lutein/zeaxanthin, and EPA/DHA, were associated with reduced risk of early AMD for the CFH Y402H genetic variant.  The highest intake of zinc and EPA/DHA reduced the risk for early AMD in people with LOC387715 A69S genetic variant.

High dietary intake of nutrients with antioxidant properties reduces the risk of early AMD in those at high genetic risk.  The study authors further suggested that clinicians should provide dietary advice to young susceptible individuals to postpone or prevent the vision-disabling consequences of AMD.

Source:
Ho L. et al; Arch Ophthalmol 2011 Jun; 129(6):758-66

COX-2 (Cyclooxygenase-2) and its products, including PGE2, are involved in many inflammatory illnesses. NSAIDs that target COX-2 lessen major inflammatory symptoms such as fever and pain suggests COX-2’s role in inflammation. Thus, any compound that inhibits COX-2 has the potential to be clinically useful against inflammatory diseases.

In an in-vitro study, researchers evaluated the effects of different glucosamine salts (GS-HCl, GS sulfate) or a GS derivative (N-acetyl GS) and galactosamine HCl (Gal-HCl), on the expression of COX-2 and production of PGE2 in human cells.  The study found that, among GS salts or derivative tested, Glucosamien HCl specifically inhibits endogenous and cytokine-driven COX-2 expression at protein level via a mechanism associated with the down-regulation of COX-2 N-glycosylation and turnover.

The findings presented in this study may provide a potential explanation for the clinical effect of glucosamine supplements, particularly glucosamine HCl supplement, which are purported to have an anti-inflammatory activity.

Source:
Byeong-Churl Jang et al; Journal Of Biological Chemistry (2007); VOL 282(38):27622–27632

Osteoarthritis is the leading cause of physical disability and impairment in life quality for millions of elderly people, both in industrialized and in developing countries, and its dramatic influence on healthcare costs is likely worsened because of the aging population and current epidemic of obesity.

Previously researchers in Italy found that three-month supplementation with Meriva Curcumin, a patented curcumin-soy lethicin phytosome complex, decreased joint pain and improved joint function in osteoarthritis (OA) patients. Since OA is a chronic condition requiring prolonged treatment, the long-term efficacy and safety of Meriva were investigated in a longer eight months study involving 100 OA patients.

In this study, 100 OA patients were treated with either 200mg/day Meriva Curcumin (treatment
Group, n=50), or a placebo (control group, n=50).  After eight month, Meriva curcumin treatment group showed significant improvement in comparison to the control group:

• The Karnofsky Performance Scale Index was improved from 73.3 at inclusion to 92.2 at the completion of the study;
• WOMAC scores for pain dropped significantly (p<0.05) from 16.6 to 7.3; The scores for stiffness were reduced significantly from 7.4 to 3.2 (p<0.05);  The global WOMAC score decreased significantly from 80.6 to 33.3; while in the control group the decrease from 77.8 to 68.8 was statistically insignificant;
• The results of the exercise (treadmill) tests (at a speed of 3 km/ hour, with a 10% inclination) indicate a 3.87-times greater improvement in physical performance;
• Meriva induced a statistically significant reduction of all markers of inflammation;
• 63% of the OA patients in the treatment group decreased use of NSAIDs and other painkillers compared to 12 percent in the control group (p<0.05);
• These results was accompanied by a decrease in gastrointestinal complaints by 38% of patients in the treatment group compared to 15 percent in controls (p<0.05) (presumably, due to decreased use of NSAIDs and the reported GI-protective effect of curcumin).

In summary, the study authors observed significant improvements of both the clinical and biochemical end points for the treatment group compared to the control group.  The authors further suggest that, with its excellent tolerability, Meriva Curcumin is an effective and safe agent for the complementary management of osteoarthritis, leading to better disease control, a decreased use of NSAIDs, and an overall improvement in quality of life.

Source:
Gianni Belcaro et al; Altern Med Rev 2010;15(4):337-344

Curcuma longa (turmeric) has a long traditional use as a treatment for inflammatory conditions.  Curcumin are believe to contribute to the therapeutic benefits of turmeric extract with three curcuminoids as the main constituents. Numerous clinical trials have investigated the mechanisms and therapeutic potential of curcumin

Curcumin has a high instability at physiological pH and an inherently low intestinal absorption.  It is therefore very poorly bioavailable. Because of curcumin’s rapid plasma clearance, its therapeutic usefulness has been somewhat limited, leading researchers to investigate the benefits of complexing curcumin with other substances to increase systemic bioavailability.

In a randomized, double-blind, crossover human study, researchers at USANA Health Sciences, in conjunction with Università del Piemonte Orientale and Indena SPA in Italy, investigated the absorption rate of a unique extract of turmeric – the Meriva Bioavailable Curcumin. Eight healthy people took either a high or low dose Meriva Curcumin, or a reference placebo.  Their serum levels of the three major curcuminoids were then evaluated.

The study found that the total curcuminoid absorption was about 29-fold higher for Meriva curcumin (high or low) than for the unformulated curcuminoid mixture.  The improved absorption, and possibly also a better plasma curcuminoid profile, might underlie the clinical efficacy of Meriva curcumin at doses significantly lower than unformulated curcuminoid mixtures.

The Meriva curcumin extract used in this clinical trial is a special patented combination of curcumin with soybean-derived lecithin, produced and distributed by Indena SpA of Milan, Italy, the world’s largest manufacturer of standardized botanical extracts.

Source:
Cuomo J et al; J Nat Prod. 2011 Apr 25; 74(4):664-9

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.