Archive for Vitamins and supplements 101
The ability of fish oil to suppress TNF alpha production
This is the future of medicine (like great-great-great grandchildrenish future‚Ä¶) where genetic differences are known to effect response rates to various interventions. TNF alpha¬†up-regulates¬†the immune system and TNF alpha blockade is one of the big new classes of disease modifying drugs for Crohn‚Äôs and rheumatoid arthritis. Here we see that different genetic polymorphisms in production of TNF alpha respond differently to fish oil supplementation. Genetic tests are already available for many known single nucleotide polymorphisms (SNiPS) that effect treatment response. Keep in mind that 6 g of fish oil is a high dosage.
AJCN ‚ÄĒ Abstracts: Grimble et al. 76 (2): 454
Fish Oil Increases Acetylcholine, Eicosanoid-Induced Contractility of Ileum
This article is very timely with the FDA‚Äôs conditional approval (see next article) of alosetron. Re-release of this drug after its withdrawal after fatal side effects is a subject of hot controversy. The drug is designed to help with diarrhea-dominant IBS. Here we see a natural approach to the opposite end of the spectrum; and I‚Äôd bet I would be hard pressed to find any fatal reactions to fish oil‚Ä¶
Nutrition.org ‚ÄĒ Abstracts: Patten et al. 132 (9): 2506
Effect of Homocysteine-Lowering Therapy With Folic Acid, Vitamin B12, and Vitamin B6 on Clinical Outcome After Percutaneous Coronary Intervention
Isn‚Äôt it a little disappointing that, while many clinicians don‚Äôt even realize that homocysteine is an independent risk factor for cardiovascular disease, we have moved beyond acceptance to clinical outcomes. The fact that an intervention as simple, cheap and safe as specific vitamin supplementation lowering risk of CVD makes this a no-brainer from a clinician‚Äôs standpoint.
When the USDA came out with the Food Guide Pyramid in 1992, smart physicians and researchers predicted increases in heart disease, diabetes and cancer.
Guess what we saw?
Increases in heart disease, diabetes and cancer.¬† But why?¬†¬†Those of you old enough to remember the Pyramid will recall that fats and oils were at the top of the pyramid with the instructions to “use sparingly.”¬† Grains, with no guidance on whole grains versus refined, made up the base of the pyramid at 6-11 servings per day.
The problem is that fats and oils, the healthy ones, are an integral part of a healthy lifestyle.¬† But the Pyramid drove fats into the category of “fattening” in the eyes of the American public.¬† To this day, many people think that foods high in fat will make them fat.¬† This is just not true.
Now that I’ve gotten this out of the way, we need to move on to the meat of today’s article.
There have been some clear associations between healthy fats found in wild caught fish, nuts and olive oil and lowered rates of certain types of cancer as well as an adjunct to mainstream cancer treatment.¬† Some examples include:
- Using omega 3 fatty acids to improve cancer outcomes.
- Olive oil use lowers colorectal cancer risk.
- EPA kills off pancreatic cancer in the lab.
- Healthy fats protect skin cells from skin cancer.
There are many more, but I think you get the idea.
This particular article¬†is a review of the anti-cancer properties of omega-3 fatty acids.¬† Here’s what the authors point out:
- Epoxydocosapentaenoic acids (EDPs) are compounds made from the omega-3 DHA.
- EDPs block the compound VEGF (vascular endothelial growth factor).¬† VEGF stimulates the growth of new blood vessels that is so important for tumor growth.
- EDFs block another compound called fibroblast growth factor 2 that also makes new blood vessels.
- EDFs block¬†endothelial cell migration–another process needed to form new blood vessels.
- EDFs block the enzyme protease, which is needed for cancer cells to metastasize.
- In special cellular studies,¬†EDPs have been shown to cut primary tumor growth and metastasis by up to 70%
- Interestingly,¬†compounds derived from the omega-6 arachidonic acid increase angiogenesis and tumor progression.
The bottom line is that an increased intake of omega-3 fatty acids and monounsaturated fats combined with a decrease in animal-based saturated fats and omega-6 fatty acids is clearly have a role to play when it comes to cancer in our bodies.
Good sources of omega-3 fatty acids include:
- wild caught fish
- grass fed meats (NOT grain finished) and wild game
- nuts and seeds (flaxseed, chia, almonds, walnuts, pecans, etc…)
- veg-a-fed eggs
Good sources of monounsaturated fats include:
- olive oil (extra virgin, cold pressed is best)
Foods high in omega-6 and animal saturated fats to avoid:
- vegetable oils (corn, soybean, peanut, cottonseed, etc…)
- commercially grown meats
- dairy products
If your fridge is a little short on items on the first 2 lists above and loaded with the third list, it’s time for a purge.¬† Your future risk of cancer depends on it.
This is certainly not the first time I’ve written about the hazards of using anti-inflammatories at the first sign of a twinge.¬† But this one is going to take it from a different viewpoint.
I think we could all agree that the process of inflammation is a natural one.¬† After all, why would the human physiology have a process in place that is useless?¬† It wouldn’t.¬† Inflammation serves several purposes.¬† One key purpose would be the prevention and management of infections.¬† Your immune system (the system responsible for the inflammatory response) gears up to fight off an invader, and, should that invader break through, it will gear up an attack on that invader,¬†be it a virus, bacteria, yeast or even a tumor cell.¬† Another key purpose is the clearing out of damaged tissue and subsequent repair of the damaged region.
Each of these actions of the immune system needs balance and control:
- Too much protection against an invader and you get allergies and asthma.
- Too strong of a reaction against an invader and you could go into shock.
- Too strong of a response to an injury and¬†undamaged tissue gets taken out in the process.
But these are all on the upswing of the inflammatory response and¬†controlling this side of things is a good thing.¬† But can our society’s obsession with anti-inflammatories be affecting the natural history of this process?¬† You bet!
Consider inflammation as pushing a boulder uphill.¬† Once you get it over the top, the going’s easy from there.¬† Anti-inflammatories may, in the initial stages, make the hill smaller.¬† But the initial stages of inflammation are supposed to end–after a few days with an infection (hopefully) and within 24 hours with an injury (depending on severity of the injury).¬† We used to think that inflammation, once started, would resolve all on its own.¬† We now know this is not true.
The resolution of inflammation is not a passive process.¬† The body has to actively end inflammation.¬† And there are some critical factors needed for this process.
Namely, our old friends, DHA and EPA from fish oils.
Specifically, DHA and EPA are required to make a class of compounds referred to as Resolvins and Protectins (I know, but I didn’t come up with the creative names…).¬† If you’re a biochemistry nerd, you can read more about them in this particular review.
This begins to explain the many benefits we see from essential fatty acid supplementation on a long list of chronic disease.¬† More importantly, you can begin to lay out some “to do” things on your journey to control and resolve inflammation in your own body.¬† These include:
- Increasing your intake of healthy fats found in such foods as¬†wild caught fish, olive oils, raw nuts, seeds and avocados.
- Decreasing your intake of less healthy fats found in hydrogenated oils and vegetable oils.
- Avoiding anti-inflammatories.¬† With the exception of aspirin, which may help the process,¬†other anti-inflammatories actually slowed or stopped the ability of EPA and DHA to halt inflammation.
- If inflammation from an autioimmune disorder or chronic pain is a concern, consider supplementing UP TO 3 full grams of¬†omega-3 / day (this does NOT mean 3 capsules per day).
So, next time you think about curbing inflammation with drugs, shift your thinking.¬† Think about how you are going to RESOLVE your inflammation instead.
Maternal Vitamin Use and Reduced Risk of Neuroblastoma
Considering that many prenatal vitamins (preferably the non-pharmaceutical brands‚Ä¶) are high in folic acid, the results of this study are not surprising. Folic acid is essential for proper differentiation of many types of cells. Providing adequate levels of folic acid may help ensure that cells of the developing fetus are well differentiated (i.e. less likely to become tumors).
ROS in aspirin-induced gastric damage: protection by vitamin C
Chalk up another benefit for Vit C. I would rather see patients fix whatever it is that requires the use of aspirin; barring that, I would now recommend Vit C to help protect against the damage that aspirin will cause the stomach. I personally take at least 2 grams of Vit C (1000mg X 2).
Synergy : Alimentary Pharmacology & Therapeutics 15 (5), 677-687
Vit C Inhibits Endothelial Cell Apoptosis in Congestive Heart Failure
In case you hadn‚Äôt already, make sure you add Vit C to the list of nutrients essential in managing cardiovascular disease. Personally I take 2,000 mg per day, but there are many instances when I recommend dosages about this. And remember that Vit E and C have a synergistic effect when taken together.
Circulation ‚ÄĒ Abstracts: R√∂ssig et al. 104 (18): 2182
Interesting question and would likely generate a wide range of answers depending upon where in the life cycle you are. But an even more important question would be, what would you be willing to DO for 2.2 more years of life?
This answer requires action and not wealth.¬† Quitting smoking (or never starting).¬† Exercising.¬† Eating a diet without processed foods.¬† Cutting back on stress.¬† All changes that you can (and should) make that have a solid foundation of research for increasing longevity.
But many times it is not merely about quantity of life.¬† Quality becomes a much more important factor when it comes to life.¬† Who wants to live to 90 but spend 5 years infirm in a bed on oxygen, your life¬†little more than existing?
No one would opt for this end to his or her life, although I could argue that lifestyle is a conscious choice done during life that will lead to this end of life, essentially meaning that you DID choose this course.¬† But what if the choice was much easier than actually exercising?
Before we get into the longevity-inducing intervention highlighted here, I need to make something clear.
Pharmaceutical interventions are typically one-cause / one cure approaches.¬† That means that we use a statin to lower your risk of having a heart attack and hope for the best (which, as you are all aware of by now, this “best” is a 1% lower risk of having a heart attack with statin use).¬† And you can’t pile up 20 drugs to give you a 20% lower risk of having a heart attack.¬† Drugs just aren’t cumulative like that.
Lifestyle, on the other hand, IS cumulative.¬† Exercise CAN work with eating more whole grains, fruits and vegetables to dramatically lower your risk of a heart attack or death.¬† This is where the power of lifestyle comes in.
So, with this in mind, this particular study looked at how much of a difference healthy fats in the blood made on longevity in this large group of study participants.
To raise your blood levels of the healthy fats like omega-3 fatty acids, you can eat raw nuts, wild caught fish, use olive oil and more seeds.¬† Supplementation with fish oils is a good idea to augment what you get from your diet.
Here’s what the researchers found:
- Higher omega 3-PUFA led to a 27% lower risk of death from all causes.
- Specifically, EPA was 17% lower, 20% lower for DHA.
- The greatest protection was on heart deaths.
- Overall, those with the highest levels lived an average of 2.22 more years after age 65 years.
Given that good quality fish oils in our office run about $15 / month, 2.2 years would cost you $390.¬† Pretty economical, if you ask me…
So, would you pay $390 for 2.2 more years of life?
Vitamin Use May Weaken Flu Shot‚Äôs Efficacy in Elderly
It‚Äôs amazing that this one¬†hasn’t¬†been plastered all over the news. Once again, we need to take some things with a grain of salt. First, I am not a fan of the flu shot and would rather see a patient do other things to stimulate overall immune health against a wide variety of diseases, not just a shot in the dark at only a few.
This study gave certain patients a limited nutrient multivitamin prior to flu vaccination and checked them one month later. This abstract does not identify how the response was checked. The author suggests that these results may be from a lack of trace minerals such as zinc in the vitamin. Here‚Äôs my spin (and this is pure speculation..). The presence of additional factors (in this case the multi) helped to balance the immune response. Remember that the Th2 response is strengthened by vaccines and Th1 is strengthened by exposure to antigens. It is possible that the presence of certain nutrients at vaccination time averted a Th2 dominant state (which zinc has been shown to do), resulting in an overall more healthy patient.
Infect Dis Clin Pract 2001:10:81-85 Older individuals who take multivitamins may not gain full benefit from influenza vaccination, a team of military doctors has found. ‚ÄúPhysicians and patients should be cautious with multivitamin use,‚ÄĚ says principal investigator Dr. Peter T. Ender, of the Wright-Patterson Air Force Base Medical Center near Dayton, Ohio. ‚ÄúDepending on the combination, they may have harmful rather than beneficial effects.‚ÄĚ Among 79 adults age 65 and older, those who took a daily multivitamin for 100 days before flu vaccination showed a poorer immune response 1 month after vaccination compared with those who took placebo. The findings are published in Infectious Diseases in Clinical Practice. One possible reason for the poor response in multivitamin users, Dr. Ender said, is that the supplement used in this study included vitamins A, B, C, D, E, as well as thiamine, riboflavin, niacin, folate and pantothenic acid, but no trace elements such as zinc. Other recent studies have suggested that multivitamins containing those trace elements do have beneficial effects on the body‚Äôs immune response. Dr. Ender concluded, ‚ÄúI would caution people [from] thinking that ‚ÄėA vitamin can do no harm, so why not take them?‚Äô ‚ÄĚ