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Feature

22 June 2016 0 Comments

blood test used to determine whether a heart is suitable for donation may be leading to unnecessary rejections, and its use should be reviewed. This is the conclusion of a new study published in the journal Circulation: Heart Failure.

Heart failure occurs when the heart is unable to pump enough oxygen-rich blood around the body to help other organs function.

According to the Centers for Disease Control and Prevention (CDC), in the United States, around 5.7 million Americans have heart failure.

In some cases, heart failure can be treated with lifestyle changes - such as a healthy diet, exercise, and quitting smoking - and medications. For end-stage heart failure, however, a heart transplant may be the only option.

According to the United Network for Organ Sharing (UNOS), as of June 10, 2016, there are 4,147 people in the U.S. waiting for a heart transplant.

However, according to Dr. Snehal R. Patel, assistant professor of medicine at Albert Einstein College of Medicine's Montefiore Medical Center in New York, NY, more than half of these patients will not receive a transplant.

"A lot of focus has been on finding ways to sign up more people as organ donors, but there is also a problem in that only an average of 1 in 3 donor hearts are placed," he adds.

In many heart transplant centers, the blood of potential donors is routinely tested for levels of troponin I - a protein that is released in response to heart damage.

Dr. Patel explains that if troponin I levels are high, then a donor heart will often be rejected out of concern that the organ is too damaged to function following transplantation - regardless of whether the heart appears healthy.

Donor troponin I levels do not affect recipient survival

For their study, the researchers assessed the outcomes of 10,943 heart transplant recipients aged 18 and older using data from UNOS. All donor hearts had normal pumping function, the authors note.

The team set out to determine whether there are any differences in outcomes for patients who received a heart from a donor with high troponin I levels.

At 30 days, 1 year, 3 years, and 5 years after heart transplantation, the researchers found no significant differences in survival between recipients whose donors had high troponin I levels and those whose levels were normal.

There was also no association between donor troponin I levels and risk of recipient death 1 year after transplantation, the researchers report.

Additionally, donor troponin I levels made no difference to recipients' incidence of primary graft failure - loss of pumping action that occurs within 30 days of transplantation - and cardiac allograft vasculopathy - a form of heart disease that can limit long-term survival following heart transplantation.

Based on their findings, Dr. Patel and colleagues believe heart transplant centers should make decisions about whether a heart is suitable for transplantation based exclusively on donor troponin I levels.

Feature

11 April 2016 0 Comments

 

 

 

Observational studies have linked lower omega-3 (n-3) polyunsaturated fatty acids (PUFAs) and higher omega-6 (n-6) PUFAs with inflammation and depression, but randomized controlled trial (RCT) data have been mixed. To determine whether n-3 decreases proinflammatory cytokine production and depressive and anxiety symptoms in healthy young adults, this parallel group, placebo-controlled, double-blind 12-week RCT compared n-3 supplementation with placebo. The participants, 68 medical students, provided serial blood samples during lower-stress periods as well as on days before an exam. The students received either n-3 (2.5g/d, 2085mg eicosapentaenoic acid and 348mg docosahexanoic acid) or placebo capsules that mirrored the proportions of fatty acids in the typical American diet. Compared to controls, those students who received n-3 showed a 14% decrease in lipopolysaccharide (LPS) stimulated interleukin 6 (IL-6) production and a 20% reduction in anxiety symptoms, without significant change in depressive symptoms. Individuals differ in absorption and metabolism of n-3 PUFA supplements, as well as in adherence; accordingly, planned secondary analyses that used the plasma n-6:n-3 ratio in place of treatment group showed that decreasing n-6:n-3 ratios led to lower anxiety and reductions in stimulated IL-6 and tumor necrosis factor alpha (TNF-α) production, as well as marginal differences in serum TNF-α. These data suggest that n-3 supplementation can reduce inflammation and anxiety even among healthy young adults. The reduction in anxiety symptoms associated with n-3 supplementation provides the first evidence that n-3 may have potential anxiolytic benefits for individuals without an anxiety disorder diagnosis. ClinicalTrials.gov identifier: NCT00519779.

 

 

 

Feature

03 February 2016 0 Comments

 

 

 

Study coauthor Shelly Gray, of the School of Pharmacy at the University of Washington, and colleagues publish their findings inThe BMJ.

Benzodiazepines are a class of drugs that increase the level of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain, producing sedative, anti-convulsant, anti-anxiety, hypnotic and muscle relaxant effects.

Benzodiazepines are most commonly used to treat anxiety andinsomnia, though they are used for a number of other conditions, including alcohol withdrawal, panic disorders and seizures. Common types of benzodiazepines include diazepam, alprazolam and flurazepam.

In the US, benzodiazepine use is highest among older individuals; a 2014 study from the National Institutes of Health (NIH) found that around 8.7% of adults aged 65-80 received a benzodiazepine prescription in 2008, compared with 2.6% of those aged 18-35.

Numerous studies, however, have associated benzodiazepine use in seniors with increased risk of dementia. A 2012 study reported by Medical News Today, for example, suggested adults aged 65 and older are 50% more likely to develop dementia within 15 years of using benzodiazepines, while a more recent study suggested benzodiazepine use for at least 3 months increases older adults' risk of Alzheimer's disease by 51%.

However, Gray and colleagues note that research assessing benzodiazepine use in older adults has been conflicting, with some studies finding no link with dementia.

"Given the enormous public health implications, we need a better understanding of the potential cognitive risks of cumulative benzodiazepine use," say the authors.

No dementia link, but seniors should still avoid benzodiazepines

With this in mind, the team set out to determine whether higher cumulative use of benzodiazepines among older adults is associated with increased risk of dementia or faster cognitive decline.

To do so, the researchers analyzed the data of 3,434 adults aged 65 and older who were part of the Adult Changes in Thought study, conducted within Group Health - a non-profit health care system in Seattle, WA.

All participants were free of dementia at study baseline, and cognitive screening was conducted at enrollment and every 2 years thereafter. Subjects were followed-up for an average of 7 years.

Pharmacy data from Group Health was analyzed to assess participants' daily use of benzodiazepines over a 10-year period.

During follow-up, 797 of the participants developed dementia. Of these, 637 developed Alzheimer's disease. The median level of benzodiazepine use among participants was the equivalent to 1 year of daily use.

The researchers found that subjects with the highest benzodiazepine use were at no higher risk for dementia or Alzheimer's than those with lower benzodiazepine use, nor did they experience faster cognitive decline.

While the researchers did identify a small increased risk of dementia among participants with low or moderate benzodiazepine use - the equivalent of up to 1 month of use or 1-4 months use, respectively - they suggest this may "represent treatment of prodromal symptoms" of dementia.

"It is also possible that people with prodromal dementia, even years before diagnosis, could be more sensitive to benzodiazepine induced acute cognitive adverse events (for example, delirium), resulting in discontinuation of the drug and avoidance, in turn leading to low levels of use," they add.

Commenting on their findings, the researchers say:

"Overall, our pattern of findings does not support the theory that cumulative benzodiazepine use at the levels observed in our population is causally related to an increased risk for dementia or cognitive decline."

Still, the team says that considering the other adverse effects associated with benzodiazepine use and the fact that evidence remains mixed as to whether the drugs may raise the risk for dementia, health care providers "are still advised to avoid benzodiazepines in older adults to prevent important adverse health outcomes, withdrawal and dependence."

 

 

 

Feature

12 June 2016 0 Comments

The National Myelodysplastic Syndromes Natural History Study (The National MDS Study) is underway, the ECOG-ACRIN Cancer Research Group and its collaborators announced today. This new study, funded by the National Institutes of Health's National Heart, Lung, and Blood Institute (NHLBI), and performed in collaboration with the National Cancer Institute (NCI), will collect detailed information and biological samples from 2000 adults with myelodysplastic syndromes (MDS) and 500 more patients receiving care for a persistent low red blood cell count (anemia) that cannot be explained. Its purpose is to build a national resource to be used by scientists in future research.

A third group will be formed as a comparison cohort by selecting 1000 patients who will be screened in the study because of symptoms of MDS, but who will be found to not actually have one of the blood disorders. In total, the study will enroll up to 3500 patients, making it the largest-ever prospective study of MDS in the U.S.

It is hoped that this national resource will help researchers to identify the causes and genetic makeup of these serious and sometimes fatal diseases. Other research could lead to new and better ways to diagnosis and treat these conditions.

MDS occur when the blood-forming cells in the bone marrow are damaged and have problems making new blood cells. Considered a type of cancer, these abnormal blood cells fail to grow properly and die sooner than normal cells, leaving affected individuals with low blood counts and a shorter lifespan. Treatment options depend on the disease severity at diagnosis and are limited in their effectiveness.

About 30,000 people every year develop MDS, which occur mostly in adults over 60 years of age and more often in men than women. Common symptoms of MDS include fatigue, unusual bleeding, bruises, and tiny red marks under the skin, paleness, and shortness of breath.

Many people with MDS develop a serious or life-threatening anemia. About one-third of people with MDS develop acute myeloid leukemia, an aggressive blood cancer.

There are many questions about the causes of MDS and what patients can expect during the course of the disease. Unfortunately, MDS lacks a large collection of patient-related disease information and human tissue samples, such as diseased blood and bone marrow samples, which provide the opportunity for scientific research and breakthroughs. Such resources are already in place for other more common diseases, but not yet for MDS.

This study requires the participation of a large network of physicians who support medical research and who examine people experiencing the symptoms of MDS. A number of organizations are collaborating on this effort. For patient recruitment, which is expected to take five to seven years, the NCI is contributing access to its two large cancer research networks, the NCI National Clinical Trials Network (NCTN) and the NCI Community Oncology Research Program (NCORP).

Physicians may enroll their patients in this study if they and their hospital, practice, or cancer center are a member of any cancer research group that belongs to either NCI network. These groups are the Alliance for Clinical Trials in Oncology, ECOG-ACRIN Cancer Research Group, NRG Oncology, and SWOG.

ECOG-ACRIN Cancer Research Group, which is leading the study, has added The National MDS Study to its portfolio of active clinical trials in leukemia, thus streamlining its implementation at clinical centers nationwide.

Patients' blood, bone marrow, and other body tissues will be processed and stored at a central laboratory and biorepository at the Moffitt Cancer Center and its M2Gen subsidiary in Tampa, Fla. Patient information and data from patient samples will be linked and stored centrally at a data coordinating center, under the supervision of The Emmes Corporation, which is coordinating the trial.

At the end of this study, the collected data and specimens will be transferred to the NHLBI and will be available to scientists throughout the country for their own research studies. In this way, The National MDS Study will enable scientists to answer questions about MDS that up to this point have been impractical to study at a single institution or even among small groups of researchers.

Feature

12 March 2016 0 Comments

WEDNESDAY, March 2, 2016 (HealthDay News) -- Prostate cancer may be more aggressive in men who are deficient in vitamin D, new research suggests.

A study of nearly 200 men having their prostate removed found those with low vitamin D levels were more likely to have rapidly growing tumors than those with normal levels of the "sunshine" vitamin.

"If men with vitamin D deficiency are more likely to have [more advanced disease] at the time of prostate surgery, then perhaps men should be tested for this when they are diagnosed with prostate cancer and subsequently supplemented with vitamin D if they are deficient," said researcher Dr. Adam Murphy. He is an assistant professor of urology at Northwestern University in Chicago.

However, another expert isn't ready to go that far.

This study can't prove that vitamin D deficiency causes aggressive prostate cancer, only that the two are associated, said Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston.

But D'Amico thinks the results are important enough to spur further study into the possible connection between vitamin D and prostate cancer. "It's a hypothesis that's worth testing," he said.

For now, though, D'Amico doesn't think enough evidence exists to recommend vitamin D supplements to prevent prostate cancer or make it less aggressive.

Murphy said he has been exploring the link between prostate cancer and vitamin D for some time. He said racial distinctions were noted in this study, too, with black men having more aggressive tumors and lower vitamin D levels than white men.

These findings suggest that one reason black men have higher odds of developing -- and dying of -- prostate cancer is because of their "higher propensity for having vitamin D deficiency from the sun-blocking effects of melanin and perhaps dietary intake differences," Murphy said. The study could not prove this, however.

The human body gets vitamin D from certain foods. These include fortified products (such as milk, orange juice and cereal), and certain fish (such as salmon), according to the U.S. National Institutes of Health. The body also makes the vitamin when the skin is exposed to sunlight. Dark-skinned people have more melanin, which prevents burning.

Murphy said men with dark skin, low vitamin D intake or low sun exposure should be tested for vitamin D deficiency when diagnosed with prostate cancer or elevated PSA (prostate specific antigen), which is associated with the cancer. He believes supplementation is warranted for those with low vitamin D levels.

The study included 190 men having prostate surgery. The researchers found that nearly 46 percent of the men had aggressive cancer, and these men had vitamin D levels about 16 percent lower than men with slower-growing tumors.

After accounting for age, PSA levels and abnormal rectal exams, Murphy and his colleagues found that vitamin D levels below 30 nanograms per milliliter (ng/mL) of blood were linked to higher odds of aggressive prostate cancer.

Feature

03 February 2016 0 Comments

 

 

 

The systematic review and meta-analysis is published in the journal Alimentary Pharmacology & Therapeutics.

The researchers - from the University of Southampton in the UK - pooled and analyzed data from nine long-term studies covering nearly half a million men and women from six countries.

They found that increasing coffee consumption may substantially reduce the risk of liver cirrhosis.

The analysis shows a dose-response relationship between coffee consumption and liver cirrhosis - with more cups per day linked to lower risk.

Two extra cups of coffee per day were linked to a 44% lower risk of developing liver cirrhosis and a nearly 50% lower risk of death to the disease.

Liver cirrhosis can be fatal because it raises the risk of liver failure and cancer.

The condition develops when healthy tissue in the liver is replaced by scarred tissue, often as a result of long-term and persistent injury from viruses like hepatitis C and toxins like alcohol.

Liver cirrhosis is an important public health concern and a significant cause of disease and death in the US. The prevalence is likely to be higher than official figures suggest because many cases are undiagnosed.

A recent estimate suggests around 0.27% of Americans - some 633,323 adults - have liver cirrhosis, with 69% unaware of the fact they have the disease.

Effect is 'larger than that of statins on reducing cardiovascular risk'
In their paper, where they discuss the results, the authors explain that coffee has many biologically active ingredients, in addition to caffeine. These include "oxidative and anti-inflammatory agents, such as chlorogenic acid, kahweol and cafestol," and there is evidence, they note, that these may "confer protection against liver fibrosis."

In addition to a direct biochemical effect, there could also be an indirect effect of coffee protecting against cirrhosis, suggest the researchers. For example, they cite lab studies that show various compounds found in coffee block hepatitis B and C viruses and studies that show links between increased coffee consumption and reduction in type 2 diabetes.

The paper concludes that the analysis shows the link between increased daily coffee consumption and reduction in risk of liver cirrhosis is large - larger than that of many medications used for the prevention of disease.

"For example," note the authors, "statin therapy reduces the risk of cardiovascular disease by 25%."

They also point out that "unlike many medications, coffee is generally well tolerated and has an excellent safety profile."

Lead and corresponding author Dr. O. J. Kennedy, of Southampton's Faculty of Medicine, concludes:

"Coffee appeared to protect against cirrhosis. This could be an important finding for patients at risk of cirrhosis to help to improve their health outcomes. However, we now need robust clinical trials to investigate the wider benefits and harms of coffee so that doctors can make specific recommendations to patients."

In November 2015, Medical News Today learned how chronic liver disease and cirrhosis are among the reasons death rates are increasing among middle-aged white Americans.

Our Knowledge Center article - "Coffee: health benefits, nutritional information" - looks at some of the other ways the popular beverage may benefit our health, as well as the risks associated with it.

 

 

 

Feature

12 June 2016 0 Comments

Vitamin B1 is a vital human nutrient that belongs to the Vitamin B complex. It plays an important role in maintaining a healthy nervous system and improving the cardiovascular functioning of the body.

Vitamin B1 is one of the eight water-soluble vitamins in the B complex family. It helps in the conversion of carbohydrates into glucose, which in turn is used to produce energy for carrying out various bodily functions. Vitamin B1 is also required for the breakdown of fats and protein.

In addition to these health benefits, it maintain the muscle tone along the walls of the digestive tract and promotes the health of the nervous system, skin, hair, eyes, mouth, and liver. It also improves the body’s ability to withstand stress and is often called the “anti-stress” vitamin.

Important Sources of Vitamin B1

 

Some of the early symptoms of deficiency might include lethargy, irritability, loss of memory, loss of sleep or appetite, weight loss, indigestion or constipation, and calf muscle tenderness. If left untreated these initial symptoms might lead to a more severe form of thiamin deficiency, known as beriberi. This condition is characterized by nerve, heart, and brain abnormalities, but the symptoms might vary in every person and depends on a number of factors. Some more examples are explained below.

Dry Beriberi: This condition might involve nerve and muscle abnormalities, a prickling sensation in the toes, a burning sensation in the feet at night, leg cramps and muscle atrophy.

Wet Beriberi: Common symptoms might include abnormally fast heart beat, fluid retention in the legs, pulmonary edema, and hypotension, which might result in shock and even death.

CerealBrain Abnormalities: In alcoholics, thiamin deficiency might result in brain abnormalities such as Wernicke-Korsakoff syndrome. Some of its common symptoms include haziness, involuntary eye movements, difficulty in walking and partial paralysis of the eyes among other debilitating symptoms. If ignored, these symptoms could become fatal. Some of the common symptoms of Korsakoff’s psychosis include loss of memory, incoherence and confabulation.

Infantile Beriberi: This variety is commonly seen in newborn children of women already suffering from thiamin deficiency who contract this condition from the mother’s milk. Heart failure, loss of reflexes and aphonia are some of the common symptoms, so be sure to have sufficient levels of vitamin B1 if you are pregnant.

Feature

08 March 2016 0 Comments

Adult stem cells provide the body with a reservoir from which damaged or used up tissues can be replenished. In organs like the intestines and skin, which need constant rejuvenating, these stem cells are dividing frequently. But in other body structures, including the hair follicles, they are held in a quiescent state--one in which they don't reproduce until they receive signals from their surroundings that it's time to regenerate.

It makes intuitive sense that stem cells, being such a valuable resource, would be used sparingly. Yet scientists have limited understanding of how their quiescence is regulated, and are even unsure of its precise biological function. In a study published recently in PNAS, Elaine Fuchs, Rebecca C. Lancefield Professor and head of the Robin Chemers Neustein Laboratory of Mammalian Cell Biology and Development, and Kenneth Lay, a graduate student in her lab, report on new insights into the biological signals that make hair follicle stem cells oscillate between states of quiescence and regenerative activity.

"In an earlier study, my lab showed that when mice age, the old fat in their skin produces higher levels of a secreted signal, called BMP," Fuchs says. "This signal acts as a molecular brake on the hair follicle stem cells, causing them to spend much longer times in quiescence."

In the present study, Lay identified a stem cell gene that is activated by BMP signaling, and showed that when this gene is missing, the stem cells grow hairs with dramatically shorter intervals. "We thought initially that the key to hair growth might be the fountain of youth," Fuchs says, "but the mice's hair coat surprisingly thinned and greyed precociously."

More growth and fewer bulges

Usually the stem cells then create a new bulge along with the new hair, while ensuring that the old bulge and the old hair stay put in the hair follicle. Only the new bulge can make another new hair, but the old bulge is kept in place to maintain a thick and lush coat. In mice, hair follicles can accumulate up to four of these bulges.

When Lay and Fuchs created mice that lack FOXC1--by disabling or "knocking out" the gene that produces this protein--they observed that the animals' hair follicle stem cells spent more time growing hairs and less time in quiescence. Over the course of nine months, while hair follicles from normal mice grew four new hairs, those from the FOXC1 knockout mice had already made new hairs seven times. "The knockout stem cells enter an overactive state in which they can't establish quiescence adequately," explains Lay.

The researchers also found that in the absence of FOXC1, hair follicles always had only one hair despite having made new hairs seven times. This is because these hair follicles could not retain their old bulges, though they generated a new bulge without a problem. As the stem cells started proliferating more, they became less able to stick together. As a result, their old bulges did not stay properly tethered to the hair follicle when the newly growing hair pushed past it. And since the bulge emits quiescence signals, its loss activated the remaining stem cells even faster.

Going grey and going bald

While the hair follicle stem cells of FOXC1-deficient mice produce hairs at a relatively breakneck pace, this profligate growth seems to wear them out. Older knockout mice had sparser, greyer coats, and they could not regenerate their fur as quickly as their normal age-matched or younger peers. A similar phenomenon has been described in mouse hematopoietic stem cells, which give rise to blood cells--those stem cells that are more active in young animals appear to become exhausted as the animals grow older.

"Hair follicle stem cells influence the behavior of melanocyte stem cells, which co-inhabit the bulge niche," explains Fuchs. "Thus, when the numbers of hair follicle stem cells declined with age, so too did the numbers of melanocyte stem cells, resulting in premature greying of whatever hairs were left." Not much is known about naturally occurring hair loss with age, but these balding knockout mice may provide a model to study it.

Feature

24 January 2016 0 Comments

According to many media reports, a recent study in JAMA Oncology found that omega-3 fatty acids can reduce the effectiveness of cancer treatment.

"Cancer patients who eat herring and mackerel or take omega-3 supplements may end up resistant to chemotherapy, a study has warned," writes the Daily Mail.

The same stories have reported the researchers' recommendation that people undergoing chemotherapy refrain from eating oily fish or taking fish oil or omega-3 supplements on the day of their treatment.

But the study in question found no such thing, while other studies have actually suggested that omega-3s might reduce the side effects of cancer drugs while increasing their effectiveness.

Study didn't even look at cancer patients

The researchers in the JAMA Oncology study actually did two separate experiments. In one, they asked 118 cancer patients whether they regularly took any supplements, and found that 11 percent took omega-3s. In a separate study, the researchers measured omega-3 levels in people without cancer.

Unsurprisingly, blood levels of omega-3s increased after taking a 10 mL supplement, and increased more after taking 50 mL. These levels returned to normal within eight hours. The study also found that when participants ate 100 grams of herring or mackerel - oily fish known to be high in omega-3s - their omega-3 blood levels increased more than when they ate tuna, which is lower in omega-3s. Omega-3 levels also increased after a meal of salmon, but returned to normal more quickly. The implications of this are unclear, since omega-3s may need to disappear from the blood to be taken up by the cells that need them.

Why should these findings cause alarm? The researchers said that according to some mouse studies, omega-3s might make cancer cells resistant to chemo drugs. Therefore, said researcher Emile Voest, "Our findings ... raise concern about the simultaneous use of chemotherapy and fish oil. ... We advise patients to temporarily avoid fish oil from the day before chemotherapy until the day thereafter.'

Some media outlets misreported this recommendation as one to also avoid fish oil on the day before and the day after treatment - even though the study showed blood levels returning to normal within eight hours.

Evidence suggests the opposite

Cancer and nutrition experts expressed skepticism that new recommendations should be made based on a study that didn't even look at cancer drug effectiveness.

"This work shows that in healthy human volunteers, taking various fish oil supplements unsurprisingly raises the level of a particular unsaturated fatty acid in the blood," said Keith Jones of the Institute of Cancer Research.

"This is a very preliminary study that takes a measurement in healthy human subjects, and one in a mouse model of cancer, and extrapolates both to human cancer patients," he said. "Further studies are needed before clear advice should be given to patients - and these would need to include a correlation between blood levels of the fatty acid in mice treated and the effect on the anti-cancer drug to demonstrate a clear link.

"There is no evidence that mice metabolize this fatty acid in the same way as humans, and particularly cancer patients."

Other studies have had very different findings, said dietitian Catherine Collins of St. George's Hospital NHS Trust.

"Other studies on fish oil and cancer drugs have shown different effects, so it's possible that the type of cancer and the anti-cancer treatment may be affected differently by the amount and type of fish oil consumed," she said.

For example, a 2014 study in the Journal of Clinical Oncology found that an omega-3 supplement significantly reduced the incidence of nerve disorders caused by the chemo drug paclitaxel. Other studies have suggested that omega-3s reduce chemo side effects, increase chemo effectiveness and reduce the rate of cancer growth, potentially lengthening and improving life in cancer patients.

Feature

16 May 2016 0 Comments

Dr. Norelle Reilly, of the Division of Pediatric Gastroenterology and the Celiac Disease Center at Columbia University Medical Center in New York, NY, has been looking into some issues relating to the gluten-free diet (GFD).

Her commentary is published in The Journal of Pediatrics.

Celiac disease (CD) is an autoimmune disease. A person who has CD cannot eat gluten, a protein found in wheat, rye, and barley.

Doing so can have serious consequences, as it can trigger an immune response that may damage the small intestine or other parts of the digestive system. Irritability and depression are common symptoms.

CD is a genetic condition, and the only treatment is to avoid gluten.

In 2015, around 0.5 percent of Americans were following a strict GFD, 25 percent reported consuming gluten-free foods, and between 15-21 percent rated "gluten-free" as "very important" when buying food.

In contrast, a market survey in 2013 indicated that 31 percent of Americans considered the diet "a fad." By 2015, 47 percent shared this view.

What is a gluten-free diet?

People who have to avoid gluten cannot eat anything containing wheat, barley, or rye flour, and some cannot eat oats.

They must avoid bread, pasta, cakes, cookies, or crackers, and should consume no sauces or gravies thickened with flour, among other items. Alternatively, they can choose gluten-free (GF) versions.

Gluten occurs in some unexpected items, such as luncheon meat, soy sauce, and rice mixes, in some flavorings and preservatives, and in certain medications. A person with CD must check the labels carefully.

Safe foods include meat, fish, fruit, vegetables, rice, potatoes, lentils, and natural seeds and nuts. Specially prepared breads, cakes, cookies, and ready meals are now widely available.

Why go gluten-free?

In 2015, a survey asked 1,500 Americans why they had chosen to "go gluten-free."

Results showed that 35 percent had "no reason" for doing so, 26 percent said it was a "healthier option," and 19 percent wanted to improve their "digestive health." Ten percent had someone in the family with a gluten sensitivity, and 8 percent had a gluten sensitivity.

According to Dr. Reilly, "Out of concern for their children's health, parents sometimes place their children on a gluten-free diet in the belief that it relieves symptoms, can prevent CD, or is a healthy alternative without prior testing for CD or consultation with a dietitian."

She calls for clearer information about the GFD because of "frequent misunderstanding" about gluten.

Misconceptions about the GFD

Dr. Reilly raises a number of issues and misconceptions about avoiding gluten.

One is that it offers a healthy lifestyle choice with no disadvantages.

In fact, Dr. Reilly points out, there is no proven benefit of avoiding gluten, unless a person has CD or a wheat allergy.

She adds that avoiding gluten could mean a higher fat and calorie intake, because packaged GF goods often contain more fat and sugar than their conventional counterparts, potentially contributing to obesity and prediabetes.

Avoiding gluten can also lead to nutritional deficiencies, especially of the B vitamins, folate, and iron, because GF products often lack fortification.

A further belief is that gluten is toxic, but Dr. Reilly notes that no evidence supports this theory. In fact, over-dependence on rice, she suggests, could mean an increased intake of arsenic, which rice has a tendency to absorb.

Some people have a close relative with CD, and they avoid gluten through fear of developing it themselves. Dr. Reilly points out that healthy relatives of people with CD do not need to avoid gluten, and nor do healthy infants who are at risk of developing CD.

What if the GFD is necessary?

A few people will be healthier and have a better quality of life with a GFD, says Dr. Reilly, but they need guidance from an experienced, registered dietitian.

She points out that CD is not the only reason to avoid gluten. Doing so can help relieve symptoms in people with a wheat sensitivity or wheat allergy.

However, there is no scientific evidence that avoiding gluten is better for a child with no confirmed diagnosis of CD or wheat allergy, and doing so could obscure a diagnosis of CD.

A GFD can add to the family budget, as GF products tend to be more costly. Inconvenience and social isolation have been reported by children, says the commentary.

In this sense, a GFD could mean a lower quality of life, potentially posing more risk than benefit.

Feature

29 February 2016 0 Comments

 

 

 

Study coauthor Dr. Nancy Turner, of the Department of Nutrition and Food Science at Texas A&M University, and colleagues say their findings may have important implications for individuals heavily exposed to ionizing radiation.

These include cancer patients undergoing radiotherapy, astronauts, radiation workers and victims of nuclear accidents.

"Bone loss caused by ionizing radiation is a potential health concern for those in occupations or in situations that expose them to radiation," Dr. Turner explains.

"The changes in remodeling activity caused by exposure to radiation can lead to impaired skeletal integrity and fragility both in animals and human radiotherapy patients."

In humans, bone loss can lead to osteoporosis - a disease in which the bones become more brittle, fragile and more vulnerable to breakage. It is estimated that osteoporosis is responsible for more than 8.9 million fractures worldwide each year.

For the study, the researchers set out to investigate a number of strategies that they believed could tackle the underlying mechanisms that contribute to ionizing radiation-related bone damage, such as radiation-induced oxidative stress.

Dried plums reduced gene expression linked to bone breakdown
The team tested a number of different antioxidant and anti-inflammatory interventions on mice that were exposed to ionizing radiation, assessing the effects the interventions had on the expression of genes linked to the breakdown of bone, as well as their effects on bone loss.

The interventions included a cocktail consisting of five different antioxidants (ascorbic acid, N-acetyl cysteine, L-selenomethionine, dihydrolipoic acid and vitamin E), dihydrolipoic acid, ibuprofen and dried plum.

The team found that dried plum was most effective for reducing expression of the genes Nfe2l2, Rankl, Mcp1, Opg and TNF-α, which are related to the breakdown of bone. Dried plum was also most effective for preventing later bone loss induced by ionizing radiation.

While the researchers are unable to explain the exact reasons why dried plums appear to protect bones from damage caused by ionizing radiation, they note that the fruit contains a number of polyphenols - including gallic acid, caffeoyl-quinic acids, coumaric acid and rutin - that have antioxidant and anti-inflammatory properties.

"Dried plums contain biologically active components that may provide effective interventions for loss of structural integrity caused by radiotherapy or unavoidable exposure to space radiation incurred over long-duration spaceflight," says Dr. Turner, adding:

 

 

 

Feature

13 January 2016 0 Comments

 

 

 


Taking a class of drugs commonly used to reduce acid in the stomach is linked to a higher risk of developing chronic kidney disease, compared with not taking them.
Stomach and esophagus
Over 15 million Americans used prescription PPIs - drugs that reduce stomach acid - in 2013, at a cost of over $10 billion.

This was the finding of a new study led by the Johns Hopkins University in Baltimore, MD, and published in JAMA Internal Medicine.

However, the authors also point out that finding a link between use of proton pump inhibitors (PPIs) and chronic kidney disease does not prove the drugs actually cause the disease - that is for further studies to establish.

It could be, they suggest, that the participants who were prescribed PPIs may have been at higher risk of chronic kidney disease for reasons unrelated to their PPI use.

However, the researchers also note that previous studies have linked use of PPIs to a form of kidney inflammation called acute interstitial nephritis.

PPIs are among the most commonly used drugs worldwide. They are used to relieve symptoms of acid reflux and gastroesophageal reflux disease (GERD). They are also prescribed for treating peptic or stomach ulcers and damage to the lower esophagus caused by acid reflux.

PPIs work by reducing the amount of stomach acid made by cells in the lining of the stomach. They are not the same as antacids, which work by neutralizing excess acid after it has entered the stomach.

There are many types and brands of PPI; examples include omeprazole (brand name Prilosec, also available without a prescription), esomeprazole (Nexium) and lansoprazole (Prevacid). The side effects vary from drug to drug.

In an accompanying editorial article - where they summarize recent evidence on the adverse effects of taking PPIs - Drs. Adam Jacob Schoenfeld and Deborah Grad, of the University of California-San Francisco, note that:

"A large number of patients are taking PPIs for no clear reason - often remote symptoms of dyspepsia or 'heartburn' that have since resolved."
10-year risk of kidney disease higher for PPI users

For their study, the Johns Hopkins researchers and their colleagues first analyzed data on 10,482 participants followed up for a median of nearly 14 years in the Atherosclerosis Risk in Communities (ARIC) study.

Fast facts about acid reflux

    Acid reflux, or gastroesophageal reflux (GER), happens when stomach contents come back up into the esophagus
    It is felt as heartburn when stomach acid touches the lining of the esophagus
    A more serious, persistent form - gastroesophageal reflux disease (GERD) - affects about 20% of the US population.



They then replicated the results in a bigger cohort of 248,751 participants followed up for a median of 6 years - these participants were members of the Geisinger Health System in Pennsylvania.

They found that at the beginning of the monitoring period, PPI users in both groups were more likely to have a higher body mass index (BMI) and to be taking aspirin, statins or drugs to control high blood pressure.

In the ARIC group, 56 of 332 participants using PPIs developed chronic kidney disease, compared with 1,382 of 10,160 non-users. These figures translate to 14.2 and 10.7 per 1,000-person years, respectively. Participants were classed as a PPI user if they were taking the drugs at the start of the follow-up.

Further analysis of these ARIC figures revealed that the 10-year absolute risk of developing chronic kidney disease in the PPI users was 11.8%, compared with 8.5% if they had not used PPIs.

When they repeated this same analysis in the Geisinger cohort, the researchers found 1,921 of 16,900 PPI users and 28,226 of 231,851 of non-users developed chronic kidney disease, which translates to 20.1 and 18.3 per 1,000 person-years, respectively.

Again, further analysis of the larger cohort showed PPI use was associated with higher risk of disease. The 10-year absolute risk of developing chronic kidney disease among the PPI users was 15.6%, compared with 13.9% had they not used the drugs.

Commenting on their own findings, the authors emphasize the point that their study "is observational and does not provide evidence of causality," but should the link between PPI use and chronic kidney disease prove to be causal, then it could have important implications for public health, given the widespread use of the drugs.

Over 15 million Americans used prescription PPIs in 2013 at a cost of over $10 billion, they note, and conclude:

    "Study findings suggest that up to 70% of these prescriptions are without indication and that 25% of long-term PPI users could discontinue therapy without developing symptoms. Indeed, there are already calls for the reduction of unnecessary use of PPIs."

In 2010, Medical News Today reported how a study by researchers from Seoul National University Hospital in South Korea, published in the Canadian Medical Association Journal, also found that use of PPIs and another class of acid reflux drug called histamine2 receptor antagonists may be linked to higher risk of pneumonia.

 

 

 

Feature

13 April 2016 0 Comments

Recent years have brought more attention to the role of carbohydrates in our diets and the differences between healthy and unhealthy carbs, most often in the context of weight control. A new study highlights one more reason to avoid sugary beverages, processed foods and other energy-dense carbohydrate-containing foods—cutting them may help reduce your risk of cancer.

In the new study, regular consumption of sugary beverages was associated with a 3 times greater risk of prostate cancer and higher intake of processed lunch foods such as pizza, burgers and meat sandwiches doubled prostate cancer risk. By contrast, healthy carbohydrate-containing foods like legumes, non-starchy vegetables, fruits and whole grains were collectively associated with a 67 percent lower risk for breast cancer.

"One of the most important findings here is that the type of carbohydrate-containing foods you consume can impact your cancer risk," said Nour Makarem, a Ph.D. student at New York University and the study's lead author. "It appears that healthy carbohydrate sources, such as legumes, tend to protect us from cancer, but non-healthy ones, such as fast foods and sugary beverages, seem to increase the risk of these cancers."

Makarem will present the research at the American Society for Nutrition Scientific Sessions and Annual Meeting during Experimental Biology 2016.

The study is based on the health records of 3,100 volunteers tracked since the early 1970s. Researchers began tracking participants' diets through detailed food frequency questionnaires starting in 1991. For the new study, Makarem and her colleagues categorized all of the study participants' food sources by glycemic index—a measure of dietary carbohydrate quality based on an item's relative impact on blood sugar levels as compared to a reference food—and glycemic load, a measure of both the quantity and quality of carbohydrates in a given food item. They then analyzed the results in relation to volunteers' cancer rates.

After taking into account multiple cancer risk factors, the study found that eating foods with a higher glycemic load was associated with an 88 percent higher prostate cancer risk. Prostate cancer is one of the most common types of cancer and the second leading cause of cancer-related death in men.

"Our study showed very strong associations between certain foods and cancer, in particular with prostate cancer," said Makarem. "There had not been very many studies on food sources and prostate cancer previously."

"Americans consume almost half of their added sugars in beverages," said Makarem. "Sugar-sweetened beverages have been shown to increase the risk of obesity and diabetes, and our study documents that they may also have a detrimental impact on cancer risk."

By contrast, consuming low-glycemic index foods such as legumes, non-starchy vegetables, most fruits and whole grains was associated with a 67 percent lower breast cancer risk. Breast cancer risk was also reduced among women who had a higher level of carbohydrate intake overall as a proportion of their total calories. However, in this study participants with in the highest level of carbohydrate intake also had higher intakes of fruits and vegetables, whole grains and legumes. These findings underscore the idea that the type of carbohydrates matters more than the total amount of carbohydrates, said Makarem.

Among individual foods, legumes such as beans, lentils and peas were associated with 32 percent lower risk of all overweight- and obesity-related cancers, including breast, prostate and colorectal cancers.

By nature of the study design, the results point only to associations, not necessarily to cause-and-effect. Nonetheless, the findings are in line with previous studies, which have shown that malignant cancer cells seem to feed on sugar, and that diets high in refined carbohydrates may lead to a range of adverse health effects primarily due to their impacts on body fatness and on the dysregulation of insulin and glucose, both of which are factors that may increase cancer risk.

"Current cancer prevention guidelines recommend avoiding sugary drinks and limiting the consumption of energy-dense foods, which tend to be high in refined carbohydrates," said Makarem. "I think our findings add to the body of evidence behind this recommendation and strengthen the associations between these types of food and cancer."

One caveat that Makarem noted is that the volunteers involved in the study were 99 percent Caucasian. Further study is needed to determine if these associations hold true in more ethnically-diverse groups.

Feature

16 February 2016 0 Comments

 

Herbal medicine, also called botanical medicine or phytomedicine, refers to using a plant's seeds, berries, roots, leaves, bark, or flowers for medicinal purposes. Herbalism has a long tradition of use outside conventional medicine. It is becoming more mainstream as improvements in analysis and quality control, along with advances in clinical research, show the value of herbal medicine in treating and preventing disease.

What is the history of herbal medicine?

Plants have been used for medicinal purposes long before recorded history. Ancient Chinese and Egyptian papyrus writings describe medicinal uses for plants as early as 3,000 BC. Indigenous cultures (such as African and Native American) used herbs in their healing rituals, while others developed traditional medical systems (such as Ayurveda and Traditional Chinese Medicine) in which herbal therapies were used. Researchers found that people in different parts of the world tended to use the same or similar plants for the same purposes.

In the early 19th century, when chemical analysis first became available, scientists began to extract and modify the active ingredients from plants. Later, chemists began making their own version of plant compounds and, over time, the use of herbal medicines declined in favor of drugs. Almost one fourth of pharmaceutical drugs are derived from botanicals.

Recently, the World Health Organization estimated that 80% of people worldwide rely on herbal medicines for some part of their primary health care. In Germany, about 600 to 700 plant based medicines are available and are prescribed by some 70% of German physicians. In the past 20 years in the United States, public dissatisfaction with the cost of prescription medications, combined with an interest in returning to natural or organic remedies, has led to an increase in herbal medicine use.

How do herbs work?

In many cases, scientists are not sure what specific ingredient in a particular herb works to treat a condition or illness. Whole herbs contain many ingredients, and they may work together to produce a beneficial effect. Many factors determine how effective an herb will be. For example, the type of environment (climate, bugs, and soil quality) in which a plant grew will affect it, as will how and when it was harvested and processed.

How are herbs used?

The use of herbal supplements has increased dramatically over the past 30 years. Herbal supplements are classified as dietary supplements by the U.S. Dietary Supplement Health and Education Act (DSHEA) of 1994. That means herbal supplements, unlike prescription drugs, can be sold without being tested to prove they are safe and effective. However, herbal supplements must be made according to good manufacturing practices.

The most commonly used herbal supplements in the U.S. include:

Echinacea (Echinacea purpurea and related species)

St. John's wort (Hypericum perforatum)

Ginkgo (Ginkgo biloba)

Garlic (Allium sativum)

Saw palmetto (Serenoa repens)

Ginseng (Panax ginseng or Asian ginseng) and Panax quinquefolius or American ginseng)

Goldenseal (Hydrastis canadensis)

Valerian (Valeriana officinalis)

Chamomile (Matricaria recutita)

Feverfew (Tanacetum parthenium)

Ginger (Zingiber officinale)

Evening primrose (Oenothera biennis)

Milk thistle (Silybum marianum)

Practitioners often use herbs together because the combination is more effective. Health care providers must take many factors into account when recommending herbs, including the species and variety of the plant, the plant's habitat, how it was stored and processed, and whether or not there are contaminants (including heavy metals and pesticides).

What is herbal medicine good for?

Herbal medicine is used to treat many conditions, such as allergies, asthma, eczema, premenstrual syndrome, rheumatoid arthritis, fibromyalgia, migraine, menopausal symptoms, chronic fatigue, irritable bowel syndrome, and cancer, among others. It is best to take herbal supplements under the guidance of a trained provider. For example, one study found that 90% of people with arthritic use alternative therapies, such as herbal medicine. Since herbal medicines can potentially interact with prescription medications, and may worsen certain medical conditions, be sure to consult with your doctor or pharmacist before taking any herbs. Some common herbs and their uses are discussed below.

Ginkgo (Ginkgo biloba) has been used in traditional medicine to treat circulatory disorders and enhance memory. Although not all studies agree, ginkgo may be especially effective in treating dementia (including Alzheimer disease) and intermittent claudication (poor circulation in the legs). It also shows promise for enhancing memory in older adults. Laboratory studies have shown that ginkgo improves blood circulation by dilating blood vessels and reducing the stickiness of blood platelets. By the same token, this means ginkgo may also increase the effect of some blood-thinning medications, including aspirin. People taking blood-thinning medications should ask their doctor before using ginkgo. People with a history of seizures and people with fertility issues should also use concern; Speak with your physician.

Kava kava (Piper methysticum) is said to elevate mood, enhance wellbeing and contentment, and produce a feeling of relaxation. Several studies show that kava may help treat anxiety, insomnia, and related nervous disorders. However, there is serious concern that kava may cause liver damage. It is not clear whether the kava itself caused liver damage in a few people, or whether it was taking kava in combination with other drugs or herbs. It is also not clear whether kava is dangerous at previously recommended doses, or only at higher doses. Some countries have taken kava off the market. It remains available in the United States, but the Food and Drug Administration (FDA) issued a consumer advisory in March of 2002 regarding the "rare" but potential risk of liver failure associated with kava-containing products.

Saw palmetto (Serenoa repens) is used by more than 2 million men in the United States for the treatment of benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate gland. Several studies suggest that the herb is effective for treating symptoms, including frequent urination, having trouble starting or maintaining urination, and needing to urinate during the night. But not all studies agree. At least one well-conducted study found that saw palmetto was no better than placebo in relieving the signs and symptoms of BPH.

St. John's wort (Hypericum perforatum) is well known for its antidepressant effects. In general, most studies have shown that St. John's wort may be an effective treatment for mild-to-moderate depression, and has fewer side effects than most other prescription antidepressants. But the herb interacts with a wide variety of medications, including birth control pills, and can potentially cause unwanted side effects, so it is important to take it only under the guidance of a health care provider.

Valerian (Valeriana officinalis) is a popular alternative to commonly prescribed medications for sleep problems because it is considered to be both safe and gentle. Some studies bear this out, although not all have found valerian to be effective. Unlike many prescription sleeping pills, valerian may have fewer side effects, such as morning drowsiness. However, Valerian does interact with some medications, particularly psychiatric medications, so you should speak to your doctor to see if Valerian is right for you.

Echinacea preparations (from Echinacea purpurea and other Echinacea species) may improve the body's natural immunity. Echinacea is one of the most commonly used herbal products, but studies are mixed as to whether it can help prevent or treat colds. A review of 14 clinical studies examining the effect of echinacea on the incidence and duration of the common cold found that echinacea supplements decreased the odds of getting a cold by 58%. It also shortened the duration of a cold by 1.4 days. Echinacea can interact with certain medications and may not be right for people with certain conditions, for example people with autoimmune disorders or certain allergies. Speak with your physician.

Buying standardized herbal supplements helps ensure you will get the right dose and the effects similar to human clinical trials. Ask your doctor or pharmacist about which herbal supplements are best for your health concerns.

Is there anything I should watch out for?

Used correctly, herbs can help treat a variety of conditions, and in some cases, may have fewer side effects than some conventional medications. Never assume that because herbs are "natural," they are safe. Some herbs may be inappropriate for people with certain medical conditions. Because they are unregulated, herbal products are often mislabeled and may contain additives and contaminants that are not listed on the label. Some herbs may cause allergic reactions or interact with conventional drugs, and some are toxic if used improperly or at high doses. Taking herbs on your own increases your risk, so it is important to consult with your doctor or pharmacist before taking herbal medicines. Some examples of adverse reactions from certain popular herbs are described below.

St. John's wort can cause your skin to be more sensitive to the sun's ultraviolet rays, and may cause an allergic reaction, stomach upset, fatigue, and restlessness. Clinical studies have found that St. John's wort also interferes with the effectiveness of many drugs, including the blood thinner warfarin (Couamdin), protease inhibitors for HIV, birth control pills, certain asthma drugs, and many other medications. In addition, St. John's wort should not be taken with prescribed antidepressant medication. The FDA has issued a public health advisory concerning many of these interactions.

Kava kava has been linked to liver toxicity. Kava has been taken off the market in several countries because of liver toxicity.

Valerian may cause sleepiness, and in some people it may even have the unexpected effect of overstimulating instead of sedating.

Garlic, ginkgo, feverfew, and ginger, among other herbs, may increase the risk of bleeding.

Evening primrose (Oenothera biennis) may increase the risk of seizures in people who have seizure disorders and bleeding in people with bleeding disorders or who take blood-thinning medications, such as warfarin (Coumadin).

Some herbal supplements, especially those imported from Asian countries, may contain high levels of heavy metals, including lead, mercury, and cadmium. It is important to purchase herbal supplements from reputable manufacturers to ensure quality. Many herbs can interact with prescription medications and cause unwanted or dangerous reactions. For example, there is a high degree of herb/drug interaction among patients who are under treatment for cancer. Be sure to consult your doctor before trying any herbal products.

Who is using herbal medicine?

Nearly one-third of Americans use herbs. Unfortunately, a study in the New England Journal of Medicine found that nearly 70% of people taking herbal medicines (most of whom were well educated and had a higher-than-average income) were reluctant tell their doctors that they used complementary and alternative medicine (CAM).

How is herbal medicine sold in stores?

The herbs available in most stores come in several different forms: teas, syrups, oils, liquid extracts, tinctures, and dry extracts (pills or capsules). You can make teas from dried herbs left to soak for a few minutes in hot water, or by boiling herbs in water and then straining the liquid. Syrups, made from concentrated extracts and added to sweet-tasting preparations, are often used for sore throats and coughs. Oils are extracted from plants and often used as rubs for massage, either by themselves or as part of an ointment or cream. Tinctures and liquid extracts are made of active herbal ingredients dissolved in a liquid (usually water, alcohol, or glycerol). Tinctures are typically a 1:5 or 1:10 concentration, meaning that one part of the herb is prepared with 5 to 10 parts (by weight) of the liquid. Liquid extracts are more concentrated than tinctures and are typically a 1:1 concentration. A dry extract form is the most concentrated form of an herbal product (typically 2:1 to 8:1) and is sold as a tablet, capsule, or lozenge.

No organization or agency regulates the manufacture or certifies the labeling of herbal preparations. This means you cannot be sure that the amount of the herb contained in the bottle, or even from dose to dose, is the same as what is stated on the label. Some herbal preparations are standardized, meaning that the preparation is guaranteed to contain a specific amount of the active ingredients of the herb. However, it is still important to ask companies making standardized herbal products about their product's guarantee. It is important to talk to your doctor or an expert in herbal medicine about the recommended doses of any herbal products.

Are there experts in herbal medicine?

Herbalists, chiropractors, naturopathic physicians, pharmacists, medical doctors, and practitioners of Traditional Chinese Medicine all may use herbs to treat illness. Naturopathic physicians believe that the body is continually striving for balance and that natural therapies can support this process. They are trained in 4-year, postgraduate institutions that combine courses in conventional medical science (such as pathology, microbiology, pharmacology, and surgery) with clinical training in herbal medicine, homeopathy, nutrition, and lifestyle counseling.

How can I find a qualified herbalist in my area?

For additional information, or to locate an experienced herbalist in your area, contact the American Herbalists Guild (AHG) site at

www.americanherbalistguild.com

www.naturopathic.org

. To located a licensed naturopath in your area, call the American Association of Naturopathic Physicians (AANP) at .

What is the future of herbal medicine?

In some countries in Europe, unlike the U.S., herbs are classified as drugs and are regulated. The German Commission E, an expert medical panel, actively researches their safety and effectiveness.

While still not widely accepted, herbal medicine is being taught more in medical schools and pharmacy schools. More health care providers are learning about the positive and potentially negative effects of using herbal medicines to help treat health conditions. Some health care providers, including doctors and pharmacists, are trained in herbal medicine. They can help people create treatment plans that use herbs, conventional medications, and lifestyle

Feature

16 December 2015 0 Comments

 

 

 

norexia nervosa is a serious eating disorder, affecting over 3 million Americans. New research published in Psychosomatic Medicine suggests that people with this debilitating disease may have very different gut microbial communities than those found in healthy individuals.

Moreover, researchers at the University of North Carolina (UNC) School of Medicine speculate that this bacterial imbalance could be linked to some of the psychological symptoms related to the disorder, which has the highest mortality rate of any mental health issue.

The research, led by Ian Carroll, PhD, senior author of the paper and assistant professor of medicine in the UNC Center for Gastrointestinal Biology and Disease, suggests that gut bacteria, the trillions of bacteria that affect digestive health and immunity, could play a prominent role in the symptoms of anorexia nervosa.

It is known that microbial diversity is a sign of better overall health. Previous studies have also suggested that the abundance and diversity of gut microbiota could also affect the so-called "gut-brain axis."

In previous research, scientists took gut microbial communities from an obese person and put them into germ-free mice, which are maintained in sterile conditions and lack intestinal microbiota. The result was a greater weight gain in mice with these bacteria than in germ-free mice that had been colonized with gut microbiota from a lean person. This suggests that gut microbes could mediate weight gain or loss.

In other experiments where gut bacteria were added to germ-free mice, altered behavior resulted, especially in relation to anxiety and stress.
Less diverse microbial communities in those with very low weight

The UNC team wanted to study this relationship further to find out if altering gut microbiota could help patients with anorexia nervosa to maintain weight and stabilize mood over time.

They collected fecal samples from 16 women with anorexia nervosa after they were first admitted into the UNC Center of Excellence for Eating Disorders, and then again on discharge from the center after their weight was restored. The samples were analyzed for composition and diversity of gut microbiota.

They also collected gut microbiota from 12 healthy individuals for comparison.

Susan Kleiman, a graduate student in Carroll's lab and first author of the paper, found significant changes in the gut bacteria populations between admission and discharge.

The samples taken at admission had fewer different types of bacteria, making the intestinal communities much less diverse. On discharge, the microbial diversity had increased but was still significantly less diverse than that of the healthy individuals.

As the microbial communities in patients with anorexia improved during clinical care and weight gain, the moods of patients also improved, suggesting a link between the two.


Learn more about anorexia nervosa

The next question is whether improving microbial abundance and diversity could help relieve symptoms related to the eating disorder.

To help them find out, Carroll and a team of researchers have received a 5-year, $2.5-million grant from the National Institutes of Mental Health (NIMH) to further study the relationship between gut microbiota and anorexia nervosa.

The team will characterize the microbiotas of a large number of people with anorexia nervosa as they enter UNC's clinic and when they are discharged, normally when they reach about 85% of their ideal body weight.

Then they will put those gut bacteria in germ-free mice, to investigate how the microbiota from anorexia nervosa patients affects the biology and behavior of the mice.

If the bacteria have a detrimental effect on the mice, it is possible that cultivating a healthy microbiota could be used in therapy for people with anorexia nervosa.

Carroll says:

    "We're not able to say a gut bacterial imbalance causes the symptoms of anorexia nervosa, including associated symptoms, such as anxiety and depression. But the severe limitation of nutritional intake at the center of anorexia nervosa could change the composition of the gut microbial community.

    These changes could contribute to the anxiety, depression, and further weight loss of people with the disorder. It's a vicious cycle, and we want to see if we can help patients avoid or reverse that phenomenon."

Treatments for anorexia nervosa need improvement. The process of weight gain and renourishment can be extremely uncomfortable, so that after leaving the hospital, patients often begin to lose weight again and face readmission.

If specific alterations in the microbiota can help decrease the discomfort of renourishment, enable better weight regulation and positively affect behavior, this could lead to better outcomes for patients.

Carroll points out that this will not be "the magic bullet for people with anorexia nervosa," because other important factors are involved. But he believes that if the gut microbiota is associated with a variety of health and brain-related issues, it could make a difference for people with anorexia nervosa.

While anorexia nervosa mostly starts during adolescence, a Spotlight from Medical News Today has previously investigated how eating disorders can affect people of any age.

 

 

 

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