مردم زیادی این روزها برای سالم ماندن، دست یافتن به اهداف ورزشکاری، مقابله با بیماری ها یا کنترل سندرم های خاص، به مکمل های غذایی رو آورده اند. بااینکه مکملها می توانند در همه ی این عرصه ها به ما کمک برسانند، اما انتخاب نوع مناسب و درست آن اهمیت زیادی دارد. از اینرو، در این مقاله سعی کرده ایم شما را در انتخاب مکمل های غذاییتان راهنمایی کنیم.

 
مولتی ویتامین ها

می توانید هر پودر پروتئینی که می خواهید را مصرف کنید، اما اگر ویتامین های لازم برای ساخت عضله و سایر بافتها به بدنتان نرسد، فقط پول و وقتتان را هدر کرده اید. بااینکه تصور میکنید تغذیه تان کاملاً صحیح است، اما ممکن است همه ی مواد مغذی مورد نیاز  از طریق رژیم غذایی به بدنتان نرسد. کمبود ویتامین و مواد معدنی در برخی غذاها میتواند دلایل مختلفی داشته باشد که خاک نامرغوب، ذخیره ی ضعیف یا پخت نادرست از آن جمله است.
به طور کلی، مصرف یک قرص مولتی ویتامین در روز از مشکلات بسیاری جلوگیری میکند. به طور مثال، محققان کلینیک مایو مصرف مولتی ویتامین ها را برای حفظ سلامت اسپرم توصیه می کنند. همچنین ویتامین B، کورتیزول تنظیم کننده سطح انرژی بدن را تنظیم می کند. مولتی ویتامین ها برای عمل کردن سایر مکمل ها در بدن نیز مفید شناخته شده اند.
دوز مصرفی: روزانه یک عدد مولتی ویتامین
سلنیوم

این ماده ی معدنی با رادیکال های آزاد مقابله میکند و درنتیجه می تواند برای دفاع از سرطان های مختلف مفید باشد. تحقیقات نشان داده اند که مردهایی که میزان این ماده ی معدنی در بدنشان بیشتر بوده، تا %48 کمتر به سرطان پروستات پیشرفته مبتلا می شوند. همچنین براساس آزمایشاتی که روی افراد سیگاری که از این مکمل غذایی استفاده می کردند انجام گرفت مشخص شد که این ماده می تواند از ابتلا به سرطان ریه نیز جلوگیری کند. اما این به آن معنا نیست که نباید سیگارتان را ترک کنید!
در تحقیق دیگری که اخیراً در سیتل انجام گرفت، مشخص شد که خوردن مولتی ویتامین ها در تقویت قدرت مقابله سلنیوم با سرطان ها، مؤثر است. این ممکن است بنا به این واقعیت باشد که مولتی ویتامین ها حاوی حداقل 30 واحد بین المللی (IU) ویتامین E می باشند که اصلی ترین کوفاکتور سلنیوم است. گوش به زنگ تحقیقات و دانستنی های جدید درمورد این ماده ی معدنی مفید باشید و در مصرف آن سهل انگاری نکنید.
دوز مصرفی: روانه 70-40 میکروگرم
اسید فولیک

این ویتامین B یکی از بهترین پیشگیرنده های سکته است. درسطح کم، جریان خون بدن را روان نگه می دارد و اجازه ی توقف به آن نمی دهد. اما چطور؟ فولیک اسید، هومو سیستئین که ترکیبی مرتبط با بیماری های قلبی و آلزایمر است را حل می کند. تحقیقات نشان می دهد که مردانی که از دوز بالای اسید فولیک استفاده می کنند، نسبت به کسانی که فقط مقدار کمی از این ماده را مصرف میکنند، تا %30 کمتر به سکته مبتلا می شوند.
اما این همه ی فواید اسید فولیک نیست. تحقیقات جدید آلمانی ها نشان داده است که اسید فولیک می تواند باعث افزایش عملکرد شناخت شود، حتی در افراد میانسال. همچنین به بدن برای هضم، استفاده، و سنتز پروتئین هایی که باعث رشد ماهیچه ها می شود کمک میکند. اسید فولیک در تولید گلوبول های قرمز خون نیز لازم است و همچنین در بالا بردن سطح انرژی و عملکرد سیستم قلبی-عروقی نیز تاثیرگذار است. و بالاخره اسید فولیک از سوزش قلب جلوگیری میکند و جایگزین مواد مغذی از دست رفته بدن می شود که همه ی اینها باعث می شود سیستم گوارش بهتر کار کند.برای اینکه از همه ی این فواید بهره ببرید لازم نیست دوز بالایی از آن را مصرف کنید. مقدار کم از این ماده که به صورت روزانه مصرف شود نیز کافی است.
دوز مصرفی: روزانه 400 میکروگرم
استیل-ال-کارنیتین

این آمینواسید بیشتر ازاینکه به شش تکه کردن عضلات شکمتان کمک کند، قوای مغزیتان را تقویت می کند. درواقع، استیل-ال-کارنیتین می تواند تاثیرات آلزایمر را در بدن کُند کند. تحقیقاتی نشان می دهد که موش های آزمایشگاهی که از این ماده استفاده کردند در تست های حافظه بهتر عمل کردند. اما چرا؟ اینطور به نظر می رسد که کارنیتین با بالا رفتن سن در بافت ها کاهش پیدا می کند و تاثیر برخی از غشاهای هسته ای را پایین می آورد. این ماده به ویژه در کسانی که به آلزایمر مبتلا می شوند، بسیار کم است. وقتی این ماده را که در بدن رو به تحلیل بوده است را به آن برسانیم، عملکرد مغز و شناختتان بهتر خواهد شد.
استیل-ال-کارنیتین همچنین در کمک به ذخائر بدن و تولید انرژی نیز موثر است و همه ما می دانیم که داشتن انرژی کافی در یادگیری امری حیاتی است. این مکمل را نیز مثل سایر مکمل ها نیازی نیست با دوز بالا مصرف کنید تا از کلیه ی فواید آن بهره مند شوید. اما مصرفتان باید ثابت و پایدار باشد.
دوز مصرفی: روزانه 100 تا 400 میکروگرم
کلسیم

این ماده ی معدنی فواید بسیار زیادی دارد که از جمله ی آن استخوان سازی، کمک به کاهش وزن، و کاهش خطر ابتلا به سرطان روده و کلسترول است. تحقیقات نشان داده است که 1000 میکروگرم کلسیم تا %7 کلسترول لیپوپروتئین پر چگالی (که کلسترو خوبی است) را در بدن افزایش می دهد. همچنین ثابت شده است که کلسیم در سلامت استخوانها به ویژه برای افرادی که تابه حال دچار شکستگی استخوان شده اند، لزایمر را در بدن کند کند. بسیار تاثیرگذار است. کلسیم باعث می شود که دوباره دچار شکستگی استخوان نشوید.
بهتر است که کلسیم مصرفی خود را با ویتامین D ترکیب کنید که آن هم برای حفظ سلامت استخوانها و سلامت کلی بدن بسیار مفید است. گرچه نور خورشید بهترین راه برای جذب ویتامین D  است، محققان دانشگاه هاوارد دریافته اند که  در عرض جغرافیایی 40 درجه نور خورشید به اندازه کافی برای ساخت ویتامین D در بدن قدرت ندارد. به همین دلیل برای این منظور نیز می توانید از مکمل استفاده کنید.
دوز مصرفی: 500 میکروگرم سیترات کلسیم به اضافه ی IU 125 ویتامین D دوبار در روز

There are many questions when it comes to supplementing iron. It is important to know what the options are, how much is necessary, and how to take it. There are many benefits to taking iron, but there are also many side effects. Interesting discoveries are being made every day on more ways that iron supplements can be used and ways to lessen the side effects.
Iron in the Body

There have been many studies on the use of iron supplements for a variety of health issues. Many of the uses are still debated and the studies are contradictory. However, recent clinical studies are promising in regards to the effects of iron aiding with issues like learning problems, ADHD, heart failure, cough caused by ACE inhibitors, and fatigue. Studies are also still pending on the effects of supplementing iron to help with athletic performance, canker sores, Chrone's disease, depression, female infertility, heavy periods and restless leg syndrome, but the results have been inconclusive at best.

Iron is essential to the proper function of the human body. As with any supplement, it must be used with care and kept safely away from children. It is best to consult with a physician to find the proper amount needed, the best form for supplementing and the most efficient way of taking it for the individual.
How Much Iron Is Enough?

Iron is a mineral that is necessary to form red blood cells that carry oxygen through our bodies. Low iron levels can make you feel tired, forgetful and even cause shortness of breath. Many people, especially vegetarians, vegans and menstruating women, can struggle to get enough iron through the foods that they eat. The recommended daily allowance (RDA) varies depending on age, gender, and situation.
Reasons for Iron Deficiency

There are many different reasons that a person might have an iron deficiency. They include anemia, pregnancy, heavy menstrual cycles, kidney disease, chemotherapy and frequent blood donations. Diet is also an important factor in the amount of iron that a person has. Strict vegetarians may need to take supplements more often than non-vegetarians since they do not consume the best source of iron- red meat.
The Various Forms Of Iron Supplements

There are two ways to take iron supplements- orally and receiving injections. Injections are given either intravenously or intramuscularly. Iron taken orally comes in pill or liquid form. Liquid iron (ferrous) is the most commonly prescribed and is the form that is best absorbed by the body. There are three types of liquid iron- ferrous gluconate, ferrous sulphate, and ferrous fumarate. The most notable difference in the three is the amount of consumable iron (elemental iron). Ferrous gluconate has the least amount of actual iron and is the easiest to take due to the decreased likelihood of side effects. Ferrous sulfate is next, with ferrous fumarate having the most. Pills or tablets have a wide variety of options. Most multi-vitamins contain enough iron for the average person. Iron pills also are available various doses as well as being time released or coated.
What To Take And What To Avoid

Foods high in vitamin c help in the absorption of iron supplements. It is highly recommended to take a 75mg supplement of vitamin c with the iron. It is also best to avoid calcium supplements, antacids, anti inflammatory pain killers, antibiotics, dairy products, coffee, tea, whole grains, eggs and spinach at least an hour before and two hours after taking iron. These interfere with the absorption of iron supplements and can increase the severity of any side effects.
References

All referenced material can be found through WebMD, The Mayo Clinic, The U.S. National Library of Medicine, and the National Institutes of Health: Office of Dietary Supplements. A comprehensive listing of open clinical trials can be found at ClinicalTrials.gov.

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Calcium - 8.7% Zinc - 4% Chromium - 3.8% Copper - 3.7% Silicon - 3.2% Magnesium - 3%
Iron Herb Notes / Side Effects

Iron is not an easily absorbed mineral. Most of the side effects involve the digestive tract. They include stomach irritation, cramping, vomiting, constipation, diarrhea, and heart burn. Liquid iron may also blacken the teeth. The form and dosage of the supplement effects the severity of the symptoms. It is extremely important not to take more than the recommended amount as taking too much iron can not only be painful, but it can also cause death. The body store excess iron which can lead to toxicity and will damage the liver, kidneys, and the heart. The most common substance that children overdose on is iron.

 A large meta-analysis involving more than 200,000 participants has found that women with type 1 diabetes have more than twice the risk of dying from heart disease compared with men who have the condition.
older lady checking blood sugar level
Poorer glycemic control and insulin management - which the authors say are more common among women than men - could be contributing factors to women's raised risk of death.

In type 1 diabetes, the pancreas does not produce sufficient levels of insulin to convert sugars, starches and other foods into energy.

Currently, around 15,000 children and 15,000 adults are diagnosed with type 1 diabetes every year in the US, costing the health care system an annual $14.9 billion.

Type 1 diabetes is becoming more common all over the world, too. The incidence of type 1 diabetes in children aged 14 years and younger has risen globally by 3% every year since 1989.

In the new study, published in The Lancet Diabetes & Endocrinology, researchers from the School of Public Health at The University of Queensland in Australia conducted a meta-analysis of all studies to examine sex-specific estimates of type 1 diabetes mortality between 1966 and 2014. In total, the team analyzed 26 studies that involved 214,114 participants with type 1 diabetes.

The study found that women with type 1 diabetes had a 37% higher excess risk of death from any cause compared with male type 1 diabetes patients. Female type 1 diabetes patients were also found to have nearly twice the risk of dying from cardiovascular disease than men, a 37% increased risk of stroke and a 44% increased risk of death from kidney disease.

However, the researchers were interested to find that type 1 diabetes does not appear to be associated with an increased risk of death from cancers in men or women.

Speculating on the reasons for the increased risks among female type 1 diabetes patients, the authors suggest that poorer glycemic control and insulin management - which the team says are more common among women than men - could be contributing factors.

مطالعات محققان دانشگاه ایالتی پنسیلوانیا نشان می دهد که یکی از ترکیبات موجود در چای سبز، سلول های سرطان دهان را نابود می کند؛ در حالی که به سلول های سالم هیچ آسیبی وارد نمی کند.


 این ترکیب EGCG نام دارد و قادر به نابود کردن تمام سلول های سرطانی دهان است.

ترکیب EGCG با غیر فعال کردن میتوکندری سلول های سرطانی، باعث نابودی این سلول ها می شود.

تحقیقات نشان می دهد که این ترکیب خواص بالقوه ای در نابودی سلول های سرطانی دیگر نیز دارد.

به گزارش پنجمین سمپوزیم بین المللی در زمینه چای و سلامت در واشنگتن، برخی از مزایای چای سبز عبارتند از :

• پلی فنول موجود در برگ چای سبز باعث کاهش وزن می شود

تحقیقات نشان داده است که چربی دور شکم مصرف کنندگان دایمی چای سبز کاملا متناسب است. چای سبز دارای ترکیباتی هستند که موجب اکسیداسیون چربی می شود.

• ترکیبات موجود در چای سبز از بروز سرطان جلوگیری می کند

برگ چای سبز حاوی پلی فنل است؛ پلی فنل از پیشرفت سرطان جلوگیری می کند. چای سبز از بروز سرطان پروستات جلوگیری می کند.

• چای سبز معمولی باعث سلامت قلب و کاهش فشار خون می شود

معمولا چربی وعده های غذایی باعث افزایش غلظت خون می شود. چای باعث اتساع رگ های خونی می شود و به این ترتیب فشار خون کاهش می یابد.

• چای سبز باعث افزایش تراکم استخوان می شود

پوکی استخوان، عمده ترین نگرانی سازمان بهداشت جهانی است. پلی فنل موجود در چای سبز، باعث استحکام استخوان می شود و از بروز پوکی استخوان جلوگیری می کند. علاوه بر این، چای باعث تقویت عملکرد عضلات و کاهش التهاب می شود. در ادامه بررسی ها آمده است که چای سبز یکی از مهمترین عوامل ترمیم و بازسازی استخوان است.

نتایج این تحقیقات در نشریه Molecular Nutrition and Food Research منتشر شده است.

study due to be presented at a conference later this year suggests that eating foods containing vitamin C, such as oranges, peppers, strawberries, papaya and broccoli, may be linked to a reduced risk for hemorrhagic stroke.

According to the US Centers for Disease Control and Prevention (CDC), stroke is the fourth leading cause of death in the US, where every year 795,000 Americans suffer a stroke and 130,000 die from one.

There are two main types of stroke: ischemic and hemorrhagic. Ischemic stroke, by far the most common type, is where a blockage in a blood vessel stops blood from getting to one or more parts of the brain. Hemorrhagic stroke is much rarer but more deadly and occurs when a weakened blood vessel in the brain ruptures and allows blood to leak into and around the brain.

Study author Dr. Stéphane Vannier, of Pontchaillou University Hospital in Rennes, France, says:

"Our results show that vitamin C deficiency should be considered a risk factor for this severe type of stroke, as were high blood pressure, drinking alcohol and being overweight in our study."

The study compared 65 patients who had experienced a hemorrhagic stroke with 65 healthy counterparts.

Both groups underwent blood tests that checked their vitamic C levels. The results showed that 41% of all participants had normal levels, 45% had depleted levels, and 14% had levels so low they were considered deficient in vitamin C.

Participants who experienced stroke had depleted levels of vitamin C

However, on average, the participants who had experienced a stroke had depleted levels, while the ones who had not had a stroke had normal levels of vitamin C in their blood.

The results have not been published in a peer-reviewed journal. The American Academy of Neurology released these details to the media in advance of its 66th Annual Meeting, due to take place in Philadelphia, PA, at the end of April, when fuller details of the study will be presented.

Dr. Vannier says more research is now needed to confirm the findings and find out how vitamin C works to reduce stroke risk.

He suggests one way vitamin C might reduce stroke risk could be by reducing blood pressure, and he adds that vitamin C has other benefits, like helping to make collagen, a protein that gives structure to skin, bones and tissue.

If confirmed, the findings add to a growing body of evidence linking dietary factors to risk of stroke. In a study published in 2012, researchers found that consuming chocolate may lower risk of any stroke. They found men who ate the largest amounts of chocolate had a 17% lower risk of stroke than men who never or very rarely ate it.

Does vitamin A do anything to help eyes and vision? Can a vitamin A deficiency cause blindness? Is it dangerous to consume too much vitamin A?

Read on for answers to these questions and other useful facts about this important antioxidant vitamin, including information about eye benefits of vitamin A and beta carotene, top vitamin A foods, and possible benefits of vitamin A eye drops.
What Is Vitamin A?

Vitamin A actually is a group of antioxidant compounds that play an important role in vision, bone growth and health of the immune system. Vitamin A also helps the surface of the eye, mucous membranes and skin be effective barriers to bacteria and viruses, reducing the risk of eye infections, respiratory problems and other infectious diseases.

In general, there are two types of vitamin A, depending on the type of food source it comes from:
Sweet potatoes and carrots are excellent sources or provitamin A carotenoids that are good for your eyes.

    Vitamin A from animal-derived foods is called retinol. This "pre-formed" vitamin A can be used directly by the body. Good food sources of retinol vitamin A include beef and chicken liver, whole milk and cheese.
    Vitamin A obtained from colorful fruits and vegetables is in the form of "provitamin A" carotenoids, which are converted to retinol by the body after the food is ingested. Good food sources of provitamin A carotenoids include carrots, sweet potatoes, spinach, kale and cantaloupes.

Beta carotene is one of the most prevalent and effective provitamin A carotenoids.
Eye Benefits of Vitamin A and Beta Carotene

Because vitamin A helps protect the surface of the eye (cornea), it is essential for good vision.

Studies show vitamin A eye drops are effective for the treatment of dry eyes. In fact, one study found that over-the-counter lubricating eye drops containing vitamin A were as effective for the treatment of dry eye syndrome as more expensive prescription eye drops formulated for dry eye relief.

Vitamin A eye drops also have been shown effective for the treatment of a specific type of eye inflammation called superior limbic keratoconjunctivitis.

Vitamin A, at least when in combination with other antioxidant vitamins, also appears to play a role in decreasing the risk of macular degeneration (AMD). In the landmark Age-Related Eye Disease Study (AREDS) sponsored by the National Eye Institute, people at high risk for the disease who took a daily multiple vitamin that included vitamin A (as beta carotene), vitamin C, vitamin E, zinc and copper had a 25 percent reduced risk of advanced AMD during a six-year period.

It also appears that a combination of vitamin A and lutein may prolong vision in people suffering from retinitis pigmentosa (RP). A recent four-year study conducted by researchers from Harvard Medical School and other prominent universities found that individuals with retinitis pigmentosa who took daily supplements of vitamin A (15,000 IU) and lutein (12 mg) had a slower loss of peripheral vision than those who did not take the combined supplements.

Because beta carotene is converted into vitamin A in the body, it's likely beta carotene (provitamin A) offers similar eye benefits as the pre-formed retinol type of vitamin A, though more research is needed to confirm this.

In early 2011, researchers at Columbia University Medical Center (New York) found that a synthetic, altered form of vitamin A might be able to slow the progression of Stargardt's disease, an inherited eye disease that causes severe vision loss in young people.

When given to mice with the same genetic defect as humans with Stargardt's disease (also called juvenile macular degeneration), the modified vitamin A inhibited the growth of clump-like deposits in the retina called "vitamin A dimers" that are associated with degenerative changes and vision loss.

The National Eye Institute has awarded the researchers a $1.25 million grant to further investigate the link between vitamin A dimers and various retinal degenerations, which could lead to new approaches to treat these diseases.

Also, Alkeus Pharmaceuticals (Cambridge, Mass.) has licensed certain patents from Columbia University related to the research and is planning to launch clinical trials for the treatment of Stargardt's disease and macular degeneration with modified vitamin A in the near future.
Vitamin A Deficiency

Vitamin A deficiency is rare in the United States, but it is common among the poor in developing countries. It's estimated that approximately 250,000 to 500,000 malnourished children worldwide become blind each year due to vitamin A deficiency that could have been prevented with a proper diet.

One of the first signs of vitamin A deficiency is night blindness. In ancient Egypt, it was discovered that night blindness could be cured by eating liver, which later was found to be a rich source of vitamin A.

A lack of vitamin A causes the cornea to become very dry, leading to clouding of the front of the eye, corneal ulcers and vision loss. Vitamin A deficiency also causes damage to the retina, which also contributes to blindness.

Because vitamin A also is important for resistance to infection and a healthy immune system, vitamin A deficiency can lead to death from respiratory and other infections.

Omega-3 benefits your heart health. An Italian study (GISSI)7 of 11,324 heart attack survivors found that patients supplementing with fish oils markedly reduced their risk of another heart attack, stroke, or death. In a separate study, 8 American medical researchers reported that men who consumed fish once or more every week had a 50 percent lower risk of dying from a sudden cardiac event than do men who eat fish less than once a month.
Omega-3 normalizes and regulates your cholesterol triglyceride levels. Compared to a statin, both fish oil and krill oil are more efficient in doing this. According to a study comparing the efficiency of krill and fish oils in reducing triglyceride levels,9 both oils notably reduced the enzyme activity that causes the liver to metabolize fat, but krill had a more pronounced effects, reducing liver triglycerides significantly more.

Fasting triglyceride levels are a powerful indication of your ability to have healthy lipid profiles, which can be indicative of your heart health.

Studies have also shown that omega-3 fats are anti-arrhythmic (preventing or counteracting cardiac arrhythmia), anti-thrombotic (prevents thrombosis or a blood clot within a blood vessel), anti-atherosclerotic (preventing fatty deposits and fibrosis of the inner layer of your arteries), and anti-inflammatory (counteracting inflammation – the heat, pain, swelling, etc).
DHA affects your child's learning and behavior. Do you want to maximize your child's intellectual potential? A study published in Plos One in June 201310 linked low levels of DHA with poorer reading, and memory and behavioral problems in healthy school-age children. In another study published in the American Journal of Clinical Nutrition in August 2013,11 children who consumed an omega-3 fat supplement as infants scored higher on rule learning, vocabulary, and intelligent testing at ages 3 to 5.

Previous research also found that children with attention deficit hyperactivity disorder (ADHD) and related behavior or learning disabilities are more likely to have low omega-3 fat levels.

Omega-3 has such great impact on your brain health – EPA and DHA keep the dopamine levels in your brain high, increase neuronal growth in the frontal cortex of your brain, and increase cerebral circulation.

Omega-3 has been found to save the lives of children going through short bowel syndrome (SBS), which is uncommon but impacts thousands of people in the United States. SBS can occur from birth (when a portion of the intestine fails to develop) or due to an infectious inflammatory disease striking premature newborns. In adults, it can be caused by surgery for Crohn's disease or injury.

A study conducted in more than 100 Mongolian schoolchildren found that daily treatment with a vitamin D supplement significantly reduced the symptoms of winter-related atopic dermatitis, a type of eczema. Led by a Massachusetts General Hospital (MGH) physician, the report in the October issue of the Journal of Allergy and Clinical Immunology supports the results of a preliminary study that showed similar results in a small group of children in Boston.

"While we don't know the exact proportion of patients with atopic dermatitis whose symptoms worsen in the winter, the problem is common," says Carlos Camargo, MD, DrPH, MGH Department of Emergency Medicine. "In this large group of patients, who probably had low levels of vitamin D, taking daily vitamin D supplements - which are inexpensive, safe and widely available - proved to be quite helpful." Camargo led both the earlier Boston pilot study and the current investigation, which was performed in collaboration with investigators from the Health Sciences University of Mongolia.

A chronic inflammatory disorder of the skin, atopic dermatitis is uncomfortable and makes patients more vulnerable to bacterial infection. Symptoms of the disorder - most commonly seen in children - often worsen during wintertime. While controlled administration of ultraviolet light, which can stimulate the production of vitamin D in the skin, is a common treatment for severe atopic dermatitis, the possibility that vitamin D deficiency contributes to the seasonal worsening of symptoms had received little consideration prior to the Boston study. That investigation involved only 11 children but provided preliminary support for the hypothesis.

The current study, conducted in collaboration with the National Dermatology Center in Mongolia, enrolled 107 children, ages 2 to 17, from nine outpatient clinics in the capital city of Ulaanbaatar. The participants - all of whom had a history of atopic dermatitis symptoms worsening either during cold weather or around the transition from autumn to winter - were randomly divided into two groups. One group received a daily vitamin D dose of 1000 IU while the other received a placebo - both delivered in odorless, colorless and tasteless drops. Neither the children's parents nor the study investigators knew to which group participants had been assigned.


Standard evaluations of atopic dermatitis symptoms were conducted at the outset of the trial and at the end of the month-long study period, and parents were also asked whether they saw any improvement in their child's condition. At the end of the month, children receiving the vitamin D supplement had an average 29 percent improvement on the primary assessment tool used, compared with 16 percent improvement in the placebo group. Additional assessments - including the report from parents - also showed significantly greater improvement among children receiving vitamin D.

While data gathered at the outset of the study could not determine whether or not participating children were deficient in vitamin D, the authors note that an even larger study of Ulaanbaatar children conducted at the same time found significant vitamin D deficiency in 98 percent of participants, supporting the probability that the children in this study were also deficient. While future studies are needed to assess the value of vitamin D treatment in adults and in children with year-round symptoms, Camargo - a professor of Medicine at Harvard Medical School - says that parents of children with symptoms that worsen in the winter should try a vitamin D supplement for a few weeks when symptoms flare to see if it helps. He encourages parents to discuss this study and their plan with their primary care provider.

In honor of National Birth Defects Prevention Month, make a PACT to get healthy before and during pregnancy to increase your chances of having a healthy baby. January 4-10 is National Folic Acid Awareness Week. You can plan ahead by getting enough folic acid each day.

Folic acid is a B vitamin. It is an important part of preconception health, which refers to the health of women and men during their reproductive years. If a woman consumes the recommended amount of folic acid before and during early pregnancy, it can help prevent some major birth defects of the baby's brain (known as anencephaly) and spine (known as spina bifida). Anencephaly is a serious birth defect in which parts of a baby's brain and skull do not form correctly. Babies born with anencephaly cannot survive. Spina bifida is a serious birth defect in which a baby's spine does not develop correctly, and can result in some severe physical disabilities. All women, but especially those who want to become pregnant, need 400 micrograms (mcg) of folic acid every day.
Woman taking a pill

All women, but especially those who want to become pregnant, need 400 micrograms (mcg) of folic acid every day.
Woman eating salad

In addition to getting 400 mcg of folic acid from supplements and fortified foods, you can eat a diet rich in folate.
Do I need folic acid?

Yes! Every woman needs to get enough folic acid each day, even if she does not plan to become pregnant. This is because our bodies make new cells every day—blood, skin, hair, nails and others. Folic acid is needed to make these new cells. Start a healthy habit today and get 400 mcg of folic acid every day.
Why can't I wait until I'm pregnant to start taking folic acid?

Birth defects of the brain and spine (anencephaly and spina bifida) happen in the first few weeks of pregnancy, often before a woman finds out she's pregnant. Also, half of all pregnancies in the United States are unplanned. These are two reasons why it is important for all women who can get pregnant to be sure to get 400 mcg of folic acid every day, even if they aren't planning a pregnancy any time soon. By the time a woman realizes she's pregnant, it might be too late to prevent these birth defects. Plan ahead! Starting today is the best option.
How do I get folic acid?

An easy way to be sure you're getting enough folic acid is to take a daily multivitamin with folic acid in it. Most multivitamins have all the folic acid you need. If you get an upset stomach from taking a multivitamin, try taking it with meals or just before bed. If you have trouble taking pills, you can try a multivitamin that is gummy or chewable. Also be sure to take it with a full glass of water.

Folic acid has been added to foods such as enriched breads, pastas, rice and cereals. Check the Nutrition Facts label on the food packaging. A serving of some cereals has 100% of the folic acid that you need each day.

In addition to getting 400 mcg of folic acid from supplements and fortified foods, you can eat a diet rich in folate. You can get food folate from beans, peas and lentils, oranges and orange juice, asparagus and broccoli, and dark leafy green vegetables such as spinach, and mustard greens.
Our Work

CDC's National Center on Birth Defects and Developmental Disabilities (NCBDDD) has made a significant contribution to neural tube defects prevention in the United States over the past two decades, and has led the way in establishing that every woman who can get pregnant should consume 400 mcg of folic acid daily to prevent neural tube defects.
Birth Defects COUNT

NCBDDD has a global initiative, Birth Defects COUNT (Countries and Organizations United for Neural Tube Defects Prevention), to significantly reduce death and lifelong disability resulting from the more than 300,000 neural tube defects that occur worldwide each year.

The initiative builds on CDC's expertise and experience in neural tube defects prevention and aims to increase folic acid intake among women of reproductive age to help reduce neural tube defects globally. Through Birth Defects COUNT, CDC provides the scientific and programmatic expertise to expand neural tube defects prevention efforts and strengthen the ability to track rates of birth defects worldwide. These efforts can help prevent approximately 150,000-210,000 neural tube defects each year in low- and middle-resource countries.
Resources for Health Professionals

A Case Western Reserve University School of Medicine study in the November 22 issue of Journal of Biological Chemistry, explains how vitamin A is generated from beta carotene, its dietary precursors. The discovery sheds new light into how beta carotene’s enzymes are utilized differently contributing to the vitamin’s production. This insight will help guide solutions for vitamin A deficiency, a global public health problem affecting more than half of all countries, according to the World Health Organization.

The study, named a Paper of the Week, led by Johannes von Lintig, PhD, associate professor of pharmacology, demonstrates that beta-carotene is converted to Vitamin A and not other metabolites, which some theorized were toxic compounds.

Vitamin A deficiency is especially prevalent in developing countries of Asia, due to largely rice-based diets which lack beta-carotene, a member of the micronutrient carotenoid family. The deficiency mainly affects pregnant women and children and leads to blindness and increases morbidity.

Understanding how vitamin A is produced in the body is essential to effective public health interventions. Efforts are underway by humanitarian groups to supplement young children and fortify foods, for example in the form of “golden rice,” rice genetically modified to contain beta-carotene. The von Lintig Laboratory’s discovery validates the benefits of fortifying foods to combat the worldwide deficiency problem. Some reports indicate the problem exists in areas of the U.S. where access to fresh fruits and vegetables is scarce.



The research team provided evidence that BCO1 directly converts beta-carotene to vitamin A. However, they discovered the second enzyme, BCO2, is also significant. It helps prepare carotenoids, other than beta-carotene, for vitamin A production. Specifically, BCO2 removes the part of the carotenoid that cannot be utilized for vitamin A production. The remaining portion of the carotenoid is then further processed by BCO1 to generate vitamin A.

“Our study shows that beta-carotene’s second enzyme does not produce a toxic compound, as had been proposed by some researchers. Rather, the enzyme aids in the metabolizing of carotenoids, aside from beta-carotene, to become vitamin A,” said von Lintig and concluded “that beta-carotene is an important and safe precursor for vitamin A in our diet. Our findings also suggest that golden rice plants are likely very safe for consumption.”

L-carnitine is a derivative of the amino acid, lysine. Its name is derived from the fact that it was first isolated from meat (carnus) in 1905. Only the L-isomer of carnitine (Figure 1) is biologically active. Carnitine is a substance that helps the body turn fat into energy. Your body makes it and stores it in the skeletal muscles, heart, brain, and sperm.
Usually, your body can make all the carnitine it needs. Some people, however, may not have enough carnitine because their bodies cannot make enough or can’t transport it into tissues so it can be used.
Some of the conditions carnitine may help treat are:
1- Heart Conditions
• Angina -- Some good evidence shows that carnitine can be used along with conventional treatment for stable angina. Several clinical trials show that L-carnitine can help reduce symptoms of angina and improve the ability of people with angina to exercise without chest pain. Do not self-treat chest pain with carnitine, however. See your health care provider for diagnosis and conventional treatment, and take carnitine only under your health care provider's supervision.
• Heart attack -- A few studies have found that carnitine may help when used with conventional medicines after a heart attack, but not all studies agree. Some small studies suggest that people who take L-carnitine supplements soon after a heart attack may be less likely to have another heart attack, die of heart disease, have chest pain and abnormal heart rhythms, or develop heart failure. However, other studies have shown no benefit. Treatment with oral carnitine may also improve muscle weakness. Carnitine should be used along with conventional medication under your health care provider supervision.
• Heart failure -- A few small studies have suggested that carnitine can help reduce symptoms of heart failure and improve exercise capacity in people with heart failure. However, more and larger studies are needed to know for sure.
2- Peripheral Vascular Disease
Decreased blood flow to the legs (called Peripheral Vascular Disease or PVD) from atherosclerosis or hardening of the arteries -- where plaque builds up in the arteries -- often causes an aching or cramping pain in the legs while walking or exercising (called intermittent claudication). Several studies show that carnitine can help reduce symptoms and increase the distance that people with intermittent claudication can walk.
3- Diabetic Neuropathy
Diabetic neuropathy happens when high blood sugar levels damage nerves in the body, especially the arms, legs, and feet, causing pain and numbness. Some small preliminary studies suggest acetyl-L-carnitine may help reduce pain and increase feeling in affected nerves. It is also possible that carnitine can help nerves regenerate. More research is needed.
4- Exercise Performance
Although carnitine is often taken to boost exercise performance, more research is needed
5- Weight Loss
Some studies do show that oral carnitine reduces fat mass, increases muscle mass, and reduces fatigue, which may contribute to weight loss in some people.
6- Alzheimer's Disease and Memory Impairment
Several early studies showed that acetyl-L-carnitine, might help slow down the progression of Alzheimer's disease, relieve depression related to senility and other forms of dementia, and improve memory in the elderly. People should take carnitine for Alzheimer's and other forms of dementia only under the supervision of their health care provider.
7- Kidney Disease and Dialysis
Because the kidneys make carnitine, kidney disease could lead to low levels of carnitine in the body. If you have kidney disease, your health care provider may prescribe carnitine -- but you shouldn’t take it without medical supervision.
8- Male Infertility
Low sperm counts have been linked to low carnitine levels in men. Several studies suggest that L-carnitine supplements may increase sperm count and mobility.
9- Erectile Dysfunction
Preliminary studies suggest propionyl-L-carnitine may help improve male sexual function. One study found that carnitine improved the effectiveness of sidenafil (Viagra) in men with diabetes who had not previously responded to Viagra. In another study, a combination of propionyl-L-carnitine and acetyl-L-carnitine improved the effectiveness of Viagra in men who had erectile dysfunction after prostate surgery. More studies are needed.
10- Hyperthyroidism
Some research suggests that L-carnitine may help prevent or reduce symptoms of an overactive thyroid, such as insomnia, nervousness, heart palpitations, and tremors. A larger, better-designed clinical trial is needed.
Dietary Sources
Red meat (particularly lamb) and dairy products are the main food sources of carnitine. It can also be found in fish, poultry, wheat, asparagus, avocados, and peanut butter.
Available Forms
Carnitine is available as a supplement in a variety of forms.
• L-carnitine: the most widely available and least expensive
• Acetyl-L-carnitine: Often used in studies for Alzheimer's disease and other brain disorders
• Propionyl-L-carnitine: Often used in studies for heart disease and peripheral vascular disease
Avoid D-carnitine supplements. They interfere with the natural form of L-carnitine and may produce unwanted side effects.
How to Take It
Pediatric
Don’t give carnitine supplements to a child without your child's health care provider's supervision.
Adult
Recommended doses of L-carnitine vary depending on the health condition being treated. The usual dose is between 1 - 3 g per day.
Precautions
You should take L - carnitine only under the supervision of a knowledgeable health care provider.
Side effects are generally mild. High doses (5 or more grams per day) may cause diarrhea. Other rare side effects include increased appetite, body odor, and rash.
Possible Interactions
Zidovudine -- In a laboratory study, L-carnitine supplements protected muscle tissue against toxic side effects from Zidovudine, a medication used to treat HIV and AIDS. More studies are needed to know whether L-carnitine would have the same effect in people.
Doxorubicin -- Treatment with L-carnitine may protect heart cells against the toxic side effects of doxorubicin, a chemotherapy medication used to treat cancer, without making the medication any less effective. Always talk to your oncologist before using any complementary or alternative therapy with chemotherapy.
Isotretinoin (Accutane) -- Accutane, a strong medication used for severe acne, can cause liver problems, as well as high cholesterol and muscle pain and weakness. These symptoms are like those seen with carnitine deficiency. Researchers in Greece showed that a large group of people who had side effects from Accutane got better when taking L-carnitine compared to those who took a placebo.
Thyroid hormone -- Carnitine may stop thyroid hormone from getting into cells, and theoretically may make thyroid hormone replacement less effective. If you take thyroid replacement hormone, talk to your health care provider before taking carnitine.
Valproic acid (Depakote) -- The anti-seizure medication valproic acid may lower blood levels of carnitine. Taking L-carnitine supplements may reduce the side effects of valproic acid. However, taking carnitine may increase the risk of seizures in people with a history of seizures.
Supporting Research
Benvenga S, Ruggieri RM, Russo A, Lapa D, Campenni A, Trimarchi F. Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind placebo-controlled clinical trial. J Clin Endocrinol Metab. 2001;86(8):3579-3594.
Berni A, Meschini R, Filippi S, Palitti F, De Amicis A, Chessa L. L-carnitine enhances resistance to oxidative stress by reducing DNA damage in Ataxia telangiectasia cells. Mutat Res. 2008;650(2):165-74.
Biagiotti G, Cavallini G. Acetyl-L-carnitine vs tamoxifen in the oral therapy of Peyronie's disease: a preliminary report. BJU Int. 2001;88(1):63-67.
Carrero JJ, Grimble RF. Does nutrition have a role in peripheral vascular disease? Br J Nutr. 2006 Feb;95(2):217-29. Review.
Cavallini G, Modenini F, Vitali G, et al. Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology. 2005;66:1080-1085.
Cruciani RA, Dvorkin E, Homel P, Malamud S, Culliney B, Lapin J, Portenoy RK, Esteban-Cruciani N. Safety, tolerability and symptom outcomes associated with L-carnitine supplementation in patients with cancer, fatigue, and carnitine deficiency: a phase I/II study. J Pain Symptom Manage. 2006 Dec;32(6):551-9.
Custer J, Rau R. Johns Hopkins:The Harriet Lane Handbook, 18th ed. Philadelphia, PA; Elsevier Mosby; 2008.
Dyck DJ. Dietary fat intake, supplements, and weight loss. Can J Appl Physiol. 2000;25(6):495-523.
Fugh-Berman A. Herbs and dietary supplements in the prevention and treatment of cardiovascular disease. Prev Cardiology. 2000;3:24-32.
Head KA. Peripheral neuropathy: pathogenic mechanisms and alternative therapies. Altern Med Rev. 2006 Dec;11(4):294-329. Review.
Hiatt WR, Regensteiner JG, Creager MA, Hirsch AT, Cooke JP, Olin JW, et al. Propionyl-L-carnitine improves exercise performance and functional status in patients with claudication. Am J Med. 2001;110(8):616-622.
Lynch KE, Feldman HI, Berlin JA, Flory J, Rowan CG, Brunelli SM. Effects of L-carnitine on dialysis-related hypotension and muscle cramps: a meta-analysis. Am J Kidney Dis. 2008;52(5):962-71.
Malaguarnera M, Cammalleri L, Gargante MP, Vacante M, Colonna V, Motta M. L-carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centurians: a randomized and controlled clinical trial. Am J Clin Nutr. 2007;86(6):1738-44.
Park M. Pediatric Cardiology for Practitioners, 5th ed. Philadelphia, PA: Mosby Elsevier, 2008.
Pettegrew JW, Levine J, McClure RJ. Acetyl-L-carnitine physical-chemical, metabolic, and therapeutic properties: relevance for its mode of action in Alzheimer's disease and geriatric depression. Mol Psychiatry. 2000;5:616-632.
Rathod R, Baig MS, Khandelwal PN, Kulkarni SG, Gade PR, Siddiqui S. Results of a single blind, randomized, placebo-controlled clinical trial to study the effect of intravenous L-carnitine supplementation on health-related quality of life in Indian patients on maintenance hemodialysis. Indian J Med Sci. 2006 Apr;60(4):143-53.
Sinclair S. Male infertility: nutritional and environmental considerations. Alt Med Rev. 2000;5(1):28-38.
Villani RG, Gannon J, Self M, Rich PA. L-carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women. Int J Sport Nutr Exerc Metab. 2000;10:199-207.
Volek J, et al. Effects of carnitine supplementation on flow-mediated dilation and vascular inflammatory responses to a high-fat meal in healthy young adults. Am J Cardiol. 2008;102(10).
Werbach MR. Nutritional strategies for treating chronic fatigue syndrome. Altern Med Rev. 2000;5(2):93-108.
Witte KK, Clark AL. Micronutrients and their supplementation in chronic cardiac failure. An update beyond theoretical perspectives. Heart Fail Rev. 2006 Mar;11(1):65-74. Review.
Witt KK, Clark AL, Cleland JG. Chronic heart failure and micronutrients. J Am Coll Cardiol. 2001;37(7):1765-1774.
Xue YZ, Wang LX, Liu HZ, Qi XW, Wang XH, Ren HZ. L-carnitine as an adjunct therapy to percutaneous coronary intervention for non-ST elevation myocardial infarction. Cardiovasc Drugs Ther. 2007;21(6):445-8.

 

 

 

Researchers at the University of Connecticut have found a new way to identify protein mutations in cancer cells. The novel method is being used to develop personalized vaccines to treat patients with ovarian cancer.

"This has the potential to dramatically change how we treat cancer," says Dr. Pramod Srivastava, director of the Carole and Ray Neag Comprehensive Cancer Center at UConn Health and one of the principal investigators on the study. "This research will serve as the basis for the first ever genomics-driven personalized medicine clinical trial in immunotherapy of ovarian cancer, and will begin at UConn Health this fall," Srivastava says.

UConn bioinformatics engineer Ion Mandoiu, associate professor of computer science and engineering, collaborated as the other principal investigator for the study, which has been in development for the past four years. The results appear online in the 22 September issue of the Journal of Experimental Medicine.

Dr. Angela Kueck, a gynecological oncologist at UConn Health, will run the initial clinical study, once it is approved by the FDA. The research team will sequence DNA from the tumors of 15 to 20 women with ovarian cancer, and use that information to make a personalized vaccine for each woman.

The researchers focused their clinical trial on patients with ovarian cancer because the disease usually responds well to surgery and chemotherapy in the short term, but often returns lethally within a year or two. That gives researchers the perfect window to prepare and administer the new therapeutic vaccines, and also means they may be able to tell within two years or so whether the vaccine made a difference. If the personalized vaccines prove to be safe and feasible, they'll design a Phase II trial to test its clinical effectiveness by determining whether they prolong patients' lives.

Identifying tiny differences

In order for the immune system to attack cancers, it first has to recognize them. Every cell in the body has a sequence of proteins on its exterior that acts like an ID card or secret handshake, confirming that it's one of the good guys. These protein sequences, called epitopes, are what the immune system 'sees' when it looks at a cell. Cancerous cells have epitopes, too. Since cancer cells originate from the body itself, their epitopes are very similar to those of healthy cells, and the immune system doesn't recognize them as bad actors that must be destroyed.

But just as even the best spy occasionally slips up on the details, cancer cell epitopes have tiny differences or mistakes that could give them away, if only the immune system knew what to look for.

"We want to break the immune system's ignorance," Srivastava says. For example, there could be 1,000 subtle changes in the cancer cell epitopes, but only 10 are "real," meaning significant to the immune system. To find the real, important differences, Mandoiu, the bioinformatics engineer, took DNA sequences from skin tumors in mice and compared them with DNA from the mice's healthy tissue.

Previous researchers had done this but looked at how strongly the immune system cells bound to the cancer's epitopes. This works when making vaccines against viruses, but not for cancers. Instead, Srivastava's team came up with a novel measure: they looked at how different the cancer epitopes were from the mice's normal epitopes. And it worked. When mice were inoculated with vaccines made of the cancer epitopes differing the most from normal tissue, they were very resistant to skin cancer.

Theoretically, this approach could work for other cancers, although the research has yet to be done.

Researchers in cancer biology, immunology, and computational bioinformatics had to work together to discover these connections. This type of collaboration is the engine driving UConn's personalized medicine and genomics research, according to UConn's vice president for research, Jeffrey Seemann.

"This research is a great example of how diverse disciplines create synergy under the umbrella of genomics," Seemann says. "UConn aims to capitalize on such synergies to make progress in many areas that tap into the genomics realm."

UConn researchers have applied for two patents for their new technique, and a Connecticut start-up company, Accuragen Inc., in which Srivastava has a financial interest, has obtained an option to license the patents.

Creating a safe, effective cancer vaccine is one of the major long-term goals of personalized medicine. Using a different approach than the one described in this paper, Srivastava's research has already created a vaccine against kidney cancer, which is in clinical use and commercially available in Russia.

"It is known that patients have genetic sequences that make them better candidates for some drugs than others. And we can figure that out much more easily now than five years ago," Srivastava says. The novelty of Srivastava's approach in this new research is that it results in a drug specifically designed for a single person. If the approach proves safe and effective, it would be the ultimate in individualized medicine.