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Providing perspectives on recent research into vitamins and nutritionals

Archive for 'October 2015'


    Biomarkers are Best Indicators of Nutritional Status

    Short and sweet. Accurate nutritional assessment requires blood sampling (until other less-invasive measures are developed). Self-reported dietary intake instruments are poorly, in statistical terms the term would be ‘weakly’, correlated with blood biomarkers.

    Lassale and colleagues asked 198 adult volunteers complete dietary records on 3 non-consecutive days. Two blood samples were taken 3 weeks apart to measure plasma concentrations of vitamin C, β-carotene, and omega-3 fatty acids – eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and eicosapentaenoic acid (EPA). 

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    Can Extra Protein Help the Elderly Age Well?

    With all the debates about fat, sugar and gluten, it is easy to forget about the other macronutrient: protein. Protein is necessary for all of us, but it is perhaps most important for older people. As people age, they tend to lose muscle mass from their bodies. Even if body weight stays the same, there is a strong tendency for muscle to turn into fat over a period of decades. Loss in muscle results in frailty and reduced ability to carry out normal, everyday activities. Helping people maintain muscle strength and function in old age is key to healthy aging. What role does protein play in muscle building in the elderly?

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    Vitamin E Helps Maintain Strong Bones

    Vitamin E is an antioxidant known to protect polyunsaturated fatty acids and other sensitive moieties within cell membranes, tissues (brain, eyes, muscles, etc) and sperm from oxidative damage. Shi and colleagues report that low vitamin E status may jeopardize bone health.

    Collecting data from 3,203 adults (1,178 women and 1,025 men), 40-75y, living in China, dietary vitamin E intake and serum α-tocopherol concentrations were positively associated with bone mineral density (BMD). 

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    Vitamin B12 Deficiency and its Contribution to Dementia and Stroke

    In a recent narrative review, Dr Spence brings attention to the contributory role that vitamin B12 deficiency plays in dementia and stroke risk. Older people are much more likely to be affected by vitamin B12 deficiency. For example, while overall less than 3% of the US population has low vitamin B12 levels, incidence of low vitamin B12 concentrations in people aged over 60 is 5%. But how is B12 deficiency linked to stroke and dementia?

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    Estimating the Impact of Salt Reduction in Packaged Soups on Public Health

    Many people do not realize that salt is an essential nutrient. The sodium in table salt regulates fluid in the body and is needed for the proper functioning of nerves and muscles. As with everything, we can have too much of a good thing. High consumption of salt can cause hypertension and contributes to cardiovascular disease risk. Salt reduction has long been touted as a means to reduce the burden of disease caused by too much salt. But is reducing salt in a single type of food, soup, likely to have a measurable effect on public health?

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    Celiac Disease and Folate Deficiency

    In 1912, Dr Casimir Funk discovered the first B vitamin. He was the first to isolate vitamin B3 (niacin). After a strange series of events, and discussion of a cast of scientific experts, the first Nobel Prize for vitamin research was jointly awarded to Eijkman and Hopkins in 1929.

    Over 100 years later, Valente and colleagues report lower serum folate in men and women with celiac disease vs healthy controls. Men and women with celiac disease had significantly lower serum folate concentrations than controls, 5.7 vs 11.7 ng/mL and 8.8 vs 13.4 ng/mL, respectively

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    Rice Fortification: An Option for Countries with Rampant Folate Deficiency?

    A recent study by Htet and co-workers reported on the micronutrient status of adolescent girls in Myanmar. There was good and bad news. On the one hand, less than 1% of the 391 anemic girls had vitamin B12 deficiency. On the other hand, over half the girls had folate deficiency, and most girls had a deficient intake of vitamins A, B6, C, folate, iron and calcium. What role could rice fortification play in reducing rates of folate deficiency?

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    Different Options for Meeting Omega-3 Recommendations with the Diet

    Recommendations for omega-3 consumption vary greatly. Healthy adults are advised to consume anywhere from 90 to 500 mg of long chain omega-3 PUFAs, but the recommendation of 250 mg per day seems to be most common. When the guidelines don’t directly mention long chain omega-3’s, they state that we should eat fish (especially fatty fish) at least twice a week, or otherwise increase consumption of foods containing omega-3. Unfortunately, it seems that it is difficult to reach these levels. Around the world, less than 20% of the population more consume than 250 mg per day omega-3. Why is this? 

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    Insights into Self-Reported Dietary Intake

    The value of dietary intake questionnaires to estimate food intake is under debate. A systematic review of 45 dietary intake studies conducted with children aged 6 to 12y finds timing of the interview to be important. As the interval between food consumption and the dietary intake survey increased, accuracy of recall diminished. Children’s age, body mass index, social desirability, food preferences, and cognitive ability were also related to accuracy.

    Among adults, self-reported intake measures have been found to systematically underestimate energy intake by hundreds of calories daily

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    Why Conduct Nutrition RCTs without Nutrition Assessment?

    When conducting randomized controlled studies (RCTs), a BIG challenge is that study participants often conceal information. Participants will lie to get into clinical trials. People are known to conceal health problems, deny use of prescription medications, and exaggerate symptoms to qualify for a study. This is a problem.

    Nutrition RCTs are particularly difficult because a true placebo treatment does not exist. Everybody eats. Everybody has some level of nutritional status ranging across the spectrum of deficient, insufficient, and adequate. 

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    Adverse Event Reporting, Dietary Supplement Use and Safety

    Hospitals collect data on emergency visits for all types of injuries, including adverse drug events (ADEs). When someone goes to the emergency room for an ADE, they are asked to identify the drugs, vaccines, and dietary supplements they have taken. This information helps the medical team determine treatment strategies. A case report is generated listing the name, dose, route, frequency and duration of every item named by the patient, regardless of whether it contributed to the ADE or not.  

    By now you may have seen headlines that “Supplements Send Thousands of Americans to Emergency Room Every Year, Study Finds”. 

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    Could Nutrition Assessment Innovations End Food Fights and Reduce Health Costs?

    A provocative viewpoint discusses obstacles to the development of cost-lowering health technologies. Basically, the authors suggest that venture capital focus on investment returns is hampering innovation. To make their case, Kellerman and Desai discuss a one-a-day miracle pill. They could have used a more realistic possibility – nutrition assessment.

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    World Food Day will be here Friday: What are you Doing?

    This Friday, October 16, will be World Food Day. The 2014 theme is Family Farming, Feeding the World, Caring for the Earth. Being born on a farm, and having family who continue to farm and innovate to increase sustainability, makes this day especially important to me.

    Without a sustainable agri-food system, food security cannot be achieved. Because of the prevalence of overweight and obesity, many believe everyone is eating too much. In reality, overweight/obesity often co-exist with inadequate vitamin and mineral intakes. 

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    Should Dairy Products be Avoided? The Devil in the Details

    Because self-reported dietary intakes are fraught with errors (under- and over-reporting of food groups with healthy perceptions, difficulties in calculating nutrient intakes from a restrictive food list, etc), biological measures of nutrient status are preferred.

    Dawczyniski and colleagues evaluated the associations of circulating fatty acids on cardiovascular outcomes, taking issue with the conclusions of Chowdhury and colleagues on the health benefits of saturated fatty acids found in dairy products. 

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    Carotenoids and Age-Related Macular Degeneration: The Impossible Clinical Trial?

    Randomized, double-blind, controlled clinical trials are seen as the gold standard for biomedical research for proving that a given intervention causes a certain result. However, there are a few issues with testing interventions for chronic diseases that begin to develop decades before the clinical disease. One example of this is age-related macular degeneration (AMD). How can we adequately test the relationship?

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    The Complexities of Vitamin D

    Two very different vitamin D research studies demonstrate the complexities of nutrition. After identifying 20 eligible studies involving 9,209 participants, Zhang and colleagues report vitamin D deficiency is associated with increased risk of gestational diabetes mellitus (GDM). Qi and colleagues report that carrying a specific vitamin D polymorphism, the T allele of DHCR7 rs 12785878, may benefit individuals with greater improvements in insulin resistance (vs non-carriers) when following a high-protein weight-loss diet. 

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    Pills / vitamins woman

    Update on Supplemental Folic Acid During Later Pregnancy

    One of our most popular posts looks at whether supplemental folic acid is worthwhile in the second and third trimesters of pregnancy. A group of researchers lead by Wang have now conducted a study that looks at supplemental folic acid use during pregnancy and risk of pre-eclampsia that provides more evidence in favor of continuing supplementation during pregnancy.

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    Should Pregnant Women Be Screened or Routinely Supplemented to Prevent Iron Deficiency Anemia?

    Pregnant women are at high risk of iron deficiency anemia, and the US Preventive Services Taskforce (USPSTF) recently updated their guidelines regarding screening for iron deficiency, or its prevention with routine supplementation. Pregnancy increases the demand for iron as both the fetus and the mother’s circulatory system require the production of iron-containing red blood cells. For this reason, guidelines for iron intake are much higher than for women who are not pregnant.

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    Fortification and Enrichment of Whole-Grain Wheat Flours: The Case for Folic Acid

    For many children, the favorite foods are all the same: French fries, pizza, sausages in all shapes and forms, candy, and white bread. For a short period of time, however, my daughter bucked the white bread trend: she was also a chocoholic and ate dark brown bread readily in the hope that it was chocolate-flavored. Ms Almost-Five has wised up to the situation, and like “normal” children she also prefers white bread. White bread is enriched so that it contains the B-vitamins of whole grain flour, however whole grain flour is not fortified with folic acid. How does choice of whole grain vs. white wheat-based products affect folate intakes?

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    Vitamin D, DHA, Lactating Women and their Babies

    Colostrum, the milk produced during the first few days of lactation, is particularly rich in nutrients needed by infants. The nutritional content of human milk continues to change during the course of the lactation and differs among women.

    Human breast milk does not contain enough vitamin D (or vitamin K) to meet infant requirements. Two options exist. Both involve increasing vitamin D intake by 1) infants directly or 2) the mother to increase the vitamin D content of her breast milk. 

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    EFSA Affirms Safety and Benefits of Vitamin E

    The Scientific Panel on Food Additives and Nutrient Sources issued a scientific opinion that all forms of vitamin E, natural and synthetic, are not of safety concern at the levels used in food. They set a upper limit (UL) of 300 mg daily.

    The Panel recommended re-assessing the data on other tocopherols, namely γ-tocopherol and δ-tocopherol, as more data become available. 

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