In The News: January 2011

Metabolic syndrome is caused by a deadly cluster of at least three of the following cardiovascular risk factors: obesity, high blood pressure, high blood sugar, high levels of triglycerides, and low levels of “good” HDL cholesterol. With nearly a quarter of the North American population affected, some doctors believe we are reaching epidemic proportions of people at risk.*

“We are in the midst of an obesity epidemic that is contributing to an increase in the number of people with the metabolic syndrome in North America,” noted senior researcher Dr. Mark Eisenberg of McGill University, in Montreal. “Thus, an increasingly large number of people are at a high cardiovascular risk.”

In Dr. Eisenberg’s report, which was published in the Journal of the American College of Cardiology, the researchers found that the metabolic syndrome increased the risk of cardiovascular disease, heart attack, and stroke by two-fold or more. Patients with the syndrome also had a 50% increased chance of dying from any cause.

—J. Finkel

A report published in the British Journal of Nutrition revealed a protective effect for a number of antioxidant nutrients against all-cause and disease-specific mortality in older individuals over a 13-year average period.*

Researchers evaluated data from 1,054 participants in the British National Diet and Nutrition Survey. Four day dietary records were analyzed for the intake of energy and nutrients. The participants were followed through September, 2008.

Increased plasma vitamin C, alpha-carotene, selenium, and zinc were significantly associated with a reduction in all-cause mortality, as was the dietary intake of vitamin C, carotenoids, zinc, copper, and total energy. “Future studies should attempt to determine, first, which nutrients are the most frequent predictors of all-cause and specific-cause mortality in different populations, and second, whether these predictions can imply causal relationships, such that dietary or other interventions might promote disease-free longevity,” the authors write.

Editor’s note: These patterns remained fundamentally similar when deaths from vascular, cancer, and respiratory diseases were separately considered, however, increased dietary vitamins C and E were found to confer a significant protective effect against cancer, and dietary vitamin E protected against respiratory disease in males (while carotenoid intake was protective in women).

—D. Dye

The journal Cell Metabolism reports that branched-chain amino acids, which include leucine, isoleucine, and valine, extended the average life span of mice when administered in their drinking water.* Normal mice given the amino acids beginning at nine months of age had a median life span of 869 days, while untreated animals had a life span of 774 days.

Further experimentation determined that supplemented animals experience an increase in cardiac and skeletal muscle mitochondria, which are the energy producing organelles of cells. There was also greater activity of a longevity-associated gene known as SIRT1, and less oxidative damage, which are effects similar to those conferred by calorie restriction in some studies. Animals given branched-chain amino acids additionally showed increased exercise endurance and motor coordination.

Editor’s note: Lead researcher Dr. Enzo Nisoli observed that amino acid supplements do not have to be digested as do the proteins which contain them, enabling them to enter the bloodstream immediately, remarking that, “They come with no energy cost.”

—D. Dye

An article published in the American Journal of Clinical Nutrition reports an association between multivitamin use and a reduced risk of myocardial infarction (MI or heart attack) in older women.*

The current study included 2,262 women with a history of cardiovascular disease and 31,671 women with no history of the disease who participated in the Swedish Mammography Cohort. Over the 10.2 year average follow-up period, 269 heart attacks occurred among women who had cardiovascular disease, and 932 occurred in those with no history. Among women who had no history of the disease, those who reported using a multi-nutrient supplement had a 27% lower adjusted risk of heart attack than those who were not supplement users. Using a multivitamin along with other supplements was associated with a 30% lower risk, and use for at least five years was linked to a 41% lower risk of myocardial infarction compared to non-users.

Editor’s note: Concerning the contradiction of the current study’s findings with other research which failed to uncover a benefit, the authors explain that ingredients and dosage of the components of multi-nutrient supplements vary, that some trials were conducted in subjects with pre-existing cardiovascular disease, and that the majority of trials had short follow-up periods.

—D. Dye

The Journal of Bone and Joint Surgery reports that nearly half of orthopedic surgery patients are deficient in vitamin D, a condition that impairs bone healing, muscle function, and surgery recovery.*

Joseph Lane, MD and colleagues reviewed the charts of 723 men and women scheduled for orthopedic surgery from January, 2007 to March, 2008 and found that 43% of the patients had insufficient preoperative vitamin D levels and 40% had deficient levels.

Sixty percent of trauma service patients had insufficient levels and 52% were deficient. A high percentage of vitamin D insufficiency was also observed in sports medicine and arthroplasty (hip and knee replacement) services.

“The take home message is that low vitamin D has an implication in terms of muscle and fracture healing, it occurs in about 50% of people coming in for orthopedic surgery, and it is eminently correctable,” Dr. Lane stated.

Editor’s note: Dr. Lane suggested that, “Patients who are planning to undergo any orthopedic procedure can request a screening (specifically, a blood test called the 25-hydroxyvitamin D test) or ask to be placed on a medically supervised vitamin D supplement regimen prior to surgery.”

—D. Dye

A report published in the Proceedings of the National Academy of Sciences suggests that some of the increase in obesity observed over the past several decades could be due to increased exposure to light at night.*

Dr. Randy Nelson and colleagues evaluated the effects of nighttime light exposure in mice. A greater increase in body mass was observed among mice exposed to constant light and those exposed to a cycle of daylight and dim light compared to animals that received standard light-dark exposure.

In another experiment, feeding during darkness prevented excess fat gain in animals exposed to the daylight/dim light cycle. Due to their nocturnal nature, mice normally consume most of their food at night when they are active, in contrast with humans, who normally eat during the day. Dr. Nelson suggests that in humans, late-night eating could be a risk factor for obesity.

Editor’s note: Exposure to light at night disrupts melatonin signaling, which could lead to changes in activity, food intake, and metabolism.

—D. Dye

Researchers at the University of Illinois report that the flavonoid luteolin helped reduce inflammation in the brains of aged mice, which restored memory to levels observed in younger animals.*

The study examined luteolin’s effect in immune cells in the brain known as microglial cells, which produce inflammatory signaling molecules in response to infection. When the researchers exposed microglial cells to a bacterial toxin, they produced inflammatory cytokines capable of destroying brain cells known as neurons. While pretreatment of neurons with luteolin showed no benefit, exposure of microglia to this compound prevented neuron death.

In an experiment with mice, adult and aged animals were fed a control diet or a luteolin-enhanced diet for four weeks. Assessment of spatial memory found increased learning and recall in older mice supplemented with luteolin compared to aged controls. In addition, inflammatory markers in the brain’s hippocampus were decreased.

Editor’s note: Luteolin is found in carrots, rosemary, celery, and some supplemental nutritional formulas.

—D. Dye

Researchers at Australia’s Queensland University of Technology (QUT) have found that gamma tocotrienol, one of eight forms of vitamin E, could help prevent prostate cancer regrowth due to an ability to inhibit prostate cancer stem cells. The research was described in an article published in the International Journal of Cancer.*

Dr. Patrick Ling and colleagues demonstrated that gamma-tocotrienol downregulates the expression of prostate cancer stem cell markers in androgen-independent prostate cancer cell lines. Pretreatment of one of the cell lines with gamma tocotrienol was found to suppress the cells’ ability to initiate tumor growth.

“Currently there is no effective treatment for metastatic prostate cancer, because it grows back after conventional therapies in more than 70% of cases,” Dr. Ling observed. “But with gamma-tocotrienol, QUT researchers have found a better way to treat prostate cancer, which has the potential to inhibit recurrence of the disease.”

Editor’s note: Dr. Ling noted that, “Previous clinical trials using another vitamin E constituent to inhibit prostate cancer development were unsuccessful, but these trials did not use the vitamin E constituent gamma-tocotrienol.”

—D. Dye

A report published in a recent issue of the journal Heart reveals an increased risk of premature death from all causes and cardiovascular disease among men whose testosterone levels were deficient.*

Researchers at Royal Hallamshire Hospital in Sheffield, England analyzed data from 930 men with cardiovascular disease who underwent elective coronary angiography in a cardiac referral center between June 2000 and June 2002. Serum total testosterone and bioavailable testosterone were measured on the day of the procedure.

The subjects were followed for an average of 6.9 years, during which 129 deaths occurred. Twenty-one percent of those with deficient bioavailable testosterone levels died from all causes over follow-up, compared to 12% of those with normal levels. Borderline low levels of total testosterone were also associated with an increased risk of dying over follow-up.

Editor’s note: The current study’s finding indicates that men with low testosterone are almost twice as likely to die over a 7-year period.

—D. Dye

People seldom die of a “sudden” heart attack. Instead, coronary artery blockage represents an accumulation of risk factors that were reversible if detected before the heart attack happened.*

A meticulous study done recently in the Annals of Internal Medicine looked at a large group whose blood was initially tested between ages 18-30. Seven additional blood tests were done on each person over a 20-year period. The results showed that those with the highest LDL (over 160 mg/dL) were 5.6 times more likely to have calcium buildup in their coronary arteries by age 45.

LDL (low-density lipoprotein) transports cholesterol from the liver throughout the vascular system. In the presence of excess LDL, too much cholesterol saturates the blood and contributes to arterial occlusion. This study in the Annals of Internal Medicine showed that over a 20-year period, those with even moderately elevated LDL (100-129 mg/dL) were 2.4 times more likely to have coronary calcification.

This study validates the need for everyone to have their blood tested for cardiac risk factors starting no later than age 18.

—J. Finkel

Diabetes is the number one cause of blindness, lower limb amputations, heart attack, stroke, dementia, and cancer, yet a recent report by the Centers for Disease Control and Prevention (CDC) states that if the current upward trend of diabetes isn’t stemmed, the number of Americans living with this disease will skyrocket.*

“Certainly the fact that diabetes prevalence is increasing and is likely to continue to increase into the future isn’t really surprising,” said Dr. M. Sue Kirkman, vice president of clinical affairs at the American Diabetes Association. “The absolute numbers in terms of the projections, are, of course, concerning and shocking.”

CDC researchers also studied the rise in obesity in the US and found that the number of Americans living with diabetes is expected to double and possibly even triple by 2050. The overwhelming majority of these people will develop type 2 diabetes, where the body loses its ability to produce insulin.

“A large number of type 2 cases can be prevented,” Ann Albright, director of the CDC’s Division of Diabetes Translation said. “A smart nutritious diet and moderate exercise, even just 30 minutes a day of vigorous walking, can help maintain proper blood sugar levels and help prevent type 2 diabetes.”

—J. Finkel

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