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Anthocyanin intake improves cardiometabolic factors

May 26 2023. A systematic review and meta-analysis published May 23, 2023, in Diabetology & Metabolic Syndrome found improved indicators of cardiometabolic risk among trial participants who received plant compounds known as anthocyanins compared with a placebo or no treatment. The protective effect for several factors was greater among those who consumed anthocyanins as a supplement or extract.

Tirang R. Neyestani and colleagues at Shahid Beheshti University of Medical Sciences reviewed 47 trials that evaluated the effects of anthocyanin intake on metabolic and cardiovascular risk factors. Twenty-three of the trials compared anthocyanin extract or supplements to a placebo or no intervention. The remainder of the trials evaluated the effects of anthocyanin-containing foods or beverages.

Men and women who received anthocyanins experienced a significantly greater decrease in body mass index (BMI) and fat mass than individuals in the control groups. When participants were analyzed according to whether they received an anthocyanin supplement/extract or anthocyanin-containing food, supplements were associated with a reduction in BMI while food was associated with an increase.

Fasting blood sugar was significantly reduced among participants who received anthocyanins compared to the control groups. This effect was significant only among those who received anthocyanin supplements. When hemoglobin A1c, a marker of long-term glucose control was examined, participants who received anthocyanin supplements or had type 2 diabetes experienced significant reductions compared to controls. Triglycerides, and total, LDL and HDL cholesterol also significantly improved in anthocyanin-treated participants.

“The findings of this meta-analysis indicate that anthocyanin intake in the forms of natural foods and supplements can induce healthy changes in body fat mass, glycemic and lipidemic status and these effects are more prominent in the subjects with above-normal values,” Dr Neyestani and associates concluded. “Further well-designed studies are needed to evaluate and compare the efficacy of anthocyanin consumption as natural food sources versus supplements.”

—D Dye

Multivitamins help maintain memory in older adults

May 24 2023. Results from a trial reported May 24, 2023, in the American Journal of Clinical Nutrition indicate a benefit for multivitamin supplementation to prevent memory loss among older individuals.

The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) included two clinical trials (COSMOS-Web and COSMOS-Mind) that evaluated the effects of multivitamin supplementation on cognitive function. COSMOS-Mind found that, compared to a placebo, supplementing with a multivitamin-mineral was associated with better scores for cognition and executive function, and less cognitive decline relative to the previous year among participants who converted to mild cognitive impairment during the course of the study.

COSMOS-Web included 3,562 men and women whose age averaged 71 years. Participants received a multivitamin supplement or a placebo daily for three years. Cognitive assessments were conducted at enrollment and yearly for the remainder of the trial. After one year, as well as on average during the three years of follow-up, participants who received multivitamins had significantly better immediate recall compared with the placebo group. "We estimate that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 years of age-related memory change," authors Lok-Kin Yeung, MD, of Columbia University and colleagues wrote.

"The findings that a daily multivitamin improved memory and slowed cognitive decline in two separate studies in the COSMOS randomized trial is remarkable, suggesting that multivitamin supplementation holds promise as a safe, accessible and affordable approach to protecting cognitive health in older adults," coauthor JoAnn Manson, MD, of Brigham and Women's Hospital stated.

"Most older adults are worried about memory changes that occur with aging," Dr Yeung added. "Our study suggests that supplementation with multivitamins may be a simple and inexpensive way for older adults to slow down memory loss."

—D Dye

Higher vitamin D levels linked with overactive bladder improvement

May 22 2023.A systematic review and meta-analysis published May 17, 2023, in Nutrition Reviews adds evidence to an association between having higher vitamin D levels and a lower risk of overactive bladder or urinary incontinence. A decreased risk of incontinence was also revealed among people who used vitamin D supplements.

"Overactive bladder (OAB) is defined as a bladder storage syndrome characterized by a cluster of symptoms, including urgency and frequent urination with or without urinary incontinence (UI)," Qiang Zhang of Children's Hospital of Chongqing Medical University and colleagues explained. "Compared with other treatments, vitamin D supplementation, which provides adjuvant therapy for behavioral therapy, is relatively inexpensive and well tolerated."

The review and meta-analysis included four randomized controlled trials, three cohort studies, three cross-sectional studies and three case-control studies that examined the relationship between vitamin D levels and overactive bladder or urinary incontinence. Vitamin D levels were lower in participants with either condition in comparison with control groups. Participants who had deficient levels of the vitamin had a 4.46 times greater risk of overactive bladder, a 30% greater risk of urinary incontinence and a 96% higher risk of having both conditions compared with those who were not deficient. Analysis of articles that reported the effects of supplementation with vitamin D found a 66% lower risk of urinary incontinence among supplemented participants compared with those who did not receive vitamin D.

In their discussion of the findings, Zhang and colleagues noted that "Vitamin D has antibacterial, anti-inflammatory, and antiproliferative properties, which make it a valuable supplement."

"The results of this systematic review and meta-analysis show that vitamin D deficiency is associated with an increased risk of overactive bladder and urinary incontinence and that vitamin D supplementation reduces the risk of urinary incontinence," they concluded.

—D Dye

RA patients may benefit from NAD+ Boosters

May 19 2023. People with rheumatoid arthritis (RA) have alterations in nicotinamide adenine dinucleotide (NAD+) metabolism, according to research reported on April 24, 2023, in Arthritis & Rheumatology.

NAD+ is a cofactor of enzymes involved in metabolism, cell signaling, immune response, oxidative stress, DNA repair, gene expression and more.

Researchers examined NAD+ levels, related gene pathways and markers of inflammation in 153 men and women with RA and 56 healthy individuals. In another group that included 44 RA patients who were starting treatment with anti-tumor necrosis factor (anti-TNF) drugs, changes in NAD+ levels and their relationship with anti-TNF response after three months were assessed.

In the first group, RA patients had lower levels of NAD+ as well as upregulated activity of genes involved in NAD+ consumption compared with the healthy group. Additionally, expression of genes involved in the synthesis of NAD+ was reduced in the RA group. Patients with high levels of inflammatory mediators had the highest disease activity scores and the lowest levels of NAD+.

Among the group of patients that received anti-TNF drugs, disease activity and NAD+ levels improved toward levels observed in healthy controls.

In leukocytes (white blood cells) obtained from RA patients, the NAD+ boosters nicotinamide riboside and niacinamide upregulated NAD+. "Due to the fact that several beneficial effects of NAD+ boosters may target pathological mechanisms present in RA, we hypothesised that these natural compounds might have a positive impact on the disease," Carlos Perez-Sanchez and colleagues wrote.

"RA patients display altered NAD+ metabolism, directly linked to their inflammatory and disease activity status, and reverted by anti-TNF therapy, "Dr Perez-Sanchez and his coauthors concluded. "The preclinical beneficial effects of NAD+ boosters in RA-leukocytes, along with their proven clinical safety, might pave the way for the development of clinical trials using these compounds."

—D Dye

Greater carotenoid levels associated with lower respiratory disease risk

May 17 2023. A study published on April 11, 2023, in the British Journal of Nutrition linked a greater intake of plant compounds known as carotenoids with a lower risk of several respiratory diseases.

"Alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein/zeaxanthin and lycopene are all natural antioxidants," Ruiming Yang of Harbin Medical University in China and colleagues wrote. "Lungs have abundant blood flowing through and are constantly exposed to high levels of oxygen, and they are prone to inhaling harmful substances, which makes them highly susceptible to oxidative stress and developing lung diseases."

Yang and colleagues analyzed data from 7,884 participants aged 20 years and older in the Third National Health and Nutrition Examination Survey (NHANES) III for the current study. Serum carotenoid levels, including alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein/zeaxanthin and lycopene were measured at enrollment.

The team found a lower 39% lower risk of emphysema among men and women whose total carotenoid levels were among the top one-third of participants in comparison with those in the lowest third. Participants in the top-third of beta-cryptoxanthin levels had a 33% lower risk of emphysema and a 34% lower risk of bronchitis. Participants whose levels of lutein/zeaxanthin were among the top two thirds had a lower risk of asthma.

When mortality from respiratory diseases was analyzed, participants whose total carotenoids, alpha-carotene, lutein/zeaxanthin and lycopene were among the top third had respective 38%, 46%, 52% and 34% lower risks than the remainder of the participants.

"Higher serum total carotenoids and beta-cryptoxanthin levels are associated with decreased prevalence of emphysema and chronic bronchitis, and higher serum total carotenoids, alpha-carotene, lutein/zeaxanthin and lycopene levels had a lower mortality of respiratory disease, "Yang and associates concluded. "These findings indicate that carotenoids can be considered a supplementary treatment for people with respiratory diseases."

—D Dye

Blueberry polyphenols improve cognitive, vascular function

May 15 2023. Results from a trial reported March 25, 2023, in the American Journal of Clinical Nutrition revealed an association between supplementing with wild blueberry powder containing a high amount of polyphenols and improvement in vascular function and cognitive performance among older men and women.

"Growing evidence from epidemiological and human intervention trials indicates that (poly)phenols may have cardioprotective properties as well as the ability to improve cognitive function," Eleanor Wood, PhD, and associates wrote. "Blueberries are high in a subgroup of (poly)phenols known as anthocyanins, as well as other phenolic compounds such as procyanidins, flavonols, and phenolic acids."

Fifty-four participants aged 65–80 received 26 grams of blueberry powder or a placebo daily for 12 weeks. Endothelial function (evaluated by flow-mediated dilation), cognitive function, arterial stiffness, blood pressure, cerebral blood flow, intestinal microbiome composition and plasma and urinary polyphenol metabolites were assessed at the beginning and end of the study.

Among participants who received blueberry powder, endothelial function, blood pressure and aspects of cognitive function, including word recall and task-switching test accuracy, improved compared with the placebo group. Urinary polyphenol excretion was significantly greater in the blueberry-supplemented group at the trial's conclusion. Changes in some plasma polyphenol metabolites among those who received blueberries were correlated with changes in flow-mediated dilation, systolic blood pressure, immediate and delayed recall and task-switching test accuracy. Correlations were also found between some gut bacteria and flow-mediated dilation and task-switching test accuracy.

"To our knowledge, this is the first study to investigate the impact of blueberry consumption on cognitive and cardiovascular function simultaneously in a group of healthy older adults," Dr Wood and colleagues announced. "Our study findings indicate that gut microbiota and vascular blood flow may play important roles in mediating the cognitive benefits shown by the consumption of (poly)phenol-rich foods."

—D Dye

Study associates enzyme increase with lower cardiovascular mortality

May 12 2023. An article published March 21, 2023, in Antioxidants documented an association between a lower risk of cardiovascular mortality and higher levels of the enzyme SIRT1 after four years of supplementation with coenzyme Q10 (CoQ10) and selenium in a clinical trial.

SIRT1, a member of the family of sirtuin enzymes, is involved in the regulation of gene transcription, and has anti-inflammatory and antioxidant properties. The expression and activity of SIRT1 declines in several organs and tissues during aging. “SIRT1 activity is regulated by NAD+ availability, and the NAD+ levels are thought to decrease with age,” the authors explained. “Previous studies indicated that the selenium/coenzyme Q10 intervention can increase the levels of NAD+.”

The current investigation is a substudy of a clinical trial in which men and women received a placebo or 200 milligrams CoQ10 plus 200 micrograms selenium for four years. Participants who received the nutrient combination experienced an increase in SIRT1 from 252 nanograms per milliliter (ng/mL) to 469 ng/mL at the end of the trial, while SIRT1 levels declined from 269 ng/mL to 190 ng/mL in the placebo group.

During a 10-year follow-up period after the end of the trial, deaths from cardiovascular disease occurred among 15% of the treatment group and 32% of the placebo group. Participants who died of cardiovascular disease had an average SIRT1 level of 242 ng/mL while levels in the remainder of the participants averaged 319 ng/mL.

“The main finding of this investigation is that a four-year intervention with combined selenium and coenzyme Q10 significantly increased the serum concentration of SIRT1, and this elevation was associated with reduced cardiovascular mortality,” the authors concluded. “We suggest that the observed increase in SIRT1 operates as a mediator and thus contributes to protection against vascular ageing and atherosclerosis.”

—D Dye

Nutrient metabolic cofactors boost cognitive function in Alzheimer patients

May 10 2023. A phase 2 study reported on January 26, 2023, in Translation Neurodegeneration resulted in improved cognition and other factors among Alzheimer disease patients who consumed a combination of nutrients designed to support metabolic function.

"A growing body of evidence suggests that impaired brain energy metabolism and mitochondrial dysfunction in Alzheimer disease may contribute to cognitive decline," Burak Yulug and colleagues wrote. "Combining multiple compounds to both reduce oxidative injury and improve bioenergetics, in other words, to target multiple pathways simultaneously, has been proposed as a therapeutic strategy associated more likely with successful translational outcomes."

The study evaluated the effects of a combination of metabolic activators that included N-acetylcysteine, the amino acid L-serine, nicotinamide riboside and L-carnitine tartrate in 69 men and women with mild to moderate Alzheimer disease. Forty-seven participants received the combined metabolic activators and 22 received a placebo. Cognitive function and other factors were evaluated before and after the 12-week treatment period.

Among participants who received the nutrient combination, Alzheimer Disease Assessment Scale-cognitive subscale scores significantly improved at the end of the treatment period compared with the beginning. When participants were divided according to whether their scores were high (indicating worse cognitive function) or low, combined metabolic activator-treated participants who scored high had significantly improved scores in comparison with the placebo group at the study's conclusion. Benefits occurred in patients with both mild and severe disease. Hippocampal volume, brain cortical thickness, and proteins and metabolites associated with glutathione and NAD+ metabolism also improved in the combined metabolic activator-treated group. No major safety concerns were identified.

"Our results indicate that treatment of Alzheimer disease patients with combined metabolic activators can lead to enhanced cognitive functions and improved clinical parameters associated with phenomics, metabolomics, proteomics and imaging analysis.," the authors concluded.

—D Dye

Higher vitamin E intake associated with lower COPD risk

May 08 2023. A study that examined data obtained from the National Health and Nutrition Examination Survey (NHANES) found a lower risk of chronic obstructive pulmonary disease (COPD) in association with a greater intake of vitamin E. The findings appeared on April 12, 2023, in Frontiers in Nutrition.

“Vitamin E is a vitamin with an antioxidant function and one of its main functions is to prevent the peroxidation of lipid molecules,” Ziyi Lu of Central South University in China and colleagues wrote. “And since oxidative stress is one of the important features of COPD, vitamin E may be a factor in the prevention of COPD.”

Liu and colleagues analyzed information from 4,706 participants in NHANES between 2013 and 2018, among whom 155 had COPD. Participants’ vitamin E intake averaged 8.66 mg per day (which equals 12.9 IU natural alpha-tocopherol), which is less than the recommended daily allowance for people 14 years of age and older of 15 mg (22.4 IU).

A 43% lower adjusted risk of COPD was found among men and women whose vitamin E intake was among the top one-third of participants compared with the lowest third. A protective effect for high vitamin E intake was found in all subgroups examined, which included participants grouped according to age, gender, race, marital status, educational level, body mass index, smoking status, or whether they had diabetes or high blood pressure.

“After analyzing data based on the NHANES database from 2013–2018, the results showed that vitamin E intake among U.S. adults was well below the recommended levels and that higher vitamin E intake was negatively associated with COPD incidence,” Liu and associates concluded.

“Thus, supplementation of vitamin E intake appears to have an important role in the prevention of COPD,” they wrote.

—D Dye

Stress relief could help reverse aging

May 05 2023. An article published in the May 2, 2023, issue of Cell Metabolism described an increase in biologic age that occurs in response to stress, which is reversible when the stress is relieved.

"Aging is classically conceptualized as an ever-increasing trajectory of damage accumulation and loss of function, leading to increases in morbidity and mortality," Jesse R. Poganik, PhD, and colleagues wrote. "However, recent in vitro studies have raised the possibility of age reversal. Here, we report that biological age is fluid and exhibits rapid changes in both directions."

The researchers evaluated biologic age by measuring DNA methylation in blood samples from older men and women before they underwent emergency surgery, as well as shortly after the surgery and prior to hospital discharge up to seven days later. The team also measured biologic age in blood samples obtained from pregnant mice and women before and after giving birth, as well as in pairs of mice that had their circulatory systems joined and patients admitted to the ICU for viral infections. They found that biologic age increased during periods of physiologic stress but was reversed upon resolution of the stressful situation.

“Traditionally, biological age has been thought to just go up and up, but we hypothesized that it’s actually much more dynamic,” Dr Poganik commented. “Severe stress can trigger biological age to increase, but if that stress is short lived, the signs of biological aging can be reversed.”

“Our findings challenge the concept that biological age can only increase over a person’s lifetime and suggest that it may be possible to identify interventions that could slow or even partially reverse biological age,” added senior author Vadim Gladyshev, PhD. “When stress was relieved, biological age could be restored. This means that that finding ways to help the body recover from stress could increase longevity.”

—D Dye

Calcium channel blocker mortality risk lower in B vitamin users

May 03 2023. Findings from a study reported April 28, 2023, in the American Journal of Clinical Nutrition revealed a protective effect for supplementation with B vitamins against the risk of mortality associated with calcium channel blocker drugs used to treat cardiovascular disease.

"The B-vitamins folic acid, vitamin B12 and B6 are water-soluble nutrients essential for diverse physiological processes, including homocysteine metabolism," Indu Dhar and colleagues wrote. "Notably, calcium channel blocker treatment has been associated with increased systemic homocysteine levels."

The study included 3,991 men and women, among whom 907 were prescribed calcium channel blockers after undergoing coronary angiography for suspected stable angina (chest pain that occurs upon physical exertion, associated with cardiovascular disease). Of this group, 2,573 were enrolled in a clinical trial in which they received folic acid, vitamin B6 and vitamin B12; folic acid plus vitamin B12; vitamin B6 alone, or a placebo for a median of four years.

During a median 10.3 years of follow-up, 356 of the subjects died from cardiovascular disease and 466 died of noncardiovascular causes. Calcium channel blocker use was associated with a 34% higher risk of dying during follow-up compared with nonuse of the drugs. Among calcium channel blocker users who were not treated with B vitamins, mortality risk was 54% greater. No significant association between calcium channel blocker use and mortality was observed in B vitamin-treated individuals.

"Among patients with suspected stable angina pectoris, the use of calcium channel blockers was associated with increased long-term risk of all-cause, cardiovascular and non-cardiovascular mortality," the authors concluded. "However, these associations were attenuated in patients receiving B-vitamin treatment, which may explain some of the heterogenic results in prior observational studies."

—D Dye

Meta-analysis concludes CoQ10 supports a healthy inflammatory response

May 01 2023. Findings from a systematic review and meta-analysis published April 28, 2023, in Molecular Nutrition & Food Research provided evidence for an association between coenzyme Q10 (CoQ10) supplementation and a healthy level of inflammation in humans.

“Considering the side effects of anti-inflammatory drugs in clinical use, it is necessary to regulate the level of inflammatory factors through diet or nutritional supplements,” the authors wrote.

The meta-analysis included 31 trials that evaluated the effects of CoQ10 on blood markers of inflammation including C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α).

Analysis of the 23 studies that evaluated the effects of CoQ10 supplementation on CRP determined a significant reduction among supplemented participants. In subgroup analyses, participants who received 100–200 milligrams CoQ10 per day, those over the age of 50 years and healthy individuals experienced a significant decrease.

Among 21 trials that included data concerning CoQ10’s correlation with IL-6, a significant reduction was also observed. Dosages of 200–300 mg per day were significant, as were reductions observed among men and participants with cardiovascular disease and other diseases.

And among 17 trials that investigated the effect of CoQ10 on TNF-a, supplementation was significantly associated with lower levels. Dosages of 300–400 mg per day were significantly more effective at reducing this marker compared to lower doses. The association between supplementation and a decrease in TNF-a was also significant among participants who were younger than 50 years of age or had unhealthy lipid levels, NAFLD and other diseases.

“Endogenous CoQ10 declines significantly with aging or in disease status,” the authors noted. “Therefore, it is necessary to add the CoQ10 through dietary supplements based on its important benefit. Based on our results, a daily supplementary dose of 300-400 mg may be considered as the effective and safe dose for reducing inflammatory factors.”

—D Dye

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