Dr. Vittoria Repetto’s Newsletter #31

Disclaimer:
Remember the information presented in this newsletter is intended for education only. Always consult with your health care practitioner on matters of health and disease.
This newsletter contains summaries of research papers published in Medical/Nutritional journals and presented at a web site for health professionals only in addition to papers and articles on chiropractic & applied kinesiology.
If you would like a complete copy of the paper, please e-mail this office at DrVittoriaRepett@aol.com stating what paper you want and the URL and I’ll happily copy & paste and email you a copy.
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Newsletter #31
Table of Contents:
1) Dr. Repetto’s Blog
2) Vitamin D May Influence Cognitive Dysfunction and Dementia
3) Dietary Soy Linked to Lower Risk for Breast Cancer Death, Recurrence
4) Gingko Biloba May Not Reduce Cardiovascular Mortality or Events
5) Electrical Stimulation of Ankle Plantar Flexors May Improve Gait After Stroke
6) Milk Thistle Treats Chemotherapy-Induced Hepatoxicity
7) In Older Women, High Testosterone Linked With High Cardiovascular Risk
Celiac Disease Increases Risk of Neurological and Psychiatric Disorders
9) Vitamin D May Reduce Cardiac Work
10) Pomegranate Ellagitannin–Derived Compounds Exhibit Antiproliferative and Antiaromatase Activity in Breast Cancer Cells In vitro(in the test tube)
11) Atherosclerosis regression & HDL Raising With Niacin Superior to Ezetimibe
12) Contraindications to Vitamin D
13) http://articles.mercola.com/sites/articles/archive/2010/01/14/Artificial-Sweeteners-Dont-Fool-Your-Brain.aspx

http://articles.mercola.com/sites/articles/archive/2010/01/23/Why-Your-DNA-Isnt-Your-Destiny.aspx

http://articles.mercola.com/sites/articles/archive/2010/01/09/Alternative-Explanation-for-Why-People-Get-Fat.aspx

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1) Dr. Repetto’s Blog – http://drvittoriarepetto.wordpress.com/
a) The Correct Use of Muscle Testing in Nutritional Evaluation in Applied Kinesiology
b) The Beginning of My Journey as a Healer
c) Cross-Hypersensitivity between Food and Pollen Allergies
d) Comment: Artificial Sweeteners: 3 Reasons To Rethink That Diet Coke

2) Vitamin D May Influence Cognitive Dysfunction and Dementia

Two papers show in separate populations that low levels of vitamin D are associated with cognitive impairment and cerebrovascular disease, including stroke. A third study of only men finds no such association.
In the first study, investigators led by Cédric Annweiler, MD, from Angers University Hospital in France, conducted a cross-sectional study exploring these questions. Their paper was released early online September 30. The researchers looked at more than 750 community-dwelling older women. Participants were from the French study known as Epidémiologie de l’Ostéoporose. The women were 75 years or older.
The researchers report that 17% of participants had vitamin D deficiency. This was defined as a serum 25-hydroxyvitamin D level of less than 10 ng/mL. Women with vitamin D deficiency had lower mean Short Portable Mental State Questionnaire scores (P < .001). They also had an odds ratio for cognitive impairment of about 2 after controlling for relevant confounders.
The authors conclude that inadequate vitamin D is associated with cognitive impairment in elderly women and that vitamin D supplements may improve or maintain cognitive function.
The second report, by investigators led by Jennifer Buell, PhD, from Tufts University in Boston, Massachusetts, and released November 25, came to a similar conclusion. The researchers also conducted a cross-sectional study — this one of more than 300 men and women.
Participants were 65 years or older and were involved in the Nutrition and Memory in Elders study. They were evaluated for dementia and cerebrovascular disease and underwent magnetic resonance imaging to assess overall and regional brain volumes, white matter hyperintensity, and infarcts.
Investigators show that 14% of the study sample had inadequate vitamin D. Another 44% were classified as vitamin D insufficient (10 to 20 ng/mL).
Patients with low vitamin D levels had higher white matter hyperintensity volume and a higher prevalence of large vessel infarcts. Low vitamin D level was also linked with an odds ratio of about 2 for all-cause dementia, Alzheimer’s disease, and stroke after controlling for relevant confounders.
The authors conclude that vitamin D deficiency is associated with an increased risk for dementia and cerebrovascular disease and that vitamin D may have vasculoprotective properties.
However, a third report, also released November 25, came to a different conclusion.
Investigators led by Yelena Slinin, MD, from the VA Medical Center and the University of Minnesota at Minneapolis, found little evidence linking vitamin D and cognitive impairment.
The researchers conducted a longitudinal assessment of more than 1600 community-dwelling men. Participants were 65 years or older and were involved in the Osteoporotic Fractures in Men Study.
Investigators assessed cognitive function using the modified Mini-Mental State Examination and the Trails B test.
At baseline, the odds ratios for cognitive impairment were between 1.6 and 1.8 in the lowest vitamin D quartile compared with the highest. However, these odds ratios did not reach statistical significance and were lower after controlling for race, ethnicity, and education.
Low vitamin D level was defined differently in this study at less than 20 ng/mL. In the other 2 studies, vitamin D deficiency was considered less than 10 ng/mL.
For incident cognitive impairment, the odds ratio for a significant decline in Mini-Mental State Examination score was 1.5 in the lowest quartile of vitamin D concentration compared with the highest quartile. The trend across the quartiles was significant. Yet again, control for confounding by race, ethnicity, and education slightly lowered the trend — enough to lose statistical significance.
The authors suggest that additional studies should be performed that include women and tests of other cognitive domains.
Editorialist Dr. Miller argues that this study is limited by a lack of women included in the work. He says it was also limited because the lowest quartile of vitamin D status consisted of all subjects with levels under 20 ng/mL. “Perhaps a reevaluation of the data comparing deficient subjects (<10 ng/ mL) to nondeficient subjects would reveal significant associations,” he notes.

Neurology. Published online September 30 and November 25, 2009

http://www.medscape.com/viewarticle/713345?src=mpnews&sp

3) Dietary Soy Linked to Lower Risk for Breast Cancer Death, Recurrence

Dietary soy intake among Chinese women with breast cancer is significantly associated with lower risk for death and recurrence, according to the results of a large, population-based cohort study reported in the December 9 issue of the Journal of the American Medical Association.
“Soy foods are rich in isoflavones, a major group of phytoestrogens that have been hypothesized to reduce the risk of breast cancer,” write Xiao Ou Shu, MD, PhD, from Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues. “However, the estrogen-like effect of isoflavones and the potential interaction between isoflavones and tamoxifen have led to concern about soy food consumption among breast cancer patients.”
The study goal was to determine the association of dietary soy intake after diagnosis of breast cancer with total mortality and cancer recurrence. In the Shanghai Breast Cancer Survival Study of 5042 female breast cancer survivors in China, women 20 to 75 years of age who were diagnosed between March 2002 and April 2006 were recruited and followed up through June 2009.
At about 6 months after cancer diagnosis, participants provided information on cancer diagnosis and treatment, lifestyle exposures after cancer diagnosis, and disease progression. Three follow-up interviews at 18, 36, and 60 months after diagnosis allowed updating of this information. To obtain survival information for participants who were lost to follow-up, the investigators used annual record linkage with the Shanghai Vital Statistics Registry database. Disease and treatment information were verified from medical record review.
Primary study endpoints were total mortality and breast cancer recurrence or breast cancer–related deaths. Adjustment for known clinical predictors and other lifestyle factors was performed using Cox regression analysis, with dietary soy intake treated as a time-dependent variable. Median follow-up was 3.9 years (range, 0.5 – 6.2 years).
During follow-up of 5033 breast cancer patients treated with surgery, there were 444 deaths and 534 recurrences or breast cancer–related deaths. Soy food intake, measured by either soy protein or soy isoflavone intake, was inversely associated with mortality and recurrence. Compared with the lowest quartile of intake of soy protein intake, the hazard ratio for the highest quartile was 0.71 (95% confidence interval [CI], 0.54 – 0.92) for total mortality and 0.68 (95% CI, 0.54 – 0.87) for recurrence. For women in the lowest and highest quartiles of soy protein intake, the multivariate-adjusted 4-year mortality rates were 10.3% and 7.4%, and the 4-year recurrence rates were 11.2% and 8.0%, respectively. Women with either estrogen receptor–positive or estrogen receptor–negative breast cancer exhibited this inverse association, as did both users and nonusers of tamoxifen.
“Among women with breast cancer, soy food consumption was significantly associated with decreased risk of death and recurrence,” the study authors write.
Limitations of this study include a relatively short follow-up period and limited statistical power for subanalyses, such as estrogen receptor status or tamoxifen use status.
“In this population-based prospective study, we found that soy food intake is safe and was associated with lower mortality and recurrence among breast cancer patients,” the study authors conclude. “The association of soy food intake with mortality and recurrence appears to follow a linear dose-response pattern until soy food intake reached 11 grams/day of soy protein; no additional benefits on mortality and recurrence were observed with higher intakes of soy food. This study suggests that moderate soy food intake is safe and potentially beneficial for women with breast cancer.”
In an accompanying editorial, Rachel Ballard-Barbash, MD, MPH, from the National Cancer Institute in Bethesda, Maryland, and Marian L. Neuhouser, PhD, from the Fred Hutchinson Cancer Research Center in Seattle, Washington, note differences between China and the United States in the quality, type, and quantity of soy food intake. Differences in screening rates and other factors in China compared with the United States may also preclude comparisons of stage- and treatment-specific results.
“Even though the findings by Shu et al suggest that consumption of soy foods among breast cancer patients is probably safe, studies in larger cohorts are required to understand the effects of these foods among diverse clinical subgroups of breast cancer patients and survivors,” the editorialists write. “In the meantime, clinicians can advise their patients with breast cancer that soy foods are safe to eat and that these foods may offer some protective benefit for long-term health. Moreover, the potential benefits are confined to soy foods, and inferences should not be made about the risks or benefits of soy-containing dietary supplements.”
The US Department of Defense Breast Cancer Research Program and the National Cancer Institute supported this study. Dr. Shu reports having received a research development fund from the United Soybean Board in 2005. The other study authors and editorialists have disclosed no relevant financial relationships.
JAMA. 2009;302:2437-2443, 2483-2484.

http://www.medscape.com/viewarticle/713543?src=mpnews&spon=7&uac=22879SK

4) Gingko Biloba May Not Reduce Cardiovascular Mortality or Events

Gingko biloba may not reduce cardiovascular mortality rates or events, according to the results of a double-blind, randomized controlled trial reported online November 24. Cardiovascular disease (CVD) was a preplanned secondary outcome of the Ginkgo Evaluation of Memory Study [GEMS]. In GEMS, a total of 3069 participants older than 75 years were randomly assigned to receive 120 mg of G biloba EGb 761 twice daily or placebo, and mean duration of follow-up was 6.1 years. CVD diagnosis and classification were based on Cardiovascular Health Study criteria. Cox proportional hazards regression adjusted for age and sex were used to determine differences in time to event between G biloba and placebo.
The G biloba and placebo groups did not differ in the total number of deaths (n = 355) or in the number of deaths from coronary heart disease (n = 87). Similarly, the groups did not differ in incident myocardial infarction (n = 164), angina pectoris (n = 207), or stroke (n = 151). Of 24 hemorrhagic strokes, 16 occurred in the G biloba group and 8 in the placebo group, but this difference was not significant.
Overall, although there was a small number of peripheral vascular disease events (n = 35), 12 (0.8%) occurred in the G biloba group and 23 (1.5%) in the placebo group (P = .04, exact test). Most of the patients who had peripheral vascular disease events had either vascular surgery or amputation.
“There was no evidence that G biloba reduced total or CVD mortality or CVD events,” the study authors write. “There were more peripheral vascular disease events in the placebo arm. G biloba cannot be recommended for preventing CVD.”
Limitations of this study include a small number of peripheral vascular disease events, the absence of measures of blood levels or urinary excretion of G biloba flavonoids or terpenoids, and the absence of measures of peripheral vascular disease at study end.
“We do not believe that the results of the GEMS trial are a definitive indication for use of G biloba for individuals with low ankle-brachial index but do add to the data on potential benefit of G biloba in peripheral vascular disease,” the study authors conclude. “Further clinical trials of peripheral vascular disease outcomes might be indicated.”
The National Center for Complementary and Alternative Medicine and the Office of Dietary Supplements, the National Institute on Aging, the National Heart, Lung, and Blood Institute; the University of Pittsburgh Alzheimer’s Disease Research Center, the Roena Kulynych Center for Memory and Cognition Research, and the National Institute of Neurological Disorders and Stroke supported this study. The conclusions of the investigators do not necessarily represent the official views of the National Center for Complementary and Alternative Medicine or the National Institutes of Health. The study authors have disclosed no relevant financial relationships.

Circ Cardiovasc Qual Outcomes. Published online November 24.

http://cme.medscape.com/viewarticle/713395?src=mpnews&spon=34&uac=22879SK

5) Electrical Stimulation of Ankle Plantar Flexors May Improve Gait After Stroke

Functional electrical stimulation of ankle plantar flexor muscles, and not just the dorsiflexor muscles, can further improve poststroke gait, the results of a small study in the December issue of Stroke suggest.
Functional electrical stimulation (FES) is typically delivered only to ankle dorsiflexors to correct foot drop during the swing phase, the authors explain, but this approach does not address the defect of decreased propulsive force generation in stroke patients.
Dr. Trisha M. Kesar and colleagues from University of Delaware, Newark, compared poststroke patterns during walking with FES delivered to both the plantar flexor and dorsiflexor muscles or just to the dorsiflexors in 13 stroke patients with hemiparesis.
Peak anterior ground reactive forces increased 18% during walking with FES of both plantar flexor and dorsiflexor muscles, the authors report, although the increase did not differ from that with FES of dorsiflexors alone.
Compared with dorsiflexor FES, FES of both plantar flexors and dorsiflexors was associated with improved swing-phase knee flexion angles, plantar flexion angle at toe-off, and swing-phase ankle dorsiflexion.
The percent contribution of the paretic leg to total propulsion was greater with FES of plantar flexors and dorsiflexors than with FES of dorsiflexors alone, the researchers note.
“Delivering FES to both the flexor muscles can help to correct poststroke gait deficits at both the ankle and knee joints and during both the swing (knee flexion, ankle dorsiflexion) and stance (propulsive force generation, ankle plantar flexion at toe-off) phases of gait,” the authors conclude.
“FES strategies, similar to the one used in the present study, when used as a gait training intervention, may produce even greater improvements in gait performance compared with those obtained by stimulating the dorsiflexors alone,” the investigators add.
Stroke 2009;40:3821-3827.

http://www.medscape.com/viewarticle/713350?src=mpnews&spon=26&uac=22879SK

6) Milk Thistle Treats Chemotherapy-Induced Hepatoxicity

Hepatoxicity caused by chemotherapy can be successfully treated with milk thistle (MT), according to a study of children with acute lymphoblastic leukemia (ALL) published online December 14 in Cancer.
“Currently, there are no substitute chemotherapy agents that provide the same effectiveness against ALL yet preserve liver function. There are also no hepatoprotective medications that allow chemotherapy to continue to be administered while preserving liver function,” write Kara M. Kelly, MD, from the pediatric oncology department at Columbia University Medical Center, New York City, and colleagues. “Thus, adjunctive agents that may enable optimal doses of chemotherapy to be administered without necessitating a decrease in the recommended doses of chemotherapy are of clinical significance and may further improve survival in children with ALL.”
Earlier studies have shown that MT reduces liver damage caused by cirrhosis or ingested toxins. The goal of this MT evaluation was to determine whether the herb can safely and effectively remedy chemotherapy-induced liver inflammation — a common adverse effect that can necessitate reduction or suspension of the cancer treatment.
The randomized controlled, double-blind study consisted of 50 children with ALL who were in the maintenance phase of therapy and had a hepatic toxicity of grade 2 or greater on amino alanine transferase (ALT), aspartate amino transferase (AST), or total bilirubin (TB) levels.
For a period of 28 days, patients received either MT (5.1 mg/kg/day) or a placebo. Patient visits and reports and chart reviews were used to monitor the safety of MT. Liver inflammation was determined by blood level increases of AST and ALT.
On day 28, there were no noteworthy alterations in mean ALT, AST, or TB levels. However, the authors write, “at day 56, the MT group had a significantly lower AST (P = .05) and a trend toward a significantly lower ALT (P = .07).” Ingesting MT seemed to produce no negative effects, and the herb did not reduce the effectiveness of chemotherapy. Furthermore, patients taking MT were more likely to maintain their prescribed chemotherapy dosages.
“Although not significantly different, chemotherapy doses were reduced in 61% of the MT group compared with 72% of the placebo group. In vitro experiments revealed no antagonistic interactions between MT and vincristine or L-asparaginase in CCRF-CEM cells,” the authors write.
The study authors noted that their research was made stronger by product quality analysis, stability testing, and a goal of quantifying plasma levels of silibinin. They also reported several limitations. These included the study’s small sample size and an MT dose that may have been smaller than necessary. They also acknowledged that those taking MT had a rate of compliance that was appreciably lower than that of the placebo group. Overall, however, they hailed their findings as an important step toward using MT to treat hepatotoxicity in cancer patients.
“Despite our study’s limitations, it provides preliminary evidence that MT may be a safe, effective, supportive-care agent,” the authors write. “Future investigations are needed to determine the appropriate dose and duration and to identify populations that may gain the largest clinical benefit.”

Cancer. Published online December 14, 2009.

http://www.medscape.com/viewarticle/713797?src=mpnews&spon=7&uac=22879SK

7) In Older Women, High Testosterone Linked With High Cardiovascular Risk

In postmenopausal women, high testosterone levels increase the risk for insulin resistance, metabolic syndrome, and coronary heart disease, a new study shows.
“Our findings suggest that even at the physiologically low levels of testosterone found in these older women, the association between testosterone and insulin resistance found in premenopausal and early postmenopausal women persists into old age,” the research team writes in the December issue of the Journal of Clinical Endocrinology and Metabolism.
The 344 women in the study ranged from 65 to 98 years of age (mean, 74.4 years), according to senior author Dr. Anne R. Cappola, of the University of Pennsylvania School of Medicine in Philadelphia, and colleagues.
Using ultrasensitive assays, the researchers determined that their cohort had a mean total testosterone level of 19.1 ng/dL a mean free testosterone level of 2.8 pg/mL. Insulin resistance, as assessed by the homeostasis model assessment of insulin resistance, rose in a stepwise manner along with total (p = 0.003) and free (p = 0.02) testosterone.
Higher free (p = 0.002) and total (p < 0.001) testosterone levels were also accompanied by stepwise decreases in insulin sensitivity, as assessed by the Quantitative Insulin Sensitivity Check Index.
Higher levels of total and free testosterone were strongly associated with abdominal obesity and high fasting glucose — two components of the metabolic syndrome strongly linked to insulin resistance.
In adjusted models, women in the top quartile of total testosterone had a three-fold greater odds of developing metabolic syndrome (odds ratio 3.15) compared to those in the bottom quartile. These women were also three times as likely to have coronary heart disease (OR 2.95) than those in the second quartile of total testosterone.
Free testosterone was not significantly associated with metabolic syndrome or coronary heart disease.
“The connection between higher levels of testosterone and these health risks is likely explained by our finding of a greater degree of insulin resistance in women with the highest testosterone levels,” Dr. Cappola told Reuters Health in an email.
She noted that because of the observational aspect of the study, “we cannot discern if testosterone is a marker or mediator of cardiovascular disease in this population.”

J Clin Endocrinol Metab 2009;94:4776-4784.

http://www.medscape.com/viewarticle/713907?src=mp&spon=22&uac=22879SK
Celiac Disease Increases Risk of Neurological and Psychiatric Disorders

Migraine and carpal tunnel syndrome are common among celiac patients, a new study shows.
After screening a cohort of 72 patients with biopsy-proven celiac disease, researchers also report that many experience psychiatric problems, with 35% of celiac patients reporting a history of depression, personality changes, or psychosis.
Atypical neurological presentations are thought to occur in 6% to 10% of celiac patients, the study authors note. Prior studies have suggested that cerebellar ataxia is the most frequent symptom. This new study observed cerebellar ataxia in 6% of patients. Another 6% had vestibular dysfunction. In all, 26% of patients experienced afferent ataxia.
About a third of patients had stance and gait problems, and many experienced deep sensory loss and reduced ankle reflexes.
“Gait disturbances in celiac disease do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment,” report investigators led by Katrin Bürk, MD, from the University of Marburg in Germany. “Neurological problems may develop despite strict adherence to a gluten-free diet.”
Neurological problems may develop despite strict adherence to a gluten-free diet.
The study is published in the December 15 issue of Movement Disorders.
The 72 patients with celiac disease were recruited through advertisements and interviewed using a standard questionnaire.
“Most studies in this field are focused on patients under primary neurological care,” the researchers note. “To exclude such an observation bias, patients with biopsy-proven celiac disease were screened for neurological disease.”
About a third of celiac patients (28%) reported a history of migraine. In many cases, there was a decrease in the frequency and intensity of migraine attacks after the introduction of a gluten-free diet.
About 20% of patients experienced carpal tunnel syndrome. “Surprisingly, epilepsy was less common than expected,” report the researchers. “Only 4 individuals presented with a history of generalized or focal seizures.”
Motor problems, such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus, were infrequent. A total of 14% of patients reported bladder dysfunction.
In celiac disease, the mechanisms leading to neurological disease are not yet understood. Deficiencies in folic acid, vitamin E, and biopterin have been implicated in the pathogenesis; however, the investigators report that replacement therapy does not resolve clinical symptoms in most cases.
The researchers point out that hypovitaminosis rarely causes overt abnormalities in celiac patients, and most with neurological symptoms do not show evidence of any nutritional deficiencies.
“The prevalence of neurological manifestations in celiac disease is striking and must be considered more than accidental,” they note. “The patients’ gluten-free diet had resolved intestinal symptoms but had not prevented the development of neurological deficits.”
The investigators suggest that because of the considerable clinical variability, many different pathogenic mechanisms are likely to contribute to the neurological and psychiatric dysfunction in celiac disease.

Mov Disord. 2009;24:2358-2362.

http://www.medscape.com/viewarticle/714823?src=mpnews&spon=26&uac=22879SK

9) Vitamin D May Reduce Cardiac Work

Low serum levels of 25-hydroxyvitamin D are linked with increased heart rate and systolic blood pressure and with the rate-pressure product (RPP), according to New Zealand and US researchers.
“The inverse association between vitamin D status and the rate-pressure product suggests that people with high vitamin D levels have hearts that work more efficiently,” lead investigator Dr. Robert K. Scragg told Reuters Health.
In a November 14th on-line publication in the American Journal of Cardiology, Dr. Scragg of the University of Auckland and colleagues observe that vitamin D may protect against cardiovascular disease, but its association with cardiac function is unclear.
To gain more information, they examined data on more than 27,000 adults who took part in the National Health and Nutrition Examination Surveys conducted from 1988 to 1994 and from 2001 to 2006.
After adjustment, participants with 25(OH)D levels of 10 ng/ml or less had a heart rate that was a significant 2.1 beats per minute faster, and systolic blood pressure that was 1.9 mm Hg higher, than those with vitamin D in the reference level (at least 35 ng/mL). For subjects with 25(OH)D levels of 10 to 14.9 ng/mL, the corresponding systolic pressure increase was 1.7 mm Hg.
Participants with levels of 10 ng/mL or less had a mean adjusted RPP that was 408 higher than the reference group. For those with levels of 10 to 14.9 ng/mL, the RPP was higher by 245.
It therefore appears that people with high vitamin D levels have “hearts that don’t beat as often and don’t have to push blood into the aorta against such a high blood pressure, as people with low vitamin D levels,” Dr. Scragg said. “Hence, they wear out less quickly.”
“This is the possible conclusion,” he added. “However, these data are only observational. Clinical trials of vitamin D supplementation are required to confirm this conclusion.”

Am J Cardiol 2010.

http://www.medscape.com/viewarticle/713675?src=mpnews&spon=26&uac=22879SK

10) Pomegranate Ellagitannin–Derived Compounds Exhibit Antiproliferative and Antiaromatase Activity in Breast Cancer Cells In vitro(in the test tube)

Estrogen stimulates the proliferation of breast cancer cells and the growth of estrogen-responsive tumors. The aromatase enzyme, which converts androgen to estrogen, plays a key role in breast carcinogenesis. The pomegranate fruit, a rich source of ellagitannins (ET), has attracted recent attention due to its anticancer and antiatherosclerotic properties. On consumption, pomegranate ETs hydrolyze, releasing ellagic acid, which is then converted to 3,8-dihydroxy-6H-dibenzo[b,d]pyran-6-one (“urolithin”) derivatives by gut microflora. The purpose of this study was to investigate the antiaromatase activity and inhibition of testosterone-induced breast cancer cell proliferation by ET-derived compounds isolated from pomegranates. A panel of 10 ET-derived compounds including ellagic acid, gallagic acid, and urolithins A and B (and their acetylated, methylated, and sulfated analogues prepared in our laboratory) were examined for their ability to inhibit aromatase activity and testosterone-induced breast cancer cell proliferation. Using a microsomal aromatase assay, we screened the panel of ET-derived compounds and identified six with antiaromatase activity. Among these, urolithin B (UB) was shown to most effectively inhibit aromatase activity in a live cell assay. Kinetic analysis of UB showed mixed inhibition, suggesting more than one inhibitory mechanism. Proliferation assays also determined that UB significantly inhibited testosterone-induced MCF-7aro cell proliferation. The remaining test compounds also exhibited antiproliferative activity, but to a lesser degree than UB. These studies suggest that pomegranate ET–derived compounds have potential for the prevention of estrogen-responsive breast cancers.

Cancer Prev Res; 3(1); 108–13

http://cancerpreventionresearch.aacrjournals.org/cgi/content/abstract/3/1/108?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=pomegranate&searchid=1&FIRSTINDEX=0&volume=3&issue=1&resourcetype=HWCIT

11) Atherosclerosis regression & HDL Raising With Niacin Superior to Ezetimibe

Adding extended-release niacin (Niaspan, Abbott) to statin therapy results in a significant regression of atherosclerosis as measured by carotid intima-media thickness (IMT), whereas the addition of ezetimibe (Zetia, Merck/Schering-Plough) to statin therapy did not, according to an eagerly anticipated study
The results, from the Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6: HDL and LDL Treatment Strategies in Atherosclerosis (ARBITER 6-HALTS) study, were presented today at the American Heart Association 2009 Scientific Sessions and published simultaneously online in the New England Journal of Medicine.
“The proper framework of the ARBITER 6-HALTS study is to compare the effectiveness of two drugs,” lead investigator Dr Allen Taylor (Medstar Research Institute, Washington, DC) told heartwire . “In this regard, the data are clear–niacin is clearly superior to ezetimibe. That’s good news for patients, and it’s also good news for doctors who need to know how different drugs compare against one another so they can practice evidence-based medicine.”
“If you practice evidence-based medicine in 2009, after high-dose statin therapy, niacin is your number-two drug,” he said. “The amount of evidence available for niacin, although it’s less than for high-dose statins, dwarfs the evidence available for any of the prevention interventions that we currently have available. It certainly dwarfs the evidence available for ezetimibe and fibrates, and we really think that niacin should be the number-two drug for all patients who are taking a statin and that doctors should rarely be using ezetimibe these days.”
Dr Steven Nissen (Cleveland Clinic, OH), also commenting on the results for heartwire , called ARBITER 6-HALTS a classic “comparative-effectiveness” study and said there have been calls in the US legislature for such trials for the past few years.
“Now, here it is,” he said. “Niacin is a 50-year-old drug, and you can buy it over the counter at your local pharmacy. When you have an inexpensive therapy like this–there are issues about being able to tolerate high-dose niacin, but if you get patients to tolerate it–niacin looks to be a better strategy.”

Click here: ARBITER 6-HALTS

http://www.medscape.com/viewarticle/712399

12) Contraindications to Vitamin D

Sarcoidosis patients react poorly to vitamin D supplementation. It appears to interact with the fundamental pathophysiology resulting in over production of 1,25(OH)2D3 and increased granuloma production. Even summer sunlight exposure can increase D levels high enough to cause hypercalcemia in these patients.
The most significant drug interactions appear to be with the vitamin D analogues. There are some moderate interactions that are not contraindications but rather indicate the need for attention.
Vitamin D increases the absorption of aluminum from aluminum-containing antacids and statins; increases the activity of digoxin since it increases calcium absorption—same problem with other calcium-channel inhibitors as well as diuretics that increase calcium retention; and increases the activity of CYP3A4 so drugs metabolized by this liver enzyme will be cleared more quickly. Drugs.com has a useful list of potential interactions that can be quickly checked. Adverse reactions to vitamin D supplementation appear to primarily occur only at accidental dosages as noted above.
A more subtle potential problem with large dosages of vitamin D is its dependence on adequate amounts of vitamins A and K2. It is beyond the scope of this editorial to address this in depth. The key is that vitamins A, D, and K2 work intricately together in a surprisingly diverse range of physiological functions. As vitamin D levels normalize, deficiencies of vitamins A or K2 become clinically apparent. The paradox of soft-tissue calcium deposition in patients with osteoporosis appears largely due to this imbalance between vitamins D, A, and K2. Similarly, much of the toxicity associated with high dosages of vitamin A appear to be due to inadequate vitamin D. Bottom line, when supplementing with vitamin D, be sure to include modest amounts of vitamins A and K2.

From :What Have We Learned About Vitamin D Dosing? by Joseph Pizzorno, ND, Editor in Chief
Integrative Medicine • Vol. 9, No. 1 • Feb/Mar 2010

The Correct Use of Muscle Testing in Nutritional Evaluation in Applied Kinesiology

When I’m meeting new people at a social or a networking event, I introduce myself as a Doctor of Chiropractic and an Applied Kinesiologist. Sometimes they have no idea what AK is and I fill them in. But most of the time, they will say something like “I had someone touch a spot on me and then pull down on my outstretched arm. It was weak. Then I held a bottle of pills and was told I needed them. Is that Applied Kinesiology?”

This is one of the big abuses of muscle testing.

In Applied Kinesiology, muscles are related to themselves and the joints they cross, their spinal innervation, their neuro-lymphathic & neuro-vascular points, the Chinese acupuncture meridian associated with them and the organs/glands via the meridian system.

So how does nutritional muscle testing work? First it is muscle specific, pulling down on an outstretched arm is not specific as it involves a number of muscles. And holding a bottle in hand stimulates nothing in your brain except maybe a placebo effect.

Here’s an example: a patient comes in with a shoulder problem and upon examination I find that one of the patient’s internal rotators – the Pectoralis Clavicular Major is weak.

The Pectoralis Clavicular is innervated by the lateral pectoral nerve that comes from the 5th & 6^th cervical spinal nerves, it is associated w/ the Stomach meridian and in Chinese five-element theory is associated with worry.

Does the patient have a weak Pectoralis on one or do both sides tested together come up weak – a possible sign of cranial faults that need to be fixed? Does the patient have a history of digestive problems, heartburn, bloating, blenching, constipation? Is the patient experiencing emotional worries?

If no, then I proceed w/ either stretching or toning the muscle, rubbing out the neuro-lymphatic and neuro-vascular points for the muscles and seeing if the meridian is involved and seeing if the C5-6 spinal segments, the shoulder joints, clavicle or the sternum (breastbone ) or the ribs need to be adjusted. I then re-test the muscle to see if the problem is now fixed.

If yes, I proceed with the above as correcting the structural first sometime will help the digestive problems. A case in point is a patient with a lack of hydrochloric acid, indicated by bilateral pectoralis major weakness. Taking hydrochloric acid may clear the weakness.

But if the HCl is given, it hides the indicator for a temporal bulge or other cranial fault. A cranial fault may be causing entrapment of the Vagus nerve, thus causing hypochlorhydria that is responsible for the digestive problem in the first place. The proper approach is to correct the cranium and any other structural factor that is causing the hypochlorhydria.

I then talk to the patient about their diet, what foods or food combinations may be problematic for them and what supplements and medications – over the counter & prescription that they may be taking and to keep a food diary in which the patient also notes any digestive problems.

For example, the patient may have been advised to take Tums in order to get calcium; unfortunately the calcium carbonate in Tums is acting as an antacid and is adversely affecting the patient’s ability to digest and absorb food (including calcium) Take the patient off the Tums and the HCL problem resolves

I also talk to the patient about any emotional problems or stresses that may be affected them and we work w/ emotional meridian releasing techniques that the patient can also do at home.

On the next visit if the structural and emotional interactions have cleared then I test for nutritional factors such as HCL, or food allergies/sensitivities The patient is tested by placing sample of either the supplement or food in their mouth and having them chew in order to stimulate gustatory receptors in the brain and then the Pectoralis is then re-tested to see if there is a change in the muscle strength. The patient is then advised take whatever strengthened the indicator muscle and asked to note any changes in their food diary.

If nutritional testing doesn’t resolve the muscle weakness, then the patient may be advised to have some standard testing done such as testing for H. Pylori or anemia which can be affecting digestion such as iron, folic acid or B12 deficiencies.

On the following visit, the patient will continue to be evaluated to see if the digestive problems have resolved, if the structural and emotional indicators have resolved and when the patient no longer needs to take the supplementation.

As you see, the proper use of applied kinesiology in evaluating nutrition is made within the total framework of the triad of health – structural, emotional, chemical and includes both standard and kinesiologicial diagnostic procedures that confirm the need for the nutrition.

The Beginning of My Journey as a Healer

It would seem that I have been heading this way for quite awhile. My journey to become a healer started with a journey of healing myself. I started this journey as a constipated child who had a cold at least once a month and whose ragweed allergy was getting worse every year.

At 18, I was in the Italian Alps; a cousin introduced to a whole grain product called muesli. It was my first un-constipated summer. Back in New York City I was having a hard time finding this product until I found this hole-in the-wall health food store. I had my first taste of carrot juice and left with the muesli, some brown rice and a resolution not to overcook my vegetables.

In the next seven years, my journey included changes in my diet, martial arts and studies of nutrition, herbs and homeopathics. During this time I was seriously thinking about what to do for the rest of my life. People around me were always asking me for back rubs; saying what good hands I had So in 1976, I started studying massage.

Also at this time, I had intensified my martial arts studies and was having muscle strains and spasms that no amount of stretching or massage seemed to help. A fellow student suggested that I go see “old Doc Christie” – a 75 yr old chiropractor whose mind was as clear as her body was strong. I would sit for hours watching her adjust her patients and listening to her talk about subluxations, nerve energy flow, spinal manipulations, extremity manipulations, enemas and liver detox. My ragweed allergy was improving.

My martial arts teacher told me about applied kinesiology; it was a technique that incorporated chiropractic with muscle balancing, organ neurovascular & neuro-lymphatic points, cranial-sacral work, nutritional consultation and acupressure therapy. In order to do this work, you couldn’t do assembly line chiropractic. You had to spend time: do a complete exam and really get to the different factors involved in the patient’s complaint.

In chiropractic college and in my practice, I have polished this idea like a diamond. I have incorporated studies on intestinal wall integrity, IgG food allergies and the interconnections between these and the immune system, the respiratory system, low back pain, arthritis, fibromyalgia, chronic fatigue and degenerative disc problems.

And by the way my ragweed allergy is long gone.

The above appeared in Free Spirit magazine; Feb-March 1998

Cross-Hypersensitivity between Food and Pollen Allergies

If you have allergies to the below, avoid the following foods/herbs:

 Birch &  Alder Hazel – No nuts, apple, plum, peach, cherry, almond, lichee, kiwi, avocado.

 Baywort  – No dandelion, chamomile, sunflower seeds, peppercorns, chili, tomato, bell pepper, carrot, fennel, anise, cilantro, cumin, parsley, dill, basil, oregano, thyme, kiwi, mango.

 Grass/weed pollen and cereal pollen – No tomato, peppermint, peanut, soybean, uncooked grain.

Comment: Artificial Sweeteners: 3 Reasons To Rethink That Diet Coke

Click here: Hemi Weingarten: Artificial Sweeteners: 3 Reasons To Rethink That Diet Coke

Thirty years ago I grabbed my friend’s coffee container by mistake; the wave of a sickly chemical sweet taste filled my mouth and I said, “how many packets of sweetener do you use”. “One,” she said and added “it’s not too sweet.”

Over the years and talking to patients, friends and friends of friends, I too have noted the

“infantilizing” effect that Hemi Weingarten talks about in this article. Advise someone who drinks diet soda to eat fruit as a snack instead of cake or change their sugar laden processed cereal for an organic whole grain cereal and you will hear “but it not sweet enough!” These people have trained their taste buds and their brains to want more and more sweets resulting in less insulin sensitivity

In fact, check out the new ads for Stevia on the television, and you will see a visual of pouring it on a bowl of berries. “What.” my un-infantilizing brain shouts”, berries are sweet already.”

Rising Autism Numbers — Leading Federal Official Says “No Question” That Environmental Exposures Are A Factor

I find the following very interesting:

Another surprise was the difference between some of the racial and ethnic categories. In 2006, the rate among non-Hispanic white children was 102-per-10,000, but among black children it was 76-per-10,000, a 34 percent difference, and among Hispanic children it was 61-per-10,000, a difference of 67 percent.

Questions to asked:
Is there less autism due to poverty?
What can’t these families afford that seems to increase autism in the more affluent?
Bottled water…BPA?
Microwaves turning natural left handed proteins in our foods into right handed neuro-toxic ones? http://drvittoriarepetto.wordpress.com/2009/12/10/the-hidden-hazards-of-microwave-cooking/
Eating more foods made from scratch as opposed to prepared or canned foods?
More on Autism
Read the Article at HuffingtonPost

HEALTHY EATING VS RESTRICTIVE EATING

not sure where I found this; but I think it sums up a lot.

Happy Holidays!!

HEALTHY EATING VS RESTRICTIVE EATING

In Charge vs. In Control
Nourishment vs. Diet
Fuel vs. Calories
Quality vs. Points
Healthy vs. Skinny
Aware vs. Preoccupied
Conscious vs. Consumed
Mindful vs. Vigilant
Information vs. Dogma
Guide vs. Rules
All foods fit vs. Good or bad
Balance vs. Perfection
Variety vs. Temptation
Moderation vs. Deprivation
Choosing vs. Earning
Deciding vs. Rationalizing
Flexible vs. Rigid
Hunger based vs. By the clock
Comfort vs. Portion sizes
Physical activity vs. Penance
Introspective vs. Smug
Effortless vs. Willpower
Trust vs. Fear
Learning vs. Failing
Self-acceptance vs. Condemnation
Enjoyment vs. Guilt
Pleasure vs. Shame

Dr. Vittoria Repetto’s Newsletter #30

Disclaimer:

Remember the information presented in this newsletter is intended for education only.Always consult with your health care practitioner on matters of health and disease.

This newsletter contains summaries of research papers published in Medical/Nutritional journals and presented at a web site for health professionals only.

If you would like a complete copy of the paper, please e-mail this office at DrVittoriaRepett@aol.com stating what paper you want and the URL and I’ll happily copy & paste and email you a copy.

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Newsletter #30

Table of Contents:

1) Dr. Repetto’s Blog

2) A Fish Tale With Merit: Omega-3 PUFAs Underrated for Heart Failure

3) New-Onset Breast Tenderness During Hormone Therapy Linked to Increased Breast Cancer Risk

4) High-Protein Diet Linked to Lower Brain Mass in Alzheimer’s Mouse Model

5) Declining Visuospatial Skills May Precede Eventual Alzheimer’s Disease Diagnosis

6) High Fructose Intake Correlated With High Blood Pressure

7) Vitamin D Has Benefits in Chronic HCV Infection

Vitamin E Improves Nonalcoholic Steatohepatitis ( Fatty Liver)

9) Frequent, Brisk Exercise After Menopause Lowers Breast Cancer Risk

10) Relationship Between Vertebral Deformities And Allergic Diseases

11) Badly done Study: Folate Supplementation Linked to Increased Cancer Incidence and Mortality

12) Vitamin D Supplementation and Cancer Prevention

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1) Dr. Repetto’s Blog – http://drvittoriarepetto.wordpress.com/

Current subjects:

a)Are you utilizing your folic acid? The case for metabolically active form of folic acid – L-5-MTHF

b)Link between Thyroid disease, breast cancer & Iodine??

c)HEALTHY EATING VS RESTRICTIVE EATING -

2) A Fish Tale With Merit: Omega-3 PUFAs Underrated for Heart Failure

At the Heart Failure Society of America 2009 Scientific Meeting, four invited faculty members meticulously made the case for an already-available substance as an example of the kind of agent for heart failure the others were looking for. Their message: omega-3 polyunsaturated fatty acids (PUFAs), usually derived from fish oil, garner far less attention as a heart-failure therapy than they deserve, given the wealth of laboratory and clinical evidence supporting a treatment effect.

That applies to prevention of heart failure, with observational studies suggesting a benefit especially in some high-risk groups, as well as to treatment of existing heart failure based on a large randomized, placebo-controlled trial.

Supporting omega-3s as a heart-failure therapy are dozens of clinical and laboratory studies defining their many physiologic effects that could potentially play a role in preventing or treating the disorder. As outlined at the meeting by Gheorghiade and the others, they include vasodilator effects with blood-pressure and heart-rate reduction, reduced oxygen consumption, neurohormone modulation, antiapoptotic and myocardial sodium- and calcium-channel effects, and prevention or slowing of myocardial fibrosis.

The most solid randomized-trial evidence for such a role comes from the recent Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico Heart Failure (GISSI-HF) trial [1], in which nearly 7000 patients with chronic NYHA class 2–4 heart failure received either omega-3 PUFAs from fish oil at 1 g/day or placebo.

As reported by heartwire when the study results were reported last year, the group getting omega-3s showed a 9% drop in all-cause mortality and an 8% decline in the composite of death or cardiovascular hospitalization over a mean of about four years. Both co–primary-end-point outcomes were significant. (In a separate randomization of the patients to either 10-mg rosuvastatin [Crestor, AstraZeneca] or placebo, the statin had no significant effect on either end point [2].)

An exceptionally large proportion of GISSI-HF patients had been on ACE inhibitors or angiotensin-receptor blockers, beta blockers, and spironolactone, and still there was a significant omega-3 effect. “It’s tough to get incremental benefit for hard end points in maximally treated patients,” observed Dr Dariush Mozaffarian (Harvard University, Boston, MA). He pointed out that for the prespecified secondary end point of cardiovascular death, the difference associated with omega-3 therapy reached 10% (p=0.045).

“There are very few drugs that you can put on top of beta blockers, ACE inhibitors, and spironolactone and actually reduce cardiovascular death by 10% in heart failure. That’s a very profound benefit,” Mozaffarian said, adding that it’s similar to the CV-death reduction seen with implantable defibrillator therapy.

http://www.medscape.com/viewarticle/710634?src=mpnews&spon=18&uac=22879SK

3) New-Onset Breast Tenderness During Hormone Therapy Linked to Increased Breast Cancer Risk

New-onset breast tenderness during conjugated equine estrogens plus medroxyprogesterone acetate (CEE+MPA) hormonal therapy is linked to increased breast cancer risk, according to an analysis of data from a randomized controlled trial reported in the October 12 issue of the Archives of Internal Medicine.

“To our knowledge, no prior published studies have addressed whether there is an association between CEE+MPA–induced new-onset breast tenderness and breast cancer risk,” lead author Carolyn J. Crandall, MD, MS, from the David Geffen School of Medicine at University of Southern California, Los Angeles, said in a news release.

In the Women’s Health Initiative (WHI) Estrogen Plus Progestin Trial, postmenopausal women with an intact uterus were randomly assigned to receive daily CEE+MPA (0.625/2.5 mg; n = 8506) or placebo (n = 8102). Mammography and clinical breast examination were performed at baseline and once yearly, and self-reported breast tenderness was evaluated at baseline and at 12 months. During follow-up (mean duration, 5.6 years), medical record review allowed confirmation of invasive breast cancer incidence.

Among 14,538 women who did not report breast tenderness at baseline, new-onset breast tenderness after 12 months occurred in 36.1% of those randomly assigned to CEE+MPA vs 11.8% of those in the placebo group (P < .001). Among women receiving CEE+MPA, those with new-onset breast tenderness had significantly higher breast cancer risk vs those without self-reported tenderness (hazard ratio, 1.48; 95% confidence interval, 1.08 – 2.03; P = .02).

“Is it because the hormone therapy is causing breast-tissue cells to multiply more rapidly, which causes breast tenderness and at the same time indicates increased cancer risk?” Dr. Crandall said. “We need to figure out what makes certain women more susceptible to developing breast tenderness during hormone therapy than other women.”

Breast cancer risk was not significantly associated with new-onset breast tenderness in the placebo group (P = .97).

Limitations of this study include annual vs more frequent assessment of breast tenderness, relatively high rates of discontinuation of combination therapy and of crossover from placebo to active therapy, and lack of generalizability to other types of hormonal therapy.

“New-onset breast tenderness during conjugated equine estrogens plus medroxyprogesterone therapy was associated with increased breast cancer risk,” the study authors write. “The sensitivity and specificity of the association between breast tenderness and breast cancer were similar in magnitude to those of the Gail model.”

The National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services supported the WHI. Dr. Crandall’s work was supported by the National Institute on Aging, National Institutes of Health, and the Tarlow-Eisner-Moss Research Endowment of the Iris Cantor–UCLA Women’s Health Center. Wyeth-Ayerst Research Laboratories supplied the active study drug and placebo. One of the study authors (Dr. Chlebowski) has disclosed various financial relationships with Astra-Zeneca, Eli Lilly & Co, Novartis International AG, Wyeth Pharmaceuticals, and Pfizer Inc.

Arch Intern Med. 2009;169:1684-1691.

http://www.medscape.com/viewarticle/710428?src=mp&spon=16&uac=22879SK

4) High-Protein Diet Linked to Lower Brain Mass in Alzheimer’s Mouse Model

A high-protein diet has been linked to lower overall brain mass in transgenic mouse models of Alzheimer’s disease (AD) — a finding that raises the possibility that such diets leave neurons more vulnerable to beta amyloid (Aβ) toxicity.

An international team of researchers led by Samuel Gandy MD, PhD, professor of neurology and psychiatry and associate director of the Alzheimer’s Disease Research Center at the Mount Sinai School of Medicine, New York City, unexpectedly found that the brains of mice fed a high-protein, low-carbohydrate diet were 5% lower in weight than brains from their counterparts who were fed other types of diets.

“We don’t know the reason for this finding, but it was very, very, obvious,” Dr. Gandy said in an interview.

In clinical terms, patients with severe AD may experience a loss in brain mass of about 20%, so a 5% difference in brain weight, said Dr. Gandy, is “quite significant.”

The study was published online October 21 in Molecular Neurodegeneration.

Effect of Dietary Composition

According to Dr. Gandy, research has shown that caloric restriction increases in longevity in lower animals and, more recently, in mammals. In addition, animal models of AD indicate that caloric-restrictive diets diminish AD pathology in mice.

“In this study we wanted to focus not so much on the caloric level of the diet but on the dietary composition and whether that made a difference to AD pathology biochemically and histologically,” he said.

To examine how dietary composition modulates cerebral amyloidosis and neuronal integrity the researchers maintained 4 groups of TgCRND8 mice from 4 to 18 weeks of age on 1 of 4 diets:

• Regular commercial chow
• High-fat/low-carbohydrate custom chow (60 kcal% fat/30 kcal% protein/10 kcal% carbohydrate)
• High-protein/low-carbohydrate custom chow (60 kcal% protein/30 kcal% fat /10 kcal% carbohydrate)
• High-carbohydrate/low-fat custom chow (60 kcal% carbohydrate/30 kcal% protein/10 kcal% fat)

At 18 weeks the mice were killed and their brains studied for wet weight, solubilizable Aβ content, amyloid plaque burden, and stereologic analysis of selected hippocampal subregions.

The authors compared the brain pathology in these mouse models of AD according to the diet they were fed. They also looked at the density of nerve cells in the hippocampus, as well as gross weight of the brains.

Not unexpectedly, the investigators found that mice that were fed a high-fat diet had higher increased levels of solubilizable Aβ, although the investigators detected no effect on plaque burden. This finding, said Dr. Gandy, is consistent with findings from previous research that show that a high-fat diet increases pathology in mouse models of AD.

In addition to the surprise finding that mice on a high-protein diet had brains that were 5% lighter than animals in the comparator groups, the investigators also found that although not statistically significant, there was a “clear trend” toward having a lower density of neurons in the hippocampus in mice that received the high-protein diet.

According to Dr. Gandy, if this finding is reflective of what is going on in the brain as a whole, it perhaps suggests that a high-protein diet makes neurons more sensitive to amyloid toxicity.

Dr. Gandy said although these findings are intriguing, they should not be overinterpreted.

“I wouldn’t rush to overinterpret a mouse experiment, but it does raise the question of ‘We should look to see if this also applies in humans,’ ” he said.

Dr. Gandy said his team has plans to conduct another similar experiment in a bid to replicate these findings. The researchers may also conduct a study of hospital records to look at outcomes in individuals, such as dialysis patients, who have been on high-protein diets long-term.

Although there are no immediate clinical recommendations, Dr. Gandy said the study highlights the benefits of a balanced diet.

“Every time we’ve looked an isolated dietary component in excess it seems to have a negative effect. Maybe the message here is that a balanced diet really is valuable and that you should get part of your calories from carbs, part from protein, and part from fat, and don’t get carried away with one source over the other,” said Dr. Gandy.

The authors have disclosed no relevant financial relationships.

Mol Neurodegener. Published online October 21, 2009.

http://www.medscape.com/viewarticle/711217?src=mpnews&spon=26&uac=22879SK

5) Declining Visuospatial Skills May Precede Eventual Alzheimer’s Disease Diagnosis

Declining cognitive abilities other than memory loss can occur long before a clinical diagnosis of Alzheimer’s disease and should be used to identify at-risk patients, according to results from a long-standing longitudinal study published in the October issue of the Archives of Neurology.

“We found that visuospatial skills, which are speeded tasks that require coordination of hand, eye, and visual representation, were the first domains to change rather than what would be expected, which were short-term memory tasks,”

For this study, the investigators examined longitudinal archival data from 444 patients enrolled at the Alzheimer’s Disease Research Center from October 1979 to December 2006.

All patients (aged 60 to 101 years) were evaluated as cognitively healthy at their first psychometric assessment and completed at least 1 additional annual clinical evaluation before the end of November 2007.

At the end of the study, 310 of the study participants remained stable (CDR = 0) throughout follow-up, whereas 134 progressed to either a clinical diagnosis of uncertain dementia (CDR = 0.5) or “dementia of the Alzheimer type” (CDR > 0.5).

For the group that progressed, the optimal inflection point for all cognitive areas evaluated was found before a diagnosis of dementia — 3 years before for visuospatial skills, 2 years before for global cognitive abilities, and 1 year before for verbal and working memory.

From http://www.braincenteramerica.com/visuospa.php:

Visuo-spatial functions represent the brain’s highest level of visual processing, and requires the proper functioning of your parietal cortex, in the upper part of the brain.

You use mental imagery and navigation to process and rotate 2-D and 3-D objects in your mind, or to virtually move throughout an image from your surroundings which you’ve reconstructed in your mind. This function is very useful in everyday life — for example, it allows you to give someone directions to your house by following the route in your mind’s eye.

Your visuo-spatial functions also enable you to estimate distance and depth. This lets you move without bumping into any of the obstacles in your path, or to judge whether you have enough time to cross an intersection before an oncoming car reaches you or before the light turns red.

Finally, visuo-spatial construction processes enable you to reproduce drawings or use components to construct objects or shapes. That comes in handy, for example, in solving 3D puzzles or glueing the pieces of a broken vase back together again.

http://cme.medscape.com/viewarticle/711066?src=mpnews&spon=18&uac=22879SK

6) High Fructose Intake Correlated With High Blood Pressure

High fructose consumption is independently associated with high blood pressure, according to findings presented here at Renal Week 2009: American Society of Nephrology 2009 Annual Meeting.

An analysis of data from more than 4500 participants in the National Health and Nutrition Examination Survey (NHANES) showed that consuming 74 grams or more of fructose per day — equivalent to about 2.5 12-ounce cans of sugary soda — correlated significantly with blood pressure of at least 135/85 mm Hg; the relation grew stronger as blood pressure rose. The survey participants had no history of hypertension.

Fructose consumption, in the form of added sugar, has been rising in Western nations since the 1900s, and parallels the growing prevalence of hypertension, said lead investigator Diana I. Jalal, MD, assistant professor of renal medicine at the University of Colorado Health Sciences Center in Aurora.

To examine the relation between the 2, she and her colleagues used the NHANES data to evaluate median fructose intake from food high in added sugar, including bakery products, dairy desserts, chocolate and other candy, dried fruits, honeys, jams, jellies, syrups, and sugar-sweetened soft drinks. Soft drinks alone account for 33% to 40% of fructose consumption in the United States, Dr. Jalal noted.

Fresh fruits were excluded from the analysis because they contain ascorbate, antioxidants, and potassium, which counteract the effect of fructose, Dr. Jalal said during her presentation. Using responses on self-administered dietary questionnaires, the investigators calculated median fructose intake of the participants to be 74 g/day. They then studied the relation between fructose consumption and blood pressure, adjusting for demographics, physical activity, other dietary factors, cardiovascular risk factors, and findings on laboratory tests. Data from 4528 adults were included in the analysis.

Daily fructose consumption of 74 g or more was independently associated with a 28% increased risk for blood pressure of 135/85 mm Hg or higher, a 36% increased risk for blood pressure of140/90 mm Hg or higher, and an 87% increased risk for blood pressure of 160/100 mm Hg or higher.

The relation was seen only between systolic blood pressure and fructose intake, Dr. Jalal said. There was no correlation between fructose consumption and diastolic blood pressure.

“In subjects with no history of hypertension, there is an independent and significant graded association between high fructose intake and systolic blood pressure levels,” she concluded. The mechanism underlying the relation is unclear.

Among other variables, black ethnicity and waist circumference were significantly associated with higher levels of fructose intake, independent of calorie or carbohydrate consumption. Inverse correlations were seen for sodium and alcohol consumption and fructose. “It seems that people either like their alcohol or they like their sugar, and they like their salt or they like their sugar,” Dr. Jalal told Medscape Nephrology.

This study shows that “we must pay more attention to the nutritional needs of our patients,” said Talal Ikizler, MD, associate professor of medicine at Vanderbilt University, and medical director of the Vanderbilt University Outpatient Dialysis Unit in Nashville, Tennessee.

Nephrologists rarely catch patients at the early stages of renal disease, when risk factor modification might still be possible, explained Dr. Ikizler, who was not involved in this research. However, internists and other primary care physicians do have these opportunities. Whenever possible, patients should be “warned of the consequences of their dietary choices early on.”

Dr. Jalal and Dr. Ikizler have disclosed no relevant financial relationships.

Renal Week 2009: American Society of Nephrology (ASN) 2009 Annual Meeting: Abstract TH-FC037. Presented October 29, 2009.

http://www.medscape.com/viewarticle/711790?src=mpnews&spon=18&uac=22879SK

7) Vitamin D Has Benefits in Chronic HCV Infection

Supplementing pegylated interferon-alfa2b and ribavirin with a daily dose of vitamin D might increase virologic response rates, according to results of a late-breaking abstract reported here at The Liver Meeting 2009, the 60th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD).

“Vitamin D is a potent immunomodulator whose impact on virologic response rates of interferon-based treatment of chronic HCV [hepatitis C] is unknown,” lead investigator Saif M. Abu-Mouch, MD, from the Department of Hepatology, Hillel Yaffe Medical Center, in Hadera, Israel, and colleagues note in their abstract.

“This preliminary study confirms the benefit of adding vitamin D to conventional antiviral therapy in patients with chronic HCV,” Dr. Abu-Mouch told meeting attendees.

In the study, 58 patients with confirmed chronic HCV (genotype 1) were randomly assigned to peginterferon-alfa2b (1.5 µg/kg once weekly) plus ribavirin (1000 to 2000 mg/day). Thirty-one patients also received vitamin D (1000 to 4000 IU/day; serum level >32 ng/mL).

The vitamin D group had a higher mean body mass index (27 vs 24 kg/m²; P < .01), viral load (68% vs 58%; P < .01), and fibrosis (Metavir scores > F2, 55% vs 18%; P < .001) than the group that did not receive vitamin D. Demographics, disease characteristics, ethnicity, baseline biochemical parameters, and adherence to treatment were similar in the 2 study groups.

A rapid virologic response was seen at week 4 in 44% of the vitamin D group and in 18% of the control group. At week 12, Dr. Abu-Mouch told Medscape Gastroenterology, 96% of the vitamin D group (26 of 27 patients) were HCV RNA-negative, as assessed by reverse-transcriptase polymerase chain reaction, as was 48% of the control group (15 of 31 patients), which was a significant difference (P < .001), he said.

The combination of peginterferon and ribavirin, the standard of care for chronic HCV, achieves a sustained virologic response in 40% to 50% of naïve patients with genotype 1, the investigators explain in a meeting abstract. Vitamin D in combination with peginterferon-ribavirin “may have synergistic effects,” Dr. Abu-Mouch said.

Meeting attendee Laurent Tsakiris, MD, from the Centre Hospitalier Universitaire de Melun in France, who was not involved in the study, told Medscape Gastroenterology that “the study is surprising and promising because vitamin D is something very easy to use and there is no toxicity.”

“It’s also interesting,” he said, “that the group treated with vitamin D had more severe disease than the control group. I think this can be considered a strong result from a small study.

The study did not receive commercial support. Dr. Abu-Mouch and Dr. Tsakiris have disclosed no relevant financial relationships.

The Liver Meeting 2009: 60th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD): Abstract LB20. Presented November 2, 2009.

http://www.medscape.com/viewarticle/711902?src=mpnews&spon=18&uac=22879SK

Vitamin E Improves Nonalcoholic Steatohepatitis ( Fatty Liver)

Supplementation with the natural form of vitamin E (RRR-α-tocopherol) has beneficial effects in patients with nonalcoholic steatohepatitis (NASH), according to findings from a late-breaking study reported here at The Liver Meeting 2009: American Association for the Study of Liver Diseases (AASLD) 60th Annual Meeting.

The findings, from a prospective randomized double-blind placebo-controlled trial, support those from smaller studies of vitamin E in patients with NASH, Arun J. Sanyal, MD, division chair from the Department of Gastroenterology, Hepatology, and Nutrition at Virginia Commonwealth University in Richmond, told meeting attendees.

NASH, for which there is no approved therapy, affects about 4% of the American population, and about 15% of patients with NASH progress to cirrhosis. It is associated with fatty liver disease, insulin resistance, and obesity.

Dr. Sanyal and colleagues studied 247 nondiabetic adults with biopsy-proven NASH with a nonalcoholic fatty liver disease (NAFLD) activity score of 4 or higher within 6 months of randomization. They allocated 80 patients to the insulin-sensitizer pioglitazone (30 mg once daily), 84 to vitamin E (800 IU/day), and 83 to placebo. Liver biopsy was performed before treatment and, in 90% of study subjects, after treatment.

According to Dr. Sanyal, after 96 weeks, 43% of patients in the vitamin E group met the primary end point — an improvement in histology, defined as a decrease in NAFLD activity score of 2 points or more (with a decrease of at least 1 point in cytologic ballooning) and no worsening of fibrosis. This compares to 34% of patients in the pioglitazone group and 19% in the placebo group.

“Pioglitazone did not meet the prespecified level of significance for the primary end point,” the researchers note in their abstract.

“Compared with those on placebo, patients on vitamin E had improved steatosis (P = .005), inflammation (P = .02), ballooning scores (P = .01), and serum ALT (P = .001), but no improvement in fibrosis scores,” they note.

Pioglitazone was superior to placebo in improving steatosis (P < .001), inflammation (P = .004), ballooning scores (P = .08), and serum ALT (P < .001). There was no improvement in fibrosis scores with pioglitazone.

Patients in the pioglitazone group gained more weight than those in the vitamin E or placebo groups (mean, 4.7 vs 0.4 vs 0.8 kg, respectively; P < .01) but were also the only ones to demonstrate improved insulin resistance (P = .03 vs placebo).

No significant changes in quality of life were evident with either treatment compared with placebo, and there were no drug-related serious adverse effects.

“Not only did vitamin E improve liver function in 40% of the patients treated with it, but the specific type of vitamin E used in the study is inexpensive, readily available, and caused no side effects in patients who participated in the study,” Dr. Sanyal noted in a conference-issued statement.

Vitamin E and pioglitazone are both active drugs for the treatment of NASH, Dr. Sanyal told Medscape Gastroenterology. However, he added, “it is important for clinicians to remember that these [treatments] are not a panacea, patients still need to be followed carefully, and the long-term risks of therapy need to be addressed in larger phase 4 studies.”

During a press conference highlighting key abstracts, AASLD President Scott L. Friedman, MD, chief of liver diseases at Mount Sinai Medical Center in New York City, said these results show that “when the vitamin E is of sufficient quality that you’re really getting antioxidant activity, you will see an impact.”

“I think these results should resurrect our efforts to use antioxidants and, more important, to develop very potent antioxidants, which of course are well tolerated in these patients,” he added.

Dr. Sanyal reports consulting for Takeda, Salix, Ikaria, Astellas, Pfizer, Gilead, Vertex, Exalenz, Bayer, Onyx, and Amylin; and receiving grant/research support from Sanofi-Aventis, Salix, Gilead, and Intercept. Dr. Friedman reports serving on advisory committees or review panels for Exalenz, Sanofi-Aventis, and Axcan; consulting for Angion, Intercept, 7TM, and Stromedix; and receiving grant/research support from Celera.

The Liver Meeting 2009: American Association for the Study of Liver Diseases (AASLD) 60th Annual Meeting: Late Breaker Abstract LB2. Presented November 2, 2009.

http://www.medscape.com/viewarticle/712062?src=mpnews&spon=18&uac=22879SK

9) Frequent, Brisk Exercise After Menopause Lowers Breast Cancer Risk

Postmenopausal women who maintain a regular, moderate to vigorous exercise program reduce their risk for breast cancer, even if they did not exercise in the past, according to a study published online October 1 in BMC Cancer.

The study, begun in 1995, consisted of 118,899 women, ages 50 to 71 years, who answered questions about their exercise habits during 4 periods of their lives: ages 15 to 18 years, 19 to 29 years, 35 to 39 years, and in the past 10 years. Participants also indicated the number of hours exercised per week, from less than 1 to more than 7, and whether their activities were light (eg, bowling and fishing) or moderate to vigorous (eg, jogging and swimming) for each of the periods.

During 6.6 years of subsequent tracking, 4287 breast cancers, mostly estrogen receptor (ER)–positive (84%; n = 1352), were diagnosed among the participating women.

Researchers found that women who maintained a high level of activity for more than 7 hours a week during the 10 years before the study reduced their risk for breast cancer by 16% vs more sedentary women in age-adjusted and multivariate (each relative risk [RR], 0.84; 95% confidence interval [CI], 0.76 – 0.93) models. Adjustment for light exercise during the recent decade did not significantly affect the risk (RR, 0.85; 95% CI, 0.76 – 0.95). Further adjustment for body mass index (BMI) had limited impact on the correlation between brisk activity and the risk for breast cancer (RR, 0.87; 95% CI, 0.78 – 0.96).

The authors noted that their results regarding physical activity after menopause are consistent with previous findings. “Our observation that recent physical activity showed a stronger inverse association with breast cancer risk than historical activity is supported by two systematic review and three prospective studies among postmenopausal women,” they point out, citing a review published in Epidemiology (2007;18:137-157) and a cohort study in the Journal of the American Medical Association (2003;290:1331-1336), among others.

Reasons for the link between activity and reduction of breast cancer risk may include the ability of exercise to reduce levels of endogenous sex hormones, modulate insulin and insulin-like growth factors, increase immunity, and reduce ongoing inflammation, according to the researchers.

One limitation of the study was a relatively low response rate by the 3.5 million members of the American Association of Retired Persons who initially received the questionnaires. The authors also note that subjects’ ability to remember physical activity that occurred 10 years ago vs in the more distant past may have colored the results. They point out that future studies of lifelong physical activity are needed to verify their findings and provide more details about how exercise intensity and timing affect breast cancer risk.

“Although controlled trials or intervention studies are the ideal study designs for disentangling the ‘dose’ of physical activity that may influence breast cancer risk, the cost and duration of such studies for researching the association of physical activity intensity and timing with primary breast cancer limits their feasibility,” the authors write. “However, interventions and experimental research will be imperative to investigate the mechanism by which physical activity intensity and timing influence breast cancer risk.”

The Intramural Research Program of the National Institutes of Health, National Cancer Institute supported this study. The study authors have disclosed no relevant financial relationships.

BMC Cancer. Published online October 2, 2009. Abstract

http://cme.medscape.com/viewarticle/710260?src=mpnews&spon=7&uac=22879SK

10) Relationship Between Vertebral Deformities And Allergic Diseases

A research verification between visceral disease and immune dysfunction from sympathetic segmental disturbances secondary to vertebral deformities has been put forward by chiropractic and various fields’ medical practitioners. We report on the positive results of a controlled study using vertebral correction treatment to reduce vertebral misalignments in patients with atopic dermatitis and bronchial asthma. We also discuss possible mechanisms for the relationship between visceral and immune dysfunction and vertebral deformities.
Methods: We divided 360 atopic dermatitis patients into six groups in the treatment frequency to compare a treatment effect. We investigated the existence of the diurnal secretion quantity change of adrenal cortex hormone to judge the present condition of the adrenal cortex functions of 1,699 atopic dermatitis patients and bronchial asthma patients. We investigated the spinal condition of 1,028 atopic dermatitis patients and bronchial asthma patients to consider the relationship between the allergic disease and the spinal misalignments. We implemented Takeda Method to 906 bronchial asthma patients and 1,827 atopic dermatitis patients and chased the treatment effect

Among 120 atopic dermatitis patients who received spinal correction treatments every day, 106 showed improvement in skin itching and 86 showed improvement in skin condition. Among 240 atopic dermatitis patients who did not receive spinal correction treatments every day, we could not obtain a sure treatment effect. As a result of the questioning about the diurnal quantity change of adrenal cortex hormone secretion to 1,699 patients, the adrenal cortex function of these patients may be in the decline condition. We obtained over 70 percent improvement in allergic symptoms by Takeda’s Method. We found that vertebral misalignment is a common and characteristic finding in patients with atopic dermatitis and bronchial asthma.

http://www.ispub.com/journal/the_internet_journal_of_orthopedic_surgery/volume_2_number_1_45/article_printable/relationship_between_vertebral_deformities_and_allergic_diseases.html

11) Badly Concluded Study: Folate Supplementation Linked to Increased Cancer Incidence and Mortality

Folic acid and vitamin B supplementation was associated with an increase in cancer incidence, cancer mortality, and all-cause mortality in a new analysis with long-term follow-up of data from 2 trials conducted in Norway, where there is no folic acid fortification of foods.

The results are reported in the November 18 issue of the Journal of the American Medical Association.

The authors, led by Marta Ebbing, MD, from Haukeland University Hospital in Bergen, Norway, say that these results, although in need of confirmation, suggest that there is a need for “safety monitoring” because there is now widespread folic acid fortification of foods and increasing use of folic acid in dietary supplements.

However, the authors of an accompanying editorial points out that data from the United States, where there has been mandatory folic acid fortification of flour and other foods since 1998, have been showing a significant decrease in cancer incidence. “These national incidence rates do not support a substantial population-wide adverse effect of the magnitude suggested in the study,” write the editorialists, Bettina F. Drake, PhD, MPH, and Graham Colditz, MD, DrPH, both from the Washington University School of Medicine in St Louis, Missouri.

“The population data from the United States do not suggest that there is a problem,” Dr. Drake said in an interview with Medscape Oncology. She pointed out that folate supplementation used in the study resulted in much higher blood levels than would be seen after eating foods fortified with folic acid. In addition, the study was conducted in individuals with heart disease and was of limited duration.

The latest results come from 2 trials conducted in 6837 patients with ischemic heart disease, in which half the participants took supplements of vitaminB (including folic acid) to lower homocysteine levels to see if this would reduce cardiovascular outcomes. It did not, and these results are in line with other large trials. At the same time, both trials showed — independently — an increase in cancer in the supplementation group, compared with the placebo group, but this was not statistically significant.

In these 2 trials, participants took supplements containing folic acid (0.8mg/d), vitamin B₁₂ (0.4mg/d), and B₆ (40 mg/d), or various combinations of these. (Dr. Repetto’s comment: The B vitamins work synergistically therefore an overabundance of some of the B vitamins can cause, after a time,  deficiency of the other B vitamins) This dose of folic acid is 4 to 6 times higher than the average dose delivered by the mandatory fortification in the United States, and is twice the recommended daily allowance, the authors note, although they add that it is below the tolerable upper intake level of 1 mg/d set by the US Institute of Medicine.

The increase in cancer incidence and mortality was “mainly driven by an increase in lung cancer incidence,” the authors write. They also pointed out that 94% of the subjects who developed lung cancer were either current or former smokers.

JAMA. 2009;302:2119-2126, 2152-2153.

http://www.medscape.com/viewarticle/712591?src=mpnews&spon=18&uac=22879SK

12) Vitamin D Supplementation and Cancer Prevention

It is estimated that approximately 1 billion people worldwide have blood concentrations of vitamin D that are considered suboptimal. Much research has been conducted over the past 30 years linking low vitamin D serum concentrations to both skeletal and nonskeletal conditions, including several types of cancers, cardiovascular disease, diabetes, upper respiratory tract infections, all-cause mortality, and many others. Several observational studies and a few prospectively randomized controlled trials have demonstrated that adequate levels of vitamin D can decrease the risk and improve survival rates for several types of cancers including breast, rectum, ovary, prostate, stomach, bladder, esophagus, kidney, lung, pancreas, uterus, non-Hodgkin lymphoma, and multiple myeloma. Individuals with serum vitamin D concentrations less than 20 ng/mL are considered most at risk, whereas those who achieve levels of 32 to 100 ng/mL are considered to have sufficient serum vitamin D concentrations.

One study, however, published in 2007 by Lappe et al, prospectively looked at the effect of vitamin D intake on the incidence of all cancers.

The purpose of the study was to determine if calcium alone or calcium plus vitamin D has an effect on reducing the incidence of all types of cancer. The study was designed as a 4-year, population-based, double-blind, randomized placebo-controlled trial. The study participants included 1024 community-dwelling women who were randomly selected from a population of healthy postmenopausal women from 9 rural counties in Nebraska. The participants’ mean age was 66.7 years, with a body mass index of 29.0 kg/m² and a baseline serum 25-hydroxyvitamin D level of 71.8 nmol/L. Subjects were randomly assigned to 1 of 3 groups: 1400 to 1500 mg supplemental calcium per day alone, 1400 to 1500 mg supplemental calcium plus 1100 IU vitamin D₃ per day, or placebo.

The results showed that both the calcium-only and the calcium plus vitamin D groups had lower rates for all cancers compared with the placebo group (P < .03. The relative risk for the development of cancer at the study’s end was 0.402 for the calcium plus vitamin D group (P = .013) and 0.532 for the calcium-only group (P = .063). The Kaplan-Meier plot of the 3 groups showing survival-free cancer over the course of the study revealed a similar time course up to 1 year, which then began to separate. The 12-month serum 25-hydroxyvitamin D level in the calcium plus vitamin D group increased by 23.9 nmol/L to 96.0 nmol/L compared with statistically unchanged levels in the other 2 groups. In multiple logistic regression models, both treatment and serum 25-hydroxyvitamin D concentrations were significant, independent predictors of cancer risk. This translated to a predicted 35% reduced risk of cancer for every 25-nmol/L (10-ng/mL) increase in serum 25-hydroxyvitamin D. The authors concluded that improving vitamin D nutritional status substantially reduced all-cancer risk in postmenopausal women and that baseline and treatment-induced serum 25-hydroxyvitamin D concentrations were strong predictors of cancer risk.

Other studies relating cancer to vitamin D have shown that people living at higher latitudes are at increased risk for Hodgkin lymphoma as well as colon, pancreatic, prostate, ovarian, breast, and other cancers. In addition, people living at higher latitudes are more likely to die from these cancers compared with those living at lower latitudes.^] Epidemiologic studies, both prospective and retrospective, have shown that individuals who have serum 25-hydroxyvitamin D levels less than 20 ng/mL have an associated 30% to 50% greater risk of colon, prostate, and breast cancer as well as a higher mortality rate from these cancers. In addition, analysis of the Women’s Health Initiative showed that women who had a serum 25-hydroxyvitamin D level less than 12 ng/mL (30 nmol/L) had a 253% increase in the risk of colorectal cancer over an 8-year follow-up period.

Data support the justification for supplementing vitamin D₃ 2000 IU/d in most adults to decrease the risk for several types of cancers and other conditions.

Am J Lifestyle Med. 2009;3(5):365-368

http://www.medscape.com/viewarticle/712529

Are you utilizing your folic acid? The case for metabolically active form of folic acid – L-5-MTHF

Roughly one-third of the general population may have a genetic variation that impairs their ability to properly utilize folic acid.

L-5-methyltetrahydrofolate (L-5-MTHF) is the metabolically active form of folic acid. The folic acid found in food has to be cleaved (digested) from protein carriers in order to be absorbed. This process is inefficient in some individuals. Once absorbed, dietary (and supplemental) folic acid has to then undergo several biochemical conversions in the body to become L-5-MTHF. Roughly one in three Americans have genetically inefficient enzymes that help create L-5-MTHF. By supplementing with L-5-MTHF, one can be assured of getting the benefits of folic acid, regardless of their ability to absorb or convert it to the active form. If you are an individual with impaired ability to utilize regular folic acid, L-5-MTHF supplementation can make a truly dramatic difference in your health.

L-5-MTHF plays a role in DNA synthesis and repair. Inadequate levels of 5-MTHF is linked to childhood leukemia. Cancers of the colon and breast are also associated with suboptimal L-5-MTHF status, as is the precancerous condition called cervical dysplasia. In a study involving smokers, high doses of folic acid and vitamin B12 reversed precancerous cellular changes in the lungs.

Folic acid’s importance to human health has to do in part with its role in a biochemical process called methylation. Methylation refers to the transfer of methyl groups (one carbon bound to three hydrogen atoms). Methylation occurs billions of times in the body each day and is essential for health.

L-5-MTHF is very important to genetic expression. Methyl groups are strategically placed on certain genes to inactivate them. Every cell in the human body has the genetic information to produce every other type of cell. The thing is that most of the genes are not active. Methyl groups (supplied indirectly by L-5-MTHF) silence the genes that should not be active in a given cell at a given time. This is obviously critical for good health. Some of the genes within our cells are tumor promoters. Proper methylation, which requires L-5-MTHF, keeps these genes silenced. The importance of L-5-MTHF involves more than its role in promoting proper genetic expression, DNA synthesis and repair.

L-5-MTHF also plays a role in dopamine and serotonin metabolism.

L-5-MTHF also plays an important role L-5-MTHF also plays an important role in detoxication of a variety of compounds, including environmental toxins (such as mercury, lead, arsenic and tin), medications, and some of the body’s own hormones. Estrogens are detoxified through methylation. Inadequate levels of L-5-MTHF cause potentially toxic build-up of estrogens in the body, which increases risk to breast, prostate and other cancers. Other conditions of estrogen excess, such as uterine fibroids and endometriosis, are also more likely to occur and be more severe. Histamine, epinephrine (adrenaline), and norepinephrine are also detoxified by methylation. Inadequate L-5-MTHF could therefore potentially worsen allergy and stress-related symptoms.

L-5-MTHF is critical for the detoxication of homocysteine. Conditions associated with elevated homocysteine levels include coronary artery disease, heart attack, stroke, deep vein thrombosis, peripheral vascular disease, miscarriage, birth defects, depression, sensorineural hearing loss, osteoporosis, cancer, arthritis, dementia, Alzheimer’s disease, Parkinson’s disease, and complications of diabetes. Do you know what your homocysteine level is?

Link between Thyroid disease, breast cancer & iodine?

I was researching articles on iodine at Pub Med – an online search engine for medical research and saw this research.

Though these studies are not recent; they are interesting to read ( see similar studies on right side of page) esp. in light of all the controversy about mammograms and highlight the need to get enough iodine into your diet.

The article starts: A renewal of the search for a link between breast cancer and thyroid disease has once again demonstrated an increased prevalence of autoimmune thyroid disease in patients with breast cancer. This is the most recent of many studies showing an association between a variety of thyroid disorders and breast cancer. Such an association is not surprising as both diseases are female predominant with a similar postmenopausal peak incidence. The significance of the presence of thyroid autoantibodies, particularly thyroid peroxidase antibodies, in serum from patients with breast cancer is unknown, but it has been suggested that antibody positivity is associated with better prognosis. One area in which thyroid and breast functions overlap is in the uptake and utilization of dietary iodide. Experimental findings showing the ability of iodine or iodine-rich seaweed to inhibit breast tumour development is supported by the relatively low rate of breast cancer in Japanese women who consume a diet containing iodine-rich seaweed.

For the rest of the article, please go to http://www.ncbi.nlm.nih.gov/pmc/articles/PMC314438/