VITAMIN D SUPPLEMENTATION DECREASES LUNG DISEASE FLARE-UPS

A new trial has found that when vitamin D deficient patients with chronic obstructive pulmonary disease (COPD) are supplemented with the vitamin, rates of respiratory flare-ups decrease by 40%.  

Chronic bronchitis and emphysema are two types of COPD. These conditions are characterized by coughing, excess mucus, shortness of breath, wheezing, fatigue, and tightness in chest but when a flare-up strikes these symptoms become so severe that individuals often require hospitalization.

This randomized controlled trial included 240 patients with COPD. For one year, half of the patients received 120,000 IU of vitamin D every 2 months (equivalent to taking 2000 IU daily) while the other half received a placebo. The risk, severity and duration of flare-ups was then compared between the two groups.  The supplemented group experienced a 40% reduction in flare-ups.  

How vitamin D reduced COPD flare-ups is not entirely understood.  Because adequate levels of vitamin D appear to be important in immune function, researchers had speculated that supplementation would decrease rates of upper respiratory tract infections, but, instead, they found that the supplemented patients and controls did not differ in their rate of respiratory infections.  Instead, it appears that the anti-inflammatory properties of vitamin D are what mediates the reduction in COPD flare-ups.  Interestingly, while it is not believed that vitamin D supplementation can prevent COPD, patients with chronic lung diseases such as asthma, cystic fibrosis, COPD, and interstitial pneumonia appear to be at increased risk for vitamin D deficiency.

What to do:  Increasingly, it is being recognized that vitamin D plays an important role not only in bone health but also immune, endocrine, and pulmonary function.  Blood tests can reliably check vitamin D levels.  If deficient, patients are often prescribed a prescription dose.  Vitamin D is naturally produced when the skin is exposed to the sun but having darker skin, excess weight, and/or older age decreases the body’s ability to produce vitamin D.  Salmon, sardines (and other fish in which the bones are eaten), and cod liver oil are some of the few foods that contain significant amounts of vitamin D.  Milk and many other products are now fortified.  When taking a supplement choose the Vitamin D₃ form.  Discuss with your provider what level of supplementation is appropriate.

Adapted from articles available at:

http://www.sciencedaily.com/releases/2014/12/141202082539.htm

https://www.vitamindcouncil.org/health-conditions/chronic-obstructive-pulmonary-disease/#

Sources:

Martineau AR, James WY, Hooper RL et al.. Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial. The Lancet Respiratory Medicine, 2014; DOI: 10.1016/S2213-2600(14)70255-3

Gilbert CR, Arum SM, Smith CM. Vitamin D deficiency and chronic lung disease. Canadian Respiratory Journal : Journal of the Canadian Thoracic Society 2009;16(3):75-80.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706673/

TART CHERRIES REDUCE URIC ACID AND INFLAMMATION ASSOCIATED WITH GOUT & AID IN SLEEP

Tart cherries, the red cherries commonly used in cherry pie, are one of the fruits highest in anti-oxidant plant compounds known as anthocyanins.  Two recent studies add to a growing body of evidence on the joint health benefits of regular tart cherry consumption.    In the studies researchers found tart cherries caused changes in how the body processes uric acid -- a substance that is elevated in those suffering from gout.  They also found that sour cherry juice reduces c-reactive protein, a biomarker of systemic inflammation.  

In the studies, healthy participants consumed tart cherry juice concentrate equivalent to 45 or 90 tart cherries.   Researchers collected blood and urine samples from the participants immediately before and at numerous intervals for up to 48 hours after the tart cherry juice was consumed.  They found that after consumption of the juice, participants’ blood levels of uric acid significantly decreased and urinary excretion of uric acid increased and that these changes persisted for more than 12 hours.  They also found that c-reactive protein levels significantly declined after consumption.

In addition to joint health benefits, tart cherries appear to help with sleep.  They are one the richest natural sources of melatonin, a hormone that helps regulate the sleep-wake cycle.  A study from April of this year, found that seniors  who drank 8 oz. of tart cherry juice in the morning and at night were able to sleep more than an hour longer each night compared to those taking a placebo.

What to do:  Studies on the cherries thus far have been relatively small but results are encouraging.  Doses and preparations used in studies have varied.  Be mindful that any of the cherry preparations add calories and natural sugars to your diet.   If you are up for giving the cherries a go, try having an 8oz glass of the juice, 2 Tablespoons of sour cherry juice concentrate, or 1-1.5 cups of sour cherries  twice daily.  Also, though perhaps not quite as packed with anthrocyanins as tart cherries, diets rich in all kinds of cherries (not just sour cherry), blueberries, and cranberries appear to be helpful in reducing gout flare-ups and increasing the body’s anti-oxidant defenses.

Sources:

Bell PG, Gaze DC, Davison GW, George TW, Scotter MJ, Howatson G. Montmorency tart cherry (Prunus cerasus L.) concentrate lowers uric acid, independent of plasma cyanidin-3-O-glucosiderutinoside. Journal of Functional Foods. 2014; 11: 82-90.  DOI: 10.1016/j.jff.2014.09.004

Bell PG, Walshe IH, Davison GW, Stevenson E, Howatson G. Montmorency cherries reduce the oxidative stress and inflammatory responses to repeated days high-intensity stochastic cycling. Nutrients. 2014;6:829-843.  DOI:10.3390/nu6020829

Seymour EM, Warber SM, Kirakosyan A, Noon KR, Gillespie B, Uhley VE, Wunder J, Urcuyo DE, Kaufman PB, Bolling SF. Anthocyanin pharmacokinetics and dose-dependent plasma antioxidant pharmacodynamics following whole tart cherry intake in human adults. Journal of Functional Foods. Sept. 2014; Available online ahead of print.  DOI: 10.1016/j.jff.2014.08.007

Liu AG, Tipton RC, Pan W, Finley JW, Prudente A, Karki N, Losso JN, Greenway FL.  Tart cherry juice increases sleep time in older adults with insomnia. Experimental Biology. 2014. San Diego, CA. April 28, 2014.  http://www.fasebj.org/content/28/1_Supplement/830.9

Adapted from articles available at:

http://www.medicalnewstoday.com/releases/283390.php

http://www.prnewswire.com/news-releases/study-tart-cherry-juice-increases-sleep-time-in-adults-with-insomnia-257037251.html

http://www.medicaldaily.com/tart-cherry-juice-found-cut-levels-uric-acid-and-inflammation-biomarker-blood-306112

LONG-TERM WEIGHT LOSS SIMILAR WHETHER FOLLOWING WEIGHT WATCHERS, ZONE, ATKINS, OR SOUTH BEACH

Millions of Americans attempt to lose weight each year, spending an estimated 66 billion on weight loss related products and services.  In a recent review, researchers examined the existing research on the weight loss and heart health effects of following Atkins, South Beach, Zone, or Weight Watchers. 

Atkins, Zone, and South Beach are all diets that emphasize carbohydrate restriction while Weight Watchers has more flexibility as to carbohydrate composition.  While the diets differ in the amount of carbohydrate allowed (with Atkins eliminating nearly all carbohydrate at the initial stages), all emphasize moderating energy intake and choosing slowly digested carbohydrates rather than refined grains and sugars.

The recent survey of the research on these diets found that after 12-months, all plans were similarly effective in producing modest weight loss but that individuals often regained most of the lost weight over time.  At 12-months out, the diets produced modest improvements in blood cholesterol and blood pressure though results varied across studies, with improvements varying more according to level of weight loss rather than diet type. 

While the diets yielded similar results, persons following Weight Watchers lost slightly more weight than those following the other plans.  Unlike the other plans, Weight Watchers, has a social component – individuals attend weekly meetings in which their progress is shared with a group.

What to do:  The fact that all four diets produced similar results indicates that weight loss is less about diet composition (i.e. low carb vs. low fat) and more about behavioral modification.  All the diets emphasized keeping a record of one’s intake and tracking one’s weight.  And, even if the diets vary significantly in their initial induction phases, long-term, they emphasize intake of high-volume low calorie foods like green vegetables, preparing foods at home rather than eating out, and limiting refined grains and sugars.  So, weight management is not about finding the magic food formula but making a long-term commitment to a healthy lifestyle and practicing the behaviors that keep you focused on making healthy food choices – making time to prepare food, tracking your weight and intake, and finding a supportive community.

Adapted from articles available at:

http://www.medpagetoday.com/Cardiology/Prevention/48539

http://www.techtimes.com/articles/20009/20141111/which-popular-diets-are-actually-effective-researchers-comb-through-atkins-weight-watchers-and-more.htm#ixzz3IsPKBgtb

http://consumer.healthday.com/vitamins-and-nutrition-information-27/dieting-to-lose-weight-health-news-195/big-name-diets-all-work-for-a-while-693622.html

Source:

Atallah R, Filion KB, Wakil SM et al. Long-term effects of 4 popular diets on weight loss and cardiovascular risk factors: A systematic review of randomized controlled trials. Circulation: Cardiovascular Quality and Outcomes.  2014; DOI: 10.1161/CIRCOUTCOMES.113.000723/-/DC1.

GOT KIDNEY STONES? PREVENT THEM NEXT TIME.

Recent studies have shown that kidney stone rates are on the rise across the country.  About 13% of men and 7% of women in the U.S. will develop a kidney stone during their lifetime. Without treatment, up to 50% of those people will have a recurrence within five years. The American College of Physicians (ACP) recently reviewed all research studies on kidney stones published since 1948 to formulate updated treatment recommendations.

Kidney stones are small, hard deposits that form inside your kidneys.  They are created when the urine becomes concentrated, allowing minerals to crystallize and stick together.  The most common symptom is severe pain. Most stones pass on their own, but medical procedures are necessary to remove some kidney stones.

What to do:  The APC advises the following to prevent stone recurrence:

• The first and foremost line of defense against kidney stones is to drink plenty of water -- at least 12 cups but fluid needs vary depending on body size, weather, activity level, etc.  Drink enough that you produce at least 2 liters of urine.  Since most of us do not measure, make sure you are drinking enough to keep your urine very light. 
• Talk with your doctor about prescription medications that help to prevent recurrence including thiazide diuretics, citrate, and allopurinol.
• Moderate foods high in oxalate (such as chocolate, beets, nuts, rhubarb, spinach, strawberries, tea, and wheat bran) and pair high oxalate foods with a calcium source such as dairy.  Do not limit calcium intake but instead eat a diet rich in calcium. 
• Control sodium intake.  High sodium intake increases calcium losses and stone formation. 
• Moderate intake of meat and animal proteins.  These foods are high in purines and increase the acidity of urine.  Organ meats, anchovies, sardines, bacon, beef, lobster, shrimp, cod, ham, veal and venison are especially high.
• Minimize intake of dark colas such as Coke & Pepsi.  These are very acidic and increase calcium in the urine.  

Adapted from article found at:

http://www.medicalnewstoday.com/releases/284722.php

Source:

Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD. Dietary and pharmacologic management to prevent recurrent nephrolithiasis in adults: A clinical practice guideline from the American College of Physicians. Annals of Internal  Medicine. 2014;161:659-667. Doi:10.7326/M13-2908

DRINKING SODA ACCELERATES CELLULAR AGING

A new study has found yet another reason to steer clear of sugary drinks.  Researchers found that independent of weight, drinking a daily 20-ounce soda is associated with an increased rate of cellular aging comparable to smoking.

Researchers assessed cellular "aging" by measuring telomere length.  Telomeres are the protective caps at the ends of chromosomes that affect how quickly cells age. They are combinations of DNA and proteins that protect the ends of chromosomes and help them remain stable. As they become shorter, and as their structural integrity weakens, the cells age and die quicker. Shorter telomeres are associated with decreased life  span as well as a host of chronic diseases including heart disease, vascular dementia, diabetes, and some types of cancer.   

In the study, researchers collected information on dietary intake and measured the telomere length of 5,309 participants, ages 20 to 65, with no history of diabetes or cardiovascular disease.  They found that compared to those who drank less than an ounce of soda daily, those who drank an average of 8-ounces of soda experienced an additional 1.9 years of aging.   About 21% of the sample consumed on average at least 20-ounces of soda per day.  This level of consumption was equivalent to an average of 4.6 years of telomere shortening. This effect on telomere length is comparable to the effect of smoking, and to  the effect of regular exercise in the opposite, anti-aging direction. 

What to do:  Quit the sugary drinks already!  Diet drinks did not appear to be associated with telomere length so opt for these when you really need something sweet but most of the time, opt for water.  Try flavoring water or seltzer with lemon, oranges, mint, a splash of juice, cucumbers, or herbal tea to keep your taste buds satisfied.  In addition to consuming a healthy diet rich in fruits and vegetables and low in sugar, maintaining a healthy weight, getting adequate sleep, exercising regularly, minimizing stress, and not smoking help to preserve telomere length.     

Adapted from articles available at:  

http://www.laweekly.com/squidink/2014/10/21/drinking-soda-may-accelerate-aging-as-much-as-smoking

http://www.ucsf.edu/news/2014/10/119431/sugared-soda-consumption-cell-aging-associated-new-study

Source:

Leung CW, Laraia BA, Needham BA, Rehkopf DH, Adler NE, Lin J, Blackburn EH, Epel ES.  Soda and cell aging: Associations between sugar-sweetened beverage consumption and leukocyte telomere length in healthy adults from the national health and nutrition examination surveys. American Journal of Public Health. 2014.  doi: 10.2105/AJPH.2014.302151

MEDITERRANEAN DIET: A HEART-HEALTHY EATING PLAN

The Mediterranean diet is a way of eating rather than a formal diet plan.  It is based on the dietary traditions of the island of Crete in Greece circa 1950.  At this time, the rates of chronic disease there were among the lowest in the world, and adult life expectancy was among the highest, even though medical services were limited.

The Mediterranean Diet  emphasizes fruits, veggies, whole grains, beans, nuts, olive oil; eating fish two or more times a week; enjoying poultry, eggs, cheese, and yogurt in moderation; and saving sweets and red meat for special occasions. Top it off with a splash of red wine (if you want). Remember to stay physically active, and you’re set.

Health Benefits of the Mediterranean Diet

There has been a lot of research on the potential health benefits of following the Mediterranean diet. Many large studies link the Mediterranean diet with reduced rates of heart disease, diabetes, stroke, rheumatoid arthritis, Alzheimer's, Parkinson's', and many types of cancer.  Even when one already has heart disease, adopting the Mediterranean diet is associated with lower rates of heart attacks and other complications.

What about the diet makes it so healthy?  It appears to reduce systemic inflammation in the body.  Its plentiful legumes, fruit, and vegetables deliver ample phytonutrients rich in antioxidants as well as heart healthy minerals such as potassium and magnesium.  The fats in the diet come primarily from olives, nuts, and avocados.  These foods are rich in monounsaturated fats that have been shown to have a positive effect on blood cholesterol. Olive oil, in particular appears to have unique anti-inflammatory properties, especially when it is combined with raw vegetables.  Also, the prominent role of fish in the diet means that it is rich in essential omega-3 fats which have been shown to lower triglycerides, decrease blood clotting, improve the health of your blood vessels, and help moderate blood pressure. Being rich in plant based foods means that the diet is very high in fiber.  Fiber helps to slow digestion and moderate the blood sugar rise after meals.  This makes it helpful in blood sugar regulation.  Also, beans are especially rich in soluble fiber which has been shown to have beneficial effects on blood cholesterol. 

HOW TO FOLLOW A MEDITERRANEAN DIET

Eat your fruits & veggies – The cornerstone of the diet is an emphasis on plant-based foods.  Fill up on these at every meal.  Vegetables are eaten several times per day, raw and cooked.  Traditionally, salad greens tossed in oil & lemon accompanied every meal.  Use fruits for snacks and dessert.

Use beans daily - Legumes including lentils, chickpeas, and beans are a daily part of the diet.  Opt for more vegetarian meals.  Legumes are very versatile.  They are great in soups, casseroles, spreads/dips (i.e. hummus, black bean dip) and salads.  Try roasting chickpeas for nutritious snack.

Make grains whole - Opt for 100% whole grain or whole wheat products.  Try to consume grains that have been minimally processed- so, instead of choosing flour-based items try cooking with the intact grain.  For example, instead of pasta, try whole grains (such as wild rice, barley, and bulgur) in salads and soups.

Go nuts - Nuts and seeds are an important part of the diet.  All types are good sources of fiber, protein and healthy fats. Keep them on hand for a quick snack.  Try blended sesame seeds (tahini) with chickpeas as a dip or spread.  Avoid candied or honey-roasted and salted nuts.

Choose olive oil instead of butter - Olive oil is the primary source of fat in the diet. "Extra-virgin" (the least processed form) contains the highest levels of protective antioxidants.  Use it instead butter or margarine which contain unhealthy saturated fats. For sautéing, choose "light" or "refined" olive oil that is formulated for high heat. The focus of the Mediterranean diet is not about limiting total fat consumption (fats typically make up 25-35% of total calories) but rather on choosing healthier types of fat.

Go fish - Eat fish twice a week or more.  Prepare a variety of fish and seafood.  Fatty fish — such as mackerel, herring, sardines, tuna and salmon — are rich sources of anti-inflammatory omega-3 fatty acids. 

Rein in the red meat, cheese, & sweets - Limit red meat to no more than a few times a month and instead opt for fish, poultry, and/or legumes. When choosing red meat, make sure it's lean and keep portions small (about the size of a deck of cards). Luncheon meats are absent from the diet.  Try to avoid processed meats as much as possible as they are particularly linked with heart disease and increased mortality.  While we think of Mediterranean food as rich in cheese, cheese is also very high in saturated fat and the traditional diet only contained very limited amounts.   Also watch out for sugar.  Refined sugars and sweets are rarely eaten and reserved for special occasions.  Instead of ice cream or cake, opt for strawberries, fresh figs, grapes, or apples. 

Smell the roses - The traditional Mediterranean diet was accompanied by a heart healthy lifestyle. Daily activity, sharing meals and enjoying the company of loved ones, and minimizing stress are all vital to long-term heart health.  Our hectic lives are a long way from Crete in the 1950's but challenge yourself to find ways to incorporate exercise, healthy social interactions, and quiet moments to release stress into your life.  Small changes can be significant and easier to fit in than you might think.    Take the stairs.  Eat lunch outdoors at a nearby park.  Use part of your lunch hour to take a 15 minute stroll with a friend.  Step away from the electronics (TV, smart phone, computer) during meals. Limit screen time during leisure hours. Go for a walk with your kids or friends after dinner.  Take a mindful moment and belly breath ten times.  

ARTIFICIAL SWEETENERS MAY IMPACT BLOOD SUGAR CONTROL

A set of intriguing but preliminary studies on mice and humans suggests that consumption of artificial sweeteners may impair the body's ability to regulate blood sugar.  The studies also suggest that this disruption of blood sugar control is due to changes in intestinal bacteria caused by artificial sweeteners. Artificial sweeteners have typically been recommended to persons with diabetes and excess weight because, unlike sugar and other natural sweeteners, they contain no calories or carbohydrates.  However, if the results of these studies hold true in future investigations, than artificial sweeteners may actually cause metabolic changes that increase the risk for diabetes. 

 

First, the researchers added three artificial sweeteners, either sucralose (Splenda), aspartame (Equal), or saccharin (Sweet n' Low), to the water of three groups of mice. Three other control groups of mice were given normal water or water with added sucrose or glucose. 11 weeks later, the mice consuming artificial sweeteners exhibited glucose intolerance (a condition in which there are greater blood sugar increases and a reduced capacity to lower blood sugar after a meal).  

The researchers then tested whether gut bacteria changes might be responsible for the metabolic changes of the mice fed the artificial sweeteners.  When they gave the artificial sweetener fed mice antibiotics that eliminated the bacteria living in their intestines, they found that the metabolic problems went away. Researchers also found they could glucose intolerance in healthy mice never exposed to artificial sweeteners by transplanting gut bacteria from the mice who had been fed saccharine.  Researchers hypothesize that when gut bacteria come into contact with artificial sweeteners, they produce substances that increase bodily inflammation and glucose intolerance.  Notably, the changes researchers observed in the gut bacteria of the mice consuming artificial sweeteners resembled the patterns of microbiota that are observed in mice with obesity and diabetes.  A previous study found similar changes in the microbiota of rats given sucralose (Splenda).

The researchers then evaluated a group of nearly 400 people who were long-term users of artificial sweeteners.   The researchers found that they were more likely to have glucose intolerance compared with people who don't normally use such sweeteners.  In a small follow-up experiment, the researchers tested blood sugar levels of seven people who don't normally consume artificial sweeteners. The researchers found that four of these people had higher fasting blood sugar levels and greater glucose intolerance after consuming the U.S Food and Drug Administration's maximum recommended daily amount of saccharine (equivalent to 8.5 packets of Sweet n' Low) for six days straight .

Previous studies on the health effects of artificial sweeteners have yielded conflicting findings. Some have found the sweeteners were associated with weight loss while others have found the exact opposite, that people who drank diet soda actually weighed more and had higher rates of excess weight and diabetes, but this may be due to the fact that persons using artificial sweeteners are doing so because they are overweight.  A recent observational study involving more than 300,000 people showed no association between consumption of artificially sweetened drinks and the development of diabetes. 

What to do:  Certainly much larger studies on humans need to be conducted before definitive conclusions about the effect of artificial sweeteners on gut bacteria and glucose intolerance can be made.  Meantime, a single 20-ounce regular soda has nearly 20 teaspoons of sugar and there is ample evidence that consumption of sugary drinks is strongly linked to excess weight which drives the development of diabetes.  So, diet drinks are likely a better alternative to regular sweet drinks if you must consume them.  But, your best bet is to drop the sweet tasting drink habit and go for water.  For added taste appeal, try flavoring water or seltzer with lemon, oranges, mint, a splash of juice, cucumbers, or herbal tea.

Sources:

Suez J, Korem T, Zeevi D, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota.  Nature.  2014;514;181-186. DOI: 10.1038/nature13793 

Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, et al.  Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats.  Journal of Toxicology & Environmental Health. 2008;71(21):1415-29. DOI: 10.1080/15287390802328630

Adapted from articles available at:

http://www.nlm.nih.gov/medlineplus/news/fullstory_148431.html

http://www.sciencedaily.com/releases/2014/09/140917131634.htm

http://well.blogs.nytimes.com/2014/09/17/artificial-sweeteners-may-disrupt-bodys-blood-sugar-controls/?_php=true&_type=blogs&_r=0

http://www.the-scientist.com/?articles.view/articleNo/41033/title/Sugar-Substitutes--Gut-Bacteria--and-Glucose-Intolerance/

http://www.economist.com/news/science-and-technology/21613311-sugar-substitutes-may-mess-gut-bacteriacausing-obesity

http://www.realclearscience.com/journal_club/2014/09/17/artificial_sweeteners_aiding_the_obesity_epidemic_108848.html