A dietary supplement of the synthetic derivative of vitamin B1 has the potential to prevent heart disease caused by diabetes, according to new research from the University of Bristol, funded by Diabetes UK. Vitamin B1 may help the body to dispose of toxins and therefore protect cells of the heart from becoming damaged.
Diabetes leaves the heart more vulnerable to stress as less oxygen and nutrients are delivered to the heart and other organs. Heart damage can be caused by high levels of glucose entering cardiovascular cells, which forms toxins that accelerate the ageing of the cell. Around 50 per cent of people with diabetes die from cardiovascular disease, and this complication is the leading cause of death among people with diabetes. Researchers warn that with increasing prevalence of diabetes ( around one in twenty people in the UK are now diagnosed with the condition ), diabetes will result in a new epidemic of heart failure unless new treatments are developed.
A team of researchers at the University of Bristol gave a synthetic derivative of vitamin B1 called benfotiamine to mice with and without diabetes. They found that treating mice with Type 1 or Type 2 diabetes with benfotiamine from the early stages of diabetes can delay progression to heart failure. They also found that the vitamin B1 derivative improved survival and healing after heart attacks in Type 1 mice ( and even in the mice without diabetes too ). Foods rich in vitamin B1 include Marmite, yeast and quorn, but it is not yet known whether changes to diet alone would provide enough of the vitamin to see the same effects as supplements achieved in mice.
Previous Diabetes UK-funded research at the University of Warwick was the first to show that people with Type 1 and Type 2 diabetes have around 75 per cent lower levels of vitamin B1 than people without diabetes. It is thought that this may not be due to diet, but due to the rate at which the vitamin is cleared from the body. Small scale clinical trials of people with Type 2 diabetes have also discovered a link between taking vitamin B1 supplements and a reduction in the signs of kidney disease.
The latest research has been published in the Journal of Molecular and Cellular Cardiology. Professor Paolo Madeddu who led this research at the University of Bristol said “Supplementation with benfotiamine from early stages of diabetes improved the survival and healing of the hearts of diabetic mice that have had heart attacks, and helped prevent cardiovascular disease in mice with both Type 1 and Type 2 diabetes. We conclude that benfotiamine could be a novel treatment for people with diabetes, and the next step in this research will be testing whether similar effects are seen in humans.”
Dr Victoria King, Head of Research at Diabetes UK said “Diabetes UK is pleased to have supported this research and is encouraged by these promising results which now need to be tested and confirmed in human trials. We would like to note that it’s still too early to draw any firm conclusions about the role of vitamin B1 in the prevention of complications and we would not advise that people look to vitamin supplements to reduce their risk of cardiovascular complications at this stage. Taking your prescribed medication, eating a healthy balanced diet and taking regular physical activity are key to good diabetes management and therefore reducing your risk of diabetes associated complications.”
Benfotiamine improves functional recovery of the infarcted heart via activation of pro-survival G6PD/Akt signaling pathway and modulation of neurohormonal response by Rajesh Katare, Andrea Caporali, Costanza Emanueli, Paolo Madeddu in the Journal of Molecular and Cellular Cardiology.
Dr. Nick and his colleagues analyzed epidemiological and health data on 156 CF patients over 40 year of age who receive care at National Jewish Health, the largest adult cystic fibrosis clinic in the nation. In addition, data were analyzed on nearly 3,000 patients from around the nation who were included in the Cystic Fibrosis Foundation Patient Registry from 1992-2007.
The researchers found that the fate of females changes considerably in the older CF population. It has long been recognized that a “gender gap” is present in CF, favoring males. Historically, females have been diagnosed later, had a poorer prognosis, and survived fewer years than males.
Accordingly, Dr. Nick's analysis showed that fewer females diagnosed as children survived to age 40. However, among those diagnosed as adults, females represented a significant majority, accounting for 72 percent of patients in Colorado and 54 percent nationally. Among the adult diagnosed patients, females survived on average 9 to 14 years longer than males.
The complex factors that account for the differential fate of female CF patients is not understood, although Dr. Nick believes it could be a mixture of behavioral and biological factors.
Dr. Nick's findings also indicate that patients diagnosed as adults do not really have milder diseases — as is commonly believed — just a delayed onset of an equally severe form of the disease. Although patients diagnosed as adults live longer than those diagnosed as children, the adult-diagnosed patients lose lung function as rapidly those diagnosed in childhood, and approximately 85% die of respiratory failure or post-transplant complications.
Dr. Nick believes there is a significant number of adults whose CF remains undiagnosed. His analysis indicates that once those patients are accurately diagnosed, proper care can significantly improve their health. Patients diagnosed as adults and subsequently followed at a CF center reversed progressive lung function decline and improved their lung function for at least four years. Older patients commonly do not get specialized CF care. It is generally recognized that the team approach to treatment provided by the 112 CF Foundation-accredited Care Centers results in better clinical outcomes. However, less than half of long-term CF survivors continued to be seen at CF Centers as they pass 40 years, with the fewest among the adult-diagnosed patients.
“In the coming years, more and more cystic fibrosis patients will be living into their 40s, 50s and beyond,” said Dr. Nick. “Our findings concerning the role of gender, in survival, progression of disease, and type of care in current long-term survivors provides important insights that will help us prepare for better treatment of the steadily aging CF population.”
Metabolic syndrome (MetS) is a condition characterised by central obesity, hypertension, and disturbed glucose and insulin metabolism. The syndrome has been linked to increased risks of both type 2 diabetes and cardiovascular diseases.
Gut microflora and metabolic syndrome
“The recent discovery by our group that patients feeding a fat-enriched diet develop diabetes and obesity through changes of their intestinal microflora has led us to envision innovative strategies aiming to hamper the development of the deleterious intestinal bacterial ecology observed during metabolic diseases,” said Professor Remy Burcelin of INSERM, who led the study.
The current study involved administering the probiotic strain B420 to diabetic mice on a high-fat diet. According to the researchers, the probiotic improved the fasting glycaemia and restored the glucose turnover rate to the level of the control mice fed with normal chow.
“Importantly, the probiotic treatment reduced the fasted insulin levels, but improved the insulin secretion upon glucose challenge, indicating an improved metabolic flexibility and restoration of normal glucose metabolism, and a potential beneficial effect on metabolic syndrome,” said Danisco.
The company added that the beneficial effect of B420 is mediated by a reduction of the pro-inflammatory molecule, plasma lipopolysaccharide (LPS). “B420 changes intestinal mucosal microbiota and reduces the efflux of LPS into plasma, thereby reducing inflammation and improving insulin metabolism,” it said.
Probiotics and obesity
A breakthrough paper published in Nature in December 2006 reported that microbial populations in the gut are different between obese and lean people, and that when the obese people lost weight their microflora reverted back to that observed in a lean person, suggesting that obesity may have a microbial component.
More findings on the topic have since trickled through the scientific web. At a scientific symposium organised by the Beneo Group in April 2008, Dr. Kieran Touhy from the University of Reading noted that obese animals have significantly lower bifidobacteria levels than their lean counterparts, which suggests potential for prebiotic fibres since the growth of these bacteria is selectively promoted by inulin and fructooligosaccharides.
Dr. Nathalie Delzenne from the Catholic University of Louvain in Belgium and Dr. Robert Welch from the University of Ulster presented results from animal and human studies, respectively, which indicated the potential of prebiotic supplementation to regulated food intake.
“This is an interesting new research area which may open up new opportunities for functional foods in the future,” said Dr Julian Stowell, head of scientific affairs for Danisco's Health and Nutrition Platform.