All Posts tagged syndrome

Increased B vitamins may ease PMS

Higher intakes of the B vitamins thiamine and riboflavin from the diet may reduce the incidence of premenstrual syndrome (PMS) by about 35 percent, suggest new findings. According to a new paper published in the American Journal of Clinical Nutrition, the link between B vitamins and PMS is biologically plausible since B vitamins such as thiamine and riboflavin are known to play important roles in the synthesis of various neurotransmitters involved in PMS.

While most women experience mild emotional or physical premenstrual symptoms, as many as 8-20 per cent of women experience symptoms severe enough to meet the definition of premenstrual syndrome, which can substantially interfere with daily activities and relationships. The new study, performed by researchers from the University of Massachusetts, Harvard, and the University of Iowa, indicates that increase intakes of certain B vitamins from food sources may help reduce the incidence of PMS.

Using data from 1,057 women with PMS and 1,968 women without PMS participating in the Nurses' Health Study II cohort, the researchers found that women with the highest average intakes of riboflavin two to four years prior to diagnosis were associated with a 35 percent lower incidence of PMS than women with the lowest average intakes. On the other hand, the researchers did not observe any benefits with other B vitamins, including niacin, folate, B6, and B12. In addition, supplemental intakes of these vitamins was not linked to PMS incidence, they added. “We observed a significantly lower risk of PMS in women with high intakes of thiamine and riboflavin from food sources only,” wrote the researchers. “Further research is needed to evaluate the effects of B vitamins in the development of premenstrual syndrome.”

Beyond the B vitamins, there is also some evidence for the potential of a diet rich in calcium and vitamin D to lower the risk of developing PMS, a condition that affects up to a fifth of all women. According to a study published in 2005 in the Archives of Internal Medicine (Vol. 165, pp1246-1252), researchers from the University of Massachusetts and GlaxoSmithKline reported for the first time that calcium and vitamin D may help prevent the initial development of PMS.

Source: The American Journal of Clinical Nutrition. Published online ahead of print, doi: 10.3945/ajcn.110.009530 “Dietary B vitamin intake and incident premenstrual syndrome” Authors: P.O. Chocano-Bedoya, J.E. Manson, S.E. Hankinson, W.C. Willett, S.R. Johnson, L. Chasan-Taber, A.G. Ronnenberg, C. Bigelow, E.R. Bertone-Johnson

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Metabolic Syndrome more likely in people with Psoriasis

Having psoriasis appears to double the risk that a person will also have a dangerous clustering of risk factors for heart disease and diabetes known as metabolic syndrome, a new study shows. Previous research has found patients with psoriasis to be at higher risk for getting diabetes and high blood pressure, but the new study, which is in the Archives of Dermatology, is one of the first to document the broader complement of cardiovascular risks associated with the disease.

“It is more than skin deep,” says Abrar Qureshi, MD, MPH, co-author of the paper and vice chairman of the department of dermatology at Brigham and Women's Hospital in Boston. “We like to tell patients that psoriasis is a systemic disease. The risk for metabolic syndrome is high.”

Psoriasis is an autoimmune disease in which the body overproduces skin cells, causing a thick, scaly, red rash to appear on the palms, soles of the feet, elbows, scalp, or lower back. It is thought to be one manifestation of chronic, body-wide inflammation. Metabolic syndrome is defined as having at least three of the following risk factors for heart disease and diabetes: high blood pressure, too much belly fat, high fasting blood sugar, low levels of HDL “good” cholesterol, and high levels of bad blood fats called triglycerides. Studies have shown that having metabolic syndrome dramatically increases the risk of heart attacks, strokes, peripheral vascular disease, and type 2 diabetes.

Researchers say it's difficult to know which of the two might be driving the other. “There's evidence on both sides of the fence,” says lead study author Thorvardur Jon Löve, MD, of Landspitali University Hospital in Reykjavik, Iceland. “There's evidence that obesity drives the development of psoriasis. There's also evidence that inflammation drives some components of insulin resistance. It's a real chicken and egg problem at this point.”

Metabolic Syndrome and Psoriasis

The new study used blood test results from nearly 2,500 people who participated in the government-sponsored National Health and Nutrition Examination Survey between 2003 and 2006. None had previously been diagnosed with diabetes. Among study participants who said that a doctor had diagnosed them with psoriasis, 40% had metabolic syndrome, compared to just 23% of those who did not have psoriasis.

The association was particularly strong in women. Nearly half of women with psoriasis had metabolic syndrome, compared to just one in 5 women without psoriasis. In contrast, psoriasis appeared to raise a man's risk of having metabolic syndrome by only about 4%. “When you get this constellation of factors together, the risk is higher than the sum of the individual factors,” Löve says. “Visit your primary care physician and bring this up.”

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“Good” bacteria helps kids with irritable bowel syndrome

Good bacteria
About 10 to 15 percent of children experience recurrent abdominal pain, the researchers said. The pain can be due to irritable bowel syndrome — which is usually relieved by defecation — or can be “functional abdominal pain,” which is not explained by another disease. While LGG has been tested before in children with abdominal pain, the studies were small and showed mixed results. The new study, which involved 141 children with irritable bowel syndrome or functional abdominal pain, was conducted in Italy between 2004 and 2008. Researchers gave the kids either the probiotic or a placebo for eight weeks. Neither the doctors nor the patients were aware which treatment they received.

Following the treatment, the patients were followed up for another 8 weeks. During the treatment and follow-up, the severity and frequency of abdominal pain decreased for both groups, but the probiotic group experienced a more drastic reduction. For instance, after 12 weeks, patients who took the probiotic reported experiencing, on average, 1.1 episodes of pain per week, compared with 3.7 weekly episodes before the treatment. Those who took the placebo reported experiencing 2.2 pain episodes per week, compared with 3.5 episodes initially.

And a greater percentage of parents of children who took the probiotic reported that their children experienced a decline in pain,compared with those whose kids took the placebo. Among kids who took the probiotic, it was mostly children with irritable bowel syndrome who showed improvements, the researchers said.

Why does it work?
The results suggest LGG may be specifically beneficial for those with irritable bowel syndrome, the researchers said. It's possible that children with irritable bowel syndrome have an imbalance of good and bad bacteria in their guts, which contributes to the pain, and the probiotics relieves pain by restoring the proper balance, Francavilla said. Probiotics have also been suggested to reduce inflammation in the gut, as well as stimulate the release of analgesic substances that relieve pain. The researchers noted they cannot be sure whether the beneficial effects will last for more than a few weeks after treatment is stopped.

The results were published in the journal Pediatrics.

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Chocolate reduces effect of Chronic Fatigue Syndrome

Chocolate reduces effect of Chronic Fatigue Syndrome

Researchers from the University of Hull and the Hull York Medical School have found dark chocolate has a significant effect on reducing the symptoms of Chronic Fatigue Syndrome (CFS). The research, published in Nutrition Journal, found that polyphenol rich chocolate eases the condition, with subjects noting significant improvements to their well-being. Chocolate is known to increase neurotransmitters like phenyl ethylamine, serotonin, and anandamide in the brain, but this is the first time that polyphenol rich chocolate in people with CFS has been studied.

darkchocolate1_v_340h

Above: Professor Steve Atkin.

Subjects with CFS having severe fatigue of at least 10 out of 11 on Chalder Fatigue Scale were enrolled on the pilot study. Participants were given one of two types of chocolate, one with a high cocoa content and the other without.

Over an eight week period the volunteers consumed one type of chocolate followed by a two week wash out period and then another eight weeks of eating the other variety. The dark chocolate contained 85% cocoa solids with the alternative containing none. Each individual bar weighed 15g with each volunteer expected to eat three per day, and also told not to consume more or make changes to their diet.

Researchers also noted the weight of subject did not significantly alter despite consuming an extra 245 calories per day for two months.

Professor Steve Atkin who led the study says: “The significance of the results is particularly surprising because of the small number of subjects in the study. A further study is needed to see what the effects would be on a larger group of people, but this is potentially very encouraging news for those who suffer from Chronic Fatigue Syndrome.”

This latest finding follows recent research also carried out at the University of Hull and the Hull York Medical School where dark chocolate was found to help reduce the risk of heart attacks in people with Type 2 diabetes by increasing the amount of good cholesterol in the blood stream.

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Poor Diet Metabolism, Lack of Exercise Increases Asthma Risk in Kids

Metabolic syndrome is a cluster of risk factors which can result in heart disease and diabetes. Researchers have now found that poor diet and lack of exercise that lead to an imbalance in metabolism may also increase a child's risk of developing asthma.

Dr. Giovanni Piedimonte and researchers from West Virginia University School of Medicine analyzed data from nearly 18,000 children aged 4 to 12 years who were taking part in the Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) project. Factors considered included triglyceride levels and evidence of acanthosis nigricans, which are raised patches of brown skin that are often biomarkers for insulin resistance.

The team also considered body mass index or BMI, and almost 21% of the children were considered obese. Fourteen percent of the children had asthma.

The researchers found that asthma prevalence among the children was strongly associated with certain symptoms of metabolic syndrome including dyslipidemia and abnormal glucose metabolism, but not weight status. Although those who were obese were more likely to have asthma, even children of a healthy weight who had imbalanced metabolism were at increased risk.

Certain metabolic factors participate in the asthma disease process by contributing to inflammation of the airways in the lungs and hyperreactivity (contraction of smooth muscle in the bronchial walls), says Dr. Piedimonte. He says that strict monitoring and control of triglyceride and glucose levels early in life may play a role in the management of chronic asthma in children.

Dr. Piedimonte would like to see the findings used as further support for universal lipid screening in children. “The rationale is that by using selective screening, we would have missed over a third of children with significant genetic dyslipidemia,” he said.

Both poor diet – one lacking in antioxidants but high in fat – and inadequate exercise play a role in the metabolic syndrome, a group of risk factors that increase the risk for coronary artery disease, stroke, and type 2 diabetes. The goal of treatment is often weight loss (if overweight), a minimum of 30 minutes of daily moderate intensity exercise, and a lowering of cholesterol, blood pressure and blood sugar through diet or medication.

Source reference:
Cottrell L, et al “Metabolic abnormalities in children with asthma” Am J Respir Crit Care Med 2010; DOI: 10.1164/rccm.201004-0603OC.

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Structural changes in brain with Irritable Bowel Syndrome

Researchers employed imaging techniques to examine and analyze brain anatomical differences between 55 female IBS patients and 48 female control subjects. Patients had moderate IBS severity, with disease duration from one to 34 years (average 11 years). The average age of the participants was 31.

Investigators found both increases and decreases of brain grey matter in specific cortical brain regions.

Even after accounting for additional factors such as anxiety and depression, researchers still discovered differences between IBS patients and control subjects in areas of the brain involved in cognitive and evaluative functions, including the prefrontal and posterior parietal cortices, and in the posterior insula, which represents the primary viscerosensory cortex receiving sensory information from the gastrointestinal tract.

“The grey-matter changes in the posterior insula are particularly interesting since they may play a role in central pain amplification for IBS patients,” said study author David A. Seminowicz, Ph.D., of the Alan Edwards Centre for Research on Pain at McGill University. “This particular finding may point to a specific brain difference or abnormality that plays a role in heightening pain signals that reach the brain from the gut.”

Decreases in grey matter in IBS patients occurred in several regions involved in attentional brain processes, which decide what the body should pay attention to. The thalamus and midbrain also showed reductions, including a region – the periaqueductal grey – that plays a major role in suppressing pain.

“Reductions of grey matter in these key areas may demonstrate an inability of the brain to effectively inhibit pain responses,” Seminowicz said.

The observed decreases in brain grey matter were consistent across IBS patient sub-groups, such as those experiencing more diarrhea-like symptoms than constipation.

“We noticed that the structural brain changes varied between patients who characterized their symptoms primarily as pain, rather than non-painful discomfort,” said Mayer, director of the UCLA Center for Neurobiology of Stress. “In contrast, the length of time a patient has had IBS was not related to these structural brain changes.”

Mayer added that the next steps in the research will include exploring whether genes can be identified that are related to these structural brain changes. In addition, there is a need to increase the study sample size to address male-female differences and to determine if these brain changes are a cause or consequence of having IBS.

The study was funded by the National Institutes of Health.

Additional authors include M. Catherine Bushnell, Ph.D., of McGill University, and Jennifer B. Labus, Joshua A. Bueller, Kirsten Tillisch and Bruce D. Naliboff, Ph.D., all of UCLA.

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Omega 3s could improve metabolic syndrome outcomes

Positive effects

The new study looked into the effects of four different diet combinations on blood lipid metabolism, in 117 patients with metabolic syndrome.

In accordance with previous suggestions, the researchers found that a low-fat, high-complex carbohydrate diet had “several detrimental effects”, including significantly increasing total triglyceride levels, and triglyceride rich lipoprotein cholesterol levels.

In contrast, intake of the same diet supplemented with omega-3 was found to have no effects on blood lipid levels, with researchers observing that a diet rich in monounsaturated fats, or a low-fat diet rich in complex carbohydrates and omega-3 fatty acids, resulted in lower circulating blood lipid levels than a diet rich in high saturated fats or a diet low in fats and high in complex carbohydrates.

The data from the study suggest a place for higher omega-3 intake in people with metabolic syndrome, and supports previous research that suggests monounsaturated fatty acids can have a positive effect on blood lipid levels.

“The long-term effect of the low-fat, high-complex carbohydrate diet, pre vs. post intervention phases, showed several beneficial effects of long chain omega-3 PUFA supplementation,” stated the researchers.

“Our data suggest that long-term intake of an isocaloric, low-fat, high-carbohydrate diet supplemented with long chain omega-3 … have beneficial effects on postprandial lipoprotein response in patients with metabolic syndrome,”

Source: The Journal of Nutrition
“A Low-Fat, High-Complex Carbohydrate Diet Supplemented with Long-Chain (n-3) Fatty Acids Alters the Postprandial Lipoprotein Profile in Patients with Metabolic Syndrome”
Authors: Y. Jimenez-Gomez, C. Marin, P. Perez-Martinez, et al

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Grapes Reduce Risk Factors

Grapes Reduce Risk Factors

In all, researchers say the study demonstrates that a grape-enriched diet can have broad effects on the development of heart disease and metabolic syndrome and the risk factors that go along with it.

“The possible reasoning behind the lessening of metabolic syndrome is that the phytochemicals were active in protecting the heart cells from the damaging effects of metabolic syndrome. In the rats, inflammation of the heart and heart function was maintained far better,” says Steven Bolling, M.D., heart surgeon at the U-M Cardiovascular Center and head of the U-M Cardioprotection Research Laboratory.

The researchers also looked for signs of inflammation, oxidative damage and other molecular indicators of cardiac stress. Again, the rats who consumed the grape powder had lower levels of these markers than rats who did not receive grapes.

There is no well-accepted way to diagnose metabolic syndrome which is really a cluster of characteristics: excess belly fat (for men, a waist measuring 40 inches or more and for women, a waist measuring 35 inches or more); high triglycerides which can lead to plague build-up in the artery walls; high blood pressure; reduced glucose tolerance; and elevated c-reactive protein, a marker for inflammation in the body.

Those with metabolic syndrome are at higher risk for cardiovascular disease and type 2 diabetes.

But the U-M study suggests that it may be possible that grape consumption can change the downhill sequence that leads to heart disease by prolonging the time between when symptoms begin to occur and a time of diagnosis.

“Reducing these risk factors may delay the onset of diabetes or heart disease, or lessen the severity of the diseases,” says E. Mitchell Seymour, Ph.D., lead researcher and manager of the U-M Cardioprotection Research Laboratory. “Ultimately it may lessen the health burden of these increasingly common conditions.”

Rats were fed the same weight of food each day, with powered grapes making up 3 percent of the diet. Although the current study was supported in part by the California Table Grape Commission, which also supplied the grape powder, the researchers note that the commission played no role in the study's design, conduct, analysis or preparation of the presentation.

Research on grapes and other fruits containing high levels of antioxidant phytochemicals continues to show promise. U-M will further its research this summer when it begins a clinical trial to test the impact of grape product consumption on heart risk factors.

“Although there's not a particular direct correlation between this study and what humans should do, it's very interesting to postulate that a diet higher in phytochemical-rich fruits, such as grapes, may benefit humans,” Bolling says.

Bolling says that people who want to lower their blood pressure, reduce their risk of diabetes or help with weakened hearts retain as much pumping power as possible should follow some tried-and-true advice to eat a healthy diet low in saturated fat, trans fat and cholesterol, achieve a desirable weight and increase physical activity.

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Probiotics Could Benefit Metabolic Syndrome

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.

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Improving Patient Outcomes

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Nastaran can translate scientific nutrition information into practical advice to help your patient make decisions about what to eat in order to achieve improved clinical and health outcomes (see Case studies). She can advise patients on a range of nutrition related conditions, including:

  • diabetes (type 1, type 2, gestational)
  • cardiovascular disease
  • gastrointestinal disorders (eg. coeliac disease, diverticulitis)
  • cancer
  • overweight and obesity
  • food allergy and intolerance
  • nutritional deficiencies/malnutrition
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