Thursday, May 28, 2015

Green tea may help reduce prostate cancer in men at high risk

Prostate cancer is the second most common type of cancer in men and is predicted to result in an estimated 220,00 cases in the United States in 2015. In recent years, an emphasis has been placed on chemoprevention - the use of agents to prevent the development or progression of prostate cancer. A team of researchers led by Nagi B. Kumar, Ph.D., R.D., F.A.D.A. at Moffitt Cancer Center recently published results of a randomized trial that assessed the safety and effectiveness of the active components in green tea to prevent prostate cancer development in men who have premalignant lesions. The results will be presented at the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

Twenty percent of green tea is consumed in Asian countries where prostate cancer death rates are among the lowest in the world and the risk of prostate cancer appears to be increased among Asian men who abandon their original dietary habits upon migrating to the U.S.

Laboratory studies have shown that substances in green tea called, "catechins" inhibit cancer cell growth, motility and invasion, and stimulate cancer cell death. Green tea catechins also prevent and reduce tumor growth in animal models. Epigallocatechin-3-gallate (EGCG) is the most abundant and potent catechin found in green tea responsible for these cancer prevention effects.

The goal of this trial was to evaluate if a one-year intervention with green tea catechins could suppress prostate cancer development in men who had high-grade intraepithelial neoplasia (HGPIN) or atypical small acinar proliferation (ASAP). The researchers used decaffeinated green tea capsules called Polyphenon E that contained a mixture of catechins that predominantly contained EGCG at a dose of 200 mgs twice a day.

The researchers compared Polyphenon E in 49 men to placebo tablets in 48 men over a 1 year treatment period. Overall, the difference in the number of prostate cancer cases at the end of 1 year between the two treatment groups was not statistically significant. However, in men who only had HGPIN at the beginning of the trial, they observed a lower combined rate of ASAP and prostate cancer development with Polyophenon E. ASAP is an entity that reflects a broad group of lesions in the prostate with insufficient changes in the cells to be definitively diagnosed as prostate cancer. Additionally, men on Polyphenon E had a significant decrease in prostate-specific antigen (PSA) levels. PSA is a biomarker that in combination with other risk factors is used to screen patients for prostate cancer, and high levels signify a higher risk of prostate cancer.

The Moffitt researchers observed a significant increase in the levels of EGCG in the blood plasma of men on Polyphenon E, and the capsules at this dose were tolerated in this group of men.

Wednesday, May 27, 2015

Eating a Mediterranean diet could cut womb cancer risk

Women who eat a Mediterranean diet could cut their risk of womb cancer by more than half (57 per cent), according to a study published today (Wednesday) in the British Journal of Cancer*.

The Italian researchers looked at the diets of over 5,000 Italian women to see how closely they stuck to a Mediterranean diet and whether they went on to develop womb cancer**.

The team broke the Mediterranean diet down into nine different components and measured how closely women stuck to them. The diet includes eating lots of vegetables, fruits and nuts, pulses, cereals and potatoes, fish, monounsaturated fats but little meat, milk and other dairy products and moderate alcohol intake.

Researchers found that women who adhered to the Mediterranean diet most closely by eating between seven and nine of the beneficial food groups lowered their risk of womb cancer by more than half (57 per cent).

Those who stuck to six elements of the diet's components reduced their risk of womb cancer by 46 per cent and those who stuck to five reduced their risk by a third (34 per cent).

But those women whose diet included fewer than five of the components did not lower their risk of womb cancer significantly.

Dr Cristina Bosetti, lead author from the IRCCS-Istituto di Ricerche Farmacologiche, said: "Our research shows the impact a healthy balanced diet could have on a woman's risk of developing womb cancer. This adds more weight to our understanding of how our every day choices, like what we eat and how active we are, affect our risk of cancer."

The study was funded by the Italian Foundation for Cancer Research, the Swiss National Science Foundation and the Swiss League Against Cancer.

Each year in the UK there are around 8,500 new cases of womb cancer, and rates have increased by around half since the early 1990s in Great Britain.

Dr Julie Sharp, Cancer Research UK's head of health information, said: "While we know that getting older and being overweight both increase a woman's risk of womb cancer, the idea that a Mediterranean diet could help reduce the risk needs more research. This is partly because this study was based on people remembering what they had eaten in the past.

"Cancer risk is affected by our age and our genes but a healthy lifestyle can also play a part in reducing the risk of some cancers. Not smoking, keeping a healthy weight, being active, eating healthily and cutting down on alcohol helps to stack the odds in your favour."

Tuesday, May 26, 2015

Dietary Guidelines for Americans linked to lower death rates in population in southeast US

Adherence to the Dietary Guidelines for Americans (DGA) is linked to lower death rates in a low-income population in southeastern US.

In a low-income population from the southeastern US, higher adherence to the Dietary Guidelines for Americans (DGA) was linked with 14%-23% lower mortality from cardiovascular disease, cancer, and other diseases, according to a study published by Wei Zheng and colleagues from Vanderbilt University, Nashville, USA, in this week's PLOS Medicine.

The researchers analyzed data from the Southern Community Cohort Study (SCCS), a study including 84,735 American adults, aged 40-79 y, who were recruited mostly from community health centers that serve low-income populations from 12 southeastern US states during 2002-2009. Over half of the participants were poor with an annual household income of less than USD 15,000 and 65% were African American. Of the 77,572 participants with follow-up information over a mean period of 6.2 years, 6,906 participants died; including 2,244 from cardiovascular disease, 1,794 from cancer, and 2,550 from other diseases.

After controlling for factors such as age, weight, exercise, smoking, household income and the presence of specific chronic diseases, the researchers found that participants with better adherence to the DGA, as reported using a food frequency questionnaire, had a lower risk of dying from diseases in the follow-up period. Participants with the healthiest diet (those in the top one-fifth) had only about 80% of the risk of death than those with the least healthy diet (those in the bottom one-fifth). This reduction by approximately 20 percent was similar for the risk of death from any disease, death from cancer, and death from cardiovascular disease.

The results support the validity of the DGA for healthy eating across the US population, however the study had some limitations. For example, participants were asked only once about their diet, their household income, and about other factors that can change over time such as exercise habits and diseases they had been diagnosed with.

The authors say: "This is the first study to our knowledge reporting this association in a low-income population that largely comprises African-Americans, providing direct evidence for disease prevention through dietary modification in this underserved population."


Foods and food components to reduce
  • Reduce daily sodium intake to less than 2,300 milligrams (mg) and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children, and the majority of adults.
  • Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.
  • Consume less than 300 mg per day of dietary cholesterol.
  • Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.
  • Reduce the intake of calories from solid fats and added sugars.
  • Limit the consumption of foods that contain refined grains, especially
    refined grain foods that contain solid fats, added sugars, and sodium.
  • If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age.5
Foods and nutrients to increase
Individuals should meet the following recommendations as part of a healthy eating pattern while staying within their calorie needs.
  • Increase vegetable and fruit intake.
  • Eat a variety of vegetables, especially dark-green
    and red and orange vegetables and beans and peas.
  • Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.
  • Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages.6
  • Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds.
  • Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry.
  • Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils.
  • Use oils to replace solid fats where possible.
  • Choose foods that provide more potassium,
    dietary fiber, calcium, and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products.
    Building healthy eating Patterns
Recommendations for specific population groups
Women capable of becoming pregnant7
Choose foods that supply heme iron, which is more readily absorbed by the body, additional iron sources, and enhancers of iron absorption such as vitamin C-rich foods.
Consume 400 micrograms (mcg) per day of synthetic folic acid (from fortified foods and/or supplements) in addition to food forms of folate from a varied diet.8
Women who are pregnant or breastfeeding7
Consume 8 to 12 ounces of seafood per week from a variety of seafood types.
Due to their high methyl mercury content, limit white (albacore) tuna to 6 ounces per week and do not eat the following four types of fish: tilefish, shark, swordfish, and king mackerel.
If pregnant, take an iron supplement, as recommended by an obstetrician or other health care provider.
Individuals ages 50 years and older
Consume foods fortified with vitamin B , such 12
as fortified cereals, or dietary supplements.

Thursday, May 21, 2015

Caffeine intake associated with reduced levels of erectile dysfunction

Men who drink the equivalent caffeine level of two to three cups of coffee a day are less likely to have erectile dysfunction (ED), according to researchers from The University of Texas Health Science Center at Houston (UTHealth).

The results of a study published (May 2015) in PLOS ONE found that men who consumed between 85 and 170 milligrams of caffeine a day were 42 percent less likely to report ED, while those who drank between 171 and 303 milligrams of caffeine a day were 39 percent less likely to report ED compared to those who drank zero to seven milligrams a day. This trend was also true among overweight, obese and hypertensive men.

"Even though we saw a reduction in the prevalence of ED with men who were obese, overweight and hypertensive, that was not true of men with diabetes. Diabetes is one of the strongest risk factors for ED, so this was not surprising," said David S. Lopez, Dr.P.H., M.P.H., lead author and assistant professor at UTHealth School of Public Health.

According to the journal article, the suggested biological mechanism is that caffeine triggers a series of pharmacological effects that lead to the relaxation of the penile helicine arteries and the cavernous smooth muscle that lines cavernosal spaces, thus increasing penile blood flow.

In the United States, 18.4 percent of men 20 years and older have ED, suggesting that more than 18 million men are affected. Caffeine is consumed by more than 85 percent of adults, according to previous research.

Data for the study came from the National Health and Nutrition Examination Survey and ED was assessed by a single question during a computer-assisted interview. Caffeine sources in the study included coffee, tea, soda and sports drinks.

Consuming chamomile = 29 percent decreased risk of death from all causes among Mexican-American women

Researchers from The University of Texas Medical Branch at Galveston have found that drinking chamomile tea was associated with a decreased risk of death from all causes in Mexican-American American women over 65. The findings were recently published online in The Gerontologist.

Chamomile is one of the oldest, most-widely used and well-documented medicinal plants in the world and has been recommended for a variety of healing applications. It is currently widely used as an herbal remedy in Mexico and among Mexican-Americans.

The study examined a seven-year period during which researchers tracked the effects of chamomile and the cause of death in older Mexican- Americans. The researchers analyzed data from 1,677 women and men from the Hispanic Established Populations for Epidemiologic Study of the Elderly, a population-based study of Mexican-Americans aged 65 and older from five Southwestern states, including Texas. Fourteen percent of the people in the study drank chamomile tea.

The data showed that consuming chamomile was associated with a 29 percent decreased risk of death from all causes among women compared with nonusers, even after adjusting for demographics, health conditions and health behaviors. This effect was not present in men.

"The reason for a difference in our reported findings between Hispanic women and men is not clear, although women were shown to be more frequent users of chamomile than men," said Bret Howrey, assistant professor in the UTMB department of family medicine. "This difference may be due to traditional gender roles whereby women manage the day-to-day activities of the household, including family health, and may also reflect greater reliance on folk remedies such as herbs."

It is unclear how chamomile use is associated with decreased mortality. Recent studies of chamomile have shown potential benefits in treating hyperglycemia, upset stomach, diabetic complications and anxiety disorder. Chamomile has also been touted for its cholesterol-lowering, antioxidant, antimicrobial, anti-inflammatory and anti-platelet effects. The exact pathway for the reduction in mortality represents an important area for future research.


Tuesday, May 19, 2015

Omega-3 fatty acids enhance cognitive flexibility in at-risk older adults

A study of older adults at risk of late-onset Alzheimer's disease found that those who consumed more omega-3 fatty acids did better than their peers on tests of cognitive flexibility -- the ability to efficiently switch between tasks -- and had a bigger anterior cingulate cortex, a brain region known to contribute to cognitive flexibility.

The analysis suggests, but does not prove, that consuming DHA and EPA, two omega-3 fatty acids found in fish, enhanced cognitive flexibility in these adults in part by beefing up the anterior cingulate cortex, the researchers report in the journal Frontiers in Aging Neuroscience.

"Recent research suggests that there is a critical link between nutritional deficiencies and the incidence of both cognitive impairment and degenerative neurological disorders, such as Alzheimer's disease," said University of Illinois neuroscience, psychology, and speech and hearing science professor Aron Barbey, who led the study with M.D./Ph.D. student Marta Zamroziewicz. "Our findings add to the evidence that optimal nutrition helps preserve cognitive function, slow the progression of aging and reduce the incidence of debilitating diseases in healthy aging populations."

The researchers focused on aspects of brain function that are sometimes overlooked in research on aging, Zamroziewicz said. "A lot of work in cognitive aging focuses on memory, but in fact cognitive flexibility and other executive functions have been shown to better predict daily functioning than memory does," she said.

"Executive function" describes processes like planning, reasoning, paying attention, problem solving, impulse control and task switching.

"These functions tend to decline earlier than other cognitive functions in aging," Zamroziewicz said.

The new research built on previous studies that found associations between omega-3 fatty acid consumption, cognitive flexibility and the size of the anterior cingulate cortex.

"There's been some work to show that omega-3 fatty acids benefit cognitive flexibility, and there's also been work showing that cognitive flexibility is linked to this specific brain region, the anterior cingulate. But there's been very little work actually connecting these pieces," Zamroziewicz said.

The new study focused on 40 cognitively healthy older adults between the ages of 65 and 75 who are carriers of a gene variant (APOE e4) that is known to contribute to the risk of developing late-onset Alzheimer's disease.

The researchers tested participants' cognitive flexibility, measured levels of the fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) in their blood, and imaged their brains using MRI. Statistical analyses teased out the relationships between these factors.

"We wanted to confirm that higher omega-3 fatty acids related to better cognitive flexibility, and we did in fact see that," Zamroziewicz said. "We also wanted to confirm that higher omega-3 fatty acids related to higher volume in the anterior cingulate cortex, and we saw that. Finally, we were able to show that higher volume in the anterior cingulate cortex was an intermediary in the relationship between omega-3 fatty acids and cognitive flexibility."

Sunshine alone not enough for vitamin D during pregnancy


Despite high levels of sunshine, low levels of vitamin D during pregnancy are common in Mediterranean women according to a study presented today at the European Congress of Endocrinology in Dublin. This finding should help lower the prevalence of early childhood diseases associated with Vitamin D deficiency such as preeclampsia, gestational diabetes, disorders in bone formation, higher risk of emergency caesarean delivery and premature birth.

It's commonly believed that sun exposure is key to maintaining normal levels of vitamin D and therefore assumed that Mediterranean women are at lower risk of hypovitaminosis than those from Northern Europe. However in countries such as Spain, Italy, Greece and Turkey, Vitamin D deficiency occurs in up to 90 % of pregnant populations.

This study shows that racial, social and cultural habits counteract the benefits of sun exposure on Vitamin D levels. Dr Karras Spiros and colleagues at the Aristotle University of Thesaloniki, Greece carried out a systematic review of vitamin D levels in 2,649 pregnant women and 1,802 newborn babies. They studied the effect of a number of different factors including, age, body mass index, race, socioeconomic status, skin types, period of gestation, sun exposure, calcium and vitamin D intake, smoking status, time of year of birth and pregnancy complications. They found that the best predictors of maternal vitamin D deficiency were dark skin, race and dress habits.

Dr Karras said, Pregnant women with vitamin D deficiencies may be at greater risk of various problems and complications, both for themselves and their babies. It's imperative for pregnant women and the medical community at large, to recognise the importance of vitamin D in overall health.

Ideally, the next stage of the research is to implement systematic screening for maternal hypovitaminosis and supplementation in a large scale European project. We are excited about the potential of integrating testing and supplementation into medical practice, making it a standard of care across Europe said Dr Karras. Keeping future mothers healthy and giving babies the best start at life, may help EU health programmes for Southern European Countries to achieve their mission to reduce infant mortality and the number of low birth weight babies.

Monday, May 18, 2015

Many children with asthma have a sensitivity to peanuts but do not know it

In recent years and months, peanut allergies in children have been in the news frequently, as scientists reveal new insights into why more and more children are developing them and what can be done to avoid them. However, until now, few have studied the connection between peanut allergy and childhood asthma.

A new study has shown that many children who have asthma have a sensitivity to peanuts, but did not know it. Conducted by researchers in the U.S., the study specifically looked at pediatric asthma patients at a pediatric pulmonary clinic.

The study will be presented at the ATS 2015 International Conference.

"Many of the respiratory symptoms of peanut allergy can mirror those of an asthma attack, and vice versa. Examples of those symptoms include shortness of breath, wheezing and coughing," said study lead author Robert Cohn, MD, MBA. "This study aimed to evaluate the proportion of asthmatic children who also demonstrated a sensitivity to peanuts."

For the study, the researchers looked at 1,517 children from the pediatric pulmonary clinic at Mercy Children's Hospital in Toledo, Ohio. They determined if the children's charts had a documented peanut allergy and if they had undergone a blood test for antibodies demonstrating a potential reaction to peanuts, known as IgE. Children were considered positive if they had a documented history of peanut allergy or a specific IgE blood test that showed a level higher than normal.
What they found was that of the 1,517 charts that were reviewed, 163, or about 11%, had a documented history of peanut allergy. Nearly 44% (665) had specific IgE testing at some point to test for peanut allergy. Out of that group, 148, or approximately 22%, had a positive test to peanut sensitivity. However, more than half of these children and their families did not suspect there was any sensitivity to peanuts. The prevalence of positive tests varied across age groups but the prevalence of known peanut allergy was strikingly similar across age groups.

"This study demonstrates children with asthma might benefit from a test for peanut sensitivity, especially when control of wheezing and coughing is difficult to achieve. If a physician is having this problem, or if a parent notices it in his or her asthmatic child, they should consider testing, even if they believe their child is not sensitive to peanuts," said Dr. Cohn. "There should be continued investigation to learn more about the connection between asthmatic children and peanut sensitivity."

Vitamin E May Protect Against Air Pollution Damage


A new study from King's College London and the University of Nottingham has found an association between the amount of vitamin E in the body, exposure to particulate pollution and lung function. The paper adds to growing evidence from previous studies suggesting that some vitamins may play a role in helping to protect the lungs from air pollution. Although the new study did not specifically demonstrate a protective effect, it is the first to show a clear link between vitamin E concentrations in the blood and exposure to fine particulate pollution in the general population.

Particulate matter (PM) is one of the main air pollutants thought to be damaging to human health. Previous studies have reported an inverse association between exposure to PM and lung function. However, the underlying mechanisms linking ambient air pollution to lung function are not yet fully understood.

The new data, published in the American Journal of Respiratory and Critical Care Medicine, looked at the association between lung function and a set of metabolites -- chemical signatures circulating in the blood -- and between these metabolites and exposure to PM10 and PM2.5 (particles smaller than 10 and 2.5 microns, respectively) determined as the concentrations of these pollutants at the participants' residence.

Two-hundred and eighty metabolites were measured in the blood of over 5,500 fasting volunteers from the TwinsUK study who had also undergone a spirometry or lung test. This test determines the lung's forced vital capacity (FVC), a measure of the amount of air you can exhale with force after you inhale as deeply as possible, and forced expiratory volume (FEV), a measure of the amount of air you can exhale with force in one breath.

A subset of this group of twins -- around 500 participants -- living in the Greater London area also had their long-term exposure to PM estimated from their postcode using computer modelling of air pollution across London. Participants completed a medical history and lifestyle questionnaire, including questions on whether they took vitamin supplements.

The profiling revealed 13 metabolites significantly associated with FVC, 10 of which were also identified for FEV. Of the metabolites associated with lung function, eight were also significantly associated with exposure to both PM2.5 and PM10. In all eight instances, a higher exposure to PM was found to correlate with lower levels of the metabolite and a lower FEV.

Among the eight metabolites identified were two well-known antioxidants, alpha tocopherol or a-tocopherol (biologically active form of Vitamin E) and a metabolite of ascorbic acid (Vitamin C) known as threonate. Both compounds have previously been linked to lung function as well as exposure to PM.

The strongest association both with PM2.5 and FEV was seen with vitamin E. Individuals with a higher exposure to PM2.5 had significantly lower levels of alpha-tocopherol and also had lower lung function. These findings provide further evidence supporting the theory that PM damages lungs through oxidative attack while alpha-tocopherol acts to minimise oxidative injury.

Dr Ana Valdes, Reader at the University of Nottingham and co-author of the study, explained: 'Our work builds on a number studies exploring whether some vitamins can counteract the negative effect on lungs caused by air pollution. More work is needed to establish whether antioxidant supplements do indeed provide protection to the lungs in the general population.'

Professor Frank Kelly, Head of the Environmental Research Group at King's College London and co-author of the study, said: 'These new findings are consistent with previous reports which observed lower levels of vitamin E in people with lung conditions such as asthma. However, we do not yet fully understand which types of particulate pollution specifically damage the lungs or which vitamins best interfere with this pathway to reduce the level of damage.'

Regular aspirin use may slow the progression of early emphysema

Regular use of aspirin may help slow the progression of early emphysema, according to new research presented at the 2015 American Thoracic Society International Conference.

"Other than smoking cessation and avoidance, there are no known methods for reducing the risk of developing emphysema," said researcher Carrie Aaron MD, of the Columbia University Medical Center in New York. "In our large general population sample, we found that regular aspirin use (three or more days per week) was associated with a slower progression of percent emphysema on computed tomography (CT) scans over 10 years."

The study, which was motivated by findings of pulmonary vascular involvement in emphysema and the importance of platelet function in other vascular diseases, included 4,471 individuals participating in the Multi-Ethnic Study of Atherosclerosis Lung Study. The percentage of lung volume with emphysematous features (percent emphysema) was assessed on up to 4 CT scans performed over approximately 10 years of follow-up. Spirometry, a measure of expiratory airflow, was performed in 81% of study subjects.

Of the 4,471 study subjects, 21% (921) used aspirin regularly, 55% were ever-smokers, and 25% of those with spirometry had results indicating airflow obstruction. Regular aspirin use was associated with a significantly slower progression of percent emphysema over ten years, when compared to those who did not use aspirin, even after adjustment for a number of potential confounding factors, including age, sex, race/ethnicity, cigarettes/day, pack-years, and hypertension. Results were consistent in propensity score analyses, performed to minimize effects of confounding by indication. Similar reductions in the rate of progression of percent emphysema were seen among ever-smokers, and greater reductions were observed among individuals with spirometric evidence of airflow obstruction.

"Our study found that persons taking aspirin regularly had a slower progression of emphysema over 10 years compared to those who did not, and that this difference was not explained by many factors that we believe affect progression of emphysema." said Dr. Aaron. "The findings might suggest that regular aspirin use may slow the progression of subclinical emphysema, perhaps through effects on platelet activation or inflammation."

Saturday, May 16, 2015

Omega-3: Intervention for childhood behavioral problems?


At the forefront of a field known as "neurocriminology," Adrian Raine of the University of Pennsylvania has long studied the interplay between biology and environment when it comes to antisocial and criminal behavior. With strong physiological evidence that disruption to the emotion-regulating parts of the brain can manifest in violent outbursts, impulsive decision-making and other behavioral traits associated with crime, much of Raine's research involves looking at biological interventions that can potentially ward off these behavioral outcomes.

A new study by Raine now suggests that omega-3, a fatty acid commonly found in fish oil, may have long-term neurodevelopmental effects that ultimately reduce antisocial and aggressive behavior problems in children.

He is a Penn Integrates Knowledge Professor with appointments in the School of Arts & Sciences and the Perelman School of Medicine.

Along with Raine, the study featured Jill Portnoy a graduate student in the Department of Criminology, and Jianghong Liu, an associate professor in the Penn School of Nursing. They collaborated with Tashneem Mahoomed of Mauritius' Joint Child Health Project and Joseph Hibbeln of the National Institute on Alcohol Abuse and Alcoholism.

It was published in the Journal of Child Psychology and Psychiatry.

When Raine was a graduate student, he, his advisor and colleagues conducted a longitudinal study of children in the small island nation of Mauritius. The researchers tracked the development of children who had participated in an enrichment program as 3-year-olds and also the development of children who had not participated. This enrichment program had additional cognitive stimulation, physical exercise and nutritional enrichment. At 11 years, the participants showed a marked improvement in brain function as measured by EEG, as compared to the non participants. At 23, they showed a 34 percent reduction in criminal behavior.

Raine and his colleagues were interested in teasing apart the mechanisms behind this improvement. Other studies suggested the nutritional component was worth a closer look.

"We saw children who had poor nutritional status at age 3 were more antisocial and aggressive at 8, 11 and 17," Raine said. "That made us look back at the intervention and see what stood out about the nutritional component. Part of the enrichment was that the children receiving an extra two and a half portions of fish a week."

Other research at the time was beginning to show that omega-3 is critical to brain development and function.

"Omega-3 regulates neurotransmitters, enhances the life of a neuron and increases dendritic branching, but our bodies do not produce it. We can only get it from the environment," Raine said.

Research on the neuroanatomy of violent criminals suggested this might be a place to intervene. Other brain-imaging researchers have shown that omega-3 supplementation increases the function of the dorsolateral prefrontal cortex, a region Raine found to have higher rates of damage or dysfunction in criminal offenders.

Raine's new study featured a randomized controlled trial where children would receive regular omega-3 supplements in the form of a juice drink. One hundred children, aged 8 to 16, would each receive a drink containing a gram of omega-3 once a day for six months, matched with 100 children who received the same drink without the supplement. The children and parents in both groups took a series of personality assessments and questionnaires at the start.

After six months, the researchers administered a simple blood test to see if the children in the experimental group had higher levels of omega-3 than those in the controls. They also had both parents and children take the personality assessments. Six months after that, the researchers had parents and children take the assessment again to see if there were any lasting effects from the supplements.

The assessments had parents rate their children on "externalizing" aggressive and antisocial behavior, such as getting into fights or lying, as well as "internalizing" behavior, such as depression, anxiety and withdrawal. Children were also asked to rate themselves on these traits.

While the children's self-reports remained flat for both groups, the average rate of antisocial and aggressive behavior as described by the parents dropped in both groups by the six-month point. Critically, however, those rates returned to the baseline for the control group but remained lowered in the experimental group, at the 12-month point.

"Compared to the baseline at zero months," Raine said, "both groups show improvement in both the externalizing and internalizing behavior problems after six months. That's the placebo effect.

"But what was particularly interesting was what was happening at 12 months. The control group returned to the baseline while the omega-3 group continued to go down. In the end, we saw a 42 percent reduction in scores on externalizing behavior and 62 percent reduction in internalizing behavior."

At both the six- and 12-month check-ins, parents also answered questionnaires about their own behavioral traits. Surprisingly, parents also showed an improvement in their antisocial and aggressive behavior. This could be explained by the parents taking some of their child's supplement, or simply because of a positive response to their child's own behavioral improvement.

The researchers caution that this is still preliminary work in uncovering the role nutrition plays in the link between brain development and antisocial behavior. The changes seen in the one-year period of the experiment may not last, and the results may not be generalizable outside the unique context of Mauritius.

Beyond these caveats, however, there is reason to further examine omega-3's role as a potential early intervention for antisocial behavior.

"As a protective factor for reducing behavior problems in children," Liu said, "nutrition is a promising option; it is relatively inexpensive and can be easy to manage."

Exercise, however modest, found progressively beneficial to the elderly

Even exercise of short duration and low intensity has life expectancy benefits for the elderly. Such conclusions have been well examined in the general population, where a recommended exercise program of 30 minutes at least five days a week (or 150 minutes per week) has been shown to reduce the average risk of death by 30 percent.

However, such a correlation between the level of physical activity and risk of death has not been so clearly determined in the elderly. Indeed, most physical activity guidelines are the same for the middle-aged adults as for the elderly, even though it is estimated that over 60% of the elderly are unable to achieve this same level of exercise.

Now, a study in a French cohort of more than 1000 elderly subjects (the PROOF study) has found a negative correlation between their level of physical activity and risk of all-cause death, suggesting that in the elderly (as in other population groups) the risk of death decreases with greater and more regular exercise.

The results of the study are presented today at EuroPRevent 2015 by Dr David Hupin from the Department of Clinical and Exercise Physiology at the University Hospital of St-Etienne-Lyon, France.

Subjects were enrolled in the study at age 65 in 2001 and followed-up for 13 years. During that follow-up their level of physical activity was monitored and categorised according to five levels of MET-h values per week: <1 1-3.74="" 150="" 3-75-7.49="" 7.5-15="" activity="" and="" brisk="" equivalent="" for="" level="" minutes="" per="" recommended="" the="" to="" up="" walking="" week="">15 MET-h per week.2 Mortality and cardiovascular events were recorded over the follow-up period and associated with exercise levels.

Results showed that around 10% of the eligible cohort died during the follow-up period. However, the risk of death was calculated to be 57% lower in those whose activity level was equal to or higher than the recommended 150 minutes per week (7.5-15 MET-h per week). And furthermore, those doing a very low level of physical activity per week (1-3.74 MET-h/week) had 51% lower risk of death than those doing the very minimum (<1 br="" differences="" in="" met-h="" risk="" significant.="" statistically="" these="" week="" were="">
There were other significant findings too - notably that starting or restarting physical activity during retirement reduced the risk of death by two-thirds, but in contrast any reduction, even in low levels of activity, exposed the elderly to a higher risk of death.

In commenting on the results, Dr Hupin said several conclusions might be drawn but notably that the level of physical activity in the elderly was negatively associated with mortality rate in a "dose-dependent" way and that even a low level of exercise below current recommendations had some protective effect.

As a simple rule for the elderly Dr Hupin recommended that at least 15 minutes of physical activity for five days a week would be a suitable first target for the elderly. "This could include brisk walking, cycling, swimming or gymnastics," he suggested, "all possibly associated with leisure time physical activity or daily life activities."

Dr Hupin emphasised that the widespread acceptance of this message would encourage more elderly people to include even "low doses" of physical activity in their usual daily activities, without experiencing high levels of fatigue or of pain. "This message should be relayed by general practitioners, who play a key and essential role in promoting exercise behaviour in the elderly," he said. "Even a little is good, and more may be better."

The findings from this PROOF study were confirmed in a meta-analysis preformed by the same group and reported at this same EuroPRevent congress.3 This analysis, drawing on data involving almost 120,000 subjects, found that "low-dose" moderate-to-vigorous physical activity - of, say, 75 minutes per week or 15 minutes per day - significantly reduced mortality in the elderly. Based on the results, Dr Hupin said that a revision of the recommendations for physical activity in the elderly may thus be warranted and beneficial - low dose physical activity can significantly reduce mortality. In this meta-analysis a low dose of activity resulted in a mortality rate reduction of 22%.

Thursday, May 14, 2015

Vitamin B3 Reduces Risk for Further Skin Cancer

An inexpensive vitamin B product, widely available over the counter, has been shown to reduce significantly the risk of developing further skin cancers in patients who have already been diagnosed with nonmelanoma skin cancer. The product is nicotinamide, taken orally 500 mg twice daily.

Nonmelanoma skin cancer is the most common cancer worldwide, she said. In Australia, it is four times more common than any other cancer, and it affects more than half the population during their lifetime.

The finding, from the Australian ONTRAC (Oral Nicotinamide to Reduce Actinic Cancer) study, was presented during a press briefing held in advance of the American Society of Clinical Oncology (ASCO) 2015 Annual Meeting.

The results released today show that patients who took nicotinamide 500 mg twice daily for 1 year showed a 23% reduction in new diagnoses of nonmelanoma skin cancer, compared with those who took placebo (P = .02). Specifically, new diagnoses of basal cell carcinoma were reduced by 20%, squamous cell carcinoma by 30%, and actinic keratoses by 13%.

ASCO President Peter Yu, MD, director of cancer research at the Palo Alto Medical Foundation, described this research as a "major advance" in prevention.

In the United States, about 5 million people each year are diagnosed with nonmelanoma skin cancer.

Tuesday, May 12, 2015

Health Benfits of Vitamin D and Sunlight - Miscellaneous Benefits


Vitamin D may play key role in preventing macular degeneration

Vitamin D has been studied extensively in relation to bone health as well as cancer. Now, a team led by a researcher at the University at Buffalo has discovered that vitamin D may play a significant role in eye health, specifically in the possible prevention of age-related macular degeneration, or AMD, among women who are more genetically prone to developing the sight-damaging disease.

In a paper published in JAMA Ophthalmology online, Amy Millen, associate professor of epidemiology and environmental health in UB's School of Public Health and Health Professions, and her team found that women who are deficient in vitamin D and have a specific high-risk genotype are 6.7 times more likely to develop AMD than women with sufficient vitamin D status and no high risk genotype.

"Most people have heard that you should eat carrots to help your vision. However, there appear to be many other ways that adequate nutrition can support eye health. Having adequate vitamin D status may be one of them," says Millen, PhD, the study's lead author. "This is not a study that can, alone, prove a causal association, but it does suggest that if you're at high genetic risk for AMD, having a sufficient vitamin D status might help reduce your risk."

"To our knowledge, this is the first study that's looked at the interaction between genetic risk and vitamin D status in the context of age-related eye disease," adds Millen.

Macular degeneration is characterized by the deterioration of the macula, a small part of the central retina where the eye's photoreceptors (rods and cones) are most highly concentrated. The leading cause of legal blindness, macular degeneration affects more than 10 million Americans -- more than cataracts and glaucoma combined -- according to the American Macular Degeneration Foundation. The disease affects a person's central vision, which is needed for common tasks such as reading and driving. The effect is similar to that of a rain drop on the center of a camera lens.

Researchers analyzed data compiled on 1,230 women ages 54 to 74 who participated in the Carotenoids in Age-related Eye Disease Study (CAREDS), which is an ancillary study of the Women's Health Initiative (WHI) Observational Study (OS). The WHI OS is a major National Institutes of Health-funded research program aimed at addressing the most common causes of death, disability and poor quality of life in postmenopausal women. UB is one of 40 WHI centers nationally. CAREDS was conducted among participants at three of the centers: University of Wisconsin (Madison), the University of Iowa (Iowa City) and the Kaiser Center for Health Research (Portland, Oregon).

Researchers were able to determine participants' vitamin D status by analyzing serum samples for a vitamin D biomarker, 25-hydroxyvitamin D [25(OH)D], which provided a glimpse into vitamin D intake through all sources: diet, supplements and sunlight.

Human skin can synthesize vitamin D when exposed to ultraviolet light, Millen explains. However, for many people, 15 to 30 minutes a day with 10 percent of their skin exposed might be sufficient. In winter months, when there is a lower solar angle, sun exposure may not be not sufficient to maintain blood level for people who live north of a line from about Washington, D.C., to Los Angeles. At these times and locations, dietary intake may be needed. Dietary sources of vitamin D include fortified foods such as milk and foods that naturally contain vitamin D such as fatty fish like salmon and mackerel.

"Macular degeneration has been found to be strongly associated with genetic risk," Millen says. Among many genes linked to AMD, one of the strongest is a specific genetic variant (Y402H) in the complement factor H gene, called CFH for short. This gene codes for the CFH protein that is involved in the body's immune response to destroy bacteria and viruses.

Inflammation is believed to be involved in the development of macular degeneration.

"People who have early stage AMD develop drusen, lipid and protein deposits that build up in the eye. Your body sees this drusen as a foreign substance and attacks it, in part via the complement cascade response," explains Millen. "CFH is one of the proteins involved in this response. We see more AMD in people who have certain variants in the gene which encodes a form of this CFH protein that is associated with a more aggressive immune response."

Vitamin D shows promise for protecting against macular degeneration because of its anti-inflammatory and antiangiogenic properties; antiangiogenic refers to slowing the growth of new blood vessels, often seen in late stages of AMD.

"Our thinking was, if a person's vitamin D status is better, would it reduce the immune response to drusen? We wanted to understand if the association between vitamin D and AMD differed depending on a person's genetic risk for AMD," says Millen. "Our study suggests that being deficient for vitamin D may increase one's risk for AMD, and that this increased risk may be most profound in those with the highest genetic risk for this specific variant in the CFH protein."

The study results, however, shouldn't prompt people to run to the nearest grocery store to purchase vitamin D supplements.

"Our message is not that achieving really high levels of vitamin D are good for the eye, but that having deficient vitamin D levels may be unhealthy for your eyes," Millen says.

Although the odds of having AMD was higher in women who were deficient for vitamin D, with 25(OH)D levels below 12 ng/mL (30 nmol/L), increasing vitamin D levels beyond 12 ng/mL did not further lower the odds of AMD to any meaningful extent, she explains.

"This study supports a role for vitamin D in eye health. That's significant because when the Institute of Medicine's report on the dietary reference intakes for vitamin D and calcium were released in 2011, the committee could only make conclusions about D related to bone health," says Millen. "There wasn't enough evidence at that time to make any recommendation based on D status and other outcomes beyond bone health."

Sun exposure, vitamin D may lower risk of multiple sclerosis

People who spend more time in the sun and those with higher vitamin D levels may be less likely to develop multiple sclerosis (MS), according to a study published in the February 8, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology. MS is a chronic disease of the brain and spinal cord, usually with recurrent flare-ups of symptoms. It is often preceded by a first episode (or event) of similar symptoms lasting days to weeks.

"Previous studies have found similar results, but this is the first study to look at people who have just had the first symptoms of MS and haven't even been diagnosed with the disease yet," said study author Robyn Lucas, PhD, of Australian National University in Canberra. "Other studies have looked at people who already have MS—then it's hard to know whether having the disease led them to change their habits in the sun or in their diet."

The multi-site study involved 216 people age 18 to 59 who had a first event with symptoms of the type seen in MS. Those people were matched with 395 people with no symptoms of possible MS who were of similar ages, of the same sex and from the same regions of Australia.

The participants reported how much sun they were exposed to during different periods of their lives, and researchers also measured the amount of skin damage participants had from sun exposure and the amount of melanin in their skin. Vitamin D levels (from sun exposure, diet and supplement use) were measured by blood tests.

The risk of having a first event, diagnosed by a doctor, ranged from approximately two to nine new cases for every 100,000 people per year in this study. The reported UV light exposure of participants ranged from about 500 to over 6,000 kilojoules per meter squared. The researchers found that the risk of having a diagnosed first event decreased by 30 percent for each UV increase of 1,000 kilojoules. They also found that people with most evidence of skin damage from sun exposure were 60 percent less likely to develop a first event than the people with the least damage. People with the highest levels of vitamin D also were less likely to have a diagnosed first event than people with the lowest levels.

Studies have shown that MS is more common in latitudes further away from the equator, and this has been confirmed in Australia.

"Added together, the differences in sun exposure, vitamin D levels and skin type accounted for a 32-percent increase in a diagnosed first event from the low to the high latitude regions of Australia," Lucas said.

Lucas noted that the effects of sun exposure and vitamin D acted independently of each other on the risk of first event. "Further research should evaluate both sun exposure and vitamin D for the prevention of MS," Lucas said.

Lucas also stated that people should continue to limit their sun exposure due to skin cancer risks. She also noted that the risks of tanning beds far outweigh any possible protective effect against MS. Exposure to the sun has not been shown to benefit people who already have MS.

New evidence shows low vitamin D levels lead to Parkinson's disease

A new study on vitamin D levels and Parkinson's disease risk points to the need for further research on whether vitamin D supplements can protect against the movement disorder, according to an editorial in the July 2010 issue of Archives of Neurology.

The author of the editorial is Marian Evatt, MD, assistant professor of neurology at Emory University School of Medicine and director of the Atlanta Veterans Affairs Medical Center's Movement Disorders Clinic.

The study, also reported in Archives of Neurology, is the first to show that low vitamin D levels can help predict whether someone will later develop Parkinson's disease. Researchers at Finland's National Institute for Health and Welfare measured vitamin D levels from more than 3000 people, using blood samples taken between 1978 and 1980, and then followed those people to see whether they developed Parkinson's. People with the lowest levels of vitamin D were three times more likely to develop Parkinson's, compared to the group with the highest levels.

Previous research had suggested a link between low vitamin D and Parkinson's, but whether this is a cause-and-effect relationship is unknown. Vitamin D may help protect the population of neurons gradually lost by people with Parkinson's disease, Evatt writes in her editorial.

Parkinson's disease affects nerve cells in several parts of the brain, particularly those that use the chemical messenger dopamine to control movement. The most common symptoms are tremor, stiffness and slowness of movement. These can be treated with oral replacement of dopamine.

Research on animals suggests that vitamin D may protect neurons that produce dopamine from toxins. Besides vitamin D levels, factors such as genetics and exposure to pesticides also are associated with the risk for developing Parkinson's disease.

Doctors have known for decades that vitamin D promotes calcium uptake and bone formation, but evidence is accumulating for additional roles regulating the immune system and the development of the nervous system. Humans can get vitamin D from exposure to sunlight or eating foods such as fatty fish or fortified foods such as milk and packaged cereals. People living at high latitudes tend to have less exposure to the sun; in the Finnish study, the average vitamin D level was about half of the currently recommended level.

Vitamin D levels are usually measured by looking at the stable, 25-hydroxy form; the current recommended level is 30-40 nanograms per milliliter of blood.

Evatt writes that public health authorities should consider raising the target vitamin D level above the current recommended target because of known benefits for bone health as well as potential benefits for the nervous system. Still, animal data suggests that too much vitamin D can also be harmful for the nervous system, and megadoses of vitamin D can induce hypercalcemia, or an excess of calcium in the blood.

"At this point, 30 ng/ml or more appears optimal for bone health in humans. However, researchers don't yet know what level is optimal for brain health or at what point vitamin D becomes toxic for humans, and this is a topic that deserves close examination," she says.

Vitamin D Fights Off Back Aches & Pains

It’s no wonder that many people feel extra soreness and aches in their backs during winter months -- they’re often not getting enough vitamin D. The body makes vitamin D from the sun’s ultraviolet rays, so it’s known as the sunshine vitamin. However, even in the sunniest parts of America, this essential vitamin for keeping bones healthy is in short supply during late fall and winter.

Up to 8 out of 10 persons will have back pain in their lifetimes. In many cases, there is no evidence of any injury, disease, or bone problem like a slipped disk. An extensive review of clinical research in a report from Pain Treatment Topics found that help may be available from a surprising champion of pain relief – Vitamin D.

According to Stewart B. Leavitt, MA, PhD, Executive Director of Pain Treatment Topics and author of the report, “our examination of the research, which included numerous clinical studies, found that patients with chronic back pain usually had inadequate levels of vitamin D. When sufficient vitamin D supplementation was provided, their pain either vanished or was at least helped to a significant extent.”

The report, “Vitamin D – A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain,” which was peer-reviewed by a panel of experts, includes the following important points:

- Vitamin D is essential for calcium absorption and bone health. Among other things,inadequate vitamin D intake can result in a softening of bone surfaces, called osteomalacia, which causes pain. The lower back seems to be particularly vulnerable.
-  In one study of 360 patients with chronic back pain, all of them were found to have inadequate levels of vitamin D. After taking vitamin D supplements for 3 months, symptoms were improved in 95% of the patients.
- The currently recommended adequate intake of vitamin D – up to 600 IU per day – is outdated and too low. According to newer research, most children and adults need at least 1000 IU per day, and persons with chronic back pain would benefit from 2000 IU or more per day of supplemental vitamin D3 (also called cholecalciferol).
- Vitamin D supplements interact with very few medicines or other agents, and are generally safe unless very high doses – such as 10,000 IU or more – are taken daily for a long period of time. However, it is always wise to check with a healthcare professional before starting a new dietary supplement.
- Vitamin D supplements are easy to take, usually have no side effects, and typically cost as little as 7 to 10 cents per day.

In conclusion, Leavitt stresses that vitamin D should not be viewed as a cure for all back pain conditions, and it is not necessarily a replacement for other pain-relief treatments. “While further research would be helpful,” he says, “extra vitamin D should be considered for all persons during winter months, and especially for those who have back aches and pains.”

Vitamin D supplementation for prevention and possibly for treatment of autism

A new study by Rhonda Patrick, PhD and Bruce Ames, PhD of Children's Hospital Oakland Research Institute (CHORI) demonstrates the impact that Vitamin D may have on social behavior associated with Autism Spectrum Disorder (ASD). Dr. Patrick and Dr. Ames show that serotonin, oxytocin, and vasopressin, three brain hormones that affect social behavior, are all activated by vitamin D hormone. Autism, which is characterized by abnormal social behavior, has previously been linked to low levels of serotonin in the brain and to low vitamin D levels, but no mechanism has linked the two until now.

In this study, Dr. Patrick and Dr. Ames show that vitamin D hormone activates the gene that makes the enzyme tryptophan hydroxylase 2 (TPH2), that converts the essential amino acid tryptophan, to serotonin in the brain. This suggests that adequate levels of vitamin D may be required to produce serotonin in the brain where it shapes the structure and wiring of the brain, acts as a neurotransmitter, and affects social behavior. They also found evidence that the gene that makes the enzyme tryptophan hydroxylase 1 (TPH1) is inhibited by vitamin D hormone, which subsequently halts the production of serotonin in the gut and other tissues, where when found in excess it promotes inflammation.

This mechanism explains many of the known, but previously not understood, facts about autism including: 1) the "serotonin anomaly" low levels of serotonin in the brain and high levels in the blood of autistic children; 2) the preponderance of male over female autistic children: estrogen, a similar steroid hormone, can also boost the brain levels of serotonin in girls; 3) the presence of autoimmune antibodies to the fetal brain in the mothers of autistic children: vitamin D regulates the production of regulatory T-cells via repression of TPH1. The Patrick/Ames mechanism is relevant to the prevention of autism, and likely its treatment.

The current guidelines for adequate vitamin D levels are concentrations above 30 ng/ml. Most Americans' vitamin D is made in the skin from exposure to UVB radiation; however, melanin pigment and sunscreen inhibit this action. This is an important cause of the well-known widespread vitamin D deficiency among dark-pigmented Americans, particularly those living in Northern latitudes. The most recent National Health and Examination survey reports that greater than 70% of U.S. population does not meet this requirement and that adequate vitamin D levels have plummeted over the last couple of decades. This precipitous drop in adequate levels of vitamin D in the US is concurrent with the rise in autism rates.

The study suggests dietary intervention with vitamin D, tryptophan and omega 3 fatty acids would boost brain serotonin concentrations and help prevent and possibly ameliorate some of the symptoms associated with ASD without side effects. There is little vitamin D present in food and fortification is still inadequate as is the amount in most multivitamin and prenatal supplements. Vitamin D supplements are inexpensive and offer a simple solution to raise vitamin D levels to an adequate status. In addition, vitamin D levels should be routinely measured in everyone and should become a standard procedure in prenatal care.

Vitamin D deficiency may compromise immune function

Older individuals who are vitamin D deficient also tend to have compromised immune function, according to new research accepted for publication in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Vitamin D plays an important role in helping the body absorb calcium needed for healthy bones. The skin naturally produces vitamin D when it is exposed to sunlight. People also obtain smaller amounts of the vitamin through foods, such as milk fortified with vitamin D. More than 1 billion people worldwide are estimated to have deficient levels of vitamin D due to limited sunshine exposure.

"Our data suggest vitamin D may be involved in maintaining the health of the immune system as well as the skeletal system," said one of the study's authors, Mary Ward, PhD, of the University of Ulster in Coleraine, U.K. "This study is the first to find a connection between vitamin D levels and inflammation in a large sample of older individuals."

The observational study of 957 Irish adults who were at least 60 years old examined vitamin D levels as well as biomarkers of inflammation. Participants who were vitamin D deficient were more likely to have high levels of these biomarkers, which are linked to cardiovascular disease and inflammatory conditions such as multiple sclerosis and rheumatoid arthritis.

"The results indicate immune function may be compromised in older individuals with vitamin D deficiency," Ward said. "Ensuring older individuals have optimal vitamin D levels may be a way to boost immune function in this population, but this needs to be confirmed through additional studies."

Low vitamin D levels raise anemia risk in children

Low levels of the "sunshine" vitamin D appear to increase a child's risk of anemia, according to new research led by investigators at the Johns Hopkins Children's Center. The study, published online Oct. 10 , 2013 in the Journal of Pediatrics, is believed to be the first one to extensively explore the link between the two conditions in children.

The researchers caution that their results are not proof of cause and effect, but rather evidence of a complex interplay between low vitamin D levels and hemoglobin, the oxygen-binding protein in red blood cells. The investigators say several mechanisms could account for the link between vitamin D and anemia, including vitamin D's effects on red blood cell production in the bone marrow, as well as its ability to regulate immune inflammation, a known catalyst of anemia.

To capture the interaction between the two conditions, researchers studied blood samples from more than 10,400 children, tracking levels of vitamin D and hemoglobin. Vitamin D levels were consistently lower in children with low hemoglobin levels compared with their non-anemic counterparts, the researchers found. The sharpest spike in anemia risk occurred with mild vitamin D deficiency, defined as vitamin D levels below 30 nanograms per milliliter (ng/ml). Children with levels below 30 ng/ml had nearly twice the anemia risk of those with normal vitamin D levels. Severe vitamin D deficiency is defined as vitamin D levels at or below 20 ng/ml. Both mild and severe deficiency requires treatment with supplements.

When investigators looked at anemia and vitamin D by race, an interesting difference emerged. Black children had higher rates of anemia compared with white children (14 percent vs. 2 percent) and considerably lower vitamin D levels overall, but their anemia risk didn't rise until their vitamin D levels dropped far lower than those of white children. The racial difference in vitamin D levels and anemia suggests that current therapeutic targets for preventing or treating these conditions may warrant a further look, the researchers say.

"The clear racial variance we saw in our study should serve as a reminder that what we may consider a pathologically low level in some may be perfectly adequate in others, which raises some interesting questions about our current one-size-fits-all approach to treatment and supplementation," says lead investigator Meredith Atkinson, M.D., M.H.S., a pediatric kidney specialist at the Johns Hopkins Children's Center.

Untreated, chronic anemia and vitamin D deficiency can have wide-ranging health consequences, including organ damage, skeletal deformities and frequent fractures, and lead to premature osteoporosis in later life.

Long known for its role in bone development, vitamin D has recently been implicated in a wide range of disorders. Emerging evidence suggests that low vitamin D levels may play a role in the development of certain cancers and heart disease and lead to suppressed immunity, the researchers note.

Anemia, which occurs when the body doesn't have enough oxygen-carrying red blood cells, is believed to affect one in five children at some point in their lives, experts say. Several large-scale studies have found severe vitamin D deficiency in about a tenth of U.S. children, while nearly 70 percent have suboptimal levels.

Low vitamin D linked to fatty liver disease in children

A UK study investigating the link between low vitamin D status and non-alcoholic fatty liver disease (NAFLD) in British children has identified a genetic variant associated with the disease's severity.

The research, conducted by the King's College Hospital Paediatric Liver Centre and the University of Surrey's School of Biosciences and Medicine, and funded by the Children's Liver Disease Foundation retrospectively analysed the medical records of 120 paediatric patients with NAFLD.

The findings could carry significant implications for UK clinicians in light of the nation's rising number of childhood NAFLD cases. High levels of vitamin D deficiency and increasing numbers of rickets cases are thought to be due to the obesity epidemic, more children increasingly choosing to play indoors rather than outside and the excessive use of sun-creams.

EASL's Educational Councillor Professor Jean-Francois Dufour of the University Clinic for Visceral Surgery and Medicine, University of Bern, Switzerland said: "The data support recent research that revealed an association between low vitamin D status and incidence of NAFLD and is an important development in helping clinicians better understand the growing rate of NAFLD in children throughout the western world."

"Identifying a gene that impacts or alters the disease is a step in the right direction and could potentially lead to the development of new treatments or diagnostic techniques to address this growing issue," Professor Dufour continued. "More research into this field is warranted and I look forward to seeing future developments over time."

NAFLD is the term used to describe fat build-up in liver cells in people who do not drink alcohol excessively. NAFLD is rapidly becoming the most common liver disease worldwide and is the most common persistent liver disorder in western countries and is estimated to affect up to 10% of Europe's paediatric population.[The disease has an estimated overall prevalence of 20% to 30% across Europe.[

Patients were found to have low vitamin D blood levels throughout the entire year, not just in the winter months, plus the majority of samples were found to be deficient or insufficient in vitamin D status compared to national UK and US health standards. The study also detected a variant of the NADSYN1 gene that was associated with NAFLD severity in patients.

Vitamin D may reduce risk of uterine fibroids, according to NIH study

Women who had sufficient amounts of vitamin D were 32 percent less likely to develop fibroids than women with insufficient vitamin D, according to a study from researchers at the National Institutes of Health.

Fibroids, also known as uterine leiomyomata, are noncancerous tumors of the uterus. Fibroids often result in pain and bleeding in premenopausal women, and are the leading cause of hysterectomy in the United States.

The study of 1,036 women, aged 35-49, living in the Washington, D.C., area from 1996 to 1999, was led by Donna Baird, Ph.D., a researcher at the National Institute of Environmental Health Sciences (NIEHS), part of NIH. Baird and her collaborators at The George Washington University and the Medical University of South Carolina screened participants for fibroids using ultrasound. They used blood samples to measure the primary circulating form of vitamin D, known as 25-hydroxy D. Those with more than 20 nanograms per milliliter of 25-hydroxy D were categorized as sufficient, though some experts think even higher levels may be required for good health. The body can make vitamin D when the skin is exposed to the sun, or vitamin D can come from food and supplements.

Study participants also completed a questionnaire on sun exposure. Those who reported spending more than one hour outside per day also had a decreased risk of fibroids. The estimated reduction was 40 percent. Although fewer black than white participants had sufficient 25-hydroxy D levels, the estimated reduction in prevalence of fibroids was about the same for both ethnic groups.

"It would be wonderful if something as simple and inexpensive as getting some natural sunshine on their skin each day could help women reduce their chance of getting fibroids," said Baird.

Baird also noted that, though the findings are consistent with laboratory studies, more studies in women are needed. Baird is currently conducting a study in Detroit to see if the findings from the Washington, D.C., study can be replicated. Other NIEHS in-house researchers, led by Darlene Dixon, D.V.M., Ph.D., are learning more about fibroid development, by examining tissue samples from study participants who had surgery for fibroids.

"This study adds to a growing body of literature showing the benefits of vitamin D," said Linda Birnbaum, Ph.D., director of NIEHS and the National Toxicology Program.

Vitamin D and Erectile Dysfunction

A paper recently published (Sorenson M, Grant W. Does vitamin D deficiency contribute to erectile dysfunction?. Dermato-Endocrinology 2012; 4:128 - 136; http://dx.doi.org10.4161/derm.20361. ) hypothesizes that vitamin D deficiency may be an important risk factor for erectile dysfunction (ED). Evidence cited supporting the link between low vitamin D and ED include that those with Asthma, depression, falls and fractures, multiple sclerosis, and periodontal disease are at greater risk of having ED. In addition, those with ED are at greater risk of developing cardiovascular disease, diabetes mellitus, and metabolic syndrome. All of these diseases are linked to vitamin D deficiency.

Vascular problems account for about half the cases of ED. There is a large body of research finding that vitamin D can maintain vascular health. The mechanisms appear to include suppressing the activity of the renin-angiotensin system, thereby lowering blood pressure, improving endothelial function, reducing inflammation, and reducing vascular calcification. Solar ultraviolet (UV) light is the primary source of vitamin D for most people. In addition, UV increases nitric oxide concentrations in the blood, which also appears to reduce the risk of ED.

Those diagnosed with ED should consider having serum 25-hydroxyvitamin D [25(OH)D] concentration measured, then adopt a program to increase concentrations to at least 40 ng/ml (100 nmol/l) through vitamin D supplementation and/or increased solar UVB exposure. Serum 25(OH)D concentrations should be re-measured a few months after starting such a program.

Those diagnosed with ED should also have their physician check for signs of early diabetes or cardiovascular disease.

According to Dr. Richard Quinton, Consultant Physician (endocrinologist), The Newcastle upon Tyne Hospitals, England:“Onset of erectile dysfunction is a life-changing event for a man of any age. Fortunately, there are now reasonably successful medical treatments for it. However, as he or she is signing the script, the Physician should remember that ED is frequently an early indicator of systemic disease. The conditions we tend to think of first in relation to ED are diabetes and hypogonadism, but any occult systemic disease can precipitate ED many years before it becomes clinically apparent.

The hypothesis presented in this paper is certainly plausible and deserves to be tested, but even if there turns out to be no direct vascular-related link between ED and hypovitaminosis D, it is highly likely that patients with symptomatic fatigue and/or musculoskeletal aches and pains secondary to the more severe end of the hypovitaminosis D spectrum will exhibit impaired erectile and sexual function.

“We know from the MRC survey that severe hypovitaminosis D is highly-prevalent even among middle-aged Caucasians in the UK, particularly in the West of Scotland. This is almost certainly due to our high latitude, prevalent cloud cover and low fish consumption. So, whilst writing that script for erection-promoting tablet, the Physician should also consider the possibility of hypovitaminosis D, particularly if the following risk factors are present: constitutively darker skin type, conscious or unconscious sun-avoidance behaviour, including culturally or behaviourally-determined forms of clothing, routine use of SPF sunblock in everyday life, shift work, obesity, medication with immunosuppressants or anticonvulsants, or bowel disease predisposing to fat soluble vitamin malabsorbtion.

“Thus, among the lifestyle changes the Physician might typically promote in the context of ED, such as “stop smoking, take more exercise, eat more healthily and lose weight”, “get more sunshine exposure to bare skin” should perhaps also be in the mix. For the purpose of maximising vitamin D photosynthesis, whilst minimising solar skin damage, the mathematically most logical solution is to expose as much skin as possible (without burning) -ie. sunbathing- rather than just exposing forearms, face and neck for a longer period. “However, we all know how hard it is to persuade our patients to make significant and sustained lifestyle changes, which is precisely why bariatric surgery has taken off in recent years. Moreover, not everyone can afford to take a “winter sun” holiday, so for many people, taking an oral vitamin D supplement may be the way forward.”

According to Dr. Stefan Pilz, Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria: "Vitamin D deficiency is associated with various risk factors for erectile dysfunction as reviewed by Marc Sorenson and William B. Grant. A role of vitamin D deficiency in the pathogenesis of erectile dysfunction can be hypothesized. Randomized controlled trials should therefore evaluate whether vitamin D supplementation exerts relevant effects with regard to erectile dysfunction."

According to Marc Sorenson, director of the Sunlight Institute and lead author, “The treatment of choice for ED has been the use of phosphodiesterase-5 inhibitors such as Viagra. While effective in relieving the ED symptoms, these drugs do nothing for the underlying cause and may lose their effectiveness over time. They may also hide from users the possibility of cardiovascular disease; therefore patients may delay seeking help. If proven in further research, vitamin D optimization has the potential to influence the cause of ED to prevent or mitigate the condition.”

According to William B. Grant, Ph.D., director of Sunlight, Nutrition and Health Research Center, a coauthor:_“This paper is the first to hypothesize a link between erectile dysfunction and vitamin D deficiency. While it is not clear what role increasing vitamin D concentrations to 40 ng/ml (100 nmol/l) will have on erectile dysfunction, it will reduce the risk of diabetes, cardiovascular disease, many types of cancer, and several infectious diseases. Thus, a diagnosis of erectile dysfunction not due to prostate surgery or psychological state should be considered a wakeup call to investigate the roles of solar UVB and vitamin D for improving overall health.”

Vitamin D deficiency = an increased risk of pelvic floor problems, including urinary incontinence

Vitamin D deficiency is higher among certain demographic segments, including women, the elderly, and the obese. All three groups also share an increased risk of pelvic floor problems, including urinary incontinence. Could there be a connection? Perhaps so, according to recent research.

A study published in Obstetrics & Gynecology compared vitamin D levels with incidence of various forms of pelvic floor disorder among 1,881 women, average age 48. Those with low levels of vitamin D (characterized as less than 30 nanograms per milliliter, or ng/ml) had a 170% increased risk of urinary incontinence, compared to those with higher blood levels.

Why might this be? As a hormone, vitamin D supports a myriad of bodily functions, including maintenance of muscle and bone. As a result, deficiency could undermine the muscular infrastructure of the pelvis needed for urinary control.

Vitamin D deficiency raises risk of schizophrenia diagnosis

Vitamin D-deficient individuals are twice as likely to be diagnosed with schizophrenia as people who have sufficient levels of the vitamin, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Vitamin D helps the body absorb calcium and is needed for bone and muscle health. The skin naturally produces this vitamin after exposure to sunlight. People also obtain smaller amounts of the vitamin through foods, such as milk fortified with vitamin D. More than 1 billion people worldwide are estimated to have deficient levels of vitamin D due to limited sunshine exposure.

Schizophrenia is a mental illness with symptoms that can include delusions and hallucinations. Since schizophrenia is more prevalent in high latitudes and cold climates, researchers have theorized vitamin D may be connected to the disorder.

"This is the first comprehensive meta-analysis to study the relationship between the two conditions," said one of the study's authors, Ahmad Esmaillzadeh, PhD, of the Isfahan University of Medical Sciences in Isfahan, Iran. "When we examined the findings of several observational studies on vitamin D and schizophrenia, we found people with schizophrenia have lower vitamin D levels than healthy people. Vitamin D deficiency is quite common among people with schizophrenia."

The researchers reviewed the findings of 19 observational studies that assessed the link between vitamin D and schizophrenia. Combined, the studies looked at vitamin D levels and the mental health of 2,804 adult participants. The studies used blood tests to determine each participant's vitamin D levels.

The meta-analysis found that people with schizophrenia had significantly lower levels of vitamin D in the blood compared to the control groups. The average difference in vitamin D levels between schizophrenic patients and control participants was -5.91 ng/ml. People with vitamin D deficiency were 2.16 times more likely to have schizophrenia than those with sufficient vitamin D in their bloodstreams. In addition, 65 percent of the participants who had schizophrenia also were vitamin D deficient.

"There is a growing trend in the nutrition science field to consider vitamin D and its relationship to conditions such as diabetes, cancer, heart disease and depression," Esmaillzadeh said. "Our findings support the theory that vitamin D may have a significant impact on psychiatric health. More research is needed to determine how the growing problem of vitamin D deficiency may be affecting our overall health."

Low vitamin D levels linked to increased risks after noncardiac surgery
Patients with low blood levels of vitamin D are at increased risk of death and serious complications after noncardiac surgery, suggests a study in Anesthesia & Analgesia.
The researchers analyzed the relationship between vitamin D level and surgical outcomes in approximately 3,500 patients who underwent operations other than heart surgery between 2005 and 2011. Only patients who had available data on vitamin D levels around the time of surgery—from three months before to one month afterward—were included in the study.
The concentration of vitamin D (specifically, 25-hydroxyvitamin D) in blood samples was analyzed as a risk factor for death, cardiovascular events, or serious infections while in the hospital. The analysis included adjustment for other factors such as demographic characteristics, medical conditions, and type and duration of surgery.
Most patients did not meet the recommended 25-hydroxyvitamin D concentration of greater than 30 nanograms per milliliter (ng/mL). The median vitamin D level was 23.5 ng/mL—more than 60 percent of patients were in the range of vitamin D insufficiency (10 to 30 ng/mL). Nearly 20 percent had vitamin D deficiency (less than 10 ng/mL).
Higher vitamin D concentrations were associated with decreased odds of in-hospital mortality/morbidity. For each 5 ng/mL increase in 25-hydroxyvitamin D level, the combined risk of death, cardiovascular events, or serious infections decreased by seven percent.
Patients at the lowest level of 25-hydroxyvitamin D (less than 13 ng/mL) were at highest risk of death or serious complications. Those with higher vitamin D levels (up to 44 ng/mL) had about half the risk as those in the lowest group. The association with low vitamin D was statistically significant only for cardiovascular complications, although there were "strong trends" for mortality and infections.