Whey protein powder

New study examines the effects of collagen peptides on cognition and sleep

Collagen supplementation has increased exponentially and has gained increasing attention, however, not all collagen is considered equal. Collagen supplements can come from a variety of sources such as, porcine, bovine, or marine. In addition, there are variations in quality and molecular weight which limit absorption and efficacy.

Collagen is digested in the gastrointestinal tract and mainly broken down into single amino acids and di-peptides and enter the blood stream and accumulate in various tissues depending on the molecular weight.

According to a recent randomized controlled trial published in the European Journal of Nutrition, researchers investigated whether glycine-rich collagen peptides could enhance sleep quality in physically active men with self-report sleep complaints.

This was a randomized, crossover design clinical trial including 13 athletic men with sleep complaints. Each individual consumed 15 grams of collagen peptide supplementation or a placebo control 1 hour prior to bedtime for 7 nights. Sleep quality was measured with subjective sleep diaries and actigraphy for 7 nights. In addition, polysomnographic sleep and core temperature were recorded on the last night. Furthermore, cognition, inflammation, and endocrine function were measured on night seven and then the following morning. Subjective sleepiness and fatigue were measured on all 7 nights. The intervention trials were separated by at least 7 days.

As a result, polysomnography showed there were less awakenings with collagen peptide supplementation compared to the placebo. The 7-day average for subjective awakenings were also less with collagen supplementation. In addition, the proportion of correct responses on the baseline Stroop cognitive test were higher in the collagen supplementation group in the morning after night 7. There were no differences in core temperature, endocrine function, inflammation, subjective sleepiness, fatigue and sleep quality, or other measures of cognitive function or sleep.

As a result, collagen peptide supplementation did not influence sleep quantity, latency, or efficiency, but it did reduce awakenings and improved cognitive function in physically active males with sleep complaints.

Other benefits of collagen supplementation include improving skin, sarcopenia, osteoporosis, and insulin resistance. It important to use a quality collagen supplement that has research behind it and is a low molecular weight to optimize absorption and efficacy.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Thomas, C, et al. Collagen peptide supplementation before bedtime reduces sleep fragmentation and improves cognitive function in physically active males with sleep complaints. Eur J Nutr. 2024 Feb;63(1):323-335.  doi: 10.1007/s00394-023-03267-w. Epub 2023 Oct 24.

New review investigates the effects of prebiotic, probiotic, and synbiotic supplementation and obesity

Obesity is preventable and reversible through lifestyle changes, proper nutrition, supplements, exercise and stress management. It is a significant health care problem that has increased significantly over the past several decades which leads to an increased risk of numerous chronic conditions such as, diabetes, cardiovascular disease, non-alcoholic fatty liver disease (NAFLD), and cancers.

Research suggests that it is not the body fat alone but the increased low-grade inflammation and metabolic dysfunction causing disease. This promotes insulin resistance in the liver and the release of inflammatory mediators from the adipose tissue. In addition, increased intestinal permeability allows translocation of proinflammatory lipopolysaccharides.

The advances in stool testing technology have revealed associations between variations of specific bacteria and increased weight gain with metabolic dysfunction and inflammation. The gut microbiome has a direct impact on metabolism, mucosal barrier, and system immune function.

Other research has indicated that obesity has a microbial component that alters the caloric extraction from ingested food. For example, if one has more Bacteroidetes bacteria, the individual tends to be leaner. High Firmicutes:Bacteroidetes ratios have been known to increase the caloric extraction from food and these individuals tend to be more obese. This also ties together the importance of dietary fiber, prebiotics, and weight loss.

According to a review published last month in Frontiers in Endocrinology, researchers investigated the role of ‘biotics’ (ie. prebioitcs, probiotics, and synbiotics) on overweight and obesity indicators.

These meta-analyses consisted of 97 studies. Consumption of prebiotic: 8-66 g/day, probiotic: 104 -1.35×1015 colony-forming unit (CFU)/day, and synbiotic: 106-1.5×1011 CFU/day and 0.5-300 g/day for 2 to 104 weeks demonstrated a beneficial effect on the overweight and obesity indicators. Furthermore, an inverse association was observed between biotics supplementation and overweight and obesity risk in adults in most of the studies.

As a result, Supplementation with biotics may result in beneficial effects on some anthropometric indices of overweight and obesity indicators such as body weight, BMI, and waist circumference.

Synbiotics, combining probiotics with prebiotics, show clear beneficial effects on waist and hip circumference, BMI, visceral fat areas, circulating leptin levels, lipid profile, and total oxidative stress.

Other nutrients to consider that can make similar changes in the microbiome include prebiotics that containing xylooligosaccharidies (XOS), probiotics that specifically contain Bifidobacterium species, and fish oil. These synbiotics have been shown to optimize the firmucutes/baceteroidetes ratio and fish oils improve insulin sensitivity and reduce inflammation.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Rasaei N, Mohammadreza H, et al. The effects of prebiotic, probiotic or synbiotic supplementation on overweight/obesity indicators: an umbrella review of the trials' meta-analyses. Front Endocrinol (Lausanne). 2024 Mar 20:15:1277921.

Brain graphic

New review investigates essential fatty acids on cognitive function

Alzheimer’s disease and related disorders (ADRD) are a group of conditions that cause mild cognitive impairment (MCI) or dementia. These conditions affect one’s ability to function socially, personally, and professionally. It’s important to recognize that Alzheimer’s disease begins long before symptoms start just like many other conditions. There is evidence that simple prevention strategies can reduce the risk of ADRD by as much as 50%.

DHA is essential for overall health and optimal central nervous system dysfunction. It is highly concentrated in the brain within metabolically active neuronal regions including synaptic membranes, synaptic vesicles, and mitochondria and makes up 15% of the total fatty acids in the cerebral cortex.

Higher DHA concentrations have been associated with improved cognition and reduced MCI and ADRD risk. Previous dosing of DHA in healthy individuals for cognitive improvement has been just over 1 gram of DHA daily with success.

According to a new review published last week in BMC Medicine, researchers investigated the effect of omega-3 fatty acids on cognitive function in middle-aged and older adults without dementia.

This meta-analysis included 24 studies consisting of 9,660 participants. Follow up was between 3 to 36 months. The research team found a beneficial effect on executive function demonstrating an upward trend within 12 months of omega-3 fatty acid supplementation. This effect was seen with a daily intake greater than 500 mg of omega-3 fatty acid supplementation.

This cognitive benefit is believed to be mediated by their influence on synaptic plasticity and neurogenesis in brain regions susceptible to oxidative stress.

Other brain supportive nutrients to consider are GPC, CDP-choline, gingko biloba, and phosphatidylserine, curcumin, folate and B12. GPC and CDP-choline are water soluble forms of choline that can cross the blood brain barrier and support brain health. These help produce more acetylcholine, neurotransmitters, as well as phosphatidylcholine in the cell membranes.

Previous research has also demonstrated that B vitamins had no effect on cognitive decline in cognitive impairment when omega-3 levels are low. However, when omega-3 levels are in an upper normal range, B vitamins slow cognitive decline and brain atrophy. These findings suggest that a combination of fish oil supplements and B vitamins may help to improve cognition and the importance of synergy as dysfunction and symptoms are often due to multifactorial causes.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Seung Wan Suh, Eunji Lim, et al. The influence of n-3 polyunsaturated fatty acids on cognitive function in individuals without dementia: a systematic review and dose-response meta-analysis. BMC Med. 2024 Mar 12;22(1):109.

New study investigates the efficacy of Palmitoylethanolamide supplementation in migraine headaches

Pain is a complex experience that many times is difficult to manage, which can significantly impact one's quality of life. Traditional approaches include medications such as opioids and non-steroidal anti-inflammatory drugs (NSAIDs), but have side effects and can lead to addiction and dependence. In addition, many older adults cannot take them due to the other medications they are prescribed. As a result, many individuals seek alternative therapies to manage their pain. One consideration is Palmitoylethanolamide (PEA), which a naturally occurring fatty acid that has been shown to have anti-inflammatory and analgesic properties.

PEA is an endogenous compound produced by the body in response to inflammation and injury and is found in various foods such as egg yolk, soybeans, and peanuts. It is also available in supplement form and has been studied extensively for its pain-relieving properties.According to a study published last month in Pharmaceuticals, researchers investigated the efficacy of PEA for reducing pain, duration, and medication usage in migraines.

This study included 64 healthy participants who suffer from migraine headaches. At the beginning of their migraine symptoms, participants supplemented with either 600 mg of PEA or a placebo. Once the supplement was taken, each individual recorded a visual analogue scale (VAS) for pain every 30 minutes for a 4-hour period or until the migraine resolved. If the migraine had not resolved 2 hours after supplementation, they were instructed to take a second dose. The PEA supplementation resolved more headaches after 2 and 8 hours and had a lower VAS for pain score at 1.5 and 4 hours. In addition, there was a significant reduction in rescue medication used compared to the placebo. Overall, PEA was safe and effective in reducing migraine pain, duration, and medication use in an otherwise healthy adult population. It is also good to use a micronized form for optimal bioavailability.

Research has shown that PEA is effective in managing various types of pain, including chronic pain, neuropathic pain, and inflammatory pain. In addition to its pain-relieving properties, PEA has also been shown to have anti-inflammatory effects and plays a role in the immune response. There is also additional on sports performance and sleep with PEA.
Other nutrients to consider include omega-3 fatty acids, phyocannabinoids, curcumin, and magnesium.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Brisky D, Skinner R, et al. Effectiveness of Palmitoylethanolamide (Levagen+) Compared to a Placebo for Reducing Pain, Duration, and Medication Use during Migraines in Otherwise Healthy Participants-A Double-Blind Randomised Controlled Study. Pharmaceuticals (Basel). 2024 Jan 23;17(2):145.

New study investigates the effects of multispecies probiotic supplementation on serum bone turnover markers in postmenopausal women with osteopenia

Osteoporosis is a silent chronic disease associated with weakened bone mass and an increased risk of fracture.

According to a new study published this week in Nutrients, researchers investigated the effects of multispecies probiotic supplementation on bone turnover markers were evaluated after 12 weeks.

This was a randomized, double-blind, placebo-controlled trial that included 40 post-menopausal with osteopenia between 45 and 70 years of age. The study was conducted between March and September 2023. One group received a multispecies probiotic supplement which contained a potency of 8 billion CFUs along with some inulin as a prebiotic, and the control group received identical placebo sachets daily over a 12-week period.

The baseline assessment consisted of serum bone resorption marker C-terminal telopeptide of type I collagen (CTX). These short proteins (peptides) make up certain regions of bones’ collagen. Collagen, specifically type 1 collagen, is the substance that makes up most of the non-mineral tissue of bone. Collagen forms the matrix upon which the mineral portion of bone accumulates. This collagen is strengthened by cross-linked proteins. They are produced during bone resorption and can be measured in blood or urine. Currently, CTX is most commonly measured in blood (serum). High serum CTX test levels have been found to correlate with low bone mineral density and to predict fracture risk. Serum CTX test levels are higher in people with osteoporosis compared to those without the disease. This is used to screen for excess bone loss and is useful for monitoring the effectiveness of osteoporosis treatments but is not diagnostic for osteoporosis like a DEXA scan.

After 12 weeks, the average difference in serum CTX at baseline versus 12 weeks was significantly different between the multispecies probiotic and placebo groups. In the individuals that took the multispecies probiotic showed a significant reduction in serum CTX levels after 12 weeks compared to the baseline. In addition, the placebo group showed no significant change.

As a results, a multispecies probiotic should be considered for a potential preventive effect on bone through their antiresorptive effect in osteopenic postmenopausal won as they are at an increased risk for progressive bone loss due to estrogen deficiency and the aging process.

Probiotics have an effect on slowing down osteoclast-induced bone resorption as well as decreasing inflammatory mediators and cytokine levels in the bone marrow and gastrointestinal tract maintaining intestinal barrier integrity. These changes send signals to promote a healthy bone homeostasis.

Other nutrients to consider include vitamins D, K1, and K2 as MK-4 as well as calcium, magnesium, delta and gamma tocotrienols, collagen peptides, and genistein. In addition, it is essential to make sure these individuals are obtaining adequate protein intake as well as addressing underlying hormonal imbalance.

Source: Vanitchanont M, Vallibhakara S, et al. Effects of Multispecies Probiotic Supplementation on Serum Bone Turnover Markers in Postmenopausal Women with Osteopenia: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 05 Feb 2024, 16(3), 461

Stethoscope and red heart on blue background, close up. Healthca

New review investigates the effect of flaxseed supplementation in patients with coronary artery disease

Heart disease continues to be a leading cause of death in the United States despite increases in risk factor management and treatment improvement. Heart disease can many times be prevented or improved when people make healthy choices. Unfortunately, traditional medicine takes a very myopic approach to cardiovascular disease and risk factors. In addition, these patients are not told that they can change the trajectory of their health concerns with diet, lifestyle, and nutritional therapeutics.

According to a new review published this month in Clinical Cardiology, researchers investigated the effects of flaxseed supplementation on anthropometric, glycemic, lipid, and inflammatory markers in patients with coronary artery disease.

This meta-analysis included 309 participants among six randomized controlled trials published between 2017 and 2022. The duration of the studies ranged between 10 and 24 weeks with a dose of flaxseed supplementation ranging between 1 gram up to 30 grams daily. There were studies with 1 gram, 2 grams, 5 grams, and 30 grams. The results did not demonstrate significant changes among lipid factors including LDL cholesterol, HDL cholesterol, and total cholesterol as well as body weight or body mass index (BMI) following flaxseed supplementation. However, flaxseed supplementation did show a significant decrease in triglyceride, fasting glucose, and hs‐CRP levels.

Flaxseeds contain ALA, a polyunsaturated fatty acid, which is recognized to have anti-inflammatory properties. In addition, the significant amount of fiber present in flaxseeds contribute to its ability to protect against inflammation.

Other nutrients to consider for overall heart health include coenzyme Q10, magnesium, fish oil, vitamin D, and delta and gamma tocotrienol isomers.

It is important to take a comprehensive approach to assessing the cardiovascular system. Health care providers have many tools today to assess cardiovascular health and support the body’s physiology. It is essential to perform a thorough assessment for these patients. This may include looking at an advanced lipid profile (ie. LipoFraction NMR Profile with lipids), chronic inflammatory markers (ferritin, hs-CRP, OxLDL), nutrient markers (magnesium, potassium, selenium, copper, folate, B12, B6, zinc, and calcium), fat soluble vitamins (CoQ10, vitamin D, vitamin K, Vitamin A, Vitmain E), oxidative stress factors (homocysteine, insulin, and lipid peroxidases), heavy metals, and a fatty acid profiles. Many of these nutrients play a synergist role with one another and it is important to adequate levels for optimal function.

Source: Sabet HR, Ahmadi M, et al. Effects of flaxseed supplementation on weight loss, lipid profiles, glucose, and high-sensitivity C-reactive protein in patients with coronary artery disease: A systematic review and meta-analysis of randomized controlled trials. Clin Cardiol. 2024 Jan;47(1):e24211.






High homocysteine levels and insufficient awareness among health care practitioners

Homocysteine is an amino acid produced as part of the body’s methylation process and is considered an independent risk factor for cardiovascular disease. This oxidative stress biomarker is associated with many cardiovascular disorders such as increased risk of atherosclerosis, stroke, abdominal aortic aneurysm, essential hypertension, and venous thrombosis as well as chronic kidney disease (CKD), hypothyroidism, and cognitive impairment. The metabolism of homocysteine is highly dependent on in vitamin B12, folate, and vitamin B6. Deficiencies in any of these may be associated with elevated homocysteine levels.

In a new review published two weeks ago in the Nutrients, researchers discussed the significance of hyperhomocysteienemia as controversy persists around its assessment and management as well as insufficient awareness among health care practitioners.

A nutritional approach of lowering homocysteine involves dietary strategies and targeted nutritional therapeutics including B-vitamins and trimeythlyglycine (TMG), which are essential for homocysteine conversion. In addition, a-acetylcysteine acutely lowers plasma homocysteine as well. Oral n-acetylcysteine given for 4 weeks at 1.8 g/d has been shown to lower plasma homocysteine and increase intracellular glutathione concentrations.

It is also important to note that individuals can have a genetic predisposition (ie. MTHFR, CBS, etc.) or be on medications that reduce folate and vitamin B!2 leading to an increase in homocysteine. A common medication that increases homocysteine levels is Metformin.

Lifestyle modifications include smoking cessation and regular physical activity. It is ideal for individuals to maintain a plasma homocysteine concentration below 10 μmol/L to lower the risk of vascular events. Collaboration with healthcare professionals and nutritionists is essential for developing personalized dietary plans addressing the specific needs and underlying health conditions.

Health care providers have many more tools today to assess cardiovascular risk and health. It is essential to perform a thorough assessment for all of these patients including a NMR lipid fractionation profile, ferritin, hs-CRP, nutrient markers (magnesium, potassium, selenium, copper, folate, B12, B6, zinc, and calcium), fat soluble vitamins (CoQ10, vitamin D, vitamin K, Vitamin A, Vitamin E), oxidative stress factors (homocysteine, insulin, and lipid peroxidases), heavy metals, and a fatty acid profile.

Each person's biochemical individuality exerts a major influence on his or her health. The level of nutrient intake that maintains the best possible health is highly variable from person to person. Lifestyle choices and environmental exposures filtered through genetic predisposition are fundamental factors in the expression of disease and a successful treatment approach must include investigation into these factors.

By Michael Jurgelewicz, DC, DACBN, DCBCN

Source: Gonzalez-Lamuno D, Arrieta-Blanco FJ, et al. Hyperhomocysteinemia in Adult Patients: A Treatable Metabolic Condition. Nutrients. 2023 Dec 30;16(1):135.

New study investigates the effects of a synbiotics in women with PCOS

Polycystic ovarian syndrome (PCOS) is associated with irregular menstrual periods, infertility, obesity, diabetes, excess hair growth, acne, and other hormonal difficulties.

Pharmaceutical interventions provide some improvements, but they do not correct many of the underlying factors and have side effects and may not be tolerated by patients. Many patients with PCOS are overweight and have dietary habits that exacerbate their condition.

In a new study published last week in BMC Women’s Health, researchers investigated the effects of synbiotics on the health-related quality of life (HRQoL) in women with polycystic ovarian syndrome (PCOS).

This was a randomized, triple-blinded, placebo-controlled trial consisting of 56 women with PCOS and was conducted between February and May 2023. Each participant was randomly assigned to receive a synbiotic formula containing 100 billion spores of Bacillus coagulans (GBI-30), 10 billion CFUs of Lactobacillus rhamnosus, 10 billion CFUs of Lactobacillus helveticus, and 500 mg of fructooligosaccharides (FOS) or placebo over a 12-week period. To evaluate the impact on the HRQoL, each participant completed a 26-Item Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ-26), 12-Item Short-Form Health Survey (SF-12) and Perceived Stress Scale (PSS-10) at baseline and at the end of the study.

Statistical analyses were performed on 52 participants who completed the study. As a result, synbiotic supplementation demonstrated improved the scores of emotional, body hair, weight, and infertility domains of the PCOSQ-26 compared to placebo group. Also, the physical score within SF-12 showed a significant improvement. On the other hand, no significant improvement was seen in the PSS-10 score.

This study demonstrates the effects of symbiotic supplementation on the health-related quality of life in women with PCOS.

Other nutrients to consider to support PCOS:

Studies have shown that an inositol deficiency is common in women with PCOS. There appears to be a reduced ability to process, metabolize, and effectively use inositol from foods which is a distinctive characteristic feature of PCOS. As a result, the nutritional requirements of PCOS patients may not be met by a simple change in the diet and that inositol should be viewed as a conditionally essential nutrient in these women.

Myo-inositol and D-chiro-inositol are both essential for patients with PCOS. The conversion of myo-inositol to D-chiro-inositol is of interest because errors here have been strongly involved in PCOS patients. Strong evidence supports that the body makes D-chiro-inositol from myo-inositol and more evidence suggests that some people are less able to make this conversion than others.  Along this spectrum, people who are completely unable to convert myo-inositol to D-chiro-inositol are only going to benefit from supplementation with D-chiro-inositol. Other people who make the conversion, but with less-than-optimal efficiency, may benefit from large doses of myo-inositol. And other individuals in between, might see the best results from a blend of the two. Since this conversion is impaired in individuals with PCOS, it is important to always include D-chiro-inositol with myo-inositol supplementation. D-chiro-inositol is the more potent form of inositol for supporting insulin resistance, however, myo-inositol is need for oocyte quality and maturation. Therefore, supplementing with D-chiro-inositol alone cannot not fulfill myo-inositol’s roles that are specific and different from D-chiro-inositol, since it does not convert to myo-inositol.

Also, essential fatty acids should be consumed in our diets for overall health, but most individuals with insulin resistance are deficient. Fish oils improve insulin sensitivity and reduce inflammation.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Hariri Z, Yari Z, et al. Synbiotic as an ameliorating factor in the health-related quality of life in women with polycystic ovary syndrome. A randomized, triple-blind, placebo-controlled trial. BMC Womens Health. 2024 Jan 3;24(1):19.

New study investigates the effect of phthalate exposure and fertility

Infertility effects approximately 7.3 million couples in the US. One of seven couple will experience difficulty conceiving. About 40-50% of these the cause is unknown. It may be related to toxicity, oxidative damage, poor nutritional status or nutritional deficiencies, heavy metal or environmental toxicity, systemic disorders, hormonal imbalances, xenobiotic exposure, age-related decline, or obesity.

According to a recent study published two weeks ago in Environmental Health Perspectives, researchers investigated the relationship of preconception phthalate metabolite exposure in fertility along with potential mechanisms including reproductive hormones, inflammation, and oxidative stress.

Phthalates are endocrine-disrupting chemicals linked to adverse pregnancy outcomes, however, their evidence to establish and maintain pregnancy have been inconclusive.

This study included 1,228 women from the Effects of Aspirin in Gestation and Reproduction (EAGer) trial who were attempting to conceive for up to 6 menstrual cycles and throughout pregnancy if they became pregnant. Twenty phthalate metabolites were measured in a consecutive 3-day pooled urine sample at enrollment. Pregnancy was determined through urinary hCG levels at the expected date of menses during each cycle and pregnancy loss as an observed loss following positive hCG. Hs-CRP and isoprostanes were measured at enrollment and reproductive hormones were measured during the follicular phase, ovulation, and luteal phase. Discrete-time Cox proportional hazards models evaluated the relationship of phthalate metabolites with the probability of achieving pregnancy and weighted Poisson models with robust variance evaluated the risk of pregnancy loss.

As a result, higher mono-(2-ethylhexyl) phthalate was associated with a lower probability of achieving pregnancy. No consistent associations were observed with pregnancy loss. Preconception phthalates were consistently associated with higher hs-CRP and isoprostanes levels as well as lower estradiol and higher follicle-stimulating hormone across the menstrual cycle.

Women’s preconception exposure to phthalates was associated with a lower probability of achieving pregnancy, changes in reproductive hormones, and increased inflammation and oxidative stress. The pre-and periconception periods may represent sensitive windows for intervening to limit the reproductive toxicity of phthalate exposure.

It is also essential to minimize further exposure by eating organic produce, drink filtered water, use household products that are fragrance-free and free of phthalates and BPA, and replace non-stick pans with glass, ceramic, or cast iron.

We all live in an ever-increasing toxic environment. More than 80,000 chemicals are introduced into the world each year and in all honesty our indoor environment is likely more toxic than our outdoor environment. We are exposed to pesticides, herbicides, chemical solvents, xenobiotics, and industrial chemicals of all kinds that we get exposed through the food we eat, the water we drink and the air we breathe. These toxins accumulate in our body and contribute to the total toxic load that can cause a variety of health problems.

Nutrients that can support detoxification pathways include n-acetyl-cysteine, glutathione, calcium D-glucarate, milk thistle, and sulforaphane.

Just like traditional doctors use a complete blood count (CBC) and a comprehensive metabolic panel (CMP) as general screening tools to help rule out health problems in their patients, Dr. Jurgelewicz assesses the functional need for specific nutrients, diet modification, antioxidant protection, detoxification through organic acid testing. This identifies imbalances before any abnormal findings on a CBC or an CMP.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Nobles CJ, Mendola R, et al. Preconception Phthalate Exposure and Women's Reproductive Health: Pregnancy, Pregnancy Loss, and Underlying Mechanisms. Environ Health Perspect. 2023 Dec;131(12):127013.


New study demonstrated the effects of time-restricted fasting in NAFLD

Non-alcoholic fatty liver disease (NAFLD) is an increasing epidemic in the U.S. and the rest of the world. It is the leading cause of abnormal liver enzymes and is associated with diabetes and obesity.

Currently there are few guidelines for diagnostic and follow up methods and limited proven treatment options. Previous research of pharmacological agents to treat nonalcoholic fatty liver disease were performed with poor results.

Insulin resistance is one of the key factors in the development of NAFLD, however, the gut-liver axis plays a significant contribution as well. Gut dysbiosis and intestinal hyperpermeability lead to liver damage by proinflammatory responses.

According to a recent study published last month in Nutrients, researchers investigated the effectiveness of time-restricted fasting (TRF) for 16 hours without calorie restrictions compared to standard care in nonalcoholic fatty liver disease.

This was a prospective single-blind randomized controlled crossover study that consisted of 32 participants with NAFLD. These patients were between the ages of 18 to 75 years of age with an ultrasound diagnosis of fatty liver disease. Everyone was randomly assigned to time-restricted fasting or standard care for 12 weeks. They were instructed to refrain from eating all food and energy-containing drinks for 16 hours from 8 pm until 12 pm the following day. During this time water, black tea, and black coffee were permitted. During the 8-hour feeding period, everyone was allowed to consume food as desired without any caloric restriction. Twenty-eight participants completed the first arm of the study and 23 completed the crossover arm. The Intermittent fasting intervention caused a significant decrease in hepatic steatosis, weight, waist circumference, and body mass index (BMI) compared to the standard care. In addition, intermittent fasting resulted in additional within-group changes that were not seen in the standard care intervention. The secondary endpoints included changes in liver stiffness, anthropometry, blood pressure, and other specific metabolic factors.

As a result, time restricted fasting offers superior improvements in patients with NAFLD, improving steatosis, weight, and waist circumference despite a modification in caloric intake. Time-restricted fasting should be considered as a primary weight loss intervention in the context of NAFLD.

These individuals have established disease and increased demands then what could be obtained from the diet alone and therefore, dietary supplements should be considered to mitigate to help reduce the progression and improve liver function in patients with NAFLD.

Other nutrients to consider include, delta and gamma tocotrienols, probiotics, carnitine, coenzyme Q10, berberine, and milk thistle.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Feehan J, Mack A, et al. Time-Restricted Fasting Improves Liver Steatosis in Non-Alcoholic Fatty Liver Disease-A Single Blinded Crossover Trial. Nutrients. 2023 Nov 22;15(223):4870.