September 28, 2022

A new review demonstrates the role of genistein in polycystic ovarian syndrome  

Polycystic ovarian syndrome (PCOS) is associated with irregular menstrual periods, infertility, obesity, diabetes, excess hair growth, acne, and other hormonal difficulties. Researchers compared the effects of lifestyle changes alone or with placebo to lifestyle combined with metformin. They found that lifestyle modification combined with taking metformin resulted in increased weight loss. As a result, there was a lower body mass index (BMI), and improved menstruation.

According to a new review published this month in the European Journal of Pharmacology, researchers demonstrated the role of genistein in polycystic ovarian syndrome (PCOS).

Genistein is the most active and abundant isoflavone found in soy and has been shown to possess an array of anti-inflammatory, antioxidant, and antiangiogenic, and anti-cancer properties. Genistein also inhibits NF-Kβ activation as well as inhibits cell growth and metastasis. Although genistein is typically derived from a soy source, it can also be sourced from the botanical, sophora japonica.

This review investigated the effects and mechanisms of genistein in patients PCOS. The review included 13 articles, 4 human studies and 9 animal studies. The human studies consisted of 24 to 146 individuals between the ages of 18 and 40 years of age over a 3-to-6-month period with doses between 36 mg and 50 mg per day. These studies demonstrated that genistein supplementation may effectively improve PCOS-related symptoms by decreasing insulin resistance and anthropometric parameters, improving ovarian morphology, regulating reproductive hormones, and reducing oxidative stress as well as inflammation.

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, CNSSource: Ramin Nasimi Doost Azgomi, Arezoo Moini Jazani, et al. Potential roles of genistein in polycystic ovary syndrome: A comprehensive systematic review. Eur J Pharmacol. 2022 Sep;175275. doi: 10.1016/j.ejphar.2022.175275.

New review of melatonin supplementation and depression

Depression is a major cause of disease burden worldwide which affects approximately 350 million people. Although there are numerous medications for the treatment of depression, less than 50% of patients take medications for depression.

According to a new review published last month in Behavior Brain Research, researchers investigated the effects of melatonin supplementation on brain derived neurotrophic factor (BDNF) concentration and clinical depressive disorder.

This review consisted of 23 studies including 1,934 individuals over 18 years of age that assessed the effect of melatonin supplementation on serum concentration of BDNF or depression score.

Overall, melatonin supplementation did not demonstrate a significant effect on BDNF concentration but it improved depression by decreasing the score. The subgroup analysis showed that melatonin supplementation did have a significant decreasing effect on BDNF levels in doses ≤ 10mg/day with more than 4 weeks of duration in men.

This review demonstrates that melatonin supplementation has a decreasing effect on depression in all duration of studies and doses. Melatonin provides a protective effect on depressive symptoms as sleep disturbance is an independent risk factor in its development or recurrence. In addition, melatonin supplementation normalizes circadian rhythms and improves sleep disturbances and acts as an antidepressant by stabilizing NMDA receptor activity. Also, altered distribution of rapid eye movement (REM) sleep in patients with depression is associated with raised amounts of early REM sleep and decreased sleep onset latency to REM sleep. Treatment with melatonin has been shown to prolong the duration of non-rapid eye movement sleep without affecting REM sleep.

Other nutrients to consider include essential fatty acids as most individuals are often deficient. Fish oils are essential for one’s overall health and reduce inflammation. 

Also, some natural alternatives to anti-depressants include Sceletium tortuosum and Saffron flower. Sceletium tortuosum has attracted increasing attention over past few decades for promoting a sense of wellbeing and treating depression andSaffron flower has had numerous studies demonstrating positive outcomes on MDD and has gone head to head with SSRIs demonstrating the same efficacy.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Shokri-Mashhadi-N, Darand M, et al. Effects of melatonin supplementation on BDNF concentrations and depression: A systematic review and meta-analysis of randomized controlled trials. Behav Brain Res. 2022 Aug 29;114083.

 

 

New Review Investigates the Efficacy of an IBS Diet in the Treatment of SIBO

Irritable bowel syndrome (IBS) can be debilitating causing cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS can affect and one’s work, sleep and relationships.

Most treatments for IBS consist of medications that are often ineffective and can have numerous side effects.

According to a review published this month in Nutrients, researchers investigated the current recommendations regarding nutrition in IBS to determine if they are suitable for patients with small intestinal bacterial overgrowth (SIBO).

A narrative literature review was carried out using several databases. Recent studies have demonstrated that dietary manipulation may have a role in mitigating SIBO gastrointestinal symptoms. Interestingly, a low FODMAP diet proposed for IBS may promote a negative shift in the gut microbiome and exacerbate the existing dysbiosis in patients with SIBO.

On the other hand, supplementation with soluble fiber can lessen the symptoms in IBS and SIBO. In addition, specific probiotic supplementation may increase the efficacy of antibiotic treatment and regulate bowel movements. Optimal dietary patterns play a key role in the treatment of SIBO.

FODMAPs act as prebiotics and modulate the gut microbiome by stimulating the growth of beneficial bacteria and promoting the production of short-chain fatty acids, so a low-FODMAP diet might be characterized as anti-prebiotic because of its reduction in beneficial bacteria species.

Most studies compared a low-FODMAP diet in IBS patients to traditional dietary recommendations, habitual diets or a high-FODMAP diet. None of the studies investigated

the impact of this diet in SIBO patients.

The effect of single strain probiotic supplementation on the modification of gut microbiome

was assessed in 11 studies. Only one study included patients with SIBO. The results

demonstrated that supplementation with Saccharomyces boulardii was associated with a significantly higher eradication rate and a decline in exhaled hydrogen compared to metronidazole therapy. The nine remaining studies were carried out in patients with IBS,

constipation, and healthy individuals.

Dietary fiber should also be considered an essential nutrient for the growth of beneficial bacteria as a prebiotic. The included studies support that increasing the

intake of fiber, particularly, soluble fiber, shows beneficial results in patients with GI

symptoms and modulation of the gut microbiome, however, studies in SIBO patients are still needed.

The gastrointestinal tract is the body’s ‘second brain,’ it is made up of a self-contained, complex network of neurons, neurotransmitters, and proteins embedded in the lining of the GI system. It is responsible for all aspects of the digestive process, from the esophagus to the stomach and small and large intestines and may be responsible for IBS symptoms.

There are other nutrients that can support patient with IBS. For example. Perilla frutescens is an herb native to Eastern Asia that demonstrates antispasmodic, prokinetic, and anti-inflammatory effects, which help normalize and promote health bowel function and provide relief from GI symptoms.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Wielgosz-Grochowska J, Domanski N, et al. Efficacy of an Irritable Bowel Syndrome Diet in the Treatment of Small Intestinal Bacterial Overgrowth: A Narrative Review. Nutrients. 2022 Aug 17;14(16):3382.

New review investigated vitamin D deficiency in PCOS

Polycystic ovarian syndrome (PCOS) is associated with irregular menstrual periods, infertility, obesity, diabetes, excess hair growth, acne, and other hormonal difficulties. Researchers compared the effects of lifestyle changes alone or with placebo to lifestyle combined with metformin. They found that lifestyle modification combined with taking metformin resulted in increased weight loss. As a result, there was a lower body mass index (BMI), and improved menstruation.

In a new review published earlier month in the Journal of Clinical Medicine, researchers investigated the physiopathology in PCOS and vitamin D deficiency.

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

Previous research has demonstrated the importance of vitamin D in patients with PCOS. Women with PCOS are often vitamin D deficient, specifically those with a higher weight.

In addition, a vitamin D deficiency is a risk factor for glucose intolerance and insulin resistance, which may lead to diabetes. Since women with PCOS and hirsutism tend to have lower levels of vitamin D than those without hirsutism, a correlation between vitamin D deficiency and hyperandrogenism can be suggested.

Vitamin D is also essential to mitigate inflammation and oxidative stress. Furthermore, vitamin D has been shown to play a role in egg quality and fertility. In general text, women with PCOS have lower vitamin D levels compared to healthy individuals.

This review demonstrates the relationship between vitamin D and the hormonal and metabolic profile of PCOS patients as well as its role in fertility. Vitamin D should have broad significance to increase natural conception in women with PCOS with a goal to decrease costs related to in vitro fertilization procedures. Vitamin D supplementation women with PCOS is a safe strategy to improve their symptoms without adverse effects.

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: Morgante G, Darino I, et al. PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment. J Clin Med. 2022 Aug 2;11(15):4509.

 

New study demonstrates the effects of magnesium supplementation in PCOS

Polycystic ovarian syndrome (PCOS) is associated with irregular menstrual periods, infertility, obesity, diabetes, excess hair growth, acne, and other hormonal difficulties. Researchers compared the effects of lifestyle changes alone or with placebo to lifestyle combined with metformin. They found that lifestyle modification combined with taking metformin resulted in increased weight loss. As a result, there was a lower body mass index (BMI), and improved menstruation.

In a new study published last week in Reproductive Biology and Endocrinology, researchers investigated the effects of abnormal uterine bleeding, alopecia, quality of life, and acne in women with PCOS.

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

This randomized clinical trial included sixty-four women with PCOS assigned to take 250 mg of magnesium supplementation per day or placebo over a 10-week period. Abnormal uterine bleeding, alopecia, quality of life, and acne were assessed by the International Federation of Gynecology and Obstetrics criteria, the Sinclair Scale, the Health Survey Quality of Life Questionnaire, and the Global Acne Grading System.

As a result, magnesium supplementation significantly improved the quality of life including physical functioning, energy, fatigue, emotional wellbeing, social functioning, general health, and total quality of life compared to the placebo. No significant effects were observed on acne, alopecia, or abnormal uterine bleeding.

This study demonstrates that magnesium supplementation in women with PCOS has a significant positive effect on improving overall quality of life. Since magnesium is a coenzyme of more than 300 enzymes in the body as well as many chemical reactions require sufficient magnesium level, it is not surprising for optimal health the body depends on adequate intake of magnesium.

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: Jaripur M, Ghasemi-Tehrani H, et al. The effects of magnesium supplementation on abnormal uterine bleeding, alopecia, quality of life, and acne in women with polycystic ovary syndrome: a randomized clinical trial. Reprod Biol Endocrinol. 2022 Aug 2;20(1):110.

New review investigates the efficacy of probiotics in patients with IBS

Irritable bowel syndrome (IBS) can be debilitating causing cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS can affect and one’s work, sleep and relationships.

Most treatments for IBS consist of medications that are often ineffective and can have numerous side effects.

According to a study published last month in Nutrients, researchers investigated the efficacy of probiotics in patient with IBS. The efficacy of probiotic supplementation in treating irritable bowel syndrome has been supported by an increasing number of clinical studies.

Although the role of gut dysbiosis in IBS pathogenesis and probiotics are demonstrated, specific strains and a personalized medicine approach is still lacking.

This systemic review set out to identify the most effective formulation and to discriminate which probiotics are most efficient in treating different symptoms in IBS. This review investigated 104 clinical studies from 2011 to 2021 revealing a prevalence of Lactobacillus rhamnosus, Lactobacillus acidophilus, and Bifidobacterium animalis subsp. lactis. In addition, multi-criteria decision analysis (MCDA) demonstrated that formulations based on Lactobacillus rhamnosus and Lactobacillus acidophilus had the highest efficacy, especially on quality of life, bloating, and abdominal pain. The clinical studies classified based upon improvement in quality of life and decreases in all IBS symptoms are based on a patient cohort of 82% women with a mean age of 36 years and suffering from IBS-M and IBS-D subtypes.

This review shows that probiotic strains such as Lactobacillus rhamnosus, Bifidobacterium animalis subps. lactis, and Lactobacillus acidophilus are helpful in treating chronic and debilitating inflammatory diseases such as IBS. This is the first review to apply MCDA analysis of nutraceuticals for clinical applications with objective comparison of the beneficial effects of probiotic formulations in improving IBS symptoms was possible.

The gastrointestinal tract is the body’s ‘second brain,’ it is made up of a self-contained, complex network of neurons, neurotransmitters, and proteins embedded in the lining of the GI system. It is responsible for all aspects of the digestive process, from the esophagus to the stomach and small and large intestines and may be responsible for IBS symptoms.

There are other nutrients that can support patient with IBS. For example. Perilla frutescens is an herb native to Eastern Asia that demonstrates antispasmodic, prokinetic, and anti-inflammatory effects, which help normalize and promote health bowel function and provide relief from GI symptoms.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Ceccherini C, Daniotti S, et al. Evaluating the Efficacy of Probiotics in IBS Treatment Using a Systematic Review of Clinical Trials and Multi-Criteria Decision Analysis. Nutrients. 2022 Jun 28;14(13):2689.

 

New study demonstrates the effects of collagen peptides on cardiovascular markers

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 systematic review and meta-analysis published last month in the British Journal of Nutrition, researchers investigated the effects of collagen peptide supplementation on cardiovascular disease related biomarkers.

Collagen peptides play essential biological roles including inhibiting the activity of angiotensin I-converting enzyme (ACE), acting as signal messengers in cellular processes in cartilage, tendons, and ligaments, and activating the mTOR signaling pathway.

Over the last decade several clinical investigations targeted the effects of collagen peptides on cardiovascular disease-related markers producing conflicting results.

This review included 12 randomized, placebo-controlled trials published up until November 2021.  The dosing ranged from 900 mg per day up to 15 grams per day over a period of 6 to 12 weeks. As a result, the research team demonstrated that collagen peptide supplementation significantly decreased fat mass and increased fat-free mass based on body mass percentage. In addition, collagen peptide supplementation showed a significant reduce in serum LDL cholesterol and systolic blood pressure. Collagen peptides suppress high blood pressure by inhibiting ACE, activating peroxisome proliferator-activated receptors (PPARs), and decreasing arterial stiffness by increasing nitric oxide. There was no effect on glycemic markers. Collagen peptides have several effects on lipid metabolism as well. It suppresses hepatic protein expression for fatty acid cholesterol synthesis as well a reduction in gene expression of C/EBP-α, PPAR-γ, and adipocyte protein 2 (aP2).

This review demonstrated that collagen peptide supplementation reduces fat mass, LDL cholesterol, and systolic blood pressure while increasing fat-free mass.

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: Jalili Z, Jalili J, et al. Effects of Collagen Peptide Supplementation on Cardiovascular Markers: A Systematic Review and Meta-analysis of Randomized, Placebo-Controlled Trials. Br J Nutr. 2022 Jun 6;1-43.

 

 

 

New review investigates vitamin D supplementation in patients with IBS

Irritable bowel syndrome (IBS) can be debilitating causing cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS can affect and one’s work, sleep and relationships.

Most treatments for IBS consist of medications that are often ineffective and can have numerous side effects.

According to a study published last month in Nutrients, researchers investigated the effects of vitamin D supplementation to see if it causes any improvements in the symptoms of IBS.

This systematic review and meta-analysis included all studies published until April 4, 2022. The search for randomized controlled trials assessing vitamin D efficacy in IBS with outcome including primary Irritable Bowel Severity Scoring System (IBS-SSS) and secondary IBS quality of life (IBS-QoL) as well as serum vitamin D 25-OH was performed in six databases. The research team included 6 studies consisting of a total of 616 patients.

As a result, the pooled analysis found no difference between vitamin D and placebo in improving IBS-SSS. However, the pooled analysis favored vitamin D over placebo regarding increasing the serum level of vitamin D 15-OH and improving the IBS-QoL.

Vitamin D can impact the gastrointestinal tract by its immunomodulatory properties. In the pathogenesis of IBS, immunological and inflammatory roles are important as research has suggested that the activation of inflammatory mediators have a crucial role in the development of IBS development. For example, the upregulated mast cells, T-cells, and other pro-inflammatory cytokines are a few known key factors.

In addition, the increased inflammation upregulates the neural activity in the intestine leading to visceral hypersensitivity as well as abdominal pain. On the other hand, decreased inflammation can improve the sensory nervous system in the gut, causing normalization of gut functionality and reduced IBS symptoms. This can be explained by the presence of vitamin D receptors in the nervous system as they play a role in the synthesis, maintenance, and upregulation of neurotransmitters levels.

The gastrointestinal tract is the body’s ‘second brain,’ it is made up of a self-contained, complex network of neurons, neurotransmitters, and proteins embedded in the lining of the GI system. It is responsible for all aspects of the digestive process, from the esophagus to the stomach and small and large intestines and may be responsible for IBS symptoms.

There are other nutrients that can support patient with IBS. For example. Perilla frutescens is an herb native to Eastern Asia that demonstrates antispasmodic, prokinetic, and anti-inflammatory effects, which help normalize and promote health bowel function and provide relief from GI symptoms. In addition, there are some specific researched strains such as Saccharomyces cerevisiae CNCM I-3856 that have been shown to reduce digestive discomfort and abdominal pain in individuals with IBS.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Abuelazm M, Muhammad S, et al. The Effect of Vitamin D Supplementation on the Severity of Symptoms and the Quality of Life in Irritable Bowel Syndrome Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients, 14(13), 2618.

 

New study demonstrates the correlations between vitamin D levels and peripheral arterial stiffness in chronic kidney disease

Over 10% of the adult population suffer from chronic kidney disease (CKD). The two leading underlying causes of end-stage kidney disease are due to type II diabetes and hypertension.

According to a new study published yesterday in Nutrients, researchers investigated the relationship between serum vitamin D 25-OH levels and brachial-ankle pulse wave velocity (baPWV) in non-dialysis patients with stage 3–5 chronic kidney disease (CKD). Vitamin D deficiency and baPWV are both independently associated with higher incidence of mortality and cardiovascular disease or cardiovascular events.

Vitamin D has an established role in mineral homeostasis and musculoskeletal function. Vitamin D is also known to exert extra-skeletal effects including modulation of endothelial function, immune function, inflammatory responses, and cell cycle regulation.

In addition, a vitamin D deficiency has been associated with albuminuria and impaired renal function in the general population as well as all-cause mortality and kidney failure requiring long-term dialysis in pre-diabetic and type II diabetes patients.

This study consisted of 180 patients with chronic kidney disease stage three to five from a renal outpatient department between January and December 2016. Assessments included serum vitamin D 25-OH levels and BaPWV. Either left or right baPWV > 18.0 m/s was considered indicative of peripheral arterial stiffness (PAS).

In this study, 73 patients (41%) were shown to have PAS. Compared to those without PAS, patients with PAS were older and had higher incidence of diabetes mellitus, higher blood pressure, higher parathyroid hormone levels, higher C-reactive protein levels, and lower levels of vitamin D levels. As a result, lower vitamin D levels and increased age were associated with PAS in patients with CKD.

Other nutrients to consider include fiber, resistant starch, fish oil, phosphatidylcholine, and n-acetyl-cysteine or glutathione.Fish oil supplementation has been shown to decrease protein in the urine as well as protect kidney function and slow the rate of kidney dysfunction. Doses up to 10 grams per day have been used.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Lee Chun-Jen, Hsieh Yi-Jen, et al. Correlation between Serum 25-Hydroxyvitamin D Level and Peripheral Arterial Stiffness in Chronic Kidney Disease Stage 3–5 Patients. 11 June 2022, Nutrients, 14(12), 2429.

New study demonstrates vitamin B6 status influences essential fatty acid status

B vitamins and omega-3 fatty acids are essential nutrients involved in numerous metabolic processes that play a significant role in cognitive health.

Previous research suggests a potential impact of aging and the relationship of vitamin B6

on polyunsaturated fatty acid (PUFA) metabolism. Limited information is known about the interrelationships between vitamin B6 and PUFAs in the elderly population.

According to a study published earlier this month in Nutrients, researchers investigated the associations of vitamin B6 intake and plasma pyridoxal 5-phosphate (PLP) levels along with plasma PUFA concentrations and ratios in older adults. In addition, they further investigated the relationship of adequate vitamin B6 status with high plasma PUFA compared to a deficient vitamin B6 status.

This cross-sectional study consisted of 461 participants at the age of 60 years and older from NHANES 2003–2004. Nutrient intakes were assessed using two 24-h recalls and supplement questionnaires. Vitamin B6 and PUFA concentrations were assessed. As a result, a higher vitamin B6 level in older adults was associated with a higher level of EPA, DHA, EPA + DHA, EPA/AA, and (EPA + DHA)/AA. Also, adequate vitamin B6 status was associated with high EPA and EPA/AA status. These findings demonstrate that sufficient vitamin B6 status positively effects PUFA metabolism in older adults.

I previously shared the importance b-vitamin and its relationship to omega-3 status in cognitive health. There was an interesting study published January 6, 2016 in the Journal of Alzheimer’s Disease. Prior studies have already established that B vitamins can slow cognitive decline in the elderly. This was most effective in those who had above average homocysteine levels, which is a common biomarker related to B vitamin status that may be toxic to the brain.  The research team found that there was a link between Omega-3 levels, homocysteine, and brain atrophy rates. There has been links between homocysteine and omega-3 fatty acids. As a result, B vitamins are essential for the synthesis of phospholipids.  In this study researchers investigated whether omega-3 fatty acid status had an effect on the treatment of B vitamins in mild cognitive impairment (MCI).

Two hundred and sixty-six participants with MCI over 70 year of age were randomized to B vitamins (folic acid, vitamins B6 and B12) or placebo for 2 years. Researchers performed baseline cognitive test performance, clinical dementia rating (CDR) scale, and plasma concentrations of homocysteine, DHA, and EPA fatty acids. The final results for verbal delayed recall, global cognition, and CDR were better in the B vitamin-treated group according to increasing baseline concentrations of omega-3 fatty acids. In contrast, the scores in the placebo group were similar across these concentrations. Among those with good omega-3 status, 33% of those on B vitamin treatment had global CDR scores >0 compared with 59% among those on placebo. Among all 3 outcome measures, higher concentrations of DHA alone significantly improved the cognitive effects of B vitamins, whereas EPA appeared to be less effective.

This study demonstrated that B vitamins had no effect on cognitive decline in MCI 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 reduce age-related memory decline.

In conclusion, there are important synergistic interrelationships between omega-3 and b-vitamins. These studies demonstrate the importance of a comprehensive approach nutritionally and not a monotherapy approach.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Kim Hyojung, Enrione Evelyn B, et al. Associations of Vitamin B6 Intake and Plasma Pyridoxal 5′-Phosphate with Plasma Polyunsaturated Fatty Acids in US Older Adults: Findings from NHANES 2003-2004. Nutrients. 2022 Jun2;14(11):2336.

Abderrahim Oulhaja, Fredrik Jerneren, Helga Refsum, A. David Smith, Celeste A. de Jager. Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment. Journal of Alzheimer’s Disease, vol. 50, no. 2, pp. 547-557, 2016.