July 1, 2022

New review investigates the effects of quercetin in polycystic ovary syndrome  

Polycystic ovary 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 that may not be tolerated by patients. Many PCOS patients are overweight and have dietary habits that exacerbate the condition.

In a new review published in Journal of Ovarian Research, researchers investigated the efficacy of quercetin supplementation in patients with PCOS. Quercetin is a polyphenol that has been shown to have both strong antioxidant as well as anti-inflammatory properties and used to treat metabolic and inflammatory disorders.

This review included a combination of three human clinical trials and five animal studies evaluating the effects of quercetin in PCOS. Five of the eight studies demonstrated beneficial effects of quercetin on the ovarian histomorphology, the maturation of the ovarian follicle, and luteinization processes. These studies showed that quercetin supplementation increases normal follicles in ovaries, restores the normal ovary anatomy, and improves histology in the uterus, which is comparable to or better than metformin. Quercetin was also shown to reduce testosterone levels, luteinizing hormone (LH), and improve insulin resistance and dyslipidemia in seven of the eight studies. This was demonstrated at a dose of 25 mg/kg. Hirsutism was only evaluated in two studies, however, both studies showed quercetin improved the condition.

This review demonstrates that quercetin can correct hormonal dysfunction and improve some of the metabolic features of PCOS by its antioxidant and anti-inflammatory properties.

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; therefore, inositol should be viewed as a conditionally essential nutrient in these individuals.

Both myo-inositol and D-chiro-inositol are essential for individuals with PCOS. Since this conversion is impaired in individuals with PCOS, it is essential to include D-chiro-inositol with myo-inositol supplementation. D-chiro-inositol is better for supporting insulin resistance and myo-inositol is needed for oocyte quality and maturation.

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: Pourteymour Fard Tabrizi F, Hajizadeh-Sharafabad F, et al. Quercetin and polycystic ovary syndrome, current evidence and future direction: a systemic review.

 

 

 

New review demonstrates the efficacy of probiotics in multiple sclerosis

Multiple sclerosis (MS) is a debilitating inflammatory, demyelinating, and autoimmune disease of the central nervous system. MS is characterized by dyskinesia, cognitive impairment, numbness, fatigue, depression, anxiety, vision loss, dizziness, and gastrointestinal dysfunction.

According to a review published in Food & Function, researchers evaluated the efficacy of probiotics in multiple sclerosis.

This systemic review consisted of 22 preclinical animal studies as well as a meta-analysis of three randomized clinical trials including 173 patients with MS. As are result, the patients receiving probiotics demonstrated significant beneficial effects on mental health parameters including the expanded disability status scale scores, Beck depression inventory scores, general health questionnaire scores, and depression anxiety and stress scores.

In addition, the patients receiving the probiotic supplements showed a significant improved insulin resistance (insulin, HOMA-IR, and QUICKI), inflammatory (IL-6, hs-CRP, and NO) and oxidative stress markers (plasma TAC, GSH, and MDA).  

This study is the first meta-analysis to demonstrate a significant difference in mental health parameters (EDSS, BDI, GSH and DASS scores) among those receiving probiotic supplementation.

Preclinical studies have demonstrated that probiotic supplementation decreases the risk and severity of MS, delays MS progression, and improves motor impairment with beneficial alterations of immune and inflammatory markers as well as intestinal microbiome compositions in MS. These results show that probiotics may have beneficial effects on the prevention and treatment of multiple sclerosis.

The gastrointestinal tract is 80% of our immune system. Whenever you have inflammation present, the tight junctions and intestinal mucosa can become damaged compromising the lining of the GI tract. Then toxic byproducts in the digestive tract can be absorbed into the bloodstream forming immune complexes which eventually affect numerous systems throughout the body causing inflammation, food sensitivities and autoimmune disorders.

Gut bacteria has been identified as an important environmental factor in overall health and all autoimmune disease. Patients may need anti-microbials, botanicals, enzymes, prebiotics, and probiotics to optimize the gastrointestinal environment. 

All practitioners treating patients with autoimmune disorders should consider a comprehensive digestive stool analysis for these individuals, which modern research supports. There are several other factors that play a role in autoimmunity such as, gluten intolerance, food sensitivities, gastrointestinal infections, hormone imbalances, heavy metal toxicity, and nutrient deficiencies (ie. vitamin D, magnesium, EFAs). These environmental influences 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: Jinchi Jiang, Chuanqi Chu, et al. Efficacy of probiotics in multiple sclerosis: a systematic review of preclinical trials and meta-analysis of randomized controlled trials. Food Funct. 2021 Mar 21;12(6):2354-2377.

New study demonstrates the effect of selenium supplementation with newly diagnosed Hashimoto’s thyroiditis

Hashimoto’s is one of the most common autoimmune diseases. Autoimmunity can occur a few different ways, but eventually the thyroid gland progressively becomes underactive due to antibody and cell mediated autoimmune processes.

Environmental triggers are what integrative doctors mainly work with in functional medicine to healthy address the dysfunction in autoimmune disease. These can be food triggers such as gluten or food sensitivities that can trigger inflammation as well as anything coming in with the food such as toxins or molds. In addition, the nutrient status of the person. This can be antioxidant status, vitamins, essential fatty acids, vitamin D, etc. Also, gut health. This includes “leaky gut” and dysbiosis. There are also toxins that can be affect the status of the immune system. These are heavy metals, xenobiotics, as well as the total toxic burden in the body.

There has been a growing interest in dietary supplements for supporting thyroid dysfunction. Many patients with thyroid dysfunction often have underlying autoimmunity or current take medication. Although these individuals may have normal lab values, they are often still symptomatic and looking for additional support. Iodine is most recognized as the major nutrient of the thyroid, however, other nutrients also play an essential role as well.

According to a study published in The International Journal of Clinical Practice, researchers investigated the effects of selenium supplementation in women with newly diagnosed Hashimoto’s thyroiditis in an area with low selenium status.

This study consisted of 29 patients between the ages of 20 and 52 years of age. Laboratory assessment included anti-thyroid peroxidase antibodies, thyroid function markers, selenium as well as antioxidant status as well as a lipid profile and glucose at baseline and the end of the study. Iodine supply and subjective assessment of physical and psychological health were also monitored. Each patient received 100 mcg of selenium for 6 months.

As a result, selenium supplementation significantly reduced anti-thyroid peroxidase antibody levels. The other thyroid markers were within normal range before and at the end of the study.

This study demonstrates a potential protective effect of selenium in limiting development of overt hypothyroidism. In addition, the increase in the concentrations of selenium in the serum of the patients verifies successful supplementation compliance.

Selenium has shown to be beneficial for thyroid dysfunction. When comparing all tissues in the body, the thyroid gland has the highest concentrations of selenium. It is required for normal thyroid function as well as thyroid hormone synthesis. Studies have demonstrated benefits in Graves’ ophthalmopathy.

Other nutrients to consider include vitamin D and myo-inositol.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS Source: Kryczyk-Koziol J, et al. Positive effects of selenium supplementation in women with newly diagnosed Hashimoto’s thyroiditis in an area with low selenium status. Int J Clin Pract. 2021 Sep;75(9):e14484.

New study demonstrates the effects of maternal omega-3 fatty acid supplementation and preterm delivery

Women preparing for pregnancy know the importance of prenatal nutrition including a good prenatal vitamin and dietary folate but may not consider fish oil supplementation as an essential supplement during pregnancy although there are numerous studies demonstrating the effects omega-3 fatty acid supplementation and neurodevelopment. Many adults including pregnant and women preparing for pregnancy do not get as much omega-3 fatty acids as they need.

According to a study published last Thursday in the FASEB Journal, researchers demonstrated that maternal supplementation with omega-3 fatty acid supplementation during pregnancy lowers inflammatory status and increases gestational age and birth weight.

This study investigated the effects of omega-3 fatty acid supplementation in pregnant women who were at risk for preterm delivery. Microvesicles isolated from arterial cord blood were obtained from 100 human newborns. Omega-3 fatty acids are shown to be related to maternal intake due to trans-placental transportation. These newborns were divided into three groups including 60 newborns born at full term, 30 newborns born preterm, and 10 newborns born preterm from women diagnosed with a threatened preterm labor risk and were given 100 mg of omega-3 fatty acid supplementation for at least 2 weeks from the diagnosis. The results demonstrated that maternal intake of omega-3 fatty acids had a positive effect on preterm babies resulting in an increase gestational age of approximately seven days and an increase in birth weight of approximately 110 grams.

These results are consistent with a recent meta-analysis on the effects of omega-3 fatty acid supplementation of 4,193 women with an increased risk of preterm delivery. This review demonstrated a reduced the risk of early preterm delivery by 58%, increasing gestational age by an average of fourteen days and birth weight by 122 grams.

There are also other benefits of omega-3 fatty acid supplementation during pregnancy. Previous research analyzing approximately 19 studies of fish oil supplementation during pregnancy demonstrated that fish oil supplement from 20 weeks pregnant through four months of breastfeeding resulted in a reduced risk of egg allergy by 30% and peanut allergy by 38%.

In addition, fish oil supplementation for 6 weeks was shown to improve biomarkers of oxidative stress and inflammation as well as improves pregnancy outcomes in patients with gestational diabetes including lower incidences of newborn hyperbilirubinemia and hospitalization.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Bruschi M, Santucci L, et al. Association between maternal omega-3 polyunsaturated fatty acids supplementation and preterm delivery: A proteomic study. FASEB J. 2020 Mar 12.

 

 

New review demonstrates the effect of fish oil on adiponectin and leptin levels

Insulin resistance is caused by an impairment of insulin’s action on glucose, protein and fat metabolism, which is associated with adipose tissue. Excessive visceral and subcutaneous fat causes adipocyte dysfunction which leads to inflammation and as a result causes a decrease in adiponectin and an increase in leptin levels.

According to a new review published in Nutrition Research, researchers investigated the effects omega-3 fatty acids on leptin and adiponectin levels.

Mostly all immune cells contain leptin receptors indicating their role in the immune response Leptin has been shown to facilitate the production of the proinflammatory cytokines that have been associated with chronic systemic inflammation in aging.

Adiponectin is a protein hormone that mediates numerous metabolic processes, such as glucose regulation, insulin sensitivity, and mitigating inflammation. It has an inverse relationship with insulin resistance, dyslipidemia, obesity, and cardiovascular disease.

This review consisted of 31 studies including 12 to 1081 participants. Twenty-nine studies used parallel designs and the remaining studies used a crossover design and a 2 ×2 factorial design. Double blinding occurred in 53% of the studies. Five studies were single-blinded and nine studies did not implement blinding. The research team included all studies on omega-3 fatty acid supplementation that reported leptin, adiponectin, or leptin/adiponectin ratio.

As a result, 18 studies demonstrated lower leptin or higher adiponectin levels from omega-3 fatty acid supplementation with 9 showing statistically significant differences. Supplementation doses and duration varied among the studies. In nine studies reporting significantly lower leptin or higher adiponectin levels the omega-3 fatty acid dosage was 520 mg to 4.2 grams day between 4 to 24 weeks in duration.

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. Other dietary supplements that have been shown to be effective for effecting adiponectin and inflammation include tocotrienols, curcumin, and quercetin.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Rausch J, Gillespie S, et al. Systematic review of marine-derived omega-3 fatty acid supplementation effects on leptin, adiponectin, and the leptin-to-adiponectin ratio. Nutr Res. 2020 Nov 17;85:135-152.

 

 

 

 

 

 

New study demonstrates the prevalence of micronutrient deficiencies in children with IBD

Inflammatory bowel disease (IBD) is an autoimmune condition where in most cases there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and the immune system gets into overloaded, overwhelmed state and loses its ability to function leading to chronic inflammation causes symptoms such as diarrhea, abdominal pain, and other debilitating symptoms and anemia.

The current medical research demonstrates the significance of micronutrient deficiencies in inflammatory bowel disease, however, many patients are told that their condition is not related to nutrition or diet.

According to a study published last week in Nutrients, researchers investigated the prevalence of anemia and micronutrient deficiencies adolescents and children with inflammatory bowel disease.

This study consisted of 165 patients under 17 years of age with Crohn’s disease and Ulcerative colitis. Laboratory assessments included iron, ferritin, zinc, vitamin D, vitamin A, vitamin E, selenium, copper, vitamin B12, and folate. These were measured at the time of diagnosis and at a one-year follow-up. Clinical disease activity was assessed using the Physician Global Assessment (PGA) scores at baseline and at the end of the study. The research team found that patients with IBD had multiple nutritional deficiencies at diagnosis with the majority of have improved at follow-up. There was a high prevalence of iron deficiency anemia, which is common in IBD. Other common deficiencies included vitamin D, vitamin A, zinc, selenium, and copper. Anemia was present in 57% at diagnosis and 25% at follow up. Many children with IBD suffer from anemia and micronutrient deficiencies at diagnosis and some fail to recover after one-year despite being in clinical remission.

This study demonstrates that micronutrient deficiencies and anemia are significant

on-going issues in patients with IBD and the importance of testing, nutritional therapeutics, and follow up.  Addressing these deficiencies may make significant improvements in the quality of life.

The research demonstrates the significance nutrition and nutrients and their essential role in chronic disease states. Lifestyle choices and environmental exposures filtered through genetic predisposition are fundamental factors in IBD, and a successful treatment approach must include investigation into these factors.

One must also investigate into the other potential environmental triggers that can cause inflammation such as, food sensitivities, toxins, and molds. Also, stool testing is essential as one can rule of bacterial infections and dysbiosis as well as assess inflammatory, immune, digestion, and absorption markers.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Rempel J, Grover K, et al. Micronutrient Deficiencies and Anemia in Children with

Inflammatory Bowel Disease. Nutrients 15 January 2021, 13(1), 236.

New study investigates the association between vitamin D and allergic diseases in children

Atopic diseases have become more prevalent over the past decade. They are caused by immune system dysfunction, genetic factors, and inherited and acquired skin barrier defects.

Vitamin D deficiency is one of the most common nutritional deficiencies and plays a important role on many chronic diseases. Vitamin D receptors (VDR) are in many different tissues and present in almost all cells of the immune system. Vitamin D has significant immunomodulatory effect and has been shown to inhibit Th1 cells by reducing pro-inflammatory cytokines, such as IL-2, INF-gamma, and TNF-alpha.

According to a new study published last week in Nutrients, researchers investigated the association between vitamin D and allergic diseases in children.

This study included 75 children with an average age of seven with atopic dermatitis and/or asthma. The control group consisted of 37 children without symptoms of allergic disease and without signs of respiratory tract infections. All of the children in the study group were divided into three subgroups including children with mild, moderate, and severe allergic disease. Laboratory assessments included vitamin D levels, phenotype of blood lymphocytes, natural T-regulatory lymphocytes, and cytokines.

As a result, a vitamin D deficiency was significantly more frequent in the group of children with an allergic disease than in the control group. Also, statistically significant higher vitamin D concentrations were seen in children with mild disease compared to children with a severe clinical course. In addition, statistically significant lower percentages of NKT lymphocytes and T-regulatory lymphocytes were in children with a vitamin D deficiency. This demonstrates a potential weakness of the immune system in these individuals. There were also statistically higher levels of interleukin-22 were observed in the children with a vitamin D deficiency suggesting a pro-inflammatory state.

These results show that children with allergies had lower average vitamin D levels compared to that of healthy children. Since the pathophysiology of atopic diseases are multifactorial as with many chronic diseases, there are several nutrients that should be considered to modulate the underlying dysfunction and immune response.

Other nutrients to consider to include fish oil, magnesium, and probiotics. Previous research has shown the intricate interrelationships among magnesium levels and omega-3 fatty acid status on vitamin D concentrations.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS Source: Lipinska-Opalka A, Tomaszewska A et al. Vitamin D and Immunological Patterns of Allergic Diseases in Children. Nutrients 8 January 2021, 13(1), 177.

New review demonstrates the effects of omega 3 fatty acid supplementation on vitamin D levels

Vitamin D and omega-3 fatty acids are essential nutrients involved in numerous metabolic processes that play a significant role in many chronic health conditions. Over the past several years numerous studies have shown that omega-3 fatty acid supplementation can effect serum vitamin D levels, however, the results have been inconsistent. This may have been due to the dose, duration, or statistical power of the studies.

According to a review published two weeks ago in Critical Reviews in Food Science and Nutrition, researchers investigated the effect of omega-3 fatty acid supplementation on vitamin D levels.

This meta-analysis consisted of 10 randomized controlled trials with a total of 601 participants that reported circulating vitamin D levels before and after supplementation with omega-3 fatty acids. As a result, there was a significant increase in vitamin D levels following omega-3 fatty acid intake. Vitamin D levels were significantly increased by approximately 9 ng/ml when supplementation was longer than 8 weeks and when the baseline vitamin D level was less than 20 ng/ml. Also, dosing at 1 gram per day resulted in higher vitamin D levels compared to other dosages but all doses led to an increase in vitamin D levels.

The relationship between vitamin D and omega-3 fatty acids is unclear. Deficiencies or insufficiencies of these two nutrients are important health concerns in clinical practice. This review specifically looked at the effect of omega-3 fatty acids on vitamin D levels, however, it is still optimal to assess both of these nutrients and address accordingly. This study demonstrates the significance of the interrelationships different nutrients have with one another and importance of a comprehensive approach over monotherapies.

Previous research has shown these the intricate interrelationships among the fat soluble vitamins, magnesium and vitamin D levels, and omega-3 fatty acid status and B-vitamins. A study published in 2018 in the American Journal of Clinical Nutrition demonstrated that magnesium can also increase vitamin D levels similarly to omega-3 supplementation. Also, a study published in the Journal of Alzheimer’s Disease demonstrated that B vitamins had no effect on cognitive decline when omega-3 levels are low but when omega-3 levels were in a normal upper range, B vitamins slow cognitive decline and brain atrophy.

By Michael Jurgelewicz, DC, DACBN, DCBCN

Source: Alhabeeb H, Kord-Varkaneh H, et al. The influence of omega-3 supplementation on vitamin D levels in humans: a systematic review and dose-response meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2020 Dec 25;1-8.

 

New review demonstrates the effectiveness of nutritional interventions for the prevention of cognitive impairment

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%.

According to a new review published two weeks ago in Critical Reviews in Food Science and Nutrition, researchers investigated the current evidence on nutritional interventions for the prevention of dementia.

This review included 18 randomized controlled trials. Nutritional interventions of cognitive impairment were identified including micronutrients supplementation, nutritional and lifestyle counseling, and fish supplementation. The sample size ranged from 20 to 640 participants with a duration of two weeks to 6 months. As a result, fifteen studies demonstrated significant beneficial effects on cognition. These results were with essential fatty acids (EPA/DHA) and micronutrient supplementation on specific cognitive domains including attention and orientation, perception, verbal functions, and language skills. Greater effects were seen in older subjects with cognitive impairment. In addition, supplementation with B-vitamins specifically folate and vitamin B12 and essential fatty acids demonstrated promising effects to minimize age-related cognitive decline.

Most of the studies using supplementation with micronutrients were based on the hypothesis that lowering homocysteine plasma levels with B-vitamin supplementation could prevent cognitive impairment. Homocysteine levels are an indicator of a potential vitamin B6, folate or B12 deficiency and are a modifiable risk factor for cognitive decline.

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

Each person’s biochemical individuality exerts a major influence on his or her health. 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, CNS

Source: McGrattan A, van Aller C, et al. Nutritional interventions for the prevention of cognitive impairment and dementia in developing economies in East-Asia: a systematic review and meta-analysis. Critical Reviews in Food Science and Nutrition. 2020. Dec 18;1-18.doi: 10.1080/10408398.2020.1848785.

 

 

New study demonstrates the efficacy of the Specific Carbohydrate Diet in patients with Crohn’s disease

Inflammatory bowel disease (IBD) is an autoimmune condition where in most cases there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and the immune system gets into overloaded, overwhelmed state and loses its ability to function leading to chronic inflammation causes symptoms such as diarrhea, abdominal pain, and other debilitating symptoms and anemia.

Traditional IBD treatments focus on altering immunological function with minimal investigation on the microbiome and intestinal barrier function.

According to a study published last week Nutrients, researchers investigated the efficacy of 3 versions of the specific carbohydrate diet (SCD) in active Crohn’s disease. The SCD was created by Sydney Haas MD, a pediatrician, to treat celiac disease. This diet eliminates all grains, sugars (except honey), all milk products (except for hard cheeses and fermented yogurt) and most processed foods.

This was a single center, double-blind study in 10 pediatric patients with mild to moderate Crohn’s disease between the ages of 7 to 18. Each Patient was randomized to either the SCD, a modified SCD including both oats and rice, or a whole foods diet. Patients were evaluated at baseline, 2, 4, 8 and at 12 weeks. Assessments included the Pediatric Crohn’s Disease Activity Index (PCDAI), CBC, C-reactive protein, ESR, albumin, stool testing, and multi-omics analysis. For the first 2 weeks, all patients went on a strict SCD after and were placed onto their randomized diet. Each Patient received nutritional counseling by a dietitian. Before each visit, patients completed a 3-day food diary to ensure compliance to the diet. Patient meals were provided and prepared by a study chef. Also, patients received a list of SCD allowed foods during the study.

As a results, at twelve weeks all of the participants achieved clinical remission. C-reactive protein levels significantly decreased in all three groups. In addition, the microbiome composition shifted in every patient over the twelve-week period. These results emphasize the significant impact diet and nutrient play in Crohn’s disease. Each diet had a significant effect on disease severity as well as on inflammatory biomarkers. The more restrictive diets were associated with the largest reductions in inflammation.

For additional support, high dose probiotics, fish oil, curcumin, glutamine, and mucilaginous botanicals can be helpful in immunomodulation and for their anti-inflammatory properties. Other common insufficiencies include magnesium, vitamin D, and iron.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Suskind D, Lee D, et al. The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn’s Disease: A Randomized Diet Controlled Trial. Nutrients 6 December 2020, 12(12), 3729