Effects of an open-label pilot study with high-dose EPA/DHA concentrates on plasma phospholipids and behavior in children with attention deficit hyperactivity disorder

Nutrition Journal 2007, 6:16 doi:10.1186/1475-2891-6-16 Paul J Sorgi ([email protected]) Edward M Hallowell ([email protected]) Heather L Hutchins ([email protected]) Barry Sears ([email protected]) Background: Attention deficit hyperactivity disorder (ADHD) is the most common neurological condition in children. This pilot study evaluated the effects of high-dose eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on the isolated plasma phospholipids and behavior in children with ADHD (primarily inattentive subtype and combined subtype). Methods: Nine children were initially supplemented with 16.2g EPA/DHA concentrates per day. The dosage was adjusted dependent on the ratio of arachidonic acid (AA) to EPA in the isolated plasma phospholipids at four weeks to reach a level normally found in the Japanese population. Results: At the end of the eight-week study, supplementation resulted in significant increases in EPA and DHA, as well as a significant reduction in the AA:EPA ratio (20.78±5.26 to 5.95±7.35, p<0.01). A psychiatrist (blind to supplement compliance or dosage modifications)reported significant improvements in behavior (inattention, hyperactivity, oppositional/defiant behavior, and conduct disorder). There was also a significant correlation between the reduction in the AA:EPA ratio and global severity of illness scores. Conclusions: The findings of this small pilot study suggest supplementation with high-dose EPA/DHA concentrates may improve behavior in children with ADHD.

Abstract

The Oxford-Durham Study: A Randomized, Controlled Trial of Dietary Supplementation With Fatty Acids in Children With Developmental Coordination Disorder Alexandra J. Richardson, DPhil(Oxon)*, and Paul Montgomery, DPhil(Oxon)‡§ ABSTRACT Background. Developmental coordination disorder (DCD) affects 5% of school-aged children. In addition to the core deficits in motor function, this condition is associated commonly with difficulties in learning, behavior, and psychosocial adjustment that persist into adulthood. Mounting evidence suggests that a relative lack of certain polyunsaturated fatty acids may contribute to related neurodevelopmental and psychiatric disorders such as dyslexia and attention-deficit/hyperactivity disorder. Given the current lack of effective, evidence-based treatment options for DCD, the use of fatty acid supplements merits investigation. Methods. A randomized, controlled trial of dietary supplementation with -3 and -6 fatty acids, compared with placebo, was conducted with 117 children with DCD (5–12 years of age). Treatment for 3 months in parallel groups was followed by a 1-way crossover from placebo to active treatment for an additional 3 months. Results. No effect of treatment on motor skills was apparent, but significant improvements for active treatment versus placebo were found in reading, spelling, and behavior over 3 months of treatment in parallel groups. After the crossover, similar changes were seen in the placebo-active group, whereas children continuing with active treatment maintained or improved their progress. Conclusions. Fatty acid supplementation may offer a safe efficacious treatment option for educational and behavioral problems among children with DCD. Additional work is needed to investigate whether our inability to detect any improvement in motor skills reflects the measures used and to assess the durability of treatment effects on behavior and academic progress. Pediatrics 2005;115:1360–1366; developmental coordination disorder, fish oil, supplementation, RCT, reading, spelling, behavior, omega-3 fatty acids, dyspraxia.

• המחסור באומגה 3
• עודף באומגה 6
• עודף סוכר ועמילן
• כיצד ניתן לחיות ללא תרופות על ידי תזונה נכונה

Is folic acid good for everyone? 1,2 A David Smith, Young-In Kim, and Helga Refsum

ABSTRACT

Fortification of food with folic acid to reduce the number of neural tube defects was introduced 10 y ago in North America. Many countries are considering whether to adopt this policy. When fortification is introduced, several hundred thousand people are exposed to an increased intake of folic acid for each neural tube defect pregnancy that is prevented. Are the benefits to the few outweighed by possible harm to some of the many exposed? In animals, a folic acid–rich diet can influence DNA and histone methylation, which leads to phenotypic changes in subsequent generations. In humans, increased folic acid intake leads to elevated blood concentrations of naturally occurring folates and of unmetabolized folic acid. High blood concentrations of folic acidmaybe related to decreased natural killer cell cytotoxicity, and high folate status may reduce the response to antifolate drugs used against malaria, rheumatoid arthritis, psoriasis, and cancer. In the elderly, a combination of high folate levels and low vitamin B-12 status may be associated with an increased risk of cognitive impairment and anemia and, in pregnant women, with an increased risk of insulin resistance and obesity in their children. Folate has a dual effect on cancer, protecting against cancer initiation but facilitating progression and growth of preneoplastic cells and subclinical cancers, which are common in the population. Thus, a high folic acid intake may be harmful for some people. Nations considering fortification should be cautious and stimulate further research to identify the effects, good and bad, caused by a high intake of folic acid from fortified food or dietary supplements. Only then can authorities develop the right strategies for the population as a whole. Am J Clin Nutr 2008;87:517–33

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Is folic acid good for everyone? 1,2

A David Smith, Young-In Kim, and Helga Refsum

Fortification of food with folic acid to reduce the number of neural tube defects was introduced 10 y ago in North America. Many countries are considering whether to adopt this policy.

When fortification is introduced, several hundred thousand people are exposed to an increased intake of folic acid for each neural tube defect pregnancy that is prevented. Are the benefits to the few outweighed by possible harm to some of the many exposed?

In animals, a folic acid–rich diet can influence DNA and histone methylation, which leads to phenotypic changes in subsequent generations. In humans, increased folic acid intake leads to elevated blood concentrations of naturally occurring folates and of unmetabolized folic acid.

High blood concentrations of folic acidmaybe related to decreased natural killer cell cytotoxicity, and high folate status may reduce the response to antifolate drugs used against malaria, rheumatoid arthritis, psoriasis, and cancer. In the elderly, a combination of high folate levels and low vitamin B-12 status may be associated with an increased risk of cognitive impairment and anemia and, in pregnant women, with an increased risk of insulin resistance and obesity in their children. Folate has a dual effect on cancer, protecting against cancer initiation but facilitating progression and growth of preneoplastic cells and subclinical cancers, which are common in the population.

Thus, a high folic acid intake may be harmful for some people. Nations considering fortification should be cautious and stimulate further research to identify the effects, good and bad, caused by a high intake of folic acid from fortified food or dietary supplements. Only then can authorities develop the right strategies for the population as a whole.

Am J Clin Nutr 2008;87:517–33

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Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease Richard J Johnson, Mark S Segal, Yuri Sautin, Takahiko Nakagawa, Daniel I Feig, Duk-Hee Kang, Michael S Gersch, Steven Benner, and Laura G Sa´nchez-Lozada

ABSTRACT Currently, we are experiencing an epidemic of cardiorenal disease characterized by increasing rates of obesity, hypertension, the metabolic syndrome, type 2 diabetes, and kidney disease. Whereas excessive caloric intake and physical inactivity are likely important factors driving the obesity epidemic, it is important to consider additional mechanisms.

We revisit an old hypothesis that sugar, particularly excessive fructose intake, has a critical role in the epidemic of cardiorenal disease. We also present evidence that the unique ability of fructose to induce an increase in uric acid may be a major mechanism by which fructose can cause cardiorenal disease.

Finally, we suggest that high intakes of fructose in African Americans may explain their greater predisposition to develop cardiorenal disease, and we provide a list of testable predictions to evaluate this hypothesis.

Am J Clin Nutr 2007;86:899 –906.

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Hyperinsulinemic diseases of civilization: more than just Syndrome X Loren Cordain*, Michael R. Eades, Mary D. Eades Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA Received 27 June 2002; received in revised form 23 December 2002; accepted 3 January 2003

Abstract Compensatory hyperinsulinemia stemming from peripheral insulin resistance is a well-recognized metabolic disturbancethat is at the root cause of diseases and maladies of Syndrome X (hypertension, type 2 diabetes, dyslipidemia, coronary artery disease, obesity, abnormal glucose tolerance).

Abnormalities of fibrinolysis and hyperuricemia also appear to be members of the cluster of illnesses comprising Syndrome X. Insulin is a well-established growth-promoting hormone, and recent evidence indicates that hyperinsulinemia causes a shift in a number of endocrine pathways that may favor unregulated tissue growth leading to additional illnesses.

Specifically, hyperinsulinemia elevates serum concentrations of free insulin-like growth factor-1 (IGF-1) and androgens, while simultaneously reducing insulin-like growth factor-binding protein 3 (IGFBP-3) and sex hormone-binding globulin (SHBG).

Since IGFBP-3 is a ligand for the nuclear retinoid X receptor a, insulin-mediated reductions in IGFBP-3 may also influence transcription of anti-proliferative genes normally activated by the body’s endogenous retinoids.

These endocrine shifts alter cellular proliferation and growth in a variety of tissues, the clinical course of which may promote acne, early menarche, certain epithelial cell carcinomas, increased stature, myopia, cutaneous papillomas (skin tags), acanthosis nigricans, polycystic ovary syndrome (PCOS) and male vertex balding.

Consequently, these illnesses and conditions may, in part, have hyperinsulinemia at their root cause and therefore should be classified among the diseases of Syndrome X. 2003 Elsevier Science Inc. All rights reserved.

Keywords: Acne; Early menarche; Epithelial cell carcinomas; Hyperinsulinemia; Increased stature; Myopia; Cutaneous papillomas (skin tags); Acanthosis nigricans; Polycystic ovary syndrome; Male vertex balding.

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Surprises from Celiac Disease

Study of a potentially fatal food-triggered disease has uncovered a process that may contribute to many autoimmune disorders

By Alessio Fasano

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Review Article

Cocoa and health: a decade of research

Karen A. Cooper1, Jennifer L. Donovan2, Andrew L. Waterhouse3 and Gary Williamson1* 1Nestle´ Research Center, Vers-Chez-les-Blanc, PO Box 44, CH-1000 Lausanne 26, Switzerland 2Department of Psychiatry and Behavioural Sciences, Medical University of South Carolina, Charleston, SC 29425, USA 3Department of Viticulture & Enology, University of California, Davis, CA 95616, USA (Received 5 December 2006 – Revised 29 May 2007 – Accepted 31 May 2007)

It has been over 10 years since the first mention in a medical journal about cocoa and chocolate as potential sources of antioxidants for health.

During this time, cocoa has been found to improve antioxidant status, reduce inflammation and correlate with reduced heart disease risk; with these results, and its popularity, it has received wide coverage in the press

However, after 10 years of research, what is known about the potential health benefits of cocoa and what are the important next steps in understanding this decadent source of antioxidants?

Cocoa: Chocolate: Health: Polyphenols: Antioxident

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DOI: 10.7860/JCDR/2012/4464.2535

Journal of Clinical and Diagnostic Research. 2012 November, Vol-6(9): 1469-1473

Study of Comparative Effects of Antioxidants on Insulin Sensitivity in Type 2 Diabetes Mellitus

A.S. Udupa, P.S. Nahar, S.H. Shah, M.J. Kshirsagar, B.B. Ghongane

ABSTRACT

Objectives: This study intended to assess the effects of the antioxidants; Alpha Lipoic Acid (ALA), omega 3 fatty acids and vitamin E on the parameters of insulin sensitivity, oxidative stress, lipid metabolism and glycaemic control in patients of type 2 diabetes mellitus.

Methods: This was a prospective, randomized, double blind, placebo controlled, single centred study. One hundred four patients with type 2 diabetes mellitus with insulin resistance were recruited for the study. They were given ALA, omega 3 fatty acids, vitamin E or placebo. Their weight, Body Mass Index (BMI) and Waist circumference were measured. The investigations which were fasting glucose and fasting total cholesterol. The insulin resistance was calculated on the basis of the BMI and the waist circumference.

Results: In the intra group analysis at the baseline (V1) vs at the end of the treatment period (V5), we observed a significant decrease in the BMI, waist circumference and the total cholesterol in the three treatment groups. In the intergroup analysis at V5, ALA, omega 3 fatty acids and vitamin E showed a significant improvement in the total cholesterol as compared to the placebo and vitamin E showed the maximum improvement.

Conclusion: ALA, omega 3 fatty acids and vitamin E showed the improvement in insulin sensitivity. Since they differ in improving different parameters all of these three can be used as an add on therapy in patients with type 2 diabetes mellitus to improve their insulin sensitivity and lipid metabolism.

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Omega-3 Fatty Acids and Athletics Artemis P. Simopoulos, MD Current Sports Medicine Reports 2007, 6:230–236 Current Medicine Group LLC ISSN 1537-890x

Human beings evolved consuming a diet that contained about equal amounts of n-6 and n-3 essential fatty acids. Today, in Western diets, the ratio of n-6 to n-3 fatty acids ranges from approximately 10:1 to 20:1 instead of the traditional range of 1:1 to 2:1.

Studies indicate that a high intake of n-6 fatty acids shifts the physiologic state to one that is prothrombotic and proaggregatory, characterized by increases in blood viscosity, vasospasm, and vasoconstriction, and decreases in bleeding time. ?-3 fatty acids, however, have anti-inflammatory, antithrombotic, antiarrhythmic, hypolipidemic, and vasodilatory properties.

Excessive radical formation and trauma during high-intensity exercise leads to an inflammatory state that is made worse by the increased amount of n-6 fatty acids in Western diets, although this can be counteracted by eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

For the majority of athletes, especially those at the leisure level, general guidelines should include EPA and DHA of about 1 to 2 g/d at a ratio of EPA:DHA of 2:1.

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a b s t r a c t

Purpose: Epidemiologic and experimental studies suggest that dietary fat intake may affect risk of pancreatic cancer, but published results are inconsistent.

Methods: We examined risk associations for specific types of dietary fat intakes and related food sources among 111,416 participants in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. We used Cox proportional hazards regression to examine associations between fat intake and pancreatic cancer risk.

Results: Over a mean 8.4 years of follow-up, 411 pancreatic cancer cases were identified. We observed an inverse association between saturated fat intake and pancreatic cancer risk (hazard ratio [HR], 0.64 comparing extreme quintiles; 95% confidence interval [CI], 0.46e0.88), but the association became weaker and nonsignificant when individuals with fewer than 4 years of follow-up were excluded to avoid possible reverse causation (HR, 0.88; 95% CI, 0.58e1.33). Total fat intake showed a similar pattern of association, whereas intakes of monounsaturated and polyunsaturated fats and fats from animal or plant sources showed no associations with risk.

Conclusions: These results do not support the hypothesis of increased pancreatic cancer risk with higher fat consumption overall or by specific fat type or source. Dietary changes owing to undetected disease may explain the observed inverse association with saturated fat.

In conclusion, our findings do not support a positive association between dietary fat intake and risk of pancreatic cancer. Instead we observed an inverse association that was attenuated with exclusion of cases with shorter term follow-up. Our results highlight the need to carefully examine possible reverse causation in studies of diet and pancreatic malignancy and the importance of basing conclusions on a body of evidence from studies with longer term follow-up.

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Effects of the brown rice diet on visceral obesity and endothelial function: the BRAVO study. Shimabukuro M, Higa M, Kinjo R, Yamakawa K, Tanaka H, Kozuka C, Yabiku K, Taira SI, Sata M, Masuzaki H.

Source

Department of Cardio-Diabetes Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.

Abstract

Brown rice (BR) and white rice (WR) produce different glycaemic responses and their consumption may affect the dietary management of obesity. In the present study, the effects of BR and WR on abdominal fat distribution, metabolic parameters and endothelial function were evaluated in subjects with the metabolic syndrome in a randomised cross-over fashion. In study 1, acute postprandial metabolic parameters and flow- and nitroglycerine-mediated dilation (FMD and NMD) of the brachial artery were determined in male volunteers with or without the metabolic syndrome after ingestion of either BR or WR. The increases in glucose and insulin AUC were lower after ingestion of BR than after ingestion of WR (P= 0·041 and P= 0·045, respectively). FMD values were decreased 60 min after ingestion of WR (P= 0·037 v. baseline), but the decrease was protected after ingestion of BR. In study 2, a separate cohort of male volunteers (n 27) with the metabolic syndrome was randomised into two groups with different BR and WR consumption patterns. The values of weight-based parameters were decreased after consumption of BR for 8 weeks, but returned to baseline values after a WR consumption period. Insulin resistance and total cholesterol and LDL-cholesterol levels were reduced after consumption of BR. In conclusion, consumption of BR may be beneficial, partly owing to the lowering of glycaemic response, and may protect postprandial endothelial function in subjects with the metabolic syndrome. Long-term beneficial effects of BR on metabolic parameters and endothelial function were also observed.