Naturopathic care can improve
blood sugar, mood in diabetes patients

Holistic approach added to benefits of usual care
in joint Group Health–Bastyr University study

Seattle (April 18, 2012)—A new joint study by Group Health Research Institute and Bastyr University Research Institute found that type 2 diabetes patients who received naturopathic care (as an adjunct to conventional care) had lower blood-sugar levels, better eating and exercise habits, improved moods, and a stronger sense of control over their condition than did patients receiving only conventional care.

The findings, published today in BMC Complementary and Alternative Medicine, show that complementary and alternative medicine (CAM) may have several positive effects on people with type 2 diabetes, which affects nearly 26 million Americans.

“The news is encouraging for those fighting the disease,” said Ryan Bradley, ND, MPH, director of the Center for Diabetes and Cardiovascular Wellness at Bastyr University and its clinic, the Bastyr Center for Natural Health. “Patients involved in the study cited the benefits of trying different approaches to find the best ways to minimize the effects of type 2 diabetes. In many ways, that strategy mirrors our partnership with Group Health in this research study—working together to discover the best possible solutions.”

Forty study participants received counseling on diet, exercise, and glucose monitoring from four naturopathic physicians (NDs) in addition to conventional diabetes care from their medical doctors, including prescription medications. Many of the participants also received stress-management care and dietary supplements. Researchers then compared these 40 participants with 329 patients receiving only conventional diabetes care.

In six months and about four naturopathic treatment visits, participants demonstrated improved self-care, more consistent monitoring of glucose, and improved moods. Hemoglobin A1c rates (a measure of blood-sugar control) were nearly a full percentage point lower for those patients. This compares with a drop of only 0.5 percent over the same time period for 329 clinically similar patients receiving only conventional diabetes care. The encouraging findings from this small observational study will need to be confirmed by a randomized trial with larger numbers of participants, according to Dr. Bradley.

Finding more effective ways of treating type 2 diabetes is important because it is one of the top-10 causes of death in Americans and is costly to treat: $1 out of every $10 spent on health care in the United States is used to fight type 2 diabetes, at a cost of $178 billion every year.

“Our number-one goal is to help patients,” added Daniel Cherkin, PhD, a senior investigator at Group Health Research Institute. “Collaboration with our research colleagues at Bastyr University allows us to explore a broader range of ways to help meet the needs of our patients.”

Source: Group Health Research Institute

Survey Finds Supplement Use on the Rise

Survey also finds consumer confidence remains steady at 84 percent

WASHINGTON, March 13, 2012 -- Sixty-nine percent of U.S. adults take dietary supplements according to a survey commissioned by the Council for Responsible Nutrition (CRN), the dietary supplement industry's leading trade association. Conducted by Ipsos Public Affairs, the survey indicates an upward trend in dietary supplement consumption, as consumer usage is up from 66 percent in 2010, 65 percent in 2009, and 64 percent in 2008.

Further, consumer confidence in dietary supplements remains steady, as the survey also finds that 84 percent of adults are confident in the safety, quality and effectiveness of supplements, with 82 percent in 2010 and 84 percent in 2009 indicating as such.

Additional 2011 survey findings:

Consumers take a variety of supplements: While most supplement users take "Vitamin/Mineral supplements" (67 percent), sizeable percentages also report taking "Specialty Supplements" (35 percent), "Herbals/Botanicals" (23 percent), and "Sports Nutrition Supplements" (17 percent).

Among "specialty supplements," fish is first: The use of Omega-3/fish oil supplements increased by two percent, from 21 percent in 2010 to 23 percent in 2011. The next two most popular in the category were Glucosamine and/or Chondroitin (8 percent) and fiber (8 percent).

More consumers take their letter vitamins: Vitamin D (22 percent vs. 19 percent in 2010), vitamin C (22 percent vs. 19 percent in 2010) and vitamin B/B complex (17 percent vs. 14 percent in 2010).

Multivitamins are still the most popular: Seventy-one percent of supplement users take a multivitamin; 53 percent report taking a multivitamin daily. Forty-nine percent of all adults reports taking multivitamins.

Part of a healthy lifestyle: "Overall health/wellness benefits" is the main reason why adults take supplements (40 percent), followed by "fill in nutrient gaps in my diet" (29 percent). When it comes to supplements, women lead the charge: The survey noted that women are more likely to be supplement users than men (74 percent vs. 64 percent, respectively).

Supplement use grows with age: Generationally, while 60 percent of adults aged 18-34 take supplements, the percentage increases to 69 percent among those aged 35-54, and to 78 percent among those 55 and over.

According to Judy Blatman, senior vice president, communications, CRN, the steady rise in supplement usage is indicative of a savvier, more health-conscience consumer. "As more consumers are educated about the role vitamins and other supplements play in their overall health and wellness, they are incorporating them into their lives along with other healthy practices such as trying to eat a healthy diet and getting regular exercise," said Ms. Blatman.

The 2011 CRN Consumer Survey on Dietary Supplements was conducted August 25-29, 2011 by Ipsos Public Affairs and funded by CRN. The survey was conducted online and included a national sample of 2,015 adults aged 18 and older from Ipsos' U.S. online panel. The survey has been conducted annually since 2000. Weighting was employed to balance demographics and ensure that the sample's composition reflects that of the U.S. adult population according to Census data and to provide results intended to approximate the sample universe. A survey with an unweighted probability sample of this size would have an estimated margin of error of +/- 2.2 percentage points.

 

Lifelong brain-stimulating habits linked to lower Alzheimer’s protein

A new study led by researchers at the University of California, Berkeley, provides even more reason for people to read a book or do a puzzle, and to make such activities a lifetime habit.

Brain scans revealed that people with no symptoms of Alzheimer’s who engaged in cognitively stimulating activities throughout their lives had fewer deposits of beta-amyloid, a destructive protein that is the hallmark of the disease.

While previous research has suggested that engaging in mentally stimulating activities – such as reading, writing and playing games – may help stave off Alzheimer’s later in life, this new study identifies the biological target at play. This discovery could guide future research into effective prevention strategies.

“These findings point to a new way of thinking about how cognitive engagement throughout life affects the brain,” said study principal investigator Dr. William Jagust, a professor with joint appointments at UC Berkeley’s Helen Wills Neuroscience Institute, the School of Public Health and Lawrence Berkeley National Laboratory. “Rather than simply providing resistance to Alzheimer’s, brain-stimulating activities may affect a primary pathological process in the disease. This suggests that cognitive therapies could have significant disease-modifying treatment benefits if applied early enough, before symptoms appear.”

An estimated 5.4 million Americans live with Alzheimer’s disease, but the numbers are growing as baby boomers age. Between 2000 and 2008, deaths from Alzheimer’s increased 66 percent, making it the sixth-leading killer in the country. There is currently no cure, but a draft of the first-ever National Alzheimer’s Plan, released this week, revealed that the U.S. government is aiming for effective Alzheimer’s treatments by 2025.

The new study, published Jan. 23 in the Archives of Neurology, puts the spotlight on amyloid – protein fibers folded into tangled plaques that accumulate in the brain. Beta-amyloid is considered the top suspect in the pathology of Alzheimer’s disease, so finding a way to reduce its development has become a major new direction of research.

A molecular model of amyloid protein fibrils. Formed when mis-folded proteins self-assemble into fibrous sheet structures, they are found in the brains of sufferers of Alzheimer's disease. The researchers note that the buildup of amyloid can also be influenced by genes and aging – one-third of people age 60 and over have some amyloid deposits in their brain – but how much reading and writing one does is under each individual’s control.

“This is the first time cognitive activity level has been related to amyloid buildup in the brain,” said study lead author Susan Landau, research scientist at the Helen Wills Neuroscience Institute and the Berkeley Lab. “Amyloid probably starts accumulating many years before symptoms appear. So it’s possible that by the time you have symptoms of Alzheimer’s, like memory problems, there is little that can be done to stop disease progression. The time for intervention may be much sooner, which is why we’re trying to identify whether lifestyle factors might be related to the earliest possible changes.”

The researchers asked 65 healthy, cognitively normal adults aged 60 and over (average age was 76) to rate how frequently they participated in such mentally engaging activities as going to the library, reading books or newspapers, and writing letters or email. The questions focused on various points in life from age 6 to the present.

The participants took part in extensive neuropsychological testing to assess memory and other cognitive functions, and received positron emission tomography (PET) scans at the Berkeley Lab using a new tracer called Pittsburgh Compound B that was developed to visualize amyloid. The results of the brain scans of healthy older individuals with various levels of lifetime cognitive activity were compared with those of 10 patients diagnosed with Alzheimer’s disease and 11 healthy people in their 20s.

The researchers found a significant association between higher levels of cognitive activity over a lifetime and lower levels of beta-amyloid in the PET scans. They analyzed the impact of other factors such as memory function, physical activity, self-rated memory ability, level of education and gender, and found that lifelong cognitive engagement was independently linked to amyloid deposition.

Notably, the researchers did not find a strong connection between amyloid deposition and levels of current cognitive activity alone.

“What our data suggests is that a whole lifetime of engaging in these activities has a bigger effect than being cognitively active just in older age,” said Landau.

The researchers are careful to point out that the study does not negate the benefits of kicking up brain activity in later years.

“There is no downside to cognitive activity. It can only be beneficial, even if for reasons other than reducing amyloid in the brain, including social stimulation and empowerment,” said Jagust. “And actually, cognitive activity late in life may well turn out to be beneficial for reducing amyloid. We just haven’t found that connection yet.”

Other study authors include researchers from UC San Francisco’s Memory and Aging Center and Department of Neurology, and Rush University Medical Center’s Alzheimer’s Disease Center in Chicago.

The National Institutes of Health and the Alzheimer’s Association helped support this research. (January 23, 2012)

 

CRN Calls New Study on Supplements and Mortality "A Hunt For Harm"

WASHINGTON -- In response to the stud, "Dietary Supplements and Mortality Rate in Older Women," published in the Archives of Internal Medicine, the Council for Responsible Nutrition (CRN), a trade association representing the dietary supplement industry, issued the following two-part statement:

Statement by Duffy MacKay, N.D., vice president, scientific and regulatory affairs, CRN:

"Dietary supplements are used by more than 150 million Americans in combination with other healthy lifestyle habits such as trying to eat a healthy diet and exercising regularly. Research consistently shows that dietary supplement users are higher educated, have higher income levels, and are more likely to engage in other healthy practices than non-supplement users.

This study did not discount those facts, and expressly noted that supplement users were more likely to be physically active, more likely to have a lower BMI and waist-to-hip ratio, and have a lower prevalence of smoking, high blood pressure, and diabetes mellitus. The authors note in their article that '...dietary supplements are commonly taken to prevent chronic disease...' The statement would be more accurate with the addition of one word: dietary supplements are commonly taken to help prevent chronic disease. In other words, dietary supplements should not be expected, in and of themselves, and without the synergy of other healthy habits, to prevent chronic disease.

This study, however, attempts to tease out one piece of the healthy equation for good health—dietary supplements. CRN maintains that nutrients may be robbed of their beneficial effects when viewed as if they were pharmaceutical agents, with scientists looking to isolate those effects, good or bad. It's important to keep in mind that this is an associative—not a cause and effect—study.

Further, the authors themselves have noted additional limitations. In fact, when the authors did their initial [minimum adjusted] analysis, it appears they actually found benefit for many of the supplements, not just calcium; yet instead of stopping there, they went on to 'further adjust' the data, possibly until they found statistics worthy of this publication's acceptance. The study may make for interesting scientific water cooler discussion, but certainly does not warrant sweeping, overstated concerns for elderly women.

Further, the authors show their own bias with this statement: 'We recommend that they [dietary supplements] be used with strong medically-based cause, such as symptomatic nutrient deficiency...' which basically means these researchers would rather wait till we all get scurvy before acknowledging any need for supplemental nutrients.

Our advice to consumers: your best chance for living a long and healthy life is to engage in healthy lifestyle practices, and many in the scientific community maintain that rational, reasonable use of vitamins and other supplements is part of that equation. Talk to your doctor, or other healthcare practitioner, if you have concerns—but read between the lines of individual studies and don't make your decisions—either for or against supplements—based solely on hype."

 

Doctors, Nurses Often Use Holistic Medicine for Themselves

By Milly Dawson, Contributing Writer
Health Behavior News Service

U.S. health care workers, especially doctors and nurses, use complementary and alternative medicine (CAM) far more than do workers in other fields, according to a new study. CAM includes diverse therapies outside the realm of conventional medicine. Overall, 76 percent of health care workers report CAM usage, compared with 63 percent of the general working population.

Health care workers use chiropractic treatment, massage and acupuncture for conditions that conventional medicine does not address well, said study co-author Lori Knutson, executive director of the Penny George Institute for Health and Healing with Allina Hospitals and Clinics in Minneapolis. While conventional providers often treat common issues such as back pain with pain medication, holistic providers address root causes, she said.

The study looked at practitioner-based CAM, such as acupuncture; self-treatment with CAM, such as practicing Pilates; and any CAM usage such as following a vegetarian diet, meditating and taking certain herbs.

Doctors and nurses had more than twice the odds of having used a practitioner-based CAM method during the prior year and nearly three times the use of self-treatment with CAM than support workers.

“As insiders, health care workers understand what’s missing in our medical system. They’re more educated than others about orthodox and alternative medicine,” said Joya Lynn-Schoen, M.D., a psychiatrist by training who instead practices alternative medicine, offering patients homeopathy, nutrition and chelation therapies. “Mainstream medicine will say, ‘Here’s a pill’ or ‘Have an operation” or ‘There’s nothing wrong with you. You’re just tired.’

(August 19, 2011)

 

Walking Slows Progression of Alzheimer's

Walking may slow cognitive decline in adults with mild cognitive impairment (MCI) and Alzheimer's disease, as well as in healthy adults, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

"We found that walking five miles per week protects the brain structure over 10 years in people with Alzheimer's and MCI, especially in areas of the brain's key memory and learning centers," said Cyrus Raji, Ph.D., from the Department of Radiology at the University of Pittsburgh in Pennsylvania. "We also found that these people had a slower decline in memory loss over five years."

Alzheimer's disease is an irreversible, progressive brain disease that slowly destroys memory and cognitive skills. According to the National Institute on Aging, between 2.4 million and 5.1 million Americans have Alzheimer's disease. Based on current population trends, that number is expected to increase significantly over the next decade.

In cases of MCI, a person has cognitive or memory problems exceeding typical age-related memory loss, but not yet as severe as those found in Alzheimer's disease. About half of the people with MCI progress to Alzheimer's disease.

"Because a cure for Alzheimer's is not yet a reality, we hope to find ways of alleviating disease progression or symptoms in people who are already cognitively impaired," Dr. Raji said.

For the ongoing 20-year study, Dr. Raji and colleagues analyzed the relationship between physical activity and brain structure in 426 people, including 299 healthy adults (mean age 78), and 127 cognitively impaired adults (mean age 81), including 83 adults with MCI and 44 adults with Alzheimer's dementia.

Patients were recruited from the Cardiovascular Health Study. The researchers monitored how far each of the patients walked in a week. After 10 years, all patients underwent 3-D MRI exams to identify changes in brain volume.

"Volume is a vital sign for the brain," Dr. Raji said. "When it decreases, that means brain cells are dying. But when it remains higher, brain health is being maintained."

In addition, patients were given the mini-mental state exam (MMSE) to track cognitive decline over five years. Physical activity levels were correlated with MRI and MMSE results. The analysis adjusted for age, gender, body fat composition, head size, education and other factors.

The findings showed across the board that greater amounts of physical activity were associated with greater brain volume. Cognitively impaired people needed to walk at least 58 city blocks, or approximately five miles, per week to maintain brain volume and slow cognitive decline. The healthy adults needed to walk at least 72 city blocks, or six miles, per week to maintain brain volume and significantly reduce their risk for cognitive decline.

Over five years, MMSE scores decreased by an average of five points in cognitively impaired patients who did not engage in a sufficient level of physical activity, compared with a decrease of only one point in patients who met the physical activity requirement.

"Alzheimer's is a devastating illness, and unfortunately, walking is not a cure," Dr. Raji said. "But walking can improve your brain's resistance to the disease and reduce memory loss over time."

 

Vitamin B12 may protect brain

Brain scans of those with high B12 levels (right) and those with low B12 levels (left).

Vitamin B12, a nutrient found in meat, fish and milk, may protect against brain volume loss in older people, according to a University of Oxford study.

For the study, 107 people between the ages of 61 and 87 underwent brain scans, memory testing and physical exams. The researchers from the Oxford Project to Investigate Memory and Ageing (OPTIMA) also collected blood samples to check vitamin B12 levels. Brain scans and memory tests were also performed again five years later.

The study, published in the journal Neurology, found that people who had higher vitamin B12 levels were six times less likely to experience brain shrinkage compared with those who had lower levels of the vitamin in their blood. None of the people in the study had vitamin B12 deficiency.

"Many factors that affect brain health are thought to be out of our control, but this study suggests that simply adjusting our diets to consume more vitamin B12 through eating meat, fish, fortified cereals or milk may be something we can easily adjust to prevent brain shrinkage and so perhaps save our memory," says Anna Vogiatzoglou of the Department of Physiology, Anatomy and Genetics at Oxford University.

"Research shows that vitamin B12 deficiency is a public health problem, especially among the elderly, so more vitamin B12 intake could help reverse this problem. Without carrying out a clinical trial, we acknowledge that it is still not known whether B12 supplementation would actually make a difference in elderly persons at risk for brain shrinkage.

"Previous research on the vitamin has had mixed results and few studies have been done specifically with brain scans in elderly populations. We tested for vitamin B12 levels in a unique, more accurate way by looking at two certain markers for it in the blood," adds Ms Vogiatzoglou.

Ms Vogiatzoglou says the study did not look at whether taking vitamin B12 supplements would have the same effect on memory.

The study was supported by the UK Alzheimer's Research Trust, the Medical Research Council, the Charles Wolfson Charitable Trust, the Norwegian Foundation for Health and Rehabilitation through the Norwegian Health Association, Axis-Shield plc and the Johan Throne Holst Foundation for Nutrition Research.

 

Vitamin E Associated With Lower Dementia Risk

Consuming more vitamin E through the diet appears to be associated with a lower risk of dementia and Alzheimer's disease, according to a report in the July issue of Archives of Neurology, one of the JAMA/Archives journals.

Oxidative stress—damage to the cells from oxygen exposure—is thought to play a role in the development of Alzheimer's disease, according to background information in the article. Experimental data suggest that antioxidants, nutrients that help repair this damage, may protect against the degeneration of nervous system cells. "Although clinical trials have shown no benefit of antioxidant supplements for Alzheimer's disease, the wider variety of antioxidants in food sources is not well studied relative to dementia risk; a few studies, with varying lengths of follow-up, have yielded inconsistent results," the authors write.

Elizabeth E. Devore, Sc.D., of Erasmus Medical Center, Rotterdam, the Netherlands, and colleagues assessed 5,395 participants 55 years and older who did not have dementia between 1990 and 1993. Participants underwent a home interview and two clinical examinations at the beginning of the study, and provided dietary information through a two-step process involving a meal-based checklist and a food questionnaire.

The researchers focused on four antioxidants: vitamin E, vitamin C, beta carotene and flavonoids. The major food sources of vitamin E were margarine, sunflower oil, butter, cooking fat, soybean oil and mayonnaise; vitamin C came mainly from oranges, kiwi, grapefruit juice, grapefruit, cauliflower, red bell peppers and red cabbage; beta carotene, from carrots, spinach, vegetable soup, endive and tomato; and flavonoids from tea, onions, apples and carrots.

Over an average of 9.6 years of follow-up, 465 participants developed dementia; 365 of those were diagnosed with Alzheimer's disease. After adjusting for other potentially related factors, the one-third of individuals who consumed the most vitamin E (a median or midpoint of 18.5 milligrams per day) were 25 percent less likely to develop dementia than the one-third of participants who consumed the least (a median of 9 milligrams per day). Dietary intake levels of vitamin C, beta carotene and flavonoids were not associated with dementia risk. Results were similar when only the participants diagnosed with Alzheimer's disease were assessed.

"The brain is a site of high metabolic activity, which makes it vulnerable to oxidative damage, and slow accumulation of such damage over a lifetime may contribute to the development of dementia," the authors write. "In particular, when beta-amyloid (a hallmark of pathologic Alzheimer's disease) accumulates in the brain, an inflammatory response is likely evoked that produces nitric oxide radicals and downstream neurodegenerative effects. Vitamin E is a powerful fat-soluble antioxidant that may help to inhibit the pathogenesis of dementia."

Future studies are needed to evaluate dietary intake of antioxidants and dietary risks, including different points at which consuming more antioxidants might reduce risk, the authors conclude. (Arch Neurol. 2010;67[7]:819-825.)