What if we told you? References for Willner Window Radio Show July 29, 2012

Article by Don Goldberg

What if we told you there was a study that demonstrated the risk of dying in older adults was substantially higher if their vitamin D levels were low?

What if we told you there was a study that indicated omega-3 fatty acids could improve inattention, impulsiveness and cooperation in children with attention-deficit hyperactivity disorder, or ADHD?

What if we told you that another study of older people showed that those taking calcium and vitamin D supplements were 9 percent less likely to die over three years than those given placebo pills?

What if we told you that a study showed that peoples with higher levels of dietary antioxidants had a lower risk of one of the most deadly forms of cancer, cancer of the pancreas?

What if we told you that a recent study showed that a high intake of vitamin E, either from diet or supplements, lowers the risk of liver cancer?

What if we told you that there was a study supporting the role of vitamin D in lowering blood pressure?

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Vitamins C and E and Selenium May Cut Pancreatic Cancer Risk
Larry Hand
July 23, 2012 — Higher intakes of the antioxidants vitamin C, vitamin E, and selenium could possibly cut the risk of developing pancreatic cancer by up to 67%, according to a study published online today in Gut. Pancreatic cancer kills more than 250,000 people a year worldwide and has the worst survival rate of any tumor.

Paul J.R. Banim, honorary researcher in the Department of Medicine, University of East Anglia, Norwich, United Kingdom, and colleagues analyzed the histories of 23,658 people aged 40 to 74 years who entered the Norfolk group of the European Prospective Investigation of Cancer (EPIC) between 1993 and 1997 and compared them with the histories of 3970 control patients. The participants were Norfolk County residents registered with 35 general practices. On 10-year follow-up, 49 people (55% of whom were men) had developed pancreatic cancer, and on 17-year follow-up, 86 (44% men) had developed pancreatic cancer.

On entry into the study, participants completed 7-day food diaries, recording their dietary intakes the first day during a baseline health check with a nurse, who also took serum blood samples for analysis. The remaining 6 days, the participants recorded food intake at home, including information on food types, portion sizes, brands, cooking methods, and recipes for 8 meal times each day.

The participants returned their complete diaries to study headquarters, and trained nutritionists entered the data into a specifically designed computer program called Data Into Nutrients for Epidemiological Research (DINER). DINER matched each diary's entry with 1 of 11,000 food items and 55,000 portion sizes and converted the data into nutrient values. To investigate whether vitamin C, vitamin E, selenium, and zinc might lower the risk of developing pancreatic cancer, the researchers divided the nutrient intake amounts into quartiles and then compared the lowest-intake quartile with a summation of the 3 higher quartiles.

"Participants eating higher intakes of all of these micronutrients were 67% less likely to develop pancreatic cancer than those eating lower amounts," the researchers write. "For selenium, the effect size was large with an approximately halving of the risk with greater intakes, and for vitamin E, there was a slightly smaller effect of borderline statistical significance. For vitamin C, inverse associations were seen in the data from both the food diaries and serum, although only the latter was statistically significant." Genetics, smoking tobacco, and type 2 diabetes are known risk factors for pancreatic cancer, and antioxidants also may play a role by stimulating the immune system by inactivating free radicals and reducing oxidative stress, the researchers write.

The researchers used Cox proportional hazards regression modeling to estimate hazard ratios (HRs) at 10 years follow-up, with the lowest quartile as baseline. The researchers write,"[T]here were inverse associations between the lowest quartile and a summation of the three higher ones for selenium (HR=0.49, 95% [confidence interval (CI)] 0.26 to 0.93, p=0.03) and vitamin E (HR=0.57, 95% CI 0.29 to 1.09, p=0.09), but not vitamin C (HR=0.68, 95% CI 0.37 to 1.26, p=0.22) or zinc (HR=0.91, 95% CI 0.44 to 1.91, p=0.81)."

Individuals consuming the 3 higher quartiles of for all 3 dietary antioxidants, vitamin C, vitamin E, and selenium, had a decreased risk for pancreatic cancer (HR, 0.33; 95% CI, 0.13 - 0.84; P = .05).

"Based on these figures and if the association is causal, then 8.2% of all pancreatic cancers could be prevented by avoiding the combined lowest intakes of vitamins C and E and selenium," the researchers write.

"Participants eating higher intakes of all of these micronutrients were 67% less likely to develop pancreatic cancer than those eating lower amounts." If a causal association is confirmed in other studies, population-based dietary recommendations could reduce risk of pancreatic cancer, the researchers add.

The primary weakness of the study, the researchers note, was possible error in participants recording habitual diet and possible changes in diet patterns over time after study recruitment. Its primary strengths were its prospective design and the use of diaries for collection of data.

"In summary," the researchers conclude, "this prospective cohort study, using dietary antioxidant data, derived for the first time from food diaries, demonstrated inverse associations with total dietary antioxidant intake, selenium and vitamin E. A role for vitamin C was supported by the serum analysis with large effect sizes."

The study was funded by The Big C Cancer Charity, Norfolk. The authors have disclosed no relevant financial interests.

Gut. Published online July 23, 2012. Article

Medscape Medical News © 2012 WebMD, LLC

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Meta-analysis shows vitamin C's potential for supporting heart health
Jun. 29, 2012 Lisa Marshall | Natural Foods Merchandiser

Don't discount Vitamin C for hypertension suggests Dr. Balz Frei, PhD, director of the Linus Pauling Institute at Oregon State University.

Balz Frei, PhD, director of the Linus Pauling Institute at Oregon State University, believes the new meta-analysis linking vitamin C with lower blood pressure is more than enough evidence to recommend C supplements for preventing or treating hypertension.

“It is a very solid analysis using the gold standard of what the medical community considers necessary to demonstrate safety and efficacy–and it worked,” he says. “If this was a study of a pharmaceutical drug, and it showed this effect, every medical doctor in the United States would start to prescribe it for hypertension, but there is often a bias against natural compounds.”

Frei says he does not recommend C supplementation in place of medication or as a stand-alone measure to prevent it. However, for those who have concerns about developing high blood pressure or those already taking medication for it, he suggests 500 mg daily, in addition to maintaining a healthy weight, quitting smoking, and eating a diet rich in fruits, vegetables and low-fat dairy.

“Five-hundred milligrams of vitamin C is absolutely benign and has great potential for benefit, so why not take it?” he says.

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Omega-3, -6 combination shows promise for inattention and cooperation in ADHD kids
By Stephen Daniells, 25-Jul-2012

**DG Note: Omega-6 was Evening Primrose!!**

A combined supplement of omega-3 and omega-6 fatty acids may improve measures of inattention, impulsiveness, and cooperation in children with attention-deficit hyperactivity disorder (ADHD), suggests new data.

Parents and teachers discerned improvements in children with ADHD after six months of supplementation with the omega-combination, but no benefits were observed after three months, report scientists from the University of Colombo and the Lady Ridgeway Hospital for Children in Sri Lanka.

“The combination of omega-3 and omega-6 was safe and effective in improving behavior and learning in the group that was studied,” they wrote in the Journal of Child Neurology .

“The current study is a pilot, and replication of the findings is required before we can advocate supplementation as a routine practice for children with behavior and learning difficulties that are refractory to standard managements.”

Promising, but…

Commenting on the study’s findings, Harry Rice, PhD, VP of scientific and regulatory affairs for the Global Organization for EPA and DHA Omega-3 (GOED), told NutraIngredients-USA:  “While the results are promising, the experimental design falls short of what I would classify as rigorous.

“For example, in AD(H)D studies, it's customary to use both a parent and a teacher rating scale for several reasons. Parent ratings are more likely to show improvement than teacher ratings. Also, similar ratings between the two scales increase the strength of the findings. Unfortunately, the current research used a parent rating scale only.”

Omega-3s and ADHD

There has been some research published that indicates that a combination of omega-3s and omega-6s may have benefits for children with ADHD.

However, the totality of the evidence from randomized clinical trials is currently too limited to allow for any recommendations, concluded a recent review in the prestigious Cochrane Database of Systematic Reviews .

For the new study, the Sri Lanka-based scientists recruited 94 children aged between 6 and 12 with ADHD to participate in their study. All of the children were receiving methylphenidate medication (Ritalin) and standard behavior therapy for at least six months.

The children were randomly assigned to receive placebo or daily supplements of omega-3 (fish oil) and omega-6 (evening primrose oil). The ratio of fish oil to primrose oil was 1.6:1, with a daily omega-3 dose of 296.37 mg, and a daily of omega-6 of 180.75 mg. The researchers used the commercial Vegepa product.

While no significant improvements were observed after three months, a significant improvement was reported by parents and teachers after six months for inattention, impulsiveness, and cooperation. No improvements in distractibility were reported by parents and teachers.

“It is possible to infer from the results that the participants of the study may have benefitted further if treatment with omega-3 and omega-6 had been continued,” said the researchers.

Source: Journal of Child Neurology
Volume 27, Number 6, Pages 747-753, doi:10.1177/0883073811435243
“Combined ?3 and ?6 Supplementation in Children With Attention-Deficit Hyperactivity Disorder (ADHD) Refractory to Methylphenidate Treatment: A Double-Blind, Placebo-Controlled Study”
Authors: H. Perera, K.C. Jeewandara, S. Seneviratne, C. Guruge

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Low vitamin D linked to increased risk of dying in older adults
27-Jul-2012

Low levels of vitamin D could mean a much greater risk of death in older adults – especially those who are frail – according to new research.

The study – published in the European Journal of Clinical Nutrition – reveals that older adults with lowvitamin D levels have a 30% greater risk of death than people who had higher levels.

Led by Ellen Smit of Oregon State University, USA, the randomised, nationally representative study found that overall, people who were frail had more than double the risk of death than those who were not frail. However, frail adults with low levels of vitamin D had triple the risk of mortality than those were not frail and who had higher levels of the sunshine vitamin.

"What this really means is that it is important to assess vitamin D levels in older adults, and especially among people who are frail," said Smit.

"Our study suggests that there is an opportunity for intervention with those who are in the pre-frail group, but could live longer, more independent lives if they get proper nutrition and exercise,” she added.

Smit noted that whilst past studies have separately associated frailty and low vitamin D with a greater mortality risk, the new study is the first to look at the combined effect.

Study details

In the study Smit and her colleagues examined more than 4,300 adults older than 60 using data from the Third National Health and Nutrition Examination Survey.

The study divided people into four groups. The low group had levels less than 50 nanograms per milliliter of vitamin D in the blood – measured as serum 25(OH)D – the highest group had vitamin D of 84 or higher.

In general, those who had lower vitamin D levels were more likely to be frail, the researchers said. However, they noted that because of the cross-sectional nature of the survey they could not determine if low vitamin D contributed to frailty, or whether frail people became vitamin D deficient because of health problems.

Smit argued however, that longitudinal analysis on death showed it may not matter which came first.

"If you have both, it may not really matter which came first because you are worse off and at greater risk of dying than other older people who are frail and who don't have low vitamin D," she said.

The authors concluded that the results of their study suggest that low serum 25(OH)D is associated with frailty, adding that there are ‘additive joint effects’ of serum 25(OH)D and frailty on all-cause mortality in older adults.

"This is an important finding because we already know there is a biological basis for this. Vitamin D impacts muscle function and bones, so it makes sense that it plays a big role in frailty," said Smit.

Source: European Journal of Clinical Nutrition
Published online ahead of print, doi:10.1038/ejcn.2012.67
“The effect of vitamin D and frailty on mortality among non-institutionalized US older adults”
Authors: E Smit, C J Crespo, Y Michael, F A Ramirez-Marrero, G R Brodowicz, S Bartlett and R E Andersen



© 2012 - William Reed Business Media SAS

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High Consumption of Vitamin E May Lower Liver Cancer Risk

Published July 18, 2012

High consumption of vitamin E either from diet or vitamin supplements may lower the risk of liver cancer, according to a study published in the Journal of the National Cancer Institute. The study was conducted by investigators from the Shanghai Cancer Institute, Vanderbilt-Ingram Cancer Center and the National Cancer Institute.

Numerous experimental studies have suggested that fat soluble  vitamin E may prevent DNA damage. Liver cancer is the third most common cause of cancer mortality in the world, the fifth most common cancer found in men and the seventh most common in women. Approximately 85% of liver cancers occur in developing nations, with 54% in China alone.

To determine the relationship between vitamin E intake and liver cancer risk, Wei Zhang, M.D., MPH., Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, and colleagues analyzed data from a total of 132,837 individuals in China who were enrolled in the Shanghai Women’s Health Study (SWHS) from 1997-2000 or the Shanghai Men’s Health Study (SMHS) from 2002-2006, two population-based cohort studies jointly conducted by the Shanghai Cancer Institute and Vanderbilt University.

Using validated food-frequency questionnaires, the researchers conducted in-person interviews to gather data on study participants’ dietary habits. Participants were asked how often they ate some of the most commonly consumed foods in urban Shanghai and whether they took vitamin supplements.

The investigators then compared liver cancer risk among participants who had high intake of vitamin E with those who had low intake.

The analysis included  267 liver cancer patients (118 women and 149 men) who were diagnosed between two years after study enrollment and an average of 10.9 (SWHS) or 5.5 (SMHS) years of follow-up. Vitamin E intake from diet and vitamin E supplement use were both associated with a lower risk of liver cancer. This association was consistent among participants with and without self-reported liver disease or a family history of liver cancer.

“We found a clear, inverse dose-response relation between vitamin E intake and liver cancer risk,” the authors write, noting a small difference between men and women in the risk estimate, which is likely attributable to fewer liver cancer cases having occurred among male participants due to the shorter follow-up period.

“Overall, the take home message is that high intake of vitamin E either from diet or supplements was related to lower risk of liver cancer in middle-aged or older people from China,” said Xiao Ou Shu, M.D., Ph.D., professor of Medicine at the Vanderbilt Epidemiology Center.

Conversely, participants who had the highest vitamin C intake from supplements and who had a family history of liver cancer or self-reported liver disease were more likely to develop liver cancer. There was no link to liver cancer among participants who had the highest levels of vitamin C or other vitamins from food.

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Vitamin D plus calcium tied to longer life: study

Sun, Jun 17 2012
(Reuters) - Older people who take vitamin D and calcium supplements may live a bit longer than their peers, according to an international review of several studies covering more than 70,000 people.

Researchers writing in the Journal of Clinical Endocrinology found that older people who were given the supplements were 9 percent less likely to die over three years than those given placebo pills. Vitamin D alone had no impact on death rates.

A 9 percent dip in death risk over a three year period might sound small, but lead researcher Lars Rejnmark said that effect is "at least as pronounced" as the benefits linked to cholesterol-lowering statins and blood pressure drugs.

"In my view, a 9 percent reduced mortality in the general population of elderly is of major importance," Rejnmark, an associate professor at Aarhus University in Denmark, told Reuters Health by email.

"Except for stopping smoking, there are not many other known interventions that are capable (of) such a reduction in the risk of death."

Rejnmark and his colleagues combined the results from eight clinical trials that involved more than 70,000 older adults, mostly women.

In each trial, people were randomly assigned to take vitamin D or a placebo. Some studies used a combination of vitamin D and calcium.

The doses varied, but most trials used a daily vitamin D dose of 10 to 20 micrograms. In the United States, health officials suggest that most adults get 15 micrograms (or 600 IU) of vitamin D per day, while people older than 70 should aim to get 20 micrograms (or 800 IU).

In trials that used calcium, the dose was 1,000 milligrams per day. In general, women older than 50, and everyone over 70, are told to get 1,200 milligrams of calcium each day.

Vitamin D and calcium are probably best know as bone-builders. Older women often take the supplements to ward off the bone-thinning disease osteoporosis - and some trials have found that the supplement combination can prevent falls and bone fractures in the elderly.

But that probably does not explain the lower death risk in this study. When the researchers factored in hip and spine fractures, they did not account for the dip in death risk.

Another possibility is that supplements curbed people's risk of dying from cancer. Rejnmark said there's some evidence that calcium and vitamin D may lower the odds of colon cancer, but the evidence is not yet "firm".

For now, he said, the findings supported getting the recommended amounts of vitamin D and calcium.

Some members of Rejnmark's team had connections to supplement makers that market vitamin D and calcium products.

(Reporting from New York by Amy Norton at Reuters Health; Editing by Elaine Lies and Robert Birsel)

© Thomson Reuters 2011. All rights reserved.