A recent study in the Journal of the American Medical Association (JAMA) proclaimed that vitamin E and vitamin C do not protect against heart disease in men. This finding provoked interest around the world. I am a true believer in proper supplementation - both for the prevention and treatment of health conditions – so I am always trying to keep up on the latest research on vitamins, minerals and herbal medicine. But that does not make me averse to studies refuting their efficacy. Intrigued, I read this study closely and I have concluded that this study was methodologically flawed from the start.
Here are some facts about the study. This article originated in the Physicians’ Health Study (PHSII) that began in 1997. The PHSII sought to answer questions relating to supplemental vitamins and their use in the prevention of cardiovascular disease, cancer, memory loss and age-related vision loss. It was funded by a grant from the BASF Corporation and the National Institutes of Health (NIH). Wyeth Pharmaceuticals and DSM Nutritional Products, Inc provided the nutrients.
A closer look reveals two primary errors in the study. First, the dose and form of Vitamin E used in this study was flawed. Vitamin E was dosed at 400 IU every other day. This dose is below the dose that is in most over the counter Vitamin E supplements. Physicians that recognize the benefits of Vitamin E recommend a higher and more therapeutic dose. The form of vitamin E used in this study was a synthetic d,l-alpha tocopherol. This form of vitamin E does have some useful properties and is the usual form of vitamin E in food and in supplements. However, the gamma form of Vitamin E, known as gamma-tocopherol, is more effective than alpha-tocopherol at inhibiting the pro-inflammatory COX-2 enzyme thus it has greater anti-inflammatory and cardioprotective benefits. Also, gamma-tocopherol is a stronger inhibitor of peroxynitrite-induce oxidation, a reaction that may impact the development of cardiovascular disease, neurodegenerative disease and cancer.
Second, Vitamin C was also under dosed. In the study, participants were only dosed at 500 mg/day. This amount is equivalent to half of an “Emer’genC” packet or a typical 1 gram capsule. In other words, this is a stunningly tiny amount of vitamin C hardly worth studying. Most evidence suggests therapeutic levels of vitamin C should be in the range of 3 grams per day, in divided doses, and in the mixed acerbate form.
Clearly we need more and better studies to evaluate the use of certain nutrients for the prevention and treatment of disease. However, if a study is going to be taken seriously, it should take a more rigorous methodological approach. This study, in my opinion, was misleading and a misuse of resources.
The contents of this blog are for informational purposes only. It is not intended as professional medical advice, diagnosis or treatment. Please see an Akasha physician or another qualified health care provider with questions regarding a medical condition or treatment.
Friday, November 28, 2008
Friday, November 7, 2008
Can An Imbalance in Gut Flora Contribute to Weight Gain?
A heatlthy gut flora is a balance between ‘good’, beneficial bacteria and ‘bad’ bacteria. Imbalances in gut flora are believed to be contributing factors to many chronic diseases such as irritable bowel syndrome, inflammatory bowel disease, autoimmune disease as well as gas and bloating. Now it appears that gut microflora may contribute to weight gain as well.
A study published in the current edition of The American Journal of Clinical Nutrition found significant differences between the gut floras of normal weight woman compared to overweight woman. Overweight woman had higher numbers of the ‘bad’ bacteria, Bacteroides and Staphlococcus, when compared to normal weight woman. In contrast, normal weight woman were shown to have higher amounts of the ‘good’ bacteria, Bifidobacterium. Interestingly, larger weight gain during pregnancy was associated with higher amounts of Bacteroides and Staphlococcus while woman with normal weight gain during pregnancy had higher numbers of the ‘good’ Bifidobacterium bacteria.
The authors offer 3 hypotheses that could explain why gut dysbiosis appears to contribute to weight gain:
1. Pathogenic (‘bad’) gut flora may cause increased glucose absorption and enhanced fat storage contributing to increased weight gain.
2. Pathogenic gut flora leads to a catabolic state (calorie storage)
3. Pathogenic gut flora contributes to low-grade, systemic inflammation which is associated with obesity and obesity related conditions such as heart disease, diabetes and depression.
Any new clues we have to understand why some women seem to gain weight easily or have difficulty loosing weight catches my attention. However, this study did not address the obvious question of whether gut dysbiosis leads to weight gain or if being overweight leads to gut dysbiosis. Clearly more research is warranted. Nonetheless, this is a promising study and may support the recommendation of eating more probiotic-rich, fermented foods and/or supplementing with a probiotic - both during a weight loss regime and during pregnancy. Because a pregnant mother’s diet and probiotic intake contributes to their developing infants intestinal flora, it may be that supplementing with probiotics during pregnancy will contribute both to the later health of the infant and possibly even protect against childhood obesity.
Am J Clin Nutr. 2008 Oct;88(4):894-9.
PMID: 18842773 [PubMed - indexed for MEDLINE]
The contents of this blog are for informational purposes only. It is not intended as professional medical advice, diagnosis or treatment. Please see an Akasha physician or another qualified health care provider with questions regarding a medical condition or treatment.
A study published in the current edition of The American Journal of Clinical Nutrition found significant differences between the gut floras of normal weight woman compared to overweight woman. Overweight woman had higher numbers of the ‘bad’ bacteria, Bacteroides and Staphlococcus, when compared to normal weight woman. In contrast, normal weight woman were shown to have higher amounts of the ‘good’ bacteria, Bifidobacterium. Interestingly, larger weight gain during pregnancy was associated with higher amounts of Bacteroides and Staphlococcus while woman with normal weight gain during pregnancy had higher numbers of the ‘good’ Bifidobacterium bacteria.
The authors offer 3 hypotheses that could explain why gut dysbiosis appears to contribute to weight gain:
1. Pathogenic (‘bad’) gut flora may cause increased glucose absorption and enhanced fat storage contributing to increased weight gain.
2. Pathogenic gut flora leads to a catabolic state (calorie storage)
3. Pathogenic gut flora contributes to low-grade, systemic inflammation which is associated with obesity and obesity related conditions such as heart disease, diabetes and depression.
Any new clues we have to understand why some women seem to gain weight easily or have difficulty loosing weight catches my attention. However, this study did not address the obvious question of whether gut dysbiosis leads to weight gain or if being overweight leads to gut dysbiosis. Clearly more research is warranted. Nonetheless, this is a promising study and may support the recommendation of eating more probiotic-rich, fermented foods and/or supplementing with a probiotic - both during a weight loss regime and during pregnancy. Because a pregnant mother’s diet and probiotic intake contributes to their developing infants intestinal flora, it may be that supplementing with probiotics during pregnancy will contribute both to the later health of the infant and possibly even protect against childhood obesity.
Am J Clin Nutr. 2008 Oct;88(4):894-9.
PMID: 18842773 [PubMed - indexed for MEDLINE]
The contents of this blog are for informational purposes only. It is not intended as professional medical advice, diagnosis or treatment. Please see an Akasha physician or another qualified health care provider with questions regarding a medical condition or treatment.
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