Author Interviews, Genetic Research, Kidney Disease, Mineral Metabolism, Pediatrics / 10.11.2019

MedicalResearch.com Interview with: Tracy McGregor, MD MSCI Alnylam Pharmaceuticals Cambridge, Massachusetts  MedicalResearch.com: What is the background for this study?
  • Lumasiran is an investigational RNA interference (RNAi) therapeutic in development for the treatment of primary hyperoxaluria type 1 (PH1). PH1 is a rare life-threatening disease in which a enzymatic deficiency in the liver results in pathologic overproduction of oxalate, often leading to recurrent kidney stones and a progressive decline in kidney function, which typically culminates in end-stage renal disease (ESRD).Patients with ESRD are at a risk of systemic oxalosis, with oxalate depositing throughout the body, including the eyes, skin, bones, and the heart. Complications associated with ESRD and/or systemic oxalosis can be fatal. For patients with ESRD treatment options are limited and include intensive dialysis as a bridge to a dual liver/kidney transplant, highlighting the unmet need for new treatment options. 
(more…)
Author Interviews, Dental Research, JAMA, Mental Health Research, Mineral Metabolism, Pediatrics / 19.08.2019

MedicalResearch.com Interview with: Rivka Green, MA Doctoral Candidate Clinical Developmental Neuropsychology York University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We conducted a study on 512 mother-child pairs from 6 major cities across Canada, about half of whom lived in a region that receives fluoridated water. We found that prenatal fluoride exposure was associated with lower IQ scores in 3-4 year old children. (more…)
AstraZeneca, Author Interviews, Kidney Disease, Mineral Metabolism / 08.07.2019

MedicalResearch.com Interview with: Steven Fishbane MD Chief, Division of Kidney Disease and Hypertension Vice President, Northwell Health for Network Dialysis Services, Northwell Health Professor of Medicine Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York  MedicalResearch.com: What is the background for this study? Response: Patients on hemodialysis have a great frequency of hyperkalemia. The hemodialysis treatment removes some potassium but not enough to get rid of this problem. Available medications to bind potassium have not been tested among these patients. The purpose of the study was to see if sodium zirconium cyclosilicate could be used as a potassium binder to reduce the risk of hyperkalemia in patients on a hemodialysis. (more…)
AstraZeneca, Author Interviews, Kidney Disease, Mineral Metabolism / 05.11.2018

MedicalResearch.com Interview with: Rahul Agrawal MD PhD VP, Global Medicines Leader AstraZeneca MedicalResearch.com: What is the background for this study?   About the study: HARMONIZE Global is a Phase III, randomized, multicenter, double-blind, placebo-controlled trial involving 267 patients with hyperkalemia (mean potassium levels greater than 5.0 mEq/L) in 47 study locations across the Asia Pacific region, which will support registration in Japan, Taiwan, Korea and Russia. Study design: The trial design of HARMONIZE Global is similar to HARMONIZE (NCT02088073) but evaluated two doses of LOKELMATM (sodium zirconium cyclosilicate) instead of three, as well as patients in different geographical regions. (more…)
Author Interviews, Kidney Disease, Mineral Metabolism, Pharmacology / 29.10.2018

MedicalResearch.com Interview with: Dr Mattias Ivarsson PhD CEO, Inositec, co-author of data MedicalResearch.com: What is the background for this study? Response: When control of factors in the blood that regulate mineral balance in the body is lost, the subsequent build-up of calcium deposits in the arterial walls and cardiac valves lead to an increase in cardiac events, particularly in patients with chronic kidney disease or diabetes, as well as all-cause mortality. There is a significant unmet need for therapeutic agents capable of reducing pathological mineral accumulation regardless of their root cause. To date, there is no approved therapy for treating calcification-dependent cardiovascular disease.  (more…)
AHA Journals, Author Interviews, Imperial College, Mineral Metabolism, Stroke / 27.10.2018

MedicalResearch.com Interview with: Dipender Gill Imperial College Healthcare NHS Trust London, United Kingdon  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Iron status has previously been associated with risk of various types of cardiovascular disease, including stroke. However, the observational research methodologies that identified these associations can be affected by confounding from environmental factors and reverse causation. We used randomly allocated genetic variants that affect iron status to investigate its effect on risk of different types of ischemic stroke, and found evidence to support that higher iron status increases risk of cardioembolic stroke. (more…)
Author Interviews, Mineral Metabolism, Vitamin D / 09.10.2018

MedicalResearch.com Interview with: "MaxMedica D-vitamin" by Midsona Sverige AB is licensed under CC BY 2.0Dr Mark J Bolland PhD Bone and Joint Research Group Department of Medicine University of Auckland New Zealand MedicalResearch.com: What is the background for this study? Response: Vitamin D supplements have long been recommended for older people to treat or prevent osteoporosis. Early evidence suggested vitamin D supplements might have benefits for musculoskeletal health, but more recent systematic reviews have reported no effect of vitamin D supplementation on fractures, falls or bone mineral density. Some authors have suggested that inadequate vitamin D doses might explain these null results. (more…)
Author Interviews, Autism, Dental Research, Mineral Metabolism, Pediatrics / 31.05.2018

MedicalResearch.com Interview with: “baby teeth” by Thomas Ricker is licensed under CC BY 2.0Christine Austin PhD Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount Sinai New York, NY 10029 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown that some metals (nutrients and toxicants) are absorbed and metabolized differently in children with autism spectrum disorder compared to neuro-typical children. However, it is not known when this dysregulation occurs and it is incredibly difficult to study prenatal metal metabolism. Teeth, which begin forming prenatally, grow by adding a new layer every day, much like the yearly growth rings in trees. Each layer formed captures many of the chemicals circulating in the body at the time. We have developed a method to measure metals in these layers to build a timeline of metal exposure during the prenatal and early childhood period. We found that the cycles of copper and zinc metabolism were disrupted in children with ASD and used this feature to develop a method to predict the emergence of autism spectrum disorder with 90% accuracy. (more…)
AstraZeneca, Author Interviews, Kidney Disease, Mineral Metabolism / 24.05.2018

MedicalResearch.com Interview with: Steven Fishbane, MD, Chief, Division of Kidney Disease and Hypertension, Northwell Health Vice President, Northwell Health for Network Dialysis Services, Northwell Health Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Lead investigator of the ZS 005 study MedicalResearch.com: What is the background for this announcement? Would you briefly explain what is meant by hyperkalemia?What are the dangers of an elevated potassium and how does LOKELMA differ from prior standard treatments?  Response: Hyperkalemia is when the potassium in the blood rises to potentially harmful levels. High potassium is primarily harmful for the heart. As the potassium level rises the risk for abnormal electrical rhythms or disruption of the heart’s pumping occur. When severe, a high potassium level can cause death. Lokelma has been demonstrated to be effective for lowering potassium levels with a great degree of consistency. It is well tolerated and has a fairly rapid onset of potassium lowering compared to other drugs for the purpose.  (more…)
Alzheimer's - Dementia, Author Interviews, Mineral Metabolism / 19.12.2017

MedicalResearch.com Interview with: Val Andrew Fajardo, PhD. NSERC Postdoctoral Fellow | Centre for Bone and Muscle Health Brock University | Department of Health Sciences St. Catharines, ON, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lithium is best known for its role as a mood stabilizer, and several ecological studies across a number of different regions have shown that trace levels of lithium in tap water can exert its mood stabilizing effect and reduce rates of suicide, crime, and homicide. The results from our study show that these trace levels of lithium could also potentially protect against Alzheimer’s disease.  These findings are actually supported by several years of research using pre-clinical and clinical models to demonstrate low-dose lithium’s neuroprotective effect against Alzheimer’s disease. In addition, we also found that trace lithium in tap water may potentially protect against obesity and diabetes – an effect that is also supported with previous literature.  In fact, some of the earlier reports of lithium’s effect of increasing insulin sensitivity and improving glucose metabolism were first published in the 1920s.  Finally, we found that trace lithium’s effect on Alzheimer’s disease may be partly mediated by its effect on obesity and diabetes. My collaborator Dr. Rebecca MacPherson who is an expert on Alzheimer’s disease as a metabolic disorder explains that this effect is in support of recent research demonstrating that obesity and diabetes are important risk factors in the development of Alzheimer’s disease.  So interventions aiming to reduce obesity and diabetes such as physical activity can go a long way in lowering risk for Alzheimer’s disease, which is also something we present in our study. (more…)
Alzheimer's - Dementia, Author Interviews, Mineral Metabolism / 07.12.2017

MedicalResearch.com Interview with: Val Andrew Fajardo, PhD. NSERC Postdoctoral Fellow | Centre for Bone and Muscle Health Brock University | Department of Health Sciences St. Catharines, ON, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lithium is best known for its role as a mood stabilizer, and several ecological studies across a number of different regions have shown that trace levels of lithium in tap water can exert its mood stabilizing effect and reduce rates of suicide, crime, and homicide. The results from our study show that these trace levels of lithium could also potentially protect against Alzheimer’s disease.  These findings are actually supported by several years of research using pre-clinical and clinical models to demonstrate low-dose lithium’s neuroprotective effect against Alzheimer’s disease. In addition, we also found that trace lithium in tap water may potentially protect against obesity and diabetes – an effect that is also supported with previous literature.  In fact, some of the earlier reports of lithium’s effect of increasing insulin sensitivity and improving glucose metabolism were first published in the 1920s.  Finally, we found that trace lithium’s effect on Alzheimer’s disease may be partly mediated by its effect on obesity and diabetes. My collaborator Dr. Rebecca MacPherson who is an expert on Alzheimer’s disease as a metabolic disorder explains that this effect is in support of recent research demonstrating that obesity and diabetes are important risk factors in the development of Alzheimer’s disease.  So interventions aiming to reduce obesity and diabetes such as physical activity can go a long way in lowering risk for Alzheimer’s disease, which is also something we present in our study. (more…)
Author Interviews, Mineral Metabolism, Pediatrics / 03.10.2017

MedicalResearch.com Interview with: Staffan Berglund MD PhD Umeå University Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Iron deficiency has been associated with impaired neurodevelopment and iron supplementation is recommended to those at risk. While it is well known that very low birth weight infants are at risk of iron deficiency, less has been known regarding the large subgroup of children born with only marginally low birth weight (2000-2500g). In the present study, we previously showed that this relatively common group of otherwise healthy children is at risk of iron deficiency during infancy (Berglund Pediatrics 2010;126). In the study published this week, we now also found that supplementation during the first six months of life had long term positive effects on their behavioral profile, with significant reduction of externalizing behavioral problems. (more…)
Author Interviews, Autism, Mineral Metabolism, Nature, Pediatrics / 05.06.2017

MedicalResearch.com Interview with: Manish Arora, PhD Associate Professor Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Autism has both genetic and environmental risk factors. Our aim was to study if exposure to toxic metals, such as lead, or disruptions in the uptake of essential nutrient elements such as manganese or zinc would be related to autism risk. Furthermore, we were interested in not only understanding how much exposure had taken place but also which developmental periods were associated with increased susceptibility to autism risk. Researchers suspect that the risk factors for autism start early in life, even prenatally, but measuring in utero exposures is technically very challenging. We used a newly developed technique that uses lasers to map growth rings in baby teeth (like growth rings in trees) to reconstruct the history of toxic metal and essential nutrient uptake. We applied this technology in samples collected from twins, including twins who were discordant for autism. This allowed us to have some control over genetic factors. We found that twins with autism had higher levels of lead in their teeth compared to their unaffected twin siblings. They also had lower levels of zinc and manganese. The lower uptake of zinc was restricted to approximately 10 weeks before birth to a few weeks after birth, indicating that as a critical developmental period. (more…)
Author Interviews, Kidney Disease, Mineral Metabolism, Nutrition, Social Issues, Transplantation / 25.04.2017

MedicalResearch.com Interview with: Ms. Shifra Mincer Medical Student in the class of 2019 SUNY Downstate Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hypophosphatemia is commonly encountered in the post-transplant setting. Early post-transplant hypophosphatemia has been ascribed to excess FGF23 and hyperphosphaturia. Many patients remain hypohosphatemic months or even years after their transplant and the mechanism was assumed to be the same, however, our group recently reported that patients with late post-transplant hypophosphatemia had very little phosphorous in their urine (Wu S, Brar A, Markell, MS. Am J Kidney Dis. 2016,67(5): A18). We hypothesized that they were not eating enough phosphorous to compensate for the acute phosphorous losses they experienced immediately post-transplant. In this study, using both 3-day diet journals and 24-hour diet recall questionnaires, we found that mean intake of phosphorous and protein was barely at the Recommended Daily Allowance, and that despite 70% of the patients using EBT, 30% of those patients still reported concerns regarding food security. Patients who reported that the cost of food influenced their dietary choices ate 43% less protein (average 48,5 gms vs. 85.8 gms) and 29% less phosphorous (average 887 mg vs 1257 mg). When ability to rise from a chair over a 30 second period was evaluated, only patients who expressed food cost concerns were unable to complete the test. (more…)
Author Interviews, Hip Fractures, Mineral Metabolism / 17.04.2017

MedicalResearch.com Interview with: Dr Setor Kunutsor Ba(Legon), MBChB(Legon), MA(Cantab), PhD(Cantab) Research Fellow Musculoskeletal Research Unit University of Bristol MedicalResearch.com: What is the background for this study? Response: Bone fractures are one of the leading causes of disability and ill health especially among the ageing population and are a burden to health care systems. There is established evidence that calcium and vitamin D play an important role in bone health. Magnesium is an essential trace element, being the second most abundant intracellular cation after potassium and the fourth most abundant cation in the body. It serves several important functions in the body, which include protein synthesis, nucleic acid synthesis, enzymatic reactions, and has also been shown to be cardio-protective. It is also an important component of bone, with majority (67 percent) of total body magnesium known to be found in the bone tissue. There have been suggestions from both human and animal experiments that magnesium may have a beneficial effect on bone health; however, its relationship with fractures is not very certain. (more…)
Author Interviews, Bone Density, JAMA, Mental Health Research, Mineral Metabolism, Pediatrics / 06.10.2016

MedicalResearch.com Interview with: Alexis Jamie Feuer MD Assistant Professor of Clinical Pediatrics Weill Cornell Medical College MedicalResearch.com: What is the background for this study? Response: Osteoporosis is a debilitating disorder characterized by low bone density and increased risk of fractures. Adolescence and young adulthood are critically important times for accruing peak bone density and failure to obtain adequate bone mass by early adulthood may result in future osteoporosis. In children, the use of certain medications can lead to a decrement in the acquisition of bone mass. Past studies have shown that stimulant medications, such as those used to treat Attention Deficit Hyperactivity Disorder (ADHD), may slow the rate of linear growth in children. To date, little research has been done to see what effects stimulant use may have on bone density and bone accrual in children. Stimulants exert their effects via activation of the sympathetic nervous system, and as there is mounting evidence that indicates the sympathetic nervous system plays a critical role in the acquisition of bone density, we sought to determine if there is any association between stimulant medication use and bone mass in the pediatric population. (more…)
Author Interviews, Endocrinology, JCEM, Kidney Disease, Mineral Metabolism / 03.10.2016

MedicalResearch.com Interview with: Jonas Esche Dipl.-Mol. Biomed University of Bonn Institute of Nutritional and Food Sciences DONALD Study MedicalResearch.com: What is the background for this study? Response: Modern western diets increase diet-dependent acid load and net acid excretion which are suggested to have adverse long-term effects on bone. Urinary potential renal acid load (uPRAL) is an established parameter to assess nutritional acid load. Urinary citrate, on the other hand, integrates nutritional and also systemic influences on acid-base homeostasis with high citrate indicating prevailing alkalization. Against this background urinary citrate excretion was used as a new index of acid-base status and its relationship with bone strength and long-term fracture risk was examined. (more…)
Author Interviews, Bone Density, Calcium, Mineral Metabolism, Nature / 16.08.2016

MedicalResearch.com Interview with: Dr. Constance Hilliard Department of History University of North Texas Denton, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: As an evolutionary historian, I have devoted the last several years to researching the health implications of genetic diversity. I was particularly concerned with the tendency of medical researchers to unwittingly use the biology of people with Northern European ancestry as a universal standard for everyone. For instance, lactose intolerance may be a disorder in that community, which suffers high rates of osteoporosis. But since 65% of the world’s population are lactose intolerant and have low rates of osteoporosis, a one-size-fits-all approach to bone health can prove dangerous for those whose ethnic-specific biological needs are overlooked. This study shows that osteoporosis is not a global problem. It has a strong and devastating impact in dairy-farming societies and is virtually non-existent in the tsetse zone of West Africa, where cattle rearing and dairying are not possible. Previous studies have tried to correlate the degenerative bone disease with socio-economic income. However, this study compares two regions of Africa with similar socio-economic conditions. In dairy-farming East Africa, the incidence of osteoporosis is 245 per 100,000. However in the tsetse belt of West Africa, where people do not consume dairy products, it is 3 per 100,000. When regression analyses are performed on 40 countries around the world, the association between dairy consumption and osteoporosis is high (0.851). It only correlates with national Gross National Product at a regression rate of 0.447. (more…)
Author Interviews, Blood Pressure - Hypertension, Mineral Metabolism, UT Southwestern / 06.07.2016

MedicalResearch.com Interview with: Wanpen Vongpatanasin, MD Professor of Medicine Norman & Audrey Kaplan Chair in Hypertension Research Director, Hypertension Section Cardiology Division UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Inorganic phosphate has been added to our processed food at an enormous amount as food preservatives and flavor enhancer such that typical American diet contains twice as much as the recommended daily allowance. A high phosphate (Pi) diet was recently shown to trigger blood pressure (BP) elevation in otherwise normal rats but the mechanisms are still unknown.We found that rats treated with high phosphate diet that mimics the excess Pi consumed by the general American population developed high BP related to increased sympathetic nerve activity (SNA), resulting in excessive peripheral vasoconstriction. This exaggerated increase in SNA and BP is evident particularly during exercise. This study is conducted in collaboration with Drs. Masaki Mizuno and Scott Smith, the two leading experts in neural control of circulation at UT Southwestern in the Department of Health Care Sciences. (more…)
Author Interviews, Blood Pressure - Hypertension, Mineral Metabolism, Nutrition, UT Southwestern / 04.07.2016

MedicalResearch.com Interview with: Dr. Wanpen Vongpatanasin MD The Norman and Audrey Kaplan Chair in Hypertension UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diet rich in fruits, vegetables, and dairy products, known as the DASH diet, is known to reduce blood pressure in hypertensive patients. More recently, the DASH diet was shown to reduce oxidative stress in people with and without high blood pressure . However, the main nutritional ingredient responsible for these beneficial effects of the DASH diet remain unknown. Because the DASH diet is rich in potassium (K), magnesium (Mg), and alkali, we performed a randomized, double-blinded, placebo-controlled study to compare effects of KMg Citrate (KMgCit), K Chloride (KCl), and K Citrate (KCit) to allow dissociation of the three in hypertensive and prehypertensive individuals. This study was conducted in collaboration with Drs. Charles Pak and Orson Moe at UT Southwestern, the two leading experts in the field of Mineral Metabolism. We found that oxidative stress was markedly reduced by KMgCit powder compared to placebo, K Chloride, and K Citrate. On the hand, KMgCit has no significant effects on blood pressure . MedicalResearch.com Editor's note:  DO NOT Take Potassium supplements unless under the direction of your health care provider. (more…)
Author Interviews, Bone Density, Endocrinology, Menopause, Mineral Metabolism, UCLA / 25.06.2016

MedicalResearch.com Interview with: Albert Shieh, MD Division of Endocrinology, Diabetes and Hypertension David Geffen School of Medicine University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: Whether an individual loses or gains bone mass is dependent on how much bone is being broken down (by osteoclasts) and being formed (by osteoblasts). Both processes occur simultaneously in the human body. At present, we can measure markers of bone breakdown (resorption) and formation. However, we hypothesized that to better predict the amount of bone mass that will be lost in the future, these markers should be combined in an "index" to reflect both processes, rather than being interpreted in isolation. Indeed, we found that the ability of our new bone balance index predicted future bone loss across the menopause transition better than the bone resorption marker alone. (more…)
Author Interviews, Mineral Metabolism, Nutrition / 30.01.2016

MedicalResearch.com Interview with: Simin Nikbin Meydani, D.V.M., Ph.D. Director, JM USDA-HNRCA at Tufts University Professor of Nutrition and Immunology Friedman School of Nutrition Science and Policy and Sackler Graduate School at Tufts University Boston, MA 02111 Medical Research: What is the background for this study? Dr. Meydani: A significant number of older people are zinc deficient which can result in a compromised immune system which weakens as the body ages, making older adults more susceptible to infections and higher incidence and morbidity from pneumonia. Older adults with impaired immune response, particularly T cell-mediated function, have a higher susceptibility to infections and cancer. Our research team from the Jean Mayer USDA Human Nutrition Research Center on Aging created a small double-blind, placebo-controlled trial involved adults age 65 or older from three Boston-area nursing homes to determine the feasibility of increasing serum zinc concentrations in older adults. The full findings are published in The American Journal of Clinical Nutrition. These results have a significant public health implication for the older adults because it shows directly that correction of a nutrient deficiency can improve immune response in older adult (a biological function which consistently has been shown to be impaired with aging). (more…)
Author Interviews, Mineral Metabolism, Supplements / 12.01.2016

MedicalResearch.com Interview with: Prof. Peter Lay PhD Professor of Inorganic Chemistry School of Chemistry | Faculty of Science Director, Vibrational Spectroscopy Core Facility Research Portfolio The University of Sydney Medical Research: What is the background for this study? What are the main findings? Response: My group has been studying the molecular mechanisms of chromium(VI)-induced cancers and the biochemistry of vanadium over the last three decades. Vanadium drugs have been in clinical trials for their anti-diabetic effects that occur via species with very similar chemistry to chromium(VI).  The more we understood the biochemistry of each, the more we questioned whether the efficacies of anti-diabetic chromium(III) supplements were associated with the generation of carcinogenic chromium(VI) and chromium(V). To test this, we conducted experiments to either provide evidence for our hypothesis or disprove it.  This work commenced some 15 years ago with studies on the changes in the nature of chromium(III) supplements exposed to simulated gastrointestinal juices, as well as in human and animal blood serum over times that mimicked the residence time of the supplements in the human body. We discovered that all supplements were changed to a range of different Cr(III) species in both the GI tract and the blood.1,2  Common species were observed, but the rates at which they formed were dependent on the nature of the chromium(III) supplement.  Both the supplements themselves and the chromium(III) species that formed in blood serum were partially oxidised to Cr(VI) at concentrations of the oxidant, hydrogen peroxide (a type of bleach), found in the blood of people with type II diabetes.1,2 One of the clinical features of patients with type II diabetes is increased levels of oxidants, such as hydrogen peroxide, in their blood and cells. These oxidants are associated with many of the side-effects of type II diabetes that are associated with reduced life expectancy. These transformed chromium(III) species bound to blood proteins were more easily oxidised to chromium(VI) than the administered Cr(III) supplements.  The faster a particular chromium(III) supplement reacted with blood proteins to form these easily oxidised chromium(III)-protein species, the more active was the Cr(III) supplement in its anti-diabetic activity in animal and human studies reported by other groups.1-5  According to many health and regulatory bodies, chromium(III) has minimal or no efficacy in glucose metabolism and no other beneficial effects, such as weight loss or muscle building, in well conducted human and animal trials with non-diabetic subjects. This is consistent with our proposed mechanism of action. It is only under oxidising physiological conditions associated with type II diabetes that chromium(III) can be partially transformed to sufficient concentrations of carcinogenic chromium(VI) to enable significant biological activity.  In a large clinical trial where diabetic patients were treated with high doses of chromium(III) picolinate (one of the least efficacious supplements in animal studies), there was no efficacy in patients with controlled type II diabetes. Only those patients with uncontrolled type II diabetes exhibited improved glucose metabolism.  These patients, who have the highest concentrations of oxidants with the ability to transform chromium(III) to chromium(VI) in blood, are therefore at the greatest risk of developing Cr-induced cancers. Even where efficacy was observed, glucose metabolism was only reduced to the levels in patients with controlled type II diabetes; i.e., no patients exhibited a return to normal glucose metabolism.4,5 Coupled with all of this information our separate studies showed that chromium(VI) and chromium(V), but not chromium(III), are strong inhibitors of protein tyrosine phosphatase (PTP) enzymes.  The relevance of this is that drugs that inhibit PTPs activate circulating insulin in people with type II diabetes.  That is, it causes insulin to bind more strongly to cells involved in glucose metabolism (such as fat cells) to bring about the cascade of biochemical reactions that import glucose into cells and metabolise it.1-5 Thus we were able to link all of the animal, human and in vitro studies to show that physiological conditions under which chromium(III) had the highest probability of being transformed to chromium(VI) were also those in which chromium(III) supplements were most active.1-5 Moreover, we were able to provide a mechanism of activity that required chromium(VI) and chromium(V) to be generated for insulin enhancing activity.1-5  What remained was to establish whether we could observe Cr(VI) and Cr(V) in cells treated with chromium(III) supplements. This has now been established in our most recent study6 that have just been published. Contrary to the press releases of the dietary supplement industry, the published paper was carefully planned to mimic those conditions found in vivo.  The chromium(III) supplement chosen was that which had a chemical structure most closely resembling those generated in blood plasma. Thus we were able to complete the circle in linking our extensive studies on the biochemistry of chromium(III) species generated from chromium(III) supplements in the blood and show that such species were absorbed by the relevant cells and partially oxidised to chromium(VI) and chromium(V). (more…)
Author Interviews, Bone Density, Mineral Metabolism, Nutrition, Pediatrics / 13.11.2015

MedicalResearch.com Interview with: Audry H. Garcia PhD Scientist Department of Epidemiology Erasmus MC, University Medical Center Rotterdam Rotterdam, The Netherlands Medical Research: What is the background for this study? What are the main findings? Dr. Garcia: Mild and chronic metabolic acidosis as a result of a diet rich in acid-forming nutrients, such as cheese, fish, meat and grain products, may interfere with optimal bone mineralization and indirectly increase the risk of osteoporosis later in life. Previous observational studies in adults have reported inverse associations between dietary acid load and bone mass. However, the evidence in younger populations is scarce; only a few studies have been performed in healthy children and adolescents with inconsistent results, and not much is known on the effects of dietary acid load on bone mass in younger children or in children with a non-European background. In a prospective multiethnic population-based cohort study of 2,850 children from the city of Rotterdam, the Netherlands, we found that dietary acid load estimated as dietary potential renal acid load (dPRAL), and as protein intake to potassium intake ratio (Pro:K) at 1 year of age, was not consistently associated with childhood bone health. Furthermore, associations did not differ by sex, ethnicity, weight status, or vitamin D supplementation. (more…)
Author Interviews, Geriatrics, Mineral Metabolism / 22.10.2015

MedicalResearch.com Interview with: Andrew M Hinson, MD UAMS Postdoctoral Research Fellow Thyroid/Parathyroid Diseases & Surgery and Donald L. Bodenner, MD, PhD Department of Otolaryngology-Head and Neck Surgery Department of Geriatrics University of Arkansas for Medical Sciences, Little Rock, Arkansas. Medical Research: What is the background for this study? Response: Proton pump inhibitors (PPIs)​ are widely prescribed, highly effective and generally safe for the treatment of acid-related gastrointestinal disorders. However, there are risks that may be elevated for some older people when PPIs are used in high doses over long periods of time. There is also evidence that fracture risk may even be higher in older patients who are being treated with concurrent oral bisphosphonate medications, which are used to prevent fractures in patients with osteoporosis. While the mechanism remains unknown, PPIs may increase fracture risk by decreasing gastrointestinal absorption (e.g., calcium, vitamin B12, and/or bisphosphonates) or by inhibiting a major mechanism by which bisphosphonates work. To learn more about this process, we studied patients 60 years or older with normal renal function and vitamin D levels to see how PPIs (with and without concurrent bisphosphonate administration) impacted measurements in parathyroid hormone (PTH) and calcium. Medical Research: What are the main findings? Response: We found that chronic PPI exposure in elderly adults is associated with mild secondary hyperparathyroidism regardless of concurrent oral blood pressure administration. Secondary hyperparathyroidism refers to the excessive secretion of PTH by the parathyroid glands in response to low blood calcium levels. This is often associated with renal failure; however, all of our patients had normal renal function. (more…)
Author Interviews, BMJ, Bone Density, Calcium, Mineral Metabolism, Orthopedics / 03.10.2015

MedicalResearch.com Interview with: Dr. Mark J Bolland Associate professor of medicine Department of Medicine University of Auckland Auckland New Zealand Medical Research: What is the background for this study? Dr. Bolland: Many guidelines advise older people to take at least 1000-1200 mg/day of calcium to improve bone density and prevent fractures. The average calcium intake in most countries is a lot less than these recommendations, and so many people take calcium supplements to increase their calcium intake. However, recent concerns about the safety of calcium supplements have led experts to recommend increasing calcium intake through food rather than by taking supplements, even though the effect of increasing dietary calcium intake on bone health had not been clearly established. Our study was designed to fill this evidence gap. Medical Research: What are the main findings? Dr. Bolland: Firstly, we found that increasing calcium intake either from the diet or by taking calcium supplements led to similar, small, one-off increases in bone density of 1-2%. These increases do not build up over time and are too small to produce significant reductions in the chance of having a fracture. Secondly, the level of dietary calcium intake is not associated with the risk of having a fracture. Thirdly, in clinical trials, calcium supplements have only small, inconsistent benefits on preventing fractures, with no effect on fractures seen in the highest quality trials (more…)
Author Interviews, Endocrinology, JCEM, Menopause, Mineral Metabolism / 01.09.2015

MedicalResearch.com Interview with: Emily Krantz (né Amundson) MD Södra Älvsborgs Hospital Borås, Sweden Medical Research: What is the background for this study? What are the main findings? Response: This study is a 10-year follow up of a double-blind placebo controlled trial in which women with post menopausal osteoporosis received Growth Hormone (GH) for 3 years (Landin-Wilhelmsen JBMR 2003;18:393-404). Positive effects of the treatment on the patients bone mineral density and bone mineral content were seen after another 7 years. Furthermore and most interestingly, fracture incidence decreased dramatically from 56% to 28% (p=.0003) in the osteoporosis patients while fractures increased significantly in the control group, from 8% to 32% (p=.0008). Health Related Quality of Life was also measured throughout the study’s duration and it did not change nor did it differ from the control group. (more…)