Supplements

MedicalResearch.com Interview with: Christopher Loftus M.D. candidate Cleveland Clinic Lerner College of Medicine Medical Research: What is the background for this study? What are the main findings? Response: Most kidney stones are made, at least partially, of calcium composite. In a prospective study of nurses in the post-menopausal age, it was found that diets that contained high amounts of calcium were beneficial in preventing kidney stones in this population. In the gut, calcium can bind to oxalate which prevents it from being absorbed into the body and decreases the concentration of calcium in the urine. However there has been debate as to whether supplemental calcium (calcium pills) has the same beneficial effects as calcium in the diet. Supplemental calcium enters the gut in large quantities all at once so it may enter the blood stream in higher concentrations over smaller amounts of time. By the same token, vitamin D plays a role in the management and balance of calcium in the body and could potentially have an effect on stone formation as well.  It has also been debated whether vitamin D supplementation has major effect on patients who are known to be stone formers.  So we reviewed CT scans of patients and 24 hour urine collections (both male and female of adult age) who were known to have kidney stones and measured the growth of stones over a period of time. Our main findings were that supplementary calcium increased the rate of stone formation in these patients. We also found that vitamin D had a protective effect and patients taking only vitamin D had a slower rate of stone progression.

[caption id="attachment_4115" align="alignleft" width="83"]Andrew I. Geller, MD Medical Officer in the Division of Healthcare Quality Promotion at CDC. Dr. Andrew Geller[/caption] MedicalResearch.com Interview with: Andrew I. Geller, M.D From the Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Medical Research: What is the background for this study? What are the main findings? Dr. Geller: In recent years some dietary supplement products have been recalled for having unapproved ingredients or contaminants, but there is very little national data about how frequently dietary supplements that are not included in such recalls cause health problems. This study looks at how often people went to emergency departments (EDs) for problems caused by dietary supplements.
  • Supplements include herbals, complementary nutritionals (such as amino acid supplements), and vitamins and minerals.
  • We studied records from 63 emergency departments from 2004-2013.
  • We calculate that every year, dietary supplements cause:
  • More than 23,000 ED visits, and
  • More than 2,000 hospitalizations.
  • More than a quarter (28%) of these ED visits were among young adults (20-34 years).
  • More than half (56%) of the ED visits made by young adults were for problems with products for weight loss or increased energy.
  • Cardiac symptoms (irregular/fast heartbeat or chest pain) were common among patients with weight loss or energy supplement problems.
  • More than 20% were young children who got into supplements meant for someone else.
  • ED visits were less common among older adults, but more than 1 in 3 (36%) of these ED visits by older adults were for swallowing problems, such as choking on a pill, most commonly vitamin/mineral supplements.

Prof. Andrew B Lemmey School of Sport, Health and Exercise Sciences Bangor University Bangor, Gwynedd, Wales, UKMedicalResearch.com Interview with: Prof. Andrew B Lemmey School of Sport, Health and Exercise Sciences Bangor University Bangor, Gwynedd, Wales, UK Medical Research: What is the background for this study? Prof. Lemmey: Substantial loss of lean mass (LM; mostly skeletal muscle) is common in patients with rheumatoid arthritis (RA), as we and others have shown that even amongst patients with well-controlled disease approximately 67% are significantly muscle wasted. This loss of muscle, termed “rheumatoid cachexia”, is a major contributor to the decreased strength and impaired physical function which continues to characterise RA. Unfortunately, current drug treatments for RA, including use of biologics and the ‘treat-to-target (T2T)’ strategy, do not reverse this LM loss, nor fully restore physical function (Lemmey et al., “Tight control of disease activity fails to improve body composition or physical function in rheumatoid arthritis patients”. Submitted to Rheumatology (Oxford), currently under review). Whilst high-intensity exercise (specifically, progressive resistance training (PRT)) has been shown to be highly effective in restoring both  lean mass and function in  rheumatoid arthritis patients (Lemmey et al., Arthritis Care & Research 2009;61(12):1726-34), the lack of uptake and adherence to sufficiently intense training (Lemmey et al., Arthritis Care & Research 2012;64(1):71-5) means this form of therapy is not widely adopted. Anabolic nutritional supplementation offers a potential adjunct treatment intervention for increasing LM, and thereby improving physical function, that could be widely accepted. Indeed, our group (Marcora et al., Clinical Nutrition 2005;24(3):442-54) has previously demonstrated that 12 weeks of daily oral protein supplementation improved lean mass and some measures of strength and function in  rheumatoid arthritis patients. Creatine (Cr) is a popular dietary supplement generally shown to have greater benefits on both lean mass and physical function than generic protein supplementation. One study (Willer et al., Rheumatology 2000;39(3):293-8) has investigated the efficacy of Cr supplementation in rheumatoid arthritis patients. In this short uncontrolled trial, twelve patients underwent 3 weeks of supplementation, and although strength increased, no changes in function were found, and body composition changes were not investigated. Using a double-blind, placebo controlled design, the current study aimed to investigate the effects of 12 weeks of oral Cr supplementation on body composition (by DXA; dual energy X-ray absorptiometry), strength (knee-extensor and handgrip) and objectively-assessed physical function (chair and walk tests) in patients with RA. Thirty-five patients (Cr=15, Pl=20) completed the study. 

MedicalResearch.com Interview with: Emanuele Cereda, MD, PhD Servizio di Dietetica e Nutrizione Clinica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy and Federico D’Andrea MD SCDO Dietetica e Nutrizione Clinica, Azienda Ospedaliera Universitaria “Maggiore della Carità”, Novara, Italy MedicalResearch: What is the background for this study? What are the main findings? Response: Pressure ulcers (PUs) represent an important indicator of patient safety and quality of care. They negatively affect patient quality of life and increase healthcare costs. PUs are closely linked to malnutrition as it contributes not only to their development but also to impaired healing. It's also a sign of neglect if the patient is in a nursing home so you may want to contact someone like this nursing home neglect lawyer if you are worried that your loved one is being mistreated. Pressure ulcers patients are frequently unable to meet energy requirements through spontaneous feeding and nutritional support becomes essential. International guidelines currently recommend nutritional assessment and nutritional support as most Pressure ulcers patients can take advantage from adequate supply of proteins and calories. Beside, recent studies have suggested that additional provision of larger amount of some nutrients putatively involved in wound healing - arginine, zinc and antioxidants - may be of additional benefit. The OEST study has specifically investigated the role of these nutrients and has demonstrated that supplementation of malnourished Pressure ulcers patients with an oral nutritional formula enriched with arginine, zinc and antioxidants improves Pressure ulcers healing, independently of the adequate supply of proteins and calories.

Jennifer Williams MSN, MPH, FNP-BC National Center on Birth Defects and Developmental Disabilities CDC, Atlanta, Georgia MedicalResearch.com Interview with: Jennifer Williams MSN, MPH, FNP-BC National Center on Birth Defects and Developmental Disabilities CDC, Atlanta, Georgia Medical Research: What is the background for this study? What are the main findings? Response: Neural tube defects are serious birth defects of the brain and spine that can cause significant disability and death. Studies have shown that taking 400 mcg of folic acid daily before and during pregnancy can reduce the prevalence of neural tube defects. Therefore, in 1992, the US Public Health Service (USPHS) recommended that all women of childbearing age in the United States who are capable of becoming pregnant consume 400mcg of folic acid per day to reduce the risk of neural tube defects. To help women meet this requirement, in 1998 the US Food and Drug Administration (FDA) mandated that folic acid be added to enriched grain products for the prevention of neural tube defects. This study looks at how many neural tube defects have been prevented annually since folic acid fortification. Using data from birth defects tracking systems, researchers found that since folic acid fortification, the birth prevalence of neural tube defects has decreased by 35% in the United States, which translates to about 1,300 babies that are born each year without a neural tube defect who might otherwise have been affected.  This study also reports that the number of babies born with a neural tube defect annually differs by the mother’s race/ethnicity. Hispanic mothers continue to be at the highest risk for having a baby with a neural tube defect.

MedicalResearch.com Interview with: Scott A. Davis, MA Research Administrative Coordinator Department of Dermatology Wake Forest School of Medicine MedicalResearch: What are the main findings of the study? Answer: St. John’s wort (SJW), a common complementary and alternative medicine (CAM) treatment for depression, is frequently used together with drugs that may interact dangerously with it. In data from the 1993-2010 National Ambulatory Medical Care Survey, a nationally representative survey of physician visits from the National Center for Health Statistics, SJW was prescribed together with drugs such as selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, warfarin, statins, digoxin, verapamil, and oral contraceptives. Using SJW together with other antidepressants may cause serotonin syndrome, a potentially fatal condition.