Metabolic Syndrome Patients Need More Vitamin C

A higher intake of vitamin C is crucial for metabolic syndrome patients trying to halt a potentially deadly cycle of antioxidant disruption and health-related problems, an Oregon State University researcher says.

That’s important news for the estimated 35 percent of the U.S. adult population that suffers from the syndrome.

“What these findings are really saying to people as we move out of the rich-food holiday season and into January is eat your fruits and vegetables,” said Maret Traber, a professor in the OSU College of Public Health and Human Sciences and Ava Helen Pauling Professor at Oregon State’s Linus Pauling Institute. “Eat five to 10 servings a day and then you’ll get the fiber, you’ll get the vitamin C, and you’ll really protect your gut with all of those good things.”

A diet high in saturated fat results in chronic low-grade inflammation in the body that in turn leads to the development of metabolic syndrome, a serious condition associated with cognitive dysfunction and dementia as well as being a major risk factor for cardiovascular disease, fatty liver disease and type 2 diabetes.

A patient is considered to have metabolic syndrome if he or she has at least three of the following conditions: abdominal obesity, high blood pressure, high blood sugar, low levels of “good” cholesterol, and high levels of triglycerides.

Findings published in Redox Biology suggest the type of eating that leads to metabolic syndrome can prompt imbalances in the gut microbiome, with impaired gut function contributing to toxins in the bloodstream, resulting in vitamin C depletion, which subsequently impairs the trafficking of vitamin E.

It’s a treadmill of antioxidant disruption that serves to make a bad situation worse; antioxidants such as vitamins C and E offer defense against the oxidative stress brought on by inflammation and the associated free radicals, unstable molecules that can damage the body’s cells.

“Vitamin C actually protects vitamin E, so when you have lipid peroxidation, vitamin E is used up and vitamin C can regenerate it,” Traber said. “If you don’t have the vitamin C, the vitamin E gets lost and then you lose both of those antioxidants and end up in this vicious cycle of depleting your antioxidant protection.”

Lipid peroxidation is the oxidative degradation of polyunsaturated fatty acids that are a major component of living cells; it’s the process by which free radicals try to stabilize themselves by stealing electrons from cell membranes, causing damage to the cell.

“If there’s too much fat in the diet, it causes injury to the gut,” Traber said. “Bacterial cell walls can then leak from the gut and slip into circulation in the body, and they’re chased down by neutrophils.”

Neutrophils are the most abundant type of white blood cells, a key part of the immune system. Neutrophils attack bacteria with hypochlorous acid: bleach.

“The white blood cells are scrubbing with bleach and that destroys vitamin C,” Traber said. “The body is destroying its own protection because it got tricked by the gut dysbiosis into thinking there was a bacterial invasion.”

And without intervention, the process keeps repeating.

“People with metabolic syndrome can eat the same amount of vitamin C as people without metabolic syndrome but have lower plasma concentrations of vitamin C,” Traber said. “We’re suggesting that’s because this slippage of bacterial cell walls causes the whole body to mount that anti-inflammatory response.”

Vitamin C is found in fresh vegetables and fruits; sources of vitamin E include almonds, wheat germ and various seeds and oils.

Federal dietary guidelines call for 65 to 90 milligrams daily of vitamin C, and 15 milligrams of vitamin E.

Scientists from the University of Iowa and Ohio State contributed to this research. The National Institutes of Health, the Center for Applied Plant Sciences and Ohio Agricultural Research and Development Center at The Ohio State University, the National Dairy Council, and DSM Nutrition supported this study.

Source: Oregon State University


Today’s Comic

What Might Make Prostate Cancer’s Return More Likely?

Obesity and other health problems may boost the chances of cancer returning after a man has his prostate removed, a new study finds.

“Prostate cancer is the most common cancer in men, and up to 30 percent of patients will develop recurrence after [prostate removal],” said study author Dr. Arash Samiei, of Allegheny Health Network’s urology department in Pittsburgh.

Samiei’s team analyzed data from 1,100 prostate cancer patients who had their prostate removed (radical prostatectomy) at a Pittsburgh hospital between 2003 and 2013. The patients were an average of age 60 when diagnosed.

Thirty-four percent were obese, and 19 percent had metabolic syndrome — a group of risk factors that increases the chances of heart disease, stroke and diabetes.

Characteristics of metabolic syndrome include high blood sugar, obesity, abnormal cholesterol or triglyceride levels, and high blood pressure, according to the U.S. National Heart, Lung, and Blood Institute.

The patients were followed for an average of four years. Prostate cancer returned in more than 32 percent of obese patients, compared with about 17 percent of those who weren’t obese, the researchers said.

Patients with metabolic syndrome had a more than four times higher risk of prostate cancer return than those without the syndrome, according to the study.

The findings are scheduled for presentation at an American Association for Cancer Research meeting, in Austin, Texas.

“Obesity and metabolic syndrome have become increasingly widespread in our society,” Samiei said in an association news release.

This study indicates that “prostate cancer patients who are obese or have metabolic syndrome undergoing [prostate removal] may have a higher chance for recurrence of the disease, and these individuals should have more focused follow-up care,” Samiei said.

Because the study is observational, it can’t prove that obesity and metabolic syndrome are responsible for cancer returning.

Still, “by preventing metabolic syndrome, men with prostate cancer may have a higher chance of a favorable oncological outcome following surgery,” Samiei said.

Source: HealthDay


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Too Little Sleep May Raise Risk of Death in People with Metabolic Syndrome

People with a common cluster of risk factors for heart disease and diabetes were approximately twice as likely to die of heart disease or stroke as people without the same set of risk factors if they failed to get more than six hours of sleep, according to a new observational study published in the association’s open access publication Journal of the American Heart Association. For those who got more sleep, the risk of death was more modest.

The study, funded in part by the American Heart Association, is the first to measure sleep duration in the laboratory rather than rely on patient reports and the first to examine the impact of sleep duration on the risk of death in those with a common cluster of heart disease risk factors.

The researchers randomly selected 1,344 adults (average age 49 years, 42 percent male) who agreed to spend one night in a sleep laboratory as part of the Penn State Adult Cohort. Based on their test results, 39.2 percent of the participants were found to have at least three of the risk factors, that when clustered together are known as the metabolic syndrome. For this study, the cluster included body mass index (BMI) higher than 30 and elevated total cholesterol, blood pressure, fasting blood sugar and triglyceride levels.

During an average follow-up of 16.6 years, 22 percent of the participants died.

Compared to people without the same cluster of risk factors, those with metabolic syndrome who clocked more than six hours of sleep time in the lab were about 1.49 times more likely to die of stroke during the 16.6-year follow-up period, while those who slept less than six hours in the lab were about 2.1 times more likely to die of heart disease or stroke. The short sleepers with metabolic syndrome were also 1.99 times more likely to die from any cause compared to those without metabolic syndrome.

The relationship was particularly striking because the researchers adjusted for sleep apnea – sleep interrupted by pauses in breathing that is a known heart disease risk.

“If you have several heart disease risk factors, taking care of your sleep and consulting with a clinician if you have insufficient sleep is important if you want to lower your risk of death from heart disease or stroke,” said study lead author Julio Fernandez-Mendoza, Ph.D., an assistant professor at Penn State College of Medicine and sleep psychologist at the Sleep Research & Treatment Center of the Penn State Health Milton S. Hershey Medical Center in Hershey, Pennsylvania.

He noted that sleep lab studies are often used to rule out sleep apnea, but physicians should also note insufficient sleep in the lab because it may signal a higher risk of death in patients with risk factors for heart disease.

A recent scientific statement from the American Heart Association on sleep duration and quality noted that an increasing number of Americans suffer from sleep difficulties or choose to curtail sleep in favor of other social, leisure, or work-related activities and this may be associated with adverse cardiovascular risks and outcomes.

As the Fernandez-Mendoza research was an observational study, the results cannot establish a cause-and-effect, only an association between short sleep and mortality in people with the metabolic syndrome. Additional limitations include that the study used only one day of sleep lab results and enrolled too few minority patients to determine whether there are racial differences in the relationship between short sleep times and mortality.

“Future clinical trials are needed to determine whether lengthening sleep, in combination with lowering blood pressure and glucose, improves the prognosis of people with the metabolic syndrome” said Fernandez-Mendoza.

Source: American Heart Association


Today’s Comic

Expanding Waistlines and Link to Metabolic Syndrome

Gisele Galoustian wrote . . . . .

For decades, American waistlines have been expanding and there is increasing cause for alarm. Researchers from the Charles E. Schmidt College of Medicine at Florida Atlantic University make the case that metabolic syndrome — a cluster of three of more risk factors that include abdominal obesity, high triglycerides, high blood pressure, abnormal lipids, and insulin resistance, a precursor of type 2 diabetes — is the new “silent killer,” analogous to hypertension in the 1970s. As it turns out, the “love handle” can be fatal.

In a commentary published in the Journal of Cardiovascular Pharmacology and Therapeutics , the authors describe how being overweight and obesity contribute to metabolic syndrome, which affects 1 in 3 adults and about 40 percent of adults aged 40 and older. Clinicians have traditionally evaluated each of the major risk factors contributing to metabolic syndrome on an individual basis. There is evidence, however, that the risk factors are more than just the sum of their parts.

“The major factor accelerating the pathway to metabolic syndrome is overweight and obesity,” said Charles H. Hennekens, M.D., Dr.P.H., the first Sir Richard Doll Professor and senior academic advisor to the dean who senior authored the paper with Dawn H. Sherling, M.D., first author and an assistant professor of integrated medical science, and Parvathi Perumareddi, D.O., an assistant professor of integrated medical science, all faculty members in FAU’s Charles E. Schmidt College of Medicine. “Obesity is overtaking smoking as the leading avoidable cause of premature death in the U.S. and worldwide.”

For optimal health, the waist should measure less than 40 inches for men and 35 inches for women. The authors explain that the visceral fat component of abdominal obesity leads not only to insulin resistance but also to the release of non-esterified free fatty acids from adipose tissue or body fat. Lipids then accumulate in other sites such as the liver and muscle, further predisposing individuals to insulin resistance and dyslipidemia — abnormal amounts of lipids. In addition, adipose tissue may produce various adipokines that may separately impact insulin resistance and cardiovascular disease risk factors.

The authors further caution that individuals with metabolic syndrome are largely asymptomatic but have a 10-year risk of a first coronary event, based on the Framingham Risk Score of 16 to 18 percent, which is nearly as high as a patient who already has experienced a prior coronary event. Moreover, they are concerned that metabolic syndrome is both underdiagnosed and undertreated.

“Visceral fat and its clinically more easily measured correlate of waist circumference are gaining increasing attention as strong predictors of metabolic syndrome even if you remove body mass index from the equation,” said Sherling. “There are patients who have a normal body mass index yet are at high risk. These patients represent an important population for clinicians to screen for metabolic syndrome.”

In the commentary, the authors emphasize the importance of therapeutic lifestyle changes beginning in childhood. They note that as the current generation of American children and adolescents reach middle age, morbidity and mortality from cardiovascular disease will increase.

“The pandemic of obesity, which begins in childhood, is deeply concerning,” said Perumareddi. “Adolescents today are more obese and less physically active than their parents and already have higher rates of type 2 diabetes. It is likely that the current generation of children and adolescents in the U.S. will be the first since 1960 to have higher mortality rates than their parents due mainly to cardiovascular disease, including coronary heart disease and stroke.”

The authors stress that obesity is a major risk factor for several cancers, especially colorectal, but also breast and prostate and that clinicians should not let the perfect be the enemy of the possible. For American adults, this implies the need for evidence-based doses of drugs of lifesaving benefit for those at high risk.

“In the U.S., cardiovascular disease will remain the leading killer due largely to obesity and physical inactivity,” said Hennekens. “Unfortunately, most people prefer prescription of pills to proscription of harmful lifestyles. The totality of evidence indicates that weight loss of 5 percent or more of body weight combined with a brisk walk for 20 or more minutes daily will significantly reduce cardiovascular events and deaths.”

According to the U.S. National Institutes of Health, approximately two-thirds of adults age 20 or older are overweight or obese with body mass indexes (BMI) greater than 25, and nearly one-third have BMIs greater than 30. Less than one-third of them are at a healthy weight with a BMI of 18.5 to 24.9. Estimated medical costs of obesity are as high as $147 billion a year for 2008, or almost 10 percent of all medical spending.

The authors also conclude that the export of American diet and lifestyle, which increases rates of obesity and physical inactivity, together with the alarming rates of export of tobacco to developing countries are resulting in cardiovascular disease emerging as the leading killer worldwide.

Source: Florida Atlantic University


Today’s Comic

Resistant Starch May Benefit People with Metabolic Syndrome

The secret ingredient is in the flour, but its impact lies within the gut.

Adding resistant starch to the diets of people with metabolic syndrome can improve bacteria in the gut, according to research from South Dakota State University. These changes help lower bad cholesterol and decrease inflammation associated with obesity.

The American Heart Association estimates that 34 percent of Americans have metabolic syndrome, a combination of conditions which significantly increases their risk of developing heart disease and Type 2 diabetes.

This is the first study to examine the prebiotic impact of resistant starch type 4 known as RS4—a nondigestible, chemically modified wheat fiber—in individuals with metabolic syndrome, explained associate professor Moul Dey of the Department of Health and Nutritional Sciences.

Unlike regular starch, RS4 works as a functional fiber, Dey explained. Because it is not broken down in the upper gastrointestinal tract, RS4 is fermented by the gut bacteria in the colon. This produces new substances, such as short-chain fatty acids, that have functions related to health.

“Human bodies harbor more bacterial cells than their own and therefore what we eat is not just for us but also for our bacteria,” Dey said. “How well we feed them contributes to how well they take care of our health. That’s where RS4 can help.”

The results were published in today’s Scientific Reports, a Nature Publishing Group academic journal. The research was supported by MGP Ingredients, the National Institutes of Health and the U.S. Department of Agriculture funding through the South Dakota Agricultural Experiment Station. Funding agencies had no role in the study design or outcome.

Using ingredient in real food

The study focused on 12 women and 8 men with metabolic syndrome from 2 Hutterite colonies in eastern South Dakota. These individuals had abdominal obesity accompanied by two of four other conditions—high blood pressure, high blood sugar levels or diabetes, high level of triglycerides in the blood stream and low levels of good cholesterol. Twelve participants were on medications for one or more of these conditions.

The starch was incorporated into the intervention group’s flour. All the meals in this communal setting are prepared from scratch and every meal contains one or two flour-based items.

“As the study was blinded, they didn’t even realize they were doing anything different, yet they were improving their health,” Dey said. “Our hypothesis was that adding RS4 in the diet makes bacteria happy and increases the health benefit of the food people normally eat. The beauty of this study is that it showed this is possible in a real-life setting.”

Unlike most dietary intervention studies, the researchers used a free-living community style environment and made minimal modifications to the participants’ habitual diet.

A healthy diet and lifestyle can reduce the risks associated with metabolic syndrome. But, altering lifelong habits and adhering to dietary guidelines in the long run is difficult. “This is where stealth ingredients, like RS4, make a lot of sense,” Dey pointed out. However, she added, “making healthy lifestyle choices remains critical.”

The intervention was conducted in two 12-week sessions with a two-week hiatus. This allowed researchers to switch the intervention and control groups so that each group served as its own control. Stool and blood samples were collected and a DXA scan to evaluate body composition was done before and after the intervention.

Doctoral candidate Bijaya Upadhyaya, master’s student Robert Juenemann and postdoctoral researcher Sailendra Nichenametla worked on the research. This work also involved collaboration with U.S. Food and Drug Administration scientist Ali Reza Fardin-Kia. Other SDSU collaborators were assistant professor Lacey McCormack, professor Jeffrey Clapper of animal science and professor Bonnie Specker, director of the E.A. Martin Endowed Program in Human Nutrition.

Decreasing cholesterol, improving gut bacteria

Use of resistant starch decreased all types of cholesterols. The participants’ baseline cholesterol levels were not high, in part, because of the medications they were taking. Despite that, the average total cholesterol of the participants dropped significantly after the intervention. In addition, the researchers observed a small decrease in average waist circumference and body fat percentage.

DNA analysis of stool samples using next-generation sequencing showed a change in the gut bacterial community structure after the intervention. “Essentially, consuming RS4 improved the balance of bacteria in the gut, some of which correlated with improved indicators of metabolic health as well as with increased levels of short chain fatty acids.”

Currently, RS4 is only available to food manufacturers for use as a fiber ingredient. Dey hopes that one day consumers will be able to buy flour fortified with RS4.

Source: newswise


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