Research Updates on
Nutrition & Dietary Therapy In Health and Healing
Compiled by Kevin W Chen, Ph.D.
Nutrition as Medical Therapy. Crit Care Nurs Clin North Am. 2014 Jun;26(2):277-287. By Yogaratnam D, Miller MA, Ross B, DiNapoli M.
Recent data support the use of nutritional agents for use as targeted medical therapy. This article reviews some of the pharmacologic roles that parenteral nutritional ingredients (selenium, lipid emulsion, insulin, and levocarnitine) can play in the setting of critical illness. KEY POINTS:
- Intravenous selenium may be a useful therapy for treating severe sepsis; a deadly syndrome for which limited treatment options exist.
- Lipid emulsion therapy has emerged as a viable treatment modality for various toxic drug exposures, including local anesthetic toxicity.
- High-dose insulin therapy has been used successfully to improve cardiac function in patients with acute calcium channel blocker overdose.
- L-Carnitine, which is required for metabolic energy production, has been found to be useful in treating encephalopathy associated with valproic acid toxicity
The therapeutic potential of medicinal foods. Adv Pharmacol Sci. 2014;2014:354264. By Ramalingum N, Mahomoodally MF.
Pharmaceutical and nutritional sciences have recently witnessed a bloom in the scientific literature geared towards the use of food plants for their diversified health benefits and potential clinical applications. Health professionals now recognize that a synergism of drug therapy and nutrition might confer optimum outcomes in the fight against diseases. The prophylactic benefits of food plants are being investigated for potential use as novel medicinal remedies due to the presence of pharmacologically active compounds. Although the availability of scientific data is rapidly growing, there is still a paucity of updated compilation of data and concerns about the rationale of these health-foods still persist in the literature. This paper attempts to congregate the nutritional value, phytochemical composition, traditional uses, in vitro and in vivo studies of 10 common medicinal food plants used against chronic noncommunicable and infectious diseases. Food plants included were based on the criteria that they are consumed as a common food in a typical diet as either fruit or vegetable for their nutritive value but have also other parts which are in common use in folk medicine. The potential challenges of incorporating these medicinal foods in the diet which offers prospective opportunities for future drug development are also discussed.
Evidence-based diabetes nutrition therapy recommendations are effective: the key is individualization. Diabetes Metab Syndr Obes. 2014 Feb 24;7:65-72. By Franz MJ, Boucher JL, Evert AB.
Current nutrition therapy recommendations for the prevention and treatment of diabetes are based on a systematic review of evidence and answer important nutrition care questions. First, is diabetes nutrition therapy effective? Clinical trials as well as systematic and Cochrane reviews report a ~1%-2% lowering of hemoglobin A1c values as well as other beneficial outcomes from nutrition therapy interventions, depending on the type and duration of diabetes and level of glycemic control. Clinical trials also provide evidence for the effectiveness of nutrition therapy in the prevention of diabetes. Second, are weight loss interventions important and when are they beneficial? Modest weight loss is important for the prevention of type 2 diabetes and early in the disease process. However, as diabetes progresses, weight loss may or may not result in beneficial glycemic and cardiovascular outcomes. Third, are there ideal percentages of macronutrients and eating patterns that apply to all persons with diabetes? There is no ideal percentage of macronutrients and a variety of eating patterns has been shown to be effective for persons with diabetes. Treatment goals, personal preferences (eg, tradition, culture, religion, health beliefs, economics), and the individual’s ability and willingness to make lifestyle changes must all be considered by clinicians and/or educators when counseling and educating individuals with diabetes. A healthy eating pattern emphasizing nutrient-dense foods in appropriate portion sizes, regular physical activity, and support are priorities for all individuals with diabetes. Reduced energy intake for persons with prediabetes or type 2 diabetes as well as matching insulin to planned carbohydrate intake are intervention to be considered. Fourth, is the question of how to implement nutrition therapy interventions in clinical practice. This requires nutrition care strategies.
PURPOSE OF REVIEW: To summarize recent research addressing the role of enteral fish oil supplementation in critical illness.
RECENT FINDINGS: A number of new multicenter trials examining both the use of fish oil given as a supplement to enteral nutrition support and given as a separate bolus, independent of nutrition delivery, have recently been reported.
SUMMARY: Mechanistic data suggest that administration of fish oil may help attenuate the systemic inflammatory response and allow for appropriate resolution of inflammation in critically ill patients. Recent data indicate that enteral fish oil given as a continuous infusion as part of complete nutrition improves outcome in critically ill patients, especially those with acute lung injury/acute respiratory distress syndrome. In contrast, the bolus administration of fish oil cannot be recommended as clinically beneficial in acute lung injury/acute respiratory distress syndrome patients. Recent trials indicate that pharmacologically administered nutrients should be studied in the same manner as other new drugs, with appropriate attention to early dosing trials, proper pre-enrollment patient selection, and understanding of the role of concomitant protein/calorie nutrition. More research continues to be needed to optimize the proper patient, dose, and timing of administration for enteral fish oil therapy in the ICU.
Vitamin E-gene interactions in aging and inflammatory age-related diseases: implications for treatment. A systematic review. Ageing Res Rev. 2014 Mar;14:81-101. By Mocchegiani E, Costarelli L, Giacconi R, et al.
Aging is a complex biological phenomenon in which the deficiency of the nutritional state combined with the presence of chronic inflammation and oxidative stress contribute to the development of many age-related diseases. Under this profile, the free radicals produced by the oxidative stress lead to a damage of DNA, lipids and proteins with subsequent altered cellular homeostasis and integrity. In young-adult age, the cell has a complex efficient system to maintain a proper balance between the levels of free radicals and antioxidants ensuring the integrity of cellular components. In contrast, in old age this balance is poorly efficient compromising cellular homeostasis. Supplementation with Vitamin E can restore the balance and protect against the deteriorating effects of oxidative stress, progression of degenerative diseases, and aging. Experiments in cell cultures and in animals have clearly shown that Vitamin E has a pivotal role as antioxidant agent against the lipid peroxidation on cell membranes preserving the tissue cells from the oxidative damage. Such a role has been well documented in immune, endothelial, and brain cells from old animals describing how the Vitamin E works both at cytoplasmatic and nuclear levels with an influence on many genes related to the inflammatory/immune response. All these findings have supported a lot of clinical trials in old humans and in inflammatory age-related diseases with however contradictory and inconsistent results and even indicating a dangerous role of Vitamin E able to affect mortality. Various factors can contribute to all the discrepancies. Among them, the doses and the various isoforms of Vitamin E family (α,β,γ,δ tocopherols and the corresponding tocotrienols) used in different trials. However, the more plausible gap is the poor consideration of the Vitamin E-gene interactions that may open new roadmaps for a correct and personalized Vitamin E supplementation in aging and age-related diseases with satisfactory results in order to reach healthy aging and longevity. In this review, this peculiar nutrigenomic and/or nutrigenetic aspect is reported and discussed at the light of specific polymorphisms affecting the Vitamin E bioactivity.
Therapeutics role of olive fruits/oil in the prevention of diseases via modulation of anti-oxidant, anti-tumour and genetic activity. Int J Clin Exp Med. 2014 Apr 15;7(4):799-808. By Rahmani AH, Albutti AS, Aly SM.
Abstract: The current mode of treatment for various diseases is based on synthetic drugs are effective but they show adverse effect and also alter the genetic and metabolic activity. Moreover, some drugs prepared from plants and their constituents show potentiality with more efficacy than synthetic agents used in clinical therapy. Earlier report has shown that regular consumption of fruits and vegetables is strongly related with reduced risk of developing various diseases. Several epidemiological studies has shown that, the incidence heart disease and cancers is lowest in the Mediterranean basin as compared to the part of the world because of their diet rich in olives and olive products. Olives are commonly consumed in Mediterranean and Arabian Peninsula and also have been documented in Holy Quran and modern scientific literatures. Earlier studies have shown that, the constituents from olive such as oleuropein, squalene and hydroxytyrosol modulate the genes functions and other activities. In this review, the medicinal value of olives and their constituents are summarized in terms of therapeutic approach in the diseases management through regulation of various activities.
Functional foods-based diet as a novel dietary approach for management of type 2 diabetes and its complications: A review. World J Diabetes. 2014 Jun 15;5(3):267-81 By Mirmiran P, Bahadoran Z, Azizi F.
Abstract: Type 2 diabetes is a complicated metabolic disorder with both short- and long-term undesirable complications. In recent years, there has been growing evidence that functional foods and their bioactive compounds, due to their biological properties, may be used as complementary treatment for type 2 diabetes mellitus. In this review, we have highlighted various functional foods as missing part of medical nutrition therapy in diabetic patients. Several in vitro, animal models and some human studies, have demonstrated that functional foods and nutraceuticals may improve postprandial hyperglycemia and adipose tissue metabolism modulate carbohydrate and lipid metabolism. Functional foods may also improve dyslipidemia and insulin resistance, and attenuate oxidative stress and inflammatory processes and subsequently could prevent the development of long-term diabetes complications including cardiovascular disease, neuropathy, nephropathy and retinopathy. In conclusion available data indicate that a functional foods-based diet may be a novel and comprehensive dietary approach for management of type 2 diabetes.
Diet and diabetes: lines and dots. J Nutr. 2014 Apr;144(4 Suppl):567S-570S. By Katz DL.
Diabetes, particularly type 2 diabetes, is epidemic in the United States among adults and children alike, and increasingly prevalent around the world. On its current trajectory, the increasing incidence of diabetes has the potential to ravage both public health and economies. There has, however, been evidence for decades that lifestyle has enormous potential to prevent chronic disease, diabetes included. Studies suggest that the combination of tobacco avoidance, routine physical activity, optimal dietary pattern, and weight control could eliminate as much as 80% of all chronic disease, and 90% of cases of diabetes specifically. None of these factors is necessarily easily achieved, but most are simple. Diet, on the other hand, is complex, and arguments abound for competing diets and related health benefits. From an expansive review of relevant literature, the case emerges that the overall theme of optimal eating for human beings is very well established, whereas the case for any given variation on that theme is substantially less so. Once the theme of healthful eating is acknowledged, the challenge shifts to getting there from here. Although much effort focuses on the wholesale conversion of dietary patterns, the introduction or removal of highly nutritious foods can have direct health effects, and potentially reverberate through the diet as well, shifting the quality of the diet and related health effects. Studies demonstrating favorable effects of daily walnut ingestion in diabetes and insulin resistance are profiled as an illustration, and an ongoing study examining the implications of daily walnut ingestion on diet quality and various biometric variables is described. The line between dietary pattern and the epidemiology of diabetes is indelibly established; we must work to connect the dots between here and there.
Depression and diet. (Article in Finnish) Duodecim. 2014;130(9):902-9. By Seppälä J, Kauppinen A, Kautiainen H. et al.
Abstract: Especially low vitamin B12 or folate and low intake of omega-3-fatty acids, but also low vitamin D may associate with increased risk of depression. B12 and folate may also be useful in the treatment of depression. The importance of individual fatty acids is unclear. The causal relationship between depression and diet, the efficacy of vitamins or dietary supplements in the treatment of depression, or the impact of diet compared with other treatment options need to be scrutinized. An overall healthy diet rich in vitamin B12, D or folate and fish oils may have positive effect also on depression.
Increased dietary protein as a dietary strategy to prevent and/or treat obesity. Mo Med. 2014 Jan-Feb;111(1):54-8. By Leidy HJ.
Obesity in America continues to be a major public health concern. Emerging scientific evidence suggests that a diet rich in high-quality protein is a beneficial dietary strategy to prevent and/or treat obesity. This paper provides a brief synopsis of the latest research regarding the effects of higher protein diets to improve body weight management and energy intake regulation. Specific focus on the effects of increased dietary protein on appetite control, satiety, and food cravings are also explored.
Food pattern, lifestyle and diabetes mellitus. Int J High Risk Behav Addict. 2014 Mar 10;3(1):e8725. By Rahati S, Shahraki M, Arjomand G, Shahraki T.
BACKGROUND: Prevalence of Type 2 diabetes is increasing rapidly worldwide. Recent data is reprehensive of increasing diabetes prevalence from 285 millions in 2010 (6.4%) to 439 millions in 2030 in adults aged 20 to 79 in different countries. Lifestyle and particularly dietary habits play an important role in the development of diabetes. Additionally, specific individual food groups and diet components such as monounsaturated fatty acids, fruits, vegetables, whole grain cereals, dietary fiber, fish, magnesium and nuts may protect against the development of diabetes, possibly through the amelioration of insulin sensitivity and its anti-inflammatory actions, while consumption of red and processed meats and saturated fat may increase the risk of type 2 diabetes.
OBJECTIVES: In this section, we studied dietary and other factors related to the effect of lifestyle in type 2 diabetes. These factors may affect the incidence of type 2 diabetes which could be corrected by lifestyle modifications.
RESULTS: Unfortunately, dietary habits in the developed and developing countries are changing towards an unhealthier direction. Consequently, emphasis should be given on encouraging at population and individual levels for adopting a healthier lifestyle, including dietary habits, to prevent the development of type 2 diabetes. Here we reviewed epidemiologic and clinical trial evidence regarding nutrients, foods and dietary patterns to diabetes risk and involved possible mechanisms.
CONCLUSIONS: Type 2 diabetes is increasingly growing in young population of developing countries, which causes a large burden on individuals and the society.
A review of the fundamentals of diet. Glob Adv Health Med. 2013 Jan;2(1):58-63. By Gaby A.
Dietary recommendations should be individualized for each patient, but certain basic principles apply to most people. A healthful diet should include a wide variety of whole, unprocessed foods that are free of additives and, if possible, grown without the use of pesticides, herbicides, and other potentially toxic agricultural chemicals. For people who do not have specific food intolerances, such a diet generally includes liberal amounts of fresh fruits and vegetables, whole grains, nuts, seeds, and legumes. For most people, animal foods such as eggs, fish, chicken, beef, and dairy products can be healthfully consumed in moderation. It is not necessary to consume animal foods to maintain good health. In fact, compared with omnivores, vegetarians have a lower risk of developing a number of chronic diseases. However, vegetarians must carefully plan their diet so as not to develop nutritional deficiencies.