Long Term Multivitamin Use in Women Reduces the Risk of Heart Attack

A new study published in the American Journal of Clinical Nutrition examined the association between multivitamin use and myocardial infarction (MI) in a large population of women.

The study included 31,671 Swedish women with no history of cardiovascular disease (CVD) and 2,262 women with a history of CVD aged 49–83 years. At the beginning of the study, the women completed a questionnaire regarding dietary supplement use, diet, and lifestyle factors. Multivitamins were estimated to contain nutrients close to recommended daily allowances.

During an average of 10.2 years of follow-up, 932 MI cases were identified in the CVD-free group and 269 cases in the CVD group. In the CVD-free group, use of multivitamins only, compared with no use of supplements, was associated with a 27% decreased risk of CVD. When multivitamins were used in conjunction with other supplements, the risk of CVD was decreased by 30%. In those that used only supplements other than multivitamins the reduction in risk was much smaller at only 7%. In women that used multivitamins for more than 5 years there was a 41% reduction in risk of CVD.

This research showed that the use of multivitamins was inversely associated with MI, especially among long-term users with no history of CVD.

Rautiainen S, Akesson A, Levitan EB, Morgenstern R, Mittleman MA, Wolk A. Multivitamin us and the risk of myocardial infarction: a population-based cohort of Swedish women. 2010. American Journal of Clinical Nutrition, Vol. 92, (5), 1251-6

High Fish & Vegetable Intake Reduces Risk of Breast Cancer

In a new study, researchers found a strong correlation between a diet high in vegetables and seafood and reduced risk of breast cancer. Lower BMI, high levels of dietary supplement use, and increased physical activity also correlated with reduced breast cancer risk.
After skin cancer, breast cancer is the most common type of cancer in women. In U.S. women, more than 1 in 4 cancers (28%) are breast cancers. Historically, breast cancer has been much more prevalent in Western countries than in Asian countries, although the gap has declined dramatically in recent years. A new study published by researchers at South Korea's National Cancer Center sheds new light on one possible explanation for this effect.

In this study, 357 breast cancer patients between the ages of 25 and 77 were matched with 357 healthy controls. A trained dietitian conducted face-to-face interviews with each study subject, collecting detailed information on lifestyle (including physical activity), demographics, and diet.

410 types of reported food were grouped into 39 food groups based on nutrient profiles and culinary usage. These food groups were then used to calculate two "dietary patterns": one characterized by regular consumption of a variety of vegetables, seafoods, and soybean products, and another characterized by above-average intake of meat (non-fish) and starch-rich foods (bread, noodles, pizza, etc). The "vegetable-seafood" diet is representative of a traditional Korean diet, while the "meat-starch" diet is representative of a traditional Western diet. Statistical analysis were then performed to look for correlations between demographics, lifestyle factors, and these two diet patterns.

Breast cancer occurrence in this study correlated strongly with higher BMI (p=0.006), lower levels of dietary supplement use (p=0.005), and low levels of physical activity (p=0.021). Additionally, a significant inverse association was seen between the vegetable-seafood pattern and breast cancer risk, while no correlation (positive or negative) was seen for the meat-starch group. Additional analysis correlated the vegetable-seafood diet with higher intakes of fiber, vitamin A, carotene, vitamin C, vitamin E, folate, and calcium (p < 0.001 for all).

This study provides strong evidence for a diet high in vegetables and seafood reducing the risk of breast cancer. As the authors note, the increasing Westernization of Korean diets may explain - at least in part - the rising rates of breast cancer in that country.

Cho YA, Kim J, Shin A, Park KS, Ro J. Dietary Patterns and Breast Cancer Risk in Korean Women. 2010. Nutrition and Cancer 62(8):1161-9.

New Diabetes Projections "Paint Sobering Picture of the Future"

Without widespread intervention, one in three American adults could have type 2 diabetes by the year 2050.

Type 2 diabetes is a chronic health condition that develops when the body becomes resistant to insulin, a hormone that regulates carbohydrate and fat metabolism. The exact mechanism by which type 2 diabetes occurs is unknown, but a number of correlating risk factors - particularly obesity and physical inactivity - are well-established. Unfortunately, the number of individuals with type 2 diabetes has increased sharply in recent years, with an estimated $174 billion cost to the United States in 2007 alone.

A number of papers have attempted to project type 2 diabetes prevalence 5, 10, and 20+ years into the future. Unfortunately, most of these projections have relied on weak or outdated metrics, including old census data, static mortality rates, and overly simple estimations of diabetes incidence. A recent paper from researchers at the National Center for Chronic Disease Prevention and Health Promotion hoped to overcome these weaknesses by utilizing recent census data and a matrix of factors derived from an extensive literature review.

The researchers describe their results as "a sobering picture of the future growth of diabetes." Their most optimistic values point to 21% of the U.S. adult population having type 2 diabetes in the year 2050. A middle-ground scenario predicts a prevalence of 25%-28%, while high-end data points to a diabetes prevalence of 33%, or 1 in 3 adults. To put these numbers in perspective, approximately 7% of the U.S. adult population had type 2 diabetes in 2007. In 1990, prevalence was below 5%.

Unlike some chronic diseases, type 2 diabetes risk can be reduced by relatively moderate lifestyle changes. Losing weight (if overweight or obese), improving dietary choices, and regular exercise are all known to reduce risk of acquiring type 2 diabetes. The authors of this paper note that such changes "can help to decrease loss in quality of life and the future cost of providing care for people with diabetes. Indeed, such efforts are essential if we hope to moderate or slow the growth of diabetes prevalence."

Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. 2010. Population Health Metrics 8:29

Regular Exercise Reduces Risk of the Common Cold

New research shows a strong correlation between regular aerobic exercise and reduced risk of upper respiratory tract infections.


Upper Respiratory Tract Infections (URTI) can be caused by more than 200 different viruses, and it is estimated that the U.S. population suffers more than one billion colds a year (2-4 per average adult, 6-10 per average child). A number of lifestyle factors contribute to URTI risk, including poor nutrient status, lack of sleep, and stress. A new paper published in the British Journal of Sports Medicine adds exercise habits to the list of lifestyle factors affecting URTI risk.

1,023 subjects between 18 and 85 years of age were recruited for this study, with 1,002 individuals completing all study requirements. Subjects were selected from multiple BMI groups (roughly one-third were of normal weight, one-third were overweight, and one-third were obese) to ensure adequate representation. A comprehensive validated survey on lifestyle, diet, activity levels, stress, and URTI incidence and severity was completed by each study participant.

After controlling for potential cofounders, total days with URTI symptoms were 43-46% lower in the highest third of aerobic activity when compared to the lowest third, while URTI severity was reduced 32-41% for the high group. Low stress levels, high exercise frequency (≥5 days/week), and high fruit intake (≥3 servings/day) also correlated with reduced URTI incidence.

The exact mechanism by which aerobic exercise reduces URTI risk is still uncertain, although it appears to be a combination of factors, including transient increases of certain immune cell types, a reduction of stress hormones, and specialized benefits to key organs (particularly the lungs, which serve as a primary barrier against URTIs).

Nieman DC, Henson DA, Austin MD, Sha W. Upper respiratory tract infection is reduced in physically fit and active adults. 2010. Br J Sports Med, ePub ahead of print. doi:10.1136/bjsm.2010.077875

Soy Phytates

Plants store phosphorus, an essential nutrient for plants and animals, in their seeds to support the growth of young seedlings. This phosphorus is stored in the form of phytate (inositol hexametaphosphate). Plant phytates are considered by some to be “anti-nutrients” because phytates consumed in the human diet can complex with essential minerals like iron and zinc and inhibit absorption in the gut. Others, however, consider phytates to be important food constituents that act not only as natural food-preserving antioxidants, but also help reduce risk of heart disease and cancer in those who consume whole grains, beans, seeds and nuts.

Soybeans contain significant amounts of phytate (1.3-1.4%), and some point to this as a reason to avoid soy foods.  However, it is important to note that most whole grains, beans, seeds, and nuts are also rich in phytates (Table 1), and there is a wealth of science to support the fact that these foods are important constituents of a healthy, well-balanced diet that supports longevity and reduced disease risk. As such, it is difficult to argue that soy should be avoided based on its phytate content when so many healthy foods contain comparable levels of phytates.

It is also important to note that on a percent basis, isolated soy protein contains far less phytate than do whole soybeans.






Table 1.  Phytate contents of some common grains, beans, and nuts.  Values from NR Reddy and SK Sathe (eds).  Food Phytates.  CRC Press, 2001. 

Food	Phytate Content (%)
Whole Wheat	0.7-1.1
Wheat Flour	0.3-1.4
Wheat Bran	2.0-5.3
Corn	0.8-1.0
Oats	1.0
Barley	1.0
Brown Rice	0.9
Soybeans	1.3-1.4
Soy Protein Isolates	0.7-0.9
Kidney Beans	2.6-2.9
Lentils	0.4-0.5
Chick Peas	0.6
Small White Beans	1.2
Great Northern Beans	2.6-2.9
Peas	0.8-1.2
Hazel Nuts	1.9
Walnuts	0.6-2.4
Almonds	1.3-3.2
Cashews	0.6-2.0

Soy and Thyroid Function

Some claim that soy foods should be avoided because they contain compounds (isoflavones) that disrupt thyroid function. We view this as a “half truth” that has little relevance for healthy individuals who consume soy at moderate levels as part of a healthy, balanced diet.

The relationship between soy consumption and thyroid function has been studied for more than 70 years. Interest in the topic grew during the 1950’s and 1960’s when several cases of goiter were identified in infants who consumed soy formulas. Subsequently, using in vitro and animal research, scientists found that at high concentrations the soy isoflavones genistein and daidzein can inhibit the activity of thyroid peroxidase and 5'-deiodinase, key enzymes involved in thyroid hormone biosynthesis.

Since that time, 14 human clinical trials have evaluated the effects of soy foods and soy isoflavones on thyroid function. All involved presumably healthy subjects, and with few exceptions the soy product used was isolated soy protein.

With only one exception, all of the studies showed either no effects or minor and clinically irrelevant effects of soy on thyroid function. The one trial that noted marked anti-thyroid effects (and the one often cited in anti-soy literature) involved Japanese adults who were fed roasted soybeans that had been pickled and stored in rice vinegar. The soy protein and isoflavone content of this food was not characterized, and the study involved no control group. As such, its relevance must be questioned.

One large study evaluated the specific effects of soy isoflavone supplements on thyroid function. Postmenopausal women between the ages of 64 and 83 were given daily doses of 90 mg of soy isoflavones or a placebo. Thyroid hormone levels were tested at baseline and again at 90 and 180 days. After six months, any differences in thyroid hormones between the groups were statistically indistinguishable.

Today, most experts agree that soy foods and isolated soy protein have little if any effect on thyroid function in normal, healthy adults. That said, the potential for soy isoflavones to disrupt thyroid function should not be ignored by people who have compromised thyroid function and/or people with suboptimal iodine status. But these groups aside, we contend that soy is a good source of protein when consumed in moderate amounts as part of a healthy, balanced diet.

In support of this position, note that Asian populations have a long history of consuming soy products without significant occurrence of goiter. This also holds true for vegetarians who consume not only higher levels of soy, but high levels of fruits and vegetables that contain other flavonoids known to inhibit thyroid enzyme activity. These flavonoids include kaempferol (found in apples, onions, green tea), naringenin (found in citrus fruits), and quercetin (found in fruits and berries). Such compounds are widely distributed in plant-derived foods and are consumed at relatively high levels (up to 1 gram or more per day) by vegetarians and vegans. Despite this, vegetarian diets have not been linked with decreased thyroid function.

Serum 25-Hydroxyvitamin D Concentrations

Serum concentration of 25(OH)D is the best indicator of vitamin D status. It reflects vitamin D produced cutaneously and that obtained from food and supplements and has a fairly long circulating half-life of 15 days. However, serum 25(OH)D levels do not indicate the amount of vitamin D stored in other body tissues. Circulating 1,25(OH)₂D is generally not a good indicator of vitamin D status because it has a short half-life of 15 hours and serum concentrations are closely regulated by parathyroid hormone, calcium, and phosphate. Levels of 1,25(OH)₂D do not typically decrease until vitamin D deficiency is severe.

There is considerable discussion of the serum concentrations of 25(OH)D associated with deficiency (e.g., rickets), adequacy for bone health, and optimal overall health (Table 1). A concentration of <15 nanograms per milliliter (ng/mL) (or <37.5 nanomoles per liter [nmol/L]) is generally considered inadequate; concentrations >15 ng/ml (>37.5 nmol/L) are recommended. Higher levels are proposed by some (>30 ng/ml or >75 nmol/L) as desirable for overall health and disease prevention, but insufficient data are available to support them. Serum concentrations of 25(OH)D consistently >200 ng/ml (>500 nmol/L) are potentially toxic.

Table 1: Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health*

ng/mL**	nmol/L**	Health status
<10-11	<25-27.5	Associated with vitamin D deficiency, leading to rickets in infants and children and osteomalacia in adults
<10-15	<25-37.5	Generally considered inadequate for bone and overall health in healthy individuals
≥15	≥37.5	Generally considered adequate for bone and overall health in healthy individuals
Consistently >200	Consistently >500	Considered potentially toxic, leading to hypercalcemia and hyperphosphatemia, although human data are limited. In an animal model, concentrations ≤400 ng/mL (≤1,000 nmol/L) demonstrated no toxicity.

* Serum concentrations of 25(OH)D are reported in both nanograms per milliliter (ng/mL) and nanomoles per liter (nmol/L).
** 1 ng/mL = 2.5 nmol/L

An additional complication in assessing vitamin D status is in the actual measurement of serum concentrations of 25(OH)D. Considerable variability exists among the various assays available and among laboratories that conduct the analyses. This means that compared to the actual concentration of 25(OH)D in a sample of blood serum, a falsely low or falsely high value may be obtained depending on the assay or laboratory used. A standard reference material for 25(OH)D became available in July 2009 that will now permit standardization of values across laboratories.

What is Choline

Choline is a dietary component necessary for cell membrane integrity and facilitating the movement of fats into and out of cells. Choline is also a precursor for acetylcholine, an important neurotransmitter in the brain. Choline also works with folic acid, vitamin B12, and methionine in methyl group metabolism and maintenance of healthy homocysteine levels. Since high levels of homocysteine increase the risk of cardiovascular disease, an adequate intake of choline may be important in reducing risk.

Pregnancy and lactation are periods when maternal reserves of choline risk becoming depleted. Because the availability of choline for normal fetal development of the brain is critical, expectant and nursing mothers should make certain their choline intake is adequate.

Although choline can be found in a wide variety of foods, some of the richest sources are foods high in cholesterol and fat (e.g. beef liver). Because many Americans have been advised to decrease their consumption of fatty foods, choline intake in some populationi groups may be inadequate. Healthy sources of choline include Brussel sprouts, broccoli, eggs, lean beef, milk, peanuts, and certain seafoods (shrimp, salmon, and cod).

High Vitamin B Levels Associated With Reduced Risk of Colorectal Cancer

In a recent population-based European study, individuals with higher vitamin B2 and B6 levels had significantly decreased risks of colorectal cancer.

New research reported in the October 2010 issue of Cancer Epidemiology, Biomarkers and Prevention shows a correlation between higher levels of vitamins B2 (riboflavin) and vitamin B6 and a reduced risk of developing colorectal cancer. B-vitamins are essential for metabolism and have been linked to a reduced risk of colorectal cancer in previous studies. Since associations with the B-vitamin folate have been studied most often, researchers in the current study focused on potential associations of other B vitamins (B2, B6, and B12) and colorectal cancer.

This European population-based study included subjects who were participants in the Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 1,365 adults diagnosed with colorectal cancer and 2,319 age and gender-matched control subjects. Blood samples were taken at enrollment and analyzed for vitamins B2, B6, and B12, as well as 8 variants of genes that relate to the function of these vitamins.

After an average follow-up of 3.6 years, individuals whose vitamin B6 levels were among the top 20 percent of participants had a 32 percent lower risk of developing colorectal cancer when compared to those whose levels were in the lowest 20 percent. Among those whose vitamin B2 levels were highest, the risk was 29 percent lower than those whose levels were lowest. There were no significant associations for vitamin B12 and colorectal cancer. Vitamin levels were lower in smokers compared to nonsmokers, and the benefits for vitamin B6 were stronger in males who consumed ≥30 g (one ounce) of alcohol per day.

This research is the first population-based study to indicate that vitamin B2 is inversely associated with colorectal cancer, and it supports previously suggested inverse associations of vitamin B6 with colorectal cancer.

Simone J.P.M. Eussen et al. Vitamins B2, B6, and B12, and Related Genetic Variants as Predictors of Colorectal Cancer Risk. Cancer Epidemiol Biomarkers Prev; 19(10); 2549–61.

Folic Acid (Vitamin B9)

Folic acid is a water-soluble B vitamin with a role as a regulating coenzyme for cellular metabolism and cell division.

Folic acid helps form the building blocks of DNA and RNA needed for protein synthesis in human cells. Rapidly growing tissues - such as those of a fetus - and rapidly regenerating cells - like red blood cells and immune cells - have an especially high need for folic acid.

Folic acid requirements increase during pregnancy. Deficiencies of folic acid during pregnancy are associated with low birth weight and an increased incidence of neural tube defects, including anencephaly and spina bifida. In one study, women at high risk of giving birth to babies with neural tube defects lowered their risk by as much as 72% by taking folic acid supplements prior to and during pregnancy. Medical experts, other healthcare professionals, and the March of Dimes recommend that all women of childbearing age supplement with 400 mcg of folic acid per day. Such supplementation would protect against the formation of neural tube defects during the time between conception and when pregnancy is discovered. If a woman waits until after pregnancy to begin taking folic acid supplements, it is likely too late to prevent a neural tube defect.

Folic acid deficiency has also been associated with high homocysteine levels and an increased risk for stroke, heart disease, and cognitive diseases like Alzheimer's disease. A folic acid deficiency may also result in a form of anemia (which can be remedied with supplementation).

It is difficult to accurately estimate how much folic acid is present in food. The best food sources appear to be vegetables (asparagus, broccoli, brussels sprouts, legumes), nuts, and seeds.

Additional Resources:

• Dietary Supplement Fact Sheet: Folate (from the National Institute of Health)
• Folic acid (folate) - U.S. National Library of Medicine
• Folic acid - Centers for Disease Control and Prevention (CDC)
• Folic acid - American Pregnancy Association
• Folic acid - American Cancer Society
• Folic acid - Wikipedia
• Folic acid - Linus Pauling Institute

Soy and Weight Loss

Some claim that soy-based meal-replacement formulas are ineffective for weight loss. However, the fact is that soy protein has been used effectively as a component of weight loss diets for more than 20 years. Animal studies have shown that soy protein and its associated bioactive isoflavones and peptides can have beneficial effects on glucose metabolism, fat metabolism, insulin sensitivity, metabolic rate, food intake and weight loss.  Studies in humans have further shown that increased intakes of soy or animal protein can increase metabolic rate, decrease appetite, and increase satiety. Furthermore, randomized clinical trials and clinical weight loss studies have shown that diets based on soy protein are every bit as effective - if not more effective - than diets based on dairy protein when it comes to helping people lose weight and abdominal fat.

The truth is that weight loss is much more a function of reducing caloric intake and increasing calories burned through exercise, as opposed to simply using soy or whey protein in the diet.

The Nutritional Value of Soy Protein

Several scales for assessing the nutritional value of protein have been developed over the years. These have been used to rate various proteins for their ability to support growth, supply important amino acids, and generally satisfy the human protein requirement. The first broadly accepted standard was the Protein Effectiveness Ratio (PER). Developed in 1919, this method focused on the growth-supporting characteristics of a given protein, and it used rats (rather than humans) as the test animal. Because of the metabolic differences between rodents and humans, this method has been largely discredited and is rarely used today.

A second method, the Biological Value (BV) scale, is based on the retention of protein nitrogen by the body. It is thought to be a good measure of protein utilization. The BV scale stretches from 0 to 100, with a score of 100 indicating that virtually 100% of a given protein's nitrogen is retained by the body. Some people - particularly in the sports world - use this method, but it is not widely accepted within the community of nutritional scientists.

Most nutritionists (and many in the sports sector) now consider the Protein Digestibility Corrected Amino Acid Score (PDCAAS) to be the international standard for assessing protein quality. This approach, developed by the Food and Agriculture Organization and endorsed by the U.S. Food and Drug Administration, considers the amino acid balance of a given protein as it compares with the amino acid needs of humans, with specific reference to 2-5 year old children. It also takes into account the digestibility of the protein, or how fully the protein is broken down and absorbed by the body. The PDCAAS scale stretches from 0.0 to 1.0, with a score of 1.0 indicating that the protein completely satisfies human needs from a quality perspective.

During the 1990’s, whey protein became the protein of choice among bodybuilders, due in large part to an intense and successful marketing campaign sponsored by the dairy industry. That marketing promotion was based on the fact that some whey protein isolates have a rating of 100 on the BV scale. In comparison, egg-white protein (the traditional standard for bodybuilders) typically ranks in the 90’s, while most fish, beef, and soy proteins rank in the 70’s on the BV scale. (You will see a wide variety of BV scores for these foods because different people express the ratios in different ways, and the techniques for measuring BV are imprecise and not easily replicated from one experiment to another.)

However, when the PDCAAS approach is employed, soy protein isolates, whey protein isolates, and egg white protein all score a complete 1.00, meaning they all exhibit very high - and essentially equivalent - nutritional value in supporting human health.

The high PDCAAS score for soy protein isolates speaks to two important points. First, soy protein is well-digested and absorbed by humans. (This is the “D” of PDCAAS). Second, soy protein is complete. It contains all the essential amino acids in a proper balance for human growth, development, and health. (This is the “AA” of PDCAAS.)

Some authors have claimed that soy is lacking in the essential amino acid methionine, as if to imply that soy contains no methionine. This is incorrect. Soy may not be rich in methionine, but it contains enough to supply human needs under most circumstances. Furthermore, it is important to point out that human methionine requirements can be partially met by another sulfur-containing amino acid (cysteine). When cysteine + methionine content is considered, soy protein is nutritionally excellent.

Soy Allergies and Sensitivities

Soy is on the Food and Agriculture Organization’s list of the eight most prevalent food allergens. This list includes milk, eggs, fish, crustacea, wheat, peanuts, tree nuts, and soy. Together, these foods account for about 90% of food allergies.

That said, it is important to understand that these high-profile food allergies differ widely in their incidence, severity, and symptoms, and that soy protein - relative to milk and nut proteins, for example - is a relatively mild allergen. Consider the following:

• Milk and peanut allergies are each 5-6 times more prevalent than soy allergies. In fact, the true incidence of soy allergy - as confirmed by double blind, placebo-controlled food challenges - is quite low. Research indicates that allergic reactions to soy occur predominately in children less than four years of age, and most estimates agree that &lt;1.0% of children (probably 0.2-0.4% of children) have true soy allergies. Moreover, 90% of children who have reactions to soy outgrow the allergy by age four. Given these statistics, it is safe to assume that &lt;0.1% of adults (fewer than 1 in 1,000) are allergic to soy.
• Food allergen reaction thresholds, or the minimum oral dose of protein that elicits an allergic response, tend to be several orders of magnitude (more than 100-1000 times) higher for soy than for milk and peanut proteins. In other words, it takes 100-1000 times more soy protein than milk or peanut protein to initiate an allergic response in sensitive people.
• Soy allergies tend to produce mild symptoms relative to other food allergies. In a summary report of clinical food challenge studies, it was noted that in 80% of reported cases, symptoms of soy allergies were minimal to mild, with the remaining 20% being moderate. No severe allergic reactions to soy were reported. In comparison, milk and peanut allergies produced minimal-to-mild symptoms in 50-70% of cases, moderate symptoms in 20-30% of cases, and severe symptoms in 10-15% of cases.

In summary, soy proteins can produce allergic reactions in some people, but relative to milk, peanut, and the other high-profile food allergens, reactions to soy are less common, more difficult to trigger, and less severe.

Beyond true allergic reactions, some people may be sensitive to the “non-digestible” sugars and fiber in soy. These components can cause abdominal bloating and gas, just like the sugars and fibers in most beans and just like the lactose in milk. Such symptoms are generally reduced, if not eliminated, when people use highly refined soy protein isolates which are 90-92% soy protein and only 3-4% carbohydrate (fiber plus simple and complex sugars and starches).

Alpha Lipoic Acid

Alpha lipoic acid (ALA), also known as lipoic acid (LA) or thioctic acid, is a vitamin-like antioxidant. Some refer to ALA as the "universal antioxidant" because it has the unique attribute of being both fat and water-soluble. Another unique aspect of ALA is its ability to regenerate other antioxidants back to active states, including vitamin C, vitamin E, glutathione, and Coenzyme Q10.

Several experimental and clinical studies have shown potential therapeutic uses for alpha lipoic acid in addressing diabetes, atherosclerosis, cataracts, heavy metal poisoning, neurodegenerative diseases, and HIV infection.

Alpha lipoic acid is produced naturally by most organisms, including humans. It is also present in many foods, with above-average amounts in organ meats (kidney, heart, liver), potatoes, spinach, and broccoli.  Unfortunately, total dietary availability of ALA is quite poor. One of the first groups of researchers to isolate alpha-lipoic acid required nearly 10 tons of liver residue to produce a mere 30mg of crystalline LA. Because of this, all supplemental ALA is produced synthetically.

Currently no RDI value has been set, nor has the issue been adequately studied. Some researchers believe that the amount needed for therapeutic antioxidant activity exceeds that produced by our bodies or consumed in a normal diet. As such, alpha lipoic acid is a strong candidate for dietary supplementation. Maintenance doses of 10-25 mg per day have been suggested, while doses up to several hundred milligrams per day have been used therapeutically.

Vitamin C (Mineral Ascorbates)

Vitamin C, also known as ascorbic acid or ascorbate, plays two important roles in the body. First, it is a cofactor or cosubstrate for eight enzyme systems involved in various functions, including collagen synthesis, ATP synthesis in mitochondria, and hormone biosynthesis. Second, vitamin C is a powerful water-soluble antioxidant with a vital role in protecting cells and tissues from damaging oxidizing agents, including superoxides, hydroxyl radicals, and other free radicals. All these functions derive from one fundamental property: vitamin C is a powerful reducing agent (or electron donor) capable of neutralizing reactive oxidants.

Related functions performed by vitamin C include regenerating vitamin E to its active state, promoting iron absorption in the intestines by keeping iron in its reduced form, and participation in DNA transcription and protein synthesis regulation.

The richest dietary sources of vitamin C include cantaloupe, grapefruit, honeydew, kiwi, mango, oranges and other citrus fruits, strawberries, and watermelon. The richest vegetable sources include asparagus, broccoli, brussels sprouts, dark green leafy vegetables, and peppers.

Although vitamin C is generally non-toxic, very high dosages (several grams or more) may cause or contribute to gastrointestinal distress and diarrhea.

Additional Resources:

• Vitamin C - U.S. National Library of Medicine
• Vitamin C - Physicians' Desktop Reference
• Vitamin C - Mayo Clinic
• Vitamin C - Linus Pauling Institute
• Vitamin C - Wikipedia

What is Elemental Calcium

Due to its high reactivity, calcium is rarely found in its elemental (or pure) state in nature. Similarly, you cannot buy pure calcium; it is always combined with another element to make it less reactive. During digestion, your body breaks the combination of calcium and other elements apart to make the calcium available for absorption.

What this means is that a 500 mg calcium supplement tablet may not be 500 mg of calcium, but a 500 mg mixture of calcium and other elements. The actual amount of usable calcium in a supplement is called elemental calcium.

Check out this hub: Do Calcium Supplements Cause Kidney Stones and Constipation for more information about Calcium

Beta-Carotene & Vitamin A

Carotenoids comprise a diverse class of antioxidant molecules that help protect the body from oxidative damage. Approximately 700 natural carotenoids have been isolated and characterized. Most are derived from plants, where they serve multiple functions: photosynthetic pigments, photoprotectants, and free radical scavengers. Some 50-60 carotenoids are present in a typical diet with the major sources being fruits and vegetables.

Beta-carotene is one of the best known carotenoids, likely because: (1) it is one of the most abundant in a typical adult diet, and (2) it provides two nutritional functions - in addition to its role as an antioxidant, the human body converts beta-carotene into vitamin A.

Other members of the antioxidant carotenoid family include alpha-carotene, cryptoxanthin, zeaxanthin, lutein, and lycopene. Unlike beta-carotene, most of these nutrients are not converted to vitamin A in significant amounts.

Beta carotene's role as an antioxidant is based on its extensive system of conjugated double bonds which, upon reacting with an oxygen atom, absorb and diffuse that oxygen's potentially destructive energy. The oxygen atom returns to a lower energy state, and beta carotene dissipates the absorbed energy harmlessly (as heat). Similar mechanisms are involved in quenching the oxidative potential of hydroxyl radicals and other free radical compounds.

As provitamin A, beta carotene contributes to an entirely different set of functions by supplying a portion of the body's requirement for retinol (vitamin A). In fact, a single molecule of beta-carotene can be cleaved in the body to produce two molecules of vitamin A. Other carotenoids (including alpha-carotene, gamma-carotene, and cryptoxanthin) provide provitamin A activity, but yield only one molecule of vitamin A when metabolized.

Retinol (vitamin A) is an essential nutrient associated with three important functions, the best-defined of which involves human vision. Retinol is a functional constituent of rhodopsin, a protein located in the retina of the eye that absorbs light and triggers a series of biochemical reactions that ultimately initiate nerve impulses, resulting in sight.

Secondly, vitamin A is involved in the activation of gene expression and the control of cell differentiation. It is through this function that vitamin A affects immune function, taste, hearing, appetite, skin renewal, bone development, and growth.

Vitamin A's third role involves control of embryonic development. Here it is thought that retinoic acid modulates the expression of certain genes that govern patterns of sequential development of various tissues and organs in the body.

Vitamin A deficiency is a major public health issue, particularly in developing countries. It has been estimated that 500,000 preschool-age children worldwide become blind each year as a result of vitamin A deficiency. Millions of others suffer from night blindness, a common clinical sign of inadequate vitamin A intake. Further estimates suggest that more than 100 million children worldwide suffer from vitamin A inadequacy without showing clinical signs of acute deficiency. Beta-carotene is known to be an effective dietary cure for vitamin A deficiency and an effective remedy for symptoms of this disorder.

Epidemiological studies support long-term beneficial effects of beta-carotene intake on a number of degenerative diseases. For example, the relationship between beta-carotene intake and cancer has received considerable attention in recent years. Epidemiological evidence suggests that long-term intake of dietary beta-carotene may reduce the risk of several types of cancer. Similar findings pertain to heart disease and immune health.

Dietary sources rich in beta carotene and other provitamin A carotenoids include carrots, broccoli, yellow squash, corn, tomatoes, papayas, oranges, and dark green leafy vegetables like spinach, kale and Chinese cabbage. Beta-carotene is heat stable, so it is not degraded during prolonged boiling or microwaving.

What is Coenzyme Q10

Coenzyme Q10, or ubiquinone, is a compound with an essential role in mitochondrial electron transport, making it a fundamental part of cellular energy production.

Coenzyme Q10 is also an antioxidant. Its ability to quench free radicals helps maintain the structural integrity and stability of cell membranes (including intracellular membranes). It is also capable of improving oxidation resistance of low-density lipoprotein (LDL) cholesterol. Additional evidence suggests that Coenzyme Q10 uses its antioxidant capabilities to regenerate vitamin E.

CoQ10's other name, ubiquinone, signifies its ubiquitous (widespread) distribution in the human body. Highest levels of Coenzyme Q10 are found in the heart, liver, kidney, and pancreas.

CoQ10 supplementation has therapeutic benefits for several diseases. Some of the best-documented effects involve cases of heart failure, ischemic heart disease, certain muscular dystrophies, hypertension, and periodontal disease.

CoQ10 is synthesized in all cells of the body. It is also absorbed from food. Major sources of dietary CoQ10 include meats, fish, and vegetable oils (particularly soybean, sesame, and rapeseed oils). Vegetables are generally low in CoQ10, with the exception of spinach and broccoli.

As aging occurs, the body's ability to synthesize CoQ10 diminishes significantly. Deficiencies may also result from reduced assimilation from dietary sources.

Coenzyme Q10 supplements are generally considered safe and are best absorbed by the body when taken with foods. The usual maintenance dose is 10-30 mg per day, although higher doses are used therapeutically for the treatment of heart and blood vessel disease.

Maternal Vitamin B12 Levels Influence Cognitive Development in Children

A recent study demonstrates an association between maternal vitamin B12 status during pregnancy and children's cognitive functioning at age 9. Higher maternal plasma vitamin B12 concentration in pregnancy was an independent predictor of the child's cognitive performance.

Vitamin B12 is an important nutrient for brain development and function. Since fetal requirements are provided by the mother through the placenta, inadequate maternal levels directly affect the amount available to the fetus. Research has consistently shown that maternal nutritional status can influence metabolic, cardiovascular, and psychiatric health of their future children.

In a recent study, investigators analyzed the relationship between maternal plasma vitamin B12 status during pregnancy and the child's cognitive function at 9 years of age. Previous research had shown that maternal vitamin B12 status influenced intrauterine growth and insulin resistance in children at 6 years of age.

Subjects included two groups of children born in the Pune Maternal Nutrition Study. The two groups were selected based on the maternal plasma vitamin B12 concentration at 28 weeks of gestation. Group 1 included 49 children born to mothers with the lowest plasma levels of vitamin B12. Group 2 included 59 children born to mothers with the highest plasma levels of B12.

The differences in tested intelligence and visual agnosia (the ability to recognize shapes, people, sounds, smells, and objects) were not significantly different between the groups. However, children from group 2 performed significantly better on a test for sustained attention and on a test of short-term memory. The differences were still significant after appropriate adjustments for confounding factors.

Result of this study support the idea that maternal vitamin B12 status in pregnancy influences cognitive function in offspring

Bhate V, et al. Vitamin B12 status of pregnant Indian women and cognitive function in their 9-year-old children. 2008. Food Nutr Bull 29(4): 249–54.

What is Magnesium

Magnesium is an essential mineral for many fundamental processes in the body. It normally exists in the body as a charged particle (or ion) and is primarily stored in bones. Magnesium plays an integral role in hundreds of enzymatic functions and is important for nerve, muscle, and bone health.

Magnesium helps with the absorption of calcium and depends on vitamin D for its own absorption. Food dietary sources of magnesium include spinach, legumes, nuts, and grains.

The recommended dietary allowance for magnesium is 400 mg/d for men and 310 mg/d for women. Excessive intake can lead to gastrointestinal discomfort, but no adverse effect has been seen for long-term consumption of amounts less than or equal to 700 mg/d.

By the way, Magnesium silicate is used in tablet formulations as a glidant and anti-caking agent.

What is Phylloquinone (Vitamin K)

Vitamin K (koagulation vitamin) is an essential nutrient required for the normal biosynthesis and activation of several key proteins. There are three forms of this vitamin.

• Vitamin K1, also known as phylloquinone or phytonadione, is found in green plants and is the form included in dietary supplements.
• Vitamin K2, also called menaquinone, is produced by bacteria, including some found in the human intestinal tract.
• Vitamin K3 or menadione, a synthetic derivative, is used as a source of vitamin K in animal feeds.

Vitamin K is an essential cofactor for enzymatic activity. It assists in the enzymatic carboxylation of glutamic acid, an amino acid found in most proteins. This carboxylation occurs after the amino acid has been incorporated into the protein chain. The added carboxyl (-COOH) groups provide a site at which calcium can bind to the protein. Through the above activity, vitamin K is involved in converting an inactive precursor of prothrombin (blood coagulation factor II) into biologically active prothrombin.

Vitamin K is similarly involved in the synthesis of at least five other proteins involved in the regulation of blood clotting. In all cases, it is thought that vitamin K assists in activating these proteins through establishment of calcium-binding sites. Other vitamin-K-dependent proteins whose function depends on calcium binding have been identified in bone, kidney, and vascular tissues. In bone, these proteins appear to be involved in bone crystal formation and bone remodeling. As a result, the potential role of vitamin K in osteoporosis has received increasing attention.

The best food sources of vitamin K are green vegetables, including spinach, broccoli, Brussels sprouts, kale, and turnip greens.

No known toxicity is associated with the administration of high doses of the natural phylloquinone form of vitamin K.

Can someone on blood-thinning medication (aspirin, Plavix, Coumadin/Warfarin) take supplements containing vitamin K?

It is strongly recommended that anyone currently on Coumadin therapy discuss the use of vitamin K-containing supplements (including the Essentials, HealthPak, and Active Calcium) with their physician. Aspirin and Plavix, which both work by different mechanisms than Coumadin, are not affected by normal vitamin K intake.

Additional Resources:
Vitamin K - U.S. National Library of Medicine
Vitamin K - Physicians' Desktop Reference
Vitamin K - Wikipedia
Vitamin K - Linus Pauling Institute

What Are Possible Results of a Vitamin D Deficiency?

What is Cholecalciferol (Vitamin D3)? Vitamin D is a fat-soluble nutrient essential for bone growth and general health. It is acquired through diet and exposure to sunlight. Light-induced synthesis occurs in the skin when ultraviolet light reacts with a form of cholesterol, converting it to vitamin D. This molecule is then altered by the liver and kidneys to form the physiologically active vitamin.

Several compounds have vitamin D or potential vitamin D activity. The most important forms are vitamin D2 (ergocalciferol) and Vitamin D3 (cholecalciferol). The latter is the form normally found in humans, and it is also the form used in most nutritional supplements and clinical research.

A unique property of vitamin D is that it functions very much like a hormone. Its target tissues include the kidneys, intestines, and bones, where it helps regulate calcium and phosphorus homeostasis. Its specific activity in the intestines involves stimulating the synthesis of active transport proteins that mediate absorption of calcium. In bone tissue, vitamin D plays a role in regulating calcium deposition (bone mineralization) and mobilization. A role for vitamin D in immune system modulation is now under investigation.

Vitamin D is an essential component of bone health in both children and adults. Without vitamin D, bones do not calcify properly, leading to the condition known as "rickets." Vitamin D also plays an important role in tooth development. It is necessary for proper tooth eruption, growth, and strength. Through its role in regulating calcium and phosphorus metabolism, vitamin D plays a continuing role in maintaining a stable nervous system, normal heart activity, and normal blood clotting.

Exposure to the sun is the most important source of vitamin D for most humans. Limited amounts of vitamin D are available from food, including fortified milk, certain types of fish, and fortified breakfast cereals. Vitamin D deficiency is most directly related to poor bone health, including rickets and osteomalacia. However, vitamin D deficiency is also associated with an increased risk of other disorders, including certain cancers, type I diabetes, multiple sclerosis, tuberculosis, rheumatoid arthritis, muscle weakness and pain, depression, hypertension, and pregnancy complications. While many of these associations are actively being researched to determine the extent of their connection with vitamin D deficiency, we currently know that vitamin D unquestionably exerts a significant influence on many body systems.

Calcium and Vitamin D Enhance Heart Health Benefits of Weight Loss

Weight Loss & Heart Health

Weight loss and reduced waist circumference are related to an improvement in heart health and factors related to metabolic syndrome. According to recent research, supplementing with calcium and vitamin D during weight loss enhances heart health benefits in women with typically low calcium intakes.

Recent research has shown that overweight individuals with low calcium and dairy consumption are at increased risk of developing metabolic syndrome. These findings suggest that adequate calcium intake could create a healthier metabolic profile.

Canadian researchers investigated this issue by testing cardiovascular benefits of long-term calcium supplementation in women with low calcium intake. Healthy, overweight or obese women with a daily calcium intake of less than 800 mg/day were randomly assigned to one of two groups: a group consuming two tablets/day of a calcium + vitamin D supplement (600 mg elemental calcium and 200 IU vitamin D/tablet), or a group consuming placebo. Both groups completed a 15-week reduced calorie weight-loss program.

Significant decreases in LDL cholesterol levels, as well as the ratios of total to LDL and LDL to HDL were seen the calcium + vitamin D group. These changes were independent of changes due to fat loss and reduced waist circumference. A tendency for more beneficial changes in HDL cholesterol, triglycerides, and total cholesterol was also observed in the calcium+D group.

This was the first study to show that calcium and vitamin D enhance the beneficial effects of weight loss on cardiovascular risk factors in overweight women with typically low calcium intakes.

Major GC, et al. Supplementation with calcium + vitamin D enhances the beneficial effect of weight loss on plasma lipid and lipoprotein concentrations. 2007. American Journal of Clinical Nutrition 85(1): 54-9.