Thursday, January 18, 2007

Meal replacements drinks effective for weight maintenance

The most difficult part of any weight loss program is not losing the weight, but keeping it off. As a result, many people opt for a medication like Orlistat. Results from a new study now show that meal replacement drinks can be as effective at helping dieters maintain weight than medications. Researchers compared the benefit of using meal replacement drinks to Orlistat in two groups of people that had lost significant amounts of weight. A year after their weight loss, the group using meal replacement drinks had maintained weight even better than the group using the medication. For many people, meal replacements drinks may be an effective, simple and safe method to maintaining a healthy weight.

Meal replacement drinks have been shown to be as effective as medications for maintaining weight loss according to a study published in the Journal of the American College of Nutrition. Participants followed a liquid very low calorie diet (VLCD) for 12 weeks followed by 4 weeks of re-introduction to solid food. At week 16, the subjects were randomly selected to receive either meal replacements or Orlistat (medication), both combined with a structured meal plan calculated to maintain weight loss. For one year, all subjects followed a weight management program that included topics such as lifestyle, physical activity, and nutrition. During the VLCD, the meal replacement group lost an average of 50.2 lbs and the Orlistat group lost an average of 49 lbs. During weight maintenance, there were no significant differences in physical activity, fruit and vegetable intake and pedometer steps between the groups. After one year, the meal replacement group had regained only 5.9 lbs and the Orlistat group had regained 6.2 lbs. Meal replacements and Orlistat were both effective in maintaining weight significantly below baseline levels over a year period of time.

Source: A Comparison of Meal Replacements and Medication in Weight Maintenance after Weight Loss James D. LeCheminant, MS, Dennis J. Jacobsen, PhD, Matthew A. Hall, PhD and Joseph E. Donnelly, EdD, Journal of the American College of Nutrition, Vol. 24, No. 5, 347-353 (2005).

Friday, January 12, 2007

Long-term use of common acid reflux medications increases risk of hip fracture

A recent study published in the Journal of the American Medical Association found that long-term use of certain acid reflux/heartburn medications was associated with an increased risk of hip fracture. The medications in question, known as proton pump inhibitors (PPIs), are effective at reducing production of stomach acid, but in so doing, they also interfere with dietary calcium absorption, and may be related to an increased risk of osteoporosis and bone fracture.

The results of this study question the advisability of using PPIs on a regular basis over the long-term (one year or more), particularly at their higher doses. This does not mean people who are prescribed these medications should stop using them. Acid reflux is a significant medical condition that is associated with an increased risk for esophageal cancer. In many cases the medications are known to not only reduce acid reflux but aid in repair of the damaged esophagus.

However, there are possibly many people with occasional heartburn or less severe reflux that are taking these medications unnecessarily. There are other approaches to dealing with heartburn. First and foremost, people who experience heartburn should try to prevent it through simple lifestyle changes such as eating smaller meals, avoiding foods that cause heartburn, not eating meals right before going to bed, and reducing alcohol intake.

In addition, properly made chewable calcium supplements can often be used effectively for relief of upset stomach, sour stomach, occasional heartburn and occasional acid indigestion. This approach is particularly attractive in light of concerns over osteoporosis, especially if the chewable calcium supplements used are complete and include vitamin D, magnesium, and other bone health nutrients. Importantly, if symptoms of acid reflux persist, it is important to work with your doctor to address the situation.

Thursday, January 11, 2007

Bipolar disorder/manic depression

Bipolar disorder, also known as manic-depression, is a mood disorder in which the person experiences severe pathologic swings from hyperactivity and euphoria to sadness and depression.

This disease may be dominated by manic or depressive episodes, or moods may be mixed.2

At Risk
According to the American Psychiatric Association, approximately 0.4% to 1.6% of adults have bipolar disorder. This disorder is equally common in women and men, more common in higher socioeconomic groups, and associated with high levels of creativity. Thirty years is the average age for the onset of bipolar disorder.3

Prevention and Management
Mania is treated with lithium. About 14 days are required before improvement is noted. When manic symptoms are severe, lithium is usually administered in combination with an antipsychotic such as haloperidol, until the acute symptoms abate, allowing tapering and discontinuation of the antipsychotic. Lithium is slightly more effective in preventing manic than depressive episodes. The depressive phase is treated the same as for any major depressive disorder. 4

Nutritional Influences:
Folic acid, vitamin B12 or vitamin C may be deficient, and supplementation may be beneficial.5
Supplementation with omega-3 fatty acids may benefit some patients.6

Additional Information
Disclaimer: These websites, addresses and/or phone numbers are provided for information purposes only. USANA, Inc. makes no claim, actual or implied, regarding the content or validity of the information obtained from these outside sources.

Fava M, Borus JS, Alpert JE, Nierenberg AA, Rosenbaum JF, Bottiglieri T. Folate, vitamin B12, and homocysteine in major depressive disorder. Am J Psychiatry 1997 Mar;154(3):426-8.
OBJECTIVE: The authors examined the relationships between levels of three metabolites (folate, vitamin B12, and homocysteine) and both depressive subtype and response to fluoxetine treatment in depressed patients.
METHOD: Fluoxetine, 20 mg/day for 8 weeks, was given to 213 outpatients with major depressive disorder. At baseline, depressive subtypes were assessed, and a blood sample was collected from each patient. Serum metabolite levels were assayed. Response to treatment was determined by percentage change in score on the 17-item Hamilton Depression Rating Scale. RESULTS: Subjects with low folate levels were more likely to have melancholic depression and were significantly less likely to respond to fluoxetine. Homocysteine and B12 levels were not associated with depressive subtype or treatment response.
CONCLUSIONS: Overall, the results are consistent with findings linking low folate levels to poorer response to antidepressant treatment. Folate levels might be considered in the evaluation of depressed patients who do not respond to antidepressant treatment.

1 Diseases. Springhouse (PA): Springhouse Corporation;1993. p 52-66.
2 Diseases. Springhouse (PA): Springhouse Corporation;1993. p 52.
3 Werbach M. Nutritional Influences on Mental Illness. Tarzana (CA):Third Line Press. p 52-53. 4 Cecil Textbook of Medicine. 20th ed. Philadelphia:WB Saunders Company; 1996. p 2002.
5 Rudin DO. The major psychoses and neuroses as omega-3 essential fatty acid deficiency syndrome: Substrate pellagra. Biol Psychiatry 1981;16(9):837-50.


Monday, January 01, 2007

Nutritional health: ADD/ADHD

Image: Time Magazine, July 18, 1994: Attention Deficit Disorder


* Attention Deficit Disorder and Attention Deficit/Hyperactivity Disorder are not well understood and have been difficult to define. The American Psychiatric Association describes ADD/ADHD as "a disease of infancy and childhood characterized by developmentally inappropriate inattention, impulsiveness, and hyperactivity." Affected children typically have problems in school because of their inability to persist with tasks or to organize their work. They do not appear to listen or to hear what is said, and are unable to sit still. The activity is haphazard and not goal-directed. Some children display the inattention component without hyperactivity.
* These disorders are far more common in boys than in girls, and half of all cases occur before age four.1
* Symptoms are grouped into inattention and hyperactivity-impulsivity categories. Diagnosis of attention-deficit hyperactivity disorder is based on the person demonstrating at least six symptoms from one or both of these categories. 2


* Although the causes are not clear, dopamine, a brain neurotransmitter, is thought to play a role in attention deficit hyperactivity disorder. People with ADHD may have malfunctioning D4 dopamine receptors. 3


* A patient with symptoms mainly from the inattention category is classified as predominantly inattentive type.
* A patient with mainly hyperactivity-impulsivity symptoms is diagnosed as a predominantly hyperactive-impulsive type.
* Someone with at least six symptoms from both groups has combined-type attention-deficit hyperactivity disorder. This is the most common type. 4

At Risk

* It is thought that children are born with this disorder. It affects boys more than girls.5
* Complications during pregnancy, delivery and infancy are positively correlated with incidence of ADD/ADHD.6
* There may be a genetic element to this disorder. Diagnosing and treating family members may be helpful. 7,8

Prevention and Management


* Because pregnancy, delivery and infancy complications may lead to higher incidence of ADD and ADHD, good prenatal care, including healthy behavior by the mother, is important. 9

Nutritional Influences:

* Contrary to popular belief, sugar does not seem to increase hyperactivity in children. 10
* Some researchers believe that essential fatty acid deficiency may play a role in ADD/ADHD in some children. 11

Additional Information
Disclaimer: These websites, addresses and/or phone numbers are provided for information purposes only. USANA, Inc. makes no claim, actual or implied, regarding the content or validity of the information obtained from these outside sources.



Stevens LJ, Zentall SS, Deck JL, Abate ML, Watkins BA, Lipp SR, Burgess JR. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr 1995 Oct;62(4):761-768. Attention-deficit hyperactivity disorder (ADHD) is the term used to describe children who are inattentive, impulsive, and hyperactive. The cause is unknown and is thought to be multifactorial. Based on the work of others, we hypothesized that some children with ADHD have altered fatty acid metabolism. The present study found that 53 subjects with ADHD had significantly lower concentrations of key fatty acids in the plasma polar lipids (20:4n-6, 20:5n-3, and 22:6n-3) and in red blood cell total lipids (20:4n-6 and 22:4n-6) than did the 43 control subjects. Also, a subgroup of 21 subjects with ADHD exhibiting many symptoms of essential fatty acid (EFA) deficiency had significantly lower plasma concentrations of 20:4n-6 and 22:6n-3 than did 32 subjects with ADHD with few EFA-deficiency symptoms. The data are discussed with respect to cause, but the precise reason for lower fatty acid concentrations in some children with ADHD isnot clear.

LaHoste GJ, Swanson JM, Wigal SB, Glabe C, Wigal T, King N, Kennedy JL. Dopamine D4 receptor gene polymorphism is associated with attention deficit hyperactivity disorder. Mol Psychiatry 1996 May;1(2):121-4. Dopamine is believed to play a major role in the manifestation of attention deficit hyperactivity disorder (ADHD), which affects 3-6% of school-age children and shows evidence of familiarity. The dopamine D4 receptor, which is preferentially distributed in cortical and limbic regions of the brain, is currently of major interest because of the high degree of functionally relevant variability in its gene (DRD4), and the association of this gene with Novelty Seeking behavior. We examined the variability in the length of a region of DRD4 that contains a 48-bp repeat sequence in children with ADHD and controls matched for ethnicity. ADHD children differed from controls in that the 7-fold repeat form of DRD4 occurred significantly more frequently than in the control sample. This form of the receptor has previously been shown to mediate a blunted intracellular response to dopamine. Although ADHD is likely to be multifactorial in its etiology and its heritability is likely to be polygenetic, the present findings suggest that polymorphic variation in the gene encoding the D4 dopamine receptor may be a contributing factor in the expression of symptoms associated with ADHD.


1 Stevens LJ, Zentall SS, Deck JL, Abate ML, Watkins BA, Lipp SR, Burgess JR. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr 1995 Oct;62(4):761-768.
2 Diseases. Springhouse (PA):Springhouse Corporation; 1993 p 50.
3 LaHoste G. Dopamine DR receptor gene polymorphism is associated with attention deficit hyperactivity disorder. Mol Psychiatry 1996 May;1(2):83-4.
4 Diseases. 2nd ed. Springhouse (PA):Springhouse Corporation; 1993. p 898.
5 Milberger S. Pregnancy, delivery and infancy complications and attention deficit hyperactivity disorder: issues of gene-environment interaction. Biol Psychiatry 1997 Jan 1;41(1):65-75.
6 Hechtman L. Families of Children with attention deficit hyperactivity disorder: a review. Can J Psychiatry 1996 Aug;41(6):350-60
7 Comings D. Genetic aspects of childhood behavioral disorders. Child Psychiatry Hum Dev 1997 Spring;27(3):139-50.
8 Milberger S. Pregnancy, delivery and infancy complications and attention deficit hyperactivity disorder: issues of gene-environment interaction. Biol Psychiatry 1997 Jan 1;41(1):65-75.
9 Kanarek R. Does sucrose or aspartame cause hyperactivity in children? Nutr Rev 1994 May;52(5):173-5.


Higher levels of vitamin D reduce the risk of multiple sclerosis

People with higher circulating vitamin D levels are significantly less likely to develop multiple sclerosis, according to a new study by Harvard researchers.

The RDA for vitamin D was recently increased in the elderly to 600 IU per day. Many reports and most experts suggest levels between 600-1,000 IU per day, especially for those in northern climates or with poor sunlight exposure. Typical dietary intake is between 100-200 IU per day. A report published in the December 20, 2006 issue of the Journal of the American Medical Association concluded that having a higher serum level of vitamin D is associated with a lower risk of multiple sclerosis (MS) among men and women. The finding adds to those of previous studies that suggest that the vitamin may have a protective effect against the disease. Harvard researchers studied more than 250 individuals diagnosed with multiple sclerosis between 1992 and 2004. The team determined that for every 50 nanomole per liter increase in serum vitamin D among white participants there was a 41 percent decrease in the risk of MS. Whites in the top one-fifth of serum vitamin D concentrations had the lowest risk of the disease, and those in the lowest fifth had the greatest risk. Those with the highest vitamin D levels experienced a 62 percent lower risk of MS compared to those in the group with the lowest levels. The results of this study suggest that high circulating levels of vitamin D are associated with a lower risk of multiple sclerosis.

Source: Serum 25-Hydroxyvitamin D Levels and Risk of Multiple Sclerosis, Kassandra L. Munger, Lynn I. Levin, Bruce W. Hollis, Noel S. Howard, Alberto Ascherio, JAMA 2006;296:2832-2838.