naturopathydigest.com -- Critical Research

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Critical Research

Critical Research is a regular feature in Naturopathy Digest. Each month, we provide abstracts from studies published in the top peer-reviewed journals; each abstract includes the complete citation and an online link to the journal. Whenever possible, this link directs you to a page where you can order the full text of the study, if desired.

Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial.

BE Hurwitz, JR Klaus, MM Llabre, et al.

Background: Despite findings that selenium supplementation may improve immune functioning, definitive evidence of its impact on human immunodeficiency virus (HIV) disease severity is lacking.
Methods: High selenium yeast supplementation (200 mug/d) was evaluated in a double-blind, randomized, placebo-controlled trial. Intention-to-treat analyses assessed the effect on HIV-1 viral load and CD4 count after 9 months of treatment. Unless otherwise indicated, values are presented as mean +/- SD.
Results: Of the 450 HIV-1-seropositive men and women who underwent screening, 262 initiated treatment and 174 completed the 9-month follow-up assessment. Mean adherence to study treatment was good (73.0% +/- 24.7%) with no related adverse events. The intention-to-treat analyses indicated that the mean change (Delta) in serum selenium concentration increased significantly in the selenium-treated group and not the placebo-treated group (Delta = 32.2 +/- 24.5 vs 0.5 +/- 8.8 microg/L; P<.001), and greater levels predicted decreased HIV-1 viral load (P<.02), which predicted increased CD4 count (P<.04). Findings remained significant after covarying age, sex, ethnicity, income, education, current and past cocaine and other drug use, HIV symptom classification, antiretroviral medication regimen and adherence, time since HIV diagnosis, and hepatitis C virus co-infection. Follow-up analyses evaluating treatment effectiveness indicated that the nonresponding selenium-treated subjects whose serum selenium change was less than or equal to 26.1 microg/L displayed poor treatment adherence (56.8% +/- 29.8%), HIV-1 viral load elevation (Delta = +0.29 +/- 1.1 log(10) units), and decreased CD4 count (Delta = -25.8 +/- 147.4 cells/microL). In contrast, selenium-treated subjects whose serum selenium increase was greater than 26.1 microg/L evidenced excellent treatment adherence (86.2% +/- 13.0%), no change in HIV-1 viral load (Delta = -0.04 +/- 0.7 log(10) units), and an increase in CD4 count (Delta = +27.9 +/- 150.2 cells/microL).
Conclusions: Daily selenium supplementation can suppress the progression of HIV-1 viral burden and provide indirect improvement of CD4 count. The results support the use of selenium as a simple, inexpensive, and safe adjunct therapy in HIV spectrum disease.
Source: Arch Intern Med. Jan 22, 2007;167(2):148-54.

Childhood asthma and fruit consumption in South London.

BJ Okoko, PG Burney, R Newson, et al.

We investigated whether wheezing is less common in children who consume more apples and other fruits. We carried out a population based survey of 2640 primary school children aged 5-10 years in Greenwich, south London. Information about asthma symptoms and fruit consumption was obtained by questionnaire. After controlling for potential confounders, eating bananas one or more times daily (compared to eating less than once a month) was negatively associated with current wheeze (odds ratio 0.66 (95% CI: 0.44, 1.00); p=0.05), and with ever wheeze (OR 0.69 (0.50, 0.95); p=0.02), but not with ever asthma (OR 0.80 (0.56,1.14); p=0.22). Drinking apple juice from concentrate one or more times a day (compared to drinking less than once a month) was also negatively associated with current wheeze (OR 0.53 (34, 0.83); p=0.006), weakly associated with ever wheeze (OR 0.74 (-0.54, 1.02); p=0.07), but not associated with ever asthma. Consumption of apples, other fruits and orange juice was not significantly associated with asthma symptoms. We found no association between eating fresh apples and asthma symptoms in this population, but found some evidence to suggest that a higher consumption of apple juice from concentrate, and bananas, may protect against wheezing in children.
Source: Eur Respir J. Feb 14, 2007;29:1161-8.

The contribution of changes in diet, exercise, and stress management to changes in coronary risk in women and men in the multisite cardiac lifestyle intervention program.

JJ Daubenmier, G Weidner, MD Sumner, et al.

Background: The relative contribution of health behaviors to coronary risk factors in multicomponent secondary coronary heart disease (CHD) prevention programs is largely unknown.
Purpose: Our purpose is to evaluate the additive and interactive effects of 3-month changes in health behaviors (dietary fat intake, exercise, and stress management) on 3-month changes in coronary risk and psychosocial factors among 869 nonsmoking CHD patients (34% female) enrolled in the health insurance-based Multisite Cardiac Lifestyle Intervention Program.
Methods: Analyses of variance for repeated measures were used to analyze health behaviors, coronary risk factors, and psychosocial factors at baseline and 3 months. Multiple regression analyses evaluated changes in dietary fat intake and hours per week of exercise and stress management as predictors of changes in coronary risk and psychosocial factors.
Results: Significant overall improvement in coronary risk was observed. Reductions in dietary fat intake predicted reductions in weight, total cholesterol, low-density lipoprotein cholesterol, and interacted with increased exercise to predict reductions in perceived stress. Increases in exercise predicted improvements in total cholesterol and exercise capacity (for women). Increased stress management was related to reductions in weight, total cholesterol/high-density lipoprotein cholesterol (for men), triglycerides, hemoglobin A1c (in patients with diabetes), and hostility.
Conclusions: Improvements in dietary fat intake, exercise, and stress management were individually, additively and interactively related to coronary risk and psychosocial factors, suggesting that multicomponent programs focusing on diet, exercise, and stress management may benefit patients with CHD.
Source: Ann Behav Med. Feb 2007;33(1):57-68.

Maternal seafood consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC study): an observational cohort study.

JR Hibbeln, JM Davis, C Steer, et al.

Background: Seafood is the predominant source of omega-3 fatty acids, which are essential for optimum neural development. However, in the USA, women are advised to limit their seafood intake during pregnancy to 340 g per week. We used the Avon Longitudinal Study of Parents and Children (ALSPAC) to assess the possible benefits and hazards to a child's development of different levels of maternal seafood intake during pregnancy.
Methods: 11,875 pregnant women completed a food frequency questionnaire assessing seafood consumption at 32 weeks' gestation. Multivariable logistic regression models including 28 potential confounders assessing social disadvantage, perinatal, and dietary items were used to compare developmental, behavioral, and cognitive outcomes of the children from age 6 months to 8 years in women consuming none, some (1-340 g per week), and >340 g per week.
Findings: After adjustment, maternal seafood intake during pregnancy of less than 340 g per week was associated with increased risk of their children being in the lowest quartile for verbal intelligence quotient (IQ) (no seafood consumption, odds ratio [OR] 1.48, 95% CI 1.16-1.90; some, 1.09, 0.92-1.29; overall trend, p=0.004), compared with mothers who consumed more than 340 g per week. Low maternal seafood intake was also associated with increased risk of suboptimum outcomes for prosocial behavior, fine motor, communication, and social development scores. For each outcome measure, the lower the intake of seafood during pregnancy, the higher the risk of suboptimum developmental outcome.
Interpretation: Maternal seafood consumption of less than 340 g per week in pregnancy did not protect children from adverse outcomes; rather, we recorded beneficial effects on child development with maternal seafood intakes of more than 340 g per week, suggesting that advice to limit seafood consumption could actually be detrimental. These results show that risks from the loss of nutrients were greater than the risks of harm from exposure to trace contaminants in 340 g seafood eaten weekly.
Source: Lancet. Feb 17, 2007;369(9561):578-85.

Participation in weight-related sports is associated with higher use of unhealthful weight-control behaviors and steroid use.

M Vertalino, ME Eisenberg, M Story, D Neumark-Sztainer

Objective: To determine whether adolescents who participate in a weight-related sport are at increased risk for unhealthful weight-control behaviors and steroid use.
Design: This was a population-based study (Project EAT [Eating Among Teens]).
Subjects/Setting: Subjects were 4,746 adolescents (50.2% males, 49.8% females) from 31 public middle and high schools in the Minneapolis/St Paul area of Minnesota.
Statistical Analysis Performed: Descriptive statistics, chi2 analyses, and multiple logistic regression were used. Data were adjusted for sociodemographic variables and body mass index.
Main Outcome Variables: Unhealthful weight-control behaviors and steroid use.
Results: More males (20.4%) than females (16.2%) reported participation in a weight-related sport. Males who reported participation in a weight-related sport had an increased risk of past-week vomiting (odds ratio [OR]=5.7), laxative use (OR=6.8), as well as past-year vomiting (OR=4.9), laxative use (OR=3.4), diuretic use (OR=6.0), and steroid use (OR=3.7), compared with those males who did not report participation. Females who reported participation in a weight-related sport had an increased risk of past week vomiting (OR=2.1), as well as past year vomiting (OR=2.0), laxative use (OR=2.6), and steroid use (OR=2.6), compared with those who did not report participation in a weight-related sport.
Conclusions: The current study shows that participation in a sport that adolescents perceive as emphasizing weight is strongly associated with unhealthful weight-control behaviors and steroid use. Preventive efforts, targeting parents, coaches, and adolescents are needed to decrease this risk.
Source: J Am Diet Assoc. March 2007;107(3):434-40.

Objectively measured physical activity and fat mass in a large cohort of children.

AR Ness, SD Leary, C Mattocks, et al.

Background: Previous studies have been unable to characterize the association between physical activity and obesity, possibly because most relied on inaccurate measures of physical activity and obesity.
Methods and Findings: We carried out a cross sectional analysis on 5,500 12-year-old children enrolled in the Avon Longitudinal Study of Parents and Children. Total physical activity and minutes of moderate and vigorous physical activity (MVPA) were measured using the Actigraph accelerometer. Fat mass and obesity (defined as the top decile of fat mass) were measured using the Lunar Prodigy dual x-ray emission absorptiometry scanner. We found strong negative associations between MVPA and fat mass that were unaltered after adjustment for total physical activity. We found a strong negative dose-response association between MVPA and obesity. The odds ratio for obesity in adjusted models between top and the bottom quintiles of minutes of MVPA was 0.03 (95% confidence interval [CI] 0.01-0.13, p-value for trend <0.0001) in boys and 0.36 (95% CI 0.17-0.74, p-value for trend = 0.006) in girls.
Conclusions: We demonstrated a strong graded inverse association between physical activity and obesity that was stronger in boys. Our data suggest that higher intensity physical activity may be more important than total activity.
Source: PLoS Med. March 20, 2007;4(3):e97.