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.

A bivariate whole-genome linkage scan suggests several shared genomic regions for obesity and osteoporosis.

ZH Tang, P Xiao, SF Lei, et al.

A genome-wide bivariate analysis was conducted for body fat mass (BFM) and bone mineral density (BMD) in a large Caucasian sample. We found some quantitative trait loci (QTLs) shared by BFM and BMD in the total sample and the gender-specific subgroups, and QTLs with potential pleiotropy were disclosed. Introduction: BFM and BMD, as the respective measure for obesity and osteoporosis, are phenotypically and genetically correlated. However, specific genomic regions accounting for their genetic correlation are unknown. Materials and Methods: To systemically identify the shared genomic regions for BFM and BMD, we performed a bivariate whole-genome linkage scan (WGLS) in 4498 Caucasian individuals from 451 families for BFM and BMD at the hip, spine, and wrist respectively. Linkage analyses were performed in the total sample and in the male and female subgroups, respectively. Results: In the entire sample, suggestive linkages were detected at 7p22-p21 (LOD=2.69) for BFM & spine BMD, 6q27 (LOD=2.30) for BFM & hip BMD, and 11q13 (LOD=2.64) for BFM & wrist BMD. Male-specific suggestive linkages were found at 13q12 (LOD=3.23) for BFM & spine BMD and at 7q21 (LOD=2.59) for BFM & hip BMD. Female-specific suggestive LOD scores were 3.32 at 15q13 for BFM & spine BMD, and 3.15 at 6p25-24 for BFM & wrist BMD. Conclusions: Several shared genomic regions for BFM and BMD were identified here. Our data may benefit further positional and functional studies, aiming at eventually uncovering the complex mechanism underlying the shared genetic determination of obesity and osteoporosis.
Source: J Clin Endocrinol Metab. May 1, 2007 [Epub ahead of print].

Effect of Melothria maderaspatana leaf-tea consumption on blood pressure, lipid profile, anthropometry, fibrinogen, bilirubin, and albumin levels in patients with hypertension.

B Raja, K Kaviarasan, MM Arjunan, KV Pugalendi

Objective: To determine the effect of Melothria maderaspatana (Linn.) leaf-tea on blood pressure, plasma lipid profile, fibrinogen, albumin together with serum bilirubin and anthropometric measurements in volunteer participants with hypertension, because all these variables have been shown to influence vascular events.
Subjects and Design: A total of 50 subjects-25 (mean age of 58 +/- 9.0 years; 12 were women) with mild-to-moderate hypertension (systolic blood pressure [SBP] >/= 140 mm Hg; diastolic blood pressure [DBP] >/= 90 mm Hg) and 25 normotensives (mean age of 48 +/- 8.0 years; 11 women)-were selected for this study. Plasma lipid profile, fibrinogen, albumin, serum bilirubin, and anthropometric measurements were measured at baseline and after leaf-tea consumption by the patient with hypertension for 45 days.
Results: SBP and DBP gradually decreased and pulse rate decreased. The total cholesterol, low-density lipoprotein cholesterol and triglycerides, and phospholipids levels decreased significantly and high-density lipoprotein cholesterol and serum bilirubin levels increased after tea consumption in patients with hypertension. We also observed significant body weight loss and reduction in fibrinogen levels. There was no significant difference in plasma level of albumin.
Conclusions: Thus, M. maderaspatana leaf-tea consumption gradually decreased BP and showed beneficial effects on blood lipid profile, fibrinogen, bilirubin, and body mass index in patients with hypertension.
Source: J Altern Complement Med. April 2007;13(3):349-54.

Whole-grain intake and carotid artery atherosclerosis in a multiethnic cohort: the Insulin Resistance Atherosclerosis Study.

PB Mellen, AD Liese, JA Tooze, et al.

Background: Whole-grain intake has been shown to be inversely associated with cardiovascular events, but an association with atherosclerosis is less well established.
Objective: We sought to evaluate the association of whole-grain intake with carotid intimal medial thickness (IMT) and IMT progression in a multiethnic cohort.
Design: This study evaluated 1178 participants in the Insulin Resistance Atherosclerosis Study. Baseline whole-grain intake was estimated on the basis of intake of dark breads, cooked cereals, and high-fiber cereals assessed with a validated food-frequency questionnaire. Bilateral carotid IMT was evaluated ultrasonographically, yielding 16 IMT measures at baseline and year 5. Multivariate models evaluated the independent association of whole-grain intake with common carotid artery (CCA) and internal carotid artery (ICA) IMT and IMT progression.
Results: The cohort had a mean (+/-SD) age of 55.2 +/- 8.4 y and was 56% female. The baseline median whole-grain intake was 0.79 servings/d. Whole-grain intake was inversely associated with CCA IMT (beta +/- SE: -0.043 +/- 0.013, P = 0.005) and IMT progression (beta +/- SE: -0.019 +/- 0.011, P = 0.09) in models adjusted for demographics, energy intake, energy expenditure, cardiovascular disease risk factors, and medication use. This association was less significant for ICA IMT (beta +/- SE: -0.049 +/- 0.023, P = 0.05) and not significant for ICA IMT progression (beta +/- SE: -0.013 +/- 0.014, P = 0.35). The relation between whole-grain intake and CCA IMT remained significant after adjustment for mediating pathways (lipids, adiposity, and insulin resistance), nutrient constituents, and a principal components-derived healthy dietary pattern.
Conclusions: Whole-grain intake is inversely associated with CCA IMT, and this relation is not attributable to individual risk intermediates, single nutrient constituents, or larger dietary patterns.
Source: Am J Clin Nutr. June 2007;85(6):1495-502.

Improvement of naturally aged skin with vitamin A (retinol).

R Kafi, HS Kwak, WE Schumacher, et al.

Objective: To evaluate the effectiveness of topical retinol (vitamin A) in improving the clinical signs of naturally aged skin.
Design: Randomized, double-blind, vehicle-controlled, left and right arm comparison study.
Setting: Academic referral center. Patients The study population comprised 36 elderly subjects (mean age, 87 years), residing in 2 senior citizen facilities. Intervention Topical 0.4% retinol lotion or its vehicle was applied at each visit by study personnel to either the right or the left arm, up to 3 times a week for 24 weeks.
Main Outcome Measures: Clinical assessment using a semiquantitative scale (0, none; 9, most severe) and biochemical measurements from skin biopsy specimens obtained from treated areas.
Results: After 24 weeks, an intent-to-treat analysis using the last-observation-carried-forward method revealed that there were significant differences between retinol-treated and vehicle-treated skin for changes in fine wrinkling scores (-1.64 [95% CI, -2.06 to -1.22] vs -0.08 [95% CI, -0.17 to 0.01]; P<.001). As measured in a subgroup, retinol treatment significantly increased glycosaminoglycan expression (P = .02 [n = 6]) and procollagen I immunostaining (P = .049 [n = 4]) compared with vehicle.
Conclusions: Topical retinol improves fine wrinkles associated with natural aging. Significant induction of glycosaminoglycan, which is known to retain substantial water, and increased collagen production are most likely responsible for wrinkle effacement. With greater skin matrix synthesis, retinol-treated aged skin is more likely to withstand skin injury and ulcer formation along with improved appearance.
Source: Arch Dermatol. May 2007;143(5):606-12.

Randomized trial of exercise therapy in women treated for breast cancer.

AJ Daley, H Crank, JM Saxton, et al.

Purpose: To examine the effects of aerobic exercise therapy on quality of life (QoL) and associated outcomes in women treated for breast cancer. Evidence suggests that exercise may be beneficial, but no trial has included an exercise-placebo and a usual-care group to control for the attention effects that might be associated with aerobic exercise interventions in cancer patients.
Patients and Methods: A total of 108 women who had been treated for breast cancer 12 to 36 months previously were randomly assigned to supervised aerobic exercise therapy (n = 34), exercise-placebo (body conditioning; n = 36), or usual care (n = 38). Exercise therapy and exercise-placebo sessions took place three times per week for 8 weeks. Outcomes included QoL, depression, exercise behavior, aerobic fitness; outcomes were assessed at baseline and at the 8- and 24-week follow-up.
Results: Analyses of covariance revealed a significant mean difference of 9.8 units in Functional Assessment of Cancer Therapy-General (primary outcome) favoring aerobic exercise therapy at 8 weeks, relative to usual care. Significant differences that favored aerobic exercise therapy relative to usual care were recorded for Functional Assessment of Cancer Therapy-Breast, social/family well-being, functional well-being, and breast cancer subscale scores at 8-week follow-up. Psychological health outcomes improved modestly for both intervention groups; these improvements were sustained for several end points.
Conclusion: Exercise therapy had large, clinically meaningful, short-term beneficial effects on QoL in women treated for breast cancer; this finding cannot be attributable to attention, given that the exercise-placebo group did not report similar effects relative to usual care.
Source: J Clin Oncol. May 1, 2007;25(13):1713-21.

Triphala, an Ayuervedic herbal medicine inhibits in vitro and in vivo growth of pancreatic cancer cells.

Yan Shi, Sanjay K. Srivastava

Triphala (TPL) is one of the most popular Ayurvedic medicines, generally used as an antioxidant as well as for the treatment of various intestinal-related disorders. This herbal drug consists of the dried and powdered fruits of three plants, Terminalia chebula, Emblica officinalis, and Terminalia bellerica in equal proportions. Here we report for the first time the anti-cancer effects of the aqueous extract of TPL on pancreatic cancer cells in vitro and in vivo and further evaluated the molecular mechanisms of TPL-induced apoptosis. TPL suppressed the growth of capan-2 pancreatic cancer cells, but not normal immortal human pancreatic ductal epithelial (HPDE) cells, via induction of apoptosis. TPL-induced apoptosis was associated with elevated reactive oxygen species production. Interestingly, TPL treatment caused phosphorylation of p53 at Ser-15 and ERK at Thr-202/Tyr-204 in capan-2 cells having wild type p53. Pretreatment of cells with pifithrin-a (specific inhibitor of p53) or U0126 (specific MEK/ERK inhibitor), significantly attenuated TPL-induced apoptosis. Similarly, pretreatment of capan-2 cells with N-acetyl cysteine (NAC), a general antioxidant, inhibited TPL-induced apoptosis by inhibiting the phosphorylation of p53 and ERK. Moreover, orally feeding 50mg/kg 5 days/week significantly suppressed the growth of capan-2 pancreatic tumor xenograft in vivo in athymic nude mice, without any toxic effects. Reduced tumor growth in TPL fed mice was due to increased apoptosis in the tumors cells as revealed by TUNEL staining. Taken together, our results strongly suggest that TPL has a potential to be used as novel therapeutic agent for the treatment of pancreatic cancer.
Source: AACR Annual Meeting, April 14-18, 2007 in Los Angeles.

Frequency of eating homegrown produce is associated with higher intake among parents and their preschool-aged children in rural Missouri.

MS Nanney, S Johnson, M Elliott, D Haire-Joshu

Objective: The purpose of this study was to identify whether or not there are associations between frequency of eating homegrown produce among rural parents and their preschool children and overall intake.
Study Design: A cross-sectional study, including parents (n=1,658) and their preschool children (aged 2 to 5 years) enrolled in a parent education program, in eight rural Southeast Missouri counties was conducted.
Main Outcome Measures: Parents completed a telephone interview answering questions for themselves and their preschool child about their fruit and vegetable intake during the past 7 days using a 29-item food frequency questionnaire (82% response rate).
Statistical Analysis Performed: Frequency of eating homegrown fruits and vegetables was examined and categorized as almost always/always (n=226), sometimes (n=871), and rarely/never (n=546). Odds ratios with 95% confidence intervals, independent sample t tests (two-sided) analyses, and analysis of covariance (with post hoc tests) were conducted.
Results: Significant differences were found in the overall fruit and vegetable diets and nutrient quality between all three groups for both parents and their preschool children. Furthermore, frequency of eating homegrown fruits and vegetables promoted a positive home environment with increased availability of produce (rarely/never=4.3 items, sometimes=4.7 items, almost always/always=5.2 items), preschooler's preference for them (rarely/never=3.5 favorites, sometimes=3.7 favorites, almost always/always=4.8 favorites) and parental role modeling (rarely/never=5.3 fruit and vegetable eating observations, sometimes=6.2 fruit and vegetable eating observations, almost always/always=6.3 fruit and vegetable eating observations). Interactions within the larger community food environment were not significantly affected as measured by weekly food dollars spent (rarely/never=$136, sometimes=$117, almost always/always=$137) or eating out the previous month (rarely/never=7.7 times, sometimes=7.2 times, almost always/always=7.0 times).
Conclusions: Our findings suggest that educational programs promoting awareness of local produce sources and facilitating the development of gardening programs may be a worthwhile investment.
Source: J Am Diet Assoc. April 2007;107(4):577-84.

Metabolic effects of interventions to increase exercise in adults with type 2 diabetes.

VS Conn, AR Hafdahl, DR Mehr, et al.

Aims/Hypothesis: The aim of this meta-analysis was to integrate the results of primary research testing the effect of diabetes self-management interventions that included recommendations to increase exercise on metabolic outcomes among adults with type 2 diabetes.
Materials and Methods: Extensive literature searching strategies were used to identify published and unpublished intervention studies that measured glycated hemoglobin outcomes. Primary study results were coded. Fixed- and random-effects meta-analytic procedures included moderator analyses.
Results: Data were synthesized across 10,455 subjects from 103 research reports. The overall mean weighted effect size for two-group comparisons was 0.29 (higher mean for treatment than control). This effect size is consistent with a difference in HbA(1c) means of 0.45% (e.g. 7.38% for treatment subjects vs 7.83% for control subjects). For single-group studies, the overall mean weighted effect size was 0.32-0.34. Control group subjects experienced no improvement in metabolic control during participation in the studies. Interventions that targeted multiple health behaviors resulted in smaller effect size estimates (0.22) than interventions that focused only on exercise behaviors (0.45). Funded studies reported greater improvements in metabolic controls. Studies with a greater proportion of female subjects reported lower effect sizes. Baseline HbA(1c) and BMI were unrelated to metabolic outcomes.
Conclusions/Interpretation: These findings suggest that self-management interventions that include exercise recommendations improve metabolic control, despite considerable heterogeneity in the magnitude of the intervention effect. Interventions that emphasize exercise may be especially effective in improving metabolic control. Primary research testing interventions in randomized trials to confirm causal relationships would be constructive.
Source: Diabetologia. May 2007;50(5):913-21.