In This Issue….                                                 

-   Study confirms antacids may cause heart problems by depleting magnesium
-   Researchers clarify the role of vitamin D in sleep disorders
-   Nutritional status of mom alters how genes are expressed in offspring
-   Study shows why nerves won’t grow when deficient in zinc
-   Could CoQ10 be a new marker for male infertility and sperm health?

CLINICAL UPDATE – Study confirms antacids may cause heart problems by depleting magnesium


421 patients who were admitted to a New York hospital for chest pain and heart attack were evaluated in this study. Of these patients, 44% were taking proton pump inhibitors (antacids) for gastrointestinal upset. The authors correlated whether those taking antacids were more likely to have low magnesium or develop arrhythmias (irregular heartbeat), which is known to be caused by insufficient magnesium. They found a “significant association between the PPI use, magnesium levels, and the occurrence of cardiovascular events,” leading to the researchers’ conclusion that “patients receiving PPIs should be followed closely for magnesium deficiency especially if they experience acute cardiovascular events.”  

This study comes on the heels of other studies showing magnesium depletion as a common side effect of antacid use, which may also present clinically as osteoporosis. In fact, the FDA issued a warning that use of antacids for more than 14 days increases the risk of bone fractures significantly. The magnesium-depleting effects of antacids on bone health is now gaining attention as a result. Other side effects of antacid use include B12 deficiency and an over 30% increased risk of bacterial infections, including pneumonia and Clostridium difficile.
(International Journal of General Medicine, June 2013)
(QJM: Monthly Journal of the Association of Physicians, 2010)
(Expert Review of Clinical Pharmacology, July 2013)
(Current Opinion in Gastroenterology, 2012)


LINK to ABSTRACT
Effects of proton pump inhibitors and electrolyte disturbances on arrhythmias.
LINK to ABSTRACT Hypomagnesaemia due to proton-pump inhibitor therapy: a clinical case series.
LINK to ABSTRACT Perils and pitfalls of long-term effects of proton pump inhibitors.
LINK to ABSTRACT Proton pump inhibitors: potential adverse effects.
LINK to FREE FULL TEXT (International Journal of General Medicine)
LINK to FREE FULL TEXT (QJM)
LINK to FDA Warning on PPI Use and Increased Risk of Fractures


CLINICAL UPDATE – Researchers clarify the role of vitamin D in sleep disorders


A group of scientists recently sought to clarify the role vitamin D plays in regulating sleep patterns. They point out that several key inflammatory chemicals in the body that regulate inflammation – tumor necrosis factor alpha (TF-α), interleukin 1 (IL-1), and certain prostaglandins – also regulate sleep and these inflammatory chemicals are significantly affected by vitamin D status, a relationship that has been well established. In another recent review, the link between vitamin D and sleep was tested in 1500 patients with abnormal sleep patterns. Sleep improved only in patients that achieved adequate blood levels of vitamin D (60-80 ng/mL) after two years of supplementation.(Sleep Medicine Review, September 2013)
(Medical Hypotheses, 2012)


LINK to ABSTRACT The link between vitamin D metabolism and sleep medicine.
LINK to ABSTRACT The world epidemic of sleep disorders is linked to vitamin D deficiency.

CLINICAL UPDATE – Nutritional status of mom alters how genes are expressed in offspring


This paper reviews evidence that maternal nutritional deficiencies predispose offspring to disease, specifically metabolic diseases. Interestingly, the authors also state that “paternal nutritional imbalance also increases the likelihood of metabolic disease in offspring” through epigenetic mechanisms. Scientists are now confident that the environment, specifically micronutrient deficiencies, alters gene expression much more profoundly than previously thought. An epigenetic study out of Germany confirmed this theory – they showed conclusively that deficient vitamin D status of the mother changed the way muscle cells developed in her offspring. The vitamin D deficiency directly altered genes that controlled muscle development.
(Current Opinion in Clinical Nutrition and Metabolic Care, July 2013)
(Molecular Nutrition and Food Research, August 2013)



LINK to ABSTRACT Nutrition and reproduction: links to epigenetics and metabolic syndrome in offspring.
LINK to ABSTRACT Maternal vitamin D deficiency causes smaller muscle fibers and altered transcript levels of genes involved in protein degradation, myogenesis, and cytoskeleton organization in the newborn rat.

CLINICAL UPDATE – Study shows why nerves won’t grow when deficient in zinc


When scientists studied the growth of nerves and their ability to regenerate under zinc-deficient conditions, they found the reason neural repair is compromised when insufficient zinc is available. Zinc deficiency alters genes that participate in neuronal differentiation, in both adults and during young development. Zinc altered these genes by reducing the amount of vitamin A receptor activity, which ultimately compromised neuronal growth. In their conclusion, they show “that zinc deficiency has implications for both developmental and adult neurogenesis.”
(Journal of Nutritional Biochemistry, November 2013)

LINK to ABSTRACT Zinc regulation of transcriptional activity during retinoic acid-induced neuronal differentiation.

CLINICAL UPDATE – Could CoQ10 be a new marker for male infertility and sperm health?


In two separate studies, the relationship between the potent antioxidant coenzyme Q10 and sperm function in diagnosed infertile men was assessed. In one study, blood levels of coQ10 were correlated to improved sperm motility in a group of infertile men. In another study, three months of oral supplementation with Coq10 significantly improved semen parameters, highlighting the importance of oxidative stress in the pathogenesis as well as the diagnosis of male infertility.”
(Andrologia, August 2013)
(Medical Journal of Slovakia, 2013)

LINK to ABSTRACT Coenzyme Q10 supplementation in infertile men with low-grade varicocele: an open, uncontrolled pilot study.
LINK to ABSTRACT Importance of the assessment of coenzyme Q10, alpha-tocopherol and oxidative stress for the diagnosis and therapy of infertility in men.