In This Issue….                                                                         

-           Triglycerides lowered with vitamin D supplements
-           Carnitine lowers inflammation in patients with blocked arteries
-           Could too much folic acid affect liver function?
-           Trial suggests plasma zinc does not reflect functional zinc status
-           How common is B12 deficiency in OCD?
-           Research suggests heart disease patients be screened for nutrient status to improve outcomes

CLINICAL UPDATE – Triglycerides lowered with vitamin D supplements
Fifty-six patients with hypercholesterolemia were divided into two groups – half receiving 2000 IU/ day of vitamin D and half receiving a placebo for six months. In the supplemented group, triglycerides were decreased by 28 mg/dL more than in the placebo group. The result was even more dramatic in patients whose vitamin D levels were lower than 30ng/mL at baseline (commonly accepted as a deficient level). In these deficient patients, the difference in reduced triglycerides between supplemented and placebo was 37 mg/dL.
(Clinical Nutrition, April 2015)

LINK to ABSTRACT
 Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: A randomized placebo-controlled trial. 

CLINICAL UPDATE – Carnitine lowers inflammation in patients with blocked arteries
Thirty-nine patients with confirmed coronary artery disease (identified by having over 50% stenosis on a major artery) were given either 1000 mg per day of L-carnitine or placebo. After twelve weeks, several markers of inflammation – interleukin-6, C-reactive protein and tumor necrosis factor alpha – were all significantly reduced compared baseline levels. Inflammation in the supplemented group was significantly lower than in the placebo group as well leading authors to conclude that “L-carnitine supplementation, due to its antioxidant effects, may have potential utility to reduce inflammation in coronary artery disease.”
(Nutrition, March 2015)

LINK to ABSTRACT Antiinflammatory effects of L-carnitine supplementation (1000 mg/d) in coronary artery disease patients.

CLINICAL UPDATE – Could too much folic acid affect liver function?
In this animal study, a very high diet of folic acid (10 times the recommended amount) was given to two groups of mice for six months – one group with homozygous MTHFR mutation and another group with heterozygous MTHFR mutation. At the end of the trial period, liver samples were examined and revealed damage to liver cells consistent with non-alcoholic fatty liver disease. The authors stated that high folic acid inhibited MTHFR activity in vitro creating a “pseudo-MTHFR deficiency,” which resulted in liver cell damage, specifically damage to cell membranes and altered lipid metabolism.

These findings “may have clinical implications for individuals consuming high-dose folic acid supplements, particularly for those who are MTHFR deficient” suggest the authors. This study also implies the dangers of “more is better” approach that is common with over-the-counter supplements and suggests targeted supplementation is wiser approach.
(American Journal of Clinical Nutrition, March 2015)

LINK to ABSTRACT High folic acid consumption leads to pseudo-MTHFR deficiency, altered lipid metabolism, and liver injury in mice. LINK to FREE FULL TEXT 

CLINICAL UPDATE – Trial suggests plasma zinc does not reflect functional zinc status
In this randomized, placebo controlled trial, forty women were given either placebo or 20 mg zinc sulfate daily for 17 days. Plasma levels of zinc were measured. In addition, a functional biomarker of zinc that measured DNA damage (strand breaks) that authors suggest is indicative of intracellular zinc was also measured. After the supplementation period, plasma zinc did not change. However, the DNA damage was decreased 24% in the supplemented group, suggesting that plasma zinc may not reflect functional zinc status.
(Nutrition Research, January 2015)

LINK to ABSTRACT Zinc supplementation reduced DNA breaks in Ethiopian women.

CLINICAL UPDATE – How common is B12 deficiency in OCD?
Blood levels of vitamin B12, folate and homocysteine were measured in 35 patients with diagnosed obsessive-compulsive disorder (OCD) as well as 22 controls. Standardized clinical testing was also performed to quantify anxiety and obsessive-compulsive tendencies in each patient. In those with OCD, vitamin B12 levels were 16% lower. In addition, 31% of the OCD patients exhibited B12 deficiency while 0% of the control patients showed B12 deficiency by conventional standards. (Functional B12 deficiency may actually have been higher.) Researchers suggest the B12 deficiency impairs methylation pathways in the brain which is required for the production of serotonin and other neurotransmitters, thus contributing to the clinical effects of OCD.
(Neuropsychiatric Disease and Treatment, September 2014)

LINK to ABSTRACT Vitamin B12, folate, and homocysteine levels in patients with obsessive-compulsive disorder. LINK to FREE FULL TEXT 

CLINICAL UPDATE – Research suggests heart disease patients be screened for nutrient status to improve outcomes
In this paper, the role of several nutrients – Vitamin B12, B6, folate, magnesium, arginine and fatty acids – in both the prevention and treatment of heart failure and cardiac arrhythmias is highlighted. The authors elaborate on the mechanism of action these nutrients have for preventing cardiac events. Specifically, the nutrients directly influence the metabolism of nitric oxide and certain beneficial prostaglandins while simultaneously suppressing pro-inflammatory cytokines resulting in vasodilation and platelet anti-aggregation. The authors state that individuals at high risk for CAD, cardiac arrhythmias and heart failure “need to be screened for plasma levels of magnesium, folic acid, vitamins B12 and B6” as well as other anti-inflammatory fatty acid derivatives.
(Nutrition, February 2015)

LINK to ABSTRACT Nutritional factors in the prevention and management of coronary artery disease and heart failure.