April 2017 – Vol. 11, Issue 4

In This Issue…

  • This “new” HDL gains attention as a powerful new disease risk marker
  • Vitamin D linked to longer telomeres, suggests study
  • Vitamin B1 remains best treatment for rare neurological disease in alcoholics
  • Zinc’s role in gut health gains attention
  • Carnitine supplements may improve constipation in disabled patients


CLINICAL UPDATE – This “new” HDL gains attention as a powerful new disease risk marker
          In the past decade, the standard cholesterol test has lost favor as a tool for measuring cardiovascular risk, largely due to the fact that it is outdated and not clinically representative of true heart disease risk.  It has been replaced by superior and more clinically relevant lipoprotein particle testing, in which lipoprotein particles – not the cholesterol inside them – are classified, counted, and reported.  It has long been understood that certain lipoproteins are more harmful than others, and conversely that certain lipoproteins are linked to protection against heart attacks.  For example, the National Cholesterol Education Program (NCEP), launched years ago by the National Institutes of Health, specifically notes that a certain type of high density lipoprotein knows as HDL2b is indicative of healthy cholesterol clearance via the liver and that higher levels (which is good) are associated with reduced heart disease risk.
          Emerging research now suggests that another type of high density lipoprotein – called HDL3 – is also linked to reduced risk of cardiovascular events, perhaps even more so than HDL2b.  In this study, lipoproteins were classified in 3094 people and correlated to cardiac events including heart attack, stroke or hospitalization.  Higher levels of HDL3 were associated with a lower risk of cardiovascular events.  Further, HDL2 and small-dense LDL, both of which are specific NCEP risk factors, were not correlated to cardiac events.  These results suggest that low HDL3 may be a particularly important, albeit not widely recognized (yet), risk factor for heart disease.
           (Atherosclerosis, August 2016)
           LINK to ABSTRACT
Relationship of baseline HDL subclasses, small dense LDL and LDL triglyceride to cardiovascular events in the AIM-HIGH clinical trial.


CLINICAL UPDATE – Vitamin D linked to longer telomeres, suggests study
          Telomeres – the protective DNA caps on every chromosome which shorten over time as a cell ages – have been correlated with chronic diseases in hundreds of studies.  A shorter telomere equates to an aging cell, and the cumulative effect of this may manifest as the degenerative diseases commonly associated with aging, including heart disease, cancer and dementia.  Low vitamin D has also been linked to several chronic diseases.  In this study, researchers sought to link the two – low vitamin D and shorter telomeres.  Telomere length was measured via PCR (polymerase chain reaction) on 4260 American adults ranging in age from 20 years old to over 60.  In the age group of 40-59 years, blood levels of vitamin D were correlated to telomere length.  In other words, higher vitamin D = longer telomeres.
          In a different study on participants from the same government-sponsored  survey (NHANES, National Health and Nutrition Examination Survey), 4347 American adults were evaluated for vitamin D levels and telomere length.  After adjusting for common demographic factors (age, race, education), higher vitamin D was linked to longer telomeres.  However, after adjusting for common physical factors (smoking, BMI, activity levels), no correlation was seen.  This suggests that vitamin D may very well be correlated with telomere length, but other factors play such a big role in healthy aging (such as not smoking or getting regular exercise) that these factors make the vitamin D-telomere connection less clear.
          (Journal of Nutrition, April 2017)
          (Archives of Medical Science, February 2017)
LINK to ABSTRACT Serum 25-Hydroxyvitamin D Has a Modest Positive Association with Leukocyte Telomere Length in Middle-Aged US Adults.
          LINK to ABSTRACT The association of telomere length and serum 25-hydroxyvitamin D levels in US adults: the National Health and Nutrition Examination Survey. LINK TO FREE FULL TEXT



CLINICAL UPDATE – Vitamin B1 remains best treatment for rare neurological disease in alcoholics
         Marchiafava-Bignami Disease is a rare syndrome characterized by degeneration of the middle part o f the brain (corpus callosum).  In this disease, the corpus callosum, which connects the right and left hemispheres of the brain, demyelinates  but unlike other demyelination diseases (such as multiple sclerosis), it is not characterized by inflammation.  The number one risk factor is chronic alcoholism, and it can present clinically as seizures, depression, dementia or coma.
          In this review paper, this unusual disorder is described and reviewed, most notably its current treatment, which is vitamin B1 (thiamine) supplementation.  Vitamin B1 is a cofactor in the maintenance of the myelin sheath (nerve tissue insulation).  It is often deficient in chronic alcoholics, and this review paper confirms how deficiency in vitamin B1 is extremely common in this disease.
          (European Journal of Clinical Nutrition, August 2016)
          LINK to ABSTRACT
Thiamine deficiency, oxidative metabolic pathways and ethanol-induced neurotoxicity: how poor nutrition contributes to the alcoholic syndrome, as Marchiafava-Bignami disease.




CLINICAL UPDATE – Zinc’s role in gut health gains attention
          When cells representing the outer layer (epithelium) of the colon were given zinc in vitro, the expression of certain enzymes that regulate intestinal integrity increased after 24 hours.  When compared to colon cells that did not receive any zinc, cells that were exposed to zinc showed a measurable improvement in barrier integrity (the junctions between cells were stronger).  In addition, zinc enhanced cell differentiation in the experimental colon cells, which facilitates cellular turnover and tissue repair, a process that is particularly important in the colon and digestive tract.  This research confirms zinc’s role in maintaining intestinal integrity and consequently, a healthy digestive tract.
          (Journal of Nutritional Biochemistry, May 2017)
          LINK to ABSTRACT
Zinc enhances intestinal epithelial barrier function through the PI3K/AKT/mTOR signaling pathway in Caco-2 cells.



CLINICAL UPDATE – Carnitine supplements may improve constipation in disabled patients
          A group of 27 hospitalized patients, all with either severe motor or severe intellectual disabilities were enrolled in this study.  14 patients who experienced significant constipation  comprised a group and the remaining 13 patients who did not experience constipation comprised a group.  Levels of the nutrient carnitine, which is needed to transport fatty acids into cells and which is commonly deficient in disabled patients, were measured in all 27 patients.  The researchers found that carnitine levels were much lower in the constipated group and that  the severity of constipation was correlated to carnitine levels. Further, constipation was relieved after carnitine supplementation,  possibly due to its role in proper muscle and nerve function.
          (Journal of Clinical Biochemistry and Nutrition, March2017)
          LINK to ABSTRACT
Supplementation with carnitine reduces the severity of constipation: a retrospective study of patients with severe motor and intellectual disabilities.  LINK to FREE FULL TEXT