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Inflammation moderates the effects of lifestyle modification on neurocognition among individuals with resistant hypertension.
Avorgbedor, F, Blumenthal, JA, Hinderliter, A, Ingle, K, Lin, PH, Craighead, L, Tyson, C, Kraus, W, Sherwood, A, Smith, PJ
Journal of clinical hypertension (Greenwich, Conn.). 2023;25(1):106-110
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Plain language summary
Hypertension is one of the primary causes of cardiovascular disease, stroke, Alzheimer’s Disease, and Alzheimer’s Disease and related dementias (AD/ADRD). Among individuals with hypertension, those with resistant hypertension (RH) appear to have the greatest risk of cerebrovascular disease and associated cognitive impairment. The aim of this study was to investigate the potential influence of individual differences in pre-treatment inflammatory profiles on changes in cognition following lifestyle modification among RH participants in the TRIUMPH clinical trial. This study is a report based on the TRIUMPH study which was a randomised clinical trial. One hundred forty patients with RH were randomised with 2:1 allocation to either a 4-month Centre-based Lifestyle intervention or Standardized Education and Physician Advice. Results show that basal levels of elevated peripheral inflammation may represent an intermediate phenotype of risk for cognitive decline. In fact, individuals with higher levels of c-reactive protein at baseline demonstrated greater improvements in Executive Function/Learning following participation in an intensive lifestyle intervention. Authors conclude that their findings may help inform targeted treatments to reduce ADRD among middle-aged and older adults with cardiovascular disease risk factors.
Abstract
Individuals with resistant hypertension (RH) have the greatest risk of cerebrovascular disease and cognitive impairment among individuals with hypertension. Elevated levels of pro-inflammatory cytokines may represent a critical yet unexamined factor influencing the impact of healthy lifestyle changes on cognitive function. We explored the influence of inflammation on changes in cognition following lifestyle modification among individuals with RH participating in the TRIUMPH clinical trial. One hundred forty participants with RH completed a battery of neurocognitive tests along with the inflammatory marker C-reactive protein (hsCRP) and were subsequently randomized to an intensive 4-month lifestyle modification intervention or to education and physician advice control. Results indicated that the effects of lifestyle modification on Executive Function and Learning were moderated by pre-intervention hsCRP levels (P = .049), with treatment efficacy increasing across levels of baseline inflammation levels (low: d = 0.12; mild: d = 0.43; moderate: d = 0.81). We conclude that inflammatory profiles may help identify individuals more likely to improve executive functioning resulting from lifestyle modification.
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The Effect of Selenium Supplementation on Clinical Outcomes, Metabolic Profiles, and Pulsatility Index of the Uterine Artery in High-Risk Mothers in Terms of Preeclampsia Screening with Quadruple Test: a Randomized, Double-Blind, Placebo-Controlled Clinical Trial : Selenium and preeclampsia.
Mesdaghinia, E, Shahin, F, Ghaderi, A, Shahin, D, Shariat, M, Banafshe, H
Biological trace element research. 2023;201(2):567-576
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Preeclampsia (PE) is a disease related to high blood pressure during pregnancy, which can result in birth complications and even death of the mother and/or infant. Selenium, which is a nutrient derived from the diet is involved in several processes within the body and levels have shown controversial relationships with PE. This randomised control trial of 60 individuals aimed to determine the effects of selenium supplementation for 12 weeks in women at high risk of PE. The results showed that selenium supplementation helped to alleviate inflammation, which is associated with PE. It also helped to improve blood flow to the uterus, sleep quality, depression, and feelings of anxiety. It was concluded that selenium supplementation for 12 weeks in pregnant women at an increased risk of PE had beneficial effects on factors which may contribute to PE. This study could be used by healthcare professionals to understand that nutrient deficiencies may be involved in poorer outcomes during pregnancy and the importance of recommending a nutrient dense diet and pregnancy vitamins which contain adequate amounts of selenium.
Abstract
Data on the effects of selenium (Se) supplementation on clinical outcomes, metabolic profiles, and pulsatility index (PI) in high-risk mothers in terms of preeclampsia (PE) screening with quadruple tests are scarce. This study evaluated the effects of Se supplementation on clinical outcomes, metabolic profiles, and uterine artery PI on Doppler ultrasound in high-risk mothers in terms of PE screening with quad marker. The current randomized, double-blind, placebo-controlled trial was conducted among 60 high-risk pregnant women screening for PE with quad tests. Participants were randomly allocated into two groups (30 participants each group), received either 200 µg/day Se supplements (as Se amino acid chelate) or placebo from 16 to 18 weeks of pregnancy for 12 weeks. Clinical outcomes, metabolic profiles, and uterine artery PI were assessed at baseline and at the end of trial. Se supplementation resulted in a significant elevation in serum Se levels (β 22.25 µg/dl; 95% CI, 18.3, 26.1; P < 0.001) compared with the placebo. Also, Se supplementation resulted in a significant elevation in total antioxidant capacity (β 82.88 mmol/L; 95% CI, 3.03, 162.73; P = 0.04), and total glutathione (β 71.35 µmol/L; 95% CI, 5.76, 136.94; P = 0.03), and a significant reduction in high-sensitivity C-reactive protein levels (β - 1.52; 95% CI, - 2.91, - 0.14; P = 0.03) compared with the placebo. Additionally, Se supplementation significantly decreased PI of the uterine artery in Doppler ultrasound (β - 0.09; 95% CI, - 0.14, - 0.04; P = 0.04), and a significant improvement in depression (β - 5.63; 95% CI, - 6.97, - 4.28; P < 0.001), anxiety (β - 1.99; 95% CI, - 2.56, - 1.42; P < 0.001), and sleep quality (β - 1.97; 95% CI, - 2.47, - 1.46; P < 0.001). Se supplementation for 12 weeks in high-risk pregnant women in terms of PE screening with quad marker had beneficial effects on serum Se level, some metabolic profiles, uterine artery PI, and mental health. IRCT Registration: htpp:// www.irct.ir ; identifier IRCT20200608047701N1.
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Mitochondria in health and disease
Alex Manos is one of the UK’s leading Functional Medicine practitioners who specialises in SIBO and gut-related disorders, as well as mould illness and mycotoxins. He is also very passionate about physical therapy, movement, resiliency, life coaching, nutritional therapy, and biohacking. He is a lecturer at various colleges and institutions including the Institute of Optimum Nutrition (ION) and on the MSc program at The Centre For Nutritional Education and Lifestyle Management (CNELM).
2023
Abstract
An enlightening conversation between Alex and Ray Griffiths about the importance of mitochondria in health and disease, to the extent that Ray has written a whole book on this topic. They delve into the mechanisms and explore how mitochondria orchestrate numerous processes in our cells and not just energy production. They discuss mitochondrial dysfunction and ways to support mitochondria including potential functional laboratory testing options. Ray believes that as practitioners, we should be looking at the research to see how mitochondria may be involved in the pathophysiology of any health condition that we are presented with, such is their key role as environmental sensors in the body.
Sponsored Video
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Specialized Pro-resolving Mediators (SPMs) in Real World Clinical Practice
Metagenics Institute is a trusted, peer-to-peer, evidence-based educational resource for nutrition and personalized medicine. At Metagenics Institute, we translate credible research with scientific integrity into innovative and actionable clinical decision-making. Metagenics Institute supports a diverse practitioner base to optimize patient outcomes by shifting existing paradigms in healthcare. Our mission is to transform healthcare by inspiring and educating practitioners, and their patients, about personalized lifestyle medicine.
2023
Abstract
In this webinar, Dr Jennifer Stagg describes her experience seeing patients who have conditions that involve chronic inflammation and the solutions she uses to manage the underlying inflammation and the condition itself. We know that chronic inflammation is caused by obesity, poor lifestyle, and aging and is associated with a variety of conditions that lead to arthritis, cancer, atherosclerosis, neurological diseases, and insulin resistance and type 2 diabetes. The first step in the process to see if SPMs are an appropriate therapy for a particular patient is assessment. Providers can measure clinically relevant biomarkers of inflammation like hsCRP, TNF-alpha, Ferritin, ESR, and Fibrinogen. Patients might also measure their quality of life by taking a brief pain inventory, such as the American Chronic Pain Association Quality of Life Scale. Dr Stagg's findings show reductions in proinflammatory markers, pain scores, and improvements in pain-related quality of life
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Real World Clinical Experiences with Specialised Pro-resolving Mediators
Metagenics Institute is a trusted, peer-to-peer, evidence-based educational resource for nutrition and personalized medicine. At Metagenics Institute, we translate credible research with scientific integrity into innovative and actionable clinical decision-making. Metagenics Institute supports a diverse practitioner base to optimize patient outcomes by shifting existing paradigms in healthcare. Our mission is to transform healthcare by inspiring and educating practitioners, and their patients, about personalized lifestyle medicine.
2023
Abstract
This presentation by Dr. Cory Rice is entitled “Specialized Pro-resolving Mediators in Real World Clinical Practice.” This is part of our peer-to-peer knowledge sharing series. Incorporating SPMs in clinical practice for patients with chronic disease, particularly those who need nutritional support for lifestyle medicine. Dr. Rice also provides several patient case studies in which he describes how SPMs have provided improved health outcomes to his patients. As we know, many chronic health conditions are associated with underlying inflammation. SPMs activate the resolution pathway of inflammation so that treatments can be focused on the symptoms of the specific disease.
Sponsored Video
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The Role of Specialized Pro-Resolving Mediators in the Resolution of Chronic Inflammation
Metagenics Institute is a trusted, peer-to-peer, evidence-based educational resource for nutrition and personalized medicine. At Metagenics Institute, we translate credible research with scientific integrity into innovative and actionable clinical decision-making. Metagenics Institute supports a diverse practitioner base to optimize patient outcomes by shifting existing paradigms in healthcare. Our mission is to transform healthcare by inspiring and educating practitioners, and their patients, about personalized lifestyle medicine.
2023
Abstract
In this webinar Jennifer Stagg, ND presents an overview of the use of SPMs in clinical practice. Her research shows that the use of SPMs bring about an effective resolution response to chronic and acute inflammation. Dr Stagg presents the causes of most inflammation in both young and old and the symptoms that are associated with its disease pathogenesis. Recorded at the AANP Pre-Conference in Salt Lake City, Utah at the 2016 American Association of Naturopathic Physicians Annual Convention & Exhibition.
Sponsored Case Study
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Specialized Pro-Resolving Mediators (SPMs) Case Study
Metagenics Institute is a trusted, peer-to-peer, evidence-based educational resource for nutrition and personalized medicine. At Metagenics Institute, we translate credible research with scientific integrity into innovative and actionable clinical decision-making. Metagenics Institute supports a diverse practitioner base to optimize patient outcomes by shifting existing paradigms in healthcare. Our mission is to transform healthcare by inspiring and educating practitioners, and their patients, about personalized lifestyle medicine.
2023
Abstract
This paper is entitled, “Supplementation with Specialized Pro-Resolving Mediators Reduces Inflammatory Biomarkers and Improves Reported Clinical Symptomology in Subjects with Chronic Inflammatory Conditions: Results from a Multi-Center Open-Case Series” Highlights: Inflammation has 2 phases: initiation and resolution. Many chronic health issues are linked to unresolved inflammation Specialized pro-resolving mediators (SPMs) are endogenous molecules essential for resolution of inflammation but may not be produced in required levels in certain condition Multi-center case study assessed effects of a proprietary SPM supplement (LM-O3) on inflammatory biomarkers in 34 men and women (21-75 y/o) with conditions indicating raised inflammatory tone Results showed a 43% reduction in high-sensitivity C-reactive protein (hs-CRP) at 4 weeks with concurrent reduction in prostaglandin E2 (PGE2) At 8 weeks, hs-CRP remained reduced, and PGE2 was reduced to within normal range Functional measurements including reported measures of pain as well as quality of life indicated continued improvement at 4 and 8 weeks Adverse events were minimal and managed without incident.
Sponsored Podcast
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New Hope for Fibromyalgia Patients
Metagenics Institute is a trusted, peer-to-peer, evidence-based educational resource for nutrition and personalized medicine. At Metagenics Institute, we translate credible research with scientific integrity into innovative and actionable clinical decision-making. Metagenics Institute supports a diverse practitioner base to optimize patient outcomes by shifting existing paradigms in healthcare.
2023
Abstract
This podcast features Dr Kara Fitzgerald in conversation with Dr. Erik Lundquist, who heads a large, integrative clinic out in Southern California. Erik recently completed a clinical pilot study looking at the use of SPMs (just 2 gelcaps per day) in patients diagnosed with fibromyalgia (Dr. Lundquist reports that the bulk of these patients have underlying mold exposure or Lyme as the primary etiology for FMS).
Sponsored Video
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Resolving Inflammation
Metagenics Institute is a trusted, peer-to-peer, evidence-based educational resource for nutrition and personalized medicine. At Metagenics Institute, we translate credible research with scientific integrity into innovative and actionable clinical decision-making. Metagenics Institute supports a diverse practitioner base to optimize patient outcomes by shifting existing paradigms in healthcare. Our mission is to transform healthcare by inspiring and educating practitioners, and their patients, about personalized lifestyle medicine.
2023
Abstract
Ryan Lazarus, DC contrasts conventional vs. Functional Medicine approaches in the treatment of chronic inflammation, one of the most common chemical imbalances patients are facing today. Chronic inflammation exerts deleterious systemic effects in the body and is linked to most chronic diseases, such as neurodegenerative diseases, pain and energy disorders, gut dysfunction, autoimmunity and allergies, cancer, and aging. Dr. Lazarus describes major biochemical and nutritional players involved in the two distinct phases of inflammation—initiation and resolution. He shares clinical scenarios that can impair patients’ ability to resolve inflammation and describes strategic modalities to help resolve inflammation, namely a superfamily of lipid mediators known as specialized pro-resolving mediators (SPMs).
Sponsored Journal Article
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Treatment With a Marine Oil Supplement Alters Lipid Mediators and Leukocyte Phenotype in Healthy Patients and Those With Peripheral Artery Disease
Paper authors: Melinda S. Schaller, MD; Mian Chen, MD; Romain A. Colas, PhD; Thomas A. Sorrentino, MD; Ann A. Lazar, PhD, MS; S. Marlene Grenon, MD, CM; Jesmond Dalli, PhD; Michael S. Conte, MD The Journal of the American Heart Association (JAHA): Cardiovascular and Cerebrovascular Disease is an international, peer-reviewed, open access, scientific journal that publishes all types of original research articles, including studies conducted with human subjects and experimental models, as well as applied clinical, epidemiological, and healthcare policy papers related to cardiovascular and cerebrovascular diseases. Our mission is to assist the science, scientist, and society in creating a world of longer, healthier lives. Our vision is to innovate and incorporate promising technologies to communicate freely-available, high-priority, high-quality content, which accelerates scientific progress and advances heart and brain health. We value integrity, excellence and inclusiveness. JAHA is an official journal of the American Heart Association and seeks to be the leading open access scientific journal with a cardiovascular and cerebrovascular disease remit in the world.
2023
Abstract
What Is New? This is the first study to elucidate the omega‐3 and omega‐6 polyunsaturated fatty acid lipid mediator profile in peripheral artery disease. We have shown that a short‐course, oral marine oil supplement can remodel these lipid mediator pathways to induce a less inflammatory and pro‐resolution phenotype. What Are the Clinical Implications? This study provides a foundation for characterizing biochemical and cellular biomarkers of inflammation and resolution in peripheral artery disease to allow for future work correlating upstream nutritional or pharmacologic interventions, immune cell function, and downstream clinical events.