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Treatment of functional bowel disorders in an integrative medicine clinic resulting in improved digestive tract symptoms.
Wagner, LE, Bridges, KM, Hinman, JM, He, J, Buckles, D, Dunn, W, Drisko, J, Sullivan, DK, Carlson, SE
JGH open : an open access journal of gastroenterology and hepatology. 2024;8(1):e13022
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Functional bowel disorders (FBDs), including irritable bowel syndrome (IBS), are conditions without a physically identifiable cause and as a result, are difficult to treat, require more physician time and impact patients' quality of life. They are linked to disordered gut-brain interactions, and diagnosis is based on patient-reported gastrointestinal symptoms in the absence of detectable physical abnormalities. The holistic approach of integrative medicine (IM) presents an interesting avenue for FBD management. This retrospective review assessed the outcome of 57 IM clinic patients, who were diagnosed with FBDs (constipation or diarrhoea-dominant IBS, mixed IBS, functional diarrhoea/constipation/ bloating). Characteristic of IM approaches the interventions were tailored specifically to the individual needs, deploying a group of therapies, including elimination diets, vitamin or mineral supplementation, magnesium supplementation, GI-related supplementation, fermented foods, hydration, non-diet lifestyle modification, referrals and GI-related medication. Symptoms were measured using a medical symptom questionnaire (MSQ). Post-intervention (average 8.75 months) most patients (75.4%) experienced an improvement in digestive symptoms. The most common intervention was an elimination diet (predominantly gluten, grains, dairy or casein), followed by supplementation. The findings suggest that IM interventions, particularly dietary changes, can effectively alleviate symptoms in FBD patients, especially for diarrhoea-dominant conditions. They also showed that less strict elimination diets may be equally effective and easier to adhere to than a low FODMAP diet. Limitations of the study included its retrospective nature, small sample size, and difficulty in comparing interventions due to their individualised nature. In addition, self-paying patients may have been more motivated to comply. A small number of patients did not experience changes and possible reasons are discussed, acknowledging that organic GI diseases were not ruled out. Future research should explore the effectiveness of dietary interventions further and consider using more IBS-specific measuring tools, as an interdisciplinary approach may be beneficial in managing FBDs effectively.
Abstract
BACKGROUND AND AIM Functional bowel disorders (FBDs), including irritable bowel syndrome (IBS) and others, are conditions without a physically identifiable etiology that, as a result, are difficult to treat. Alternatives to traditional medical interventions are needed because IBS patients require more of physician time and higher healthcare spending. The goal of this study was to determine the efficacy of alternative lifestyle interventions for patients with FBDs seen in an integrative medicine (IM) clinic at an academic medical center. METHODS We performed a retrospective chart review to determine whether patients with FBDs had improvement in symptoms following predominantly nutrition-based IM interventions that included recommendations for dietary supplements and elimination diets. We measured symptoms before and after intervention (average time between measurements 8.75 months) using a medical symptoms questionnaire (MSQ) commonly used to quantify symptom change in IM clinics. RESULTS Digestive tract symptoms, as measured by the MSQ, improved significantly in patients (n = 57) with FBDs following IM intervention. The MSQ Digestive Tract subtotal for FBD patients decreased from 10.2 (SD, 5.4) to 7.2 (SD, 5.2) (P < 0.001) after IM intervention. CONCLUSIONS Patients in an IM clinic had improved digestive tract symptoms scores following IM intervention. Because nutrition-based interventions were the primary intervention recommended by IM providers, primary care physicians and gastroenterologists may wish to consider referring FBD patients to registered dietitian-nutritionists (RDNs) skilled in implementing elimination diets.
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Effects of vitamin D, omega-3 and a simple strength exercise programme in cardiovascular disease prevention: The DO-HEALTH randomized controlled trial.
Gaengler, S, Sadlon, A, De Godoi Rezende Costa Molino, C, Willett, WC, Manson, JE, Vellas, B, Steinhagen-Thiessen, E, Von Eckardstein, A, Ruschitzka, F, Rizzoli, R, et al
The journal of nutrition, health & aging. 2024;28(2):100037
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There is an increased risk of developing cardiovascular disease in older adults with an increase in metabolic markers such as lipid levels and blood pressure in old age. Previous studies have shown that non-pharmaceutical interventions such as supplementation with marine omega-3 fatty acids and vitamin D and increasing physical activity may help reduce these metabolic marker levels. This DO-HEALTH double-blinded, randomised, placebo-controlled trial investigated the benefits of marine omega-3 fatty acids, vitamin D3 and a strength training home exercise programme (SHEP) in reducing the lipid levels, hypertension, and other cardiovascular biomarkers and reducing the risk of major cardiovascular events in active older adults. The interventions included supplementation of vitamin D3 2000 IU/day, 1 g omega-3 PUFA of marine origin (330 mg EPA: 660 mg DHA) and 30 minutes of strength training for three days a week. The Do-Health study ran for three years and 2157 active older adults enrolled into the study. This trial showed that omega-3 fatty acid supplementation decreased triglycerides and increased High-density lipoprotein levels. Omega 3 supplementation also showed a non-significant reduction in low-density lipoproteins, non-HDL and total cholesterol in older active adults. The intervention strategies did not show any benefits on hypertension or prevention of major cardiovascular events. Further robust studies using different dosages of supplements and different study durations are required to determine the efficacy of omega-3 fatty acid and vitamin D3 supplementation and strength training in reducing metabolic and cardiovascular biomarkers. However, healthcare professionals can use the results of this trial to understand the benefits of omega-3 fatty acid supplementation in older active adults.
Abstract
BACKGROUND The effects of non-pharmaceutical interventions in the prevention of cardiovascular diseases (CVD) in older adults remains unclear. Therefore, the aim was to investigate the effect of 2000 IU/day of vitamin D3, omega-3 fatty acids (1 g/day), and a simple home strength exercise program (SHEP) (3×/week) on lipid and CVD biomarkers plasma changes over 3 years, incident hypertension and major cardiovascular events (MACE). METHODS The risk of MACE (coronary heart event or intervention, heart failure, stroke) was an exploratory endpoint of DO-HEALTH, incident hypertension and change in biomarkers were secondary endpoints. DO-HEALTH is a completed multicentre, randomised, placebo-controlled, 2 × 2 × 2 factorial design trial enrolling 2157 Europeans aged ≥70 years. RESULTS Participants' median age was 74 [72, 77] years, 61.7% were women, 82.5% were at least moderately physically active, and 40.7% had 25(OH)D < 20 ng/mL at baseline. Compared to their controls, omega-3 increased HDL-cholesterol (difference in change over 3 years: 0.08 mmol/L, 95% CI 0.05-0.10), decreased triglycerides (-0.08 mmol/L, (95%CI -0.12 to -0.03), but increased total- (0.15 mmol/L, 95%CI 0.09; 0.2), LDL- (0.11 mmol/L, 0.06; 0.16), and non-HDL-cholesterol (0.07 mmol/L, 95%CI 0.02; 0.12). However, neither omega-3 (adjustedHR 1.00, 95%CI 0.64-1.56), nor vitamin D3 (aHR 1.37, 95%CI 0.88-2.14), nor SHEP (aHR 1.18, 95%CI 0.76-1.84) reduced risk of MACE or incident hypertension compared to control. CONCLUSION Among generally healthy, active, and largely vitamin D replete, older adults, treatment with omega-3, vitamin D3, and/or SHEP had no benefit on MACE prevention. Only omega-3 supplementation changed lipid biomarkers, but with mixed effects. TRIAL REGISTRATION CLINICALTRIALS. GOV IDENTIFIER NCT01745263.
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Systematic review and meta-analysis of nutrient supplements for treating sarcopenia in people with chronic obstructive pulmonary disease.
Huang, WJ, Ko, CY
Aging clinical and experimental research. 2024;36(1):69
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Tobacco smoking and air pollution are leading causes of chronic obstructive pulmonary disease (COPD). Mortality and morbidity are on the rise worldwide due to the increase in COPD. COPD is a risk factor for sarcopenia, an age-related reduction in muscle mass and muscle strength. Non-pharmaceutical interventions, such as nutritional supplementation, are considered a management strategy for sarcopenia related to COPD, as they can address nutritional deficiencies and energy requirements in old age. This systematic review and meta-analysis included twenty-nine randomised controlled trials to assess the effects of nutritional supplementation for reducing sarcopenia in patients with COPD. The included studies used different nutritional supplements such as energy-type nutritional supplements, essential amino acids, essential amino acid-enriched nutritional supplements, whey protein, β-hydroxy β-methyl butyrate, creatine, creatine in combination with coenzyme Q10, vitamin D, vitamin B12, polyunsaturated fatty acids, magnesium citrate or nutritional antioxidant supplements. The intervention duration ranged from four weeks to twenty-four weeks. The result of this systematic review and meta-analysis showed a significant improvement in body weight, fat-free mass, and a 6-minute walk test. There was a non-significant improvement in handgrip strength and quadriceps muscle strength. Healthcare professionals can use the results of this study to understand the benefits of nutritional supplementation in improving body composition and muscle strength. However, further robust studies are required to evaluate the efficacy of nutritional supplementation in COPD patients due to the high heterogeneity of the included studies.
Abstract
Individuals with chronic obstructive pulmonary disease (COPD) are prone to malnutrition and sarcopenia as a result of nutritional deficiencies and increased energy metabolism. However, the effects of nutrient supplements (NS) on treating sarcopenia in patients with COPD are not well established from systematic evidence. This meta-analysis examined the effect of NS on sarcopenia in patients with COPD. A systematic search of multiple databases was conducted, and 29 randomized controlled trials involving 1625 participants (age, mean [SD] = 67.9 [7.8] years) were analyzed. NS demonstrated significant improvements in body weight (MD,1.33 kg; 95% CI, 0.60, 2.05 kg; P = 0.0003; I2 = 87%), fat-free mass index (MD, 0.74 kg/m2; 95% CI, 0.21, 1.27 kg/m2; P = 0.007; I2 = 75%), and 6-min walk test (MD, 19.43 m; 95% CI, 4.91, 33.94 m; P = 0.009; I2 = 81%) compared with control. However, NS had nonsignificant effects on handgrip strength (SMD, 0.36; 95% CI, - 0.15, 0.88; P = 0.16; I2 = 87%) and quadriceps muscle strength (SMD, 0.11; 95% CI, - 0.06, 0.27; P = 0.20; I2 = 25%) compared with the control. In conclusion, NS may be an effective treatment for improving body composition and physical performance in COPD. Future studies should explore the effects of intervention durations, specific NS types, or combined training in patients with COPD and sarcopenia.
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Effects of active vitamin D analogues on muscle strength and falls in elderly people: an updated meta-analysis.
Xiong, A, Li, H, Lin, M, Xu, F, Xia, X, Dai, D, Sun, R, Ling, Y, Qiu, L, Wang, R, et al
Frontiers in endocrinology. 2024;15:1327623
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There is an increased risk of falls in old age due to the reduction in muscle strength and increased muscle loss. Vitamin D deficiency is considered associated with sarcopenia and decreased muscle strength. Previous research has demonstrated that different forms of vitamin D supplementation can lead to an improvement in muscle strength among elderly individuals, however, results were conflicting. This meta-analysis of twelve randomised controlled trials investigated the effects of different Vitamin D analogues such as calcitriol, alfacalcidol and eldecalcitol, on muscle strength and falls in elderly people. A subgroup analysis was conducted to assess the enhancing effect of calcium supplementation on the effect of vitamin D, either vitamin D alone or vitamin D in combination with calcium. Supplementation with vitamin D analogues significantly improved quadriceps strength and reduced the risk of falls in elderly people. The dosage of vitamin D analogues and the duration of the intervention varied highly between the included studies. Further robust studies are required to evaluate the benefits of Vitamin D and calcium supplements due to the high heterogeneity between the included studies. Healthcare professionals can use the results of this study to understand the effect of different vitamin D analogues in reducing the risk of falls in elderly people.
Abstract
BACKGROUND Elderly people are at high risk of falls due to decreased muscle strength. So far, there is currently no officially approved medication for treating muscle strength loss. The active vitamin D analogues are promising but inconsistent results have been reported in previous studies. The present study was to meta-analyze the effect of active vitamin D analogues on muscle strength and falls in elderly people. METHODS The protocol was registered with PROSPERO (record number: CRD42021266978). We searched two databases including PubMed and Cochrane Library up until August 2023. Risk ratio (RR) and standardized mean difference (SMD) with 95% confidence intervals (95% CI) were used to assess the effects of active vitamin D analogues on muscle strength or falls. RESULTS Regarding the effects of calcitriol (n= 1), alfacalcidol (n= 1) and eldecalcitol (n= 1) on falls, all included randomized controlled trials (RCT) recruited 771 participants. Regarding the effects of the effects of calcitriol (n= 4), alfacalcidol (n= 3) and eldecalcitol (n= 3) on muscle strength, all included RCTs recruited 2431 participants. The results showed that in the pooled analysis of three active vitamin D analogues, active vitamin D analogues reduced the risk of fall by 19%. Due to a lack of sufficient data, no separate subgroup analysis was conducted on the effect of each active vitamin D analogue on falls. In the pooled and separate analysis of active vitamin D analogues, no significant effects were found on global muscle, hand grip, and back extensor strength. However, a significant enhancement of quadriceps strength was observed in the pooled analysis and separate analysis of alfacalcidol and eldecalcitol. The separate subgroup analysis on the impact of calcitriol on the quadriceps strength was not performed due to the lack to sufficient data. The results of pooled and separate subgroup analysis of active vitamin D analogues with or without calcium supplementation showed that calcium supplementation did not affect the effect of vitamin D on muscle strength. CONCLUSIONS The use of active vitamin D analogues does not improve global muscle, hand grip, and back extensor strength but improves quadriceps strength and reduces risk of falls in elderly population.
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Lifestyle and Migraine - NED Infobite
Infobite 31_October 2022. Summaries of key research on migraines and lifestyle factors
2024
Abstract
The exact causes of migraine headaches are still unknown. It seems likely that the aetiology is multi-factorial. This NED Infobite includes studies looking at anti-inflammatory agents such as curcumin and omega-3's, the impacts of optimising Vitamin D and partaking exercise and how targeting overweight and obesity may also reduce the frequency and duration of migraines. BANT's scientific NED InfoBites are designed to provide key elements of the latest research using plain language. They provide quick overviews on particular health issues and nutrition topics for a speedy introduction to the science. Visually attractive and easily shareable with clients and social media followers.
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Thyroid Health - NED Infobite
Infobite 36_April 2023. Summaries of key research on thyroid health
2024
Abstract
Thyroid disease takes multiple forms and has far reaching effects on human health. This NED Infobite looks at different supplementation options, in particular focusing on synbitoics, Vitamin D, omega-3 fatty acids and selenium. BANT's scientific NED InfoBites are designed to provide key elements of the latest research using plain language. They provide quick overviews on particular health issues and nutrition topics for a speedy introduction to the science. Visually attractive and easily shareable with clients and social media followers.
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ADHD and Nutrition - NED Infobite
Infobite 41_September 2023. Summaries of key research on ADHD and aspects of nutrition
2024
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Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition that affects about 5-7% of children, which can persist into adulthood. This NED Infobite looks at gut health, Vitamin D and different aspects of dietary intake in relation with ADHD. BANT's scientific NED InfoBites are designed to provide key elements of the latest research using plain language. They provide quick overviews on particular health issues and nutrition topics for a speedy introduction to the science. Visually attractive and easily shareable with clients and social media followers.
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Ageing and the Microbiome - NED Infobite
Infobite 45_January 2024. Summaries of key research on the microbiome and ageing
2024
Abstract
Associations between the microbiome and aspects of ill-health in older adults are growing. This NED Infobite includes studies probiotic use and bone density in older women, probiotic use and memory in older adults, and the effect of Vitamin D supplementation on the gut microbiome in older adults. BANT's scientific NED InfoBites are designed to provide key elements of the latest research using plain language. They provide quick overviews on particular health issues and nutrition topics for a speedy introduction to the science. Visually attractive and easily shareable with clients and social media followers.
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IBD and the Microbiome - NED Infobite
Infobite 49_March 2024. Summaries of key research on
2024
Abstract
Inflammatory bowel disease (IBD), including Crohn disease and ulcerative colitis, are chronic inflammatory diseases of the gastrointestinal tract, characterised by periods of remission and relapse of symptoms. This NED Infobite includes studies looking at dietary options for symptom management, including the low-FODMAP diet, a look at the role of proteins and links with Vitamin D. BANT's scientific NED InfoBites are designed to provide key elements of the latest research using plain language. They provide quick overviews on particular health issues and nutrition topics for a speedy introduction to the science. Visually attractive and easily shareable with clients and social media followers.
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Bone Health and Osteoporosis - NED Infobite
Infobite 50_April 2024. Summaries of key research on bone health, in particular osteoporosis
2024
Abstract
Osteoporosis, a progressive systematic skeletal disease, is caused by diminished bone density and strength, which may increase the risk of fragility fractures, particularly in the spine, pelvis and femur. This NED Infobite includes research into the role of polyphenols and probiotics in the bone density of menopausal women, as well as looking at calcium citrate supplementation and the combination of vitamin D and exercise. BANT's scientific NED InfoBites are designed to provide key elements of the latest research using plain language. They provide quick overviews on particular health issues and nutrition topics for a speedy introduction to the science. Visually attractive and easily shareable with clients and social media followers.
