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Alternative Medicine Review - A Journal of Clinical Therapeutics

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One-Year Consumption of a Grape Nutraceutical Containing Resveratrol Improves the Inflammatory and Fibrinolytic Status of Patients in Primary Prevention of Cardiovascular Disease

João Tomé-Carneiro, Manuel Gonzálvez, Mar Larrosa, et al. Am J Cardiol. 2012 Apr 19. [Epub ahead of print]

The search for complementary treatments in primary prevention of cardiovascular disease (CVD) is a high-priority challenge. Grape and wine polyphenol resveratrol confers CV benefits, in part by exerting anti-inflammatory effects. However, the evidence in human long-term clinical trials has yet to be established. We aimed to investigate the effects of a dietary resveratrol-rich grape supplement on the inflammatory and fibrinolytic status of subjects at high risk of CVD and treated according to current guidelines for primary prevention of CVD. Seventy-five patients undergoing primary prevention of CVD participated in this triple-blinded, randomized, parallel, dose–response, placebo-controlled, 1-year follow-up trial. Patients, allocated in 3 groups, consumed placebo (maltodextrin), a resveratrol-rich grape supplement (resveratrol 8 mg), or a conventional grape supplement lacking resveratrol, for the first 6 months and a double dose for the next 6 months. In contrast to placebo and conventional grape supplement, the resveratrol-rich grape supplement significantly decreased high-sensitivity C-reactive protein (−26%, p = 0.03), tumor necrosis factor-α (−19.8%, p = 0.01), plasminogen activator inhibitor type 1 (−16.8%, p = 0.03), and interleukin-6/interleukin-10 ratio (−24%, p = 0.04) and increased anti-inflammatory interleukin-10 (19.8%, p = 0.00). Adiponectin (6.5%, p = 0.07) and soluble intercellular adhesion molecule-1 (−5.7%, p = 0.06) tended to increase and decrease, respectively. No adverse effects were observed in any patient. In conclusion, 1-year consumption of a resveratrol-rich grape supplement improved the inflammatory and fibrinolytic status in patients who were on statins for primary prevention of CVD and at high CVD risk (i.e., with diabetes or hypercholesterolemia plus ≥1 other CV risk factor). Our results show for the first time that a dietary intervention with grape resveratrol could complement the gold standard therapy in the primary prevention of CVD.

PMID: 22520621

Commentary by Gregory Kelly, ND:

There are a few important things to pay attention to in this study. One is its length. This study lasted for 1 year. The researchers found that a resveratrol-rich supplement positively affected a variety of biomarkers of chronic inflammation, without producing adverse effects, when continuously supplemented for this amount of time. Since, chronic inflammation often requires long-term intervention, knowing that this intervention was safe and effective to give long-term is an important finding. The other factor that really stood out was the dose used. The group that received the resveratrol-containing supplement for a year only took the equivalent of 8 mg a day of resveratrol. This is an extremely low dose. It is not hard to find resveratrol products containing between 100-500 mg of resveratrol. In fact, it can be much more difficult to find products with a low dose, equivalent to what was found in this study. While results of this study do not mean the high dose would not have worked as well or better (it might have), it is important that we follow where the existing evidence leads us. And, in this case, it leads us to a conclusion that we can expect a very modest dose of resterveratrol to have a positive clinical effect in the situation studied in this research.


Calorie restriction-like effects of 30 days of resveratrol supplementation on energy metabolism and metabolic profile in obese humans.

Timmers S, Konings E, Bilet L, et al. Calorie restriction-like effects of 30 days of resveratrol supplementation on energy metabolism and metabolic profile in obese humans. Cell Metab 2011;14:612-622.

Resveratrol is a natural compound that affects energy metabolism and mitochondrial function and serves as a calorie restriction mimetic, at least in animal models of obesity. Here, we treated 11 healthy, obese men with placebo and 150 mg/day resveratrol (resVida) in a randomized double-blind crossover study for 30 days. Resveratrol significantly reduced sleeping and resting metabolic rate. In muscle, resveratrol activated AMPK, increased SIRT1 and PGC-1α protein levels, increased citrate synthase activity without change in mitochondrial content, and improved muscle mitochondrial respiration on a fatty acid-derived substrate. Furthermore, resveratrol elevated intramyocellular lipid levels and decreased intrahepatic lipid content, circulating glucose, triglycerides, alanine-aminotransferase, and inflammation markers. Systolic blood pressure dropped and HOMA index improved after resveratrol. In the postprandial state, adipose tissue lipolysis and plasma fatty acid and glycerol decreased. In conclusion, we demonstrate that 30 days of resveratrol supplementation induces metabolic changes in obese humans, mimicking the effects of calorie restriction.  PMID: 22055504

Commentary by Gregory Kelly, ND:

Calorie restriction has been extensively studied for its ability to extend the life span in a variety of organisms and animals. Unfortunately, intentionally eating significantly less – in calorie restriction studies the goal is usually about 25 percent less – than a person usually eats leads to large increases in hunger. Forcing animals to be chronically hungry when you control their access to food is one thing. Asking a person to live a lifetime with hunger when they are surrounded by food is another. Because of this, there has been a search for other ways to extend life span. Certain natural compounds appear to mimic at least some of the effects of calorie restriction on genes and life span. Resveratrol is one of these compounds, which has lead to it being considered as a potential calorie restriction mimetic. In this short-term human study – 30 days – supplementation of resveratrol to obese individuals induced many of the physiological and gene changes that occur when calories are restricted. Longer studies would be needed to verify whether these positive changes would be maintained over a longer period of supplementation. And much, much longer studies would be required before any longevity effect in humans could be established. Despite these limitations, this study adds to the growing evidence base demonstrating significant effects of this molecule.

Fish-oil supplementation enhances the effects of strength training in elderly women.

Rodacki CL, Rodacki AL, Pereira G, et al. Fish-oil supplementation enhances the effects of strength training in elderly women. Am J Clin Nutr 2012;95:428-436.

BACKGROUND: Muscle force and functional capacity generally decrease with aging in the older population, although this effect can be reversed, attenuated, or both through strength training. Fish oil (FO), which is rich in n-3 (omega-3) PUFAs, has been shown to play a role in the plasma membrane and cell function of muscles, which may enhance the benefits of training. The effect of strength training and FO supplementation on the neuromuscular system of the elderly has not been investigated. OBJECTIVE: The objective was to investigate the chronic effect of FO supplementation and strength training on the neuromuscular system (muscle strength and functional capacity) of older women. DESIGN: Forty-five women (aged 64 ± 1.4 y) were randomly assigned to 3 groups. One group performed strength training only (ST group) for 90 d, whereas the others performed the same strength-training program and received FO supplementation (2 g/d) for 90 d (ST90 group) or for 150 d (ST150 group; supplemented 60 d before training). Muscle strength and functional capacity were assessed before and after the training period. RESULTS: No differences in the pretraining period were found between groups for any of the variables. The peak torque and rate of torque development for all muscles (knee flexor and extensor, plantar and dorsiflexor) increased from pre- to posttraining in all groups. However, the effect was greater in the ST90 and ST150 groups than in the ST group. The activation level and electromechanical delay of the muscles changed from pre- to posttraining only for the ST90 and ST150 groups. Chair-rising performance in the FO groups was higher than in the ST group. CONCLUSIONS: Strength training increased muscle strength in elderly women. The inclusion of FO supplementation caused greater improvements in muscle strength and functional capacity. PMID: 22218156

Commentary by Gregory Kelly, ND

This study tried to determine whether fish oil had a synergistic effect with strength training in older women (women had an average age of 64 years). One group of women did strength training for 90 days. Another group participated in the same strength training and took 2 grams a day of fish oil. A third group did the same strength training, and, prior to starting, took fish oil for 2 months. Not surprisingly, strength training improved muscle strength and aspects of muscle performance, which is an important health goal in aging individuals (male or female). In both groups that received fish oil the improvements were even greater. This is a promising finding, because of the importance of maintaining muscle size, strength, and performance as we age. And this is not the first study that has looked at the effects of fish oil combined with exercise. Nor is it the first study that has found additive effects. As an example, fish oil has been reported to work synergistically with walking for reducing abdominal fat. In other words, people who walked and took fish oil lost more abdominal fat than did people who only walked. Now, in addition to having an additive effect with aerobic exercise, fish oil also appears to have an additive effect with strength training exercise.

Effects of melatonin and tryptophan on healing of gastric and duodenal ulcers with Helicobacter pylori infection in humans.

Celinski K, Konturek PC, Konturek SJ, et al. Effects of melatonin and tryptophan on healing of gastric and duodenal ulcers with Helicobacter pylori infection in humans. J Physiol Pharmacol 2011;62:521-526.

Melatonin (MT) and its precursor L-tryptophan (TRP) are implicated in the protection of gastric mucosa against aspirin-induced lesions and in the acceleration of healing of idiopathic gastro-duodenal ulcers, but no information is available whether these agents are also effective in healing of gastroduodenal ulcers accompanied by Helicobacter pylori (H. pylori) infection. In this study three groups A, B and C, each including 7 H. pylori-positive patients with gastric ulcers and 7 H. pylori-positive patients with duodenal ulcers, aging 28-50 years, were randomly assigned for the treatment with omeprazole 20 mg twice daily combined with placebo (group A), MT administered in a dose of 5 mg twice daily (group B) or TRP applied in a dose of 250 mg twice daily (group C). All patients underwent routine endoscopy at day 0 during which the gastric mucosa was evaluated and gastric biopsies were taken for the presence of H. pylori and histopathological evaluation. The rate of ulcer healing was determined by gastroduodenoscopy at day 0, 7, 14 and 21 after the initiation of the therapy. Plasma MT, gastrin, ghrelin and leptin were measured by specific RIA. At day 21, all ulcers were healed in patients of groups B and C but only 3 out of 7 in group A of gastric ulcers and 3 out of 7 in duodenal ulcers. Initial plasma MT showed similar low levels in all three groups but it increased several folds above initial values in ulcer patients at day 7, 14 and 21. Plasma gastrin and leptin levels showed a significant rise over initial values in patients treated with omeprazole and placebo, MT or TRP while plasma ghrelin levels were not significantly affected by these treatments. We conclude that MT or TRP added to omeprazole treatment, significantly accelerates healing rate of H. pylori infected chronic gastroduodenal ulcers over that obtained with omeprazole alone and this likely depends upon the significant rise in plasma MT and possibly also in leptin levels, both hormones involved in the mechanism of gastroprotection and ulcer healing. PMID: 22204799

Free Full Text: http://www.jpp.krakow.pl/journal/archive/10_11/pdf/521_10_11_article.pdf

Spore powder of Ganoderma lucidum improves cancer-related fatigue in breast cancer patients undergoing endocrine therapy: a pilot clinical trial.

Zhao H, Zhang Q, Zhao L, et al. Spore powder of Ganoderma lucidum improves cancer-related fatigue in breast cancer patients undergoing endocrine therapy: a pilot clinical trial. Evid Based Complement Alternat Med 2012;2012:809614.

The fatigue prevalence in breast cancer survivors is high during the endocrine treatment. However, there are few evidence-based interventions to manage this symptom. The aim of this study was to investigate the effectiveness of spore powder of Ganoderma lucidum for cancer-related fatigue in breast cancer patients undergoing endocrine therapy. Spore powder of Ganoderma lucidum is a kind of Basidiomycete which is a widely used traditional medicine in China. 48 breast cancer patients with cancer-related fatigue undergoing endocrine therapy were randomized into the experimental or control group. FACT-F, HADS, and EORTC QLQ-C30 questionnaires data were collected at baseline and 4 weeks after treatment. The concentrations of TNF-α, IL-6, and liver-kidney functions were measured before and after intervention. The experimental group showed statistically significant improvements in the domains of physical well-being and fatigue subscale after intervention. These patients also reported less anxiety and depression and better quality of life. Immune markers of CRF were significantly lower and no serious adverse effects occurred during the study. This pilot study suggests that spore powder of Ganoderma lucidum may have beneficial effects on cancer-related fatigue and quality of life in breast cancer patients undergoing endocrine therapy without any significant adverse effect. PMID: 22203880

Free Full Text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236089/