October 29, 2011

Sleep, for your heart's sake

We all know the benefits of a good night's sleep, but did you know not getting enough sleep could do harm to your heart?
New study published in
Circulation warns against possible risk of myocardial infarction if you suffer of prolonged insomnia.
We all know that even short term sleep deprivation can cause strong effect on general health, but this is one of the few prospective studies that investigated insomnia as risk factor for acute cardiovascular events in the long term.
The study was large, involving 50,000 adults who live in Norway. Partecipants have been followed for 11 years. By that time, 2,386 of them had had their
first heart attack already.
Difficulties initiating and maintaining sleep and having a feeling of nonrestorative sleep were associated with a 45% increase in AMI risk.
This study keep in account some variables that are indipendent risk factors for IMA and that can rehinforce insomnia: Obesity,
Gastroesophageal reflux disease (GERD),
A previous study published in JAMA in 2008 already showed that Longer measured sleep is associated with lower coronary artery calcification incidence independent of examined potential mediators and confounders. A good sleeper sleeps at least 7 hours at night. One out of four of those who slept less than 5-7 hours had coronaric calcifications...
Another Study of 2006, published in the journal Hypertension showed a link between low duration and quality of sleep and high blood pressure. Researchers followed 4,800 normotensive people for 10 years.. Of those who slept less than five hours a night, 24 percent developed high blood pressure compared to only 12 percent of those who got seven or eight hours of sleep a night.
1. Psycho-reactive Insomnia (your mind can’t stop working);
2. Endogenous Insomnia: This is caused by a discomforts or pathology-related pain;
3. Exogenous Insomnia: Causes come from the environment;
4. Use of drugs or caffeine;
5. Functional Insomnia: This is caused by a functional unbalances:

  • Insufficient serotonine or melatonine production;

  • Magnesium and other minerals deficiences;

  • Thyroid Hormone Disorders

  • Excess of adrenaline production

  • Breathing disorders


  • Try to maintain a steady schedule: rising and going to bed at the same time each day;

  • Avoid distractions when it’s time to sleep;

  • Try meditation or relaxing techniques;

  • Keep the room as dark as possible – darkness triggers melatonin production;

  • Try to stay sometime at sunlight during the day if the sun shine;

  • Make regular physical exercise but not before going to bed.

  • Have the last meal or snack at last 2 hours before bedtime.

  • Consider a non-prescription sleep aid.

October 28, 2011

Cancer and pH

5 new clinical trials have been presented yesterday at Italian Istituto Superiore di Sanità, italian health governative institution.
These trials are focused on alternative and complementary approaches to cancer treatment with chemotherapy.
What is really interesting (but not new) is that eventually science is considering as clinical target the pH modifications induced by cancer cells.
Usually cancer cells change the microenvironment of the tissues and this strong lowering of pH damages or kills normal cells.
The 5 studies developed by "International Society for Proton Dynamics in Cancer" (ISPDC) tested these alternative approaches in patients affected by melanoma and osteosarcoma, two very aggressive forms of cancer.
Results seem very encouraging.
So very soon we could see Sodium Bicarbonate (common baking soda)among anti-tumoral agents or included in protocols for cancer treatments.
All these therapies are based on molecules that target tissue pH:
- Inhibiting acid production (pomp proton inhibitors)
- Balancing tissue pH (Sodium Bicarbonate)
- Changing their state (Acridine Orange)

October 27, 2011

From Pyramid to Circle: New Food Paradigms

October 26, 2011

Potential use of IAP to regulate Gut Microbiota

Human-Bacteria interactions: IAP may regulate microbiota.

Scientists increasingly recognize the importance of microbiota for human health.
Billion of billion of “bacterias and viruses” (more in number than the human cells) live inside our gut and sometimes they are good guests sometimes not.

The good bacteria, called probiotics, can liberate nutrients from food, fend off pathogenic microorganisms, and help regulate metabolism.

Of course there are many kinds of interactions between gut cells and bacteria and some of them are stricly regulated by intestinal hormones and enzymes like
Intestinal alkaline phosphatase.
IAP is an enzyme produced by enterocites and it could play an important regulatory role in the Microbiota equilibrium

"IAP was discovered more than 50 years ago. Its role in fat metabolism is well documented; however, during the past decade, IAP has also been recognized for its role in maintaining the gut mucosa—the epithelial cell barrier that lines the GI tract—according to Hodin and co-authors. Hodin is currently funded by the NIDDK to delineate the mechanisms that govern IAP gene regulation to better characterize the dynamic physiological role this enzyme plays in metabolism and immune defense. Orally administered IAP might be an effective treatment for bacterial pathogenesis as well as a variety of disease conditions associated with dysregulated intestinal microbiota,” wrote the researchers. Other conditions associated with dysregulated intestinal microbiota include inflammatory bowel disease (IBD), AIDS, and obesity."
The finding also provides clues to understanding and treating conditions such as Clostridium difficile-associated disease.
The role of IAP appears very important because it can imodify pH of the gut.
We know very well that every little change in gut pH immediately causes a change in gut flora composition.
It is too early to understand the real clinical potential of these research but for sure it can help us to better undestand the incredible world that we carry inside... Our Microbiota.

To read more about the study, visit NIDDK

Weird suggestions on Salt Consumption

I love scientific research because if you browse on Pubmed you can find the most weird things, and things get worse when information is explained to people in general terms by scientific journalists.
Below I found a research from a Belgian group recently published on the Journal of the American Medical Association:
The title of the article is:

The title became

Let's say something about the study:
Limits: Against all previous evidences, observational study, conducted in young people with very low cardiovascular risk.

: Eat stack of salt because it does not hurt
ANGEL VOICE: Don't listen and limit daily salt intake to 1.500mg

October 25, 2011

CANDIDA: The white threat for our health

Candida is a type of yeast which is classified in the same group as fungus.
Even when you are healthy, bacteria and yeasts, including Candida albicans, are present in your body. Normally, these micro-organisms exist on and in you without causing any harm.
Thriving in a dark, moist environment, Candida can be found in the mouth, digestive tract, vagina, or skin folds. Other areas of the body that may be colonized by Candida are the ears, dental cavities, groin, under the breasts or nails. When in correct systemic balance, Candida is not a harmful organism and will not cause troublesome symptoms.

But sometimes it became a causal agent of opportunistic oral and genital infections in humans.
Prevention is important, as treatment for Candida albicans can be unsuccessful and infections can become recurrent.
DIAGNOSING CANDIDA: Overgrowt can be diagnosticated as follows:
- Candida Immune Complex Assay Test;
- Stool Test;
- A Candida culture may also be tested with samples taken from your oral cavity (thrush) or during a gynecologic visit;
- Some modern lab test search for fungine cathabolites in urine or blood;

● Oral Thrush - A mouth infection caused by Candida that manifests with white sores or spots around the lips, on the tongue, gums, and inside the cheeks
● Esophagitis - Candida that spreads to the esophagus from the mouth
● Skin candidiasis - A diaper rash that is common in babies
● Vaginal yeast infection - A white, curd-like discharge occurs along with itching and severe burning while urinating or during sex
● Deep candidiasis - Candida spreads through the bloodstream to the entire body which causes fever, shock, and multiple organ failure.
- Unbalanced diet, with a predominance of fermented substances and
- refined carbohydrates;
- Stress and hardship, conditions that alter one's emotional responses
- Intestinal imbalances and Leaky gut syndrome;
- Insufficient intake of minerals and vitamins necessary to ensure intestinal equilibrium and to keep the defenses active;
- Use and abuse of drugs and toxic substances.
THERAPIES: Fungine infections always need a medical consultation to evaluate the importance and the kind of yeast or fungus that is attaking our body.
According to the age of the patient and the site of the infection, treatments could be started by the general pratictioner, pediatrist, dermatologist or gynecologist.
Physicians usually follow the “Clinical Practice Guidelines for the Management of Candidiasis” 2009 Update by IDSA

But if we browse the guidelines we can find only indications
of anti-fungine drugs.
Not one word rearding diet, natural remedies or complementary approaches.
Not one word.

Now we will let the physicians to establish the best therapy and we will focus on what could be a complementary approach to the drug treatments.

DIET: Candida lives of sugars and carbohydrates. So you need to limit as much as possible sugar intake (included sugar –added foods) during treatment. These substances foment candida and encourage insulin overproduction, thereby favoring inflammation and immune system intervention. Food intolerances must always be kept under control (in the case of candidiasis, there is often the presence of a yeast intolerance), because they uselessly occupy the immune defenses with food. This will results in an unbalanced diet but it is necessary for the period of treatment. You should always be followed by a nutritionist when starting unbalanced diets.
Many natural products are known for their anti-fungine activity. The list include
- Berberine (Hcl or plant extract like Coptis (Coptis chinensis) root & rhizome or Oregon Grape (Berberis aquifolium);
- Blak Wallnuts;
- Cat’s Claw;
- Caprilic Acid;
- Essential Oils (Melaleuca, Tee Tree, Lavender, Rosmary, Sage, Oregano);
- Garlic estracts;
- Grapefruit seeds extracts;
- Melissa Officinalis extracts;
You’d better rotate these natural fungicide to obtain a better result, since our undesidered guest easely adapts itself to the treatment.
Intestinal barrier integrity is a key factor to stop fungine antigens before they get in. Fungine antigens can prompt inflammation and auto-immune responses.
Even if the inflammatory response can activate some kind of cell mediated activity, it will be not enough to contrast the parasite and it will create troubles to the guest.
To restore your intestinal barrier some ingresients could help:
- L glutamine
- Prebiotics that are not potential food for the yeast;
It works feeding the cells that form the interior lining of the instestinal tract. These cells use a lot of energy for cellular division. We change the inerior lining every 2-3 days.
Repopulation of the gut with good bacterial is essential.
In nature no space is left free. Every niche of our intestines is colonizated by bacteria, viruses or yeasts. Supplementing bacteria with probiotic activity can shift the equilibrium of the intestinal flora toward health.
The strongest is your immune system the harder will be for candida albicans to stay with you.
Some natural products can rehinforce your immunity:
- Vit D
- Pantotenic Acid
- Molibdenum
- Zinc
- Selenium
You can help your liver detoxify from Candida catabolites with
- N acetylcisteine (NAC)

- Glutatione
Re-infections from mouth and anus are very common.
Furthermore infections can reach the genitourinary tract creating more troubles.
You should use flourinated tooth paste and take care of your igiene.
Some of the remedies listed above should not be used during pregnancy or pbreast feeding because they are counterindicater (greapefrout seeds) or they can alter milk taste and force the baby o stop breeding (garlic extracts). In generar if you are pregnant or are breast feeding do not start any action before a medical consultation.

October 23, 2011


Would you eat 10 tea spoons of sugar one after the other?
I don't think so..
But this is what we do everytime we drink a can of soft drinks like Coke.
Here we can know more about sugar content of many foods, drinks and snaks that we usually eat.
It is true that carbohydrates (and sugar is one of them) are an essential components of any balanced diet (that should have a percentage of carboidrates of about 30%), but it is also true that:
- A regular refined carbohydrates and sugars abuse causes overweight, obesity and many chronical diseases like tipe II diabetes;
- Regular use of sugar-added soft drinks, fruit juices and flavoured milks should be avoided particularly during meals when we usually eat enough carbohydrates.
- We should not encourage children to start using sugar-added drinks because they induce addiction;

Added sugars in soft drinks, fruit juices and flavoured milks contains empty calories.These calories are called empty because they carry energy but not nutrients (like minerals and vitamins) and they have an high Glicemic Index.

The glycemic index is found by measuring the increase in glycemia that is produced when a subject is given 50 grams of sugar extracted from a food. Therefore, the glycemic index tells us how quickly the sugar concentration in the blood rises and is expressed in relation to the increase produced by 50 grams of pure glucose.
This means that the index doesn't depend upon the sugar content of each single food. Let's look at an example: melon has a very high glycemic index but this doesn't take into consideration the fact that in order to reach 50 grams of sugar a person would have to eat 6-7 melons at one time. This explains why we can't only consider this parameter when we evaluate the body's response and especially the insulin response.
The glycemic load, on the other hand, is determined by multiplying the glycemic index by the quantity of sugar contained in the foods that are consumed. By introducing the variable of the amount of carbohydrates ingested in every single food that is eaten, we can reach a more precise evaluation of its affect upon the body

Whole grains provide calories with a lower Glicemic Index and they respect our metabolic paths not charging too much on our metabolic response.

Collaborative Vs. Competitive: The perfect Mix

We are all both Collaborative and Competitive persons according to situations and periods of life.
But there are individuals that can not survive with this mix.
You would die in few days if you are a fireman and you are not 100% collaborative.
You would day in few days if you are the boxe world champion and you are not 100% competitive.
But for most of us the extreme possibilities are not the best approach to survive and to have an happy and fullfilled life.
We are social living being so it is natural to develope and mantain a good social network (both online and in the real world).

Foto from Maurizio Goetz Facebook Page

And it is normal somebody will commit to excellence trying to do the best (this means also better that others).
So what I suggest is to know yourself and balance your Collaboration and Competitive souls in order to obtain your Perfect Mix.
I am a father of a child of 9 and it is difficult to explain my point of view.
Modern western culture is unbalanced toward competitivity. Collaboration is too ofter underestimated or considered weakness.
I try to be a good model for him and probably this is the only way to be a father.

October 22, 2011

English Guidelines for Autism (NICE)

Last month the National (England) Institute for Health and Clinical Excellence (NICE) published guidelines on autism.
Two more sets are expected in 2012 (autism in adults) and 2013 (management of autism) .

These guidelines focus on improving recognition, referral and diagnosis of children and young people with autism.

We can download a brief or a full report.

New evidences seems to link low-birthweight and autism.

The study appears online in the November issue of Pediatrics.

Low-birthweight babies are five times more likely to develop autism than normal-weight babies. 862 premature, low-birthweight infants have been followed until they were 21 years old.
Their birthweights ranged from 500 grams (1.1 pound) to 2,000 grams (4.4 pounds).
Five percent of the children in the study developed autism, compared with 1 percent of those in the general population.

No time to waste against Alzheimer

There is no time to waste according to the Alzheimer's Foundation of America (AFA) to fight AD.
So "NO TIME TO WASTE is the title of a specific, hard-hitting report full og recommendations on both care and cure to tackle Alzheimer's disease.

The report urges swift implementation of a national strategy plan on this growing public health crisis that threatens an increasing number of American families.

We needed a "bold but practical" approach and calls for formulating solutions within—as well as outside of—current government programs to ultimately "defeat" Alzheimer's disease.
Alzheimer's disease, which results in loss of memory and other intellectual functions, currently affects more than 5.1 million Americans and is the sixth leading cause of death.

With advanced age the greatest risk factor for the disease, the incidence doubles every five years after age 65.

The Alzheimer's Foundation of America, based in New York, is a national nonprofit organization that unites more than 1,600 member organizations nationwide with the goal of providing optimal care and services to individuals confronting dementia, and to their caregivers and families.

October 21, 2011

World Osteoporosis Day - Italy

World Osteoporosis Day is observed annually on 20 October, and launches a year-long campaign dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease

Italy is one of the 90 countries where activities and events are organized to rise awareness among people at risk. Many major hospitals and university medical dept. open their ambulatories for free or reduced-price consultations, tests and other forms of medical advice.

For example we can list: Ospedale Molinette di Torino

Risk factors for bone fractures linked to osteoporosis include:

  • Early or surgical menopouse

  • Low density bone pick due to anorexia in young age

  • Cigarette smoke

  • Use of Cortison drugs for at least 6 months

It is true that women are more exposed to risks of bone fractures but it is also true that severe osteoporosis is observed in men as well.

Eating well, ensuring sufficient vitamin D and staying physically active are two essential components of a healthy lifestyle. These are also the pillars of osteoporosis prevention at all stages of life

A new report issued by the International Osteoporosis Foundation (IOF) for World Osteoporosis Day puts the spotlight on the severe impact of spinal fractures and calls on health professionals to recognize the signs of these fractures in their patients.

Vit D Fact Sheet

Calcium Fact Sheet

October 20, 2011

Ages For Diagnosis And Treatment Of ADHD In Children Expanded By AAP

Updated guidelines from the American Academy of Pediatrics (AAP) offer new information on diagnosing and treating Attention-Deficit/Hyperactivity Disorder (ADHD) in younger children and in adolescents.

Since now HCPs could diagnose the problem only when children reached 6 years.
Now they can start at 4 up and treat young patients up to 18 years (former limit was 12).

The new guidelines describe the special considerations involved in diagnosing and treating preschool children and adolescents. They also include interventions to help children with hyperactive/impulsive behaviors that do not meet the full diagnostic criteria for ADHD.

I am not a psichiatrist nor a pedagogist.
I am worried that such an early diagnose could prompt treatments without a full evaluation of psycological and behaioural alternatives, although new guideline recommend in preschool children (ages 4 and 5) with ADHD, behavioral interventions (such as group or individual parent training in behavior management techniques) before starting drugs.

Behind every behavioural disorder It may be present complex problems and most probably the pharmaceutical solution is not enough olistic.

The promonters of such change state that "Treating children at a young age is important, because when we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school,"

ADHD is the most common neurobehavioral disorder in children, occurring in about 8 percent of children and youth.

Reference: Clinical Practice Guidelines for the Diagnosis, Evaluation and Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder - Pediatrics

Resoulces: Book ADHD: What Every Parent Needs to Know."
Parent information will also be available here Healthychildren.org website

October 17, 2011

Calcium in pregnancy may halve the risk of pre-eclampsia

We all know that Calcium is not only important to prevent osteoporosis.
Most doctors recommend calcium during pregnancy to protect against birth complications and loss of bone density caused by the developing babies.

A new research about the importance of calcium during pregnancy is now published
in the Cochrane Database of Systematic Reviews
Researchers gathered data from 21 randomized controlled trials involving 17,000 pregnant women. The studies compared whether taking supplements was any better than a placebo or no treatment at all in having a healthy pregnancy and delivery.

It seems that calcium supplements did not lower the risk of preterm birth or low birth weight but they can help prevent pre-eclampsia, (increased blood pressure) in pregnant women.
The study showed that the frequency of pre-eclampsia in women that used Ca supplements was about -50%.

Stocking up on calcium when young is essential for building strong bones. A diet which has sufficient calcium, vitamin D and phosphorus is important, as are genetic factors and exercise. The recommended calcium intake varies depending on where one is in one's life cycle.
An average recommended daily intake of 800mg is stipulated in the European nutrition-labelling directive.
However certain groups of the population have higher requirements up to 1200 - 1500mg (young people aged 11-24, pregnant and lactating women, postmenopausal women who are not having hormone replacement therapy).

Calcium content of some food 300 mg Ca are found in:
25-30 g hard cheese (emmental, parmiggiano, cheddar, etc)
50 g soft cheese (camembert, brie, etc)
200 g skimmed milk or yoghurt
150 g almonds nuts, dried figs
200 g dried beans
500 g green vegetables (cabbage, leeks, spinach, broccoli), wholemeal bread
0.7 l of certain calcium-rich mineral waters (check with the label)

October 16, 2011

Estrogens and Obesity: Lack of will or hormonal disbalance?

We can not consider obesity as a "drugs deficiency", only "lack of will" or a simple behavioural disorder.
Neurophysiological signals are strongly influencing our current wheight.
Estrogens, for example, play an important role in regulating our food intake and satiety.

Before menopause, women are protected from obesity and associated disorders by estrogens, and the sudden fall in estrogens blood level around age 52 is often associated to wheight gain.

In the hypothalamus there are two estrogen receptors, estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ). Activation of ERα by estrogens reduces food intake and increases body weight.
This new research published in the current number of "Cell Metabolism" focus on estrogens activity on two different cell populations' receptors in the hypothalamus. This activity can cause wheight gain and eventually promote obesity.

Rerearchers focused their work on neurons in the hypothalamus of brain that carry an estrogen receptor alpha – a molecule that takes estrogen signals into the neurons. The hypothalamus links the nervous system to the endocrine system to regulate multiple physiological processes, including those controlling body weight.
Don't forget that estrogen receptors have been found in many peripheral tissues including adipose tissue. Their biological activity has not been completely explained.

Here you can read more on "estrogen receptors and obesity" and about the "Metabolic impact of sex horones in Obesity"

I am sure that this kind of research will help us to better undestand complexity
linked to obesity and chronic diseases and to find remedies for epidemic of obesity that is speading form the rich to the developing countries.

October 15, 2011

Manganese and Skin health

Manganese is a chemical that can be considered both an heavy metal pollutant and a essential trace mineral for all known living beings. The human body contains about 12-20 mg of manganese (200 times less than iron), which is stored mainly in the bones, liver and kidneys. In the human brain the manganese is bound to manganese metalloproteins.

Manganese(II) ions function as cofactors or a number of enzymes in higher organisms, where they are essential in detoxification of superoxide free radicals. It aids in the formation of connective tissue. It enables the body to utilize vitamin C, B1, biotin as well as choline. It is a cofctor in metabolism of fat, sex hormones and breast milk in females.

IN LARGER AMOUNTS: and with greater activity by inhalation, manganese can cause a poisoning syndrome in mammals, with neurological damage which is sometimes irreversible (impaired motor skills and cognitive disorders).

MANGANESE IN FOODS: you can found Manganese almonds, wallnuts, avocados, eggs, brown rice, spices, whole grains, leafy greens, liver, tea and coffee.

NUTRITION TIP: A daily cup of tea proves a good portion of your manganese intake.

DEFICIENCES: Severe deficiencies are rare and can cause growth retardation, changes in circulating HDL cholesterol and glucose levels, reproductive failure. Serious deficiency in children can result in paralysis, deafness and blindness. Sub-clinical deficiencies can be linked to depression, weakness, tremors, irrational behaviour, leg cramps.

RDA (Recommended Daily Allowance) in Italy: is 1-10 mg a day (LARN 1996).
According to the Italian law nutritional supplements can not contain more that 10mg per day per dose for adults. This follow the European Union Population Reference Intake for males aged 18 years and over that indicate "acceptable range of intakes": 1-10 mg.

ABSORPTION: Manganese is not easily absorbed but we need only small amounts that are generally retreived from food in healthy subjects. Leaky gut sindrome, chronic inflammatory diseases and alterations of the intestinal barrier can reduce Mn absorpition. Absorption is also negatively influenced in the presence of calcium, phosphorous, zinc, cobalt and soy proteins. Don’t forget that refined grains contain only 50% of whole grains, so a diet based on refined food can lead to a sub-clinical deficiency.

LAB TESTS: Serum manganese concentrations in combination with lymphocyte manganese-dependent superoxide dismutase (MnSOD) activity and perhaps blood arginase activity, appear to be the best ways to monitor ingestion of insufficient manganese. Serum manganese concentrations in combination with brain MRI (magnetic resonance imaging) scans, and perhaps a battery of neurofunctional tests, appear to be the best ways to monitor excessive exposure to manganese.


The role of Manganese for skin health can be summarized as follow:
- structural;

  • Needed to build collagen

  • It helps to have a high bone density

  • Necessary for energy production

  • Active in DNA repair

- related to the cofactor activity in the MnSOD.
Antioxidants scavenge damaging particles in the body known as free radicals. These particles occur naturally in the body but can damage cell membranes, interact with genetic material, and possibly contribute to the aging process as well as the development of a number of health conditions. Antioxidants such as MnSOD can neutralize free radicals and may reduce or even help prevent some of the damage they cause.
Recent studies have shown that antioxidant enzyme expression and activity are drastically reduced in most human skin diseases, leading to propagation of oxidative stress and continuous disease progression. Numerous studies have shown that MnSOD can be induced to protect against pro-oxidant insults resulting from cytokine treatment, ultraviolet light, irradiation, certain tumors, amyotrophic lateral sclerosis, and ischemia/reperfusion. In addition, overexpression of MnSOD has been shown to protect against pro-apoptotic stimuli as well as ischemic damage. Regulation of antioxidant activity is a new target for dermatologists.
Probably the role of MnSOD beyond its essential role for survival and suggest a
novel strategy for an antioxidant approach to cancer intervention.

There are several forms of supplementary manganese including: manganese gluconate, manganese sulfate, manganese ascorbate, and manganese amino acid chelates. Typical supplemental intake of manganese ranges from 2 to 5 milligrams daily. Interactions can occur if taken together with oral contraceptives (not recommended). The regulatory mechanisms of Mn homeostasis are bypassed via the parenteral route so elimination via the hepatobiliary system is impaired, resulting in tissue or brain accumulation. It is unnecessary for Mn to be prescribed routinely for pediatric or long-term PN patients.

MANGANESE AND approved EU health claim for skin health:
EU states that Mn is requested for production of enzimes involved in proteic and lipidic metabolism. Mn contributes to the normalmanifacture of collagen.

October 14, 2011

Almonds and diabetes

Walnuts and almonds consumption can help you fighting and preventing diabetes.
Adding these nuts to your diet can result in ameliorations in obesity, hyperlipidemia, hypertension, and hyperglycemia.
MedDiets and nuts-enriched MedDiets seem to be effective in the prevention of diabetes in subjects at high cardiovascular risk, and a preventive effect is demonstrated also in healthy subjects.
Women in a Harvard School of Public Health study who reported eating 5 or more 1 ounce servings of nuts/peanuts per week reduced their risk of Type 2 diabetes by almost 30 percent compared to those who rarely or never ate nuts.

HCP are usually cautious in recommending walnuts and almonds regular consumption due to their high caloric power and high fat content.
That's true. Infact:
100g of Wallnuts provides Kcalories 582- 650
100g of Almonds provides Kcalories 578- 600

But it is not needed to eat 1Kg, nor it is recommended!!!!

PORTION: 1 oz or 28g is equal to 20-22 almonds or 14 half wallnuts or 28 penuts
It's 160-180 KCalories.

CAUTION: Nuts in general are among the 5 most frequent food allergens.
Be sure not to be allergic to nuts befor adding them to your diet.

J Am Coll Nutr. 2010 Jun;29(3):189-97.
Almond consumption and cardiovascular risk factors in adults with prediabetes
Tested: Insulin sensitivity and CV risks
Comparedwith: nut free diet
Conclusions:An ADA diet consisting of 20% of calories as almonds over a 16-week period is effective in improving markers of insulin sensitivity and yields clinically significant improvements in LDL-C in adults with prediabetes

Nutr Metab (Lond). 2011 Jan 28;8(1):6.
Acute and second-meal effects of almond form in impaired glucose tolerant adults: a randomized crossover trial
Tested: Postprandial concentrations of blood glucose, insulin, non-esterified free fatty acids (NEFA), glucagon-like peptide-1 (GLP-1) and appetitive sensations
Conclusions: Inclusion of almonds in the breakfast meal decreased blood glucose concentrations and increased satiety both acutely and after a second-meal in adults with IGT. The lipid component of almonds is likely responsible for the immediate post-ingestive response, although it cannot explain the differential second-meal response to AB versus WA and AO

Metabolism. 2011 Apr;60(4):474-9. Epub 2010 May 23.
Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus
Tested: fasting insulin, fasting glucose, and homeostasis model assessment of insulin resistance index
Conclusions: incorporation of almonds into a healthy diet has beneficial effects on adiposity, glycemic control, and the lipid profile, thereby potentially decreasing the risk for cardiovascular disease in patients with type 2 diabetes mellitus

J Nutr. 2006 Dec;136(12):2987-92.
Almonds decrease postprandial glycemia, insulinemia, and oxidative damage in healthy individuals
Tested:effect of decreasing postprandial glucose excursions on measures of oxidative damage
Conclusions: Almonds are likely to lower this risk by decreasing the glycemic excursion and by providing antioxidants

European Journal of Clinical Nutrition(2009)
Long-term effects of increased dietary polyunsaturated fat from walnuts on metabolic parameters in type II diabetes
Conclusions:Dietary fat can be manipulated with whole foods such as walnuts, producing reductions in fasting insulin levels.

In 2003, the U.S. Food and Drug Administration (FDA) approved this package label "qualified" health claim for nuts:
Scientific evidence suggests but does not prove that eating 1.5 ounces per day of most nuts, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.”

October 13, 2011

Apple's apps for HCP: my opinion

A new section of Apple store dedicated to Health Care Professionals started in September.
We can find six cathegories of apps:
reference apps
educational apps
EMR & patient monitoring apps
imaging apps
point of care apps

The sixth cathegory, called personal care apps, is for consumers.
In this sections we can find many "must have" for anybody involved in health care, like PubMed On tap, and Micromedex Drug and iTriage.
I like iTriage even if it is focused on USA and many services are not working in Europe yet.
I already congratulated with the people who developed the app and I think that they are doing well in this "early stage" sector without having the investments of Google Health!
I like the Merk manual but it costs 27,99 euro.
I tested Muscle trigger points and I think that it can be useful for students and FKTR's.
Patients can benefit of iHealth BPM and Diabetes Buddy to keep on track fighting their chronic disease. Don't forget that diabetes and hypertension are the most terrible cardiovascular killers.
In the near future mobile apps for health care will be commonly used and I think that governative authorities should immediately play a central role helping developers in standardizing protocols, languages and data formats.
This will allows HCP to access patient's data everywhere and whenever is needed.
Governative authorities could also plan to use the "open data" generated by the people to promote research and population studies.

October 11, 2011

Present and Future of Probiotics

Stevia is eventually going to be approved in Italy

Used for centuries in South America and some Asian countries,
Stevia is a plant that attracts considerable attention from the food industry for its use as sweetener especially after that Coca cola co. and Pepsi co. started to use one of its extract as ingredient of their soft drinks.

The genus Stevia is composed of 240 shrubs and herbs of the Asteraceae family.
The most famous specie is Stevia rebaudiana, well known for its sweet leaves with a licorice-lke after taste.
Extracts of the Stevia rebaudiana with a 95% purity of rebaudioside A (Reb A) were given the FDA thumbs up in the US in late 2008.
In Europe the EU declined approval for dried stevia in 2000, however, saying more research was needed.
In January 2011, EFSA revised their consumer exposure estimates.

For high consumers, the estimates are up to four times the EFSA established Acceptable Daily Intake (ADI) of 4 mg per kg body weight per day (mg/kg bw/day).

The revised exposure estimates for high consumers are: children from 1.7 to 16.3 mg/kg bw/day; adults from 5.6 to 6.8 mg/kg bw/day.
Wim Debeuckelaere of the Directorate General for Health and Consumers (DG Sanco) stated in June 2011 that stevia is on schedule for approval by the EC before the end of 2011 at the latest.
Meanwhile, France approved 97% rebaudioside sweeteners, under a clause that allows pre-emption of EU approval for a two year period.
Industrial suppliers of stevia sweeteners are moving in to take advantage of these opportunities starting from Jan 2012.

But in Italy, the extracts and dried portions of the plant cannot currently be used as food ingredient yet and they are sold in strange ways, like "bath salts".

Stevia leaves and exstracts counts no calories and consequently they have a low glycaemic index (which means it does not cause the same spike in blood sugar levels as sucrose and other refined carbohydrates).
So Stevia and its extracts can be considered elective sweeteners for diabetic patients.
30 years of free use in Japan seems to confirm the safety profile.

Some positive effects on blood pressure and glicemic control are currently scientifically investigated.

I personally tested both the dried leaves and the rebaudioside extracts and I was astonished by the sweetener power. Beeing hundreds of time more sweet than sugar you need only very low quantities to change the taste of drinks and foods.

I personally don't like the persistence af sweet taste after (sometimes) minutes of use but the problem can be solved using lower quantities.

Licorice-like after tast can be avoided using different extracts but some people like it.

October 10, 2011

Gastrointestinal Health and OTC sales in Italy

Looking at the OTC sales in Italy (Q1-2 2011) we can see that gastrointestinal health accounts for about 50%.
We can find a low dosed probiotic at 3° and 4° position, for about 4.9 million boxes and rectal glycerin formulations for constipation at position 9° and 10° for more than 3 million boxes.

Italians seems not much interested in quality looking at this data.
Infact they prefer to use a rectal formulation for the acute constipation instead of a prebiotic with adaptogen effects.
They ignore
Ministero della Salute guidelines on the use of probiotics that recommend to use only live organisms and a dose of at least 10billion a day for the adults.

As usual, first 2 positions are strongly held by diclofenac and paracetamol brands that may have well known side effects on the gastrointestinal tract.

We find first antiacid at position 17° with 1 million boxes sold. Antiacids are generally safe but patients should not ignore possible interactions with frequently prescribed drugs like antibiotics tetracyclines and fluoroquinolones or bisphosfonates.

A recent study published on "Drug" described "
Clinically significant drug interactions with antacids: an update"

The authors explain that antiacids-drug interactions are more frequent now that antiacids are sold without prescription and suggestions from health care professionals.

Antiacid-drug interactions can be more important if the antiacid is coupled with a proton pump inhibitor and the mechanisms can be a gastric pH-dependent by H2RAs and a cation-mediated chelation by antacids.

Adiposity in children and its correlation with BP

The effect of adiposity on blood pressure in children is minimal until the body mass index reaches the 85th percentile, at which point it intensifies, according to a study published online Oct. 3 in Hypertension.

Wanzhu Tu, Ph.D. followed 1,111 children for 4.5 years. Blood tests and BP were measured.

"There is a marked intensification of the influence of adiposity on BP when children reach the categories of overweight and obese. Among the possible pathways, leptin may be a potentially important mediator acting through the sympathetic nervous system (reflected in heart rate)," the authors write.

BMI was used in this study to meaure adiposity but a new index can give furter information about the real fat percentage.

This new index is called Body Adiposity Index (BAI) and it is calculated using Hip circumference and Height.

Try to calculate your BAI and compare it with your BMI.

Here you can calculate your BMI

Are the 2 indexes telling you the same story?

Iron deficiency in obese people linked to inflammation

It is difficult to think at obesity as a condition linked to nutritional carencies because we normally think that it is caused by excess of nutrients.

Obesity is not caused by excess of nutrients
It is caused by excess of empty calories and bad fats.

The paradox is that you can also witness nutritional carencies like hypoferremia (iron deficiency) in obese people.

A clinical trial with 172 healthy non-obese (BMI <30 kg/m2), and 234 obese (BMI ≥30 kg/m2) has been conducted to understand mechanisms involved in the hypoferremia of obesity. Results are published here.

Researchers found in obese patients:
- inadequate bioavailable iron relative to body weight
- diminished intestinal absorption
- decreased iron bioavailability induced by inflammatory adipokines

This study confiirms that obesity is a condition where inflammatory pathways are over-activated and nutritional carencies can be present despite the excess of food intake.

Falsely normal ferritin concentrations are commonly found and are likely increased by chronic inflammation. So this marker if measured alone can be misleading in obese people.

October 08, 2011

Probiotics and Longevity: New Theory

Very interesting theory tries to link probiotics use and longevity.
The article is published on the current issue of Medical Hypotheses
(Volume 77, Issue 4 , Pages 469-472, October 2011).

Authors think that Probiotics-induced increase of large intestinal luminal polyamine concentration may promote longevity
We read from the abstract that: "Many mechanisms contribute to senescence, such as telomere shortening in replicative cells, cumulative damage to DNA leading to genomic instability, and oxidative damage to molecules by reactive oxygen species (ROS). These include chronic low-grade inflammation (inflammageing), a major risk factor for ageing and age-related diseases, such as Alzheimer’s disease and type II diabetes"

The authors discuss in this article the rationale and recent evidence for probiotic-induced upregulation of intestinal luminal polyamine (PA) production in the extension of lifespan by preventing inflammageing.

US Trends on Health and Nutrition from HHS

The U.S. Department of Health and Human Services (HHS) released findings from its Final Review for Healthy People 2010 on October 6, 2011.
Download the Healthy People 2010 Final Review

In this interesting report we can find interesting statistical data regarding health of U.S. population, what's happened in the last 10 years and how much health target have been achieved or not.

Of course these data can not be extended to European population but can be used as indicators of trends in western populations.

I recommend the section regarding nutrition where we can find (for example) data on
calcium intake and iron deficiency in population.

For example we see that iron deficiency is about 9% in general population up to 36% in low income pregnant women.