Q1 and Q 2 2014 Quarterly Research Review

Quarterly Research Review

Mother’s Nutrient Status Impacts Infant Development

Research publications during Q1&2 of 2014 were dominated by reports on nutrient requirements during pregnancy to enhance foetal and infant development and function including:

  • The impact of maternal iodine status to achieve full potential.
  • The requirement for DHA to attain optimal development.
  • The improvement of language skills by DHA.
  • The reduction in respiratory symptoms by DHA.

 

All good to promote Mother & Baby product sales.

To support Active Memory, two separate studies showing:

  • DHA improves memory, and reduces anxiety and depression.
  • PS improves and maintains memory and attention.

Two separate pioneer discoveries help us to understand how DHA gets into the brain.

In support of Efalex Brain Formula, a study showing that:

  • Fish oil/EPO + methylphenidate more effectively reduces ADHD symptoms than either alone
  • Fish oil/EPO reduces the sides effects of the drug

Other reports include:

  • Omega-3 supplementation reduces depression.
  • Higher blood GLA and  DGLA are associated with lower overall and breast cancer rates.

 

Impact of Iodine

A policy statement from the Council on Environmental Health and published in the American Academy of Pediat- rics, urged pregnant  women to take iodine supplements to boost their child’s brain de- velopment. Dietary iodine, historically derived from fish and fortified salt is no longer common in the diet since fish intake has declined and most salt now comes from processed foods prepared with unfortified salt. In addition vegans, because they  don’t eat fish, likely have iodine deficiency. Iodine deficiency is also prevalent in the South East of the UK where in an Efamol/Wassen sponsored study, 100 pregnant women were recently tested in their first trimester. Iodine status was significant better in those taking an iodine prenatal supplements (n=42) than in those not taking one.  Based on these findings, the authors stated a national survey of iodine status in UK pregnant women is required2. In France, a systematic literature review including 13 papers found that compared to  in 1952, iodine status is better and  more  women  are  using iodine supplements  before and during pregnancy. However, iodine status could stand to be improved before pregnancy and iodine supplementation prevents infant psychomotor and neuro intellectual disorders.

Maternal iodine deficiency also:

  • impacts foetal and infant brain development and reduces their full potential.
  • increases mother and child vulnerabilities to effects of environmental pollutants including tobacco smoke.
  • reduces verbal IQ and reading ability of 8-9 year olds.

Maternal supplementation improves foetal and infant iodine nutrition according to  a recent study of 1508 preg- nant and 87 lactating women and their offspring. Iodine levels were higher in infants from mothers supplemented with 200 µg iodine daily than in those not supplemented5. The American Thyroid Association and the National Academy of Sciences recommends1: 290 µg total daily iodide in breast feeding mothers, which  generally  requires 150 µg of supplemented iodine.

Supplemental iodine should come from potassium Efamol Mother &  Baby meets all recommendations:

  • provides 150 µg of iodide from potassium iodine.
  • can be taken before and during pregnancy and while breast.

 

  1. Council on Environmental Health. Iodine deficiency, pollutant chemicals and the thyroid: New information on an old problem. Pediatrics 2014 May 26. pii:peds.2014-0900.
  2. Bath SC et al. Iodine deficiency in pregnant women living in the South East of the UK: the influence of diet and nutritional supplements on iodine  Br J Nutr 2014 May;111 (9):1622-31.
  3. Patey-Perra S. Benefits and risks of iodine supplementation during pregnancy: a review of observational and experimental studies in mild-to-moderate iodine deficiency areas. Rev Epidemiol Sante Publique 2014 Feb;62(1):65-74.
  4. Leung AM & Brent GA. Children of mothers with iodine deficiency during regency are more likely to have lower verbal IQ and reading scores at 8-9 years of age. Evid Based Nurs 2013 Dec
  5. Sukkhojaiwaratkul D atl. Effects of maternal iodine supplementation during pregnancy and lactation on iodine status and neonatal thyroid-stimulating hormone. J Perinatol 2014 Apr 17. doi:10.1038/jp.2014.62.

 

DHA Needed for Optimal Development

A newly published literature review aptly showed that the docosahexaenoic acid (DHA) rich human brain requires an ample and sustained source of dietary DHA to reach its full potential1. Brain and nervous tissue is rich in DHA and DHA is required for the brain to function correctly. DHA is scare in terrestrial plants, but in contrast is plentiful at the shoreline where  it is made by single celled algae and ends up in marine animals including fish. The human brain accumulates DHA up to age 18 with most being taken up half-way through gestation up to 2 years of age. Infants fed formula contain- ing only alpha-linolenic acid as an omega-3 source and no DHA, have lower  DHA status than those given formula with DHA. Those infants receiving  DHA have better vision and brain function. Vegan mothers have much lower levels of DHA in their breast milk than non-vegans. EnvirOmega – a good way for them to increase DHA in their milk so their babies can reach their full potential.

  1. Brenna JT & Carlson SE. Docosa- hexaenoic acid and human brain development: Evidence that a dietary supply is needed for optimal development. J Hum Evol 2014 Apr 26.pii  S 0 0 4 7 – 2 4 8 4 ( 1 4 ) 00083-9.

 

DHA Supplementation in Moms During Pregnancy has Multiple Benefits for Her Baby

The importance of DHA during   pregnancy for infant development and health continues to be supported by research. During that last six months, results of two randomized, double- blind, placebo controlled trials were published that included supplemented mothers and their infants who were monitored and tested in subsequent months.

One included 270 women given either placebo or 400 mg/day of DHA from 16 weeks gestation to delivery.  At 2 months of  age, the infants in the DHA group had better visual acuity. By 18 months, they could talk and communicate better because they understood and produced more words, talked more in sentences, were  more  receptive to speech and themselves better.

The second included 1094 pregnant women aged 18-35 years with a history of atopy who took either a placebo  or 400 mg/day of algal DHA from 18- 22 weeks of gestation through delivery. At 18 months of age, the infants from DHA supplemented mothers had fewer respiratory symptoms typical of the atopic condition including less phlegm with nasal dis- charge or nasal congestion and less fever with phlegm and nasal discharge or nasal congestion.

  1. Mulder KA et al. Omega-3 fatty acid deficiency in infants before birth identified using a randomized trial of maternal DHA supplementation in pregnancy. PLOS One. 2014 Jan 10;9(1):e83764.
  2. Escamilla-Nuez MC et al. Omega-3 fatty acid supplementation during pregnancy and respiratory symptoms in children. Chest 2014 Mar 13 doi:

Mother & Baby provides 400 mg of DHA daily, enough to:

Enhance vision at 2 months of age 1

Improve language development at age 18 months1 including:

  • number of words understood and produced.
  • number of sentences used.
  • language reception and expression.

 

Decrease respiratory symptoms at 18 months of age 2  including:

  • phlegm with nasal discharge or nasal congestion.
  • fever with phlegm and nasal discharge or nasal congestion.

 

  1. Mulder KA et al. PLOS One. 2014 Jan 10;9(1):e83764.
  2. Escamilla-Nu?ez MC et al. Chest 2014 Mar 13 doi: 10.1378/chest. 13-1432

 

Active Memory Improves Memory, Reduces Anxiety & Depression

A  recent randomised  trial showed that regular use of Acive Memory improves age re- lated memory loss or delays its progression in elderly people. It included 60 patients aged 60 years  and  older  with diagnosed age related memory loss who were either untreated (control group) or took 3 capsules per day of Active Memory for 24 weeks. Before and after treat- ment, the patients were assessed by researchers who did not  know which of them were taking the Active Memory with the:

  • MMSE – Mini Mental State Exam which assesses mental status using eleven  questions that test five areas of  cognitive function, registration, attention and calculation, recall, and language
  • ABT –  Abbreviated  Barcelona  Test  Battery  which  is  a brief neuropsychological test for Spanish people older than 49 years.
  • QOL – Quality of Life Scale which provides a simple descriptive profile and a  score for quality of life status.

 

Patient improvements were greater in the Active Memory treated patients for 5 of the memory tests with the results being significantly greater for delayed free text recall. In ad- dition, there was no or less deterioration in the Active Memory treated patients for 5  of the QOL tests with the re- sults for anxiety and depression being significantly less. (See graphs below)

 

Garcia-Escrivà A et al. Efecto de los ácidos grasos poliinsaturados omega-3 sobre la función cognitiva en pacientes con deteriorio cognitivo leve. Alzheimer. Real Invest Demenc 2014;56:21-29.

PS Improves Memory

A randomised, double-blind, trial including 131 non- demented people with memory complaints taking either placebo or 100 mg daily of phosphatidylserine   (PS)  for 15 weeks found significant improvements in immediate verbal recall. In a subset of them with good cognitive performance, immediate and delayed verbal recall, learning ability and time to copy complex figures also improved. A 15 week treatment extension in 122 participants significantly improved Clinical Global Impression of Change while 9 untreated patients maintained their attention and memory.

Vakhapova V et al. Dement Geriatr Cogn Disord 2014 Feb 20;38(1-2):39-45.

Pioneer Discoveries on  How DHA Reaches the Brain

We know that DHA is abundant in the brain and is critical for its function throughout life, but little was known  about how DHA gets in the brain until now.  One  study showed it passes into the cerebrospinal fluid (CSF) while another discovered a protein that carries it from the blood into the brain. In a 6 month, randomized, double-blind trial including 204 Alzheimer’s Disease (AD) patients taking either placebo or 2.3 g of high-DHA oil  daily, 33 of them were tested for blood and CSF DHA status. DHA levels increased in both while inflammatory and AD biomarkers decreased. These results suggest that DHA is transferred across the blood brain barrier. But how does that take place?

Researchers at Duke-NUS Graduate Medical School in Singapore helped answer that question when they discovered a transporter protein called Mfad2a2.

Mice that did not have Mfad2a had brains a third smaller than those with the transporter, had memory and learning deficits and high anxiety, and were  deficient in DHA.

Mfad2a is only found in the inside lining of tiny blood vessels between the blood and the brain and so it is part of the blood-brain barrier. It is necessary to enable incorporation of DHA into a phospholipid called phosphatidylcholine that is a  main membrane fatty acid within the brain. Inability to incorporate DHA into this phospholipid reduces DHA transfer to and ultimately its levels within the brain. That has major implications for brain development and function.

We know that the brain does not produce DHA on  its own. Instead, it is transferred from the mother during fetal development, or after birth and throughout life it is synthesized in the liver or comes directly from food. Now we know how DHA from those three sources manages to find its way into brain tissue where it can do its job!

Knowing how this process occurs will enable future discoveries to further enhance brain absorption  of this essential nutrient and facilitate improvements in therapeutic formulations.

  1. Freund LY et al. Transfer of omega-3 fatty acids across the blood-brain barrier after dietary supplementation with doco- sahexaenoic acid-rich omega-3 fatty acid preparation in patients with Alzheimer’s disease: the OmegaAD study. J Intern Med 2014 Apr;275(4):428-36.
  2. Nguyen L et al. Mfad2a is a transport for the essential omega-3 fatty acid docosa- hexaenoic acid. Nature 2014;509:503-6.

 

DHA is delivered to the brain by Mfsd2a transporter protein. It is seen in red coating the walls of these mouse brain capillaries.

Drug  Treatments for ADHD  Enhanced by  LC- PUFAs

Combinations of Fish oil/EPO and methylphenidate are more effective to reduce ADHD symptoms than either alone according to a randomized  trial including 90 children  aged 6-12 years with newly diagnosed ADHD. They took either Fish oil (FO)/EPO, methylphenidate (MPH) or a combination of the two for 12 months.

Although MPH worked faster than FO/EPO, it had more side effects including headache, irritability, tension, pallor, palpitation, insomnia, tics, tremor, and nausea that were completely absent in the FO/EPO group. These side effects were re- duced by FO/EPO. In addi- tion, 93% of children im- proved  taking  the combination compared to 80% taking MPH and 60% taking FO/ EPO. The graph  below shows the percent improve- ment of ADHD symptoms and parent and clinician per- ceived improvements from baseline.

Barragán et al. Efficacy and Safety of Omeg3/6 fatty acids, methylphenidate, and  a combined  treatment  in  children  with ADHD, doi:10.1177/1087054713518239.

Omega- 3  Supplementation Improves  Symptoms  of Depression

Omega-3 supplementation significantly improves depression in people with major depressive disorder (MDD) and those with depression symptoms alike according to a recent meta-analysis which combined results from many similar randomised, controlled clinical trials. It included 11 trials on patients with diagnosed MDD accord- ing   to   the   DSM definition and 8 trials on people with depressive symptoms but no formal diagnosis of  MDD that had been published up to August 2013.

EPA appeared to be more effective for reducing depressive symptoms than DHA. In addition, omega-3’s seemed to be most valuable as treatments to be used along with conventional medication rather than by themselves. The measured effectiveness of the omega-3 treatments tested in all the studies were not influenced by the number of patients in the study, baseline depression severity, trial duration, age of the patients or study quality.

  1. Grosso G et al. Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PLoS One 2014 May 7;9(5):e96905.

 

High GLA and DGLA Reduce Overall and Breast Cancer Risk

Different types of dietary fatty acids may influence cancer growth in different ways. In addition, the same types of fatty acids under different conditions can have opposing effects. For example, PUFAs are known to be involved in several mechanisms that counteract cancer formation. At  the  same time, these same fatty acids can degrade (become rancid) and produce cancer causing agents including free oxygen radicals and lipid peroxides. Hence the answer to the question, ‘Does EPO/GLA contribute to breast cancer growth?’, is not easy to answer. However, a recent prospective case-control study has helped to clarify the relationship between plasma saturated (SFAs), (MUFAs) and PUFAs and overall cancer and breast cancer risk and the potential influence of anti-oxidants on these relationships.

The study included 250 participants within the ‘Supplementation en Vitamines et Mineraux Antioxy- dants’ (SU.VI.MAX) study who were initially diagnosed with cancer between 1994 and 2002 and an age/sex/ treatment matched control for each case. Between 1994-95 they had been part of 13,017 people enrolled in the randomised, double-blind trial and treated with either placebo or a daily anti-oxidant combination of 120 mg  of Vitamin C, 30 mg of Vitamin E, 6 mg of beta- carotene,  100 mg of selenium and 20 mg  of  zinc for 7.5 years.

Results showed that in the placebo group, higher blood gamma-linolenic acid (GLA) was associated with lower risk of overall cancer and breast cancer. When treated with either placebo or antioxidants, people with higher dihomo- gammalinolenic acid (DGLA) and a higher proportion of DGLA to linoleic acid (LA) in their blood had a lower risk. On the other hand, higher pro- portion of arachidonic acid (AA) to DGLA and higher LA was associated with increased risk in both groups as was  total PUFA in the placebo group.

Within the body, DGLA can be made from GLA. Studies have shown that DGLA can inhibit cancer growth through a number of mechanisms that:

  • prevent transformation of normal mammary cells to malignant forms.
  • prevent cell division and inhibit growth of cancer cells.
  • reduce motility, invasiveness and adhesion of cancer cells thereby preventing spread of primary.

The salient finding within  this treatment decreased cancer risk when blood PUFA levels were high. That’s because, when antioxidant status is low PUFAs can form peroxides that may cause cancer whereas high antioxidant levels protect PUFAs from degradation and thereby cancel the cancer causing effects.

Pouchieu C et al. Prospective associations between plasma saturated, mono unsaturated and poly unsaturated fatty acids and overall and breast cancer risk. Modulation by antioxidants: a nested case control  study. PLoS One 2014 9(2):

  • prevent transformation of normal mammary cells to malignant forms.
  • prevent cell division and inhibit growth of cancer cells.
  • reduce motility, invasiveness and adhesion of cancer cells thereby preventing spread of primary.

 

Pouchieu C et al. Prospective associations between plasma saturated, mono unsaturated and poly unsaturated fatty acids and overall and breast cancer risk. Modulation by antioxidants: a nested case control  study.  PLoS   One  2014 9(2): e 9 0442. doi:10. 137/journal.pone.0090442

EPO Supplementation increases blood levels of DGLA without increasing LA and while only modestly increasing AA  levels.