In this study, the authors investigated whether vitamin D levels predict dementia risk, as high vitamin D status has been hypothesized to protect against it ⁽¹⁾. The study was based on the Mini-Finland Health Survey. The people studied were 5010 men and women, aged 40-79 years, and free of dementia at baseline (in other words, they were healthy at the start of the study). During a 17-year follow up, 151 new cases of dementia (based on medical diagnosis) occurred, according to population registers. Serum vitamin D concentration was determined from blood draws. The results showed that among women, those with higher vitamin D concentrations showed a reduced risk of dementia. The hazard ratio between the highest and lowest quartiles of vitamin D was 0.33 (95% confidence interval = 0.15-0.73) in women and 0.74 (0.29-1.88) in men, after adjustment for age, month of blood draw, education, marital status, physical activity, smoking, alcohol consumption, body mass index, blood pressure, plasma fasting glucose, serum triglycerides, and serum total cholesterol. This translates roughly to a 67% decrease in dementia for women and a 26% decrease for men. The authors conclude that low vitamin D status may be a risk factor for dementia.

A recently published randomized controlled trial was completed that utilized an extension trial of qigong (Chaoyi Fanhuan qigong or CFQ in particular), for patients with fibromyalgia ⁽¹⁾. Participants received instruction in qigong (level 1 CFQ), practiced 45 min/day for 8 weeks and continued practice to 6 months; open-ended qualitative comments on experiences were invited at 8 weeks and 4 and 6 months. Extension trial participants received further instruction (level 2 CFQ) and practiced regularly for 8 weeks-6 months. The results showed that those who completed the extension trial (13 people in total), were most likely to be seeing benefit within the first 8 weeks. Those who practiced as per the protocol during the initial 8 weeks (for more than 5 hours per week), were also more likely to maintain the practice over 4 to 6 months and report beneficial health effects. The authors conclude that favorable initial experiences with qigong predispose to continued practice and more health effects.

A recent retrospective case-control study was published that examined the use of acupuncture in stroke patients ^[1]. The baseline treatment was physiotherapy, while the acupuncture group received both physiotherapy and acupuncture. A total of 132 patients were analyzed. The authors used outcome measures that included the Postural Assessment Scale for Stroke (PASS) to evaluate balance. It was subdivided into static balance (maintaining posture) and dynamic balance (changing posture). The results showed that there were no statistically significant improvement of balance in the study group. However, when patients with low Brunnstrom stage were analyzed, they showed a significant improvement in static balance. The Brunnstrom stages follows six stages of sequential motor recovery (after a stroke). Patients can plateau at any stage, but generally follow the sequence during their recovery. The authors conclude that with low Brunnstrom stage stroke patients, acupuncture therapy can improve static balance during rehabilitation. However, the effect was limited on high Brunnstrom stage patients. The study is valuable because it can help hemiplegic stroke patients.

A new study was published that examined circadian rhythms and breast cancer therapy ^[1]. Resistance to endocrine therapy (such as tamoxifen, a breast cancer drug) can be a major obstacle to successful treatment. Many forms of evidence link resistance to antiestrogen drugs in breast cancer cells with the overexpression or activation of pro-oncogenic tyrosine kinases. In addition, the disruption of circadian rhythms by night shift work or disturbed sleep-wake cycles may lead to an increased risk of breast cancer and other health conditions.

Light exposure at night suppresses the nocturnal production of melatonin (melatonin inhibits breast cancer growth). In this study, a rat model of estrogen receptor tumor were used to demonstrate how altering light and dark cycles with dim light exposure at night speed the development of breast tumours ^[1]. This speeds the development of breast tumours by increasing their metabolism and growth and conferring an intrinsic resistance to tamoxifen therapy. The authors identify that these characteristics were not observed in animals in which the circadian melatonin rhythm was not disrupted, or in animals subjected to dim light at night if they received nocturnal melatonin replacement. The results of the study also show that melatonin acts as a tumour metabolic inhibitor and a circadian-regulated kinase inhibitor that can re-establish the sensitivity of breast tumours to tamoxifen and tumour regression. The take-home message is that melatonin is extremely helpful and that disrupting the sleep-wake cycle can be harmful.

A recent review study was published that summarized the various roles of vitamin C ^[1]. One of its functions is mitigating oxidative injury-induced microcirculatory impairment, which is associated with organ failure in ischemia (which means either there is lack of oxygen) or sepsis (which means there is bacteria). Preclinical studies have shown that high-dose vitamin C can prevent or restore microcirculatory flow by activating various pathways in the body, causing the release of nitric oxide synthase (which promotes vasodilation) and by decreasing the formation of free radicals (which cause damage to cells). High-dose vitamin C can also increase antibacterial defenses. The protective effects can also be seen in critically ill patients and in combination with other antioxidants. It is unclear what the optimal dose is, as well as the optimal timing and combinations with other antioxidants. By combining vitamin C with other antioxidants, it may allow for a synergistic effect. Vitamin C is also extremely cost-effective. Given as early as possible after injurious events (or even before, if feasible, for example before surgery), is most effective. This means vitamin C could be used prior to things like cardiac surgery, organ transplant, or major gastrointestinal surgery.

Vitamin D levels (measured as serum 25-hydroxyvitamin D or 25(OH)D) have been found to be inversely associated with cardiovascular disease risk favors, dyslipidemia, hypertension, and diabetes. A recent review study identified evidence of a causal association between 25(OH)D levels and cardiovascular risk ^[1]. The authors evaluated journal articles. Many randomized controlled trials, prospective and cross-sectional studies found statistically significant inverse associations between vitamin D levels and cardiovascular risk factors. Most studies found these results in various populations, locations, and circumstances. Many studies also looked at the temporal relationship and found the same result. There was also a biological gradient, or a dose-response curve. Several mechanisms could lead from a low vitamin D level to increased risk with mediators, such as cholesterol, blood pressure, or blood sugar problems. The researchers conclude that all relevant Hill criteria for a causal association in a biological system are satisfied to indicate that a low 25(OH)D level is a cardiovascular risk factor.

Researchers recently published a study on the use of high dose vitamin B12 for the treatment of peripheral neuropathy ^[1]. No clinically effective treatment for promoting nerve growth or nerve regeneration has been established. Many experimental studies have shown that high dose methylcobalamin (vitamin B12) promotes nerve growth in those with peripheral nerve injuries. The researchers in this case assessed the safety and efficacy of an ultra-high dose vitamin B12 treatment for patients with peripheral neuropathy and chronic axonal degeneration. In the study, 14 patients with immune-mediated or hereditary neuropathy in the chronic progressive or stable phase were enrolled. 25mg/day for 10 days followed by monthly 25mg for 5 months was administered intravenously. The patients were evaluated before and 1 year following treatment. The primary endpoints were safety and improvement in a scoring tool. The researchers found no adverse effects in twelve of the patients, whereas treatment was discontinued in two patients who had seborrheic dermatitis at 3 months and respiratory tract infection at 2 months, respectively. Overall, the measured score was improved in seven of the patients and unchanged or worsened in the five remaining patients. The authors conclude that intravenous ultra-high dose vitamin B12 treatment is safe and potentially efficacious therapy for those with peripheral neuropathy.

A newly published study examined the efficacy of Korean red ginseng against bisphenol A (BPA), focusing on female quality of life ^[1]. Korean red ginseng is a processed ginseng that is believed to be safer, better preserved, and more effective than raw ginseng. It has known estrogen like effects. BPA is known as an endocrine disrupting chemical. In the study, the researchers performed a single-blind randomized clinical trial. Twenty-two young women consumed 2.7g of ginseng or placebo per day for 2 weeks and filled out questionnaires related to gynecologic complaints over 4 time points. The researchers analyzed urinary total BPA and an oxidative stress marker. The results of the study showed that ginseng consumption reduced urinary BPA and oxidative stress markers. Ginseng also alleviated menstrual irregularities, menstrual pain, and constipation. No one experienced side effects as a result of the ginseng. The study concludes that ginseng is efficient at protecting female quality of life and related oxidative stress in relation to BPA exposure.

A recently conducted systematic review and meta-analysis (essentially the highest level of evidence) was conducted to analyze the effect of probiotics on blood pressure ^[1]. Previous studies have shown that probiotic consumption may help improve blood pressure control. These researchers wanted to clarify the effects. By searching a number of high-level databases, they found eligible articles to include in their analysis. Nine trials were included. Probiotics decreased systolic blood pressure by almost 4 points and diastolic by over 2 points, compared with control groups. A larger reduction was found with multiple species as opposed to single species of probiotics for both systolic and diastolic pressure. The higher the starting blood pressure, the more significant the effect of the probiotics. However, they have to be taken for at least 8 weeks to show an effect. The other important factor was dosing: the dose had to be at least over 10 billion colony-forming units. Overall, the researchers suggest that probiotics may improve blood pressure to a modest degree.

A recently published cross-sectional study evaluated magnesium levels and their association with glycemic control in youths with type 1 diabetes mellitus ^[1]. It has been previously shown that magnesium levels may be decreased in patients with type 1 diabetes, but there are few studies looking at children. In this study, 138 children and teenagers with diabetes were recruited. The researchers measured height, weight, HbA1c, magnesium, calcium, phosophorus, potassium, sodium, and also used kidney function tests. The results showed that lower levels of magnesium were found in those with poor glycemic control, as compared to those with better glycemic control. Magnesium levels were negatively correlated with HbA1c and positively correlated with the other factors. Only magnesium levels were found to be significantly associated with HbA1c after adjustments were made. They conclude that low magnesium is associated with increased risk of poor glycemic control, potentially contributing to the early development of heart complications.

An extremely large study that took place for over 7 years has come up with a new conclusion after further analysis (1). 5505 high-risk men and women aged 55 to 80 were followed in the PREDIMED Trial for up to seven years. Participants were initially free of depression or a history of depression and did not have any history of alcohol-related problems. A food frequency questionnaire was administered by a dietician and repeated annually to assess alcohol intake. Participants were classified as new cases of depression when they reported a new clinical diagnosis of depression or started using antidepressant drugs. The results showed that alcohol intake in the range of 5 to 15g/day was significantly associated with a lower risk of depression (by about 30%, compared to those who didn't drink at all). Wine consumption in the range of two to seven drinks per week was significantly associated with a lower rate of depression (again, by about 30%). Heavy drinkers seem to be at higher risk, so too much of a good thing may be a bad idea. Moderation is important.

A new study evaluated the clinical relevance and efficacy of 3 plant extracts (Harpagophytum procumbens, Curcuma longa, and bromelain) (1). Harpagophytum is commonly known as Devil's claw and Curcuma is commonly known as turmeric. The studied complex was called AINAT and the dose was 650mg. This was a multicenter, observational, prospective, open-label survey in 8 rheumatology centers. There were 2 groups: one suffering from chronic osteoarthritis pain, the other suffering from acute osteoarthritis pain. A total of 42 patients participated. They took two of these 650mg capsules three times per day for those with acute pain and twice a day for those with chronic pain. At baseline and during a follow-up visit at 15 days for the acute pain and at 60 days for the chronic pain, researchers obtained patient's global assessment and their pain scores. The results showed that the pain score decreased significantly in both groups and they both reached the level of pain defined as PASS. No patients stopped using the treatment due to side effects. The researchers conclude that the improvement in joint pain was clinically relevant in patients treated with the AINAT capsules, for both acute and chronic pain, and that it may be a valuable and safe alternative to NSAIDs.

A recently published study evaluated the effectiveness of Pilates exercise in people with chronic low back pain through a systematic review (1). This means that multiple randomized controlled trials were examined and this usually eliminates many sources of possible bias. The authors searched 10 separate medical databases and two independent reviewers analyzed the evidence. Of a possible 152 studies, 14 randomized controlled trials were applicable and were included (the authors determined applicable studies by using the McMaster Critical Review Form for Quantitative Studies). The quality of the studies themselves ranged from ‘poor’ to ‘excellent’. The results showed that Pilates exercise provided statistically significant improvements in pain and functional ability compared to usual care and physical activity between 4 and 15 weeks, but not at 24 weeks. There were no consistent differences in improvements between Pilates versus massage therapy or other forms of exercise at any time period. The authors conclude that Pilates exercise offers great improvements in pain and functional ability compared to usual care and physical activity in the short term, but that these benefits are equivalent to massage therapy and other forms of exercise.

Nitrous oxide is the anesthetic agent used in general anesthesia. Evidence suggests that being exposed to this gas leads to higher levels of homocysteine. Homocysteine is an amino acid that has been linked to cardiovascular disease because it may make people more prone to inflammation and atherosclerosis. In other words, it can increase the risk of clots, heart attacks, and strokes. In this newly published study, the authors evaluated the effects of a single-dose of intravenous infusions of vitamin B12 before and after anesthesia (1). It was a double-blind randomized controlled trial with 60 patients scheduled for elective surgery (typically lasting more than 2 hours). They were randomized into 3 groups. The first group received vitamin B12 solution (1mg/100mL normal saline) and 100mL of normal saline as a placebo infused before and after anesthesia. The second group received placebo and vitamin B12 infusion in the reverse order. The third group received placebo at both times. Homocysteine levels were measured before and 24 hours after surgery. The results showed that patients who had been unfused with vitamin B12 before the surgery had much lower levels of homocysteine than the 2 other groups, whose levels of homocysteine increased significantly after the surgery. The authors conclude that vitamin B12 infusion is a safe and inexpensive method to decrease homocysteine levels during anesthesia.

Nut consumption has previously been associated with reduced heart disease risk. There is some mixed evidence about the effects of nuts on blood pressure and the underlying effects on how it impacts blood circulating in the body. A new study examined the effect of pistachio consumption on blood pressure, other cardiovascular factors, and heart rate variability in adults who had controlled type 2 diabetes (1). The researchers enrolled 30 adults (aged 40 to 74 years). After a 2-week run-in period, participants consumed a low-fat control diet (27% fat) containing low-fat/high-carbohydrate snacks and a moderate-fat diet (33% fat) containing pistachios (20% of total energy) for 4 weeks each, separated by a 2-week washout. After each diet period, the researchers measured blood pressure, heart rate variability at rest and during mental stress, and other cardiovascular factors. They found that the pistachio diet significantly improved a number of different cardiovascular factors (one called peripheral resistance, another called cardiac output), as well as improving measures of heart rate variability. The researchers conclude that a moderate-fat diet containing pistachios modestly improves some cardiovascular risk factors in adults with well-controlled type 2 diabetes.