Nine Recent Studies on Vitamins, Fruits+Veggies, Ketogenic Dieting for Endurance Athletes, Blood Pressure, Cognitive Function, Depression & Gene-Diet-Interactions from 10/17

Looking for the very latest on nutrition science? Look no further: most of the results presented in this installment of the short news have not yet been officially published after their presentation on a conference of the Nutrition Society.

I hope you don't mind that I decided to pool the most interesting of the latest studies from the Proceedings of the Nutrition Society in a single article. With the articles on vitamin D, B-vitamins, ketogenic diets in endurance athletes, and so on and so forth all being addressed individually, you can still skip studies you may not be interested in and get the gist (read the title and the last paragraph of each bullet point) within seconds.

As it is usually the case for short-news that are based on presentations at a conference, it will take time for the full papers to be written, reviewed and published. Accordingly, I cannot tell you how many eggs the subjects in the keto-diet study ate and whether they consumed their stakes rare or well-done... so please don't ask ;-)

Looking for more ways to improve your diet? Increase your potassium (K) intake!

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Eating a High Protein Diet? Better Watch K!

Potassium Bicarbonate = Anabolic!?

• 6 months vitamin D supplementation effectively improved 25OHD levels, but without boosting cognitive function in healthy community-dwelling older adults, randomised double-blind placebo-controlled pilot trial shows (Aspell 2017).
  
  
  
  A recent study from the Trinity Centre for Health Sciences at the St. James's Hospital (Aspell 2017) shows that 2,000IU of D3 supplemented daily does increase the 25OHD levels by almost 50%, but the battery of tests the scientists ran to determine if this would have downstream beneficial effects on the cognitive health of the 68.5y-old (mean) subjects, 18.3% of whom were D-ficient at baseline, did not show effects on global cognitive function.
  
  No clear benefit of 'D' on cognition.
  
  Yes, conducting a study that lasts for more than 6 months may yield these benefits, but, in general, the study at hand seems to confirm that the vitamin D ain't the messiah as which it was celebrated in the past decade.
• Milk significantly decreases LDL in 78 healthy, pre-menopausal women with habitually low intakes of milk (<250ml) who more than doubled their intake (Yeates 2017).
  
  
  
  After decades of being everybody's darling, milk has recently gotten a pretty bad reputation... you as a SuppVersity reader know that milk is not rat poison as some mainstream media claimed in the past (re-read my "Mill Kills [NOT]"). Accordingly, you will not be surprised that an extra 430ml/d of full-fat milk had (a) no effect on body composition, glucose management, total cholesterol, and triglycerides, but did (b) significantly reduce the levels of LDL in the 18-45-year-old women.
  
  Sign reductions in LDL w/ milk
  
  If we assume that you are lactose tolerant and like it, go for your milk people. A 1mmol/L reduction in LDL is associated w/ a 22% reduced risk of major cardiovascular events (Baigent 2010) - even in people with LDL levels as low as 2 mmol/L! Personally, I don't like the taste of pure milk, but dairy products like quark, yogurt, and cheese (likewise a falsely vilified health food) are a staple in my diet.
• Overrated? Increasing fruit and veggie intake, alone, doesn't improve blood pressure according to six randomized controlled fruit and vegetable intervention trials that were pooled analysis by British researchers (Elsahoryi 2017).
  
  
  
  People expect wonders from fruits and veggies, wonders of which a recent study from the Queen's University Belfast have now shown that they won't occur even if the participants of RCTs actually managed to increase their fruit and veggie (FV) intake, significantly.
  
  When pooling the slopes and standard deviations from the six largest trials, there simply isn't a significant decrease in either systolic or diastolic blood pressure per portion change in fruit and vegetable intake.
  
  No effect of adding F/V to (bad) diet
  
  Let's be clear here, this doesn't mean that fruit and veggies don't have to play an important role in healthy diets. It does, however, tell you that - in the absence of other dietary changes, weight loss, and increased physical activity - simply adding a couple of servings on top of your mad Western diet ain't going to save your heart, kidney, and other organs from the damaging effects of increased blood pressure.
• Personalized nutrition: Riboflavin attenuates increase in blood pressure in pregnant women w/ MTHFR 677C→T gene polymorphism (O'Sullivan 2017)
  
  Having increased blood pressure during pregnancy is not just a temporary problem. In fact, studies show that it will also increase the risk of blood pressure disturbances later in life. Accordingly, the results of the latest study from the Ulster University, the University College Dublin, and the University College Cork are of great importance...
  
  
  ... at least for those women who harbor an MTHFR 677C→T gene polymorphism and have been shown to be at greatest risk of abnormal blood pressure levels during pregnancy (McNulty 2017), this increased risk can be mitigated by a high Riboflavin status.
  
  No, this doesn't mean that riboflavin supplementation will help!
  
  It will take RCTs to confirm or refute the hypothesis that supplemental riboflavin is going to help women with MTHFR 677C→T gene polymorphism control their blood pressure during pregnancy, and rejoice: the study is already underway.
• New study doesn't support link between high folate + low B12 and various measures of cognitive function in adults over 50 (O'Connor 2017).
  
  While folate has long been considered a super-vitamin, recent studies showing a high prevalence of elevated folate and low B12 levels in older people w/ cognitive problems suggested that, at least, unbalanced high folate levels could be a serious problem for granny and grandpa.
  
  
  A recent re-analysis of data from The Irish Longitudinal Study on Aging didn't find either the Mini-Mental State Examination (MMSE) scores, or the Montreal Cognitive Assessment (MoCA), or the verbal fluency to be superior in subjects w/ normal B12:folate ratios  (see Figure) compared to peers with an abnormal cobalamine to folate ratio below 258pmol/L:45.3nmol/L.
  
  This doesn't mean that high folate and, even more so, low B12 ain't no problem! And still evidence that simply popping pills ain't just missing: it looks as if it didn't help.
  
  It is important to note that the lack of associations between a low-B12-high-folate profile in a single cohort does (a) not negate the existence of such a relationship. Furthermore, there's (b) plenty of evidence that having adequate levels of both, folate and vitamin B12 and (thus) low levels of homocysteine are of essential importance to cognitive function as we age (Wolters 2004). The bad news, however, is that meta-analyses show that simply popping pills is not the solution: "Randomized trials show no effect of folic acid, with or without other B vitamins, on cognitive function within 3 years of the start of treatment." (Wald 2010).
• Without fortified foods and B-supplements, it's hard to cover get enough B to ward off depression, scientists from the University of Ulster write (Moore 2017).
  
  The scientists base this statement on a re-analysis of data from the Trinity Ulster Department of Agriculture Ageing Cohort with more than 5000 subjects that found significantly higher levels of all relevant B-vitamins with increasing fortified food intakes.
  

  

  Table 1: B-vitamin levels in subjects relying on natural food sources, only, consumers of different amounts of fortified foods and supplement users (Moore 2017).

  Since low levels of folate, vitamin B6, and riboflavin all being associated with a 47-48% increased risk of depression in the same cohort, that's bad news for people who avoid both: fortified foods and supplements.
  
  If you want to stay mentally healthy as you age, watch your B-vitamin intake!
  
  When we hear about B-vitamins and aging, we usually think about cognitive decline. That the ever-increasing rates of depression in older individuals may also be driven by a lack of B-vitamins, on the other hand, is commonly overlooked. Unfortunately, the same goes for the general lack of folate, vitamin B6, and riboflavin in the diet of older individuals - a lack that can be compensated by both: fortification and supplementation, as the data from the study at hand suggests.
• 9 grams of milk hydrolysate are enough to significantly ameliorate the glucose response to a standardized breakfast in healthy young men (Keane 2017).
  
  It's not news that whey protein, in general, and its fastest absorbing incarnation, i.e. hydrolyzed whey protein, can significantly improve the glucose-response to standardized meals. What scientists and functional food designers alike didn't know, yet, is whether the effects that have been previously observed with 20g and more will also occur with significantly lower intakes of a form of milk protein that ... let's be honest, here... simply tastes like crap.
  
  
  Now, a brief glance at the glucose curves Keane and Gibney recorded in their recent RCT with 13 young, healthy, male participants, indicates that even 9 grams of hydrolyzed milk protein are enough to elicit significant improvements in post-prandial glucose levels.
  
  Insulin haters rejoice: The low dosage doesn't even significantly elevate insulin
  
  In that, the study at hand didn't just demonstrate that even low(er) amounts of the bitter milk hydrolyzate can significantly reduce glycemic excursions in response to a standardized breakfast. It did also show that 9 grams of hydrolyzed milk protein can do so without exorbitant increases in insulin (as you can see insulin will still increase, but according to Keane and Gibney only non-significantly, while 12g still produced a significant increase), of which I've previously told you that they are one out of three interrelated factors that are responsible for the reduced glycemic response (the other ones are the associated increases in GLP-1 and GIP).
• Ketogenic diet reduces iron status in endurance athletes to an extent that may compromise their performance, US researchers demonstrate (McSwiney 2017).
  
  After 12 weeks on a ketogenic diet (<50g/d carbohydrates >75% energy from fat), the trained endurance athletes in a recent study from the Waterford Institute of Technology showed significantly reduced markers of iron status.
  

  

  Table 2: Differential effect on "iron" levels of endurance athletes on high-CHO vs. ketogenic diet.

  While the control diet, which delivered 65% of the energy as carbohydrates and only 20% as fat (protein intakes were identical between groups), conserved the total and corpuscular levels of the oxygen-carrying hemoglobin, the subjects who had been randomly assigned to the ketogenic diet exhibited significant reductions in all three: Hb, MCH, and MCHC.
  
  The significant reduction in oxygen-carrying hemoglobin could be a problem for keto-athletes, but that was not tested in the study at hand.
  
  As highlighted in the subheading, the study didn't include performance testing, but unlike the decrease in hematocrit* in the high-carb group, the significant reduction in total (-9.3%; p < 0.05) and corpuscular hemoglobin could significantly impair the oxygenation of skeletal muscle and thus negatively affect the exercise performance of endurance athletes [*note: many will even think that the decreasing haematocrit levels may be a health benefit as high levels are associated W/ increased mortality and heart disease (Gagnon 1994) - keep in mind, though, endurance athletes usually hover at the lower end of the Hct range, anyway, and that's likewise associated with cardiovascular problems]. 

Non-Adherence and Design Problems: Two Reasons Why Recent Diet Study May Fail to Show Benefits of High(er) Protein + Dairy Intakes in Overfat (>37%) Women | learn more

Bottom line: In as much as I want to make it easier for you to get the gist out of today's research update, I am not going to summarize the already summarized bottom lines to the individual studies again. That simply doesn't make sense. So, if you want the gist and implications, read the headlines and the last paragraph of each of the mini-write-ups.

What I can and will do for you, though, is to warn you of "luxury yogurts" of which a recent study from the Food Safety Authority of Ireland (Kemp 2017) says that they are generally no healthy food choices. With levels of sugar and/or saturated fats way beyond what the health claims on the labels mislead the average consumer to believe | Comment!

References:

• Aspell, N., Healy, M., Mc Partlin, J., Lawlor, B., & O'Sullivan, M. (2017). Effects of vitamin D supplementation on cognitive function in healthy, community dwelling older adults: Results from a randomised double-blind placebo-controlled pilot trial. Proceedings of the Nutrition Society, 76(OCE3). doi:10.1017/S002966511700132X.
• Baigent, C., Blackwell, L., Emberson, J., Holland, L. E., Reith, C., Bhala, N., ... & Collins, R. (2010). Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials.
• Elsahoryi, N., Patterson, C., McKinley, M., Neville, C., Baldrick, F., Mulligan, C., . . . Woodside, J. (2017). The effect of increased fruit and vegetable consumption on systolic and diastolic blood pressure in six randomized controlled fruit and vegetable intervention trials: A pooled analysis. Proceedings of the Nutrition Society, 76(OCE3). doi:10.1017/S002966511700129X.
• Gagnon, D. R., Zhang, T. J., Brand, F. N., & Kannel, W. B. (1994). Hematocrit and the risk of cardiovascular disease—the Framingham study: a 34-year follow-up. American heart journal, 127(3), 674-682.
• Keane, L., & Gibney, E. (2017). The effect of various doses of a milk protein hydrolysate on the post-prandial glycaemic response in a healthy male cohort. Proceedings of the Nutrition Society, 76(OCE3). doi:10.1017/S002966511700146X.
• Kemp, B., White-Flynn, T., Lyons, O., Cronin, B., O'Donovan, C., Donovan, C., & Flynn, M. (2017). Is it yoghurt or is it a dessert? Proceedings of the Nutrition Society, 76(OCE3). doi:10.1017/S0029665117001422.
• McNulty, Helene, et al. "Riboflavin, MTHFR genotype and blood pressure: a personalized approach to prevention and treatment of hypertension." Molecular aspects of medicine 53 (2017): 2-9.
• McSwiney, F., Wardrop, B., Volek, J., & Doyle, L. (2017). Effect of a 12 week low carbohydrate ketogenic diet versus a high carbohydrate diet on blood count indicators of iron status in male endurance athletes. Proceedings of the Nutrition Society, 76(OCE3). doi:10.1017/S0029665117001458
• Moore, K., Hughes, C., Hoey, L., Ward, M., Porter, K., Strain, J., . . . McNulty, H. (2017). Role of fortification and supplementation in achieving optimal biomarker status of B-vitamins for better mental health in older adults. Proceedings of the Nutrition Society, 76(OCE3). doi:10.1017/S0029665117001215
• O'Connor, D., Laird, E., O'Halloran, A., Molloy, A., & Kenny, R. (2017). Variations in vitamin B12 and folate balance: Implications for cognitive function? Findings from The Irish Longitudinal Study on Ageing (TILDA). Proceedings of the Nutrition Society, 76(OCE3). doi:10.1017/S0029665117001227
• O'Sullivan, E., Pentieva, K., Ward, M., McAuley, A., Strain, J., McNulty, B., . . . McNulty, H. (2017). Riboflavin, MTHFR 677C→T and blood pressure in pregnant and non-pregnant women. Proceedings of the Nutrition Society, 76(OCE3). doi:10.1017/S0029665117001240.
• Wolters, M., Ströhle, A., & Hahn, A. (2004). Cobalamin: a critical vitamin in the elderly. Preventive medicine, 39(6), 1256-1266.
• Yeates, A., Gilmartin, N., O'Kane, S., Pourshahidi, L., Mulhern, M., & Strain, J. (2017). The effect of cow's milk consumption on cardiometabolic health in women of childbearing age. Proceedings of the Nutrition Society, 76(OCE3). doi:10.1017/S0029665117001318.

Studies Confirm: Natural and Synthetic Vitamins Can Differ in Quantity & Quality of Effects! Vitamins A-E, B's & More

Pills or fruits, one are funky and useless, the other ancient and healthy!?

In a 2000 paper in Medical Hypothesis, R.J. Thiel writes "[t]here appears to be a tendency to label those who profess that natural vitamins are better than synthetic ones as quacks" (Thiel. 2000). No wonder, after all, every good text book will inform future physicians and researchers that the difference between natural and synthetic alpha-tocopherol was a mere quantitative one.

In other words, as long as you make sure that you administer 1.36x the amount of "natural" vitamin E in,   all-rac-α-tocopherol should do the exact same as its natural cousin.

Learn more about the effects of your diet on your health at the SuppVersity

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Even common sense, should tell us, though, that it is unlikely that a colorful mix of  four vitamin E stereoisomers (SRR, SRS, SSR, and SSS) won't have the same effect as pure RRR-alpha-tocopherol as it can be found in nature. Accordingly, Thiel may be right, when he writes that "[t]his broad brush label may be stifling legitimate nutrition research" (Thiel. 2000). In his paper he addresses several issues, including the often heard claim that the body cannot distinguish between natural and synthetic forms of vitamin E, a claim of which he argues that it is misleading because

• it neglects the effect of different structures on absorption and utilization of vitamins (Schumann. 1997; Vinson. 1988, 1989 & 1999);
• it ignores the size differences between the various isomers that will directly affect the absorption of and bioavailability of the nutrients (Macrae. 1993); 
• it does not seem to consider the fact that "natural" vitamins in the original sense come in a nutrient matrix that will have profound effects on both the absorption & activity and the effects of vitamin E containing foods (and complex supplements | Jenkins. 1994);
• it ignores the fact that most USP vitamins are crystalline in structure (Ensminger. 1993; Macrae. 1993), while most vitamins in food are not (and are actually present in complex carbohydrates, proteins, and lipids | Thiel. 1999)

All this  does not mean that USP vitamins do not have any value (they clearly do), but studies have shown that vitamins in natural food complexes are better than USP isolated vitamins; and here is a handful of examples:

• Vitamin A - As it is the case for many other vitamins, the term vitamin A refers to a whole class of molecules, called "retinoids", which include both retinol and its natural metabolites as well as a large number of synthetic analogues that have structural similarities to retinol but may subserve only some (or none) of the functions of natural vitamin A (Ross. 1999).
  
  

  

  Neural tube & other defects increase sign. w/ high doses of synthetic, but not food-borne natural retinol (Rothman. 1995).

  As Thiel points out, some of the commonly used forms found in synthetic supplements are not naturally found in food (Ross. 1999). Some of them have been linked to liver cirrhosis (Fallon. 1990). More specifically, it has been reported that consumption of more than 10 000 I.U. per day of synthetic vitamin A increased the rate of birth defects, while consumption of natural vitamin A from foods (including betacarotene, a precursor) did not (Rothman. 1995).
  
  Retinyl acetate is the major synthetic form of vitamin A and is a vinyl or coal tar at one or more stages of processing (depending upon the manufacturer) (Hu. 1992). An animal study found that synthetic vitamin A in the form of retinyl acetate significantly reduced vitamin E utilization (Schelling. 1995); this has not been shown to occur with natural vitamin A (i.e. Ross. 1999). An animal study concluded that a natural food complex vitamin A was probably less toxic than a synthetic USP form and was 1.54 times more absorbed into the blood (Vinson. 1989).

Please note: Most of the differences are of quantitative nature, which means that you will have to take more of the "synthetic" version to achieve similar steady state levels. Only in some cases, the effects are qualitatively different. However, in some genetically disadvantaged individuals, who cannot do the conversion that is necessary for e.g. folic acid or pyridoxin (B6), these differences can be qualitative (because the agents don't work at all or, as in the case of folic acid) even break the whole system.

• Thiamin, Vitamin B1 - The free vitamin B1 (called thiamin) is a base. When it is synthesized it becomes a solid salt such as thiamin hydrochloride or thiamin mononitrate (Tanphaichitr. 1994). Synthetically thiamin is usually marketed as thiamin hydrochloride or thiamin mononitrate and is a made from Grewe diamine (a coal tar derivative) processed with ammonia and other chemicals (Hui. 1992). No thiamin hydrochloride (often listed as thiamin HCL) or thiamin mononitrate is naturally found in food or the body (thiamin pyrophos phate is the predominant form in the body (Tanphaichitr. 1994))).
  
  Against that background it's not surprising that an animal study found that a natural food complex vitamin B1 was absorbed 1.38 times more into the blood and was retained 1.27 times more in the liver than an isolated USP thiamin hydrochloride (Vinson. 1989).
• Riboflavin, Vitamin B2 - The free vitamin B2 (called riboflavin) is a weak base. When synthesized it becomes an orange amorphous solid. Some synthetic riboflavin analogues have very weak vitaminic activity (Kanno. 1991).
  
  Animal studies indicate that a natural food complex vitamin B2 was absorbed into the blood and was retained 1.92 times more in the liver than an isolated USP riboflavin (Vinson. 1989).
• Niacinamide, Vitamin B3 - ‘Niacin is a generic term, the two coenzymes that are the metabolically active forms of niacin (are) nicotinamide adenine dinucleotide (NAD) and NAD phosphate (NADP).
  
  

  

  Peas, peanut(butter), poultry, ... if it starts with "p" it's a good source of niacin ;-)

  Only small amounts of free forms of niacin occur in nature. Most of the niacin in food is present as a component of NAD and NADP nicotinamide is more soluble in water, alcohol, and ether than nicotinic acid. Beef, legumes, cereal grains, yeast, and fish are significant natural food sources of vitamin B3, of which studies indicate that it has a 3.94 times higher absorption rate than synthetic B3 and will be retained 1.7 times more efficiently in the liver than isolated USP niacinamide (Vinson. 1989).
• Pyridoxine, Vitamin B6 - Just like B2 & B3, the USP "vitamin B6", pyridoxine is not the naturally occuring form of the vitamin. It is thus not surprising that the absorption of the "original" is 2.54 times more into the blood and its retention in the liver is 1.56 times higher compared to the USP form (Vinson. 1989).
• Folate, Vitamin B9 - Is one of the few vitamins where many experts acknowledge that its use as a dietary supplement is bogus. No wonder, pteroylglutamic acid, the common pharmacological (USP) form known as folic acid, is not found significantly as such in the body and appears to be absorbed differently than folate (Herbert. 1999). Folic acid is not found in foods, but folate is (23). Herbert reports a study found ‘that consumption of more than 266 mg of synthetic folic acid (PGA) results in absorption of unreduced PGA, which may in fact interfere with folate metabolism for a period of years’ (Herbert. 1999).
  
  Against that backround the fact that the natural food complex folate is absorbed only 1.07 times more into the blood, yet retained 2.13 times more in the liver than isolated USP folic acid (Vinson. 1989) appears less important than the potential interference of excess folic acid intakes with the metabolism of "true" folate which has been shown to trigger liver fibrosis (Marsillach. 2008) and is associated with the development and progression of cancer (with the exception of colorectal cancer | Kim. 2008; Ulrich. 2006).
• Vitamin C, ascorbic acid - The name gives it away, there is no chemical difference between "natural" and "synthetic" vitamin C; it's both plain ascorbic acid. What is missing if you get your vitamin C in pill instead of apple, citrus-fruit and other food-born forms are yet
  the active form of vitamin C, dehydroascorbic acid (DHAA), and its natural synergists which are required for vitamin C to work optimally.
  
  Studies have shown that the "bioavailability of vitamin C in food and 'natural form' supplements is not significantly different from that of pure synthetic AA" (10) which is true, when we look at ascorbic acid in isolation like Mangels et al. (Mangels. 1993) did.
  

  

  Mangels et al. compared the rate (dVit-C/dt), i.e. the slope of the graphs that depict the repletion rates after an 8-week cycle on a vitamin C deficient diet for various forms of vitamin C (Mangels. 1993).

  Mangels et al. did yet ignore the individual and synergistic effects of DHAA or other food constituents associated with natural vitamin C which may have positive effects other than raising serum ascorbate levels. Preliminary data from Vinson et al. (1988) however suggests that vitamin C complexed in food is absorbed 1.74 times more into red blood cells than isolated USP  ascorbic acid, while another found it to be 1.35 times more absorbed into the plasma.
  
  A result that leaves no doubt that simple serum vitamin C measurements as they are done in most studies may be insufficient to identify the subtle advantages of natural vitamin C which does not come in pill form (don't believe the supplement companies claiming they used "natural vitamin C" had figured out what you need to imitate nature).
• Vitamin D - While it has not been proven that any single USP isolated form of vitamin D has all the benefits as natural occurring forms of vitamin D, there is also insufficient evidence that the currently (over-)hyped vitamin D3 supplements alone would be insufficient and should be replaced by something like a "natural full spectrum vitamin D supplement".
  

  

  25OHD content (µg/100g) of chicken & egg, pork, beef, fish, dairy (various sources; more)

  One thing to keep in mind, though, is the fact that there is more to vitamin D than D3; naturally high vitamin D foods like eggs, for example, are "high vitamin D foods" that contain, among other isoforms of vitamin D, also the already active form calcitriol and may thus have a significantly more pronounced health benefit than powders, caps and pills. 
• Vitamin E - As SuppVersity reader you know that supplemental alpha-tocopherol pills have little to do with the full spectrum of tocopherols and trienols foods have to offer.
  
  I have written about this in the past so extensively that I don't want to explain everything for the 10414th time. So, if you are interested in tocotrienols and tocopherols, browse the archive. What I would like to focus on, today, is the difference between synthetic and natural alpha-tocopherol. What is undebated is the that synthetic vitamin E is mixture of eight epimers’, while natural alpha-tocopherol contains only the [d]-epimer of alpha-tocopherol (9). As Thiel points out in his review, the existing evidence clearly

  "indicates that although synthetic vitamins have some of the benefits of natural vitamins, they really do not replace all the benefits of natural ones" (Thiel. 2000).

  This is not surprising, since un foods, natural vitamin E is always found with lipids and other food substances of which Acuff et al. that it is absorbed 3.42 times better than synthetic vitamin E in cord blood during pregnancy.
  
  

  

  The higher urinary excretion of synthetic (d₆) vs. natural (d₃) vitamin E suggests that the human body wants to get rid of the synthetic mix (Traber. 1998).

  Similar results have been observed in rodents, where vitamin E complexed in foods was 2.6 times more retained than isolated USP d-alpha tocopheryl acid succinate (which is the so-called ‘natural form’ once it is isolated from its food complex | Venson. 1989). Results that are in line with observations, Traber et al. made, when they studied human urine and fount that natural vitamin E was not only 2.7 times better absorbed than synthetic vitamin E, but that the body may want to rid itself of the synthetic as quickly as possible (Traber. 1998). 

Bottom line: If you briefly recap the previously reported results, it appears as if the divide between natural and synthetic was less pronounced than some bullocks-website would have it. On the other hand, the often-heard claim that natural and synthetic vitamins were identical is questionable and in some cases like folic acid, vitamin E and others simply false.

One of the reasons we even have to worry about adequate vitamin intakes despite living in abundance, is the quality of our foods (or rather their lack of quality). Food processing techniques can reduce the amount of every known essential vitamin. The refining of rice reduce B-complex vitamins and initially led to deaths in Asia due to beriberi. And even if synthetic USP vitamins are added to white rice, it does not contain the same nutrients as unpolished brown rice (nor does white
flour contain the same nutrients as whole flour).

The reductions in liver vitamin A + E in pigs fed diets containing the fat substitute Olestra and identical amounts of synthetic vits what happens when we replace natural vitamin (Daher. 1997).

"The refining of whole grains (including wheat, rice, and corn) has resulted in a dramatic reduction of their natural food complex nutrients. The milling of wheat to white flour reduces the natural food complex vitamin and mineral content by 40–60%. Various food processing techniques (including pasteurization of milk) reduce the available vitamin B6 in foods by 10–50%. The recently introduced artificial fat olestra (also known as Olean) robs the body of oil soluble vitamins (vitamins A, D, E, and K) and carotenoid antioxidants (betacarotene, lutein, lycopene) [...] Irradiation of meat and other foods ‘changes the characteristics of food’ and has been found to reduce levels of vitamins A, B1, B6, E, K, and other nutrient levels" (Thiel. 2000).

The list could and will be continued, after all it appears to be certain that hitherto unknown nutrients will also be affected from food processing; and even if we found all of them and replaced them with USP isolates it is, we cannot be sure that the effects would be better than for some of the previously discussed vital nutrients. Against that background you don't have to be "paleo" to ask yourself if the synthetically enhanced foods will ever offer all, or even almost all of the health benefits the original unprocessed foods have | Comment on Facebook!

References:

• Acuff, Robert V., et al. "Transport of deuterium-labeled tocopherols during pregnancy." The American journal of clinical nutrition 67.3 (1998): 459-464.
• Daher, George C., Dale A. Cooper, and John C. Peters. "Physical or temporal separation of olestra and vitamins A, E and D intake decreases the effect of olestra on the status of the vitamins in the pig." The Journal of nutrition 127.8 (1997): 1566S-1572S.
• Ensminger A. H., Ensminger M. E., Konlade J. E., Robson J. R. K. Food & Nutrition Encyclopedia, 2nd ed. New York: CRC Press, 1993.
• Fallon, Michael B., And James L. Boyer. "Hepatic toxicity of vitamin A and synthetic retinoids." Journal of gastroenterology and hepatology 5.3 (1990): 334-342.
• Herbert, Victor, and K. C. Das. "Folic acid and vitamin B12." Modern nutrition in health and disease 1 (1994): 402-25.
• Herbert V. Folic Acid In Modern Nutrition in Health and Disease, 9th ed. Baltimore: William & Wilkins, 1999: 433–446.
• Hui J. H. Encyclopedia of Food Science and Technology. New York: John Wiley, 1992.
• Jenkins, D. J. A., T. M. S. Wolever, and A. L. Jenkins. "Diet factors affecting nutrient absorption and metabolism." Modern nutrition in health and disease 8 (1994): 583-602.
• Kanno, Choemon, et al. "Binding form of vitamin B2 in bovine milk: Its concentration, distribution and binding linkage." Journal of nutritional science and vitaminology 37.1 (1991): 15-27.
• Kim, Young-In. "Folic acid supplementation and cancer risk: point." Cancer Epidemiology Biomarkers & Prevention 17.9 (2008): 2220-2225.
• Macrae R., Robson R. K., Sadler M. J. Encyclopedia of Food Science and Nutrition. New York: Academic Press, 1993. 
• Mangels, Ann R., et al. "The bioavailability to humans of ascorbic acid from oranges, orange juice and cooked broccoli is similar to that of synthetic ascorbic acid." The Journal of nutrition 123.6 (1993): 1054-1061.
• Marsillach, Judit, et al. "Moderately high folic acid supplementation exacerbates experimentally induced liver fibrosis in rats." Experimental Biology and Medicine 233.1 (2008): 38-47.
• Ross A. C. Vitamin A and retinoids. In Modern Nutrition in Health and Disease, 9th ed. Baltimore: William & Wilkins, 1999: 305–327.
• Rothman, Kenneth J., et al. "Teratogenicity of high vitamin A intake." New England Journal of Medicine 333.21 (1995): 1369-1373.
• Schelling, Gerald T., et al. "Bioavailability and interaction of vitamin A and vitamin E in ruminants." The Journal of nutrition 125.6 Suppl (1995): 1799S-1803S.
• Schumann, K, et al.  "Bioavailability of oral vitamins, minerals, and trace minerals in perspective". Arzneimittelforschung, 47 (1997), pp. 369–38.
• Tanphaichitr V. Thiamin. In Modern Nutrition in Health and Disease, 8th ed. Philadelphia: Lea & Febiger, 1994: 359–365.
• Thiel, R. "Vitamins are naturally found in food complexes." ANMA Monito 3.1 (1999): 5-9.
• Traber, Maret G., Angelika Elsner, and Regina Brigelius-Flohé. "Synthetic as compared with natural vitamin E is preferentially excreted as α-CEHC in human urine: studies using deuterated α-tocopheryl acetates." FEBS letters 437.1 (1998): 145-148.
• Ulrich, Cornelia M., and John D. Potter. "Folate supplementation: too much of a good thing?." Cancer Epidemiology Biomarkers & Prevention 15.2 (2006): 189-193.
• Vinson, Joe A., and Pratima Bose. "Comparative bioavailability to humans of ascorbic acid alone or in a citrus extract." The American journal of clinical nutrition 48.3 (1988): 601-604.
• Vinson J., Bose P., Lemoine L., Hsiao K. H. "Bioavailability studies". In Nutrient Availability: Chemical and Biological Aspects. Cambridge (UK): Royal Society of Chemistry, 1989: 125–127.
• Vinson, Joe A., et al. "A citrus extract plus ascorbic acid decreases lipids, lipid peroxides, lipoprotein oxidative susceptibility, and atherosclerosis in hypercholesterolemic hamsters." Journal of Agricultural and Food Chemistry 46.4 (1998): 1453-1459.

Grape Seed Extract Protects EPA & DHA From Intestinal Oxidation. Niacin Shifts Muscle Fiber Type. Cholesterol & Sialic Acid Build Babies' Brains. Pro-Diabetic GUMPs 4 Kids

"What? Don't gimme that look. I did walk to the fast-food outlet. I swear!" - When it comes to how much they sit around, people love to lie... ah, I mean they often overestimate their activity level - especially the really lazy ones ;-)

It's not always easy to find a "figure of the week" and actually the on I am going to present you today is not "week specific". It is rather related to yesterday's post on the statistics of the diabesity epidemic. That said, you may remember that the gap between "more" and "less" active individuals was widening, but on average the NHANES stats would suggest that the average US citizen is not sitting around much longer today (or rather in 2004) than 40 years ago. Now, the NHANES data is based on a questionnaire of which Healy et al., who have analyzed the accuracy of these self-reported activity levels in a 2010 paper (Healy. 2011), found that the difference between the real and the claimed sedentary time increases by one hour for every 3h of sedentary time (at least for people with a sedentary time of >7h)

In other words, someone who actually sits on his booty for 10h will be telling you that he would be sitting around for 9 hours. It should be said though that there are outlier on both sides so that it may well be that the guy will boldly lie to you and tell you he would sit around max. 7h per day. The chances that he underestimates his activity level, on the other hand, are slim; and if he does it's by no more than 1h.

Now that we have already been talking about health, why don't we simply keep on this track and take a look at a handful of recently published studies which may help you to do what it takes to keep "healthy, happy and lean" (cf. "bottom line" of yesterday's post): learn what's good for you (and your family) and take responsibility for your own well-being.

Grape seed extract to protect and deliver unoxidized omega-3 fatty acids

(Maestre. 2013) -- If we assume that you want your omega-3 fatty acids unoxidized (this is by no means sure, see link beneath the image on the right), it would be prudent to ingest your fish, but even more so the unprotected fish oil from caps with some grape seed extract.

Surströmming, a Swedish delicates that's essentially rancid fish. Can't be healthy? Well, even with pure, yet oxidized fish oils did not have any negative health effects in previously healthy individuals in (read more)

That's at least what a recent study by scientists from the Department of Seafood Chemistry at the Instituto de Investigaciones Marina in Vigo, Spain and their US colleagues from the Department of Nutritional Sciences at the Rutgers University in New Brunswick, NJ, would suggest.

In their latest paper that has been published in the last issue of the Journal of Nutrition the scientists report that the addition polyphenol-rich grape seed extract (GSE) during the in-vitro digestion of omega-3 fatty decreased the amounts of oxidation products in the stomach compartment and intestinal dialysate and would thus facilitate a higher uptake of intact omega-3 fatty acids in the intestine.

Want more type I and less type II fibers? Niacin is your friend, then

(Ringseis. 2013) -- Hard do believe but after one months of niacin supplementation (750 mg/kg diet niacin aka vitamin B3, also "nicotinic acid") the obese Zucker rats in a recent study by Robert Ringseis, Susann Rosenbaum, Denise K. Gessner et al. exhibited a statistically significant shift towards a more oxidative (type I) muscle type.

Is there a connection between niacin and the diabesity epidemic or is the increase in niacin intake (also due do fortification) and the explosion of the obesity and diabetes rates coincidence?
(Figure from Zhou. 2010)

Unfortunately the latter are not without side effects - especially for those who don't really need to lower their blood lipids, where the administration of high dosages of nicotinic acid will induce transient insulin resistance (Poynten. 2003). And contrary to hyperlipidemic obese individuals the he increased use of fatty acids by the skeletal muscle is a cold comfort for healthy people like (I hope) you, especially in view of the fact that it adds to already existent negative modulators of insulin sensitivity such as aging (Chang. 2006)

And while these "pro-diabetic" effects may not be as pronounced from nicotinamide (the stuff that's usually in supps, because it won't make you flush), the latter has also been shown to reduce insulin sensitivity in people with at high risk of insulin dependent diabetes mellitus (Greenbaum. 1996).The increased oxidative capacity went hand in hand with the well-known lipid lowering effects of niacin (Creider. 2012).

The main difference being that the 2g of nicotineamide the subjects in that study received lack most of the beneficial effects of "real" niacin. So is the common practice to "fortify" foods with this stuff turning all of us into diabetics (cf. Li. 2012)? I tend to agree with Paul Jaminet who wrote an excellent article on that matter back in the day that it is - on it's own - probably not a problem, but if you add tons of multivitamins and other niacin / nicotinamide laden supps on top, you could in fact risk running into trouble without even the slightest chance to see any benefits.

Sialic acid and cholesterol two vitally important bad guys

Low (or insufficient?) sialic acid (in mmol/L), another reason for the inferiority of formula vs. breast milk (Wang. 2001) - use your brain and make sure your kids will be able to use theirs, as well (Wang. 2001).

(Scholtz. 2013) -- I guess you are by now over the "dietary cholesterol is bad for you" mantra and probably did not even know that sialic acid (SA) is another of those supposedly bad guys, which do eventually turn out to be as bad as the jacketed metal bullets are made of.

The latter is what a recent study from the University of Kansas Medical Center clearly indicated for both of them cholesterol, as well as sialic acid, a monosaccharide with a nine-carbon backbones that's a derivate of neuroaminic acids. While it has been implicated in cancer development, influenza infection or bacterial infections (as a food for the bacteria), the recent paper by Scholtz and her coworkers clearly shows that it's high presence in human milk is just like that of cholesterol necessary for optimal brain development:

"Cholesterol exposure from conception to P32 increased cortex weight (P = 0.003) and the concentrations of cortical cholesterol (P = 0.006), protein (P = 0.034), and ganglioside SA (P = 0.02). Independent of cholesterol feeding, SA fed from P17 to P32 [post natal day 17 to 32] increased the cortical ganglioside SA concentration (P-trend = 0.007)."

Their conclusion that "[d]ietary cholesterol and SA independently contribute to brain cortex composition during early brain development." (Scholtz. 2013) also puts a huge question mark behind the current nutrient composition of infant formulas which are significantly lower in both these "bad" nutrients than mother's milk. And I guess I don't have to mention that the "healthy" soy "milk" is almost devoid of both this vital nutrients.

Pro-Diabetic formula - "Growing Up Milk Powders" today, insulin therapy tomorrow?

(Brand-Miller. 2013) -- It's really amazing how parents are fooled by the industry to believe they would do their kids a favor, when they buy "milk products" that have been specifically formulated for kids: Sweet and delicious, just like kids like it, so that parents who are worried about the health of their kids don't have fret, when the little ones refuse to drink their milk. If only they knew,...

What to make of this study? The study was sponsored by the Fonterra Research Centre, who certainly have a vested interest in pointing out the weaknesses of the sugary "dairy" products of their competition. And the "milk replacements" that have been tested in the study are mainly used in Asia (in fact, all products are sold and were purchased in Malaysia and Indonesia), but that does not nullify the results and the validity of the scientists conclusion that "there is the potential for the risks to outweigh the benefits if manufacturers do not take a responsible approach in formulation" (Brand-Miller. 2013)

Yeah, if only the knew about the results of a recent study by Jennie Brand-Miller, Fiona Atkinson and Angela Rowan who studied the glycemic index and glycemic load of 7 products that had been specifically selected to represent the full spectrum of 58 previously analyzed so-called "Growing Up Milk Powders" (GUMPs) and found that:

"[Milk p]roducts containing maltodextrins, corn or glucose syrups increased the GI by more than 2-fold, and glycemic load (GL) by 7-fold compared to milk powders with no added  carbohydrates." (Brand-Miller. 2013)

Just to make sure no one misses the crucial point here. Even products that contain maltodextrin or corn syrup and could thus carry a label like "no added sugar" will raise the insulin level 2x more than regular milk and an even 7x higher glycemic load.

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That's it for today, but obviously there is more for those of you who feel the weight of the initially mentioned responsibility on their shoulders and want to make sure they don't mess up on the SuppVersity's facebook wall. Let's see, what do we have?

"Strong is the Better Sexy!" Study Shows: Athletes Are Better Role Models for Women Than Sexualized Cover Models for young women (read more)
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• Healthy marathon running - if at all, only for women!? Men 5.7x more likely to suffer from sudden cardiac arrest (SCA) during a marathon. 11/13 men with SCA are 40+ (read more)
• Sex differences in body dissatisfaction and its effects on eating behavior in athletes: Women hate themselves for each lbs of body fat. Men are more complex (also consider BMI) and don't change their diet if they feel they are too fat / skinny (read more)
• Common CoQ10 wisdom debunked: CoQ10 + Selenium do not reduce statin induced myopathy (read more)
• Woman with slimmer waistlines improve their significant other's sexual performance... or if your girlfriend has a 120er waist your chances of having erectile dysfunction increase significantly (read more)
• There is more & still more to come in the course of the next 24h @ www.facebook.com/SuppVersity

Assuming you are still hungry for more, I suggest you head over to CasePerformance to learn why supplements are so freaking expensive and price is no indicator of quality let alone efficacy in the 2nd installment of the CasePerformance New Year's Resolution Series.

References:

• Brand-Miller J, Atkinson F, Rowan A. Effect of added carbohydrates on glycemic and insulin responses to children&#8217;s milk products. Nutrients. 2013 Jan 10;5(1):23-31.
• Chang AM, Smith MJ, Galecki AT, Bloem CJ, Halter JB. Impaired beta-cell function in human aging: response to nicotinic acid-induced insulin resistance. J Clin Endocrinol Metab. 2006 Sep;91(9):3303-9. Epub 2006 Jun 6.
• Creider JC, Hegele RA, Joy TR. Niacin: another look at an underutilized lipid-lowering medication. Nat Rev Endocrinol. 2012 Sep;8(9):517-28.
• Greenbaum CJ, Kahn SE, Palmer JP. Nicotinamide's effects on glucose metabolism in subjects at risk for IDDM. Diabetes. 1996 Nov;45(11):1631-4. 
• Healy GN, Clark BK, Winkler EA, Gardiner PA, Brown WJ, Matthews CE. Measurement of adults' sedentary time in population-based studies. Am J Prev Med. 2011 Aug;41(2):216-27.
• Li D, Sun WP, Zhou YM, Liu QG, Zhou SS, Luo N, Bian FN, Zhao ZG, Guo M. Chronic niacin overload may be involved in the increased prevalence of obesity in US children. World J Gastroenterol. 2010 May 21;16(19):2378-87.
• Maestre R, Douglass JD, Kodukula S, Medina I, Storch J. Alterations in the Intestinal Assimilation of Oxidized PUFAs Are Ameliorated by a Polyphenol-Rich Grape Seed Extract in an In Vitro Model and CACO-2 Cells. J Nutr. 2013 Jan 16.
• Poynten AM, Gan SK, Kriketos AD, O'Sullivan A, Kelly JJ, Ellis BA, Chisholm DJ, Campbell LV. Nicotinic acid-induced insulin resistance is related to increased circulating fatty acids and fat oxidation but not muscle lipid content. Metabolism. 2003 Jun;52(6):699-704.
• Ringseis R, Rosenbaum S, Gessner DK, Herges L, Kubens JF, Mooren FC, Krüger K, Eder K. Supplementing Obese Zucker Rats with Niacin Induces the Transition of Glycolytic to Oxidative in Skeletal Muscle Fibers. J. Nutr. 2013; 143: 125-131.
• Scholtz SA, Gottipati BS, Gajewski BJ, Carlson SE. Dietary Sialic Acid and Cholesterol Influence Cortical Composition in Developing Rats. J Nutr. February 1, 2013; 143(2):132-135.
• Wang B, Brand-Miller J, McVeagh P, Petocz P. Concentration and distribution of sialic acid in human milk and infant formulas. Am J Clin Nutr. 2001 Oct;74(4):510-5.
• Zhou SS, Li D, Zhou YM, Sun WP, Liu QG. B-vitamin consumption and the prevalence of diabetes and obesity among the US adults: population based ecological study. BMC Public Health. 2010 Dec 2;10:746.

B-Vitamins & Diabetes: Protective or Causative?

In a very interesting study, scientists from China and Japan (Zhou. 2010) found that "long-term exposure to high level of the B vitamins may be involved in the increased prevalence of obesity and diabetes in the US in the past 50 years". At first this appears to be counterintuitive, since we have been told over and over that B-Vitamins are not only good for our health, but that we could not even "overdose" them. While the latter has been questioned for years and certainly is not the case for e.g. B6 and niacin, even the former seems questionable, if you read the results from the above mentioned study:

The prevalences of diabetes and adult obesity were highly correlated with per capita consumption of niacin, thiamin and riboflavin with a 26- and 10-year lag, respectively (R2 = 0.952, 0.917 and 0.83 for diabetes, respectively, and R2  = 0.964, 0.975 and 0.935 for obesity, respectively). [...] The relationships between the diabetes or obesity prevalence and per capita niacin consumption were´similar both in different age groups and in male and female populations. The prevalence of adult obesity and diabetes was highly correlated with the grain contribution to niacin (R2 = 0.925 and  0.901, respectively), with a 10- and 26-year lag, respectively.

These results (especially those referring to the detrimental effect of niacin) confirm test-tube studies conducted by a group of scientists from South Korea earlier this year (Choi. 2010), who found that

NA [nicotinic acid] alters gene expression in insulin-sensitive tissues by various mechanisms. Some of the NA-induced changes in gene expression are discussed as potential mechanisms underlying wanted and unwanted effects of NA treatment.

Just anecdotal: My personal perspective on B-vitamins has changed since my overall energy and well being, as well as my physique have largely improved after stopping to take those B-vitamin (over-)loaden mulit-vitamin preparations like Now ADAM, CL Orange Triad, Animal Pak, ON Opti-Men etc. But remember: it is mere speculation that this could in fact be related to their high B-vitamin contents - could be any other constituent, as well.