January 26th, 2016

Does the Source of Selenium Matter in Cancer Prevention?

awareness-24160_960_720Introduction:

What if some of the large clinical studies assessing the benefits (or risks) of selenium supplementation in cancer prevention have used the wrong form? That looks to be the case as a new study from the University of Miami sheds light on the different effects of selenium-rich yeast versus another form of selenium known as selenomethionine. What the researchers have discovered is that there are proteins produced when making selenium-rich yeast that have anti-cancer properties beyond simply providing a source of selenium.

Background Data:

The results from studies looking at selenium in prostate cancer prevention have shown conflicting results. These may be related to the form of selenium being used. In the Nutritional Prevention of Cancer (NPC) study, supplementation with SelenoExcell, a selenium-enriched yeast, was associated with a 52% decrease in the development of prostate cancer. In contrast, in the SELECT study, selenomethionine failed to show any protective effects alone or when combined with synthetic vitamin E. The difference in results may be entirely related to the form of selenium being used. Here are some possible explanations for these conflicting results:

  • Selenomethionine has been shown to have only a modest effect in increasing prostate tissue selenium levels. In contrast, SelenoExcell is significantly more effective in increasing selenium levels in prostate tissue, especially at the 400 mcg selenium per day dosage.
  • In a clinical trial in men, only SelenoExcell was shown to significantly decrease markers of oxidative stress. When the men received selenomethionine there was no decrease in these same markers.
  • In the process of incorporating the selenium into the yeast it leads to the productions of yeast proteins that reduce cancer cell growth in experimental studies. These proteins may contribute to the overall superiority of SelenoExcell versus other forms of selenium.

In addition to selenomethionine, there are inorganic selenium salts like sodium selenite available in the marketplace. However, selenium salts are less effectively absorbed and are not as biologically active compared to organic forms of selenium, especially SelenoExcell.

New Data:

Researchers evaluated the effects of a group selenium-containing compounds from selenized yeast known as selenoglycoproteins (SGPs). The SGPs were evaluated for their impact on the interactions of lung and breast tumor cells with cells that line blood vessels (endothelial cells). Currently there are no therapies aimed at preventing the spread of cancer by specifically targeting the adhesion and migration of tumor cells into other areas of the body. Results from the detailed study showed that SGPs extracted from Se-enriched yeast possess the ability to reduce the adhesion of tumor cells to endothelial cells. In addition, the researchers also showed that SGPs also blocked the migration of tumor cells into underlying tissue. Furthermore, SGPs were shown to block the tumor promoting effects of nuclear factor kappa-B (NF-κB). This action has profound influence as NF-κB is a master regulator of proinflammatory reactions and gene expression. NF-κB activation is a key factor in cancer cell growth and metastasis. By blocking NF-κB, the SGPs have an effect far beyond the action of simply providing a form of selenium.

Commentary:

These results are extremely provocative. If the science above is confusing, let me try to restate what it is telling us. Basically, it has long been assumed that selenium-rich yeast was beneficial because it provided a superior form of selenium. Once absorbed the selenium would be utilized as a valuable antioxidant as part of an antioxidant enzyme known as glutathione peroxidase. What the emerging science indicates is that the selenium-containing proteins that are produced in the process of making selenized yeast may turn out to be more important than the selenium itself. In other words, these proteins may be the real protective factor.

For more information on SelenoExcell, click here.

Reference:

Wrobel JK, Choi JJ, Xiao R, et al. Selenoglycoproteins attenuate adhesion of tumor cells to the brain microvascular endothelium via a process involving NF-κB activation. J Nutr Biochem. 2015 Feb;26(2):120-9.

December 15th, 2015

Light Therapy is More Effective than Prozac in Major Depression

lighttherapyIntroduction:

Bright light therapy has a proven track record of success in the treatment of seasonal affective disorder (SAD), commonly referred to as the winter blues. A new study from the University of British Columbia shows that this simple and safe therapy is effective for non-seasonal major depression. In fact, researchers showed light therapy was much more effective than fluoxetine (Prozac).

Background Data:

During the winter months, sufferers of SAD typically feel depressed; they generally slow down, oversleep, overeat, and crave carbohydrates. In the summer, these same people feel elated, active, and energetic. Although many variables may be responsible for SAD, the lack of exposure to full-spectrum natural light appears to be the most logical explanation. The antidepressive effects of full-spectrum light therapy have been demonstrated in well-monitored, controlled studies in SAD.

The typical protocol used in clinical studies involved using specialized light boxes providing full-spectrum fluorescent tubes vs. regular tubes. Patients were then instructed to sit three feet away from the light anywhere from 30 minutes a day, up to three hours total, in morning and evening.

The antidepressant effect of light therapy is thought to be due to restoring proper melatonin synthesis and secretion by the pineal gland leading to re-establishment of the proper circadian rhythm – the normal rhythm of hormone secretion that occurs each day.

New Data:

Led by noted SAD and light therapy expert Raymond Lam, M.D., the UBC researchers randomly assigned 122 patients with major depression to either light therapy alone for 30 minutes a day; a placebo device, which did not provide full-spectrum lighting; the combination of light therapy plus fluoxetine, 20 mg a day; or the placebo device plus a placebo. Approximately 30 patients were enrolled in each of the four treatment groups.

All of the patients had a score of 20 or higher on two different standard scales of depression (HDS and MADRS) when the study started indicating significant depression. Furthermore, the duration of the current major depressive disorder episode ranged from a low of 45 weeks to 90 weeks.

Light therapy consisted of 30 minutes a day of exposure to a full-spectrum fluorescent light box as soon as possible after awakening. At the end of the 8-week treatment interval, mean changes in the depression score from baseline (MADRS) were significantly greater among those who received bright light therapy alone, compared to fluoxetine alone. Most significant was that 43.8% of the patients getting the bright light therapy went into remission compared to only 19.4% of the subjects taking fluoxetine. Best results were seen with combination of bright light therapy and fluoxetine than for any of the other treatment groups with a 58.6% remission rate.

These results show quite clearly that light therapy possesses an antidepressant effect even in non-seasonal major depression.

Commentary:

Light boxes similar to those used in clinical trials are available online and generally cost between $69 and $199. An alternative is to get outdoors in sunlight for 30 minutes a day or replace standard light bulbs with full-spectrum light bulbs in areas of your home or office where you spend a considerable amount of time.

Here are some other recommendations for SAD since it is that time of year:

  • Melatonin supplementation alone has produced mixed results in clinical trials in SAD. Nonetheless, some people do seem to respond to 2-3 mg of melatonin at bedtime and for further support in resetting their biological clock. I recommend taking the special form of vitamin B12 (methylcobalamin) at a dosage of 3-5 mg the first thing in the morning.
  • Vitamin D3 is absolutely essential for proper brain chemistry and neurotransmitter action. To insure optimal vitamin D status during the winter months, most health experts, myself included, are advocating daily dosages of 2,000 to 5,000 IU, even in apparently healthy adults.
  • John’s Wort extract (SJWE) has shown to be very effective in reducing depression scores in patients with SAD and can be used to enhance the effects of the bright light therapy instead of standard antidepressant drugs. Typical dosage is 900 to 1,800 mg daily. Because SJWE can increase the activity of a drug detoxifying enzyme in the liver, it has been found to decrease the plasma concentrations of a long list of drugs. As a general rule, if you are taking any prescription medication, including birth control pills, do not take St. John’s wort without approval from your physician.

Reference:

Lam RW, Levitt AJ, Levitan RD, et al. Efficacy of Bright Light Treatment, Fluoxetine, and the Combination in Patients With Nonseasonal Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2015 Nov 18:1-9.

Dr. Michael Murray
12/15/15

December 8th, 2015

Grape Seed Extract Lowers Blood Pressure in Double-Blind Study

Grape Seed Extract Lowers Blood PressureIntroduction:

A simple dietary supplement has once again been shown to produce valuable health benefits. Specifically, a new study published in the British Journal of Nutrition has validated the effects of a previous study showing grape seed extract can effectively and safely normalize blood pressure in many subjects. This new study is very good news for the 74 million Americans with high blood pressure as it offers a safe alternative to the use of drugs to lower blood pressure, all of which carry a significant risk for side effect.

Background Data:

Grape seed extract contains flavonoid compounds known as procyanidolic oligomers (PCOs) or oligomeric proanthocyanidins (OPCs). Studies have shown that supplementation with PCOs for six weeks at daily dosages of 100 to 300 mg considerably improves the serum (blood) total antioxidant capacity and oxygen radical absorbance capacity score (ORAC). Grape seed and/or pine bark extract have shown significant benefits in clinical studies including in the following health conditions:

Blood pressure refers to the resistance produced each time the heart beats and sends blood coursing through the arteries. The peak reading of the pressure exerted by this contraction is the systolic pressure. Between beats the heart relaxes, and blood pressure drops. The lowest reading is referred to as the diastolic pressure. A normal blood pressure reading for an adult is: 120 (systolic) / 80 (diastolic). High blood pressure (BP) readings can be divided into the following levels:

  • Prehypertension (120-139/80-89)
  • Borderline (120-160/90-94)
  • Mild (140-160/95-104)
  • Moderate 140-180/105-114)
  • Severe (160+/115+)

New Data:

In a previous double-blind study, grape seed extract (GSE) was shown to normalize high blood pressure in patients with initial blood pressure in the range of 150/95 mm Hg when combined with standard dietary guidelines. To follow up these impressive results, researchers from the Center for Nutrition Research at the Illinois Institute of Technology and the University of California, Davis, CA, sought to evaluate the ability of GSE to lower blood pressure (BP) in individuals with pre-hypertension (120-139/80-89 mm Hg).

A total of 36 subjects with pre-hypertension were randomized to ingest a juice containing 0 mg (placebo) or 150 mg GSE twice daily for 6 weeks preceded by a 2-week period where both groups took the placebo beverage and followed by 4-week no-beverage follow-up.

Patients had their blood pressure (BP) measured at screening and at the 0, 6 and 10 weeks of the trial. Results showed that subjects taking the GSE for six weeks significantly reduced both their systolic (-5.6%) and diastolic BP (-4.7%). However, subjects with higher initial BP experienced greater BP reduction; nearly double the effect size. The majority of subjects were able to achieve normal BP measurements with GSE supplementation. In contrast, no effect was noted in the placebo group. BP returned to baseline levels after the 4-week discontinuation period of the GSE beverage indicating that the results are only apparent while the GSE is being consumed.

The researchers concluded “GSE was found to be safe and to improve BP in people with pre-hypertension.”

Commentary:

Every effort through diet and supplementation should be made to get your blood pressure below 120/80 mm Hg. All of the current classes of blood pressure lowering drugs possess significant side effects and 80% of people with high BP can lower their blood pressure without drugs. In fact, in head-to-head comparisons, many non-drug therapies such as diet, exercise, relaxation therapies, and dietary supplements like GSE have proved superior to drugs in cases of prehypertension to mild high BP and are without side effects.

For moderate through severe hypertension, drug therapy may be necessary, but should be ideally used as a bridge therapy until dietary, lifestyle, and supplement strategies to lower blood pressure take hold. In patients with moderate through severe hypertension, drug therapy is appropriate, but should still be thought of as a secondary approach.

Reference:

Park E, Edirisinghe I, Choy YY, Waterhouse A, Burton-Freeman B. Effects of grape seed extract beverage on blood pressure and metabolic indices in individuals with pre-hypertension: a randomised, double-blinded, two-arm, parallel, placebo-controlled trial. Br J Nutr. 2015;Nov 16:1-13.

Dr. Michael Murray
12/8/15