Metagenics Food Supplements

Old time Remedies from 1800's

To link to my Metagenic website for ordering, click here : Metagenics Site

Medicine as it is currently practiced does not recommend changes in diet or nutritional advice very often. In allergy we are used to recommending dietary as well as lifestyle changes every day. This has lead me to incorporate food supplementation into my practice. I see a lot of disease that has failed standard medical therapy and this has led me to exploring new and inovative therapies into my practice. In the current medical literature there are studies that support the use of specific food supplementation for specific diseases. I wish that medicine studied this area of treatment more but it is tremendously expensive to perform a study and the "Carrot Growers of America" just don't have an extra 250 Million dollars to fund a study. I will suggest some products below that have worked for me and my patients and what evidence I have for their use. One should not be surprised that disease and illness may respond to dietary supplements. Nutrition is the foundation to good health, and dietary supplements may prove to be some of the most powerful medicines ever discovered. An especially exciting discovery is that dietary supplements may enhance the effects of specific drugs.[ Multiple dietary antioxidants enhance the efficacy of standard and experimental cancer therapies and decrease their toxicity. Prasad KN - Integr Cancer Ther - 01-DEC-2004; 3(4): 310-22] This discovery may lead to more effective and safer protocols for the treatment of cancer, heart and lung disease, and a host of chronic medical conditions. Information about dietary supplements is becoming more common in the popular medical literature and is creating increased curiosity and an increased awareness. I use Metagenics because they are a registered Food Supplement company and are at least evaluated by the FDA.

Daily Multivitamins and Anti-Oxidants

Fifty percent of older adults have a vitamin and mineral intake less than the RDA, and 10% to 30% have subnormal levels of vitamins and minerals [Wakimoto P, Block G. Dietary intake, dietary patterns, and changes with age: an epidemiological perspective. J Gerontol Biol Sci Med Sci 2001;56:65-80] . Populations at high risk for inadequate vitamin intake include elderly people, vegans, alcohol-dependent individuals, patients with malabsorption and many patients on medication for disease. Evidence of importance of vitamins in disease states has been found for nine vitamins. Inadequate folate status is associated with neural tube defect and cancers. Folate and vitamins B6 and B12 are required for homocysteine metabolism, and are associated with coronary heart disease risk. Vitamin E and lycopene decrease the risk of prostate cancer. Vitamin D is associated with decreased occurrence of fractures when taken with calcium. Zinc [Zinc A.G.™] , beta-carotene, and vitamin E slow the progression of macular degeneration. In observational studies (case-control or cohort design), people with high intake of antioxidant vitamins by regular diet or as food supplements have a lower risk of myocardial infarction and stroke than people who are low consumers of antioxidant vitamins. The associations in observation studies have been shown for carotene, ascorbic acid, and tocopherol. The current general recommendations are * one multivitamin daily * extra vitamin E for patients with cardiovascular risk factors or Alzheimer's dementia * extra vitamin D for patients with known osteoporosis, osteoporosis risk factors, or strong risk factors for vitamin D deficiency * extra folate for patients with cardiovascular risk factors (especially smokers) and alcoholics * extra thiamine for alcoholics. This may be inadequate for most patients interested in the treating the following disease states.

Nutrition and Allergy

Antioxidants have been proven to be very useful in preventing adverse effects of environmental agents/pollutants (such as in allergies, asthma and lung disease). Use of flavored cod liver oil and a multivitamin-mineral with selenium [ Multigenics® +
E-400 Selenium™] as adjunctive therapy for children with chronic/recurrent sinusitis is an effective, inexpensive, non-invasive intervention that clinicians can use for selected patients. [Nutritional supplements as adjunctive therapy for children with chronic/recurrent sinusitis: pilot research. Linday LA - Int J Pediatr Otorhinolaryngol - 01-JUN-2004; 68(6): 785-93]  There are a number of reports that suggest that antioxidants, such as ascorbate and tocopherol, are useful in preventing ozone-induced lung responses. Exposure to pollutants is linked to loss of antioxidants from the airway, and asthmatic subjects have been reported to have decreased baseline airway fluid antioxidant levels. Dr. Samet et al found that combination therapy with ascorbate and tocopherol prevented ozone-induced decreases in lung function in healthy volunteers who had preceded supplementation with an antioxidant-depleted diet. Dr. Trenga et al found that vitamin E and C pretreatment blunted acute bronchospastic response to sulfur dioxide (SO2) challenge in persons who had been exposed to ozone (using the SO2 as a replacement for methacholine). Studies suggest that genetic factors might determine which asthmatic subjects are better candidates for antioxidant supplement therapy like those with GSTM1 deficiency (Glutathione-S-transferases (GSTs) are defense pathway components and are central to protection from oxidants and ozone). Animal studies suggest that the thiol-based antioxidants N-acetyl-cysteine and bucillamine decrease the adjuvant effects of diesel exhaust particles.

Two factors thought to influence the risk of asthma are sensitization to house dust mites and the preventive effect of increased omega-3 fatty acids. Although house dust mite allergen avoidance is used as a preventive strategy in many disease trials, the effect of omega-3 fatty acid supplementation in the primary prevention of asthma and allergic disease is not frequently suggested. There was a significant 10.0% reduction in the prevalence of cough and asthma development in atopic children in the active diet supplement group. These results suggest that our interventions, designed to be used in simple public health campaigns, may have a role in preventing the development of allergic sensitization and airways disease in early childhood. This offers the prospect of reducing allergic disease in later life.

The Obesity Problem and Metabolic Syndrome

The metabolic syndrome, also referred to as syndrome X, Reaven syndrome, or the insulin resistance syndrome, is a constellation of risk factors within an individual that may precede type 2 diabetes and increases the risk of cardiovascular disease. It is the consequence of a genetic predisposition as well as lifestyle factors such as obesity-inducing dietary habits and physical inactivity. Characteristics of this syndrome include abdominal obesity, dyslipidemia, hypertension, insulin resistance (with or without glucose intolerance or diabetes), microalbuminuria, and a prothrombotic or proinflammatory state. This condition poses a serious public health problem because of its prevalence and the increased risk for cardiovascular disease, diabetes, and the complications of these diseases. An analysis of data from the Third National Health and Nutrition Examination Survey (NHANES) indicated that the overall prevalence of the metabolic syndrome was 23.7% in the US population, and that the prevalence ranged from 6.7% among individuals aged 20 to 29 years to 43.5% among those aged 60 to 69 years. These findings suggest that ≥47 million people in the US population have the metabolic syndrome. The primary targets of treatment include obesity and physical inactivity, several trials have illustrated the value of treating with dietary supplements [UltraMeal®] [MetaGlycemX™] . Data on the following dietary supplements have been identified: chitosan, chromium picolinate, Ephedra sinica, Garcinia cambogia, glucomannan, guar gum, hydroxy-methylbutyrate, plantago psyllium, pyruvate, yerba maté, and yohimbe. The reviewed studies provide encouraging data but no evidence that any specific dietary supplement is effective for reducing body weight consistently. [Insulin resistance-associated cardiovascular disease: potential benefits of conjugated linoleic acid. Aminot-Gilchrist DV - Am J Clin Nutr - 01-JUN-2004; 79(6 Suppl): 1159S-1163S Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial. Villareal DT - JAMA - 10-NOV-2004; 292(18): 2243-8] DHEA or Linoleic acd replacement [Ultra CLA®] could play a role in prevention and treatment of the metabolic syndrome associated with abdominal obesity. Data suggest that chromium Cr supplementation was an effective treatment strategy to minimize increased oxidative stress in type 2 diabetes mellitus patients whose HbA(1C) level was >8.5%, and the Cr in EU groups might act as a prooxidant.

Properties of a perfect antiaging therapy

A desirable antiaging therapy should have four features: (1) the treatment acts by modifying the aging process or its direct effects, (2) it should promote continued good health or reduce disability, (3) it should not simply be targeted to symptoms associated with normal aging, and (4) use of the therapy should produce a longer life that does not simply consist of prolonged poor health. First, by definition, an antiaging medicine or therapy should act to address either the aging process or its direct effects on molecules, cells, or tissues. An antiaging therapy needs to alter mechanisms related to aging, such as oxidative stress, protein misfolding, hormone changes, or cell senescence. Prolonging life by itself is not a true measure of one of these therapies, because immunization, proper sanitation, use of seat belts, and specific disease treatments (such as the use of aspirin in patients with coronary artery disease), can all produce increased longevity without having the effect of modulating the aging process.

Second, the use of an antiaging therapy should promote continued good health or reduce disability. An important goal of antiaging medicine is addressing two major failings of disease-specific and focused treatments: the decline of overall patient health and functioning over time due to aging, and the related increase in disability. An antiaging therapy should address the causative role aging plays in future disease and disability. Third, an antiaging therapy should not be simply targeted to symptoms associated with the aging (such as wrinkled skin or normal short-term memory loss) without addressing the underlying aging process and altering its role in health and disease. Finally, antiaging medicines or treatments will likely have enhanced longevity as an effect. An important aspect of these additional years of life is that the time should consist of good health and function rather than a prolonging of a period of poor health. A true failure, both from the individual and societal prospective, would be a therapy that results in the significant prolongation of a period of life consisting of significant functional disability (such as time in a nursing home), or to poor medical health, producing physical discomfort and repeated hospitalization.

Do we have this therapy yet? I don't think so but the problem from my standpoint is should we stand still until it is found and we are then either disabled or dead. I think we should use the information we have on hand at present and form a plan for lifestyle modification with advice on diet, exercise, weight loss, and smoking cessation. We should attempt specific treatments, such as nutritional supplements, using the best evidence of benefit currently available. Most studies show that patients have depressed intakes of the trace materials zinc, copper, selenium, and chromium. Multiple potential manifestations of trace metal deficiencies may occur. If mineral supplementation is to be initiated, it is important to administer doses that would be below the tolerable upper intake level and in a form that most patients tolerate. Many of the negative studies of zinc or iron supplementation used doses well above this tolerable level, and the negative results of these studies may be due to this inappropriate dosing. The most important factor for supplementation is persistance. Stay on what you tolerate.

Pre and Probiotics

Probiotics are truly a timeless concept. Initially standard components of the human diet, potentially beneficial bacteria and yeast have been eliminated systematically through modern methods of preparing and preserving foods. Although the concept of probiotics is not new, the science of probiotics is in its infancy. Only recently have techniques been developed to identify, culture, and produce the probiotics that are suitable for medical use consistently. Furthermore, the potential uses for these organisms may extend far beyond what originally was thought. Probiotic ingestion can be recommended as a preventative approach to maintaining the balance of the intestinal microflora and thereby enhance 'well-being'. Research into the use of probiotic intervention in specific illnesses and disorders has identified certain patient populations that may benefit from the approach. A survey of the literature indicates positive results in over one hundred human trials, with prevention/treatment of infections the most frequently reported output. Increased levels of probiotics induce a 'barrier' influence against common pathogens. Mechanisms of effect are likely to include the excretion of acids (lactate, acetate), competition for nutrients and gut receptor sites, immunomodulation and the formation of specific antimicrobial agents. As such, persons susceptible to diarrhoeal infections may benefit greatly from probiotic intake. On a more chronic basis, it has been suggested that some probiotics can help maintain remission in the inflammatory conditions, allergies, ulcerative colitis and pouchitis. Moreover, studies have suggested that probiotics are as effective as anti-spasmodic drugs in the alleviation of irritable bowel syndrome. The approach of modulating the gut flora for improved health has much relevance for the management of those with acute and chronic gut disorders. Other target groups could include those susceptible to nosocomial infections, as well as the elderly, who have an altered microflora, with a decreased number of beneficial microbial species. Also, the use of prebiotics in association with useful probiotics may be a worthwhile approach. A prebiotic is a dietary carbohydrate(FOS) selectively metabolised by probiotics. Combinations of probiotics and prebiotics are known as synbiotics. When used appropriately, probiotics represent a potentially beneficial adjunct to other proved therapies and have the added benefit of providing a stabilizing influence on the delicate balance between the ecosystem that consists of the human and its flora. Clinical trials with probiotics, especially in the treatment of atopic eczema, food allergy, antibiotic-associated diarrhea, vaginitis, invasive candidiasis, inflammatory bowel disease and asthma have yielded encouraging results. Experimental studies have found that probiotics exert strain-specific effects in the intestinal lumen and on epithelial cells and immune cells with anti-allergic potential. These effects include enhancement in antigen degradation and gut barrier function and induction of regulatory and proinflammatory immune responses, the latter of which occurs more likely beyond the intestinal epithelium.

Probiotics and inflammatory bowel disease

Probiotics are live microbial food ingredients that confer a health benefit by favorably altering the enteric flora. These nonpathogenic food-grade organisms are usually of the genera Bifidobacterium or Lactobacillus but may include other bacteria, such as noninvasive coliforms, and even nonbacterial organisms, such as Saccharomyces boulardii. Probiotics have begun to attract research attention, and although probiotic research is at an early stage with regard to controlled trials, there is encouraging preclinical and clinical evidence for efficacy in treating IBD.

In genetically engineered animal models of IBD, probiotics prevent or attenuate disease. Probiotic lactobacilli may inhibit not only inflammation, but also development of colon cancer in the interleukin-10 knockout murine model of enterocolitis. The most impressive evidence to date for efficacy of probiotic therapy in IBD is in patients with pouchitis. A trial found that a combination of 8 probiotic bacterial strains was highly effective compared with placebo in maintaining disease remission in patients with recurrent pouchitis.

Brief List of Sources on Dietary Supplements

Current Literature on Supplementation

Metabolic effects of orally administered amino acid mixture in elderly subjects with poorly controlled type 2 diabetes mellitus. Solerte SB - Am J Cardiol - 22-APR-2004; 93(8A): 23A-29A
Abstract:
The reduction of muscle mass and increased protein catabolism in aging can determine the occurrence of metabolic alterations-such as hyperglycemia and reduced insulin sensitivity-in elderly subjects with diabetes mellitus. Therefore, the aim of the study was to evaluate the effect of nutritional supplementation with oral amino acid mixture (OAAM) in elderly subjects with type 2 diabetes. This approach was conducted in an attempt to antagonize muscle catabolism by means of increased endogenous protein synthesis and to improve glucose metabolism and insulin sensitivity. A randomized, open-label, crossover study was conducted in poorly controlled (glycosylated hemoglobin level [HbA(1c)] >7%) elderly subjects (age range, 65 to 85 years) with type 2 diabetes. OAAM significantly reduced fasting and postprandial blood glucose and HbA(1c), whereas all parameters remained substantially unchanged in the group treated with placebo. Fasting insulin levels and insulin resistance increased at baseline in all subjects with diabetes and decreased during OAAM supplementation. These results persisted also after crossover from OAAM to placebo. No changes in blood lipid levels, creatinine, homocysteine, and urinary albumin excretion rate were observed throughout the study, whereas a mild but significant increase of high-density lipoprotein cholesterol was found after OAAM supplementation. We suggest that increased amino acid availability for skeletal muscle function and strength could ameliorate metabolic control and insulin sensitivity in elderly patients with poorly controlled type 2 diabetes.

Primary prevention: phytoprevention and chemoprevention of colorectal cancer. Turini ME - Hematol Oncol Clin North Am - 01-AUG-2002; 16(4): 811-40
Abstract:
Considering the various stages of carcinogenesis and the numerous tumor types and available chemoprevention agents, knowledge of the etiology and the type of cancer to be treated, or possibly prevented, and understanding of the mechanisms by which agents exert their chemoprevention benefits may provide for improved strategy in designing therapeutic regimens. Because cancer usually develops over a 10- to 20-year period, it may be necessary for some agents to be provided before or early in the initiation steps of carcinogenesis to have beneficial effects. On the other hand, some agents may be more suitable for CRC prevention if provided at a later stage of carcinogenesis. Gene array, genomics, and proteomics are useful tools in advancing our understanding of the molecular events involved in carcinogenesis and in identifying markers of risk and surrogate end-points for colorectal cancer progression. These techniques may also serve for screening, identifying, and providing treatment targets for high-risk patients populations. Treatment could be developed depending on a patient's individual needs and genomic tumor profile. Clinical markers and surrogate end-points should be considered, together with molecular measurements, to more accurately assess risk. NSAIDs and COXIBs are clinically recognized as chemoprevention agents, and clinical trials evaluating their efficacy are ongoing. Treatment protocols, including dose and timing, remain to be determined, however. DFMO may best be used in combination with other chemoprevention agents. Dietary fiber and calcium supplements, as part of an overall low-fat diet, may decrease CRC risk. Long-term compliance with this regimen may be necessary to effect a beneficial outcome. Folate holds promise but needs further investigation, especially because its beneficial effects may depend on cancer type. Phytochemicals have been identified as strong candidates for use as agents to prevent colorectal cancer in cell culture and in rodent models of carcinogenesis. Their potential as chemoprevention agents must be demonstrated in clinical trials. In vitro and animal studies indicated that combination therapy may be a promising strategy over the monotherapy approach; clinical trials addressing the safety and efficacy of some combinations (DFMO/sulindac, fiber/calcium) are underway. The gastrointestinal tract and other organs are constantly exposed to a mixture of potentially toxic compounds and molecules considered favorable to health. Homeostasis between stress-mediated by toxic compounds and defensive mechanisms, is key for the maintenance of health and the prevention of disease. Whereas aggressive pharmacologic treatment may be necessary for patients at high risk for cancer, dietary supplements may be useful for populations at normal risk. The message for cancer prevention in the general population may well remain: keep a balanced healthy diet, eating a variety from all food groups, as part of a healthy lifestyle that includes moderate exercise.

Reversal of cancer-related wasting using oral supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine. May PE - Am J Surg - 01-APR-2002; 183(4): 471-9
Abstract:
BACKGROUND: Cancer-related cachexia is caused by a diverse combination of accelerated protein breakdown and slowed protein synthesis. The hypothesis proposed in this study is that supplementation of specific nutrients known to positively support protein synthesis and reduce protein breakdown will reverse the cachexia process in advanced cancer patients. METHODS: Patients with solid tumors who had demonstrated a weight loss of at least 5% were considered for the study. Patients were randomly assigned in a double-blind fashion to either an isonitrogenous control mixture of nonessential amino acids or an experimental treatment containing beta-hydroxy-beta-methylbutyrate (3 g/d), L-arginine (14 g/d), and L-glutamine (14 g/d [HMB/Arg/Gln]). The primary outcomes measured were the change in body mass and fat-free mass (FFM), which were assessed at 0, 4, 8, 12, 16, 20, and 24 weeks. RESULTS: Thirty-two patients (14 control, 18 HMB/Arg/Gln) were evaluated at the 4-week visit. The patients supplemented with HMB/Arg/Gln gained 0.95 +/- 0.66 kg of body mass in 4 weeks, whereas control subjects lost 0.26 +/- 0.78 kg during the same time period. This gain was the result of a significant increase in FFM in the HMB/Arg/Gln-supplemented group (1.12 +/- 0.68 kg), whereas the subjects supplemented with the control lost 1.34 +/- 0.78 kg of FFM (P = 0.02). The response to 24-weeks of supplementation was evaluated by an intent-to-treat statistical analysis. The effect of HMB/Arg/Gln on FFM increase was maintained over the 24 weeks (1.60 +/- 0.98 kg; quadratic contrast over time, P <0.05). There was no negative effect of treatment on the incidence of adverse effects or quality of life measures. CONCLUSIONS: The mixture of HMB/Arg/Gln was effective in increasing FFM of advanced (stage IV) cancer. The exact reasons for this improvement will require further investigation, but could be attributed to the observed effects of HMB on slowing rates of protein breakdown, with improvements in protein synthesis observed with arginine and glutamine.