New study in Journal of the American Medical Association shows that a multivitamin + selenium slows progression of HIV

The Journal of the American Medical Association has published a new study showing that a multivitamin and selenium combination supplement significantly reduced immune decline and morbidity in people with HIV who were treatment naïve (=not on antiretroviral/ARV therapy). This was a two year study with individuals who had CD4 counts above the recommended threshold for beginning ARV treatment. Over the two-year period, the combination of a daily multivitamin plus the mineral selenium cut by about half the risk of reaching the point where ARV therapy would be recommended (CD4 count of 200-250).

This study shows the importance of daily multivitamin + selenium supplementation for HIV+ people who are recently infected and/or have relatively high CD4 counts. It also provides further confirmation of the value of multivitamin, multimineral supplement strategies like the one included in the NYBC MAC-Pack.

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Probiotics Conference Report

Below is a report on a recent conference on one of our favorite categories of supplement–PROBIOTICS.
We aren’t surprised that prestigious scientific organizations like the New York Academy of Sciences devote their resources to spreading the word about Probiotics. Over the last 100 years, these “friendly bacteria” have been the subject of an enormous amount of scientific study, confirming their crucial role in maintaining the human body’s immune system. And we also know that many NYBC members over the years have benefited from use of Probiotics such as the Jarrodophilus line from Jarrow, or Florastor (Saccharomyces boulardii). For a full list of these Probiotics, with indications for their use and dosing recommendations, see the NYBC catalog at PROBIOTICS AT NYBC

Report on
Probiotics, Prebiotics, and the Host Microbiome:
The Science of Translation
Wednesday, June 12, 2013 | 7:45 AM – 6:00 PM
/The New York Academy of Sciences
George M. Carter

This was a day-long series of discussions, with nearly 70 posters that brought together a variety of researchers, clinicians and, of course, pharma reps sniffing around for profits.  And all about the horrors of–BACTERIA! Of course, some bacteria cause disease…but most of them not only don’t, but we need them to live. And there are indeed a lot of them!

These good ones, when they are found in the diet or as a supplement, are known as probiotics, such as acidophilus or bifidobacteria. They are found, for example, in yogurt or other fermented foods. Prebiotics, on the other hand, are substances that help to facilitate the growth of those good bacteria, but are otherwise non-digestible. They include fiber (soluble or insoluble) and agents such as beta glucans, inulin and oligosaccharides.

There seemed to be a general feeling of anticipation as our knowledge grows about the microbes we share—and depend upon for our survival. Various populations of microbes live in distinct communities on and in our bodies. Each bacterium has its own set of DNA, just like each of our human cells (except cells like platelets and red blood cells). All of our human cell  DNA contributes about 25,000 genes. By contrast, if you add up all the “bugs” in and on our bodies, that figure runs into the MILLIONS of genes, recent estimates placing the number at about 8 million. And if you removed all the microbes from your body, aside from killing you, that entire amount of bacteria would weigh up to 3 pounds!

That collection of microbes and their genes and gene-products are known as the microbiome.  This is a complex system of various species of bacteria that interact with the host (us) and other bacteria. They tend to form ecologies at various sites so that the crew found in your nostrils may not be the same as that found in the gut, the vagina, or on the skin, for example. And the patterns of bugs that colonize us are different from person to person to some degree—and even change over the course of a lifetime.

These various types of bacteria are categorized by their taxonomy. Taxa refers to the genus, species and strain of the bacteria; for example, you may have heard of Lactobacillus acidophilus, often found in enriched yogurts. “Lactobacillus” is the genus name and “acidophilus” is the species. These also may be divided into further subtypes known as strains, so one strain is L. acidophilus L1, used to feed cattle to reduce the amount of bad bacteria such as E. coli O157:H7.

And these bacteria are necessary for our survival. They perform a huge number of functions, including producing some vitamins, training our immune systems, blocking bad bacteria from growing, and even altering our moods. They communicate within and between species of bacteria, as well as with our body. Some of them may cause trouble, including Helicobacter pylori (ulcers) and Clostridia difficile (colitis). How best to treat a dysbiosis (=microbial imbalance on or inside the body)  is evolving as we increase our understanding of the relationships and ecologies of these bacterial communities.

The alterations in the nature of these communities arise from the time we are born. If one is born by a Caesarean, one tends to get more of the microbes of the mother’s skin as opposed to the vaginal microbial system that the infant collects during a vaginal birth. Whether this has any longer term clinical impact remains unclear, though some evidence suggests that those born by Caesarean may be at higher risk of allergies or asthma. The microbiota tend to establish themselves as a more adult phenotype by the tender age of 2 or 3.  Some researchers are developing models that look at similarities in the patterns of the microbes such that people are divided into 2 or 3 enterotypes.Although this attempt at classification is still evolving, it may help us see how an individual’s response to or problems with host bacteria can be understood and managed.

Indeed, some of the sessions focused on new discoveries of particular bacteria that appear to be associated with protection from certain diseases, or may be implicated in causing disease. One group discussed their findings of a putative association of Akkermansia muciniphilia with the development of diabetes, while others focused on patterns of the microbiome that might underscore a potential for obesity. Many of the sessions were devoted to research in mice, which was moderately interesting from an academic perspective. Others looked at the inter-relationship between probiotics and brain function as well as “gut feelings” (the gut containing what some have dubbed a second brain’s worth of neuronal innervation).

This raised some  issues abouthow to study these agents in the context of a Food and Drug Administration that is at the least bureaucratically hostile to the study of dietary supplements and currently forbids them to be marketed as preventing, curing or mitigating diseases. Discussion was devoted to these challenges, but I think it failed to get to the heart of the matter, namely, that we need—VERY carefully[1]—to address how to create rulemaking with regard to Investigational New Drug requirements that does not require an absurd level of documentation of safety for products ALREADY on the market and in widespread use!

Other studies in humans can avoid the onerous process of acquiring an IND by using a primary endpoint (what the study seeks to establish) that is more in line with either the supplement’s use as a “medical food” (a very narrow definition), or that seeks to improve outcomes to structure or function of the body (the currently allowed dietary supplement claim).

The frightening prospect, to me, was the pharma reps sniffing around, no doubt seeing how they can “capitalize” on and/or patent products to extract huge profits. The notion of “public-private” partnerships in this arena gives me the horrors as it usually means taking away access except for the wealthy. We’re talking about products found in yogurt that have been used for millennia!

Still, the day also had a couple of remarkable and straightforward studies. The most exciting was the work of a group who helped women in various nations in Africa to produce their own probiotics and yogurt. This had the added advantage of creating an economic opportunity for the women, increasing respect from male householders as they brought in income while also improving health outcomes. This was augmented even more by the addition of a powder of the dried leaves of Moringa, a plant that grows like a weed from South America, throughout Africa, South and Southeast Asia, and which has a good array of micronutrient vitamins and minerals. Not in huge amounts, but fairly comprehensive.

A speaker from Scotland, Mr. Burns, also discussed the kind of “grassroots” organizing that they undertook in Scottish hospitals to translate research into the public health sphere. The point of this exhilarating talk was how to get from the bench to the bedside—in short, he was promoting a very comprehensive strategy for creating awareness among physicians and others, working with district leaders and hospital administrators. Their efforts got them, for example, to adhere more closely to checklists for surgeries and pneumonia management. By requiring and getting more attention to these matters, they were able to successfully, and dramatically, drop death rates. Some of these programs have run now for over 10 years, and involve getting physicians and others to prescribe probiotics or prebiotics and  actually use them in preventing C. diff. or better management of bacterial vaginosis,or management of HIV-related diarrhea!

It was a day packed with information and interesting people. I attended with Dr. Henry Sacks of Mount Sinai School of Medicine, with whom I have been working on a grant from the National Institutes of Health to undertake meta-analyses of various questions relating to the use of Complementary and Alternative Medicine (CAM) approaches to managing HIV disease and ARV side effects. We are finishing up work on our first two questions, the use of a multivitamin/mineral among HIV+ people, and the management of peripheral neuropathy with Cannabis sativa. Our next question, which we are now beginning to work on, is the use of probiotics!

For more information, abstracts and so forth, please visit the NYAS website.

______

Footnote:
[1]  Any changes in IND rulemaking should be careful to avoid opening the floodgates to drug companies using such changes to weaken safety or oversight of new drugs, of course. Accelerated approval has been abused by the companies to push more drugs more rapidly onto the market that are NOT medically superior or addressing a desperate need as antiretroviral drugs were in the mid-90s.

Pomegranate juice and heart health

In the past decade, there have been a number of studies of the potential of pomegranate juice to support cardiovascular health and provide additional health benefits as well. Recently we reviewed a research report published in 2012 that looked at the cardiovascular and immune system benefits of pomegranate juice for hemodialysis patients. This was a randomized placebo controlled double-blind trial (a kind of research design that is likely to produce reliably objective findings). The patients were followed for one year as they used pomegranate juicee three times a week while continuing their dialysis treatments. The results:

Pomegranate juice intake resulted in a significantly lower incidence rate of the second hospitalization due to infections. Furthermore, 25% of the patients in the pomegranate juice group had improvement and only 5% progression in the atherosclerotic process, while more than 50% of patients in the placebo group showed progression and none showed any improvement.

And the conclusion:

Prolonged pomegranate juice intake improves nontraditional CV [cardiovascular] risk factors, attenuates the progression of the atherosclerotic process, strengthens the innate immunity, and thus reduces morbidity among HD [hemodialysis] patients.

Of course, this research involved a special group of patients, those on hemodialysis. But, as a well-designed study, it does, we think, provide a fairly strong endorsement of the health benefits of pomegranate juice.

For more on pomegranate juice, see the NYBC entry

http://nybcsecure.org/product_info.php?cPath=40&products_id=333

Note that NYBC also carries the Douglas supplement Cardio-Edge, which includes pomegranate:

http://nybcsecure.org/product_info.php?cPath=35&products_id=284

Reference: Shema-Didi, L et al. One year of pomegranate juice intake decreases oxidative stress, inflammation, and incidence of infections in hemodialysis patients: a randomized placebo-controlled trial. Free Radic Biol Med. 2012 Jul 15;53(2):297-304. doi: 10.1016/j.freeradbiomed.2012.05.013. Epub 2012 May 17.

Green foods for immune support

As we pass through the short days of winter, which also brings the cold and flu season to those of us in the northern hemisphere, our thoughts may turn to fortifying ourselves with a good diet, making it as healthy as possible till that day when the arugula sprouts in the garden or the new crop of berries arrives (ok, getting a little poetical here!)

Anyway, here are NYBC suggestions for green foods and green/red foods combinations, which many use to boost the nutritional content of their diet when that boost is most needed:

Organic DAILY 5 (Jarrow). A mix of greens and reds (fruits). Used as directed, it is a 30-day supply, at $23.40/month. It is a blend of high quality, organic (USDA seal) fruits and vegetables, rich in antioxidants such as proanthocyanidins.

Each single (6 g) scoop provides 3,240 mg of a blend of organic fruits and vegetables, including apple, carrot, raspberry, strawberry, cranberry, blueberry, beet powder acerola powder, broccoli and spinach. In addition, each scoop includes 1,720 mg of organic flax seed powder as well as 110 mg of a blend of organic barley grass, wheat grass and oat bran powders.

Green Vibrance is a more complex mix of probiotics, greens, and immune supportive nutrients. The list of ingredients is long, so please follow the link to see how this green food supplement is structured. A month’s supply is $38.50, and a 60-day Green Vibrance is also available for the savings-conscious. (The large size will save you about 20% off the one-month version, if our calculations are correct.)

PharmaNAC at NYBC

PharmaNAC, an effervescent tablet formulation of NAC (N-acetylcysteine), has been available from the New York Buyers Club for several years. We are pleased to offer this formulation, both because it’s a high quality preparation with careful manufacturing controls and protective packaging, and because ongoing research on NAC has continued to point to its usefulness in many fields, from respiratory and immune system support to serving as an antidote to acetaminophen (common tradename: Tylenol) overdose.

Here are some product details from the manufacturer:

N-acetylcysteine or “NAC” for short, is a derivative of the amino acid L-cysteine, which is an essential precursor used by the body to produce glutathione. Glutathione is an important and powerful antioxidant produced by the body to help protect against free radical damage, and is a critical factor in supporting a healthy immune system.

PharmaNAC:
• Certified European Good Manufacturing Process (GMP) grade NAC.
• Effective way to help boost glutathione levels.
• Effervescent, quick-dissolving tablets allow NAC to enter cells readily, ensuring rapid absorption.
• Quality controlled according to pharmaceutical guidelines.
• Compliant to the standards of European Pharmacopoeia and United States Pharmacopoeia.
• Individually wrapped tablets in a 4-layer (paper/plastic/foil plastic) air-tight material to prevent moisture and air from degrading the NAC (a major problem with most other over the counter NAC).

For information on purchasing, see the NYBC entry at

http://nybcsecure.org/product_info.php?products_id=258

Beta glucans and immune function

We were interested to see an entry by Dr. Mark Hyman a few days ago on the Huffington Post in which he spoke of beta glucans as part of an approach to staying healthy during cold and flu season: “Much research has shown that these compounds [beta-1,3-glucan and beta-1,6-glucans] up-regulate the function of our innate immune system. This part of your immune system is the first line of defense against viruses and bacteria. It helps your white blood cells bind to and kill viruses and bacteria.”

Here’s the description of the product Beta Max, which NYBC stocks from Jarrow. (The capsules are listed as containing 250 mg of at least 75% beta-1,3-glucan and beta-1,6-glucans.)

Beta glucans enhance the power of the immune system by activating a certain type of white blood cell known as macrophages. These cells patrol the body and fend off foreign invaders such as bacteria and fungi by engulfing them.

Research has shown that beta glucans also have a positive action on other white blood cells such as B-Lymphocytes, Natural Killer cells, and Suppressor T cells. The end outcome is that the body becomes better equipped at immune-mediated activities such as fighting off infection and combating cancer. Beta glucans have been used, therefore, in immune-compromised surgical patients to lower the rate of infection and both as a preventive measure against cancer and as an adjunct to chemotherapy.

Beta glucans are also well known to be effective in lowering blood lipid levels and is the key factor for why oat bran is so beneficial in this regard. Like other soluble fiber components, beta glucans work by binding cholesterol, facilitating its elimination from the body. Because beta glucans lower the bad LDL and increase the good HDL blood cholesterol levels, they are useful in preventing coronary heart disease.

Astragalus extract studied to strengthen immune response to HIV

We’re always fascinated when modern laboratory science identifies mechanisms that help to explain how traditional botanicals work. Here’s an example regarding Astragalus, among the traditional botanicals of Chinese medicine. On this blog you can find several reports of earlier research pointing to this herb’s application to immune support. But according to UCLA investigators who have just published their findings in the Journal of Immunology, an extract of Astragalus also performs a very specific function at the cellular level in support of immune function–and thus may hold special promise for enhancing the effectiveness of HIV treatments.

Here’s a description of the new Astragalus research posted on http://www.aidsmeds.com on Nov. 10, 2008:

When cells reproduce, their DNA gets capped at the ends by long repeated strands of genes called telomeres. Telomeres protect the genes, much like the plastic tips on the ends of shoelaces. Unfortunately, telomeres get shorter every time a cell reproduces, which ultimately causes the cells to become “exhausted” and to stop functioning properly. This occurs naturally as a person ages, but more rapidly in the HIV-fighting CD4 and CD8 cells of people with HIV.

One of the lead researchers in telomeres and HIV, Rita Effros, PhD, and her colleague Steven Russell Fauce, PhD, of the department of pathology at UCLA, had experimented with gene therapy as a way to keep telomeres from shortening. But ultimately the researchers turned to what could potentially be a much less expensive method: an extract from the medicinal plant astragalus.

According to Effros and Fauce, the extract, TAT2, keeps an enzyme called telomerase turned on. CD4s and CD8s can naturally produce telomerase, which helps keep telomeres from shortening, but only for so long. After a cell has divided too many times, the telomerase gene turns off.

In test tube experiments, Effros and Fauce exposed CD4 and CD8 cells collected from HIV-positive patients to TAT2. Not only did the substance slow the shortening of the cells’ telomeres, but it also increased the cells’ production of proteins known to inhibit HIV replication.

While studies of TAT2 have not yet been conducted in people, the authors believe the strategy “could be useful in treating HIV disease, as well as immunodeficiency and increased susceptibility to other viral infections associated with chronic diseases or aging.”

Reference: http://www.aidsmeds.com/articles/hiv_astragalus_telomere_1667_15595.shtml

The story is being widely reported this week, so you’ll find other accounts as well. We also note that Astragalus has been one of the botanicals stocked by HIV/AIDS buyers’ clubs for years, based both on its use for immune support in Traditional Chinese Medicine, and on a recent wave of scientific interest. (Of course we’d like to have more information on the relationship between the extract employed in the UCLA study and the components of the botanical as it is traditionally harvested and crafted for medicinal use.)

For more information, see other entries under “Astragalus” on this blog, or the NYBC entry:

Astragalus