Dietary supplement linked to increased muscle mass in the elderly

A supplemental beverage used to treat muscle-wasting may help boost muscle mass among the elderly, according to a new study. The results were presented today at The Endocrine Society's 95th Annual Meeting in San Francisco.

23 jun 2013--The supplemental beverage, called Juven, contains three amino acids, including arginine. Amino acids are the building blocks of proteins, and are required for cell growth and repair. The amino acid arginine is especially important because it increases growth-hormone production, which causes the body to produce a critical protein called insulin-like growth factor 1, or IGF-1. This protein promotes growth and development and, as its name suggests, is similar in structure to the hormone insulin.

Previously, studies showed that Juven helped increase muscle mass in patients with AIDS or cancer. These earlier findings led this study's investigators to hypothesize that the increased muscle mass could result from greater blood concentrations of IGF-1. They theorized that these increased protein levels could have the same benefits among the elderly, who also experience decreased muscle mass and strength related to drops in hormone production that occur with aging. In turn, increased muscle strength could potentially improve quality of life among the elderly.

They found that participants who received Juven had significant increases in lean body mass, while those who received placebo did not have any change. In addition, blood concentrations of IGF-1 increased among Juven recipients, but not among the placebo group. The correlation between the improved IGF-1 concentrations and increased lean tissue, however, was not statistically significant.

"The amino acid cocktail of the dietary supplement Juven appears to hold promise for increasing lean body in healthy older adults," said study lead author Amy C. Ellis, PhD, assistant professor at the University of Alabama at Tuscaloosa. "However, more research is needed to determine the cause-and-effect relationship and the mechanisms by which the amino acids in Juven may favorably affect body composition of healthy, older adults."

Study participants were 29 healthy adults between the ages of 65 and 87 years. Each received either Juven® or a placebo drink twice a day, along with their regular daily diet, for six months. At the beginning of the study and again six months later, investigators used a special test to measure lean body mass. At both times, they also assessed participants' blood levels of IGF-1 after fasting.

The National Institutes of Health and the Center for Aging at the University of Alabama-Birmingham funded the study. Abbott Laboratories, the manufacturer of Juven®, provided the dietary supplement and the placebo.

Provided by The Endocrine Society

Certain dietary supplements associated with increased risk of death in older women

Consuming dietary supplements, including multivitamins, folic acid, iron and copper, among others, appears to be associated with an increased risk of death in older women, according to a report in the October 10 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. The article is part of the journal's Less Is More series.

11 oct 2011--The use of dietary supplements in the United States has increased considerably over the last decade, according to background information in the article. "At the population level, dietary supplements contributed substantially to the total intake of several nutrients, particularly in elderly individuals," the authors write.

Jaakko Mursu, Ph.D., of the University of Eastern Finland, Kuopio, Finland, and the University of Minnesota, Minneapolis, and colleagues used data collected during the Iowa Women's Health Study to examine the association between vitamin and mineral supplements and mortality (death) rate among 38,772 older women (average age 61.6 years). Supplement use was self-reported in 1986, 1997 and 2004 via questionnaires.

Among the 38,772 women who started follow-up with the first survey in 1986, 15,594 deaths (40.2 percent) occurred over an average follow-up time of 19 years. Self-reported supplement use increased substantially between 1986 and 2004, with 62.7 percent of women reporting use of at least one supplement daily in 1986, 75.1 percent in 1997 and 85.1 percent in 2004.

The authors found that use of most supplements was not associated with reduced total mortality in older women, and many supplements appeared associated with increased mortality risk. After adjustment, use of multivitamins, vitamin B6, folic acid, iron, magnesium, zinc and copper, were all associated with increased risk of death in the study population. Conversely, calcium supplements appear to reduce risk of mortality. The association between supplement intake and mortality risk was strongest with iron, and the authors found a dose-response relationship as increased risk of mortality was seen at progressively lower doses as women aged throughout the study.

Findings for both iron and calcium supplements were replicated in separate, short-term analyses with follow-up occurring at four years, six years and 10 years.

"Based on existing evidence, we see little justification for the general and widespread use of dietary supplements," the authors conclude. "We recommend that they be used with strong medically based cause, such as symptomatic nutrient deficiency disease."

In an invited commentary, Goran Bjelakovic, M.D., D.M.Sc., of the University of Nis, Nis, Serbia, and Christian Gluud, M.D., D.M.Sc., of Copenhagen University Hospital, Copenhagen, Denmark, discuss the findings of Mursu and colleagues saying they "add to the growing evidence demonstrating that certain antioxidant supplements, such as vitamin E, vitamin A, and beta-carotene, can be harmful."

"Dietary supplementation has shifted from preventing deficiency to trying to promote wellness and prevent disease," the authors write. "Until recently, the available data regarding the adverse effects of dietary supplements has been limited and grossly underreported. We think the paradigm 'the more the better' is wrong. One should consider the likely U-shaped relationship between micronutrient status and health."

"We cannot recommend the use of vitamin and mineral supplements as a preventive measure, at least not in a well-nourished population," the authors conclude. "Older women (and perhaps men) may benefit from intake of vitamin D3 supplements, especially if they have insufficient vitamin D supply from the sun and from their diet. The issue of whether to use calcium supplements may require further study."

More information: Arch Intern Med. 2011;171[18]:1625-1633

Provided by JAMA and Archives Journals

Potential for Harm in Dietary Supplements

By JANE E. BRODY
8 april - A form of substance abuse rampant in this country is rarely discussed publicly or privately. It involves abusing legally sold dietary supplements — vitamins, minerals, herbals and homeopathic remedies — all of which can be sold over the counter without prior approval for safety and effectiveness.
Although there was much publicity about the hazards of ephedra, once widely used as a weight-loss aid until it was found to be deadly, many other heralded dietary supplements have the potential for harm, especially when taken in large doses or in various combinations with one another or with medically prescribed prescription drugs.
Still other problems can arise when these poorly regulated supplements are taken by people with known or hidden health problems or when patients fail to report their use to health professionals who treat them.
For example, Dr. Richard A. Nathan, a dental surgeon in San Francisco, wrote in January about a patient who needed a tooth extracted and minor periodontal surgery. She told Dr. Nathan that she was taking two drugs, for cholesterol and blood pressure, neither of which he said would present a problem to safe surgery and normal healing.
Thus, Dr. Nathan was perplexed when the patient returned five days later unhealed, with an unattached flap of tissue, severe bleeding and an infection.
“Based on my 30 years of experience, it looked as though the patient was an out-of-control diabetic or had a severely compromised immune system,” he told me. “Neither was the case. However, when I asked the patient again what medications she was taking, she admitted that she was on multiple — 18 to be exact — over-the-counter supplements, for a total of 43 pills and capsules a day.”
Six of these — green tea, grapeseed, ginkgo biloba turmeric, salmon oil and vitamin E, he said, “are known to increase bleeding due to inhibition of platelet aggregation,” the first step in forming a clot. Within a week after discontinuing all supplements, her mouth began to heal normally.
Problems Not Reliably Reported
While this case may represent an extreme, the problem is by no means an isolated one. No one knows how many such adverse effects befall supplement users, because there has been no reliable reporting system.
A new federal law requires supplement manufacturers to report serious adverse effects to the Food and Drug Administration, but it depends on consumers to call in reactions. Experts say most consumers are unlikely to relate health problems to a supplement they assume to be safe, and even if they do, they may be reluctant to report an adverse effect from a self-medicated substance.
Not so for Michael Alexander of San Francisco. In September, he wrote to Kaiser Permanente that a vitamin supplement he had regularly bought from the Kaiser pharmacy caused years of leg cramps, eventually diagnosed by a neurologist as vitamin B6-induced neuropathy. The supplement had 100 milligrams of B6, or 50 times the recommended daily amount. The ill effect developed even though Mr. Alexander cut each tablet in four parts and took “only” 25 milligrams daily.
According to a 2002 Harris poll, 70 percent of adults in the United States take vitamins, minerals, herbs or other supplements. Their use of supplements has been increasing, fed by the belief that they can make people feel better, give them greater energy, improve health and prevent and treat disease. Although some supplements are beneficial, others may or may not be. Others may be downright dangerous. Even so-called safe supplements can be hazardous in too large amounts or the wrong combinations.
Vitamins A, B6, B12, C, E and K; niacin; folic acid; calcium; magnesium; iron; and zinc can be hazardous when combined with various prescription drugs and over-the-counter remedies. Yet patients often fail to mention using such supplements to physicians.
“Consumers don’t realize that there’s a big difference between dietary supplements, homeopathic remedies and over-the-counter medications,” David Schardt, senior nutritionist for the Center for Science in the Public Interest, a watchdog group in Washington, said in an interview. “They’re all sold side by side in stores. Yet there’s a vast difference in the evidence for safety and effectiveness that manufacturers must have to sell them.”
Over-the-counter medications like ibuprofen, inhalers and reflux inhibitors have to be shown as safe and effective before the F.D.A. will let them be marketed. But thanks to the 1994 Dietary Supplement Health and Education Act, neither dietary supplements nor homeopathic remedies are required to provide premarket evidence of safety and effectiveness. To remove such a product from the market, the F.D.A. has to prove that it is dangerous, a challenging task for the understaffed, budget-strapped agency.
Homeopathic Medical Claims
Homeopathic remedies slip under an even lower wire. While dietary supplements can make only structure and function claims, products labeled homeopathic — a designation decided by the industry, not the F.D.A. — can assert medical effects, Mr. Schardt explained. Thus, the homeopathic zinc supplement Cold-EEZE, claims to fight colds, but Cold-fX, sold as a zinc dietary supplement, cannot make such a claim.
Consumers are often swayed by reports of health benefits attributed to various supplements, and assume that they are risk free and can be safely taken in any amount. Although a small dose may be good, more is not necessarily better. In fact, it may be harmful. Megadoses of vitamins or minerals are no longer acting as nutrients but as drugs or, in some cases, as toxic agents.
For example, observational studies of people who eat foods rich in antioxidants like vitamins A and E and beta-carotene have suggested these substances improve health. But well-designed clinical trials found increased death rates among people who take them as supplements. And while low vitamin C doses can suppress harmful free radicals, very high doses promote their formation. The initial promise that vitamin E could protect against heart attacks and cancer failed to stand up to scientific scrutiny, which instead found that it increased the risk of heart failure.
Led by testimonials and articles in health food publications and on the Internet, consumers also tend to confuse structure and function claims with medical benefits. They are not the same. Just because beta-carotene in carrots aids normal vision does not mean it can correct nearsightedness. Or a substance for forming blood cells will not necessarily be useful to prevent or treat a disease of blood-forming tissue like leukemia.
A National Institutes of Health panel in May 2006 noted: “The F.D.A. has insufficient resources and legislative authority to require specific safety data from dietary supplement manufacturers or distributors before or after their products are made available to the public. The constraints imposed on F.D.A. make it difficult for the health of the American public to be adequately protected.”

FDA Warns on Sexual Enhancement Dietary Supplements

The FDA is warning consumers against True Man and Energy Max capsules. The products, marketed as "all-natural" dietary supplements for erectile dysfunction and sexual enhancement, contain illegal prescription-drug analogs.
An FDA analysis found that Energy Max pills contained an analog of sildenafil (Viagra); True Man pills contained either an analog of vardenafil (Levitra) or an analog of sildenafil.
A survey released by the agency last year showed that seven different "natural" supplements contained similar illegal substances. The FDA warns that these undeclared ingredients may interact with nitrates found in certain prescription drugs and can cause dangerously low blood pressure.