Tuesday 12 April 2016

Vitamin A supplements for children could save 600,000 lives a year

Vitamin A supplements for children could save 600,000 lives a year

Children in low and middle income countries should be given vitamin A supplements to prevent death and illness, concludes a study published in the BMJ

The researchers argue that the effectiveness of vitamin A supplementation is now so well-established that further trials would be unethical, and they urge policymakers to provide supplements for all children at risk of deficiency.

Vitamin A is an essential nutrient that must be obtained through diet. Vitamin A deficiency in children increases vulnerability to infections like diarrhoea and measles and may also lead to blindness. Globally, the World Health Organisation estimates that 190 million children under the age of 5 may be vitamin A deficient. But, despite widespread efforts, vitamin A programmes do not reach all children who could benefit.

So a team of researchers based in the UK and Pakistan analysed the results of 43 trials of vitamin A supplementation involving over 200,000 children aged 6 months to 5 years. Differences in study design and quality were taken into account to minimise bias.

They found vitamin A supplements reduced child mortality by 24% in low and middle income countries. It may also reduce mortality and disability by preventing measles, diarrhoea and vision problems, including night blindness.

The authors say that, if the risk of death for 190 million vitamin A deficient children were reduced by 24%, over 600,000 lives would be saved each year and 20 million disability-adjusted life years (a measure of quantity and quality of life) would be gained.

Based on these results, the authors strongly recommend supplementation for children under 5 in areas at risk of vitamin A deficiency. They conclude: "The evidence for vitamin A is compelling and clear. Further trials comparing vitamin A with placebo would be unethical."

This view is supported in an accompanying editorial by two experts at Harvard School of Public Health, who say "effort should now focus on finding ways to sustain this important child survival initiative and fine tune it to maximise the number of lives saved


 E. Mayo-Wilson, A. Imdad, K. Herzer, M. Y. Yakoob, Z. A. Bhutta. Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysisBMJ, 2011; 343 (aug25 1)

Thursday 7 April 2016

Chromium May Cut Carb Craving in Depression

Depression Health Center
Chromium May Cut Carb Craving in Depression

Could Also Cut Risk of Diabetes, Researchers Say
A popular nutritional supplement may reduce serious carb cravings in people with depression.

The supplement is chromium picolinate. The new finding comes from a small clinical trial sponsored by Nutrition 21, which years ago purchased the patent rights to chromium picolinate from the U.S. Department of Agriculture.

John P. Docherty, MD, president of Comprehensive Neuroscience Inc., White Plains, N.Y., and adjunct professor of psychiatry at Cornell University, penned the report. Docherty presented the findings at the National Institute of Mental Health's annual New Clinical Drug Evaluation Unit Conference, held this week in Phoenix.

"It is an exciting finding," Docherty tells WebMD. "The real benefit of this is the high rate of response in this subgroup of depressed patients. If this finding holds up, it is a very important finding for depression. And there was a very, very favorable side effect profile."

Chromium Picolinate's Effects on Metabolism
Chromium picolinate is a nutritional supplement. The "picolinate" part of the compound is thought to enhance the body's ability to absorb chromium. Chromium is a necessary mineral. The typical Western diet barely contains an adequate amount of chromium -- so chromium supplements are quite popular. It's the second most popular mineral supplement in the U.S.

All kinds of claims have been made about chromium picolinate. Few of them are proven. One known effect is the supplement's ability to increase the body's sensitivity to insulin, helping it work better to control blood sugars. It's not clear whether the supplement provides significant help to people with diabetes. A recent analysis of well-designed studies showed that it does not significantly affect blood sugar or insulin levels in people who do not have diabetes.

Depression, Diabetes, and Carb Craving
Docherty notes that there is a connection between diabetes and depression. People with depression, he says, are twice as likely to get diabetes. What's the link?

The most common form of depression, ironically, is called atypical depression. Instead of losing their appetite, people with atypical depression often overeat. Many of these people report an almost irresistible craving for carbs.

Docherty's study enrolled 113 people with atypical depression. Two-thirds took chromium picolinate supplements for eight weeks, and one-third got a placebo.

Depression, Diabetes, and Carb Craving continued...
When the researchers looked at all the patients -- those with and without carb cravings -- they found no overall depression benefit from the chromium supplement compared to placebo. It did, however, cut carb craving.

But chromium did improve depression in certain patients. Researchers found that atypical depression patients who also had carb cravings improved with chromium compared to placebo.

"In that group with high carb craving -- a third of the patients -- we had a very significant benefit from chromium picolinate," Docherty says. "Compared with placebo, it had a 2-to-1 advantage in reducing depression overall."

Maybe, Docherty speculates, this small study has found the missing link between depression and diabetes.

"This could turn out to be a very big benefit if the relationship between depression and diabetes is mediated by carb craving," he says. "It might be that if you eat more carbs, you tax your insulin system more and are at greater risk for diabetes. This treatment chromium picolinate may lower high risk of diabetes in people with depression. That would be terrific."

Chromium Picolinate for Carb Craving?
It is not clear that chromium picolinate -- or anything else -- can help normal people eat fewer carbs, says Leslie Bonci, MPH, RD, director of sports nutrition at the University of Pittsburgh Medical Center. She is also a nutritional consultant for several sports teams and the Pittsburgh Ballet Theatre.

"What is carb craving? It would be really difficult to define that," Bonci tells WebMD. "Yes, there are some people who are going to gear more toward the pasta and potatoes than steak and tofu, but that doesn't have a clinical definition. ... It would be a stretch to say that across the board, carb cravers should go with chromium. Bodies aren't that smart. Psychological and environmental factors do a lot more to determine the cravings we have."

On the other hand, Bonci says, the findings regarding insulin sensitivity and chromium picolinate are "exciting." Moreover, she explains, many people do get too little chromium in their diets.

Huge exposures to chromium can be dangerous. But Bonci notes that people who take chromium supplements don't get harmful side effects.
By Daniel J. DeNoon

SOURCES: Docherty, J.P. Poster presentation, 44th Annual Meeting of the New Clinical Drug Evaluation Unit, Phoenix, June 1-4, 2004. John P. Docherty, MD, president, Comprehensive Neuroscience Inc., White Plains, N.Y.; and adjunct professor of psychiatry, Cornell University. Leslie Bonci, MPH, RD, director, sports nutrition, University of Pittsburgh Medical Center.