This study was designed to test the effects of n-3 polyunsaturated fatty acids (PUFAs) on left ventricular (LV) systolic function in chronic heart failure (HF) due to non-ischemic dilated cardiomyopathy (NICM). A total of 133 patients with NICM and minimal symptoms on standard therapy were randomized to receive n-3 PUFAs or placebo. For the first month, patients took 5 caps/d (~4250 mg combined EPA+DHA), after which they took 2 caps per day (1700 mg) for 11 months. Both groups were treated with an ACE inhibitor/angiotensin-receptor blocker, a beta blocker, and furosemide. LV function and functional capacity were assessed by echocardiography and cardiopulmonary exercise testing at baseline and at 12 months. After 12 months, the n-3 PUFAs group and the placebo group differed significantly (p <0.001) in regard to: 1) LV ejection fraction (increased by 10.4% and decreased by 5.0% respectively); 2) peak VO(2) (increased by 6.2% and decreased by 4.5% respectively); 3) exercise duration (increased by 7.5% and decreased by 4.8% respectively); and 4) mean New York Heart Association functional class (decreased from 1.88 ± 0.33 to 1.61 ± 0.49 and increased from 1.83 ± 0.38 to 2.14 ± 0.65 respectively). The hospitalization rates for heart failure were 6% in the n-3 PUFAs and 30% in the placebo group (p = 0.0002). (J Am Coll Cardiol. 2010 Dec 29.) PMID: 21215550.

Prevalence of coeliac disease was assessed among 100 autoimmune liver disease patients in Iran and compared it with the prevalence in healthy individuals. The study also sought to determine if rates of celiac disease among autoimmune liver patients had been evaluated in Western populations. Among Iranian participants in the study, elevated prevalence of coeliac disease (10-15%) was observed compared to the general population (0.1-1%). To a lesser extent, the prevalence was high in patients with autoimmune hepatitis (2-4%). In our systematic review, prevalence of coeliac disease in autoimmune hepatitis in the majority of studies was 4% or more; several studies also reported such prevalence in primary biliary cirrhosis. CONCLUSIONS: Since coeliac disease is common among patients with autoimmune liver disease, screening autoimmune liver disease patients for coeliac disease is indicated. Although the magnitude of benefit from a gluten-free diet in reversing autoimmune liver disease in patients with coeliac disease is controversial, it may reduce the risk of further complications of coeliac disease. (Dig Liver Dis. 2010 Sep;42(9):620-3.) PMID: 20236872

During stage 1, 72 Danish children aged 4 to 11 years were assigned to GFCF diet (A) or no-diet (B) groups. Participants were assessed at baseline, 8, and 12 months using the Autism Diagnostic Observation Schedule (ADOS) and the Gilliam Autism Rating Scale (GARS) to assess core autism behaviours; Vineland Adaptive Behaviour Scales (VABS) to ascertain developmental level; and Attention-Deficit Hyperactivity Disorder – IV scale (ADHD-IV) to determine inattention and hyperactivity. Based on per protocol analysis, data for 26 diet children and 29 controls were available at 12 months. At this point, there was a significant improvement in the GFCF diet group on sub-domains of ADOS, GARS and ADHD-IV measures. At this point, given the improvement seen in the treatment group (A), the control group (B) was also offered treatment. Data from18 group A and 17 group B participants were available at 24 months. Analysis based on inter- and intra-group comparisons showed evidence of sustained clinical group improvements with a possible plateau effect for diet. Further studies are required to ascertain potential best- and non-responders to intervention. (Nutr Neurosci. 2010 Apr;13(2):87-100.) PMID: 20406576

This study examined whether inositol in combination with melatonin improves oocyte quality, fertilization rate, and pregnancy rate compared to inositol alone in women undergoing in vitro fertilizaiton (IVF). Starting on the day of GnRH administration, 65 women undergoing IVF were randomized into two groups to receive either myo-inositol + folic acid + melatonin, or myo-inositol plus folic acid alone, administered continuously. The mean number of oocytes retrieved did not differ between the two groups (P=0.65). The group cotreated with melatonin had a significantly greater mean number of mature oocytes (P=0.047) and a lower mean number of immature oocytes (P=0.001). The mean number of high quality embyos was higher in the melatonin group (=0.01). Fertilization rates did not differ between the two groups, but the clinical pregnancy rate and implantation rate tended to be higher in the group cotreated with melatonin. There were a total of 22 pregnancies: 13 in the melatonin group and 9 in the control group; P=0.26). Biochemical pregnancy rate and miscarriage rate were similar in both groups. Melatonin augments the activity of myo-inositol and folic acid by improving oocyte quality and pregnancy outcome in women with a history of low oocyte quality. (Eur Rev Med Pharmacol Sci. 2010 Jun;14(6):555-61.) PMID: 20712264.

Steatohepatitis is characterized by abnormal liver lipid metabolism and altered mitochondrial function. Carnitine is an essential cofactor for mitochondrial beta oxidation of fatty acids. This study examined the effect of carnitine supplementation on liver function and peripheral blood mitochondria copy number in patients with non alcoholic fatty liver disease (NAFLD). Forty-five NAFLD patients were assigned to a carnitine group or a control group. Liver function tests and analysis of peripheral blood mitochondrial DNA were performed before and following three months of treatment. Carnitine treatment was associated with reduction of ALT, AST, and total bilirubin. In comparison, there was no change in AST, ALT, and total bilirubin associated with treatment in the control group. Peripheral mitochondrial DNA copy number was significantly increased from 158.8+/- 69.5 copies to 241.6+/-180.6 copies (p=0.025) in the carnitine group, but not in the control group. Carnitine improved liver function and mitochondrial numbers in NAFLD. (Korean J Gastroenterol. 2010 Jun;55(6):384-9.) PMID: 20571306.

The effect of vitamin B6 on inflammation was investigated in randomized controlled trial of patients with rheumatoid arthritis (RA). A total of 35 patients were randomly allocated to receive either 5 mg folic acid only, or 100 mg vitamin B6 plus 5 mg folic acid daily for 12 weeks. The following parameters were measured at baseline and after 12 weeks: Plasma pyridoxal 5’-phosphate (PLP), serum folate, inflammatory parameters (hs-CRP, ESR, IL-6, TNF-alpha), and immune parameters (WBC count, total lymphocytes, T-cells (CD3), B-cells (CD19), T-helper cells (CD4), and T-suppressor cells(CD8)). In the vitamin B6 group, plasma IL-6 and TNF-alpha levels significantly decreased at week 12. There were no significant changes with respect to immune responses in either group, except for the percentage of total lymphocytes in the vitamin B(6) group compared to baseline. Plasma IL-6 levels were significantly inversely related to plasma PLP after adjusting for confounders (P=0.01). High dose vitamin B6 suppresses pro-inflammatory cytokines IL-6 and TNF-alpha in patients with RA. (Eur J Clin Nutr. 2010 Sep;64(9):1007-13.) PMID: 20571496.

The VITATOPS-DEP study was a randomized, double-blind, placebo-controlled trial of daily folic acid (2 mg), vitamin B6 (25 mg), and vitamin B12 (0.5 mg) for 1 to 10.5 years in stroke survivors. The primary endpoint was the onset of major depression, as defined by the DSM-IV, after randomization. Secondary outcomes were the prevalence of DSM-IV major or minor depression at the end of treatment. Among 273 people who completed the final assessment after 7.1 ± 2.1 years (mean ± standard deviation) of follow up, B-vitamins were associated with a significantly lower risk of major depression compared with placebo (18.4% vs 23.3%, adjusted hazard ratio 0.48, 95% CI 0.31-0.76). There was also a trend toward a lower risk of major or minor depression at the end of the trial compared with placebo (19.1% vs 27.7%; adjusted odds ratio 0.58; 95%CI 0.31-1.09). Long-term treatment of poststroke survivors with B-vitamin supplementation may be an effective, safe, and affordable intervention to reduce the burden of poststroke depression. (Ann Neurol. 2010 Oct;68(4):503-10.) PMID: 20976769.

Gabadone is a proprietary combination of 5-hydroxytryptophan (5-HTP), GABA and choline forumalated in low doses for effects on sleep. Secondary ingredients are: grape seed extract, hydrolyzed whey protein, valerian extract, ginkgo biloba, glutamic acid, and cocoa. This study sought to investigate the combination’s effect on sleep parameters. Eighteen patients with sleep disorders received 2 capsules of Gabadone or placebo at bedtime for 1 week. In the active group, the baseline time to fall asleep was 32.3 minutes, which was reduced to 19.1 after Gabadone (P = 0.01 compared to baseline, and p=0.02 compared to placebo which showed no significant improvement). In the active group, the baseline duration of sleep was 5.0 hours, and this increased to 6.83 hours after Gabadone (P = 0.01), while there was no significant change in the placebo group (p=0.01 between groups). Objective measurement of parasympathetic function as measured by 24-hour heart rate variability also improved in the active group compared with placebo. An amino acid preparation containing both GABA and 5-hydroxytryptophan reduced time to fall asleep, decreased sleep latency, increased the duration of sleep, and improved quality of sleep. (Am J Ther. 2010 Mar-Apr;17(2):133-9.) PMID: 19417589

Elevated prostate-specific antigen (PSA) reflects the presence of inflammation in the prostate, predisposing to prostate cancer. Normalization of the PSA value may prevent the development of prostate cancer. This randomized controlled trial investigated whether a combination of isoflavones and curcumin is able to lower PSA. 85 men who had received prostate biopsies but were free of prostate cancer were assigned to receive a supplement containing soy isoflavones (40mg) and curcumin (100mg) or placebo for 6 months. In the overall population there was no significant effects between the isoflavone/ curcumin combination and placebo. However, among the group of patients who had PSA >or= 10 mcg/ml at baseline and were treated with the isoflavone/ curcumin combination, PSA levels decreased significantly from 18.8 to 10.2 mcg/ml (P = 0.01). In vitro results also showed that this combination synergistically downregulated androgen receptor expression and PSA production in prostate cancer cells. Soy isoflavones and curcumin are capable of decreasing elevated PSA in humans and synergistically exert anticancer effects in prostate cancer cells. (Prostate. 2010 Jul 1;70(10):1127-33.) PMID: 20503397

Korean ginseng has traditionally been used to improve male sexual function and fertility. Animal studies have also shown that Korean red ginseng (KRG) has a relaxing effect on the clitoral cavernosal muscle and vaginal smooth muscle, but this has not been examined in women. This study assessed whether KRG extract would improve sexual function in menopausal women. In a placebo-controlled, double-blind, crossover clinical study, 32 menopausal women received 3g ginseng per day or placebo for 8 weeks. After a 2-week wash out period, participants were crossed over to the other arm. Outcome measures were the Female Sexual Function Index (FSFI) and Global Assessment Questionnaire (GAQ). Korean Red Ginseng significantly improved scores for sexual arousal (P = 0.006) on FSFI, and global symptoms on GAQ (P = 0.046) compared to placebo. There were no severe adverse events, but there were two cases of vaginal bleeding that occurred during KRG treatment. Korean ginseng might be used to improve sexual function in menopausal women. (J Sex Med. 2010 Apr;7(4 Pt 1):1469-77.) PMID: 20141583