HEALTH

Higher BMI equates to greater nutrient shortfalls

BY Michael Johnsen

 

NORTHRIDGE, Calif. — A study published this month in the Journal of the American College of Nutrition concluded that body weight status is associated with inadequate intake of micronutrients, specifically that the higher an individual's body mass index or BMI, the greater the nutrient shortfalls. 
 
"Insufficiency of micronutrient intake is a global nutrition issue," said Victor Fulgoni, SVP Nutrition Impact and corresponding study author. "The NHANES data shows that a high percent of the population have problems meeting recommended nutrient intake for vitamins A, C, D and E, magnesium and calcium." Nutrient shortfalls are nutrient intakes that do not meet estimated average requirements (EAR), which is established by the Institute of Medicine.
 
While the majority of Americans are lacking adequate nutrient intake, the study revealed that overweight and obese adults are at a higher risk for nutrient inadequacy. Compared to normal weight adults, obese adults had about 5% to 12% lower intakes of micronutrients and higher prevalence of nutrient inadequacy. For example, 48% of normal weight individuals don't meet the EAR for calcium, while 50% of overweight and 51% of obese individuals fall short of calcium requirements. Also, 45% of normal weight individuals don't meet the EAR for vitamin A, while 50% of overweight and 52% of obese individuals fall short of vitamin A requirements. What's more, according to the Centers for Disease Control and Prevention, more than 67% of Americans are overweight or obese.
 
"To our knowledge this is the first time intakes of micronutrients were assessed by body weight status using a large database, inclusive of more than 18,000 Americans, providing a nationally representative population-based sample of adults," commented James Brooks, VP science, technology and quality for Pharmavite and study author. "The study showed that dietary supplement users had higher overall intakes and a lower prevalence of inadequacy of micronutrients compared to non-supplement users," he said. "This suggests the possibility that dietary supplements may help with filling the gap in nutrient inadequacies."
 
The Pharmavite supported study compared usual intake for essential nutrients by body weight status in adult Americans using data from the National Health and Nutrition Examination Survey (NHANES), 2001-2008.
 
 
 
 
 

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CRN and Informa Exhibitions to host four webinars in 2015

BY Michael Johnsen

WASHINGTON — The Council for Responsible Nutrition and Informa Exhibitions (formerly Virgo) on Tuesday announced the continuation of their industry wide webinar series through 2015, with four webinars addressing key issues facing the industry. 
           
“Through our ongoing partnership with Informa, we’ve been pleased to offer educational webinars to the dietary supplement and functional food industry that have generated enormous interest from companies that are both members and non-members,” said Steve Mister, president and CEO, CRN. “These webinars not only give our participants exposure to our own association staff, but are popular because they also offer expert advice from outside attorneys and regulatory consultants, and include insights from government officials at FDA and FTC — all who share an interest in ensuring our industry complies with the myriad laws and rules we live under."   
 
One of the webinar topics this year will focus on FDA’s expected issuance of the revised New Dietary Ingredient draft guidance. No issuance date has been announced by FDA, but the agency continues to say it is a high priority. Once the revised draft guidance is issued, CRN will carefully select those experts best suited to address the aspects of the guidance industry stakeholders will need clarity on, and announce a date. The topics for other webinars are still under consideration. 
 
For a list of past webinars with Informa that are now available on demand, as well as updates on webinars to come, visit: www.crnusa.org/webinars-informa
 
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How quickly smokers’ bodies break down nicotine may identify optimal smoking cessation product

BY Michael Johnsen

TORONTO — In a first-of-its-kind randomized clinical trial, researchers from the Centre for Addiction and Mental Health and collaborators have shown the benefits of a personalized approach to smoking treatment, based on how quickly smokers break down nicotine in their bodies.
 
Nearly 70% of smokers who try to quit smoking relapse within one week. Researchers have long theorized that some individuals may be genetically programmed to have an easier time quitting than others, but have been unable to provide guidance on the most successful approach — nicotine patch versus prescription pills, for instance.
 
"In this new trial, we've shown that it is possible to optimize quit rates for smokers, while minimizing side effects, by selecting treatment based on whether people break down nicotine slowly or normally," stated study colead Rachel Tyndale, senior scientist in CAMH's Campbell Family Mental Health Research Institute and a professor of Pharmacology & Toxicology and Psychiatry at the University of Toronto.
 
The multisite study was published online in The Lancet Respiratory Medicine. Tony George, CAMH Chief of Schizophrenia, led the clinical study at the CAMH site.
 
"Normal" metabolizers of nicotine were significantly more likely to remain abstinent from smoking after treatment with the drug varenicline (Chantix, manufactured by Pfizer) compared to the nicotine patch, at the end of treatment and six months later. "Slow" metabolizers, on the other hand, could benefit the most from the nicotine patch, the authors suggest. Varenicline was just as effective as the nicotine patch for "slow" metabolizers, but it led to more side effects than the patch.
 
"This is a much-needed, genetically-informed biomarker that could be translated into clinical practice," commented colead Caryn Lerman, a professor of Psychiatry and director of the Center for Interdisciplinary Research on Nicotine Addiction at the University of Pennsylvania. "Matching a treatment choice based on the rate at which smokers metabolize nicotine could be a viable strategy to help guide choices for smokers and ultimately improve quit rates."
 
The difference between slow and normal metabolizers is how long nicotine stays in the body after quitting. Nicotine levels drop more quickly in normal metabolizers, putting them at risk to succumb to cravings and relapse. But they are also more likely to be helped by medications such as varenicline, which can increase levels of the "feel-good" hormone dopamine and reduce cravings.
 
 
In the clinical trial, 1,246 smokers seeking treatment were categorized as either slow metabolizers (662) or normal metabolizers (584). They were randomized to receive one of the following for 11 weeks: the nicotine patch plus a placebo pill; varenicline plus placebo patch; or both placebo pill and patch. All received behavioral counselling. The trial was conducted at four academic medical centers: the Perelman School of Medicine at the University of Pennsylvania, CAMH and the University of Toronto, the State University of New York at Buffalo, and MD Anderson Cancer Center.
 
Participants' status as either a normal or slow metabolizer was based on a measure called the nicotine metabolite ratio. NMR is the ratio of two chemical products of nicotine, which break down at different rates based on different genetic versions of CYP2A6, a liver enzyme. Participants' smoking behavior was assessed at the end of treatment, and six and 12 months later.
 
Among normal metabolizers, nearly 40% taking varenicline were still abstaining from smoking at the end of treatment, compared to 22% on the nicotine patch. The quit rates, as expected, based on the difficulty of prolonged quitting success, decreased at six and 12 months, but the overall pattern of response for both normal and slow metabolizers on the patch and varenicline remained.
 
"Our data suggest that treating normal metabolizers with varenicline, and slow metabolizers with the nicotine patch, could provide a practical clinical approach. What's more, extending the duration of these treatments beyond 11 weeks could potentially sustain the benefit of tailored treatment," according to the authors.
 
"These findings support the use of the nicotine metabolite ratio as a genetically informed biomarker to guide treatment choices," Tyndale said. "And also underscore the notion that tobacco dependence is a heterogeneous condition, and that smoking cessation treatments are not equally effective for all smokers."
 

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