Welcome to the May 2024 issue of Research Extracts. “The Extracts” is designed to keep busy practitioners and savvy consumers up to date on the latest research on diet, nutrients, botanicals, the microbiome, the environment, and lifestyle approaches to good health and wellness. Our medical team, including NDs, MDs, PhDs, RDs, an MS clinical nutrition, an MS biology, and an LAc, summarizes the essence of several interesting recent studies.

In this issue: (1) Mental Health Moment: Treatment for mental health issues and CVD risk, (2) intermittent fasting to support metabolic health, (3) whey protein for muscle mass support, and (4) a multi-vitamin/mineral for cognitive aging.

Mental Health Moment: Effect of Anxiety and Depression Treatment on CVD

Heart disease is the leading cause of death in the United States and causes health-care costs to rise substantially. Prior research shows that depression and anxiety are common in individuals with both heart failure (HF) and coronary artery disease (CAD). Living with depression and anxiety can adversely impact physical health outcomes and overall quality of life.

This study reviewed the effects of depression and anxiety treatment on outcomes of HF or CAD. The participants were adults ages 21-64 who were enrolled in Ohio’s Medicaid program during the 3-year study period; 92.2 percent of participants were diagnosed with anxiety and 55.5 percent were diagnosed with depression.

The clinical measures of concern were hospital readmission rates, emergency room visits for CAD and/or HF, all-cause mortality, and heart disease mortality. Mental health treatment types included psychotherapy, pharmacotherapy, or a combination of the two.

In looking at hospital re-admission rates during the three years, there was a 75-percent reduced risk of re-admission in participants receiving both psychotherapy and medication treatments, a 49-percent reduced risk for just psychotherapy, and a 58-percent reduced risk with medication alone. Participants receiving both psychotherapy and medication treatments had a 74-percent reduced risk of an emergency room visit, while there was a 49-percent reduced risk with psychotherapy only and a 53-percent reduced risk with medication alone.

These results illustrate the positive impacts that mental health treatment can have on cardiovascular health. With rates of CVD increasing, coordination of care that focuses on whole person health and wellness is essential in addressing the importance of the mind-body connection.

Note: Explore another Take 5 Daily article that examines the mind-body connection in heart disease: Chronic Stress Can Harm the Heart – Can Meditation Help?

Contributed by Carly Duffy, MPH, RD

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Intermittent Fasting and Metabolic Status in Healthy Adults

Intermittent fasting (IF) is a broad term for various types of fasting methods in which eating and fasting are time-restricted, although neither is eliminated for extended time periods. Some common IF methods include 16/8 (fasting for 16 hours and then consuming all daily calories in the remaining eight hours), 20/4 (20 hours of fasting alternating with four hours of eating), and alternate day fasting (fasting for 24 hours every other day). Because much of the research regarding IF has been conducted in populations with metabolic conditions, less is known about the effects of IF in a healthy adult population.

In a parallel study, healthy adults ages 18-65 were randomized to one of three IF regimens – 16/8 fasting, 20/4 fasting, or alternate-day fasting, each for four weeks. Body composition measured by bioelectrical impedance, body mass index (BMI), body weight, waist-to-hip ratio, and blood metabolic markers were measured at three times points – baseline, four weeks later but prior to initiating the IF interventions, and at the conclusion of the four weeks of IF.

There were no significant differences between the three fasting interventions across body composition measurements or blood metabolic markers. However, several statistically significant differences from baseline to completion were identified within the individual fasting groups. Participants in the 16/8 and 20/4 fasting groups experienced a significant decrease in waist-to-hip ratio, while individuals in the alternate-day fasting group experienced a significant decrease in BMI, body weight, fat-free mass, and skeletal muscle mass during the fasting portion of the trial. 

Note: Explore more of the science behind intermittent fasting in the following Take 5 Daily articles: Is Intermittent Fasting Right for You? and Intermittent Fasting: Five Tips for Success.

Contributed by Jennifer L. Greer, ND, MEd

Reference

Whey Protein and Resistance Training Synergistically Improves Muscle Mass and Strength in the Elderly

Significant loss of skeletal muscle and strength is a cause of concern in aging populations, most often due to increased risk of physical disability and other comorbidities.

A systematic review and network meta-analysis examined 78 randomized clinical trials to compare the effect of different protein supplements on increasing muscle mass, strength, and mobility in older individuals (mean age, 70.2) undergoing resistance training. Participants included men and women with an average BMI of 25.8, all of whom were considered sedentary, frail, or identified as having significant previous loss of muscle mass and strength.

A total of 11 different treatment options were analyzed, including six different protein sources (whey, milk, casein, beef, soy, or peanut) combined with resistance training (RT), or standalone treatments of RT, whey protein, milk protein, soy protein, or beef – all compared to placebo or “regular care” (RC) − which did not include protein or RT.

A daily average of 30 grams of protein was provided in 53 of the studies; whereas, 25 studies administered an average of 26 grams immediately following RT on training days only.

The studies assessed muscle mass using variations of whole-body lean mass, fat-free mass, appendicular lean mass, muscle thickness, muscle cross-sectional area, and circumference of arms and/or legs. Strength was assessed using handgrip and/or measures of leg strength (maximum voluntary contraction of quadriceps, hamstrings, and/or hip abductors). And mobility was assessed using measures of walking speed, chair rising ability, timed up-and-go task (TUG), and/or Short Physical Performance Battery (SPPB) score.

Across all outcomes, combinations of protein and resistance training yielded significantly greater results than any individual therapy alone. However, whey protein plus RT was considered the most effective treatment overall for increasing muscle mass, leg strength, and physical mobility (chair rise performance and SPPB score).* Although whey protein plus RT was considered the most effective overall, favorable improvements in chair rise performance were also found with milk and soy protein plus RT. No significant changes were observed in handgrip strength or TUG task with any intervention.

Results indicate that whey protein was particularly effective for improving muscle mass in the 57 short-term studies (≤12 weeks),* with a synergistic effect when paired with resistance training, highlighting it as a superior protein choice to increase muscle mass more rapidly in the aging population compared to other sources.

Note: Thorne’s Whey Protein Isolate, available in chocolate or vanilla, features 21 grams of bioavailable protein per serving to help maintain healthy muscle mass – with added enzymes (bromelain and papain) for optimal digestion and protein assimilation.* 

Contributed by Carina Toledo, MS, MHI, CNS

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Multi-Vitamin/Mineral to Support Cognitive Function

Studies examining the health benefits of multi-vitamin/mineral (MVM) supplements have yielded mixed results.

This study examined the effects of an MVM on cognitive support in an aging population. A sub-cohort of 492 participants (average age, 69.6) of the larger COSMOS (Cocoa Supplement and Multivitamin Outcomes Study) completed an evaluation of the effects of a MVM on cognitive function.

This portion of the study was double-blinded, placebo-controlled of MVM supplementation or placebo in participants who were available for in-person neuropsychiatric examination at Women and Brigham’s Hospital in Boston, Massachusetts, at the beginning and end of two years. There was a further meta-analysis of individuals in two other sub-cohorts – one evaluated by telephone and one online, each annually for three years.

Results:

Over the 2-year period, the in-person clinical group experienced:

  1. Modest improvement in global cognition*
  2. Statistically significant improvements in episodic memory – translating to a 4.8-year decrease in cognitive age*

Over the course of the study, the meta-analysis of three groups (in-person, telephone, and online; 5,000 participants) found:

  1. Significant improvements in global cognition*
  2. Significant improvements in episodic memory*

Analysis of the overall effect during the study periods found a decreased rate of cognitive aging of two years in the MVM group compared to placebo.*

Note: Considering the above research and the fact that an MVM is an excellent way to fill potential dietary nutrient gaps, it is prudent to consider taking one. Thorne offers several options for older adults, including Advanced Nutrients, Women’s Multi 50+, and Men’s Multi 50+. 

Contributed by Kathi Head, ND

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