Welcome to the September 2023 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, which includes 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: gender differences in stress responses, (2) nutritional supplements benefit picky eaters, (3) kiwifruit improves sleep in athletes, and (4) long-term PPI use increases dementia risk.

Mental Health Moment: How Men and Women Experienced Anxiety Differently During the Pandemic

Social support plays a protective role in various aspects of physical and mental health. Whether this support comes from the greater community or one-on-one between individuals, having others to rely on is a great benefit for handling challenges. Previous research suggests that women value personal support from friends and family more than men; whereas, men get more benefit from work-related support from coworkers or supervisors to alleviate job-related concerns.

This study examines the effects of social support in different settings on mental health conditions and quality of life during the COVID-19 pandemic and compared gender differences. The participants were adult members of the STAAB-COVID-One cohort. They provided blood samples and completed questionnaires that obtained data about quality of life, mental health, perceived social support, and concerns at home and the workplace.

The study found anxiety was a central factor that both genders experienced, but in different ways. In men, increased anxiety levels were associated more with workplace concerns, while women had higher anxiety levels associated with stressors in their personal lives. Combatting that anxiety, women reported higher quality of life when perceiving increased personal support from family and friends; this same correlation was not seen in men. Women also reported lower depression levels with higher workplace support, indicating that the benefits of workplace support can extend to overall health.

Contributed by Carly Duffy, MPH, RD

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Nutritional Supplements Improved Nutritional Adequacy and BMI in Young Picky Eaters

Most parents are familiar with the struggle of getting their picky eaters to consume nutrient-dense foods, especially when they are considered underweight according to the World Health Organization (WHO) growth standards chart.

A total of 321 children (39.9% girls; ages 2-4 years), all of whom were between the 3rd and 15th percentiles for WHO growth standards, were divided into three groups – one control group and two different intervention groups. The control group received dietary counseling alone, while the remaining two groups received either a milk-based or lactose-free nutritional supplement in addition to nutritional counseling. Both supplements delivered 28 vitamins and minerals, protein, and prebiotic fiber.

Weight, height, mid-upper-arm circumference, and dietary intake (using a 24-hour food recall), were measured on days 1 (baseline), 7, 30, 60, and 90 by a trained dietitian blinded to the intervention groups.

At the 90-day mark, a significant increase in BMI and weight was reported in both supplement groups compared to control, and arm circumference was increased with the milk-based supplement.

Overall energy intake was higher in the supplement groups compared to dietary counseling alone. In addition, the supplement group received a higher intake of specific vitamins and minerals that were inadequate at the beginning of the trial, including iron, vitamin A, and thiamin. Appetite scores increased slightly, along with consumption of fruits, vegetables, and overall food intake in the supplement groups.

The researchers concluded that nutritional supplement use in conjunction with dietary counseling improves nutritional adequacy in picky eaters without interfering with normal food consumption.

Note: To alleviate nutritional gaps in the diet of picky eaters, Thorne’s Kids Multi + features 15 science-backed nutrients in a convenient, dissolvable disk for children ages 4 and up.

For a child who needs additional protein and daily nutrients to complement their diet, consider Thorne’s VeganPro Complex, which features protein, prebiotic fiber, an immune-supportive mushroom blend, and a complete vitamin and mineral profile, available in delicious chocolate and vanilla flavors.

Contributed by Carina Toledo, MS Clinical Nutrition, MHI

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Eating Kiwifruit Improves Sleep and Recovery in Athletes

Sufficient sleep and nutritional intake are constant challenges for elite athletes and their demanding schedules. Yet both are necessary for performance, recovery, and to reduce risk of injury. Kiwifruit is a food that contains naturally occurring melatonin, an important hormone for sleep and circadian rhythm regulation, as well as vitamin C, antioxidants, and other nutrients important for recovery. Might consumption of kiwifruit improve sleep and recovery in elite athletes?

To investigate this question, 15 elite level running and sailing athletes were recruited to participate in an open-label trial. Participants completed pre- and post-study interview questionnaires at baseline and study completion. They also maintained a daily sleep diary throughout the five weeks of the trial. Participants consumed two medium-sized kiwifruits one hour before bedtime daily.

Eighty-seven percent of participants were classified as poor sleepers at baseline, while only 33 percent remained poor sleepers at the trial’s completion. Reported sleep quality improved significantly over the course of the trial, and mean sleep hours per night improved from 7.6 hours at baseline to 8.6 hours at completion. Although the authors note the small sample size and use of sleep diaries as limitations of the study, they conclude that kiwifruit consumption one hour before bedtime is a potential strategy for improving sleep and recovery of elite athletes.

Note: If sleep is elusive, then in addition to kiwifruit, consider a Thorne sleep supplement. If you are an athlete looking for muscle recovery and restful sleep, try Thorne’s RecoveryPro® or Thorne’s Sleep Bundle for Athletes.*

Contributed by Jennifer L. Greer, ND, MEd

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Long-Term Use of PPIs Can Increase Dementia Risk

Use of proton-pump inhibitors (PPIs) to block stomach acid has increased exponentially the past 20 years, in part because they are available over the counter. Their use is linked to an increased risk for several chronic conditions, including cardiovascular disease, kidney disease, and stroke. Previous studies linking PPI use and dementia risk have yielded mixed results and have not assessed their potential cumulative effect. In this current long-term study – an arm of the Atherosclerosis Risk in Communities (ARIC) Study – 5,712 dementia-free participants (average age 75) were assessed. The ARIC participants were followed from 1987 to 2013, although the PPI assessment did not begin until their last periodic visit (between 2011 and 2013) at which time they were asked about current PPI use, as well as duration of use prior to that visit. Previous PPI use was categorized as: never, 1 day-2.8 years, 2.8-4.4 years, and over 4.4 years. The outcome measured was incidence of dementia at follow-up.

At follow-up assessment, 585 cases of dementia had developed over approximately 5.5 years. If PPIs were used, the length of use ranged from 112 days to more than 20 years. Although participants who reported using PPIs did not have an increased risk of dementia, those who reported PPI use for greater that 4.4 years had a 33 percent increased risk of developing dementia during the follow-up period compared to participants who had never used PPIs. There were no associations with dementia for use of PPIs for less time.

Note: Although PPIs have been approved for short-term use for gastroesophageal reflux disease (GERD) and stomach ulcers, they are too often used long-term and for mere indigestion or heartburn. Next time you feel stomach or esophagus irritation, try something soothing like a tea made from warm water and a capsule or two of Thorne’s GI Relief.*

Contributed by Kathi Head, ND

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