These B-Vites Benefit the Brain
From eNewsletter 5/9/2022
DID YOU KNOW there were three recent studies lauding B-vitamins for their beneficial effect on cognition and memory? In a study from Science Translational Medicine, niacinamide limited Alzheimer's disease progression when used in lab models. Past epidemiology studies of niacin and Alzheimer's disease showed that people who had higher levels in their diet had diminished risk of the disease. While it is well known that serum folate deficiency increases the likelihood of deficits in cognitive performance and neurological functioning, a study in Evidence-Based Mental Health confirmed that it also correlates with both dementia risk and all-cause mortality. A recent study in Nutrition Reviews suggests that among a large population of subjects without dementia aged 50 years and above, the risk of incident dementia was significantly decreased among those with higher intake of folate. NOTE: getting the proper source of folate is critical. The only way to truly know is through genetical analysis of the MTHFR gene for folate, as well as genes for B-2, B-6, B-12, and choline.
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Cholesterol Lowering Therapy Update
Steve: As we have reported recently from multiple medical journals, there is much more to managing cholesterol than just statin medication. Specifically, statins do nothing to lower small particle LDL, which comprises the greatest cardiovascular risk when levels are high. A new study from American Journal of Cardiovascular Drugs mentions new pharmaceuticals that, are either here or coming soon, claim to do a much better job managing cholesterol than statin medication. Note: we do not condone medication unless it is the last resort, or if you have heterozygous familial hypercholesterolemia. However, if you are currently on a statin, we want you to be as informed as possible about alternatives. PCSK9-inhibitors, whose effects on cardiovascular outcomes are well-known but are still too costly for the masses, hopefully will come down in price, because they actually lower small particle LDL levels. Recently approved inclisiran is a monoclonal antibody, thus an option in patients who are statin intolerant or for whom a statin is contraindicated. It was also found to be efficacious for heterozygous familial hypercholesterolemia. Recently approved bempedoic acid focuses on lipid lowering in the small intestine, thus is an option in patients who are statin intolerant or for whom a statin is contraindicated. The aforementioned will become part of daily use recommendations, if not already. PCSK9-inhibitors seem relatively well tolerated, but we would not recommend taking inclisiran or bempedoic until there is more long-term safety data. Evinacumab is a potent inhibitor of lipoprotein lipase, which helps lower plasma levels of triglycerides as well as LDL. This therapy is currently in phase II trials. While we abhor any kind of inhibitor, we mentioned it because it's at least encouraging that scientists realize that there is more to the cardiac puzzle than just lowering LDL. Triglycerides play a huge part. Lipidomics This new screening tool gives you an idea how ludicrous relying on just serum LDL levels really is. According to this state-of-the-art screening tool, there are 282 lipid (fat) biomarkers, 69 of which are associated with at least cardiovascular disease and type 2 diabetes. In the very near future, this screening tool should be widely available to physicians all over the world. We just need them to use it! In the Circulation study, researchers tested dietary elements that would lower some of the bad lipid biomarkers. Monounsaturated fatty acids such as olive oil, and omega-3 fatty acids such as fish oil, were found to be most effective for lipid risk reduction.