Nope, chromium doesn’t help with blood sugar (and other myths) – This Week in Science for Holistic Health – 11Jun2016


Table of Contents

Welcome to This Week in Science for Holistic Health!

I scour the science news for interesting and relevant research for a holistic approach to health to keep you up-to-date!

This edition is the “debunk edition” (with a few disproves of common beliefs):

Before we begin, know that these “debunk” articles are not based on some random “new study”, but are fairly strong reviews and/or meta-analyses of many published studies; so they hold more weight than any individual observational study.(1)

  • Food & Eating – Cocoa is not so anti-inflammatory after all.

  • Supplements & Nutrients – No evidence that chromium helps with glycemic control in T2DM.

  • Disease Prevention – Calories matter!  Higher energy density = increased adiposity, weight, BMI and obesity.

  • Anatomy & Physiology – Yes, there is “metabolically healthy obese”.


Food & Eating

Impact of Cocoa Consumption on Inflammation Processes-A Critical Review of Randomized Controlled Trials.

BACKGROUND:  Cocoa flavanols have strong anti-inflammatory properties in vitro. If these also occur in vivo, cocoa consumption may contribute to the prevention or treatment of diseases mediated by chronic inflammation. This critical review judged the evidence for such effects occurring after cocoa consumption.


CONCLUSIONS:  Little evidence exists that consumption of cocoa-rich food may reduce inflammation, probably by lowering the activation of monocytes and neutrophils. The efficacy seems to depend on the extent of the basal inflammatory burden. Further well-designed RCTs with inflammation as the primary outcome are needed, focusing on specific markers of leukocyte activation and considering endothelial microparticles as marker of vascular inflammation.

How anti-inflammatory is cocoa, really??? #cocoa #antiinflammatory Click To Tweet


Food Literacy: How Do Communications and Marketing Impact Consumer Knowledge, Skills, and Behavior? Workshop Summary.

In September 2015, the National Academies of Sciences, Engineering, and Medicine’s Food and Nutrition Board convened a workshop in Washington, DC, to discuss how communications and marketing impact consumer knowledge, skills, and behavior around food, nutrition, and healthy eating. The workshop was divided into three sessions, each with specific goals that were developed by the planning committee: Session 1 described the current state of the science concerning the role of consumer education, health communications and marketing, commercial brand marketing, health literacy, and other forms of communication in affecting consumer knowledge, skills, and behavior with respect to food safety, nutrition, and other health matters. Session 2 explored how scientific information is communicated, including the credibility of the source and of the communicator, the clarity and usability of the information, misconceptions/ misinformation, and the impact of scientific communication on policy makers and the role of policy as a macro-level channel of communication. Session 3 explored the current state of the science concerning how food literacy can be strengthened through communication tools and strategies. This report summarizes the presentations and discussions from the workshop.

How does food marketing influence consumer knowledge? #food #marketing Click To Tweet


Non-cereal ingredients for the attenuation of glycaemic response to bread: a review of the clinical evidence.

Lowering postprandial blood glucose response remains at the forefront of scientific interest, due to emerging evidence of potential health benefits. Although a large variety of commercial bread products is available, specific postprandial effects of different carbohydrate sources in humans have not been elucidated. The purpose of the present review is to critically record the human studies investigating the efficacy of non-cereal based ingredients on the modulation of glycaemic response to bread. The review of the literature revealed that the substitution of refined flours for legume flours is the main alternative strategy for reducing glycaemic response to bread beyond cereal ingredients. The incorporation of fruit-derived ingredients, specific dietary fibre originating from various sources, and the micronutrient enrichment of bread with trivalent chromium constitute novel and promising strategies for the production of low GI breadstuff. In agreement to the above, bakery industry should focus on technological aspects calculating on the suggested approaches in order to obtain health-promoting bread products based on ingredients originating from non-cereal sources.

What should we add to bread to make it less glycemic? #legumeflour #fibre #GI #bread Click To Tweet

Oats-From Farm to Fork.

Oats have a long history of use as human food and animal feed. From its origins in the Fertile Crescent, the oat has adapted to a wide range of climatic conditions and geographic regions. Its unique macro-, micro-, and phytonutrient composition, high nutritional value, and relatively low agricultural input requirements makes oats unique among cereal crops. The health benefits of the oats are becoming well established. While the connection between oat β-glucan fiber in reducing the risk of cardiovascular disease and controlling glycemia have been unequivocally established, other potential benefits including modulation of intestinal microbiota and inflammation continue to be explored. Advances in food technology are continuing to expand the diversity of oat-based foods, creating opportunities to deliver the health benefits of oats to a larger segment of the population.

How awesome are #oats anyway? #nutrition #food #grain #fiber Click To Tweet


A Critical Look at Prebiotics Within the Dietary Fiber Concept.

This article reviews the current knowledge of the health effects of dietary fiber and prebiotics and establishes the position of prebiotics within the broader context of dietary fiber. Although the positive health effects of specific fibers on defecation, reduction of postprandial glycemic response, and maintenance of normal blood cholesterol levels are generally accepted, other presumed health benefits of dietary fibers are still debated. There is evidence that specific dietary fibers improve the integrity of the epithelial layer of the intestines, increase the resistance against pathogenic colonization, reduce the risk of developing colorectal cancer, increase mineral absorption, and have a positive impact on the immune system, but these effects are neither generally acknowledged nor completely understood. Many of the latter effects are thought to be particularly elicited by prebiotics. Although the prebiotic concept evolved significantly during the past two decades, the line between prebiotics and nonprebiotic dietary fiber remains vague. Nevertheless, scientific evidence demonstrating the health-promoting potential of prebiotics continues to accumulate and suggests that prebiotic fibers have their rightful place in a healthy diet.

Are you eating enough prebiotics? #prebiotics #fiber #GI #cholesterol #gutmicrobiota Click To Tweet


Supplements and Nutrients

Chromium supplements for glycemic control in type 2 diabetes: limited evidence of effectiveness.

Note from Leesa – This conclusion is similar to the one at where they reviewed 29 studies and came up with this: “In looking at the entirety of the data on type II diabetic persons, there does appear to be a mild reduction in fasting blood glucose despite no apparent changes in insulin sensitivity or HbA1c. No significant or reliable effect in non-diabetic persons.”

Some adults with type 2 diabetes mellitus (T2DM) believe that chromium-containing supplements will help control their disease, but the evidence is mixed. This narrative review examines the efficacy of chromium supplements for improving glycemic control as measured by decreases in fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c).

On the basis of the low strength of existing evidence, chromium supplements have limited effectiveness, and there is little rationale to recommend their use for glycemic control in patients with existing T2DM. Future meta-analyses should include only high-quality studies with similar forms of chromium and comparable inclusion/exclusion criteria to provide scientifically sound recommendations for clinicians.

No evidence for #chromium #supplements for #glycemic control in #diabetes - #T2DM Click To Tweet


Insulin-Sensitizing Effects of Omega-3 Fatty Acids: Lost in Translation?

Omega-3 polyunsaturated fatty acids (n-3 PUFA) of marine origin, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), have been long studied for their therapeutic potential in the context of type 2 diabetes, insulin resistance, and glucose homeostasis. Glaring discordance between observations in animal and human studies precludes, to date, any practical application of n-3 PUFA as nutritional therapeutics against insulin resistance in humans. Our objective in this review is to summarize current knowledge and provide an up-to-date commentary on the therapeutic value of EPA and DHA supplementation for improving insulin sensitivity in humans. We also sought to discuss potential mechanisms of n-3 PUFA action in target tissues, in specific skeletal muscle, based on our recent work, as well as in liver and adipose tissue. We conducted a literature search to include all preclinical and clinical studies performed within the last two years and to comment on representative studies published earlier. Recent studies support a growing consensus that there are beneficial effects of n-3 PUFA on insulin sensitivity in rodents. Observational studies in humans are encouraging, however, the vast majority of human intervention studies fail to demonstrate the benefit of n-3 PUFA in type 2 diabetes or insulin-resistant non-diabetic people. Nevertheless, there are still several unanswered questions regarding the potential impact of n-3 PUFA on metabolic function in humans.

Omega-3s improve #insulinsensitivity in animals, but not humans #omega3 #EPA #DHA Click To Tweet


Leucine in Obesity: Therapeutic Prospects.

Obesity develops from an imbalance of energy homeostasis and is associated with chronic low-grade inflammation in white adipose tissues (WAT). Inflammation is involved in the pathophysiology of many obesity-induced disorders including insulin resistance and diabetes. Increasing evidence has shown that dietary leucine supplementation positively affects the parameters associated with obesity and obesity-related metabolic disorders. The beneficial effects include increased loss of body weight, reduced WAT inflammation, improved lipid and glucose metabolism, enhanced mitochondrial function, and preserved lean body mass. Although these beneficial effects have not been clearly established, dietary leucine supplementation, either alone or as part of a therapeutic regimen, may be a good nutritional tool in the prevention and management of obesity and obesity-induced metabolic disorders.

Leucine #supplements for obesity? #leucine #obesity #moreresearchneeded Click To Tweet


The antioxidant, immunomodulatory, and anti-inflammatory activities of Spirulina: an overview.

Spirulina is a species of filamentous cyanobacteria that has long been used as a food supplement. In particular, Spirulina platensis and Spirulina maxima are the most important. Thanks to a high protein and vitamin content, Spirulina is used as a nutraceutical food supplement, although its other potential health benefits have attracted much attention. Oxidative stress and dysfunctional immunity cause many diseases in humans, including atherosclerosis, cardiac hypertrophy, heart failure, and hypertension. Thus, the antioxidant, immunomodulatory, and anti-inflammatory activities of these microalgae may play an important role in human health. Here, we discuss the antioxidant, immunomodulatory, and anti-inflammatory activities of Spirulina in both animals and humans, along with the underlying mechanisms. In addition, its commercial and regulatory status in different countries is discussed as well. Spirulina activates cellular antioxidant enzymes, inhibits lipid peroxidation and DNA damage, scavenges free radicals, and increases the activity of superoxide dismutase and catalase. Notably, there appears to be a threshold level above which Spirulina will taper off the antioxidant activity. Clinical trials show that Spirulina prevents skeletal muscle damage under conditions of exercise-induced oxidative stress and can stimulate the production of antibodies and up- or downregulate the expression of cytokine-encoding genes to induce immunomodulatory and anti-inflammatory responses. The molecular mechanism(s) by which Spirulina induces these activities is unclear, but phycocyanin and β-carotene are important molecules. Moreover, Spirulina effectively regulates the ERK1/2, JNK, p38, and IκB pathways. This review provides new insight into the potential therapeutic applications of Spirulina and may provide new ideas for future studies.

Spirulina, the high #nutrient cyanobacteria that is #antiinflammatory #antioxidant and helps #immunity - #spirulina Click To Tweet


Adverse effects of homeopathy, what do we know? A systematic review and meta-analysis of randomized controlled trials.


  • This review address the naive assumption that because of the generally diluted doses used homeopathy must be safe.

  • This review touches the neglected issue of the distinction between homeopathic aggravation, adverse reactions and adverse effects.

  • We found a similar risk for homeopathic treatment compared to controls such as placebo and conventional medicine

OBJECTIVES:  Homeopathy is a popular treatment modality among patient, however there is sparse research about adverse effects of homeopathy. A concept unique for homeopathy, is homeopathic aggravation that is understood as a transient worsening of the patients’ symptoms before an expected improvement occurs. From a risk perspective it is vital that a distinction between homeopathic aggravations and adverse effects is established. There is a lack of systematic information on how frequent adverse effects and homeopathic aggravations are reported in studies. Therefore, a systematic review and meta-analysis were performed.

DESIGN AND SETTING:  Sixteen electronic databases were searched for Randomized Controlled Trials (RCTs). The searches were limited from the year 1995 to January 2011. Forty-one RCTs, with a total of 6.055 participants were included. A subtotal of 39 studies was included in the additional meta-analysis.

CONCLUSION:  Adverse effects including the concept of homeopathic aggravations are commonly reported in trials. The meta-analysis demonstrated that the proportion of patients experiencing adverse effects to be similar for patients randomized to homeopathic treatment compared to patients randomized to placebo and conventional medicine.

Homeopathic aggravations and #adverseeffects - #homeopathy Click To Tweet



NOTE from Leesa:  If you have experienced an adverse event related to your use of any supplement or medication, AND you’re in Canada or the USA, you can report them directly to the health authorities at the links below.  Health Canada’s MedEffect link is reference (3), and the FDA’s MedWatch link is reference (4).


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Diseases/Conditions and Prevention/Treatments

Associations between dietary energy density and obesity: A systematic review and meta-analysis of observational studies.


  • Energy density (ED) was directly associated with weight gain, adjusted means for body mass index (in men and women separately), and adiposity risk in cohort studies.
  • No significant association was observed between ED and weight and elevated odds of abdominal obesity in cross-sectional studies.
  • We found no evidence of publication bias.

OBJECTIVE:  Although many studies have shown an association between dietary energy density (DED) and obesity, there has been no systematic review and meta-analysis on this topic. Therefore, the objective of this study was to qualitatively and quantitatively review and summarize the literature on association between DED and obesity.

CONCLUSION:  The present review showed that DED was directly associated with risk of excess adiposity, higher weight change, and BMI. Lower DED should be considered a prevention strategy for obesity.

Calories matter! #diet #energydensity #adiposity #weight #BMI #obesity - #calories Click To Tweet


Complex Relationships Between Food, Diet, and the Microbiome.

Diet is a risk factor in several medically important disease states, including obesity, celiac disease, and functional gastrointestinal disorders. Modification of diet can prevent, treat, or alleviate some of the symptoms associated with these diseases and improve general health. It is important to provide patients with simple dietary recommendations to increase the probability of successful implementation. These recommendations include increasing vegetable, fruit, and fiber intake, consuming lean protein sources to enhance satiety, avoiding or severely limiting highly processed foods, and reducing portion sizes for overweight and obese patients.

Food, diet, microbiome & #obesity #celiac #GI - #food #diet #microbiome Click To Tweet


Unhealthy diets, obesity and time discounting: a systematic literature review and network analysis.

There is an increasing policy commitment to address the avoidable burdens of unhealthy diet, overweight and obesity. However, to design effective policies, it is important to understand why people make unhealthy dietary choices. Research from behavioural economics suggests a critical role for time discounting, which describes how people’s value of a reward, such as better health, decreases with delay to its receipt. … Nineteen out of 25 cross-sectional studies found time discount rates positively associated with overweight, obesity and unhealthy diets. Experimental studies indicated that lower time discounting was associated with greater weight loss. Findings varied by how time discount rates were measured; stronger results were observed for food than monetary-based measurements. Network co-citation analysis revealed a concentration of research in nutrition journals. Overall, there is moderate evidence that high time discounting is a significant risk factor for unhealthy diets, overweight and obesity and may serve as an important target for intervention.

The longer someone thinks it will take to reach their health goal, the less they value it - #diet #overweight #obesity Click To Tweet


Effective Patient-Provider Communication in Pediatric Obesity.

Effective patient-provider communication is not a primary focus of medical school curricula. Motivational interviewing (MI) is a patient-centered, directive communication framework appropriate for in health care. Research on MI’s causal mechanisms has established patient change talk as a mediator of behavior change. Current MI research focuses on identifying which provider communication skills are responsible for evoking change talk. MI recommends informing, asking, and listening. Research provides evidence that asking for and reflecting patient change talk are effective communication strategies, but cautions providers to inform judiciously. Supporting a patient’s decision making autonomy is an important strategy to promote health behaviors.

How you communicate with and support your client affects their behavior - #communication #inform #ask #listen #support Click To Tweet


Environmental determinants of polycystic ovary syndrome.

In this review, we summarize existing research on a variety of environmental factors potentially involved in the etiology, prevalence, and modulation of polycystic ovary syndrome (PCOS), and we suggest avenues for future research. The main environmental factors we consider include environmental toxins, diet and nutrition, socioeconomic status, and geography. There is some evidence that environmental toxins play a role in disrupting reproductive health, but there is limited research as to how these toxins may affect the development of PCOS. Although research has also shown that PCOS symptoms are reduced with certain dietary supplements and with weight loss among obese women, additional research is needed to compare various approaches to weight loss, as well as nutritional factors that may play a role in preventing or mitigating the development of PCOS. Limited studies indicate some association of low socioeconomic status with certain PCOS phenotypes, and future research should consider socioeconomic conditions during childhood or adolescence that may be more relevant to the developmental onset of PCOS. Finally, the limited scope of comparable international studies on PCOS needs to be addressed, because global patterns of PCOS are potentially valuable indicators of cultural, environmental, and genetic factors that may contribute to excess risk in certain regions of the world.

What affects PCOS? #toxins #supplements #weight #nutrition - #PCOS Click To Tweet


Following in the Footsteps of the North Karelia Project – Prevention of Type 2 Diabetes


  • T2D is increasing and predisposes to serious complications.

  • On population level, T2D trends follow the obesity trends.

  • The risk of T2D can be markedly reduced by lifestyle intervention.

  • High-risk individuals can be identified with FINDRISC, a simple T2D risk score.

  • Finnish national T2D program has lead the way to many international initiatives.

…”The lifestyle intervention was delivered primarily by study nutritionists during individual counselling sessions and highlighted by study physicians at annual clinical visits [8]. The intervention goals were to reduce body weight (5% or more reduction from baseline weight), limit dietary fat (<30% of total energy consumed) and saturated fat (<10% of total energy consumed), and to increase both dietary fiber intake (15 g/1,000 kcal or more) and physical activity (≥30 min/day). T2D status was assessed annually by a repeated 75-g oral glucose tolerance testing.

The intervention group showed significantly greater improvement in each intervention goal compared with the control group.”…

T2D improved with #weightloss #lessfat #morefiber #exercise - #diabetes #T2D #T2DM Click To Tweet

The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies.

OBJECTIVE:  Diet may influence the risk of gestational diabetes mellitus (GDM), but inconsistent findings have been reported. The purpose of this study was to synthesize evidence from observational studies on the associations between dietary factors and GDM.

CONCLUSIONS:  The findings support current dietary guidelines to limit consumption of foods containing saturated fat and cholesterol, such as processed meat and eggs, as part of an overall balanced diet. Further large prospective studies are warranted.

Gestational #diabetes - limit #saturatedfat #cholesterol and eat a balanced #diet - #fat Click To Tweet

Anatomy & Physiology

Does Metabolically Healthy Obesity Exist?

The relationship between obesity and other metabolic diseases have been deeply studied. However, there are clinical inconsistencies, exceptions to the paradigm of “more fat means more metabolic disease”, and the subjects in this condition are referred to as metabolically healthy obese (MHO). They have long-standing obesity and morbid obesity but can be considered healthy despite their high degree of obesity. We describe the variable definitions of MHO, the underlying mechanisms that can explain the existence of this phenotype caused by greater adipose tissue inflammation or the different capacity for adipose tissue expansion and functionality apart from other unknown mechanisms. We analyze whether these subjects improve after an intervention (traditional lifestyle recommendations or bariatric surgery) or if they stay healthy as the years pass. MHO is common among the obese population and constitutes a unique subset of characteristics that reduce metabolic and cardiovascular risk factors despite the presence of excessive fat mass. The protective factors that grant a healthier profile to individuals with MHO are being elucidated.

Metabolically #healthy #obese - lower risk of #metabolic and #heart #disease - #heartdisease #CVD Click To Tweet


Plasma/Serum Zinc Status During Aerobic Exercise Recovery: A Systematic Review and Meta-Analysis.

BACKGROUND:  Exercise and the subsequent recovery processes have been proposed to induce disturbances in zinc homeostasis. We previously reported acute increase in serum zinc concentration immediately after aerobic exercise; the change in the indices of zinc status during exercise recovery was not explored.

OBJECTIVE:  The aim of the current analysis is to determine the changes in zinc biomarkers during recovery from an aerobic exercise bout.

CONCLUSIONS:  The present analysis showed that serum zinc levels decrease significantly during exercise recovery, compared to pre-exercise levels. This extends our previous report of an increase in serum zinc immediately after exercise. We postulate that the exercise-induced fluctuations in zinc homeostasis are linked to the muscle repair mechanisms following exercise; the potential for zinc to enhance the exercise recovery process remains to be determined.

What's the connection between #zinc levels and #exercise - #muscle repair Click To Tweet


“We are what our bacteria eat”: the role of bacteria in personalizing nutrition therapy in gastrointestinal conditions.

Note from Leesa – this is a great read for anyone who deals with gut issues (microbiome, IBS, IBD, diabetes, NAFLD, colorectal cancer)!

The theme for the 2016 World Digestive Health Day is ‘Your Diet and Gut Health’. The World Gastroenterology Organization (WGO) thereby wishes to raise awareness of the relationship between what we eat and gastrointestinal symptoms. WDHD is celebrated each year on May 29th . This brief review article on behalf of the New Zealand Society of Gastroenterology will highlight recent developments in this highly active area of research with a special emphasis on gastrointestinal disorders.

GI microbiome's interaction with #IBS #IBD #diabetes #NAFLD #colorectal #cancer Click To Tweet


Bosom Buddies: The Symbiotic Relationship Between Infants and Bifidobacterium longum ssp. longum and ssp. infantis. Genetic and Probiotic Features.

The intestinal microbiota is a complex community that plays an important role in human health from the initial steps of its establishment. Its microbial composition has been suggested to result from selective pressures imposed by the host and is modulated by competition among its members. Bifidobacterium longum is one of the most abundant species of the Bifidobacterium genus in the gut microbiota of healthy breast-fed infants and adults. The recent advancements of ‘omics techniques have facilitated the genetic and functional studies of different gut microbiota members. They have revealed the complex genetic pathways used to metabolize different compounds that likely contribute to the competitiveness and persistence of B. longum in the colon. The discovery of a genomic island in B. longum ssp. infantis that encodes specific enzymes for the metabolism of human milk oligosaccharides suggests a specific ecological adaptation. Moreover, B. longum is widely used as probiotic, and beneficial effects in infant health have been reported in several studies.

Benefits of B longum as #probiotic for #infants - #gut #microbiota #breastfeed Click To Tweet



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Inclusion Criteria for This Week in Science for Holistic Health posts:

  • Studies must be published in a peer-reviewed medical journal or highly credible website (e.g. within the last few weeks,

  • Articles must be relevant to a holistic approach to health (specifically nutrition & lifestyle factors),

  • Studies were done on people unless noted otherwise (animal and tissue studies have unknown relevance to people),

  • I also include new science-based books that look interesting (’cause I LOVE reading!).

  • None of the above applies if it’s a response to something in the media. 😉

  • P.S. – The titles are hyperlinked to the actual studies, so feel free to “geek out”. 🙂

Enjoy! 🙂

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Leesa Klich is a science-based holistic nutritionist living at the intersection of science and holistic health (it’s really, really interesting here!) 🙂 At NutritionInteractions she helps holistic-minded people taking medications maximize the benefits of good nutrition. She also helps holistic health professionals find and understand science-based health information. She has a MSc in Toxicology and Nutritional Science, over a decade experience in drug/supplement safety, and is also a Registered Holistic Nutritionist. For a list of free health resources, click here.


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(1) Compound Interest – Rough Guide to Types of Scientific Evidence




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