Healthcare analytics, AI solutions for biological big data, providing an AI platform for the biotech, life sciences, medical and pharmaceutical industries, as well as for related technological approaches, i.e., curation and text analysis with machine learning and other activities related to AI applications to these industries.
Article SELECTION from Collection of Aviva Lev-Ari, PhD, RN Scientific Articles on PULSE on LinkedIn.com for Training Small Language Models (SLMs) in Domain-aware Content of Medical, Pharmaceutical, Life Sciences and Healthcare by 15 Subjects Matter
Article selection: Aviva Lev-Ari, PhD, RN
#1 – February 20, 2016
Contributions to Personalized and Precision Medicine & Genomic Research
Eight Subcellular Pathologies driving Chronic Metabolic Diseases – Methods for Mapping Bioelectronic Adjustable Measurements as potential new Therapeutics: Impact on Pharmaceuticals in Use
In this curation we wish to present two breaking through goals:
Goal 1:
Exposition of a new direction of research leading to a more comprehensive understanding of Metabolic Dysfunctional Diseases that are implicated in effecting the emergence of the two leading causes of human mortality in the World in 2023: (a) Cardiovascular Diseases, and (b) Cancer
Goal 2:
Development of Methods for Mapping Bioelectronic Adjustable Measurements as potential new Therapeutics for these eight subcellular causes of chronic metabolic diseases. It is anticipated that it will have a potential impact on the future of Pharmaceuticals to be used, a change from the present time current treatment protocols for Metabolic Dysfunctional Diseases.
According to Dr. Robert Lustig, M.D, an American pediatric endocrinologist. He is Professor emeritus of Pediatrics in the Division of Endocrinology at the University of California, San Francisco, where he specialized in neuroendocrinology and childhood obesity, there are eight subcellular pathologies that drive chronic metabolic diseases.
These eight subcellular pathologies can’t be measured at present time.
In this curation we will attempt to explore methods of measurement for each of these eight pathologies by harnessing the promise of the emerging field known as Bioelectronics.
Unmeasurable eight subcellular pathologies that drive chronic metabolic diseases
Glycation
Oxidative Stress
Mitochondrial dysfunction [beta-oxidation Ac CoA malonyl fatty acid]
Insulin resistance/sensitive [more important than BMI], known as a driver to cancer development
Membrane instability
Inflammation in the gut [mucin layer and tight junctions]
Epigenetics/Methylation
Autophagy [AMPKbeta1 improvement in health span]
Diseases that are not Diseases: no drugs for them, only diet modification will help
Image source
Robert Lustig, M.D. on the Subcellular Processes That Belie Chronic Disease
These eight Subcellular Pathologies driving Chronic Metabolic Diseases are becoming our focus for exploration of the promise of Bioelectronics for two pursuits:
Will Bioelectronics be deemed helpful in measurement of each of the eight pathological processes that underlie and that drive the chronic metabolic syndrome(s) and disease(s)?
IF we will be able to suggest new measurements to currently unmeasurable health harming processes THEN we will attempt to conceptualize new therapeutic targets and new modalities for therapeutics delivery – WE ARE HOPEFUL
In the Bioelecronics domain we are inspired by the work of the following three research sources:
Michael Levin is an American developmental and synthetic biologist at Tufts University, where he is the Vannevar Bush Distinguished Professor. Levin is a director of the Allen Discovery Center at Tufts University and Tufts Center for Regenerative and Developmental Biology. Wikipedia
THE VOICE of Dr. Justin D. Pearlman, MD, PhD, FACC
PENDING
THE VOICE of Stephen J. Williams, PhD
Ten TakeAway Points of Dr. Lustig’s talk on role of diet on the incidence of Type II Diabetes
25% of US children have fatty liver
Type II diabetes can be manifested from fatty live with 151 million people worldwide affected moving up to 568 million in 7 years
A common myth is diabetes due to overweight condition driving the metabolic disease
There is a trend of ‘lean’ diabetes or diabetes in lean people, therefore body mass index not a reliable biomarker for risk for diabetes
Thirty percent of ‘obese’ people just have high subcutaneous fat. the visceral fat is more problematic
there are people who are ‘fat’ but insulin sensitive while have growth hormone receptor defects. Points to other issues related to metabolic state other than insulin and potentially the insulin like growth factors
At any BMI some patients are insulin sensitive while some resistant
Visceral fat accumulation may be more due to chronic stress condition
Fructose can decrease liver mitochondrial function
A methionine and choline deficient diet can lead to rapid NASH development
PEER-REVIEWED MEDICAL JOURNAL PUBLISHES LANDMARK STUDY ON EFFICACY AND SAFETY OF FDgard® (COLM-SST), DEMONSTRATING RAPID REDUCTION OF FUNCTIONAL DYSPEPSIA (FD OR RECURRING, MEAL-TRIGGERED INDIGESTION) SYMPTOMS WITHIN 24 HOURS
FDgard® (COLM-SST), a solid-state microsphere formulation of caraway oil and
l-Menthol, taken daily and proactively 30-60 minutes before meals, showed
statistically significant, rapid reduction of Functional Dyspepsia (FD)
symptoms within 24 hours and, additionally, relief of severe FD symptoms.
FDREST™ clinical trial with FDgard
represents an important medical advance, as no previous trials have shown rapid
relief of FD symptoms. There are no approved products for this highly prevalent
condition.
In FDREST, patients
received greater and more durable benefits with the addition of FDgard taken
daily and proactively to their typical medical regimen.
FDREST is the first
clinical trial in FD to use patented, Site
Specific Targeting (SST®) technology to deliver the FDgard
formulation to the upper belly (duodenum), the primary site of disturbance in
FD.
FDgard represents an
effective, safe and well-tolerated option to address the unmet medical needs of
millions of adults with FD.
Reporter: Gail S. Thornton
Boca Raton Fl., – (April 30, 2019) – IM HealthScience today announced that Clinical and Translational Gastroenterology (CTG), a peer-reviewed medical journal, has published the U.S. results of a landmark, double-blind, placebo-controlled study, FDREST™ (Functional Dyspepsia Reduction Evaluation and Safety Trial), which showed statistically significant, rapid reduction of Functional Dyspepsia (FD or recurring, meal-triggered indigestion) symptoms within 24 hours and, additionally, relief of severe FD symptoms.
The
FDREST study demonstrated that patients who took COLM-SST (FDgard®) on a daily
and proactive basis, 30 to 60 minutes before meals, along with commonly used
off-label FD medications versus patients who took placebo along with commonly
used off-label FD medications, experienced a statistically significant, rapid
reduction of FD symptoms within 24 hours across the FD study population.
This
study had a higher hurdle than previous studies on a similar combination of
ingredients. Firstly, concomitant medications for FD symptoms were allowed in
order to assess FDgard in a real-world setting. Second, only a subgroup of
patients in FDREST was categorized into the high-symptom burden, while they
constituted the entire groups in previous studies. Among this subgroup of
patients with the high-symptom burden, FDgard showed efficacy at 24 hours. In
spite of the polypharmacy and use of rescue medications for FD, after 48 hours
of first dose, FDgard helped further improve symptoms at 4 weeks, especially in
those high-symptom burden patients. In all cases, FDgard was safe and well-tolerated.
The
study results of FDREST were first presented at Digestive Disease Week (DDW),
the largest gathering of gastroenterologists, in May 2017.
Study Commentary
Commenting on the study, lead author William Chey, M.D., FACG, Director in the Division of Gastroenterology, Michigan Medicine Gastroenterology Clinic, Ann Arbor, said, “This landmark study was designed to answer a very important scientific question about the effectiveness, safety, and tolerability of a novel and innovative formulation of caraway oil and l-Menthol designed as solid state, enteric coated microspheres for targeted duodenal release for FD. In patients taking their usual medications for FD, FDgard was found to be effective, safe and well tolerated in rapidly reducing symptoms and in relieving severe symptoms.” Chey continued, “The positive finding at 24 hours is clinically important as symptoms are often triggered by a meal and patients are looking for rapid relief of those symptoms.”
The
study authors also cited the importance of utilizing the microsphere-based
site-specific targeting of FDgard (caraway oil and l-Menthol, the active
ingredient in peppermint oil) to the duodenum. They wrote, “This site
(duodenum) was targeted primarily due to mounting evidence that gastroduodenal
mucosal integrity and low-grade inflammation play a role in FD. Furthermore,
studies have shown that caraway oil and peppermint oil act on the duodenum to
induce smooth muscle relaxation, and that l-Menthol has anti-inflammatory
effects.” This may help normalize motility effects.
About FDREST™
FDREST™ (Functional Dyspepsia Reduction and Evaluation Safety Trial) was a multi-centered, post-marketing, parallel group,
U.S-based study conducted at seven university-based or gastroenterology
research-based centers (study period July 1, 2015, to September 14, 2016). The
study was designed to compare the efficacy, safety and tolerability of FDgard
plus commonly used, off-label medications for FD vs. a control group of placebo
plus commonly used, off-label medications prescribed for FD.
Ninety-five patients were enrolled
(mean age = 43.4 years; 75.8 percent women). At 24 hours, the active arm
reported a statistically significant reduction in Postprandial Distress Syndrome
(PDS) symptoms (P = 0.039), and a
nonsignificant trend toward benefit of Epigastric Pain Syndrome (EPS) symptoms
(P = 0.074). In patients with more
severe symptoms, approximately three-quarters showed substantial global
improvement (i.e., clinical global impressions) after 4 weeks of treatment vs.
half in the control arm. These differences were statistically significant for
patients with EPS symptoms (epigastric pain or discomfort and burning) (P = 0.046), and trending toward
significance for patients with PDS symptoms (early satiety, abdominal
heaviness, pressure and fullness) (P
= 0.091). There were no statistically significant differences between groups
for Global Overall Symptom scores for the overall population at 2 and 4 weeks.
Dr. Chey said, “The results of this
high-quality study highlight an advance in the management of FD, as current
off-label medications such as PPIs, H2RAs and antidepressants offer only a
modest level of therapeutic gain over placebo and may be associated with
adverse events, especially with continued use. FDgard addresses a significant
unmet medical need for a product to help manage symptoms in the 1 in 6 adults
suffering from this common disorder.”
About Functional
Dyspepsia (FD)
Functional
dyspepsia is a very common disorder affecting 11 percent – 29.2 percent of the
world’s population1, making it comparable in prevalence to IBS. However,
unlike IBS, there is no FDA approved product to treat FD. Sufferers are often
treated off-label with prescribed proton pump inhibitors (PPIs), histamine
type-2 receptor antagonists (H2RAs), antidepressants, and prokinetics. While
offering relief to a portion of FD patients, some of these have been associated
with adverse events. Functional dyspepsia can have a negative effect on
workplace attendance and productivity, with associated costs estimated in
excess of $18 billion annually.2
In
FD, which is typically recurring, meal-triggered indigestion with no known
organic cause, the normal digestive processes are disrupted along with
digestion and absorption of food nutrients. FD is accompanied by symptoms such
as epigastric pain or discomfort, epigastric burning, postprandial fullness,
inability to finish a normal sized meal, heaviness, pressure, bloating in the
upper abdomen, nausea, and belching. When doctors diagnose FD, they often
identify patients as those who have these symptoms for at least three months,
with symptom onset six months previously.
About FDgard®
FDgard® is a
nonprescription medical food designed to address the unmet medical need for
products to help manage Functional Dyspepsia (FD or recurring, meal-triggered
indigestion) and its accompanying symptoms. FDgard capsules contain
caraway oil and l-Menthol, the primary component in peppermint oil, for the
dietary management of FD. These two main ingredients are specially formulated
to be available in a solid state. With
patented Site Specific Targeting (SST®) technology pioneered by IM
HealthScience, FDgard capsules release individually triple-coated, solid-state
microspheres of caraway oil and l-Menthol quickly and reliably where they are
needed most in FD — the duodenum or upper belly. The l-Menthol helps with
smooth muscle relaxation and provides analgesic and anti-inflammatory
activities.3–5 Caraway oil helps mitigate the effect of gastric acid on
the stomach wall and also helps to normalize gallbladder function and may help
to normalize motility in the small intestine (primarily the duodenum) and in
the stomach.6,7 In addition to caraway oil and l-Menthol, FDgard also
provides fiber and amino acids (from gelatin protein). These ingredients have
additional positive effects on the gut wall and thus help toward normalizing
digestion and absorption.
Caraway
oil and peppermint oil have a history of working in FD. In multiple clinical
studies, the combination of caraway oil and peppermint oil has been shown to
manage FD and its accompanying symptoms, such as reducing the intensity of
epigastric pain, pain frequency, dyspeptic discomfort, and the intensity of
sensations of pressure, abdominal heaviness and fullness significantly better
than control.8,9 Cisapride, no longer an FDA-approved pro-motility drug
after its removal from the market in 2000 due to cardiovascular side effects,
was shown to have efficacy similar to a caraway oil/peppermint oil formulation10.
Complete
and final results from a real-world, observational study of 600 patients who
took FDgard, called FDACT™ (Functional Dyspepsia Adherence and Compliance Trial), were selected after peer
review and presented by William D. Chey, M.D., FACG, at the World Congress of
Gastroenterology at ACG 2017 in Orlando, Florida. The data showed there was a
consistently high level of patient satisfaction and rapid improvement of FD
symptoms with the product. A majority of patients (95 percent) reported major
or moderate improvement in their overall FD symptoms, while many patients (86.4
percent) indicated experiencing relief from symptoms within 2 hours after
taking FDgard. The findings from FDACT
substantiate the data reported in FDREST.
The usual adult dose of
FDgard is 2 capsules, as needed, up to two times a day, not to exceed six
capsules per day. Many physicians are now recommending taking FDgard daily and
proactively 30-60 minutes before a meal, as this enables the supportive effect
of FDgard to start as early as possible. While FDgard does not require a
prescription and is available in retail outlets and online, it is a medical
food that should be used under medical supervision.
About IM HealthScience®
IM
HealthScience® (IMH) is the innovator of IBgard®and
FDgard®for the dietary management of Irritable Bowel Syndrome
(IBS) and Functional Dyspepsia (FD or recurring, meal-triggered indigestion),
respectively. In 2017, IMH added Fiber Choice®, a line of prebiotic
fibers, to its product line via an acquisition. The sister subsidiary of IMH,
Physician’s Seal®, also provides REMfresh®,
a
well-known continuous release and absorption melatonin
(CRA-melatonin™) supplement for sleep.
IMH is a privately held company based in Boca
Raton, Florida. It was founded in 2010 by a team of highly experienced
pharmaceutical research and development and management executives. The company
is dedicated to developing products to address overall health and wellness,
especially in digestive health conditions with a high unmet medical need. The
IM HealthScience advantage comes from developing products based on its
patented, targeted-delivery technologies called Site Specific Targeting (SST).
For more information, visit www.imhealthscience.com to learn about
the company, or www.IBgard.com,
1. Mahadeva S, Goh KL. Epidemiology of
functional dyspepsia. A global perspective. World J Gastroenterol. 2006.
doi:10.3748/wjg.v12.i17.2661.
2. Lacy BE, Weiser KT, Kennedy AT, Crowell
MD, Talley NJ. Functional dyspepsia: the economic impact to patients. Aliment
Pharmacol Ther. 2013;38(May):170-177. doi:10.1111/apt.12355.
3. Amato A, Liotta R, Mulè F. Effects of
menthol on circular smooth muscle of human colon: Analysis of the mechanism of
action. Eur J Pharmacol. 2014. doi:10.1016/j.ejphar.2014.07.018.
4. Liu B, Fan L, Balakrishna S, Sui A, Moris
JB, Jordt S-E. TRPM8 is the Principal Mediator of Menthol-induced Analgesia of
Acute and Inflammatory Pain. Pain. 2013;154(10):2169-2177.
doi:10.1016/j.pain.2013.06.043.TRPM8.
5. Juergens U, Stober M, Vetter H. The
anti-inflammatory activity of L-menthol compared to mint oil in human monocytes
in vitro: a novel perspective for its therapeutic use in inflammatory diseases.
Eur J Med Res. 1998;3(12):539-545.
6. Alhaider A, Al-Mofleh I, Mossa J,
Al-Sohaibani M, Rafatullah S, Qureshi S. Effect of Carum carvi on
experimentally induced gastric mucosal damage in Wistar albino rats. Int J
Pharmacol. 2006;2(3):309-315.
7. Micklefield G, Jung O, Greving I, May B.
Effects of intraduodenal application of peppermint oil (WS 1340) and caraway
oil (WS 1520) on gastroduodenal motility in healthy volunteers. Phyther Res.
2003;17:135-140. doi:10.1002/ptr.1089.
8. May B, Köhler S, Schneider B. Efficacy
and tolerability of a fixed combination of peppermint oil and caraway oil in
patients suffering from functional dyspepsia. Aliment Pharmacol Ther.
2000;14:1671-1677. doi:10.1046/j.1365-2036.2000.00873.x.
9. Rich G, Shah A, Koloski N, et al. A
randomized placebo-controlled trial on the effects of Menthacarin, a
proprietary peppermint- and caraway-oil-preparation, on symptoms and quality of
life in patients with functional dyspepsia. Neurogastroenterol Motil.
2017;29(May):e13132. doi:10.1111/nmo.13132.
10. Madisch A, Heydenreich C, Wieland V,
Hufnagel R, Hotz J. Treatment of Functional Dyspepsia with a Fixed Peppermint
Oil and Caraway Oil Combination Preparation as Compared to Cisapride – A
multicenter, reference-controlled double-blind equivalence study. Arzneimittelforsch
Drug Res. 1999;49(II):925-932.
This information is for educational purposes only and is not meant to be a substitute for the advice of a physician or other health care professional. This information should not be used for diagnosing a health problem or disease. While medical foods do not require prior approval by the FDA for marketing, they must comply with regulations. It should not be assumed that medical foods are alternatives for FDA-approved drugs. Only doctors can definitively diagnose functional dyspepsia. Use under medical supervision. The company will strive to keep information current and consistent but may not be able to do so at any specific time. Generally, the most current information can be found on www.fdgard.com. Individual results may vary.
Other related articles were published in this Open Access Online Scientific Journal include the following:
The bacterial makeup of human milk is influenced by the mode of breastfeeding, according to a new study. Although previously considered sterile, breast milk is now known to contain a low abundance of bacteria. While the complexities of how maternal microbiota influence the infant microbiota are still unknown, this complex community of bacteria in breast milk may help to establish the infant gut microbiota. Disruptions in this process could alter the infant microbiota, causing predisposition to chronic diseases such as allergies, asthma, and obesity. While it’s unclear how the breast milk microbiome develops, there are two theories describing its origins. One theory speculates that it originates in the maternal mammary gland, while the other theory suggests that it is due to retrograde inoculation by the infant’s oral microbiome.
To address this gap in knowledge scientists carried out bacterial gene sequencing on milk samples from 393 healthy mothers three to four months after giving birth. They used this information to examine how the milk microbiota composition is affected by maternal factors, early life events, breastfeeding practices, and other milk components. Among the many factors analyzed, the mode of breastfeeding (with or without a pump) was the only consistent factor directly associated with the milk microbiota composition. Specifically, indirect breastfeeding was associated with a higher abundance of potential opportunistic pathogens, such as Stenotrophomonas and Pseudomonadaceae. By contrast, direct breastfeeding without a pump was associated with microbes typically found in the mouth, as well as higher overall bacterial richness and diversity. Taken together, the findings suggest that direct breastfeeding facilitates the acquisition of oral microbiota from infants, whereas indirect breastfeeding leads to enrichment with environmental (pump-associated) bacteria.
The researchers argued that this study supports the theory that the breast milk microbiome is due to retrograde inoculation. Their findings indicate that the act of pumping and contact with the infant oral microbiome influences the milk microbiome, though they noted more research is needed. In future studies, the researchers will further explore the composition and function of the milk microbiota. In addition to bacteria, they will profile fungi in the milk samples. They also plan to investigate how the milk microbiota influences both the gut microbiota of infants and infant development and health. Specifically, their projects will examine the association of milk microbiota with infant growth, asthma, and allergies. This work could have important implications for microbiota-based strategies for early-life prevention of chronic conditions.
Hypertriglyceridemia: Evaluation and Treatment Guideline
Reporter and Curator: Dr. Sudipta Saha, Ph.D.
Severe and very severe hypertriglyceridemia increase the risk for pancreatitis, whereas mild or moderate hypertriglyceridemia may be a risk factor for cardiovascular disease. Individuals found to have any elevation of fasting triglycerides should be evaluated for secondary causes of hyperlipidemia including endocrine conditions and medications. Patients with primary hypertriglyceridemia must be assessed for other cardiovascular risk factors, such as central obesity, hypertension, abnormalities of glucose metabolism, and liver dysfunction. The aim of this study was to develop clinical practice guidelines on hypertriglyceridemia.
The diagnosis of hypertriglyceridemia should be based on fasting levels, that mild and moderate hypertriglyceridemia (triglycerides of 150–999 mg/dl) be diagnosed to aid in the evaluation of cardiovascular risk, and that severe and very severe hypertriglyceridemia (triglycerides of >1000 mg/dl) be considered a risk for pancreatitis. The patients with hypertriglyceridemia must be evaluated for secondary causes of hyperlipidemia and that subjects with primary hypertriglyceridemia be evaluated for family history of dyslipidemia and cardiovascular disease.
The treatment goal in patients with moderate hypertriglyceridemia should be a non-high-density lipoprotein cholesterol level in agreement with National Cholesterol Education Program Adult Treatment Panel guidelines. The initial treatment should be lifestyle therapy; a combination of diet modification, physical activity and drug therapy may also be considered. In patients with severe or very severe hypertriglyceridemia, a fibrate can be used as a first-line agent for reduction of triglycerides in patients at risk for triglyceride-induced pancreatitis.
Three drug classes (fibrates, niacin, n-3 fatty acids) alone or in combination with statins may be considered as treatment options in patients with moderate to severe triglyceride levels. Statins are not be used as monotherapy for severe or very severe hypertriglyceridemia. However, statins may be useful for the treatment of moderate hypertriglyceridemia when indicated to modify cardiovascular risk.
Micronutrients, Macronutrients and Dietary Patterns: Nutrition and Fertility
Reporter: Aviva Lev-Ari, PhD, RN
Folic acid.Folic acid is important for germ cell production and pregnancy. The recommended daily dose to prevent neural tube defects is 400-800 µg. Women who take folic acid-containing multivitamins are less likely to be anovulatory, and the time to achieve a pregnancy is reduced. Those who consume more than 800 µg of folic acid daily are more likely to conceive with assisted reproductive technology (ART) than those whose daily intake is less than 400 µg.
Vitamin D. Vitamin D may affect fertility through receptors found in the ovaries and endometrium. An extremely low vitamin D level (< 20 ng/mL) is associated with higher risk for spontaneous miscarriage risk. Some reports suggest that women with adequate vitamin D levels (> 30 ng/mL) are more likely to conceive after ART when compared with those whose vitamin D levels are insufficient (20-30 ng/mL), or deficient (< 20 ng/mL). These findings, however, are inconclusive.
Carbohydrates. Dietary carbohydrates affect glucose homeostasis and insulin sensitivity, and by these mechanisms can affect reproduction. The impact is most pronounced among women with polycystic ovary syndrome (PCOS). In women with PCOS, a reduction in glycemic load improves insulin sensitivity as well as ovulatory function. Whole grains have antioxidant effects and also improve insulin sensitivity, thereby positively influencing reproduction.
Omega-3 supplements. Omega-3 polyunsaturated fatty acids lower the risk for endometriosis. Increased levels of omega-3 polyunsaturated fatty acids are associated with higher clinical pregnancy and live birth rates.
Protein and dairy. Some reports suggest that dairy protein intake lowers ovarian reserve. Other reports suggest improved ART outcomes with increased dairy intake. Meat, fish, and dairy products, however, can also serve as vehicles for environmental contamination that may adversely affect the embryo. Fish, on the other hand, has been shown to exert positive effects on fertility.
Dietary approach. In general, a Mediterranean diet is favored (high intake of fruits, vegetables, fish, chicken, and olive oil) among women diagnosed with infertility.
Recommendations
A well-balanced diet, rich in vegetables and fruits, is preferred for infertile women and should provide the required micro- and macronutrients. It remains common for patients consume a wide variety of vitamin, mineral, and micronutrient supplements daily.[4] Supplements should not replace food sources of vitamins and trace elements because of differences in bioavailability (natural versus synthetic), and inaccuracy of label declarations may result in suboptimal intake of important nutrients.[5,6] Furthermore, naturally occurring vitamins and micronutrients are more efficiently absorbed.
With respect to overall diet, women are advised to follow a caloric intake that won’t contribute to being overweight or obese. Obesity is on the rise among younger people, including children. Obese women have a lower chance of conceiving and are less likely to have an uncomplicated pregnancy.[7] Proper weight can be maintained with an appropriate diet and regular exercise.
Finally, women must abstain from substances that are potentially harmful to pregnancy (eg, smoking, alcohol, recreational drugs, high caffeine intake).
Causes of Infertility
ovulatory defect,
tubal occlusion,
low sperm counts), and many
Factors lower the chance of pregnancy
older age,
lower ovarian reserve,
endometriosis
Factors can’t be altered
age and
ovarian reserve
Modifiable Factors:
body weight and
lifestyle habits
REFERENCES
Zinaman MJ, Clegg ED, Brown CC, O’Connor J, Selevan SG. Estimates of human fertility and pregnancy loss. Fertil Steril. 1996;65:503-509. Abstract
Practice Committee of American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertil Steril. 2013;99:63. Abstract
Chiu YH, Chavarro JE, Souter I. Diet and female fertility: doctor, what should I eat? Fertil Steril. 2018;110:560-569. Abstract
Kantor ED, Rehm CD, Du M, White E, Giovannucci EL. Trends in dietary supplement use among US adults from 1999-2012. JAMA. 2016;316:1464-1474. Abstract
Carr AC, Vissers MC. Synthetic or food-derived vitamin C—are they equally bioavailable? Nutrients. 2013;5:4284-4304. Abstract
Yetley EA. Multivitamin and multimineral dietary supplements: definitions, characterization, bioavailability, and drug interactions. Am J Clin Nutr. 2007;85:269S-276S. Abstract
Practice Committee of American Society for Reproductive Medicine. Obesity and reproduction: an educational bulletin. Fertil Steril. 2008;90(5 Suppl):S21-S29. Abstract
Live 11:00 AM- 12:00 Mediterranean Diet and Lifestyle: A Symposium on Diet and Human Health : Opening Remarks October 19, 2018
Reporter: Stephen J. Williams, Ph.D.
11:00Welcome
Prof. Antonio Giordano, MD, PhD.
Director and President of the Sbarro Health Research Organization, College of Science and Technology, Temple University
Welcome to this symposium on Italian lifestyle and health. This is similar to a symposium we had organized in New York. A year ago Bloomberg came out with a study on higher longevity of the italian population and this study was concluded that this increased longevity was due to the italian lifestyle and diet especially in the southern part of Italy, a region which is older than Rome (actually founded by Greeks and Estonians). However this symposium will delve into the components of this healthy Italian lifestyle which contributes to this longevity effect. Some of this work was done in collaboration with Temple University and sponsored by the Italian Consulate General in Philadelphia ( which sponsors programs in this area called Ciao Philadelphia).
Greetings: Fucsia Nissoli Fitzgerald, Deputy elected in the Foreign Circumscription – North and Central America Division
Speaking for the Consulate General is Francesca Cardurani-Meloni. I would like to talk briefly about the Italian cuisine and its evolution, from the influence of the North and South Italy, economic factors, and influence by other cultures. Italian cooking is about simplicity, cooking with what is in season and freshest. The meal is not about the food but about comfort around the table, and comparible to a cullinary heaven, about sharing with family and friends, and bringing the freshest ingredients to the table.
Consul General, Honorable Pier Attinio Forlano, General Consul of Italy in Philadelphia
11:30The Impact of Environment and Life Style in Human Disease
Prof. Antonio Giordano MD, PhD.
To follow or Tweet on Twitter please use the following handles (@) and hashtags (#):
Announcement 11AM- 5PM: Live Conference Coverage from Mediterranean Diet and Lifestyle: A Symposium on Diet and Human Health @S.H.R.O. and Temple University October 19, 2018
Reporter: Stephen J. Williams, Ph.D.
The Sbarro Health Research Organization, in collaboration with the Consulate General of Italy in Philadelphia will sponsor a symposium on the Mediterranean Diet and Human Health on October 19, 2018 at Temple University in Philadelphia, PA. This symposium will discuss recent finding concerning the health benefits derived from a Mediterranean-style diet discussed by the leaders in this field of research.
Mediterranean Diet
The description of the Mediterranean Diet stems from the nutritionist Ancel Keys, who in 1945, in the wake of the US Fifth Army, landed in Southern Italy, where he observed one of the highest concentrations of centenarians in the world. He also noticed that cardiovascular diseases, widespread in the USA, were less frequent there. In particular, among the Southern Italians, the prevalence of “wellness” diseases such as hypertension and diabetes mellitus, was particularly associated with fat consumption, suggesting that the main factor responsible for the observations was the type of diet traditionally consumed among people facing the Mediterranean Sea, which is low in animal fat, as opposed to the Anglo-Saxon diet. The link between serum cholesterol and coronary heart disease mortality was subsequently demonstrated by the Seven Countries Study. Later, the concept of Mediterranean Diet was extended to a diet rich in fruits, vegetables, legumes, whole grains, fish and olive oil as the main source of lipid, shared among people living in Spain, Greece, Southern Italy and other countries facing the Mediterranean basin …
Prof. Antonino De Lorenzo, MD, PhD.
The Symposium will be held at:
Biolife Science Building, Room 234
Temple University, 1900 North 12th street
Philadelphia, PA 19122
For further information, please contact:
Ms. Marinela Dedaj – Sbarro Institute, Office #: 215-204-9521
11:00Welcome
Prof. Antonio Giordano, MD, PhD.
Director and President of the Sbarro Health Research Organization, College of Science and Technology, Temple University
Greetings
Fucsia Nissoli Fitzgerald
Deputy elected in the Foreign Circumscription – North and Central America Division
Consul General, Honorable Pier Attinio Forlano
General Consul of Italy in Philadelphia
11:30The Impact of Environment and Life Style in Human Disease
Prof. Antonio Giordano MD, PhD.
12.00 The Italian Mediterranean Diet as a Model of Identity of a People with a Universal Good to Safeguard Health?
Prof. Antonino De Lorenzo, MD, PhD.
Director of the School of Specialization in Clinical Nutrition, University of Rome “Tor Vergata”
Professor of Molecular Biology at Temple University in Philadelphia, PA where he is also Director of the Sbarro Institute for Cancer Research and Molecular Medicine. He is also Professor of Pathology at the University of Siena, Italy. He has published over 500 articles, received over 40 awards for his contributions to cancer research and is the holder of 17 patents.
Full Professor of Human Nutrition and Director of the Specialization School in Food Science at the University of Rome “Tor Vergata”. He is the Coordinator of the Specialization Schools in Food Science at the National University Council and Coordinator of the PhD. School of “Applied Medical-Surgical Sciences” Director of UOSD “Service of Clinical Nutrition, Parenteral Therapy and Anorexia”. He also serves as President of “Istituto Nazionale per la Dieta Mediterranea e la Nutrigenomica”.
Iris Maria Forte is an oncology researcher of INT G. Pascale Foundation of Naples, Italy. She majored in Medical Biotechnology at the “Federico II” University of Naples, earned a PhD. in “Oncology and Genetics” at the University of Siena in 2012 and a Master of II level in “Environment and Cancer” in 2014. Iris Maria Forte has worked with Antonio Giordano’s group since 2008 and her research interests include both molecular and translational cancer research. She published 21 articles mostly focused in understanding the molecular basis of human cancer. She worked on different kinds of human solid tumors but her research principally focused on pleural mesothelioma and on cell cycle deregulation in cancer.
Professor in the Department of Nutrition and Food Studies. He has a Doctorate in Agricultural Sciences (Dr.sc.agr.) from Hohenheim University, Stuttgart (Germany), MA in Political Sciences from the Istituto Universitario Orientale, Naples (Italy), BA/MA in Modern Foreign Languages and Literature from the Università La Sapienza, Rome (Italy). His research explores the intersections among food, media, and politics. His most recent projects focus on Food Design and the synergies between Food Studies and design.
Prof. Lisa Sasson, MS
Dietetic Internship Director and a Clinical Associate Professor in the department. She has interests in dietetic education, weight and behavior management, and problem-based learning. She also is a private practice nutritionist with a focus on weight management. She serves as co-director of the Food, Nutrition and Culture program in Florence Italy, the New York State Dietetic Association and the Greater New York Dietetic Association (past president and treasurer).
Director of Demographic Studies for The John D. Calandra Italian American Institute, Queens College, City University of New York. He has conducted social science research on Italian Americans. His research has included the educational and occupational achievements; Italian language studies at the elementary and secondary levels, high school non-completion rates; negative media portrayals of ethnic populations including migration studies and global diaspora.
Agricultural entrepreneur, Manager of the Italian Consortium for Biogas (CIB) and delegate for the Bioeconomy National Department of Confagricoltura. He developed A.R.T.E based on a model of agricultural circular economy, beginning and ending in the ground. He constructed the first biogas plant in the territory creating a new way to make agriculture, investing in research and development, experimentation and most of all, in people. In a few short years, he succeeded to close the production chain producing goods characterized by their high quality and usage of renewable energy.
Vice-President for Institutional and International Relations of the Istituto Nazionale per la Dieta Mediterranea e la Nutrigenomica (I.N.D.I.M.). Has managed relations with the academic institutions to increase awareness and develops projects for the diffusion of the Mediterranean Diet. She served as Director of Finance for the National Institute of Nutrition, for the Ministry of Agriculture and Forestry.
About the Sbarro Health Research Organization
The Sbarro Health Research Organization (SHRO) is non-profit charity committed to funding excellence in basic genetic research to cure and diagnose cancer, cardiovascular diseases, diabetes and other chronic illnesses and to foster the training of young doctors in a spirit of professionalism and humanism. To learn more about the SHRO please visit www.shro.org
To follow or Tweet on Twitter please use the following handles (@) and hashtags (#):
Researchers have suggested that omega-3 polyunsaturated fatty acids from oily fish (long-chain omega-3 (LCn3), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), as well as from plants (alpha-linolenic acid (ALA)) benefit cardiovascular health. Guidelines recommend increasing omega-3-rich foods, and sometimes supplementation, but recent trials have not confirmed this.
OBJECTIVES:
To assess effects of increased intake of fish- and plant-based omega-3 for all-cause mortality, cardiovascular (CVD) events, adiposity and lipids.
SEARCH METHODS:
We searched CENTRAL, MEDLINE and Embase to April 2017, plus ClinicalTrials.gov and World Health Organization International Clinical Trials Registry to September 2016, with no language restrictions. We handsearched systematic review references and bibliographies and contacted authors.
SELECTION CRITERIA:
We included randomised controlled trials (RCTs) that lasted at least 12 months and compared supplementation and/or advice to increase LCn3 or ALA intake versus usual or lower intake.
DATA COLLECTION AND ANALYSIS:
Two review authors independently assessed studies for inclusion, extracted data and assessed validity. We performed separate random-effects meta-analysis for ALA and LCn3 interventions, and assessed dose-response relationships through meta-regression.
MAIN RESULTS:
We included 79 RCTs (112,059 participants) in this review update and found that 25 were at low summary risk of bias. Trials were of 12 to 72 months’ duration and included adults at varying cardiovascular risk, mainly in high-income countries. Most studies assessed LCn3 supplementation with capsules, but some used LCn3- or ALA-rich or enriched foods or dietary advice compared to placebo or usual diet.Meta-analysis and sensitivity analyses suggested little or no effect of increasing LCn3 on all-cause mortality (RR 0.98, 95% CI 0.90 to 1.03, 92,653 participants; 8189 deaths in 39 trials, high-quality evidence), cardiovascular mortality (RR 0.95, 95% CI 0.87 to 1.03, 67,772 participants; 4544 CVD deaths in 25 RCTs), cardiovascular events (RR 0.99, 95% CI 0.94 to 1.04, 90,378 participants; 14,737 people experienced events in 38 trials, high-quality evidence), coronary heart disease (CHD) mortality (RR 0.93, 95% CI 0.79 to 1.09, 73,491 participants; 1596 CHD deaths in 21 RCTs), stroke (RR 1.06, 95% CI 0.96 to 1.16, 89,358 participants; 1822 strokes in 28 trials) or arrhythmia (RR 0.97, 95% CI 0.90 to 1.05, 53,796 participants; 3788 people experienced arrhythmia in 28 RCTs). There was a suggestion that LCn3 reduced CHD events (RR 0.93, 95% CI 0.88 to 0.97, 84,301 participants; 5469 people experienced CHD events in 28 RCTs); however, this was not maintained in sensitivity analyses – LCn3 probably makes little or no difference to CHD event risk. All evidence was of moderate GRADE quality, except as noted.Increasing ALA intake probably makes little or no difference to all-cause mortality (RR 1.01, 95% CI 0.84 to 1.20, 19,327 participants; 459 deaths, 5 RCTs),cardiovascular mortality (RR 0.96, 95% CI 0.74 to 1.25, 18,619 participants; 219 cardiovascular deaths, 4 RCTs), and it may make little or no difference to CHD events (RR 1.00, 95% CI 0.80 to 1.22, 19,061 participants, 397 CHD events, 4 RCTs, low-quality evidence). However, increased ALA may slightly reduce risk of cardiovascular events (from 4.8% to 4.7%, RR 0.95, 95% CI 0.83 to 1.07, 19,327 participants; 884 CVD events, 5 RCTs, low-quality evidence), and probably reduces risk of CHD mortality (1.1% to 1.0%, RR 0.95, 95% CI 0.72 to 1.26, 18,353 participants; 193 CHD deaths, 3 RCTs), and arrhythmia (3.3% to 2.6%, RR 0.79, 95% CI 0.57 to 1.10, 4,837 participants; 141 events, 1 RCT). Effects on stroke are unclear.Sensitivity analysis retaining only trials at low summary risk of bias moved effect sizes towards the null (RR 1.0) for all LCn3 primary outcomes except arrhythmias, but for most ALA outcomes, effect sizes moved to suggest protection. LCn3 funnel plots suggested that adding in missing studies/results would move effect sizes towards null for most primary outcomes. There were no dose or duration effects in subgrouping or meta-regression.There was no evidence that increasing LCn3 or ALA altered serious adverse events, adiposity or lipids, although LCn3 slightly reduced triglycerides and increased HDL. ALA probably reduces HDL (high- or moderate-quality evidence).
AUTHORS’ CONCLUSIONS:
This is the most extensive systematic assessment of effects of omega-3 fats on cardiovascular health to date. Moderate- and high-quality evidence suggests that increasing EPA and DHA has little or no effect on mortality or cardiovascular health (evidence mainly from supplement trials). Previous suggestions of benefits from EPA and DHA supplements appear to spring from trials with higher risk of bias. Low-quality evidence suggests ALA may slightly reduce CVD event risk, CHD mortality and arrhythmia.
Co-Editor: The VOICES of Patients, Hospital CEOs, HealthCare Providers, Caregivers and Families: Personal Experience with Critical Care and Invasive Medical Procedures
In a national survey, the Fiber Choice® line of chewable prebiotic fiber tablets and gummies, achieved the #1 share of gastroenterologist (GE) recommendations, more than four times greater than that for the nearest branded competitor
Fiber Choice contains a well-studied prebiotic fiber that promotes regularity and supports the growth of beneficial microorganisms for general digestive health
The convenience, taste and efficacy of Fiber Choice, makes it a GE-endorsed choice toward helping address the “fiber gap” in American diets
Boca Raton, Fla. – (June 3, 2018) – IM HealthScience® (IMH), innovators of medical foods and dietary supplements, today announced a high-quality and replicated nationwide survey conducted among a representative and projectible sample of U.S. gastroenterologists, which revealed Fiber Choice® as the #1-recommended chewable prebiotic fiber brand.
The results of a ProVoice survey, fielded in May 2018 by IQVIA, showed Fiber Choice as the leader by far. Its share of gastroenterologist endorsements was more than four times greater than that of its nearest branded competitor.
Less than 3 percent of Americans get the recommended minimum amount of fiber, and 97 percent need to increase their fiber intake[1]. Although the recommended daily fiber intake is 25 to 38 grams[2], most Americans only get about half that amount. This “fiber gap” reflects a diet with relatively few high-fiber foods, such as fruits, vegetables, nuts, legumes and whole-grains, and is large enough for the U.S. government to deem it a public health concern for most of the U.S. population.
To help bridge this gap, gastroenterologists recommend fibers including Fiber Choice chewable tablets and gummies. For doctors, it’s a simple, convenient and tasty way to help their patients get the fiber needed for overall good digestive health.
“Dietary fiber is known for keeping our bodies regular,” said Michael Epstein, M.D., FACG, AGAF, a leading gastroenterologist and Chief Medical Advisor of IM HealthScience. “Most importantly, it’s essential that you get enough fiber in your diet. One way to do that is to supplement your daily intake of dietary fiber with natural, prebiotic fiber supplements.”
Inulin, the 100 percent natural prebiotic soluble fiber in Fiber Choice, has been studied extensively and has been shown to support laxation and overall digestive health as well as glycemic control, lowered cholesterol, improved cardiovascular health, weight control and better calcium absorption.
Fiber Choice can be found in the digestive aisle at Walmart, CVS, Target, Rite Aid and many other drug and food retailers.
About ProVoice Survey
ProVoice has the largest sample size of any professional healthcare survey in the U.S., with nearly 60,000 respondents across physicians, nurse practitioners, physician assistants, optometrists, dentists, and hygienists, measuring recommendations across more than 120 over-the-counter categories. Manufacturers use ProVoice for claim substantiation, promotion measurement, and HCP targeting.
IQVIA fielded replicated surveys in April 2018 and May 2018 respectively among U.S. gastroenterologists for IM HealthScience. The ProVoice survey methodology validated the claim at a 95 percent confidence level that “Fiber Choice® is the #1 gastroenterologist-recommended chewable prebiotic fiber supplement.”
About Fiber Choice®
The Fiber Choice® brand of chewables and gummies is made of inulin [pronounced: in-yoo-lin], a natural fiber found in many fruits and vegetables. Inulin works by helping to build healthy, good bacteria in the colon, while keeping food moving through the digestive system. This action has a beneficial and favorable effect in softening stools and improving bowel function.
Research shows that the digestive system does more than digest food; it plays a central role in the immune system. The healthy bacteria that live in the digestive tract promote immune system function, so prebiotic fiber helps nourish the body. Inulin also has secondary benefits, too, of possibly lowering cholesterol, balancing blood chemistry and regulating appetite, which can help reduce calorie intake and play a supporting role in weight management.
The usual adult dosage with Fiber Choice Chewable tablets is two tablets up to three times a day and for Fiber Choice Fiber Gummies is two gummies up to six per day.
About IM HealthScience®
IM HealthScience® (IMH) is the innovator of IBgardand FDgardfor the dietary management of Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD), respectively. In 2017, IMH added Fiber Choice®, a line of prebiotic fibers, to its product line via an acquisition. The sister subsidiary of IMH, Physician’s Seal®, also provides REMfresh®, a well-known continuous release and absorption melatonin (CRA-melatonin™) supplement for sleep. IMH is a privately held company based in Boca Raton, Florida. It was founded in 2010 by a team of highly experienced pharmaceutical research and development and management executives. The company is dedicated to developing products to address overall health and wellness, including conditions with a high unmet medical need, such as digestive health. The IM HealthScience advantage comes from developing products based on its patented, targeted-delivery technologies called Site Specific Targeting (SST). For more information, visit www.imhealthscience.com to learn about the company, or www.IBgard.com, www.FDgard.com, www.FiberChoice.com, and www.Remfresh.com.
This information is for educational purposes only and is not meant to be a substitute for the advice of a physician or other health care professional. You should not use this information for diagnosing a health problem or disease. The company will strive to keep information current and consistent but may not be able to do so at any specific time. Generally, the most current information can be found on www.fiberchoice.com. Individual results may vary.
[2] Institute of Medicine. 2005. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: The National Academies Press. https://doi.org/10.17226/10490.
Other related articles published in this Open Access Online Scientific Journal include the following:
2012pharmaceutical
sjwilliamspa