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Friday, April 26, 2024
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Researchers have uncovered new clues to the mystery of how the gut’s nervous system affects glucose metabolism in the rest of the body. Their findings could lead to new treatments for type 2 diabetes.

Type 2 diabetes causes the body’s cells to become less sensitive to signals from insulin, the hormone responsible for regulating levels of glucose in the blood.

This low sensitivity is called insulin resistance, and it keeps the cells from absorbing the extra glucose that enters the bloodstream after a meal.

Over time, high concentrations of glucose in the blood damage tissues all over the body, causing complications such as heart disease, vision loss, and kidney disease.

The Centers for Disease Control and Prevention (CDC) estimate that more than 30 million people in the United States have type 2 diabetes.

Changes to the diet, exercise, and other aspects of life can improve symptoms and even reverse the condition in some people. Drugs are also available to treat type 2 diabetes, but they can cause side effects such as nausea and diarrhea.

Another drawback to some antidiabetic drugs is that they have to be injected.

Discovering oral treatments that are not only effective but also free of side effects is therefore a priority for diabetes researchers.

Now, a group of scientists, many affiliated with the French National Institute of Health and Medical Research, or INSERM, in Toulouse, believe that they are a step closer to developing such a treatment. They have published their findings in the journal Gut.

Friendly bacteria

This latest research builds on previous work suggesting that fat, or lipid, molecules produced by “friendly” gut bacteria can improve blood glucose metabolism.

These lipids are thought to influence the gut-brain axis — the vital two-way communication between the brain and the gut’s highly developed nervous system, also known as the enteric nervous system or “second brain.”

In type 2 diabetes, communication between the gut and brain appears to break down. As a result, after a meal, the brain fails to send signals to the liver, muscles, and fat tissue telling them to absorb more glucose from the bloodstream. This, in turn, leads to insulin resistance.

Normally the duodenum, the first part of the small intestine, signals to the brain, which involves a relaxation of the smooth muscles in its lining. In individuals with type 2 diabetes, however, these muscles are permanently contracted, or hypercontractile, so the signal is never sent.

The researchers believe that friendly gut bacteria are the key to reversing hypercontractility and restoring healthy glucose metabolism.

Nutrients that feed friendly bacteria are called prebiotics. In particular, carbohydrates called fructooligosaccharides (FOS) are known to promote the growth of bacteria that improve glucose metabolism through the production of various lipids.

However, the identity of these lipids has remained unknown until now.

Key lipids

To find out more, the researchers fed mice a special diet supplemented with FOS. Then, they compared the contents of their colons with those of mice that did not receive supplementary FOS.

The team discovered that the only lipid with significantly increased levels in the colons of the FOS mice was a lipid called 12-HETE.

When they fed 12-HETE to diabetic mice, the lipid not only reduced duodenal hypercontraction but also improved the mice’s blood glucose levels.

To explore whether these results applied to humans, the scientists analyzed biopsies from the duodenums of people with type 2 diabetes who had received antidiabetic treatments and those of healthy volunteers who had not.

They found that there was 38% less 12-HETE in the duodenums of the people with diabetes, compared with the healthy volunteers. The researchers acknowledge that this finding was not statistically significant, but also point to the small numbers of volunteers in their study.

Finally, they showed that 12-HETE reduces muscle contraction in the duodenum by boosting the signal from a nerve receptor called the mu-opioid receptor. This restored communication between the gut and the brain.

Intimate relationships

This study is one of the latest to reveal intimate relationships between the bacteria in the human gut, known collectively as the microbiota, and our health.

The scientists are optimistic that their work will inspire new treatments, which could either boost production of 12-HETE in the gut or involve taking the lipid orally, as a supplement.

In their paper, the researchers conclude:

“Using a combination of nutritional and pharmacological approaches, we have identified a new mode of communication between gut microbes and the host. In addition, we have identified novel targets and their mechanisms of action in rodents, and possibly in humans. The identification of specific targets […] to treat [type 2 diabetes] and its comorbidities represent a groundbreaking solution to develop medications without side effects.”

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Diabetes Mellitus is a metabolic disorder caused by the failure of insulin to pump glucose into the cells of the body. The failure can be at the level of the cells where the cells do not respond to insulin by opening the door through which glucose passes into the cells. Insulin failure can also be due to complete or partial failure of the beta-cells of the pancreas, with the result that there is no insulin or not enough in circulation.

There are mainly two types of diabetes: Type 1 DM which used to be known as juvenile-onset diabetes is common among young children. It is due to an autoimmune disorder whereby the immune system of individual attacks and destroys the beta cells of the pancreas of the same individual. In this type of diabetes, there is no insulin in circulation at all and the individual must receive an injection of insulin daily for life.

Type 2 DM, used to be known as adult-onset diabetes mellitus, affects mainly adults. It is a disorder that is associated with partial failure of the function of insulin. In this type of DM, the patients are not dependent on insulin. They are treated with drugs by the orthodox medical practitioners. This is the focus of our discussion and in alternative medicine, patients have done well with lifestyle and diet changes, exercise, and natural supplements.
Insulin resistance

As I mentioned earlier, insulin, a hormone produced and secreted by the beta cells of the pancreas, is responsible for driving glucose in the blood circulation into the cells either for energy production or storage. What this means is that after every carbohydrate meal and the glucose level in the blood begins to rise, insulin production and release also start to increase. This insulin drives the glucose above the normal blood level of insulin into the cells. When that is done and the level of glucose in the blood returns to normal, insulin secretion stops.

Now, our meals in this part of the world are high carbohydrate and high-fat diet. The carbohydrate portion of what we eat is mainly starchy foods that have high glycaemic indices. The glycaemic index of a nutrient is the rate at which such a nutrient is absorbed into the blood (or the rate at which a nutrient appears in the blood) and causes the release of insulin. These starchy nutrients with high glycaemic indices being the mainstay of our diet cause a sudden release of insulin into the circulation. I am talking about foods such as white flour products, polished rice, pasta, yam, potatoes etc. These types of food cause what is known as an insulin spike or surge. This is the sudden outpouring of insulin into the circulation in response to the sudden increase of glucose. This will, in a short period of time, drive all the glucose into the cells. When this is done, the individual begins to feel hungry and reaches for a soft drink and a snack, both of which will stimulate another insulin spike. This is repeated all day long for several weeks, months, and even years until there comes a time when the cells no longer respond appropriately to the insulin; response begins to diminish. As it happens, the level of glucose in the blood will continue to rise and force the beta cells of the pancreas to secrete more insulin to try and drive the glucose into the cells. As this goes on, the level of insulin reaches an all-time high, a condition that is known as hyperinsulinaemia.

There are very high levels of insulin in the circulation which should effectively regulate the blood glucose level. However, we find that after some time, the cells become resistant to the insulin which begins to fail in their function of pumping glucose into the cells. Along with the elevated blood insulin, there’s also hyperglycemia (elevated blood glucose.) This is the disorder that is referred to as insulin resistance.

The following are features of the adverse effects of elevated insulin level in the body: hypertension, low HDL (good) cholesterol, high LDL (bad) cholesterol, high triglycerides, increased incidences of blood clots, increased rate of inflammation of the arteries, and development of central obesity (weight gain mainly around the lower abdomen, giving an apple appearance.

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Eating in the evening is associated with a higher intake of calories, as well as lower quality food, according to a new study.

Maintaining a healthful diet is associated with how late in the day people consume most of their food, according to research presented at the European and International Conference on Obesity (ECOICO 2020).

The study found that people who consume most of their calories in the evening tend to consume more of them and have a lower quality diet.

The study’s aim was to explore the connection between the evening consumption of calories — the measure of energy intake (EI) — and diet quality. Judith Baird, a researcher from the Nutrition Innovation Centre for Food and Health at Ulster University in Northern Ireland, United Kingdom, led the study.

Hunger rhythms

Previous studies have found that hunger follows a daily rhythm and that this rhythm is, in some ways, not what people might expect. Although people typically cease eating during an extended period of sleep, they break that fast with what is often the smallest meal of the day.

Meanwhile, hunger tends to be strongest late in the day, peaking at about 8:00 p.m., after most people have completed the majority of their daily activities.

EI consumption naturally tends to be a response to hunger, and other research has investigated the effect of meal timing on metabolism and other bodily processes. The new study, however, looks at its implications for the quantity and quality of food that people consume.

Data used in the study

Beginning in 2008, the U.K.’s National Diet and Nutrition Survey (NDNS) captured detailed information regarding food consumption, nutrient intake, and nutritional status for individuals over the age of 18 months. Each year, the survey collected responses from a representative sample of 1,000 people. Baird and her colleagues analyzed data from 1,177 adults who participated in the survey from 2012 through 2017.

Overall, the researchers found that the participants were, on average, consuming nearly 40% (39.8%) of their daily EI after 6:00 p.m.

Looking at the data more closely, the researchers divided people into quartiles according to the proportion of their daily EI that they consumed after 6:00 p.m. The people in the lowest quartile consumed less than 31.4% of their EI in the evening, while those in the highest quartile ate more than 48.6% during evening hours.

What the data say

The researchers detected two significant trends in the data. First, the study found that eating later affected the total EI for the day.

People who consumed most of their daily EI earlier tended to eat fewer calories over the course of a day.

The findings also suggested that meal timing affects the nutritional quality of food. Baird and her colleagues assessed individuals’ diets as they had reported them in the food diaries that they had supplied to the NDNS. To do this, they consulted the rankings listed in the Nutrient-Rich Food Index. The index rates foods according to their ratio of important nutrients to calorie value.

People who consumed more of their calories during the evening tended to have significantly poorer quality diets.

“Our results suggest that consuming a lower proportion of EI in the evening may be associated with a lower daily energy intake, while consuming a greater proportion of energy intake in the evening may be associated with a lower diet quality score. – The study authors

The study authors present their insights as just one facet of a deeper understanding of the effect of a person’s daily food rhythms and the amount and quality of food that they consume. They conclude:

“Timing of energy intake may be an important modifiable behavior to consider in future nutritional interventions. Further analysis is now needed to examine whether the distribution of energy intake and/or the types of food consumed in the evening are associated with measures of body composition and cardiometabolic health.”

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Exercising women who struggle to consume enough calories and have menstrual disorders can simply increase their food intake to recover their menstrual cycle, according to a study accepted for presentation at ENDO 2020, the Endocrine Society’s annual meeting, and publication in the Journal of the Endocrine Society.

The study found that exercising women with menstrual disorders can start menstruating again by consuming an additional 300-400 calories a day.

“These findings can impact all exercising women, because many women strive to exercise for competitive and health-related reasons but may not be getting enough calories to support their exercise,” said lead researcher Mary Jane De Souza, Ph.D., of Penn State University.

By consuming enough calories, exercising women with menstrual disorders can avoid complications associated with a condition known as the Female Athlete Triad, De Souza said. This is a medical condition that starts with inadequate food intake that fails to meet the body’s needs. It leads to menstrual disorders and poor bone health. It is associated with a high incidence of stress fractures.

The study included 62 young, exercising women with infrequent menstrual periods. Thirty-two women increased their calorie intake an average of 300-400 calories a day, and 30 maintained their exercise and eating habits for the 12-month study. Women who consumed the extra calories were twice as likely to have their menstrual period during the study compared with the women who maintained their regular exercise and eating routine.

“This strategy is easy to implement with the help of a nutritionist. It does not require a prescription and avoids complications from drug therapy,” De Souza said. “The findings will encourage healthcare providers to try to help exercising women with menstrual disorders who consume too few calories to eat more, and this may help them to be healthier athletes and avoid bone complications.”

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After examining the link between metabolites in urine and overall health, researchers created a 5-minute test to reveal a person’s nutritional fingerprint.

Research finds a new way to look at the relationship between what we eat and our health.

It might seem obvious that good nutrition is linked to good health. Still, it has proven difficult to identify specific links between foods and health outcomes. Two new studies from scientists at Imperial College London (ICL), United Kingdom, and various collaborators report insights from the analysis of metabolites in urine.

The researchers have created a 5-minute urine test that can capture a person’s “nutritional fingerprint.”

“Diet is a key contributor to human health and disease, though it is notoriously difficult to measure accurately because it relies on an individual’s ability to recall what and how much they ate. For instance, asking people to track their diets through apps or diaries can often lead to inaccurate reports about what they really eat,” explains study author Joram Posma, of ICL’s Department of Metabolism, Digestion, and Reproduction.

“This research reveals this technology can help provide in-depth information on the quality of a person’s diet and whether it is the right type of diet for their individual biological makeup.” — Joram Posma, study co-author

The first study reveals links

Scientists from ICL and their collaborators — from Northwestern University in Chicago, IL, the University of Illinois at Chicago, and Murdoch University in Australia — authored the first of the two studies. It appears in the journal Nature Food.

Metabolites are molecules that the body produces during cellular metabolism, and some are measurable in a person’s urine.

Working with 1,848 study participants in the U.S., the researchers were able to identify associations between 46 different metabolites and food types.

Co-author Paul Elliot, Chair in Epidemiology and Public Health Medicine at ICL, explains:

“Through careful measurement of people’s diets and collection of their urine excreted over two 24-hour periods, we were able to establish links between dietary inputs and urinary output of metabolites that may help improve understanding of how our diets affect health. Healthful diets have a different pattern of metabolites in the urine than those associated with worse health outcomes.”

Metabolites were linked with the ingestion of alcohol, citrus fruit, fructose (fruit sugar), glucose, red meats, and other animal proteins, such as chicken. Nutrients, including vitamin C and calcium, were also associated with metabolites in the study.

Metabolites’ associations with health outcomes also became apparent in the data. For instance, the scientists found that the metabolites formate and sodium were linked to obesity and higher blood pressure.

The second study and the 5-minute fingerprint

For the second research project, which also appears in Nature Food, the ICL team worked again with scientists from Murdoch University, along with researchers from Newcastle University and Aberystwyth University, both in the U.K.

The study reports that the scientists were able to produce an easy-to-administer urine test that could reveal a person’s metabolite profile in the form of a Dietary Metabotype Score (DMS).

Study author Isabel Garcia-Perez, of Imperial College, says:

“Our technology can provide crucial insights into how foods are processed by individuals in different ways — and can help health professionals, such as dietitians, provide dietary advice tailored to individual patients.”

In evaluating the test, the scientists conducted experiments with 19 people whom they instructed to follow one of four types of diets (ranging from very healthful to unhealthful) strictly based on the World Health Organization’s (WHO’s) guidelines. The healthiest adhered 100% to the WHO recommendations, and the least healthy just 25% of them.

The study authors found that even among those who reported following the same diet, there were differences in the DMS.

WHO recommendations contain a great deal of latitude in the choice of specific foods. One recommendation, for example, is, “Fruit, vegetables, legumes (e.g., lentils and beans), nuts, and whole grains (e.g., unprocessed maize, millet, oats, wheat, and brown rice).”

The researchers found that, in general, the more healthful the person’s diet, the higher the DMS. Those with higher scores also had lower blood sugar and excreted an increased amount of energy from the body in the urine.

The study characterizes the difference between high energy urine and low energy urine as meaning that a person with a higher DMS would be losing 4 extra calories a day, which equates to about 1,500 calories a year, and would thus avoid about 215 g of body fat annually.

Next up for the team is investigating the use of this new technology in people at risk of cardiovascular disease.

Rethinking diets

Aside from the obvious value of the 5-minute test, the studies suggest that it may be time to use the new findings to personalize healthful food recommendations.

Newcastle University’s John Mathers says:

“We show here how different people metabolize the same foods in highly individual ways. This has implications for understanding the development of nutrition-related diseases and for more personalized dietary advice to improve public health.”

The link between specific metabolites, foods, and outcomes also raises other considerations, according to ICL’s Gary Frost, another co-author:

“These findings bring a new and more in-depth understanding to how our bodies process and use food at the molecular level. The research brings into question whether we should rewrite food tables to incorporate these new metabolites that have biological effects in the body.”

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According to a new study analyzing the data of thousands of people, an excessive intake of a certain kind of amino acid — present in protein-rich foods — is associated with a higher cardiometabolic risk.

person slicing meat
A new study in humans adds to the evidence that protein-rich foods, such as meat, may have a negative effect on heart health.

Many people follow diets that are high in protein, which can help with weight loss and building muscle mass.

However, increasingly, researchers are starting to question whether protein-rich foods provide enough benefits to offset the potential risks.

For the most part, various recent studies have suggested that high protein foods may affect the health of the heart and the cardiovascular system.

For example, a study in animal models that Medical News Today covered last week found that diets that are high in protein may be directly responsible for cardiovascular problems, such as atherosclerosis.

Now, hot on its heels, a new study in humans points out a link between eating foods with a high sulfur amino acid content — typically high protein foods — and an increased cardiometabolic risk.

The research — the findings of which appear in EClinicalMedicine — comes from Pennsylvania (Penn) State University in State College.

Proteins comprise tiny compounds called amino acids, which vary in their components. Some contain atoms of the element sulfur, which gives them their name: sulfur amino acids.

Cardiometabolic risk and diet

Two sulfur amino acids occur in protein-rich food. These are methionine, an essential amino acid, and cysteine, a semi-essential amino acid.

The human body needs these amino acids to function well, and it must obtain them from a food source. The body cannot synthesize essential amino acids, and it cannot make enough of the semi-essential ones.

However, as with many other nutrients, if they are present in excessive quantities, amino acids can end up doing more harm than good.

This is what Penn State researchers noticed when they looked at the diets and health status of 11,576 individuals, whose data they accessed via the third National Health and Nutrition Examination Survey (NHANES III), which the Centers for Disease Control and Prevention (CDC) conducted.

The researchers came up with a composite cardiometabolic disease risk score assessing each participant’s risk of developing cardiometabolic problems, such as heart disease, stroke, and diabetes.

To do this, they measured the levels of tell-tale biomarkers — including cholesterol, triglycerides, glucose (sugar), and insulin — in the participants’ blood following a 10–16 hour fast.

“These biomarkers are indicative of an individual’s risk for disease, just as high cholesterol levels are a risk factor for cardiovascular disease,” explains study co-author Prof. John Richie.

“Many of these levels can be impacted by a person’s longer-term dietary habits leading up to the test,” Prof. Richie adds.

The researchers also analyzed information about the participants’ dietary habits, which included nutrient intake calculations. They excluded from the study any individuals who reported having an overly low intake of sulfur amino acids.

‘First epidemiologic evidence’

The team’s final analysis, which accounted for body weight measurements, revealed that the participants had an average intake of sulfur amino acids that was almost 2.5 times higher than the estimated average requirement of 15 milligrams per kilogram of body weight per day.

“Many people in the U.S. consume a diet rich in meat and dairy products, and the estimated average requirement is only expected to meet the needs of half of healthy individuals,” points out study co-author Xiang Gao.

“Therefore, it is not surprising that many are surpassing the average requirement when considering these foods contain higher amounts of sulfur amino acids,” says Gao.

Moreover, the investigators found that participants with higher sulfur amino acid intakes also tended to have higher composite cardiometabolic risk scores.

This association remained in place even after the researchers accounted for confounding factors, including age, biological sex, and a history of health conditions such as hypertension and diabetes.

As for the source of the sulfur amino acids, the team said that they were present in almost all foods, excluding grains, fruit, and vegetables.

“Meats and other high protein foods are generally higher in sulfur amino acid content,” notes lead author Zhen Dong, Ph.D.

“People who eat lots of plant-based products like fruits and vegetables will consume lower amounts of sulfur amino acids. These results support some of the beneficial health effects observed in those who eat vegan or other plant-based diets,” Dong adds.

The researchers caution that the current findings are, so far, only observational, pointing to an association rather than verifying causality.

“A longitudinal study would allow us to analyze whether people who eat a certain way do end up developing the diseases these biomarkers indicate a risk for,” notes Prof. Richie.

Nevertheless, he stresses that the recent study shows that researchers should pay more attention to the possible risks associated with dietary amino acids.

“For decades, it has been understood that diets restricting sulfur amino acids were beneficial for longevity in animals. This study provides the first epidemiologic evidence that excessive dietary intake of sulfur amino acids may be related to chronic disease outcomes in humans.”

– Prof. John Richie

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Experts know that processed red meats are likely to raise the risk of cardiovascular disease and death. But are unprocessed meats, fish, and poultry less harmful? New research investigates.

Several studies have established a link between consuming processed meat — such as bacon, hot dogs, sausages, and other similar meats — and an increased risk of cardiovascular disease (CVD) and death.

The higher amount of saturated fats in these foods, along with a higher level of salt and preservatives, might explain these associations. Newer research has suggested that even a low amount of these foods is enough to jeopardize health.

But what about other meats, such as unprocessed red meat, poultry, or fish? Do these foods affect cardiovascular risk and longevity in the same way?

Here, the research is more mixed. The results of several studies vary partly because the methods were different and partly because the existing prospective cohort studies had their limitations.

So, to fill this gap in the research, a group of scientists led by Victor W. Zhong, Ph.D., of Cornell University in Ithaca, New York, set out to conduct a new meta-analysis of 6 existing studies.

The pooled analysis appears in the journal JAMA Internal Medicine.

Studying intake of meat, poultry, and fish

Zhong and the team looked at prospective cohort studies that had been carried out across the United States, totaling 29,682 U.S. adults who did not have CVD at baseline.

Of the participants, 44% were men, and almost 31% were non-white.

Researchers had recorded the participants’ dietary data between 1985–2002 and clinically followed them for 30 years, until August 31, 2016.

Over a median follow-up period of 19 years, 6,963 adverse cardiovascular events and 8,875 all-cause deaths occurred.

Of the cardiovascular events, 38.6% were cases of coronary heart disease, 25% were stroke events, and 34.0% involved heart failure.

To define what constitutes 1 serving of meat and assess the participants’ diet, the researchers used the Willett Food Frequency Questionnaire.

“1 serving was equivalent to 4 [ounces] of unprocessed red meat or poultry or 3 [ounces] of fish. For processed meat, 1 serving consisted of 2 slices of bacon, 2 small links of sausage, or 1 hot dog,” explain the authors.

The median consumption in terms of servings of meat, poultry, and fish per week was 1.5 for processed meat, 3 for unprocessed red meat, 2 for poultry, and 1.6 for fish.

“Compared with participants with lower total intake of these four food types, participants with higher total intake,” write the authors, were more likely to:

  • be younger and male
  • be non-Hispanic black
  • be smokers, have diabetes, a higher body mass index (BMI), higher non-high-density lipoprotein (HDL) cholesterol levels, and consume more alcohol
  • have lower HDL cholesterol levels and eat a lower diet quality diet
  • have a higher incidence of CVD and death from any cause

The main outcome that the scientists looked for was the relative risk of CVD and all-cause mortality over the 30 years between people who consumed these different foods, as well as the difference in absolute risk over the same period.

They calculated the risks for each additional intake of 2 servings per week.

Up to 7% higher relative risk of death, CVD

Zhong and the team summarize the findings: the “intake of processed meat, unprocessed red meat, or poultry was significantly associated with incident cardiovascular disease, but fish intake was not.”

More specifically, the increased relative risks of CVD and all-cause mortality ranged from about 3% to 7%. “The increased absolute risks were less than 2% over the 30 years of follow-up,” add the authors.

More in-depth detail shows that for every 2 additional servings of processed meat per week, the relative risk of all-cause mortality rose by 3% compared with those who did not eat processed meat.

The same was true for each additional 2 servings of unprocessed meat.

The relative risk of CVD rose by 7% for every 2 servings of processed meat per week. For unprocessed red meat, this risk was 3%.

An increase of 2 weekly servings of poultry correlated with a 4% higher relative risk, whereas fish was not associated with CVD risk.

“People who consume more servings per week would have greater risks,” add the researchers.

Study of ‘critical public health’ importance

The authors deem the findings of “critical public health” importance. They also note that more research is necessary to strengthen the findings.

As it stands, the current study has some limitations, such as the self-reported nature of dietary data. This may have resulted in over or underestimation of the association.

Secondly, the scientists did not have any data on the method of food preparation. Whether the meat was fried or non-fried may have impacted the health outcomes.

Thirdly, the study only used one dietary measurement at the beginning of the study, but the dietary habits of the participants may have changed over time.

Finally, residual confounding, the observational nature of the study, and the fact that the data may only be limited to U.S. adults are further shortcomings of this research. Still, Zhong and team conclude:

“The findings of this study appear to have critical public health implications given that dietary behaviors are modifiable, and most people consume these four food types on a daily or weekly basis.”

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Two recent but separate studies have demonstrated how bitter melon and turmeric could be used to prevent, treat and reduce the progression of cancers.

Commonly called bitter melon, bitter gourd, African cucumber or balsam pear, Momordica charantia belongs to the plant family Cucurbitaceae. In Nigeria, bitter melon is called ndakdi in Dera; dagdaggi in Fula-Fulfulde; hashinashiap in Goemai; daddagu in Hausa; iliahia in Igala; akban ndene in Igbo (Ibuzo in Delta State); dagdagoo in Kanuri; akara aj, ejinrin nla, ejinrin weeri, ejirin-weewe or igbole aja in Yoruba.

Turmeric is a spice that comes from the root of Curcuma longa, a member of the ginger family, Zingaberaceae. In traditional medicine, turmeric has been used for its medicinal properties for various indications and through different routes of administration, including topically, orally, and by inhalation.

In Nigeria, it is called atale pupa in Yoruba; gangamau in Hausa; nwandumo in Ebonyi; ohu boboch in Enugu (Nkanu East); gigir in Tiv; magina in Kaduna; turi in Niger State; onjonigho in Cross River (Meo tribe).

Turmeric, also known as curcuma, produces a root that is used to produce the vibrant yellow spice used as a culinary spice so often used in curry dishes. Though native to India and parts of Asia, and is a relative of cardamom and ginger, turmeric has been domesticated in Nigeria. In Asia, turmeric is used to treat many health conditions and it has anti-inflammatory, antioxidant, and perhaps even anticancer properties.

Meanwhile, Prof. Ratna Ray from Saint Louis University in Missouri, United States (U.S.), and her colleagues, in a recent study on bitter melon, made an intriguing find. In experiments using mouse models, bitter melon extract appeared to be effective in preventing cancer tumours from growing and spreading.

The researchers report their findings in a study paper that now appears in the journal Cell Communication and Signaling. Ray grew up in India, so she was familiar not just with the culinary qualities of bitter melon, but also with its alleged medicinal properties.

This made her curious as to whether or not the plant also harbored properties that would make it an effective aid to anticancer treatments. She and her colleagues decided to put this to the test in a preliminary study by using bitter melon extract on various types of cancer cells — including breast, prostate, and head and neck cancer cells.

Laboratory tests showed that the extract stopped those cells from replicating, suggesting that it might be effective in preventing the spread of cancer. In further experiments using mouse models, the researchers found that the plant extract was able to reduce the incidence of tongue cancer.

So, in their new study, Prof. Ray and team tried to find out what might give bitter melon compounds an edge against cancer cells. This time, they used mouse models to study the mechanism through which bitter melon extract interacted with tumors of cancer of the mouth and tongue.

They saw that the extract interacted with molecules that allow glucose (simple sugar) and fat to travel around the body, in some cases “feeding” cancer cells and allowing them to thrive.

By interfering with those pathways, the bitter melon extract essentially stopped cancer tumors from growing, and it even led to the death of some of the cancer cells. Ray said: “All animal model studies that we’ve conducted are giving us similar results, an approximately 50 per cent reduction in tumor growth.”

Ray and colleagues explained that it remains unclear whether or not bitter melon would have the same effect in humans, but Prof., going forward, this is what they are aiming to find out.

“Our next step is to conduct a pilot study in [people with cancer] to see if bitter melon has clinical benefits and is a promising additional therapy to current treatments,” she noted.

Ray seemed convinced that the plant is, if nothing else, at least a positive contributor to personal health.“Some people take an apple a day, and I’d eat a bitter melon a day. I enjoy the taste,” she said.“Natural products play a critical role in the discovery and development of numerous drugs for the treatment of various types of deadly diseases, including cancer. Therefore, the use of natural products as preventive medicine is becoming increasingly important.”

Meanwhile, a recent literature review investigated whether turmeric may be useful for treating cancer. The authors concluded that it might be but noted that there are many challenges to overcome before it makes it to the clinic. The chemical in turmeric that most interests medical researchers is a polyphenol called diferuloylmethane, which is more commonly called curcumin. Most of the research into turmeric’s potential powers has focused on this chemical.

Over the years, researchers have pitted curcumin against a number of symptoms and conditions, including inflammation, metabolic syndrome, arthritis, liver disease, obesity, and neurodegenerative diseases, with varying levels of success.
Above all, though, scientists have focused on cancer. According to the authors of the recent review, of the 12,595 papers that researchers published on curcumin between 1924 and 2018, 37 per cent focus on cancer.

In the current review, which features in the journal Nutrients, the authors mainly focused on cell signaling pathways that play a role in cancer’s growth and development and how turmeric might influence them. Treatment for cancer has improved vastly over recent decades, but there is still a long path to tread before we can beat cancer. As the authors note, “the search for innovative and more effective drugs” is still vital work.

In their review, the scientists paid particular attention to research involving breast cancer, lung cancer, cancers of the blood, and cancers of the digestive system. The authors concluded: “Curcumin represents a promising candidate as an effective anticancer drug to be used alone or in combination with other drugs.”

According to the review, curcumin can influence a wide range of molecules that play a role in cancer, including transcription factors, which are vital for Deoxy ribonucleic Acid (DNA)/genetic material replication; growth factors; cytokines, which are important for cell signaling; and apoptotic proteins, which help control cell death.

Alongside the discussions surrounding curcumin’s molecular influence over cancer pathways, the authors also addressed the possible issues with using curcumin as a drug. For instance, they explain that if a person takes curcumin orally — in a turmeric latte, for example — the body rapidly breaks it down into metabolites. As a result, any active ingredients are unlikely to reach the site of a tumour.

With this in mind, some researchers are trying to design ways of delivering curcumin into the body and protecting it from undergoing metabolisation. For instance, researchers who encapsulated the chemical within a protein nanoparticle noted promising results in the laboratory and in rats.

Although scientists have published a great many papers on curcumin and cancer, there is a need for more work. Many of the studies in the current review are in vitro studies, which means that the researchers conducted them in laboratories using cells or tissues. Although this type of research is vital for understanding which interventions may or may not influence cancer, not all in vitro studies translate to humans.

Relatively few studies have tested turmeric’s or curcumin’s anticancer properties in humans, and the human studies that have taken place have been small-scale. However, aside from the difficulties and limited data, curcumin still has potential as an anticancer treatment.

Scientists are continuing to work on the problem. For instance, the authors mention two clinical trials that are underway, both of which aim to “evaluate the therapeutic effect of curcumin on the development of primary and metastatic breast cancer, as well as to estimate the risk of adverse events.”

They also refer to other ongoing studies in humans that are evaluating curcumin as a treatment for prostate cancer, cervical cancer, and lung nodules, among other diseases. The authors believe that curcumin belongs to “the most promising group of bioactive natural compounds, especially in the treatment of several cancer types.”

However, their praise for curcumin as an anticancer hero is tempered by the realities that their review has unearthed, and they end their paper on a low note: “Curcumin is not immune from side effects, such as nausea, diarrhea, headache, and yellow stool. Moreover, it showed poor bioavailability due to the fact of low absorption, rapid metabolism, and systemic elimination that limit its efficacy in diseases treatment. Further studies and clinical trials in humans are needed to validate curcumin as an effective anticancer agent.”

Meanwhile, an earlier study published in journal Current Pharmacology Reports established that besides diabetes, bitter melon is effective in treating other chronic diseases such as cancer and Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS).

The study is titled “Bitter Melon as a Therapy for Diabetes, Inflammation, and Cancer: a Panacea?” The researchers noted: “Over the last few decades, multiple well-structured scientific studies have been performed to study the effects of bitter melon in various diseases. Some of the properties for which bitter melon has been studied include: antioxidant, anti-diabetic, anticancer, anti-inflammatory, antibacterial, antifungal, antiviral, anti-HIV, anthelmintic, hypotensive, anti-obesity, immuno-modulatory, anti-hyperlipidemic, hepato-protective, and neuro-protective activities. This review attempts to summarize the various literature findings regarding medicinal properties of bitter melon. With such strong scientific support on so many medicinal claims, bitter melon comes close to being considered a panacea.”

According to Food as Medicine: Functional Food Plants of Africa published 2017 by CRC Press, “…Dietary use of bitter melon or its juice decreases blood glucose levels, increases High Density Lipo-protein (HDL)/good cholesterol, and decreases triglyceride levels, thus exhibiting antiatherogenic qualities. Extract of bitter melon in supplement form has been widely used as a traditional medicine for diabetic patients.

When administered alone, it has a modest hypoglycemic effect at doses of at least 2000 mg/day. This botanical supplement enhances the cellular uptake of glucose and promotes insulin release, potentiating its effect, and in animal studies has been shown to increase the number of insulin-producing beta cells in diabetic animals. Bitter melon has also been found to reduce adiposity and oxidative stress in addition to reducing blood triglycerides and Low Density Lipo-proteins (LDL)/bad cholesterol.”

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Walnuts may not just be a tasty snack, they may also promote good-for-your-gut bacteria. New research suggests that these “good” bacteria could be contributing to the heart-health benefits of walnuts. In a randomized, controlled trial, researchers found that eating walnuts daily as part of a healthy diet was associated with increases in certain bacteria that can help promote health. Additionally, those changes in gut bacteria were associated with improvements in some risk factors for heart disease.

Kristina Petersen, assistant research professor at Penn State, said the study — recently published in the Journal of Nutrition — suggests walnuts may be a heart- and gut-healthy snack.

“Replacing your usual snack — especially if it’s an unhealthy snack — with walnuts is a small change you can make to improve your diet,” Petersen said. “Substantial evidence shows that small improvements in diet greatly benefit health. Eating two to three ounces of walnuts a day as part of a healthy diet could be a good way to improve gut health and reduce the risk of heart disease.”Previous research has shown that walnuts, when combined with a diet low in saturated fats, may have heart-healthy benefits. For example, previous work demonstrated that eating whole walnuts daily lowers cholesterol levels and blood pressure.

According to the researchers, other research has found that changes to the bacteria in the gastrointestinal tract — also known as the gut microbiome — may help explain the cardiovascular benefits of walnuts.“There’s a lot of work being done on gut health and how it affects overall health,” said Penny Kris-Etherton, distinguished professor of nutrition at Penn State. “So, in addition to looking at factors like lipids and lipoproteins, we wanted to look at gut health. We also wanted to see if changes in gut health with walnut consumption were related to improvements in risk factors for heart disease.”

For the study, the researchers recruited 42 participants with overweight or obesity who were between the ages of 30 and 65. Before the study began, participants were placed on an average American diet for two weeks. After this “run-in” diet, the participants were randomly assigned to one of three study diets, all of which included less saturated fat than the run-in diet. The diets included one that incorporated whole walnuts, one that included the same amount of alpha-linolenic acid (ALA) and polyunsaturated fatty acids without walnuts, and one that partially substituted oleic acid (another fatty acid) for the same amount of ALA found in walnuts, without any walnuts.

In all three diets, walnuts or vegetable oils replaced saturated fat, and all participants followed each diet for six weeks with a break between diet periods. To analyze the bacteria in the gastrointestinal tract, the researchers collected fecal samples 72 hours before the participants finished the run-in diet and each of the three study diet periods. “The walnut diet enriched a number of gut bacteria that have been associated with health benefits in the past,” Petersen said. “One of those is Roseburia, which has been associated with protection of the gut lining. We also saw enrichment in Eubacteria eligens and Butyricicoccus.”

The researchers also found that after the walnut diet, there were significant associations between changes in gut bacteria and risk factors for heart disease. Eubacterium eligens was inversely associated with changes in several different measures of blood pressure, suggesting that greater numbers of Eubacterium eligens was associated with greater reductions in those risk factors.

Additionally, greater numbers of Lachnospiraceae were associated with greater reductions in blood pressure, total cholesterol, and non-High Density Lipo-protein (HDL) cholesterol. There were no significant correlations between enriched bacteria and heart-disease risk factors after the other two diets.

Regina Lamendella, associate professor of biology at Juniata College, said the findings are an example of how people can feed the gut microbiome in a positive way. “Foods like whole walnuts provide a diverse array of substrates — like fatty acids, fiber and bioactive compounds — for our gut microbiomes to feed on,” Lamendella said. “In turn, this can help generate beneficial metabolites and other products for our bodies.” Kris-Etherton added that future research can continue to investigate how walnuts affect the microbiome and other elements of health.

“The findings add to what we know about the health benefits of walnuts, this time moving toward their effects on gut health,” Kris-Etherton said. “The study gives us clues that nuts may change gut health, and now we’re interested in expanding that and looking into how it may affect blood sugar levels.”

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The muscles, ligaments, and tissues of the pelvic floor support the bladder, rectum, and sexual organs. When the supportive structures weaken or become especially tight, doctors describe it as pelvic floor dysfunction. It is a common health issue.

When a person has pelvic floor dysfunction, the organs in the pelvis may drop. They often press down on the bladder or rectum, causing a leakage of urine or stool. Or, a person with this condition may have trouble urinating or passing stool.

Keep reading to learn more about pelvic floor dysfunction — including the symptoms, treatments, and some exercises that may help.

What is pelvic floor dysfunction?

The pelvic floor is made up of muscles, ligaments, and tissues that surround the pelvic bone. The muscles attach to the front, back, and sides of the bone, as well as to the lowest part of the spine, called the sacrum.

The function of the pelvic floor is to support the organs in the pelvis, which can include the:

  • bladder
  • rectum
  • urethra
  • uterus
  • vagina
  • prostate

People with pelvic floor dysfunction may have weak or especially tight pelvic floor muscles.

When the muscles tighten, or spasm, people may have trouble urinating or passing stool. When they weaken, the organs within the pelvis may drop and press down on the rectum and bladder.

The table below outlines several common types of pelvic floor dysfunction.

Type of pelvic floor dysfunctionDescription
Obstructed defecationThis occurs when stool enters the rectum, but the body cannot fully evacuate the bowels.
RectoceleThis involves tissue from the rectum protruding into the vagina. Stool may get caught in this pocket, forming a bulge in the vagina.
Pelvic organ prolapseThis refers to the pelvic floor stretching and the pelvic organs dropping as a result of age, childbirth, or a collagen disorder.
Paradoxical puborectalis contractionThis involves a pelvic floor muscle called the puborectalis contracting. When it happens, trying to pass stool may feel like pushing against a closed door.
Levator syndromeThis involves the pelvic floor muscles spasming after bowel movements. It can cause lasting dull pain or achy pressure high in the rectum.
CoccygodyniaThis refers to pain in the tailbone that worsens during and after bowel movements.
Proctalgia fugaxThis involves painful spasms of the rectum and muscles in the pelvic floor.
Pudendal neuralgiaThis refers to irritation or damage to the pudendal nerves, which help the pelvis function.
UrethroceleThis refers to the urethra pressing into the vagina.
EnteroceleThis involves the small intestine descending and pushing into the vagina, forming a bulge.
CystoceleThis involves the bladder dropping and pushing into the vagina.
Uterine prolapseThis refers to the uterus descending and pushing into the vagina.

Symptoms

Pelvic floor dysfunction can cause a variety of symptoms, and some can interfere with daily life.

Depending on the type of pelvic floor dysfunction, a person may experience:

  • pelvic pain
  • pressure
  • a bulge somewhere in the lower pelvic region
  • stress urinary incontinence, which involves a small amount of urine leaking from the body due to an activity such as coughing
  • involuntary leakage of stool
  • incomplete urination
  • bowel movement dysfunction
  • pain during sexual intercourse

Also, some people who see their doctors about bladder overactivity find that pelvic floor dysfunction is responsible.

Causes

Many issues can cause the structures of the pelvic floor to weaken, including:

  • age
  • systemic diseases
  • lasting health issues that cause increased pressure in the abdomen and pelvis, such as a chronic cough
  • pregnancy
  • trauma during delivery
  • multiple deliveries
  • large babies
  • operative delivery

Research indicates that stress urinary incontinence, pelvic organ prolapse, or both occur in about half of all women who have given birth. These issues are closely associated with birth-related injury to the pelvic floor muscles.

The pelvic floor muscles can also stretch naturally with age. Stress urinary incontinence and pelvic organ prolapse become more common with increasing age in females, for example.

Collagen disorders can also affect the muscles’ ability to support the pelvic organs.

Meanwhile, coccygodynia usually stems from trauma to the tailbone, such as from a fall. That said, in about one-third of people with the condition, the cause of coccygodynia is unknown. The pain can make having a bowel movement difficult.

Exercises

Doctors recommend pelvic floor exercises in various situations.

They may particularly benefit pregnant women because the pelvic floor muscles can stretch and weaken during labor. Strengthening these muscles may help prevent incontinence after the baby is born. Some doctors recommend that women who wish to become pregnant start the exercises ahead of time.

Males can also benefit from pelvic floor exercises, though the dysfunction is more common in females. In males, these exercises can help prevent pelvic organ prolapse and urinary incontinence and improve sexual intercourse.

To exercise these muscles, a person should be sitting comfortably. Then, they should attempt to squeeze their pelvic muscles without holding their breath.

It is important to isolate the correct muscles without tightening those of the stomach, buttocks, or and thighs.

Doctors recommend that females aim to do 10 long squeezes — holding each for 10 seconds — followed by 10 short squeezes. However, initially, it may be a good idea to practice holding a squeeze for a few seconds at a time.

By practicing frequently, a person should be able to add more contractions to their routine week by week. It is important to do this gradually and to avoid overworking the muscles.

Within a few months, a person may notice a reduction in their symptoms. Even if symptoms resolve completely, a person should continue strengthening these muscles.

There are physical therapists who specialize in pelvic floor dysfunction. A person may find that consulting one of these professionals leads to a better outcome.

Treatment

Doctors determine the cause of pelvic floor dysfunction before recommending treatment because different types of dysfunction require different approaches.

The purpose of treatment is to relieve or reduce symptoms and improve the person’s quality of life. For some people, a combination of treatment methods works best.

Doctors may recommend:

  • Dietary changes: For example, eating more fiber, drinking more fluids, and taking certain medications can make bowel movements easier.
  • Laxatives: Taking a daily laxative may help people with pelvic floor dysfunction pass stool, but it is important to consult a healthcare provider first because not all laxatives are equally effective.
  • Pain relief: Some people require injections of pain relief or anti-inflammatory medication to relieve their symptoms.
  • Biofeedback: This involves electrical stimulation, ultrasound therapy, or massage of the pelvic floor muscles to help improve rectal sensation and muscle contraction.
  • Pessary: A doctor or nurse inserts a pessary into the vagina to support prolapsed organs. This type of device can help treat various symptoms of pelvic floor dysfunction, either as an alternative to surgery or while a person awaits surgery.
  • Surgery: When prolapse interferes with daily activities, a doctor may recommend surgery. Large rectoceles also require surgery if the person experiences symptoms.

Stem cell therapies

Researchers behind a 2016 study investigated whether a stem cell-based therapy could resolve pelvic floor dysfunction in rats.

The researchers engineered the stem cells to produce and release elastin and collagen into the pelvic floor and injected them into rats with pelvic floor dysfunction.

The elastin and collagen promoted the repair of pelvic floor structures and decreased signs of stress urinary incontinence.

In a final component of the study, the researchers developed stem cells that blocked a factor that stops the production of elastin. This promoted increased production and release of elastin into the pelvic floor.

With further studies, researchers may find that similar therapies are effective in humans.

When to see a doctor

Anyone who experiences painful bowel movements, difficulty urinating or passing stool, pelvic pain, or pain during sexual intercourse should speak with a doctor.

An unusual bulge in the lower pelvic region may also be a reason to see a doctor, though a bulge alone may not be a cause for concern.

People with pelvic floor dysfunction have plenty of treatment options. While the topic may be uncomfortable to bring up with a doctor, it is important to seek professional advice about these symptoms.

While some family doctors may not be familiar with pelvic floor dysfunction, specialists such as colorectal doctors, urologists, and gynecologists can help diagnose the issue and recommend the best course of action.

Summary

Pelvic floor dysfunction can affect anyone, but pregnant women have the highest risk.

The various types of pelvic floor dysfunction stem from different causes, and a doctor must identify the underlying issue before developing a treatment plan.

Exercises can help some people with pelvic floor dysfunction. Depending on the cause, a doctor may also recommend dietary changes, medication, a pessary, biofeedback, or surgery.

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