Friday Research Review: Vitamin B6 supplementation improves rheumatoid arthritis symptoms


Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis.

Original Research Article


Authors: Huang, S.C., Wei, JC-C, and Huang (2010); Y-C. European J. of Clinic. Nutr.
Review: Ali Al-Rajhi, MPH
Huang et al. (2010) investigated if there were benefits of B6 supplementation on inflammatory and immune responses with rheumatoid arthritis (RA) patients. The study design was a single-blind co-intervention at a Taiwanese hospital. The control group (n=15) were given 5 mg/day of folic acid while the experimental group (n=20) were given 5 mg/day of folic acid and 100mg/day of vitamin B6. Over a 12 week period measurements were taken of plasma PLP, serum folate, inflammatory parameters (e.g., hs-CRP, ESR, IL-6, TNF-a), and immune parameters (e.g., white blood cell, total lymphocyte, T-cell, B-cell, T-helper cell, T-suppressor). Overall, researchers found that patients with RA, supplementation with 100 mg/day doses of B6 “suppressed pro-inflammatory cytokines (IL-6 and TNF-a).”

The first strength I noticed was an aspect of the research methodology; researchers took the effort to stay in constant  contact with all their participants through  weekly reminders to take their tablets and have them log their diet (via 24 diet recall at week 0 and 12) before their clinical visit. I believe the small study population made it feasible to stay in consistent contact and it ensured higher compliance. Also, researchers eliminated the interference of folate metabolism by methotrexate (usually taken to treat RA) by co-intervening folic acid into the study.

There were weaknesses in the study as well. The obvious was the low study population. The p-values for all of the measures were either not significant or approaching a trend, expect for plasma interleukin-6. Another limitation were the inclusion of patients taking methotrexate; this should be more of an exclusion factor. Also, I believe the population samples was likely to be homogeneous (Taiwanese), which cannot be generalizable to other poulations and there were far fewer men then women that participated (2 of 15 in control and 3 of 17 in experimental). The limitations that the researchers indicated include the loss of eight patients may have “decreased the degree of effect of plasma PLP on inflammatory and immune response,” that the study was a “single-blind rather than a double-blind study,” and “the short disease duration of our patients.”

There is potential for future research to strength the potential claims this paper found. First, increasing the study population to a number that is found in similar research that contain similar population characteristics. Second, establishing more stringent exclusion factors such as not allowing patients traking methotrexate. Lastly, establishing a double-blind study versus the single-blind design that was chosen for the study.

Snake Oil? The scientific evidence for popular health supplements

I recently watched a TED presentation given by David McCandless and decided to check out his website – InformationIsBeautiful.net. I found THIS great interactive tool that weighs the strength of scientific evidence for various supplements that we consume daily.  Check it out!

snakeoil_supplements_956

Friday Research Review

1) Sociologists Weigh In On Obesity Increasing The Length Of Hospital Stays. (source: Science Daily)

Sociologists found a direct relationship between obesity and duration and frequency of hospital stays. Researchers found that, on average, obese persons stayed one and a half days longer than those with normal weight. Sociologists attribute the connection to disease–46 percent of obese adults have high blood pressure. Obesity is also linked to an increased risk of heart disease, diabetes, stroke and other illnesses. The researchers also note that the longer a person has been obese, the more likely their hospital stay is lengthened.

2) Mapping US Engagement in Global Public Health (source: Policy Pointers/Kaiser Family Foundation)

This 137-page report (yes, it’s very detailed) represents an effort to map the United States government’s engagement in global health activities as a basis for analysis and to help decision makers understand the scope and organization of programs, policies, authorities, funding and coordinating mechanisms that comprise US support for public health abroad.

3) Fast Food Industry in India: A Study (source: Scribed)

Friday Research Review

1) Hans Rosling: Let my dataset change your mindset. (source: TED)

2) Hormone Therapy For Prostate Cancer Patients With Heart Conditions Linked To Increased Death Risk. (source: Science Daily)

Men with coronary artery disease-induced congestive heart failure or heart attack who receive hormone therapy before or along with radiation therapy for treatment of prostate cancer have an associated increased risk of death, according to a study in the August 26 issue of JAMA.

3) Global Health Facts. (source: Kaiser Family Foundation)

Global Health Facts (developed by the KFF) provides a slue of global health data. The website allows users to access accurate health data by country and create custom data sheets based on multiple health indicators.



Friday Research Review

1) Performance Incentives for Global Health: Potential and Pitfalls – Brief (source: Center for Global Development)

Rena Eichler and Ruth Levine summarize the findings of their book, Performance Incentives for Global Health: Potential and Pitfalls. Global health donors, like national governments, have traditionally paid for inputs such as doctors’ salaries or medical equipment in the hope that they would lead to better health. Performance incentives offered to health workers, facility managers, or patients turn the equation on its head: they start with the performance targets and let those most directly affected decide how to achieve them. Funders pay (in money or in kind) when health providers or patients reach specified goals. Evidence shows that such incentives can work in a variety of settings. But making them effective requires careful planning, implementation, and monitoring and evaluation.

2) Global Nutrition Institutions: Is There an Appetite for Change? (source: Center for Global Development)

This paper describes the major institutional weaknesses in global nutrition and presents two recommendations to address the joint problems of incoherence, lack of institutional leaders, and persistent underfunding. First, within the domain of global health—where a significant part of the programmatic response rests—current and potential funding agencies at the international level could create a shared set of principles that lay out expectations for the coordination, coherence, and collaboration among institutions that currently do or might receive funding for global nutrition programs. Funders could collaborate to create a strong incentive for UN agencies, the World Bank, privately funded initiatives, and others to work together to fulfill key functions, including norm-setting, advocacy, scientific inquiry, program and technical support, capacity-building, and implementation at the national level. A second priority is for leaders in UN agencies to act on specific opportunities to elevate the agenda of nutrition security within the work of the UN System High-Level Task Force for the Global Food Security Crisis, which is stimulating and coordinating a response among the UN system and international financial institutions.

3) Developmental Perspectives on Nutrition and Obesity From Gestation to Adolescence (source: CDC, PCD)

Obesity results from a complex combination of factors that act at many stages throughout a person’s life. Therefore, examining childhood nutrition and obesity from a developmental perspective is warranted. A developmental perspective recognizes the cumulative effects of factors that contribute to eating behavior and obesity, including biological and socioenvironmental factors that are relevant at different stages of development. A developmental perspective considers family, school, and community context. During gestation, risk factors for obesity include maternal diet, overweight, and smoking. In early childhood, feeding practices, taste acquisition, and eating in the absence of hunger must be considered. As children become more independent during middle childhood and adolescence, school nutrition, food marketing, and social networks become focal points for obesity prevention or intervention. Combining a multilevel approach with a developmental perspective can inform more effective and sustainable strategies for obesity prevention.