Only One-Fifth of Global Population Achieves Sufficient Vitamin E Status to Receive Functional Health Benefits

A recent study published in the International Journal for Vitamin and Nutrition Research (1) establish that just 21% of the studies of the examined populations globally reach a serum α-tocopherol concentration of ≥30 μmol/L. This is the vitamin E threshold that several studies suggest has major effects on human health in multiple areas. The research is unique, and the first of its kind to review over 170 existing papers worldwide on studies into vitamin E intake levels and serum concentrations. The findings conclude that vitamin E status is inadequate in a substantial part of the reviewed populations. Infographic: Vitamin E status remains low in most countries

Vitamin E StatusVitamin E is an essential micronutrient that protects cell membranes from oxidative damage, including those rich in polyunsaturated fatty acids (PUFAs). The higher the level of PUFA intake, the more vitamin E is required. This study finds vitamin E status to be alarmingly low globally. Modern changes in diet may be a contributing factor. Vitamin E status can be increased by eating more foods high in vitamin E, such as vegetable oils, green vegetables, nuts, seeds, whole grain bread; fortified foods and beverages, and dietary supplements.

Dr. Simin Meydani, Director of Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University comments: “This global assessment of vitamin E status – the first of its kind – is an important step to generate awareness because so many people around the world do not consume recommended amounts of vitamin E. An adequate vitamin E intake is needed to maintain the immune system, cognitive function, cardiovascular health, and liver function. The findings of the publication suggest that health authorities need to dedicate more attention to the intake, status, and role of vitamin E in human health.”

Applying a Recommended Daily Allowance (RDA) of 15 mg/day and Estimated Average Requirement (EAR) of 12 mg/day to all populations with a minimum age of 14 years, 82% and 61% of data points were below the RDA and EAR respectively. The new paper further reveals that globally 13% of the scientific publications indicated serum concentrations below the suggested deficiency threshold concentration of 12 μmol/L, mostly in newborns and children.

Szabolcs Péter, MD, PhD, Senior Scientist at DSM, and one of the co-authors says: “This comprehensive review of vitamin E dietary intake and serum concentrations demonstrates that the majority of the reported intake values worldwide are below recommended levels. Similarly, it shows that a considerable proportion of the global population do not reach the proposed optimal serum concentration for vitamin E. This study should help stimulate needed research to understand the complex field of vitamin E and its impact on human health.”

The study found that vitamin E intake differed regionally. People living in the Middle East and Africa (27%) were more likely to be consuming below the RDA, but the prevalence was also relatively high in Asia Pacific (16%) and Europe (8%). Considering a threshold concentration of 30 μmol/L recommended by experts, 27% of the American, 80% of the Middle East/African, 62% of the Asian, and 19% of the European populations are below this serum value. On the other hand, only 21% of the total data points included in this global review reach a desirable mean serum concentration of 30 μmol/L or higher. This can be explained by varying diets and nutrient availability across the world.

Reference

1. Szabolcs P, Angelika F, Roos FF, Wyss A, Eggersdorfer M, Hoffmann K, Weber P. A Systematic review of global alpha-tocopherol status as assessed by nutritional intake levels and blood serum concentrations. Int J Vitam Nutr Res 2016. DOI: 10.1024/0300-9831/a000281.

Digestive Enzyme Therapy: A Possible Option in Autism Spectrum Disorder

There is growing evidence for a gut-brain connection associated with autism spectrum disorder (ASD), which suggests a potential benefit for digestive enzyme therapy in autistic children (1). Working with an Egyptian team, Geir Bjørklund and collaborators performed a double-blind, randomized clinical trial on 101 children with ASD (82 boys and 19 girls) aged from 3 to 9 years (1). The autistic children were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision (DSM-IV-TR) diagnostic criteria. Structured interviews of at least one hour were first performed both with the parents and the children. In a later two hours session was the Childhood Autism Rating Scale (CARS) applied. After this, the children with ASD were randomized to receive digestive enzymes or placebo (1). It was found that autistic children that received digestive enzyme therapy for three months had significant improvement in emotional response, general impression autistic score, general behavior, and gastrointestinal symptoms. These results indicate that digestive enzyme therapy in the future may be a possible option in the treatment protocols for ASD (1).

The first author of the article, Khaled Saad, is Associate Professor of Pediatrics at Assiut University, Assiut, Egypt. Geir Bjørklund is the founder and president of the Council for Nutritional and Environmental Medicine (CONEM).

 

Reference

1. Saad K, Eltayeb AA, Mohamad IL, Al-Atram AA, Elserogy Y, Bjørklund G, El-Houfey AA, Nicholson B. A randomized, placebo-controlled trial of digestive enzymes in children with autism spectrum disorders. Clin Psychopharmacol Neurosci 2015; 13(2): 188-193.

 

Vitamin D Deficiency Correlates with Severity of Autism and Shows Improvement with Supplementation

Vitamin D deficiency has been previously reported in patients with autism spectrum disorder (ASD). However, the data on the relationship between vitamin D deficiency and the severity of ASD are limited. In collaboration with Egyptian researchers, Geir Bjørklund (2015) performed a case-controlled cross-sectional analysis on 122 children with ASD, to assess their vitamin D status compared to healthy control children and the relationship between the degree of vitamin D deficiency and the severity of ASD (1).

Fifty-seven percent of the patients with ASD in the study had vitamin D deficiency, and 30% had vitamin D insufficiency. The vitamin D levels in the children with severe ASD were significantly lower than those in children with mild/moderate ASD. It was found that the vitamin D levels had significant negative correlations with the Childhood Autism Rating Scale (CARS) scores (1).

106 children with low serum vitamin D levels (<30 ng/ml) then participated in an open-label trial of vitamin D supplementation. The patients were given 300 IU/kg/day (not to exceed 5000 IU/day) for three months. Eighty-three ASD patients completed three months of daily vitamin D treatment. 80.72% (67/83) of the children with ASD who received vitamin D3 treatment had significantly improved outcome, which was mainly in the sections of the Childhood Autism Rating Scale and aberrant behavior checklist subscales that measure behavior, stereotype, eye contact, and attention span (1). Of the 16 parameters measured, ten showed highly statistically significant improvements (see table below).

 

Parameter  P Value (* highly statistically significant)
Relating to people <0.001*
Emotional Response <0.001*
Imitation <0.001*
Body use 0.01*
Object use 0.01*
Adaption to change 0.004*
Listening response 0.01*
Taste, smell, touch 0.1
Visual response 0.003*
Fear 0.13
Verbal communication 0.3
Activity level 0.32
Non-verbal communication 0.2
Intellectual response 0.1
General impression <0.001*
Total CARS score <.001*

 

The researchers concluded that as vitamin D is inexpensive, readily available and safe it may have beneficial effects in ASD patients, particularly when the final serum level is more than 40 ng/ml (1). It should be noted that these results were achieved after only three months of vitamin D supplementation. In a condition that is often present at birth and lasts a lifetime, this is a highly significant finding and should be fully explored immediately.

The first author of the study, Khaled Saad, is Associate Professor of Pediatrics at Assiut University, Assiut, Egypt. Geir Bjørklund is founder and president of the Council for Nutritional and Environmental Medicine (CONEM). Also, one of the coauthors is John Cannell, MD. He is the founder of the Vitamin D Council in San Luis Obispo, California, United States. The study is registered in UMIN Clinical Trials Registry: UMIN000016770.

 

Reference

1. Saad K, Abdel-rahman AA, Elserogy YM, Al-Atram AA, Cannell JJ, Bjørklund G et al. Vitamin D Status in Autism Spectrum Disorders and the Efficacy of Vitamin D Supplementation in Autistic Children. Nutr Neurosci. Article first published online: 15 Apr 2015. DOI: http://dx.doi.org/10.1179/1476830515Y.0000000019.

 

Increased Frequency of Metal Allergy in Patients with Connective Tissue Disorders

Stejskal, Reynolds, and Bjørklund examined the frequency of metal allergy in 38 patients with connective tissue disorders (1). Of these patients, 16 had rheumatoid arthritis, 13 had Sjögren’s syndrome, and nine had systemic lupus erythematosus. A control group of 43 healthy age and sex-matched subjects were included in the study. Metal allergy was evaluated using the optimized lymphocyte transformation test MELISA. For all subjects, the primary source of metal exposure was dental metal restorations. Most of the tested patients (87%) reacted to at least one metal, and many (63%) reacted to two or more of the tested metals. 43% of the healthy subjects in the study reacted to one metal, and 18% reacted to two or more metals. The increased frequency of metal allergy in the patient group compared with the control group was statistically significant (P < 0.0001). The most frequent allergens in the study were nickel, mercury, gold, and palladium.

Vera Stejskal is Associate Professor of Immunology at University of Stockholm, Sweden. She is founder and president of the MELISA Medica Foundation. Tim Reynolds is Professor of Clinical Biochemistry at the University of Wolverhampton, and a consultant chemical pathologist working at Burton Hospitals NHS Foundation Trust, Burton upon Trent, United Kingdom. Geir Bjørklund is founder and president of the Council for Nutritional and Environmental Medicine (CONEM).

Reference
1. Stejskal V, Reynolds T, Bjørklund G. Increased frequency of delayed type hypersensitivity to metals in patients with connective tissue disease. J Trace Elem Med Biol 2015; 31: 230-236.

 

New Branch of CONEM in Algeria

Igor G. Bondarenko, MD, PhD
Board Secretary of CONEM

The number of members of the Council for Nutritional and Environmental Medicine (CONEM) is growing, and its representation is being surely spread. On the 13th March this year, CONEM was enriched by a new branch member – the Algerian Society for Nutrition and Orthomolecular Medicine (SANMO). This society was founded in 2009 by Ilyès Baghli, MD, who has recently been re-elected to the presidency of this society.

SANMO’s mission is education in and promotion of the science of nutrition and orthomolecular medicine, including those via TV and press conferences and publication of newsletters and books on orthomolecular medicine. Presently, there are over 120 members of SANMO in Algeria.

Let us all congratulate and welcome SANMO as an Algerian branch of CONEM!

 

Participants at SANMO

Participants at SANMO’s symposium in March 2015 where the application for membership in CONEM were signed.

 

Ilyès Baghli, MD ,signed the application

The president of SANMO Dr. Ilyès Baghli signs the application for SANMO to be a part of CONEM

 

Representatnts of the Algerian Branch of CONEM

We congratulate and welcome the Algerian Society for Nutrition and Orthomolecular Medicine (SANMO) as an Algerian branch of CONEM

 

CONEM SANMO signed

The application from SANMO to be a part of CONEM signed by the societys board of directors and members of the scientific council.

Evidence Supporting a Link between Dental Amalgams and Chronic Illness, Fatigue, Depression, Anxiety, and Suicide

Norway and Sweden have banned amalgam, reportedly due to environmental concerns. However, the use and toxic risk of dental amalgam fillings is still a subject of ongoing debate in many countries. Now, a review conducted by a team of international researchers has provided new evidence that mercury exposure from dental amalgam may cause or contribute to many chronic illnesses, as well as depression, anxiety and suicide.

The review article by Janet K. Kern and coworkers is published in Neuroendocrinology Letters (2014; 35 (7): 537-552). Three of the authors, Kern, Geir Bjørklund and Boyd E. Haley, are members of the Council for Nutritional and Environmental Medicine (CONEM). Kern is a director of CONEM. Bjørklund is founder and president of the association. 

 

Janet K. Kern, David A. Geier, Geir Bjørklund, Paul G. King, Kristin G. Homme, Boyd E. Haley, Lisa K. Sykes, and Mark R. Geier

Evidence supporting a link between dental amalgams and chronic illness, fatigue, depression, anxiety, and suicide

Neuro Endocrinol Lett 2014; 35 (7): 537-552 

 

ABSTRACT

The purpose of this review is to examine the evidence for a relationship between mercury (Hg) exposure from dental amalgams and certain idiopathic chronic illnesses – chronic fatigue syndrome (CFS), fibromyalgia (FM), depression, anxiety, and suicide. Dental amalgam is a commonly used dental restorative material that contains approximately 50% elemental mercury (Hg0) by weight and releases Hg0 vapor. Studies have shown that chronic Hg exposure from various sources including dental amalgams is associated with numerous health complaints, including fatigue, anxiety, and depression – and these are among the main symptoms that are associated with CFS and FM. In addition, several studies have shown that the removal of amalgams is associated with improvement in these symptoms. Although the issue of amalgam safety is still under debate, the preponderance of evidence suggests that Hg exposure from dental amalgams may cause or contribute to many chronic conditions. Thus, consideration of Hg toxicity may be central to the effective clinical investigation of many chronic illnesses, particularly those involving fatigue and depression.

 

ADHD, Autism, and Phenylketonuria

Acta Neurologica BelgicaResearchers at Assiut University have in collaboration with Geir Bjørklund evaluated the neuropsychological status in 78 children with early and continuously treated phenylketonuria (PKU) in Assiut, Upper Egypt. The article was on 10 January  2015 published online first in Acta Neurologica BelgicaThe first author of the study, Khaled Saad, is Associate Professor of Pediatrics at Assiut University, Assiut, Egypt. Bjørklund is founder and president of the Council for Nutritional and Environmental Medicine (CONEM).

 

Khaled Saad, Yasser Elserogy, Ahmed A. Abdel rahman, Abdulrahman Abdullah Al-Atram, Ismail L. Mohamad, Tarek T. H. ElMelegy, Geir Bjørklund, and Amira A. El-Houfy

ADHD, autism and neuroradiological complications among phenylketonuric children in Upper Egypt

Acta Neurol Belg. Article first published online: 10 JAN 2015. doi: 10.1007/s13760-014-0422-8 

 

ABSTRACT

The aim of this study is to evaluate the neuropsychological status in a cohort of children with early and continuously treated phenylketonuria in Assiut, Upper Egypt. The study was implemented in seventy-eight phenylketonuria (PKU) children. Only 34 patients met the inclusion criteria. Investigated patients were evaluated according to detailed history, neurological examination, Childhood Autism Rating Scale, full scale Intelligence Quotient, attention deficit hyperactivity disorder, electroencephalography and magnetic resonance imaging (MRI). This study concluded that the prognosis for early diagnosed children with PKU treated from the first weeks of life is generally good. However, they are at increased risk for neurological complications and behavioral problems. So, neonatal screening for PKU is highly recommended in Egypt, for early detection and management. In addition, neuropsychological and MRI assessments in PKU children should be done.

 

 

Copper Amalgam and Norwegian Dental Health Personnel

Fig 1 Heating of copper amalgam

Fig 1 Heating of copper amalgam

Copper amalgams, consisting 60-70% mercury (Hg) and 30-40% copper (Cu) (1, 2), were used very commonly in Norway for children with caries – allegedly because they were thought to inhibit the development of new caries. But they were used in a way making them far more dangerous for dental health personnel than other types of amalgam because the amalgam powder was heated in a metal spoon in a gas flame until Hg droplets could be observed (Fig 1). In poorly ventilated rooms, this gave an enormous Hg exposure by inhalation to the dental health personnel, but even more to the dental assistants than to the dentists.

The average levels of occupational exposure to Hg among dental health personnel was earlier very high, at least in the Scandinavian countries including Norway, and in some cases (not very infrequently) excessively high (3, 4), especially in public dental health clinics with large numbers of schoolchildren as patients, where copper amalgam was used as a matter of routine to make fillings for the children because of its assumed cariostatic effect. A medical student at the University of Oslo made a student thesis, where he studied the Hg concentration in the air in dental health clinics, and in some of them found excessively high levels far exceeding (by more than a factor of 10) what was at that time the maximal permitted levels of exposure (3). This student thesis was carried out under supervision of his older brother, who was working in a leading position at the Norwegian Institute of Occupational Health. But the older brother, who had been the supervisor, did never inform the Directorate of Occupational Health about his younger brother’s observations, as nevertheless had been his duty (because of his job in a leading position at the institute) to do (Olav Albert Christophersen, personal communication).

The late Dr. Hans Tjønn, who at that time was chief doctor at the Institute of Occupational Health, had suspected that the conditions at Norwegian dental health clinics were not satisfactory from the point of view of occupational hygiene, and had taken up this question in meetings both with the Norwegian Directorate of Health and professors at the Faculty of Dentistry at the University of Oslo (Olav Albert Christophersen, personal communication). But he had been assured both by the people in the Norwegian Directorate of Health and the professors at the Faculty of Dentistry that everything was O.K., and that there was no need for him to be worried (Olav Albert Christophersen, personal communication). If he had been informed about the findings of Jon Norseth, he would have had the evidence he needed to tell the people in the Norwegian Directorate of Health that their assumptions about good occupational health conditions in the Norwegian dental health clinics were far from correct (Olav Albert Christophersen, personal communication). And the Norwegian Directorate of Occupational Health had the necessary legal mandate in Norwegian law (Arbeidsmiljøloven) that it would not have been necessary for them to ask the Directorate of Health for permission in order to stop the problems. If that, historically counterfactually, had happened, several hundred Norwegian dental health assistants and dentists might have been spared for sometimes severe health problems caused by Hg poisoning, and also because of poisoning by some of those organic toxic substances that have been much used in dental health clinics, such as chloroform and hydroquinone.

This article is based on/excerpted from material by Olav Albert Christophersen and Geir Bjørklund.

 

References

1. Bjørklund G. The history of dental amalgam (in Norwegian). Tidsskr Nor Laegeforen 1989; 109: 3582-3585.

2. Bjørklund G. Health authorities and copper amalgam (in Norwegian). Tenner & Helse 1995; No. 2/3: 3-6.

3. Norseth J. Exposure to mercury in public dental clinics in Oslo–an occupational hazard evaluation (in Norwegian). Nor Tannlaegeforen Tid 1977; 87: 371-376.

4. Bjørklund G. Mercury in dental workers’ occupational environment. A toxicological risk evaluation (in Norwegian). Tidsskr Nor Laegeforen 1991; 111: 948-951.

 

Medical Geology: An Emerging Discipline in Environmental and Human Health

Olle Selinus, PhD
Former geologist at the Geological Survey of Sweden (SGU), and now Associated Professor at Linneaus University in Kalmar, Sweden. Board member of CONEM.

Medical geology is the science dealing with the influence of geology on the distribution of health in humans and animals. Medical geology is a rapidly growing discipline that has the potential of helping medical and public health communities all over the world pursue a wide range of environmental and naturally induced health issues. Medical geology brings together geoscientists and medical/public health researchers to address health problems caused, or exacerbated by geological materials (rocks, minerals, atmospheric dust, and water) and processes.  Among the environmental health problems that geoscientists are working on in collaboration with the medical and public health community are: exposure to toxic levels of trace essential and non-essential elements such as arsenic and mercury; trace element deficiencies; exposure to natural dusts and to radioactivity; naturally occurring organic compounds in drinking water; volcanic emissions, etc.

Among the medical geology described are examples of both deficiency and toxicity of trace element exposure. Goiter is a widespread and serious health problem in many developing countries caused by deficiency of iodine. Deficiency of selenium in soil is the principal cause of juvenile cardiomyopathy and muscular abnormalities. Overexposure to arsenic is one of the most widespread medical geology problems affecting more than one hundred million people in Bangladesh, India, China, Europe, Africa and North and South America. The arsenic exposure is primarily due to naturally high levels in groundwater, but combustion of mineralized coal has also caused arsenic poisoning in several developing countries. Dental and skeletal fluorosis also impacts the health of millions of people around the world and is due to naturally high concentrations in drinking water and, to a lesser extent, coal combustion. Other medical geology issues described include geophagia in developing countries, exposure to radon, natural global dusts and ingestion of high concentrations of organic compounds in drinking water.

Promotion of medical geology under ICSU, UNESCO etc, under leadership from Sweden, has been carried out at meetings in many countries, organization and sponsoring of symposia on medical geology and also providing financial support for students and professionals to participate. Short courses have been presented in almost 45 countries since 2001, attended by thousands of students and professionals with backgrounds in geoscience, biomedical/public health science, enviromental science, chemistry, etc.

The International Medical Geology Association (IMGA) was established in January 2006. This was done from Sweden. Every second year IMGA has an international conference. The next will be in Portugal July 2015. Information can be found on the website http://www.medicalgeology.org.

 

References

Selinus O, ed. Medicinsk geologi. Lund: Studentlitteratur, 2010.

Selinus O, Finkelman B, Centeno J, eds. Medical Geology: A Regional Synthesis. Dordrecht: Springer, 2010.

Selinus O, Alloway B, Centeno JA, Finkelman RB, Fuge R, Lindh U, Smedley P, eds. Essentials of Medical Geology: Revised Edition. Dordrecht: Springer, 2013.

 

Serum Zinc and Copper Levels in Autistic Children

NeuroReport 25 (15) 2014In collaboration with Chinese researchers, Geir Bjørklund investigated the serum levels of zinc (Zn) and copper (Cu) in 60 Chinese children with autism (48 boys, 12 girls) and a control group of 60 healthy sex-matched and age-matched individuals. The researchers also evaluated the severity of autism using the Childhood Autism Rating Scale (CARS) score. The mean serum Zn levels and Zn/Cu ratio in the study were significantly lower in the autistic children compared with the control group (P<0.001). At the same time were the serum Cu levels significantly higher in the autistic children compared with the control group (P<0.001). It was in the study found a significant negative association between the Zn/Cu ratio and CARS scores (r=-0.345, P=0.007). 

The original article is published in NeuroReport (2014; 25 (15): 1216–1220). Bjørklund is founder and president of Council for Nutritional and Environmental Medicine (CONEM).

 

Si-Ou Li, Jia-Liang Wang, Geir Bjørklund, Wei-Na Zhao, and Chang-Hao Yin

Serum copper and zinc levels in individuals with autism spectrum disorders

Neuroreport 2014; 25 (15): 1216-1220

 

ABSTRACT

Trace elements play a critical role in the pathogenesis of autism spectrum disorders (ASD). The aim of this study was to investigate the serum levels of zinc (Zn) and copper (Cu) in Chinese children with ASD. Sixty patients (48 males, 12 females) diagnosed with ASD and 60 healthy sex-matched and age-matched control participants were assessed for serum Zn and Cu content at admission. The severity of ASD was also evaluated using the Childhood Autism Rating Scale (CARS) score. The results indicated that the mean serum Zn levels and Zn/Cu ratio were significantly lower in children with ASD compared with normal cases (P<0.001, respectively), whereas serum Cu levels were significantly higher (P<0.001). There was a significant negative association between Zn/Cu and CARS scores (r=-0.345, P=0.007). On the basis of the receiver operating characteristic curve, the optimal cut-off value of serum levels of Zn/Cu as an indicator for an auxiliary diagnosis of autism was projected to be 0.665, which yielded a sensitivity of 90.0% and a specificity of 91.7%; the area under the curve was 0.968 (95% confidence interval, 0.943-0.993). In conclusion, these results suggested an association between serum levels of Zn and Cu and ASD among Chinese patients, and the Zn/Cu ratio could be considered a biomarker of ASD.