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Nutraceutical: Hyaluronic acid (Hyal-Joint)
Indication: Knee osteoarthritis (OA)
Source: Nutr J, January 21, 2008;7:3.
Research: In this study, investigators examined the effect of dietary supplementation with a natural extract of chicken combs with a high content of hyaluronic acid (60%) (Hyal-Joint) on pain and quality of life in subjects with knee OA. Twenty subjects 40 years of age and older with knee OA (pain for at least 15 days in the previous month, with symptoms persisting over the past 6 months) participated in this randomized, double-blind, controlled trial. Ten subjects received Hyal-Joint (80 mg/day) and 10 received placebo for 8 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and quality of life by the Short Form-36 (SF-36v2) were administered at baseline and after 4 and 8 weeks of treatment.
Results: WOMAC pain was similar in both study groups. As compared with baseline, subjects in both groups showed statistically significant improvements in WOMAC pain, stiffness, physical function subscales and in the aggregate score, but the magnitude of changes was higher in the Hyal-Joint group for WOMAC physical function and total symptoms. At 8 weeks, changes in bodily pain and social functioning were of greater magnitude in subjects given Hyal-Joint. According to researchers, while this pilot clinical trial showed that daily supplementation of Hyal-Joint was useful to enhance several markers of quality of life in adults with knee OA, the results warrant further study in larger sample sizes.
Nutraceutical: Omega 3 fatty acids
Indication: Depression (during pregnancy)
Source: J Clin Psychiatry, March 18, 2008:e1-e8. [Epub ahead of print]
Research: Perinatal depression is common, and treatment remains challenging. According to researchers, depression has been reported to be associated with the abnormality of omega 3 polyunsaturated fatty acids (PUFAs). A profound decrease of omega 3 PUFAs in the mother during pregnancy is associated with the higher demand of fetal development and might precipitate the occurrence of depression. In this study, researchers set out to examine the efficacy of omega 3 PUFA monotherapy for the treatment of depression during pregnancy. From June 2004 to June 2006, they conducted an 8-week, double-blind, placebo-controlled trial comparing omega 3 PUFAs (3.4 grams per day) with placebo in pregnant women with major depressive disorder (DSM-IV criteria). No psychotropic agent was given 1 month prior to or during the study period. The Hamilton Rating Scale for Depression (HAM-D) was scored every other week as the primary measurement of efficacy, while the Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) were secondary measures. Thirty-six subjects were randomly assigned to either omega 3 PUFAs or placebo, and 33 among them were evaluated in more than two visits.
Results: A total of 24 subjects completed the study. As compared to the placebo group, subjects in the omega 3 group had significantly lower HAM-D scores at weeks 6 and 8, a significantly higher response rate (62% vs. 27%), and a higher remission rate, although the latter did not reach statistical significance (38% vs. 18%). At the study end point, subjects in the omega 3 group also had significantly lower depressive symptom ratings on the EPDS and BDI. The omega 3 PUFAs were well tolerated and there were no adverse effects on the subjects and newborns. Researchers believe omega 3 PUFAs may have therapeutic benefits in depression during pregnancy. With regard to the safety issue and psychotherapeutic effect, as well as health promotion to mothers and their newborns, they believe it is worth conducting replication studies in a larger sample with a broad regimen of omega 3 PUFAs in pregnant women with depression.
Nutraceutical: Pine bark extract (Pycnogenol)
Indication: Knee osteoarthritis (OA)
Source: Phytother Res, April 2008;22(4): 518-23.
Research: Researchers conducted a randomized, double-blind, placebo-controlled study on 156 patients with osteoarthritis of the knee (OA). Patients were administered 100 mg Pycnogenol or placebo daily for 3 months. Symptoms were evaluated by WOMAC index scores and mobility by recording their walking performance on a treadmill. Patients were permitted to continue taking their choice of pain medication provided they recorded every tablet in a diary for later evaluation. To describe and rate OA symptoms (joint pain, stiffness and physical function), WOMAC questionnaires were evaluated by the investigator and patient at the start and after 3 months of treatment. Patients were trained on a treadmill test and performance evaluation was recorded on total distance that could be covered without pain. Measuring foot volume by the water-displacement method was used to evaluate ankle/ foot edema in a randomly selected subgroup of subjects within the two treatment groups.
Results: After 3 months, scores for pain dropped significantly for the Pycnogenol treatment group but no significant effects were recorded for the placebo group. Scores for stiffness were reduced by 53%. The scores for physical function were reduced by 57% in the Pycnogenol group. The global WOMAC score decreased following Pycnogenol treatment and very little in the placebo group, from 56% vs. almost 10% for Pycnogenol and placebo, respectively. Results of exercise tests on the treadmill demonstrated an increased performance after 3 months of Pycnogenol treatment. At the start of the study, patients could only walk a mean of 74 yards without feeling pain but after 3 months they could walk 216 yards, compared to the placebo group, which noted 71 yards at the beginning of the study and 96 yards at the end.
Nutraceutical: Vitamin K2 (see downloadable monograph below)
Indication: Prostate cancer
Source: Am J Clin Nutr, April 2008;87(4): 985-92.
Research: Investigators evaluated the association between dietary intake of phylloquinone (vitamin K1) and menaquinones (vitamin K2) and total and advanced prostate cancer in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition. At baseline, habitual dietary intake was assessed by means of a food frequency questionnaire. Dietary intake of phylloquinone and menaquinones (MK-4-14) was estimated by using previously published HPLC-based food-content data. Multivariate-adjusted relative risks of total and advanced prostate cancer in relation to intakes of phylloquinone and menaquinones were calculated in 11,319 men by means of Cox proportional hazards regression.
Results: During a mean follow-up time of 8.6 years, 268 incident cases of prostate cancer, including 113 advanced cases, were identified. Researchers observed a non-significant inverse association between total prostate cancer and total menaquinone intake, specifically linked to a 35% reduction in risk for prostate cancer. The association was stronger for advanced prostate cancer—with an increased intake of vitamin K2 linked to a 63% reduction in risk. Menaquinones from dairy products had a stronger inverse association with advanced prostate cancer than did menaquinones from meat. Phylloquinone intake was unrelated to prostate cancer incidence.
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