Archive for month: January, 2024

In today’s fast-paced world where time is a valuable commodity, individuals are increasingly turning to quick solutions to address the challenges of daily life. Nowhere is this more evident than in the realm of health, where the demand for convenient fixes has led to the widespread adoption of multivitamin preparations.

These supplements are often viewed as a remedy for nutritional gaps resulting from unhealthy lifestyles and dietary choices. The routine practice of self-medicating with a blend of vitamins—such as B complex, vitamin C, D, B12, A, and calcium—has become commonplace.

However, beneath the surface of this everyday habit lies a growing concern—a concern arising from a lack of understanding regarding genuine medical needs for these supplements and the potential risks associated with uninformed self-medication.

Exploring Deficiencies: How to Recognize Signs of Vitamin and Mineral Deficits?

Spotting specific deficiencies in vitamins or minerals can be challenging, given the variability and potential overlap of symptoms with other health issues. A shortage of vitamin D might manifest as increased fatigue, muscle weakness, and bone pain, particularly in individuals with limited sun exposure.

Inadequate iron levels could result in feelings of fatigue, weakness, and paler skin. Vitamin B12 deficiency may present with tiredness, weakness, and a tingling sensation in the extremities. Low calcium levels might be indicated by muscle cramps and weak, brittle nails.

Vitamin C deficiency may lead to gum bleeding and easy bruising. Symptoms such as muscle cramps and irregular heartbeat could signal a magnesium shortage, while low potassium levels might contribute to muscle weakness and irregular heartbeats.

If a deficiency is suspected, consulting a healthcare specialist is advisable. Subsequent blood tests can provide an accurate diagnosis, and personalized guidance on dietary changes or supplementation can be tailored based on individual needs.

Harnessing the Power of Everyday Foods: Your Best Source of Nutrients

Incorporating a diverse range of foods with varying nutritional content into your diet can help ensure you receive the most essential nutrients. It’s crucial to note that the body absorbs nutrients from whole foods more efficiently than from supplements. Additionally, adopting a colourful and varied diet provides a wide array of phytochemicals and antioxidants, essential for overall health.

When it comes to boosting vitamin D levels, sun exposure remains the most effective method and can be complemented by small quantities found in fatty fish like salmon and mackerel, egg yolks, and fortified dairy products. Iron sources span lean meats, poultry, fish, legumes, tofu, and iron-fortified cereals.

Vitamin B12 can be sourced from meat, fish, dairy, eggs, and fortified foods such as cereals and plant-based milk alternatives. Calcium-rich options encompass dairy products, fortified plant-based milk, tofu, leafy greens, and almonds.

Abundant in citrus fruits, strawberries, kiwi, bell peppers, tomatoes, and broccoli, vitamin C plays a crucial role in your diet. Magnesium sources include nuts, seeds, whole grains, legumes, leafy greens, and fish.

Foods high in potassium, such as bananas, oranges, potatoes, sweet potatoes, spinach, tomatoes, beans, and yogurt, contribute significantly to overall health. Additionally, folate, or Vitamin B9, can be derived from leafy greens, legumes, avocados, citrus fruits, and fortified cereals. Including green leafy vegetables and beetroot in your diet aids in iron supplementation.

However, it’s important to acknowledge that factors like the quality of food, changes in dietary preferences, and reduced nutrient absorption as we age can lead to multiple deficiencies, necessitating the need for supplementary intake.

In physiological conditions like pregnancy and lactation, increased requirements call for appropriate doses of vitamins. Other situations requiring supplementation include malnutrition, chronic alcohol consumption, malabsorption, bariatric surgery, inborn errors of metabolism, and patients undergoing hemodialysis.

Beyond the Quick Fix: The Risks of Uninformed Self-Medication

While most multivitamins are safe when used as directed and sticking to recommended daily amounts, excessive intake can lead to complications. For instance, an excess of vitamin D can result in issues like high calcium levels and kidney stones.

Doctors typically prescribe vitamins for specific reasons, such as pregnant women taking folic acid to prevent certain birth defects and individuals with weak bones receiving vitamin D. If a vitamin B12 deficiency is identified, a prescription may be necessary to avoid problems like nerve issues and anaemia.

However, there’s no one-size-fits-all solution when it comes to taking multivitamins for general health, especially if you’re already maintaining a balanced diet. Consulting a doctor before reaching for over-the-counter vitamins is a wise approach. Your body’s unique needs deserve professional guidance to determine what’s right for you.

According to the researchers, this is the first study to investigate allergic sensitisation concerning exposure to air pollution from a landscape fire in a non-occupational setting. They did not observe a relationship between in-utero exposure or exposure during the first 2 years following the birth to PM2.5 (particulate matter with an aerodynamic diameter < 2.5 μm) emitted by coal smoke and allergic sensitisation, but increased background PM2.5 concentrations were tied to a higher prevalence of sensitisation to dust.

In terms of sensitisation to specific allergens, amongst the tested allergens, the only positive association was found with dust.

There is inconsistent evidence on the relationship between air pollution and allergic sensitisation in childhood, and this relationship has not been investigated in the context of smoke events predicted to increase with climate change. Thus, Myriam Ziou, University of Tasmania, Hobart, Tasmania, Australia, and colleagues aimed to evaluate associations between exposure in two early life periods to severe levels of PM2.5 from a mine fire, background PM2.5, and allergic sensitisation later in childhood.

For this purpose, they measured specific immunoglobulin E (IgE) levels for seven aeroallergens and total IgE levels in a cohort of children exposed to the Hazelwood coal mine fire, either in utero or during the first two years, in a region in Australia where ambient levels of PM2.5 are generally low.

They estimated personal exposure to fire-specific PM2.5 emissions based on a high-resolution meteorological and pollutant dispersion model and detailed reported movements of pregnant mothers and young children during the fire. The usual exposure to PM2.5 at the residential address at birth was also estimated using a national satellite-based land-use regression model.

Associations between PM2.5 sources and sensitization to cat, dust, grass, and fungi were estimated seven years after the fire with logistic regression, while associations with total IgE levels were estimated with linear regression.

One hundred three children presenting to the 2021 clinical follow-up agreed to provide a blood sample. Those born overseas (n=2) were excluded as their background exposure could not be estimated accurately, which led to the inclusion of 101 children. Of 101 children, 50 were born before the start of the fire, four were born during the fire, 29 were in utero during the whole fire period, and 18 were conceived after the fire.

The study led to the following findings:

• Sensitisation to D. pteronyssinus had the highest prevalence (35.4%), while Cl. herbarum had the lowest (2.0%).
• There were various levels of correlation between sensitisation to allergens from different categories, the strongest being between perennial rye grass pollen and D. pteronyssinus.
• No association was found between the levels of fire-related PM2.5 and the odds of sensitisation to any of the distinct allergen categories, for both peak and cumulative exposure. Exposure to fire-related PM2.5 was not linked with sensitisation to any category either.
• Early life background exposure to PM2.5 was positively associated with the odds of being sensitised to dust (adjusted OR = 1.90), but not with cat, grass, fungi, or overall sensitization.
• No evidence was observed of a relationship between exposure to fire-related or background PM2.5 and overall total IgE in the blood.

“Our study indicates chronic exposure to relatively low air pollution levels in early life could have a stronger association with atopy development than time-limited high levels, which may be part of the mechanism relating air pollution to allergic diseases, such as atopic dermatitis and allergic rhinitis,” the researchers wrote.

“Larger studies are needed to examine periods of increased risk during pregnancy and infancy based on knowledge of the maturation of the immune system,” they concluded.

Reference:

Ziou, M., Gao, C.X., Wheeler, A.J. et al. Exposure to air pollution concentrations of various intensities in early life and allergic sensitisation later in childhood. BMC Pulm Med 23, 516 (2023). https://doi.org/10.1186/s12890-023-02815-8

Alexandra J. Lansky, Yale School of Medicine, New Haven, CT, United States of America, and colleagues revealed that statins do not appear to reduce the risk of post-TAVR atrial fibrillation or conduction abnormalities.

Post-TAVR conduction disturbances and atrial fibrillation are reported to be associated with markedly worse short- and long-term prognoses. Statins have multiple pleiotropic effects that may be beneficial in the periprocedural periods of cardiac interventions. They have anti-inflammatory, antioxidant, and antithrombotic effects, can reduce sympathetic activity, and may down-regulate the renin-angiotensin system. It has been hypothesized that statins may protect against incident AF or conduction disturbance.

To determine the effect of antecedent statin usage on arrhythmias and conduction disturbances after TAVR, the research team retrospectively collected data on consecutive patients in the Yale New Haven Health TAVR Registry. It included patients who did not have a prior pacemaker, had at least 1 pre- and post-TAVR electrocardiogram, and did not have a change to their statin regimen during the index hospitalization.

The primary endpoint of the study was the composite of new pacemaker placement, other new conduction disturbances, and new AF evaluated at seven days post-TAVR.

The study revealed the following findings:

• 612 patients met the inclusion criteria between 2012 and 2019. Of these, 162 patients were not on antecedent statins, and 450 were (28 low-intensity, 225 moderate-intensity, and 197 high-intensity).
• After 1:1 propensity matching, 99 patients on moderate-/high-intensity statins were matched to 99 patients not on antecedent statins.
• At 7 days, there was no significant difference in the occurrence of the primary endpoint (57 % statin users versus 46 % non-statin users).
• There was a trend toward increased conduction disturbances 7 days after TAVR in statin users (56 % versus 42 %), but rates of AF (5 % versus 8 %) and pacemaker placement (9 % versus 15 %) were numerically lower in statin users.
• There was no significant difference in persistent conduction disturbances (21 % versus 18 %).

“The study did not find a significant benefit of statin use on post-TAVR conduction disturbances, incident AF, or permanent pacemaker (PPM placement), however, its power to detect differences in individual endpoints was limited,” the researchers wrote.

“Further studies are needed to identify if statins or other medications change the incidence of these complications,” they concluded.

Reference:

Shah, T., Maarek, R., See, C., Huang, H., Wang, Y., Parise, H., Forrest, J. K., & Lansky, A. J. (2024). Effect of antecedent statin usage on conduction disturbances and arrhythmias after transcatheter aortic valve replacement. Cardiovascular Revascularization Medicine, 59, 3-8. https://doi.org/10.1016/j.carrev.2023.07.022