« Older Entries

Pills for the Brain

Screen Shot 2015-01-15 at 9.11.26 AMPop this pill and improve your memory. Swallow that one and reduce your cognitive decline. We see ads for such products all the time and I suspect they will increase as the baby boomers reach senior citizenhood. The most popular brain boosting supplements are fish oil pills and they are also probably the best studied ones. The results are not encouraging. When all the studies are pooled, we are left with the possibility of a barely significant improvement in recalling lists of words soon after they have been learned, but the effect does not last. Extracts of the ginkgo biloba tree are also popular, and here the prospects are even dimmer. There is no impact on memory, despite claims of increased circulation in the brain. And ginkgo can interfere with the action of anticoagulants and has also been shown to be an animal carcinogen.

B vitamins are also sold with claims of enhancing memory, usually rationalized by their reduction of homocysteine, a chemical in the blood that may affect circulation in the brain. No benefits from B vitamin intake have been demonstrated when it comes to memory or cognitive function except in the case of people who have high homocysteine levels due to a diet that is very low in B vitamins. There is some concern that folic acid, one of the B vitamins, may spur the growth of polyps in the colon at doses greater than 800 micrograms a day. Phosphatidyl serine is a natural component of nerve cell membranes and its promoters argue that a deficiency leads to impaired communication between nerve cells which in turn impairs cognitive function. Sounds reasonable, except that proper controlled trials have come up empty. The same goes for vinpocetine, a compound originally isolated from the lesser periwinkle plant by Hungarian chemist Csaba Szantay in 1975. It is widely used in Europe to treat strokes and memory problems with claims of increased circulation to the brain. It does indeed increase circulation, much like ginkgo, but there is no compelling evidence for memory improvement.

People with failing memory and worried about Alzheimer’s disease are sometimes seduced by advertisements for Huperzine A, extracted from a type of moss. Some studies have shown that it increases levels of acetylcholine in the brain, a chemical that is in short supply in Alzheimer’s. But despite increasing acetylcholine, aside from a few questionable studies in China, there is no evidence that it improves memory. Unfortunately when it comes to memory pills, they are best forgotten. There is, however, hope that a nasal spray containing insulin can increase the absorption of glucose into brain cells and improve cognitive function. But in the meantime, the best bet to maintain good brain function is to monitor blood glucose and blood pressure, eat a diet rich in fruits, vegetables and whole grains, and low in simple carbs and saturated fat. And don’t forget that physical exercise also exercises your brain.

Dr. Joe Schwarcz

You Asked: Can the “Smart Drinking Pill” reduce the risk of drinking alcohol?

Screen Shot 2014-12-30 at 6.05.47 PMThe jury is out on whether drinking small amounts of alcohol is beneficial or detrimental. Some studies suggest a drink a day may be good for the heart. On the other hand, alcohol is a known carcinogen linked to cancers of the mouth, esophagus and breast. But when it comes to consuming excessive amounts of alcohol, the verdict is in. Liver damage, hypertension, neuropathies, seizures, gout, pancreatitis and dementia are all possible consequences of too much alcohol. And then of course there is the problem of impaired driving and life destruction due to addiction.
Liver damage is a major concern and one that is addressed by the makers of the “Smart Drinking Pill.” They claim that the mixture of plant extracts, vitamins and minerals in the pill can prevent liver damage and present an “option other than to quit drinking.” Milk thistle, artichoke extract and dandelion root are backed by some evidence in terms of offering liver protection, and the vitamins may be of some help given that people who drink a lot tend to have depleted levels. Liver function is generally determined by measuring blood levels of two enzymes, namely aspartate transaminase (AST) and alanine transaminase (ALT) that are produced by the liver as it detoxifies foreign substances. High levels indicate the liver has to work excessively and is prone to damage.
The single piece of evidence provided by makers of “The Smart Drinking Pill” is a blood test of a single individual whose AST and ALT went from high to normal after two months on the pill with no change in alcohol consumption. And what was this individual’s consumption? Thirty to forty drinks a week! Suggesting that reduction of the liver enzymes means that you can “responsibly enjoy alcohol without having to suffer the negative health consequences” is absolutely foolish. At that level of consumption there are many other risks than liver damage. If someone is drinking that quantity of alcohol the only smart thing to do is to cut back. The Smart Drinking Pill just encourages unhealthy behaviour.
Dr. Joe Schwarcz

You Asked: Nutritional yeast and adverse reactions?

nutritional yeastHad a question from a gentleman with a history of bloating after meals. He had a particularly bad episode after a dinner that included chicken Florentine soup and he wondered whether the “nutritional yeast” added to the soup could be the cause.  Nutritional yeast is just an inactivated form of the yeast that has been used for brewing beer and making wine for millennia. Because it has been inactivated with heat or salt, it does not cause fermentation, that is it does not convert sugar into alcohol. It is basically composed of protein with a good load of vitamins and minerals and has commonly been used as a dietary supplement. Indeed, Marmite and Vegemite are two formulations of the yeast that are popular in the UK and Australia, although having tasted these, I can’t understand why.

Nutritional yeast is basically used to add flavour to foods. Part of the effect is due to its natural content of glutamic acid which brings out flavour. Indeed, glutamate is the active component of the classic flavor additive monosodium glutamate (MSG). Some people do have an adverse reaction to glutamate but it is rare. It is, however, possible that some other component in nutritional yeast can cause a problem in susceptible individuals. Idiosyncratic reactions to food are not uncommon. The only way to determine if the yeast causes a problem is to carry out a challenge. Has anyone experienced an adverse reaction with nutritional yeast?

Dr. Joe Schwarcz

Seedy business in grape seed extracts

grapesA modest amount of red wine reduces the risk of heart disease, possibly because of the polyphenols it contains. Grape seed extract contains the same polyphenols as found in wine and has therefore been widely marketed as a dietary supplement with claims of having a beneficial effect on the human cardiovascular system. The problem here, though, is that the studies that have explored the effects of grape seed extract on human subjects have shown either none or minimal benefits. One study showed a slight increase in the resting diameter of the brachial artery in the arm, a finding of unknown clinical significance.

A meta analysis of nine randomized controlled trials concluded that grape seed extract had no effect on blood cholesterol, inflammation as determined by C-reactive protein levels, or triglycerides. There was a slight decrease of 1.5 mm Hg in systolic blood pressure, which is minimal when compared with what can be achieved with medication.

Overall there does not seem to be much evidence for taking grape seed extract supplements, although given that there is a great variety in supplement composition, it is possible that some specific supplements may be more effective than others. Unfortunately there are no quality control standards, as is clearly demonstrated by a recent analysis of 21 extracts purchased from a variety of outlets. Compared with authentic grape seed extract, there was great variability in chemical composition of the commercial extracts, but on average they all contained significantly less polyphenols than the authentic samples.

That, though, was not the only problem. Six of the samples contained no detectable quantities of grape seed extract, but were instead composed of peanut skin extract. Peanut skin does contain a variety of polyphenols similar to that found in grape seeds but the presence of peanut extract raises the issue of allergenicity. It is certainly possible that people with a peanut allergy may react to the adulterated extract. The motivation for such adulteration is financial, since peanut skin extract is much cheaper than authentic grape seed extract. Adulteration and lack of reliable data about composition is not the only problem. Let’s remember that even with authentic grape seed extract there is no compelling evidence of health benefits. And what about that glass of red wine with dinner? Drink it because you like it, not because of the polyphenols it contains. And we won’t even mention that ethanol is a carcinogen.

Dr. Joe Schwarcz

Ebola scams are sickening

ebolaWe’ve seen it before. A medical crisis emerges and the scam artists crawl out of the woodwork. Fearful citizens pop open their wallets and fork out hard-earned money for nonsensical “cures.” When it comes to a disease for which science cannot offer an effective treatment, quacks quickly rush in to fill the vacuum. This is just what is happening with Ebola. Claims about preventing infection, and even treating the disease, range from the laughable like eating organic dark chocolate to the totally inane recipe from a Norwegian homeopath for preparing a remedy from the body fluids of an Ebola victim. Homeopathy is based on the scientifically bankrupt notion that a substance capable of causing symptoms in a healthy person can cure those symptoms in an ill person if it is sufficiently diluted. This is nonsensical at any time, but handling the body fluids of an infected person is not a recipe for a cure, it is a recipe for disaster.

One would think that reasonable homeopaths, if such a term is ever applicable, would not support this absurd regimen. But homeopaths certainly have supported other “remedies” for Ebola, such as those concocted from various types of snake venom. Why? Because snake venom can cause intense bleeding, so in the perverse world of homeopathy, in an extremely diluted version it should be a remedy to stop hemorrhaging, a classic sign of Ebola infection. Of course the treatment is useless, but at least the only person at risk is the one collecting the snake venom. And that is unlikely to be the homeopath.

Homeopathic remedies are not the only ones being touted as effective tools in the battle against the Ebola virus. “Nanosilver” is also a hot item thanks to some clever pseudoscientific promotional lingo. Silver has been shown to have antimicrobial properties, begins the sales pitch, and then goes on to describe how silver is used in water purifiers and is even woven into socks to reduce odour caused by microbes. True enough. But deodourizing socks is a long way from destroying the Ebola virus in the body. Colloidal silver can, however, do something. It can cause an irreversible condition known as argyria in which skin colour is permanently altered by deposits of silver. Essential oils from plants won’t fare any better than silver in dealing with the Ebola virus. “Thieves oil,” a blend of cinnamon, rosemary, clove, eucalyptus and lemon oils, is hyped by some as an infection preventative. Seems like an appropriate name for a product that takes money and offers nothing in return.

Other plants, such as bitter kola, astragalus and elderberry are also said to contain compounds that can destroy the Ebola virus and are promoted by some hucksters as a treatment. They clamor for testing such herbal remedies and complain that while untested pharmaceutical products such as Zmapp are being fast-tracked, there is no will to test herbs. Yes, Zmapp is being fast-tracked because it has a plausible chance of working, backed by the solid science of monoclonal antibodies. Vague claims of herbal preparations “boosting immunity” will not do. The immune system is a complex network of organs, specialized cells, antibodies, vitamins, hormones and various other molecules. Nobody knows just what should be boosted to help fight the Ebola virus. This is not to say that herbal remedies have no potential. Honeysuckle tea, for example, has recently been shown to contain a “microRNA” that interferes with messenger RNA and is capable of silencing two genes that flu viruses need to replicate.

In Africa, there have been cases of desperate Ebola victims seeking out healers who claim to have herbal cures. There is at least one account of such a healer actually having exacerbated the problem when infected people came to be healed and ended up inadvertently spreading the disease including to the healer, who reportedly then died of Ebola.

Perhaps the greatest publicity for a supposed preventative has been garnered by vitamin C, a substance that in most minds is associated with health and justifiably so. An extreme deficiency of this vitamin causes scurvy and more mild deficiencies can lead to an increased release of the stress hormone cortisol from the adrenal glands. Cortisol raises blood sugar, suppresses the immune system and decreases bone formation. But none of this means that it can treat an Ebola infection. Yet that is the obvious implication of a product that has seen a meteoric rise in sales recently. The cleverly named Ebola-C sells for $34.95 for 60 tablets of vitamin C, 500 mgs per tablet. This is about ten times the price of no-name brands available everywhere. There is zero evidence that Ebola-C has any effect on the prevention or treatment of an Ebola infection.

The brains behind this marketing scam is New York businessman Todd Spinelli who claims to have gotten the idea from Dr. Oz. Well, I’m not one to come to the rescue of a guy who has dispensed a truckload of questionable advice, but in this case he did not claim that vitamin C could prevent Ebola infection. He did have a show on Ebola that included a segment in which he talked about stress and how vitamin C could reduce the negative effects of cortisol but he did not link this to Ebola. Of course it may be true that Spinelli heard him prattle on about vitamin C on the same program as his Ebola discussion and that sparked a marketing idea.
Some promoters of vitamin C supplements have rationalized that Ebola and scurvy have similarities in that both conditions are associated with excessive bleeding. Since vitamin C treats scurvy it may have an effect on an Ebola infection as well, they suggest. This is like arguing that since brain tumours are associated with headaches, they could conceivably be treated with aspirin. Makes no sense.

Even vitamin C supplement advocates, and there are many in the medical community, agree that small doses of oral vitamin C are ineffective in the battle against viruses. But some claim that massive intravenous doses, of the order of 30-50 grams a day, can wipe out viruses and should be tried on Ebola victims. They base this on baseless reports that large doses of vitamin C have cured victims of polio, Yellow Fever and Dengue Fever. Of course since intravenous vitamin C hasn’t been tried on Ebola patients, it is impossible to say categorically that it will not cure Ebola, but given what we know about infectious diseases, it’s a good bet that the only result of intravenous vitamin C would be diarrhea. Not the best thing for a dehydrated patient.

Joe Schwarcz

Green coffee beans give science a black eye

Dr. Oz
Dr. Oz  didn’t mince his words when he described the wondrous effects of green coffee been extract. “Magical,” “staggering,” an “unprecedented discovery!” “Finally, a cure for obesity” he breathlessly gushed. I gasped too. Not at the results of the study that sent Oz into rapture, but at the credulity of the man. Losing 10.5% of one’s body weight and 16% of body fat in 22 weeks without any dieting or exercise? Just by taking green coffee bean extract? That would indeed be a miracle. If only the study had been properly conducted and involved more than 16 people.

But what we actually had was a study so sloppy that it was rejected by the journals to which it was originally submitted. That’s when, as the story goes, the manufacturer of the green coffee bean supplement, Applied Food Sciences, hired University of Scranton Professors Joe Vinson and Bryan Burnham to rewrite the paper to make it acceptable for publication. It seems these two had nothing to do with the research and were more or less hired guns. Obviously there is a major ethical issue here with university professors basically writing a paper about research that they were not involved in.

Granted, Dr. Oz could not have been aware of the sordid history of the publication but having been trained in science he should have known better than to tout a piece of ragged research that involved so few subjects as a “miracle.” His unbridled enthusiasm for the supplement led to skyrocketing sales but a pretty rough landing for the hopeful who bought into the easy weight loss scheme. But the Federal Trade Commission (FTC) in the U.S. didn’t buy  the outrageous claims and launched an investigation, quickly concluding that the lead investigator in the study had altered some of the data and was even unclear about which subjects had taken the coffee bean extract and which the placebo. “Sloppy” would be the kind expression, “fraudulent” the more realistic one.

The FTC doesn’t take kindly to such fiddling with data and initiated legal proceedings. The result was a fine of $3.5 million for the company and a promise to desist from false advertising in the future. By this time Vinson and Burnham were feeling the heat and have now decided to retract the paper because as they said, “the sponsors of the study cannot assure the validity of the data.” What on earth are they talking about? Being the authors of the paper, didn’t they think of verifying the data before? They relied on the manufacturer of the product being tested to check the data? Does one ask the fox to check on the welfare of the chickens in the hen house? If it turns out that Vinson and Burnham were really paid to write this paper without having been involved in the research, some sort of disciplinary action is indicated.

“Green coffee bean-gate” should be widely publicized because it is an excellent example of how a credulous TV personality, shoddy science and a curious lack of judgment by a couple of professors can result in the runaway sales of a questionable product. A black eye for science.

Joe Schwarcz 

You Asked: Is fish really brain food?

brain foodIs fish really brain food? P.G. Wodehouse certainly thought so. In his wonderful “Jeeves” stories, Bertie Wooster encourages his brainy butler to eat more fish whenever a particularly challenging problem arises. But to what extent does fiction mirror real life? One can make a theoretical case for fish consumption based on the fact that docosahexaenoic acid, or DHA, the famous omega-3 fat in fish, is the main component of brain cell membranes, and that communication between brain cells is a function of the integrity of these membranes.

There is actually some experimental evidence to support a link between fish consumption and brain health. Infants born to mothers who consumed more fish during pregnancy have been shown to have improved verbal intelligence, better fine motor skills and pro-social behavior. A study has also correlated fish intake during pregnancy with IQ in 8-year old children. It is likely that these effects are due to increased blood levels of DHA in the offspring, but as is generally the case, the scenario is complicated. When blood is drawn from umbilical cords, it turns out that the concentration of the various fatty acids depends on the genetics both of the mother and the baby. In other words, depending on genotypes, an infant may benefit more or less from fish in the mom’s diet.

What about brain function at the other extreme of life, senior citizens? To get some insight here, researchers examined MRI brain scans of 260 individuals over the age of 65 who had normal cognitive function looking for differences associated with fish consumption as determined by dietary surveys. Subjects who ate baked or broiled but not fried fish every week had larger grey matter volumes in the areas of the brain responsible for memory and cognition. Interesting, but there was no determination as to whether these increased volumes translated to any change in brain power.

Curiously, no relationship was found with omega-3 fat intake as calculated from the diet surveys, suggesting that eating fish weekly may prevent brain ageing regardless of omega-3 content. But it may also be that eating fish is a marker for some other effect. People who ate fish were more likely to have a university education than those who didn’t. So perhaps it is mental exercise that was responsible for the changes in brain volume. There is also evidence that eating fish reduces the risk of heart disease. Maybe eating fish makes people smarter and more capable of understanding why they should be following the guidelines designed to reduce the risk of heart disease.

Joe Schwarcz

Green tea extracts and liver disease

green tea extractI think we are safe in saying that green tea doesn’t make taste buds frolic. So why do people drink it? The same reason for which the Chinese have been consuming it for millennia. Its supposed health benefits. Green tea doesn’t contain the flavourful compounds that form when tea leaves are allowed to ferment. During fermentation enzymes are released that convert the naturally occurring polyphenols in the leaves to a host of tasty compounds. Instead of being fermented, green tea is made by steaming or drying fresh tea leaves in order to prevent oxidation of the polyphenols. It is these polyphenols that in laboratory and animal studies show anti-cancer effects as well as increased rates of metabolism.

But how can on benefit from tea’s polyphenols without having to put up with green tea’s unappealing flavor? Supplement manufacturers have found a way. Just extract the catechins, the main class of polyphenols in tea, and plunk them in a pill. Then promote the pill as a cancer-fighting or fat burning supplement. But here we run into a problem. Such dietary supplements are poorly regulated and the amount of catechins they contain can be far greater than that available from drinking tea. The high doses may indeed help to increase metabolism and result in weight loss but possibly at a high cost. Just ask the teenager who walked into the emergency room at Texas Children’s Hospital with his chest, face and eyes bright yellow due to severe liver damage after using a concentrated green tea extract he bought at a nutrition store as a “fat burning” supplement. Doctors feared he may need a liver transplant but luckily his liver, an organ that has regenerative properties, managed to recover. He did, however, have to give up sporting activities and will require regular checkups of his liver function.

Unfortunately this is not an isolated case and such cases are not limited to green tea extracts. Various herbal supplements have been linked with liver damage, some because of undeclared ingredients, such as steroids. These are promoted as bodybuilding supplements and may actually have an effect because of the hidden steroids. People generally assume that herbal products that are sold are tested for safety and efficacy but this is not the case. Until regulations are tightened the incidence of liver damage from dietary supplements is going to continue to increase.

 Joe Schwarcz
« Older Entries
Blog authors are solely responsible for the content of the blogs listed in the directory. Neither the content of these blogs, nor the links to other web sites, are screened, approved, reviewed or endorsed by McGill University. The text and other material on these blogs are the opinion of the specific author and are not statements of advice, opinion, or information of McGill.