Natural Standard Blog

Debate: Lung Cancer Supplements

The Natural Products Association (NPA) expressed its concern regarding findings presented at the American Thoracic Society 2007 International Conference that indicated no statistically significant relationships between dietary supplements and lung cancer.

The sub-study from the Vitamins and Lifestyle (VITAL) study isolated the effect of vitamin supplements on lung cancer risk. The NPA has objected to this link, as it believes that the study model used should have been a randomized clinical trial and not a cohort study.

The study found that there is no correlation between any benefits on lung cancer and supplementation. The results are controversial as the U.S. public spends billions of dollars on supplements every year for the prevention of cancer.

Lung cancer is a disease in which the cells of lung tissues grow uncontrollably and form tumors. Lung cancer is the most lethal of all cancers worldwide, responsible for up to three million deaths annually.

More than 90,000 men and 79,000 women are diagnosed each year with cancer of the lungs and bronchi (the air tubes leading to the lungs) in the United States. It occurs most often between the ages of 55 and 65.

Currently, lung cancer is the leading cause of cancer death in women, overshadowing breast cancer, ovarian cancer and uterine cancers combined. About six out of ten people with lung cancer die within one year of being diagnosed with the disease, and between seven and eight people will die within two years of diagnosis.

The sub-study was conducted as part of the larger cohort study conducted in Western Washington State over a period of ten years. It investigated the link between supplement use and cancer risk.

The researchers focused on prostate, breast, lung and colorectal cancers, and multivitamins, vitamins C and E, folate, omega-3 fatty acids and fiber.

Between 2000 and 2002, 77,738 men and women between the ages of 50 and 76 participated. They answered a baseline questionnaire that included detailed information on their use of 38 different supplements, their diet and exercise patterns, as well as their medical history and pharmaceutical drug consumption.

Within this study, 393 cases of lung cancer were reported. Researchers adjusted results for risk factors such as smoking, age, sex, cancer history, lung disease and history of lung cancer, but found no statistically significant relationships between different types of supplements and lung cancer.

The NPA found fault with the questionnaire calling the data ambitious and calling for a comparison with all data outside of the study to accurately reflect the state of the science that the majority demonstrates a positive effect of vitamins E and C and folate on chronic disease.

The trade association maintains that there is no way to confirm that respondents accurately reported their consumption of supplements and medications or their lifestyle patterns.

Theses findings challenged the supplement industry, as studies linking supplements to disease risk or pointing to allegedly placebo-like effects of such products come to the public's attention.

Integrative therapies that have been studied in the treatment of lung cancer include lycopene, PSK (protein-bound polysaccharide obtained from a mushroom thought to have antimicrobial, antiviral and antitumor properties), selenium, vitamin A, vitamin B6 and vitamin B12.

For more information about the integrative therapies listed above, please visit Natural Standard's Foods, Herbs & Supplements database. For more information about lung cancer, please visit Natural Standard's  Medical Conditions database.

Summer Sun Safety

With summer almost officially here, Natural Standard would like to provide readers with a few summer sun safety tips.

A recent study found that retin-A, alpha hydroxy acid and microdermabrasion products, which are used to minimize wrinkles and improve skin tone, might make the skin more susceptible to sun damage.

Experts recommend wearing protective clothing and sunblock with a minimum SPF of 15. Individuals are also encouraged to use a sunblock that is specially formulated for the lips.

Herbs and supplements that may make individuals more sensitive to the sun include alfalfa, ambrette, belladonna, bitter orange, cashew, chlorella, chlorophyll, chondroitin sulfate, dong quai, fennel, feverfew, glucosamine, lavender, lime, oak moss, riboflavin, shiitake, St. John's wort and vitamin B6. For more information about the interactions associated with these herbs and supplements, please visit Natural Standard's Interactions Checker.

Integrative therapies studied for sunburn protection include beta-carotene, green tea, lutein, lycopene, pycnogenol and selenium. Beta-carotene, a highly pigmented, fat-soluble compound naturally present in many fruits, grains, oil and vegetables (green plants, carrots, sweet potatoes, squash, spinach, apricots, and green peppers), has the strongest scientific evidence in the prevention of sun damage.

For more information about integrative solutions for sunburns and sunburn protection, please visit Natural Standard's Comparative Effectiveness database.

Supplements for Burn Injuries

Trace element supplementation after major burns modulates antioxidant status and clinical course by way of increased tissue trace element.

Researchers from the University Hospital (CHUV), Lausanne, Switzerland and the Royal Liverpool University Hospital and University of Liverpool in the United Kingdom explained that patients might develop nutritional deficiencies, including trace element (TE) deficiencies, after major burns. Various complications, such as infections and delayed wound healing, influence the clinical course of such patients.

The study investigated the effects of large, intravenous doses of TE supplements on circulating and cutaneous TE tissue concentrations, antioxidant status and clinical outcome after major burns.

In the prospective, randomized, placebo-controlled trial, 21 patients (average age 35) with burns on 45 ± 21 percent of their body surface area were given intravenous copper, selenium and zinc (TE group) or vehicle (V group) with a saline solution for 14-21 days. Blood and urine samples were collected for 20 days, and skin biopsy specimens were collected on days three, 10 and 20.

The age of the patients and the severity of their burns did not differ significantly between the groups. Plasma TE concentrations were significantly higher in the TE group. In burned areas, skin contents of both selenium and zinc increased significantly by day 20. The study also found that plasma and tissue antioxidant status was improved by supplementation.

The number of infections in the first 30 days was significantly lower in the TE group. Wound healing was improved in the TE group, with lower requirements for regrafting.

Researchers concluded that TE supplementation resulted in higher circulating plasma and skin tissue contents of selenium and zinc and improved antioxidant status. These changes were associated with improved clinical outcome, including fewer lung infections and better wound healing.

Other integrative therapies studied for the treatment of burns include acupuncture, aloe, arginine (L-arginine), astragalus, beta-glucan, bromelain, danshen, honey, hydrotherapy, pantothenic acid (vitamin B5), phosphates, phosphorus, prayer, distant healing, propolis, selenium, thymus extract and zinc.

For more information about the integrative therapies listed above, please visit Natural Standard's Foods, Herbs & Supplements database or Health & Wellness database.

Music Therapy May Offer Health Benefits

A group of recent studies has investigated the effects of music therapy on a variety of patients, from young, grieving youth to terminally ill elderly.

Music therapy has been studied for a number of illnesses with strong, positive scientific evidence including mood enhancement, relaxation, stress, anxiety, autism, cystic fibrosis, dementia, depression, grief, infant development, neonatal care, mental performance, nausea/vomiting, pain, Parkinson's disease, quality of life, schizophrenia, sedation, sleep quality and stress.

Music is an ancient tool of healing that was recognized in the writings of Pythagoras, Aristotle and Plato. The modern discipline of music therapy began early in the 20th Century with community musicians visiting veterans' hospitals around the country to play for those suffering from the traumas of war. Patients' responses led to the hiring of musicians by hospitals.

Music is used to influence physical, emotional, cognitive and social well-being and improve quality of life for healthy people, as well as those who are disabled or ill. It may involve either listening to or performing music, with or without the presence of a music therapist.

Music therapists work in psychiatric hospitals, prisons, rehabilitative facilities, medical hospitals, outpatient clinics, day treatment centers, agencies serving developmentally disabled persons, community mental health centers, drug and alcohol programs, senior centers, nursing homes, hospice programs, correctional facilities, halfway houses, schools and private practice.

An Australian study investigated music therapy referral trends with palliative care and found that healthcare providers commonly prescribe music therapy. Researchers analyzed music therapy (MT) referral trends from palliative care team members across nine Australian inpatient and community-based palliative care settings. In the study, 354 participants (196 female, 158 male) were referred ranging in age from four to 98 years old, and most were diagnosed with cancer (323 participants, or 91 percent). Nurses (167, or 47 percent) referred most frequently to music therapy.

Thirty-six percent, or 130 patients, were referred for symptom-based reasons, and 24.5 percent, or 87, patients were referred for support and coping.

Researchers concluded that study results suggest implications for service delivery of music therapy practice, interdisciplinary care and benchmarking of music therapy services.

In a related study, scientists evaluated and compared the effects of Orff-based music therapy, social work and wait-list control groups on behavioral problems and grief symptoms of bereaved school-aged children.

Social work and music therapy sessions were provided weekly for one hour over an eight-week period. Twenty-six participants attended three different public elementary schools, and each school was randomly assigned to one of the conditions. Pre- and post-test measures consisted of the Behavior Rating Index for Children (BRIC) and the Bereavement Group Questionnaire for Parents and Guardians (BP). The BRIC measured behavioral distress and the BP measured grief symptoms prior to and following participation in the assigned conditions.

The study found that participants in the music therapy group significantly improved in behaviors and grief symptoms, and those in the social work group experienced a significant reduction in their behavioral problems but not their grief symptoms. Participants in the wait-list control group made no significant improvements in either their grief symptoms or behavioral problems.

Researchers concluded that study results support the use of Orff-based music therapy interventions for bereaved children in a school-based grief program.

Another study from the "Journal of Music Therapy" explored the effect of music therapy on the spirituality of persons in an in-patient hospice unit as measured by self-reporting.

Ten participants were used as their own control in an ABAB design format. Session A consisted of about 30 minutes of music therapy, after which the patient/subject responded to a spiritual well-being questionnaire. Session B consisted of about 30 minutes of a non-music visit, after which the patient/subject responded to a spiritual well-being questionnaire.

The study found a statistically significant increase in spiritual well-being scores on music days.

And finally, a study examined the effects of music therapy on pain, also in a hospice setting. The focus of the study was to describe current trends in pain assessment in end of life care with a secondary focus on music therapy techniques commonly used to address pain for hospice patients.

Study authors conducted a survey of 72 board certified music therapists and 92 hospice and palliative nurses. The survey found that most music therapists in the hospice setting incorporate formal pain assessment into their practice; both nursing professionals and music therapists surveyed utilized multiple assessment tools to assess patient pain.

Researchers concluded that there are a variety of music therapy techniques utilized by music therapists with hospice patients to address acute and chronic pain symptoms.

For more information about music therapy, please visit Natural Standard's Health & Wellness database.

Coenzyme Q10 for Parkinson's Disease

A new study suggests that coenzyme Q10, or CoQ10, may be a safe treatment option for patients with Parkinson's disease, although the extent of its effectiveness is still unknown.

Parkinson disease (PD) is a chronic disease of the central nervous system caused by lowered levels of the inhibitory neurotransmitter dopamine. The disease is characterized by tremors or trembling of the arms, jaw, legs and face; stiffness or rigidity of the limbs and trunk; slowness of movement and impaired balance and coordination.

CoQ10 is a fat-soluble antioxidant found in most tissues in the body and in many foods. In the body, it produces energy for cells. CoQ10 levels decrease with age and may be low in patients with cardiovascular diseases, muscular dystrophies, Parkinson's disease, cancers, diabetes or AIDS.

Researchers from the University of Ulm in Germany investigated possible protective effects of CoQ10 in early PD to determine whether nanoparticular CoQ10 is safe and displays symptomatic effects in patients with mid-stage PD without motor fluctuations.

According to study authors, the multicenter, placebo-controlled, randomized, stratified, double-blind, parallel-group, single-dose clinical trial was organized by the German Coenzyme Q10 Study Group and sponsored by the German Parkinson Association (Neuss, Germany) and MSE Pharmazeutika GmbH (Bad Homburg, Germany). Subjects were enrolled between September 2003 and January 2005 at 13 movement disorder clinics. One hundred thirty-one patients with PD without motor fluctuations and a stable anti-parkinsonian treatment were randomly assigned to placebo or nanoparticular CoQ10 100 milligrams three times a day for a treatment period of three months.

The study subjects underwent evaluation with the Unified Parkinson's Disease Rating Scale (UPDRS) at each visit on a monthly basis. The primary outcome variable was the change of the sum score of the UPDRS parts II and III between the baseline and three-month visits. The study participants ranged in age from 40 to 75 years and had received their diagnosis of PD according to the UK Brain Bank criteria with a rating on the modified Hoehn-Yahr scale between II and III and 16 points or more on the UPDRS motor score and were on stable anti-parkinsonian medication with or without levodopa for at least four weeks prior to study enrollment.

After three months of treatment, the subjects underwent a withdrawal from the study drug for two months and a final assessment of the severity of the symptoms of PD was made. Doses of levodopa and all other antiparkinsonian medications were kept constant throughout the study.

Of a total of 131 subjects enrolled in the study, 106 (81 percent) completed the trial according to the protocol. Sixty-four subjects were assigned to receive CoQ10 and 67 to receive placebo. All randomized patients received at least one dose of the study drug. One third of the patients (37 of 131, or 34.9 percent) had coexisting medical conditions at baseline. The most common were cardiovascular disorders (in 20 patients, or 15.3 percent) such as hypertension and arrhythmia. Other medical conditions (in 15, or 11.5 percent of the patients) included infections, glaucoma and sleep apnea.

The study found that there was an improvement in ADL/motor function in both groups. Researchers noted that the efficacy data demonstrated a significant placebo effect in both treatment groups.

The researchers concluded that nanoparticular CoQ10 at a dosage of 300 milligrams/day is safe and well tolerated and leads to plasma levels similar to 1,200 milligrams/day of standard formulations. Although the study demonstrated a significant increase in plasma levels of CoQ10 toward levels observed with high doses of standard CoQ10 formulations in PD and other disorders, the study failed to show improvement of PD symptoms and did not meet its primary or secondary end points. Future studies will need to explore the protective effects of CoQ10 at the highest effective dose.

There is promising evidence from both clinical trials and case series for the use of CoQ10 in the treatment of Parkinson's disease. Future controlled studies with larger numbers of participants, and appropriate dosages of CoQ10 would make a more compelling case.

Integrative therapies with good scientific evidence in the treatment of Parkinson's include 5-HTP and music therapy. For more information on these and other integrative therapies for PD, please visit Natural Standard's Medical Conditions database

Apples for Athletes

A polyphenol extract from apples may help reduce fatigue and improve physical performance during exercise, a new study reports.

Researchers from Osaka City University Graduate School of Medicine and the Japanese Ministry of Education, Culture, Sports, Science and Technology examined the effects of Applephenon* and vitamin C (ascorbic acid) administration on physical fatigue.

The double-blinded, placebo-controlled, three-way crossover study used an apple polyphenol extract (Applephenon) from unripe apples. Eighteen healthy volunteers (average age 39, nine women) were randomized to receive either 1,200 milligrams/day of Applephenon, 1,000 milligrams/day of ascorbic acid or placebo for eight days.

The fatigue-inducing physical task consisted of workload trials on a bicycle ergometer at fixed workloads for two hours on two occasions. During the test, subjects performed non-workload trials with maximum velocity for 10 seconds at 30 minutes after the start of the test and 30 minutes before the end of the test.

The change in maximum velocity between the trials was higher in the group given Applephenon than in the group given placebo; ascorbic acid had no effect.

Researchers explained that the active component of Applephenon is procyanidin, a type of flavonoid with antioxidant activity.

The researchers concluded that Applephenon reduces physical fatigue and ascorbic acid does not. Study authors suggested that studies involving a long-term fatigue-inducing period must be performed to evaluate the effects of Applephenon on long-term fatigue.

*Applephenon is trademarked.

For more information about apples and other fruits, please visit Natural Standard's  Foods, Herbs and Supplements database.