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Tuesday, May 28, 2013

Vitamin C Does Not Lower Uric Acid Levels In Gout Patients

Main Category: Gout
Also Included In: Nutrition / Diet
Article Date: 16 May 2013 - 0:00 PDT Current ratings for:
Vitamin C Does Not Lower Uric Acid Levels In Gout Patients
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Despite previous studies touting its benefit in moderating gout risk, new research reveals that vitamin C, also known ascorbic acid, does not reduce uric acid (urate) levels to a clinically significant degree in patients with established gout. Vitamin C supplementation, alone or in combination with allopurinol, appears to have a weak effect on lowering uric acid levels in gout patients according to the results published in the American College of Rheumatology (ACR) journal, Arthritis & Rheumatism.

Gout is an inflammatory arthritis that causes excruciating pain and swelling triggered by the crystallization of uric acid within the joints. Estimates from the ACR report that more than 8.3 million Americans suffer with gout. Medical evidence reports that long-term gout management requires treatment with medications that lower urate levels by inhibiting uric acid production (allopurinol) or increasing uric acid excretion (probenecid) through the kidneys.

"While current treatments are successful in reducing the amount of uric acid in the blood, there are many patients who fail to reach appropriate urate levels and need additional therapies," explains lead author, Prof. Lisa Stamp, from the University of Otago in Christchurch, New Zealand. "Vitamin supplementation is one such alternative therapy and the focus of our current study, which looked at the effects of vitamin C on urate levels in patients with gout."

The team recruited gout patients who had urate levels greater than the ACR treatment target level of 0.36 mmol/L (6 mg/100 mL). Of the 40 participants with gout, 20 patients already taking allopurinol were given an additional 500 mg dose of vitamin C daily or had the dose of allopurinol increased, while another 20 patients not already taking allopurinol were either started on allopurinol or vitamin C (500 mg/day). Researchers analyzed blood levels of vitamin C (ascorbate), creatinine and uric acid at baseline and week eight.

Study findings show that a modest vitamin C dose for eight weeks did not lower urate levels to a clinically significant degree in gout patients, but did increase ascorbate. The results differ from previous research which found that vitamin C reduced urate levels in healthy individuals without gout, but with high levels of uric acid (hyperuricemia). In fact, the Stamp et al. study found that reduction of uric acid was significantly less in gout patients taking vitamin C compared to those who started or increased their dose of allopurinol.

"Though vitamin C may reduce risk of developing gout, our data does not support using vitamin C as a therapy to lower uric acid levels in patients with established gout," concludes Prof. Stamp. "Further investigation of the urate lowering effects of a larger vitamin C dose in those with gout is warranted."

May is Arthritis Awareness Month in the U.S. and October 12, 2013 is designated as World Arthritis Day.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our gout section for the latest news on this subject. “Clinically insignificant effect of supplemental vitamin C on serum urate in patients with gout; a pilot randomised controlled trial.”,
Lisa K Stamp, John L O’Donnell, Christopher Frampton, Jill Drake, Mei Zhang and Peter T Chapman.
Arthritis and Rheumatism; Published Online: May 16, 2013 (DOI: 10.1002/art.37925). Please use one of the following formats to cite this article in your essay, paper or report:

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19 May. 2013. APA

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Saturday, May 25, 2013

Population-Based Efforts May Be Necessary To Lower Excessive Dietary Sodium Intake

Main Category: Nutrition / Diet
Also Included In: Hypertension;??Heart Disease
Article Date: 16 May 2013 - 0:00 PDT Current ratings for:
Population-Based Efforts May Be Necessary To Lower Excessive Dietary Sodium Intake
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Recent studies that examine links between sodium consumption and health outcomes support recommendations to lower sodium intake from the very high levels some Americans consume now, but evidence from these studies does not support reduction in sodium intake to below 2,300 mg per day, says a new report from the Institute of Medicine.

Despite efforts over the past several decades to reduce dietary intake of sodium, a main component of table salt, the average American adult still consumes 3,400 mg or more of sodium a day - equivalent to about 1 ? teaspoons of salt. The current Dietary Guidelines for Americans urge most people ages 14 to 50 to limit their sodium intake to 2,300 mg daily. People ages 51 or older, African Americans, and people with hypertension, diabetes, or chronic kidney disease - groups that together make up more than 50 percent of the U.S. population - are advised to follow an even stricter limit of 1,500 mg per day. These recommendations are based largely on a body of research that links higher sodium intakes to certain "surrogate markers" such as high blood pressure, an established risk factor for heart disease.

The expert committee that wrote the new report reviewed recent studies that in contrast examined how sodium consumption affects direct health outcomes like heart disease and death. "These new studies support previous findings that reducing sodium from very high intake levels to moderate levels improves health," said committee chair Brian Strom, George S. Pepper Professor of Public Health and Preventive Medicine at the University of Pennsylvania Perelman School of Medicine. "But they also suggest that lowering sodium intake too much may actually increase a person's risk of some health problems."

While cautioning that the quantity of evidence was less-than-optimal and that the studies were qualitatively limited by the methods used to measure sodium intake, the small number of patients with health outcomes of interest in some of the studies, and other methodological constraints, the committee concluded that: evidence supports a positive relationship between higher levels of sodium intake and risk of heart disease, which is consistent with previous research based on sodium's effects on blood pressure; studies on health outcomes are inconsistent in quality and insufficient in quantity to conclude that lowering sodium intake levels below 2,300 mg/day either increases or decreases the risk of heart disease, stroke, or all-cause mortality in the general U.S. population; evidence indicates that low sodium intake may lead to risk of adverse health effects among those with mid- to late-stage heart failure who are receiving aggressive treatment for their disease; there is limited evidence addressing the association between low sodium intake and health outcomes in population subgroups (i.e., those with diabetes, kidney disease, heart disease, hypertension or borderline hypertension; those 51 years of age and older; and African Americans). While studies on health outcomes provide some evidence for adverse health effects of low sodium intake (in ranges approximating 1,500 to 2,300 mg daily) among those with diabetes, kidney disease, or heart disease, the evidence on both the benefit and harm is not strong enough to indicate that these subgroups should be treated differently from the general U.S. population. Thus, the evidence on direct health outcomes does not support recommendations to lower sodium intake within these subgroups to or even below 1,500 mg daily; and further research is needed to shed more light on associations between lower levels of sodium (in the 1,500 to 2,300 mg/day range) and health outcomes, both in the general population and the subgroups. The report does not establish a "healthy" intake range, both because the committee was not tasked with doing so and because variability in the methodologies used among the studies would have precluded it.

The recent studies suggest that dietary sodium intake may affect heart disease risk through pathways in addition to blood pressure. "These studies make clear that looking at sodium's effects on blood pressure is not enough to determine dietary sodium's ultimate impact on health," said Strom. "Changes in diet are more complex than simply changing a single mineral. More research is needed to understand these pathways."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our nutrition / diet section for the latest news on this subject. The report was sponsored by the Centers for Disease Control and Prevention. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.
National Academy of Sciences Please use one of the following formats to cite this article in your essay, paper or report: