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Low status of Vitamin D tied to back pain in older women

May 28, 2008

Older women who aren't getting enough vitamin D appear to be at risk for suffering from back pain, new research shows. "Given that low vitamin D status is fairly prevalent in older adults and that there are significant functional consequences to untreated chronic pain, these findings argue strongly for querying adults about their pain and potentially screening older women with significant back pain for vitamin D deficiency," Dr. Gregory E. Hicks of the University of Delaware in Newark and his colleagues write.

     Among older people, vitamin D deficiency has been tied to a number of health problems, including an increased risk of bone fracture, Hicks and colleagues note in the Journal of the American Geriatrics Society. Lack of the vitamin could also, theoretically, contribute to musculoskeletal pain, they add. To investigate the relationship the scientists looked at blood levels of vitamin D in 958 people 65 and older. 58% of the women in the study, and 27% of the men had at least some moderate pain in at least one region of the body. For men, there was no direct relationship between vitamin D levels and pain. Women with Vitamin D deficiency, on the other hand, were nearly twice as likely to have back pain that was moderate or worse. The gender- and back-specific effects of vitamin D found in the study could be because lack of the vitamin can cause osteomalacia (bone softening) which is more common in women and often manifests itself as low back pain, the researchers say. The study is published in the May 2008 issue of the Journal of the American Geriatrics Society.

Cocoa flavanols show promise for diabetic cardiovascular health

     A new study indicates that cocoa flavanols could help improve blood vessel health in diabetes patients, potentially offering protection against cardiovascular complications; standard medication does not offer these benefits. People who suffer from type 2 diabetes are known to have impaired blood vessel function, which puts them at higher risk of cardiovascular disease. Indeed, even when medical treatment such as oral anti-hyperglycemic agents or insulin addresses the main symptoms of diabetes, as many as two thirds of diabetics are said to eventually die as a result of cardiovascular disease and stroke. The researchers of the new study note that "the overall prognosis is unfavorable due to deteriorated cardiovascular risk".
     This has caused diabetes experts to cast about for new approaches and lifestyle changes that could help reduce the risk of diabetes complications. The team, made up of scientists from Germany and the US, were aware of epidemiological data showing that diets rich in flavanols are associated with a reduced cardiovascular risk. They set out to test the feasibility and efficacy of a dietary intervention based on daily intake of a Cocoa beverage standardized for flavanol content, and its effects on vascular function in diabetes sufferers.

     The study was conducted in two parts. The first, a prospective study involving ten people with type 2 diabetes also taking medication, was intended to ascertain the immediate effects of the Cocoa flavanol containing beverage on flow-mediated dilation (FMD), the measure of a blood vessel's healthy ability to relax improving blood flow (the major reason why most high blood pressure treating drugs were developed was to relax blood vessels and improve or restore healthy circulation).  The beverages contained different flavanol levels - either 75mg, 371mg, or 963 mg. The participants' blood vessel function was measured in the hours following consumption, and a positive correlation was found between flavanol dose and immediate FMD improvements.
    In the second part of the study 41 adults with type 2 diabetes, also currently taking medication, were divided into two groups. Members of one group were given a Cocoa beverage containing 321 mg of flavanols three times a day, for 30 days. Members of the second group received a control Cocoa beverage containing very little (just 25mg) Cocoa flavanol. The two beverages had the same calories, nutrients and other cocoa compounds.
     In the studies the researchers saw that the flavanols' immediate effect on FMD was complemented by a sustained improvement over the 30 day period. Indeed, a 30% increase in FMD was seen between day one and day 30; the implications with regard to health and quality of life could be remarkable. Paul Zimmet, MD, PhD, director of the International Diabetes Institute in Australia, was upbeat about the potential; "While more research is needed, this study shows tremendous potential for future flavanol-based applications," he said. The study is published in the June 3rd, 2008 issue of the Journal of the American College of Cardiology.