In the News

New study Confirms Vitamin K Status Marker link to cardio risk

Experts urge evaluation of diet at routine check-ups

Why Does COVID-19 Impact Only Some Organs, Not Others?

GI symptoms linked to behavioral problems in children, especially those with autism

New study Confirms Vitamin K Status Marker link to cardio risk

Clinical Biochemistry recently published a Danish population study that examined the link between inactive matrix Gla protein (MGP), a known biomarker for K-vitamins status, and cardiovascular risk, and concluded that high levels of this inactive protein were positively associated with a history of cardiovascular disease (CVD) due to the role vitamin K2 plays in vascular calcification. 

According to “Undercarboxylated matrix Gla-protein: A biomarker of vitamin K2 status and cardiovascular risk”1, dephosphorylated uncarboxylated matrix Gla-protein (dp-ucMGP) is a biomarker of functional

vitamin K status. High plasma dp-ucMGP concentrations reflect a low vitamin K status and have been related to vascular calcification. The purpose of the study was to assess plasma levels of dp-ucMGP and the association between plasma dp-ucMGP, CVD-risk factors, and history of CVD in a general population.

Plasma dp-ucMGP measurements were performed using the IDS-iSYS InaKtif MGP assay in 491 consecutive participants in a Danish general population study (229 males and 262 females, aged 19–71 years). The researachers concluded:  ”Increased plasma dp-ucMGP levels were positively associated with cardiovascular risk factors such as arterial stiffness (as reflected by increased ePWV), hypertension, obesity, and history of CVD events. These findings support that dp-ucMGP is a biomarker of cardiovascular risk and lend support to the hypothesis that vitamin K status plays a role in vascular calcification and risk of CVD… Prospective studies could establish the causal direction of these associations and whether increased vitamin K intake represents a preventive measure against vascular calcification and CVD-risk.

NattoPharma is encouraged by these findings as they provide another level of evidence that vitamin K2 is an essential cardio-protective nutrient, specifically as the researchers note: “Different studies have found an association between dietary vitamin K intake and CVDs. Particularly menaquinone (K2) is associated with a decreased risk of coronary heart disease and all-cause mortality.”

”It still remains a common misunderstanding that vitamin K, in general, impacts arterial calcificiation, when in fact it is Vitamin K2 that is available beyond the liver to support bone and cardiovascular health,” says Dr. Hogne Vik, NattoPharma Chief Medical Officer. ”Our studies with MenaQ7 have shown that K status was more efficiently improved in adults as well as children with supplementation of Vitamin K2 as MK-7.2 Both of NattoPharma’s cardiovascular intervention trials showed improved vascular health with just 180mcg – our 3-year study3 cardiovascular study in healthy postmenopausal women showed improved arterial flexibility, and now our 1-year study4 in men and women showed a significant decrease in dp-ucMGP.”

References:

1 T. Jespersen, et al. Uncarboxylated matrix Gla-protein: a biomarker of vitamin K status and cardiovascular risk. Clinical Biochemistry https://doi.org/10.1016/j.clinbiochem.2020.05.005

2 Theuwissen E, Magdeleyns EJ, Braam LAJLM, et al. Vitamin K status in healthy volunteers. Food Funct. 2014 Feb;5(2):229-34.

3 Knapen MHJ, Braam LAJLM, Drummen NE, Bekers O, Hoeks APG, Vermeer C. Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women: A double-blind randomised clinical trial. Thromb Haemost. 2015 May;113(5):1135-44.

4 Vermeer C and Vik H. Effect of Menaquinone-7 (vitamin K2) on vascular elasticity in healthy subjects: results from a one-year study. 2020 Vascul Dis Ther, 5: doi: 10.15761/VDT.1000179.

About NattoPharma and MenaQ7®

NattoPharma ASA, based in Norway, is the world’s leader in vitamin K2 research and development. NattoPharma is the exclusive international supplier of MenaQ7® Vitamin K2 as MK-7, the best documented, vitamin K2 as menaquinone-7 (MK-7) with guaranteed actives and stability, clinical substantiation, and international patents granted and pending; and now the new MenaQ7® Full Spectrum, which delivers menaquinones 6, 7, and 9. The company has a multi-year research and development program to substantiate and discover the health benefits of Vitamin K2 for applications in the marketplace for functional food and dietary supplements. With a global presence, the company established its North American subsidiary, NattoPharma USA, Inc., in Edison, NJ, and NattoPharma R&D Ltd. in Cyprus. For more information, visit www.nattopharma.com or www.menaq7.com.

Experts urge evaluation of diet at routine check-ups

The time has come for routine health care visits to include some form of dietary assessment and counseling, according to a new scientific statement from the American Heart Association published today in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal. The statement, written by a group of nutrition and cardiovascular disease experts, recommends the adoption of a rapid diet screening tool that can be integrated into electronic health record platforms across all health care settings.

“Dietary patterns and quality are not sufficiently prioritized when addressing modifiable risk factors during regular health care office visits. Given the evidence that diet contributes to disease and mortality, it is a risk factor worth screening for continuously,” said Maya Vadiveloo, Ph.D., R.D., chair of the statement writing group and assistant professor of nutrition and health sciences in the College of Health Science at the University of Rhode Island in Kingston, Rhode Island.

Poor diet quality has surpassed all other risk factors for death, accounting for 11 million deaths and about half of cardiovascular disease (CVD) deaths globally, according to the 2017 Global Burden of Disease Study, a comprehensive report on the health impact of diet in 195 countries around the world.

The statement authors reviewed 15 existing screening tools, assessing each to provide insight on the feasibility of incorporating an evidence-based dietary screening tool into routine practice.

The authors list numerous reasons why members of a health care team may not address diet quality during a routine office visit: lack of training and knowledge; lack of time and reimbursement; competing demands during the often short office visit; and that nutrition services aren’t integrated into many health care settings.

“However, these barriers can be overcome,” said Vadiveloo. “We want a valid, reliable way to assess diet that reflects the best science, and most of the tools assessed take under 10 minutes to use.” Three of the tools assessed meet criteria set forth in the statement and may provide a framework to help practices incorporate diet screening into their workflow. The Powell and Greenberg Screening Tool asks two questions about fruit and vegetable consumption and sugary food and juice consumption. The Rapid Eating Assessment for Participants-Shortened assessment and the Mediterranean Diet Adherence Screener ask more than 10 questions and cover major food groups, as well as processed foods and alcohol consumption.

The keys to an effective diet screening tool include:

• Using an evidence-based approach;
• Assessing the total dietary pattern, not just a single food or nutrient;
• Speed;
• The ability to give actionable next steps and support to patients; and
• The ability to track and monitor dietary change over time.

“There are other tools beyond what was assessed, and additional tools could be developed,” said Vadiveloo.

While the statement does not endorse a specific screening tool, it encourages critical conversations among clinicians, individuals with diet/lifestyle expertise and specialists in information technology to adopt rapid diet screening tools for adults in primary care and relevant specialty care and prevention settings.

“An important component in addition to evaluating diet quality is targeting actionable changes – helping patients set achievable dietary goals - and then following up at the next visit,” said Alice H. Lichtenstein, D.Sc., vice-chair of the writing group and lead and senior scientist of the Cardiovascular Nutrition Team at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston.

Areas for future study include testing and validating screener tools in diverse populations, as well as among special clinical populations (pediatrics, geriatrics, etc.), and evaluating the feasibility of implementing these tools in clinical settings.

A healthy diet can improve cardiovascular disease risk and outcomes. What you eat (and how much) can affect other controllable risk factors, such as cholesterol, blood pressure, diabetes and being overweight.

The scientific statement was written on behalf of the American Heart Association’s Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Stroke Council.

Co-authors and members of the writing group are Cheryl Anderson, Ph.D., M.P.H.; Karen Aspry, M.D., M.S.; Randi Foraker, Ph.D.; Skylar Griggs, M.S., R.D., L.D.N.;  Laura L. Hayman, Ph.D., M.S.N.; Emily Johnston, M.P.H., R.D.N., C.D.E.; Neil J. Stone, M.D.; and Anne N. Thorndike, M.D., M.P.H. Author disclosures are in the manuscript.

Additional Resources:

• Available multimedia is located on the right column of the release link: https://newsroom.heart.org/news/experts-urge-evaluation-of-diet-at-routine-check-ups?preview=b0751d6475bdf889ea0683fbfb1e1f6e
• After 5 a.m. ET, Friday, Aug. 7, 2020, view the manuscript online.
• Understand your risks to prevent a heart attack
• Healthy Eating: Eat Smart
• Follow AHA/ASA news on Twitter @HeartNews
• Follow news from the AHA’s Circulation: Cardiovascular Quality and Outcomes journal @CircOutcomes

The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Heart Association

The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

Why Does COVID-19 Impact Only Some Organs, Not Others?

In severe cases of COVID-19, damage can spread beyond the lungs and into other organs, such as the heart, liver, kidney and parts of the neurological system. Beyond these specific sets of organs, however, the virus seems to lack impact.

Ernesto Estrada, from the University of Zaragoza and Agencia Aragonesa para la Investigación Foundation in Spain, aimed to uncover an explanation as to how it is possible for these damages to propagate selectively rather than affecting the entire body. He discusses his findings in the journal Chaos, from AIP Publishing.

In order to enter human cells, the coronavirus relies on interactions with an abundant protein called angiotensin-converting enzyme 2.

“This receptor is ubiquitous in most human organs, such that if the virus is circulating in the body, it can also enter into other organs and affect them,” Estrada said. “However, the virus affects some organs selectively and not all, as expected from these potential mechanisms.”

Once inside a human cell, the virus’s proteins interact with those in the body, allowing for its effects to cultivate. COVID-19 damages only a subset of organs, signaling to Estrada that there must be a different pathway for its transmission. To uncover a plausible route, he considered the displacements of proteins prevalent in the lungs and how they interact with proteins in other organs.

“For two proteins to find each other and form an interaction complex, they need to move inside the cell in a subdiffusive way,” Estrada said.

He described this subdiffusive motion as resembling a drunkard walking on a crowded street. The crowd presents obstacles to the drunkard, stunting displacement and making it difficult to reach the destination.

Similarly, proteins in a cell face several crowded obstacles they must overcome in order to interact. Adding to the complexity of the process, some proteins exist within the same cell or organ, but others do not.

Taking these into account, Estrada developed a mathematical model that allowed him to find a group of 59 proteins within the lungs that act as the primary activators affecting other human organs. A chain of interactions, beginning with this set, triggers changes in proteins down the line, ultimately impacting their health.

“Targeting some of these proteins in the lungs with existing drugs will prevent the perturbation of the proteins expressed in organs other than the lungs, avoiding multiorgan failure, which, in many cases, conduces the death of the patient,” Estrada said.

How the affected proteins travel between organs remains an open question that Estrada is dedicating for future studies.

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The article, "Fractional diffusion on the human proteome as an alternative to the multi-organ damage of SARS CoV-2," is authored by Ernesto Estrada. The article will appear in Chaos on Aug. 11, 2020 (DOI: 10.1063/5.0015626). After that date, it can be accessed at http://aip.scitation.org/doi/full/10.1063/5.0015626.

GI symptoms linked to behavioral problems in children, especially those with autism

A new UC Davis Health study found that common gastrointestinal (GI) symptoms such as diarrhea, constipation and bloating are linked to troubling sleep problems, self-harm and physical complaints in preschool children. According to the study, published Aug. 6 in Autism Research, these GI symptoms are much more common and potentially disruptive in young kids with autism.

“Clinicians and parents need to be aware of the high occurrence of GI problems in kids with autism,” said Bibiana Restrepo, assistant clinical professor of pediatrics and first author on the study. “This study highlights the link between GI symptoms and some problematic behaviors we see in preschool-aged children.”

Children with autism experience more gastrointestinal symptoms

Gastrointestinal concerns are frequently reported by parents of children with autism spectrum disorder (ASD). Researchers from the UC Davis MIND Institute evaluated the presence of GI symptoms in preschool-aged children with and without autism.

The study included 255 (184 males/71 females) children with ASD between two and 3.5 years of age and 129 (75 males/54 females) typically developing children in the same age group. Pediatricians specializing in autism interviewed caregivers during the children’s medical evaluation. They asked the parents how often their children experienced GI symptoms such as difficulty swallowing, abdominal pain, bloating, diarrhea, constipation, painful stooling, vomiting, difficulty swallowing, blood in stool and blood in vomit.

The researchers grouped children in two categories: those who experienced one or more GI symptom and those who never or rarely had GI symptoms in the last three months. They compared the children in the two groups on measures of developmental, behavioral and adaptive functioning.

The study found that preschool-aged children with ASD were 2.7 times more likely to experience GI symptoms than their typically developing peers. In fact, almost 50% of children with ASD reported frequent GI symptoms - compared to 18% of children with typical development. Around 30% of the children with ASD experienced multiple GI symptoms.

Problem behaviors as an expression of GI discomfort in children

Multiple GI symptoms were associated with increased challenges with sleep and attention, as well as problem behaviors related to self-harm, aggression and restricted or repetitive behavior in both autistic and typically developing children. The severity of these problems was higher in children with autism.

“Problem behaviors may be an expression of GI discomfort in preschool-aged children,” said Christine Wu Nordahl, associate professor at UC Davis MIND Institute and the department of psychiatry and behavioral sciences. “GI symptoms are often treatable, so it is important to recognize how common they are in children with autism. Treating their GI symptoms could potentially provide some relief to the kids and their parents.”

The study found no link between GI symptoms and the children’s cognitive development or gender. GI symptoms were equally common in male and female preschool children.

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Funding for this study was provided by the National Institute of Mental Health (R01MH104438, R01MH103284, R01MH103371, R01HD090214), the MIND Institute Intellectual and Developmental Disabilities Research Center (U54HD079125) and an Autism Center of Excellence grant awarded by the National Institute of Child Health and Development (NICHD) (P50 HD093079).

The co-authors on the study were Sally Rogers, Brianna Heath, Alexa Hechtman, Marjorie Solomon and David Amaral at UC Davis MIND Institute and the Department of Psychiatry and Behavioral Sciences in UC Davis; Kathleen Angkustsiri at the UC Davis MIND Institute and the Department of Pediatrics in UC Davis; Sandra Taylor at the Department of Public Health Sciences in UC Davis; Jacqueline Cabral at the Department of Community Health in Tufts University; and Paul Ashwood at the Department of Medical Microbiology and Immunology in UC Davis.

Article: Restrepo et al. "Developmental-Behavioral Profiles in Children with Autism Spectrum Disorder and Co-occurring Gastrointestinal Symptoms," Autism Research.