Vitamin D deficiency treated by consuming UVB-irradiated mushrooms

Vitamin D deficiency treated by consuming UVB-irradiated mushrooms.

Vitamin D deficiency treated by consuming UVB-irradiated mushrooms

Andrew Ozzard, DCH, MRCPCH, GP Registrar and Gurdip Hear, BSc, DCH, DRCOG, DFFP, MRCGP, GP Trainer

Crosby House Surgery, Slough
Gavin Morrison, MBBS, FY1

Leighton Hospital, Crewe, Cheshire
Mike Hoskin, DRCOG, MRCGP, GP Trainer

Abstract

Deficiency of vitamin D is usually caused by dietary deficiency and/or lack of exposure to sunlight in dark skinned individuals living at northern latitudes. Simple vitamin D deficiency is commonly treated by prescribing a vitamin D containing calcium supplement. This report presents a patient who rejected this approach and instead, after researching alternative treatment options independently, opted to self-treat by consuming UVB-irradiated mushrooms. The beneficial effect of this on the patient’s plasma biochemical markers is shown. Further research into the beneficial effect of consuming UVB-irradiated mushrooms is required.

Keywords: food irradiation, vitamin D, vitamin D deficiency
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ADJUVANT USE OF THE KETOGENIC DIET FOR THE TREATMENT OF MALIGNANT BRAIN TUMORS INHIBITS CYCLOOXYGENASE-2 EXPRESSION AND REDUCES TUMOR-ASSOCIATED EDEMA

53. Basic Science

Title: ADJUVANT USE OF THE KETOGENIC DIET FOR THE TREATMENT OF MALIGNANT BRAIN TUMORS INHIBITS CYCLOOXYGENASE-2 EXPRESSION AND REDUCES TUMOR-ASSOCIATED EDEMA

Author: Adrienne C Scheck PhD
Co-authors Eric C. Woolf, Gregory Turner, Vikram D. Kodibagkar, Rohini Vidya Shankar, Mark C. Preul, Mohammed G. Abdelwahab, Julie A. Charlton. Phoenix, AZ Keywords: glioma, edema, cyclooxygenase 2, mouse model

Malignant gliomas are uniformly fatal despite treatment including surgery, chemotherapy and radiation. One source of morbidity is brain edema caused by tumor growth and/or treatment. This can have a variety of sequelae including headaches, seizures and steroid dependence. We previously used a bioluminescent intracranial mouse model of malignant glioma to demonstrate that a ketogenic diet (KD) extends survival following tumor implantation, and potentiates the therapeutic effects of radiation and chemotherapy. The KD also prevents the increased expression of Cyclooxygenase 2 (COX2) seen in tumors from animals fed standard rodent chow (SD). COX2 is a mediator of inflammation and we hypothesize that KD is reducing tumor-associated edema through its inhibition and concomitant downstream effects. Bioluminescence is a quantitative measure of live tumor cells and we have found that animals maintained on KD have more tumor-associated bioluminescence when they succumb! to their disease than do animals maintained on SD. Survival is a function of overall tumor burden consisting of the tumor and peritumoral edema. The increased bioluminescence in tumor from animals fed KD suggests that the diet may be reducing the contribution of peritumoral edema to the overall tumor burden. Taken together, our data demonstrates that metabolic alteration not only affects tumor bioenergetics, it alters the expression of genes involved in other aspects of tumor growth and therapy response. The adjuvant use of KD for brain tumor therapy may improve the patients’ quality of life in addition to extending survival.

Supported by Students Supporting Brain Tumor Research and Arizona Biomedical Research Commission.

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A PET AND MRI APPROACH TO STUDY BRAIN GLUCOSE AND KETONE METABOLISM DURING AGING AND ALZHEIMER’S DISEASE.

52.
Title A PET AND MRI APPROACH TO STUDY BRAIN GLUCOSE AND KETONE METABOLISM DURING AGING AND ALZHEIMER’S DISEASE.

Author: Alexandre Courchesne-Loyer, MSc1,2,
Co-Authors: Christian A. Castellano, PhD1,2, Scott Nugent, BSc1,2, Maggie Roy, MSc1,2, Mélanie Fortier, MSc1, Sébastien Tremblay, PhD1,4, Éric Turcotte MD4, Tamas Fulop MD, PhD1,3, Stephen C. Cunnane, PhD1,2,3,

(1) Research Center on Aging, Sherbrooke, QC, Canada
(2) Department Physiology and Biophysics, Université de Sherbrooke, QC, Canada
(3) Department of Medicine, Université de Sherbrooke, QC, Canada
(4) Department of Radiobiology and Nuclear Medicine, Université de Sherbrooke, QC, Canada

Key words: PET, ketone, Alzheimer’s

Background: Lower brain glucose uptake can be present before the onset of aging- associated cognitive deterioration and may increase the risk of Alzheimer’s disease (AD). Ketones are the brain’s main alternative energy substrates to glucose. We have developed the positron emission tomography (PET) tracer – [11C]-acetoacetate ([11C]-AcAc) – to study brain ketone metabolism in humans. Our goal was to assess whether deteriorating brain fuel uptake affects uptake of any brain fuel or is specific to glucose. This approach might also be informative about how ketogenic treatments improve cognition in AD and mild cognitive impairment.

Methods: Healthy elderly (65-85 y; n=15) and young adults (18-30 y; n=15), and 8 patients with mild AD underwent a dual tracer brain PET protocol with [11C]-AcAc followed by [18F]-FDG. Cerebral metabolic rates of AcAc (CMRAcAc) and glucose (CMRg) were calculated using an image-derived input function with correction for brain atrophy.

Results: Compared to young adults, CMRAcAc in the healthy elderly was 20-25% lower in specific brain regions, notably the superior frontal cortex and cingulate (p<0.01); CMRg in the elderly was also 15-20% lower in the caudate, thalamus and frontal cortex (p<0.01). Different brain regions had lower CMRg and CMRAcAc in AD than in the elderly.

Conclusion: Both major brain fuels are affected in aging and in AD but differently depending on the brain regions. We are developing protocols with ketogenic pharmaceuticals/nutriceuticals in order to sustainably induce mild ketonemia to determine whether it can correct or bypass deteriorating brain glucose uptake, thereby hopefully reducing the risk of cognitive decline. Financial support from CRC, CIHR, CFI, FRQS, CFQCU and the Université de Sherbrooke.

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Two adult case reports of improved neurological status with the removal of gluten from diet

Two adult case reports of improved neurological status with the removal of gluten from diet

Author: Sue Wood Co-author Beth Zupec-Kania
1.Dietitian, Matthews Friends Clinics 2.Nutrition Consultant

Key words: 1. Gluten-free 2. Gluten sensitivity 3. Epilepsy 4. Neurological dysfunction

Introduction: Gluten sensitivity is a systemic autoimmune or immune mediated disease with diverse manifestations 1. Coeliac disease (CD) is the most commonly recognized of these and estimated to occur in at least 1% of the population. There has been conflicting data provided by studies of the association between epilepsy and coeliac disease. However, a recent review concluded with the recommendation that routine screening for CD be performed on all patients with intractable epilepsy, particularly those with temporal lobe epilepsy and hippocampal sclerosis2, 3.
We present two adult cases of intractable epilepsy where gluten exclusion has led to an improvement in seizures and/ or neurological symptoms. Ketogenic diet regimes are readily gluten free and this may carry more significance, particularly in the management of adult cases of intractable epilepsy, than previously thought.

Case 1: A 62 year old female with a long standing history of gastro-intestinal disturbance and a 7 year history of intractable temporal lobe epilepsy with hippocampal sclerosis (negative TTG and jejunal biopsy) was started on a strict gluten free diet trial prior to consideration of ketogenic therapy. Within three months, the absence seizures resolved and this has now been maintained for sixteen months. Infrequent seizure incidences have been traced back to accidental exposure to gluten and generally occur within one to two hours of eating.

Case 2: A 47 year old female with medication resistant epilepsy was initiated on a modified ketogenic diet restricted to 30 grams of carbohydrate daily resulting in strong ketosis. Her tonic-clonic seizures reduced to greater than 50% after 3 months and she was able to return to activities of daily living. In attempts to improve the selection of carbohydrate in her diet, gluten-containing foods were removed (breads and cereals) and were replaced with equivalent carbohydrate from vegetables. Her husband noticed a dramatic improvement in her cognition and balance however no change in seizure-control. The gluten-free diet restriction was maintained due to these neurological benefits.

1. Hippocampal sclerosis in refractory temporal lobe epilepsy is associated with gluten sensitivity J Neurol Neurosurg Psychiatry 2009 80: 626-630.
M Peltola, K Kaukinen, P Dastidar, et al.
2.Gluten sensitivity: from gut to brain Lancet Neurol 2010; 9: 318–30

M Hadjivassiliou, D Sanders, R Grünewald, et al.

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The effect and Long-term retention rate of ketogenic diet in Chinese patients.

The effect and Long-term retention rate of ketogenic diet in Chinese patients

Author: DENG Yu Hong
Co-authors ZHOU Jin-Hua, LI Bing-Mei, LIU Xiao-Rong, LIAO Wei-Ping

Changgang Dong road 250, haiZhu, Guangzhou, GuangDong, P.R China,510260

Keyword 1 ketogenic diet Keyword 2 refractory epilepsy Keyword 3 effect
Keyword 4 retention rate

Objective: To evaluate the effect and long-term retention of ketogenic diet (KD) in add-on therapy for refractory epilepsy patients with Chinese eating habits.

Methods: 28 Chinese patients with refractory epilepsy were recruited in one and half a year. In the first three months, there were no changes of the anti-epilepsy drug. All patients were hospitalized and started with fat / (protein + carbohydrates) = 4:1 diet, then maintained the 4:1 diet after discharged. According to the recruiting day, the follow-up period persist from 3 months to 12 months. The retention rate, the efficacy and the incidence of side effects on specific follow-up time point were observed.

Results: On the third month, 68% of patients reduced >50% seizures, 43% (12/28) of patients reduced >90% seizures, 11% were seizure-free. The retention rate was 68% (19/28) at the third month, while it was 43% (10/23) at the sixth month and 28% (5 /18) at the twelfth year. The major side effect s in the first two weeks included gastrointestinal reactions, ketoacidosis and low glucose; the major side effects in the persistence period were constipation, hyperlipidemia, and hypoalbuminemia. Only one patient withdrew the diet due to side effects.

Conclusions: KD in Chinese refractory epilepsy patients is highly effective, but the long-term retention rate is low probably related to the Chinese eating habits. Better implementation needs to be further studied.

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