Medical Updates

CHD Risk Reduction

EPA and omega-3s reduce the risk of coronary heart disease

The results of a recently published study in the Mayo Clinic Proceedings confirmed that eicosapentaenoic acid (EPA) and omega-3s reduce the risk of coronary heart disease (CHD). The results clearly showed significant reduction in CHD risk in higher risk populations – 16% in those with high triglycerides and 14% in those with high LDL cholesterol (Figure 1). The risk reductions were stronger in patient population with elevated triglycerides and LDL cholesterols.

This research is unique as it evaluated the effects of EPA and DHA on coronary heart disease. This is important as coronary heart disease accounts for half of all cardiovascular deaths. The results of the study confirm the importance of EPA and DHA omega-3s for cardiovascular health. As per Adam Ismail, Executive Director, GOED, “The results confirm that increasing omega-3s is a healthy lifestyle intervention that can contribute towards reductions in CHD risk”. Our body naturally makes small amounts of DHA that is insufficient to meet the body’s requirements. It is thus essential to get amounts our body needs from food or supplements.

1. Alexander DD1, Bassett JK, Weed DL, et al. Meta-Analysis of Long-Chain Omega-3 Polyunsaturated Fatty Acids (LCω-3PUFA) and Prostate Cancer. Nutr Cancer. 2015;67(4):543-54.
2. Kubié J. New Study Finds EPA and DHA Omega-3s Lower Risk of Coronary Heart Disease. Accessed on March 08, 2017.
3. Docosahexaenoic acid (DHA). Available at Accessed on March 08, 2017.

Glucosamine and community pharmacy

Glucosamine remains a popular treatment option for osteoarthritis. The recent past has seen a surge in the success of sale of glucosamine in pharmacies. Despite debates regarding its effectiveness and some studies proving its effectiveness while some others either unable to answer the question or find any advantage, the current state of glucosamine and its demand prove the effectiveness and safety of glucosamine. Some researchers suggest the pharmacy team to help the patients evaluate the products after three months of use.

Maesschalck J. Is there a place for glucosamine in the community pharmacy? J Pharm Belg. 2012;(2):13-23.

Glucosamine/chondroitin improves joint symptoms in women with breast cancer

Aromatase inhibitor (AI) associated joint symptoms are one of the major reasons of treatment discontinuation among women suffering from breast cancer. The results of a study published in the November 2012 issue of Supportive Care in Cancer, suggests that glucosamine/chondroitin treatment results in moderate improvements in AI induced arthralgias. In addition, while the treatment with glucosamine-sulfate (1,500 mg/day) + chondroitin-sulfate (1,200 mg/day) for 24 weeks was associated with minimal side-effects, it was no associated with any change in estradiol levels.

Greenlee H, Crew KD, Shao T et al. Phase II study of glucosamine with chondroitin on aromatase inhibitor-associated joint symptoms in women with breast cancer. Support Care Cancer. 2012 Nov 1. [Epub ahead of print].

Benefits of glucosamine in pain and other symptoms of knee osteoarthritis

The results of a study published in the Experimental and Therapeutic Medicine shows the beneficial effects of glucosamine-based dietary supplement combined with chondroitin sulphate and antioxidant micronutrients viz. methylsulfonylmethane, guava leaf extract and vitamin D. Although, the 16-week, randomized, double-blinded, placebo-controlled trial conducted on 32 subjects showed inconclusive results, the researchers suggested that the tested glucosamine-based combination supplement might have a beneficial effect on pain and other symptoms associated with knee osteoarthritis.

Nakasone Y, Watabe K, Watanabe K et al. Effect of a glucosamine-based combination supplement containing chondroitin sulfate and antioxidant micronutrients in subjects with symptomatic knee osteoarthritis: A pilot study. Exp Ther Med. 2011;2(5):893-899.

Vitamin C Prevents Bone Loss in Animal Models

Researchers at Mount Sinai School of Medicine have shown for the first time in an animal model that vitamin C actively protects against osteoporosis (bones become brittle and can fracture), a disease that affects a large proportion of population worldwide.

The findings of this research which was published in the recent edition of journal PLoS ONE is expected to have profound health implications and its therapeutic potential is worth exploring as per the lead researcher Mone Zaidi, MD, Professor of Medicine (Endocrinology, Diabetes and Bone Disease, and of Structural and Chemical Biology, and Director of the Mount Sinai Bone Program.

"The medical world has known for some time that low amounts of vitamin C can cause scurvy and brittle bones, and that higher vitamin C intake is associated with higher bone mass in humans, "said Dr. Zaidi. ”What this study shows is that large doses of vitamin C, when ingested orally by mice, actively stimulate bone formation to protect the skeleton. It does this by inducing osteoblasts, or premature bone cells, to differentiate into mature, mineralizing specialty cells."

"Further research may discover that dietary supplements may help prevent osteoporosis in humans," said Dr. Zaidi. "If so, the findings could be ultimately useful to developing nations where osteoporosis is prevalent and standard medications are sparse and expensive."

Zhu LL, Cao J, Sun M et al. Vitamin C prevents hypogonadal bone loss. PLoS One. 2012;7(10):e47058.

Women and Risk of Osteoporosis

A new study published in the Journal of Clinical Endocrinology & Metabolism describes a new method that could be used for measuring bone health. This new method has been suggested for women of mixed racial or ethnic backgrounds and could improve the odds of correctly diagnosing their risk of osteoporosis and bone fractures.

Currently, assessing osteoporosis and the risk of fractures from small accidents like falls requires a bone density scan. But because these scans don't provide other relevant fracture-related information, such as bone size and the amount of force a bone is subjected to during a fall, each patient's bone density is examined against a national database of people with the same age and race or ethnicity. However, this approach is not effective for people of mixed race or ethnicity as comparison databases cannot account for mixed heritage.

"All the current ways of determining your risk for fractures require knowing your race and ethnicity correctly, and they ignore the fact that racial and ethnic groups are not homogenous," said study co-author Dr. Arun Karlamangla, a professor of medicine in the geriatrics division at the David Geffen School of Medicine at UCLA. "It also flies in the face of the current reality in Southern California, where so many people are of mixed ethnicity."

The researchers studied data on nearly 2,000 women in the U.S. between the ages of 42 and 53 who were of Caucasian, African American, Japanese and Chinese heritage. The data came from the Study of Women's Health Across the Nation.

Using the new composite bone strength indices, the researchers tested how the method predicted fracture risk in this group of women over a period of 10 years. They found that when they did not take into account the women's race or ethnicity, they were able to predict fracture risk using the indices just as accurately as they could using the traditional method of combining bone mineral density measures with race and ethnicity information.

The researchers noted that further study is needed to determine if the same strength measures will work in men. Their findings also do not show how well these measures will continue working as women age. The results of the study do, however, point toward a new approach for assessing fracture risk, they say.

Ishii S, Greendale GA, Cauley JA et al. Fracture risk assessment without race/ethnicity information. J Clin Endocrinol Metab. 2012;97(10):3593-602.