Beyond Ozempic: New Obesity Drugs Could Be Cheaper and Even More Effective

Coloured scanning electron micrograph (SEM) of a sample of fat tissue, showing fat cells (adipocytes, red yellow) surrounded by fine strands of supportive connective tissue. The lipid-storage cells called adipocytes enlarge during the development of obesity. Credit: Steve Gschmeissner/Scence Photo Library/Getty Images

Two new drugs for treating obesity are on course to become available in the next few years — and they offer advantages beyond those of the highly effective blockbuster drugs already on the market.

The first, called orforglipron, is easier to use and to produce, and it will probably be cheaper than existing treatments. The second, retatrutide, has an unprecedented level of efficacy, and could raise the bar for pharmacological obesity treatment.

“They’re both breakthroughs,” says endocrinologist Daniel Drucker at the University of Toronto in Canada, who was not involved in the recent research on either drug.

Results from phase II clinical trials of both drugs were announced at a meeting of the American Diabetes Association this month and in the New England Journal of Medicine. Phase II trials provide data on a drug’s efficacy and ideal dosage in a small group of participants….Continue reading….

By: Saima Sidik, Nature magazine

Source: Beyond Ozempic: New Obesity Drugs Could Be Cheaper and Even More Effective – Scientific American

Critics:

Dietary supplements, foodstuffs, or programs for weight loss are heavily promoted through advertisements in print, on television, and on the internet. The US Food and Drug Administration recommends caution with use of these products, since many of the claims of safety and effectiveness are unsubstantiated, and many of the studies purporting to demonstrate their effectiveness are funded by the manufactures and suffer a high degree of bias.

Individuals with anorexia nervosa or bulimia nervosa, and some athletes, try to control body weight with diet pills, laxatives, or diuretic medications, although the latter two generally have no impact on body fat and only cause short-lived weight-loss through dehydration. Both diuretics and laxatives can cause electrolyte abnormalities which may cause cognitive, heart, and muscle problems, and can be fatal.

Canadian clinical practice 2006 guidelines state that there is insufficient evidence to recommend in favor of or against using herbal medicine, dietary supplements or homeopathy against obesity. Some botanical supplements include high dosages of compounds found in plants with stimulant effects including yohimbine and higenamine.

Caffeine, coffee and green tea can suppress appetite (the hormone ghrelin) and decrease caloric intake (food consumption). It can also cause beneficial changes in fat metabolism or lipolytic actions. According to a review, habitual intake of 3 to 4 cups of coffee appears to be safe and to be associated with the most robust beneficial effects.

Thermogenic actions and, in the case of the caffeinated drink mate (yerba maté), prolonged gastric emptying time may also play a role. Some anti-obesity medications can have severe, even, lethal side effects, fen-phen being a famous example. Fen-phen was reported through the FDA to cause abnormal echocardiograms, heart valve problems, and rare valvular diseases.

One of, if not the first, to sound alarms was Sir Arthur MacNalty, Chief Medical Officer (United Kingdom). As early as the 1930s, he warned against the use of 2,4-Dinitrophenol as an anti-obesity medication and the injudicious and/or medically unsupervised use of thyroid hormone to achieve weight reduction. The side effects are often associated with the medication’s mechanism of action.

In general, stimulants carry a risk of high blood pressure, faster heart rate, palpitations, closed-angle glaucoma, drug addiction, restlessness, agitation, and insomnia. Another medication, orlistat, blocks absorption of dietary fats, and as a result may cause oily spotting bowel movements (steatorrhea), oily stools, stomach pain, and flatulence.

A similar medication designed for patients with Type 2 diabetes is Acarbose; which partially blocks absorption of carbohydrates in the small intestine, and produces similar side effects including stomach pain and flatulence…

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Daily Multi Vitamins May Improve Brain Function In Older People

A daily multivitamin and mineral supplement may reduce cognitive decline in older people, according to a US study that is the first to demonstrate they may benefit ageing brain function.

The trial, involving more than 2,200 over-65s, suggests that daily supplements may slow cognitive decline by about 60%, or nearly two years, with the most substantial effects seen in older people with a history of cardiovascular disease.

But while experts in Alzheimer’s disease and dementia are encouraged by the findings, they caution that larger studies are needed to confirm the effect before recommending daily multivitamins to help protect older people from cognitive decline. Previous tests of dietary supplements have had no effect on the disease.

“We provide the first evidence in a long-term, randomised controlled trial of older women and men that daily use of a safe, readily accessible, and low-cost multivitamin-mineral can improve cognition,” the researchers wrote in Alzheimer’s and Dementia, the Journal of the Alzheimer’s Association. “This finding could have important public health implications for brain health and resilience against future cognitive decline.”

With populations ageing around the world, dementia has become one of the leading global health challenges, but there are no drugs that can cure any of the common types. In the UK, about 850,000 people live with dementia, most of which is Alzheimer’s disease or “vascular dementia”. People over 65, and those with diabetes, high blood pressure, high cholesterol and depression, are most at risk.

Researchers at Wake Forest University in North Carolina and Brigham and Women’s Hospital in Boston investigated whether a daily cocoa extract or multivitamins with minerals improved memory and other mental tasks in 2,262 people aged 65 and over. The researchers rated the participants’ “global cognition” before and during the three-year trial through tests involving word lists, number problems, verbal fluency and story recall.

Cocoa extract is rich in substances called flavanols and past research has suggested that they may have some benefit for brain function. But the latest trial found daily cocoa supplements made no difference to people’s cognitive performance. Daily multivitamin-mineral supplements, however, appeared to improve cognitive scores, in particular for those with cardiovascular disease, a known risk factor for dementia. The results suggest “either greater relative improvement or more protection from cardiovascular disease-related cognitive decline”, the authors wrote.

Prof Laura Baker, co-principal investigator on the Cosmos study at Wake Forest University, said it was too early to recommend daily multivitamins to prevent cognitive decline. “While these preliminary findings are promising, additional research is needed in a larger and more diverse group of people. Also, we still have work to do to better understand why the multivitamin might benefit cognition in older adults,” she said.

Prof Tara Spires-Jones, group leader at the UK Dementia Research Institute at Edinburgh University, said the study was well conducted, but noted that most people involved were highly educated white people.

“It will be important to confirm that the results hold up in the wider population,” she said. “It is also not clear from this study whether multivitamin use will prevent diseases affecting cognition like Alzheimer’s disease. Several dietary supplements have been tested as treatments for Alzheimer’s disease and so far none have been effective.”

Dr Maria Carrillo, chief scientific officer at the Alzheimer’s Association, said: “This is the first positive, large-scale, long-term study to show that multivitamin-mineral supplementation for older adults may slow cognitive ageing. While the Alzheimer’s Association is encouraged by these results, we are not ready to recommend widespread use of a multivitamin supplement to reduce risk of cognitive decline in older adults.

“Independent confirmatory studies are needed in larger, more diverse study populations,” she added. “It is critical that future treatments and preventions are effective in all populations.”

By:  

Source: Daily multi-vitamins may improve brain function in older people – US study | Health | The Guardian

Critics by Johns Hopkins Medicine

Half of all American adults—including 70 percent of those age 65 and older—take a multivitamin or another vitamin or mineral supplement regularly. The total price tag exceeds $12 billion per year—money that Johns Hopkins nutrition experts say might be better spent on nutrient-packed foods like fruit, vegetables, whole grains and low-fat dairy products.

The researchers concluded that multivitamins don’t reduce the risk for heart disease, cancer, cognitive decline (such as memory loss and slowed-down thinking) or an early death. They also noted that in prior studies, vitamin E and beta-carotene supplements appear to be harmful, especially at high doses.

“Pills are not a shortcut to better health and the prevention of chronic diseases,” says Larry Appel, M.D., director of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research. “Other nutrition recommendations have much stronger evidence of benefits—eating a healthy diet, maintaining a healthy weight, and reducing the amount of saturated fat, trans fat, sodium and sugar you eat.”

The exception is supplemental folic acid for women of child-bearing potential, Appel says. “Folic acid prevents neural tube defects in babies when women take it before and during early pregnancy. That’s why multivitamins are recommended for young women.” The Centers for Disease Control and Prevention recommends that all women of reproductive age get 400 micrograms of folic acid daily. The amount of iron in a multivitamin may also be beneficial for women of child-bearing potential, Appel adds.

“I don’t recommend other supplements,” Appel says. “If you follow a healthy diet, you can get all of the vitamins and minerals you need from food.”

Whole grains: Grains such as whole wheat, brown rice and barley still have their fiber-rich outer shell, called the bran, and inner germ. It provides vitamins, minerals and good fats. Choosing whole grain side dishes, cereals, breads and more may lower the risk for heart disease, type 2 diabetes and cancer and improve digestion, too.

Saturated fat: A type of fat found in abundance in butter, whole milk, ice cream, full-fat cheese, fatty meats, poultry skin, and palm and coconut oils. Saturated fat raises levels of heart-threatening LDL cholesterol in your bloodstream. It can also interfere with your body’s ability to absorb blood sugar easily. Limiting saturated fat can help control your risk for heart disease.

Omega-3 fatty acids (oh-may-ga three fah-tee a-sids): Healthy polyunsaturated fats that the body uses to build brain-cell membranes. They’re considered essential fats because our body needs them but can’t make them on its own; we must take them in through food or supplements. A diet rich in omega-3s—found in fatty fish, like salmon, tuna and mackerel, as well as in walnuts, flaxseed and canola oil—and low in saturated fats may help protect against heart disease, stroke, cancer and inflammatory bowel disease.

The amounts of each vitamin type in multivitamin formulations are generally adapted to correlate with what is believed to result in optimal health effects in large population groups. However, these standard amounts may not correlate what is optimal in certain subpopulations, such as in children, pregnant women and people with certain medical conditions and medication.

The health benefit of vitamins generally follows a biphasic dose-response curve, taking the shape of a bell curve, with the area in the middle being the safe-intake range and the edges representing deficiency and toxicity.[16] For example, the Food and Drug Administration recommends that adults on a 2,000 calorie diet get between 60 and 90 milligrams of vitamin C per day. This is the middle of the bell curve. The upper limit is 2,000 milligrams per day for adults, which is considered potentially dangerous.

In particular, pregnant women should generally consult their doctors before taking any multivitamins: for example, either an excess or deficiency of vitamin A can cause birth defects. Long-term use of beta-carotene, vitamin A, and vitamin E supplements may shorten life and increase the risk of lung cancer in people who smoke (especially those smoking more than 20 cigarettes per day), former smokers, people exposed to asbestos, and those who use alcohol.

Many common brand supplements in the United States contain levels above the DRI/RDA amounts for some vitamins or minerals. Severe vitamin and mineral deficiencies require medical treatment and can be very difficult to treat with common over-the-counter multivitamins. In such situations, special vitamin or mineral forms with much higher potencies are available, either as individual components or as specialized formulations.

Multivitamins in large quantities may pose a risk of an acute overdose due to the toxicity of some components, principally iron. However, in contrast to iron tablets, which can be lethal to children, toxicity from overdoses of multivitamins are very rare. There appears to be little risk to supplement users of experiencing acute side effects due to excessive intakes of micronutrients.There also are strict limits on the retinol content for vitamin A during pregnancies that are specifically addressed by prenatal formulas.

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FatBlaster Max Has Just Been Banned Here’s Everything You Need To Know About Diet Supplements

Australia’s regulator has banned FatBlaster Max, an over-the-counter pill that claimed (with no evidence) to be able to help you lose weight. FatBlaster Max can no longer be purchased, after the Therapeutic Goods Administration (TGA) found the company behind the pills registered the medicine with no mention of weightloss properties and failed to produce any evidence substantiating its advertised claim it led to weight loss.

The ban has put over-the-counter weightloss pills back in the spotlight, shining light on an unregulated area that is immensely popular. Studies show one in seven people have tried an over-the-counter weightloss pill, undoubtedly enticed by their promises of helping people lose weight easily and rapidly. But do over-the-counter weightloss pills really work? Here’s everything you need to know about the weightloss supplements currently claiming a big share of Australia’s billion-dollar weight-loss industry.

What exactly are over-the-counter weightloss pills?

Broadly speaking, over-the-counter pills are anything you buy from a pharmacist without a prescription, like cold and flu remedies and paracetamol. Some over-the-counter medications are also available at retailers like supermarkets, service stations and health food stores. Over-the-counter weightloss pills are essentially dietary and herbal supplements marketed and sold with claims of assisting with weight loss.

The important distinction between over-the-counter weightloss pills and weightloss medications prescribed by a doctor is that prescription weightloss drugs – like all pharmaceutical drugs – must go through clinical trials and provide Australia’s drug regulator with evidence of their effectiveness and safety. Worryingly, the distributors of over-the-counter diet pills and supplements are not required to produce any evidence of their products’ efficacy and safety before they hit the Australian market. The TGA only requires them to hold, but not necessarily make freely available, evidence substantiating their claims.

How do over-the-counter weightloss pills help you lose weight?

Over-the-counter weightloss pills usually claim to have several herbal or natural ingredients that help you lose weight in one of four ways:

  1. by suppressing your appetite or making you feel full using ingredients like a tropical fruit called Garcinia cambogia or glucomannan, a dietary fibre made from the root of the konjac plant
  2. by speeding up your metabolism and your body’s ability to burn fat using components like the herb Ephedra sinica or a fatty acid (conjugated linoleic acid) found in meat and dairy products
  3. by blocking your body’s ability to digest things like carbohydrates and fat using Phaseolus vulgaris (also known as the common bean) or a variety of green tea leaf called Camellia sinensis
  4. by absorbing fat in the foods you eat, relying on ingredients like chitosan, a product created using the shells of crustaceans and insects.

Do these weightloss pills work?

In a word: no.

Most advertising for over-the-counter weightloss pills and dietary supplements will proudly claim a product’s results are backed by “clinical trials” and “scientific evidence”, but the reality is a host of independent studies don’t support these claims.Two recent studies by the University of Sydney examined data from more than 120 placebo-controlled trials of herbal and dietary supplements for weight loss, including products featuring the ingredients described above. None of the supplements provided clinically meaningful weight loss.

If they don’t work, why are they allowed to be sold?

Given there are few to no checks and even less accountability when compared to prescription weightloss drugs, the researchers’ findings should come as no surprise.

Recent studies suggest weightloss supplement companies have conducted very few high-quality studies. Many trials are too small, poorly designed and don’t accurately report the composition of the supplements being investigated. This is because there are no guidelines currently covering how these types of trials should be conducted.

The good news is the Australian regulator is taking some action on the claims made by distributors of these weightloss supplements, with the TGA recently banning the sale of FatBlaster Max. While the reality is the most likely thing to be damaged by over-the-counter weightloss pills is your hip pocket, the TGA’s action also serves as an important reminder that the safety of over-the-counter weightloss supplements can never be guaranteed.

Several products have been banned from sale around the world after causing serious health problems. This includes the TGA and America’s Food and Drug Administration banning dietary supplements containing ephedra in 2018, when supplements containing this stimulant herb were associated with cases of heart attack, seizure, stroke and sudden death.

Real harm is also caused by the over-the-counter weightloss industry feeding on people’s desire for a quick fix to achieve rapid weight loss. The reality is there is no wonder pill. Losing weight and achieving lasting results comes down to: following evidence-based care from health-care professionals and making meaningful changes to your diet, exercise and lifestyle that you can sustain for life. A spokesperson for FatBlaster said the company is disappointed with the TGA’s decision and it is evaluating options for next steps.

It said the TGA’s requirements had changed during the years that FatBlaster Max Tablets have been on the market and the company has taken great care to update all packaging, advertising and claims to ensure compliance with these requirements. The listing cancellation does not impact the wider FatBlaster range.

By :

Source: FatBlaster Max has just been banned. Why? Here’s everything you need to know about diet supplements

Critics  Mayo Clinic Staff

Are you an adult who has serious health problems because of your weight? Have you tried diet and exercise but haven’t been able to lose enough weight? If you answered yes to these questions, a prescription weight-loss drug may be an option for you. You should know, however, that prescription weight-loss drugs are used in addition to — not instead of — diet and exercise.

Who is a candidate for weight-loss drugs?

Your doctor may consider a weight-loss drug for you if you haven’t been able to lose weight through diet and exercise and you meet one of the following:

  • Your body mass index (BMI) is greater than 30.
  • Your BMI is greater than 27 and you have a serious medical problem related to obesity, such as diabetes or high blood pressure.

Before selecting a medicine for you, your doctor will consider your history and health challenges. Then your doctor will talk with you about the pros and cons of prescription weight-loss drugs. It’s important to note that weight-loss drugs aren’t for everyone. For example, prescription weight-loss drugs shouldn’t be used if you’re trying to get pregnant, are pregnant or are breast-feeding.

How well do weight-loss drugs work?

Prescription weight-loss drugs approved for long-term use (more than 12 weeks) produce significant weight loss compared with placebo. The combination of weight-loss medication and lifestyle changes results in greater weight loss than lifestyle changes do alone. Over the course of a year, that can mean a weight loss of 3% to 7% of total body weight above that achieved with lifestyle changes alone. That may seem like a modest amount. But a sustained weight loss of 5% to 10% can have important health benefits, such as lowering blood pressure, blood sugar and triglyceride levels.

What you should know about weight-loss drugs

Mild side effects, such as nausea, constipation or diarrhea, are common. They may lessen over time. Rarely, serious side effects can occur. For this reason, it’s important to thoroughly discuss treatment options with your doctor.Weight-loss drugs can be expensive and aren’t always paid for by insurance. Ask your insurance company about coverage. Many people gain back some of the weight they lost when they stop taking weight-loss drugs. However, adopting healthy lifestyle habits may help limit weight gain.

How long does drug therapy last?

How long you’ll take a weight-loss drug depends on if the drug helps you lose weight. If you’ve lost enough weight to improve your health and you haven’t had serious side effects, your doctor may suggest that you take the drug indefinitely. If you haven’t lost at least 5% of your body weight after three to six months on the full dose of a drug, your doctor will probably change your treatment and may switch you to a different weight-loss drug.

What drugs are approved for weight loss?

Four weight-loss drugs have been approved by the U.S. Food and Drug Administration for long-term use:

  • Bupropion-naltrexone (Contrave)
  • Liraglutide (Saxenda)
  • Orlistat (Xenical)
  • Phentermine-topiramate (Qsymia)

Most prescription weight-loss drugs work by decreasing appetite or increasing feelings of fullness. Some do both. The exception is orlistat. It works by interfering with absorption of fat.

Bupropion-naltrexone

Bupropion-naltrexone is a combination drug. Naltrexone is used to treat alcohol and opioid dependence. Bupropion is an antidepressant and quit-smoking aid. Like all antidepressants, bupropion carries a warning about suicide risk. Bupropion-naltrexone can raise blood pressure, and monitoring is necessary at the start of treatment. Common side effects include nausea, headache and constipation.

Liraglutide

Liraglutide is also used to manage diabetes. Unlike other weight-loss drugs, liraglutide is given by injection. Nausea is a common complaint. Vomiting may limit its use.

Orlistat

Orlistat is also available in a reduced-strength form without a prescription (Alli). Orlistat can cause bothersome gastrointestinal side effects, such as flatulence and loose stools. You need to follow a low-fat diet when taking this medicine. Rare cases of serious liver injury have been reported with orlistat. However, no cause-and-effect relationship has been established.

Phentermine-topiramate

Phentermine-topiramate is a combination of a weight-loss drug (phentermine) and an anticonvulsant (topiramate). Phentermine has the potential to be abused because it acts like an amphetamine. Other possible side effects include an increase in heart rate and blood pressure, insomnia, constipation, and nervousness. Topiramate increases the risk of birth defects. Phentermine by itself (Adipex-P, Lomaira) is also used for weight loss. It’s one of four similar weight-loss drugs approved for short-term use (less than 12 weeks). The other drugs in this group aren’t widely prescribed.

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Melatonin Overdoses In Kids Increase 530% Over Past Decade

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Over the past decade, the number of children overdosing on melatonin, a sleep aid, has increased by 530%, according to a new study published by the Centers for Disease Control and Prevention.

The largest increase, a 38% jump, came in the first year of the coronavirus pandemic, which the study’s authors say was likely because more children were spending more time at home.In 2021 alone, more than 50,000 calls were placed to poison control centers in the United States about melatonin ingestion by kids, the study found.

“Most were unintentional exposure, meaning the parent did not give the child melatonin,” said ABC News chief medical correspondent Dr. Jennifer Ashton, also a board-certified OBGYN. “So the implication is the child got into it themselves.” Here are four things for parents to know to help keep kids safe.

1. Melatonin is a widely-accessible supplement.

Melatonin is a hormone that plays a role in sleep, according to the National Institutes of Health. In the U.S., melatonin supplements are considered dietary supplements, which means they are accessible to the public without the regulations of a prescription drug.

Melatonin supplements come in the form of tablets, capsules, liquid and even gummies, which may make them more attractive to kids. According to the study’s authors, “Increased sales, availability, and widespread use have likely resulted in increased access and exposure risk among children in the home.”

2. Melatonin has not been widely studied in kids.

There have not yet been enough studies on melatonin and kids to know the full impact of the supplement, according to the NIH. Even in adults, according to the NIH, the long-term impacts of melatonin are not well-known, even if the supplement does appear to be mostly safe with short-term use. With kids, because melatonin is a hormone, there is a possibility that taking it by supplement could impact hormonal development like puberty and menstruation, according to the NIH.

3. Melatonin ingestion by a child is a medical emergency

According to Ashton, when a child ingests melatonin without adult supervision, it is a medical emergency that requires immediate action. “You either want to bring them to an emergency room or contact a poison control center,” she said. Symptoms of melatonin ingestion in kids includes abdominal pain, nausea or vomiting, excessive tiredness and labored breathing.

4. Parents should store melatonin out of kids’ reach.

Ashton said parents should keep all medications and supplements, including melatonin, out of the reach of kids, even young teenagers. Bottle tops should also be kept securely closed, according to Ashton, who encouraged parents to talk to their kids about medication safety.

“You always want to use any medication exposure as an opportunity to really teach that child about medication, that it should only be given by an adult, is not candy and can have consequences both good and bad,” she said. The CDC also has additional tips HERE for keeping medication safely away from kids.

By Katie Kindelan

Source: Melatonin overdoses in kids increase 530% over past decade: What parents need to know to keep kids safe

Critics by

It’s not easy to get good sleep, especially during a worrisome pandemic with no end in sight, so it’s not surprising that bottles of sleep-inducing melatonin pills have become bedside staples. But this increased availability of melatonin at home, particularly in easy-to-consume forms like gummies, has had serious, and in some cases deadly, consequences for the children who either accidentally get their hands on it or are given it by a caregiver.

A new study published by the CDC found that melatonin overdoses in children increased 530% from 2012 to 2021, with the largest spike — a 38% increase — occurring from 2019 to 2020, when the COVID pandemic started. The researchers looked at melatonin overdoses in children and teens. More than 260,000 cases were reported to US poison control centers over the last decade, including more than 4,000 hospitalizations and nearly 300 that resulted in intensive care.

Five children required mechanical ventilation and two children — a 3-month-old and a 1-year-old — died at home following melatonin poisoning. The researchers said child-resistant packaging for melatonin “should be considered” and that healthcare providers need to better warn parents about the supplement’s “potential toxic consequences.”

The study’s lead researcher Dr. Karima Lelak, who is a pediatric emergency medicine physician at the Children’s Hospital of Michigan in Detroit, said melatonin may not be as harmless as people make it out to be, and that safe storage is absolutely critical. “Parents should really see melatonin just as any other medication that has the potential to do harm to kids, and it can be even more dangerous because it can look like candy,” Lelak told BuzzFeed News. “If a parent takes their melatonin after reading this paper and puts it in their medicine cabinet, I am humbled because I think that’s really a big take-home point: safe storage.”

Melatonin supplements work by mimicking melatonin, a hormone naturally found in our bodies that is produced by the brain in response to darkness. Supplements are mostly used to treat sleep disorders, but they’re an accessible over-the-counter product anyone can buy and use to help improve sleep (and they’re often promoted to parents as a sleep aid for children). Melatonin is regulated by the FDA as a dietary supplement, requires no prescription to take, and is widely available in pill, liquid, and gummy form.

The majority of melatonin overdoses were accidental, occurred at home, and were treated in a setting outside of healthcare, the researchers found; most involved boys younger than 5. Melatonin consumption comprised about 5% of all childhood overdoses reported to poison control centers in 2021, compared with 0.6% in 2012, the study found. The supplement was the most frequently consumed substance among kids reported to poison control centers in 2020, likely because children were spending more time at home due to pandemic-related school closures and stay-at-home orders.

The 10-year study also showed that melatonin ingestions are leading to more serious outcomes over time. Whereas most hospitalized patients involved teenagers who may have intentionally taken too much of the hormone, the biggest jump in hospital admissions occurred among kids younger than 5 who accidentally overdosed on melatonin. It’s still unclear why the severity of melatonin ingestions among kids is getting worse, but the researchers speculate that quality control issues with the supplements themselves may play a role.

Melatonin sales in the US surged 150% between 2016 and 2020 in response to public demand. Studies conducted in Canada have shown that melatonin sold in stores often fails to match some of its label’s claims in terms of dosage, with the most variation found in the chewable products that kids are more likely to consume. This research has led to some important changes in Canada’s health policies involving melatonin, including the banning of certain over-the-counter products. However, such “drug quality studies and legislation initiatives in the United States are lacking,” the researchers wrote.

What’s more, these studies have found that some melatonin products are often contaminated with “potentially clinically significant” doses of serotonin, a byproduct of melatonin, that can lead to serotonin toxicity in kids, causing symptoms such as confusion, high blood pressure, overactive reflexes, and a rapid heartbeat. Most of the children included in the study who accidentally consumed too much melatonin didn’t have any symptoms, but those who did had gastrointestinal, cardiovascular, or central nervous system issues, including nausea, drowsiness, abdominal pain, and vomiting, Lelak said.

It’s difficult to know how much melatonin is too much because there isn’t an established dosage deemed safe for consumption, according to Lelak. It could be one pill or an entire bottle, but it will depend on how old someone is, the symptoms they’re showing after ingestion (if any), and their body size. About 15% to 25% of children and adolescents have trouble falling and staying asleep, according to the American Academy of Pediatrics. However, the group warns, parents should speak with their pediatrician before giving their kids melatonin.

Dr. Shalini Paruthi, a spokesperson for the American Academy of Sleep Medicine, previously told BuzzFeed News that parents should wait until their kids are at least 3 years old before giving them melatonin because children younger than that have “unformed neurological and endocrine systems.” It’s also a good idea to first address poor sleep behaviors to ensure kids are getting quality sleep…

 

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Tomatoes Gene-Edited To Provide More Vitamin D

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Now, a team of researchers have come up with a potential new and vegan source of vitamin D: tomatoes gene edited using CRISPR-Cas9 technology to contain a precursor to vitamin D.

If the process is adopted commercially by farmers and producers, these tomatoes could help address vitamin D insufficiency, which the study said affects 1 billion people globally.

“This exciting discovery not only improves human health but contributes to the environmental benefits associated with more plant-based diets — often linked with a challenge in securing some key vitamins and minerals widely found and bioavailable in animal products,” Guy Poppy, a professor of ecology at the University of Southampton, told the Science Media Centre in London. He wasn’t involved in the research.

Vitamin D supplements are widely available in many countries, but coauthor Cathie Martin, a professor at the John Innes Centre in Norwich, England, said that eating a tomato was “so much better than taking a pill.”

“I think that having a dietary source (of vitamin D) in the form of a plant also means that you can get added benefit from eating tomatoes. We don’t eat enough fruit and veg anyway. A tomato is a good source of vitamin C as well,” she said at a news briefing.The study published Monday in the scientific journal Nature Plants.

Sunshine vitamin

The main source of vitamin D for most people is dietary, but our body also makes the micronutrient when skin is exposed to UVB light — that’s why it’s sometimes called the sunshine vitamin. The scientists harnessed a similar process in tomato plants.

The compound in the skin that can make vitamin D is known as 7-DHC, or provitamin D3, and it’s also found in tomato plant leaves and unripe green fruit. The researchers blocked a gene in tomato plants that normally converts provitamin D3 into cholesterol, which enabled provitamin D3 to accumulate in the ripe tomato fruit. The tomato plant on the left is gene edited.

To convert the provitamin D3 into vitamin D3 that helps our bodies, the tomatoes were treated with UVB light. The study found that provitamin D3 in one tomato — once converted to vitamin D3 — would be equivalent to the amount of vitamin D3 contained in two medium-size eggs or 28 grams (1 ounce) of tuna.

A trial in the United Kingdom is assessing whether growing the tomato plants outdoors, where they would be exposed to natural sunlight, would automatically result in the conversion of 7-DHC to vitamin D3.

The first fruits are expected to ripen by the end of June, Martin said. The tomatoes could also be sun-dried once picked, removing the need for treatment with UVB light, she added. The UK Parliament passed new legislation earlier this year that is designed to facilitate trials of gene-edited crops.

Other vegetables

The gene-blocking technique, which the researchers are making freely available with the publication of the paper, could also be applied to other species of solanaceous plant such as bell peppers, chiles, eggplants and potatoes, Martin said.

Mushrooms can also be a source of vitamin D when treated with UVB light or wild grown, according to the researchers. However, these plants produced vitamin D2, which the paper said was “substantially less bioeffective” than vitamin D3, which comes from meat and dairy.

Also, vitamin D3 supplements typically aren’t vegan, said Susan Lanham-New, a professor of nutritional sciences at the University of Surrey in the UK. She wasn’t involved in the study.

 “Lanolin, which is the main source (for D3), is extracted from sheep’s wool. The sheep is still alive so it is OK for vegetarians. But it is not for vegans and that’s one of the things that makes this study very extraordinary is that you have a D3 source (from a plant),” she said at the briefing.

The leaves of the gene-edited tomato plants also contained a substantial amount of provitamin D, the researchers said. They were looking at ways this waste material could be turned into vegan vitamin D supplements. The study team hoped this could act as incentive for producers to plant and produce the biofortified tomatoes.

The gene-edited tomatoes looked indistinguishable from and tasted the same as regular tomatoes, said coauthor Jie Li, a postdoctoral researcher at the John Innes Centre, and gene editing didn’t affect the plan’s growth, development or yield.

The scientists who devised the CRISPR-Cas9 gene-editing technology won the Nobel prize in 2020. The tool is having a major impact on biomedical research, clinical medicine, agriculture and farming. Like a pair of precision scissors, it can target predetermined sites in genetic material, knocking out a particular gene or inserting new genetic material.

Source: Tomatoes gene-edited to provide more vitamin D – CNN

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