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New study shows fortified “doogh” improves inflammatory markers in patients with type 2 diabetes

Newswise — Chevy Chase, MD— Daily intake of vitamin D-fortified doogh (Persian yogurt drink) improved inflammatory markers in type 2 diabetics and extra calcium conferred additional anti-inflammatory benefits, according to a recent study accepted for publication in The Endocrine Society’sJournal of Clinical Endocrinology and Metabolism (JCEM).

Inflammation is known to have a central role in the development of type 2 diabetes and its further complications like coronary heart disease and stroke. Vitamin D carries benefits for skeletal health but evidence of an anti-inflammatory effect from clinical studies in humans remains scarce.

“Our previous research showed that improvement of vitamin D status by regular daily intake of a fortified yogurt drink resulted in lowered blood glucose levels in diabetic patients,” said Tirang Neyestani, PhD, of Shahid Beheshti University of Medical Sciences in Tehran, Iran and lead author of the study. “The current study found that consuming a vitamin D-fortified yogurt drink also decreased serum substances like highly sensitive C-reactive protein (hsCRP) which are known to have an inflammatory role.”

In this study, researchers conducted a double-blind, randomized, controlled trial over 12 weeks in 90 patients with type 2 diabetes. Study participants were randomly allocated to one of three groups to receive two 250mL bottles a day of either plain doogh, vitamin D-fortified doogh or calcium plus vitamin D-fortified doogh. Vitamin D levels, insulin resistance, and inflammatory markers such as hsCRP, fibrinogen and adiponectin were measured in blood samples taken from study participants.

“Our study showed for the first time that adiponectin, a substance secreted by fat tissue that has an anti-inflammatory effect, increased when calcium and vitamin D-fortified doogh was consumed,” said Neyestani. “Our findings may offer interesting therapeutic options for diabetic patients.”

Other researchers working on the study include: Bahareh Nikooyeh, Hamid Alavi-Majd, Nastaran, Shariatzadeh, Ali Kalayi, Nima Tayebinejad, Soudabeh Heravifard, Shabnam Salekzamani and Malihe Zahedirad, all with Shahid Beheshti University of Medical Sciences.

The article, “Improvement of vitamin D status via daily intake of fortified yogurt drink either with or without extra calcium ameliorates systemic inflammatory biomarkers, including adipokines, in the subjects with type 2 diabetes,” appears in the June 2012 issue of JCEM.

Vitamin D levels linked with health of blood vessels

A lack of vitamin D, even in generally healthy people, is linked with stiffer arteries and an inability of blood vessels to relax, research from the Emory/Georgia Tech Predictive Health Institute has found.

The results add to evidence that lack of vitamin D can lead to impaired vascular health, contributing to high blood pressure and the risk of cardiovascular disease. Study participants who increased their vitamin D levels were able to improve vascular health and lower their blood pressure.

The data is being presented on Sunday by Ibhar Al Mheid, MD, a cardiovascular researcher at Emory University School of Medicine, at the annual American College of Cardiology meeting in New Orleans. Al Mheid is one of five finalists for the ACC’s Young Investigators Award competition in physiology, pharmacology and pathology. He is working with Arshed Quyyumi, MD, professor of medicine and director of the Emory Cardiovascular Research Institute.

The 554 participants in the study were Emory or Georgia Tech employees –average age 47 and generally healthy — who are taking part in the Center for Health Discovery and Well Being, part of the Emory/Georgia Tech Predictive Health Institute.

The average level of 25-hydroxyvitamin D (a stable form of the vitamin reflecting diet as well as production in the skin) in participants’ blood was 31.8 nanograms per milliliter. In this group, 14 percent had 25-hydroxyvitamin D levels considered deficient, or less than 20 nanograms per milliliter, and 33 percent had levels considered insufficient, less than 30 nanograms per milliliter.

The researchers monitored the ability of participants’ blood vessels to relax by inflating and then removing a blood pressure cuff on their arms. To allow blood to flow back into the arm, blood vessels must relax and enlarge – a change that can be measured by ultrasound. The researchers also made other measurements of smaller blood vessels and examined the resistance to blood flow imposed by the arteries.

Even after controlling for factors such as age, weight and cholesterol, people with lower vitamin D levels still had stiffer arteries and impaired vascular function, Al Mheid says.

“We found that people with vitamin D deficiency had vascular dysfunction comparable to those with diabetes or hypertension,” he says.

Throughout the body, a layer of endothelial cells lines the blood vessels, controlling whether the blood vessels constrict or relax and helping to prevent clots that lead to strokes and heart attacks.

“There is already a lot known about how vitamin D could be acting here,” Al Mheid says. “It could be strengthening endothelial cells and the muscles surrounding the blood vessels. It could also be reducing the level of angiotensin, a hormone that drives increased blood pressure, or regulating inflammation.”

Most Americans generally get the majority of their vitamin D from exposure to sunlight or from dietary supplements; fortified foods such as milk or cereals are a minor source. A few foods, such as oily fish, naturally contain substantial amounts of vitamin D.

Participants whose vitamin D levels increased over the next six months, either from dietary supplements or ample sun exposure, tended to improve their measures of vascular health and had lower blood pressure. Forty-two study participants with vitamin D insufficiency whose levels later went back to normal had an average drop in blood pressure of 4.6 millimeters mercury.

“This was an observational study, rather than an interventional one, and it was difficult to tease out how the people who restored their vitamin D levels got there,” Al Mheid says. “We are hoping to conduct a study where we have participants take a defined regimen of vitamin D.”

“With his findings showing the relationship between vitamin D deficiency and vascular dysfunction, Dr. Mheid has helped advance our understanding of the importance of Vitamin D in preventing a common health problem in aging adults,” says Kenneth Brigham, MD, medical director of the Emory/Georgia Tech Center for Health Discovery and Well Being. “Additionally, ongoing health studies based on the Center’s collection of health information from participants will yield more discovery as the Center continues to develop.”