Mg Of Niacin Research Articles

Association between dietary niacin intake and Helicobacter pylori seropositivity in US adults: A cross-sectional study.

This study delves into the association between dietary niacin intake and Helicobacter pylori seropositivity, a topic gaining prominence in academic discourse. However, the precise role of Niacin in the development and progression of Helicobacter pylori seropositivity remains inadequately understood. Thus, this research aims to investigate the connections between H. pylori seropositivity and dietary niacin intake using a nationally representative sample of adults. A cross-sectional analysis encompassed 4,000 participants from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States between 1999 and 2000, all aged 20 years or older. The study employed the generalized additive model (GAM) and multivariate logistic regression to explore the potential relationship between niacin intake and Helicobacter pylori seropositivity. Subgroup analyses were performed based on gender, age, diabetes, hypertension, and hyperlipemia. Analyzing cross-sectional data from NHANES 1999-2000 involving individuals aged 20 years and above revealed that out of 4,000 participants, 1,842 tested positive for H. pylori via serology. Multivariate analyses unveiled a significant inverse correlation between niacin intake and H. pylori seropositivity. Adjusted odds ratios (ORs) for dietary niacin intake in quartiles Q2 (13.31-19.26 mg/d), Q3 (19.27-27.42 mg/d), and Q4 (>27.42 mg/d) compared to Q1 (<13.31 mg/d) were 0.83 (95% CI: 0.69-1.01), 0.74 (95% CI: 0.61-0.90), and 0.66 (95% CI: 0.54-0.81), respectively. Moreover, a nonlinear L-shaped relationship (P = 0.022) emerged between niacin intake and H. pylori seropositivity, indicating minimal risk of H. pylori infection at approximately 44.69 mg of niacin per day in the diet. This study suggests a potential link between increased dietary niacin intake and reduced prevalence of Helicobacter pylori seropositivity. This correlation is bolstered by plausible mechanisms involving immunomodulatory function, mitochondrial dysfunction, and cellular oxidative stress.

Association of niacin intake with constipation in adult: result from the National Health and Nutrition Examination

BackgroundAlthough dietary intake is believed to be associated with constipation, there is currently a lack of research exploring the relationship between niacin intake and constipation. Therefore, the aim of this study is to investigate the association between niacin intake in adults and constipation using data from the National Health and Nutrition Examination Survey (NHANES).MethodsThis study included 5170 participants (aged ≥ 20 years) from the NHANES survey conducted between 2009 and 2010. Participants who reported experiencing constipation “always”, “most of the time”, or “sometimes” in the past 12 months were defined as constipation cases. The daily niacin intake was obtained from dietary recall and dietary supplement recalls of the patients. Weighted multivariate logistic regression analysis, restricted cubic spline regression, subgroup analysis, and interaction analysis were used to assess the correlation between niacin intake and constipation.ResultsAfter adjustment for covariates, the multivariate logistic regression model showed that low niacin intake was associated with a higher risk of constipation (Model 1: OR: 0.917, 95% CI 0.854–0.985, P = 0.023; Model 2: OR: 0.871, 95% CI 0.794–0.955, P = 0.01). After dividing niacin intake into four groups, a daily intake of 0–18 mg niacin was associated with a higher risk of constipation (Model 1: OR: 1.059, 95% CI 1.012–1.106, P = 0.019; Model 2: OR: 1.073, 95% CI 1.025–1.123, P = 0.013). The restricted cubic spline regression analysis also showed a non-linear relationship between niacin intake and the risk of constipation.ConclusionThe findings of this study suggested that daily intake of 0–18 mg of niacin was associated with a higher risk of constipation compared to a daily intake of 18–27 mg of niacin.

Safety, tolerability, and clinical and neural effects of single-dose psilocybin in obsessive-compulsive disorder: protocol for a randomized, double-blind, placebo-controlled, non-crossover trial.

Psilocybin may help treat obsessive-compulsive disorder (OCD). To date, only one open-label study of psilocybin for OCD exists, necessitating further investigation with a randomized controlled design. The neural correlates of psilocybin's effects on OCD have also not been studied. This first-of-its-kind trial aims to evaluate the feasibility, safety, and tolerability of psilocybin in the treatment of OCD, provide preliminary evidence on the effects of psilocybin on OCD symptoms, and elucidate neural mechanisms that may mediate psilocybin's effects on OCD. We use a randomized (1:1), double-blind, placebo-controlled, non-crossover design to examine the clinical and neural effects of either a single dose of oral psilocybin (0.25 mg/kg) or active placebo-control agent (250 mg of niacin) on OCD symptoms. We are enrolling 30 adult participants at a single site in Connecticut, USA who have failed at least one trial of standard care treatment (medication/psychotherapy) for OCD. All participants will also receive unstructured, non-directive psychological support during visits. Aside from safety, primary outcomes include OCD symptoms over the past 24 h, assessed by the Acute Yale-Brown Obsessive-Compulsive Scale and Visual Analog Scale ratings. These are collected by blinded, independent raters at baseline and the primary endpoint of 48 h post-dosing. Total follow-up is 12 weeks post-dosing. Resting state neuroimaging data will be collected at baseline and primary endpoint. Participants randomized to placebo will be offered the chance to return for an open-label dose of 0.25 mg/kg. All participants will be required to provide written informed consent. The trial (protocol v. 5.2) was approved by the institutional review board (HIC #2000020355) and registered with ClinicalTrials.gov (NCT03356483). This study may represent an advance in our ability to treat refractory OCD, and pave the way for future studies of neurobiological mechanisms of OCD that may respond to psilocybin.

Effects of niacin on intestinal epithelial Barrier, intestinal Immunity, and microbial community in weaned piglets challenged by PDCoV

The objective was to evaluate effects of niacin on the intestinal epithelial barrier, intestinal immunity, and microbial community in weaned piglets challenged by Porcine Deltacoronavirus (PDCoV). In this study, fifteen weaned piglets were randomly assigned to 1 of 3 groups, (1) control group, normal diet; (2) PDCoV group, infected with 1 × 107 TCID50 of the PDCoV CHN-HN-17 strain by oral administration; (3) NA + PDCoV group, infected with 1 × 107 TCID50 of the PDCoV CHN-HN-17 strain by oral administration following administration of 40 mg of niacin for three days. The results showed that PDCoV infection induced diarrhea and other clinical symptoms with intestinal villi shedding and atrophy in weaned piglets. Niacin alleviated the symptoms of diarrhea and intestinal damage of PDCoV-infected weaned piglets. Additionally, PDCoV increased (P < 0.05) the mRNA expression of tight junction proteins [zonula occludens-1 (ZO-1) and Claudin] and antimicrobial peptides [porcine β defensin 1 (pBD1), pBD2, proline-arginine rich 39-amino acid peptide (PR39) and protegrin 1–5 (PG1-5) in the jejunum and ileum of weaned piglets, while niacin increased (P < 0.05) the expression of PG1-5 compared with PDCoV. PDCoV increased (P < 0.05) the contents of serum interleukin-1β (IL-1β), IL-8 and intestinal IL-8, and up-regulated the mRNA expression of tumor necrosis factor-α (TNF-α), IL-1β, IL-6, IL-10, IL-12, and IL-18 in ileum of weaned piglets compared with control. However, niacin decreased (P < 0.05) the contents of serum IL-1β, IL-6 and intestinal IL-10 and IL-8, and also reduced (P < 0.05) the mRNA expression of ileal TNF-α, IL-10 and IL-12 in the PDCoV-infected piglets. Compared with control, PDCoV up-regulated (P < 0.05) the mRNA expression of key genes related to innate immune and antiviral molecules [toll-like receptor 4 (TLR4), NOD1, NOD2, DDX58, CCL2, STAT2, Mx1, IFN-γ, and protein kinase R (PKR) in the ileum of weaned piglets. Niacin decreased (P < 0.05) the mRNA expression of NOD1, NOD2, STAT2, IFN-γ, and PKR in PDCoV-infected weaned piglets. Moreover, the mRNA expression of IL-6 decreased (P < 0.05) and 2′-5′-oligoadenylate synthetase (OAS), IFN-α, and PKR increased (P < 0.05) in PDCoV-infected IPEC-J2 cells treated with niacin in vitro. Furthermore, niacin decreased (P < 0.05) the elevation of protein expression including inducible NOS (iNOS), nuclear factor-κB (NF-κB p65), inhibitor kappa B (IKKβ), histone deacetylase [Sirtuin 1 (SIRT1) and histone deacetylase 7 (HDAC7) and phosphorylation of histone H3 at serine s10 (pH3s10) in the ileum of PDCoV-infected piglets, and increased (P < 0.05) the expression of G protein-coupled receptor (GPR109A). PDCoV disrupted the composition and structure of microflora in the colon of weaned piglets, and reduced the relative abundance of the beneficial bacteria Spirobacterium, but niacin could improve the intestinal microbial flora of the PDCoV-infected piglets associated with increasing the relative abundance of Lactobacillus. Overall, niacin could alleviate diarrhea, intestinal barrier damages, intestinal immune response and colonic microflora disfunction in PDCoV-infected weaned piglets.

Development of a Pennywort (Centella asiatica) Ice Cream with Passion Fruit (Passiflora edulis)

Ice cream is a popular frozen dessert usually made of milk, cream, sugar, and flavoring. The goal of this study was to determine methods to enhance ice cream nutritionally through the addition of pennywort (Centella asiatica) and passion fruit (Passiflora edulis) extract. Pennywort is a nutritious leaf but not commonly utilized as food. The development of the product through laboratory experiments. The standardized ingredients and procedures were determined after five trial formulations. The pennywort leaf was dehydrated using the Multi-Commodity Heat Pump Dryer and ground using a food processor. Coconut milk was first chilled then mixed with soya milk from fresh soybeans. Sugar, vanilla, salt, pennywort and passion fruit extract were mixed using a blender. The mixture was poured into a plastic cup and frozen for 24 hours. The pennywort ice cream with passion fruit containeds 177 kcal per serving (125 ml). Each serving contained 33g of carbohydrates, 5g of protein, 2.8 g of fat, 88mg of calcium, 85mg of phosphorus, 1.1 mg of niacin, 0.9 mg of iron, 0.04 mg of thiamine, and 0.03 mg of riboflavin. The cost of one serving was ₱17. The product was evaluated by 30 individuals from both genders and was rated by the majority as like extremely in terms of odor, color, appearance, texture. Its taste was rated as like very much. This study showed that utilizing pennywort and passion fruit to enhance the taste and nutrient content of ice cream is possible.

Development of Power Vegan Cupcake

The objective of this study was to develop a healthy eating on the go for busy people. The Power Vegan Cupcake is a plant-based, nutrient-dense product, and is made from local plant-based ingredients. Saluyot and soymilk were used as replacements for egg and milk. Brown rice flour, muscuvado, banana, raisins, and peanuts made the cupcake a complete food. The dry ingredients were sifted and mixed. Saluyot and pandan leaves were boiled for 15 minutes and then cooled, blended, and strained. The saluyot puree and pandan juice were then mixed with the dry ingredients, soy milk, and vanilla. The batter was mixed, and raisins and banana were added. The batter was baked in an oven for 25 minutes at 200°C. Each Power Vegan Cupcake (70g) contained 41.7g of carbohydrates, 4.7g of protein, and 3.12g of fat for a total calorie content of 198.4kcal. It also contained 28.75ug of Vitamin A, 2.4mg of Vitamin C, 50.6mg of calcium, 1.5mg of iron, 0.17mg of thiamin, 0.19mg of riboflavin, 2.93mg of niacin, and 98.7mg of phosphorus. The product was found to contain a higher amount of carbohydrates, protein, and micronutrients compared to regular cupcakes on the market. Thirty respondents, ages 18-29, evaluated the product. The results showed a rating of like very much from 63%, 53%, and 50% of the evaluators in terms of appearance, texture, and taste, respectively. Advance development of saluyot as egg substitute for strict vegetarian foods is recommended.

Proximate, vitamin and mineral assays of an underutilised indigenous vegetable in West Africa Salvia elegans Vahl (Lamiales: Lamiaceae) in enhancing diet diversification

The main objective of this research is to explore the proximate, minerals and vitamin assays of Salvia elegans Vahl (Lamiales: Lamiaceae) with the aim of promoting their consumption. Proximate analysis was carried out following the method described by the Association of Official Analytical Chemist (AOAC). Minerals was analysed by atomic absorption spectrophotometer and vitamins are analysed using high performance liquid chromatography. The proximate analysis moisture content of (2.565 +/- 0.14), crude protein (24.24 +/- 0.13), crude fibre (6.67 +/- 0.03), ash (16.95 +/- 0.19), CHO (48.08 +/- 0.6 cru g/100 gDM, calcium (265.25 mg/kg), iron (245.4 mg/g), sodium (374.45 +/- 0.10 mg/100 g), magnesium (76.53 mg/100 g), copper (1.20 mg/100 g), potassium (199.53 mg/100 g), Zn (102.90 mg/100 g), manganese (4.95 mg/100 g). Also contain 7.98 mg of B1 (thiamine), 3.33 mg of riboflavin, 48.93 mg of niacin, ascorbic acid (252.02 mg/100 g), retinol (98.06 mg), cholecalciferol (8.64 mg) and tocopherols (10.97 mg). The consumption of S. elegans could complement other food sources in effecting positive impact of vitamins, fibres and minerals in supplementation on the growth of stunted children, building of bones, tissue formation and on the prevalence of disease such as typhoid, scurvy, and rickets. Therefore, the cultivation and consumption of the plant should be encouraged.

Investigation of poly(methyl acrylate) grafted chitosan as a polymeric drug carrier

The graft copolymerization of methyl acrylate (MA) onto chitosan in aqueous medium was investigated using potassium persulfate (KPS) as initiator. The grafting conditions were optimized by studying the effects of the polymerization variables (the initiator concentration, the ratio of monomer to chitosan, and reaction temperature) on the percentage of grafting (PG). PG was found to depend on these variables, and the highest grafting percentage (256 %) could be obtained at chitosan = 1 g, KPS = 4.5 × 10−3 M, methyl acrylate monomer = 6 g, T = 60 °C and t = 180 min. The graft copolymer was characterized by Fourier transform infrared spectra analysis, thermogravimetry (differential thermogravimetry, differential scanning calorimetric), X-ray powder diffraction as well as CP-MAS 13C NMR spectroscopy. These analyses are highly confirmed the formation of poly(methyl acrylate) grafted chitosan (PMAGC). Furthermore, the gelation of the grafted polymers (PG 68, 122, 218 and 256 %) in distilled water has been studied, and the results revealed that the percentage of swelling number increase with increasing PG of the polymers. Controlled release of niacin (vitamin B3) from the hydrogel of the grafted polymers (PG 68, 122 and 256 %) in aqueous medium has been studied using ultraviolet absorption to follow quantities released at different times (for each experiment: PMAGC 100 mg, niacin 2.46 mg, distilled water 100 ml). The study was repeated again with same conditions except the using of 4.92 mg of niacin instead of 2.46 mg (PG of the grafted polymer is 256 %). The diffusion coefficient (D, cm2/h) of niacin from the hydrogel of the grafted polymer (PG 256 %) was calculated depending on Higuchi model (diffusion coefficient of the first load is 0.00194 cm2/h while 0.00255 cm2/h of the second load).

Abstract P267: Relationship of Coffee Consumption and its Urinary Biomarker to Blood Pressure: The Intermap Study

Background: Coffee, one of the most commonly consumed beverages, is complex, with substantial differences in chemical composition among cups, depending on the origin of the product, how it is processed and prepared. Studies suggest that coffee consumption may help prevent several chronic diseases, e.g., Alzheimer’s disease, type 2 diabetes, and breast cancer. After caffeine, the second most abundant compound in coffee is trigonelline, also known as N -Methylnicotinic acid (NMNA), a niacin-related compound. Coffee contains about 10-40 mg of niacin per 100 g (the daily recommended dose of niacin is 14 mg for women and 16 mg for men). The influence of coffee on blood pressure (BP) is not clear; only the effect of caffeine has been studied extensively. Objective: To investigate associations of coffee consumption with the level of its urinary biomarker NMNA, and their relationships with BP among 2,157 US men and women ages 40-59 from the International Collaborative Study on Macro-/Micronutrients and Blood Pressure (INTERMAP). Methods: The INTERMAP Study is a cross-sectional epidemiologic investigation with standardized quality-controlled methods; four 24-hour dietary recalls; 2 timed 24-hour urine collections, 8 BP measurements, and questionnaire data were accrued. Proton nuclear magnetic resonance ( 1 H-NMR) spectroscopy was performed to obtain urinary metabolite profiles for all participants. Urinary NMNA was calculated from area under the curve of a triplet at δ 8.84 in each spectrum, and was expressed as a relative integral. Associations of BP with consumption of coffee and urinary NMNA, were assessed by multiple linear regression; possible confounders included age, gender, population sample, 24-hr urinary sodium and potassium excretions, and dietary variables. Results: Mean coffee consumption was 400 mg/day; relative urinary NMNA integral was 0.001. Sex-age-sample adjusted correlation (r) between urinary NMNA level and coffee consumption was 0.76 for mg/day; r between NMNA and niacin intake was 0.08; r between coffee and niacin, 0.16. There was a non-significant positive association between coffee intake and BP in all regression models adjusted for confounders including height and weight; data for relation of NMNA with BP were qualitatively similar to the foregoing. With adjustment for possible confounders, differences in systolic blood pressure (SBP) were 0.5 mm Hg (95% CI, -0.7 to 1.6) for coffee intake higher by 2 SD, 900 mg/day. Differences in SBP for 2 SD urinary NMNA integral were similar, 0.5 mm Hg (-0.6 to 1.7). For hypertensive participants, difference in SBP was 2.3 mm Hg (-0.7 to 5.4) for coffee intake 2 SD higher, and 2.7 mm Hg (-0.4 to 5.7) for urinary NMNA integral 2 SD higher. Conclusion: Higher coffee intake may raise BP, especially among hypertensive persons. Urinary NMNA apparently is a good biomarker for validation of coffee consumption among free-living people.

Cystoid macular edema induced by low doses of nicotinic Acid.

Cystoid macular edema (CME) is a condition that involves the macula, causing painless vision loss. In this paper, we report a case of niacin-induced bilateral cystoid macular edema (CME) in a middle-age woman taking low dose of niacin (18 mg of nicotinic acid). Optical coherence tomography (OCT) showed retinal thickening and cystoid spaces in both eyes, whereas fluorescein angiography (FA; HRA 2, Heidelberg Engineering) revealed the absence of fluorescein leakage also in later phases. Four weeks after discontinuation of therapy there were a complete disappearance of macular edema at funduscopic examination and an improvement of visual acuity in both eyes. Furthermore OCT showed a normal retinal profile in both eyes. In our opinion considering the wide availability of niacin, medical monitoring and periodical examination should be considered during niacin administration. To our knowledge, this is the first report in the literature that described the very low-dose niacin-induced bilateral niacin maculopathy.

The determination of water‐soluble vitamins and in vitro digestibility of selected Czech cheeses

SummaryWater‐soluble vitamins, in vitro organic matter digestibility (OMD) and dry matter digestibility (DMD) values were determined in various different Czech cheeses. An HPLC method for the simultaneous determination of niacin, pantothenic acid and pyridoxine in cheese was established. Different hydrolysis conditions and enzymes were used to release these vitamins from their complex form. The cheeses contained on average 2.04 mg of niacin, 3.24 mg of pantothenic acid and 2.16 mg of pyridoxine per 100 g of fresh mass. An enzymatic method was applied for the evaluation of OMD and DMD in cheeses. In vitro digestibility values ranged from 83.29% to 99.99% for organic matter (OMD) and 83.33% to 99.87% for dry matter (DMD) after two different enzymatic digestions (pepsin, pancreatin). In addition, cheeses incubated with pepsin plus pancreatin, OMD and DMD were strongly digested (99.04–99.83%, 97.73–99.74%).

Acute Effects of a Caffeine-Containing Supplement on Bench Press and Leg Extension Strength and Time to Exhaustion During Cycle Ergometry

The purpose of the present study was to examine the acute effects of a caffeine-containing supplement (SUPP) on 1 repetition maximum (1RM) bench press and leg extension strength, as well as time to exhaustion (TTE), during cycle ergometry at a power output that corresponded to 80% of VO2peak. The study used a double-blinded, placebo-controlled, crossover design. Twenty-one untrained men (mean +/- SD age = 23.0 +/- 2.6 yr) were randomly assigned to take either the SUPP or placebo (PLAC) first. The SUPP contained 400 mg of caffeine, 66.7 mg of capsicum extract, 10 mg of bioperine, and 40 mg of niacin, and the PLAC was microcrystalline cellulose. Sixty minutes after taking either the SUPP or PLAC, the subjects were tested for 1RM bench press and leg extension strength, as well as TTE. After 1 week of rest, the subjects ingested the opposite substance (SUPP or PLAC) and were retested for 1RM bench press and leg extension strength, as well as TTE. The results indicated that the SUPP had no effect on 1RM bench press strength, 1RM leg extension strength, or TTE at 80% VO2peak. These findings did not support the use of the caffeine-containing SUPP in the present study as an ergogenic aid in untrained individuals.

Does nicotinic acid (niacin) lower blood pressure?

Nicotinic acid (niacin) is a well-established treatment for dyslipidaemia – an important cardiovascular disease (CVD) risk factor. However, niacin may also reduce blood pressure (BP), which is another important CVD risk factor. This review examines the limited publicly available data on niacin’s BP effects. Acute administration of immediate-release niacin may lower BP because of niacin’s acute vasodilatory effects. Although not always supported by clinical trial data, the package insert of a prescription, extended-release niacin describes niacin-induced acute hypotension. From a chronic standpoint, larger studies, such as the Coronary Drug Project, suggest that niacin may lower BP when administered over a longer period of time. Post hoc analyses of some of the more recent niacin clinical trials also support a more chronic, dose-dependent, BP-lowering effect of niacin. Because laropiprant [a prostaglandin D2 (PGD2) type 1 (DP1) receptor antagonist] does not attenuate niacin’s BP-lowering effects, it is unlikely that any chronic lowering of BP by niacin is due to dilation of dermal vessels through activation of the DP1 receptor by PGD2. Further research is warranted to evaluate the extent and mechanisms of niacin’s effects on BP.

Influence of xantinole nicotinic acid on cutaneous microcirculation in patients with coronary artery disease and hyperlipoproteinemia

Xantinole nicotinic acid (NA) dose dependently lowers plasma levels of atherogenic lipoproteins and increases blood flow through vasodilation. The aim of this study was to evaluate the effect of NA on cutaneous microcirculation in patients with coronary artery disease and hyperlipidemia. In this open pilot study, five men and three women (74.2+/-9.1 yrs; 81.4+/-7.9 kg; 171.6+/-7.0 cm) with angiographically proven coronary artery disease and hyperlipidemia were included. Nailfold capillary microscopy was used for measurements of erythrocyte velocities at rest and after three minutes of ischemia, before and one hour after intake of 1000 mg of NA. The blood pressure (120+/-12/73+/-8 mmHg vs. 113+/-10/72+/-5 mmHg; p=0.19/0.83) and the heart rate (72+/-8/min vs. 70+/-7/min; p=0.38) remained unchanged. The mean capillary red blood cell velocity at rest (v(RBC); 0.27+/-0.23 mm/s vs. 0.32+/-0.18 mm/s; p=0.089) and the time to maximal post ischemia erythrocyte velocity (t(peak); 21.0+/-7.9 s vs. 24.3+/-15.5 s; p=0.49) did not change. The maximal post ischemic erythrocyte velocity (v(maxRBC); 0.93+/-0.33 mm/s vs. 1.19+/-0.19 mm/s; p=0.0096) raised slightly but significantly, the duration of post-ischemia hyperemia (DpH; 101+/-16 s vs. 127+/-15 s; p=0.0005) increased markedly. One patient reported about flush in the whole body. The administration of 1000 mg of NA resulted in a significant improvement of the cutaneous microcirculation in patients with coronary artery disease and hyperlipidemia.

Vitamins and Perinatal Outcomes Among HIV-Negative Women in Tanzania

The mother's micronutrient status is a key determinant of fetal growth and survival. While iron and folate supplements now are provided to pregnant women in many developing countries, the dietary intake of other micronutrients often is inadequate. Multivitamin supplements have significantly lowered rates of fetal death, preterm birth, and low birth weight in HIV-positive Tanzanian women. The present, similarly designed trial was done to learn whether supplements are equally effective in HIV-negative women. The double-blind trial enrolled 8468 women at 12-27 weeks' gestational age, all of whom received supplemental iron and folic acid prenatally. Participants received either a multivitamin supplement or placebo daily up to 6 weeks after delivery. The supplement included 20 mg of vitamin B 1 , 20 mg of vitamin B 2 , 25 mg of vitamin B 6 , 100 mg of niacin, 50 μg of vitamin B 12 , 500 mg of vitamin C, 30 mg of vitamin E, and 0.8 mg of folic acid. These doses were, on average, at least twice the recommended dietary allowance (RDA) and, in several instances, 6-10 times the RDA. Vitamin A and zinc were omitted. A total of 8137 women gave birth to a live infant and were eligible for analyses of birth weight and prematurity. Women in the supplement and placebo groups had similar baseline characteristics. The interval from randomization to 6 weeks postpartum averaged 5.6 months. Compliance during this interval averaged 80% and did not differ significantly between the two study groups. Low birth weight (less than 2500 g) was significantly less common in the multivitamin group than in placebo recipients; the relative risk (RR) was 0.82, with a 95% confidence interval (CI) of 0.70-0.95. Mean birth weight was modestly but significantly higher in the multivitamin group. Supplementation had no significant effects on the risk of either preterm birth (before 37 weeks' gestation) or fetal death. The risk of a small-for-gestational-age infant was reduced 23% in the multivitamin group. The RR of cesarean delivery in the multivitamin group compared to the placebo group was 1.15 (95% CI, 0.99-1.33). Supplementation did not significantly influence the risk of maternal death. Maternal anemia was less frequent in women given supplements, and they had significantly higher hemoglobin levels. The low cost of vitamin supplements and their positive effects on the risk of low birth weight and a small-for-gestational-age infant recommend their use by all pregnant women. Prenatal vitamin supplementation could prove to be a very cost-effective means of improving birth outcomes in developing countries.

Commentary on: Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance by Griffiths et al.

The article by Griffiths et al. in this issue of Psychophar-macology should make all scientists interested in humanpsychopharmacology sit up and take notice. It is the firstwell-designed, placebo-controlled, clinical study in morethan four decades to examine the psychological conse-quences of the effects of the hallucinogenic (psychedelic)agent known as psilocybin. In fact, one would be hard-pressed to find a single study of psychedelics from anyearlier era that was as well-done or as meaningful. Perhapsmore importantly, despite the notion by many people thatpsychedelics are nothing more than troublesome drugs ofabuse, the present study convincingly demonstrates that,when used appropriately, these compounds can produceremarkable, possibly beneficial, effects that certainlydeserve further study.Although many people seem to believe that “psyche-delics” simply appeared during the turbulent 1960s, in factthe use of these materials spans back through manymillennia of human history. Ancient substances with namessuch as Soma (India), Kykeon (Greece), and Teonanacatl(South America) served for thousands of years as psycho-pharmacological catalysts in a variety of sacred religiousand magical rituals (Nichols 2004; Schultes and Hofmann1979). Peyote, the ceremonial use of which is now thoughtby anthropologists to date back at least 5,000 years, isrevered as a sacrament by the Native American Church.Ayahuasca, a decoction made from plants that grow in theAmazon basin, is a sacrament used by a syncretic church inBrazil. This church has a small following in the US that hasjust received a favorable decision by the US Supreme Courtallowing them continued use of this material.The parallel between mystical states and the effects ofpsychedelic drugs is well-known among those familiar withthe literature. Aldous Huxley, in his classic but controver-sial 1954 book, The Doors of Perception, (Huxley 1970)noted the similarity of his own mescaline-induced state toexperiences described by mystics and visionaries from avariety of cultures. Perhaps it is not surprising then that thename “entheogen,” with the connotation that these materi-als reveal god within, is becoming increasingly popularamong those who continue to use these substances forpurposes that are neither medical nor “recreational.”We must, therefore, take note of what has come to beknown as the “Good Friday Experiment,” carried out byWalter Pahnke for his Ph.D. studies at a small privatechapel in Boston. His 1963 Ph.D. dissertation was titledDrugs and Mysticism. An analysis of the relationshipbetween psychedelic drugs and the mystical consciousness.He described in an experiment with 20 student volunteersfrom a local Christian theological seminary. Subjects weregiven either 30 mg of psilocybin or 200 mg of nicotinicacid as a “placebo.” The experiment was carried out in areligious setting during a Good Friday service. Pahnkeconcluded, “Under the conditions of this experiment, thosesubjects who received psilocybin experienced phenomenawhich were indistinguishable from, if not identical with,certain categories defined by our typology of mysticism.”Clearly, these substances have profound effects onhuman consciousness, and in the 1950s and 1960s, thedrug known as LSD was hailed as a revolutionary newtechnology for psychiatry. LSD was intensively investigat-ed for its medical potential and for possible use as anadjunct to psychotherapy until clinical research was

The RENUVA SYSTEM Increases Growth Hormone and Insulin‐like Growth Factor‐1 in Man.

Growth hormone declines with age. Growth hormone deficiency decreases energy, cognitive powers and gives other age related symptoms. These symptoms are reversed with growth hormone replacement. Growth hormone is stimulated by amino acids, nicotinic acid and growth hormone releasing peptides. The RENUVA SYSTEM contains 480 mg of amino acids, 38 mg of nicotinic acid and 1,500 mg of growth hormone releasing peptides 2 and 6. The proprietary system delivers, by mouth, 90% of peptides into the blood stream including large proteins like growth hormone. Since growth hormone is released in pulses, measurements have great variability. Growth hormone acts through insulin-like growth factor-1 (IGF-1) which varies less and is used clinically to gauge growth hormone effects. This study examines the rise in growth hormone and IGF-1 in response to the RENUVA SYSTEM. Thirteen healthy subjects over 40 years of age on no regular medications other than contraception or hormone replacement therapy were given the RENUVA SYSTEM after an overnight fast. Blood was drawn and analyzed for growth hormone and IGF-1 at-10, -5, 0, 30, 60, 90, 120 and 180 minutes. There was a 98 ± 50% (SEM) average rise in growth hormone from baseline to peak value (p<0.05). IGF-1 rose from 198 ± 15.3 ng/ml at baseline to 241 ± 17.4 ng/ml at 120 minutes (p<0.02). Although 2 subjects had mild transient flushing, there were no other adverse events, and the RENUVA SYSTEM was well-tolerated. The RENUVA SYSTEM produces a statistically significant rise in growth hormone and IGF-1.

Safety and compliance with once-daily niacin extended-release/ lovastatin as initial therapy in the Impact of Medical Subspecialty on Patient Compliance to Treatment (IMPACT) study

Niacin extended-release/lovastatin is a new combination product approved for treatment of primary hypercholesterolemia and mixed dyslipidemia. This open-labeled, multicenter study evaluated the safety of bedtime niacin extended-release/lovastatin when dosed as initial therapy and patient compliance to treatment in various clinical practice settings. A total of 4,499 patients with dyslipidemia requiring drug intervention was enrolled at 1,081 sites. Patients were treated with 1 tablet (500 mg of niacin extended-release/20 mg of lovastatin) once nightly for 4 weeks and then 2 tablets for 8 weeks. Patients also received dietary counseling, educational materials, and reminders to call a toll-free number that provided further education about dyslipidemia and niacin extended-release/lovastatin. Primary end points were study compliance, increases in liver transaminases to >3 times the upper limit of normal, and clinical myopathy. Final study status was available for 4,217 patients (94%). Compliance to niacin extended-release/lovastatin was 77%, with 3,245 patients completing the study. Patients in the southeast and those enrolled by endocrinologists had the lowest compliance and highest adverse event rates. Flushing was the most common adverse event, reported by 18% of patients and leading to discontinuation by 6%. Incidence of increased aspartate aminotransferase and/or alanine aminotransferase >3 times the upper limit of normal was <0.3%. An increase of creatine phosphokinase to >5 times the upper limit of normal occurred in 0.24% of patients, and no cases of drug-induced myopathy were observed. Niacin extended-release/lovastatin 1,000/40 mg, dosed as initial therapy, was associated with good compliance and safety and had very low incidences of increased liver and muscle enzymes.

Conversion Ratio of Tryptophan to Niacin in Japanese Women Fed a Purified Diet Conforming to the Japanese Dietary Reference Intakes

In order to establish the human requirements of niacin, it is first important to know how much tryptophan is converted to niacin in the human body. In a general, 60 mg of tryptophan is equivalent to 1 mg of niacin, whereas the conversion ratio of tryptophan to niacin is yet to be confirmed. The aim of this study was to know the conversion ratio of tryptophan to niacin in Japanese females fed a purified diet, which followed the Japanese Dietary Reference Intakes. Ten young Japanese females were housed in the same facility and given the same daily living activity schedule for 7 d. The composition of their purified diet was conformed to the Dietary Reference Intakes in Japan. The diet was niacin free. In order to investigate the conversion ratio, daily urinary outputs were collected. Tryptophan-niacin metabolites in the urine were measured and the conversion ratio of tryptophan to niacin calculated. The conversion ratio was calculated by comparing the dietary intake of tryptophan and the sum of the niacin catabolites such as N1-methylnicotinamide, N1-methyl-2-pyridone-5-carboxamide, and N1-methyl-4-pyridone-3-carboxamide, which were derived only from the dietary intake of tryptophan. The ratio was calculated as 1.5 +/- 0.1 (mean +/-SE for 10 women; in molar basis) on the last day of the experiment. It was calculated that if the excretory percentage of niacin metabolites in the urine were 60%, of the tryptophan ingested, the conversion factor would be a value of 67, meaning that is 67 mg of tryptophan is equal to 1 mg of niacin.

Adverse Effects From Inappropriate Medication Administration via a Jejunostomy Feeding Tube

Numerous complications can arise when administering medications to patients receiving continuous enteral feeding. We report a case of a patient who could not be fed by mouth and was receiving continuous jejunal enteral feeding who had an adverse event associated with inappropriate administration of a medication via his jejunostomy tube. He had taken an extended-release niacin product before hospitalization for type IIb hyperlipidemia. The patient was inappropriately given a single dose of 750 mg of niacin as the short-acting tablets that were crushed and administered via the jejunostomy tube. He experienced severe cutaneous flushing, a feeling of warmth, itching, nausea, and emesis. He was noted to have "prickly heat" to the forehead, according to the nursing notes. A discussion of problems and guidelines for medication administration in adult patients receiving continuous tube feeding is provided.