Welcome to the January 2019 edition of Thorne’s Research Extracts. This is Thorne’s monthly research update on diet, nutrient, botanical, and lifestyle approaches to good health. Knowing that busy practitioners can’t always focus on the latest research, our medical team of NDs, MDs, PhDs, RDs, and MS (Biol) has summarized the essence of the very most interesting studies.

Tai chi shows promise with fibromyalgia

Contributed by Jacqueline Jacques, ND

Many studies have confirmed the benefits of exercise for mitigating fibromyalgia. The focus has largely been on aerobic exercise, and a recommendation for moderate intensity aerobic exercise is considered to be a standard of care.

However, the fatigue that often accompanies fibromyalgia can make adherence difficult, even when the benefits are well established. Recently, several trials have indicated that gentler “mind-body” types of movement therapy, such as tai chi, qi gong, and yoga can be beneficial for fibromyalgia and other types of chronic pain.

The intent of the current study was to follow patients for one year. Individuals with diagnosed fibromyalgia (n=226) were randomized to an aerobic exercise group or a tai chi group for 24 weeks of 60-minute classes 1-2 times weekly. Following the 24 weeks, the patients were encouraged to continue home exercise through telephone coaching and follow up.

The tai chi participants had an overall better outcome on the Revised Fibromyalgia Impact Questionnaire (FIQR) compared to the aerobic participants.

The longer that patients stayed with practicing tai chi, the better the outcome. In addition to the FIQR improvements (which evaluates the intensity of pain, physical function, fatigue, morning tiredness, depression, anxiety, job difficulty, and overall wellbeing), participants in the tai chi arm had secondary benefits for depression, anxiety, self-efficacy, and coping skills.

This data indicates that tai chi can be a viable alternative to aerobic exercise in fibromyalgia patients with potential additional benefits if the practice can be maintained long-term.

  • Wang C, Schmid C, Fielding R, et al. Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. BMJ 2018;360:k851
  • https://www.bmj.com/content/360/bmj.k851

FDA approves qualified health claim for high oleic oils and cardiovascular benefit with conditions

Contributed by Sheena Smith, MS (Biol) 

After reviewing the available scientific evidence, the U.S. Food and Drug Administration (FDA) approved a request for a qualified health claim that high oleic acid oils can provide cardiovascular benefits when they contain at least 70-percent oleic acid (a monounsaturated fat) per serving, and they replace more saturated fats/oils without increasing total calories.

Qualified oils include, but are not limited to, high oleic olive, sunflower, safflower, canola, and algal oils. Other foods such as meats, eggs, seeds, pasta, and avocados also contain high oleic oil content.

With the FDA’s approval, qualified food labeling can now include specific statements indicating that evidence supports a possible reduction in coronary heart disease risk with the consumption of 20 grams of high oleic oils per day instead of a comparable quantity of more saturated fats/oils. A disclaimer will still be required.  


Magnesium status and supplementation influence on vitamin D status and metabolism

Contributed by Laura Kunces, PhD

Seventy-nine percent of U.S. adults don’t achieve the RDA for magnesium. This is particularly concerning because magnesium can reverse resistance to vitamin D supplementation, and magnesium deficiency is related to reduced vitamin D levels and impaired parathyroid hormone response.

Vanderbilt University researchers published a placebo-controlled, randomized trial studying the interactions of magnesium supplementation on vitamin D levels and cardiovascular status in 180 adults (ages 40-85) as part of a larger on colorectal health.

Based on two 24-hour dietary recalls, subjects supplemented magnesium to a customized amount that would reduce the calcium:magnesium intake ratio to 2.3 (average 205 mg of magnesium) for 12 weeks.

Researchers measured the various vitamin D sub-fractions in the blood, including active and non-active vitamins D2 and D3. After adjusting for age, sex, BMI, and sample collection season, researchers found magnesium supplementation had positive effects on total vitamin D levels in participants who had baseline vitamin D levels around 30 ng/mL but had a negative effect on those with vitamin D levels approaching 50 ng/mL.

They conclude magnesium supplementation could degrade vitamin D3 if plasma vitamin D levels are in a higher range.

Thorne commentary: It should be noted this study population did not have clinically low magnesium levels or overt vitamin D deficiency at the start of this trial, which is inconsistent with a random sampling of U.S. adults.

Only two subjects had vitamin D levels less than 12 ng/mL, and the upper range was not disclosed. Research has previously established a positive relationship between magnesium supplementation and improved vitamin D status in individuals who are deficient in both.

Therefore, in many cases, continuing to check blood levels and providing personalized recommendations for vitamin D and magnesium is still best for the individual.

  • Dai Q, Zhu X, Manson J, et al. Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial. Am J Clin Nutr 2018;108(6):1249-1258.

Beyond the Female Athlete Triad: low energy availability and its prevalence in male athletes

Contributed by Joel Totoro, RD

Low energy availability (LEA) is a situation that arises when energy intakes, intentional or unintentional, consistently fall short of the energy demands of training and competing. LEA has long been associated with and studied as a part of, the Female Athlete Triad, along with amenorrhea and low bone-mineral density. 

Recently, the more inclusive term Relative Energy Deficiency in Sport (RED-S) has been adopted, because male athletes are also at risk for LEA, which can impact testosterone concentration and bone mineral density.

This review examined the prevalence of RED-S in male athletes, specifically cyclists, jockeys, rowers, and combat sports, and found that, while there are differences in the manifestations of RED-S in the different cohorts, there is a significant incidence of RED-S in male athletes.

As our knowledge of LEA in male athletes increases, the authors recommend further investigations into the impact of RED-S on individual male athletes across multiple sports, beyond the “at-risk” populations examined in their review.

  • Burke L, Close G, Lundy B, et al. Relative energy deficiency in sport in male athletes: a commentary on its presentation among selected groups of male athletes. Int J Sport Nutr Exerc Metab 2018;28(4):364-374.