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Niacin & Heart Disease. Alan Paraso. Niacin. Thompson J, Manore M, Vaughn L. The Science of Nutrition. 2 nd Ed . San Francisco, CA: Pearson Education, Inc ; 2011 . Medeiros D, Wildman R. Advanced Human Nutrition. 2 nd Ed . Sudbury, MA: Jones & Bartlett Learning, LLC; 2012.
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Niacin & Heart Disease Alan Paraso
Niacin Thompson J, Manore M, Vaughn L. The Science of Nutrition. 2nd Ed. San Francisco, CA: Pearson Education, Inc; 2011. Medeiros D, Wildman R. Advanced Human Nutrition. 2nd Ed. Sudbury, MA: Jones & Bartlett Learning, LLC; 2012. • Essential B vitamin (Vitamin B3); can be found in fortified grains and most cuts of meat/fish/poultry. • Two forms: nicotinic acid & nicotinamide important for the formation of coenzymes NAD and NADP (TCA cycle). • Coenzymes important for the oxidation-reduction rxns involved in catabolism of carbohydrates, fat and protein for energy. • Other functions • DNA replication & repair • Cell differentiation.
Niacin (cont.) Thompson J, Manore M, Vaughn L. The Science of Nutrition. 2nd Ed. San Francisco, CA: Pearson Education, Inc; 2011. Medeiros D, Wildman R. Advanced Human Nutrition. 2nd Ed. Sudbury, MA: Jones & Bartlett Learning, LLC; 2012. • Niacin digestion • Coenzyme forms digested to nicotinamide. • Most absorption in small intestine; some in stomach via mucosal enterocytes. • RDA: • Men: 16 mg/ day • Women: 14 mg/day
Heart Disease • #1 Killer in the U.S. – 600,000+ deaths in 2008 • Main CVD: Coronary artery disease (CAD) • Others include: atherosclerosis, stroke, high blood pressure, etc. • Risk factors: Overweight/obesity, physical inactivity, smoking. • Symptoms: chest pains, weakness, light-headed, and heart attacks. Center for Disease Control. Heart Disease. http://cdc.gov/heartdisease/. Accessed April 2, 2012.
Niacin on HDL Thomson, Wadsworth. Drug Effects on HDL: Niacin. 2007.
Warnholtz et al Wanholtz A, Wild P, Ostad M, et al. effects of oral niacin on endothelial dysfunction in patients with coronary artery disease: results of the randomized, double-blind placebo-controlled INEF study. Atherosclerosis. 2009;204(1):216-221. doi: 10.1016/j.atherosclerosis.2008.08.003 • Conducted study to test the effects of ERN on LDL levels, HDL levels, and endothelial functioning in patients w/ CAD. • 12-weeks, 107 patients, double-blind treatment • 1000mg ERN or placebo • Criteria • CAD • LDL level >70 mg/dl • HDL level <65 mg/dl • Endothelial dysfunction w/ flow-mediated dilation of <8%. • Results – Increase in HDL levels, Decrease in LDL levels; endothelial function remained unchanged.
Conclusion Research shows that niacin raises HDL concentrations Does not necessarily decrease the risk of cardiovascular disease More studies should be conducted with stricter guidelines, if possible.
References Thompson J, Manore M, Vaughn L. The Science of Nutrition. 2nd Ed. San Francisco, CA: Pearson Education, Inc; 2011. Medeiros D, Wildman R. Advanced Human Nutrition. 2nd Ed. Sudbury, MA: Jones & Bartlett Learning, LLC; 2012. Center for Disease Control. Heart Disease. http://cdc.gov/heartdisease/. Accessed April 2, 2012. Thomson, Wadsworth. Drug Effects on HDL: Niacin. 2007. Wanholtz A, Wild P, Ostad M, et al. effects of oral niacin on endothelial dysfunction in patients with coronary artery disease: results of the randomized, double-blind placebo-controlled INEF study. Atherosclerosis. 2009;204(1):216-221. doi: 10.1016/j.atherosclerosis.2008.08.003