Past News Items - November 2023

In the News

Kyowa Hakko Educates the Educators on Cognizin® Citicoline and brain health supplements during a unique event in New York City

Acupuncture becomes more mainstream as pain therapy

Fatty liver disease gets a new name

Following a Mediterranean diet reduces the risk of cognitive decline in older people

Kyowa Hakko Educates the Educators on Cognizin® Citicoline and brain health supplements during a unique event in New York City

Leading international health ingredient manufacturer Kyowa Hakko U.S.A., Inc. celebrated a first-of-its-kind event in New York City on November 8th, embracing the company's vision of improving people's health while addressing the increasing interest in brain health supplements.

With consumer demand for brain health supplements on the rise, the Neuro Navigators event was a meeting of the minds where experts and authorities of science, education and influence debunked some of the myths surrounding dietary supplements and presented facts backed by science and regulations to an engaged audience of dietitians and nutritionists.

Karen E. Todd, RD, CSCS, EP-C, CISSN and Vice President Global Brand Marketing for Kyowa Hakko, U.S.A., Inc., led the conversation with opening remarks that covered the overall state of the industry where 74 percent of U.S. adults have reported taking supplements, according to the 2023 CRN Consumer Survey in Dietary Supplement.

Along with keynote speaker, nationally recognized Keri Glassman, MS, RD, CDN, panelists and guest speakers at the event included Danielle Citrolo, PharmD and VP Scientific and Regulatory Affairs, Kyowa Hakko, U.S.A., Inc.; Ashley Jordan Ferira, Ph.D., RDN and Vice President of Scientific Affairs at mindbodygreen; Hannah Margaret Allen, panel, Q&A moderator and head of content at mindbodygreen; Crystal Webber, MS, RD and & Chief Innovation Officer of FIG - Formulation Innovations Group, Diana Morgan, MS, CISSN and Vice President Global Regulatory & Government Affairs for Nutrabolt® and Amy Gorin, MS, RDN and CEO of Master the Media.

Attendees heard exciting discussions about choosing the right supplements as one of the tools at people's disposal to achieve optimal brain health. They also learned that although there are different things to look for in a label, highlighting these three items: branded ingredients, third-party certifications and regulated claims are key when searching for trustworthy supplements. There was great interest in the discussions on the power of research to validate the studies behind supplements. Kyowa Hakko's branded ingredient Cognizin® Citicoline is a case in point due to its over 30 clinical studies.

Discussions about the regulation of the supplement industry, which the U.S. Food & Drug Administration (FDA) oversees under its subcategory of food, received a great reception among attendees due in part to the recent surge in news articles discussing the role of dietitians and experts endorsing products - transparency was the key take-away.

Gummies and guiding consumers on how to choose better ones was the talk of the day as one of the market trends that are here to stay. Finally, the main goal of the event, educating healthcare professionals on assessing and identifying supplements with the best-quality ingredients and effective doses while ensuring they have the right tools to guide their clients responsibly, was achieved.

Kyowa Hakko U.S.A. President, Gerard Adams, in a post event interview indicated the Kirin Group's (parent company of Kyowa Hakko) values were exemplified during the event with a display of passion, integrity and diversity. "From the participation and enthusiasm of both the livestream and in-person audience to the transparency, with which we pride ourselves on as the trusted supplier and partner for our customers and consumers, combined with the diversity of these women of science-focused event, supported everything that we passionately believe in."

To learn more about Cognizin® Citicoline, please visit: https://cognizin.com. For interviews with any of the speakers, contact Giselle Chollett at giselle@adinnyc.com or 917.386.7116.

About Cognizin® Citicoline:

Cognizin® Citicoline, manufactured by Kyowa Hakko Bio Co., Ltd., is a clinically studied and branded form of Citicoline, a natural substance made endogenously in the body and especially vital to brain health. Citicoline is a potent brain-health nutrient. A proprietary form of citicoline, Cognizin® has been clinically studied to support mental energy, focus, attention, and recall. Cognizin® is manufactured through a fermentation process to yield high quality and high purity. Cognizin® is also highly stable, GRAS, ultra-pure, and allergen-free. For more information on Cognizin®, visit Cognizin.com.

About Kyowa Hakko USA:

Kyowa Hakko USA is the North & South American office of Kyowa Hakko Bio Co. Ltd., an international health ingredients manufacturer and world leader in the development, manufacturing, and marketing of pharmaceuticals, nutraceuticals, and food & beverage products. Kyowa is the maker of branded ingredients, including IMMUSE™ LC-Plasma, Eyemuse™ Lacticaseibacillus paracasei KW3110, Cognizin® Citicoline, Pantesin® Pantethine, Setria® Glutathione, as well as L-Alanyl-L-Glutamine. For more information, visit http://www.kyowa-usa.com.

Acupuncture becomes more mainstream as pain therapy

In the 1970s, when Brenda Loew first heard that her grandmother was seeking pain relief from an acupuncturist in New York City’s Chinatown, she was horrified.

“Why would she want to have needles stuck in her?” Loew remembers thinking. “It sounded barbaric.”

Today Loew laughs at that reaction. She’s an acupuncture teaching associate with UW Medicine’s Osher Center for Integrative Health and has been in practice for over 30 years.

Acupuncture has become increasingly mainstream, especially as more patients seek out safer methods of pain relief, she said.

"The opioid epidemic is a national public health tragedy that continues to escalate and that is one reason that acupuncture has been catapulted into medical services around the country,” she said. “Due to overprescribing opioids for years, the Centers for Disease Control and Prevention advises maximizing nonpharmacological options, including acupuncture."

Current standard nonopioid treatments for managing chronic pain include COX2-selective and nonselective nonsteroidal anti-inflammatory drugs , which carry both analgesic and anti-inflammatory properties. However, these agents have adverse side effects on gastrointestinal and cardiovascular function, Loew said.

A recent nationwide study by the National Institutes of Health  found high rates of persistent chronic pain among U.S. adults. Among people with chronic pain, almost two-thirds continue to suffer for more than a year, the study reported.

For decades, the treatment was viewed with suspicion by many practitioners of Western medicine. In the 1970s, the first acupuncture clinic opened in New York City, and the state of Nevada started to accept acupuncture as a medical modality. As of January 2018, there were 37,886 licensed acupuncturists in the United States.

Small studies and meta-analyses have found acupuncture effective in treatment for arthritis and chronic pain and in palliative care for cancer. It’s been shown to influence the immune system and circulation, Loew noted.

Acupuncture stimulates neurotransmitters and encourages the release of endorphins in the body, among other mechanisms. The needles, about the width of a human hair, are inserted at various points in the body. Typically, about 10 to 20 needles are inserted, and sessions last 30 to 50 minutes.

Loew receives patient referrals not only for chronic back and neck pain, but also for gynecological pain, menstrual pain, knee pain, joint pain and headaches. Long COVID patients are seeking care from acupuncturists for balance, brain fog, pain, stress and anxiety, she said.

Loew acknowledges that acupuncture’s healing mechanisms are not wholly understood. 

“We do know that there is a broad neuro response and that the body's own opioid peptides are stimulated through needle therapy,” she said. “We also know that acupuncture affects blood flow, affects breathing, augments immunity and appears to have a global effect on every system of the body.”

“We live in an amazing time when we can integrate the best of Eastern and Western medicine. The ancestors, including my grandmother, had the wisdom to pursue such treatments to help people feel better," Loew said.

Written by Barbara Clements - 253-740-5043, bac60@uw.edu   

Fatty liver disease gets a new name

The former Metabolic and Fatty Liver Clinic at the University of Chicago Medicine is getting a new name that transcends mere signage.

Clinic director Mary E. Rinella, MD, spearheaded a years-long process to change nomenclature (perceived characteristics) surrounding the disease worldwide.

The new terminology drops stigmatizing words, precisely describes the condition and identifies a subgroup of patients omitted under the former diagnostic criteria, said Rinella, a board-certified transplant hepatologist and professor at University of Chicago Pritzker School of Medicine.

The new, neutral name under consideration is the Metabolic Liver Clinic. The change is subtle, but it reflects a shift in how clinicians and patients approach a disease that affects up to 30% of adults worldwide.

No more ‘fatty’

Gone is the long-used, problematic term “nonalcoholic fatty liver disease,” which most members of a 236-person multinational panel of clinicians, patients, public health and regulatory representatives agreed could create stigma. But that wasn’t the only reason for dissatisfaction with the label, Rinella said.

“Nonalcoholic liver disease is an exclusionary diagnosis,” she said. “You're saying what it's not – ‘It's not alcohol, but what is it?’”

The answer: it's a metabolic disease. Fat accumulates in the cells of the liver, causing inflammation and scarring that can lead to liver cancer or the need for a transplant.

That’s why the new name for nonalcoholic fatty liver disease is “metabolic dysfunction-associated steatotic liver disease,” or MASLD, which reflects the underpinnings of the disease and changes the conversation with patients, Rinella said.

“It speaks to the abnormal metabolism that leads to this liver disease,” she said. “It points you toward an understanding of how you got there in the first place.”

People with diabetes, obesity, high blood pressure and high cholesterol are at high risk, but the disease can be asymptomatic and undiagnosed, Rinella said.

Patients sometimes land in her clinic after an ultrasound, CT scan or blood test reveals the disease. A screening tool known as FIB-4 can help identify liver disease and is recommended for at-risk people, particularly individuals with diabetes.

“If you catch it early enough, you can reverse it. The problem is that it's not noticed, and then people get super sick and they get cirrhosis, or they get cancer,” Rinella said.

An alphabet of new names

MASLD is part of a constellation of new, neutral names announced in June at the European Association for the Study of the Liver (EASL) Congress. The news was published simultaneously in Hepatology, Journal of Hepatology and Annals of Hepatology, on behalf of the American Association for Study of Liver Disease, the EASL in Switzerland and the Asociación Latinoamericana para el Estudio del Hígado in South America (ALEH).

Steatotic liver disease is the overarching term for liver disease with metabolic or alcohol-related causes, Rinella said.

The new category, “MetALD,” covers patients with metabolic liver disease who consume moderate amounts of alcohol, bridging a gap between MASLD and alcohol-related liver disease.

Until now, such patients would have been excluded from clinical trials for MASLD, “which means that we may not understand how they respond to treatment,” Rinella said.

“There are actually medications that would work nicely in a patient population like that, so there's already research activity starting on that group of patients,” she said.

Worldwide change

The Nomenclature Development Initiative led by Rinella came about after an alternate name was proposed for what is now MASLD. That term, metabolic dysfunction-associated fatty liver disease, or MAFLD, began to gain traction, but it also represented a “very significant” problem by setting more stringent metabolic criteria and allowing for concomitant alcohol use, Rinella said.

As a result, MAFLD defined a patient population that differed from the standard group that served as the basis for decades of research, she said.

MASLD, while providing an affirmative definition, retains alcohol limits in use and is sufficiently broad for the patient population to have near-complete overlap with NAFLD, Rinella said. With the new MetALD category, “disease course in this important population can be assessed and addressed,” Rinella said.

The nomenclature initiative was built around transparency and consensus, using a Delphi process (which uses the collective opinion of panel members).

“We did this to bring all parties together to try and reach a common ground,” Rinella said.

The work is still incomplete. One challenge is changing billing codes, not just in the U.S., but around the globe, Rinella said.

Organizations large and small will have to make the transition in a way that avoids confusing patients or losing identity and referrals — a discussion that will be had before the new clinic name is finalized at UChicago Medicine, Rinella said.

“It just takes time,” Rinella said.

The new terminology “has been taken up extremely well,” she said. “Surprisingly well, actually. All over the world, it’s being used.”

Following a Mediterranean diet reduces the risk of cognitive decline in older people

Old people who follow a Mediterranean diet are at a lower risk of cognitive decline, according to a study published in the journal Molecular Nutrition and Food Research. The study provides new evidence for a better understanding of the biological mechanisms related to the impact of the diet on cognitive health in the ageing population.

The study is led by Mireia Urpí-Sardá, adjunct lecturer and member of the Biomarkers and Nutritional & Food Metabolomics research group of the Faculty of Pharmacy and Food Sciences, the Institute for Nutrition and Food Safety (INSA-UB), the Food and Nutrition Torribera Campus of the University of Barcelona, and the CIBER on Frailty and Healthy Ageing (CIBERFES).

This European study, part of the Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL) was carried out over twelve years and it involved 840 people over 65 years of age (65% of whom were women) in the Bourdeaux and Dijon regions of France.

Healthy diet and cognitive performance

According to Cristina Andrés-Lacueva, UB professor and head of the CIBERFES group, “within the framework of the study, a dietary metabolomic index has been designed —based on biomarkers obtained from the participants’ serum— on the food groups that form part of the Mediterranean diet. Once this index is known, its association with cognitive impairment is evaluated”.

in the study, baseline levels of saturated and unsaturated fatty acids, gut microbiota-derived polyphenol metabolites and other phytochemicals in serum that reflect individual bioavailability were chosen as biomarkers. Some of these indicators have not only been recognized as marks of exposure to the main food groups of the Mediterranean diet but have also been held responsible for the health benefits of the Mediterranean dietary pattern.

The metabolome or set of metabolites — related to food and derived from gut microbiota activity — was studied through a large-scale quantitative metabolomic analysis from the serum of the participants without dementia, from the beginning of the study. Cognitive impairment was assessed by five neuropsychological tests over twelve years.

As a result, the study reveals a protective association between the score of the Mediterranean diet based on serum biomarkers and cognitive decline in older people.

Biomarkers to study the benefits of the diet

According to Mercè Pallàs, professor at the UB Neurosciences Institute (UBneuro), "the use of dietary pattern indices based on food-intake biomarkers is a step forward towards the use of more accurate and objective dietary assessment methodologies that take into account important factors such as bioavailability".

Expert Alba Tor-Roca, first author of the study and CIBERFES researcher at the UB, explains that “we found that adherence to Mediterranean diet assessed by a panel of dietary biomarkers is inversely associated with long-term cognitive decline in older people. These results support the use of these indicators in long-term follow-up assessments to observe the health benefits associated with the Mediterranean diet or other dietary patterns and therefore, guide personalized counselling at older ages”.

The study was carried out in collaboration with teams from the Department of Genetics, Microbiology and Statistics of the Faculty of Biology and the Department of Pharmacology, Toxicology and Therapeutic Chemistry of the Faculty of Pharmacy and Food Sciences of the UB. Teams from the University of Bordeaux and the INRAE centre at Clermont-Ferrand University (France), King’s College London (United Kingdom), the University of Amsterdam (the Netherlands) and the Parcelsus Medical University in Salzburg (Austria) have also participated.

Funding was obtained through the International Joint Programming Actions PCIN-2015-229, the European Regional Development Funds (ERDF) and from the former Ministry of Economy, Industry and Competitiveness (MINECO) through the Joint Programming Initiative “A Healthy Diet for a Healthy Life”.