BTW the Weston Price link in the article is a bad link—they must have moved their recipes elsewhere. Explore eating patterns and physical activity levels. At the request of an autism parent group about 6 months ago, I checked out iron levels in our population of 3, autism patients. Every year we discover another micro-nutrient with a vital function in the body. M anaging chronic diseases in cats Veterinary Medicine Little S states "Don't restrict dietary protein for cats experiencing mild to moderate chronic renal insufficiency creatinine 1.
J Nutr Marta Guasch-Ferré et al. Low-dose vitamin B-6 effectively lowers fasting plasma homocysteine in healthy elderly persons who are folate and riboflavin replete. Am J Clin Nutr 73 4: The use of B vitamin supplements and peripheral arterial disease risk in men are inversely related. J Nutr 9: Lower ischemic heart disease incidence and mortality among vitamin supplement users.
Can J Cardiol 12 Vitamin D and cardiovascular disease risk. Endothelial dysfunction occurs in children with two genetic hyperlipidemias: J Pediatr 1: Morris, CD, Carson, S.
Routine vitamin supplementation to prevent cardiovascular disease: Preventive Services Task Force. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Antioxidant nutrient supplementation reduces the susceptibility of low density lipoprotein to oxidation in patients with coronary artery disease.
J Am Coll Cardiol 30 2: Vitamin E administration improves impairment of endothelium-dependent vasodilation in patients with coronary spastic angina. Vitamin E improves arterial compliance in middle-aged men and women. Potential clinical and economic effects of homocyst e ine lowering. Arch Intern Med Ness A, Sterne J.
Hypertension and ascorbic acid. Additional benefit of vitamin E supplementation to simvastatin therapy on vasoreactivity of the brachial artery of hypercholesterolemic men. J Am Coll Cardiol 32 3: Effects of vitamin E on chronic and acute endothelial dysfunction in smokers. International Journal of Clinical Medicine. Vitamin C and risk of coronary heart disease in women. J Am Coll Cardiol 42 2: Effects of a short-term vitamin D 3 and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women.
J Clin Endocrinol Metab 86 4: Low vitamin d levels predict stroke in patients referred to coronary angiography. Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography.
J Clin Endocrinol Metab 93 Effect of antioxidant vitamins on the transient impairment of endothelium-dependent brachial artery vasoactivity following a single high-fat meal. A randomized, single-blind, placebo-controlled trial of the effects of mg alpha-tocopherol on the oxidation resistance of atherogenic lipoproteins. Am J Clin Nutr 68 5: Vitamin E and heart disease: Free Radic Biol Med 28 1: Importance of both folic acid and vitamin B12 in reduction of risk of vascular disease.
Effect of vitamin E and beta carotene on the incidence of angina pectoris. A randomized, double-blind, controlled trial. Oral vitamin C and endothelial function in smokers: Effects of calcium supplementation on serum lipid concentrations in normal older women: Am J Med 5: The role of antioxidants in preventive cardiology. Curr Opin Cardiol 12 2: Vitamin E consumption and the risk of coronary heart disease in men. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women.
Coenzyme Q10 protects the aging heart against stress: Ann N Y Acad Sci Vitamin C inhibits endothelial cell apoptosis in congestive heart failure. The effect of folic acid supplementation on plasma homocysteine in an elderly population. Controlled trial of fish oil for regression of human coronary atherosclerosis. Coenzyme Q10 and cardiovascular disease: J Cardiovasc Nurs 16 4: Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: Decreased rate of coronary restenosis after lowering of plasma homocysteine levels.
Vitamin E ingestion does not improve arterial endothelial dysfunction in older adults. Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: Cardiovasc Drugs Ther Vitamin E supplementation improves endothelial function in type I diabetes mellitus: J Am Coll Cardiol 36 1: Vitamin intervention for stroke prevention trial: Vitamin E consumption and the risk of coronary disease in women.
Epidemiologic evidence for vitamin E in prevention of cardiovascular disease. Am J Clin Nutr 62 6 Suppl: Steinberg FM, Chait A. Antioxidant vitamin supplementation and lipid peroxidation in smokers. Am J Clin Nutr 68 2: Vitamin E plus aspirin compared with aspirin alone in patients with transient ischemic attacks.
Am J Clin Nutr 62 suppl: Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study.
Effect of different antilipidemic agents and diets on mortality: Arch Intern Med 7: Does folic acid decrease plasma homocysteine and improve endothelial function in patients with predialysis renal failure?. Association of n-3 polyunsaturated fatty acids with stability of atherosclerotic plaques: Effect of chromium nicotinic acid supplementation on selected cardiovascular disease risk factors.
Biol Trace Elem Res 55 3: Effect of folic acid and antioxidant vitamins on endothelial dysfunction in patients with coronary artery disease. J Am Coll Cardiol 36 3: Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: Vitamin B, vitamin B-6, and folate nutritional status in men with hyperhomocysteinemia. Am J Clin Nutr 57 1: Endothelial dysfunction by acute hyperhomocyst e inaemia: Clin Sci Colch Hyperhomocysteinaemia and endothelial dysfunction in young patients with peripheral arterial occlusive disease.
Combined vitamin B6 plus folic acid therapy in young patients with arteriosclerosis and hyperhomocysteinemia. J Vasc Surg 20 6: Folate, vitamin B12, and risk of ischemic and hemorrhagic stroke: Comparison of the effect of low-dose supplementation with L-5methyltetrahydrofolate or folic acid on plasma homocysteine: Am J Clin Nutr 77 3: Assessment of three levels of folic acid on serum folate and plasma homocysteine: Eur J Clin Nutr 56 8: Effects of oral folic acid supplementation on endothelial function in familial hypercholesterolemia.
A randomized placebo-controlled trial. Effect of homocysteine-lowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: Effect of homocysteine-lowering treatment with folic acid plus vitamin B on cerebrovascular atherosclerosis and white matter abnormalities as determined by MRA and MRI: Eur J Clin Invest 34 4: Use of antioxidant vitamins for the prevention of cardiovascular disease: The effect of dietary w-3 fatty acids on coronary atherosclerosis.
Randomized trial of folic acid supplementation and serum homocysteine levels. Dietary intake of dairy products, calcium, and vitamin D and the risk of hypertension in middle-aged and older women. Vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med 5: Vitamin D deficiency and risk of cardiovascular disease. Effects of hormone replacement therapy and antioxidant vitamin supplements on coronary atherosclerosis in postmenopausal women: Coenzyme Q 10 improves endothelial dysfunction of the brachial artery in Type II diabetes mellitus.
Increased adhesiveness of isolated monocytes to endothelium is prevented by vitamin C intake in smokers. Vitamin D and calcium dyshomoeostasis-associated heart failure. Wijendran V, Hayes KC. Dietary n-6 and n-3 fatty acid balance and cardiovascular health. Annu Rev Nutr Influence of folic acid on postprandial endothelial dysfunction. Arterioscler Thromb Vasc Biol 20 1: Effect of very-low-dose niacin on high-density lipoprotein in patients undergoing long-term statin therapy.
Am Heart J 3: The effects of vitamin D supplementation on physical function and quality of life in older patients with heart failure: Circ Heart Fail 3 2: The effect of micronutrient supplementation on quality-of-life and left ventricular function in elderly patients with chronic heart failure.
European Heart J Folic acid improves arterial endothelial function in adults with hyperhomocystinemia. Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia: Am J Clin Nutr 67 5: Mechanism of cardioprotection by resveratrol, a phenolic antioxidant present in red wine Review. Int J Mold Med 8 1: Ye Z, Song H. Antioxidant vitamins intake and the risk of coronary heart disease: Eur J Cardiovasc Prev Rehabil 15 1: Intake of antioxidant vitamins and risk of death from stroke in postmenopausal women.
Am J Clin Nutr 72 2: Vitamin E supplementation and cardiovascular events in high-risk patients. The heart outcomes prevention evaluation study investigators.
N Engl J Med 3: Effects of long-term daily low-dose supplementation with antioxidant vitamins and minerals on structure and function of large arteries. Arterioscler Thromb Vasc Biol 24 8: Vitamin K in the treatment and prevention of osteoporosis and arterial calcification.
Am J Health Syst Pharm 62 Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women. Allen SC, Raut S. Biochemical recovery time scales in elderly patients with osteomalacia. J R Soc Med 97 Effect of vitamin D supplementation on vitamin D status and bone turnover markers in young adults. Eur J Clin Nutr Role of vitamin D, its metabolites, and analogs in the management of osteoporosis.
Rheum Dis Clin North Am 20 3: A high phylloquinone intake is required to achieve maximal osteocalcin gamma-carboxylation. Am J Clin Nutr 76 5: Vitamin K nutrition and osteoporosis. J Nutr 7: Fracture prevention with vitamin D supplementation: J Bone Min Res 22 4: Gain in bone mineral mass in prepubertal girls years after discontinuation of calcium supplementation: The effect of glucosamine supplementation on people experiencing regular knee pain.
Br J Sports Med 37 1: Association between dietary conjugated linoleic acid and bone mineral density in postmenopausal women. J Am Coll Nutr 24 3: Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: A cost effectiveness analysis of calcium and vitamin D supplementation, etidronate, and alendronate in the prevention of vertebral fractures in women treated with glucocorticoids.
J Rheumatol 30 1: The effect of calcium supplementation on bone density in premenarcheal females: J Clin Endocrinol Metab 89 Vitamin D3 and calcium to prevent hip fractures in the elderly women. Combined calcium and vitamin D3 supplementation in elderly women: Osteoporos Int 13 3: Effects of calcium, dairy product, and vitamin D supplementation on bone mass accrual and body composition in year old girls: Skeletal site selectivity in the effects of calcium supplementation on areal bone mineral density gain: J Clin Endocrinol Metab 90 6: Vitamin D supplementation and bone mineral density in early postmenopausal women.
Am J Clin Nutr 77 5: Calcium for prevention of osteoporotic fractures in postmenopausal women. J Bone Miner Res 12 9: J Biol Chem 2: Effects of n-3 fatty acids on cartilage metabolism. Proc Nutr Soc 61 3: Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. Rates of bone loss in postmenopausal women randomly assigned to one of two dosages of vitamin D. Am J Clin Nutr 61 5: Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women.
Ann Intern Med 7: A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. Association between serum concentrations of hydroxyvitamin D3 and periodontal disease in the US population. Sustained effect of short-term calcium supplementation on bone mass in adolescent girls with low calcium intake.
Fang Fang Zhang and Sarah Booth. Low Vitamin D Linked to Osteoarthritis. AgResearch Magazine July Vitamin A intake and hip fractures among postmenopausal women.
Calcium, vitamin D, milk consumption, and hip fractures: Am J Clin Nutr 77 2: Vitamin D-deficiency in Asia. J Steroid Biochem Mol Biol Calcium and vitamin D nutrition and bone disease of the elderly. Public Health Nutr 4 2B: Effects of exercise on bone mineral density in calcium-replete postmenopausal women with and without hormone replacement therapy. Osteoporos Int 14 8: Calcium and vitamin-D supplementation on bone structural properties in peripubertal female identical twins: Osteoporos Int [Epub ahead of print].
Vitamin D supplementation in older women. Longitudinal follow-up of bone mineral density in children with nephritic syndrome and the role of calcium and vitamin D supplements. Nephrol Dial Transplant 20 8: Vitamin D insufficiency in internal medicine residents. Calcif Tissue Int 76 1: Vitamin D in adult health and disease: Harris S, Dawson-Hughes B. Rates of change in bone mineral density of the spine, heel, femoral, neck and radius in healthy postmenopausal women.
Bone Miner 17 1: A randomized, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: Age Ageing 33 1: Am J Clin Nutr 85 suppl: Nutritional factors in osteoporosis. A randomized controlled trial of vitamin D supplementation on preventing postmenopausal bone loss and modifying bone metabolism using identical twin pairs. J Bone Miner Res 15 Zinc intakes and plasma concentrations in men with osteoporosis: Nutrition in Bone Health Revisited: A Story Beyond Calcium.
Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 7: Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: Calcium supplementation and increases in bone mineral density in children.
N Engl J Med 2: Dietary silicon intake is positively associated with bone mineral density in men and premenopausal women of the Framingham Offspring Cohort.
Journal of Bone and Mineral Research 19 2: Calcium supplementation and bone mineral accretion in adolescent girls: Am J Clin Nutr 87 2: Vitamin D and calcium supplementation prevents osteoporotic fractures in elderly community dwelling residents: J Bone Miner Res 19 3: A follow-up study on the effects of calcium-supplement withdrawal and puberty on bone acquisition of children.
A randomized double-blind controlled calcium supplementation trial, and bone and height acquisition in children. Br J Nutr Bone mineral acquisition in low calcium intake children following the withdrawal of calcium supplement. Double-blind, controlled calcium supplementation and bone mineral accretion in children accustomed to a low-calcium diet. Vitamin D supplementation and fracture incidence in elderly persons: Ann Intern Med 4: Calcium supplementation and bone mineral density in adolescent girls.
Effect of boron supplementation on blood and urinary calcium, magnesium, and phosphorus, and urinary boron in athletic and sedentary women. Effects of boron supplementation on bone mineral density and dietary, blood, and urinary calcium, phosphorus, magnesium, and boron in female athletes. Environ Health Perspect Suppl 7: Supplementation with oral vitamin D3 and calcium during winter prevents seasonal bone loss: J Bone Miner Res 19 8: Prevention of hip fractures by correcting calcium and vitamin D insufficiencies in elderly people.
Scand J Rheumatol Suppl Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. J Bone Miner Res 17 4: Serum retinol levels and the risk of fracture. Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: Arthrit Res Ther 12 1: A co-twin study of the effect of calcium supplementation on bone density during adolescence.
Osteoporos Int 7 3: Meta-analyses of therapies for postmenopausal osteoporosis. Meta-analysis of the efficacy of vitamin D treatment in preventing osteoporosis in postmenopausal women.
Endocr Rev 23 4: Effect of calcium or 25OH vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of J Clin Endocrinol Metab 85 9: Randomised controlled trial of calcium and supplementation with cholecalciferol vitamin D3 for prevention of fractures in primary care.
Soy protein and isoflavones: Am J Clin Nutr 68 6 Suppl: Vitamin D and health in the 21st century: Am J Clin Nutr 80 suppl: Correcting calcium nutritional deficiency prevents spine fractures in elderly women. J Bone Miner Res 11 Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: Effect of calcium supplementation on bone loss in postmenopausal women. Calcium supplementation suppresses bone turnover during weight reduction in postmenopausal women.
J Bone Miner Res Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects. J Am Geriatr Soc 53 The Role of Trace Minerals in Osteoporosis.
Effect of folate and mecobalamin on hip fractures in patients with stroke: Meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. The roles of vitamins D and K in bone health and osteoporosis prevention. Proc Nutr Soc 56 3: Chemistry, nutritional sources, tissue distribution and metabolism of vitamin K with special reference to bone health.
J Nutr 4 Suppl: Effect of a calcium and exercise intervention on the bone mineral status of y-old adolescent girls. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. Evaluation of glucosamine sulfate compared to ibuprofen for the treatment of temporomandibular joint osteoarthritis: J Rheumatol 28 6: Hypovitaminosis D in medical inpatients. Effect of four monthly oral vitamin D3 cholecalciferol supplementation on fractures and mortality in men and women living in the community; randomized double blind controlled trial.
The need for more vitamin D. Vitamin D supplementation suppresses age-induced bone turnover in older women who are vitamin D deficient. One year of oral calcium supplementation maintains cortical bone density in young adult female distance runners.
Effect of vitamin K2 treatment on carboxylation of osteocalcin in early postmenopausal women. Gynecological Endocrinology 22 8: Vitamin D supplementation during infancy is associated with higher bone mineral mass in prepubertal girls. J Clin Endocrinol Metab Am J Clin Nutr 85 2: Current maternal-infant micronutrient status and the effects on birth weight in the United Arab Emirates.
East Mediterr Health J 15 6: Growth and development in term infants fed long-chain polyunsaturated fatty acids: Visual, cognitive, and language assessments at 39 months: Pediatrics 3 Pt 1: Folic acid supplementation and the occurrence of congenital heart defects, orofacial clefts, multiple births, and miscarriage. Am J Clin Nutr 81 suppl: Bath SC et al. Effect of inadequate iodine status in UK pregnant women on cognitive outcomes in their children: Calcium supplementation to prevent hypertensive disorders of pregnancy.
Prevention of neural-tube defects with folic acid in China. Vitamin B12 status of pregnant Indian women and cognitive function in their 9-year-old children. Food Nutr Bull 29 4: Dietary essential fatty acid supply and visual acuity development. Invest Ophthalmol Vis Sci A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in term infants.
Dev Med Child Neurol 42 3: J Nutr 6: Occurrence of omphalocele in relation to maternal multivitamin use: Occurrence of congenital heart defects in relation to maternal multivitamin use. Am J Epidemiol 9: Dietary omega-3 fatty acids for women. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Effect of calcium supplementation on pregnancy-induced hypertension and preeclampsia: Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age.
Am J Clin Nutr 85 3: Visual-acuity development in healthy preterm infants: Am J Clin Nutr 58 1: Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: Vitamin C and E supplementation in women at risk of preeclampsia is associated with changes in indices of oxidative stress and placental function. Am J Obstet Gynecol 3: Antioxidant vitamin status during pregnancy in relation to cognitive development in the first two years of life.
Early Hum Dev 85 7: Christian P, Stewart CP. Maternal micronutrient deficiency, fetal development, and the risk of chronic disease. J Nutr 3: Maternal vitamin D deficiency, ethnicity and gestational diabetes. Diabet Med 25 6: Developmental origins of osteoporotic fracture: Do multivitamin supplements attenuate the risk for diabetes-associated birth defects?. Czeizel AE, Dudas I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation.
The effect of oral magnesium substitution on pregnancy induce leg cramps. Am J Obstet Gynecol 1: Folate levels and neural tube defects: Dawodu A, Wagner CL.
Mother-child vitamin D deficiency: Arch Dis Child 92 9: Denise HM Heppe et al. Maternal first-trimester diet and childhood bone mass: Am J Clin Nutr doi: Maternal vitamin D intake during pregnancy and early childhood wheezing. Low maternal vitamin E intake during pregnancy is associated with asthma in 5-year-old children.
High prevalence of vitamin D deficiency in newborn infants of high-risk mothers. Maternal vitamin D intake during pregnancy is inversely associated with asthma and allergic rhinitis in 5-year-old children.
Clin Exp Allergy 39 6: Maternal vitamin B12 and the risk of fetal neural tube defects in Egyptian patients. Clin Lab 53 Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr 62 1: Maternal serum hydroxyvitamin d and measures of newborn and placental weight in a U. Effect of increasing breast milk docosahexaenoic acid on plasma and erythrocyte phospholipids fatty acids and neural indices of exclusively breast fed infants.
Eur J Clin Nutr 51 9: The effect of zinc supplementation on pregnancy outcome. Effects of maternal vitamin A status on kidney development: Pediatr Nephrol 22 2: Rev Obstet Gynecol 1 4: Folic acid supplements in pregnancy and early childhood respiratory health.
Arch Dis Child 94 3: Vitamin D supplementation and reduced risk of preeclampsia in nulliparous women. Maternal folate and cobalamin status predicts vitamin status in newborns and 6-month-old infants.
The role of polyunsaturated fatty acids in term and preterm infants and breastfeeding mothers. Pediatr Clin North Am 48 1: Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women. Prevention of preeclampsia by linoleic acid and calcium supplementation: Obstet Gynecol 91 4: Effects of supplementation with omega 3 long-chain polyunsaturated fatty acids on retinal and cortical development in premature infants.
Am J Clin Nutr 57 5 Suppl: Vitamin D requirement during pregnancy and lactation. J Bone Miner Res 22 Suppl 2: Nutritional vitamin D status during pregnancy: Vitamin D deficiency and insufficiency in pregnant women: Br J Nutr 6: Essential fatty acids in mothers and their neonates.
Low serum vitamin B12 is associated with recurrent pregnancy loss in Syrian women. Clin Chem Lab Med 46 9: Hyppönen E, Boucher BJ. Avoidance of vitamin D deficiency in pregnancy in the United Kingdom: Br J Nutr 3: The effect of maternal and cord-blood vitamin C, vitamin E and lipid peroxide levels on newborn birth weight.
Effects of maternal docosahexaenoic acid intake on visual function and neurodevelopment in breastfed term infants. Am J Clin Nutr 82 1: Maternal dietary intake of vitamin A and risk of orofacial clefts: Am J Epidemiol Kaitlin M March et al.
First published July 8, , doi: Intake of vitamin C and E in pregnancy and risk of pre-eclampsia: High frequency of maternal vitamin B12 deficiency as an important cause of infantile vitamin B12 deficiency in Sanliurfa province of Turkey. Eur J Nutr 45 5: Vitamin D in pregnancy and lactation: Maternal fish oil supplementation in lactation: Vitamin D deficiency in a healthy group of mothers and newborn infants.
Clin Pediatr 46 1: Trial of calcium to prevent preeclampsia. Impact of maternal probiotic-supplemented dietary counselling on pregnancy outcome and prenatal and postnatal growth: Low maternal vitamin D status and fetal bone development: J Bone Miner Res 25 1: Are long-chain polyunsaturated fatty acids essential nutrients in infancy?. Perinatal outcomes, including mother-to-child transmission of HIV, and child mortality and their association with maternal vitamin D status in Tanzania.
J Infect Dis 7: Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab 94 3: Prenatal maternal diet affects asthma risk in offspring.
Fetal intraventricular bleeding possibly due to maternal vitamin K deficiency. Fetal Diagn Ther 24 4: Maternal vitamin B12 status and risk of neural tube defects in a population with high neural tube defect prevalence and no folic acid fortification. Prevention of neural tube defects: Implications of vitamin D deficiency in pregnancy and lactation.
Am J Obstet Gynecol 5: Low maternal vitamin B12 status is associated with intrauterine growth retardation in urban South Indians. Eur J Clin Nutr 60 6: Vitamin D insufficiency common in newborns, children and pregnant women living in Newfoundland and Labrador, Canada. Matern Child Nutr 5 2: Hayes and Nigel A. Maternal iron status in early pregnancy and birth outcomes: Prevalence of suboptimal vitamin D status during pregnancy.
Ir Med J 8: Influence of calcium intake on gestational hypertension. Ann Nutr Metab Maternal vitamin D in pregnancy may influence not only offspring bone mass but other aspects of musculoskeletal health and adiposity. Med Hypotheses 71 2: Prenatal vitamin supplementation and pediatric brain tumors: Childs Nerv Syst 14 Vitamins C and E to prevent complications of pregnancy-associated hypertension. Clin Exp Allergy 40 5: Relationship between pregnancy outcomes and maternal vitamin D and calcium intake: Gynecol Endocrinol 22 El-Sayed and Azza A.
The effect of zinc supplementation on pregnancy outcomes: Calcium supplementation in mild preeclampsia remote from term: Obstet Gynecol 85 6: Am J Epidemiol 2: Risks of orofacial clefts in children born to women using multivitamins containing folic acid periconceptionally.
DNA methylation, insulin resistance, and blood pressure in offspring determined by maternal periconceptional B vitamin and methionine status. Proc Natl Acad Sci Slovis TL, Chapman S. Pediatr Radiol 38 Amer Coll Obstet Gynecol 3: Childhood cancer and vitamins: Pediatr Blood Cancer 50 2 Suppl: Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children.
Vitamin B and neural tube defects: Am J Clin Nutr 89 2: Essential fatty acids in visual and brain development. Multivitamin use and the risk of preterm birth. Calcium metabolism, calcium supplementation and hypertensive disorders of pregnancy.
Genetic and lifestyle factors related to the periconception vitamin B12 status and congenital heart defects: Mol Genet Metab 94 1: Effects of maternal vitamin supplements on malaria in children born to HIV-infected women. Am J Trop Med Hyg 76 6: High-dose vitamin D3 supplementation in a cohort of breastfeeding mothers and their infants: Breastfeed Med 1 2: Periconceptional folic acid exposure and risk of occurrent neural tube defects.
Effect of long-chain polyunsaturated fatty acids in infant formula on problem solving at 10 months of age. Early life factors in the pathogenesis of osteoporosis. Curr Osteoporos Rep 7 4: Nutritional control of fetal growth. Nutr Rev 64 5 Pt 2: Vitamin B12 and folate concentrations during pregnancy and insulin resistance in the offspring: Young GL, Jewell D.
Interventions for leg cramps in pregnancy. Cochrane Database Syst Rev 1: Vitamin D deficiency and supplementation during pregnancy. Clin Endocrinol Oxf 70 5: Zatollah Asemi et al. Magnesium supplementation affects metabolic status and pregnancy outcomes in gestational diabetes: First published May 27, , doi: Clinical manifestations of infants with nutritional vitamin B12 deficiency due to maternal dietary deficiency.
Maternal plasma hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS One 3 Synergistic inhibition of cyclooxygenase-2 expression by vitamin E and aspirin.
Free Rad Bio Med 29 Adams JS, Hewison M. Unexpected actions of vitamin D: Nat Clin Pract Endocrinol Metab 4 2: Vitamin D in defense of the human immune response.
Vitamin D-directed rheostatic regulation of monocyte antibacterial responses. J Immunol 7: Adorini L, Penna G. Control of autoimmune diseases by the vitamin D endocrine system. Nat Clin Pract Rheumatol 4 8: Role of zinc administration in prevention of childhood diarrhea and respiratory illnesses: Vitamin D and autoimmunity: Ann Rheum Dis 66 9: Effect of multivitamin and multimineral supplements on morbidity from infections in older people MAVIS trial: Vitamin D supplementation to prevent infections: Age Ageing 36 5: Vitamin D signaling in immune-mediated disorders: Evolving insights and therapeutic opportunities.
Mol Aspects Med 29 6: Vitamin D3 and the immune system: Nutr Res Rev 20 1: Antimicrobials, mucosal coating agents, anesthetics, analgesics, and nutritional supplements for alimentary tract mucositis. Support Care Cancer 14 6: Effect of a multivitamin and mineral supplement on infection and quality of life. A randomized, double-blind, placebo-controlled trial. Selenium and vitamin E status: J Nutr 5: Immune-enhancing role of vitamin C and zinc and effect on clinical conditions.
Slowing the progression of chronic renal failure Grauer GF states "There are, however, potential undesirable effects associated with dietary protein reduction. Reduced protein diets are also of concern for cats with metabolic acidosis, because, according to Nutrition and renal function in cats and dogs: Sufficient, High Quality Protein. As discussed previously, during the breakdown of dietary protein in the digestive process, waste substances are created which are filtered out of the blood by the kidneys and excrete d via urination.
Unfortunately damaged kidneys find it harder to do this, which is why your CKD cat may feel poorly. You will note the reference to not feeding more protein than your cat's body needs to maintain normal function. This is the crux of the matter. You do not want to feed an extremely low level of protein so your cat suffers weight loss and malnutrition; but nor do you want to be loading your cat's body with unnecessarily high levels of protein which contribute to your cat feeling ill.
The goal in CKD is not to feed low protein or high protein. The goal is to feed sufficient protein with the correct balance and number of amino acids to maintain the cat's health and body weight, but in a form which needs as little breaking down as possible. When talking about CKD, that is what we mean by "high quality protein", not reaching for organic, high quality meat. In addition to the amount of protein, patients with CKD should receive protein of high biologic value.
For most people, the easiest way to achieve this is to feed a therapeutic kidney diet because these diets have a protein level in this range. This does not mean they are low protein foods.
If you find your cat starts to exhibit weight or muscle loss, you could consider trying one of the therapeutic kidney diets with protein at the higher end of the suggested range. A good choice would be egg whites.
If you cannot persuade your cat to eat a therapeutic kidney diet see Which Foods to Feed for tips on how to do this , you can also check the food data tables to find other foods which are relatively low in protein; but don't forget the therapeutic kidney diets have other important attributes, and the protein they do contain is good quality from the CKD perspective, something which is not always easy to replicate with non-therapeutic kidney foods.
When To Feed Reduced Protein. IRIS Stages 1 and 2. Because of the potential downsides of protein restriction, it is not necessarily a good idea to feed reduced protein food in all cases. However for cats with proteinuria , it states "feed a renal clinical diet" regardless of the stage the cat is in.
The study concludes "Our results suggest that cats with early renal insufficiency fed a test food designed to promote healthy aging, over a 6 month period, were more likely to have stable renal function evidenced by stable serum SDMA concentrations compared with cats fed owner's-choice foods. It is also difficult to compare the effect of the therapeutic kidney diet because not enough is known about the alternative foods that were fed. Other vets believe that it is better to wait until the disease is more advanced before starting a therapeutic kidney diet.
M anaging chronic diseases in cats Veterinary Medicine Little S states "Don't restrict dietary protein for cats experiencing mild to moderate chronic renal insufficiency creatinine 1. These cats require adequate protein and calories to maintain body weight and to avoid muscle wasting and anemia. If your cat also has hyperthyroidism, it can be even more of a concern since hyperthyroid cats are prone to weight loss and muscle wasting.
Diet and nutritional management for hyperthyroid cats Peterson ME the man who discovered hyperthyroidism in cats states that "The major problem that I have with some of the prescription kidney diets is that they restrict protein to the point that some cats — especially those with concurrent hyperthyroidism —will continue to catabolize their own muscle mass despite adequate control of the thyroid condition.
Unfortunately, it can often be easier to switch a cat to a reduced protein diet when the cat is stable with lower numbers. Treatment recommendations for CKD in cats International Renal Interest Society says that introducing a therapeutic diet "may be accomplished more easily early in the course of CKD, before inappetance develops.
If you are concerned, consider adding foods with high biologic value but minimal nitrogenous waste to your cat's therapeutic kidney diet. If you decide not to feed reduced protein to your CKD cat, please do ensure that your cat has a low phosphorus intake and an increased essential fatty acids intake. IRIS Stages 3 and 4.
Cats who are in Stages 3 and 4 would therefore also be advised to eat a therapeutic kidney diet. Another factor to consider is your cat's BUN level.
Since BUN is influenced by protein intake, it does often help the cat feel better if you restrict protein intake as your cat's BUN levels rise. In Slowing the progression of chronic renal failure Dr GF Grauer states that "As the renal failure progresses, additional dietary protein reduction will likely be necessary. You may panic if you cannot get your cat to eat a reduced protein food.
Take a deep breath. M anaging chronic diseases in cats Veterinary Medicine Little S states "Never try to force an anorexic patient with chronic renal insufficiency to eat a protein-restricted diet.
Instead, concentrate on encouraging anorexic patients to eat. See the Which Foods to Feed page for more tips on getting your cat to eat the therapeutic kidney diet and what to do if you can't succeed.
Consider feeding tube intervention e. See the Persuading Your Cat To Eat page for more information on feeding tubes and tips on getting your cat to eat.
Whatever you do, monitor your cat's weight and muscle status closely. Controlling phosphorus levels is extremely important for CKD cats, because high phosphorus levels are very damaging to their health and can make the disease progress more quickly. This is such an important topic that I have an entire page devoted to phosphorus control. Please read it and do everything you can to keep your cat's phosphorus levels low - it can make all the difference to your cat's wellbeing and can also prolong survival.
Just as cats need a diet relatively high in protein, so they also need relatively high levels of fat compared to a human or dog. Older cats may process fat less efficiently than younger cats, which may be a factor in weight loss. Fat does not result in a lot of waste products like protein, so processing it is not a strain on the kidneys; plus cholesterol is not an issue for cats the way it is for humans.
Studies indicate that cat foods containing even higher amounts of fat are safe. In most therapeutic kidney foods, the fat content is increased to compensate for the lower protein levels. Some senior cat foods also have relatively high levels of fat and relatively low levels of protein; as a bonus, they often also have low phosphorus levels.
Therefore, if your cat won't eat a therapeutic kidney diet, it is worth considering senior foods, although do check the protein level is not too low. The kidneys cannot process sodium as effectively in CKD, which increases the risk of hypertension high blood pressure in humans. It used to be thought that the same applied to cats, and it was therefore recommended that sodium intake should be restricted.
Research in Applied Veterinary Medicine 7 4 pp found that sodium intake appeared to have no effect on in blood pressure in CKD cats, but that levels of BUN, creatinine and phosphorus were higher in the cats eating a high sodium diet compared to those eating a low sodium diet.
Even in cats with creatinine over 1. These results are consistent with the majority of other studies evaluating sodium intake in cats, as well as with the National Research Council's assessment, all of which indicate that sodium at 1. Effects of dietary salt intake on renal function: The study concludes "The results of this 2 year study do not support the suggestion that chronic increases in dietary salt intake are harmful to renal function in older cats.
Increased dietary sodium increases urine output and may decrease the risk of forming calcium oxalate uroliths due to the decrease in relative supersaturation of solutes. However, caution should be used in increasing the sodium intake of patients with renal disease as increased dietary sodium may have a negative effect on the kidneys independent of any effect on blood pressure. So should you restrict sodium intake or not?
Treatment recommendations for CKD in cats International Renal Interest Society states on page 5 that there is no evidence that reducing sodium intake is helpful for CKD cats, and that it should certainly not take the place of medication for hypertension , but if you do opt to reduce your cat's sodium intake, you should do it gradually.
The food data tables provide information about the sodium content of many cat foods available in the USA and UK. This occurs because potassium is easily lost through increased urination and vomiting. Therapeutic kidney diets contain extra potassium all cat foods need some potassium , and this is usually in the form of potassium citrate, because potassium citrate may help with a problem seen in some CKD cats called metabolic acidosis.
If your cat refuses to eat a therapeutic diet, your vet can give you a potassium supplement instead, if appropriate; some cats need a potassium supplement whether or not they eat the therapeutic kidney diet. Many commercial cat foods are acidified in order to reduce the risk of FLUTD feline lower urinary tract disease.
These foods often say that they are designed to maintain urinary tract health; or they may contain cranberries or additional Vitamin C. However, these foods which are actually designed to treat a different kind of problem to CKD may have the effect of increasing the amounts of potassium lost in the urine, which is bad for CKD cats.
It is therefore best not to feed acidified foods to CKD cats, who tend to have quite high acid levels anyway. Please see the Potassium page for more information about potassium.
It also states "Our analysis indicates that cats have a ceiling for carbohydrate intake, which limits ingestion and constrains them to deficits in protein and fat intake relative to their target on high-carbohydrate foods. In The carnivore connection to nutrition in cats Zoran D Journal of the American Veterinary Medical Association pp, Dr Zoran writes "It is clear that cats have a greater need than dogs or other omnivores for protein in their diet.
Cats also have several physiologic adaptations that reflect their expected low CHO [carbohydrate] intake These specific differences do not mean cats cannot use starch. In fact, cats are extremely efficient in their use of simple sugars. However, it does underscore their development as carnivores and the expected low amounts of grain in their typical diet.
These digestive differences may mean that high amounts of CHO in diets may have untoward effects on cats. Therefore, if you are trying to reduce your CKD cat's protein intake, I would recommend increasing the fat in the diet see above rather than the carbohydrates.
If you are feeding a therapeutic kidney diet, this will often be done automatically - many of these diets increase the fat content rather than the carbohydrates in order to offset the reduced protein content. Pet Education has an interesting article about carbohydrates in the feline diet. Fibre is the non-digestible component of complex carbohydrate. It is important for good digestive health.
Increased fibre may help with elevated calcium levels in the body hypercalcaemia , although one type of fibre, fructooligosaccharides or FOS, may actually increase calcium levels in the body see below. It may also assist with two commonly seen CKD problems, toxin reduction and the control of constipation.
There are a number of ways of categorising fibre types, but one way is to divide it into fermentable and non-fermentable. Which fibres are fermentable depends upon the species of bacteria eating the fibre in the cat's gastrointestinal tract.
Diet and large intestinal disease in dogs and cats JW Simpson The Journal of Nutrition SS has a table showing soluble and fermentable fibres. In terms of general health, you do not necessarily want the most fermentable fibres.
Dietary fiber for cats: It concludes that the diet "which contained the most fermentable fibers, severely decreased nutrient digestibility and resulted in poor stool characteristics. Diets that contain moderately fermentable fiber provide fermentation end products that may be important in maintaining the health of the gastrointestinal tract of the cat.
There has long been interest in whether other bodily mechanisms might be useful for relieving the load on damaged CKD kidneys. Bowel as a substitute in renal failure EA Friedman American Journal of Kidney Diseases 28 6 pp states "Extraction, modification, or recycling of nitrogenous wastes by the gastrointestinal tract is a potentially low-cost means of substituting for missing renal function. Multiple approaches to the bowel as a substitute kidney have been attempted. One way of doing this may be via increased fibre intake in the form of fermentable fibre prebiotics.
Fermentable fibre provides a source of carbohydrate for the bacteria in the gut. These bacteria, which are essential to health, increase in number when provided with additional fermentable fibre, and the more bacteria there are, the more nitrogen is excreted in the faeces.
This increased faecal excretion may help to reduce the load on the kidneys by diverting the excretion of urea from the kidneys. You can read more about this in the Treatments chapter. Non-fermentable fibre can be helpful for CKD cats because it reduces the risk of constipation, a common problem in CKD cats, by holding water in the stool. Most commercial cat foods have sufficient levels of fibre for a healthy cat, but if your cat suffers from constipation you may wish to add more fibre in the form of something such as pumpkin, baby peas or psyllium.
Please see Constipation for more information on dealing with constipation. Feline Constipation explains more about fibre and gut health. Side Effects and Interactions. Some forms of fibre, such as fructooligosaccharides FOS , may also bind calcium in the small intestine and lead to an increase in calcium levels in the body hypercalcaemia.
This can be a problem for cats who already have high blood calcium levels. Inulin and guar gum may do this, as may slippery elm bark and lactulose , two treatments commonly used for constipation in CKD cats.
Fibre may also affect taurine levels in some foods. I would therefore recommend discussing additional fibre with your vet before adding it, and avoiding its use in a cat who already has high calcium levels. They are essential because the cat's body cannot synthesise them in sufficient amounts, so they have to be obtained from food. Commercial diets tend to contain far more Omega-6, partly because Omega-6 EFAs are cheaper and more stable, but this may create a potentially harmful imbalance. The correct balance is not yet known, though some believe it is probably around 5: Essential fatty acids are important for many bodily functions.
It has been known for many years that they have an effect on the skin - the first signs of an imbalance or deficiency are usually a dry coat, itchy skin or matted fur. Recently it appears that they may have an important role in controlling inflammation. Research in rats and humans indicates that the addition of omega-3 fatty acids to the diet may delay the progression of CKD.
Small Animal Practice 38 1 pp added essential fatty acid supplements in the form of fish oil to dog foods. It concludes "newer data indicate that dietary supplementation with specific antioxidants is an important consideration for limiting renal oxidant stress and progression of CKD. Nutritional management of renal disease: Dietary omega-3 fatty acid supplementation in the form of fish oil can have beneficial effects in reducing GCP.
This ties in with what one kidney specialist vet has informed me, that oversupplementation can throw off the correct ratio of Omega-3s to Omega-6s, and might be detrimental in some cases. Omega-3 fatty acid supplementation for dogs and cats with heart disease Nutrition Service at Cummings Veterinary Medical Center at Tufts University states "Potential risk factors include decreased platelet function and coagulation, and possibly suppressed wound healing Other potential effects include soft feces, diarrhea, flatulence, vomiting, and halitosis.
Nutrition and renal function: At higher levels of supplementation, renal function was actually increased in normal cats. These data support the assertion that this dietary maneuver is safe for normal cats and provides some encouragement for further consideration for dietary n-3 PUFA supplementation in cats with renal disease, systemic hypertension, or hypersensitivity reactions.
Almost everybody I know of who has added essential fatty acids to their cat's treatment plan, whether in a therapeutic kidney diet or as a supplement, has been happy with the results, reporting an improvement in general wellbeing. Additional EFAs do cause vomiting in some cats though, and I've heard from a number of people whose cats had pancreatitis and who felt essential fatty acids did not agree with these cats, causing problems such as diarrhoea.
However, there are no reports of omega-3 fatty acid or fish oil supplements causing pancreatitis in dogs, cats, or humans. Theoretically, omega-3 fatty acids could prevent pancreatitis because of decreased blood triglyceride concentrations.
An extremely high dosage of omega-3 fatty acids or a fish oil supplement in addition to a very high fat diet would likely be required to induce pancreatitis. An increased level of essential fatty acids compared to standard cat foods is one of the features of therapeutic kidney diets. If you wish to give additional essential fatty acids, ask your vet if they are appropriate for your cat.
Since cats as obligate carnivores benefit from animal-based products, the most appropriate form of essential fatty acid supplement is fish oil. Oils from the liver, such as cod liver oil, are not suitable because they contain too much Vitamin A and D. Omega-3 fatty acid supplementation for dogs and cats with heart disease Nutrition Service at Cummings Veterinary Medical Center at Tufts University states "We also recommend avoiding cod liver oil for this purpose as it is too high in vitamins A and D when administered at this dose and can cause toxicity of these vitamins.
If fish oils are given, extra vitamin E is also required in order to avoid a problem called steatitis. Waltham International Symposium ppSS discusses this. Many products, especially veterinary ones, already contain vitamin E in an appropriate dosage it may be referred to as tocopherol , in which case you do not need to supplement Vitamin E.
However, I would ask your vet how much to give, because too much vitamin E can be dangerous. It has been on the market since January The manufacturer states that the product was tested on an informal basis on 18 CKD cats in the Montreal area over a period of about eight months. This product is basically a combination of essential fatty acids, Vitamin E which you need to add when you are supplementing fish oils, but which is also an antioxidant and CoQ10 ubiquinol , also an antioxidant, but in a concentrated formula.
You can read more about it in the Treatments chapter. Some people prefer to give krill oil to their cats because they find their cats tolerate it better. Krill oil is made from crustaceans rather than fish and contains additional antioxidants called astaxanthin and canthaxanthin. The essential fatty acids in krill oil are phospholipids in fish-based oils they are triglycerides.
This was due to increased urinary P excretion associated with the phospholipids content of these oils sources. Although further studies are needed, susceptible individuals should be aware of a potential risk of increasing phospholipids consumption on renal health.
Personally, I think I would be more comfortable using fish oil. If you are in Europe, especially Italy, you may be offered a new product called Nefrokrill, which contains potassium citrate , lanthanum carbonate a phosphorus binder and essential fatty acids. You can read more about it here. Vegetable-based oils , such as coconut oil or olive oil or flax seed linseed oil , are not recommended, because they do not contain the essential fatty acids which a cat needs.
Essential Fatty Acids Dosage. It can be a bit tricky working out an appropriate dose of essential fatty acids for cats.
The National Research Council gives an upper limit for dogs but gives no upper limit for cats. As far as fish oils are concerned, Pet MD discusses the dangers of giving too much but says that if you take the NRA recommendations for dogs, "Translating the data suggests that a dose between mg combined EPA and DHA per pound of body weight is safe for dogs and cats.
This dose is far less than those used to treat serious conditions where the risk of side effects is less important. Top 5 therapeutic uses of Omega-3 fatty acids Chandler ML Clinician's Brief Feb pp states "the amount to supplement is somewhat empiric and depends on the amount in the diet. The higher dosages often are used to lower serum triglyceride concentrations in patients with hypertriglyceridemia, whereas lower dosages are more commonly used for inflammatory conditions, renal disease, and cardiac disease.
There are a small number of commercial pet foods that contain this dose for example, the Royal Canin Early Cardiac Diet for Dogs. However, in most cases, supplements are needed to achieve this dose. As you can see, there is no definitive dose, and many of the recommendations relate to a particular amount of EPA eicosapentaenoic acid. So if your cat weighs 8 lb 3. You will need to check the product you're considering to see how much EPA it contains. Many fish oil capsules are mg strength.
I expect your head is spinning by now! Generally speaking, it is probably safe to give your cat one mg fish oil capsule daily. Do check with your vet first though. Therapeutic kidney diets contain increased amounts of EFAs, so if your cat is eating such a food, you may not need additional supplementation, or may need a reduced dose. The dosage for krill oil which is made from crustaceans rather than fish is mg per day. If you are using Nefrokrill, the dosage is here. Essential fatty acids are commonly available in either capsule form or in pump bottles.
Instead, mix the oil you can open the capsule with your cat's food. You don't have to give the daily dose in one amount, you can divide it between your cat's meals.
Although most cats like fish, the oils can be a bit strong, and many cats dislike the smell. Some cats may vomit after eating them. It is therefore wise to start off very slowly, just using one drop at first which you add to a smelly food that may disguise the taste, and gradually increase the dose over several days or even weeks. If your cat still hates it, you can either decant the oil into a gelcap, try finding a less smelly product, or discuss with your vet whether to continue with the supplement.
Some members of my support group find krill oil is more acceptable to their cats. It takes months to see the full effect of essential fatty acid supplements. If you think they help your cat, you should use them on an ongoing basis. If you don't see any difference, or if your cat seems to react badly to them e. Essential fatty acids can easily go off they become rancid. Store them in the fridge, and be sure to sniff them before giving them to your cat.
Many people simply use human products, and in some cases they and their cat use the same one. If your cat doesn't like the brand you buy, you may need to shop around to find one that is acceptable. Pet Education has a very helpful overview of essential fatty acids, with a comparison of various brands available in the USA. Omega-3 fatty acid supplementation for dogs and cats with heart disease Nutrition Service at Cummings Veterinary Medical Center at Tufts University recommends particular brands for cats and dogs with heart disease.
Consumer Lab has a summary of its findings with regard to the quality of EFAs, including the names of some of the US products which met with its approval, but you need to be a member to read it.
Environmental Defense Fund has a table showing which brands remove contaminants from their products. Welactin is a veterinary product available in both softgel capsules and pump bottle. One pump contains approximately 1. You can often find it on Amazon but a couple of members of my support group have found it does not seem to last too well when purchasing it there. For those in Canada, it is also available from Amazon Canada.
Grizzly Salmon Oil is made from wild Alaskan salmon. Twinlab makes a krill oil product called Krill Essentials. This is also available from other suppliers, such as Vitacost , among others. If you are in Canada, 60 softgels are available from Healthy Planet Canada. A couple of members of my support group have found it does not seem to last too well when purchasing from Amazon in the USA but I have not had any complaints about buying it from Amazon UK.
Salmopet is a salmon-based fish oil which is widely available in Europe. Omega 6 oils which is not ideal. Your vet may also have a suitable product in stock. Amino acids are the components of protein. There are 23 amino acids which cats need, and they can manufacture twelve of these themselves, but the other eleven must be obtained from food.
The ones which the cat cannot manufacture are called essential amino acids. Taurine is one example of an amino acid which cats must obtain from food.
Pet Education has a list of the essential amino acids for cats. If you feed a commercial diet, it will contain the correct balance of amino acids for cats. However, if you feed homemade food, it is critical to ensure that the diet has the correct balance of amino acids. However, they concluded "the magnitude of these changes is mild and of little clinical relevance.
Oral supplement of six selective amino acids arrests progression of renal failure in uremic patients Yatzidis H International Urology and Nephrology 36 4 pp found that amino acid supplements appeared to help human patients with glomerulonephritis.
An amino acid called L-lysine is sometimes recommended for cats with feline herpes. Two potential contraindications include renal and hepatic disease in which patients may have difficulty eliminating the large amounts of nitrogen generated from l-lysine metabolism. There are a couple of amino acid supplements that are marketed for CKD cats.
There is more information about them on the Holistic Treatments page. The amino acid of greatest relevance to cats is taurine. Taurine is most concentrated in the heart, retinas eyes and the brain. In the cat, it is essential for the digestion of fats, which cannot be achieved without taurine in the diet. A lack of sufficient taurine in a cat's diet can cause blindness and a type of heart disease called dilated cardiomyopathy.
Since taurine is only found in animal-based products, this is one reason why cats are obligate carnivores - eating the flesh of another animal is the easiest and best way for a cat to take in an adequate amount of taurine. If cats eat a higher fat or higher fibre canned diet, they may also require additional taurine. Metabolic acidosis may affect taurine levels. Acid-base, electrolytes and renal failure Polzin DJ, Osborne CA, James K Supplement to Compendium on Continuing Education for the Practising Veterinarian 21 11 K states "Studies on the effects of dietary acidification in cats have revealed that chronic metabolic acidosis can cause negative potassium balance, which may in turn promote There is plenty of taurine in all cat foods, and an even higher level in therapeutic kidney diets.
However, some people do choose to give taurine supplements to their CKD cats a taurine supplement is usually essential if you are feeding a homemade diet. Unlike cats, the human body can produce its own taurine, so this might be a factor in the side effects seen in this study.
I don't know if there would be a similar risk with cats, but please do not supplement taurine without your vet's approval. Pet MD has some information about taurine deficiency in cats. Another amino acids that cats require is arginine. Arginine is important for insulin production in cats, and is also necessary to convert ammonia into urea, a role so important that a cat fed a diet deficient in arginine will develop high ammonia levels and may die.
Arginine is also used to make nitrous oxide in the kidneys. It is thought that nitrous oxide plays a critical role in regulating blood flow through the kidneys, and it is known that the amount of blood flowing through the kidneys can affect kidney function.
L-arginine levels are often very low in CKD cats, so it is possible that supplementing this might increase nitrous oxide levels and thus help kidney function. It appears to be detrimental in cases of glomerulonephritis.
I would not supplement l-arginine without your vet's approval. This is an amino acid which encourages the natural production of BMP-7 , which may help the kidneys regenerate. Apparently studies are in hand for human CKD patients with this amino acid but I don't know anybody who has used it in a cat.
Do not use it without checking with your vet first. If your cat is eating a therapeutic kidney diet, in principle additional vitamins should not be necessary, since suitable extra vitamins are added to these foods. However, if your cat is not eating these foods, additional vitamins may be necessary. Vitamin B is helpful for most CKD cats regardless of whether and what they are eating, and is particularly important for cats who are anaemic. Do not give vitamins to your cat without your vet's approval because excess vitamin intake can be very dangerous.
The National Academy of Science gives guidelines on the daily vitamin requirements of cats. This vitamin is fat soluble, and is stored in the body rather than excreted. For this reason, there is a risk of toxicity when supplementing it. Omega-3 fatty acid supplementation for dogs and cats with heart disease Nutrition Service at Cummings Veterinary Medical Center at Tufts University states "Humans with renal failure have a reduced capacity to excrete vitamin A, and although no similar information exists in dogs and cats, the feeding of supplements containing vitamin A is not recommended.
In any event, a vitamin A deficiency is extremely rare, so it is highly unlikely that your cat requires supplementation of any kind.
For this reason care should be taken when considering the use of multi-vitamin tablets, which may contain vitamin A. DVM News Magazine states on page 2 that fat soluble vitamins should not be given to excess. Although vitamin B is commonly referred to as if it were a single vitamin, there are actually a number of B vitamins. These are essential vitamins, which means that they cannot be manufactured in the cat's body, so must be obtained from external sources i.