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Australian Journal of Pharmacy : September 2005
pharmacy ed cdi feature • approved CPE higher than the 100 to 200µg daily as recommended for pregnant women. The maximum safe level of intake of iodine is considered to be 2000µg/day for adults and 1000µg/day for children.3 As people are likely to use a gargle only for a day or two it would seem that its use would not cause hyperthyroidism. References 1. Iodine urged for pregnancy. AJP 2005;86:616. 2. Eastman C. Iodine supplementation: the benefits for pregnant and lactating women in Australia and New Zealand. Obstetrics & Gynaecology 2005;7:65–66. 3. English RM. Iodine. J Food Nutr 1982;39:173-180. Dietary niacin may protect against Alzheimer’s disease IACIN is the generic descriptor for two closely related compounds nicotinamide and nicotinic acid, which act similarly as nutrients. Niacin functions metabolically as a component of the coenzymes nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP), both of which are involved in energy metabolism. They are vital in cell metabolism. Severe deficiencies of niacin and tryptophan, a precursor from which the body can synthesize niacin, are the principal causes of pellagra. Pellagra is characterised by skin lesions, gastrointestinal disturbances and nervousness. Depression, dermatitis, dementia and diarrhoea are common symptoms. CNS symptoms include organic psychosis, characterised by memory impairment, disorientation, confusion, and confabulation (excitement, depression, mania, and delirium predominate in some patients; in others, the reaction is paranoid). N Yeast, meat, fish, potatoes and green vegetables are good sources of niacin That is, dementia can be caused by severe niacin deficiency, but it is unknown whether variation in intake of niacin in the usual diet is linked to neurodegenerative decline. In a large, prospective study it was examined whether dietary intake of niacin was associated with incident Alzheimer’s disease (AD) and cognitive decline.1 Between 1993–2002 3,718 people aged 65 years and older, with no Alzheimer’s disease, completed a dietary questionnaire and they were all checked for signs of cognitive decline at three and six years using four cognitive tests. At three years, 815 randomly selected people were checked for clinical changes and their dietary niacin intake was assessed by means of food frequency questionnaires. Of these 815 people, 131 were diagnosed with Alzheimer’s disease. After adjusting the results for the risk factors of age, gender, race, educational levels, and the ApoE gene, it was found that those with the lowest food intake of niacin (an average of 12.6mg/day) were 80 per cent more likely to be diagnosed with Alzheimer’s disease than those with the highest intake (22.4mg/day). Energy adjusted niacin intake had a protective effect on 756 ? THE AUSTRALIAN JOURNAL OF PHARMACY, VOL.86 SEPTEMBER 2005 development of Alzheimer’s disease and cognitive decline. An analysis of the larger group showed that the rate of cognitive decline among those with the highest niacin intake was almost half that of those with the lowest intake. It was concluded: ‘Dietary niacin may protect against Alzheimer’s disease and age-related cognitive decline.’ In considering their results the authors consider that niacin’s role in Alzheimer’s disease has not been thoroughly explored. They point out that previous research has indicated that niacin has an important role in DNA synthesis and repair and neural cell signalling. It also acts as a potent antioxidant in brain cells. Comment The Australian recommended dietary intakes (expressed as mean daily intake) for niacin (mg niacin equivalents) in adults are: • Men 19-64 years: 19 • Men 64+ years: 16 • Women 19-54 years: 13 • Women 54+ years: 11 1. Morris MC, Evans DA, Bienias JL, et al. Dietary niacin and the risk of incident Alzheimer’s disease and of cognitive decline. Journal of Neurology Neurosurgery and Psychiatry 2004;75:1093–1099. ¦ ¦