Nutrition Research
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			Dietary Factors
 
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			Food & Beverages
 
 
	Summary
	Limited research indicates that L-carnitine supplementation (under medical supervision) may improve exercise tolerance in individuals with peripheral arterial disease (PAD). Moderate consumption of alcoholic beverages has been associated with a decreased risk of developing PAD.
	Disease Overview
	Peripheral arterial disease (PAD) results from atherosclerosis of the arteries that supply blood to the head, organs, and limbs. PAD most commonly affects the arteries in the legs.
	Due to the narrowed arteries and reduced blood flow to the extremities, cramping, pain, and fatigue may occur, especially during physical activity. The activity-induced muscle pain associated with PAD is clinically termed intermittent claudication. Left untreated, PAD can lead to tissue damage or infection.
	See below for specific information about nutrients and dietary factors relevant to intermittent claudication.
			Table 1. Conditions and Causes of Narrowed or Blocked Arteries
| 
					Condition | 
					Caused by Atherosclerosis of | 
| 
					Coronary Artery Disease | 
					the arteries that supply blood to the heart | 
| 
					Carotid Artery Disease | 
					the arteries that supply blood to the brain | 
| 
					Peripheral Arterial Disease | 
					the arteries that supply blood to the head, organs, and limbs | 
 
	DEFINITIONS
	Atherosclerosis - the buildup of plaque inside arterial walls
	Plaque – a deposit of fat, cholesterol, immune cells, fibrin (a blood clotting protein), and other substances that forms inside arterial walls
	Claudication - pain caused by insufficient blood flow during exercise
	Periphery - the outer regions of the body; away from the heart
	Nutrition Research
	DEFINITIONS
	Test tube (in vitro) experiment - a research experiment performed in a test tube, culture dish, or other artificial environment outside of a living organism; in vitro is a Latin phrase meaning in glass
	Animal experiment - a research experiment performed in a laboratory animal; many different animal species are studied in the laboratory, including terrestrial (land), aquatic (water), and microscopic animals
	Observational study - a human research study in which no experimental intervention or treatment is applied, and participants are simply observed over time
	Randomized controlled trial - a human research study in which participants are assigned by chance alone to receive either an experimental agent (the treatment group) or a placebo (the control group)
	Placebo - a chemically inactive substance
	 
	L-Carnitine
	What it does
	General
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		L-carnitine is a compound that can be made inside the body and obtained from food and dietary supplements. It is considered a conditionally essential nutrient because in some situations, the body’s demand for L-carnitine exceeds its capacity to make it.
 
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		L-carnitine helps the body convert fat into useable energy.
 
	Peripheral Arterial Disease (PAD)-specific
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		Supplemental forms of carnitine, L-carnitine and propionyl-L-carnitine, administered in conjunction with standard drug therapy appear to improve cardiac and skeletal muscle function during ischemia.
 
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		Propionyl-L-carnitine in particular may benefit ischemic tissue by replenishing intermediates of energy metabolism or by increasing blood vessel dilation (widening).
 
	What we know
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		Several randomized controlled trials have found that oral supplementation with propionyl-L-carnitine improves exercise tolerance (walking performancy) in some patients with intermittent claudication.
 
	DEFINITION
	Ischemia - inadequate blood supply to an organ or part of the body
	For references and more information, see the section on intermittent claudication and PAD in L-carnitine article. 
	
	 
	Alcoholic Beverages
	What they do
	General
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		Alcoholic beverages contain ethanol and other ingredients with bioactive properties that may benefit health.
 
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		When consumed in moderation (no more than two drinks/day for men and one drink/day for women), alcoholic beverages have been associated with beneficial effects in the cardiovascular system.
 
	Peripheral Arterial Disease (PAD)-specific
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		Moderate alcohol consumption favorably influences several atherosclerotic risk factors: it increases HDL-C levels, inhibits factors involved in blood clot formation, and may have an anti-inflammatory effect.
 
	What we know
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		There is some evidence that moderate alcohol consumption is associated with a decreased risk of PAD.
 
	For references and more information, see the section on the Potential Health Benefits of Moderate Alcohol Consumption in the Alcoholic Beverages article. 
	