The role of calcium in human aging

Renal Contributions to Age-Related Changes in Mineral Metabolism

Aging results in a general decline in function in most systems. This is particularly true with respect to the skeleton and renal systems, impacting mineral homeostasis. Calcium and phosphate regulation requires tight coordination among the intestine, bone, parathyroid gland, and kidney. The role of the intestine is to absorb calcium and phosphate from the diet. The bone stores or releases calcium and phosphate depending on the body's needs. In response to low plasma ionized calcium concentration, the parathyroid gland produces parathyroid hormone, which modulates bone turnover. The kidney reabsorbs or excretes the minerals and serves as the final regulator of plasma concentration. Many hormones are involved in this process in addition to parathyroid hormone, including fibroblast growth factor 23 produced by the bone and calcitriol synthesized by the kidney. Sclerostin, calcitonin, osteoprotegerin, and receptor activator of nuclear factor‐κB ligand also contribute to tissue‐specific regulation. Changes in the function of organs due to aging or disease can perturb this balance. During aging, the intestine cannot absorb calcium efficiently due to decreased expression of key proteins. In the bone, the balance between bone formation and bone resorption tends toward the latter in older individuals. The kidney may not filter blood as efficiently in the later decades of life, and the expression of certain proteins necessary for mineral homeostasis declines with age. These changes often lead to dysregulation of organismal mineral homeostasis. This review will focus on how mineral homeostasis is impacted by aging with a particular emphasis on the kidney's role in this process. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Incorporation of Barium Ions into Biomaterials: Dangerous Liaison or Potential Revolution?

In the present manuscript, a brief overview on barium, its possible utilization, and the aftermath of its behavior in organisms has been presented. As a bivalent cation, barium has the potential to be used in a myriad of biochemical reactions. A number of studies have exhibited both the unwanted outcome barium displayed and the advantages of barium laden compounds, tested in in vitro and in vivo settings. The plethora of prospective manipulations covered the area of hydrogels and calcium phosphates, with an end goal of examining barium's future in the tissue engineering. However, majority of data revert to the research conducted in the 20th century, without investigating the mechanisms of action using current state-of-the-art technology. Having this in mind, set of questions that are needed for possible future research arose. Can barium be used as a substitute for other biologically relevant divalent cations? Will the incorporation of barium ions hamper the execution of the essential processes in the organism? Most importantly, can the benefits outweigh the harm?

Preclinical evaluation of acute systemic toxicity of magnesium incorporated poly(lactic-co-glycolic acid) porous scaffolds by three-dimensional printing

Biodegradable polymer scaffolds combined with bioactive components which accelerate osteogenesis and angiogenesis have promise for use in clinical bone defect repair. The preclinical acute toxicity evaluation is an essential assay of implantable biomaterials to assess the biosafety for accelerating clinical translation. We have successfully developed magnesium (Mg) particles and beta-tricalcium phosphate (β-TCP) for incorporation into poly(lactic-co-glycolic acid) (PLGA) porous composite scaffolds (PTM) using low-temperature rapid prototyping three-dimensional-printing technology. The PTM scaffolds have been fully evaluated and found to exhibit excellent osteogenic capacity for bone defect repair. The preclinical evaluation of acute systemic toxicities is essential and important for development of porous scaffolds to facilitate their clinical translation. In this study, acute systemic toxicity of the PTM scaffolds was evaluated in mice by intraperitoneal injection of the extract solutions of the scaffolds. PTM composite scaffolds with different Mg and β-TCP content (denoted as PT5M, PT10M, and PT15M) were extracted with different tissue culture media, including normal saline, phosphate-buffered saline , and serum-free minimum essential medium , to create the extract solutions. The evaluation was carried out following the National Standard. The acute toxicity was fully evaluated through the collection of extensive data, including serum/organs ion concentration, fluorescence staining, and in vivo median lethal dose measurement. Mg in major organs (heart, liver, and lung), and Mg ion concentrations in serum of mice, after intraperitoneal injection of the extract solutions, were measured and showed that the extract solutions of PT15M caused significant elevation of serum Mg ion concentrations, which exceeded the safety threshold and led to the death of the mice. In contrast, the extract solutions of PT5M and PT10M scaffolds did not cause the death of the injected mice. The median lethal dose of Mg ions in vivo for mice was determined for the first time in this study to be 110.66 mg/kg, and the safety level of serum magnesium toxicity in mice is 5.4 mM, while the calcium serum safety level is determined as 3.4 mM. The study was approved by the Animal Care and Use Committee of Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (approval No. SIAT-IRB-170401-YGS-LYX-A0346) on April 5, 2017. All these results showed that the Mg ion concentration of intraperitoneally-injected extract solutions was a determinant of mouse survival, and a high Mg ion concentration (more than 240 mM) was the pivotal factor contributing to the death of the mice, while changes in pH value showed a negligible effect. The comprehensive acute systemic toxicity evaluation for PTM porous composite scaffolds in this study provided a reference to guide the design and optimization of this composite scaffold and the results demonstrated the preclinical safety of the as-fabricated PTM scaffold with appropriate Mg content, strongly supporting the official registration process of the PTM scaffold as a medical device for clinical translation.

Consumption of Calcium and Knowledge About Calcium Sources and Nutrition Labels Among Lower Secondary School Students in Thailand

Objective

A three study research program was conducted to identify high calcium products available in the market (study I), identify high calcium products that were known or consumed by lower secondary school students in the last three months (study II), and identify the amount and sources of calcium that students had consumed in the prior 24 hours, their knowledge about sources of high calcium and how to interpret calcium information on nutrition labels of food packages (study III).

Methods

In study I, a cross-sectional market survey was employed. In studies II and III, a school-based cross-sectional survey was employed. The survey population was students enrolled in grades 7–9 (11–14 years old) in a medium-sized lower secondary school in semi-urban Khon Kaen, Thailand. A total of 309 students were invited, with 168 and 209 students participating in studies II and III, respectively. Data were collected with self-administered questionnaires.

Results

Ninety-three high calcium products were identified. Only 49 were known or consumed by students in the last three months. The median amount of calcium consumed in the previous 24 hours was 410 mg (IQR: 160, 983). Only 31.1% of students (65/209) consumed more than the Thai recommended daily intake (TRDI) of calcium (800mg) in the previous 24 hours. Their main source of calcium was milk. Other high calcium items that were consumed were malt drink, minnow, canned fish, calcium fortified soy milk and Chinese kale. The overall average knowledge score was 6.5±2.4 out of a maximum of 17. The average knowledge scores for high calcium food sources and for interpreting the calcium information on a sample nutrition label were 4.6+1.8 (out of 12), and 1.9±1.2 (out of 5), respectively.

Discussion

Students should be introduced to high calcium products in their community such as hard tofu, minnow, and small freshwater shrimp. Educational programs on nutrition label interpretation are needed.

A Nutraceutical Formula Is Effective in Raising the Circulating Vitamin and Mineral Levels in Healthy Subjects: A Randomized Trial

Low levels of nutrient intake are common in industrialized countries. This has negative implications on health and is associated with chronic diseases. Supplementation of vitamins, minerals, and key nutrients to optimal levels may, therefore, be beneficial for individual health and for the health economy. Although the use of supplements has become very common, due to a lack of monitoring, there is very limited data on the efficacy of supplementation with different formulas. In this study, we present the results of a randomized controlled study on the efficacy of a novel formulated nutraceutical, N247, in 250 healthy volunteers aged 26-75 years and a placebo control group (n = 35). The broad-spectrum formulation of N247 includes essential vitamins, minerals, and trace elements that are adequately balanced in regard to synergies and related metabolic functions. Moreover, tolerance, safety, and nutrient availability is an important aspect of daily, long-term use of N247. After 3 months of regular N247 use, levels of vitamins and minerals in serum were significantly increased in the N247 group compared with the control group and a placebo group, with excellent compliance rates. Coupled with additional natural ingredients that aim to increase the potency of the nutrients, N247 may represent a novel and beneficial supplement for individuals with nutritional deficiencies. Clinical Trial Registration:https://clinicaltrials.gov/, identifier: NCT04054505.

Use of Meat-Bone Paste to Develop Calcium-Enriched Liver Pâté

The production technology of meat-bone paste and its effect on chemical, mineral and amino acid compositions of liver pâté were studied. The liver was replaced by meat-bone paste in the concentration of 5, 10, 15, 20, and 25% for the production of experimental samples. The compositional analysis of pâté manufactured with meat-bone paste showed that the reformulation did not influence the content of moisture (~56%), fat (~28%), or protein (~11%) while producing a significant increase of ash and a decrease of carbohydrates in comparison with control pâtés. The higher amounts of minerals of bone-meat paste, including calcium (3080 mg/100 g), magnesium (2120 mg/100 g), phosphorous (2564 mg/100 g), and iron (7.30 mg/100 g), explained the higher amount of both ash and these minerals in the reformulated samples compared to the control samples. The total caloric value (~300 kcal/100 g) was also unaffected by the addition of bone-meat paste. The content of both essential and non-essential amino acids decreased with the inclusion of meat-bone paste, although this decrease was lower in essential (6280 mg/100 g in control vs. 5756 mg/100 g in samples with 25% of meat-bone paste) than in non-essential amino acids (6080 mg/100 g in control vs. 3590 mg/100 g in samples with 25% of meat-bone paste). This fact is due to several essential amino acids not showing differences between control and reformulated samples, while in non-essential amino acids, these differences were greater. The results of this study showed that meat-bone paste addition is a good strategy to produce liver pâté enriched in minerals and with minimum influence on the content of the other important nutrients. Therefore, these results can be used for the design of new liver pâté with an increased nutritional significance by using meat industry by-products. According to the balance of minerals, the use of 15% of meat-bone paste to reformulate liver pâté is the best strategy used in the present research. However, additional studies on the stability (during storage), shelf-life, and sensory acceptability of these reformulated pâtés should be carried out.

Effect of high pressure heating on physical and chemical characteristics of Asian sea bass (Lates calcarifer) backbone

Physical and chemical properties of Asian sea bass (Lates calcarifer) backbone subjected to high pressure heating (autoclaving, 121ºC) for different times (30 min; AT-30; 60 min; AT-60; 90 min; AT-90) were studied. As heating time augmented, the increases in protein, α-amino group and hydroxyproline contents in liquor were attained, while hardness was declined indicating that more organic compounds were leached out from the bone matrix. More pronounced XRD pattern was observed in backbone autoclaved for 90 min as a consequence of nano-hydroxyapatite crystals agglomeration. Extension of high-pressure heating time reduced the organic matters as elucidated by TGA and DTA data. Asian sea bass backbone heated at 121ºC for 90 min using autoclave had the lowered protein and lipid contents but increased ash content with highest calcium (29.65 ± 0.69%), phosphorus (15.80 ± 0.07%) and iron (15.10 ± 0.61 mg/kg) contents, compared to those with shorter heating time. Therefore, pre-heat treatment could reduce the organic compounds and decrease bone hardness for further process, especially for bio-calcium production.

Calcium Levels Differences in Men with Schizophrenia Treated with Olanzapine and Risperidone in Prof. Dr. M Ildrem Psychiatric Hospital Medan

BACKGROUND: Second generation of antipsychotic medications is widely administrated in Indonesia and there is a distinctive difference in plasma calcium level in those receiving risperidone and olanzapine. According to several studies, decreased bone density is one of the deleterious effects affecting schizophrenic individuals receiving risperidone and olanzapine. AIM: The objective of the study was to determine the difference in serum calcium levels between men with schizophrenia who treated with olanzapine and risperidone at Prof. Dr. M Ildrem Psychiatric Hospital, Medan. METHODS: This is an experimental pre-test and post-test that compares two groups, namely the intervention group and the control group. Eligible subjects are those who meet our inclusion criteria in the following; age between 15 and 35 years old, total score of PANSS between 90 and 150, and normal serum calcium level. The subjects of the study were 60 men with schizophrenia, namely 30 who received olanzapine and 30 who received risperidone. The sampling method is non-probability sampling with a consecutive sampling type. RESULTS: There was a decrease in the total serum calcium level with the antipsychotic risperidone and olanzapine after 4 weeks, and a higher decrease occurred in the risperidone treatment group compared to olanzapine (p = 0.023). CONCLUSION: There was a significant decrease in serum calcium levels among men with schizophrenia who received risperidone therapy compared with those who received olanzapine therapy between the beginning and the end of week 4. It is expected that clinicians can consider giving antipsychotic therapy olanzapine in people with schizophrenia with low calcium levels.

Statistical Approach and Neutron Activation Analysis for Determining Essential and Toxic Elements in Two Kinds of Algerian Artemisia Plant

In this study, two kinds of Artemisia plant, Artemisia campestris L. and Artemisia herba-alba Asso., collected from different locations in Djelfa province, Algeria, were subjected to an instrumental neutron activation analysis (INAA) in order to determine their essential and toxic elements for the first time. The obtained results for both types revealed the existence of twenty-one elements, namely, As, Ba, Br, Ca, Ce, Co, Cr, Cs, Eu, Fe, Hf, K, La, Na, Rb, Sb, Sc, Sm, Sr, Yb, and Zn, where, the elements K, Ca, Fe, and Na respectively showed a significant concentration. On the other hand, the tolerable daily intake (TDI) of the studied plants for an adult person per day was within the tolerance limits imposed by the World Health Organization (WHO). Hence, these findings might therefore be used to offer scientific basis for an optimum usage of the studied plants and so enriches the database of medicinal herbs.

Calcium: More Than Bone? Implications for Clinical Practice and Theory

Serum calcium is routinely screened, but rarely scrutinized in the context of normal, physiologic functioning. This brief review strives to explore the implications of serum calcium, suggests guidelines for its interpretation, and discusses the implications of high, low, and “normocalcemia” in the clinical setting. We find that serum Ca²⁺ concentrations are a valuable prognostic indicator in routine metabolic workups and advocate for greater attention, on behalf of the provider, to variations in a patient’s calcemic status. Variations in calcemic status are primarily tied to malignancy, impaired parathyroid hormone (PTH) secretion, defects in vitamin D synthesis, insulin-like growth factor 1 (IGF-1) fluctuation, genetic syndromes (DiGeorge syndrome) and calcium-sensing receptor (CaSR) mutation. Prognostic implications for high and low serum Ca²⁺ include, but are not limited to, increased thromboembolic and major adverse cardiovascular event (MACE) risk, cardiac remodeling, hypertension, cognitive decline, and insulin resistance.

Mineral Composition of Lentils: Physiological Functions, Antinutritional Effects, and Bioavailability Enhancement

Lentil (Lens culinaris) is an important nutritious crop, grown and consumed throughout the world due to its high macro- and micronutrients contents, including minerals. Minerals have several beneficial influences on human health. Thus, lentils play a major role in food security, particularly among low-income countries. The current review aims to highlight the present knowledge on the mineral composition of lentils, compare it with the recommended dietary allowance and adequate intake of minerals, investigate the literature regarding its physiological role, give detailed information on different antinutritional factors preventing its bioavailability, and present adopted solutions to enhance the bioavailability of minerals in lentil seeds. Thereby, a literature search was conducted using reliable sources: Elsevier, Springer, PubMed, and CrossRef. Based on the previous studies, 100 g of cooked lentils, for example, may be enough to cover the recommended dietary allowance/adequate intake of iron in infants under six months and children aged one to three years. One hundred grams of cooked lentils may also cover the recommended dietary allowance/adequate intake of zinc and magnesium in infants and children aged one to three years. Hence, it is imperative that the scientists continue to show the significance of pulses as a mineral source and their effects on human health. Indeed, lentils should be exploited for a variety of purposes, mainly towards eliminating malnutrition, on the condition of being well-balanced. Lentils should be incorporated either in snacks or while preparing household, school, or hospital meals, particularly in developing countries.

Phosphocalcic metabolism and the role of vitamin D, vitamin K2, and nattokinase supplementation

Calcium is involved in bone metabolism, regulation of nerve signaling, and release of neurotransmitters. Phosphorus is a structural component of ATP, participates in metabolic energy regulation, and ensures stability to biological membranes and cells. Vitamin D and vitamin K are important for intestinal absorption and renal excretion of calcium and phosphorus. Vitamin D plays a regulatory role in bone formation, carbohydrate metabolism, immune responses, and cardiovascular regulation. Research has linked vitamin D deficiency to the development of diabetes mellitus, hypertension, cancer, and osteoporosis. Vitamin K has been associated with a reduced risk of osteoporosis, cancer, and cardiovascular diseases (due to improved vascular elasticity). This review highlights the importance of vitamins D and K in the metabolism of calcium and phosphorus and explores various molecular mechanisms that help maintain the system's mineral homeostasis. Moreover, the paper reviews the enzyme nattokinase's role in thrombotic prevention due to its fibrinolytic activity.

Invited review: A 2020 perspective on pasture-based dairy systems and products

Grazing pasture is the basis for dairy production systems in regions with temperate climates, such as in Ireland, New Zealand, parts of Australia, the United States, and Europe. Milk and dairy products from cows on pasture-based farms predominantly consuming fresh grazed grass (typically classified as "grass-fed" milk) have been previously shown to possess a different nutrient profile, with potential nutritional benefits, compared with conventional milk derived from total mixed ration. Moreover, pasture-based production systems are considered more environmentally and animal welfare friendly by consumers. As such, there is significant potential for market capitalization on grass-fed dairy products. As competition in this space increases, the regulations of what constitutes as grass-fed vary between different regions of the world. With this in mind, there is a need for clear and independently accredited grass-fed standards, defining the grass-fed criteria for labeling of products as such, subsequently increasing the clarity and confidence for the consumer. This review outlines the numerous effects of pasture production systems on dairy product composition, nutritional profile, and sustainability, and highlights potential future methods for authentication.

Edible Insects versus Meat-Nutritional Comparison: Knowledge of Their Composition Is the Key to Good Health

Recently, attention has been drawn to the fact that increasing the consumption of edible insects may positively impact the state of the natural environment and reduce the problem of malnutrition in large parts of society. Indeed, insects are seen as an alternative to traditional meat products, primarily meat. This article aimed to compare the nutritional value of edible insects and meat. Based on tables of composition and nutritional value and on the licensed computer program Diet 6D, data on the nutritional value of 10 commonly consumed meat types were compiled. Based on a literature review, data on the nutritional value of seven commercially available edible insect species were collected and collated. There was a comparison of 100 g of edible insects with 100 g of meat (fresh weight). In addition, the atherogenic index thrombogenic index, the hypocholesterolemic/hypercholesterolemic ratio, and the nutritional quality index were calculated. It was found that both meat and insects are rich in nutrients, including those considered essential for the proper development and functioning of the human body. At the same time, it has been shown that the content of individual nutrients in both insects and meat varies significantly.

Strategies for Reducing Sodium Intake in Bakery Products, a Review

Nowadays, the dietary sodium chloride intake is higher than the daily recommended levels, especially due to its prominent presence in food products. This may cause an increase of high blood pressure leading to cardiovascular diseases. Cereal products, and in particular bread, are the main source of salt in human diet. However, salt is a critical ingredient in bread making, and its reduction can have a negative impact on bread quality. This review focuses on physiological role of sodium chloride, its effect on the human body and legislative recommendations on its consumption. Moreover, it presents sodium chloride effects on the bread making from the technological and sensory point of view and presents different options for salt reduction in foods focusing on bakery products. It may be concluded that salt reduction in bread making while maintaining dough rheological properties, yeast fermentation rate, bread quality through its loaf volume, color, textural properties, sensory characteristics is difficult to be achieved due to sodium chloride’s multifunctional role in the bread-making process. Several strategies have been discussed, focusing on sodium chloride replacement with other type of salts, dry sourdough and flavor enhancers.

The Effects of Calcium, Magnesium, Phosphorus, Fluoride, and Lead on Bone Tissue

Bones are metabolically active organs. Their reconstruction is crucial for the proper functioning of the skeletal system during bone growth and remodeling, fracture healing, and maintaining calcium-phosphorus homeostasis. The bone metabolism and tissue properties are influenced by trace elements that may act either indirectly through the regulation of macromineral metabolism, or directly by affecting osteoblast and osteoclast proliferation or activity, or through becoming part of the bone mineral matrix. This study analyzes the skeletal impact of macroelements (calcium, magnesium, phosphorus), microelements (fluorine), and heavy metals (lead), and discusses the concentration of each of these elements in the various bone tissues.

Poly(acrylic acid) Hydrogel Microspheres for a Metal-Ion Sensor

Monodispersed cross-linked poly(acrylic acid) (PAA) droplets (PAA X-droplets), prepared using the microfluidic method with in situ ultraviolet curing, were used as small spherical sensors to simultaneously detect both Ca²⁺ and Mg²⁺ in human saliva and serum. The PAA X-droplet treated with KOH (PAA_KOH X-droplet) was used as a reference droplet because of its highly swollen state. The PAA_KOH X-droplets shrunk in response to the presence of divalent metal ions (Ms) by forming a bridged structure of COO-M-OOC. The sizes of the PAA_KOH X-droplets were precisely and dynamically monitored in the poly(dimethylsiloxane) (PDMS) channel with passing time when the aqueous metal-ion solutions were flowing at a controlled flow rate. The sizes of the PAA_KOH X-droplets continuously decreased to the saturated constant size. The saturated size of the PAA_KOH X-droplet did not change; however, the speed of size reduction increased with an increase in the concentration of the divalent metal ion. The saturated size was studied using the saturated diameter ratio (R_sat-dia) with respect to the initial diameter of the PAA_KOH X-droplet before the metal-ion treatment, and the speed of the size reduction was investigated using the inverse time to reach half the saturated diameter reduction (T_1/2^-1). Ca²⁺ and Mg²⁺ exhibited R_sat-dia values of 75.9 and 83.6%, respectively, when the flow rate was 5 μL min^-1, regardless of the metal concentration. The T_1/2^-1s for the Ca²⁺ and Mg²⁺ linearly increased with an increase in their concentrations. The R_sat-dia of the aqueous Ca²⁺/Mg²⁺ mixture solution had a linear relationship with φ [= C_Ca/(C_Ca + C_Mg), where C_Ca and C_Mg are the molar concentrations of Ca²⁺ and Mg²⁺, respectively]. The T_1/2^-1 of the aqueous Ca²⁺, Mg²⁺ mixture solution was calculated by adding the individual T_1/2^-1s of pure aqueous Ca²⁺ and Mg²⁺ solutions. Using the R_sat-dia and T_1/2^-1 of the Ca²⁺/Mg²⁺ mixture aqueous solution, the individual C_Ca and C_Mg in the mixture solution were successfully calculated. This method was applied to the human saliva and serum in which the major metal ions are Ca²⁺ and Mg²⁺, and other metal ions existed in undetectable amounts by the PAA_KOH X-droplets. This method is simple, cost-effective, and highly accurate and solves the hurdles of separating the interference effect of a Mg²⁺ ion when a Ca²⁺ ion is measured in biofluids.

Synergic Effect of Selected Ingredients and Calcium Chloride on the Technological, Molecular and Microbial Usefulness of Eggshells and Their Impact on Sensory Properties in a Food Model System

Lower levels of calcium in adults increase the risk for osteoporosis, and in children, low calcium levels can impact their potential adult height. The study objective was to analyze the bioavailability and physicochemical properties of a calcium preparation based on chicken eggs. The base calcium preparation was enriched with one of a variety of biologically active substances, inter alia, vitamin D3, vitamin K, lysine, lactose, magnesium chloride and inulin. The newly developed calcium preparations were subjected to structural analysis using X-ray diffraction and scanning electron microscopy, and the hydrodynamic diameter for the molecules was determined using the dynamic light scattering method and their zeta potential. To determine the optimum storage conditions of calcium preparations, their hygroscopicity and bulk density were determined. The calcium preparations were also added to selected food products, such as apple juice with mango, fruit dessert (jelly) and beef meatballs. The enriched food products were subjected to sensory analysis. The study demonstrated the significant influence of additives to calcium preparation in terms of its hygroscopicity and morphology. It was found that all products with the addition of analyzed preparations were characterized by high sensory desirability. The results presented in the study comprise the basis for the development of new food products, enriched with calcium.

Mineral Biofortification of Vegetables as a Tool to Improve Human Diet

Vegetables represent pillars of good nutrition since they provide important phytochemicals such as fiber, vitamins, antioxidants, as well as minerals. Biofortification proposes a promising strategy to increase the content of specific compounds. As minerals have important functionalities in the human metabolism, the possibility of enriching fresh consumed products, such as many vegetables, adopting specific agronomic approaches, has been considered. This review discusses the most recent findings on agronomic biofortification of vegetables, aimed at increasing in the edible portions the content of important minerals, such as calcium (Ca), magnesium (Mg), iodine (I), zinc (Zn), selenium (Se), iron (Fe), copper (Cu), and silicon (Si). The focus was on selenium and iodine biofortification thus far, while for the other mineral elements, aspects related to vegetable typology, genotypes, chemical form, and application protocols are far from being well defined. Even if agronomic fortification is considered an easy to apply technique, the approach is complex considering several interactions occurring at crop level, as well as the bioavailability of different minerals for the consumer. Considering the latter, only few studies examined in a broad approach both the definition of biofortification protocols and the quantification of bioavailable fraction of the element.

Phytochemical and Nutritional Quality Changes During Irrigation and Postharvest Processing of the Underutilized Vegetable African Nightshade

Underutilized or traditional leafy vegetables are grown in the wild and cultivated. They are consumed as nutritional accompaniments to staples, either raw (fresh), cooked, or in a dried form, through custom, habit, and tradition. These traditional leafy vegetables are natural rich sources of phytochemicals and nutritional compounds. Over time, the keenness for consumption of traditional vegetables has become less popular. Poor nutrient diets are the main cause of mortality and morbidity, especially in developing countries, where the problem is predominant due to poverty. Consumption of traditional vegetables can assist in the prevention of chronic disease development, as they contain various bioactive compounds that exhibit multiple health benefits. Traditional leafy vegetables play a vital role in combatting hunger, food insecurity, and malnutrition, and most are suitable for food intervention programs. African nightshade (Solanum family) is one such commonly consumed traditional leafy vegetable. During dry seasons, communities often face shortages of vegetables; thus, the preservation of edible leaves is one strategy to help overcome this problem. The adoption of solar drying and fermentation are traditional methods to extend the availability of African nightshade vegetables. Additionally, the agronomy practices and postharvest processing methods affect the phytochemicals and nutritional compounds of African nightshade accessions. This mini-review provides information on changes in phytochemicals, nutrition, and antinutritive compounds with different postharvest processing methods and irrigation. The review provides the justification to promote the cultivation for consumption, by identifying the potential African nightshade accessions that are rich in phytonutritional compounds. This mini-review summarizes and discusses the major information on (i) the micro- and macronutrients present in Solanum retroflexum, the most commonly consumed nightshade species compared with other traditional vegetables in Southern Africa, (ii) the composition of phytochemical compounds present in different nightshade accessions, (iii) the impact of irrigation on phytochemical composition in different nightshade species, and (iv) the impact of postharvest processing on phytochemicals and antinutritive compounds in S. retroflexum. Inclusion of African nightshade, especially S. retroflexum, with the main staple foods can improve protein, iron, and calcium levels in daily diets, which will help to improve people's health and well-being.

Low-carbohydrate diets: Effects on metabolism and exercise - A comprehensive literature review

BACKGROUND & AIMS

Low-carbohydrate diets (LCD) have gained substantial attention in recent years for their potential in health promotion and treatment of diseases, but they remain controversial in nutrition guidelines and exercise performance. Herein, through a literature review, we discuss the current evidence base by considering management of LCD and potential coupling of these dietary regiments with physical exercise.

METHODS

We performed a comprehensive literature review with no date limits as a means of including seminal to current studies.

RESULTS

Reduction of CHO intake decreases muscle glycogen, yielding greater fat oxidation and associated metabolic benefits. LCD may promote fat mass loss and regulation of biochemical parameters, such as lipid and glycemic biomarkers. The therapeutic potential of LCD towards noncommunicable diseases, particularly obesity and its comorbidities, is therefore reasonable as a dietary candidate in this context. Potential benefits to this approach are linked to enhancement of mitochondrial gene expression and mitochondrial biogenesis. As such, LCD may be a feasible tool in a 'periodized nutrition' for athletes and within clinical scenarios. Long-term observational follow-up studies have demonstrated increased mortality and cardiovascular implications of LCD. However, harmful associations may depend on the food source (e.g., animal-based vs. plant-based foods).

CONCLUSION

LCD may decrease body mass, waist circumference, and improve fat and carbohydrate metabolism. When combined with exercise, LCD seems to be an effective strategy in regulating metabolic factors of cardiovascular diseases. Conversely, LCD may be associated with higher mortality and metabolic dysregulations if it contains large amounts of animal-based foods, particularly saturated fat.

A review of micronutrient deficiencies and analysis of maize contribution to nutrient requirements of women and children in Eastern and Southern Africa

This paper reviews and analyses the importance of maize as staple food in Eastern and Southern Africa (E&SA) and contributes in understanding the nexus between maize nutritional composition and prevalence of micronutrient deficiencies (MNDs) in these regions. MNDs remain a major public health concern particularly for women and children, with calcium, iodine, iron, selenium, zinc, folate and vitamin A deficiencies being the most common. Estimates of their prevalence are among the highest in E&SA: iron-deficient anemia affected 26 to 31% of women of reproductive age, and deficiencies up to 53%, 36%, 66%, 75% and 62% for vitamin A, iodine, zinc, calcium and selenium, respectively, were measured in populations of these regions. Besides, these two regions show the highest worldwide maize per capita consumption (g/person/day) as main staple, with 157 in Eastern Africa and 267 in Southern Africa, including up to 444 in Lesotho. The analysis of food composition tables from these regions showed that 100 g of maize foods consumed by these populations could to some extent, contribute in satisfying dietary reference intakes (DRIs) of children and women in energy, proteins, carbohydrates, magnesium, zinc, vitamins B1 and B6. However, it provides very low supply of fats, calcium, sodium, selenium, vitamins C, A and E. The high occurrence of MNDs and considerable nutritional potential of maize consumed in E&SA can be explained by loss of nutrients due to processing practices, low food diversification and reduced nutrients bioavailability. Success cases of the main strategies to tackle the issue of MNDs in these regions by improving maize nutritional quality are discussed in this paper. Maize fortification was shown to improve nutrition and health outcomes of population. Increasing dietary diversity by complementing maize with other foods has improved nutrition through integration of micronutrient-rich foods in the diet. Mostly, biofortification has successfully contributed in reducing vitamin A and zinc deficiencies in rural communities more than nutrient supplementation, fortification and dietary diversity.

The Dioscorea Genus (Yam)-An Appraisal of Nutritional and Therapeutic Potentials

The quest for a food secure and safe world has led to continuous effort toward improvements of global food and health systems. While the developed countries seem to have these systems stabilized, some parts of the world still face enormous challenges. Yam (Dioscorea species) is an orphan crop, widely distributed globally; and has contributed enormously to food security especially in sub-Saharan Africa because of its role in providing nutritional benefits and income. Additionally, yam has non-nutritional components called bioactive compounds, which offer numerous health benefits ranging from prevention to treatment of degenerative diseases. Pharmaceutical application of diosgenin and dioscorin, among other compounds isolated from yam, has shown more prospects recently. Despite the benefits embedded in yam, reports on the nutritional and therapeutic potentials of yam have been fragmented and the diversity within the genus has led to much confusion. An overview of the nutritional and health importance of yam will harness the crop to meet its potential towards combating hunger and malnutrition, while improving global health. This review makes a conscious attempt to provide an overview regarding the nutritional, bioactive compositions and therapeutic potentials of yam diversity. Insights on how to increase its utilization for a greater impact are elucidated.

Chemical and elemental analysis of the edible fruit of five Carpobrotus species from South Africa: assessment of nutritional value and potential metal toxicity

Edible wild fruits of five Carpobrotus species (C. acinaciformis, C. deliciosus, C. dimidiatus, C. edulis subspecies edulis and C. mellei) were assessed for their nutritional value by determining the proximate chemical composition. Fruits were high in moisture (77.6% to 90.3%), carbohydrates (58.8% to 70.3%) and energy (1240 to 1370 kJ 100 g^-1), with adequate amounts of protein (8.1% to 26.0%) and low in lipids (0.9% to 2.4%). Elemental concentrations were in decreasing order of Ca > Mg > Fe > Mn > Zn ~ Cu > Cr > Se ~ Ni ~ Co. Most fruits were rich in Cr (contributing between 30% and 143% towards its RDA) and C. delicious and C. mellei being rich in Mn, contributing 49 to 156% towards its RDA. Except for C. dimidiatus, toxicity studies revealed all species to contain low levels of toxic metals (As, Cd and Pb) making them suitable for human consumption.

Response regarding the importance of vitamin D and calcium among undergraduate health sciences students in Al Kharj, Saudi Arabia

BACKGROUND

Vitamin D and calcium are essential dietary components for human body, and their deficiency is linked to poor bone health and osteoporosis. Adequate knowledge of health staff regarding vitamin D and calcium is critical for general population awareness. The current work was to evaluate the awareness regarding the importance of vitamin D and calcium among undergraduate health science students in Al Kharj.

METHODS

A self-distributed validated questionnaire-based cross-sectional study was conducted. Undergraduate health science students in Prince Sattam bin Abdulaziz University from the College of Medicine, College of Pharmacy, College of Dentistry, and College of Applied Medical Science were included in the study. Students between the age of 18 and 25 years have participated in the study.

RESULTS

Four hundred fifty-seven undergraduate health science students participated in the study. The vast majority of students knew about the importance of calcium (96.7%) and vitamin D (95.4%), whereas only 89.4% knew about osteoporosis. The participant students reported in their answers that the sources of knowledge were the Internet (42.8%), physicians (41.5%), textbooks (21.2%), teachers (19.1%), family and relatives (18.3%), and/or other sources (6.1%). The overall attitude was poor in about (54%) of the participants showing gender differences regarding sun-exposure duration and supplementation of calcium and vitamin D.

CONCLUSION

The study revealed that both male and female undergraduate health science students in Al Kharj were familiar with the importance of vitamin D and calcium; however they reported improper attitude that warrants further health guidance and educational programs.

Breaking the vicious circle of diet, malnutrition and oral health for the independent elderly

Aging impairs senses, mastication, oral status and function, causing nutritional needs and diet insufficiencies. The present needs of independent older adults suggest that health research and oral health care should shift from reductionist disease management to integral and personal treatment plans, including lifestyle, psychological, nutritional and oral health coaching approaches. Dentists and other medical professionals that work in the field of gerodontology should be educated on the macro and micronutrient needs of the elderly and incorporate certain nutritional plans early in the life of their patients with their approval and cooperation, in order to postpone tooth loss and masticatory impairment. Old recipes such as the Mediterranean diet should be kept as a base for all the elderly and be enriched in a customized interpersonal way from the dentist as well as the medical professional according to the specific needs of one's oral and general health status. In this nonsystematic review paper, the basic aspects of the vicious cycle of nutrition and oral health status are discussed and suggestions of major nutrients' influence and needs for independent elders are reported. Based on the scientific data collected, suggestions are made for the food industry for better quality and dosage of foods for this category of individuals. Such strategies can be a whole new area of interest for the food industry in order to obtain better quality of food packaging for the independent OA with accepted texture, odor, colors, macronutrients and micronutrients' consistency and in specific portions.

Effect of the mixture of mulberry leaf powder and KGM flour on promoting calcium absorption and bone mineral density in vivo

BACKGROUND

In this paper, mulberry leaf powder (MLP) and konjac glucomannan (KGM) flour were used as raw materials, and animal experiments were designed to evaluate the effects of a mixture of MLP and KGM on bone density. The femoral bone microstructure of mice and pathological changes were observed by using micro-computed tomography) and haematoxylin and eosin (HE) staining methods, respectively. A three-point bending test was used to determine the biomechanical properties of the femur.

RESULTS

Results indicated that the calcium content of MLP was high, reaching 16 148.5 mg kg^-1 , and the total proportion of water-soluble calcium, calcium pectinate, and calcium carbonate accounted for about 60% of the total calcium content. Serum alkaline phosphatase (AKP) activity was significantly lower, and serum calcium content was significantly higher (P < 0.05), in the MLP + KGM group (KM) than in the low-calcium control group, whereas no significant difference (P > 0.05) was found for serum phosphorus content. KM had a longer femur length, a higher bone mineral density (BMD) (P > 0.05), and significantly greater femur diameter, dry weight, index and bone calcium content (P < 0.05). However, these parameters were not significantly different from those of the calcium carbonate control group (P > 0.05).

CONCLUSION

The results indicate that the MLP/KGM mixture can reduce the high rate of bone turnover and the corresponding loss of bone mass caused by calcium deficiency and is thus effective in enhancing bone density. © 2019 Society of Chemical Industry.

Magnesium, Calcium, Potassium, Sodium, Phosphorus, Selenium, Zinc, and Chromium Levels in Alcohol Use Disorder: A Review

Macronutrients and trace elements are important components of living tissues that have different metabolic properties and functions. Trace elements participate in the regulation of immunity through humoral and cellular mechanisms, nerve conduction, muscle spasms, membrane potential regulation as well as mitochondrial activity and enzymatic reactions. Excessive alcohol consumption disrupts the concentrations of crucial trace elements, also increasing the risk of enhanced oxidative stress and alcohol-related liver diseases. In this review, we present the status of selected macroelements and trace elements in the serum and plasma of people chronically consuming alcohol. Such knowledge helps to understand the mechanisms of chronic alcohol-use disorder and to progress and prevent withdrawal effects, also improving treatment strategies.

Calcium Bioavailability of Opuntia ficus-indica Cladodes in an Ovariectomized Rat Model of Postmenopausal Bone Loss

Osteoporosis is a disease of the skeletal system characterized by low bone mass and bone weakening, which increase the risk of fracture. This disease is associated with menopause because hypoestrogenism induces the maturation and activation of osteoclasts. In addition, a low dietary intake of calcium leads to low bone mineral density and postmenopausal osteoporosis. The objectives of this work were to determine calcium bioavailability of Opuntia ficus-indica cladodes at a late maturity stage and to assess its contribution in improving bone health in an ovariectomized rat model. Two-month-old Wistar female rats (n = 35) were used and distributed in seven experimental groups: (i) control group (Crtl), (ii) sham group (SH), (iii) ovariectomized group (OVX), (iv) ovariectomized group supplemented with calcium citrate (CCa), (v) ovariectomized group supplemented with O. ficus-indica powder (NI), (vi) ovariectomized group supplemented with soluble fiber from O. ficus-indica (FS) and (vii) ovariectomized group supplemented with insoluble fiber from O. ficus-indica (FI). Our results showed that calcium in the soluble fiber of O. ficus-indica is bioavailable and contributes to improve the physical, densitometric, biomechanical and microstructural properties of bones in ovariectomized rats. These findings indicated that O. ficus-indica cladodes at a late maturity stage represent a good source of bioavailable calcium and consumption of these cladodes might be beneficial for the prevention of osteoporosis and other bone diseases.

Antioxidant and nutritional evaluation of Bhu Udumbara (Ficus semicordata Buch.-Ham. ex Sm.) leaves and fruits: An extra pharmacopoeial drug of Ayurveda

Background:

Ficussemicordata Buch.-Ham. ex Sm. (Moraceae) has been attributed with copious therapeutic claims in Indian traditional medical systems, especially for its ethnomedicinal and economical uses.

Aims:

The present study was carried out to evaluate the heavy metal, pesticide, aflatoxin content, antioxidant and nutritional value of leaves and fruits of F. semicordata.

Materials and Methods:

Heavy metal content; pesticide residues; aflatoxin content; antioxidant potential; and different nutritional parameters such as total carbohydrate, true protein, protein, total fat, energy, Vitamin C, Vitamin A, iron, zinc, manganese, phosphorus, calcium of the leaves, and fruits were evaluated following the standard guidelines.

Results:

Fruit powder shows the presence of 72.94 ppm Pb while <0.01 ppm Pb in leaf powder whereas Cd, Hg, and as were <0.01 ppm in both leaf and fruit powders. Pesticide residue and aflatoxin cotent in both leaves and fruit were below the limit of quantification. Antioxidant activities of both leaves and fruits increased with increasing concentrations in the dose-dependent manner by Diphenylpicrylhydrazyl (DPPH) assay, ferric-reducing antioxidant power assay and phosphomolybdenum assay. Fruits are found more nutritious with highest content of true protein, total fat, energy, Vitamin A, iron, zinc and phosphorus whereas the leaves are having highest content of total carbohydrate, protein, Vitamin C, manganese and calcium.

Conclusion:

The results of this study shows that in the leaves and fruits of F. semicordata mercury, cadmium, arsenic, pesticides residues and aflatoxin content are below the limit of quantification and possess mild antioxidant properties. Fruits are found more nutritious with the highest content of true protein, total fat, energy, Vitamin A, iron, zinc and phosphorus. Being wild, it is easily accessible and cheaper source of nutrition.

Clinical study of the tolerability of calcium carbonate-casein microcapsules as a dietary supplement in a group of postmenopausal women

Background

Calcium is an essential macronutrient; however, currently supplements are often associated with gastrointestinal (GI) adverse events. The authors investigated the tolerability of a new delivery system for calcium supplementation, based on the functionalization of calcium carbonate (CaCO₃) particles by casein proteins, in a randomized, prospective, double-blind, active comparator clinical trial.

Methods

Around 208 postmenopausal women were enrolled and randomized 1:1:1:1 to one of the four calcium supplements, taken for 30 days: (1) microencapsulated CaCO₃ (microCaCO₃) with a 90:10 mineral to protein ratio; (2) microCaCO₃ with a 95:5 mineral to protein ratio; (3) conventional CaCO₃ tablets; and (4) calcium citrate tablets (CaCitr). The Gastrointestinal Symptom Rating Scale (GSRS) questionnaire was used to evaluate the GI tolerability and the Treatment Satisfaction Questionnaire for Medication (TSQM) to analyze the satisfaction of the participants with the use of the calcium supplements.

Results

The mean GSRS scores at baseline differed among the groups from 3.95 to 5.35 without statistical significance. After 1 month use of supplements, the group given microCaCO₃ with a 90:10 mineral to protein ratio, showed the lowest mean GSRS score (6.07), while the group given conventional CaCO₃ showed the highest score (11.86). According to the completed TSQM questionnaire, the use of supplements was easier for both microCaCO₃ groups in comparison with conventional supplements.

Conclusions

The microCaCO₃ supplement has shown promising results in the context of GI tolerability and patient satisfaction in the use of supplements compared to conventional calcium supplements. The reduction of GI adverse events may increase the compliance to calcium supplements especially important among groups at risk of calcium deficiency.

Relative bioavailability and pharmacokinetic comparison of calcium glucoheptonate with calcium carbonate

Adequate calcium intake is important for the prevention of bone loss and osteoporosis. For some populations such as those of Southeast Asia where calcium intake is very low, supplements represent a suitable dietary source of calcium. The objective of this study was to compare the relative oral bioavailability of calcium from calcium glucoheptonate, a highly soluble calcium salt containing 8.2% of elemental calcium, to that of calcium carbonate. A single-dose, randomized-sequence, open-label, two-period crossover study, with a 7-day washout period, was conducted in 24 Indonesian healthy adult volunteers. After a 12-hour (overnight) fast, subjects received either two oral ampoules of 250 mg/10 mL of calcium glucoheptonate each or one effervescent tablet of calcium carbonate containing 500 mg of elemental calcium. The relative oral bioavailability of calcium from calcium glucoheptonate as compared to calcium carbonate was 92% within 6 hours and 89% within 12 hours after study drug administration. The 90% confidence intervals for the mean test/reference ratios of the maximum plasma concentration and the area under the concentration-time curve at 12 hours post-administration were 77.09%-120.31% and 60.58%-122.30%, respectively. Five subjects experienced a total of eight adverse events which were all mild and transient; no serious adverse events or deaths were reported. These results indicate that calcium glucoheptonate is associated with a high relative bioavailability of calcium compared to calcium carbonate, and is well-tolerated. Calcium glucoheptonate might thus be a potential choice for calcium supplementation in Southeast Asian populations.

Probiotic Lactobacillus strains from Mongolia improve calcium transport and uptake by intestinal cells in vitro

The aim of this study was to investigate the probiotic properties of 174 Lactobacillus strains isolated from Mongolian dairy products, and particularly their impact on intestinal calcium uptake and absorption. All isolates underwent a first screening based on cell surface hydrophobicity, acid tolerance, tolerance to gastro-intestinal digestion, autoaggregation, adhesion and cytotoxicity against intestinal cells. Six Lactobacillus strains from different species (L. casei, L. kefiranofaciens, L. plantarum, L. fermentum, L. helveticus and L. delbrueckii) were selected, and their impact on intestinal calcium uptake and transport was investigated using Caco-2. Five strains were able to improve total calcium transport after 24 h contact with a differentiated Caco-2 cell monolayer. Concomitantly the L. plantarum strain was able to increase cellular calcium uptake in Caco-2 cells by 10% in comparison to control conditions. To determine which pathway(s) of calcium absorption was modulated by the strains, a qPCR-based study on 4 genes related to calcium/vitamin D metabolism or tight junction integrity was conducted on mucus-secreting intestinal HT-29 MTX cells. The L. plantarum strain modulates the transcellular pathway by regulating the expression of vitamin D receptor (1.79 fold of control) and calcium transporter (4.77 fold of control) while the L. delbrueckii strain acts on the paracellular pathway by modulating claudin-2 expression (2.83 fold of control). This work highlights the impact of Lactobacillus probiotic strains on intestinal calcium absorption and for the first time give some evidence about the cellular pathways involved.

Serum ionised calcium and the risk of acute respiratory failure in hospitalised patients: a single-centre cohort study in the USA

OBJECTIVES

The objective of this study was to evaluate the risk of acute respiratory failure in all hospitalised patients based on admission serum ionised calcium.

DESIGN

A retrospective cohort study.

SETTING

A tertiary referral hospital in Rochester, Minnesota, USA.

PARTICIPANTS

All hospitalised patients who had serum ionised calcium measurement within 24 hours of hospital admission from January 2009 to December 2013. Patients who were mechanically ventilated at admission were excluded.

PREDICTORS

Admission serum ionised calcium levels was stratified into six groups: ≤4.39, 4.40-4.59, 4.60-4.79, 4.80-4.99, 5.00-5.19 and ≥5.20 mg/dL.

PRIMARY OUTCOME MEASURE

The primary outcome was the development of acute respiratory failure requiring mechanical ventilation during hospitalisation. Logistic regression analysis was fit to assess the independent risk of acute respiratory failure based on various admission serum ionised calcium, using serum ionised calcium of 5.00-5.19 mg/dL as the reference group.

RESULTS

Of 25 709 eligible patients, with the mean serum ionised calcium of 4.8±0.4 mg/dL, acute respiratory failure requiring mechanical ventilation occurred in 2563 patients (10%). The incidence of acute respiratory failure was lowest when admission serum ionised calcium was 5.00-5.19 mg/dL, with the progressively increased risk of acute respiratory failure with decreased serum ionised calcium. In multivariate analysis with adjustment for potential confounders, the increased risk of acute respiratory failure requiring mechanical ventilation was significantly associated with admission serum ionised calcium of ≤4.39 (OR 2.52; 95% CI 2.12 to 3.00), 4.40-4.59 (OR 1.76; 95% CI 1.49 to 2.07) and 4.60-4.79 mg/dL (OR 1.48; 95% CI 1.27 to 1.72), compared with serum ionised calcium of 5.00-5.19 mg/dL. The risk of acute respiratory failure was not significantly increased when serum ionised calcium was at least 4.80 mg/dL.

CONCLUSION

The increased risk of acute respiratory failure requiring mechanical ventilation was observed when admission serum ionised calcium was lower than 4.80 mg/dL in hospitalised patients.

Nutrition Transition and Cancer

Urbanization, population aging, and climatic changes have mostly contributed to nutrition transition and, consequently, to effects of food habits on the epidemic of chronic non-communicable diseases (NCDs), especially cancer. Climatic changes are negatively affecting crop production, particularly biodiversity, leading to reduced food choices and, consequently, nutritional value and the protection conferred from consumption of a variety of nutrients essential in a healthy diet. This brief review analyzes the possible link between rapid demographic changes, climatic and environmental crises, and the current food system as possible factors contributing to the role of nutrition transition in the onset of cancer.

Impact of Changes in Serum Calcium Levels on In-Hospital Mortality

Background and objectives: Calcium concentration is strictly regulated at both the cellular and systemic level, and changes in serum calcium levels can alter various physiological functions in various organs. This study aimed to assess the association between changes in calcium levels during hospitalization and mortality. Materials and Methods: We searched our patient database to identify all adult patients admitted to our hospital from January 1st, 2009 to December 31st, 2013. Patients with ≥2 serum calcium measurements during the hospitalization were included. The serum calcium changes during the hospitalization, defined as the absolute difference between the maximum and the minimum calcium levels, were categorized into five groups: 0–0.4, 0.5–0.9, 1.0–1.4, 1.5–1.9, and ≥2.0 mg/dL. Multivariable logistic regression was performed to assess the independent association between calcium changes and in-hospital mortality, using the change in calcium category of 0–0.4 mg/dL as the reference group. Results: Of 9868 patients included in analysis, 540 (5.4%) died during hospitalization. The in-hospital mortality progressively increased with higher calcium changes, from 3.4% in the group of 0–0.4 mg/dL to 14.5% in the group of ≥2.0 mg/dL (p < 0.001). When adjusted for age, sex, race, principal diagnosis, comorbidity, kidney function, acute kidney injury, number of measurements of serum calcium, and hospital length of stay, the serum calcium changes of 1.0–1.4, 1.5–1.9, and ≥2.0 mg/dL were significantly associated with increased in-hospital mortality with odds ratio (OR) of 1.55 (95% confidence interval (CI) 1.15–2.10), 1.90 (95% CI 1.32–2.74), and 3.23 (95% CI 2.39–4.38), respectively. The association remained statistically significant when further adjusted for either the lowest or highest serum calcium. Conclusion: Larger serum calcium changes in hospitalized patients were progressively associated with increased in-hospital mortality.

Association between Serum Calcium and Risk of Cardiometabolic Disease among Community-dwelling Adults in Taiwan

Serum calcium, although only comprising 1% of total body calcium, is involved in intracellular signal pathways, vascular dilatation/constriction, and muscle contraction, which are crucial for insulin secretion, cholesterol catabolism, and blood pressure regulation. As far as we know, research on the relationship between serum calcium level and metabolic syndrome (MetS), diabetes, and hypertension in one longitudinal study is rare. Owing to the crucial role of serum calcium in human cardiometabolic physiology and lack of related study so far, this study aims to describe the relationship between serum calcium level and the incidence of MetS, diabetes, and hypertension. During the period 2010-2016, there are two parts to our study: cross-sectional analysis and longitudinal analysis. Logistic regression was applied for cross-sectional analysis of the association between serum calcium level or albumin-corrected calcium (ACCA) and the prevalence of MetS, diabetes, or hypertension. Receiver operating characteristic (ROC) curve analysis was used for calculating of optimal cut-off value of serum calcium and ACCA. Cox proportional regression for development of MetS, diabetes, and hypertension according to different cut-off values of serum calcium level and ACCA were conducted. At baseline, there were 27,364 participants in our study. Serum calcium level had positive association with diabetes in the total population, male, and female. ACCA level had positive association with diabetes in the total population, male, and female. In unadjusted and multivariate Cox proportional hazard models, serum calcium level was associated with increased risk of incident MetS in the total population and male. ACCA was associated with increased risk of incident MetS in the total population and male. ACCA was associated with increased risk of incident diabetes in the total population and male participants. This study describes the relationship between serum calcium level and the incidence of MetS, diabetes, and hypertension. Higher serum calcium level is associated with increased risk of MetS, diabetes, and hypertension.

Toward 'element balance' in ADHD: an exploratory case control study employing hair analysis

Background: Head hair analysis has been used for decades to clarify mineral relationships to symptoms of ADHD, but there is little consensus among findings. We sought to explore 33 hair element concentrations and their 528 calculated ratios among two groups of boys, one with ADHD and one without.Method: 107 boys aged 7-12 years were recruited; 55 with ADHD and 52 non-ADHD Controls. Hair minerals were compared using Mann-Whitney U tests, p<0.01 was used for significance. Dietary data were obtained using a 138 item food frequency questionnaire (FFQ).Results: There were three group differences on individual elements: bismuth/Bi: 8 fold higher in ADHD, chromium/Cr: 15% lower in ADHD and germanium/Ge: 11% lower in ADHD, Cr level being the strongest predictor of ADHD symptoms. We found thirty significant group differences in element ratios, two thirds involving Bi and eight of these showing that as ADHD severity increased, the ratios with Bi as the denominator decreased (r ranging from -0.263 to -0.433, p<0.01). From the FFQ, tinned fruit was consumed more often in the ADHD group. Hair arsenic levels were somewhat elevated across both ADHD and Control groups.Discussion: While element 'imbalance' appears to be associated with ADHD, we did not replicate any previous study results of group differences on individual elements. We have raised the possibility that the ratios may be far more important than any one individual element in better elucidating the effects that minerals may have on the pathogenesis of ADHD. These are cautionary findings requiring replication.

The Effects of Psychological and Environmental Stress on Micronutrient Concentrations in the Body: A Review of the Evidence

Stress is the nonspecific response of the body to any demand for change. Excess or chronic psychological or environmental stress is associated with an increased risk of mental and physical diseases, with several mechanisms theorized to be associated with its detrimental effects. One underappreciated potential mechanism relates to the effects of psychological and environmental stress on micronutrient concentrations. Micronutrients (vitamins and minerals) are essential for optimal physical and mental function, with deficiencies associated with an array of diseases. In this article, animal and human studies investigating the effects of various psychological and environmental stressors on micronutrient concentrations are reviewed. In particular, the effects of psychological stress, sleep deprivation, and physical exercise on micronutrient concentrations and micronutrient excretion are summarized. Micronutrients identified in this review include magnesium, zinc, calcium, iron, and niacin. Overall, the bulk of evidence suggests stress can affect micronutrient concentrations, often leading to micronutrient depletion. However, before definitive conclusions about the effects of stress can be made, the impact of different stressors, stress severity, and acute versus chronic stress on micronutrient concentrations requires investigation. Moreover, the impact of stress on micronutrients in different populations varying in age, gender, and premorbid health status and the durability of changes after a stressor is resolved require examination. The medical, physical, and psychological implications of nutrient changes caused by a stressor also remain to be determined.

Potential Antioxidant Activity of Calcium and Selected Oxidative Stress Markers in Lead- and Cadmium-Exposed Workers

Occupational lead (Pb) and cadmium (Cd) exposure occurs during processing and casting of nonferrous metals such as zinc. In contrast to Pb and Cd, Ca is essential for living organisms due to its important role in a multitude of functions, from cell signaling to bone growth. Pb and Cd exposure affects calcium metabolism in various ways. The aim of this study was to investigate the blood levels of Pb, Cd, and Ca and the levels of selected oxidative stress biomarkers in workers exposed to Pb and Cd. Population groups included 264 male employees in a lead-zinc smelter. The study population was divided into two subgroups based on the median of Ca serum level (2.42 mmol/l): the low-Ca-level group (L-Ca group) and the high-Ca-level group (H-Ca group). Ca level was significantly higher in the H-Ca group than in the L-Ca group due to the study design (by 26%). The level of zinc protoporphyrin (ZPP) was significantly higher in the L-Ca group than in the H-Ca group by 13%, while the blood lead levels (PbB) were similar in the examined groups. The level of cadmium (CdB) was significantly higher in the L-Ca group than in the H-Ca group by 33%. From oxidative stress markers in serum, only the levels of malondialdehyde (MDA) and ceruloplasmin (CER) were significantly higher in the L-Ca group than in the H-Ca group, by 12% and 4%, respectively. The correlation analysis showed negative correlations between Ca level and the levels of PbB, ZPP, CdB, and MDA. The presented results indicate that Ca level modulates the serum concentration of Cd and has an impact on Pb-induced impairment of heme synthesis. The higher Ca levels may lead to a decrease in the concentration of lipid peroxidation products. Moreover, serum calcium level seems to be able to modify the level of acute-phase proteins. Obtained results suggest that higher Ca level may be useful in reducing Cd level in occupationally exposed workers.

Compound Analysis of Jing Liqueur and nrf2 Activation by Jing Liqueur—One of the Most Popular Beverages in China

The aim of this study is to identify the minor compounds in Jing liqueur, determine the concentration of metals, amino acids, and polysaccharides, and evaluate their Nrf2 activity and cytotoxicity. Jing liqueur that contains Chinese medicine is one of the best-selling liqueurs in China, which is also marketed in the United States. Totally, we have isolated 189 minor compounds including one new molecule (7) from a concentrated Jing liqueur, with the concentrations of most isolated compounds at micromolar levels. The structures of all these compounds were determined by using MS and NMR (1D and 2D) or by comparison of their chemical and physical data with reported values in the literatures. Besides, the concentrations of iron (0.52 mg/L), zinc (0.21 mg/L), calcium (11.0 mg/L), L-proline (2.33 mg/L), L-arginine (1.73 mg/L), total amino acids (9.84 mg/L), and total polysaccharides (337.4 mg/L) were determined. Jing liqueur, the five fractions and most of the compounds isolated from Jing liqueur were screened for their activities in the Nrf2-ARE and MTT assays. At 5.2 mg/mL the crude enhanced the Nrf2 activity. At 80 μg/mL, fraction IV weakly but fraction V strongly activated Nrf2. Among the compounds screened in the Nrf2 assay, eighteen activated Nrf2 at 40 μg/mL and compounds 51 and 126 from fraction V were the most active. The crude, all the five fractions, and Nrf2 activators were not cytotoxic toward HepG2 cells. In conclusion, Jing liqueur contains different classes of compounds including flavonoids, terpenoids, alkaloids, coumarins, cinnamic acid or coumaric acid, and phenyl ethanol (or acetic acid) derivatives, benzoquinone, naphthoquinone, anthraquinones or phenanphrene derivatives, xanthones, chromone, and γ-pyrone derivatives, lignans, other aromatic compounds, and others. Jing liqueur and the eighteen compounds, which were isolated from Jing liqueur, could activate Nrf2 without any cytotoxicity.

Unforeseen Hodgkin Lymphoma Hidden behind Hypercalcemia

As one of the leading causes of hypercalcemia, malignancy is an essential consideration when patients present with such symptomology. While certain tumors are more known to cause hypercalcemia, it can occur with almost any type of cancer. Hodgkin lymphoma is an infrequent cause of hypercalcemia. Only a few case reports have been published in the literature to date. We report an unusual case of a 61-year-old female who presented with altered mental status, nausea, vomiting, and dizziness and was found to have multiple enlarged lymph nodes, and blood work showed hypercalcemia. Biopsy of the cervical lymph node showed Hodgkin lymphoma of the nodular sclerosis subtype. Our case aims to raise awareness of this rare but significant presentation of hypercalcemia and how timely treatment of calcium levels can facilitate the employment of available chemotherapeutic options.

Association of supplemental calcium and dairy milk intake with all-cause and cause-specific mortality in the UK Biobank: a prospective cohort study

Excessive Ca intakes have been proposed to associate with vascular calcification and a higher risk of prostate cancer. We investigated the associations of supplemental and dietary Ca intake with mortality using data from 497 828 UK Biobank participants. The average follow-up was 4·2 years and 14 255 participants died, 8297 from cancer, 2959 from CVD and 572 from respiratory disease. The use of Ca supplements and milk consumption were associated with differences in mortality in younger (≤65 years) but not in older participants (>65 years, Pinteraction ≤ 0·04 for all comparisons). Among participants <65 years, there was an inverse association between Ca supplementation (OR 0·91, 95 % CI 0·83, 0·99) and milk consumption (OR 0·93, 95 % CI 0·86, 1·00) with respect to all-cause mortality. In the same age group, milk drinkers had lower odds of cancer mortality (OR 0·89, 95 % CI 0·80, 0·98) but Ca supplement use was associated with increased odds of respiratory mortality (OR 1·69, 95 % CI 1·16, 2·74). All associations in participants aged ≥65 years were null after full adjustment. In sensitivity analyses stratified by hormone replacement therapy, Ca supplement use was associated with decreased odds of cancer mortality in users but increased risk in other women (OR 0·81, 95 % CI 0·69, 0·94 v. OR 1·17, 95 % CI 1·01, 1·35, respectively). To conclude, we saw little evidence for harm with dietary or supplemental Ca. Further studies are required to confirm the proposed interaction with hormone replacement therapy and to exclude reverse causation as a determinant in the association between Ca supplements and increased risk of respiratory diseases.

Current Trends on Seaweeds: Looking at Chemical Composition, Phytopharmacology, and Cosmetic Applications

Seaweeds have received huge interest in recent years given their promising potentialities. Their antioxidant, anti-inflammatory, antitumor, hypolipemic, and anticoagulant effects are among the most renowned and studied bioactivities so far, and these effects have been increasingly associated with their content and richness in both primary and secondary metabolites. Although primary metabolites have a pivotal importance such as their content in polysaccharides (fucoidans, agars, carragenans, ulvans, alginates, and laminarin), recent data have shown that the content in some secondary metabolites largely determines the effective bioactive potential of seaweeds. Among these secondary metabolites, phenolic compounds feature prominently. The present review provides the most remarkable insights into seaweed research, specifically addressing its chemical composition, phytopharmacology, and cosmetic applications.

Phytochemical screening and nutraceutical potential of sandbox tree (Hura crepitans L.) seed oil

The aim of this research was to assess the nutraceutical potential of Hura crepitans seed oil in food chemi- stry. For that, we determined the phytochemical composition, physicochemical parameters, mineral composition, as well as proximates of the oil under study. The yield of the oil obtained by the Soxhlet method was 47.8 ± 0.2%. According to the phytochemical screening result, the oil contained saponin, alkaloid, terpenoids, steroids, and cardenolides. Quantitative analysis of proximates for the Hura crepitans seed oil displayed 10.1 ± 0.4% of protein, 19.4 ± 0.1% of crude fibres, 14.5 ± 0.5% of carbohydrates, 5.3 ± 0.2% of water, and 2.9 ± 0.1% of ash. Some selected physicochemical parameters such as refractive index, pH, and specific gravity were 1.47; 5.2; and 0.80, respectively. Cloud point was 6.20°C. Metal content determination revealed the presence of mineral substances such as magne- sium (119.51 ± 0.25 mg/kg), potassium (4.25 ± 0.04 ppm), iron (4.01 ± 0.03 mg/kg), manganese (3.66 ± 0.02 ppm), so- dium (2.18 ± 0.02 ppm), calcium (0.11 ± 0.001 ppm), zinc (0.04 ± 0.001 µg/g), and cadmium (0.0028 ± 0.0004 mg/kg). However, such minerals as nickel and lead were not detected. The structural analyse was carried out based on phy- sicochemical properties and spectroscopic data of the Hura crepitans seed oil. The results of the research proved the nutraceutical potential of this oil to use as raw materials in various areas of industry.

Biomarkers of Osteoporosis: An Update

Background:

Osteoporosis, characterized by compromised bone quality and strength is associated with bone fragility and fracture risk. Biomarkers are crucial for the diagnosis or prognosis of a disease as well as elucidating the mechanism of drug action and improve decision making.

Objective:

An exhaustive description of traditional markers including bone mineral density, vitamin D, alkaline phosphatase, along with potential markers such as microarchitectural determination, trabecular bone score, osteocalcin, etc. is provided in the current piece of work. This review provides insight into novel pathways such as the Wnt signaling pathway, neuro-osseous control, adipogenic hormonal imbalance, gut-bone axis, genetic markers and the role of inflammation that has been recently implicated in osteoporosis.

Methods:

We extensively reviewed articles from the following databases: PubMed, Medline and Science direct. The primary search was conducted using a combination of the following keywords: osteoporosis, bone, biomarkers, bone turnover markers, diagnosis, density, architecture, genetics, inflammation.

Conclusion:

Early diagnosis and intervention delay the development of disease and improve treatment outcome. Therefore, probing for novel biomarkers that are able to recognize people at high risk for developing osteoporosis is an effective way to improve the quality of life of patients and to understand the pathomechanism of the disease in a better way.