151
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Murphy CH, Flanagan EM, De Vito G, Susta D, Mitchelson KAJ, de Marco Castro E, Senden JMG, Goessens JPB, Mikłosz A, Chabowski A, Segurado R, Corish CA, McCarthy SN, Egan B, van Loon LJC, Roche HM. Does supplementation with leucine-enriched protein alone and in combination with fish-oil-derived n-3 PUFA affect muscle mass, strength, physical performance, and muscle protein synthesis in well-nourished older adults? A randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 2021; 113:1411-1427. [PMID: 33871558 PMCID: PMC8168361 DOI: 10.1093/ajcn/nqaa449] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/29/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Leucine-enriched protein (LEU-PRO) and long-chain (LC) n-3 (ω-3) PUFAs have each been proposed to improve muscle mass and function in older adults, whereas their combination may be more effective than either alone. OBJECTIVE The impact of LEU-PRO supplementation alone and combined with LC n-3 PUFAs on appendicular lean mass, strength, physical performance and myofibrillar protein synthesis (MyoPS) was investigated in older adults at risk of sarcopenia. METHODS This 24-wk, 3-arm parallel, randomized, double-blind, placebo-controlled trial was conducted in 107 men and women aged ≥65 y with low muscle mass and/or strength. Twice daily, participants consumed a supplement containing either LEU-PRO (3 g leucine, 10 g protein; n = 38), LEU-PRO plus LC n-3 PUFAs (0.8 g EPA, 1.1 g DHA; LEU-PRO+n-3; n = 38), or an isoenergetic control (CON; n = 31). Appendicular lean mass, handgrip strength, leg strength, physical performance, and circulating metabolic and renal function markers were measured pre-, mid-, and postintervention. Integrated rates of MyoPS were assessed in a subcohort (n = 28). RESULTS Neither LEU-PRO nor LEU-PRO+n-3 supplementation affected appendicular lean mass, handgrip strength, knee extension strength, physical performance or MyoPS. However, isometric knee flexion peak torque (treatment effect: -7.1 Nm; 95% CI: -12.5, -1.8 Nm; P < 0.01) was lower postsupplementation in LEU-PRO+n-3 compared with CON. Serum triacylglycerol and total adiponectin concentrations were lower, and HOMA-IR was higher, in LEU-PRO+n-3 compared with CON postsupplementation (all P < 0.05). Estimated glomerular filtration rate was higher and cystatin c was lower in LEU-PRO and LEU-PRO+n-3 postsupplementation compared with CON (all P < 0.05). CONCLUSIONS Contrary to our hypothesis, we did not observe a beneficial effect of LEU-PRO supplementation alone or combined with LC n-3 PUFA supplementation on appendicular lean mass, strength, physical performance or MyoPS in older adults at risk of sarcopenia. This trial was registered at clinicaltrials.gov as NCT03429491.
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Affiliation(s)
- Caoileann H Murphy
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Ellen M Flanagan
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Giuseppe De Vito
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland,Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Davide Susta
- School of Health and Human Performance, Dublin City University, Dublin, Ireland,Department of Normal Physiology, IM Sechenov First Moscow State Medical University, Moscow, Russia
| | - Kathleen A J Mitchelson
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Elena de Marco Castro
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Joan M G Senden
- Department of Human Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Joy P B Goessens
- Department of Human Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Agnieszka Mikłosz
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
| | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
| | - Ricardo Segurado
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland,UCD Centre for Support and Training in Analysis and Research (CSTAR), University College Dublin, Dublin, Ireland
| | - Clare A Corish
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | | | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Luc J C van Loon
- Department of Human Movement Sciences, Maastricht University, Maastricht, Netherlands
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152
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Münzer T. [Anti-Aging - healthy aging]. Dtsch Med Wochenschr 2021; 146:543-551. [PMID: 33853172 DOI: 10.1055/a-0986-5052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Anti-aging products still are a big business worldwide. The most active promoters of anti-aging products currently are internet dealers, the cosmetic and the dairy industry or companies that sell nutritional supplements. Only a few of the advertised substances however have been studied in clinical trials under robust conditions. Several drugs demonstrate positive effects on intracellular mechanisms that are associated with delayed cellular aging. This does not mean that they are in delaying human aging. In contrast, key elements that provide successful healthy and long aging in humans are physical and mental activity a balanced, mediterranean diet and social contacts.
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153
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Shardell M, Cappola AR, Guralnik JM, Hicks GE, Kritchevsky SB, Simonsick EM, Ferrucci L, Semba RD, Shaffer NC, Harris T, Eiriksdottir G, Gudnason V, Cotch MF, Orwoll E, Ensrud KE, Cawthon PM. Sex-specific 25-hydroxyvitamin D threshold concentrations for functional outcomes in older adults: PRoject on Optimal VItamin D in Older adults (PROVIDO). Am J Clin Nutr 2021; 114:16-28. [PMID: 33826696 PMCID: PMC8246604 DOI: 10.1093/ajcn/nqab025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/26/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Threshold serum 25-hydroxyvitamin D [25(OH)D] concentrations for extraskeletal outcomes are uncertain and could differ from recommendations (20-30 ng/mL) for skeletal health. OBJECTIVES We aimed to identify and validate sex-specific threshold 25(OH)D concentrations for older adults' physical function. METHODS Using 5 large prospective, population-based studies-Age, Gene/Environment Susceptibility-Reykjavik (n = 4858, Iceland); Health, Aging, and Body Composition (n = 2494, United States); Invecchiare in Chianti (n = 873, Italy); Osteoporotic Fractures in Men (n = 2301, United States); and Study of Osteoporotic Fractures (n = 5862, United States)-we assessed 16,388 community-dwelling adults (10,376 women, 6012 men) aged ≥65 y. We analyzed 25(OH)D concentrations with the primary outcome (incident slow gait: women <0.8 m/s; men <0.825 m/s) and secondary outcomes (gait speed, incident self-reported mobility, and stair climb impairment) at median 3.0-y follow-up. We identified sex-specific 25(OH)D thresholds that best discriminated incident slow gait using machine learning in training data (2/3 cohort-stratified random sample) and validated using the remaining (validation) data and secondary outcomes. RESULTS Mean age in the cohorts ranged from 74.4 to 76.5 y in women and from 73.3 to 76.6 y in men. Overall, 1112/6123 women (18.2%) and 494/3937 men (12.5%) experienced incident slow gait, 1098/7011 women (15.7%) and 474/3962 men (12.0%) experienced incident mobility impairment, and 1044/6941 women (15.0%) and 432/3993 men (10.8%) experienced incident stair climb impairment. Slow gait was best discriminated by 25(OH)D <24.0 ng/mL compared with 25(OH)D ≥24.0 ng/mL in women (RR: 1.29; 95% CI: 1.10, 1.50) and 25(OH)D <21.0 ng/mL compared with 25(OH)D ≥21.0 ng/mL in men (RR: 1.43; 95% CI: 1.01, 2.02). Most associations between 25(OH)D and secondary outcomes were modest; estimates were similar between validation and training datasets. CONCLUSIONS Empirically identified and validated sex-specific threshold 25(OH)D concentrations for physical function for older adults, 24.0 ng/mL for women and 21.0 ng/mL for men, may inform candidate reference concentrations or the design of vitamin D intervention trials.
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Affiliation(s)
| | - Anne R Cappola
- University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Jack M Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gregory E Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | | | - Richard D Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | | | - Mary Frances Cotch
- National Eye Institute, Intramural Research Program, Division of Epidemiology and Clinical Applications, Bethesda, MD, USA
| | - Eric Orwoll
- Oregon Health & Science University, Portland, OR, USA
| | - Kristine E Ensrud
- University of Minnesota Department of Medicine and Division of Epidemiology, Minneapolis, MN, USA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
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154
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de Boer IH, Prince DK, Williams K, Allen NB, Burke GL, Hoofnagle AN, Hsu S, Li X, Liu KJ, McClelland RL, Michos ED, Psaty BM, Shea SJ, Rice KM, Rotter JI, Siscovick DS, Tracy RP, Watson KE, Kestenbaum BR. The Multi-Ethnic Study of Atherosclerosis individual response to vitamin D trial: Building a randomized clinical trial into an observational cohort study. Contemp Clin Trials 2021; 103:106318. [PMID: 33588078 PMCID: PMC8089051 DOI: 10.1016/j.cct.2021.106318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 11/21/2022]
Abstract
The INdividual response to VITamin D (INVITe) trial was a randomized, placebo-controlled, parallel group trial of vitamin D3 supplementation (2000 IU daily) designed to determine clinical and genetic characteristics that modify the response to vitamin D supplementation. To enhance internal and external validity and reduce cost, the INVITe trial was nested within the Multi-Ethnic Study of Atherosclerosis (MESA), an ongoing prospective observational cohort study. The INVITe trial enrolled a community-based population of 666 racially and ethnically diverse participants from January 2017 to April 2019. This represents 30% of 2210 MESA participants approached for screening, and 96% of those found to be eligible. Barriers to enrollment included delayed initiation of the trial relative to scheduled MESA study visits, a lower number of available MESA participants than expected, and a high prevalence (18%) of high-dose vitamin D supplementation (>1000 IU daily, an exclusion criterion). The final study visit was attended by 611 participants (92%), and median adherence was 98%. Our experience suggests that integration of a randomized trial into an existing observational cohort study may leverage strengths of the source population and enhance enrollment, retention, and adherence, although with limited enrollment capacity. The INVITe trial will use rigorously-collected data to advance understanding of individual determinants of vitamin D response.
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Affiliation(s)
- Ian H de Boer
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, United States of America.
| | - David K Prince
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, United States of America
| | - Kayleen Williams
- Department of Biostatistics, University of Washington, Seattle, WA, United States of America
| | - Norrina B Allen
- Department of Internal Medicine, Northwestern University, Chicago, IL, United States of America
| | - Gregory L Burke
- Division of Public Health Sciences Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA, United States of America
| | - Simon Hsu
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, United States of America
| | - Xiaohui Li
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Kiang J Liu
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States of America
| | - Robyn L McClelland
- Department of Biostatistics, University of Washington, Seattle, WA, United States of America
| | - Erin D Michos
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States of America; Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, WA, United States of America; Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of America
| | - Steven J Shea
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, United States of America; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Kenneth M Rice
- Department of Biostatistics, University of Washington, Seattle, WA, United States of America
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - David S Siscovick
- New York Academy of Medicine, New York, NY, United States of America
| | - Russell P Tracy
- Departments of Pathology & Laboratory Medicine, and Biochemistry, University of Vermont Larner College of Medicine, Burlington, VT, United States of America
| | - Karol E Watson
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Bryan R Kestenbaum
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, United States of America
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155
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Steurer J. [Not Available]. PRAXIS 2021; 110:277-278. [PMID: 33849285 DOI: 10.1024/1661-8157/a003652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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156
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Berger MM, Herter-Aeberli I, Zimmermann MB, Spieldenner J, Eggersdorfer M. Strengthening the immunity of the Swiss population with micronutrients: A narrative review and call for action. Clin Nutr ESPEN 2021; 43:39-48. [PMID: 34024545 PMCID: PMC7987506 DOI: 10.1016/j.clnesp.2021.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The enormous health impact of the COVID-19 pandemic has refocused attention on measures to optimize immune function and vaccine response. Dietary deficiencies of micronutrients can weaken adaptive immunity. The aim of this review was to examine links between micronutrients, immune function and COVID-19 infection, with a focus on nutritional risks in subgroups of the Swiss population. METHODS Scoping review on the associations between selected micronutrients (vitamins D and C, iron, selenium, zinc, and n-3 PUFAs) and immunity, with particular reference to the Swiss population. These nutrients were chosen because previous EFSA reviews have concluded they play a key role in immunity. RESULTS The review discusses the available knowledge on links between sufficient nutrient status, optimal immune function, and prevention of respiratory tract infections. Because of the rapid spread of the COVID-19 pandemic, controlled intervention studies of micronutrients in the context of COVID-19 infection are now underway, but evidence is not yet available to draw conclusions. The anti-inflammatory properties of n-3 PUFAs are well established. In Switzerland, several subgroups of the population are at clear risk of nutrient deficiencies; e.g., older adults, multiple comorbidities, obesity, pregnancy, and institutionalized. Low intakes of n-3 PUFA are present in a large proportion of the population. CONCLUSION There are clear and strong relationships between micronutrient and n-3 PUFA status and immune function, and subgroups of the Swiss population are at risk for deficient intakes. Therefore, during the COVID-19 pandemic, as a complement to a healthy and balanced diet, it may be prudent to consider supplementation with a combination of moderate doses of Vitamins C and D, as well as of Se, Zn and n-3 PUFA, in risk groups.
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Affiliation(s)
- Mette M Berger
- Lausanne University Hospital (CHUV) & University of Lausanne, Lausanne, Switzerland.
| | - Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zürich, Zurich, Switzerland.
| | | | | | - Manfred Eggersdorfer
- Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
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157
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Abstract
Frailty is a condition marked by greater susceptibility to adverse outcomes, including disability and mortality, which affects up to 50% of those 80 years of age and older. Concurrently, serum vitamin D insufficiency and deficiency, for which as many as 70% of older adults may be at risk, potentially play an important role in frailty onset and progression. Large population driven studies have uncovered associations between low serum vitamin D levels and higher incidence of frailty. However, attempts to apply vitamin D therapeutically to treat and/or prevent frailty have not yielded consistent support for benefits. Given the complexity and inconsistency arising from human studies involving vitamin D, our research group has recently published on animal models of vitamin D insufficiency. Combining our model with the emerging development of animal frailty assessment, we identified that higher than standard levels of vitamin D supplementation may delay frailty in mice. In this viewpoint article, we will discuss current knowledge regarding the importance of vitamin D in frailty progression, the emerging significance of animal models in addressing these relationships, and the future for pre-clinical and clinical research.
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158
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Burtscher J, Millet GP, Burtscher M. Evaluation of a Strength-Training Program on Clinical Outcomes in Older Adults. JAMA 2021; 325:1110-1111. [PMID: 33724320 DOI: 10.1001/jama.2021.0337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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159
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Bischoff-Ferrari HA, Theiler R, de Godoi Rezende Costa Molino C. Evaluation of a Strength-Training Program on Clinical Outcomes in Older Adults-Reply. JAMA 2021; 325:1112-1113. [PMID: 33724322 DOI: 10.1001/jama.2021.0304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Heike A Bischoff-Ferrari
- Department of Geriatric Medicine and Aging Research, University Hospital Zurich, Zurich, Switzerland
| | - Robert Theiler
- Department of Geriatric Medicine and Aging Research, University Hospital Zurich, Zurich, Switzerland
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160
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Nigg CR, Resnick B, Marquez DX. Evaluation of a Strength-Training Program on Clinical Outcomes in Older Adults. JAMA 2021; 325:1111-1112. [PMID: 33724319 DOI: 10.1001/jama.2021.0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Claudio R Nigg
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | | | - David X Marquez
- Department of Kinesiology and Nutrition, University of Illinois at Chicago
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161
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Affiliation(s)
- David E Leaf
- Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora
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162
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Baumann CW, Manini TM, Clark BC. Evaluation of a Strength-Training Program on Clinical Outcomes in Older Adults. JAMA 2021; 325:1111. [PMID: 33724318 PMCID: PMC8148633 DOI: 10.1001/jama.2021.0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Cory W. Baumann
- Ohio Musculoskeletal and Neurological Institute and the Department of Biomedical Sciences at Ohio University, Athens, Ohio, USA
| | - Todd M. Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida, USA
| | - Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute and the Department of Biomedical Sciences at Ohio University, Athens, Ohio, USA
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163
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Vitamin D and Cardiovascular Disease: An Updated Narrative Review. Int J Mol Sci 2021; 22:ijms22062896. [PMID: 33809311 PMCID: PMC7998446 DOI: 10.3390/ijms22062896] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/16/2022] Open
Abstract
During the last two decades, the potential impact of vitamin D on the risk of cardiovascular disease (CVD) has been rigorously studied. Data regarding the effect of vitamin D on CVD risk are puzzling: observational data indicate an inverse nonlinear association between vitamin D status and CVD events, with the highest CVD risk at severe vitamin D deficiency; however, preclinical data and randomized controlled trials (RCTs) show several beneficial effects of vitamin D on the surrogate parameters of vascular and cardiac function. By contrast, Mendelian randomization studies and large RCTs in the general population and in patients with chronic kidney disease, a high-risk group for CVD events, largely report no significant beneficial effect of vitamin D treatment on CVD events. In patients with rickets and osteomalacia, cardiovascular complications are infrequently reported, except for an increased risk of heart failure. In conclusion, there is no strong evidence for beneficial vitamin D effects on CVD risk, either in the general population or in high-risk groups. Whether some subgroups such as individuals with severe vitamin D deficiency or a combination of low vitamin D status with specific gene variants and/or certain nutrition/lifestyle factors would benefit from vitamin D (metabolite) administration, remains to be studied.
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164
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Bivona G, Lo Sasso B, Gambino CM, Giglio RV, Scazzone C, Agnello L, Ciaccio M. The Role of Vitamin D as a Biomarker in Alzheimer's Disease. Brain Sci 2021; 11:brainsci11030334. [PMID: 33800891 PMCID: PMC8000099 DOI: 10.3390/brainsci11030334] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 01/01/2023] Open
Abstract
Vitamin D and cognition is a popular association, which led to a remarkable body of literature data in the past 50 years. The brain can synthesize, catabolize, and receive Vitamin D, which has been proved to regulate many cellular processes in neurons and microglia. Vitamin D helps synaptic plasticity and neurotransmission in dopaminergic neural circuits and exerts anti-inflammatory and neuroprotective activities within the brain by reducing the synthesis of pro-inflammatory cytokines and the oxidative stress load. Further, Vitamin D action in the brain has been related to the clearance of amyloid plaques, which represent a feature of Alzheimer Disease (AD), by the immune cell. Based on these considerations, many studies have investigated the role of circulating Vitamin D levels in patients affected by a cognitive decline to assess Vitamin D’s eventual role as a biomarker or a risk factor in AD. An association between low Vitamin D levels and the onset and progression of AD has been reported, and some interventional studies to evaluate the role of Vitamin D in preventing AD onset have been performed. However, many pitfalls affected the studies available, including substantial discrepancies in the methods used and the lack of standardized data. Despite many studies, it remains unclear whether Vitamin D can have a role in cognitive decline and AD. This narrative review aims to answer two key questions: whether Vitamin D can be used as a reliable tool for diagnosing, predicting prognosis and response to treatment in AD patients, and whether it is a modifiable risk factor for preventing AD onset.
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Affiliation(s)
- Giulia Bivona
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Bruna Lo Sasso
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
- Department of Laboratory Medicine, AOUP “P. Giaccone”, 90127 Palermo, Italy
| | - Caterina Maria Gambino
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Rosaria Vincenza Giglio
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Concetta Scazzone
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Luisa Agnello
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Marcello Ciaccio
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
- Department of Laboratory Medicine, AOUP “P. Giaccone”, 90127 Palermo, Italy
- Correspondence:
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165
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Vitamin D, Omega-3-Fettsäuren und Krafttraining ohne messbare Effekte bei Älteren. Dtsch Med Wochenschr 2021. [DOI: 10.1055/a-1349-3295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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166
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Bischoff-Ferrari HA, Kressig RW, Meier C, Stute P. Empfehlung zu Vitamin D im Rahmen der COVID-19-Pandemie für Geriater*Innen und Hausärzt*Innen. JOURNAL FÜR GYNÄKOLOGISCHE ENDOKRINOLOGIE/SCHWEIZ 2021. [PMCID: PMC7889707 DOI: 10.1007/s41975-021-00180-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Heike A. Bischoff-Ferrari
- Geriatrie, Universitätsspital Zürich, Zürich, Schweiz
- Universitäre Klinik für Akutgeriatrie, Stadtspital Waid & Triemli, Zürich, Schweiz
- Lehrstuhl Geriatrie und Altersforschung, Universität Zürich, Zürich, Schweiz
| | - Reto W. Kressig
- Universitäre Altersmedizin FELIX PLATTER, Basel, Schweiz
- Klinische Professur für Geriatrie, Universität Basel, Basel, Schweiz
| | - Christian Meier
- Klinik für Endokrinologie, Diabetologie und Metabolismus, Universitätsspital Basel, Basel, Schweiz
- Endokrinologische Praxis, Osteologisches Universitätsforschungszentrum DVO, Basel, Schweiz
| | - Petra Stute
- Abteilung für Gynäkologische Endokrinologie und Reproduktionsmedizin, Frauenklinik, Inselspital, Friedbühlstrasse 19, 3010 Bern, Schweiz
- Schweizerische Gesellschaft für Gynäkologische Endokrinologie und Menopause, SGEM, Lausanne, Schweiz
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167
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Thiem U, Heppner HJ, Sieber C. [Less can be more-Examples on medication in older and geriatric patients from current studies]. Internist (Berl) 2021; 62:363-372. [PMID: 33630097 DOI: 10.1007/s00108-021-00981-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 11/25/2022]
Abstract
Polypharmacy, i.e. the prescription of five or more different drugs for medicinal treatment, is a typical problem in older and geriatric patients. Polypharmacy predisposes to different negative health sequelae, such as undesired side effects, drug interactions, potentially inappropriate medication, reduced functional abilities, increased hospitalization and increased mortality. Various consensus groups and specialist societies have developed recommendations on how to handle polypharmacy in geriatric patients. Although concepts to reduce the number of drugs are considered necessary, in many areas there is a lack of evidence on how to limit polypharmacy in geriatric patients and to reduce and discontinue medication. This article presents examples of recent studies dealing with potentially inappropriate medication, vitamin D substitution and antipsychotic drugs, which show how to critically appraise a prescribed medication, to critically check the indications for drugs and to discontinue drug use.
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Affiliation(s)
- U Thiem
- Lehrstuhl für Geriatrie und Gerontologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
- Zentrum für Altersmedizin, Medizinisch-Geriatrische Klinik, Albertinen-Haus, Sellhopsweg 18-22, 22459, Hamburg, Deutschland.
| | - H J Heppner
- Lehrstuhl für Geriatrie, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Deutschland
- Klinik für Geriatrie mit Tagesklinik, Helios Klinikum, Schwelm, Deutschland
- Lehrstuhl für Innere Medizin und Geriatrie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland
| | - C Sieber
- Lehrstuhl für Innere Medizin und Geriatrie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland
- Department für Innere Medizin, Kantonsspital Winterthur, Winterthur, Schweiz
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168
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Surdu AM, Pînzariu O, Ciobanu DM, Negru AG, Căinap SS, Lazea C, Iacob D, Săraci G, Tirinescu D, Borda IM, Cismaru G. Vitamin D and Its Role in the Lipid Metabolism and the Development of Atherosclerosis. Biomedicines 2021; 9:172. [PMID: 33572397 PMCID: PMC7916166 DOI: 10.3390/biomedicines9020172] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/12/2022] Open
Abstract
Vitamin D, a crucial hormone in the homeostasis and metabolism of calcium bone, has lately been found to produce effects on other physiological and pathological processes genomically and non-genomically, including the cardiovascular system. While lower baseline vitamin D levels have been correlated with atherogenic blood lipid profiles, 25(OH)D supplementation influences the levels of serum lipids in that it lowers the levels of total cholesterol, triglycerides, and LDL-cholesterol and increases the levels of HDL-cholesterol, all of which are known risk factors for cardiovascular disease. Vitamin D is also involved in the development of atherosclerosis at the site of the blood vessels. Deficiency of this vitamin has been found to increase adhesion molecules or endothelial activation and, at the same time, supplementation is linked to the lowering presence of adhesion surrogates. Vitamin D can also influence the vascular tone by increasing endothelial nitric oxide production, as seen in supplementation studies. Deficiency can lead, at the same time, to oxidative stress and an increase in inflammation as well as the expression of particular immune cells that play a pivotal role in the development of atherosclerosis in the intima of the blood vessels, i.e., monocytes and macrophages. Vitamin D is also involved in atherogenesis through inhibition of vascular smooth muscle cell proliferation. Furthermore, vitamin D deficiency is consistently associated with cardiovascular events, such as myocardial infarction, STEMI, NSTEMI, unstable angina, ischemic stroke, cardiovascular death, and increased mortality after acute stroke. Conversely, vitamin D supplementation does not seem to produce beneficial effects in cohorts with intermediate baseline vitamin D levels.
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Affiliation(s)
- Andrei Mihai Surdu
- Fifth Department of Internal Medicine, Cardiology Clinic, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Oana Pînzariu
- Sixth Department of Medical Specialties, Endocrinology, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Dana-Mihaela Ciobanu
- Sixth Department of Medical Specialties, Diabetes and Nutritional Diseases, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Alina-Gabriela Negru
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
| | - Simona-Sorana Căinap
- Pediatric Clinic No 2, Cardiology Department, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Cecilia Lazea
- Pediatric Clinic No 1, Cardiology Department, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Daniela Iacob
- Pediatric Clinic No 3, Cardiology Department, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - George Săraci
- Internal Medicine Department, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Dacian Tirinescu
- Sixth Department of Medical Specialties, Nephrology, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Ileana Monica Borda
- Sixth Department of Medical Specialties, Medical Rehabilitation, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Gabriel Cismaru
- Fifth Department of Internal Medicine, Cardiology-Rehabilitation, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
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169
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Dietary Supplements, Strength Training Offer no Significant Effects in Older Adults. Am J Nurs 2021; 121:69. [PMID: 33497135 DOI: 10.1097/01.naj.0000734160.02330.1c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
According to this study: A study of adults age 70 or older without major comorbidities showed that treatment with vitamin D3, omega-3 fatty acids, or a strength training exercise program didn't result in clinically significant changes in blood pressure, nonvertebral fractures, physical performance, infection rates, or cognitive function.
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170
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Scragg R, Sluyter JD. Is There Proof of Extraskeletal Benefits From Vitamin D Supplementation From Recent Mega Trials of Vitamin D? JBMR Plus 2021; 5:e10459. [PMID: 33553994 PMCID: PMC7839821 DOI: 10.1002/jbm4.10459] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/18/2022] Open
Abstract
Scientific interest in possible extraskeletal effects of vitamin D first appeared in the 1930s soon after the structure of vitamin D was characterized, and increased in the 1980s with the development of assays of 25-hydroxyvitamin D status as a marker of vitamin D status, which in observational epidemiological studies was shown to be inversely associated with many nonskeletal diseases. This resulted in the start of seven large randomized controlled trials (n > 2000 participants in each) of vitamin D supplementation giving higher doses than previously used. The intervention periods in these trials collectively started in 2009 and continued to 2020. They have recruited participants, mostly of both sexes and over the age of 50 years, from many countries and have given either daily or monthly doses of vitamin D. Collectively, the trials have a wide range of outcomes with the main focus on the prevention of cancer, cardiovascular disease, and fractures, besides many other outcomes. The findings of four trials have been published, and they have shown that vitamin D supplementation does not prevent hard-disease endpoints, such as cardiovascular disease, cancer, fractures, or falls, aside from a possible beneficial effect against cancer mortality. In contrast, beneficial effects were seen for intermediate outcomes such as BMD of spine and hips, arterial function, and lung function, especially in people with vitamin D deficiency. The finding of a benefit primarily in people with vitamin D deficiency, if confirmed by the other trials, would support a population approach to preventing vitamin D deficiency using fortification rather than the high-risk approach of screening for deficiency combined with supplementation. The findings on other outcomes from the three published trials, along with the findings from the four unpublished trials, are expected within the next 2 to 3 years to clarify the role of vitamin D supplementation in preventing nonskeletal disease. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Robert Scragg
- School of Population Health University of Auckland Auckland New Zealand
| | - John D Sluyter
- School of Population Health University of Auckland Auckland New Zealand
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171
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Fatty Acids and Cardiovascular Risk. Evidence, Lack of Evidence, and Diligence. Nutrients 2020; 12:nu12123782. [PMID: 33317164 PMCID: PMC7764656 DOI: 10.3390/nu12123782] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 12/11/2022] Open
Abstract
One of the most controversial areas of nutrition research relates to fats, particularly essential fatty acids, in the context of cardiovascular disease risk. A critical feature of dietary fatty acids is that they incorporate into the plasma membrane, modifying fluidity and key physiological functions. Importantly, they can reshape the bioavailability of eicosanoids and other lipid mediators, which direct cellular responses to external stimuli, such as inflammation and chronic stress conditions. This paper provides an overview of the most recent evidence, as well as historical controversies, linking fat consumption with human health and disease. We underscore current pitfalls in the area of fatty acid research and critically frame fatty acid intake in the larger context of diet and behavior. We conclude that fundamental research on fatty acids and lipids is appropriate in certain areas, but the rigor and reproducibility are lacking in others. The pros and cons are highlighted throughout the review, seeking to guide future research on the important area of nutrition, fat intake, and cardiovascular disease risk.
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