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Ayaz A, Zaman W, Radák Z, Gu Y. Harmony in Motion: Unraveling the Nexus of Sports, Plant-Based Nutrition, and Antioxidants for Peak Performance. Antioxidants (Basel) 2024; 13:437. [PMID: 38671884 PMCID: PMC11047508 DOI: 10.3390/antiox13040437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
The intricate interplay between plant-based nutrition, antioxidants, and their impact on athletic performance forms the cornerstone of this comprehensive review. Emphasizing the pivotal importance of dietary choices in the realm of sports, this paper sets the stage for an in-depth exploration of how stress and physical performance are interconnected through the lens of nutrition. The increasing interest among athletes in plant-based diets presents an opportunity with benefits for health, performance, and recovery. It is essential to investigate the connection between sports, plants, and antioxidants. Highlighting the impact of nutrition on recovery and well-being, this review emphasizes how antioxidants can help mitigate oxidative stress. Furthermore, it discusses the growing popularity of plant-based diets among athletes. It elaborates on the importance of antioxidants in combating radicals addressing stress levels while promoting cellular health. By identifying rich foods, it emphasizes the role of a balanced diet in ensuring sufficient intake of these beneficial compounds. Examining stress within the context of sports activities, this review provides insights into its mechanisms and its impact on athletic performance as well as recovery processes. This study explores the impact of plant-based diets on athletes including their types, potential advantages and challenges. It also addresses the drawbacks of relying on plant-based diets, concerns related to antioxidant supplementation and identifies areas where further research is needed. Furthermore, the review suggests directions for research and potential innovations in sports nutrition. Ultimately it brings together the aspects of sports, plant-based nutrition, and antioxidants to provide a perspective for athletes, researchers and practitioners. By consolidating existing knowledge, it offers insights that can pave the way for advancements in the ever-evolving field of sports nutrition.
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Affiliation(s)
- Asma Ayaz
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
| | - Wajid Zaman
- Department of Life Sciences, Yeungnam University, Gyeongsan 38541, Republic of Korea;
| | - Zsolt Radák
- Research Institute of Sport Science, University of Physical Education, 1123 Budapest, Hungary;
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
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2
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Clark A, Kuznesof S, Waller A, Davies S, Wilson S, Ritchie A, Duesterloh A, Harbord L, Hill TR. The Influence of Storage and Cooking on the Vitamin D Content of 25-Hydroxyvitamin D 3-Enriched Eggs. Foods 2023; 12:2522. [PMID: 37444260 DOI: 10.3390/foods12132522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Food fortification is an effective approach to improve vitamin D (VD) concentrations in foods. Eggs are a useful food vehicle for enrichment with VD via its hydroxylated metabolite, 25-hydroxyvitamin D (25-D3), in hen feed. This study determined the impact of time of lay, storage conditions (ambient and refrigeration) and common cooking methods (boiling, frying, scrambling, poaching and microwaving) on the vitamin D metabolite concentration of eggs enriched with 25-D3. Processed samples were freeze-dried and analysed for D3 and 25-D3 using an HPLC-MS(/MS) method. The results indicated that storage and cooking practices influence VD metabolites, with 25-D3 showing true retention of 72-111% and concentrations of 0.67-0.96 µg/100 g of whole egg. Vitamin D3 showed true retention of 50-152% and concentrations of 0.11-0.61 µg/100 g of whole egg. Depending on the storage and method of cooking applied, the calculated total VD activity of enriched eggs ranged from 3.45 to 5.43 µg/100 g of whole egg and was 22-132% higher in comparison to standardised VD content for non-enriched British eggs. The study suggests that 25-D3 is a stable metabolite in eggs following storage and cooking, and that 25-D3-enriched eggs may serve as a potent dietary source of VD.
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Affiliation(s)
- Adam Clark
- Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Sharron Kuznesof
- Applied Social Sciences, School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Anthony Waller
- DSM Nutritional Products Ltd., Heanor, Derbyshire DE75 7SG, UK
| | - Sarah Davies
- DSM Nutritional Products Ltd., Heanor, Derbyshire DE75 7SG, UK
| | - Simon Wilson
- Noble Foods Ltd., North Scarle, Lincolnshire LN6 9HA, UK
| | - Avril Ritchie
- Noble Foods Ltd., North Scarle, Lincolnshire LN6 9HA, UK
| | | | - Lance Harbord
- RLC & RM Harbord & Son, Bryants Court Farm, Ross-on-Wye, Herefordshire HR9 6JA, UK
| | - Thomas Robert Hill
- Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
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Shin HR, Lee YJ, Ly SY. Optimal Serum 25(OH)D Levels and Vitamin D Intake in Korean Postmenopausal Women. Nutrients 2023; 15:nu15081856. [PMID: 37111073 PMCID: PMC10144100 DOI: 10.3390/nu15081856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Vitamin D plays a crucial role in regulating the growth and maintenance of the musculoskeletal system. Postmenopausal women are vulnerable to bone fractures because of the decrease in bone mineral density (BMD). Therefore, this study aimed to identify the determinants that influence BMD and the 25(OH)D levels in Korean postmenopausal women. This study collected general and dietary intake information, measured biochemical indices, and conducted BMD tests in 96 postmenopausal women residing in a metropolitan area in Korea. This study analyzed factors that influenced serum 25-hydroxyvitamin D (25(OH)D) and BMD, as well as the correlation between the intact parathyroid hormone (iPTH) and serum 25(OH)D levels. The serum 25(OH)D levels increased by 0.226 ng/mL in the summertime, 0.314 ng/mL in the wintertime, and 0.370 ng/mL on annual average when vitamin D intake rose by 1 µg/1000 kcal. When the serum 25(OH)D levels were ≥18.9 ng/mL, the iPTH levels did not rapidly increase. To maintain the serum 25(OH)D levels at ≥18.9 ng/mL, a daily vitamin D intake of ≥13.21 µg was required. Consequently, consuming vitamin D-fortified foods or vitamin D supplements is necessary to improve both bone health and vitamin D nutritional status.
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Affiliation(s)
- Hye Ran Shin
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Ye Jin Lee
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Sun Yung Ly
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Republic of Korea
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Novel Approach for the Approximation of Vitamin D3 Pharmacokinetics from In Vivo Absorption Studies. Pharmaceutics 2023; 15:pharmaceutics15030783. [PMID: 36986644 PMCID: PMC10052077 DOI: 10.3390/pharmaceutics15030783] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/16/2023] [Accepted: 02/25/2023] [Indexed: 03/02/2023] Open
Abstract
The changing environment and modified lifestyles have meant that many vitamins and minerals are deficient in a significant portion of the human population. Therefore, supplementation is a viable nutritional approach, which helps to maintain health and well-being. The supplementation efficiency of a highly hydrophobic compound such as cholecalciferol (logP > 7) depends predominantly on the formulation. To overcome difficulties associated with the evaluation of pharmacokinetics of cholecalciferol, a method based on the short time absorption data in the clinical study and physiologically based mathematical modeling is proposed. The method was used to compare pharmacokinetics of liposomal and oily formulations of vitamin D3. The liposomal formulation was more effective in elevating calcidiol concentration in serum. The determined AUC value for liposomal vitamin D3 formulation was four times bigger than that for the oily formulation.
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Asfour MH, Abd El-Alim SH, Kassem AA, Salama A, Gouda AS, Nazim WS, Nashaat NH, Hemimi M, Abdel Meguid N. Vitamin D 3-Loaded Nanoemulsions as a Potential Drug Delivery System for Autistic Children: Formulation Development, Safety, and Pharmacokinetic Studies. AAPS PharmSciTech 2023; 24:58. [PMID: 36759398 DOI: 10.1208/s12249-023-02501-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/27/2022] [Indexed: 02/11/2023] Open
Abstract
The aim of the current study is the development of a vitamin D3 (VD3)-loaded nanoemulsion (NE) formulation to improve VD3 oral bioavailability for management of vitamin D inadequacy in autistic children. Eight NE formulations were prepared by high-speed homogenization followed by ultrasonication. Four vegetable oils were employed along with two concentrations of Span 20 as the emulsifier. Glycerol, fructose, and mango flavor were included as viscosity modifier, sweetening, and flavoring agents, respectively. The prepared VD3-loaded NE formulations exhibited high drug content (> 98%), droplet size (DS) ranging from 61.15 to 129.8 nm with narrow size distribution, zeta potential values between - 9.83 and - 19.22 mV, and acceptable pH values (4.59-5.89). Storage stability showed that NE formulations underwent coalescence and phase separation during 6 months at room temperature, whereas at refrigerated conditions, formulations showed slight creaming. The optimum formulation (VD3-NE6) revealed a non-significant DS growth at refrigerated conditions and spherical morphology under transmission electron microscopy. VD3-NE6 did not produce any toxic effects to rats treated orally for 3 months, where normal blood picture and kidney and liver functions were observed compared to control rats. Also, serum calcium, oxidative stress, and apoptosis biomarkers remained within normal levels, indicating the safety of the optimum formulation. Furthermore, evaluation of VD3-NE6 oral bioavailability depicted a significant increase in AUC0-72 and Cmax with decreased Tmax compared to plain VD3. The optimum formulation demonstrated improved stability, safety, and oral bioavailability indicating the potential for successful management of vitamin D deficiency in autistic children.
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Affiliation(s)
- Marwa Hasanein Asfour
- Pharmaceutical Technology Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Sameh Hosam Abd El-Alim
- Pharmaceutical Technology Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt.
| | - Ahmed Alaa Kassem
- Pharmaceutical Technology Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Abeer Salama
- Pharmacology Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Amr Sobhi Gouda
- Biochemical Genetics Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Walaa Samy Nazim
- Biochemical Genetics Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Neveen Hassan Nashaat
- Research On Children With Special Needs Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Maha Hemimi
- Research On Children With Special Needs Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Nagwa Abdel Meguid
- Research On Children With Special Needs Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
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Feng C, Song X, Chalamaiah M, Ren X, Wang M, Xu B. Vitamin D Fortification and Its Effect on Athletes' Physical Improvement: A Mini Review. Foods 2023; 12:foods12020256. [PMID: 36673348 PMCID: PMC9857868 DOI: 10.3390/foods12020256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/09/2023] Open
Abstract
Poor vitamin D status is a widespread problem regardless of age and sex, emphasizing the necessity of new food sources to improve vitamin D levels. Currently, approximately 60% of dietary vitamin D consumption occurs via fortified foods. Vitamin D insufficiency (50-90%) is widespread according to age and region, despite different levels of sunlight exposure. The food industry must identify more effective strategies to increase normal dietary vitamin D intake and improve overall health. Strategies for vitamin D fortification include bioaddition, wherein a vitamin D-rich food source is added to staple foods during processes. These bioadditive strategies expand the range of vitamin D-containing foods and appeal to different preferences, cultures, and economic statuses. In several countries, vitamin D deficiency places athletes at a high risk of disease susceptibility. Due to low sun exposure, athletes in countries with higher and lower levels of sunlight have similar risks of vitamin D deficiency. In this review, we summarize recent technical advances to promote vitamin D utilization by humans during sports activities and in relation to the normal practices of athletes.
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Affiliation(s)
- Cong Feng
- Department of Physical Education, Jiangsu University, Zhenjiang 212013, China
| | - Xinjie Song
- School of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou 310023, China
- Correspondence:
| | - Meram Chalamaiah
- Department of Agricultural, Food and Nutritional Science (AFNS), 4-10 Ag/For Centre, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Xiaofeng Ren
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Mingxing Wang
- Department of Business Administration, School of Business, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Baoguo Xu
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
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Vitamin D in Neurological Diseases. Int J Mol Sci 2022; 24:ijms24010087. [PMID: 36613531 PMCID: PMC9820561 DOI: 10.3390/ijms24010087] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Vitamin D may have multiple effects on the nervous system and its deficiency can represent a possible risk factor for the development of many neurological diseases. Recent studies are also trying to clarify the different effects of vitamin D supplementation over the course of progressive neurological diseases. In this narrative review, we summarise vitamin D chemistry, metabolism, mechanisms of action, and the recommended daily intake. The role of vitamin D on gene transcription and the immune response is also reviewed. Finally, we discuss the scientific evidence that links low 25-hydroxyvitamin D concentrations to the onset and progression of severe neurological diseases, such as multiple sclerosis, Parkinson's disease, Alzheimer's disease, migraine, diabetic neuropathy and amyotrophic lateral sclerosis. Completed and ongoing clinical trials on vitamin D supplementation in neurological diseases are listed.
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8
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Kessi-Pérez EI, González A, Palacios JL, Martínez C. Yeast as a biological platform for vitamin D production: A promising alternative to help reduce vitamin D deficiency in humans. Yeast 2022; 39:482-492. [PMID: 35581681 DOI: 10.1002/yea.3708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 11/08/2022] Open
Abstract
Vitamin D is an important human hormone, known primarily to be involved in the intestinal absorption of calcium and phosphate, but it is also involved in various non-skeletal processes (molecular, cellular, immune, and neuronal). One of the main health problems nowadays is the vitamin D deficiency of the human population due to lack of sun exposure, with estimates of one billion people worldwide with vitamin D deficiency, and the consequent need for clinical intervention (i.e., prescription of pharmacological vitamin D supplements). An alternative to reduce vitamin D deficiency is to produce good dietary sources of it, a scenario in which the yeast Saccharomyces cerevisiae seems to be a promising alternative. This review focuses on the potential use of yeast as a biological platform to produce vitamin D, summarizing both the biology aspects of vitamin D (synthesis, ecology and evolution, metabolism, and bioequivalence) and the work done to produce it in yeast (both for vitamin D2 and for vitamin D3 ), highlighting existing challenges and potential solutions. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Eduardo I Kessi-Pérez
- Centro de Estudios en Ciencia y Tecnología de Alimentos (CECTA), Universidad de Santiago de Chile (USACH), Santiago, Chile.,Departamento de Ciencia y Tecnología de los Alimentos, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Adens González
- Centro de Estudios en Ciencia y Tecnología de Alimentos (CECTA), Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - José Luis Palacios
- Centro de Estudios en Ciencia y Tecnología de Alimentos (CECTA), Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Claudio Martínez
- Centro de Estudios en Ciencia y Tecnología de Alimentos (CECTA), Universidad de Santiago de Chile (USACH), Santiago, Chile.,Departamento de Ciencia y Tecnología de los Alimentos, Universidad de Santiago de Chile (USACH), Santiago, Chile
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9
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Souza SVS, Borges N, Vieira EF. Vitamin d-fortified bread: Systematic review of fortification approaches and clinical studies. Food Chem 2022; 372:131325. [PMID: 34649031 DOI: 10.1016/j.foodchem.2021.131325] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/13/2021] [Accepted: 10/02/2021] [Indexed: 12/18/2022]
Abstract
Vitamin d-fortified bread has been proposed as a strategy to increase the average daily intake and serum status of this nutrient. This review aimed to bring together the different types of scientific articles on vitamin d-fortified bread. The databases used for the research were PUBMED, WEB of SCIENCE and SCOPUS; all original indexed studies written in English, published between January 2000 and March 2021, were considered. Three important points were identified: i) theoretical models of fortification; ii) stability, bioaccessibility, and bioavailability studies of vitamin d-fortified breads; and iii) clinical effects of vitamin d-fortified breads. This review showed that vitamin d-fortified bread is a promising vehicle for fortification strategy effects, leading to increased serum concentrations of 25(OH)D and decreased parathyroid hormone. However, further studies are needed to elucidate the effects and effectiveness of this fortification strategy in the prevention/treatment of vitamin D deficiency.
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Affiliation(s)
- Suene V S Souza
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Rua do Campo Alegre, 4150-180 Porto, Portugal
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Rua do Campo Alegre, 4150-180 Porto, Portugal; CINTESIS, Center for Health Technology and Services Research (CINTESIS). Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Elsa F Vieira
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4249-015 Porto, Portugal
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Umar SA, Tasduq SA. Ozone Layer Depletion and Emerging Public Health Concerns - An Update on Epidemiological Perspective of the Ambivalent Effects of Ultraviolet Radiation Exposure. Front Oncol 2022; 12:866733. [PMID: 35359420 PMCID: PMC8960955 DOI: 10.3389/fonc.2022.866733] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/17/2022] [Indexed: 12/15/2022] Open
Abstract
Solar ultraviolet (UV) radiation exposure is the primary etiological agent responsible for developing cutaneous malignancies. Avoiding excessive radiation exposure, especially by high-risk groups, is recommended to prevent UV-induced photo-pathologies. However, optimal sun exposure is essential for the healthy synthesis of about 90% of vitamin D levels in the body. Insufficient exposure to UV-B is linked to vitamin D deficiency in humans. Therefore, optimal sun exposure is necessary for maintaining a normal state of homeostasis in the skin. Humans worldwide face a major existential threat because of climate change which has already shown its effects in several ways. Over the last 4 to 5 decades, increased incidences in skin cancer cases have led international health organizations to develop strong sun protection measures. However, at the same time, a growing concern about vitamin D deficiency is creating a kind of exposure dilemma. Current knowledge of UV exposure to skin outweighs the adverse effects than the beneficial roles it offers to the body, necessitating a correct public health recommendation on optimal sun exposure. Following an appropriate recommendation on optimal sun exposure will lead to positive outcomes in protecting humans against the adverse effects of strict recommendations on sun protection measures. In this short review, we spotlight the ambivalent health effects of UV exposure and how ozone layer depletion has influenced these effects of UVR. Further, our aim remains to explore how to lead towards a balanced recommendation on sun protection measures to prevent the spurt of diseases due to inadequate exposure to UV-B.
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Affiliation(s)
- Sheikh Ahmad Umar
- Department of Biological Sciences, Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
- Pharmacokinetics-Pharmacodynamics (PK-PD) and Toxicology Division, Council of Scientific and Industrial Research-Indian (CSIR) Institute of Integrative Medicine, Jammu, India
| | - Sheikh Abdullah Tasduq
- Department of Biological Sciences, Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
- Pharmacokinetics-Pharmacodynamics (PK-PD) and Toxicology Division, Council of Scientific and Industrial Research-Indian (CSIR) Institute of Integrative Medicine, Jammu, India
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Hutchings N, Babalyan V, Heijboer AC, Baghdasaryan S, Qefoyan M, Ivanyan A, Ackermans MT, Formenti AM, Lesnyak O, Giustina A, Bilezikian JP. Vitamin D status in Armenian women: a stratified cross-sectional cluster analysis. Eur J Clin Nutr 2022; 76:220-226. [PMID: 33986494 PMCID: PMC8821010 DOI: 10.1038/s41430-021-00934-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 04/17/2021] [Accepted: 04/22/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vitamin D plays a critical role in skeletal development and maintenance, thus sufficiency is an important goal for public health programs. Given the absence of foods fortified in vitamin D in Armenia, we hypothesized that vitamin D insufficiency would be widespread. METHODS We conducted a random modified cluster model survey of vitamin D status of women in the country. We measured 25-hydroxyvitamin D [25(OH)D] by liquid chromatography mass spectrometry in dried blood spot samples and utilized a questionnaire to assess lifestyle factors. RESULTS In summer, we sampled 1206 participants from 40 communities in Armenia. Mean 25-OH D level among women aged 18-24 was 20 ± 8 ng/mL; aged 25-64 was 21 ± 7 ng/mL; and >65 was 18 ± 8 ng/mL. The country-wide mean of the entire female population was 20 ± 8 ng/mL. A majority (>54%) had 25-OH D levels <20 ng/mL with nearly 13% having 25-OH D levels <12 ng/mL. Participants who reported calcium, vitamin D, or multivitamin supplementation had higher levels of 25-OH D (p values 0.004, 0.0002, and 0.03 respectively) as did pre- vs. postmenopausal women (p = 0.01), pregnant vs. nonpregnant women (p = <0.0001), and women who had experienced a sunburn in the past year (p = 0.004). CONCLUSION In Armenia, there is a high prevalence of vitamin D insufficiency. This information provides data that can be used to inform public health directives to address this pervasive threat to optimal health.
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Affiliation(s)
- Nicholas Hutchings
- School of Medicine, University of California, Irvine, CA, USA.
- Osteoporosis Center of Armenia, Yerevan, Armenia.
| | | | - Annemieke C Heijboer
- Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, Vrije Universiteit Amsterdam & University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Arus Ivanyan
- Yerevan State Medical University, Yerevan, Armenia
| | - Mariëtte T Ackermans
- Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, Vrije Universiteit Amsterdam & University of Amsterdam, Amsterdam, The Netherlands
| | - Anna Maria Formenti
- Institute of Endocrine and Metabolic Sciences, San Raffaele, IRCCS Hospital, Vita-Salute University, Milano, Italy
| | - Olga Lesnyak
- North West State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia
| | - Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele, IRCCS Hospital, Vita-Salute University, Milano, Italy
| | - John P Bilezikian
- College of Physicians and Surgeons, Columbia University, New York, NY, USA
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12
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Krušič S, Hribar M, Hafner E, Žmitek K, Pravst I. Use of Branded Food Composition Databases for the Exploitation of Food Fortification Practices: A Case Study on Vitamin D in the Slovenian Food Supply. Front Nutr 2022; 8:775163. [PMID: 35059424 PMCID: PMC8763681 DOI: 10.3389/fnut.2021.775163] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/12/2021] [Indexed: 12/11/2022] Open
Abstract
Vitamin D deficiency is a worldwide public health concern, which can be addressed with voluntary or mandatory food fortification. The aim of this study was to determine if branded food composition databases can be used to investigate voluntary fortification practices. A case study was conducted using two nationally representative cross-sectional datasets of branded foods in Slovenia, collected in 2017 and 2020, and yearly sales data. Using food labeling data we investigated prevalence of fortification and average vitamin D content, while nutrient profiling was used to investigate overall nutritional quality of the foods. In both datasets, the highest prevalence of vitamin D fortification was observed in meal replacements (78% in 2017; 100% in 2020) and in margarine, corresponding to high market share. Other food categories commonly fortified with vitamin D are breakfast cereals (5% in 2017; 6% in 2020), yogurts and their imitates (5% in 2017; 4% in 2020), and baby foods (18% in both years). The highest declared average content of vitamin D was observed in margarine and foods for specific dietary use (7-8 μg/100g), followed by breakfast cereals (4 μg/100g), while the average content in other foods was below 2 μg/100g. Only minor differences were observed between 2017 and 2020. Major food-category differences were also observed in comparison of the overall nutritional quality of the fortified foods; higher overall nutritional quality was only observed in fortified margarine. Our study showed that branded food composition databases are extremely useful resources for the investigation and monitoring of fortification practices, particularly if sales data can also be used. In the absence of mandatory or recommended fortification in Slovenia, very few manufacturers decide to add vitamin D, and even when this is the case, such products are commonly niche foods with lower market shares. We observed exceptions in imported foods, which can be subject to fortification policies introduced in other countries.
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Affiliation(s)
- Sanja Krušič
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
| | - Maša Hribar
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Edvina Hafner
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Žmitek
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
- VIST—Faculty of Applied Sciences, Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
- VIST—Faculty of Applied Sciences, Ljubljana, Slovenia
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13
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Gavioli EM, Miyashita H, Hassaneen O, Siau E. An Evaluation of Serum 25-Hydroxy Vitamin D Levels in Patients with COVID-19 in New York City. J Am Coll Nutr 2021; 41:201-206. [PMID: 33605826 PMCID: PMC7898298 DOI: 10.1080/07315724.2020.1869626] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AIM Deterioration of patients from COVID-19 is associated with cytokine release syndrome attributed to an elevation in pro-inflammatory cytokines. Vitamin D reduces proinflammatory cytokines, and has the possibility of reducing complications from respiratory tract illnesses. METHOD This was a retrospective, observational, cohort study of patients with COVID-19 disease within a New York City Health System. Adult patients were included if they tested positive for SARS-CoV-2, and had a serum 25-hydroxy vitamin D level (25(OH)D) within the three previous months prior to their detected SARS-CoV-2 test. Patients were compared and evaluated based upon their 25(OH)D levels. The primary endpoints were hospitalization, need for oxygen support, and 90-day mortality. RESULTS 437 COVID-19 patients were included [67 (IQR: 56-79) years] within this cohort. Deficient plasma 25(OH)D levels (<20 ng/ml) were associated with an increased likelihood of oxygen support [OR:2.23 (95% CI: 1.46-3.44, p = 0.0002)] from COVID-19. Deficient plasma 25(OH)D levels were not independently associated with 90-day mortality or risk of hospitalization. Hospitalization rates (98%), oxygen support (93%), and mortality rates (49%) were highest in patients who had 25(OH)D levels less than 10 ng/ml when compared to other 25(OH)D levels. CONCLUSION Serum 25-hydroxy vitamin D levels may affect the need for oxygen support therapy in patients with COVID-19.
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Affiliation(s)
- Elizabeth Marie Gavioli
- Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, New York, USA.,Mount Sinai Beth Israel, New York, New York, USA
| | | | - Omar Hassaneen
- Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, New York, USA
| | - Evan Siau
- Mount Sinai Beth Israel, New York, New York, USA.,Icahn School of Medicine at Mount Sinai, New York, New York, USA
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14
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Karamizadeh M, Seif M, Holick MF, Akbarzadeh M. Developing a Model for Prediction of Serum 25-Hydroxyvitamin D Level: The Use of Linear Regression and Machine Learning Methods. J Am Coll Nutr 2021; 41:191-200. [PMID: 33555236 DOI: 10.1080/07315724.2020.1869624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Because vitamin D status affects many organs and tissues of the body, it is important to determine the factors affecting it. The purpose of this study was to develop a model for predicting the serum 25-hydroxyvitamin D [25(OH)D] level in healthy young adults. METHOD This cross-sectional study was conducted on 201 healthy individuals aged 20 to 40 years old in Shiraz, Iran. Data regarding demographic characteristics, vitamin D intake through supplements, and sun exposure habits were gathered. Serum 25(OH)D concentration was also measured. Data were analyzed with R software using linear regression and different machine learning methods such as conditional tree, conditional forest and random forest. RESULTS Based on the linear regression, male sex (p < 0.001), taking 50,000 IU vitamin D3 supplement monthly (p < 0.001), and lower waist circumference (p = 0.018) were identified as effective factors in increasing serum 25(OH)D levels. According to the conditional tree, taking 50,000 IU vitamin D3 supplement monthly (p < 0.001) and sex (p < 0.001) were two main factors in the classification of individuals in terms of serum 25(OH)D levels. Besides, conditional forest and random forest results showed that the most important variable was taking 50,000 IU vitamin D3 supplement monthly. CONCLUSIONS Supplement use is the first and most important predictor of 25(OH)D levels and other factors, including sex and waist circumference, are ranked thereafter, and the importance of these factors is greater in those who do not take vitamin D3 supplements.
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Affiliation(s)
- Malihe Karamizadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Michael F Holick
- Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Marzieh Akbarzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Tan Y, McClements DJ. Improving the bioavailability of oil-soluble vitamins by optimizing food matrix effects: A review. Food Chem 2021; 348:129148. [PMID: 33515946 DOI: 10.1016/j.foodchem.2021.129148] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/21/2020] [Accepted: 01/17/2021] [Indexed: 02/07/2023]
Abstract
The potency of oil-soluble vitamins (vitamins A, D, E and K) in fortified foods can be improved by understanding how food matrices impact their bioavailability. In this review, the major food matrix effects influencing the bioavailability of oil-soluble vitamins are highlighted: oil content, oil composition, particle size, interfacial properties, and food additives. Droplet size and aggregation state in the human gut impact vitamin bioavailability by modulating lipid digestion, vitamin release, and vitamin solubilization. Vitamins in small isolated oil droplets typically have a higher bioavailability than those in large or aggregated ones. Emulsifiers, stabilizers, or texture modifiers can therefore affect bioavailability by influencing droplet size or aggregation. The dimensions of the hydrophobic domains in mixed micelles depends on lipid type: if the domains are too small, vitamin bioavailability is low. Overall, this review highlights the importance of carefully designing food matrices to improve vitamin bioavailability.
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Affiliation(s)
- Yunbing Tan
- Department of Food Science, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - David Julian McClements
- Department of Food Science, University of Massachusetts Amherst, Amherst, MA 01003, USA; Department of Food Science & Bioengineering, Zhejiang Gongshang University, 18 Xuezheng Street, Hangzhou, Zhejiang 310018, China.
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16
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Use of Vitamin D Bolus in Fortified Juice for Improving Vitamin D Status in Children with Cerebral Palsy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1339:257-264. [DOI: 10.1007/978-3-030-78787-5_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Iossifidis S, Vaiou M, Challa A, Migdanis A, Migdanis I, Moula AI, Papageorgiou M, Kokkinos G, Deligiorgis D, Varitimidis SE, Malizos KN, Moulas AN. Use of Fortified Bread for Addressing Vitamin D Deficiency. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1337:371-378. [DOI: 10.1007/978-3-030-78771-4_42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Increased Body Mass Index (BMI) and Sunscreen Use Are Associated with Inadequate Vitamin D Status in Greek Adults in Winter. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1337:307-314. [DOI: 10.1007/978-3-030-78771-4_34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Jiang Q, Zhang M, Mujumdar AS. UV induced conversion during drying of ergosterol to vitamin D in various mushrooms: Effect of different drying conditions. Trends Food Sci Technol 2020; 105:200-210. [PMID: 32982063 PMCID: PMC7508054 DOI: 10.1016/j.tifs.2020.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/28/2020] [Accepted: 09/19/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mushrooms are increasingly popular around the world as a nutritional food which is an excellent source of vitamin D2. Although natural mushrooms often contain very little vitamin D2 as many are grown in the dark, they are rich in ergosterol, a precursor to vitamin D2. Ergosterol can be converted to vitamin D2 under ultraviolet radiation. Due to the high water content of fresh mushroom, its quality deteriorates rapidly after harvest, and drying is the most commonly used technology to extend the shelf life. The vitamin D2 content of dried mushrooms depends on the drying conditions used. SCOPE AND APPROACH In this review, the chemistry of the photo-conversion process of ergosterol to vitamin D2 under ultraviolet radiation is introduced. The ergosterol and vitamin D contents in different mushroom varieties are discussed. The effects of several drying methods and the influence of different drying conditions are reviewed.Key findings and conclusions: Thermal drying in the presence of UV has been proven to convert ergosterol into vitamin D and enhance the nutritional content of all types of edible mushrooms. Solar drying, hot air drying, freeze drying, microwave drying and infrared drying can be used for mushrooms drying under selected operating conditions. A critical evaluation of published literature demonstrates the importance of applying appropriate drying methodology to maximize the nutritional value of various types of edible mushrooms.
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Affiliation(s)
- Qiyong Jiang
- State Key Laboratory of Food Science and Technology, Jiangnan University, 214122, Wuxi, Jiangsu, China
- International Joint Laboratory on Food Safety, Jiangnan University, 214122, Wuxi, Jiangsu, China
| | - Min Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, 214122, Wuxi, Jiangsu, China
- Jiangsu Province Key Laboratory of Advanced Food Manufacturing Equipment and Technology, Jiangnan University, 214122, Wuxi, Jiangsu, China
| | - Arun S Mujumdar
- Department of Bioresource Engineering, Macdonald Campus, McGill University, Montreal, Quebec, Canada
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20
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Tan Y, Li R, Liu C, Muriel Mundo J, Zhou H, Liu J, McClements DJ. Chitosan reduces vitamin D bioaccessibility in food emulsions by binding to mixed micelles. Food Funct 2020; 11:187-199. [PMID: 31833516 DOI: 10.1039/c9fo02164g] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Consumption of sufficiently high quantities of dietary fibers has been linked to a range of health benefits. Recent research, however, has shown that some dietary fibers interfere with lipid digestion, which may reduce the bioavailability of oil-soluble vitamins and nutraceuticals. For this reason, we examined the impact of a cationic polysaccharide (chitosan) on the bioaccessibility of vitamin D using the standardized INFOGEST in vitro digestion model. The vitamin D was encapsulated within an emulsion-based delivery system that contained whey protein-coated corn oil droplets. Our results showed that chitosan promoted severe droplet flocculation in the small intestine and reduced the amount of free fatty acids detected using a pH-stat method. However, a back-titration of the digested sample showed that the lipids were fully digested at all chitosan levels used (0.1-0.5%), suggesting that chitosan may have bound some of the free fatty acids released during lipid digestion. The presence of the chitosan decreased the bioaccessibility of vitamin D by about 37%, but this effect did not depend strongly on chitosan concentration (0.1-0.5%). It was hypothesized that chitosan bound to the vitamin-loaded mixed micelles and promoted their precipitation. The knowledge gained in this study might provide useful insights in designing emulsion-based delivery systems with high vitamin bioaccessibility.
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Affiliation(s)
- Yunbing Tan
- Department of Food Science, University of Massachusetts Amherst, Amherst, MA 01003, USA.
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21
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Molaveisi M, Shahidi‐Noghabi M, Naji‐Tabasi S. Vitamin
D3
‐loaded
nanophytosomes
for enrichment purposes: Formulation, structure optimization, and controlled release. J FOOD PROCESS ENG 2020. [DOI: 10.1111/jfpe.13560] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Mohammad Molaveisi
- Department of Food Chemistry Research Institute of Food Science and Technology (RIFST) Mashhad Iran
| | - Mostafa Shahidi‐Noghabi
- Department of Food Chemistry Research Institute of Food Science and Technology (RIFST) Mashhad Iran
| | - Sara Naji‐Tabasi
- Department of Food Nanotechnology Research Institute of Food Science and Technology (RIFST) Mashhad Iran
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22
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McCourt A, McNulty BA, Walton J, O'Sullivan A. Efficacy and safety of food fortification to improve vitamin D intakes of older adults. Nutrition 2020; 75-76:110767. [PMID: 32248053 DOI: 10.1016/j.nut.2020.110767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to determine the best foods for potential vitamin D food fortification and to model the efficacy and safety of different food fortification scenarios in adults ≥50 y of age in Ireland. METHODS National Adult Nutrition Survey vitamin D data for participants ≥50 y of age were updated. Vitamin D from foods with natural and added vitamin D was estimated and daily vitamin D intake patterns were examined. Data modeling was used to estimate the effects of target food fortification scenarios. RESULTS Almost two-thirds of the mean daily vitamin D intake of adults ≥50 y of age (7 ± 7 µg) comes from foods with added vitamin D. Milk and bread are the most frequently consumed foods across all meals and were subsequently targeted for the data modeling exercise. Results from the data modeling show that vitamin D intake increased between 9 and 17 µg/d, depending on the fortification scenario. Fortifying milk or bread resulted in ∼30% or ∼55% of individuals meeting the Recommended Daily Allowance (RDA); however, fortifying both simultaneously resulted in ∼70% meeting the RDA. CONCLUSIONS Currently, the majority of Irish adults ≥50 y of age are not meeting dietary recommendations for vitamin D. Fortification of commonly consumed foods such as milk and bread could improve daily intakes such that ∼70% of the cohort would meet the minimum recommendation. Future research should examine the efficacy of different food fortification scenarios to improve vitamin D intakes for older adults.
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Affiliation(s)
- Aislinn McCourt
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Breige A McNulty
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Janette Walton
- School of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Aifric O'Sullivan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland.
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23
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Serum Vitamin D Deficiency Is an Independent Risk Factor for Thyroid Eye Disease. Ophthalmic Plast Reconstr Surg 2020; 36:17-20. [DOI: 10.1097/iop.0000000000001437] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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24
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Impact of an indigestible oil phase (mineral oil) on the bioaccessibility of vitamin D3 encapsulated in whey protein-stabilized nanoemulsions. Food Res Int 2019; 120:264-274. [DOI: 10.1016/j.foodres.2019.02.031] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 12/12/2022]
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25
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Pilz S, Zittermann A, Trummer C, Theiler-Schwetz V, Lerchbaum E, Keppel MH, Grübler MR, März W, Pandis M. Vitamin D testing and treatment: a narrative review of current evidence. Endocr Connect 2019; 8:R27-R43. [PMID: 30650061 PMCID: PMC6365669 DOI: 10.1530/ec-18-0432] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 01/16/2019] [Indexed: 12/11/2022]
Abstract
Vitamin D testing and treatment is a subject of controversial scientific discussions, and it is challenging to navigate through the expanding vitamin D literature with heterogeneous and partially opposed opinions and recommendations. In this narrative review, we aim to provide an update on vitamin D guidelines and the current evidence on the role of vitamin D for human health with its subsequent implications for patient care and public health issues. Vitamin D is critical for bone and mineral metabolism, and it is established that vitamin D deficiency can cause rickets and osteomalacia. While many guidelines recommend target serum 25-hydroxyvitamin D (25[OH]D) concentrations of ≥50 nmol/L (20 ng/mL), the minimum consensus in the scientific community is that serum 25(OH)D concentrations below 25-30 nmol/L (10-12 ng/mL) must be prevented and treated. Using this latter threshold of serum 25(OH)D concentrations, it has been documented that there is a high worldwide prevalence of vitamin D deficiency that may require public health actions such as vitamin D food fortification. On the other hand, there is also reason for concern that an exploding rate of vitamin D testing and supplementation increases costs and might potentially be harmful. In the scientific debate on vitamin D, we should consider that nutrient trials differ from drug trials and that apart from the opposed positions regarding indications for vitamin D treatment we still have to better characterize the precise role of vitamin D for human health.
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Affiliation(s)
- Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Armin Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Christian Trummer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Verena Theiler-Schwetz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Lerchbaum
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Martin H Keppel
- University Institute for Medical and Chemical Laboratory Diagnostics, Paracelsus Medical University, Salzburg, Austria
| | - Martin R Grübler
- Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Winfried März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, Ruperto-Carola University of Heidelberg, Heidelberg, Germany
- Synlab Medical Center of Human Genetics Mannheim, Mannheim, Germany
| | - Marlene Pandis
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Falcone V, Stopp T, Feichtinger M, Kiss H, Eppel W, Husslein PW, Prager G, Göbl CS. Pregnancy after bariatric surgery: a narrative literature review and discussion of impact on pregnancy management and outcome. BMC Pregnancy Childbirth 2018; 18:507. [PMID: 30587161 PMCID: PMC6307154 DOI: 10.1186/s12884-018-2124-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 11/27/2018] [Indexed: 02/07/2023] Open
Abstract
Bariatric surgery (BS) is regarded to be the most effective treatment of obesity with long lasting beneficial effects including weight loss and improvement of metabolic disorders. A considerable number of women undergoing BS are at childbearing age.Although the surgery mediated weight loss has a positive effect on pregnancy outcome, the procedures might be associated with adverse outcomes as well, for example micronutrient deficiencies, iron or B12 deficiency anemia, dumping syndrome, surgical complications such as internal hernias, and small for gestational age (SGA) offspring, possibly due to maternal undernutrition. Also, there is no international consensus concerning the ideal time to conception after BS. Hence, the present narrative review intents to summarize the available literature concerning the most common challenges which arise before and during pregnancy after BS, such as fertility related considerations, vitamin and nutritional deficiencies and their adequate compensation through supplementation, altered glucose metabolism and its implications for gestational diabetes screening, the symptoms and treatment of dumping syndrome, surgical complications and the impact of BS on pregnancy outcome. The impact of different bariatric procedures on pregnancy and fetal outcome will also be discussed, as well as general considerations concerning the monitoring and management of pregnancies after BS.Whereas BS leads to the mitigation of many obesity-related pregnancy complications, such as gestational diabetes mellitus (GDM), pregnancy induced hypertension and fetal macrosomia; those procedures pose new risks which might lead to adverse outcomes for mothers and offspring, for example nutritional deficiencies, anemia, altered maternal glucose metabolism and small for gestational age children.
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Affiliation(s)
- Veronica Falcone
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Tina Stopp
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Michael Feichtinger
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Wunschbaby Institut Feichtinger, Lainzerstrasse 6, Vienna, Austria
| | - Herbert Kiss
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Wolfgang Eppel
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Peter Wolf Husslein
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Gerhard Prager
- Department of General Surgery, Division of Bariatric Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christian S Göbl
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Miertuš S, Ondrejovič M, Gartland KMA. Biotechnology in Europe: A challenge for Central and East European countries. J Biotechnol 2018; 285:42-43. [PMID: 30176271 DOI: 10.1016/j.jbiotec.2018.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Stanislav Miertuš
- University of Ss. Cyril and Methodius in Trnava, Nám. J. Herdu 2, 917 01 Trnava, Slovakia.
| | - Miroslav Ondrejovič
- University of Ss. Cyril and Methodius in Trnava, Nám. J. Herdu 2, 917 01 Trnava, Slovakia
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