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Singh DP, Gopinath P. Tragacanth gum-based nano-nutraceuticals synthesis by encapsulation of beetroot juice and Ocimum basilicum leaves for micronutrient deficient population. Int J Biol Macromol 2023; 253:127502. [PMID: 37863139 DOI: 10.1016/j.ijbiomac.2023.127502] [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] [Received: 05/01/2023] [Revised: 09/18/2023] [Accepted: 10/02/2023] [Indexed: 10/22/2023]
Abstract
Micronutrient deficiencies, such as iron, folic acid, and vitamins C and D, are currently prevalent due to inadequate consumption of natural food sources, namely raw vegetables and fruits. This deficiency is compounded by the growing reliance on synthetic nutraceuticals and processed food, which exhibit poor absorbency within the gastrointestinal tract. Scientific studies consistently indicate that naturally prepared whole foods are superior in terms of nutrient absorption compared to processed and synthetic supplements. To address this issue, we utilized FDA-approved tragacanth gum (TG) in the synthesis of nano-nutraceuticals by encapsulating beetroot juice and ball-milled sweet basil (Ocimum basilicum). TG, in its micro or macro form, possesses the remarkable ability to form hydrogels capable of absorbing water up to 50 times its weight. However, the hydrogel-forming property diminishes when TG is reduced to the nanoscale. We effectively exploited these properties to facilitate the synthesis of nano-nutraceuticals. The procedure involved encapsulating beetroot juice and sweet basil nanopowder using TG hydrogel, followed by freeze-drying. Subsequently, the freeze-dried encapsulated TG composite was subjected to ball-milling to achieve the desired nano-nutraceuticals. These nano-nutraceuticals naturally contain essential nutrients such as iron, folic acid, ascorbic acid, chlorophyll, niacin, and sugars, without the need for chemical processing or preservatives.
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Affiliation(s)
- Dravin Pratap Singh
- Centre for Nanotechnology, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand 247667, India
| | - P Gopinath
- Centre for Nanotechnology, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand 247667, India; Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand 247667, India.
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2
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Christensen C, Matthiessen J, Fagt S, Biltoft-Jensen A. Dietary supplements increase the risk of excessive micronutrient intakes in Danish children. Eur J Nutr 2023; 62:2449-2462. [PMID: 37127694 PMCID: PMC10421806 DOI: 10.1007/s00394-023-03153-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE Dietary supplement use is common in Northern Europe. Many dietary supplements contain 100% of nutrient reference values (NRV) of micronutrients. This study investigates the contribution of dietary supplements to micronutrient intake, the prevalence of excess intake of micronutrients, and parental characteristics of dietary supplement use in Danish children. METHODS Data on 499 4-10-year-old children from the Danish National Survey of Diet and Physical Activity 2011-2013 were analysed using non-parametric statistics to compare micronutrient intake from the diet and dietary supplements to the reference intake (RI), and to the tolerable Upper Intake Level (UL) for users and non-users of dietary supplements. Furthermore, characteristics of the parents of users and non-users of dietary supplements were examined by logistic regression analysis. RESULTS Sixty-four percent of the children were dietary supplement users. Multivitamin-mineral supplements were the most frequently used type of supplement (60%). Children of never-smokers were more likely to use supplements than children of smokers. Users had significantly higher total intakes of 15 micronutrients compared to non-users. Intakes of vitamin A, zinc, and iodine from the diet alone exceeded ULs in 12-30% of the children. Use of dietary supplements gave rise to 21-73% of children in exceedance of the aforementioned three ULs as well as the UL for iron (6-45%). CONCLUSION Dietary supplement use was common among 4-10-year-old Danish children and resulted in a considerable proportion of users exceeding the ULs for vitamin A, zinc, iodine, and iron. The long-term health consequences of exceeding these ULs for children are unknown.
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Affiliation(s)
- Camilla Christensen
- Research Group for Nutrition, Sustainability and Health Promotion, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark.
| | - Jeppe Matthiessen
- Research Group for Nutrition, Sustainability and Health Promotion, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Sisse Fagt
- Research Group for Nutrition, Sustainability and Health Promotion, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Anja Biltoft-Jensen
- Research Group for Nutrition, Sustainability and Health Promotion, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
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Hammersen T, Buchert J, Zietzschmann S, Diederichs S, Richter W. Inverse Regulation of Cartilage Neogenesis at Physiologically Relevant Calcium Conditions by Human Articular Chondrocytes and Mesenchymal Stromal Cells. Cells 2023; 12:1659. [PMID: 37371129 DOI: 10.3390/cells12121659] [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: 05/19/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Elaborate bioreactor cultivation or expensive growth factor supplementation can enhance extracellular matrix production in engineered neocartilage to provide sufficient mechanical resistance. We here investigated whether raising extracellular calcium levels in chondrogenic cultures to physiologically relevant levels would provide a simple and inexpensive alternative to enhance cartilage neogenesis from human articular chondrocytes (AC) or bone marrow-derived mesenchymal stromal cells (BMSC). Interestingly, AC and BMSC-derived chondrocytes showed an opposite response to a calcium increase from 1.8 mM to 8 mM by which glycosaminoglycan (GAG) and collagen type II production were elevated during BMSC chondrogenesis but depressed in AC, leading to two-fold higher GAG/DNA values in BMSC-based neocartilage compared to the AC group. According to control treatments with Mg2+ or sucrose, these effects were specific for CaCl2 rather than divalent cations or osmolarity. Importantly, undesired pro-hypertrophic traits were not stimulated by calcium treatment. Specific induction of PTHrP mRNA and protein by 8.0mM calcium only in AC, along with negative effects of recombinant PTHrP1-34 on cartilage matrix production, suggested that the PTHrP pathway contributed to the detrimental effects in AC-based neocartilage. Altogether, raising extracellular calcium levels was discovered as a novel, simple and inexpensive stimulator for BMSC-based cartilage neogenesis without the need for special bioreactors, whereas such conditions should be avoided for AC.
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Affiliation(s)
- Tim Hammersen
- Research Center for Experimental Orthopaedics, Department of Orthopaedics, Heidelberg University Hospital, 69118 Heidelberg, Germany
| | - Justyna Buchert
- Research Center for Experimental Orthopaedics, Department of Orthopaedics, Heidelberg University Hospital, 69118 Heidelberg, Germany
| | - Severin Zietzschmann
- Orthopaedic Hospital, Department of Orthopaedics, Heidelberg University Hospital, 69118 Heidelberg, Germany
| | - Solvig Diederichs
- Research Center for Experimental Orthopaedics, Department of Orthopaedics, Heidelberg University Hospital, 69118 Heidelberg, Germany
| | - Wiltrud Richter
- Research Center for Experimental Orthopaedics, Department of Orthopaedics, Heidelberg University Hospital, 69118 Heidelberg, Germany
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Al-Thani G, Ibrahim AE, Alomairi M, Salman BI, Hegazy MM, Al-Harrasi A, El Deeb S. Toxic Elemental Impurities in Herbal Weight Loss Supplements; A Study Using ICP-OES Microwave-Assisted Digestion. TOXICS 2023; 11:272. [PMID: 36977037 PMCID: PMC10053313 DOI: 10.3390/toxics11030272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/08/2023] [Accepted: 03/15/2023] [Indexed: 06/18/2023]
Abstract
The tendency of using weight loss herbal preparations is continuously increasing, especially for the widespread consumption of junk food that is characterized by high calories. Weight loss herbal preparations are considered a type of food supplement product, and, as such, the regulations governing their quality control might be minimal. These products could be locally formulated in any country or internationally imported. Being non-controlled products, the herbal weight-loss products may contain high levels of elemental impurities that might exceed the permissible ranges. Moreover, these products contribute to the total daily intake (TDI) of such elements, which might represent concerns about their potential toxicological danger. In this research, the elemental contents in such products were investigated. The inductively coupled plasma with optical emission spectrometer (ICP-OES) was used to determine the levels of 15 elemental contents, namely, Na, K, Ca, Mg, Al, Cu, Fe, Li, Mn, As, Co, Cr, Cd, Ni and Pb. The results showed that seven micro-elements, namely Cd, Co, Ni, Cr, Pb, Li and Cu, were either not detectable or at a concentration much lower than their tolerable limits. However, all studied macro-elements (Na, K, Ca and Mg), together with Fe, were found at considerable, yet safe levels. On the other hand, Mn, Al and As contents showed perturbing levels in some of the studied products. Finally, a conclusion was highlighted for the necessity for stricter surveillance of such herbal products.
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Affiliation(s)
- Ghanim Al-Thani
- Natural and Medical Sciences Research Center, University of Nizwa, PC 616, Birkat Al Mauz, Nizwa P.O. Box 33, Oman
| | - Adel Ehab Ibrahim
- Natural and Medical Sciences Research Center, University of Nizwa, PC 616, Birkat Al Mauz, Nizwa P.O. Box 33, Oman
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Port-Said University, Port Said 42526, Egypt
| | - Mohammed Alomairi
- Natural and Medical Sciences Research Center, University of Nizwa, PC 616, Birkat Al Mauz, Nizwa P.O. Box 33, Oman
| | - Baher I. Salman
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt
| | - Mostafa M. Hegazy
- Department of Pharmacognosy and Medicinal Plants, Faculty of Pharmacy, Al-Azhar University, Cairo 11884, Egypt
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Center, University of Nizwa, PC 616, Birkat Al Mauz, Nizwa P.O. Box 33, Oman
| | - Sami El Deeb
- Natural and Medical Sciences Research Center, University of Nizwa, PC 616, Birkat Al Mauz, Nizwa P.O. Box 33, Oman
- Institute of Medicinal and Pharmaceutical Chemistry, Technische Universitaet Braunschweig, 38106 Braunschweig, Germany
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Developing New Cyclodextrin-Based Nanosponges Complexes to Improve Vitamin D Absorption in an In Vitro Study. Int J Mol Sci 2023; 24:ijms24065322. [PMID: 36982396 PMCID: PMC10049479 DOI: 10.3390/ijms24065322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
Vitamin D plays an important role in numerous cellular functions due to the ability to bind the Vitamin D receptor (VDR), which is present in different tissues. Several human diseases depend on low vitamin D3 (human isoform) serum level, and supplementation is necessary. However, vitamin D3 has poor bioavailability, and several strategies are tested to increase its absorption. In this work, the complexation of vitamin D3 in Cyclodextrin-based nanosponge (CD-NS, in particular, βNS-CDI 1:4) was carried out to study the possible enhancement of bioactivity. The βNS-CDI 1:4 was synthesized by mechanochemistry, and the complex was confirmed using FTIR-ATR and TGA. TGA demonstrated higher thermostability of the complexed form. Subsequently, in vitro experiments were performed to evaluate the biological activity of Vitamin D3 complexed in the nanosponges on intestinal cells and assess its bioavailability without cytotoxic effect. The Vitamin D3 complexes enhance cellular activity at the intestinal level and improve its bioavailability. In conclusion, this study demonstrates for the first time the ability of CD-NS complexes to improve the chemical and biological function of Vitamin D3.
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Beninger P. Drug-Drug Interactions: How to Manage the Risk-A Stakeholder Approach. Clin Ther 2023; 45:106-116. [PMID: 36754731 DOI: 10.1016/j.clinthera.2023.01.009] [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: 09/13/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 02/09/2023]
Abstract
Drug-drug interactions (DDIs) are well-recognized, chronic, multidimensional issues that have defied efforts to make substantial reductions in the burden of effects on patients and the health care system. This Commentary offers a stakeholder approach to characterizing the problem and identifying potential ways to address the risks posed by DDIs. Stakeholders may comprise 2 groups: a triad consisting of the patient, the prescriber, and the pharmacist and a pentad of institutional stakeholders consisting of institutions of education and training for prescribers and pharmacists, drug development sector companies, regulatory agencies, payer institutions, and publishing companies of journals on healthcare topics. Suggested strategic opportunities to mitigate the risk of harm from DDIs include the following: (1) identify critical leadership to set the agenda, manage the process, and mark progress; (2) enhance self-advocacy skills, particularly for patients; (3) create more opportunities for patients to learn, understand, and participate in the process; (4) establish and enhance partnerships between and among stakeholders; (5) seek broader use of regulatory machinery; (6) institutionalize principles of conservative prescribing and deprescribing in medical education and professional training; (7) establish, highlight, and promote DDI in HEDIS quality metrics, key performance indicators, and balanced scorecards; (8) encourage publishers to engage the issue more deeply by developing dedicated specialty journals for physicians, pharmacists, and cross-professional audiences and encourage journal editors to dedicate sections in pharmacy and clinical journals; and (9) involve the political process to include markers for DDI mitigation and to set performance goals in US Food and Drug Administration-directed legislation.
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Affiliation(s)
- Paul Beninger
- Public Health & Community Medicine, Tufts University School of Medicine, Boston, Massachusetts.
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Singh DP, Packirisamy G. Applications of nanotechnology to combat the problems associated with modern food. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:479-487. [PMID: 35870139 DOI: 10.1002/jsfa.12146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 06/15/2023]
Abstract
Currently, modern lifestyle diseases (LSD) such as cancer, diabetes, hypertension, cardiovascular and thyroid disease are commonly seen among people of different age groups. One of the root causes of this LSD is the type of food that we are eating. Staple crops like rice, sugarcane, vegetables and wheat are grown with the application of agrochemicals (e.g., glyphosate), traces of which are found in our food; after that, it gets ultra-processed in factories; e.g., chips and snacks are fried using saturated fats (trans fat); sugar and wheat (derivatives bread, buns, cookies) are processed using toxic chemicals (bleaching agents). As a result, the nutritional value of food is compromised due to low dietary fiber content and synthetic additives - e.g., sucralose (artificial sweetener) - which promotes inflammation and weakens our immune system, causing our body to become sensitive to microbial infection and many other LSDs. To strengthen the immune system, people start taking synthetically prepared supplements and drugs for a prolonged time, which further deteriorates the body organs and their normal function; e.g., prolonged medication for hypothyroidism poses a risk of heart attack and joint pain. Nanotechnology solves the above problems in the food, nutraceuticals and agriculture sectors. Nanotechnology-based naturally processed products such as nano-nutraceuticals, nanofood, nanofertilizers and nanopesticides will benefit our health. They possess desirable properties such as high bioavailability, targeted delivery, least processing and sustained release. With the help of nanotechnology, we can get nutritional and agrochemical-free food. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Dravin Pratap Singh
- Nanobiotechnology Laboratory, Centre for Nanotechnology, Indian Institute of Technology Roorkee, Roorkee, India
| | - Gopinath Packirisamy
- Nanobiotechnology Laboratory, Centre for Nanotechnology, Indian Institute of Technology Roorkee, Roorkee, India
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, India
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8
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Strawbridge R, Kerr-Gaffney J, Bessa G, Loschi G, Freitas HLO, Pires H, Cousins DA, Juruena MF, Young AH. Identifying the neuropsychiatric health effects of low-dose lithium interventions: A systematic review. Neurosci Biobehav Rev 2023; 144:104975. [PMID: 36436738 DOI: 10.1016/j.neubiorev.2022.104975] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lithium is widely evidenced for its neuropsychiatric benefits. Advantages of 'sub-therapeutic' doses are increasingly being reported, which is apposite given enduring concerns around adverse effects of 'therapeutic' doses. We aimed to synthesise all available evidence from interventional studies investigating low-dose lithium (LDL) across neuropsychiatric outcomes. METHODS Electronic databases were systematically searched to include studies where a group of adult humans were treated with LDL (∼serum level ≤0.6 mmol/L), where data describing a neuropsychiatric outcome were reported either before and after treatment, and/or between lithium and a comparator. RESULTS 18 articles were examined and grouped according to outcome domain (cognition, depression, mania, and related constructs e.g., suicidality). Significant benefits (versus placebo) were identified for attenuating cognitive decline, and potentially as an adjunctive therapy for people with depression/mania. Across studies, LDL was reported to be safe. CONCLUSIONS Despite the paucity and heterogeneity of studies, LDL's apparent pro-cognitive effects and positive safety profile open promising avenues in the fields of neurodegeneration, and augmentation in affective disorders. We urge future examinations of LDL's potential to prevent cognitive/affective syndromes.
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Affiliation(s)
- Rebecca Strawbridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Jess Kerr-Gaffney
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Giulia Bessa
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Giulia Loschi
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | | | - Hugo Pires
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - David A Cousins
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mario F Juruena
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Concomitant Administration of Capecitabine and Folate Supplements: Need to Encourage Medication Reconciliation. Pharmaceuticals (Basel) 2022; 15:ph15111388. [DOI: 10.3390/ph15111388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/27/2022] [Accepted: 11/08/2022] [Indexed: 11/12/2022] Open
Abstract
Hand-Foot syndrome (HFS) and diarrhoea are dose-limiting Adverse Drug Reactions (ADRs) of capecitabine-based chemotherapy. Four polymorphisms in the dihydropyrimidine dehydrogenase (DPYD) gene, encoding the DPD enzyme responsible for the metabolism of fluoropyrimidines, such as capecitabine, are strongly associated with severe ADRs, and their screening should be performed before starting treatment. Moreover, capecitabine-related toxicity may worsen due to drug-drug and drug-supplement interactions. Here we investigated factors responsible for severe HFS and diarrhoea presented by two patients, non-carriers of the recommended DPYD single nucleotide polymorphisms (SNPs) but carriers of other genetic variants suggested to increase the risk of capecitabine-related ADRs. Through careful therapy recognition, we demonstrated that, unbeknownst to the oncologists, the patients were taking folic acid during the treatment with capecitabine at a dosage higher than 2000 mg/m2, which is the maximum tolerated dose when folate is administered. To resolve the ADRs, the therapy had to be drastically changed. In one case, dose reduction of capecitabine and discontinuation of lipid-lowering agents were carried out. In the other case, discontinuation of capecitabine and folic acid and capecitabine re-administration were performed after a month. Genetic and environmental factors should be considered good predictors of severe capecitabine-related toxicity. Medication reconciliation should be encouraged to avoid the harmful consequences of inappropriate treatments.
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Tinsley GM, Harty PS, Stratton MT, Siedler MR, Rodriguez C. Liposomal Mineral Absorption: A Randomized Crossover Trial. Nutrients 2022; 14:nu14163321. [PMID: 36014827 PMCID: PMC9414097 DOI: 10.3390/nu14163321] [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: 07/20/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/25/2022] Open
Abstract
Multivitamin/mineral (MVM) supplements are one of the most popular dietary supplement categories. The purpose of this analysis was to determine if a novel liposomal delivery mechanism improves mineral absorption from an MVM product. In a randomized crossover trial, 25 healthy participants (12 females, 13 males) completed two testing sessions in which blood samples were collected at baseline and 2, 4, and 6 h following the ingestion of either a liposomal MVM or a nutrient-matched standard MVM. Analysis of MVM products indicated an elemental iron content of 9.4 and 10.1 mg (~50% U.S. FDA Daily Value) and an elemental magnesium content of 22.0 and 23.3 mg (~5% U.S. FDA Daily Value) in the liposomal and standard MVM products, respectively. Blood samples were analyzed for concentrations of iron and magnesium using colorimetric assays. Changes in mineral concentrations were analyzed using linear mixed models, and pharmacokinetic parameters were compared between conditions. For iron, statistically significant condition × time interactions were observed for percent change from baseline (p = 0.002), rank of percent change from baseline (p = 0.01), and raw concentrations (p = 0.02). Follow-up testing indicated that the liposomal condition exhibited larger changes from baseline than the standard MVM condition at 4 (p = 0.0001; +14.3 ± 18.5% vs. −6.0 ± 13.1%) and 6 h (p = 0.0002; +1.0 ± 20.9% vs. −21.0 ± 15.3%) following MVM ingestion. These changes were further supported by a 50% greater mean incremental area under the curve in the liposomal condition (33.2 ± 30.9 vs. 19.8 ± 19.8 mcg/dL × 6 h; p = 0.02, Cohen’s d effect size = 0.52). In contrast, no differential effects for magnesium absorption were observed. In conclusion, iron absorption from an MVM product is enhanced by a liposomal delivery mechanism.
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Karagiannis D, Mitsis K, Nikita KS. Development of a Low-Power IoMT Portable Pillbox for Medication Adherence Improvement and Remote Treatment Adjustment. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22155818. [PMID: 35957374 PMCID: PMC9370836 DOI: 10.3390/s22155818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 05/14/2023]
Abstract
Patients usually deviate from prescribed medication schedules and show reduced adherence. Even when the adherence is sufficient, there are conditions where the medication schedule should be modified. Crucial drug-drug, food-drug, and supplement-drug interactions can lead to treatment failure. We present the development of an internet of medical things (IoMT) platform to improve medication adherence and enable remote treatment modifications. Based on photos of food and supplements provided by the patient, using a camera integrated to a portable 3D-printed low-power pillbox, dangerous interactions with treatment medicines can be detected and prevented. We compare the medication adherence of 14 participants following a complex medication schedule using a functional prototype that automatically receives remote adjustments, to a dummy pillbox where the adjustments are sent with text messages. The system usability scale (SUS) score was 86.79, which denotes excellent user acceptance. Total errors (wrong/no pill) between the functional prototype and the dummy pillbox did not demonstrate any statistically significant difference (p = 0.57), but the total delay of the intake time was higher (p = 0.03) during dummy pillbox use. Thus, the proposed low-cost IoMT pillbox improves medication adherence even with a complex regimen while supporting remote dose adjustment.
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12
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Salas S, Cottet V, Dossus L, Fassier P, Ginhac J, Latino-Martel P, Romieu I, Schneider S, Srour B, Touillaud M, Touvier M, Ancellin R. Nutritional Factors during and after Cancer: Impacts on Survival and Quality of Life. Nutrients 2022; 14:2958. [PMID: 35889914 PMCID: PMC9323157 DOI: 10.3390/nu14142958] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Abstract
The French National Cancer Institute conducted a collective expertise study with researchers and clinical experts from the French Network for Nutrition And Cancer Research (NACRe Network). The objective was to update the state of knowledge on the impacts of nutritional factors on clinical endpoints during or after cancer. Data from 150 meta-analyses, pooled analyses or intervention trials and 93 cohort studies were examined; they concerned 8 nutritional factors, 6 clinical events and 20 cancer locations. This report shows that some nutritional factors have impacts on mortality and on the risks of recurrence or second primary cancer in cancer patients. Therefore, high-risk nutritional conditions can be encountered for certain cancer sites: from the diagnosis and throughout the health care pathways, weight loss (lung and esophageal cancers), malnutrition (lung, esophageal, colorectal, pancreatic, gastric and liver cancers), weight gain (colorectal, breast and kidney cancers) and alcohol consumption (upper aerodigestive cancers) should be monitored; and after cancer treatments, excess weight should be detected (colorectal, breast and kidney cancers). These situations require nutritional assessments, and even support or management by health care professionals, in the context of tertiary prevention. This report also highlights some limitations regarding the existing literature and some needs for future research.
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Affiliation(s)
- Sébastien Salas
- AP-HM, Timone Hospital, Aix Marseille University, 13000 Marseille, France;
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
| | - Vanessa Cottet
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- INSERM UMR1231/CIC 1432, University Hospital, LabEx LipSTIC ANR-11-LABX-0021, University of Burgundy-Franche-Comté, 21000 Dijon, France
| | - Laure Dossus
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- International Agency for Research on Cancer, 69000 Lyon, France
| | - Philippine Fassier
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- Gustave Roussy Institute, 94800 Villejuif, France
| | - Julie Ginhac
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Epidemiology and Statistics Research Centre (CRESS), University of Paris, 93022 Bobigny, France
| | - Paule Latino-Martel
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Epidemiology and Statistics Research Centre (CRESS), University of Paris, 93022 Bobigny, France
| | - Isabelle Romieu
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- International Agency for Research on Cancer, 69000 Lyon, France
| | - Stéphane Schneider
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- University Hospital, University of Côte d’Azur, 06000 Nice, France
| | - Bernard Srour
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Epidemiology and Statistics Research Centre (CRESS), University of Paris, 93022 Bobigny, France
| | - Marina Touillaud
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- Léon-Bérard Cancer Centre, UA8 Inserm, 69000 Lyon, France
| | - Mathilde Touvier
- The French Network for Nutrition and Cancer Research (NACRe Network), 78350 Jouy-en-Josas, France; (L.D.); (P.F.); (J.G.); (P.L.-M.); (I.R.); (S.S.); (B.S.); (M.T.); (M.T.)
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Epidemiology and Statistics Research Centre (CRESS), University of Paris, 93022 Bobigny, France
| | - Raphaëlle Ancellin
- The French National Cancer Institute (INCa), 92012 Boulogne-Billancourt, France;
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Sesso HD, Rist PM, Aragaki AK, Rautiainen S, Johnson LG, Friedenberg G, Copeland T, Clar A, Mora S, Moorthy MV, Sarkissian A, Wactawski-Wende J, Tinker LF, Carrick WR, Anderson GL, Manson JE. Multivitamins in the prevention of cancer and cardiovascular disease: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial. Am J Clin Nutr 2022; 115:1501-1510. [PMID: 35294969 PMCID: PMC9170475 DOI: 10.1093/ajcn/nqac056] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/01/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Although older adults commonly take multivitamin-multimineral (MVM) supplements to promote health, evidence on the use of daily MVMs on invasive cancer is limited. OBJECTIVES The study objective was to determine if a daily MVM decreases total invasive cancer among older adults. METHODS We performed a randomized, double-blind, placebo-controlled, 2-by-2 factorial trial of a daily MVM and cocoa extract for prevention of cancer and cardiovascular disease (CVD) among 21,442 US adults (12,666 women aged ≥65 y and 8776 men aged ≥60 y) free of major CVD and recently diagnosed cancer. The intervention phase was from June 2015 through December 2020. This article reports on the MVM intervention. Participants were randomly assigned to daily MVM or placebo. The primary outcome was total invasive cancer, excluding nonmelanoma skin cancer. Secondary outcomes included major site-specific cancers, total CVD, all-cause mortality, and total cancer risk among those with a baseline history of cancer. RESULTS During a median follow-up of 3.6 y, invasive cancer occurred in 518 participants in the MVM group and 535 participants in the placebo group (HR: 0.97; 95% CI: 0.86, 1.09; P = 0.57). We observed no significant effect of a daily MVM on breast cancer (HR: 1.06; 95% CI: 0.79, 1.42) or colorectal cancer (HR: 1.30; 95% CI: 0.80, 2.12). We observed a protective effect of a daily MVM on lung cancer (HR: 0.62; 95% CI: 0.42, 0.92). The composite CVD outcome occurred in 429 participants in the MVM group and 437 participants in the placebo group (HR: 0.98; 95% CI: 0.86, 1.12). MVM use did not significantly affect all-cause mortality (HR: 0.93; 95% CI: 0.81, 1.08). There were no safety concerns. CONCLUSIONS A daily MVM supplement, compared with placebo, did not significantly reduce the incidence of total cancer among older men and women. Future studies are needed to determine the effects of MVMs on other aging-related outcomes among older adults. This trial is registered at www.clinicaltrials.gov as NCT02422745.
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Affiliation(s)
- Howard D Sesso
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Pamela M Rist
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Susanne Rautiainen
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Lisa G Johnson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Georgina Friedenberg
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Trisha Copeland
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Allison Clar
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Samia Mora
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - M Vinayaga Moorthy
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ara Sarkissian
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - William R Carrick
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Garnet L Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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14
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Dwyer JT, Saldanha LG, Bailen RA, Gahche JJ, Potischman N, Bailey RL, Jun S, Long Y, Connor E, Andrews KW, Pehrsson PR, Gusev PA. Do Multivitamin/Mineral Dietary Supplements for Young Children Fill Critical Nutrient Gaps? J Acad Nutr Diet 2022; 122:525-532. [PMID: 34687947 PMCID: PMC11056952 DOI: 10.1016/j.jand.2021.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nearly a third of young US children take multivitamin/mineral (MVM) dietary supplements, yet it is unclear how formulations compare with requirements. OBJECTIVE Describe the number and amounts of micronutrients contained in MVMs for young children and compare suggested amounts on product labels to micronutrient requirements. DESIGN Cross-sectional. SETTING All 288 MVMs on the market in the United States in the National Institutes of Health's Dietary Supplement Label Database in 2018 labeled for children 1 to <4 years old. MAIN OUTCOME MEASURES Number of MVM products and amounts per day of micronutrients in each product suggested on labels compared with requirements represented by age-appropriate Daily Values (DV). Micronutrients of public health concern identified by the Dietary Guidelines for Americans (DGA) 2015-2020 (DGA 2015) and DGA 2020-2025 (DGA 2020) or those of concern for exceeding the upper tolerable intake levels. STATISTICAL ANALYSES Number of products and percent DV per day provided by each micronutrient in each product. RESULTS The 288 MVMs contained a mean of 10.1 ± 2.27 vitamins and 4.59 ± 2.27 minerals. The most common were, in rank order, vitamins C, A, D, E, B6, B12; zinc, biotin, pantothenic acid, iodine, and folic acid. For micronutrients denoted by the DGA 2015 and DGA 2020 of public health concern, 56% of the 281 products containing vitamin D, 4% of the 144 with calcium, and none of the 60 containing potassium provided at least half of the DV. The upper tolerable intake level was exceeded by 49% of 197 products with folic acid, 17% of 283 with vitamin A, and 14% of 264 with zinc. Most MVMs contained many of 16 other vitamins and minerals identified in national surveys as already abundant in children's diets. CONCLUSIONS A reexamination of the amounts and types of micronutrients in MVMs might consider formulations that better fill critical gaps in intakes and avoid excess.
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Affiliation(s)
- Johanna T Dwyer
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland.
| | - Leila G Saldanha
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | - Richard A Bailen
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | - Jaime J Gahche
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | - Nancy Potischman
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Shinyoung Jun
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Yue Long
- Abt Associates, Rockville, Maryland
| | | | - Karen W Andrews
- Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Bethesda, Maryland
| | - Pamela R Pehrsson
- Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Bethesda, Maryland
| | - Pavel A Gusev
- Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Bethesda, Maryland
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15
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Lachowicz JI, Lecca LI, Meloni F, Campagna M. Metals and Metal-Nanoparticles in Human Pathologies: From Exposure to Therapy. Molecules 2021; 26:6639. [PMID: 34771058 PMCID: PMC8587420 DOI: 10.3390/molecules26216639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 01/13/2023] Open
Abstract
An increasing number of pathologies correlates with both toxic and essential metal ions dyshomeostasis. Next to known genetic disorders (e.g., Wilson's Disease and β-Thalassemia) other pathological states such as neurodegeneration and diabetes are characterized by an imbalance of essential metal ions. Metal ions can enter the human body from the surrounding environment in the form of free metal ions or metal-nanoparticles, and successively translocate to different tissues, where they are accumulated and develop distinct pathologies. There are no characteristic symptoms of metal intoxication, and the exact diagnosis is still difficult. In this review, we present metal-related pathologies with the most common onsets, biomarkers of metal intoxication, and proper techniques of metal qualitative and quantitative analysis. We discuss the possible role of drugs with metal-chelating ability in metal dyshomeostasis, and present recent advances in therapies of metal-related diseases.
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Affiliation(s)
| | | | | | - Marcello Campagna
- Division of Occupational Medicine, Department of Medical Sciences and Public Health, University of Cagliari, 09048 Monserrato, CA, Italy; (J.I.L.); (L.I.L.); (F.M.)
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16
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Zechariah S, Waller JL, De Leo G, Stallings J, Gess AJ, Lehman L. Content and Face Validation of a Novel, Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) to Evaluate Registered Dietitians' Competence: A Delphi Consensus from the United States. Healthcare (Basel) 2021; 9:healthcare9091225. [PMID: 34574998 PMCID: PMC8472113 DOI: 10.3390/healthcare9091225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
The nutrition-focused physical examination (NFPE) is an integral component of nutrition assessment performed by registered dietitian nutritionists (RDNs) to determine signs of malnutrition and other nutrition-related complications. Increased use of this essential skill among RDNs and the transformation of dietetics education to a competency-based model in the near future calls for appropriately validated tools to measure RDNs' NFPE competence. To fill the need for a validated competency tool, this study developed an Interactive Nutrition-Specific Physical Exam Competency Tool (INSPECT) utilizing the initial 70 items identified in the first phase of the study. The second phase of this study aimed to test the preliminary version of the INSPECT for content and face validity. An expert panel of 17 members provided consensus recommendations through the Delphi process. Internal consistency of the consensus was measured with Cronbach's alpha (α) and α of ≥0.70 was defined as acceptable a priori. Inter-rater agreement among the expert panel was determined using the intraclass correlation coefficient (ICC) and an a priori ICC of 0.75 to 0.9 was established as good and >0.9 as excellent agreement. The results showed acceptable face validity (α = 0.71) and excellent content validity for the INSPECT, with an internal consistency of α = 0.97 in the first round and α = 0.96 in the second round. The inter-rater agreement was also excellent with ICC = 0.95 for each of the Delphi rounds. A total of 52 items were retained from the preliminary version of the INSPECT. Open feedback from the experts allowed for the consolidation of 11 similar items for better scoring and evaluation and thus, a total of 41 items were included in the final version of the INSPECT. The final version of the INSPECT is currently being studied in real-life, multi-site clinical settings among practicing RDNs to examine construct validity, reliability, and item-level psychometric properties. Ultimately, the validated INSPECT will be available for the competency evaluation of RDNs practicing in clinical settings.
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Affiliation(s)
- Sunitha Zechariah
- College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (G.D.L.); (J.S.)
- Correspondence:
| | | | - Gianluca De Leo
- College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (G.D.L.); (J.S.)
| | - Judith Stallings
- College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (G.D.L.); (J.S.)
| | - Ashley J. Gess
- College of Education, Augusta University, Augusta, GA 30912, USA;
| | - Leigh Lehman
- School of Occupational Therapy, Brenau University, Gainesville, GA 30501, USA;
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17
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Ishitsuka K, Sasaki S, Mezawa H, Konishi M, Igarashi M, Yamamoto-Hanada K, Nakayama SF, Ohya Y. Dietary supplement use in elementary school children: a Japanese web-based survey. Environ Health Prev Med 2021; 26:63. [PMID: 34090343 PMCID: PMC8180069 DOI: 10.1186/s12199-021-00985-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background A variety of dietary supplements are commercially available. However, the efficacy and safety of dietary supplement use in children are not well established. Understanding dietary supplement use is important for developing public health policy regarding dietary supplements. This study aimed to investigate the types of dietary supplements used and characteristics of dietary supplement users among Japanese elementary school children. Method We conducted a cross-sectional web-based questionnaire study. Dietary supplement use, socio-demographics, and health-related behaviors were assessed through mother-reported questionnaire. Types of dietary supplements were identified based on ingredient using product barcodes and brand names. Multivariate logistic regression analysis was conducted to investigate the socio-demographics and health-related behaviors associated with supplement use. Results Among 4933 children, 333 (6.8%) were identified as dietary supplement users. The most common supplement was amino acids or protein (1.4%), followed by n–3 fatty acids or fish oil (1.0%), probiotics (1.0%), multivitamins (0.9%), multivitamin-minerals (0.8%), and botanicals (0.8%). Overall, any dietary supplement use was significantly associated with the highest frequency of sports participation (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.65–4.02), highest household income (OR, 1.87; 95% CI, 1.13–3.10), highest maternal educational level (OR, 1.82; 95% CI, 1.31–2.52), and male sex (OR, 1.38; 95% CI, 1.09–1.75). The highest frequency of sports participation was significantly associated with higher odds of use of amino acids or protein (OR, 6.06; 95% CI, 1.78–20.6) and multivitamins (OR, 3.56; 95% CI, 1.11–11.5), compared to the lowest frequency of sports participation. Conclusion This study showed that Japanese children primarily use non-vitamin, non-mineral supplements. Non-vitamin, non-mineral supplements should thus be included in future studies aimed at monitoring dietary supplement use. We also found that dietary supplement use in children was associated with sports participation. Guidelines for dietary supplement use for children, in particular sport participants, are needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00985-7.
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Affiliation(s)
- Kazue Ishitsuka
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. .,Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.,Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Hidetoshi Mezawa
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Mizuho Konishi
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Maki Igarashi
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Kiwako Yamamoto-Hanada
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Shoji F Nakayama
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, 305-8506, Japan
| | - Yukihiro Ohya
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
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18
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Ng JY, Tahir U, Dhaliwal S. Barriers, knowledge, and training related to pharmacists' counselling on dietary and herbal supplements: a systematic review of qualitative studies. BMC Health Serv Res 2021; 21:499. [PMID: 34034710 PMCID: PMC8147056 DOI: 10.1186/s12913-021-06502-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 05/10/2021] [Indexed: 12/23/2022] Open
Abstract
Background Pharmacists are recognized as one of the most accessible healthcare providers and are licensed to advise patients on drugs and health products including dietary and herbal supplements (DHSs). The objective of this study was to identify barriers, knowledge, and training that pharmacists report related to DHSs counselling. Methods MEDLINE, EMBASE, AMED and CINAHL were systematically searched from database inception to May 8th, 2020. Eligible articles contained qualitative data with a specific focus on pharmacists’ perceived knowledge, training, and barriers to DHSs counselling. Relevant data were extracted, and a thematic analysis was conducted. Results Nineteen articles met the inclusion criteria. The following three main themes were identified: challenges to pharmacists obtaining DHSs education, postgraduate workplace challenges surrounding DHSs, and pharmacists’ perceived role and importance on DHSs. Low knowledge of DHSs and the limited regulations surrounding DHSs acting as a barrier to counselling were common findings supported by the eligible articles. Conclusions A lack of pharmacists’ knowledge and awareness of DHSs stems from a variety of factors including a lack of education and training in the field, limited regulations surrounding DHSs, and inadequate availability of DHS information resources in the pharmacy. Pharmacists were unable to confidently counsel patients due to these aforementioned factors in addition to reporting that they lacked time. Further research that reviews pharmacy education and workplace training, and improving DHS regulations are warranted future directions.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - Umair Tahir
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Simran Dhaliwal
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
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19
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Ancellin R, Cottet V, Dossus L, Fassier P, Gaillot de Saintignon J, Ginhac J, Romieu I, Salas S, Schneider S, Srour B, Touillaud M, Touvier M, Latino-Martel P. [Impact of nutritional factors during and after cancer]. Bull Cancer 2021; 108:455-464. [PMID: 33836862 DOI: 10.1016/j.bulcan.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/07/2021] [Indexed: 02/07/2023]
Abstract
Nutritional factors (diet, weight, alcohol, physical activity) are identified as factors having an impact on the onset of several cancer sites. Less abundant scientific data also underline their impact on the tumor progression. A review of the scientific literature was carried out by a group of experts established by the French National Cancer Institute (INCa) to better document the influence of nutritional factors during and after cancer on outcomes such as overall mortality, cancer specific mortality, recurrence, second primary cancers and quality of life. This analysis of the literature completes messages of reduction of alcohol consumption, prevention of undernutrition or excess weight and adherence to dietary recommendations, avoiding the use of dietary supplements, fasting or restrictive diets and strengthens messages promoting the practice of physical activity and the fight against sedentary lifestyle.
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Affiliation(s)
- Raphaëlle Ancellin
- Institut national du cancer, 52, avenue André-Morizet, 92100 Boulogne-Billancourt, France.
| | - Vanessa Cottet
- CHU de Dijon, université de Bourgogne-Franche-Comté, Inserm UMR1231 & CIC1432, 7, boulevard Jeanne-d'Arc, 21079 Dijon, France
| | - Laure Dossus
- Centre international de recherche sur le cancer (CIRC), 150, cours Albert-Thomas, 69008 Lyon, France
| | | | | | - Julie Ginhac
- Cellule de coordination, domaine de Vilvert, réseau national alimentation cancer recherche (Réseau NACRe), 78350 Jouy-en-Josas, France
| | - Isabelle Romieu
- Center for Research on Population Health, National Institute of Public Health, Mexico, Mexique; Emory University, Hubert Department of Global Health, Atlanta, Georgia, États-Unis
| | - Sébastien Salas
- CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - Stéphane Schneider
- Université Côte d'Azur, CHU de Nice, Hôpital de l'Archet, 151, route de Saint-Antoine, 06200 Nice, France
| | - Bernard Srour
- Cellule de coordination, domaine de Vilvert, réseau national alimentation cancer recherche (Réseau NACRe), 78350 Jouy-en-Josas, France; Université Sorbonne Paris Nord, université de Paris (CRESS), Inrae U1125, Cnam, équipe de recherche en épidémiologie nutritionnelle (EREN), centre de recherche en épidémiologie et statistiques, Inserm U1153, 74, rue Marcel-Cachin, 93017 Bobigny, France
| | - Marina Touillaud
- Centre Léon-Bérard, Inserm UA8 « Radiations : défense, santé et environnement », 28, rue Laennec, 69008 Lyon, France
| | - Mathilde Touvier
- Université Sorbonne Paris Nord, université de Paris (CRESS), Inrae U1125, Cnam, équipe de recherche en épidémiologie nutritionnelle (EREN), centre de recherche en épidémiologie et statistiques, Inserm U1153, 74, rue Marcel-Cachin, 93017 Bobigny, France
| | - Paule Latino-Martel
- Cellule de coordination, domaine de Vilvert, réseau national alimentation cancer recherche (Réseau NACRe), 78350 Jouy-en-Josas, France
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20
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Yang F, Tian X, Han B, Zhao R, Li J, Zhang K. Tracking high-risk β-lactamase gene (bla gene) transfers in two Chinese intensive dairy farms. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 274:116593. [PMID: 33548670 DOI: 10.1016/j.envpol.2021.116593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/17/2021] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
Extended-spectrum β-lactam antibiotics are critically important antibiotics for humans, but their use in food-animals poses a potential threat for public health. This paper addressed the occurrence of high-risk β-lactamase genes (bla genes) in intensive dairy farms, and assessed the effects of different waste treatment technologies at dairies on the propagation and dissemination of bla genes. Results showed that ESBL genes (blaTEM-1, blaOXA-1), ampC β-lactamase genes (blaampC) and carbapenemase genes (blaGES-1, blaNDM) were prevalent in dairy cow waste, and even prevailed through each processing stage of solid manure and dairy wastewater. Significant levels of bla genes were present in the final lagoon (from 104 to 106 copies/mL, representing from 10% to 151%, of raw influent levels), raising the possibility of dissemination to the receiving environment. This concern was validated by the investigation on farmland that had long-term undergone wastewater irrigation, where causing an increase in bla gene levels in soils (approximately 1-3 orders of magnitude). More troublesomely, considerable levels of certain bla genes were still observed in the bedding material (up to 105 and 107 copies/g), which would directly threaten the dairy cow health. Otherwise, correlation analysis showed that both bacterial community and environmental factors played important roles in the bla genes abundances in dairy farms. This study demonstrated the prevalence of high-risk bla genes in dairy farms, and also underscored that dairy waste was a non-ignored great source of multidrug resistance for their surroundings.
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Affiliation(s)
- Fengxia Yang
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Xueli Tian
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Bingjun Han
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Run Zhao
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Jiajia Li
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Keqiang Zhang
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China.
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Levothyroxine Interactions with Food and Dietary Supplements-A Systematic Review. Pharmaceuticals (Basel) 2021; 14:ph14030206. [PMID: 33801406 PMCID: PMC8002057 DOI: 10.3390/ph14030206] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/07/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022] Open
Abstract
Levothyroxine (l-thyroxine, l-T4) is a drug of choice for treating congenital and primary hypothyroidism. Although clinically significant interactions between l-T4 and food can alter the safety and efficacy of the treatment, they still seem to be generally underestimated by patients, physicians and pharmacists. This review aimed to investigate the effects of meals, beverages, and dietary supplements consumption on l-T4 pharmacokinetics and pharmacodynamics, to identify the most evident interactions, and to perform the recommendations for safe co-administering of l-T4 and food. A total of 121 studies were identified following a systematic literature search adhering to PRISMA guidelines. After full-text evaluation, 63 studies were included. The results proved that l-T4 ingestion in the morning and at bedtime are equally effective, and also that the co-administration of l-T4 with food depends on the drug formulation. We found limited evidence for l-T4 interactions with coffee, soy products, fiber, calcium or iron supplements, and enteral nutrition but interestingly they all resulted in decreased l-T4 absorption. The altered l-T4 efficacy when ingested with milk, juices, papaya, aluminium-containing preparations, and chromium supplements, as well as observed enhancement effect of vitamin C on l-T4 absorption, shall be further investigated in larger, well-designed studies. Novel formulations are likely to solve the problem of coffee, calcium and iron induced malabsorption of l-T4. Maintaining a proper time interval between l-T4 and food intake, especially for coffee and calcium, or iron supplements, provides another effective method of eliminating such interactions.
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Beeram I, Mortensen SJ, Yeritsyan D, Momenzadeh K, von Keudell A, Nazarian A. Multivitamins and risk of fragility hip fracture: a systematic review and meta-analysis. Arch Osteoporos 2021; 16:29. [PMID: 33575883 DOI: 10.1007/s11657-021-00893-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/15/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE Hip fracture is a severe complication of osteoporosis and is associated with a significant healthcare burden worldwide. This meta-analysis explores the association between combined multivitamin use and hip fracture risk. Our results provide more patient-centered insight into the impact of supplement use on osteoporosis outcomes. METHODS We searched three online databases in August 2019 and included studies that reported on multivitamin use in patients with osteoporotic hip fractures. The inclusion criteria were (1) adult patients with osteoporotic hip fractures, (2) availability of full-text articles in English, and (3) at least 1 year of follow-up. No suitable randomized controlled trials could be identified for inclusion in the analysis. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS Eight studies containing 80,148 subjects in total were included in this study. Among these, 4237 cases of fragility hip fracture were reported. The average age was 69±5.3 years, and 21% of subjects were male. Multivitamin use was found to be significantly associated with a lower risk of sustaining a fragility hip fracture (OR 0.49, 95%CI: 0.32-0.77). The Begg and Mazumdar test and funnel plot indicated that no significant publication bias was present. CONCLUSION Combined multivitamins are amongst the most widely used supplements and are often preferred over single vitamins. Our meta-analysis indicates that multivitamin use is significantly protective against osteoporotic hip fracture. In the future, randomized controlled trials should be performed to establish multivitamins as effective preventative measures for this injury.
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Affiliation(s)
- Indeevar Beeram
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Sharri J Mortensen
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA
| | - Diana Yeritsyan
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA
| | - Kaveh Momenzadeh
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA
| | - Arvind von Keudell
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School Orthopaedic Trauma Initiative, Boston, MA, USA
| | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA.
- Harvard Medical School Orthopaedic Trauma Initiative, Boston, MA, USA.
- Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia.
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Zhang YY, Stockmann R, Ng K, Ajlouni S. Opportunities for plant-derived enhancers for iron, zinc, and calcium bioavailability: A review. Compr Rev Food Sci Food Saf 2020; 20:652-685. [PMID: 33443794 DOI: 10.1111/1541-4337.12669] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/08/2020] [Accepted: 10/20/2020] [Indexed: 12/31/2022]
Abstract
Understanding of the mechanism of interactions between dietary elements, their salts, and complexing/binding ligands is vital to manage both deficiency and toxicity associated with essential element bioavailability. Numerous mineral ligands are found in both animal and plant foods and are known to exert bioactivity via element chelation resulting in modulation of antioxidant capacity or micobiome metabolism among other physiological outcomes. However, little is explored in the context of dietary mineral ligands and element bioavailability enhancement, particularly with respect to ligands from plant-derived food sources. This review highlights a novel perspective to consider various plant macro/micronutrients as prospective bioavailability enhancing ligands of three essential elements (Fe, Zn, and Ca). We also delineate the molecular mechanisms of the ligand-binding interactions underlying mineral bioaccessibility at the luminal level. We conclude that despite current understandings of some of the structure-activity relationships associated with strong mineral-ligand binding, the physiological links between ligands as element carriers and uptake at targeted sites throughout the gastrointestinal (GI) tract still require more research. The binding behavior of potential ligands in the human diet should be further elucidated and validated using pharmacokinetic approaches and GI models.
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Affiliation(s)
- Yianna Y Zhang
- School of Agriculture and Food, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, Australia.,CSIRO Agriculture & Food, Werribee, VIC, Australia
| | | | - Ken Ng
- School of Agriculture and Food, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Said Ajlouni
- School of Agriculture and Food, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, Australia
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Reliability of Self-Administered Questionnaire on Dietary Supplement Consumption in Malaysian Adolescents. Nutrients 2020; 12:nu12092853. [PMID: 32957625 PMCID: PMC7551120 DOI: 10.3390/nu12092853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 11/20/2022] Open
Abstract
The repeatability of most questionnaires utilized in previous studies related to the consumption of dietary supplements (DS) among youth has not been well documented. Thus, a simple and easy-to-administer questionnaire to capture the habitual use of DS in the past one year known as the dietary supplement questionnaire (DiSQ) was developed and supported with external reliability evaluation. Analyses were done based on a convenience sample of 46 secondary school students. To elicit information regarding the intake of DS, the questionnaire was partitioned into two domains. The first domain was used to identify vitamin/mineral (VM) supplements, while the second domain was utilized to identify non-vitamin/non-mineral (NVNM) supplements. Cohen’s kappa coefficient (k) was used to evaluate the test–retest reliability of the questionnaire. Questionnaire administration to the respondents was done twice whereby a retest was given two weeks after the first test. Between test and retest, the reliability of individual items ranged from moderate to almost perfect for the VM (k = 0.53–1.00) and NVNM (k = 0.63–1.00) domains. None of the items had “fair” or ”poor” agreement. Various correlation coefficients can be obtained for the DiSQ but are generally reliable over time for assessing information on the consumption of supplements among the adolescent population.
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Goudarzi S, Memar Montazerin S, Najafi H, Shojaei F, Chi G. Effect of Vitamins and Dietary Supplements on Cardiovascular Health. Crit Pathw Cardiol 2020; 19:153-159. [PMID: 32053519 DOI: 10.1097/hpc.0000000000000212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cardiovascular disease marks the leading cause of mortality and morbidity in the United States. Pharmacological therapies have been developed to reduce the burden of cardiovascular diseases in the setting of large-scale randomized controlled trials. In contrast, vitamins and minerals have not undergone an equal level of scrutiny, and the evidence of cardiovascular benefit remains elusive. Multivitamins are the most popular over-the-counter supplements in the United States, despite the lack of clear benefit as a means of primary or secondary cardiovascular prevention. Recent studies indicate a potential role of multivitamins in secondary prevention when concomitantly administered with chelation therapy. Additionally, preclinical and observational studies have shown preliminary evidence of cardiovascular protection with dietary supplements such as carnitine, arginine, and coenzyme Q10. This review summarizes the currently available data about the effect of vitamins and other dietary supplements on the cardiovascular system.
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Affiliation(s)
- Sogand Goudarzi
- From the Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Chandra-Hioe MV, Xu H, Arcot J. The efficiency of ultrasonic-assisted extraction of cyanocobalamin is greater than heat extraction. Heliyon 2019; 6:e03059. [PMID: 31909249 PMCID: PMC6939108 DOI: 10.1016/j.heliyon.2019.e03059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/12/2019] [Accepted: 12/12/2019] [Indexed: 01/05/2023] Open
Abstract
Cyanocobalamin, like other water-soluble vitamins, is susceptible to degradation due to exposure to heat, UV, oxygen and pH. Built on our previous finding, this study aimed to assess the extraction efficiency of cyanocobalamin from dietary supplements. Particularly, cyanocobalamin extraction in a 100 °C water bath was compared with ultrasonic-assisted extraction, with and without the addition of 1 mg/L sorbitol, xylitol and erythritol. Ground defatted samples of supplement tablets were initially treated for 15 min, centrifuged and filtered before quantitative HPLC analysis. Addition of sorbitol and xylitol significantly minimised the thermal degradation during extraction in a 100 °C water bath, as shown in measured cyanocobalamin (~145 μg/tablet) that was higher than the control (100 μg/tablet, p < 0.05). Despite the addition of sugar alcohols, mean cyanocobalamin in ultrasonic extracted samples (~170 μg/tablet) was not significantly different from those without (p > 0.05). Overall, mean cyanocobalamin in sonicated samples was higher than heat-extracted counterparts, suggesting that extraction in a 100 °C water bath was likely to cause thermal degradation. It was possible that ultrasonic-assisted extraction had no effect on cyanocobalamin stability and would lead to a higher extraction efficiency. Therefore, 15 min extraction in an ultrasonic bath can be suggested to be adequate to release cyanocobalamin before its quantitative determination.
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Affiliation(s)
| | - Han Xu
- Food and Health Cluster, UNSW Sydney, Sydney, Australia
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Chang TC, Chiang H, Lai YH, Huang YL, Huang HC, Liang YC, Liu HK, Huang C. Helminthostachys zeylanica alleviates hepatic steatosis and insulin resistance in diet-induced obese mice. Altern Ther Health Med 2019; 19:368. [PMID: 31836013 PMCID: PMC6911300 DOI: 10.1186/s12906-019-2782-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/29/2019] [Indexed: 12/27/2022]
Abstract
Background Obesity and its associated health conditions, type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD), are worldwide health problems. It has been shown that insulin resistance is associated with increased hepatic lipid and causes hepatic steatosis through a myriad of mechanisms, including inflammatory signaling. Methods Helminthostachys zeylanica (HZ) is used widely as a common herbal medicine to relieve fever symptoms and inflammatory diseases in Asia. In the present study, we evaluated whether HZ has therapeutic effects on obesity, NAFLD and insulin resistance. The protective effects of HZ extract were examined using free fatty acid-induced steatosis in human HuS-E/2 cells and a high-fat diet-induced NAFLD in mice. Results The major components of the HZ extract are ugonins J and K, confirmed by HPLC. Incubation of human hepatocytes, HuS-E/2 cells, with palmitate markedly increased lipid accumulation and treatment with the HZ extract significantly decreased lipid deposition and facilitated AMPK and ACC activation. After 12 weeks of a high-fat diet with HZ extract treatment, the HFD mice were protected from hyperlipidemia and hyperglycemia. HZ extract prevented body weight gain, adipose tissue expansion and adipocyte hypertrophy in the HFD mice. In addition, fat accumulation was reduced in mice livers. Moreover, the insulin sensitivity-associated index, which evaluates insulin function, was also significantly restored. Conclusions These results suggest that HZ has a promising pharmacological effect on high-fat diet-induced obesity, hepatic steatosis and insulin resistance, which may have the potential for clinical application.
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Babaahmadifooladi M, Jacxsens L, Van de Wiele T, Laing GD. Gap analysis of nickel bioaccessibility and bioavailability in different food matrices and its impact on the nickel exposure assessment. Food Res Int 2019; 129:108866. [PMID: 32036919 DOI: 10.1016/j.foodres.2019.108866] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/05/2019] [Accepted: 11/24/2019] [Indexed: 02/08/2023]
Abstract
The metal nickel is well known to cause nickel allergy in sensitive humans by prolonged dermal contact to materials releasing (high) amounts of nickel. Oral nickel exposure via water and food intake is of potential concern. Nickel is essential to plants and animals and can be naturally found in food products or contamination may occur across the agro-food chain. This gap analysis is an evaluation of nickel as a potential food safety hazard causing a risk for human health. In the first step, the available data regarding the occurrence of nickel and its contamination in food and drinks have been collected through literature review. Subsequently, a discussion is held on the potential risks associated with this contamination. Elevated nickel concentrations were mostly found in plant-based foods, e.g. legumes and nuts in which nickel of natural origin is expected. However, it was observed that dedicated and systematic screening of foodstuffs for the presence of nickel is currently still lacking. In a next step, published studies on exposure of humans to nickel via foods and drinks were critically evaluated. Not including bioaccessibility and/or bioavailability of the metal may lead to an overestimation of the exposure of the body to nickel via food and drinks. This overestimation may be problematic when the measured nickel level in foods is high and bioaccessibility and/or bioavailability of nickel in these products is low. Therefore, this paper analyzes the outcomes of the existing dietary intake and bioaccessibility/bioavailability studies conducted for nickel. Besides, the available gaps in nickel bioaccessibility and/or bioavailability studies have been clarified in this paper. The reported bioaccessibility and bioavailability percentages for different food and drinks were found to vary between <LOD and 83% and between 0 and 30% respectively. This indicates that of the total nickel contained in the foodstuffs only a fraction can be absorbed by the intestinal epithelium cells. This paper provides a unique critical overview on nickel in the human diet starting from factors affecting its occurrence in food until its absorption by the body.
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Affiliation(s)
- Mehrnoosh Babaahmadifooladi
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Gent, Belgium; Department of Green Chemistry and Technology, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Gent, Belgium.
| | - Liesbeth Jacxsens
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Gent, Belgium.
| | - Tom Van de Wiele
- Center for Microbial Ecology and Technology (CMET), Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Gent, Belgium.
| | - Gijs Du Laing
- Department of Green Chemistry and Technology, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Gent, Belgium.
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Akça SN, Sargın HS, Mızrak ÖF, Yaman M. Determination and assessment of the bioaccessibility of vitamins B1, B2, and B3 in commercially available cereal-based baby foods. Microchem J 2019. [DOI: 10.1016/j.microc.2019.104192] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Position of the Academy of Nutrition and Dietetics: Micronutrient Supplementation. J Acad Nutr Diet 2019; 118:2162-2173. [PMID: 30366569 DOI: 10.1016/j.jand.2018.07.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 12/15/2022]
Abstract
It is the position of the Academy of Nutrition and Dietetics that micronutrient supplements are warranted when requirements are not being met through the diet alone. Those with increased requirements secondary to growth, chronic disease, medication use, malabsorption, pregnancy and lactation, and aging may be at particular risk for inadequate dietary intakes. However, the routine and indiscriminate use of micronutrient supplements for the prevention of chronic disease is not recommended, given the lack of available scientific evidence. A few specific age and disease states that may benefit from micronutrient supplementation are discussed. The most common dietary supplements used by both children and adults in the United States contain micronutrients. Consumers may not be well informed about the safety and use of these products, and some may have difficulty interpreting product labels. Thus, the expertise of registered dietitian nutritionists and nutrition and dietetic technicians, registered, is needed to guide the safe and appropriate selection and use of micronutrient supplements. To accomplish this, registered dietitian nutritionists and nutrition and dietetic technicians, registered, must keep up to date on efficacy, safety, and the regulatory issues influencing the use of these products. This position paper aims to increase awareness of current issues relevant to micronutrient supplementation and of the resources available to assist registered dietitian nutritionists and nutrition and dietetic technicians, registered, in evaluating their potential benefits and adverse outcomes.
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Chen F, Du M, Blumberg JB, Ho Chui KK, Ruan M, Rogers G, Shan Z, Zeng L, Zhang FF. Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study. Ann Intern Med 2019; 170:604-613. [PMID: 30959527 PMCID: PMC6736694 DOI: 10.7326/m18-2478] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The health benefits and risks of dietary supplement use are controversial. OBJECTIVE To evaluate the association among dietary supplement use, levels of nutrient intake from foods and supplements, and mortality among U.S. adults. DESIGN Prospective cohort study. SETTING NHANES (National Health and Nutrition Examination Survey) data from 1999 to 2010, linked to National Death Index mortality data. PARTICIPANTS 30 899 U.S. adults aged 20 years or older who answered questions on dietary supplement use. MEASUREMENTS Dietary supplement use in the previous 30 days and nutrient intake from foods and supplements. Outcomes included mortality from all causes, cardiovascular disease (CVD), and cancer. RESULTS During a median follow-up of 6.1 years, 3613 deaths occurred, including 945 CVD deaths and 805 cancer deaths. Ever-use of dietary supplements was not associated with mortality outcomes. Adequate intake (at or above the Estimated Average Requirement or the Adequate Intake level) of vitamin A, vitamin K, magnesium, zinc, and copper was associated with reduced all-cause or CVD mortality, but the associations were restricted to nutrient intake from foods. Excess intake of calcium was associated with increased risk for cancer death (above vs. at or below the Tolerable Upper Intake Level: multivariable-adjusted rate ratio, 1.62 [95% CI, 1.07 to 2.45]; multivariable-adjusted rate difference, 1.7 [CI, -0.1 to 3.5] deaths per 1000 person-years), and the association seemed to be related to calcium intake from supplements (≥1000 mg/d vs. no use: multivariable-adjusted rate ratio, 1.53 [CI, 1.04 to 2.25]; multivariable-adjusted rate difference, 1.5 [CI, -0.1 to 3.1] deaths per 1000 person-years) rather than foods. LIMITATIONS Results from observational data may be affected by residual confounding. Reporting of dietary supplement use is subject to recall bias. CONCLUSION Use of dietary supplements is not associated with mortality benefits among U.S. adults. PRIMARY FUNDING SOURCE National Institutes of Health.
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Affiliation(s)
- Fan Chen
- Friedman School of Nutrition Science and Policy, Tufts University, and Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts (F.C.)
| | - Mengxi Du
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts (M.D., J.B.B., L.Z., F.F.Z.)
| | - Jeffrey B Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts (M.D., J.B.B., L.Z., F.F.Z.)
| | | | - Mengyuan Ruan
- Friedman School of Nutrition Science and Policy and School of Medicine, Tufts University, Boston, Massachusetts (M.R.)
| | - Gail Rogers
- Friedman School of Nutrition Science and Policy and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts (G.R.)
| | - Zhilei Shan
- Friedman School of Nutrition Science and Policy, Tufts University, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Z.S.)
| | - Luxian Zeng
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts (M.D., J.B.B., L.Z., F.F.Z.)
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts (M.D., J.B.B., L.Z., F.F.Z.)
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Nutritionist and obesity: brief overview on efficacy, safety, and drug interactions of the main weight-loss dietary supplements. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2019; 9:32-49. [PMID: 31391923 DOI: 10.1038/s41367-019-0007-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Over the past 20 years the use of dietary supplements as adjuvant therapy for weight loss gained growing favor among consumers and dietician-nutritionists, with the subsequent astounding increase in health costs. Despite the reassuring label of natural remedy for losing weight, dietary supplements contain a wide variety of ingredients on which available information is rather scanty and scientifically incomplete. Currently, there is little evidence that weight-loss supplements offer effective aids to reduce weight and meet criteria for recommended use. Robust, randomized, placebo-controlled studies to provide clear-cut scientific evidence of their efficacy and potential side effects in clinical practice are still lacking. Understanding the evidence for the efficacy, safety, and quality of these supplements among nutritionists and physicians is critical to counsel patients appropriately, especially considering the risk of serious adverse effects and interference with concomitant therapies. Detailed information on the efficacy and safety of the most commonly used weight-loss dietary supplements has been recently published by the National Institutes of Health (NIH). However, in this report the thorny issue that may result from drug interactions with weight-loss dietary supplements has been not sufficiently addressed. The aim of this review was to provide a synthetic, evidence-based report on efficacy and safety of the most commonly used ingredients in dietary supplements marketed for weight loss, particularly focusing on their possible drug interactions.
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Bailey RL. Current regulatory guidelines and resources to support research of dietary supplements in the United States. Crit Rev Food Sci Nutr 2018; 60:298-309. [PMID: 30421981 PMCID: PMC6513729 DOI: 10.1080/10408398.2018.1524364] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 12/31/2022]
Abstract
The U.S. Dietary Supplement Health and Education Act (DSHEA) established the regulatory framework for dietary supplements as foods through the Food and Drug Administration (FDA). DSHEA outlined the legal definition, labeling requirements, and process for adverse event reporting for dietary supplements. FDA also issued formal guidance on current Good Manufacturing Practice to ensure that processes for preparation, packaging, labeling, and storage of supplements and ingredients are documented and meet specifications to ensure purity, composition, and strength. However, efficacy of dietary supplements is not required under U.S. law. Despite regulations to improve the marketplace, many challenges remain; as a result, the quality and safety of products available can be highly variable, especially for botanical and herbal products. The ability of regulators to successfully carry out their mission is hampered by the sheer number of products and manufacturing facilities and a lack of analytical methods for all ingredients and products in the marketplace, this is especially difficult for herbal and botanical dietary supplements. Safety issues continue to exist such as adulteration and contamination, especially with specific product types (i.e. body building, sexual enhancement). Thus, a need remains for continued efforts and improved techniques to assess the quality of dietary supplements, especially with regard to purity, bioavailability, and safety. This review will highlight the existing American regulatory framework for dietary supplements and will describe the remaining regulatory barriers to ensuring that safe and high-quality dietary supplements are offered in the marketplace.
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Affiliation(s)
- Regan L Bailey
- Department of Nutrition Science, Purdue University, , West Lafayette, Indiana 47907, USA
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Abstract
In the past, vitamins and minerals were used to cure deficiency diseases. Supplements nowadays are used with the aim of reducing the risk of chronic diseases of which the origins are complex. Dietary supplement use has increased in the UK over recent decades, contributing to the nutrient intake in the population, but not necessarily the proportion of the population that is sub-optimally nourished; therefore, not reducing the proportion below the estimated average requirement and potentially increasing the number at risk of an intake above the safety limits. The supplement nutrient intake may be objectively monitored using circulation biomarkers. The influence of the researcher in how the supplements are grouped and how the nutrient intakes are quantified may however result in different conclusions regarding their nutrient contribution, the associations with biomarkers, in general, and dose-response associations specifically. The diet might be sufficient in micronutrients, but lacking in a balanced food intake. Since public-health nutrition guidelines are expressed in terms of foods, there is potentially a discrepancy between the nutrient-orientated supplement and the quality of the dietary pattern. To promote health, current public-health messages only advocate supplements in specific circumstances, but not in optimally nourished populations.
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Quantitative assessment of dietary supplement intake in 77,000 French adults: impact on nutritional intake inadequacy and excessive intake. Eur J Nutr 2018; 58:2679-2692. [DOI: 10.1007/s00394-018-1815-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
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Rajakumari R, Oluwafemi OS, Thomas S, Kalarikkal N. Dietary supplements containing vitamins and minerals: Formulation, optimization and evaluation. POWDER TECHNOL 2018. [DOI: 10.1016/j.powtec.2018.06.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Binns CW, Lee MK, Lee AH. Problems and Prospects: Public Health Regulation of Dietary Supplements. Annu Rev Public Health 2018; 39:403-420. [DOI: 10.1146/annurev-publhealth-040617-013638] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Colin W. Binns
- School of Public Health, Curtin University, Perth, Western Australia 6845, Australia;,
| | - Mi Kyung Lee
- School of Health Professions, Murdoch University, Perth, Western Australia 6150, Australia
| | - Andy H. Lee
- School of Public Health, Curtin University, Perth, Western Australia 6845, Australia;,
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D'Adamo CR, Novick JS, Feinberg TM, Dawson VJ, Miller LE. A Food-Derived Dietary Supplement Containing a Low Dose of Iron Improved Markers of Iron Status Among Nonanemic Iron-Deficient Women. J Am Coll Nutr 2018. [PMID: 29533710 DOI: 10.1080/07315724.2018.1427158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Iron deficiency is the most common nutrient deficiency in the world. While deficiency can often be resolved through dietary supplementation with iron, adverse events are common and frequently preclude compliance. The objective of this study was to determine whether a food-derived dietary supplement containing a low dose of iron and nutrients that increase iron absorption could resolve iron deficiency with fewer adverse events than reported at higher doses. METHODS A pilot clinical trial (NCT02683369) was conducted among premenopausal women with nonanemic iron deficiency that was verified by blood screening. Participants consumed a dietary supplement (Blood Builder®/Iron Response®) once daily for 8 weeks containing 26 mg of iron, vitamin C, folate, and other food-derived nutrients. Primary outcomes were markers of iron status (serum ferritin, hemoglobin, soluble transferrin receptor, total body iron stores) and secondary outcomes were self-reported fatigue and energy. All outcomes were assessed at baseline and 8 weeks. Adverse events were monitored with questionnaires, daily diaries, and contact with a physician. Dependent samples t test and Wilcoxon signed-rank test were used to analyze outcomes. RESULTS Twenty-three participants enrolled in the study. Iron deficiency was resolved in the sample (mean serum ferritin: baseline = 13.9 μg/L, 8 weeks = 21.1 μg/L, p < 0.001). All other markers of iron status, fatigue, and energy also improved during the study (p < 0.04). No adverse events were reported. CONCLUSIONS While larger and controlled studies are needed to confirm these findings, a food-derived dietary supplement with a low dose of iron and absorption-enhancing nutrients resolved iron deficiency and improved all other markers of iron status without any adverse events.
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Affiliation(s)
- Christopher R D'Adamo
- a Department of Family & Community Medicine , Center for Integrative Medicine, University of Maryland School of Medicine , Baltimore , Maryland , USA
| | - James S Novick
- b Charm City Research Group, University of Maryland St. Joseph Medical Center , Towson , Maryland , USA
| | - Termeh M Feinberg
- a Department of Family & Community Medicine , Center for Integrative Medicine, University of Maryland School of Medicine , Baltimore , Maryland , USA
| | - Valerie J Dawson
- a Department of Family & Community Medicine , Center for Integrative Medicine, University of Maryland School of Medicine , Baltimore , Maryland , USA
| | - Larry E Miller
- c Miller Scientific Consulting , Asheville , North Carolina , USA
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Schwalfenberg G, Rodushkin I, Genuis SJ. Heavy metal contamination of prenatal vitamins. Toxicol Rep 2018; 5:390-395. [PMID: 29854609 PMCID: PMC5978005 DOI: 10.1016/j.toxrep.2018.02.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 02/25/2018] [Accepted: 02/27/2018] [Indexed: 12/18/2022] Open
Abstract
Toxic elements are found in prenatal vitamins with lead at unacceptable levels in more than half of the products tested. Arsenic is also found in some products at unsafe levels. Thallium is present at levels in some products that are not acceptable. Some products have very low level, which are safer, and recommendations are made to have industry (self regulatory) and government oversight to have the least contamination of prenatal vitamins.
Prenatal vitamins are often consumed daily during gestation and postnatally for up to 18–24 months with the belief that supplementation achieves better outcomes. Detrimental effects of gestational exposure to adverse chemical agents are gathering increasing attention. This study was designed to assess toxic element contamination in prenatal supplements. Twenty-six commonly used prenatal vitamin brands including one prescription brand were collected from Canadian health-food outlets and pharmacies, and tested for toxic element contamination. Results were compared to established endpoints. All samples contained Lead with average amounts being (0.535 μgm), 20/51 samples exceeded established standards for lead toxicity (0.50 μgm/day), with one sample yielding 4. μgm/day. Three samples registered inorganic arsenic levels above acceptable limits. Cadmium levels did not exceed current standards. Toxic elements such as Aluminum, Nickel, Titanium and Thallium were detected in all samples. Cumulative intake of prenatal supplement over many months may constitute a significant source of toxic element exposure to the mother and offspring. With several samples exceeding known standards for gestational toxic element exposure, guidelines for routine monitoring and reporting are required. In keeping with recommendations from the International Federation of Obstetrics and Gynecology, industry regulation would be welcomed to protect expectant mothers and their vulnerable offspring.
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Affiliation(s)
| | - Ilia Rodushkin
- Scandinavia Division of A.L.S. Laboratory Group, Sweden.,Luleå University of Technology, Sweden
| | - Stephen J Genuis
- Department of Obstetrics and Gynecology, University of Alberta, Canada
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Blumberg JB, Bailey RL, Sesso HD, Ulrich CM. The Evolving Role of Multivitamin/Multimineral Supplement Use among Adults in the Age of Personalized Nutrition. Nutrients 2018; 10:nu10020248. [PMID: 29470410 PMCID: PMC5852824 DOI: 10.3390/nu10020248] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/08/2018] [Accepted: 02/19/2018] [Indexed: 12/31/2022] Open
Abstract
Micronutrient deficiencies occur in segments of the adult population in the United States. Multivitamin/multimineral supplements (MVMS) are widely used by this population, which reduces inadequacies in micronutrient intake, but the potential for exceeding tolerable upper intake levels in others should be considered. There are concerns associated with the excessive intake of certain nutrients, particularly folic acid, and potential untoward consequences. The advent of nutrigenomics and the enhanced ability to directly study the interactions between nutrition and genetic variants and expression will allow for the conduct of more targeted studies with specific endpoints and may ultimately lead to progress in the field of personalized nutrition. The role of MVMS in health maintenance and chronic disease prevention remains controversial. Conducting studies in this area has been hampered by, among other factors, inconsistent definitions of MVMS, ranging from as few as three vitamins to broad-spectrum products containing more than two dozen vitamins and minerals. Results from some observational studies and large-scale, randomized, controlled trials suggest that MVMS may reduce the risk of some forms of cancer and, potentially, cardiovascular disease. The ongoing COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is expected to build on this research and provide additional insights into these areas.
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Affiliation(s)
- Jeffrey B Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, 711 Washington Street, Boston, MA 02111, USA.
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, 700 West State Street, West Lafayette, IN 47907, USA.
| | - Howard D Sesso
- Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue East, 3rd Floor, Boston, MA 02215, USA.
| | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USA.
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Pakdeesuwan A, Araki T, Payoungkiattikun W, Neubert LK, Jangpromma N, Klaynongsruang S. Development, characterization and determination of biological properties of crocodile hemoglobin (Crocodylus siamensis
) tablets. J Food Biochem 2018. [DOI: 10.1111/jfbc.12503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anawat Pakdeesuwan
- Department of Biochemistry; Faculty of Science, Khon Kaen University; Khon Kaen Thailand
- The Protein and Proteomics Research Center for Commercial and Industrial Purposes (ProCCI); Faculty of Science, Khon Kaen University; Khon Kaen Thailand
| | - Tomohiro Araki
- Department of Bioscience, School of Agriculture; Tokai University; Aso, Kumamoto Japan
| | - Wisarut Payoungkiattikun
- The Protein and Proteomics Research Center for Commercial and Industrial Purposes (ProCCI); Faculty of Science, Khon Kaen University; Khon Kaen Thailand
| | - Lorenz K. Neubert
- The Protein and Proteomics Research Center for Commercial and Industrial Purposes (ProCCI); Faculty of Science, Khon Kaen University; Khon Kaen Thailand
| | - Nisachon Jangpromma
- The Protein and Proteomics Research Center for Commercial and Industrial Purposes (ProCCI); Faculty of Science, Khon Kaen University; Khon Kaen Thailand
- Faculty of Science, Khon Kaen University; Khon Kaen Thailand
| | - Sompong Klaynongsruang
- Department of Biochemistry; Faculty of Science, Khon Kaen University; Khon Kaen Thailand
- The Protein and Proteomics Research Center for Commercial and Industrial Purposes (ProCCI); Faculty of Science, Khon Kaen University; Khon Kaen Thailand
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Monitoring of essential and toxic elements in multi-ingredient food supplements produced in European Union. J Verbrauch Lebensm 2018. [DOI: 10.1007/s00003-018-1148-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Effect of long-term nutraceutical and dietary supplement use on cognition in the elderly: a 10-year systematic review of randomised controlled trials. Br J Nutr 2018; 119:280-298. [DOI: 10.1017/s0007114517003452] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractNutraceuticals have generated interest as a way to mitigate the cognitive decline in older adults. The aim of this systematic review was to determine the evidence for these claims from the scientific literature in randomised, double-blinded, controlled trials (duration: ≥1 year; participants: n≥100; age(mean): ≥65 years). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched four electronic databases (PubMed, Scopus, CINAHL and Web of Science) and identified twenty-five studies published between the 15·June·2006 and 14·June·2016. Interventions included B-vitamins, n-3 fatty acids, antioxidant vitamins and herbs. Of the B-vitamin studies, four found benefits to cognition with supplementation. The first of these B-vitamin studies, in individuals with mild cognitive impairment (n 266; duration=2 years), included benefit to executive function (P=0·015) and improvements in the Mini-Mental State Examination (MMSE) among participants with baseline homocysteine above 11·3 µmol/l (P<0·001). In the same sample, the second study found cognitive benefits of B-vitamins dependent on the higher baseline plasma n-3 fatty acid status. The third B-vitamin study (n 900; duration=2 years) reported improved performance in immediate (P=0·046) and delayed recall (P=0·013), whereas the fourth study (n 856; duration=2 years) reported slower rate of cognitive decline in the MMSE (P=0·05). One study investigating DHA treatment (n 402; duration=1·5 years) revealed the slower rate of cognitive change in apoE e4 non-carriers (P=0·03). As only five included studies revealed notable benefits, presently based on the specific compounds explored here, there is not compelling evidence to support the use nutraceuticals to improve cognition in the elderly. Future long-term trials of nutraceuticals should investigate interactions with lifestyle, blood biomarkers and genetic risk factors.
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Issa OM, Roberts R, Mark DB, Boineau R, Goertz C, Rosenberg Y, Lewis EF, Guarneri E, Drisko J, Magaziner A, Lee KL, Lamas GA. Effect of high-dose oral multivitamins and minerals in participants not treated with statins in the randomized Trial to Assess Chelation Therapy (TACT). Am Heart J 2018; 195:70-77. [PMID: 29224648 DOI: 10.1016/j.ahj.2017.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 09/01/2017] [Indexed: 12/28/2022]
Abstract
IMPORTANCE In a prespecified subgroup analysis of participants not on statin therapy at baseline in the TACT, a high-dose complex oral multivitamins and multimineral regimen was found to have a large unexpected benefit compared with placebo. The regimen tested was substantially different from any vitamin regimen tested in prior clinical trials. OBJECTIVE To explore these results, we performed detailed additional analyses of participants not on statins at enrollment in TACT. DESIGN TACT was a factorial trial testing chelation treatments and a 28-component high-dose oral multivitamins and multiminerals regimen versus placebo in post-myocardial infarction (MI) patients 50 years or older. PARTICIPANTS There were 460 (27%) of 1,708 TACT participants not taking statins at baseline, 224 (49%) were in the active vitamin group and 236 (51%) were in the placebo group. SETTING Patients were enrolled at 134 sites around the United States and Canada. INTERVENTION Daily high-dose oral multivitamins and multiminerals (6 tablets, active or placebo). MAIN OUTCOME The primary end point of TACT was time to the first occurrence of any component of the composite end point: all-cause mortality, MI, stroke, coronary revascularization, or hospitalization for angina. RESULTS The primary end point occurred in 137 nonstatin participants (30%), of which 51 (23%) of 224 were in the active group and 86 (36%) of 236 were taking placebo (hazard ratio, 0.62; 95% confidence interval, 0.44-0.87; P=.006). Results in the key TACT secondary end point, a combination of cardiovascular mortality, stroke, or recurrent MI, was consistent in favoring the active vitamin group (hazard ratio, 0.46; 95% confidence interval, 0.28-0.75; P=.002). Multiple end point analyses were consistent with these results. CONCLUSION AND RELEVANCE High-dose oral multivitamin and multimineral supplementation seem to decrease combined cardiac events in a stable, post-MI population not taking statin therapy at baseline. These unexpected findings are being retested in the ongoing TACT2.
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Taylor RM, Fealy SM, Bisquera A, Smith R, Collins CE, Evans TJ, Hure AJ. Effects of Nutritional Interventions during Pregnancy on Infant and Child Cognitive Outcomes: A Systematic Review and Meta-Analysis. Nutrients 2017; 9:E1265. [PMID: 29156647 PMCID: PMC5707737 DOI: 10.3390/nu9111265] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/06/2017] [Accepted: 11/13/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Epidemiological studies have demonstrated that folate, iodine and iron intake during pregnancy impacts on foetal brain development and cognitive function. However, in human studies, the relationship with other dietary nutrients is less clear. OBJECTIVE This systematic review aims to critically appraise the current literature and meta-analyses results from nutritional interventions during pregnancy that aimed to optimise infant and child cognitive outcomes. DESIGN Ten electronic databases were searched for articles published up to August 2017. The search was limited to articles published in English. Randomised controlled trials (RCTs) testing the impact of any nutritional intervention (dietary counselling, education, nutrient supplementation, fortified foods and/or foods) during pregnancy on cognitive outcomes of children (<10 years old). Two independent reviewers assessed study eligibility and quality using the American Dietetic Association quality criteria checklist for primary research. Standardised mean differences were used for nine cognitive domains to measure effects for meta-analyses. RESULTS A total of 34 RCTs were included (21 studies included children aged less than 35 months, 10 studies included children aged 36-60 months and 3 studies included children aged 61-119 months). The types of nutritional interventions included nutrient supplements, whole foods, fortified foods and nutrition education. The following nine cognition outcomes: attention, behaviour, crystallised intelligence, fluid intelligence, global cognition, memory, motor skills, visual processing, and problem solving were not significantly impacted by nutritional interventions, although 65% of studies conducted post-hoc data analyses and were likely to be underpowered. Although, long chain polyunsaturated fatty acids (LCPUFA) supplementation was associated with a marginal increase in crystallised intelligence (Effect size (ES): 0.25; 95% confidence interval (95% CI): -0.04, 0.53), the effect was not statistically significant (p = 0.09), with significant study heterogeneity (p = 0.00). CONCLUSIONS LCPUFA supplementation may be associated with an improvement in child crystallised intelligence, however further research is warranted. The remaining eight cognition domains were not significantly impacted by maternal nutritional interventions.
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Affiliation(s)
- Rachael M Taylor
- Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW 2308, Australia.
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.
- Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - Shanna M Fealy
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.
- Faculty of Health and Medicine, School of Nursing & Midwifery, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Alessandra Bisquera
- Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
- Clinical Research Design IT and Statistical Support (CReDITSS) Unit, Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - Roger Smith
- Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW 2308, Australia.
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.
- Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - Clare E Collins
- Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Tiffany-Jane Evans
- Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
- Clinical Research Design IT and Statistical Support (CReDITSS) Unit, Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - Alexis J Hure
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.
- Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
- Priority Research Centre for Gender, Health and Ageing, University of Newcastle, Callaghan, NSW 2308, Australia.
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Blumberg JB, Frei BB, Fulgoni VL, Weaver CM, Zeisel SH. Impact of Frequency of Multi-Vitamin/Multi-Mineral Supplement Intake on Nutritional Adequacy and Nutrient Deficiencies in U.S. Adults. Nutrients 2017; 9:nu9080849. [PMID: 28792457 PMCID: PMC5579642 DOI: 10.3390/nu9080849] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 07/26/2017] [Accepted: 08/07/2017] [Indexed: 12/28/2022] Open
Abstract
Although >50% of U.S. adults use dietary supplements, little information is available on the impact of supplement use frequency on nutrient intakes and deficiencies. Based on nationally representative data in 10,698 adults from the National Health and Nutrition Examination Surveys (NHANES) 2009 to 2012, assessments were made of intakes from food alone versus food plus multi-vitamin/multi-mineral supplements (MVMS) of 17 nutrients with an Estimated Average Requirement (EAR) and a Tolerable Upper Intake Level (UL), and of the status of five nutrients with recognized biomarkers of deficiency. Compared to food alone, MVMS use at any frequency was associated with a lower prevalence of inadequacy (p < 0.01) for 15/17 nutrients examined and an increased prevalence of intakes >UL for 7 nutrients, but the latter was ≤4% for any nutrient. Except for calcium, magnesium, and vitamin D, most frequent MVMS use (≥21 days/30 days) virtually eliminated inadequacies of the nutrients examined, and was associated with significantly lower odds ratios of deficiency for the examined nutrient biomarkers except for iron. In conclusion, among U.S. adults, MVMS use is associated with decreased micronutrient inadequacies, intakes slightly exceeding the UL for a few nutrients, and a lower risk of nutrient deficiencies.
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Affiliation(s)
- Jeffrey B Blumberg
- Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Balz B Frei
- Linus Pauling Institute and Department of Biochemistry & Biophysics, Oregon State University, Corvallis, OR 97331, USA.
| | | | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA.
| | - Steven H Zeisel
- Nutrition Research Institute, Department of Nutrition, University of North Carolina, Kannapolis, NC 28081, USA.
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Robinson CM, Karet Frankl FE. Magnesium lactate in the treatment of Gitelman syndrome: patient-reported outcomes. Nephrol Dial Transplant 2017; 32:508-512. [PMID: 26940126 PMCID: PMC5837242 DOI: 10.1093/ndt/gfw019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/24/2016] [Indexed: 12/13/2022] Open
Abstract
Background: Gitelman syndrome (GS) is a rare recessively inherited renal tubulopathy associated with renal potassium (K) and magnesium (Mg) loss. It requires lifelong K and Mg supplementation at high doses that are at best unpalatable and at worst, intolerable. In particular, gastrointestinal side effects often limit full therapeutic usage. Methods: We report here the analysis of a cohort of 28 adult patients with genetically proven GS who attend our specialist tubular disorders clinic, in whom we initiated the use of a modified-release Mg preparation (slow-release Mg lactate) and who were surveyed by questionnaire. Results: Twenty-five patients (89%) preferred the new treatment regimen. Of these 25, 17 (68%) regarded their symptom burden as improved and seven reported no worsening. Of the 25 who were not Mg-treatment naïve, 13 (59%) patients reported fewer side effects, 7 (32%) described them as the same and only 2 (9%) considered side effects to be worse. Five were able to increase their dose without ill-effect. Overall, biochemistry improved in 91% of the 23 patients switched from therapy with other preparations who chose to continue the modified-release Mg preparation. Eleven (48%) improved both their Mg and K mean levels, 3 (13%) improved Mg levels only and in 7 cases (30%), K levels alone rose. Conclusions: Patient-reported and biochemical outcomes using modified-release Mg supplements were very favourable, and patient choice should play a large part in choosing Mg supplements with GS patients.
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Affiliation(s)
- Caroline M Robinson
- Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Fiona E Karet Frankl
- Division of Renal Medicine and Division of Experimental Medicine, University of Cambridge, Cambridge, UK.,Department of Medical Genetics, Cambridge Institute for Medical Research, Addenbrookes Hospital, Hills Road, Cambridge, UK
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Đuriš J, Čalija B, Vidović B, Dobričić V, Milić J, Ibrić S. Comparative analysis of mechanical and dissolution properties of single- and multicomponent folic acid supplements. J Food Compost Anal 2017. [DOI: 10.1016/j.jfca.2017.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Andrews KW, Roseland JM, Gusev PA, Palachuvattil J, Dang PT, Savarala S, Han F, Pehrsson PR, Douglass LW, Dwyer JT, Betz JM, Saldanha LG, Bailey RL. Analytical ingredient content and variability of adult multivitamin/mineral products: national estimates for the Dietary Supplement Ingredient Database. Am J Clin Nutr 2017; 105:526-539. [PMID: 27974309 PMCID: PMC5267296 DOI: 10.3945/ajcn.116.134544] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 11/07/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Multivitamin/mineral products (MVMs) are the dietary supplements most commonly used by US adults. During manufacturing, some ingredients are added in amounts exceeding the label claims to compensate for expected losses during the shelf life. Establishing the health benefits and harms of MVMs requires accurate estimates of nutrient intake from MVMs based on measures of actual rather than labeled ingredient amounts. OBJECTIVES Our goals were to determine relations between analytically measured and labeled ingredient content and to compare adult MVM composition with Recommended Dietary Allowances (RDAs) and Tolerable Upper Intake Levels. DESIGN Adult MVMs were purchased while following a national sampling plan and chemically analyzed for vitamin and mineral content with certified reference materials in qualified laboratories. For each ingredient, predicted mean percentage differences between analytically obtained and labeled amounts were calculated with the use of regression equations. RESULTS For 12 of 18 nutrients, most products had labeled amounts at or above RDAs. The mean measured content of all ingredients (except thiamin) exceeded labeled amounts (overages). Predicted mean percentage differences exceeded labeled amounts by 1.5-13% for copper, manganese, magnesium, niacin, phosphorus, potassium, folic acid, riboflavin, and vitamins B-12, C, and E, and by ∼25% for selenium and iodine, regardless of labeled amount. In contrast, thiamin, vitamin B-6, calcium, iron, and zinc had linear or quadratic relations between the labeled and percentage differences, with ranges from -6.5% to 8.6%, -3.5% to 21%, 7.1% to 29.3%, -0.5% to 16.4%, and -1.9% to 8.1%, respectively. Analytically adjusted ingredient amounts are linked to adult MVMs reported in the NHANES 2003-2008 via the Dietary Supplement Ingredient Database (http://dsid.usda.nih.gov) to facilitate more accurate intake quantification. CONCLUSIONS Vitamin and mineral overages were measured in adult MVMs, most of which already meet RDAs. Therefore, nutrient overexposures from supplements combined with typical food intake may have unintended health consequences, although this would require further examination.
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Affiliation(s)
- Karen W Andrews
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD;
| | - Janet M Roseland
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | - Pavel A Gusev
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | - Joel Palachuvattil
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | - Phuong T Dang
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | - Sushma Savarala
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | - Fei Han
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | - Pamela R Pehrsson
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | | | - Johanna T Dwyer
- Office of Dietary Supplements, NIH, Department of Health and Human Services, Bethesda, MD; and
| | - Joseph M Betz
- Office of Dietary Supplements, NIH, Department of Health and Human Services, Bethesda, MD; and
| | - Leila G Saldanha
- Office of Dietary Supplements, NIH, Department of Health and Human Services, Bethesda, MD; and
| | - Regan L Bailey
- Office of Dietary Supplements, NIH, Department of Health and Human Services, Bethesda, MD; and,Department of Nutrition Science, Purdue University, West Lafayette, IN
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