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McCubbin AJ, Irwin CG, Costa RJS. Nourishing Physical Productivity and Performance On a Warming Planet - Challenges and Nutritional Strategies to Mitigate Exertional Heat Stress. Curr Nutr Rep 2024:10.1007/s13668-024-00554-8. [PMID: 38995600 DOI: 10.1007/s13668-024-00554-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2024] [Indexed: 07/13/2024]
Abstract
PURPOSE OF REVIEW: Climate change is predicted to increase the frequency and severity of exposure to hot environments. This can impair health, physical performance, and productivity for active individuals in occupational and athletic settings. This review summarizes current knowledge and recent advancements in nutritional strategies to minimize the impact of exertional-heat stress (EHS). RECENT FINDINGS: Hydration strategies limiting body mass loss to < 3% during EHS are performance-beneficial in weight-supported activities, although evidence regarding smaller fluid deficits (< 2% body mass loss) and weight-dependent activities is less clear due to a lack of well-designed studies with adequate blinding. Sodium replacement requirements during EHS depends on both sweat losses and the extent of fluid replacement, with quantified sodium replacement only necessary once fluid replacement > 60-80% of losses. Ice ingestion lowers core temperature and may improve thermal comfort and performance outcomes when consumed before, but less so during activity. Prevention and management of gastrointestinal disturbances during EHS should focus on high carbohydrate but low FODMAP availability before and during exercise, frequent provision of carbohydrate and/or protein during exercise, adequate hydration, and body temperature regulation. Evidence for these approaches is lacking in occupational settings. Acute kidney injury is a potential concern resulting from inadequate fluid replacement during and post-EHS, and emerging evidence suggests that repeated exposures may increase the risk of developing chronic kidney disease. Nutritional strategies can help regulate hydration, body temperature, and gastrointestinal status during EHS. Doing so minimizes the impact of EHS on health and safety and optimizes productivity and performance outcomes on a warming planet.
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Affiliation(s)
- Alan J McCubbin
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia.
| | - Christopher G Irwin
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Ricardo J S Costa
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia
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Rüggeberg A, Meybohm P, Nickel EA. Preoperative fasting and the risk of pulmonary aspiration-a narrative review of historical concepts, physiological effects, and new perspectives. BJA OPEN 2024; 10:100282. [PMID: 38741693 PMCID: PMC11089317 DOI: 10.1016/j.bjao.2024.100282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/27/2024] [Indexed: 05/16/2024]
Abstract
In the early days of anaesthesia, the fasting period for liquids was kept short. By the mid-20th century 'nil by mouth after midnight' had become routine as the principles of the management of 'full stomach' emergencies were extended to include elective healthy patients. Back then, no distinction was made between the withholding of liquids and solids. Towards the end of the last century, recommendations of professional anaesthesiology bodies began to reduce the fasting time of clear liquids to 2 h. This reduction in fasting time was based on the understanding that gastric emptying of clear liquids is rapid, exponential, and proportional to the current filling state of the stomach. Furthermore, there was no evidence of a link between drinking clear liquids and the risk of aspiration. Indeed, most instances of aspiration are caused by failure to identify aspiration risk factors and adjust the anaesthetic technique accordingly. In contrast, long periods of liquid withdrawal cause discomfort and may also lead to serious postoperative complications. Despite this, more than two decades after the introduction of the 2 h limit, patients still fast for a median of up to 12 h before anaesthesia, mainly because of organisational issues. Therefore, some hospitals have decided to allow patients to drink clear liquids within 2 h of induction of anaesthesia. Well-designed clinical trials should investigate whether these concepts are safe in patients scheduled for anaesthesia or procedural sedation, focusing on both aspiration risk and complications of prolonged fasting.
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Affiliation(s)
- Anne Rüggeberg
- Department of Anaesthesiology and Pain Therapy, Helios Klinikum Emil von Behring, Berlin, Germany
| | - Patrick Meybohm
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Eike A. Nickel
- Department of Anaesthesiology and Pain Therapy, Helios Klinikum Emil von Behring, Berlin, Germany
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3
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Felicijan T, Bogataj M. Forecasting the effect of water gastric emptying patterns on model drug release in an in vitro glass-bead flow-through system. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2024; 74:269-287. [PMID: 38815199 DOI: 10.2478/acph-2024-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 06/01/2024]
Abstract
Oral solid dosage forms are most frequently administered with a glass of water which empties from the stomach relatively fast, but with a certain variability in its emptying kinetics. The purpose of this study was thus to simulate different individual water gastric emptying (GE) patterns in an in vitro glass-bead flow-through dissolution system. Further, the effect of GE on the dissolution of model drugs from immediate-release tablets was assessed by determining the amount of dissolved drug in the samples pumped out of the stomach compartment. Additionally, different HCl solutions were used as dissolution media to assess the effect of the variability of pH of the gastric fluid on the dissolution of three model drugs: paracetamol, diclofenac sodium, and dipyridamole. The difference in fast and slow GE kinetics resulted in different dissolution profiles of paracetamol in all studied media. For diclofenac sodium and dipyridamole tablets, the effect of GE kinetics was well observed only in media, where the solubility was not a limiting factor. Therefore, GE kinetics of co-ingested water influences the drug release from immediate-release tablets, however, in certain cases, other parameters influencing drug dissolution can partly or fully hinder the expression of this effect.
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Affiliation(s)
- Tjaša Felicijan
- 1University of Ljubljana, Faculty of Pharmacy Department of Biopharmaceutics and Pharmacokinetics 1000 Ljubljana, Slovenia
| | - Marija Bogataj
- 1University of Ljubljana, Faculty of Pharmacy Department of Biopharmaceutics and Pharmacokinetics 1000 Ljubljana, Slovenia
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Quist JR, Rud CL, Frumer K, Julsgaard M, Dahl Baunwall SM, Hvas CL. Osmolality in oral supplements drives ileostomy output: Defining the Goldilocks zone. Clin Nutr ESPEN 2024; 61:88-93. [PMID: 38777478 DOI: 10.1016/j.clnesp.2024.03.003] [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: 06/26/2023] [Revised: 01/14/2024] [Accepted: 03/05/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Patients with an ileostomy often have impaired quality of life, sodium depletion, secondary hyperaldosteronism, and other organ-specific pathologies. The osmolality of oral supplements influences ileostomy output and increases sodium loss. We hypothesized the existence of an osmolality range in which fluid absorption and secondary natriuresis are optimal. METHODS This was a single-center, quasi-randomized crossover intervention study, including patients with an ileostomy and no home parenteral support. After an 8-h fasting period, each patient ingested 500 mL of 3-18 different oral supplements and a standardized meal during the various intervention periods, followed by a 6-h collection of ileostomy and urine outputs. The primary outcome was 6-h ileostomy output. RESULTS A total of 14 ileostomy patients with a median age of 65 years (interquartile range 38-70 years) were included. The association between osmolalities (range 5-1352 mOsm/kg) and ileostomy output forecasted an S-curve. A linear association between osmolality of oral supplements (range 290-600 mOsm/kg) and ileostomy output was identified and assessed with a mixed-effects model. Ileostomy output increased by 57 g/6 h (95% confidence interval (CI) 21-94) when the oral supplement osmolality increased by 100 mOsm/kg (p = 0.005). CONCLUSION Osmolality in oral supplements correlated with ileostomy output. Our results indicate that patients with an ileostomy may benefit from increased ingestion of oral supplements with osmolalities between 100 and 290 mOsm/kg. We define this range as the Goldilocks zone, equivalent to optimal fluid and electrolyte absorption.
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Affiliation(s)
| | - Charlotte Lock Rud
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark
| | - Karen Frumer
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark
| | - Mette Julsgaard
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark
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Funnell MP, Juett LA, Reynolds KM, Johnson DA, James RM, Mears SA, Cheuvront SN, Kenefick RW, James LJ. Iterative assessment of a sports rehydration beverage containing a novel amino acid formula on water uptake kinetics. Eur J Nutr 2024; 63:1125-1137. [PMID: 38349552 PMCID: PMC11139694 DOI: 10.1007/s00394-024-03325-x] [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: 07/10/2023] [Accepted: 01/10/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE Rapid gastric emptying and intestinal absorption of beverages is essential for rapid rehydration, and certain amino acids (AA) may augment fluid delivery. Three sugar-free beverages, containing differing AA concentrations (AA + PZ), were assessed for fluid absorption kinetics against commercial sugar-free (PZ, GZ) and carbohydrate-containing (GTQ) beverages. METHODS Healthy individuals (n = 15-17 per study) completed three randomised trials. Three beverages (550-600 mL) were ingested in each study (Study 1: AA + PZ [17.51 g/L AA], PZ, GZ; Study 2: AA + PZ [6.96 g/L AA], PZ, GZ; Study 3: AA + PZ [3.48 g/L AA], PZ, GTQ), containing 3.000 g deuterium oxide (D2O). Blood samples were collected pre-, 2-min, 5-min, and every 5-min until 60-min post-ingestion to quantify maximal D2O enrichment (Cmax), time Cmax occurred (Tmax) and area under the curve (AUC). RESULTS Study 1: AUC (AA + PZ: 15,184 ± 3532 δ‰ vs. VSMOW; PZ: 17,328 ± 3153 δ‰ vs. VSMOW; GZ: 17,749 ± 4204 δ‰ vs. VSMOW; P ≤ 0.006) and Tmax (P ≤ 0.005) were lower for AA + PZ vs. PZ/GZ. Study 2: D2O enrichment characteristics were not different amongst beverages (P ≥ 0.338). Study 3: Cmax (AA + PZ: 440 ± 94 δ‰ vs. VSMOW; PZ: 429 ± 83 δ‰ vs. VSMOW; GTQ: 398 ± 81 δ‰ vs. VSMOW) was greater (P = 0.046) for AA + PZ than GTQ, with no other differences (P ≥ 0.106). CONCLUSION The addition of small amounts of AA (3.48 g/L) to a sugar-free beverage increased fluid delivery to the circulation compared to a carbohydrate-based beverage, but greater amounts (17.51 g/L) delayed delivery.
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Affiliation(s)
- Mark P Funnell
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Loris A Juett
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Kirsty M Reynolds
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Drusus A Johnson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Ruth M James
- Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK
| | - Stephen A Mears
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Samuel N Cheuvront
- Entrinsic Bioscience, LLC, Norwood, MA, 02062, USA
- Sports Science Synergy, LLC, Franklin, MA, 02038, USA
| | | | - Lewis J James
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK.
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Skarlovnik T, Lamut A, Hostnik G, Gole B, Bren U. Osmolality and Tonicity of Isotonic Beverages. Foods 2024; 13:1483. [PMID: 38790783 PMCID: PMC11120308 DOI: 10.3390/foods13101483] [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: 04/10/2024] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
This study aimed to measure and compare the osmolality and tonicity of isotonic beverages that can be bought on the Slovenian market. The main goal was to examine how good is the agreement between the measured osmolalities of the beverages and the requirements for isotonic beverages set up by EFSA. Osmolalities were measured with an osmometer using the freezing point depression method. Afterwards, two complementary methods for the observation of tonicity were developed. Erythrocytes were exposed to standard NaCl solutions of different osmolalities to observe their influence on the volume and shape of cells following the turbidity of the solution and the morphology of erythrocytes. These two methods enabled us to determine whether standard solutions were hypo-, iso-, or hypertonic. In this way, we found that the osmolality of 12 out of the 18 investigated isotonic beverages was in the range of 270-330 mOsm/kg, as required by EFSA. However, six samples did not meet this criterion and should therefore not have the label "isotonic" or be described as such. The measurements of turbidity of solutions indicated that most isotonic beverages exhibit a lower tonicity than standard NaCl solutions of identical osmolality. However, examination of the erythrocytes in isotonic beverages showed that the measurements were additionally complicated by the low pH values of these beverages. Finally, by demonstrating how different components of isotonic beverages pass through the erythrocyte membranes, we found that even isoosmolal beverages are often not isotonic, as the concentration of actively transported sugars in these beverages is relatively high.
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Affiliation(s)
- Tjaša Skarlovnik
- Faculty of Chemistry and Chemical Engineering, University of Maribor, Smetanova 17, SI-2000 Maribor, Slovenia; (T.S.); (G.H.)
| | - Andraž Lamut
- Meditop d.o.o., Ulica Vita Kraigherja 5, SI-2000 Maribor, Slovenia;
- Institute for Environmental Protection and Sensors, d.o.o., Beloruska ulica 7, SI-2000 Maribor, Slovenia
| | - Gregor Hostnik
- Faculty of Chemistry and Chemical Engineering, University of Maribor, Smetanova 17, SI-2000 Maribor, Slovenia; (T.S.); (G.H.)
| | - Boris Gole
- Faculty of Medicine, University of Maribor, Taborska ulica 8, SI-2000 Maribor, Slovenia;
| | - Urban Bren
- Faculty of Chemistry and Chemical Engineering, University of Maribor, Smetanova 17, SI-2000 Maribor, Slovenia; (T.S.); (G.H.)
- Institute for Environmental Protection and Sensors, d.o.o., Beloruska ulica 7, SI-2000 Maribor, Slovenia
- Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Glagoljaška 8, SI-6000 Koper, Slovenia
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7
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Podéus H, Simonsson C, Nasr P, Ekstedt M, Kechagias S, Lundberg P, Lövfors W, Cedersund G. A physiologically-based digital twin for alcohol consumption-predicting real-life drinking responses and long-term plasma PEth. NPJ Digit Med 2024; 7:112. [PMID: 38702474 PMCID: PMC11068902 DOI: 10.1038/s41746-024-01089-6] [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: 11/13/2023] [Accepted: 03/29/2024] [Indexed: 05/06/2024] Open
Abstract
Alcohol consumption is associated with a wide variety of preventable health complications and is a major risk factor for all-cause mortality in the age group 15-47 years. To reduce dangerous drinking behavior, eHealth applications have shown promise. A particularly interesting potential lies in the combination of eHealth apps with mathematical models. However, existing mathematical models do not consider real-life situations, such as combined intake of meals and beverages, and do not connect drinking to clinical markers, such as phosphatidylethanol (PEth). Herein, we present such a model which can simulate real-life situations and connect drinking to long-term markers. The new model can accurately describe both estimation data according to a χ2 -test (187.0 < Tχ2 = 226.4) and independent validation data (70.8 < Tχ2 = 93.5). The model can also be personalized using anthropometric data from a specific individual and can thus be used as a physiologically-based digital twin. This twin is also able to connect short-term consumption of alcohol to the long-term dynamics of PEth levels in the blood, a clinical biomarker of alcohol consumption. Here we illustrate how connecting short-term consumption to long-term markers allows for a new way to determine patient alcohol consumption from measured PEth levels. An additional use case of the twin could include the combined evaluation of patient-reported AUDIT forms and measured PEth levels. Finally, we integrated the new model into an eHealth application, which could help guide individual users or clinicians to help reduce dangerous drinking.
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Affiliation(s)
- Henrik Podéus
- Department of Biomedical Engineering (IMT), Linköping University, Linköping, Sweden
| | - Christian Simonsson
- Department of Biomedical Engineering (IMT), Linköping University, Linköping, Sweden
- Center for Medicine Imaging and Visualization Science (CMIV), Linköping University, Linköping, Sweden
| | - Patrik Nasr
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
- Wallenberg Center for Molecular Medicine, Linköping University, Linköping, Sweden
| | - Mattias Ekstedt
- Center for Medicine Imaging and Visualization Science (CMIV), Linköping University, Linköping, Sweden
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Stergios Kechagias
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Peter Lundberg
- Center for Medicine Imaging and Visualization Science (CMIV), Linköping University, Linköping, Sweden
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - William Lövfors
- Department of Biomedical Engineering (IMT), Linköping University, Linköping, Sweden
- School of Medical Sciences and Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Gunnar Cedersund
- Department of Biomedical Engineering (IMT), Linköping University, Linköping, Sweden.
- Center for Medicine Imaging and Visualization Science (CMIV), Linköping University, Linköping, Sweden.
- School of Medical Sciences and Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
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Otsuka J, Okamoto Y, Enoki Y, Maejima D, Fujii N, Kenny GP, Mündel T, Cotter JD, Amano T. Effects of ingesting beverages containing glycerol and sodium with isomaltulose or sucrose on fluid retention in young adults: a single-blind, randomized crossover trial. Appl Physiol Nutr Metab 2024; 49:667-679. [PMID: 38377479 DOI: 10.1139/apnm-2023-0483] [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] [Indexed: 02/22/2024]
Abstract
We evaluated changes in hyperhydration and beverage hydration index (BHI, a composite measure of fluid balance after consuming a test beverage relative to water) during resting, induced by the consumption of beverages containing glycerol and sodium supplemented with fast-absorbing sucrose or slow-absorbing isomaltulose. In a randomized crossover, single-blinded protocol (clinical trials registry: UMIN000042644), 14 young physically active adults (three women) consumed 1 L of beverage containing either 7% glycerol + 0.5% sodium (Gly + Na), Gly + Na plus 7% sucrose (Gly + Na + Suc), Gly + Na plus 7% isomaltulose (Gly + Na + Iso), or water (CON) over a 40 min period. We assessed the change in plasma volume (ΔPV), BHI (calculated from cumulative urine output following consumption of water relative to that of the beverage), and blood glucose and sodium for 180 min after initiating ingestion. Total urine volume was reduced in all beverages containing glycerol and sodium compared to CON (all P ≤ 0.002). The addition of isomaltulose increased BHI by ∼45% (3.43 ± 1.0 vs. 2.50 ± 0.7 for Gly + Na, P = 0.011) whereas sucrose did not (2.6 ± 0.6, P = 0.826). The PV expansion was earliest for Gly + Na (30 min), slower for Gly + Na + Suc (90 min), and slowest for Gly + Na + Iso (120 min) with a concomitant lag in the increase of blood glucose and sodium concentrations. Supplementation of beverages containing glycerol and sodium with isomaltulose but not sucrose enhances BHI from those of glycerol and sodium only under a resting state, likely due to the slow absorption of isomaltulose-derived monosaccharides (i.e., glucose and fructose).
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Affiliation(s)
- Junto Otsuka
- Laboratory for Exercise and Environment Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Yumi Okamoto
- Laboratory for Exercise and Environment Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Yasuaki Enoki
- Advanced Research Institutes, Bourbon Corporation, Niigata, Japan
| | - Daisuke Maejima
- Advanced Research Institutes, Bourbon Corporation, Niigata, Japan
| | - Naoto Fujii
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| | - Toby Mündel
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - James D Cotter
- School of Physical Education, Sport and Exercise Sciences, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Tatsuro Amano
- Laboratory for Exercise and Environment Physiology, Faculty of Education, Niigata University, Niigata, Japan
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Chapman CL, Holt SM, O'Connell CT, Brazelton SC, Medved HN, Howells WAB, Reed EL, Needham KW, Halliwill JR, Minson CT. Hypohydration attenuates increases in creatinine clearance to oral protein loading and the renal hemodynamic response to exercise pressor reflex. J Appl Physiol (1985) 2024; 136:492-508. [PMID: 38205553 PMCID: PMC11212816 DOI: 10.1152/japplphysiol.00728.2023] [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: 10/11/2023] [Revised: 12/20/2023] [Accepted: 01/08/2024] [Indexed: 01/12/2024] Open
Abstract
Insufficient hydration is prevalent among free living adults. This study investigated whether hypohydration alters 1) renal functional reserve, 2) the renal hemodynamic response to the exercise pressor reflex, and 3) urine-concentrating ability during oral protein loading. In a block-randomized crossover design, 22 healthy young adults (11 females and 11 males) underwent 24-h fluid deprivation (Hypohydrated) or 24-h normal fluid consumption (Euhydrated). Renal functional reserve was assessed by oral protein loading. Renal hemodynamics during the exercise pressor reflex were assessed via Doppler ultrasound. Urine-concentrating ability was assessed via free water clearance. Creatinine clearance did not differ at 150 min postprotein consumption between conditions [Hypohydrated: 246 mL/min, 95% confidence interval (CI): 212-280; Euhydrated: 231 mL/min, 95% CI: 196-265, P = 0.2691] despite an elevated baseline in Hypohydrated (261 mL/min, 95% CI: 218-303 vs. 143 mL/min, 95% CI: 118-168, P < 0.0001). Renal artery vascular resistance was not different at baseline (P = 0.9290), but increases were attenuated in Hypohydrated versus Euhydrated at the end of handgrip (0.5 mmHg/cm/s, 95% CI: 0.4-0.7 vs. 0.8 mmHg/cm/s 95% CI: 0.6-1.1, P = 0.0203) and end occlusion (0.2 mmHg/cm/s, 95% CI: 0.1-0.3 vs. 0.4 mmHg/cm/s 95% CI: 0.3-0.6, P = 0.0127). There were no differences between conditions in free water clearance at 150 min postprotein (P = 0.3489). These data indicate that hypohydration 1) engages renal functional reserve and attenuates the ability to further increase creatinine clearance, 2) attenuates increases in renal artery vascular resistance to the exercise pressor reflex, and 3) does not further enhance nor impair urine-concentrating ability during oral protein loading.NEW & NOTEWORTHY Insufficient hydration is prevalent among free living adults. This study found that hypohydration induced by 24-h fluid deprivation engaged renal functional reserve and that oral protein loading did not further increase creatinine clearance. Hypohydration also attenuated the ability to increase renal vascular resistance during the exercise pressor reflex. In addition, hypohydration neither enhanced nor impaired urine-concentrating ability during oral protein loading. These data support the importance of mitigating hypohydration in free living adults.
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Affiliation(s)
- Christopher L Chapman
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - Sadie M Holt
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - Cameron T O'Connell
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - Shaun C Brazelton
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - Hannah N Medved
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - William A B Howells
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - Emma L Reed
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - Karen Wiedenfeld Needham
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - John R Halliwill
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - Christopher T Minson
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
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Flood P, Hanrahan N, Nally K, Melgar S. Human intestinal organoids: Modeling gastrointestinal physiology and immunopathology - current applications and limitations. Eur J Immunol 2024; 54:e2250248. [PMID: 37957831 DOI: 10.1002/eji.202250248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/15/2023]
Abstract
Human intestinal organoids are an ideal model system for studying gastrointestinal physiology and immunopathology. Altered physiology and mucosal immune response are hallmarks of numerous intestinal functional and inflammatory diseases, including inflammatory bowel disease (IBD), coeliac disease, irritable bowel syndrome (IBS), and obesity. These conditions impact the normal epithelial functions of the intestine, such as absorption, barrier function, secretion, and host-microbiome communication. They are accompanied by characteristic intestinal symptoms and have significant societal, economic, and healthcare burdens. To develop new treatment options, cutting-edge research is required to investigate their etiology and pathology. Human intestinal organoids derived from patient tissue recapitulate the key physiological and immunopathological aspects of these conditions, providing a promising platform for elucidating disease mechanisms. This review will summarize recent reports on patient-derived human small intestinal and colonic organoids and highlight how these models have been used to study intestinal epithelial functions in the context of inflammation, altered physiology, and immune response. Furthermore, it will elaborate on the various organoid systems in use and the techniques/assays currently available to study epithelial functions. Finally, it will conclude by discussing the limitations and future perspectives of organoid technology.
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Affiliation(s)
- Peter Flood
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Naomi Hanrahan
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Department of Medicine, School of Medicine, University College Cork, Cork, Ireland
- Biochemistry and Cell Biology, University College Cork, Cork, Ireland
| | - Ken Nally
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Biochemistry and Cell Biology, University College Cork, Cork, Ireland
| | - Silvia Melgar
- APC Microbiome Ireland, University College Cork, Cork, Ireland
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Rolls BJ, Roe LS, Keller KL. Children's Energy Intake Generally Increases in Response to the Energy Density of Meals but Varies with the Amounts and Types of Foods Served. Am J Clin Nutr 2024; 119:185-195. [PMID: 37890673 PMCID: PMC10808835 DOI: 10.1016/j.ajcnut.2023.10.019] [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: 05/30/2023] [Revised: 09/24/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Food energy density (ED; kcal/g) is positively related to energy intake in numerous studies. A recent secondary analysis proposed that when the ED of consumed food is above a breakpoint, adults sense calories and adjust meal size to minimize overconsumption. OBJECTIVES We conducted a secondary analysis of measured intakes in preschool children to assess how meal energy intake was related to meal ED as well as to meal portions, eating occasions, and menus. METHODS We analyzed weighed intakes from 6355 meals served to 94 children aged 3 to 5 y in 2 randomized crossover trials. We provided children with all their daily food and milk for multiple periods of 5 consecutive days in their usual childcare setting. We used linear mixed models with repeated measures to analyze the effects on energy intake of meal ED and meal weight, either as served or as consumed. RESULTS Energy intake at meals was related to the ED and portions of served food and also to the ED and weight of consumed food (all P < 0.0001). Energy intake was also significantly affected by the eating occasion and the foods served on the menus. Children selectively ate higher-ED items, which were served in smaller amounts than lower-ED options. Meal energy intake was curvilinear across consumed ED; it initially increased (slope: 113 ± 2 kcal/ED unit) but decreased at higher-ED meals (deceleration: -11 ± 1 kcal/ED unit2) without evidence of a clear breakpoint. This trajectory may be attributable to the relatively limited portions of higher-ED foods that were served. CONCLUSIONS Children's energy intake generally increased with greater ED; at higher-ED meals, however, energy intake decreased in a curvilinear manner without a clear breakpoint. This reduction in intake at higher ED could be explained by meal-related factors such as the portions served rather than by sensitivity to meal energy content. This study was registered at clinicaltrials.gov as NCT03010501 and NCT03242863.
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Affiliation(s)
- Barbara J Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States.
| | - Liane S Roe
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Kathleen L Keller
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States; Department of Food Science, The Pennsylvania State University, University Park, PA, United States
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12
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Rodríguez-Ayala M, Donat-Vargas C, Moreno-Franco B, Mérida DM, Ramón Banegas J, Rodríguez-Artalejo F, Guallar-Castillón P. Association of a healthy beverage score with total mortality in the adult population of Spain: A nationwide cohort study. PLoS Med 2024; 21:e1004337. [PMID: 38261590 PMCID: PMC10805278 DOI: 10.1371/journal.pmed.1004337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/21/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Despite the substantial evidence of the relationship between diet and mortality, the role of beverage consumption patterns is not well known. The aim of this study was to assess the association of the adherence to a Healthy Beverage Score (HBS) and all-cause mortality in a representative sample of the Spanish adult population. METHODS AND FINDINGS We conducted an observational cohort study using data from the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA), which included 12,161 community-dwelling individuals aged ≥18 years recruited in 2008 to 2010 and followed until January 2022. At baseline, food consumption was collected using a validated diet history. The HBS consists of 7 items, each of which is scored from 1 to 4 (highest adherence). The HBS ranges from 7 to 28 points with a higher score representing a healthier pattern. Adherence was assigned as a higher consumption of low-fat milk, and coffee and tea, a lower consumption of whole-fat milk, no consumption of fruit juice, artificially sweetened beverages, or sugar-sweetened beverages, and no or moderate consumption of alcohol. Total mortality was ascertained by linkage to the Spanish National Death Index. Statistical analyses were performed with Cox models and adjusted for the main confounders, including sociodemographic, lifestyle, dietary variables, and morbidity. After a mean follow-up of 12.5 years (SD: 1.7; range: 0.5 to 12.9), a total of 967 deaths occurred. For all-cause mortality, the fully adjusted hazard ratio (HR) for the highest versus lowest sex-specific quartiles of HBS was 0.72 (95% confidence interval [0.57, 0.91], p linear-trend = 0.015), corresponding to an 8.3% reduction in the absolute risk of death. A linear relationship between the risk of death and the adherence to the HBS was observed using restricted cubic splines. The results were robust to sensitivity analyses. The main limitation was that repeated measurements on beverage consumption were not available and beverage consumption could have changed during follow-up. CONCLUSIONS In this study, we observed that higher adherence to the HBS was associated with lower total mortality. Adherence to a healthy beverage pattern could play a role in the prevention of premature mortality.
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Affiliation(s)
- Montserrat Rodríguez-Ayala
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Department of Microbiology and Parasitology, Hospital Universitario La Paz, Madrid, Spain
| | - Carolina Donat-Vargas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- ISGlobal, Campus Mar., Barcelona, Spain
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Belén Moreno-Franco
- Instituto de Investigación Sanitaria (IIS) Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain
- CIBERCV (CIBER of Cardiovascular), Instituto de Salud Carlos III, Madrid, Spain
| | - Diana María Mérida
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - José Ramón Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC., Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC., Madrid, Spain
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13
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Pérez-Castillo ÍM, Williams JA, López-Chicharro J, Mihic N, Rueda R, Bouzamondo H, Horswill CA. Compositional Aspects of Beverages Designed to Promote Hydration Before, During, and After Exercise: Concepts Revisited. Nutrients 2023; 16:17. [PMID: 38201848 PMCID: PMC10781183 DOI: 10.3390/nu16010017] [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: 11/07/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Hypohydration can impair aerobic performance and deteriorate cognitive function during exercise. To minimize hypohydration, athletes are recommended to commence exercise at least euhydrated, ingest fluids containing sodium during long-duration and/or high-intensity exercise to prevent body mass loss over 2% and maintain elevated plasma osmolality, and rapidly restore and retain fluid and electrolyte homeostasis before a second exercise session. To achieve these goals, the compositions of the fluids consumed are key; however, it remains unclear what can be considered an optimal formulation for a hydration beverage in different settings. While carbohydrate-electrolyte solutions such as sports drinks have been extensively explored as a source of carbohydrates to meet fuel demands during intense and long-duration exercise, these formulas might not be ideal in situations where fluid and electrolyte balance is impaired, such as practicing exercise in the heat. Alternately, hypotonic compositions consisting of moderate to high levels of electrolytes (i.e., ≥45 mmol/L), mainly sodium, combined with low amounts of carbohydrates (i.e., <6%) might be useful to accelerate intestinal water absorption, maintain plasma volume and osmolality during exercise, and improve fluid retention during recovery. Future studies should compare hypotonic formulas and sports drinks in different exercise settings, evaluating different levels of sodium and/or other electrolytes, blends of carbohydrates, and novel ingredients for addressing hydration and rehydration before, during, and after exercise.
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Affiliation(s)
| | | | | | - Niko Mihic
- Real Madrid, Medical Services, 28055 Madrid, Spain; (J.L.-C.); (N.M.)
| | | | | | - Craig A. Horswill
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60608, USA;
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14
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Funai Y, Ichijo K, Suzuki S, Tateishi Y, Inoue K, Tamai I, Shirasaka Y. Quantitative analysis of gastrointestinal fluid absorption and secretion to estimate luminal fluid dynamics in rats. Sci Rep 2023; 13:17454. [PMID: 37838772 PMCID: PMC10576741 DOI: 10.1038/s41598-023-44742-y] [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: 01/12/2023] [Accepted: 10/11/2023] [Indexed: 10/16/2023] Open
Abstract
The drug absorption profile is dependent on the luminal drug concentration, which in turn is influenced by the gastrointestinal (GI) fluid dynamics. In the present study, therefore, we aimed to examine the luminal fluid dynamics by kinetically analyzing fluid absorption and secretion along the GI tract in rats using the in situ closed-loop technique with non-absorbable fluorescein isothiocyanate-dextran 4000 (FD-4) and tritium water labeling ([3H]water) under different osmotic conditions. We found that the luminal fluid volume in the jejunum and ileum, but not the colon, gradually decreased and reached a steady state. In contrast, [3H]water almost completely disappeared in all intestinal regions. Kinetic analysis revealed the following rank order for the rate constant of fluid secretion: jejunum > ileum > colon, whereas a negligible regional difference was observed in the rate constant of fluid absorption. Fluid secretion under an isosmotic condition (300 mOsm/kg) was higher than that at 0 mOsm/kg in all intestinal regions, though no significant changes in fluid absorption were observed. Thus, the fluid secretion process appears to be the major determinant of the regional differences in GI fluid dynamics. Our findings indicate that the luminal fluid volume is altered as a result of water ingestion, absorption, and secretion, and finally reaches an apparent steady state, which is regulated mainly by the process of fluid secretion.
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Affiliation(s)
- Yuta Funai
- Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan
- School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Kazuki Ichijo
- School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Satoru Suzuki
- Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan
- School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Yuta Tateishi
- School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Katsuhisa Inoue
- School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Ikumi Tamai
- Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan
| | - Yoshiyuki Shirasaka
- Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan.
- School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan.
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15
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Pryor RR, Larson JR, Vandermark LW, Johnson BD, Schlader ZJ. Water consumption patterns impact hydration markers in males working in accordance with the National Institute for Occupational Safety and Health recommendations. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:414-425. [PMID: 37267511 DOI: 10.1080/15459624.2023.2221713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The impact of water consumption bolus volume and frequency on hydration biomarkers during work in the heat is unknown. In a randomized, crossover fashion, eight males consumed either 500 mL of water every 40 min or 237 mL of water every 20 min during 2 hr of continuous walking at 6.4 kph, 1.0% grade in a 34 °C/30% relative humidity environment, followed by 2 hr of rest. Hydration biomarkers and variables were assessed pre-work, post-work, and after the 2 hr recovery. There were no differences in body mass between trials at any time point (all p > 0.05). Percent change in plasma volume during work was not different when 237 mL of water was repeatedly consumed (-1.6 ± 8.2%) compared to 500 mL of water (-1.3 ± 3.0%, p = 0.92). Plasma osmolality was maintained over time (p = 0.55) with no difference between treatments (p = 0.21). When consuming 500 mL of water repeatedly, urine osmolality was lower at recovery (205 ± 108 mOsmo/L) compared to pre-work (589 ± 95 mOsmo/L, p < 0.01), different from repeatedly consuming 237 mL of water which maintained urine osmolality from pre-work (548 ± 144 mOsmo/L) through recovery (364 ± 261 mOsmo/L, p = 0.14). Free water clearance at recovery was greater with repeated consumption of 500 mL of water (1.2 ± 1.0 mL/min) compared to 237 mL of water (0.4 ± 0.8 mL/min, p = 0.02). Urine volume was not different between treatments post-work (p = 0.62), but greater after 2 hr of recovery when repeatedly consuming 500 mL of water compared to 237 mL (p = 0.01), leading to greater hydration efficiency upon recovery with repeated consumption of 237 mL of water (68 ± 12%) compared to 500 mL (63 ± 14%, p = 0.01). Thirst and total gastrointestinal symptom scores were not different between treatments at any time point (all p > 0.05). Body temperatures and heart rate were not different between treatments at any time point (all p > 0.05). Drinking larger, less frequent water boluses or drinking smaller, more frequent water boluses are both reasonable strategies to promote adequate hydration and limit changes in body mass in males completing heavy-intensity work in the heat.
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Affiliation(s)
- Riana R Pryor
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - Jonathan R Larson
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - Lesley W Vandermark
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - Blair D Johnson
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Zachary J Schlader
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
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16
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Gong Y, Tong S, Li X, Chen X, Liu Y, Li N, Xu J, Xu R, Guo Y, Xiao F, Chen X, Chen W. Intestinal Villi-Inspired Mathematically Base-Layer Engineered Microneedles (IMBEMs) for Effective Molecular Exchange during Biomarker Enrichment and Drug Deposition in Diversified Mucosa. ACS NANO 2023; 17:15696-15712. [PMID: 37549304 DOI: 10.1021/acsnano.3c02944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
The mucosa-interfacing systems based on bioinspired engineering design for sampling/drug delivery have manifested crucial potential for the monitoring of infectious diseases and the treatment of mucosa-related diseases. However, their efficiency and validity are severely restricted by limited contact area for molecular transfer and dissatisfactory capture/detachment capability. Herein, inspired by the multilayer villus structure of the small intestine that enables high nutrient absorption, a trigonometric function-based periodic pattern was fabricated and integrated on the base layer of the microneedle patch, exhibiting a desirable synergistic effect with needle tips for deep sample enrichment and promising molecular transfer, significantly improving the device-mucosa bidirectional interaction. Moreover, mathematical modeling and finite element analysis were adopted to visualize and quantify the microcosmic molecular transmission process, guiding parameter optimization in actual situation. Encouragingly, these intestinal villi-inspired mathematically base-layer engineered microneedles (IMBEMs) have demonstrated distinguished applicability among mucosa tissue with varying surface curvatures, tissue toughness, and local environments, and simultaneously, have gained favorable support from healthy volunteers receiving preliminary test of IMBEMs patches. Overall, validated by numerous in vitro and in vivo tests, the IMBEMs were confirmed to act as a promising candidate to facilitate mucosa-based sampling and topical drug delivery, indicating highly clinical translation potential.
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Affiliation(s)
- Yusheng Gong
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Shuai Tong
- Department of Immunology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xixuan Li
- Department of Histology and Embryology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiuli Chen
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yushuang Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Nan Li
- Department of Biochemistry and Molecular Biology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jiarong Xu
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Rengui Xu
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yusong Guo
- Department of Biochemistry and Molecular Biology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Fei Xiao
- Key Laboratory of Material Chemistry for Energy Conversion and Storage, Ministry of Education, Hubei Key Laboratory of Material Chemistry and Service Failure, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Xiaoyuan Chen
- Departments of Diagnostic Radiology and Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 117597, Singapore
- Departments of Chemical and Biomolecular Engineering, and Biomedical Engineering, Faculty of Engineering, National University of Singapore, 117597, Singapore
- Clinical Imaging Research Centre, Centre for Translational Medicine, Yong Loo Lin School of Medicine, and Nanomedicine Translational Research Program, National University of Singapore, 117597, Singapore
- NUS Center for Nanomedicine, Yong Loo Lin School of Medicine, National University of Singapore, 117597, Singapore
| | - Wei Chen
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation, Huazhong University of Science and Technology, Wuhan 430030, China
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17
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Martinez IG, Mika AS, Biesiekierski JR, Costa RJS. The Effect of Gut-Training and Feeding-Challenge on Markers of Gastrointestinal Status in Response to Endurance Exercise: A Systematic Literature Review. Sports Med 2023; 53:1175-1200. [PMID: 37061651 DOI: 10.1007/s40279-023-01841-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Nutrition during exercise is vital in sustaining prolonged activity and enhancing athletic performance; however, exercise-induced gastrointestinal syndrome (EIGS) and exercise-associated gastrointestinal symptoms (Ex-GIS) are common issues among endurance athletes. Despite this, there has been no systematic assessment of existing trials that examine the impact of repetitive exposure of the gastrointestinal tract to nutrients before and/or during exercise on gastrointestinal integrity, function, and/or symptoms. OBJECTIVE This systematic literature review aimed to identify and synthesize research that has investigated the impact of 'gut-training' or 'feeding-challenge' before and/or during exercise on markers of gastrointestinal integrity, function, and symptoms. METHODS Five databases (Ovid MEDLINE, EMBASE, CINAHL Plus, Web of Science Core Collection, and SPORTDiscus) were searched for literature that focused on gut-training or feeding-challenge before and/or during exercise that included EIGS and Ex-GIS variables. Quality assessment was conducted in duplicate and independently using the Cochrane Collaboration's risk-of-bias (RoB 2) tool. RESULTS Overall, 304 studies were identified, and eight studies were included after screening. Gut-training or feeding-challenge interventions included provision of carbohydrates only (n = 7) in various forms (e.g., gels or liquid solutions) during cycling or running, or carbohydrate with protein (n = 1) during intermittent exercise, over a varied duration (4-28 days). Gut discomfort decreased by an average of 47% and 26% with a 2-week repetitive carbohydrate feeding protocol (n = 2) and through repeated fluid ingestion over five trials (n = 1), respectively. Repetitive carbohydrate feeding during exercise for 2 weeks resulted in the reduction of carbohydrate malabsorption by 45-54% (n = 2), but also led to no significant change (n = 1). The effect of gut-training and feeding-challenges on the incidence and severity of Ex-GIS were assessed using different tools (n = 6). Significant improvements in total, upper, and lower gastrointestinal symptoms were observed (n = 2), as well as unclear results (n = 4). No significant changes in gastric emptying rate (n = 2), or markers of intestinal injury and permeability were found (n = 3). Inconclusive results were found in studies that investigated plasma inflammatory cytokine concentration in response to exercise with increased carbohydrate feeding (n = 2). CONCLUSIONS Overall, gut-training or feeding-challenge around exercise may provide advantages in reducing gut discomfort, and potentially improve carbohydrate malabsorption and Ex-GIS, which may have exercise performance implications.
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Affiliation(s)
- Isabel G Martinez
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Alice S Mika
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Jessica R Biesiekierski
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Ricardo J S Costa
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia.
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18
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Individual Variability Is More Important Than Analytical Methods When Calculating Relative Speed of Beverage Bioavailability. Int J Sport Nutr Exerc Metab 2023; 33:102-111. [PMID: 36634306 DOI: 10.1123/ijsnem.2022-0153] [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: 07/13/2022] [Revised: 10/25/2022] [Accepted: 12/05/2022] [Indexed: 01/14/2023]
Abstract
Deuterium oxide (D2O) appearance in blood is a marker of fluid bioavailability. However, whether biomarker robustness (e.g., relative fluid delivery speed) is consistent across analytical methods (e.g., cavity ring-down spectroscopy) remains unclear. Fourteen men ingested fluid (6 ml/kg body mass) containing 0.15 g/kg D2O followed by 45 min blood sampling. Plasma (D2O) was detected (n = 8) by the following: isotope-ratio mass spectrometry after vapor equilibration (IRMS-equilibrated water) or distillation (IRMS-plasma) and cavity ring-down spectroscopy. Two models calculated D2O halftime to peak (t1/2max): sigmoid curve fit versus asymmetric triangle (TRI). Background (D2O) differed (p < .001, η2 = .98) among IRMS-equilibrated water, IRMS-plasma, and cavity ring-down spectroscopy (152.2 ± 0.8, 147.2 ± 1.5, and 137.7 ± 2.2 ppm), but did not influence (p > .05) D2O appearance (Δppm), time to peak, or t1/2max. Stratifying participants based on mean t1/2max (12 min) into "slow" versus "fast" subgroups resulted in a 5.8 min difference (p < .001, η2 = .73). Significant t1/2max model (p = .01, η2 = .44) and Model × Speed Subgroup interaction (p = .005, η2 = .50) effects were observed. Bias between TRI and sigmoid curve fit increased with t1/2max speed: no difference (p = .75) for fast (9.0 min vs. 9.2 min, respectively) but greater t1/2max (p = .001) with TRI for the slow subgroup (16.1 min vs. 13.7 min). Fluid bioavailability markers are less influenced by which laboratory method is used to measure D2O as compared with the individual variability effects that influence models for calculating t1/2max. Thus, TRI model may not be appropriate for individuals with slow fluid delivery speeds.
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19
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Falkenhain K, Daraei A, Little JP. The Effect of Novel Exogenous Ketone Supplements on Blood Beta-Hydroxybutyrate and Glucose. J Diet Suppl 2023; 21:38-52. [PMID: 36847287 DOI: 10.1080/19390211.2023.2179152] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Exogenous ketone monoesters can raise blood β-OHB and lower glucose without other nutritional modifications or invasive procedures. However, unpleasant taste and potential gastrointestinal discomfort may make adherence to supplementation challenging. Two novel ketone supplements promise an improved consumer experience but differ in their chemical properties; it is currently unknown how these affect blood β-OHB and blood glucose compared to the ketone monoester. In a double-blind randomized cross-over pilot study, N=12 healthy individuals (29 ± 5 years, BMI = 25 ± 4 kg/m2, 42% female) participated in three experimental trials with a different ketone supplement providing 10 grams of active ingredient in each; (i) the monoester (R)-3-hydroxybutyl (R)-3-hydroxybutyrate, (ii) D-β-hydroxybutyric acid with R-1,3-butanediol, and (iii) R-1,3-butanediol. Blood β-OHB and glucose were measured via finger prick capillary blood samples at baseline and across 240 minutes post-supplementation. Supplement acceptability, hunger, and gastrointestinal distress were assessed via questionnaires. β-OHB was elevated compared to baseline in all conditions. Total and incremental area under the curve (p < 0.05) and peak β-OHB (p < 0.001) differed between conditions with highest values seen in the ketone monoester condition. Blood glucose was reduced after consumption of each supplement, with no differences in total and incremental area under the curve across supplements. Supplement acceptability was greatest for D-β-hydroxybutyric acid with R-1,3-butanediol, with no effect on hunger or evidence of gastrointestinal distress across all supplements. All ketone supplements tested raised β-OHB with highest values seen after ketone monoester ingestion. Blood glucose was lowered similarly across the assessed time frame with all three supplements.
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Affiliation(s)
- Kaja Falkenhain
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Ali Daraei
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
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Benjamin CL, Dobbins LW, Sullivan SG, Rogers RR, Williams TD, Marshall MR, Ballmann CG. The Effect of Fluid Availability on Consumption and Perceptual Measures during Aerobic Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1310. [PMID: 36674064 PMCID: PMC9858706 DOI: 10.3390/ijerph20021310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Fluid availability may alter drinking behavior; however, it is currently unknown if the availability of fluid impacts behavior and gastrointestinal issues (GI) that are often associated with increased fluid intake. The purpose of this study was to determine if ad libitum (AL) versus periodic (PER) fluid intake influences fluid consumption and GI distress during exercise in trained athletes. Male and female Division I NCAA Cross Country athletes (n = 11; age = 20 ± 1 years) participated in this counterbalanced crossover study. Each participant completed a moderate intensity 10 km run on two separate occasions. In one trial, participants had unlimited availability to fluid to consume AL. In the other trial, participants consumed PER fluid at stations placed every 3.2 km. Assurance of euhydration prior to each trial was confirmed via urine specific gravity (USG) and urine color. Subjective perceptions of thirst and gastric fullness were assessed pre- and post-exercise via Likert questioning and a visual analog scale, respectively. Participants started each trial euhydrated (AL = 1.009 USG ± 0.009; PER = 1.009 USG ± 0.009; urine color AL, 3 ± 1; urine color PER, 2 ± 1). Fluid volume consumption was significantly higher during the AL condition compared to PER (p = 0.050). Thirst significantly increased from pre- to post-run regardless of treatment (p < 0.001); however, there was no significant difference between the groups (p = 0.492). Feelings of fullness did not change pre-post trial (p = 0.304) or between trials (p = 0.958). Increased fluid availability allows for increased fluid consumption without the negative experience of GI discomfort.
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Affiliation(s)
| | - Luke W. Dobbins
- Department of Kinesiology, Samford University, Birmingham, AL 35226, USA
| | | | - Rebecca R. Rogers
- Department of Kinesiology, Samford University, Birmingham, AL 35226, USA
- SHP Research Collaborative, University of Alabama at Birmingham, Birmingham, AL 35226, USA
| | - Tyler D. Williams
- Department of Kinesiology, Samford University, Birmingham, AL 35226, USA
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21
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Robledo M, Álvarez B, Cuevas A, González S, Ruano-Gallego D, Fernández L, de la Cruz F. Targeted bacterial conjugation mediated by synthetic cell-to-cell adhesions. Nucleic Acids Res 2022; 50:12938-12950. [PMID: 36511856 PMCID: PMC9825185 DOI: 10.1093/nar/gkac1164] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
Genetic interventions on microbiomes, for clinical or biotechnological purposes, remain challenging. Conjugation-based delivery of genetic cargo is still unspecific and limited by low conjugation rates. Here we report an approach to overcome these problems, based on a synthetic bacterial adhesion system. Mating assemblers consist on a synthetic adhesion formed by the expression on the surface of donor and target cells of specific nanobodies (Nb) and their cognate antigen (Ag). The Nb-Ag bridge increased 1-3 logs transfer of a variety of plasmids, especially in liquid media, confirming that cell-cell docking is a main determinant limiting mating efficiency. Synthetic cell-to-cell adhesion allows efficient conjugation to targeted recipients, enhancing delivery of desired genes to a predefined subset of prey species, or even specific pathogenic strains such as enterohemorrhagic Escherichia coli (EHEC), within a bacterial community. The synthetic conjugation enhancer presented here optimizes plasmid delivery by selecting the target hosts with high selectivity.
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Affiliation(s)
- Marta Robledo
- Correspondence may also be addressed to Marta Robledo.
| | - Beatriz Álvarez
- Department of Microbial Biotechnology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB-CSIC), Campus UAM Cantoblanco, 28049 Madrid, Spain
| | - Ana Cuevas
- Intergenomics Group, Instituto de Biomedicina y Biotecnología de Cantabria (IBBTEC), CSIC-Universidad de Cantabria, 39011, Santander, Spain
| | - Sheila González
- Intergenomics Group, Instituto de Biomedicina y Biotecnología de Cantabria (IBBTEC), CSIC-Universidad de Cantabria, 39011, Santander, Spain
| | - David Ruano-Gallego
- Department of Microbial Biotechnology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB-CSIC), Campus UAM Cantoblanco, 28049 Madrid, Spain
| | - Luis Ángel Fernández
- Department of Microbial Biotechnology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB-CSIC), Campus UAM Cantoblanco, 28049 Madrid, Spain
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22
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Capitán-Jiménez C, Aragón-Vargas LF. Post-Exercise Voluntary Drinking Cessation Is Associated with the Normalization of Plasma Osmolality and Thirst Perception, but Not of Urine Indicators or Net Fluid Balance. Nutrients 2022; 14:nu14194188. [PMID: 36235840 PMCID: PMC9572470 DOI: 10.3390/nu14194188] [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: 08/23/2022] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Post-exercise rehydration has been widely studied, with particular emphasis on retention of ingested fluid; comparatively little research has been conducted on why we drink more or less. To identify physiological values corresponding to voluntary drinking cessation (VDC), nine males exercised intermittently at 70−80% HRmax in the heat (WBGT = 28.1 ± 0.7 °C) to achieve a dehydration of approximately 4.0% body mass (BM). After exercise, participants were instructed to drink water as long and as much as they needed. Urine color (Ucolor), specific gravity (USG), osmolality (Uosm), plasma osmolality (Posm), fullness, BM, and thirst perception (TP) were measured pre- and post-exercise and at VDC. Each variable was compared for the three points in time with a one-way ANOVA. Participants reached dehydration of −3.6 ± 0.3% BM. Pre-exercise USG (1.022 ± 0.004) was lower than at VDC (1.029 ± 0.004, p = 0.022), Uosm did not change over time (p = 0.217), and Ucolor was lower pre-exercise (3.4 ± 0.7) vs. post-exercise (5.5 ± 1.23, p = 0.0008) and vs. VDC (6.3 ± 1.1, p < 0.0001). Posm showed a difference between pre-exercise (289.5 ± 2.3) and post-exercise (297.8 ± 3.9, p = 0.0006) and between post-exercise and VDC (287.3 ± 5.4, p < 0.0001). TP post-exercise (96.4 ± 4.34) was significantly higher than pre-exercise (36.2 ± 19.1) and VDC (25.0 ± 18.2, p < 0.0001). At VDC, participants had recovered 58.7 ± 12.1% of BM loss. At the point of voluntary drinking cessation, Posm and thirst perception had returned to their pre-exercise values, while rehydration relative to initial BM was still incomplete.
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Affiliation(s)
- Catalina Capitán-Jiménez
- Department of Nutrition, Universidad Hispanoamericana, San Jose 10101, Costa Rica
- Human Movement Science Research Center, Universidad de Costa Rica, San Pedro 11501, Costa Rica
- Correspondence: ; Tel.: +506-88749572
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23
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Rochira I, Chanpong A, Biassoni L, Easty M, Morris E, Saliakellis E, Lindley K, Thapar N, Rybak A, Borrelli O. Transpyloric propagation and liquid gastric emptying in children with foregut dysmotility. Neurogastroenterol Motil 2022; 34:e14334. [PMID: 35254724 DOI: 10.1111/nmo.14334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 09/14/2021] [Accepted: 01/19/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND/OBJECTIVES Gastric emptying (GE) requires precise antropyloroduodenal coordination for effective transpyloric flow, the mechanisms of which are still unclear. We aimed to correlate gastric antral function assessed by antroduodenal manometry (ADM) with GE scintigraphy (GES) for liquid feeds in children with suspected gastrointestinal dysmotility. METHODS Children who underwent both ADM and GES over a five-year period were reviewed. ADM tracings were re-analyzed to assess antral frequency, amplitude, and motility index (MI) pre-prandially and postprandially. Transpyloric propagation (TPP) was defined as antegrade propagated antral activity preceding duodenal phase III of the migrating motor complex (MMC). TPP was defined as "poor" if occurring in <50% of all presented duodenal phases III. For GES, regions of interest over the whole stomach, fundus, and antrum were drawn to calculate GE half-time (GE-T1/2 ) and retention rate (RR) in each region at 1 and 2 h. RESULTS Forty-seven children (median age: 7.0 years) were included. Twenty-two had PIPO, 14 functional GI disorders, and 11 gastroparesis. Children with poor TPP had longer GE-T1/2 (113.0 vs 66.5 min, p = 0.028), higher RR of the whole stomach and fundus at 1 h (79.5% vs 63.5%, p = 0.038; 60.0% vs 41.0%, p = 0.022, respectively) and 2 h (51.0% vs 10.5%, p = 0.005; 36.0% vs 6.5%, p = 0.004, respectively). The pre-prandial antral amplitude of contractions inversely correlated with GE-T1/2 , RR of the whole stomach, and fundus at 2 h. CONCLUSIONS TPP during phase III of the MMC correlated with gastric emptying of liquid and its assessment on ADM might predict abnormalities in postprandial gastric function.
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Affiliation(s)
- Ilaria Rochira
- Neurogastroenterology & Motility Unit, Gastroenterology Department, Great Ormond Street Hospital for Children, London, UK.,Department of Paediatrics, Children's Hospital, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Atchariya Chanpong
- Neurogastroenterology & Motility Unit, Gastroenterology Department, Great Ormond Street Hospital for Children, London, UK.,Division of Gastroenterology and Hepatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.,Stem cell and Regenerative Medicine, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Lorenzo Biassoni
- Nuclear Medicine Unit, Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Marina Easty
- Nuclear Medicine Unit, Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Elizabeth Morris
- Nuclear Medicine Unit, Department of Radiology, Great Ormond Street Hospital for Children, London, UK.,Nuclear Medicine Physics, Clinical Physics, Barts Health NHS Trust, London, UK
| | - Efstratios Saliakellis
- Neurogastroenterology & Motility Unit, Gastroenterology Department, Great Ormond Street Hospital for Children, London, UK
| | - Keith Lindley
- Neurogastroenterology & Motility Unit, Gastroenterology Department, Great Ormond Street Hospital for Children, London, UK
| | - Nikhil Thapar
- Neurogastroenterology & Motility Unit, Gastroenterology Department, Great Ormond Street Hospital for Children, London, UK.,Stem cell and Regenerative Medicine, UCL Great Ormond Street Institute of Child Health, London, UK.,Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Anna Rybak
- Neurogastroenterology & Motility Unit, Gastroenterology Department, Great Ormond Street Hospital for Children, London, UK
| | - Osvaldo Borrelli
- Neurogastroenterology & Motility Unit, Gastroenterology Department, Great Ormond Street Hospital for Children, London, UK
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24
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New ESAIC fasting guidelines for clear fluids in children: Much ado about nothing or is it? Eur J Anaesthesiol 2022; 39:639-641. [PMID: 35822222 DOI: 10.1097/eja.0000000000001674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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25
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Folwarski M, Kłęk S, Zoubek-Wójcik A, Szafrański W, Bartoszewska L, Figuła K, Jakubczyk M, Jurczuk A, Kamocki Z, Kowalczyk T, Kwella B, Matras P, Sonsala-Wołczyk J, Szopiński J, Urbanowicz K, Zmarzły A. Foods for Special Medical Purposes in Home Enteral Nutrition-Clinical Practice Experience. Multicenter Study. Front Nutr 2022; 9:906186. [PMID: 35873447 PMCID: PMC9301075 DOI: 10.3389/fnut.2022.906186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Enteral nutrition (EN) with foods for special medical purposes (FSMP) is recommended for most patients on home enteral nutrition (HEN). Although there are disease-specific guidelines for energy, protein, and micronutrient provision, only a few studies are showing real-life experience in the long-term use of FSMP. Methods In a multicenter study, the influence of the FSMP composition and administration technique (bolus vs. continuous) on protein and energy provision in HEN was analyzed. Provision of vitamins and minerals was compared to recommended daily allowance (RDA) and upper tolerable limit (UL). Results Approximately, 772 patients on HEN, mostly (88.6%) with oncological and neurological diseases, were enrolled. The patients on standard FSMP received less protein and energy than those on hypercaloric and protein enriched despite receiving higher volumes of EN (p < 0.05). No differences were observed in jejunal feeding with oligomeric vs. polymeric FSMP in terms of energy, protein, and volume. Continuous gastric feeding provided more protein, energy, and volume vs. bolus feeding (p < 0.05). Significant number of patients received less than 100% RDA of vitamin D (50.5%), vitamin B3 (49%), vitamin K (21.8%), vitamin B5 (64.3%), vitamin B9 (60%). Majority of the patients received less than 100% RDA of sodium (80.2%), potassium (99%), chloride (98%), calcium (67%), magnesium (87%), fluoride (99%), and iodine (43%). Approximately, 43.63% of cancer and 49.9% of neurological patients received less than 1 g/kg/day of protein and 51.7% of cancer and 55.5% of neurological patients received less than 25 kcal/kg/day. Conclusion Awareness of the available compositions of FSMP and advantageous profiles of specific diets may lead to the implementation of recommendations for EN. HEN professionals need to analyze all the patient's needs and requirements to provide more tailored matching of nutritional support.
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Affiliation(s)
- Marcin Folwarski
- Department of Clinical Nutrition and Dietetics, Medical University of Gdańsk, Gdańsk, Poland
- Home Enteral and Parenteral Nutrition Unit, Department of General Surgery, Nicolaus Copernicus Hospital, Gdańsk, Poland
| | - Stanisław Kłęk
- Surgical Oncology Clinic, Maria Skłodowska-Curie National Cancer Institute, Kraków, Poland
| | | | - Waldemar Szafrański
- Home Enteral and Parenteral Nutrition Unit, Department of General Surgery, Nicolaus Copernicus Hospital, Gdańsk, Poland
| | - Lidia Bartoszewska
- First Department General and Transplant Surgery and Clinical Nutrition Medical University of Lublin, Home Enteral and Parental Nutrition Unit SPSK4, Lublin, Poland
| | | | - Marlena Jakubczyk
- Department of Anaesthesiology and Intensive Care Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
- Nutritional Team, Home Enteral and Parenteral Nutrition Clinic University Hospital No. 1 in Bydgoszcz, Toruń, Poland
| | - Anna Jurczuk
- Outpatient Clinic of Nutritional Therapy Clinical Hospital of Białystok, Białystok, Poland
| | - Zbigniew Kamocki
- 2nd Department of General, Gastroenterological and Oncological Surgery Medical University of Białystok, Białystok, Poland
| | | | - Bogna Kwella
- Department of Clinical Nutrition, Provincial Specialist Hospital, Olsztyn, Poland
| | - Przemysław Matras
- First Department General and Transplant Surgery and Clinical Nutrition Medical University of Lublin, Home Enteral and Parental Nutrition Unit SPSK4, Lublin, Poland
| | | | - Jacek Szopiński
- Department of General Hepatobiliary and Transplant Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
- General Surgery and Clinical Nutrition Ward, Community Hospital Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | | | - Anna Zmarzły
- Gromkowski City Hospital Wrocław, Clinical Nutrition Unit, Wrocław, Poland
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26
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Amano T, Watanabe D, Otsuka J, Okamoto Y, Takada S, Fujii N, Kenny GP, Enoki Y, Maejima D. Comparison of hydration efficacy of carbohydrate-electrolytes beverages consisting of isomaltulose and sucrose in healthy young adults: A randomized crossover trial. Physiol Behav 2022; 249:113770. [PMID: 35247444 DOI: 10.1016/j.physbeh.2022.113770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 12/16/2022]
Abstract
Isomaltulose is a low glycemic and insulinaemic carbohydrate now used as an alternative sweetener in beverages. However, it remains unclear if hydration status may be impacted differently with the consumption of beverages containing isomaltulose as compared to sucrose, a common beverage sweetener. Thirteen young adults (7 women) consumed 1 L of a carbohydrate beverage (with low electrolyte content) containing either 6.5%-sucrose, 6.5%-isomaltulose, or water within a 15 min period. For each beverage, beverage hydration index (BHI, a composite measure of fluid balance after consuming a test beverage relative to water) was calculated from urine volume produced over a 3 h period following ingestion of the carbohydrate beverages relative to water. The change in plasma volume (ΔPV), blood glucose, and lactate concentrations were assessed every 30 min post-beverage consumption. Isomaltulose ingestion attenuated urine production as compared to water and sucrose (P ≤ 0.005) over the 3 h post-ingestion period. However, no differences were observed between sucrose and water (P = 0.055). BHI was 1.53 ± 0.44 for isomaltulose (P ≤ 0.022 vs. sucrose and water) and 1.20±0.29 for sucrose (P = 0.210 vs. water). A transient reduction in ΔPV was observed following the ingestion of the isomaltulose beverage (at 30 min, P = 0.007 vs. sucrose). Thereafter, no differences in ΔPV between beverages were measured. Increases in blood glucose and lactate, indices of absorption and utility of glucose, were delayed in the isomaltulose as compared to sucrose beverage. In summary, we demonstrated a greater BHI with a carbohydrate-electrolyte beverage containing isomaltulose as compared to sucrose. This may in part be attributed to a delayed absorption of isomaltulose reducing diuresis.
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Affiliation(s)
- Tatsuro Amano
- Laboratory for Exercise and Environmental Physiology, Faculty of Education, Niigata University, Niigata, Japan.
| | - Daichi Watanabe
- Laboratory for Exercise and Environmental Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Junto Otsuka
- Laboratory for Exercise and Environmental Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Yumi Okamoto
- Laboratory for Exercise and Environmental Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Shota Takada
- Laboratory for Exercise and Environmental Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| | - Yasuaki Enoki
- Advanced Research Institutes, Bourbon Corporation, Niigata, Japan
| | - Daisuke Maejima
- Advanced Research Institutes, Bourbon Corporation, Niigata, Japan
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27
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Berry CW, Murray B, Kenney WL. Scientific basis for a milk permeate-based sports drink – A critical review. Int Dairy J 2022. [DOI: 10.1016/j.idairyj.2021.105296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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28
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A Food First Approach to Carbohydrate Supplementation in Endurance Exercise: A Systematic Review. Int J Sport Nutr Exerc Metab 2022; 32:296-310. [PMID: 35231883 DOI: 10.1123/ijsnem.2021-0261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 11/18/2022]
Abstract
This systematic review analyzed whether carbohydrate source (food vs. supplement) influenced performance and gastrointestinal (GI) symptoms during endurance exercise. Medline, SPORTDiscus, and citations were searched from inception to July 2021. Inclusion criteria were healthy, active males and females aged >18 years, investigating endurance performance, and GI symptoms after ingestion of carbohydrate from a food or supplement, <60 min before or during endurance exercise. The van Rosendale scale was used to determine risk of bias, with seven studies having low risk of bias. A total of 151 participants from 15 studies were included in the review. Three studies provided 0.6-1 g carbohydrate/kg body mass during 5-45 min precycling exercise (duration 60-70 min) while 12 studies provided 24-80 g/hr carbohydrate during exercise (60-330 min). Except one study that suggested a likely harmful effect (magnitude-based inferences) of a bar compared to a gel consumed during exercise on cycling performance, there were no differences in running (n = 1) or cycling (n = 13) performance/capacity between food and supplemental sources. Greater GI symptoms were reported with food compared with supplemental sources. Highly heterogenous study designs for carbohydrate dose and timing, as well as exercise protocol and duration, make it difficult to compare findings between studies. A further limitation results from only one study assessing running performance. Food choices of carbohydrate consumed immediately before and during endurance exercise result in similar exercise performance/capacity responses to supplemental carbohydrate sources, but may slightly increase GI symptoms in some athletes, particularly with exercise >2 hr.
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29
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Mallefet P, Armogida M, Doll WJ, Page RC, Sandefer EP. A single-dose, open-label, randomized, scintigraphic study to investigate the gastrointestinal behavior of 2 triple-combination cold products (acetaminophen, phenylephrine, and dextromethorphan) in healthy male volunteers. Trials 2022; 23:128. [PMID: 35135601 PMCID: PMC8822665 DOI: 10.1186/s13063-022-06037-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/16/2022] [Indexed: 11/26/2022] Open
Abstract
Background Common cold symptoms may be mitigated by products in caplet, nasal spray, and oral solution formulations, although variations exist in the bioavailability of the active ingredients contained within these products. Rapid gastric emptying (GE) of these active ingredients is important for reducing the delay between drug absorption and onset of cold symptom relief. Hot drink cold remedies are associated with greater comfort and may enhance the bioavailability of active ingredients. The objective of this study was to characterize the gastrointestinal transit of powder (reconstituted in hot water) and caplet formulations of commercially available multisymptom cold medications. Methods This was an open-label, single-dose, parallel-group study. Healthy male adults under fasted conditions were randomized 1:1 to receive a single dose of radiolabeled Theraflu Daytime Severe Cold and Cough powder for oral solution or radiolabeled Theraflu ExpressMax Daytime Severe Cold and Cough caplet. External gamma scintigraphy was utilized to monitor GE and intestinal transit of two radiolabeled drug formulations. Results A total of 28 participants completed the study. The mean ± SE GE onset times were 1.1 ± 0.3 min and 8.5 ± 1.8 min for powder and caplet formulations, respectively. The mean ± SE GE completion times were 121 ± 13 min and 65 ± 13 min, respectively. Despite the similar mean times to GE25%, the powder had later mean GE50% (23 ± 3.0 vs 16 ± 3.2 min, respectively) and GE90% (85 ± 12 vs 36 ± 9 min, respectively) than caplets. Caplets had a shorter overall GE half-life, lower total gastric exposure, and faster transit time through the small intestine versus the powder formulation. No serious safety events were observed. Conclusion The results of this study in healthy male adults suggest that the Theraflu powder formulation had a more rapid GE onset but longer time to GE completion than the caplet formulation. Trial registration ClinicalTrials.govNCT03415243 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06037-x.
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Affiliation(s)
- Pascal Mallefet
- GSK Consumer Healthcare, Route de l'Etraz 2, 1260, Nyon, Switzerland.
| | - Marianna Armogida
- GSK Consumer Healthcare, Route de l'Etraz 2, 1260, Nyon, Switzerland
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30
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Funai Y, Takemura M, Inoue K, Shirasaka Y. Effect of Ingested Fluid Volume and Solution Osmolality on Intestinal Drug Absorption: Impact on Drug Interaction with Beverages. Eur J Pharm Sci 2022; 172:106136. [PMID: 35121020 DOI: 10.1016/j.ejps.2022.106136] [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: 06/07/2021] [Revised: 01/17/2022] [Accepted: 01/31/2022] [Indexed: 11/03/2022]
Abstract
It was recently shown that osmolality-dependent fluid movement is a significant factor causing the clinically observed apple juice (AJ)-atenolol interaction. Here we examined whether osmolality-dependent fluid movement may also explain the AJ volume dependence of the AJ-atenolol interaction. In Wistar rats, the luminal fluid volume after administration of different volumes of purified water (0.5 and 1.0 mL) gradually reduced to a similar steady-state level, while that after administration of different volumes of AJ (0.5 and 1.0 mL) increased and attained different apparent steady-state levels. It was hypothesized that osmolality-dependent fluid secretion would account for the volume dependence of the apparent steady-state. Indeed, the luminal concentration of FD-4, a non-permeable compound, after administration in AJ was attenuated depending upon the ingested volume, whereas that after administration in purified water was independent of the ingested fluid volume. An in vivo pharmacokinetic study in rats showed that co-administration of AJ and hyperosmotic solution (adjusted to the osmolality of AJ) with atenolol volume-dependently reduced the AUC and Cmax of atenolol significantly. These results show that osmolality-dependent variations in luminal fluid volume may indirectly influence the absorption characteristics of drugs, and can account for the observed volume dependence of beverage-drug interactions.
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Affiliation(s)
- Yuta Funai
- Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa, 920-1192, Japan.; School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan.
| | - Miyuki Takemura
- Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa, 920-1192, Japan.; School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Katsuhisa Inoue
- School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Yoshiyuki Shirasaka
- Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa, 920-1192, Japan.; School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan
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Ranganathan P, Khandekar S, Doctor J, Awaskar S, Alex N, Medha L. Ultrasound-guided estimation of gastric residual volume using Perlas's formula: A validation study in patients. Indian J Anaesth 2022; 66:255-259. [PMID: 35663207 PMCID: PMC9159396 DOI: 10.4103/ija.ija_783_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/08/2022] [Accepted: 03/28/2022] [Indexed: 11/22/2022] Open
Abstract
Background and Aims: Bedside ultrasound (US) is used to evaluate gastric residual volume (GRV) and assess aspiration risk. We examined the accuracy of US-guided measurement of GRV using Perlas’s formula, by two trained anaesthesiologists, in patients who had consumed different types and volumes of fluids. Methods: Patients with no risk factors for delayed gastric emptying were included. Each assessor independently determined the baseline US-guided GRV. The patients were randomly allocated to receive no drink or 100 or 200 mL of water or milk. US-guided GRV was re-assessed within 5 min after the intervention. Investigators were blinded to the measurements performed by each other and to the randomisation arm. The primary outcome was the agreement between actual volumes consumed and estimated change in GRV. Results: Agreement between actual volume consumed and estimated change in GRV was poor [Intra-class correlation coefficient (ICC) 0.46, 95% confidence interval (CI) 0.09 to 0.72; P = 0.09 for assessor 1 and ICC 0.37; 95% CI 0.02 to 0.66; P = 0.03 for assessor 2]. Conclusion: US-guided GRV measurements using Perlas’s formula, performed by trained anaesthesiologists may not be a reliable measure of GRV.
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Schindler V, Hente J, Murray FR, Hüllner M, Becker AS, Giezendanner S, Schnurre L, Bordier V, Pohl D. Adding a liquid test meal to a standardized lactulose hydrogen breath test significantly influences abdominal symptom generation and hydrogen values. Eur J Gastroenterol Hepatol 2021; 33:1485-1494. [PMID: 34609811 DOI: 10.1097/meg.0000000000002042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE While single sugar tests are controversially discussed, combination tests with meals are gaining more attention. The aim of this study was to analyze the impact of adding a test meal to lactulose hydrogen breath tests (LHBT) on hydrogen values and abdominal symptoms in patients with functional gastrointestinal disorders (FGIDs). METHODS Data of 81 FGID patients between 2014-2018 were analyzed. Patients underwent LHBT with 30 g lactulose + 300 mL water and a nutrient challenge test (NCT) including 400 mL liquid test meal + 30 g lactulose. To statistically assess the effect of a test meal on abdominal symptoms and H2, mixed-effect models were used. RESULTS Adding a test meal to LHBT showed a significant increase in nausea [odds ratio (OR) 1.4; 95% confidence interval (CI), 1.1-1.7], decrease in abdominal pain (OR 0.7; 95% CI, 0.6-0.9), borborygmi (OR 0.5; 95% CI, 0.4-0.6), diarrhea (OR 0.4; 95% CI, 0.3-0.6), and H2 production (estimate -5.3, SE 0.7, P < 0.001). The effect on bloating was only significant in functional dyspepsia, irritable bowel syndrome-functional dyspepsia mixed type and functional abdominal pain/bloating (OR 0.1; 95% CI, 0.0-0.2; OR 1.7; 95% CI, 1.2-2.3 resp OR 4.4; 95% CI, 1.8-10.6). CONCLUSIONS Significant effects on abdominal symptoms and H2 production by adding a test meal to LHBT in FGID patients are shown. Increased occurrence of nausea may be caused by gastric/duodenal hypersensitivity; decreased H2, diarrhea and borborygmi by slower and more physiologic gastric emptying resulting in later arrival of the test substance in the bowel. We recommend NCTs instead of LHBT to more physiologically represent FGID patients' meal-induced burden.
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Affiliation(s)
| | | | | | | | - Anton S Becker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich
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The Hydrating Effects of Hypertonic, Isotonic and Hypotonic Sports Drinks and Waters on Central Hydration During Continuous Exercise: A Systematic Meta-Analysis and Perspective. Sports Med 2021; 52:349-375. [PMID: 34716905 PMCID: PMC8803723 DOI: 10.1007/s40279-021-01558-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 01/25/2023]
Abstract
Background Body-fluid loss during prolonged continuous exercise can impair cardiovascular function, harming performance. Delta percent plasma volume (dPV) represents the change in central and circulatory body-water volume and therefore hydration during exercise; however, the effect of carbohydrate–electrolyte drinks and water on the dPV response is unclear. Objective To determine by meta-analysis the effects of ingested hypertonic (> 300 mOsmol kg−1), isotonic (275–300 mOsmol kg−1) and hypotonic (< 275 mOsmol kg−1) drinks containing carbohydrate and electrolyte ([Na+] < 50 mmol L−1), and non-carbohydrate drinks/water (< 40 mOsmol kg−1) on dPV during continuous exercise. Methods A systematic review produced 28 qualifying studies and 68 drink treatment effects. Random-effects meta-analyses with repeated measures provided estimates of effects and probability of superiority (p+) during 0–180 min of exercise, adjusted for drink osmolality, ingestion rate, metabolic rate and a weakly informative Bayesian prior. Results Mean drink effects on dPV were: hypertonic − 7.4% [90% compatibility limits (CL) − 8.5, − 6.3], isotonic − 8.7% (90% CL − 10.1, − 7.4), hypotonic − 6.3% (90% CL − 7.4, − 5.3) and water − 7.5% (90% CL − 8.5, − 6.4). Posterior contrast estimates relative to the smallest important effect (dPV = 0.75%) were: hypertonic-isotonic 1.2% (90% CL − 0.1, 2.6; p+ = 0.74), hypotonic-isotonic 2.3% (90% CL 1.1, 3.5; p+ = 0.984), water-isotonic 1.3% (90% CL 0.0, 2.5; p+ = 0.76), hypotonic-hypertonic 1.1% (90% CL 0.1, 2.1; p+ = 0.71), hypertonic-water 0.1% (90% CL − 0.8, 1.0; p+ = 0.12) and hypotonic-water 1.1% (90% CL 0.1, 2.0; p+ = 0.72). Thus, hypotonic drinks were very likely superior to isotonic and likely superior to hypertonic and water. Metabolic rate, ingestion rate, carbohydrate characteristics and electrolyte concentration were generally substantial modifiers of dPV. Conclusion Hypotonic carbohydrate–electrolyte drinks ingested continuously during exercise provide the greatest benefit to hydration. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s40279-021-01558-y.
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Bandegan A, Huang L, Longstaffe FJ, Lemon PW. Dose-Response Oxidation of Ingested Phytoglycogen during Exercise in Endurance-Trained Men. J Nutr 2021; 151:2942-2948. [PMID: 34255078 DOI: 10.1093/jn/nxab219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/09/2021] [Accepted: 06/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Phytoglycogen (PHY; PhytoSpherix; Mirexus Biotechnologies), a highly branched polysaccharide extracted from sweet corn, has considerable potential for exercise oxidation due to its low viscosity in water, high water retention, and exceptional stability. OBJECTIVES Using gas chromatography-isotope ratio mass spectrometry, we investigated dose-response oxidation of ingested PHY during prolonged, moderate-intensity exercise. METHODS Thirteen men (≥1 y endurance-training experience, ≥6 d·wk-1, ∼1-1.5 h·d-1; age, 25.7 ± 5.5 y; mass, 79.3 ± 10.0 kg; V̇O2max, 59.9 ± 5.5 mL·kg-1·min-1; means ± SDs) cycled for 150 min (50% maximal watt output) while ingesting PHY concentrations of 0.0% (0.0 g·min-1), 3.6% (0.5 g·min-1), 7.2% (1.0 g·min-1), 10.8% (1.5 g·min-1), or 14.4% (2 g·min-1) in water (2100 mL) (n = 7-10/dose). Substrate oxidation was determined using stable-isotope methods and indirect calorimetry. RESULTS PHY oxidation plateaued between 60 and 150 min of exercise and increased (P < 0.001) from 0.49 to 0.72 g·min-1 with 0.5- and 1.0-g·min-1 doses without further increases (0.76 and 0.73 g·min-1; P > 0.05) with 1.5 or 2 g·min-1. Peak PHY oxidation (0.84 ± 0.04 g·min-1) occurred in the final 30 min of exercise with 2 g·min-1. Exercise blood glucose was greater (5.1 mmol·L-1) with 1.0-, 1.5-, and 2-g·min-1 doses compared with that of 0.5 (4.7 mmol·L-1) or 0.0 g·min-1 (4.2 mmol·L-1) (P < 0.0001). Gastrointestinal distress was minimal except with 2 g·min-1 (P < 0.001). CONCLUSIONS In male endurance athletes, PHY oxidation plateaued at 0.72-0.76 g·min-1 during 150 min of cycling at 50% Wmax (peak oxidation of 0.84 g·min-1 occurred during the final 30 min). This trial was registered at clinicaltrials.gov as NCT02909881.
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Affiliation(s)
- Arash Bandegan
- Exercise Nutrition Research Laboratory, University of Western Ontario, London, Ontario, Canada
| | - Li Huang
- Department of Earth Sciences, University of Western Ontario, London, Ontario, Canada
| | - Fred J Longstaffe
- Department of Earth Sciences, University of Western Ontario, London, Ontario, Canada
| | - Peter Wr Lemon
- Exercise Nutrition Research Laboratory, University of Western Ontario, London, Ontario, Canada
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Millard-Stafford M, Snow TK, Jones ML, Suh H. The Beverage Hydration Index: Influence of Electrolytes, Carbohydrate and Protein. Nutrients 2021; 13:nu13092933. [PMID: 34578811 PMCID: PMC8465972 DOI: 10.3390/nu13092933] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/12/2021] [Accepted: 08/20/2021] [Indexed: 01/21/2023] Open
Abstract
The beverage hydration index (BHI) facilitates a comparison of relative hydration properties of beverages using water as the standard. The additive effects of electrolytes, carbohydrate, and protein on rehydration were assessed using BHI. Nineteen healthy young adults completed four test sessions in randomized order: deionized water (W), electrolytes only (E), carbohydrate-electrolytes (C + E), and 2 g/L dipeptide (alanyl-glutamine)-electrolytes (AG + E). One liter of beverage was consumed, after which urine and body mass were obtained every 60 min through 240 min. Compared to W, BHI was higher (p = 0.007) for C + E (1.15 ± 0.17) after 120 min and for AG + E (p = 0.021) at 240 min (1.15 ± 0.20). BHI did not differ (p > 0.05) among E, C + E, or AG + E; however, E contributed the greatest absolute net effect (>12%) on BHI relative to W. Net fluid balance was lower for W (p = 0.048) compared to C + E and AG + E after 120 min. AG + E and E elicited higher (p < 0.001) overall urine osmolality vs. W. W also elicited greater reports of stomach bloating (p = 0.02) compared to AG + E and C + E. The addition of electrolytes alone (in the range of sports drinks) did not consistently improve BHI versus water; however, the combination with carbohydrate or dipeptides increased fluid retention, although this occurred earlier for the sports drink than the dipeptide beverage. Electrolyte content appears to make the largest contribution in hydration properties of beverages for young adults when consumed at rest.
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Goelen N, Doperé G, Byloos K, Ghysels S, Putzeys G, Vandecaveye V, Morales J, Van Huffel S, Tack J, Janssen P. Gastric accumulation of enteral nutrition reduces pressure changes induced by phasic contractility in an isovolumetric intragastric balloon. Neurogastroenterol Motil 2021; 33:e14088. [PMID: 33534195 DOI: 10.1111/nmo.14088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/15/2020] [Accepted: 01/05/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND An isovolumetric intragastric balloon to continuously measure gastric phasic contractility was recently developed by us. We aimed to investigate the readout of this technique in relation to gastric content and gastric emptying. METHODS In this crossover investigation, the VIPUNTM Gastric Monitoring System, which comprises a double lumen nasogastric feeding tube with integrated intragastric balloon, was used to assess phasic gastric contractility by interpretation of the pressure in an isovolumetric balloon in 10 healthy subjects. Balloon pressure was recorded in fasted state, during a 2-hour intragastric nutrient infusion (1 kcal/ml at 25, 75, or 250 ml/h) and 4 hours post-infusion, and quantified as Gastric Balloon Motility Index (GBMI), ranging from 0 (no contractility) to 1 (maximal contractility). Gastric accumulation was quantified with magnetic resonance imaging and gastric emptying with a13 C-breath test. Results are expressed as mean(SD). KEY RESULTS GBMI was significantly lower during infusion at 250 ml/h compared to baseline (0.13(0.05) versus 0.46(0.12)) and compared to infusion at 25 (0.54(0.21)) and 75 ml/h (0.43(0.20)), all P < 0.005. Gastric content volume was larger after infusion at 250 versus 75 ml/h (P < 0.001). Half-emptying time and accumulation were both negatively correlated with postprandial contractility. Postprandial GBMI was significantly lower when GCV>0 ml compared to when the stomach was empty. CONCLUSIONS AND INFERENCES Enteral nutrition dose-dependently decreased the contractility readout. This decrease was linked to gastric accumulation of enteral nutrition.
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Affiliation(s)
- Nick Goelen
- Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
| | - Glynnis Doperé
- Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
| | - Kris Byloos
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Stefan Ghysels
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Guido Putzeys
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | | | - John Morales
- Department of Electrical Engineering ESAT, Signal Processing and Data Analytics, STADIUS Center for Dynamical Systems, KU Leuven, Leuven, Belgium
| | - Sabine Van Huffel
- Department of Electrical Engineering ESAT, Signal Processing and Data Analytics, STADIUS Center for Dynamical Systems, KU Leuven, Leuven, Belgium
| | - Jan Tack
- Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
| | - Pieter Janssen
- Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium.,VIPUN Medical, Mechelen, Belgium
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Commentary on: Impact of drinking Chinese green tea on postoperative short outcomes for gastric cancer: a randomized controlled trial. Eur J Clin Nutr 2021; 75:1679-1680. [PMID: 34168296 DOI: 10.1038/s41430-021-00944-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/01/2021] [Accepted: 05/12/2021] [Indexed: 11/08/2022]
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Rüggeberg A, Dubois P, Böcker U, Gerlach H. [Preoperative fluid fasting : Establishment of a liberal fluid regimen using fasting cards]. Anaesthesist 2021; 70:469-475. [PMID: 34106289 DOI: 10.1007/s00101-021-00918-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/07/2020] [Accepted: 01/08/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Preoperative fasting times for clear liquids surpass by far the recommendations of the specialist societies. The aim of this study was to introduce a liberal regimen for preoperative fasting of clear liquids using fasting cards as a training tool and to evaluate the implementation. MATERIAL AND METHODS We developed a liberalized regimen of preoperative clear fluid fasting times, which allows patients to drink water, apple juice, tea and coffee until being called to the operating theatre. Each patient receives a bed-side fasting card with written information specifying fasting times for solid food and liquids. Patients who are allowed to drink water, apple juice, tea and coffee until the call to the operating theatre receive a blue fasting card. Patients with coexisting diseases or conditions that can affect gastric emptying or who need longer fasting times because of the surgical procedure get a yellow fasting card on which fasting times for fluids and solids can be documented individually. Patients who need to be nil per os (for example patients with ileus or bowel obstruction, emergency care) receive a red fasting card. On the back of the card the information is written in English, Turkish, Russian and Arabic. After a period of 8 months all surgical ward managers were asked to complete a questionnaire to assess the implementation of the new fasting regimen. RESULTS The response rate of the questionnaire was 100%. Without exception all interviewees would recommend the use of our liberalized fasting regimen. Almost all would also support the implementation of fasting cards. Out of 11 wards 9 found that patients were more relaxed and asked for intravenous fluids less often while waiting for surgery. The multilingual nature of the cards makes it easier to deal with patients who do not speak German. All ward managers consistently approved the new regimen in the event they themselves would need an operation. In order to make the fasting cards also usable in the future for rescue centers and functional units, such as endoscopy, echo or cardiac catheters, the reasons for fasting on the blue and yellow cards have been extended to operation or examination and on the red card to illness, operation or upcoming examination. CONCLUSION Patients should be allowed to drink water and hypotonic clear fluids until shortly before an operation to avoid complications of overly long fasting times. Fasting cards help to implement this by providing easy to understand information for patients and healthcare workers. This concept should be clearly structured, transparent for everyone, written down and brought to the attention of the patient without a language barrier.
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Affiliation(s)
- Anne Rüggeberg
- Klinik für Anästhesie, operative Intensivmedizin und Schmerztherapie, Vivantes Klinikum Neukölln, Rudower Str. 48, 12351, Berlin, Deutschland.
| | - Peggy Dubois
- Pflegedirektion, Vivantes Klinikum Neukölln, Berlin, Deutschland
| | - Ulrich Böcker
- Klinik für Innere Medizin, Gastroenterologie, Diabetologie und Hepatologie, Vivantes Klinikum Neukölln, Rudower Straße 48, 12351, Berlin, Deutschland
| | - Herwig Gerlach
- Klinik für Anästhesie, operative Intensivmedizin und Schmerztherapie, Vivantes Klinikum Neukölln, Rudower Str. 48, 12351, Berlin, Deutschland
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Doctor JR, Chandan P, Shetty N, Gala K, Ranganathan P. Ultrasound-guided assessment of gastric residual volume in patients receiving three types of clear fluids: A randomised blinded study. Indian J Anaesth 2021; 65:289-294. [PMID: 34103742 PMCID: PMC8174594 DOI: 10.4103/ija.ija_1291_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/23/2020] [Accepted: 01/05/2021] [Indexed: 01/01/2023] Open
Abstract
Background and Aims: Ultrasonography (USG) is used to evaluate gastric residual volume (GRV); however, this technique may have inter-assessor variability. This study aimed to measure GRV in three groups of fasted patients 2 h after they received 200 mL of water, clear apple juice or apple-flavoured oral rehydration solution (ORS) and to determine inter-assessor reliability of USG-guided GRV measurement. Methods: We randomised 90 adult patients planned for elective cancer surgery, with no risk factors for delayed gastric emptying, to receive 200 mL of water, clear apple juice or apple-flavoured ORS after overnight fasting. Two hours later, two blinded assessors (a trained anaesthesiologist and a radiologist) independently determined USG-guided GRV. The primary outcome was GRV measured by the radiologist. The secondary outcome was inter-assessor correlation and agreement in GRV measurements. Results: There was no statistically significant difference in median GRV between groups (apple-flavoured ORS 74.8 mL, apple juice 63.7 mL, and water 62.1 mL, P = 0.11). We found poor correlation between measurements of radiologist and anaesthesiologist (Intra-class correlation coefficient 0.3, 95% confidence intervals 0.09 to 0.48, P value 0.002). The average (mean) bias was 5.4 mL (standard deviation 42.3 mL) and the 95% limits of agreement were -79.2 ml to +90 ml. Conclusion: Patients receiving 200 mL of water, clear apple juice or apple-flavoured ORS had comparable GRV after 2 h. There was poor correlation and agreement between GRV measurements of different assessors, indicating that more training may be required for anaesthesiologists to attain proficiency in the quantitative assessment of GRV.
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Affiliation(s)
- Jeson Rajan Doctor
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Pramila Chandan
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Nitin Shetty
- Department of Radiodiagnosis, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Kunal Gala
- Department of Radiodiagnosis, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Priya Ranganathan
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Murakami T, Bodor E, Bodor N. Factors and dosage formulations affecting the solubility and bioavailability of P-glycoprotein substrate drugs. Expert Opin Drug Metab Toxicol 2021; 17:555-580. [PMID: 33703995 DOI: 10.1080/17425255.2021.1902986] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Expression of P-glycoprotein (P-gp) increases toward the distal small intestine, implying that the duodenum is the preferential absorption site for P-gp substrate drugs. Oral bioavailability of poorly soluble P-gp substrate drugs is low and varied but increases with high-fat meals that supply lipoidal components and bile in the duodenum.Areas covered: Absorption properties of P-gp substrate drugs along with factors and oral dosage formulations affecting their solubility and bioavailability were reviewed with PubMed literature searches. An overview is provided from the viewpoint of the 'spring-and-parachute approach' that generates supersaturation of poorly soluble P-gp substrate drugs.Expert opinion: The oral bioavailability of P-gp substrate drugs is difficult to predict because of their low solubility, preferential absorption sites, and overlapping substrate specificities with CYP3A4, along with the scattered intestinal P-gp expression/function. To attain high and steady oral bioavailability of poorly soluble P-gp substrate drugs, physicochemical modification of drugs to improve solubility, or oral dosage formulations that generate long-lasting supersaturation in the duodenum, is preferred. In particular, supersaturable lipid-based drug delivery systems that can increase passive diffusion and/or lymphatic absorption are effective and applicable to many poorly soluble P-gp substrate drugs.
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Affiliation(s)
| | | | - Nicholas Bodor
- Bodor Laboratories, Miami, Florida, USA.,College of Pharmacy, University of Florida, Gainesville, Florida, USA
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Priyadarshini S, Arunkumar E, Moses J, Anandharamakrishnan C. Predicting human glucose response curve using an engineered small intestine system in combination with mathematical modeling. J FOOD ENG 2021. [DOI: 10.1016/j.jfoodeng.2020.110395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Buddington RK, Wong T, Howard SC. Paracellular Filtration Secretion Driven by Mechanical Force Contributes to Small Intestinal Fluid Dynamics. Med Sci (Basel) 2021; 9:medsci9010009. [PMID: 33572202 PMCID: PMC7931054 DOI: 10.3390/medsci9010009] [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: 12/15/2020] [Revised: 01/26/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
Studies of fluid secretion by the small intestine are dominated by the coupling with ATP-dependent generation of ion gradients, whereas the contribution of filtration secretion has been overlooked, possibly by the lack of a known mechanistic basis. We measured apical fluid flow and generation of hydrostatic pressure gradients by epithelia of cultured mouse enterocytes, Caco-2 and T-84 cells, and fibroblasts exposed to mechanical force provided by vigorous aeration and in response to ion gradients, inhibitors of ion channels and transporters and in vitro using intact mouse and rat small intestine. We describe herein a paracellular pathway for unidirectional filtration secretion that is driven by mechanical force, requires tight junctions, is independent of ionic and osmotic gradients, generates persistent hydrostatic pressure gradients, and would contribute to the fluid shifts that occur during digestion and diarrhea. Zinc inhibits the flow of fluid and the paracellular marker fluorescein isothyocyanate conjugated dextran (MW = 4 kD) across epithelia of cultured enterocytes (>95%; p < 0.001) and intact small intestine (>40%; p = 0.03). We propose that mechanical force drives fluid secretion through the tight junction complex via a “one-way check valve” that can be regulated. This pathway of filtration secretion complements chloride-coupled fluid secretion during high-volume fluid flow. The role of filtration secretion in the genesis of diarrhea in intact animals needs further study. Our findings may explain a potential linkage between intestinal motility and intestinal fluid dynamics.
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Affiliation(s)
- Randal K. Buddington
- School of Health Studies, University of Memphis, Memphis, TN 38152, USA;
- Babies Taking Flight, Memphis, TN 38117, USA
- Correspondence: ; Tel.: +1-662-418-2666
| | - Thomas Wong
- School of Health Studies, University of Memphis, Memphis, TN 38152, USA;
| | - Scott C. Howard
- Department of Acute and Tertiary Care, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA;
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Russo I, Della Gatta PA, Garnham A, Porter J, Burke LM, Costa RJS. Assessing Overall Exercise Recovery Processes Using Carbohydrate and Carbohydrate-Protein Containing Recovery Beverages. Front Physiol 2021; 12:628863. [PMID: 33613323 PMCID: PMC7890126 DOI: 10.3389/fphys.2021.628863] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/12/2021] [Indexed: 12/31/2022] Open
Abstract
We compared the impact of two different, but commonly consumed, beverages on integrative markers of exercise recovery following a 2 h high intensity interval exercise (i.e., running 70-80% V̇O2 max intervals and interspersed with plyometric jumps). Participants (n = 11 males, n = 6 females) consumed a chocolate flavored dairy milk beverage (CM: 1.2 g carbohydrate/kg BM and 0.4 g protein/kg BM) or a carbohydrate-electrolyte beverage (CEB: isovolumetric with 0.76 g carbohydrate/kg BM) after exercise, in a randomized-crossover design. The recovery beverages were provided in three equal boluses over a 30 min period commencing 1 h post-exercise. Muscle biopsies were performed at 0 h and 2 h in recovery. Venous blood samples, nude BM and total body water were collected before and at 0, 2, and 4 h recovery. Gastrointestinal symptoms and breath hydrogen (H2) were collected before exercise and every 30 min during recovery. The following morning, participants returned for performance assessment. In recovery, breath H2 reached clinical relevance of >10 ppm following consumption of both beverages, in adjunct with high incidence of gastrointestinal symptoms (70%), but modest severity. Blood glucose response was greater on CEB vs. CM (P < 0.01). Insulin response was greater on CM compared with CEB (P < 0.01). Escherichia coli lipopolysaccharide stimulated neutrophil function reduced on both beverages (49%). p-GSK-3β/total-GSK-3β was greater on CM compared with CEB (P = 0.037); however, neither beverage achieved net muscle glycogen re-storage. Phosphorylation of mTOR was greater on CM than CEB (P < 0.001). Fluid retention was lower (P = 0.038) on CEB (74.3%) compared with CM (82.1%). Physiological and performance outcomes on the following day did not differ between trials. Interconnected recovery optimization markers appear to respond differently to the nutrient composition of recovery nutrition, albeit subtly and with individual variation. The present findings expand on recovery nutrition strategies to target functionality and patency of the gastrointestinal tract as a prerequisite to assimilation of recovery nutrition, as well as restoration of immunocompetency.
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Affiliation(s)
- Isabella Russo
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
| | - Paul A. Della Gatta
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Andrew Garnham
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
| | - Judi Porter
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Louise M. Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Ricardo J. S. Costa
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
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Flickinger JC, Rappaport JA, Barton JR, Baybutt TR, Pattison AM, Snook AE, Waldman SA. Guanylyl cyclase C as a biomarker for immunotherapies for the treatment of gastrointestinal malignancies. Biomark Med 2021; 15:201-217. [PMID: 33470843 PMCID: PMC8293028 DOI: 10.2217/bmm-2020-0359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 12/18/2020] [Indexed: 12/12/2022] Open
Abstract
Gastrointestinal cancers encompass a diverse class of tumors arising in the GI tract, including esophagus, stomach, pancreas and colorectum. Collectively, gastrointestinal cancers compose a high fraction of all cancer deaths, highlighting an unmet need for novel and effective therapies. In this context, the transmembrane receptor guanylyl cyclase C (GUCY2C) has emerged as an attractive target for the prevention, detection and treatment of many gastrointestinal tumors. GUCY2C is an intestinally-restricted protein implicated in tumorigenesis that is universally expressed by primary and metastatic colorectal tumors as well as ectopically expressed by esophageal, gastric and pancreatic cancers. This review summarizes the current state of GUCY2C-targeted modalities in the management of gastrointestinal malignancies, with special focus on colorectal cancer, the most incident gastrointestinal malignancy.
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Affiliation(s)
- John C Flickinger
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Jeffrey A Rappaport
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Joshua R Barton
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Trevor R Baybutt
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Amanda M Pattison
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Adam E Snook
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Scott A Waldman
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
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The role of circular folds in mixing intensification in the small intestine: A numerical study. Chem Eng Sci 2021. [DOI: 10.1016/j.ces.2020.116079] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Kollmann P, Elfers K, Maurer S, Klingenspor M, Schemann M, Mazzuoli-Weber G. Submucosal enteric neurons of the cavine distal colon are sensitive to hypoosmolar stimuli. J Physiol 2020; 598:5317-5332. [PMID: 32880976 DOI: 10.1113/jp280309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/24/2020] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Neurons of the enteric submucous plexus are challenged by osmolar fluctuations during digestion and absorption of nutrients. Central neurons are very sensitive to changes in osmolality but knowledge on that issue related to enteric neurons is sparse. The present study focuses on investigation of osmosensitivity of submucosal neurons including potential molecular mediating mechanisms. Results show that submucosal neurons respond to hypoosmolar stimuli with increased activity which is partially mediated by the transient receptor potential vanilloid 4 channel. We provided important information on osmosensitive properties of enteric neurons. These data are fundamental to better explain the nerve-mediated control of the gastrointestinal functions during physiological and pathophysiological (diarrhoea) conditions. ABSTRACT Enteric neurons are located inside the gut wall, where they are confronted with changes in osmolality during (inter-) digestive periods. In particular, neurons of the submucous plexus (SMP), located between epithelial cells and blood vessels may sense and respond to osmotic shifts. The present study was conducted to investigate osmosensitivity of enteric submucosal neurons and the potential role of the transient receptor potential vanilloid 4 channel (TRPV4) as a mediator of enteric neuronal osmosensitivity. Therefore, freshly dissected submucosal preparations from guinea pig colon were investigated for osmosensitivity using voltage-sensitive dye and Ca2+ imaging. Acute hypoosmolar stimuli (final osmolality reached at ganglia of 94, 144 and 194 mOsm kg-1 ) were applied to single ganglia using a local perfusion system. Expression of TRPV4 in the SMP was quantified using qRT-PCR, and GSK1016790A and HC-067047 were used to activate or block the receptor, respectively, revealing its relevance in enteric osmosensitivity. On average, 11.0 [7.0/17.0] % of submucosal neurons per ganglion responded to the hypoosmolar stimulus. The Ca2+ imaging experiments showed that glia responded to the hypoosmolar stimulus, but with a delay in comparison with neurons. mRNA expression of TRPV4 could be shown in the SMP and blockade of the receptor by HC-067047 significantly decreased the number of responding neurons (0.0 [0.0/6.3] %) while the TRPV4 agonist GSK1016790A caused action potential discharge in a subpopulation of osmosensitive enteric neurons. The results of the present study provide insight into the osmosensitivity of submucosal enteric neurons and strongly indicate the involvement of TRPV4 as an osmotransducer.
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Affiliation(s)
- Patrick Kollmann
- Chair of Human Biology, Technical University of Munich, Freising, Germany
| | - Kristin Elfers
- Institute for Physiology and Cell Biology, University of Veterinary Medicine, Foundation, Hannover, Germany
| | - Stefanie Maurer
- Chair of Molecular Nutritional Medicine, Else Kröner-Fresenius Center for Nutritional Medicine & ZIEL Institute for Food & Health, TUM School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Martin Klingenspor
- Chair of Molecular Nutritional Medicine, Else Kröner-Fresenius Center for Nutritional Medicine & ZIEL Institute for Food & Health, TUM School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Michael Schemann
- Chair of Human Biology, Technical University of Munich, Freising, Germany
| | - Gemma Mazzuoli-Weber
- Institute for Physiology and Cell Biology, University of Veterinary Medicine, Foundation, Hannover, Germany
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Pino J, Gómez S, Olivares M, Quera R, Simian D, Escaffi MJ, Ibáñez P. EFECTOS DEL EJERCICIO EN ENFERMEDADES DEL TUBO DIGESTIVO. REVISTA MÉDICA CLÍNICA LAS CONDES 2020. [DOI: 10.1016/j.rmclc.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Monnard CR, Montani JP, Grasser EK. Short-term cardiovascular responses to ingestion of mineral water in healthy non-obese adults: Impact of mineral components. J Funct Foods 2020. [DOI: 10.1016/j.jff.2020.104017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Angulin-2/ILDR1, a tricellular tight junction protein, does not affect water transport in the mouse large intestine. Sci Rep 2020; 10:10374. [PMID: 32587380 PMCID: PMC7316798 DOI: 10.1038/s41598-020-67319-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/23/2020] [Indexed: 11/09/2022] Open
Abstract
Angulin-2/ILDR1 is a member of the angulin protein family, which is exclusively expressed at tricellular tight junctions in epithelia. Tricellular tight junctions are found where three cells meet and where three bicellular tight junction strands converge. Tricellular tight junctions are thought to be important for paracellular permeability of ions and water in epithelial tissues. It was recently reported that angulin-2/ILDR1 knockout mice have water transport abnormalities in the kidney. Since angulin-2/ILDR1 is the main tricellular tight junction protein in the large intestine, the goal of this research was to examine the effect of angulin-2/ILDR1 knockout on large intestinal paracellular water transport. We found that Ildr1 knockout mice showed no detectable phenotype other than deafness. In addition, paracellular transport as assessed by Ussing chamber was unchanged in Ildr1 knockout mice. However, we found that in the colon and the kidney of Ildr1 knockout mice, another tricellular tight junction protein, angulin-1/LSR, changes its expression pattern. We propose that with this replacement in tissue localization, angulin-1/LSR compensates for the loss of angulin-2/ILDR1 and maintains the barrier and function of the epithelia in the large intestine as well as the kidney.
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James LJ, Funnell MP, James RM, Mears SA. Does Hypohydration Really Impair Endurance Performance? Methodological Considerations for Interpreting Hydration Research. Sports Med 2020; 49:103-114. [PMID: 31696453 PMCID: PMC6901416 DOI: 10.1007/s40279-019-01188-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The impact of alterations in hydration status on human physiology and performance responses during exercise is one of the oldest research topics in sport and exercise nutrition. This body of work has mainly focussed on the impact of reduced body water stores (i.e. hypohydration) on these outcomes, on the whole demonstrating that hypohydration impairs endurance performance, likely via detrimental effects on a number of physiological functions. However, an important consideration, that has received little attention, is the methods that have traditionally been used to investigate how hypohydration affects exercise outcomes, as those used may confound the results of many studies. There are two main methodological limitations in much of the published literature that perhaps make the results of studies investigating performance outcomes difficult to interpret. First, subjects involved in studies are generally not blinded to the intervention taking place (i.e. they know what their hydration status is), which may introduce expectancy effects. Second, most of the methods used to induce hypohydration are both uncomfortable and unfamiliar to the subjects, meaning that alterations in performance may be caused by this discomfort, rather than hypohydration per se. This review discusses these methodological considerations and provides an overview of the small body of recent work that has attempted to correct some of these methodological issues. On balance, these recent blinded hydration studies suggest hypohydration equivalent to 2–3% body mass decreases endurance cycling performance in the heat, at least when no/little fluid is ingested.
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Affiliation(s)
- Lewis J James
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
| | - Mark P Funnell
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - Ruth M James
- Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Stephen A Mears
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
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