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Renaud D, Höller A, Michel M. Potential Drug-Nutrient Interactions of 45 Vitamins, Minerals, Trace Elements, and Associated Dietary Compounds with Acetylsalicylic Acid and Warfarin-A Review of the Literature. Nutrients 2024; 16:950. [PMID: 38612984 PMCID: PMC11013948 DOI: 10.3390/nu16070950] [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: 03/05/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
In cardiology, acetylsalicylic acid (ASA) and warfarin are among the most commonly used prophylactic therapies against thromboembolic events. Drug-drug interactions are generally well-known. Less known are the drug-nutrient interactions (DNIs), impeding drug absorption and altering micronutritional status. ASA and warfarin might influence the micronutritional status of patients through different mechanisms such as binding or modification of binding properties of ligands, absorption, transport, cellular use or concentration, or excretion. Our article reviews the drug-nutrient interactions that alter micronutritional status. Some of these mechanisms could be investigated with the aim to potentiate the drug effects. DNIs are seen occasionally in ASA and warfarin and could be managed through simple strategies such as risk stratification of DNIs on an individual patient basis; micronutritional status assessment as part of the medical history; extensive use of the drug-interaction probability scale to reference little-known interactions, and application of a personal, predictive, and preventive medical model using omics.
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Affiliation(s)
- David Renaud
- DIU MAPS, Fundamental and Biomedical Sciences, Paris-Cité University, 75006 Paris, France
- DIU MAPS, Health Sciences Faculty, Universidad Europea Miguel de Cervantes, 47012 Valladolid, Spain
- Fundacja Recover, 05-124 Skrzeszew, Poland
| | - Alexander Höller
- Department of Nutrition and Dietetics, University Hospital Innsbruck, 6020 Innsbruck, Austria
| | - Miriam Michel
- Department of Child and Adolescent Health, Division of Pediatrics III—Cardiology, Pulmonology, Allergology and Cystic Fibrosis, Medical University of Innsbruck, 6020 Innsbruck, Austria
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Kassis A, Fichot MC, Horcajada MN, Horstman AMH, Duncan P, Bergonzelli G, Preitner N, Zimmermann D, Bosco N, Vidal K, Donato-Capel L. Nutritional and lifestyle management of the aging journey: A narrative review. Front Nutr 2023; 9:1087505. [PMID: 36761987 PMCID: PMC9903079 DOI: 10.3389/fnut.2022.1087505] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/28/2022] [Indexed: 01/25/2023] Open
Abstract
With age, the physiological responses to occasional or regular stressors from a broad range of functions tend to change and adjust at a different pace and restoring these functions in the normal healthy range becomes increasingly challenging. Even if this natural decline is somehow unavoidable, opportunities exist to slow down and attenuate the impact of advancing age on major physiological processes which, when weakened, constitute the hallmarks of aging. This narrative review revisits the current knowledge related to the aging process and its impact on key metabolic functions including immune, digestive, nervous, musculoskeletal, and cardiovascular functions; and revisits insights into the important biological targets that could inspire effective strategies to promote healthy aging.
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Affiliation(s)
- Amira Kassis
- Whiteboard Nutrition Science, Beaconsfield, QC, Canada,Amira Kassis,
| | | | | | | | - Peter Duncan
- Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | | | - Nicolas Preitner
- Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Diane Zimmermann
- Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Nabil Bosco
- Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Karine Vidal
- Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Laurence Donato-Capel
- Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland,*Correspondence: Laurence Donato-Capel,
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3
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Food as medicine? Exploring the impact of providing healthy foods on adherence and clinical and economic outcomes. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 5:100129. [PMID: 35478519 PMCID: PMC9032066 DOI: 10.1016/j.rcsop.2022.100129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background Methods Results Conclusion
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Moloney L, Jarrett B. Nutrition Assessment and Interventions for the Prevention and Treatment of Malnutrition in Older Adults: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2021; 121:2108-2140.e6. [PMID: 34581276 DOI: 10.1016/j.jand.2020.09.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Abstract
Older adults living in the community or long-term residence such as a nursing home are at increased risk for malnutrition due to factors such as depression and isolation. The purpose of this scoping review is to identify the best available research that evaluates the validity and reliability of nutrition assessment tools, and the effectiveness of nutrition interventions to prevent or treat malnutrition among older adults. A literature search was conducted in Medline, Embase, CINAHL, and Cochrane Central databases to identify clinical trials, published in the English language, evaluating assessment and intervention methods aimed to treat or prevent malnutrition among older adults living in the community or their long-term residence such as nursing homes. Articles were screened by 2 reviewers, then data were extracted and narratively synthesized. The literature search retrieved 20,937 articles and 197 articles were included in narrative synthesis. A total of 73 assessment articles were identified, 36 of which were validity and reliability trials. A total of 122 intervention articles were identified, the majority of which were randomized controlled trials. A few of the most commonly evaluated interventions were oral nutrition supplements, medical nutrition therapy, fortification and enrichment, and nutrition education. Several systematic reviews were identified, however, that did not meet the criteria of this review. There is a need to conduct systematic reviews for nutrition assessment and intervention trials to guide development of evidence-based nutrition practice recommendations for older adults living in the community or their long-term residence.
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Affiliation(s)
- Lisa Moloney
- Academy of Nutrition and Dietetics, Evidence Analysis Center, Chicago, IL.
| | - Brittany Jarrett
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
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5
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Schmid G. Einflussnahme auf das Bewegungssystem durch individuelle Anpassung der Makro- und Mikronährstoffzufuhr. MANUELLE MEDIZIN 2020. [DOI: 10.1007/s00337-020-00693-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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6
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Dams S, Holasek S, Tsiountsioura M, Malliga DE, Meier-Allard N, Poncza B, Lackner S, Jansenberger Y, Lamprecht M. An encapsulated fruit, vegetable and berry juice powder concentrate increases plasma values of specific carotenoids and vitamins. INT J VITAM NUTR RES 2019; 91:77-86. [PMID: 31726948 DOI: 10.1024/0300-9831/a000609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Vitamins and carotenoids are organic compounds that are important for vital functions of the human organism. Since the human body is not able to synthesize most of these micronutrients, they need to be supplied by the intake of food or supplements. The aim of this study was to analyze whether a whole food based, encapsulated fruit, berry, and vegetable juice powder concentrate provides bioavailable carotenoids and vitamins A (all-trans retinol), E and C. Eighteen healthy subjects received 6 capsules a day for 8 weeks, which provided 2.91 mg β-carotene, 490 μg vitamin A, 18.7 mg vitamin E, 159 mg vitamin C, 6.1 mg lutein and 1 mg lycopene. Plasma concentrations of several carotenoids and vitamins before and after supplementation were measured. After 8 weeks of supplementation, the plasma concentration of the following carotenoids increased significantly: α-carotene increased from 59.6 ± 22.4 nmol/L to 85.7 ± 24.2 nmol/L (p = 0.002), β-cryptoxanthin from 106.7 ± 39.8 nmol/L to 151.9 ± 57.9 nmol/L (p = 0.017), and lycopene from 1.2 ± 0.5 μmol/L to 1.7 ± 0.5 μmol/L (p = 0.005). Significant increases were also observed for plasma concentrations of vitamin C from 70 ± 20 μmol/L to 90 ± 10 μmol/L (p < 0.001), all-trans retinol from 1.99 ± 0.24 μmol/L to 2.30 ± 0.66 μmol/L (p = 0.015), and α-tocopherol from 27 ± 6 μmol/L to 32 ± 6 μmol/L (p = 0.008). For those micronutrients with accepted plasma reference ranges, all observed increases levelled off around the upper limit of the individual reference range. The data demonstrate that the investigated supplement is able to increase plasma concentrations of certain carotenoids and vitamins of healthy subjects within 8 weeks.
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Affiliation(s)
- Sebastian Dams
- Otto Loewi Research Center, Division of Immunology and Pathophysiology, Medical University of Graz, Graz, Austria.,Green Beat - Institute of Nutrient Research and Sport Nutrition, Graz, Austria
| | - Sandra Holasek
- Otto Loewi Research Center, Division of Immunology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Melina Tsiountsioura
- Green Beat - Institute of Nutrient Research and Sport Nutrition, Graz, Austria.,The Juice Plus+® Science Institute, Memphis, Tennessee, USA
| | - Daniela-Eugenia Malliga
- Green Beat - Institute of Nutrient Research and Sport Nutrition, Graz, Austria.,Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Nathalie Meier-Allard
- Otto Loewi Research Center, Division of Immunology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Brigitte Poncza
- Otto Loewi Research Center, Division of Immunology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Sonja Lackner
- Otto Loewi Research Center, Division of Immunology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Yvonne Jansenberger
- Green Beat - Institute of Nutrient Research and Sport Nutrition, Graz, Austria
| | - Manfred Lamprecht
- Green Beat - Institute of Nutrient Research and Sport Nutrition, Graz, Austria.,The Juice Plus+ Science Institute, Memphis, Tennessee, USA.,Otto Loewi Research Center, Division of Physiological Chemistry, Medical University of Graz, Graz, Austria
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Denniss RJ, Barker LA, Day CJ. Improvement in Cognition Following Double-Blind Randomized Micronutrient Interventions in the General Population. Front Behav Neurosci 2019; 13:115. [PMID: 31191268 PMCID: PMC6547837 DOI: 10.3389/fnbeh.2019.00115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/14/2019] [Indexed: 11/20/2022] Open
Abstract
The impact of poor nutrition on physiological health is well understood (Costarelli et al., 2013). Less is known about the effects of diet on brain function and cognition in the general population (Ames, 2010; Parletta et al., 2013; White et al., 2017) and we are still in the early stages of understanding the role of specific nutrients to normal and pathological neuronal functioning. In the present study, the putative effect of a multivitamin/mineral or vitamin D supplement on cognitive function over an 8-week period was compared with volunteers taking vitamin C. Healthy adults (N = 60) were recruited, age range 21-59 years ( x ¯ = 39.07 years, SD = 11.46), with participants randomly allocated to conditions in a double-blind protocol. Participants also completed a 14-day food diary to gather information on micronutrient intake. The cognitive test battery included measures from the Wechsler Adult Intelligence Scale-III (WAIS-III; Wechsler et al., 2008), Wechsler Memory Scale-IV (WMS-IV; Wechsler, 2009) and Delis-Kaplan Executive Function System (D-KEFS; Delis et al., 2001), along with the Doors and People (Baddeley et al., 1994) and a serial reaction time task. Analyses showed better performance on some tasks in all groups following the intervention period, notably on measures of verbal and visual memory and visuomotor processing speed. The Multivitamin group showed significant improvements on tasks of visual strategy generation (along with the Vitamin C group), motor planning, explicit and implicit learning, and working memory. This evidence suggests that sub-optimal micronutrient intake may have a negative effect on cognition across the lifespan.
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Affiliation(s)
- Rebecca J. Denniss
- Centre for Behavioural Science and Applied Psychology, Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, United Kingdom
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8
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Chen LY, Wu YH, Huang CY, Liu LK, Hwang AC, Peng LN, Lin MH, Chen LK. Predictive factors for dementia and cognitive impairment among residents living in the veterans' retirement communities in Taiwan: Implications for cognitive health promotion activities. Geriatr Gerontol Int 2018; 17 Suppl 1:7-13. [PMID: 28436185 DOI: 10.1111/ggi.13039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2017] [Indexed: 12/13/2022]
Abstract
AIM To identify potentially modifiable risk factors for cognitive decline among veterans' home residents in Taiwan METHODS: The present retrospective cohort study was part of the Veteran Affairs-Comprehensive Geriatric Assessment study that retrieved data of the comprehensive geriatric assessment for 946 residents living at four veterans' homes in Taiwan. The study participants were interviewed every 3-6 months from January 2012 and December 2014. Demographic characteristics,multimorbidity by Charlson's Comorbidities Index, physical function by the Barthel Index, cognition by the Mini-Mental State Examination (MMSE), depression by the five-item Geriatric Depression Scale and nutritional status by the Mini-Nutrition Assessment-Short Form were collected for analysis. A generalized estimating equation model was used after it was adjusted for age, educational level, five-item Geriatric Depression Scale, and problem of communication difficulty to identify potential modifiable risk factors for cognitive decline. RESULTS The mean age of the participants was 85.7 ± 5.2 years, with a mean follow-up period of 41 ± 21.6 weeks. The prevalence of cognitive impairment (defined by MMSE <24) was 65.6%, whereas 34% of the study participants were positive for depressive symptoms. Approximately one-fifth of the study participants were using psychotropic agents, which was higher among participants with cognitive impairment (23.6% vs 15.6%, P < 0.05) than those without. In the generalized estimating equation model, physical function, nutritional status, depressive symptoms, ex-drinker, multimorbidity and stool incontinence were positively correlated with MMSE score; whereas advanced age, low educational level (<6 years), presence of communication difficulty and use of psychotropic agents were inversely associated with the MMSE score. CONCLUSIONS Physical function and nutritional status were positively associated with the MMSE score, and use of psychotropic agents was negatively correlated with cognitive function. Further intervention study is required to improve the cognitive health of older adults living in the veterans' retirement communities. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 7-13.
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Affiliation(s)
- Liang-Yu Chen
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Hui Wu
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chung-Yu Huang
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Kuo Liu
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Biomedical informatics, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - An-Chun Hwang
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Hsieh Lin
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
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9
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The Efficacy and Pharmacological Mechanism of Zn 7MT3 to Protect against Alzheimer's Disease. Sci Rep 2017; 7:13763. [PMID: 29061973 PMCID: PMC5653791 DOI: 10.1038/s41598-017-12800-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/15/2017] [Indexed: 11/13/2022] Open
Abstract
Alzheimer’s disease (AD) is one of the leading causes of death for people over 65 years. Worse still, no completely effective therapeutic agent is available so far. One important pathological hallmark of AD is accumulated amyloid-β (Aβ) plaques with dysregulated metal homeostasis. Human metallothionin 3 (MT3), a regulator of metal homeostasis, is downregulated at least 30% in AD brain. So far, some in vitro studies demonstrated its multiple functions related to AD. However, it is a great pity that systematic in vivo studies of MT3 on AD model animals are still a blank so far. In this study, we treated APP/PS1 mice with sustained drug release of Zn7MT3 directly to the central nervous system, and investigated the role and molecular mechanism of Zn7MT3 to protect against AD mice systematically. The results demonstrated that Zn7MT3 can significantly ameliorate cognitive deficits, regulate metal homeostasis, abolish Aβ plaque load, and reduce oxidative stress. Additionally, it has been confirmed that MT3 is penetrable to the blood brain barrier of AD mice. All these results support that Zn7MT3 is an effective AD suppressing agent and has potential for applications in Alzheimer’s disease therapy.
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Skvarc DR, Dean OM, Byrne LK, Gray L, Lane S, Lewis M, Fernandes BS, Berk M, Marriott A. The effect of N-acetylcysteine (NAC) on human cognition - A systematic review. Neurosci Biobehav Rev 2017; 78:44-56. [PMID: 28438466 DOI: 10.1016/j.neubiorev.2017.04.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 04/13/2017] [Accepted: 04/15/2017] [Indexed: 12/15/2022]
Abstract
Oxidative stress, neuroinflammation and neurogenesis are commonly implicated as cognitive modulators across a range of disorders. N-acetylcysteine (NAC) is a glutathione precursor with potent antioxidant, pro-neurogenesis and anti-inflammatory properties and a favourable safety profile. A systematic review of the literature specifically examining the effect of NAC administration on human cognition revealed twelve suitable articles for inclusion: four examining Alzheimer's disease; three examining healthy participants; two examining physical trauma; one examining bipolar disorder, one examining schizophrenia, and one examining ketamine-induced psychosis. Heterogeneity of studies, insufficiently powered studies, infrequency of cognition as a primary outcome, heterogeneous methodologies, formulations, co-administered treatments, administration regimes, and assessment confounded the drawing of firm conclusions. The available data suggested statistically significant cognitive improvements following NAC treatment, though the paucity of NAC-specific research makes it difficult to determine if this effect is meaningful. While NAC may have a positive cognitive effect in a variety of contexts; larger, targeted studies are warranted, specifically evaluating its role in other clinical disorders with cognitive sequelae resulting from oxidative stress and neuroinflammation.
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Affiliation(s)
- David R Skvarc
- School of Psychology, Deakin University, Melbourne, Australia; Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia
| | - Olivia M Dean
- Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Parkville, Australia
| | - Linda K Byrne
- School of Psychology, Deakin University, Melbourne, Australia
| | - Laura Gray
- Deakin University, School of Medicine, Geelong, Australia
| | - Stephen Lane
- Deakin University, School of Medicine, Geelong, Australia; Biostatistics Unit, Barwon Health, Geelong, Australia
| | - Matthew Lewis
- School of Psychology, Deakin University, Melbourne, Australia; Aged Psychiatry Service, Caulfield Hospital, Alfred Health, Caulfield, Australia
| | - Brisa S Fernandes
- Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Parkville, Australia
| | - Andrew Marriott
- Department of Anaesthesia, Perioperative Medicine & Pain Management, Barwon Health, Geelong, Australia; Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia.
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11
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Farina N, Llewellyn D, Isaac MGEKN, Tabet N. Vitamin E for Alzheimer's dementia and mild cognitive impairment. Cochrane Database Syst Rev 2017; 4:CD002854. [PMID: 28418065 PMCID: PMC6478142 DOI: 10.1002/14651858.cd002854.pub5] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Vitamin E occurs naturally in the diet. It has several biological activities, including functioning as an antioxidant to scavenge toxic free radicals. Evidence that free radicals may contribute to the pathological processes behind cognitive impairment has led to interest in the use of vitamin E supplements to treat mild cognitive impairment (MCI) and Alzheimer's disease (AD). This is an update of a Cochrane Review first published in 2000, and previously updated in 2006 and 2012. OBJECTIVES To assess the efficacy of vitamin E in the treatment of MCI and dementia due to AD. SEARCH METHODS We searched the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (ALOIS), the Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, LILACS as well as many trials databases and grey literature sources on 22 April 2016 using the terms: "Vitamin E", vitamin-E, alpha-tocopherol. SELECTION CRITERIA We included all double-blind, randomised trials in which treatment with any dose of vitamin E was compared with placebo in people with AD or MCI. DATA COLLECTION AND ANALYSIS We used standard methodological procedures according to the Cochrane Handbook for Systematic Reviews of Interventions. We rated the quality of the evidence using the GRADE approach. Where appropriate we attempted to contact authors to obtain missing information. MAIN RESULTS Four trials met the inclusion criteria, but we could only extract outcome data in accordance with our protocol from two trials, one in an AD population (n = 304) and one in an MCI population (n = 516). Both trials had an overall low to unclear risk of bias. It was not possible to pool data across studies owing to a lack of comparable outcome measures.In people with AD, we found no evidence of any clinically important effect of vitamin E on cognition, measured with change from baseline in the Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-Cog) over six to 48 months (mean difference (MD) -1.81, 95% confidence interval (CI) -3.75 to 0.13, P = 0.07, 1 study, n = 272; moderate quality evidence). There was no evidence of a difference between vitamin E and placebo groups in the risk of experiencing at least one serious adverse event over six to 48 months (risk ratio (RR) 0.86, 95% CI 0.71 to 1.05, P = 0.13, 1 study, n = 304; moderate quality evidence), or in the risk of death (RR 0.84, 95% CI 0.52 to 1.34, P = 0.46, 1 study, n = 304; moderate quality evidence). People with AD receiving vitamin E showed less functional decline on the Alzheimer's Disease Cooperative Study/Activities of Daily Living Inventory than people receiving placebo at six to 48 months (mean difference (MD) 3.15, 95% CI 0.07 to 6.23, P = 0.04, 1 study, n = 280; moderate quality evidence). There was no evidence of any clinically important effect on neuropsychiatric symptoms measured with the Neuropsychiatric Inventory (MD -1.47, 95% CI -4.26 to 1.32, P = 0.30, 1 study, n = 280; moderate quality evidence).We found no evidence that vitamin E affected the probability of progression from MCI to probable dementia due to AD over 36 months (RR 1.03, 95% CI 0.79 to 1.35, P = 0.81, 1 study, n = 516; moderate quality evidence). Five deaths occurred in each of the vitamin E and placebo groups over the 36 months (RR 1.01, 95% CI 0.30 to 3.44, P = 0.99, 1 study, n = 516; moderate quality evidence). We were unable to extract data in accordance with the review protocol for other outcomes. However, the study authors found no evidence that vitamin E differed from placebo in its effect on cognitive function, global severity or activities of daily living . There was also no evidence of a difference between groups in the more commonly reported adverse events. AUTHORS' CONCLUSIONS We found no evidence that the alpha-tocopherol form of vitamin E given to people with MCI prevents progression to dementia, or that it improves cognitive function in people with MCI or dementia due to AD. However, there is moderate quality evidence from a single study that it may slow functional decline in AD. Vitamin E was not associated with an increased risk of serious adverse events or mortality in the trials in this review. These conclusions have changed since the previous update, however they are still based on small numbers of trials and participants and further research is quite likely to affect the results.
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Affiliation(s)
- Nicolas Farina
- Brighton and Sussex Medical SchoolCentre for Dementia StudiesBrightonUKBN1 9QH
| | - David Llewellyn
- University of ExeterMedical SchoolExeterUK+44 (0) 1392 726018
| | | | - Naji Tabet
- Brighton and Sussex Medical SchoolCentre for Dementia StudiesBrightonUKBN1 9QH
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Abstract
BACKGROUND Vitamin E occurs naturally in the diet. It has several biological activities, including functioning as an antioxidant to scavenge toxic free radicals. Evidence that free radicals may contribute to the pathological processes behind cognitive impairment has led to interest in the use of vitamin E supplements to treat mild cognitive impairment (MCI) and Alzheimer's disease (AD). This is an update of a Cochrane Review first published in 2000, and previously updated in 2006 and 2012. OBJECTIVES To assess the efficacy of vitamin E in the treatment of MCI and dementia due to AD. SEARCH METHODS We searched the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (ALOIS), the Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, LILACS as well as many trials databases and grey literature sources on 22 April 2016 using the terms: "Vitamin E", vitamin-E, alpha-tocopherol. SELECTION CRITERIA We included all double-blind, randomised trials in which treatment with any dose of vitamin E was compared with placebo in people with AD or MCI. DATA COLLECTION AND ANALYSIS We used standard methodological procedures according to the Cochrane Handbook for Systematic Reviews of Interventions. We rated the quality of the evidence using the GRADE approach. Where appropriate we attempted to contact authors to obtain missing information. MAIN RESULTS Four trials met the inclusion criteria, but we could only extract outcome data in accordance with our protocol from two trials, one in an AD population (n = 304) and one in an MCI population (n = 516). Both trials had an overall low to unclear risk of bias. It was not possible to pool data across studies owing to a lack of comparable outcome measures.In people with AD, we found no evidence of any clinically important effect of vitamin E on cognition, measured with change from baseline in the Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-Cog) over six to 48 months (mean difference (MD) -1.81, 95% confidence interval (CI) -3.75 to 0.13, P = 0.07, 1 study, n = 272; moderate quality evidence). There was no evidence of a difference between vitamin E and placebo groups in the risk of experiencing at least one serious adverse event over six to 48 months (risk ratio (RR) 0.86, 95% CI 0.71 to 1.05, P = 0.13, 1 study, n = 304; moderate quality evidence), or in the risk of death (RR 0.84, 95% CI 0.52 to 1.34, P = 0.46, 1 study, n = 304; moderate quality evidence). People with AD receiving vitamin E showed less functional decline on the Alzheimer's Disease Cooperative Study/Activities of Daily Living Inventory than people receiving placebo at six to 48 months (mean difference (MD) 3.15, 95% CI 0.07 to 6.23, P = 0.04, 1 study, n = 280; moderate quality evidence). There was no evidence of any clinically important effect on neuropsychiatric symptoms measured with the Neuropsychiatric Inventory (MD -1.47, 95% CI -4.26 to 1.32, P = 0.30, 1 study, n = 280; moderate quality evidence).We found no evidence that vitamin E affected the probability of progression from MCI to probable dementia due to AD over 36 months (RR 1.03, 95% CI 0.79 to 1.35, P = 0.81, 1 study, n = 516; moderate quality evidence). Five deaths occurred in each of the vitamin E and placebo groups over the 36 months (RR 1.01, 95% CI 0.30 to 3.44, P = 0.99, 1 study, n = 516; moderate quality evidence). We were unable to extract data in accordance with the review protocol for other outcomes. However, the study authors found no evidence that vitamin E differed from placebo in its effect on cognitive function, global severity or activities of daily living . There was also no evidence of a difference between groups in the more commonly reported adverse events. AUTHORS' CONCLUSIONS We found no evidence that the alpha-tocopherol form of vitamin E given to people with MCI prevents progression to dementia, or that it improves cognitive function in people with MCI or dementia due to AD. However, there is moderate quality evidence from a single study that it may slow functional decline in AD. Vitamin E was not associated with an increased risk of serious adverse events or mortality in the trials in this review. These conclusions have changed since the previous update, however they are still based on small numbers of trials and participants and further research is quite likely to affect the results.
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Affiliation(s)
- Nicolas Farina
- Brighton and Sussex Medical SchoolCentre for Dementia StudiesBrightonUKBN1 9QH
| | - David Llewellyn
- University of ExeterMedical SchoolExeterUK+44 (0) 1392 726018
| | | | - Naji Tabet
- Brighton and Sussex Medical SchoolCentre for Dementia StudiesBrightonUKBN1 9QH
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13
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Ventriglia M, Brewer GJ, Simonelli I, Mariani S, Siotto M, Bucossi S, Squitti R. Zinc in Alzheimer's Disease: A Meta-Analysis of Serum, Plasma, and Cerebrospinal Fluid Studies. J Alzheimers Dis 2016; 46:75-87. [PMID: 25697706 DOI: 10.3233/jad-141296] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To evaluate whether zinc levels in serum, plasma, and cerebrospinal fluid are altered in Alzheimer's disease (AD), we performed meta-analyses of 27 studies on the topic published from 1983 to 2014. The subjects' sample obtained by merging studies was a pooled total of 777 AD subjects and 1,728 controls for serum zinc studies, 287 AD subjects and 166 controls for plasma zinc, and of 292 AD subjects and 179 controls for CSF zinc. The main result of this meta-analysis is the very high heterogeneity among the studies either in demographic terms or in methodological approaches. Although we considered these effects in our analyses, the heterogeneity persisted and it has to be taken into account in the interpretation of the results. Our meta-analysis indicated that serum zinc appears significantly decreased in AD patients compared with healthy controls, and this result is confirmed when serum and plasma studies were analyzed together. If we considered the age-matched studies, the meta-analysis carried out on only six studies showed no significant difference in zinc levels between AD and healthy controls (SMD =-0.55, 95% CI (-1.18; 0.09); p = 0.094; I2 = 91%). In the light of these findings, we speculated about the possibility that the decreases observed could indicate a possible dietary zinc deficiency and we suggested that the possible involvement of zinc alterations in AD may have an interplay with copper metabolism.
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Affiliation(s)
- Mariacarla Ventriglia
- Fatebenefratelli Foundation for Health Research and Education, AFaR Division, "San Giovanni Calibita" Fatebenefratelli Hospital, Rome, Italy
| | - George J Brewer
- Department of Human Genetics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ilaria Simonelli
- Department of Neuroimaging, IRCCS San Raffaele Pisana, Rome, Italy
| | - Stefania Mariani
- Fatebenefratelli Foundation for Health Research and Education, AFaR Division, "San Giovanni Calibita" Fatebenefratelli Hospital, Rome, Italy
| | | | - Serena Bucossi
- Istituto Scienze e Tecnologie della Cognizione (ISTC) - CNR, Department of Neuroscience, Fatebenefratelli Hospital, Rome, Italy.,Laboratorio di Neurodegenerazione, IRCCS San Raffaele Pisana, Italy
| | - Rosanna Squitti
- Fatebenefratelli Foundation for Health Research and Education, AFaR Division, "San Giovanni Calibita" Fatebenefratelli Hospital, Rome, Italy.,Laboratorio di Neurodegenerazione, IRCCS San Raffaele Pisana, Italy
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14
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Karadima V, Kraniotou C, Bellos G, Tsangaris GT. Drug-micronutrient interactions: food for thought and thought for action. EPMA J 2016; 7:10. [PMID: 27182287 PMCID: PMC4866329 DOI: 10.1186/s13167-016-0059-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 04/20/2016] [Indexed: 11/10/2022]
Abstract
Micronutrients are indispensable for a variety of vital functions. Micronutrient deficiencies are a global problem concerning two billion people. In most cases, deficiencies are treatable with supplementation of the elements in lack. Drug-nutrient interactions can also lead to micronutrient reduce or depletion by various pathways. Supplementation of the elements and long-term fortification programs for populations at risk can prevent and restore the related deficiencies. Within the context of Predictive, Preventive, and Personalized Medicine, a multi-professional network should be developed in order to identify, manage, and prevent drug-micronutrient interactions that can potentially result to micronutrient deficiencies.
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Affiliation(s)
| | | | | | - George Th Tsangaris
- Proteomics Research Unit, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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15
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Price RJ, Lillycrop KA, Burdge GC. Folic acid supplementation in vitro induces cell type–specific changes in BRCA1 and BRCA 2 mRNA expression, but does not alter DNA methylation of their promoters or DNA repair. Nutr Res 2015; 35:532-44. [DOI: 10.1016/j.nutres.2015.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 04/01/2015] [Accepted: 04/07/2015] [Indexed: 12/31/2022]
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16
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Han S, Mizoi M, Nakatani E, Adachi S, Miyakoshi Y, Yanagisawa H. Improvement of serum zinc levels in young Japanese women by provision of food information. Biol Trace Elem Res 2015; 164:169-77. [PMID: 25537076 DOI: 10.1007/s12011-014-0211-5] [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] [Received: 10/01/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
Abstract
We investigated whether or not an intervention of providing food information improves serum Zn levels in ninety-two 18-20-year-old Japanese women. The mean serum Zn level of the participants was 73.09 ± 10.56 (mean ± SD) μg/dL, where 79 % of the participants had lower than the reference Zn level (80 μg/dL) proposed by the Japan Society for Biomedical Research on Trace Elements. Participants were divided into food information (INF) group, supplement (SPL) group, and control (C) group, and their serum Zn levels were measured before and after 2 weeks of intervention. The results showed that changes in serum Zn levels were (expressed in μg/dL): 71.23 ± 8.42 to 76.83 ± 12.22 in INF group (NS; not significant), 72.72 ± 10.77 to 84.07 ± 12.03 in SPL group (P < 0.01), and 72.69 ± 9.46 to 74.52 ± 11.44 in C group (NS). Percentage of normal subjects in serum Zn level (>79 mg/dL) were significantly increased in INF group (16.7 to 40%, P < 0.05) and SPL group (17.2 to 69%, P < 0.001) by each intervention. Food information only entailed a table of food items with high Zn content (card-type) and Zn intake menu (recipes). The results suggested that providing food information is effective in improving latent low Zn in young Japanese women.
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Affiliation(s)
- Soonja Han
- Department of Public Health, Graduate School of Nutritional Sciences, Sagami Women's University, Sagamihara, Kanagawa, Japan
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17
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Abstract
Older adults are becoming a significant percentage of the world's population. A multitude of factors, from the normal aging process to the progression of chronic disease, influence the nutrition needs of this very diverse group of people. Appropriate micronutrient intake is of particular importance but is often suboptimal. Here we review the available data regarding micronutrient needs and the consequences of deficiencies in the ever growing aged population.
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Affiliation(s)
- Stephanie C Montgomery
- Division of General Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Stephanie M Streit
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Mara Lee Beebe
- Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina
| | - Pinckney J Maxwell
- Division of Gastrointestinal and Laparoscopic Surgery, Medical University of South Carolina, Charleston, South Carolina
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