Oxidative damage and inflammation in obese diabetic Emirati subjects supplemented with antioxidants and B-vitamins: a randomized placebo-controlled trail

Amino Acids, B Vitamins, and Choline May Independently and Collaboratively Influence the Incidence and Core Symptoms of Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a developmental disorder of variable severity, characterized by difficulties in social interaction, communication, and restricted or repetitive patterns of thought and behavior. In 2018, the incidence of ASD was 2.4 times higher than estimated in 2000. Behavior and brain development abnormalities are present in the complex disorder of ASD. Nutritional status plays a key role in the incidence and severity of the core symptoms of ASD. The aim of this study was to review the available peer-reviewed studies that evaluated the relationship between amino acids, choline, B vitamins, and ASD incidence and/or severity of symptoms. Through examining plasma profiles, urine samples, and dietary intake, researchers found that low choline, abnormal amino acid, and low B vitamin levels were present in children with ASD compared to those without ASD. The evidence supports the need for future research that implements simultaneous supplementation of all essential nutrients in individuals with ASD and among prenatal mothers. Future evidence could lead to scientific breakthroughs, ultimately reducing the rates of ASD incidence and severity of symptoms by applying nutritional interventions in at-risk populations.

Urinary Oxidative Damage Markers and Their Association with Obesity-Related Metabolic Risk Factors

Oxidative damage and inflammation are possible mechanisms linking obesity to diabetes and related complications. This study investigates the levels of oxidative damage markers in the urine of community free-living subjects with increased prevalence of obesity. Methods: Participants were assessed regarding clinical, anthropometric, and physical activity data at baseline and at 6 months. Blood and urine samples were taken for the measurements of oxidative markers in urine ((glutathione (GSH), thiobarbituric acid reactive substances (TBARS), pteridine, 8-isoprostane and 8-hydroxy-2′-deoxyguanosine (8-OH-dG)), metabolic and inflammatory markers, and related biochemical variables in the blood. Univariate and multiple regression analyses were used to assess the association between oxidative markers and other clinical prognostic indicators. Results: Overall, 168 participants with a complete 6-month follow-up with a mean (±SD) age of 41 ± 12 (119 (71%) females) were included in the study. In multiple regression analysis, log-transformed urinary pteridine levels were significantly correlated with log-transformed urinary GSH, 8-isoprostane, and TBARS after adjusting for urinary creatinine at both baseline and follow-up. Significant correlations were also found between oxidative damage markers and cardiovascular disease risk factors, including systolic blood pressure, HbA1c, plasma glucose, us-C-reactive proteins, total cholesterol, and HDL. Higher TBARS levels were found in males and diabetic subjects, with lower GSH in diabetic hypertensive and obese subjects, but the latter result did not reach statistical significance. We found nonsignificantly higher TBARS, 8-isoprostane, and pteridine levels in smokers compared to those in nonsmokers. All measured urinary oxidative damage markers levels were higher in obese subjects compared with normal-weight subjects, but results did not reach statistical significance. Conclusion: we found significant associations between urinary oxidative damage and metabolic risk factors, and higher levels of urinary oxidative damage markers in diabetic, hypertensive, smoker, and male subjects.

Effects of folate supplementation on recurrence and metabolic status of cervical intraepithelial neoplasia grade 2/3 in overweight and obese women: a randomized double-blind placebo-controlled trial

BACKGROUND AND OBJECTIVE

Inconsistent evidence showed that folate supplementation may be associated with reduced risk of cancer due to improved metabolic profiles and reduced markers of oxidative stress and inflammation. The aim of this investigation was to quantify the effects of folate supplementation on the recurrence and other metabolic factors of women with cervical intraepithelial neoplasia grade 2/3 (CIN2/3).

METHODS

This randomized, double-blind, placebo-controlled clinical trial was performed among 60 overweight/obese women with CIN2/3. Definitive CIN2/3 confirmation was done via biopsy, pathological diagnosis, as well as colposcopy. Participants were randomly assigned to the intervention group to take 5 mg/day folate supplements or placebo group (n = 30 in each group) for 12 weeks.

RESULTS

The results of the current study showed a non-significant decrease in recurrence of CIN2/3 in the folate group in comparison with the placebo group (3.3% vs. 16.7%, P = 0.08). Compared with the placebo, folate supplementation significantly decreased plasma homocysteine (Hcy) levels (P < 0.001), serum insulin values (in the crude model) (P = 0.01), and homeostasis model assessment of insulin resistance (P = 0.01). Also, folate supplementation resulted in a significant improvement in the quantitative insulin sensitivity check index (P = 0.002) and total antioxidant capacity (P = 0.04) and a significant reduction in high-sensitivity C-reactive protein (P = 0.015) in comparison with the placebo group.

CONCLUSIONS

In conclusion, folate supplementation for 12 weeks among overweight/obese women with CIN2/3 showed a non-significant decrease in its recurrence and had beneficial effects on insulin sensitivity, inflammation, and oxidative stress markers.

Is Inflammation Status in Postbariatric Patients Predictive for Their Response to Vitamin B12 Supplementation Therapy?

Background

Several studies indicate that there is a relationship between vitamin B12 levels and inflammatory status. Some studies showed a significantly correlation between vitamin B12 status and inflammation. The aim of this study is to investigate the influence of inflammatory status on the effect of different vitamin B12 supplementation regimes.

Methods

We selected patients with a vitamin B12 deficiency based on methylmalonic acid (MMA) levels. A moderate vitamin B12 deficiency was defined as an MMA blood level between ≥300 and 430 nmol/L. In included patients, C-reactive protein (CRP), leukocytes, serum vitamin B12, and MMA levels were measured at baseline and after 6 months of follow-up.

Results

A total of 63 patients were included, treated with 3, 6, or no intramuscular vitamin B12 injections. In the 6 intramuscular injections group, the presupplementation CRP levels significantly predicted the response in terms of vitamin B12 increase (P = 0.015). Also, there was a significant reduction in CRP levels (P = 0.03) after 6 injections. There was a significant correlation between presupplementation MMA and presupplementation CRP (r = 0.127, P = 0.049).

Conclusion

This study showed that presupplementation CRP levels significantly predicted the response on 6 intramuscular vitamin B12 injections in patients after bariatric surgery. Second, the 6 intramuscular injection regimen showed a significant reduction in CRP levels. Third, there was a significant correlation between MMA and presupplementation CRP. This might indicate that there is interplay between the vitamin B12 supplementation and inflammatory levels in patients after bariatric surgery.

Effects of Folic Acid Supplementation on Inflammatory Markers: A Grade-Assessed Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials

It has been theorized that folic acid supplementation improves inflammation. However, its proven effects on inflammatory markers are unclear as clinical studies on this topic have produced inconsistent results. To bridge this knowledge gap, this systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of folic acid supplementation on serum concentrations of the inflammatory markers C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Methods: To identify eligible RCTs, a systematic search up to April 2021 was completed in PubMed/Medline, Scopus, Web of Science, EMBASE, Cochrane databases, and Google Scholar using relevant keywords. A fix or random-effects model was utilized to estimate the weighted mean difference (WMD) and 95% confidence interval (95% CI). Results: Twelve RCTs were included in the present meta-analysis. The pooled analysis revealed that serum concentrations of CRP (WMD: −0.59 mg/L, 95% CI −0.85 to −0.33, p < 0.001) were significantly reduced following folic acid supplementation compared to placebo, but did not affect serum concentrations of IL-6 (WMD: −0.12, 95% CI −0.95 to 0.72 pg/mL, p = 0.780) or TNF-α (WMD: −0.18, 95% CI −0.86 to 0.49 pg/mL, p = 0.594). The dose–response analysis demonstrated a significant relationship between an elevated dosage of folic acid supplementation and lower CRP concentrations (p = 0.002). Conclusions: We found that folic acid supplementation may improve inflammation by attenuating serum concentrations of CRP but without significant effects on IL-6 and TNF-α. Future RCTs including a larger number of participants and more diverse populations are needed to confirm and expand our findings.

Associations Between Different Dietary Vitamins and the Risk of Obesity in Children and Adolescents: A Machine Learning Approach

BACKGROUNDS

Simultaneous dietary intake of vitamins is considered as a common and real scenario in daily life. However, limited prospective studies have evaluated the association between multivitamins intake and obesity in children and adolescents.

OBJECTIVES

This study aimed to evaluate the relationship between the intake of different dietary vitamins and the risk of obesity in children (6-11 years) and adolescents (12-19 years).

METHODS

We conducted a cross-sectional study based on data from U.S. National Health and Nutrition Examination Survey, 2013-2016. A total of 3634 children and adolescents were included who had available data on dietary vitamins, obesity and covariates. We analyzed the dietary intake levels of nine vitamins, including vitamin A, vitamin B₁, vitamin B₂, vitamin B₆, vitamin B₁₂, vitamin C, vitamin D, vitamin E, vitamin K. Multivariate logistic regression was used to model the associations between vitamins and obesity. Bayesian kernel machine regression (BKMR) was employed to explore the joint and independent effects of vitamins on obesity among children and adolescents.

RESULTS

In the multivariate logistic regression model, five vitamins (vitamin A, vitamin B₁, vitamin B₂, vitamin B₁₂, and vitamin D) were negatively associated with obesity in children and adolescents. BKMR analysis showed that when the concentration of the nine vitamins was at or above the 55th percentile compared with the median value, the combined intake of these vitamins could significantly reduce the risk of obesity in children and adolescents. Potential interactions between vitamin B₂ and vitamin B₁₂ in increasing the risk of obesity in children and adolescents were observed.

CONCLUSIONS

We determine the combined effects of multivitamins on obesity in children and adolescents, and observe a significant interaction between vitamin B₂ and vitamin B₁₂. Further cohort studies are needed to clarify the health effects of multivitamins intake in a larger population.

Interrelations Between Inflammatory and Oxidative Stress Biomarkers in Obese Women with Two Complications (Hypertension, Diabetes)

Background and aims: Interaction between oxidative stress and inflammation has not been comprehensively investigated in the association obesity – diabetes - hypertension. Our aim was to investigate interrelations between inflammatory and oxidative stress biomarkers in obese women with two complications (hypertension, type 2 diabetes).

Material and Methods: 54 obese patients without complications, 46 diabetic patients with obesity, 48 hypertensive diabetic obese women, and 120 healthy controls were recruited from the department of nuclear medicine (Algeria). Inflammatory and oxidative stress biomarkers were assayed by appropriate methods.

Results: Inflammatory markers were significantly higher in all obese groups compared to controls. Elevated pro-oxidants and decreased antioxidant markers were noted in obese women. These alterations were accentuated when obesity was associated with hypertension and diabetes. A positive interrelationship between inflammatory mediators and oxidative status, and a negative one with antioxidants were noted during obesity. Hypertension and diabetes enhanced these correlations. Leptin, C-reactive protein, catalase, superoxide dismutase, ion superoxide, peroxynitrite were found to be the best inflammatory and oxidative stress biomarkers that can predict diabetes and hypertension in obese women.

Conclusions: oxidative stress and inflammation were intimately interconnected in women obesity associated with diabetes and hypertension.

Oxidative stress mediates depot-specific functional differences of human adipose-derived stem cells

Background

Visceral (VS) fat depot is known to have defective adipogenic functions compared to subcutaneous (SC) fat, but its mechanism of origin is unclear.

Objective

We tested our hypothesis that the degree of oxidative stress in adipose-derived stem cells (ASCs) from these depots may account for this difference.

Methods

ASCs were isolated from VS (omental region) and SC (abdominal region) fat depots of human subjects undergoing bariatric surgery. ASCs from VS and SC fat were investigated for their cellular characteristics in reactive oxygen species (ROS), metabolism, gene expression, proliferation, senescence, migration, and adipocyte differentiation. ASCs were also treated with antioxidant ascorbic acid (vitamin C).

Results

We found that human VS-derived ASCs exhibit excessive oxidative stress characterized by high reactive oxygen species (ROS), compared to SC-derived ASCs. Gene expression analyses indicate that the VS-ASCs exhibit higher levels of genes involved in pro-oxidant and pro-inflammatory pathways and lower levels of genes in antioxidant and anti-inflammatory pathways. VS-ASCs have impaired cellular functions compared to SC-ASCs, such as slower proliferation, early senescence, less migratory activity, and poor adipogenic capability in vitro. Treatment with ascorbic acid decreased ROS levels drastically in VS-ASCs. Ascorbic acid treatment substantially improved proliferation, senescence, migration, and adipogenic capacities of compromised ASCs caused by high ROS.

Conclusions

This finding suggests the fat depot-specific differences of cellular defects originating from stem cell population. Considering clinical potentials of human ASCs for cell therapies, this also offers a possible strategy for improving their therapeutic qualities through antioxidants.

Electronic supplementary material

The online version of this article (10.1186/s13287-019-1240-y) contains supplementary material, which is available to authorized users.

Vitamin B12 in Relation to Oxidative Stress: A Systematic Review

The triage theory posits that modest micronutrient deficiencies may induce reallocation of nutrients to processes necessary for immediate survival at the expense of long-term health. Neglected processes could in time contribute to the onset of age-related diseases, in which oxidative stress is believed to be a major factor. Vitamin B12 (B12) appears to possess antioxidant properties. This review aims to summarise the potential antioxidant mechanisms of B12 and investigate B12 status in relation to oxidative stress markers. A systematic query-based search of PubMed was performed to identify eligible publications. The potential antioxidant properties of B12 include: (1) direct scavenging of reactive oxygen species (ROS), particularly superoxide; (2) indirect stimulation of ROS scavenging by preservation of glutathione; (3) modulation of cytokine and growth factor production to offer protection from immune response-induced oxidative stress; (4) reduction of homocysteine-induced oxidative stress; and (5) reduction of oxidative stress caused by advanced glycation end products. Some evidence appears to suggest that lower B12 status is related to increased pro-oxidant and decreased antioxidant status, both overall and for subclinically deficient individuals compared to those with normal B12 status. However, there is a lack of randomised controlled trials and prospective studies focusing specifically on the relation between B12 and oxidative stress in humans, resulting in a low strength of evidence. Further work is warranted.

Oxidative damage and associated inflammatory risk factors in obese Emirati women. Body mass index versus waist circumference

Objectives:

To establish whether body mass index (BMI) or waist circumference (WC) is a better predictor of cardio metabolic risk factors that are associated with increased visceral fat among obese women from the United Arab Emirates (UAE).

Methods:

In this cross-sectional study, 333 obese subjects visiting community health centers in Al Ain city, UAE, were recruited between 2012 and 2015. After a written consent subjects had anthropometric, clinical and biochemical measurements. Fasting serum and plasma samples were collected for the measurement of markers of oxidative damage, antioxidants and inflammation. Outcome measures were compared between 4 equal BMI and WC quartiles.

Results:

We observed significantly higher blood pressure, c-reactive protein levels, IL6 levels, and protein carbonyls contents and lower b-carotene levels in the fourth quartile than in the first quartile for both BMI and WC (p<0.01). Glutathione peroxidase and adiponectin both decreased and TNF-a increased with increasing WC quartiles but not BMI quartiles; however, the results were statistically significant only for TNF-a (p=0.032).

Conclusion:

Both elevated BMI and elevated WC are associated with increased cardio metabolic risk factors in obese Emirati women; however, WC is a stronger predictor than is BMI.

Association between vitamin deficiency and metabolic disorders related to obesity

Inappropriate food behavior contributes to obesity and leads to vitamin deficiency. This review discusses the nutritional status of water- and fat-soluble vitamins in obese subjects. We verified that most vitamins are deficient in obese individuals, especially the fat-soluble vitamins, folic acid, vitamin B₁₂ and vitamin C. However, some vitamins have been less evaluated in cases of obesity. The adipose tissue is considered a metabolic and endocrine organ, which in excess leads to changes in body homeostasis, as well as vitamin deficiency which can aggravate the pathological state. Therefore, the evaluation of vitamin status is of fundamental importance in obese individuals.

Effect of folic acid and metformin on insulin resistance and inflammatory factors of obese children and adolescents

Background:

Considering the increasing trend of obesity, especially in developing countries such as Iran, and the role of inflammatory factors and insulin resistance (IR) in the occurrence of obesity-related complications as well as the safety of some agents such as folic acid and metformin, this clinical trial was designed to investigate the effect of metformin and folic acid on inflammatory factors and IR among obese children.

Materials and Methods:

In this randomized, double-blind, controlled clinical trial study, sixty obese children aged 6–12 years were enrolled. Selected obese children were randomly allocated in two interventional (1 mg/daily folic acid or 1000 mg metformin for 8 weeks) groups. Biochemical measurements including homeostasis model assessment of IR (HOMA-IR), homocysteine (Hcy), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8) were measured between and within the groups before and after trial.

Results:

In each group, thirty obese children were studied. The groups were age- and sex-matched. After folic acid and metformin administration, mean of Hcy, HOMA-IR, TNF-α, and IL-8 decreased significantly (P < 0.05). IL-6 decreased significantly after folic acid use (P < 0.05).

Conclusion:

The findings of this trial indicated that both metformin and folic acid could decrease IR and level of Hcy in obese children and adolescents. The effectiveness of metformin on IR was more significant than folic acid. Regarding the effectiveness of the two studied agents on inflammatory factors, it is suggested that the role of folic acid was superior to metformin. It is suggested that metformin is a proper agent for obese children with IR and folic acid is an appropriate supplement for obese children with increased inflammatory factors.

Vitamin E reduces adipose tissue fibrosis, inflammation, and oxidative stress and improves metabolic profile in obesity

OBJECTIVE

To test whether enhancing the capability of adipose tissue to store lipids using antioxidant supplementation may prevent the lipotoxic effects and improve the metabolic profile of long-term obesity.

METHODS

C57BL/6J mice were randomized into three experimental groups for 28 weeks: control group (n = 10) fed chow diet (10% kcal from fat), obese group (O, n = 12) fed high-fat (HF) diet (45% kcal from fat), and obese group fed HF diet and supplemented twice a week with 150 mg of α-tocopherol (vitamin E) by oral gavage (OE, n = 12).

RESULTS

HF diet resulted in an obese phenotype with a marked insulin resistance, hypertriglyceridemia, and hepatic steatosis in O mice. Histological analysis of obese visceral adipose tissue (VAT) revealed smaller adipocytes surrounded by a fibrotic extracellular matrix and an increased macrophage infiltration, with the consequent release of proinflammatory cytokines. Vitamin E supplementation decreased oxidative stress and reduced collagen deposition in the VAT of OE mice, allowing a further expansion of the adipocytes and increasing the storage capability. As a result, circulating cytokines were reduced and hepatic steasosis, hypertriglyceridemia, and insulin sensitivity were improved.

CONCLUSIONS

Our results suggest that oxidative stress is implicated in extracellular matrix remodeling and may play an important role in metabolic regulation.

Effects of black adzuki bean (Vigna angularis) extract on proliferation and differentiation of 3T3-L1 preadipocytes into mature adipocytes

The aim of this work was to investigate the effects of black adzuki bean (BAB) extract on adipocytes, and to elucidate the cellular mechanisms. In order to examine the proliferation of preadipocytes and differentiating adipocytes, cell viability and DNA content were measured over a period of time. Lipid accumulation during cell differentiation and the molecular mechanisms underlying the effects of BAB on the transcriptional factors involved, with their anti-adipogenic effects, were also identified. We observed that BAB exhibits anti-adipogenic effects through the inhibition of proliferation, thereby lowering mRNA expression of C/EBPβ and suppressing adipogenesis during the early stage of differentiation. This, in turn, resulted in a reduction of TG accumulation in a dose- and time-dependent manner. Treating the cells with BAB not only suppressed the adipogenesis-associated key transcription factors PPARγ and C/EBPα but also significantly decreased the mRNA expression of GLUT4, FABP4, LPL and adiponectin. The expression of lipolytic genes like ATGL and HSL were higher in the treatment group than in the control. Overall, the black adzuki bean extract demonstrated an anti-adipogenic property, which makes it a potential dietary supplement for attenuation of obesity.

Evaluation of oxidative stress levels in the conjunctival epithelium of patients with or without dry eye, and dry eye patients treated with preservative-free hyaluronic acid 0.15 % and vitamin B12 eye drops

PURPOSE

Increased levels of oxidative stress have been seen in animal models of dry eye and in the conjunctival epithelial cells of patients with Sjögren's syndrome. The aims of this study were to compare the levels of oxidative stress in patients with dry eye and patients without dry eye and to evaluate the effects of treatment with preservative-free eye drops containing hyaluronic acid 0.15 % and vitamin B12 on oxidative stress and dry eye symptoms.

METHODS

Three cohorts of patients who were to undergo planned cataract surgery were enrolled: patients with dry eye randomized to either no treatment (n = 29) or treatment (n = 32) with hyaluronic acid/vitamin B12 eye drops, and patients without dry eye (n = 42). Patients were assessed by Schirmer's type I test, fluorescein clearance test (FCT), Break Up Time (BUT), and Ocular Surface Disease Index (OSDI). Lipid peroxidation, a marker of oxidative stress, was assessed by LP-CHOLOX test.

RESULTS

Compared with patients without dry eye, patients with dry eye had significantly increased levels of oxidative stress, higher OSDI and FCT scores, and significantly lower Schirmer's test and BUT scores. Treatment with eye drops containing hyaluronic acid 0.15 % and vitamin B12 was associated with significantly reduced levels of oxidative stress and OSDI and FCT scores and significantly increased Schirmer's test and BUT scores.

CONCLUSIONS

These findings indicate that oxidative stress is associated with dry eye and that hyaluronic acid/vitamin B12 eye drops may attenuate oxidative stress and inflammation, improving dry eye symptoms. Further study in controlled clinical trials is warranted.

Oxidative damage and inflammation in obese diabetic Emirati subjects

Visceral obesity is more common in the Arab population and more closely related to morbidity, including diabetes and related cardiovascular diseases (CVD). Possible mechanisms that link visceral fat/obesity to diabetes and CVD complications include inflammation and increased oxidative stress; however, few data are available from the Arab population. Our aim was to determine whether increased adiposity in obese diabetic United Arab Emirates citizens is associated with sub-clinical inflammation and/or increased oxidative stress. A hundred diabetic patients who were part of a randomized controlled trial of nutritional supplements had their baseline characteristics assessed from anthropometric and clinical data following informed written consent. We used WHO figures to classify general and central obesity. Fasting blood samples were collected for the measurement of antioxidants and markers of oxidative damage and inflammation. We found that increased adiposity measured by both body mass index and waist circumference was associated with increased C-reactive protein (CRP) and decreased vitamin C after adjusting for age, duration and treatment of diabetes (p < 0.05). Although there is a clear trend of increased inflammatory markers, notably CRP, and decreased antioxidants with increased BMI and waist circumference in both men and women, the results are statistically significant for women only. CRP were also inversely associated with HDL. Overall, we found that BMI underestimates the rates of obesity compared to waist circumference and that increased adiposity is associated with increased inflammation and decreased HDL and antioxidant status.

The role of reactive oxygen species in obesity therapeutics

Obesity is a major risk factor for multiple severe health conditions, including cardiovascular diseases, diabetes and cancer. It is often related to an increased risk of morbidity and mortality and, as it can be accompanied by non-fatal health problems, quality of life is seriously reduced due to related conditions including hypertension, sleep apnea, osteoarthritis, respiratory problems and infertility. Evidence suggests that oxidative stress is related to obesity and its complications. In obese patients, there is an increase in levels of reactive oxygen species and nitrogen species and antioxidant defenses are undermined in comparison to normal-weight counterparts. In addition, these parameters inversely correlate with central adiposity. In this review, the authors discuss current concepts concerning the relationship between obesity and oxidative stress and mitochondrial impairment. Potential interventions to improve redox balance are also explored.

The effects of folate supplementation on inflammatory factors and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled clinical trial

OBJECTIVE

This study was conducted to determine the effects of folate supplementation on inflammatory factors and biomarkers of oxidative stress among women with polycystic ovary syndrome (PCOS).

DESIGN, PATIENTS AND MEASUREMENTS

This randomized, double-blind, placebo-controlled clinical trial was conducted among 69 women diagnosed with PCOS and aged 18-40 year old. Participants were randomly assigned to three groups receiving the following: (1) folate-1: 1 mg/d folate supplements (N = 23); (2) folate-5: 5 mg/d folate supplements (N = 23) and (3) placebo (N = 23) for 8 weeks. Fasting blood samples were taken at the beginning of the study and after 8 weeks to measure homocysteine (Hcy), inflammatory factors including high-sensitivity C-reactive protein (hs-CRP), nitric oxide (NO), biomarkers of oxidative stress including total antioxidant capacity (TAC), glutathione (GSH), malondialdehyde (MDA) and homoeostatic model assessment-beta cell function (HOMA-B).

RESULTS

Supplementation with 5 mg/d folate resulted in reduced plasma Hcy (-2·23 vs -1·86 and 1·16 μm, respectively, P < 0·05), HOMA-B (-7·63 vs 1·43 and 13·66, respectively, P < 0·05), serum hs-CRP (-212·2 vs -262·4 and 729·8 μg/l, respectively, P < 0·05) and plasma MDA concentrations (-0·48 vs -0·24 and 0·69 μm, respectively, P < 0·01) compared with folate-1 and placebo groups. Furthermore, a significant rise in plasma TAC (0·64 vs -3·53 and -215·47 mm, respectively, P < 0·01) and GSH levels (162·1 vs 195·8 and -158·2 μm, respectively, P < 0·01) was also observed following the administration of 5 mg/d folate supplements compared with folate-1 and placebo groups.

CONCLUSIONS

In conclusion, folate supplementation (5 mg/d) in women with PCOS had beneficial effects on inflammatory factors and biomarkers of oxidative stress.

Effects of the Mediterranean diet supplemented with coenzyme q10 on metabolomic profiles in elderly men and women

BACKGROUND

Characterization of the variations in the metabolomic profiles of elderly people is a necessary step to understand changes associated with aging. This study assessed whether diets with different fat quality and supplementation with coenzyme Q10 (CoQ) affect the metabolomic profile in urine analyzed by proton nuclear magnetic resonance spectroscopy from elderly people.

METHODS

Ten participants received, in a cross-over design, four isocaloric diets for 4-week periods each: Mediterranean diet supplemented with CoQ (Med + CoQ diet); Mediterranean diet; Western diet rich in saturated fat diet; low-fat, high-carbohydrate diet enriched in n-3 polyunsaturated fat.

RESULTS

Multivariate analysis showed differences between diets when comparing Med + CoQ diet and saturated fat diet, with greater hippurate urine levels after Med + CoQ diet and higher phenylacetylglycine levels after saturated fat diet in women. Following consumption of Med + CoQ, hippurate excretion was positively correlated with CoQ and β-carotene plasma levels and inversely related to Nrf2, thioredoxin, superoxide dismutase 1, and gp91(phox) subunit of NADPH oxidase gene expression. After saturated fat diet consumption, phenylacetylglycine excretion was inversely related to CoQ plasma level and positively correlated with isoprostanes urinary level.

CONCLUSIONS

The association between hippurate excretion and antioxidant biomarkers along with the relationship between phenylacetylglycine excretion and oxidant biomarkers suggests that the long-term consumption of a Med + CoQ diet could be beneficial for healthy aging and a promising challenge in the prevention of processes related to chronic oxidative stress, such as cardiovascular and neurodegenerative disease.

Visceral obesity in normal-weight patients suffering from chronic schizophrenia

BACKGROUND

BMI (body mass index) can be misleading regarding the level of adiposity in a normal-weight individual. Recently, a bioelectrical impedance analysis (BIA) method was developed that can measure body composition variables. The main objectives of this study were to use BIA to compare the body composition variables between chronic non-diabetic schizophrenic patients with normal weight and healthy individuals. The secondary objective was to compare the nutritional pattern of schizophrenia patients with that of matched healthy subjects, and to identify possible relationships between the content of different components of their diet and visceral adiposity.

METHODS

The subjects were 52 normal-weight patients (33 males and 19 females) diagnosed with schizophrenia based on the DSM-IV and 45 (23 males and 22 females) BMI- matched controls. The patients had been receiving atypical or typical antipsychotic agents for at least one year before enrollment into the study but continuously for 3 months preceding the study and were psychiatrically stable. Body fat (kg), percent (%) body fat, fat-free mass, VAT (visceral adipose tissue) and SAT (subcutaneous adipose tissue) were measured using the bioelectrical impedance analysis (BIA) method. Daily food rations (DFR) were quantitatively evaluated by a 24-h dietary recall method covering 3 days preceding the examination.

RESULTS

In normal-weight patients schizophrenia was significantly linked with higher VAT, VAT/SAT ratio and lower fat- free mass. Men had over 5 times and women over 2 times as much VAT as BMI matched groups. In women with schizophrenia and in their controls, the amount of magnesium, niacin and vitamin B6 in their diet inversely correlated with VAT, while in men lower zinc and vitamin C intake was related to higher visceral adiposity.

CONCLUSIONS

Our study has shown that normal-weight patients with chronic schizophrenia have higher levels of visceral fat (VAT) than controls but similar volume of subcutaneous adipose tissue (SAT). Although no clear conclusion can be made regarding cause-and-effect relationships between the dietary content of food served to our patients and visceral obesity, we suggest that schizophrenia diet should be further investigated as a possible factor related to this type of obesity.

Effect of antioxidants and B-group vitamins on risk of infections in patients with type 2 diabetes mellitus

Previous studies have revealed that diabetic patients have a decline in immunity and an increased risk of infections, and this may be associated with poor micronutrient status. The aim of this study was to measure the effect of dietary supplements on risk of infection in patients with type 2 diabetes mellitus. One hundred patients with type 2 diabetes mellitus were randomly assigned to receive an oral dose of daily B-group vitamins and antioxidant vitamins (n = 50) or an identical placebo (n = 50) daily for 90 days. Patients had baseline, three and 12 month assessment for nutritional status, fruits and vegetables intake, physical activity and self-reported infections. Supplementation with antioxidants and B-group vitamins significantly increased the plasma concentration of vitamin E and folate and reduced homocysteine in the intervention group (p-values were 0.006, 0.001 and 0.657, respectively). The number of infections reported by the treatment group after three months of supplements was less than that reported by the placebo group, 9 (27%) vs. 15 (36%) (p = 0.623). Corresponding numbers of infections at 12 months were 25 (67.5%) and 27 (56.3%), respectively (p = 0.488). Up to 90% of the diabetic patients were either overweight or obese with a sedentary life style, and their body weight increased further during three months of follow up. The study showed that multivitamin supplements improved vitamin blood concentrations; however, this did not reduce the number of infections in diabetic patients.