Effects of Water Restriction and Water Replenishment on the Content of Body Water with Bioelectrical Impedance among Young Adults in Baoding, China: A Randomized Controlled Trial (RCT)

Probiotic treatment induces changes in intestinal microbiota but does not alter SCFA levels in peritoneal dialysis patients-a randomized, placebo-controlled trial

The gut microbiota alterations interact with the pathogenesis and progression of chronic kidney disease (CKD). Probiotics have received wide attention as a potential management in CKD. We investigated the effects of Lactobacillus paracasei N1115 (LP N1115) on intestinal microbiota and related short-chain fatty acids (SCFAs) in end stage kidney disease patients on peritoneal dialysis (PD) in a single-center, prospective, randomized, double-blind, placebo-controlled study. The patients were randomly allocated into two groups. The intervention group (n = 38, PR group) was given the probiotics (two bags) containing fructooligosaccharide (FOS) (additive amount > 80%), maltosaccharin, and LP N1115 (additive amount > 3 × 1010 CFU/bag) every day whereas the control group (n = 19, PL group) received placebo (two bags) containing only pregelatinized starch and lactose, both for 12 weeks. In addition to collecting fecal samples for 16S rRNA gene high-throughput sequencing and SCFAs analysis, gastrointestinal (GI) symptoms were also assessed at baseline and after the intervention. Probiotics administration caused significant changes in the composition of gut microbiota, as indicated by increased abundance of beneficial bacteria (Firmicutes), decreased Bacteroidetes, and opportunistic pathogens (Fusobacterium, Bilophila) (p < 0.05). However, there was no significant difference in intestinal microbial diversity. SCFAs levels increased in PR group although the change was not statistically significant between the two groups (P > 0.05). In addition, probiotics administration could effectively reduce GI symptoms, particularly in dyspepsia and constipation (p < 0.05). Together, the results suggest that probiotics administration caused significant changes in the composition of gut microbiota and also could effectively reduce GI symptoms, particularly in dyspepsia and constipation in PD patients. Trial registration: This study was registered with the Chinese Clinical Trial Registry (Trial registration number: ChiCTR-INR-17011718; Date of the first registration: 21/06/2017).

Habitual water intake impacted the body composition of young male athletes in free-living conditions: a cross-sectional study

The study aimed to explore the associations between water intake and body composition and differences of body composition in different water itake and hydration statuses among young male athletes. A cross-sectional study was conducted among 111 young male athletes in Beijing, China. Total drinking fluids (TDF) and water from food were assessed using a 7-day, 24-h fluid intake record questionnaire and the duplicate portion method, respectively. The osmolality of 24-hour urine and blood samples was tested. Body composition was measured using a bioelectrical impedance analyzer twice at 5-min intervals. Participants were divided into two groups based on the recommendations of total water intake (TWI) and TDF in China, as well as into three groups based on 24-h urine osmolality. Pearson's correlation coefficients were calculated to determine the relationship between water intake and body composition. Chi-square tests and Student's t-tests were used to compare differences. A total of 109 participants completed the study. TDF (r = 0.230, p = 0.016; r = 0.234, p = 0.014; r = 0.242, p = 0.011) and TWI (r = 0.275, p = 0.004; r = 0.243, p = 0.011; r = 0.243, p = 0.011) were positively correlated with total body water (TBW), intracellular water (ICW), and extracellular water (ECW). TBW/body weight (BW) was positively associated with TDF percentage of BW (TDF/BW) (r = 0.267, p = 0.005), water from food percentage of BW (r = 0.217, p = 0.024), and TWI percentage of BW (TWI/BW) (r = 0.316, p = 0.001). Participants who met the TDF recommendation of China had 1.3 kg higher skeletal muscle mass (SMM), 0.9 kg higher ICW, and 0.5% higher TBW/BW than those who did not (all p < 0.05), with fat-free mass (FFM) and TBW being higher (p = 0.051; p = 0.050). Those who met the TWI recommendation of China had 1.3 kg higher SMM, 2.4 kg higher FFM, 1.1 kg higher ICW, 0.6 kg higher ECW, and 1.7 kg higher TBW than their counterparts (all p < 0.05). Moderate associations were found between water intake and body composition. No significant differences were observed among participants in three hydration statuses (all p > 0.05). Participants who met the TWI or TDF recommendations had better body composition distribution than their counterparts. Thus, habitual water intake, not hydration status, affects body composition among athletes in free-living conditions.

Association between ICW/TBW ratio and cancer prognosis: Subanalysis of a population-based retrospective multicenter study

BACKGROUND & AIMS

Disease burden is known to alter cellular integrity and water balance. Therefore, the intracellular water/total body water (ICW/TBW) ratio is used as an adjunctive indicator to predict disease severity and prognosis. The ICW/TBW ratio of patients with cancer, who typically present with low muscle mass, poor nutritional status, and high inflammatory response, reportedly differs from that of the healthy population. Herein, we aimed to evaluate the effect of the ICW/TBW ratio on the prognosis of different subgroups of patients with cancer.

METHODS

This multicenter cohort study included 2787 patients with malignancies between June 2014 and December 2018. The association between covariates and overall survival (OS) was assessed using restricted cubic spline models. The multivariate Cox regression model included variables demonstrating a statistical significance in the univariate Cox regression analysis (P < 0.05) without multicollinearity. The generated nomogram used the C-index and calibration curves to validate the predictive accuracy of the scoring system.

RESULTS

The optimal cut-off value for the ICW/TBW ratio was 0.61. The ICW/TBW ratio was an independent prognostic factor (hazard ratio [HR]: 0.621; 95 % confidence interval [CI]: 0.537-0.719, P < 0.001). Moreover, the ICW/TBW ratio had a greater impact on the prognosis of patients receiving chemoradiotherapy than on those receiving chemotherapy alone (chemoradiotherapy: HR = 0.495, P = 0.005 vs. chemotherapy: HR = 0.646, P < 0.001). Multivariate Cox regression analysis showed that sex, age, tumor stage, body mass index, neutrophil-to-lymphocyte ratio (NLR), and ICW/TBW ratio were associated with OS. Subsequently, a nomogram was developed incorporating these variables and yielded a C-index of 0.743.

CONCLUSIONS

The ICW/TBW ratio was associated with muscle mass, nutritional status, and inflammation. A low ICW/TBW ratio is an independent risk factor for poor prognosis in patients with cancer, especially when they are female, have advanced cancer stage, have sarcopenia, and are receiving radiotherapy.

Assessment of Hydration Status and Blood Pressure in a Tertiary Care Hospital at Al-Khobar

Background

High blood pressure is a major cardiovascular risk factor. It is a leading cause of increasing morbidity and mortality worldwide. One-third of the adult population worldwide suffers from hypertension. Salt intake, obesity, decreased physical activity, and smoking are well known to increase blood pressure. Fluid retention is the main contributing factor to primary hypertension and adversely affects the cardiovascular system. The emerging evidence suggests a relationship between blood pressure and hydration status. Our study aims to assess the correlation between hydration status and blood pressure. We aim to assess the hydration status in subjects with normal and high blood pressure and to investigate the association of hydration status with hemodynamic measurement.

Methodology

This cross-sectional and observational study included adult (>18 years) male and female subjects who agreed to participate. In total, 235 subjects were recruited by convenience sampling from (1) patients and caregivers attending geriatric and internal medicine clinics, and (2) visitors coming to King Fahad University Hospital at Al-Khobar. There were five patients on oral diuretics who were excluded from the study. Data were collected from September 2021 to March 2022. Hydration status was measured by a bioelectrical impedance analyzer (Bioscan 920, Maltron International Ltd. Rayleigh, UK). Hemodynamic measurements included heart rate per minute, systolic blood pressure, diastolic blood pressure, pulse pressure (the difference between systolic and diastolic blood pressure), and mean arterial pressure calculated as blood diastolic pressure plus one-third of pulse pressure. Statistical analyses were performed using SPSS statistics for windows, version 28.0 (IBM Corp., Armonk, NY, USA). Descriptive data were reported using means with standard deviations for numerical data and relative frequencies (percentage) for categorical data. P-values of less than 0.05 were considered statistically significant. Comparison between groups was done using a one-way analysis of variance test.

Results

Extracellular water percentage was higher in hypertensive (45.0 ± 2) than prehypertensive (43.5 ± 3) or normotensive (43.0 ± 2) (p = 0.001) subjects. In contrast, intracellular water percentage and total body water percentage were significantly negatively related to hypertension status.

Conclusions

Our results have shown a strong association between hypertension status and hydration parameters. In our study, hypertensive subjects tended to have lower total body water percentage and intracellular water percentage (bioimpedance value) than normotensive subjects. This might promote more research regarding the relationship between hypohydration and cardiovascular disease pathophysiology. This outcome should raise awareness about proper hydration as hypohydration can be a causative factor for hypertension.

Acute Water Supplementation Improved the Body Composition of Young Female Adults After Water Restriction of 12 h in Baoding, China: A Randomized Controlled Trial (RCT)

Insufficient intake of water may influence the balance of water in the human body. In this study, we explore the impacts of water supplementation on body composition indices among young adults after 12 h of water restriction, with the aim to determine the optimum volume of water for improving body water composition. A randomized controlled trial study was conducted among 64 young men and women in Baoding, China. After fasting overnight for 12 h, anthropometric measurements and urine and blood samples were collected as a baseline test at 8:00 a.m. of Day 2. Body composition was determined by measuring the ECW (extracellular water), ICW (intracellular water), and TBW (total body water) through bioelectrical impedance analysis (BIA). The participants were randomly divided into four groups, including water supplementation (WS) groups 1, 2, and 3, with 500, 200, and 100 mL of water, respectively, and a no water supplementation (NW) group. After 90 min, they were reassessed in a rehydration test (at 10:00 a.m. of Day 2). Repeated measurement ANOVA was used to assess the impact of water supplementation on body composition. Comparing the baseline and rehydration tests, interactions between time and volume were not significant among the men (all p > 0.05). Among women, a significant interaction was only found in ECW (p = 0.043), with TBW tending toward being significant (p = 0.055). Comparing the baseline and rehydration tests, the ECW in WS group 1, WS group 3, and the NW group all decreased (p = 0.028, p = 0.001, and p = 0.029), with reductions of 0.1, 0.3, and 0.2 kg, respectively; however, no significant decrease was observed in WS group 2 (p = 0.329). Furthermore, comparing the WS groups with the NW group in the rehydration test, the differences were not significant (p = 1.000, p = 1.000, and p = 0.288, respectively). Between men and women within groups, all of the body composition indices differed significantly, both at baseline and rehydration tests (all p < 0.05). Water supplementation led to changes in the distribution of the water content in young female adults in this study-but not men-after 12 h of water restriction, with no decrease in ECW. Finally, we found that 200 mL was the minimum volume capable of improving the water content distribution in participants in this study.

Trial Registration

[www.chictr.org.cn], identifier [ChiCTR-IOR-17011568].