Priority use of medium-chain fatty acids during high-intensity exercise in cross-country skiers

Background

One of the topics discussed in sports science is the use of medium-chain saturated fat as an energy-saving nutrient additive when approaching high-intensity exercise. The purpose of this study was to compare the blood concentrations of medium-chain and long-chain fatty acids (FAs) across different intensity loads.

Methods

Fifteen male highly trained athletes from the Russian cross-country skiing team participated in the study. Blood samples were drawn at rest, at the peak of veloergometric test with a growing exercise load till exhaustion (97–100% VO2max), and after competitions. The plasma FA profile was determined using gas-liquid chromatography.

Results

We observed a substantial increase in the concentrations of capric acid (С10:0) (+?164.1%), lauric acid (С12:0) (+?223.9%), and myristic acid (С14:0) (+?130.2%) in skiers after a sprint distance (1.3?km). A less intense increase in the concentrations of these acids (p?<?0.05) was observed after a middle length distance or cycle exercise «until exhaustion». No significant differences in long-chain saturated FA content relative to baselines during exercise tests or competitions were revealed.

Conclusions

In conclusion, the obtained results demonstrate activation of the lipolysis and the oxidation of medium-chain FA involved in the energy supply for highly trained athletes at maximum exercise loads.

     

Effects of a single dose of beetroot juice on cycling time trial performance at ventilatory thresholds intensity in male triathletes

Background

Beetroot juice (BJ) is classified as a high-level supplement for improving sports performance. There is some controversy over the benefits of BJ supplementation for endurance exercise performance, especially when referring to well-trained athletes. This study examines the effects of acute BJ supplementation on cardioventilatory responses, exercise economy/efficiency, slow component of oxygen uptake, time trial performance, blood lactate, energy consumption, and carbohydrate and fat oxidation.

Methods

Twelve well-trained, male triathletes (aged 21–47 yr) were assigned in a randomized, double-blind, crossover design to receive 70 ml of BJ (6.5 mmol NO₃^?) or placebo (PL). Three hours after taking the supplement, participants completed an endurance test on a cycle ergometer at a constant work rate (W) corresponding to first ventilatory threshold (VT1) (30 min) and second ventilatory threshold (VT2) time trial (~?15 min).

Results

Maximal oxygen uptake was 54.78?±?3.13 mL·min^??1·kg^??1, and gross efficiency was >?22% at each load intensity and experimental condition. No significant interaction effect (supplement*intensity) was observed on any of the cardioventilatory variables, efficiency/economy, VT2 time trial, energy expenditure, carbohydrate oxidation and fat oxidation (p?>?0.05).

Conclusion

Our findings do not support an improvement in the variables examined in response to acute BJ supplementation. Probably, higher doses are needed for improving time trial performance in male triathletes during a cycle ergometer test conducted at a load intensity equivalent to the first and second ventilatory threshold.

     

Development and validation of a dietary screener for carbohydrate intake in endurance athletes

Background

Studies have shown that the majority of endurance athletes do not achieve the minimal recommended carbohydrate (CHO) intake of 6 g/kg of body weight (BW), with potentially negative impacts on recovery and performance. The purpose of this study was to develop and validate a rapid and easy to use dietary screener to identify athletes who do and do not achieve a CHO intake >?6 g/kg BW in the context of endurance sports.

Methods

The dietary screener was developed using multiple logistic regression modeling of data from a sample of 1571 non-athlete adults (826 women and 745 men, mean age 44.75?±?14.2 years) among whom dietary intake was assessed using a validated web-based food frequency questionnaire (web-FFQ). Three models were developed based on whole food intake using the 5, 10 and 15 most significant variables predicting CHO intake. The three models were then validated in a target population of non-elite endurance athletes having taken part in multisport events (n =?175, 64 women and 111 men, mean age 37.1?±?11.3 years) and compared using sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) and c-statistics.

Results

The 15-variables model provided significantly better accuracy in predicting CHO intake adequacy in non-elite endurance athletes (c-statistic?=?0.94) compared with the 10- and 5-variables model (c-statistic?=?0.90 and 0.71 respectively). The 15-variables model predicts CHO intake adequacy in the target population of endurance athlete with a sensitivity of 89.5%, a specificity of 87.3% and PPV and NPV of 77.3 and 94.5%, respectively.

Conclusion

We have successfully developed a short and valid dietary screener that identifies endurance athletes at risk of not achieving a CHO intake >?6 g/kg BW. Use of this rapid screener may help alleviate the highly prevalent issue of suboptimal CHO consumption in the endurance sports realm.

     

Effect of whey protein supplementation on levels of endocannabinoids and some of metabolic risk factors in obese women on a weight-loss diet: a study protocol for a randomized controlled trial

Background

Besides the effects of dietary long chain PUFA on circulating endocannabinoids concentrations, the impact of other nutrients on these system is not known and, whether changes in plasma endocannabinoids levels correlated with changes in body composition and biochemical metabolic risk factors in obese individuals, however, still remains to be characterized.

Methods

We will conduct a 2 months’ open label, parallel-group, randomized controlled trial to determine the effect of whey protein supplementation on levels of endocannabinoids, glycemic and lipid profile, inflammatory factors, adipocytokines and body composition in 60 premenopausal obese women on a weight-loss diet.

Conclusion

Due to strong relationship between endocannabinoids level and insulin resistance and obesity, in this trial, we will illustrate the other benefits of weight loss diet on health and metabolic risk factors. Also for the first, the effects of simultaneous weight loss diet and whey protein supplementation on these variables will be determined.

Trial registration

Iranian Registry of Clinical Trials IRCT2017021410181N8.

     

The effect of chronic soluble keratin supplementation in physically active individuals on body composition,blood parameters and cycling performance

Background

Keratins are structural, thiol-rich proteins, which comprise 90% of total poultry feather weight. Their favourable amino acid profile suggests the potential for use as a protein source and ergogenic aid for endurance athletes, following treatment to increase digestibility. This study investigated whether 4 weeks of soluble keratin (KER) consumption (0.8 g/kg bodyweight/day) by 15 endurance-trained males would have favourable effects on body composition, blood and cardiorespiratory variables, and cycling performance, compared to casein protein (CAS).

Methods

Supplementation was randomized, blinded and balanced, with a minimum eight-week washout period between trials. An exercise test to measure oxygen consumption during submaximal and maximal cycling exercise was completed at the start at and end of each intervention. Anthropometric (DEXA) and blood measures were made prior to and following each intervention period.

Results

Total body mass and percentage body fat did not change significantly (p?>?0.05). However, a significantly greater increase in bone-free lean mass (LM) occurred with KER compared to CAS (0.88 kg vs 0.07 kg; p?<?0.05). While no change in LM was evident for the trunk and arms, leg LM increased (0.45?±?0.54 kg; p?=?0.006) from baseline with KER. KER was not associated with changes in blood parameters, oxygen consumption, or exercise performance (p?>?0.05).

Conclusions

These data suggest that KER is not useful as an ergogenic aid for endurance athletes but may be a suitable protein supplement for maximizing increases in lean body mass.

     

Comparison of a sports-hydration drink containing high amylose starch with usual hydration practice in Australian rules footballers during intense summer training

Background

Fluid deficits exceeding 1.6% can lead to physical and cognitive impairment in athletes. Sport drinks used by athletes are often hyper-osmolar but this is known to be suboptimal for rehydration in medical settings and does not utilize colonic absorptive capacity. Colonic absorption can be enhanced by fermentative production of short chain fatty acids (SCFA) from substrates such as high amylose maize starch (HAMS). This study therefore compared, in elite Australian Football League (AFL) players at the height of outdoor summer training, a novel dual-action sports oral rehydration strategy that contained HAMS as well as glucose, to their usual rehydration practices (Control). The primary outcome markers of hydration were hematocrit and body weight.

Methods

A randomized single-blind crossover study was undertaken in thirty-one AFL players; twenty-seven completed the study which was conducted on four days (two days in the Intervention arm and two in Control arm). The Intervention arm was comprised a 50-100 g evening preload of an acetylated HAMS (Ingredion Pty Ltd) followed by consumption of a specially formulated sports oral rehydration solution (SpORS) drink during intense training and recovery. Players followed their usual hydration routine in the Control arm. Quantitative assessments of body weight, hematocrit and urine specific gravity were made at three time-points on each day of training: pre-training, post-training (90 min), and at end of recovery (30–60 min later). GPS tracking monitored player exertion.

Results

Across the three time-points, hematocrit was significantly lower and body weight significantly higher in Intervention compared to Control arms (p <?0.02 and p =?0.001 respectively, mixed effects model). Weights were significantly heavier at all three assessment points for Intervention compared to Control arms (Δ =?0.30?±?0.13, p =?0.02 pre-training; Δ =?0.43?±?0.14, p =?0.002 post training; and Δ =?0.68?±?0.14, p <?0.001 for recovery). Between the pre-training and end-of-recovery assessments, the Control arm lost 0.80 kg overall compared with 0.12 kg in the Intervention arm, an 85% lower reduction of bodyweight across the assessment period.

Conclusion

The combination of the significantly lower hematocrit and increased body weight in the Intervention arm represents better hydration not only at the end of training as well as following a recovery period but also at its commencement. The magnitude of the benefit seems sufficient to have an impact on performance and further studies to test this possibility are now indicated.

Trial registration

Trial is listed on the Australian New Zealand Clinical Trials Registry (ACTRN 12613001373763). 

     

Dietary intake of professional Australian football athletes surrounding body composition assessment

Background

Sports Dietitians aim to assist in improving performance by developing nutrition knowledge (NK), enhancing dietary intake and optimising body composition of athletes. In a high-pressure environment, it is important to identify factors that may compromise an athlete’s nutrition status. Body composition assessments are regularly undertaken in sport to provide feedback on training adaptions; however, no research has explored the impact of these assessments on the dietary intake of professional athletes.

Methods

This cross-sectional study assessed dietary intake (7-day food diary), nutrition knowledge (Nutrition for Sport Knowledge Questionnaire) and body composition (Dual-energy X-ray absorptiometry) of 46 professional male Australian football (AFL) athletes during a 2017 pre-season training week (7 days) where body composition assessments were undertaken. Dietary intake was assessed against International Olympic Committee recommendations for professional athletes.

Results

Overall, no athlete met dietary their recommended energy intake (15?±?1.1 vs. 9.1?±?1.8 MJ, respectively) or carbohydrate recommendations (6–10 vs. 2.4?±?0.9 g·kg-1·day-1). Only 54% met protein recommendations. Secondary analyses demonstrated significant associations between education status and energy intake (P <?0.04) and vegetable intake (P <?0.03), with higher levels of education being associated with higher intakes. A moderately positive association was observed between NK scores and meeting estimated energy requirements (r =?0.33, P =?0.03). NK scores were also positively associated with protein (r =?0.35, P =?0.02), fibre (r =?0.51, P =?0.001) and calcium intakes (r =?0.43, P =?0.004).

Conclusions

This research identified that the dietary intake of professional AFL athletes during a pre-season training week where body composition assessments were undertaken did not meet current recommendations. Several factors may influence the dietary intake of AFL athletes, including lower education levels, poor NK and dietary intake restriction surrounding body composition assessment. Athletes may require support to continue with performance-based nutrition plans in periods surrounding body composition assessment.

     

Efficacy of heat-killed <Emphasis Type="Italic">Lactococcus lactis</Emphasis> JCM 5805 on immunity and fatigue during consecutive high intensity exercise in male athletes: a randomized,placebo-controlled,double-blinded trial

Background

Lactococcus lactis JCM 5805 (LC-Plasma) is a unique lactic acid bacteria (LAB) which activates plasmacytoid dendritic cells (pDC). We aimed to evaluate the effect of LC-Plasma on dendritic cell (DC) activity and subjective indices of upper respiratory tract infections (URTI) and fatigue in athletes under high intensity exercise.

Methods

We conducted a randomized, placebo-controlled, double-blinded trial. Fifty-one male subjects belonging to a university sports club were randomized into placebo (n?=?25) and LC-Plasma (n?=?26) groups. Individuals ingested placebo capsules containing cornstarch or LC-Plasma capsules containing 100 billion cells of heat-killed LC-Plasma per day for 13 days. During the intervention period, subjects performed high intensity exercise according to their sports club training regime. Blood and saliva sampling were obtained at days 1 and 14, and physical conditions were recorded in a diary. We investigated expression of maturation markers on DCs, muscle damage and stress markers and used student’s t test adjusted by Bonferoni’s method for multiple comparison between groups. These data were presented as mean?±?SD. We also investigated cumulative days of symptoms regarding infections and fatigue and used Chi-square test for comparison between groups. These data were presented as cumulative number.

Results

CD86 as maturation marker on pDC was significantly increased in the LC-Plasma group at day 14 (Placebo: 296?±?70 vs. LC-Plasma: 365?±?115; Mean Fluorescent Intensity; p?=?0.013). Cumulative days of URTI were significantly lower in the LC-Plasma group (Placebo: URTI positive 56, URTI negative 256 vs. LC-Plasma: URTI positive 39, URTI negative 299; days; p?=?0.028) and symptoms like sneeze or running nose were significantly lower in the LC-Plasma group (Placebo: Symptom positive 52, Symptom negative 258, vs. LC-Plasma: Symptom positive 36, Symptom negative 301; days; p?=?0.032). Moreover, the cumulative days of fatigue were significantly fewer in the LC-Plasma group (Placebo: Symptom positive 128, Symptom negative 182, vs. LC-Plasma: Symptom positive 110, Symptom negative 225; days; p?=?0.032). Markers of muscle damage and stress markers were not significantly different between groups.

Conclusion

We consider that heat-killed LC-Plasma supplementation relieves morbidity and symptoms of URTI via activation of pDC and decreases fatigue accumulation during consecutive high intensity exercise in athletes. However, LC-Plasma ingestion did not affect markers of muscle damage and stress.

Trial registration

UMIN-CTR, UMIN000020372. Registered 28 December 2015.

     

The influence of frequently consumed beverages and snacks on dental erosion among preschool children in Saudi Arabia

Background

To determine the prevalence of dental erosion and its association to commonly used beverages and snacks among 3 to 5 year old preschool children in Riyadh, Saudi Arabia.

Methods

Three hundred eighty-eight preschool children between 3 and 5 years old were selected from 10 different schools using a cluster random sample selection; there were 184 (47%) boys and 204 (53%) girls. The surfaces of each tooth were examined for erosion, and the level of tooth wear was recorded. Data on the frequently used beverages and snacks were obtained by questionnaires completed by the parents of the preschool children.

Results

Among the 388 children examined, 47% exhibited low erosion, 10% exhibited moderate erosion and 4% exhibited severe erosion. There was no statistically significant difference between boys and girls in terms of the prevalence of erosion. Sixty percent of the children regularly consumed juice drinks. Among daily consumers, 84% of children showed erosion prevalence with strongly significant association (p?<?0.005). Holding the drink in the mouth also showed a significant association with erosion (p?<?0.02).

Conclusion

It was concluded that an association was found between the prevalence of dental erosion and the frequency of citrus and carbonated juice consumed by the preschool children in Saudi Arabia.

     

Citrulline malate supplementation does not improve German Volume Training performance or reduce muscle soreness in moderately trained males and females

Background

Use of supplements to aid performance is common practice amongst recreationally active individuals, including those without a sufficient evidence base. This investigation sought to assess whether acute supplementation with 8 g of citrulline malate (CM) (1.11: 1 ratio) would improve anaerobic performance.

Methods

A randomised double blind placebo control trial was employed, using a counterbalanced design. We recruited recreationally active men and women to take part in an isokinetic chair protocol, based on German Volume Training (GVT) whereby participants attempted to perform 10 sets of 10 repetitions against a force representing 70% of their peak concentric force.

Results

The number of repetitions achieved over the course of the GVT was 94.0?±?7.9 and 90.9?±?13.9 for placebo and CM respectively. There was no significant difference between the placebo and CM treatment for number of repetitions (P?=?0.33), isometric (P?=?0.60), concentric (P?=?0.38), or eccentric (P?=?0.65) peak force following the GVT. Total muscle soreness was significantly higher in the CM compared to the placebo treatment following the GVT protocol over 72 h (P?=?0.01); although this was not accompanied by a greater workload/number of repetitions in the CM group.

Conclusions

We conclude that an acute dose of CM does not significantly affect anaerobic performance using an isokinetic chair in recreational active participants. Practical implications include precaution in recommending CM supplementation. Coaches and athletes should be aware of the disparity between the chemical analyses of the products reviewed in the present investigation versus the manufacturers’ claims.

     

Effects of differently shaped TiO<Subscript>2</Subscript>NPs (nanospheres,nanorods and nanowires) on the <Emphasis Type="Italic">in vitro</Emphasis> model (Caco-2/HT29) of the intestinal barrier

Background

The biological effects of nanoparticles depend on several characteristics such as size and shape that must be taken into account in any type of assessment. The increased use of titanium dioxide nanoparticles (TiO₂NPs) for industrial applications, and specifically as a food additive, demands a deep assessment of their potential risk for humans, including their abilities to cross biological barriers.

Methods

We have investigated the interaction of three differently shaped TiO₂NPs (nanospheres, nanorods and nanowires) in an in vitro model of the intestinal barrier, where the coculture of Caco-2/HT29 cells confers inherent intestinal epithelium characteristics to the model (i.e. mucus secretion, brush border, tight junctions, etc.).

Results

Adverse effects in the intestinal epithelium were detected by studying the barrier’s integrity (TEER), permeability (LY) and changes in the gene expression of selected specific markers. Using Laser Scanning Confocal Microscopy, we detected a different behaviour in the bio-adhesion and biodistribution of each of the TiO₂NPs. Moreover, we were able to specifically localize each type of TiO₂NPs inside the cells. Interestingly, general DNA damage, but not oxidative DNA damage effects, were detected by using the FPG version of the comet assay.

Conclusions

Results indicate different interactions and cellular responses related to differently shaped TiO₂NPs, nanowires showing the most harmful effects.

     

Soy versus whey protein bars: Effects on exercise training impact on lean body mass and antioxidant status

Background

Although soy protein may have many health benefits derived from its associated antioxidants, many male exercisers avoid soy protein. This is due partly to a popular, but untested notion that in males, soy is inferior to whey in promoting muscle weight gain. This study provided a direct comparison between a soy product and a whey product.

Methods

Lean body mass gain was examined in males from a university weight training class given daily servings of micronutrient-fortified protein bars containing soy or whey protein (33 g protein/day, 9 weeks, n = 9 for each protein treatment group). Training used workouts with fairly low repetition numbers per set. A control group from the class (N = 9) did the training, but did not consume either type protein bar.

Results

Both the soy and whey treatment groups showed a gain in lean body mass, but the training-only group did not. The whey and training only groups, but not the soy group, showed a potentially deleterious post-training effect on two antioxidant-related related parameters.

Conclusions

Soy and whey protein bar products both promoted exercise training-induced lean body mass gain, but the soy had the added benefit of preserving two aspects of antioxidant function.

     

Association of dietary patterns,anthropometric measurements,and metabolic parameters with C-reactive protein and neutrophil-to-lymphocyte ratio in middle-aged and older adults with metabolic syndrome in Taiwan: a cross-sectional study

Background

Metabolic syndrome is commonly associated with inflammation. The underlying factors of inflammation in metabolic syndrome are not fully understood. The objective of the study was to determine the association of dietary patterns, anthropometric measurements, and metabolic parameters with inflammatory markers in middle-aged and older adults with metabolic syndrome in Taiwan.

Methods

A total of 26,016 subjects aged ≥35 y with metabolic syndrome were recruited from Mei Jau institution between 2004 and 2013 for a cross sectional study. Metabolic syndrome was defined by the International Diabetes Federation. Multivariate logistic regression was performed to evaluate the association of dietary patterns, anthropometric measurements, and metabolic parameters with C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in men and women with metabolic syndrome. Crude and adjusted models were analyzed by gender.

Results

The western dietary pattern, obesity, high body fat, high waist or hip circumference, and high waist-to-hip ratio were significantly associated with increased odds ratios of high CRP and NLR in both genders. High systolic or diastolic blood pressure (BP), low high-density lipoprotein-cholesterol (HDL-C), high low-density lipoprotein-cholesterol (LDL-C), high total cholesterol (TC), high serum triglycerides (TG), and high fasting blood glucose (FBG) were significantly correlated with increased odds ratios of high CRP in both genders. Low HDL-C, high LDL-C, high serum TG, and high FBG were significantly associated with increased odds ratios of high NLR in both genders. However, high systolic (OR?=?1.124, 95% CI 1.047–1.206, P?<?0.01) or diastolic BP (OR?=?1.176, 95% CI 1.087–1.273, P?<?0.001) and high TC (OR?=?1.138, 95% CI 1.062–1.220, P?<?0.001) were significantly correlated with increased odds ratios of high NLR only in men.

Conclusions

The western dietary pattern, obese-related anthropometric parameters, and most components of metabolic syndrome are positively associated with CRP levels and NLR in men and women with metabolic syndrome.

     

Neuroinflammation is induced by tongue-instilled ZnO nanoparticles via the Ca<Superscript>2+</Superscript>-dependent NF-κB and MAPK pathways

Background

The extensive biological applications of zinc oxide nanoparticles (ZnO NPs) in stomatology have created serious concerns about their biotoxicity. In our previous study, ZnO NPs were confirmed to transfer to the central nervous system (CNS) via the taste nerve pathway and cause neurodegeneration after 30 days of tongue instillation. However, the potential adverse effects on the brain caused by tongue-instilled ZnO NPs are not fully known.

Methods

In this study, the biodistribution of Zn, cerebral histopathology and inflammatory responses were analysed after 30 days of ZnO NPs tongue instillation. Moreover, the molecular mechanisms underlying neuroinflammation in vivo were further elucidated by treating BV2 and PC12 cells with ZnO NPs in vitro.

Results

This analysis indicated that ZnO NPs can transfer into the CNS, activate glial cells and cause neuroinflammation after tongue instillation. Furthermore, exposure to ZnO NPs led to a reduction in cell viability and induction of inflammatory response and calcium influx in BV2 and PC12 cells. The mechanism underlying how ZnO NPs induce neuroinflammation via the Ca²⁺-dependent NF-κB, ERK and p38 activation pathways was verified at the cytological level.

Conclusion

This study provided a new way how NPs, such as ZnO NPs, induce neuroinflammation via the taste nerve translocation pathway, a new mechanism for ZnO NPs-induced neuroinflammation and a new direction for nanomaterial toxicity analysis.

     

Association between eating behaviour and diet quality: eating alone vs. eating with others

Background

To discover the association between eating alone and diet quality among Korean adults who eat alone measured by the mean adequacy ratio (MAR),

Methods

The cross-sectional study in diet quality which was measured by nutrient intakes, indicated as MAR and nutrient adequacy ratio (NAR) with the Korean National Health and Nutrition Examination Survey (KNHANES) VI 2013–2015 data. Study population was 8523 Korean adults. Multiple linear regression was performed to identify the association between eating behaviour and MAR and further study analysed how socioeconomic factors influence the diet quality of those who eat alone.

Results

We found that the diet quality of people who eat alone was lower than that of people who eat together in both male (β: ??0.110, p?=?0.002) and female participants (β: ??0.069, p?=?0.005). Among who eats alone, the socioeconomic factors that negatively influenced MAR with the living arrangement, education level, income levels, and various occupation classifications.

Conclusions

People who eat alone have nutrition intake below the recommended amount. This could lead to serious health problems not only to those who are socially disadvantaged but also those who are in a higher social stratum. Policy-makers should develop strategies to enhance diet quality to prevent potential risk factors.

     

Use of plant stanol ester margarine among persons with and without cardiovascular disease: Early phases of the adoption of a functional food in Finland

Background

The plant stanol ester margarine Benecol^® is a functional food that has been shown to lower effectively serum total and LDL-cholesterol. The purpose of this post-marketing study is to characterize users of plant stanol ester margarine with and without cardiovascular disease.

Methods

A cohort of plant stanol ester margarine users was established based on a compilation of 15 surveys conducted by the National Public Health Institute in Finland between 1996–2000. There were 29 772 subjects aged 35–84 years in the cohort. The users of plant stanol ester margarine were identified by the type of bread spread used.

Results

The plant stanol ester margarine was used as bread spread by 1332 (4.5%) subjects. Almost half (46%) of the users reported a history of cardiovascular disease. Persons with cardiovascular disease were more likely to use plant stanol ester margarine (8%) than persons without cardiovascular disease (3%). Users with and without cardiovascular disease seemed to share similar characteristics.In particular, they were elderly people with otherwise healthy life-styles and diet. They were less likely smokers, more likely physically active and less likely obese than nonusers. The users reported being in good or average health in general and having used cholesterol-lowering drugs.

Conclusion

Plant stanol ester margarine seems to be used by persons for whom it was designed and in a way it was meant: as part of efforts for cardiovascular disease risk reduction.

     

In utero exposure to extra vitamin D from food fortification and the risk of subsequent development of gestational diabetes: the D-tect study

Background

The primary aim of this study was to assess whether exposure during fetal life to extra vitamin D from food fortification was associated with a reduction in the risk of subsequently developing gestational diabetes mellitus (GDM). Furthermore, we examined whether the effect of the vitamin D from fortification differed by women’s season of birth.

Methods

This semi-ecological study is based on the cancellation in 1985 of the mandatory policy to fortify margarine with vitamin D in Denmark, with inclusion of entire national adjacent birth cohorts either exposed or unexposed to extra vitamin D in utero. The identification of GDM cases later in life among both exposure groups was based on the Danish national health registers. Logistic regression analyses generating odds ratios (ORs) and 95% confidence intervals (95% CIs) were performed.

Results

Women who were prenatally exposed to the extra vitamin D from fortification tended to have a lower risk of subsequently developing GDM than unexposed women (OR 0.87, 95%CI 0.74,1.02, P?=?0.08). When analyses were stratified by women’s season of birth, exposed women born in spring had a lower risk of developing GDM compared to unexposed subjects (OR 0.68, 95%CI 0.50,0.94, p?=?0.02).

Conclusion

This study suggests that prenatal exposure to extra vitamin D from mandatory fortification may lower the risk of developing gestational diabetes among spring-born women.

Trial registration

This study is part of the D-tect project, which is registered on clinicaltrials.gov: NCT03330301.

     

The role of soluble fiber intake in patients under highly effective lipid-lowering therapy

Background

It has been demonstrated that statins can increase intestinal sterol absorption. Augments in phytosterolemia seems related to cardiovascular disease.

Objective

We examined the role of soluble fiber intake in endogenous cholesterol synthesis and in sterol absorption among subjects under highly effective lipid-lowering therapy.

Design

In an open label, randomized, parallel-design study with blinded endpoints, subjects with primary hypercholesterolemia (n = 116) were assigned to receive during 12 weeks, a daily dose of 25 g of fiber (corresponding to 6 g of soluble fibers) plus rosuvastatin 40 mg (n = 28), rosuvastatin 40 mg alone (n = 30), sinvastatin 40 mg plus ezetimibe 10 mg plus 25 g of fiber (n = 28), or sinvastatin 40 mg plus ezetimibe 10 mg (n = 30) alone.

Results

The four assigned therapies produced similar changes in total cholesterol, LDL-cholesterol, and triglycerides (p < 0.001 vs. baseline) and did not change HDL-cholesterol. Fiber intake decreased plasma campesterol (p < 0.001 vs. baseline), particularly among those patients receiving ezetimibe (p < 0.05 vs. other groups), and β-sitosterol (p = 0.03 vs. baseline), with a trend for lower levels in the group receiving fiber plus ezetimibe (p = 0.07). Treatment with rosuvastatin alone or combined with soluble fiber was associated with decreased levels of desmosterol (p = 0.003 vs. other groups). Compared to non-fiber supplemented individuals, those treated with fibers had weight loss (p = 0.04), reduced body mass index (p = 0.002) and blood glucose (p = 0.047).

Conclusion

Among subjects treated with highly effective lipid-lowering therapy, the intake of 25 g of fibers added favorable effects, mainly by reducing phytosterolemia. Additional benefits include improvement in blood glucose and anthropometric parameters.

     

Effects of cyclic parenteral nutrition on parenteral-associated liver dysfunction parameters

Introduction

One of the most common complications of parenteral nutrition (PN) is liver dysfunction (LD). Therapeutic approaches for LD include, among others, administering cyclic parenteral nutrition (cPN), allowing some hours for metabolic rest. The purpose of this study was to evaluate the effectiveness of cPN in treating PN-associated LD.

Materials and methods

A retrospective observational study was carried out at the Costa del Sol Hospital in Spain between 2013 and 2014. The study involved inpatients ≥18 years old prescribed with cPN due to the development of PN-associated LD. The hepatic biochemical parameters measured at baseline and after completion of cPN included aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP) and total bilirubin (TB). Quantitative values (age, biochemical parameters) were compared using matched Student’s t-test; the mean change in qualitative variables (sex, indication of PN, hepatic comorbidities, presence of insulin in cPN, infection during cPN, management of LD prior to cPN administrarion) was estimated using Mann-Whitney U test, and bivariate correlation between quantitative variables was determined by Spearman’s coefficient of correlation.

Results

Thirty-seven patients met inclusion criteria. All hepatic function parameters except ALP improved after the administration of cPN, with statistically significant differences (p < 0.05) in AST GGT and TB.

Conclusion

cPN improves PN-associated LD by restoring abnormal AST, GGT, and BT levels to normal, and reducing ALT levels close to normal. The results obtained suggest that the administration of cPN is effective in reverting PN-associated LD.