REVIEW | doi:10.20944/preprints202008.0299.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Obesity; Eating Disorders; Adolescents; Prevention programs; Systematic Review
Online: 13 August 2020 (10:38:34 CEST)
An effective behavior changes program is the first-line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support among other environmental factors. The aim of this systematic review was to compare the impact of two types of obesity prevention programs, inclusive of behavior change components on weight outcomes. Energy-balance studies were aimed at reducing calories from high-energy sources and increasing PA levels, while “shared risk factors for obesity and eating disorders” focused on reducing disordered eating behaviors to promote a positive relationship with food and eating. A systematic search of ProQuest, PubMed, PsycInfo, SciELO, and Web of Science identified 8825 articles. Twenty were considered “energy-balance” and fifteen “shared-risk factors for obesity and eating disorders”. Overall, energy-balance studies were unable to support a maintenance weight status, diet, and PA over time. Shared risk factors programs also did not result in significant differences in weight status over time. However, the majority of shared risk factors studies demonstrated reduced body dissatisfaction, dieting, and weight-control behaviors. More research is needed to examine how a shared risk factor approach can address both obesity and eating disorder.
Sun, 9 August 2020
Online: 9 August 2020 (22:21:25 CEST)
Purpose: Excessive intake of fat and fatty acids is associated with major health hazards such as obesity or chronic diseases. The aim of this study is to provide the first data on total fat, SFA and TFA intakes and their major food sources in Tunisian children. Methods: A total of 1200 children, aged 3 to 9 years old, were randomly selected from primary schools and kindergarten under a cross-sectional design. The 24hour recall method and food frequency questionnaire were used to assess dietary intake over a period of one week. Results: The energy percentages of total fat, SFA and TFA in Tunisian children were respectively 29.6, 11.4 and 0.15. No sex differences were found. The WHO recommendations for total fat, SFA and TFA were adopted by 58 %, 39 % and 89 % of the study population, respectively. The leading food groups of fat and fatty acids were ultra-processed foods, bread and cereals and dairy products. The meat, fish, eggs and fish alternatives were the fifth main contributors to the total fat and SFA intakes in Tunisian children. Conclusion: The implementation of a relevant strategy for fat reduction, especially from ultra-processed foods, considered as low nutrient energy-dense products, is needed to promote health among children and prevent diet-related chronic diseases.
Fri, 7 August 2020
REVIEW | doi:10.20944/preprints202008.0174.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: diet; plant sterols; stanols; omega-3 fatty acids; familial hypercholesterolemia
Online: 7 August 2020 (06:13:47 CEST)
Background: Although a cholesterol-lowering diet and the addition of plant sterols and stanols are suggested for the lipid management of children and adults with familial hypercholesterolemia, there is limited evidence evaluating such interventions in this population. Objectives: To investigate the impact of cholesterol-lowering diet and other dietary interventions on the incidence or mortality of cardiovascular disease and lipid profile of patients with familial hypercholesterolemia. Search methods: Relevant trials were identified by searching US National Library of Medicine National Institutes of Health Metabolism Trials Register and clinicaltrials.gov.gr using the following terms: diet, dietary, plant sterols, stanols, omega-3 fatty acids, fiber and familial hypercholesterolemia. Selection criteria: Randomized controlled trials evaluating the effect of cholesterol-lowering diet or other dietary interventions in children and adults with familial hypercholesterolemia were included. Data collection and analysis: Two authors independently assessed the trial eligibility and bias risk and one extracted the data, with independent verification of data extraction by a colleague. Results: A total of 17 trials were finally included, with a total of 376 participants across 8 comparison groups. The included trials had either a low or unclear bias risk for most of the parameters used for risk assessment. Cardiovascular incidence or mortality were not evaluated in any of the included trials. Among the planned comparisons regarding patients’ lipidemic profile, a significant difference was noticed for the following comparisons and outcomes: omega-3 fatty acids reduced triglycerides (mean difference [MD]: -0.27 mmol/L, 95% confidence interval [CI]: -0.47 to -0.07, p<0.01) when compared with placebo. A non-significant trend towards a reduction in subjects’ total cholesterol (MD: -0.34, 95% CI: -0.68 to 0, mmol/L, p=0.05) and low-density lipoprotein cholesterol (MD: -0.31, 95% CI: -0.61 to 0, mmol/L, p=0.05) was noticed. In comparison with cholesterol-lowering diet, the additional consumption of plant stanols decreased total cholesterol (MD: -0.62 mmol/l, 95% CI: -1.13 to -0.11, p=0.02) and low-density lipoprotein cholesterol (MD: -0.58 mmol/l, 95% CI: -1.08 to -0.09, p=0.02). The same was by plant sterols (MD: -0.46 mmol/l, 95% CI: -0.76 to -0.17, p<0.01 for cholesterol, and MD: -0.45 mmol/l, 95% CI: -0.74 to -0.16, p<0.01 for low-density lipoprotein cholesterol). No heterogeneity was noticed among the studies included in these analyses. Conclusions: Available trials confirm that the addition of plant sterols or stanols has a cholesterol-lowering effect on such individuals. On the other hand, supplementation with omega-3 fatty acids effectively reduces triglycerides and might have a role in lowering the cholesterol of patients with familial hypercholesterolemia. Additional studies are needed to investigate the effectiveness of a cholesterol-lowering diet or the addition of soya protein and dietary fibers to a cholesterol-lowering diet in familial hypercholesterolemia.
Wed, 5 August 2020
REVIEW | doi:10.20944/preprints202008.0119.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: astaxanthin; cardiovascular disease; atherosclerosis; inflammation; oxidative stress; carotenoids; antioxidant
Online: 5 August 2020 (09:53:14 CEST)
Cardiovascular disease is the most common cause of death. Oxidative stress and inflammation are pathophysiological processes involved in the development of cardiovascular diseases, so anti-inflammatory and antioxidant agents that modulate redox balance have become the targets of research to evaluate their molecular mechanisms and therapeutic properties. Astaxanthin, a carotenoid of the xanthophyll group, has potent antioxidant effects due to its molecular structure and its arrangement in the plasma membrane, factors that favor the neutralization of reactive oxygen and nitrogen species. This carotenoid also stands out for its anti-inflammatory activity, possibly interrelated with its antioxidant effect, as well as for its modulation of lipid and glucose metabolism. Considering the potential positive effects of astaxanthin on cardiovascular health evidenced by preclinical and clinical studies, this paper describes the molecular and cellular mechanisms related to the antioxidant and anti-inflammatory properties of this carotenoid in cardiovascular diseases, especially atherosclerosis.
Sun, 2 August 2020
ARTICLE | doi:10.20944/preprints202008.0041.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: COVID-19; Lockdown; endocrine diseases; daily habits; food consumption; sleep disorders; anxiety
Online: 2 August 2020 (15:32:38 CEST)
In March 2020 the World Health Organization declared the “pandemic state” due to COVID-19 imposing strict confinement of the world population. People were forced to spend more time at home, changing some daily routines, including social interactions, the possibility to perform sports, and diet habits. These changes could exert a greater impact on patients suffering from chronic diseases, such as endocrine patients. This study aimed to assess the effects of Covid-19 induced quarantine on daily habits in a group of patients with endocrine disorders, focusing on food consumption, eating, and sleep habits during the confinement. Eighty-five endocrine patients were enrolled. A structured interview was administered investigating: socio-demographic information, general medical conditions and habits adopted during the quarantine. All patients underwent the Spielberger State Anxiety Inventory (STAI-Y1) to assess state anxiety. Subjects had mainly a sedentary lifestyle. We found a significant increase in the number of cigarettes in smokers, an increase of meals consumed during the confinement and a high rate of sleep disorder occurrence, especially insomnia. The changes of daily habits were, probably, due to the alterations of routine, that determined more bore and inactivity during the day.
ARTICLE | doi:10.20944/preprints202008.0006.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: sustainable diet; carbon footprint; recommended nutrient intake; Malaysia
Online: 2 August 2020 (09:29:46 CEST)
A sustainable diet which is healthy and environmental friendly is a climate change mitigation option in addition to being a health promoting diet. However, there is a scarcity of information if the Asian diets are sustainable. Therefore, this study aimed to investigate if the diet of the Malaysian population is healthy and sustainable. This is a cross sectional study using dietary data generated from food frequency questionnaires (FFQ). The carbon footprint data were linked with the food items/ food groups in the FFQ. The nutrients of the participants’ diet were computed and the proportions of those who met the recommended nutrients intake were established. Contribution of carbon footprint for different food groups and total carbon footprint for each participant’s diet were computed and expressed as kgCO2eq. Comparison of carbon footprint from participants’ diets between age, sex and ethnicity were carried out. A total of 4825 participants were included in the analysis. Majority were Malays (66.4 %), females (84.0%), married (80.0%) and in the age groups of 30s to 40s (68.8%). The mean total energy intake was 2485+1000 kcal/day. Only 40 to 60% of all participants achieved the Malaysia Recommended Nutrient Intake (RNI) for calcium and less than half of the female participants who were aged 50 years and below fulfilled the RNI for iron. The most commonly consumed food groups were vegetables (270g/day), wheat, rice, fruits, sugar, seafood, poultry, legumes, snacks, milk and beef (46g/day). Total carbon footprint from the participants’ diets were 2.96 kgCO2eq/day, with the highest contributions of carbon footprint from rice, vegetables, beef, sugar, other cereals, poultry, seafood, wheat, milk, fruits, legume and snacks. Subgroups such as males, Malays and younger participants were more likely to consume diets with higher carbon footprint, compared to their counterparts. The participants’ diet was low in carbon footprint and environmentally friendly, however the quality of diet may need to be improved. Education measures should be targeted for all population and specifically for the sub-groups that consumed diets with higher carbon footprint.
ARTICLE | doi:10.20944/preprints202008.0004.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: food outlet usage; obesity; energy intake; energy contents
Online: 2 August 2020 (08:21:45 CEST)
Background: The frequency of visits to restaurants has been suggested to contribute to the pandemic of obesity. However, few studies have examined how individual use of these restaurants is related to BMI using new technology of reminding to avoid memory error. Aim: To investigate the association between the usage of different types of food outlets and BMI among adults in Scotland. Method: The study was cross-sectional. Participants (n = 681) completed an online survey for seven consecutive days where all food purchased at food outlets was reported each day. We explored the relationship between BMI and usage of these restaurants using auto-reminder text system. Results: Body Mass Index (BMI) of both males and females was not related to frequency of use of Full-Service Restaurants (FSRs), Fast Food Restaurants (FFRs), delivery or takeaways, when assessed individually, or combined (TFO= Total Food Outlet). Conclusion: These data do not support the widespread belief that consumption of food out of the home at fast-food and full-service restaurants, combined with that derived from deliveries and takeaways, is a major driver of obesity in UK.
Thu, 23 July 2020
REVIEW | doi:10.20944/preprints202007.0533.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Macronutrients; Micronutrients; COVID-19; SARS-CoV-2; Immunity; Complications;
Online: 23 July 2020 (07:09:30 CEST)
The novel coronavirus diseases 2019 (COVID-19) has unfolded an unprecedented worldwide public health emergency with disastrous economic consequences. Around 12 million coronavirus cases have already been identified with over half a million death. Despite numerous efforts by government as well as international organizations, these numbers are still increasing with a surprising rate. Although urgent and absolutely necessary, a reliable therapeutic or vaccine is still elusive and this status quo may remain for an uncertain period of time. Taken that into account, boosting up adaptive immunity through nutritional interventions may help subside this epidemic and save many lives. This review focuses on the nexus between a balanced diet and adaptive immunity, particularly, how poor diet may lead to compromised immunity resulting in susceptibility to the viral infections. Additionally, we discuss how nutrients (vitamins, minerals, trace elements) could be used as a tool to modulate immune response and thus impede viral infections. The study also summarized nutritional recommendations to combat COVID-19 in different countries and territories and dietary sources of those key nutrients. Moreover, different nutritional intervention strategies based on different age groups, physiological and medical conditions were also included, and the challenges of nutritional interventions towards the care of COVID-19 patient were also discussed. Since the availability of a drug or vaccine is still uncertain, a balanced diet or nutrient therapy could be used as a robust strategy to combat COVID-19. Thus, we hope this review may help to make an informed decision with regard to diet choice both at individual level as well as clinical settings.
Wed, 22 July 2020
ARTICLE | doi:10.20944/preprints202007.0531.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: dietary calcium intake; osteoporosis; fractures
Online: 22 July 2020 (14:11:35 CEST)
A low calcium intake is associated with an increased fracture risk. We assessed the dietary calcium intake in a cohort of Italian individuals evaluated for low bone mineral density (BMD). A 7-day food-frequency questionnaire was administered to 1793 individuals consecutively referred at a Centre of the Italian Society for Osteoporosis, Mineral Metabolism and Skeletal Diseases for low BMD. In 30.3% (544/1793) and 20.9% (374/1793) of subjects the calcium intake was inadequate ( <700 mg/day) and adequate (>1200 mg/day), respectively. Patients with calcium intake <700 mg/day showed a higher prevalence of diabetes mellitus, idiopathic hypercalciuria and food allergy/intolerance (8.1%, 5.1%, 7.2%, respectively) than patients with calcium intake >700 mg/day (5.3%, 3.0%, 4.1%, respectively, p<0.04 for all comparisons), also after adjusting for age, gender and BMI. In 30.3% of fractured subjects the calcium intake was <700 mg/day. In Italy, a low calcium intake is highly prevalent in individuals at risk for low BMD. Importantly, an inadequate calcium intake is highly prevalent even in patients with history of fragility fractures. Only about a fifth of patients at risk for low BMD reported an adequate calcium intake
Tue, 21 July 2020
ARTICLE | doi:10.20944/preprints202007.0473.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Pregnancy; Iodine; Dietary habits; Iodine supplement, Urinary iodine concentration
Online: 21 July 2020 (03:42:20 CEST)
Background: The nutritional status of women during pregnancy can have a considerable effect on maternal and fetal health, and on perinatal outcome. The aim was to assess the changes occurring in dietary iodine intake, KI supplementation, and smoking habit, and the impact of these changes on the urinary iodine concentration (UIC) during pregnancy in a population of women in Catalonia (Spain). Methods: Between 2009-2011 an observational study including a cohort of women whose pregnancy was monitored in the publically-funded health system in a central region of Catalonia. Women received individual educational counseling imparted, a dietary questionnaire was completed, and a urine sample collected for iodine determination at each trimester visit. Results: 633 (67.9%) women answered the questionnaire at all 3 visits. The percentage of women with a desirable UIC (≥150μg/L) increased from the first to the second trimester and remained stable in the third (p<0.001). Analysis of the relationship between UIC≥150 μg/L and the women’s dietary habits showed that the percentage with UIC≥150 μg/L increased with greater consumption of milk, fresh vegetables, and fruit in the first trimester, and the same was true for iodized salt use in all three trimesters and iodine supplementation in all three. Conclusion: During pregnancy increased intake of milk, iodized salt, and iodine supplements was associated with an increase in the UIC.
Thu, 16 July 2020
ARTICLE | doi:10.20944/preprints202007.0343.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: protein; exercise; muscle damage; creatine kinase; myoglobin; inflammation
Online: 16 July 2020 (06:33:18 CEST)
This randomized trial compared pea protein, whey protein, and water-only supplementation on muscle damage, inflammation, delayed onset of muscle soreness (DOMS), and physical fitness test performance during a 5-day period after a 90-minute eccentric exercise bout in non-athletic, non-obese males (n=92, ages 18-55 years). The two protein sources (0.9 g protein/kg divided into three doses/day) were administered under double blind procedures. The eccentric exercise protocol induced significant muscle damage and soreness, and reduced bench press and 30-second Wingate performance. Whey protein supplementation significantly attenuated post-exercise blood levels for biomarkers of muscle damage compared to water-only, with large effect sizes for creatine kinase and myoglobin during the 4th and 5th days of recovery (Cohen's d >0.80); pea protein versus water supplementation had an intermediate, non-significant effect (Cohen's d <0.50); and no significant differences between whey and pea protein were found. Whey and pea protein compared to water supplementation had no significant effects on post-exercise DOMS and the fitness tests. In conclusion, high intake of whey protein for 5 days after intensive eccentric exercise mitigated efflux of muscle damage biomarkers, with intake of pea protein having an intermediate effect in part due to the 24% lower leucine amino acid content.
Wed, 15 July 2020
ARTICLE | doi:10.20944/preprints202007.0338.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: bacteriophage; Bifidobacterium; gut microbiota; intestinal health; microbiome; probiotic
Online: 15 July 2020 (12:32:41 CEST)
Probiotics are increasingly used by consumers and practitioners to reduce gastrointestinal (GI) distress and improve gut function. Here, we sought to determine whether addition of supplemental bacteriophages (PreforPro) could enhance the effects of a common probiotic, Bifidobacterium animalis subsp. lactis (B. lactis) on GI health. We conducted a 4-week, randomized, parallel-arm, double-blind, placebo-controlled trial where primary outcomes included self-assessments of GI health, a daily stool log, and 16s rRNA analysis of gut microbial populations. We observed within group improvements in GI inflammation (p=0.01) and a trending improvement in colon pain (p=0.08) in individuals consuming B. lactis with PreforPro, but not in the group consuming only the probiotic. There was also a larger increase in Lactobacillus and short chain fatty acid-producing microbial taxa detected in stool of participants taking PreforPro with B. lactis compared to the probiotic alone. Overall, these results suggest the addition of PreforPro as a combination therapy may alter gut ecology to extend the GI benefits of consuming B. lactis or other probiotics.
Thu, 9 July 2020
ARTICLE | doi:10.20944/preprints202007.0197.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Maternal diet; Dietary behaviour change intervention; Nutrition education; Balanced plate; Qualitative methods
Online: 9 July 2020 (16:15:13 CEST)
Social, cultural, environmental and economic factors closely regulate the selection, allocation and consumption of maternal diets. We developed a nutrition behaviour change intervention to promote a balanced diet in pregnancy through practical demonstration in rural Bangladesh and tested the impact with a cluster randomised controlled trial. This paper presents the findings of the process evaluation and describes the strategies that worked for intervention compliance. We conducted in-depth interviews with pregnant women, women who birthed recently, and their husbands; focus groups with mothers and mothers-in-law; key-informant interviews with community health workers, and observation of home visits. We identified six key areas within the intervention strategy that played a crucial role in achieving the desired adherence. These included practical demonstration of portion sizes; addressing local food perceptions; demystifying animal-source foods; engaging husbands and mothers-in-law; leveraging women’s social networks; and harnessing community health workers’ social role. Practical demonstration, opportunity to participate and convenience of making of the plate with the food available in their kitchen or neighbours’ kitchen were the most commonly mentioned reasons for acceptance of the intervention by the women and their families. The balanced plate intervention helped women through practical demonstration to learn about a balanced meal by highlighting appropriate portion sizes and food diversity. The women needed active involvement of community health workers in mobilising social support to create an enabling environment essential to bring changes in dietary behaviours. Programs to promote a nutritious maternal diet should focus on encouraging the use of healthy foods through practical demonstration of portion sizes and engagement of the women and family instead of replicating the traditional information-based counselling.
Wed, 8 July 2020
ARTICLE | doi:10.20944/preprints202007.0147.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: gut microbiota; obesity; weight-loss; Mediterranean diet; 16S rRNA; High-throughput sequencing
Online: 8 July 2020 (11:07:10 CEST)
Although it is known that the gut microbiota (GM) can be modulated by diet, the efficacy of specific dietary interventions in determining its composition and diversity in obese patients remains to be ascertained. The present work aims to evaluate the impact of a moderately hypocaloric Mediterranean diet on the GM of obese and overweight patients (OB). The GM of 23 OB patients (F/M= 20/3) was compared before (T0) and after 3 months (T3) of the nutritional intervention (NI). Fecal samples were analyzed by Illumina MiSeq sequencing of the 16S rRNA gene. At baseline, the GM characterization confirmed the typical obesity-associated dysbiosis. After 3 months of NI, patients presented a statistically significant reduction of the body weight and fat mass, along with changes in the relative abundance of many microbial patterns. In fact, we observed an increased abundance in several Bacteroidetes taxa (i.e. Sphingobacteriaceae, Sphingobacterium, Bacteroides spp., Prevotella stercorea) and depletion of many Firmicutes taxa (i.e. Lachnospiraceae members, Ruminococcaceae and Ruminococcus, Veillonellaceae, Catenibacterium, Megamonas). In addition, the phylum Proteobacteria showed an increased abundance, while the genus Sutterella, within the same phylum, decreased after the intervention. Metabolic pathways, predicted by bioinformatic analyses, showed a decrease in membrane transport and cell motility after NI. The present study extends our knowledge of the GM profiles in OB, highlighting the potential benefit of a moderate caloric restriction in counteracting the gut dysbiosis.
Tue, 7 July 2020
ARTICLE | doi:10.20944/preprints202007.0106.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: polygenic risk; wellness; food frequency; principal component analysis; healthy eating index; obesity; food desert
Online: 7 July 2020 (02:36:11 CEST)
Diet influences, and is influenced by, a wide range of socioeconomic, cultural, geographic, and genetic variables. Here we survey a matrix of such interactions as well as their connection to a variety of health outcomes, in a cohort of 689 diverse adults employed at Emory University and enrolled in the Center for Health Discovery and Well-Being (CHDWB) study. Principal component analysis (PCA) of the Block Food Frequency Questionnaire revealed seven PC cumulatively explaining 25.8% and each individually at least 2% of the proportional consumption of 110 food items. PC1 is strongly correlated with the Healthy Eating Index-2015 measure, and accordingly healthier scores associate with multiple measures of physical and mental health. It, as well as PC2 (likely a measure of food expense) and PC3 (carbohydrate versus protein consumption) show significant geographic structure across the Atlanta metropolitan area, correlating with race and ethnicity, income level, age and sex. Notably, a polygenic score for body mass index (BMI) consisting of 281 SNPs explains 2.8% of the variance in PC5, which is as strong as its association with BMI itself. PC5 appears to differentiate participants with respect to conscious eating behavior related to the choice of diet or comfort foods. Our analysis adds to the growing literature on factor analysis of socio-demographic influences on nutrition and health.
Sun, 5 July 2020
ARTICLE | doi:10.20944/preprints202007.0058.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Rural; Food System; Inequities; Disparities; Food Security
Online: 5 July 2020 (09:13:17 CEST)
We seek to elucidate an aspirational vision for the food system and explore whether the characteristics of such a system inadvertently set unattainable standards for rural, low wealth communities. We apply discourse analysis to the following qualitative datasets: (1) interviews with food experts and advocates, (2) scholarly and grey literature, (3) industry websites, and (4) email exchanges between food advocates. The analysis revealed eight aspirational food system discourses: Production, Distribution, and Infrastructure; Healthy, Organic, Local Food; Behavioral Health and Education; Sustainability; Finance and Investment; Huger Relief; Demand Side Preferences; Romanticized, Community Led Transformations. Study findings reveal that of eight discourses only three encompass the experiences of rural, low wealth residents. This aspirational food system may result in the disempowerment of the needs of rural, low wealth groups; a perpetuation of the failure of groups who will be unable to reach the aspirational food vision; silencing of discourses that might question those that play a role in the inequitable distribution of income while sanctioning discourses that focus on personal or community solutions; and the absence of other policy-based solutions that address issues located within the food system. Further research is needed to inform policies and programs to mitigate food insecurity in rural, low wealth populations.
Sun, 28 June 2020
SHORT NOTE | doi:10.20944/preprints202006.0348.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Nutraceuticals; pharmaceuticals; medical approach; therapeutic; therapies; emerging companies
Online: 28 June 2020 (20:10:09 CEST)
Nutraceuticals are combination of nutrients and pharmaceuticals and these are derived from various plants, microbes and animals too. The food products that are considered as nutraceuticals are categorised based on the availability in the market. It is a medical approach to improve health and remedy for illness. Nowadays there is an increase in shift towards use of nutraceuticals as its usage provides preventive therapies to various chronic diseases. Various natural nutraceuticals are based on extracts from Ginger, turmeric, garlic, amla, cinnamon, aloe vera etc. A wide variety of therapeutic values are provided by them such as anti-inflammatory, antibacterial, antifungal properties, allergy relief, antidiabetic and cardiovascular problems. India is in its infancy stage but have many emerging companies that are trying to meet the demand of growing population. Overall ‘Nutraceuticals’ has been known as a new era of well being, in which the food industry has become a main player.
REVIEW | doi:10.20944/preprints202006.0321.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Citrus fruits; Citrus sinensis; hesperidin; COVID-19; vitamin C; SARS-CoV-2; sweet orange
Online: 28 June 2020 (08:45:24 CEST)
Among the many approaches to COVID-19 prevention, the possible role of diet has so far been somewhat marginal. Nutrition is very rich in substances with a potential beneficial effect on health and some of these could have an antiviral action or in any case be important in modulating the immune system and in defending cells from the oxidative stress associated with infection. This short review draws the attention on some components of Citrus fruits and especially of the orange (Citrus sinensis), well known for its vitamin content, but less for the function of its flavonoids. Among the latter, hesperidin has recently attracted the attention of researchers, because it binds to the key proteins of the SARS-CoV-2 virus. Several computational methods, independently applied by different researchers, showed that hesperidin has a low binding energy both with the coronavirus "spike" protein, and with the main protease that transforms the early proteins of the virus (pp1a and ppa1b) into the complex responsible for viral replication. The affinity of hesperidin for these proteins is comparable if not superior to that of common chemical antivirals. The preventive efficacy of vitamin C, at dosage attainable by diet, against viral infections is controversial, but recent reviews suggest that this substance may be useful in case of increased stress on the immune system. Finally, the reasons that suggest undertaking appropriate research on the Citrus fruits addition in the diet, as a complementary prevention and treatment of COVID-19, are discussed.
Fri, 26 June 2020
REVIEW | doi:10.20944/preprints202006.0311.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: functional food; dietary supplement; phytochemicals; nutritional neuroscience; gut microbiome; personalized nutrition; Bangladesh
Online: 26 June 2020 (12:23:14 CEST)
Plants and plant-derived food products have been used for medicinal purposes since the ancient. Medicinal Plant-based functional foods or plant-based dietary compounds are a re-emerged interest for their therapeutic benefits and nutritive supports which has implicated in healthcare systems across the world. Neurological disorders are one of the greatest threats to public health and according to the World Health Organization, about 100 million people are affected globally by several neurological and mental ailments. In a traditional medication system, medicinal plants have been applied as both neuro-therapeutic purposes and micro-macro nutrients provider for the wellbeing of psychological states e.g. anti-depressant, anti-anxiety, anti-convulsions, anti-dementia, anti-psychotic, etc. Herein, it is a topic of great interest to present a conceptual aspect by reviewing relevant scientific literature about the plant-based functional foods or bioactive phytochemicals for the prevention and treatment of mental and neurological disorders. From the literature assessment, we have found that nutritional neuroscience is becoming an advanced research discipline and there has been a growing pile of evidence concerning the therapeutic use of plant-based functional foods and/or plant-derived food compounds for the management of neurologic health, evolving with promising impact over the time.
Wed, 24 June 2020
ARTICLE | doi:10.20944/preprints202006.0291.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: food exchange list; sports foods; dietary supplements; dietetic practice; menu planning
Online: 24 June 2020 (09:41:43 CEST)
Food exchange lists have been widely used in dietary practice in health and disease situations, but there are still no exchange lists for sports foods. The aim of this study was to develop a sports foods exchange list based on previously published statistical criteria. A cross-sectional study of the nutritional composition of sports foods, regarding macronutrients and energy, was carried out. A total of 323 sports foods from 18 companies were selected and divided into seven groups: sports drinks; sports gels; sports bars; sports confectionery; protein powders; protein bars; and liquid meals. A sports foods composition database based on portion size was created. Food exchange groups, with the definition of the amounts - in grams - of each sports foods within each group, were designed using the same methodology and statistical criteria as previously published. The nutritional composition of the portions usually consumed by athletes and/or recommended in commercial packaging was used to calculate the mean energy and macronutrient values for each group. Within each sports foods group, different subgroups were defined due to differences in the main and/or secondary macronutrient. The mean nutrient values of each exchange group and the subgroups were determined according to previously established rounding criteria. This sports foods exchange list, made up of commercial sports products, is a novel tool for dietetic practice. Its management will allow dietitians to adapt dietary plans more precisely to the training and/or competition of the athlete.
Sun, 21 June 2020
ARTICLE | doi:10.20944/preprints202006.0274.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: adolescent idiopathic scoliosis; bone turnover markers; leptin; body composition
Online: 21 June 2020 (14:33:41 CEST)
The link between scoliotic deformity and bone metabolism in adolescent idiopathic scoliosis (AIS) has not been well researched. Moreover, the data concerning the cross-talk between fat tissue content/hormonal activity and bone markers in this group of patients are lacking. The objective of this study was to correlate the extent of scoliotic-curve severity with the bone turnover vs. leptin level and nutritional status in girls with AIS. The study encompassed 77 AIS girls, aged 14.7 ± 2.17 years. Scoliotic curve severity assessed by Cobb’s angle was categorized as mild (10-19o) moderate (20-39º) or severe (≥40º). Corrected height, weight, waist and hip circumferences were measured and body mass index (BMI), corrected height Z-score, BMI Z-score and waist/height ratio (WHtR) were calculated for the entire group. Body composition parameters: fat mass (FAT), fat-free mass (FFM) and predicted muscle mass (PMM) were determined using a bioelectrical impedance analyzer. Bone turnover markers (osteocalcin (OC) and amino terminal of collagen cross-links NTx) and leptin levels were assessed in serum. Multiple regression analysis showed that, OC, NTx (negatively with p<0.05) and leptin (positively with p<0.01) were significantly associated with curve severity in AIS girls. Moreover, Cobb’s angle was positively correlated with W/HtR (p<0.01)and FAT (p<0.05). One-way analysis of variance (ANOVA) revealed significant differences in leptin (p<0.05 vs. mild only), OC (p<0.05 vs. mild and moderate)) and W/HtR (p<0.01 and p<0.05 vs. mild and moderate respectively) between the three AIS severity subgroups. OC was significantly lower in the severe AIS subgroup, while leptin and W/HtR were significantly higher. Significant correlations between leptin and anthropometrical parameters as BMI z-score and W/HtR were shown. Leptin level correlated also significantly with BMI z score (p<0.001), W/HtR (p<0.0001) and body composition parameters (p<0.000001). Moreover, there was a significant negative correlation between NTx and leptin level (p<0.05). Bone metabolism in AIS girls seems to be altered and significantly related to the scoliotic curve severity. Leptin may be a crucial link in the cross-talk between bone turnover and body composition in this group of patients. Further studies concerning this topic are needed.
Fri, 12 June 2020
ARTICLE | doi:10.20944/preprints202006.0154.v1
Online: 12 June 2020 (12:39:49 CEST)
Aim: This study was designed to understand the changes in dietary and lifestyle behaviours that are major determinants of health during the COVID-19 outbreak. Methods: A cross-sectional study was conducted through an online questionnaire using a convenience sample of 415 adults living in Kuwait (age range 18-73 years). Results: The overall prevalence of being overweight and obesity among participants was 37.2% and 33.1% respectively. The study identified significant changes in the dietary habits and lifestyle behaviours of participants during COVID-19. In general, there was an increase in the percentage of participants that consumed four or more meals a day, skipped breakfast, and engaged in frequent late night snacking. Moreover, there was a drastic decrease in the frequency of fast food consumption and an increase in the percentage of participants who had their main meal freshly made. Furthermore, there was a great reduction in physical activity and an increase in the amount of screen time and sedentary behaviours. A notable increase was detected in day-time sleep and a decrease in night-time sleep among participants. Conclusion: This study indicates that due to the increased prevalence of habits conducive to increased rates of being overweight and obesity during the COVID-19 outbreak, there is a high likelihood that the pandemic will further exacerbate the already widespread problem of obesity and being overweight in Kuwait.
Tue, 9 June 2020
Subject: Medicine & Pharmacology, Nutrition Keywords: obesity; eating context; nutrient-poor foods; nutritional surveillance; adolescents; survey data analysis; data-mining; correspondence analysis; biplots
Online: 9 June 2020 (13:52:45 CEST)
Obesity is a global public health problem and the environment as its major determinant. To identify interventions an evidence base is warranted. To this aim we investigate the relationship between the consumption of foods and eating locations (like home, school/work and others) in British adolescents, using data from the UK National Diet and Nutrition Survey Rolling Program (2008–2012 and 2013-2016). Cross-sectional analysis of 62,523 food diary entries from this nationally representative sample then focused on foods contributing up to 80% total energy to the daily adolescent´s diet. Correspondence Analysis (CA) was first used to generate food-location relationship hypotheses and Logistic Regression (LR) to quantify the evidence in terms of odds ratios and formally test those hypotheses. The less-healthy foods that emerged from CA were chips, soft drinks, chocolate and meat pies. Adjusted Odds Ratios (99% CI) for consuming specific foods at a location “Other” than home (H) or school/work (S) in the 2008-12 survey sample were: for soft drinks 2.8 (2.1 to 3.8) vs. H and 2.0 (1.4 to 2.8) vs. S; for chips 2.8 (2.2 to 3.7) vs. H and 3.4 (2.1 to 5.5) vs. S; for chocolates 2.6 (1.9 to 3.5) vs. H and 1.9 (1.2 to 2.9) vs. S; and for meat pies 2.7 (1.5 to 5.1) vs. H and 1.3 (0.5 to 3.1) vs. S. These trends were confirmed in the 2013-16 survey sample. Interactions between location and BMI were not significant in either sample. In conclusion, our study showed that adolescents are more likely to consume specific less-healthy foods at locations away from home and school/work, irrespective of BMI. Such locations include leisure places, food outlets and “on the go”, hence public health policies to discourage less-healthy food choices in these locations is warranted for all adolescents.
Sun, 7 June 2020
ARTICLE | doi:10.20944/preprints202006.0069.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: RNA virus; DNA synthesis; selenium; thioredoxin reductase; SARS-coronavirus-2
Online: 7 June 2020 (09:04:57 CEST)
The biosynthesis of DNA inherently competes with RNA synthesis because it depends on the reduction of ribonucleotides (RNA precursors) to 2’-deoxyribonucleotides by ribonucleotide reductase (RNR). Hence, RNA viruses can increase viral RNA production in cells by partially blocking the synthesis of DNA, e.g. by downregulating the mammalian selenoprotein thioredoxin reductase (TR), which normally acts to sustain DNA synthesis by regenerating reduced thioredoxin, a hydrogen donor for RNR. Computational and preliminary experimental evidence supports the hypothesis that a number of pathogenic RNA viruses, including HIV-1, Ebola, Zika, some flu viruses, and SARS-CoV-2, target TR isoforms by antisense. TR knockdown would create a host antioxidant defect that could be partially rectified by increased selenium intake, or be exacerbated by selenium deficiency, contributing to viral pathogenesis. There are several non-selenium-dependent means that viruses might also exploit to slow DNA synthesis, such as targeting RNR itself, or components of the glutaredoxin system, which serves as a backup redox system for RNR. HIV-1 substantially downregulates glutathione synthesis, so it interferes with both the thioredoxin and glutaredoxin systems. Computational results suggest that, like Ebola, SARS-CoV-2 targets TR3 by antisense. TR3 is the only TR isoform that includes an N-terminal glutaredoxin domain, so antisense knockdown of TR3 may also affect both redox systems, favoring RNA synthesis. In contrast, some DNA viruses encode their own glutaredoxins, thioredoxin-like proteins and even RNR homologues – so they are doing just the opposite, favoring DNA synthesis. This is clear evidence that viruses can benefit from shifting the RNA:DNA balance to their advantage.
Thu, 4 June 2020
Subject: Medicine & Pharmacology, Nutrition Keywords: vitamin C; vitamin C status; vitamin C deficiency; global health; dietary intake; obesity; smoking; communicable disease; infection; non-communicable disease
Online: 4 June 2020 (03:49:42 CEST)
A recent review of global vitamin C status indicated a high prevalence of deficiency, particularly in low- and middle-income countries, as well as in specific subgroups within high-income countries. Here we provide a narrative of potential factors influencing vitamin C status. The in vivo status of vitamin C is primarily affected by dietary intake and supplement use. Dietary intake can be influenced by cultural aspects such as staple foods and traditional cooking practices. Environmental factors can also affect vitamin C intake and status; these include geographic region, season and climate, as well as pollution. Demographic factors such as sex, age, and race are known to affect vitamin C status, as do socioeconomic factors such as deprivation, education and social class, and institutionalization. Various health aspects affect vitamin C status; these include body weight, pregnancy and lactation, genetic variants, smoking, and disease states, including severe infections as well as various non-communicable diseases such as cardiovascular disease and cancer. Some of these factors have changed over time, therefore we also explore if vitamin C status has shown temporal changes. Overall, there are numerous factors that can affect vitamin C status to different extents in various regions of the world. Many of these factors are not taken into consideration during the setting of global recommended dietary intakes for vitamin C.
Sun, 31 May 2020
REVIEW | doi:10.20944/preprints202005.0516.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Plant-dominant diet; low-protein diet; dietary protein intake; glomerular hyperfiltration; CKD prevention; uremia
Online: 31 May 2020 (21:22:42 CEST)
Chronic kidney disease (CKD) affects >10% of the adult population. Each year approximately 120,000 Americans develop end-stage kideny disease and initiate dialysis, which is costly and associated with functional impairments, worse health-related quality of life, and high early-mortality rates exceeding 20% in the first year. Recent declarations by the World Kidney Day and the U.S. Government Executive Order seek to implement strategies that reduce the burden of kidney failure by slowing CKD progression and controlling uremia without dialysis. Pragmatic dietary interventions may have a role in improving CKD outcomes and preventing or delaying dialysis initiation. Evidence suggests that a patient-centered plant-dominant low-protein diet (PLADO) of 0.6-0.8 g/kg/day comprised of >50% plant-based sources, administered by dietitians trained in non-dialysis CKD care, can be promising. The scientific premise of the PLADO is based on the observations that high protein diets with high meat intake are not only associated with higher cardiovascular disease risk but also higher CKD incidence and faster CKD progression due to increased intraglomerular pressure and glomerular hyperfiltration. Meat intake increases production of nitrogenous end-products, worsens uremia, and may increase the risk of hyperkalemia, given constipation from the typical low fiber intake. Plant-dominant, fiber-rich, low-protein diet may lead to favorable alterations in the gut microbiome, which can modulate uremic toxin generation and slow CKD progression, along with reducing cardiovascular risk in CKD patients. PLADO is a heart-healthy, safe, flexible, and feasible diet that could be the centerpiece of a conservative and preservative CKD-management strategy that challenges the prevailing dialysis-centered paradigm.
ARTICLE | doi:10.20944/preprints202005.0514.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: AKT; D-Pinitol; ghrelin; insulin; insulin resistance; liver; phosphorylation
Online: 31 May 2020 (21:11:01 CEST)
To characterize the metabolic actions of D-Pinitol, a dietary inositol, in male Wistar rats, we analysed its oral pharmacokinetics and its effects on a) the secretion of hormones regulating metabolism (insulin, glucagon, IGF-1, ghrelin, leptin and adiponectin), b) insulin signaling in the liver and c) the expression of glycolytic and neoglucogenesis enzymes. Oral D-Pinitol administration (100 or 500 mg/Kg) resulted in its rapid absorption and distribution to plasma and liver compartments. Its administration reduced insulinemia and HOMA-IR, while maintaining glycaemia thanks to increased glucagon activity. In the liver, D-Pinitol reduced the key glycolytic enzyme pyruvate kinase and decreased the phosphorylation of the enzymes AKT and GSK-3. These observations were associate with an increase in ghrelin concentrations, a known inhibitor of insulin secretion. The profile of D-Pinitol suggests its potential use as a pancreatic protector decreasing insulin secretion through ghrelin upregulation while sustaining glycaemia through liver-based mechanisms of glycolysis control.
Wed, 27 May 2020
ARTICLE | doi:10.20944/preprints202005.0449.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: retrospective cohort; predictors; recovery; severe acute malnutrition; Jimma
Online: 27 May 2020 (08:59:02 CEST)
Background: Treatment at stabilization center is an important intervention to avert the huge burden of mortality for children with complicated severe acute malnutrition (SAM). Recent reviews indicated a wide range in recovery rate (34-88%) due to several context-specific factors. This study aimed to estimate time to recovery and to determine predictors of time to recovery among children aged 6-59 month with severe acute malnutrition. Method: Retrospective cohort study was used among 375 children aged 6-59 months admitted in Jimma university medical center, from September 2015 to September 2017. Kaplan Meir estimate and survival curve was used to compare the time to recovery using log-rank test among different characteristics. Cox Proportional Hazard Model was used to identify significant predictors of time to recovery. Results: Median time of recovery for cohort of SAM children’s was 19 days (95%CI: 17.95-20.05). Independent predictors of time to recovery were: Play stimulation, vaccination status, Tuberculosis, malaria, use of amoxicillin, deworming and shock. Conclusion: The findings of this study showed that the average length of stay on treatment and median time for recovery are within the sphere standard. Psychosocial stimulation, appropriate provision of routine medication and management of medical co-morbidity are needed to promote fast recovery.
ARTICLE | doi:10.20944/preprints202005.0436.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: obesity; meal frequency; hypocaloric diet; energy expenditure; ghrelin; weight loss
Online: 27 May 2020 (04:27:43 CEST)
Dietary approach is essential to obesity control, but the effectiveness of changes in meal frequency (MF) as strategies for loss and maintenance of body mass remain unclear. This study aimed to evaluate the influence of MF on a hypocaloric diet on weight loss, active ghrelin levels and metabolic indicators of women with obesity. This is a randomized, parallel clinical trial, including forty women, randomized in two groups, both following a hypocaloric diet, according to MF (G1 – six meals/day; G2 – three meals/day). Dietary, laboratory, anthropometric and body composition indicators were assessed, as well as energy expenditure (EE), before and after the 90 days of intervention. After intervention, both groups decreased body weight, body mass index (BMI), waist circumference, fat mass (FM), insulin and HOMA-IR. G1 increased insulin sensitivity and G2 reduced triglyceride and FM and increased fat-free mass (FFM). MF increased ghrelin levels. There were no differences in EE variables. Hypocaloric diet with different MF promoted a reduction in total weight, BMI, WC and FM and an improvement in glycidic metabolism. However, the accomplishment of the three meals/day increased the FFM and active ghrelin and reduced triglyceride, while six meals/day was more beneficial in increasing insulin sensitivity.
Tue, 26 May 2020
ARTICLE | doi:10.20944/preprints202005.0432.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: antisense; HIV-1 nef; stop codon readthrough; selenium; thioredoxin reductase
Online: 26 May 2020 (13:16:09 CEST)
The HIV-1 nef gene terminates in a 3’-UGA stop codon, which is highly conserved in the main group of HIV-1 subtypes, along with a downstream potential coding region that could extend the nef protein by 33 amino acids, if readthrough of the stop codon occurs. Antisense tethering interactions (ATIs) between a viral mRNA and a host selenoprotein mRNA are a potential viral strategy for the capture of a host selenocysteine insertion sequence (SECIS) element (Taylor et al, 2016) . This mRNA hijacking mechanism could enable the expression of virally encoded selenoprotein modules, via translation of in-frame UGA stop codons as selenocysteine (SeC). Here we show that readthrough of the 3’-terminal UGA codon of nef occurs during translation of HIV-1 nef expression constructs in transfected cells. This was accomplished via fluorescence microscopy image analysis and flow cytometry of HEK 293 cells, transfected with engineered GFP reporter gene plasmid constructs, in which GFP can only be expressed by translational recoding of the UGA codon. SiRNA knockdown of thioredoxin reductase 1 (TR1) mRNA resulted in a 67% decrease in GFP expression, presumably due to reduced availability of the components involved in selenocysteine incorporation for the stop codon readthrough, thus supporting the proposed ATI. Addition of 20 nM sodium selenite to the media significantly enhanced stop codon readthrough in the pNefATI1 plasmid construct, by >100%, supporting the hypothesis that selenium is involved in the UGA readthrough mechanism.
Sun, 24 May 2020
ARTICLE | doi:10.20944/preprints202005.0406.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Drospirenone 4mg; breastfeeding; plasma concentration; milk concentration
Online: 24 May 2020 (20:26:11 CEST)
Objective: The primary objective of this trial was to assess the transfer of drospirenone to breast milk after daily administration of an oral test preparation containing 4 mg of drospirenone at the steady state. The secondary objective of the trial was to assess the safety of the preparation based on safety clinical and laboratory measurements (at the beginning and at the end of the trial) and reporting of adverse events and/or adverse drug reactions. Patients and Methods: This was an open label, non-comparative single center study. Drospirenone 4mg per day was the first postpartum contraceptive for the study participants who were no longer breastfeeding yet were still lactating. It was administered for 7 (seven) days to achieve steady-state concentration. All participants were volunteers who planned to use oral contraceptives as their family planning method in the future. Results: A total number of 12 volunteers completed the trial according to the protocol and the samples of all the 12 study completers were analyzed. The average concentration-time curve of drospirenone in plasma 24 h after the administration of the last dose (AUC(0-24h)) was 635.33 ng*h/mL and 120 h after the single repeat dose administration (AUC(0-120h) was 1180.57 ng*h/mL, respectively. The average Cmax was 48.64 ng/mL. The average concentration-time curve of drospirenone in milk 24 h after the administration of the last dose (AUC(0-24h)) was 134.35 ng*h/mL and 120 h after the single repeat dose administration (AUC(0-120h) was 227.17 ng*h/mL respectively. The average Cmax was 10.34 ng/mL. Conclusion: On average 18.13% of plasma drospirenone made it to breast milk and the highest concentration of drospirenone in breast milk was 17.55% of that in plasma. The total quantity of drospirenone passing to breast milk is on average 4478 ng during a 24 h period representing 0.11% of the maternal daily dose. Thus, at the recommended doses, no effects on breastfed newborns/infants are anticipated with drospirenone 4 mg.
Subject: Medicine & Pharmacology, Nutrition Keywords: vitamin C status; hypovitaminosis C; vitamin C deficiency; low and middle income countries; LMIC; dietary intake; supplement; non-communicable disease; communicable disease; infection
Online: 24 May 2020 (18:16:25 CEST)
Vitamin C is an essential nutrient that must be obtained through the diet in adequate amounts to prevent hypovitaminosis C and the potentially fatal deficiency disease scurvy. Global vitamin C status and prevalence of deficiency has not previously been reported, despite vitamin C’s pleiotropic roles in both non-communicable and communicable disease. This review highlights the global literature on vitamin C status and the prevalence of hypovitaminosis C and deficiency. Related dietary intake is reported if assessed in the studies. We also explore if global vitamin C status has changed over time. Overall, the review illustrates the shortage of high quality epidemiological studies of vitamin C status in many countries, particularly low- and middle-income countries. The available evidence indicates that vitamin C deficiency is common in low- and middle-income countries and not uncommon in high income settings. Further high quality studies are required to confirm these findings, including in the countries not yet represented, and to fully understand associations with a range of disease processes. Our findings suggest a need for interventions to prevent deficiency in a range of at risk groups and regions of the world.
Sat, 16 May 2020
REVIEW | doi:10.20944/preprints202005.0265.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: vitamin D; cathelicidin; antimicrobial peptides; bacteria; mycobacteria; virus; coronavirus; sunshine; UVB phototherapy; tuberculosis; COVID-19; photosynthesis
Online: 16 May 2020 (16:02:26 CEST)
Abstract: A primary action of vitamin D is regulation of gene transcription. Many cell types possess genes that make antimicrobial peptides (AMPS) (endogenous antibiotics), recently discovered to be regulated by vitamin D. Two examples are cathelicidin and beta defensins, both bioactive against many different bacteria, fungi, mycobacteria, parasites and viruses. The signal transduction pathway is triggered by sensing microorganisms via cell surface receptors, causing intracellular production of calcitriol (1,25(OH)2D) and vitamin D receptors, leading to upregulation of AMP production. Serum 25(OH)D concentrations required to sustain adequate AMP production to eradicate infections are unknown. Vitamin D3 is photosynthesized in skin in amounts ranging from 10,000 (250 mcg) to 25,000 (625 mcg) International Units (IU) from 7-dehydrocholesterol after whole-body exposure to one minimal erythemal dose (MED) of ultraviolet B (UVB) radiation, and is impacted by many factors including geographic localities, seasonal changes and skin pigmentation. We and others have reported extended daily oral dosing with these amounts of vitamin D3 safe. We routinely observe serum 25(OH)D concentrations below 20ng/ml on new admissions, which have been reported insufficient to sustain AMP production. In contrast serum 25(OH)D concentrations above 100ng/ml have been reported after serial UVB treatments for psoriasis. Little vitamin D naturally occurs in food, and insufficient sun exposure may be causing worldwide deficiency. We review evidence suggesting that higher daily intakes of vitamin D3 than the currently recommended 600 (15 mcg) IU/day may be necessary to sustain AMP production in the face of an overwhelming infection, particularly in non-Hispanic blacks, a high risk population suffering the worst outcomes from COVID-19. We propose that increased vitamin D supplementation could provide a safe and cost-effective way to protect all populations from infections, in particular those from pandemic COVID-19.
Sun, 10 May 2020
REVIEW | doi:10.20944/preprints202005.0166.v1
Online: 10 May 2020 (14:37:36 CEST)
On March 11, 2020, coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO). This review focuses on where the body mass index (BMI) value can be used as a tool to evaluate the risk of development and/or aggravation of this disease. Databases were used to search studies published up to April 18, 2020. In total, 4285 articles and other scientific literature were found, and twelve articles were included in this systematic review. The mean BMI value of severe COVID-19 patients ranged from 24.5 to 33.4 kg/m2, versus 22.0 to 24.3 kg/m2 for non-severe patients Articles using the terms obesity or overweight, without indicating the BMI value, in these patients were common, but this is not useful as the nutritional status, when not defined by this index, is confusing due to the classification being different in the West compared to among,, Asian and Korean criteria-based adults. Furthermore, the use of BMI is important during this pandemic, as it should be applied to nutritional support therapy during hospitalization of infected patients, as well as being considered in the home confinement population.
Tue, 5 May 2020
Subject: Medicine & Pharmacology, Nutrition Keywords: Momordica; anti-microbial; photochemical; secondary metabolites
Online: 5 May 2020 (10:17:34 CEST)
Momordica species (Family Cucurbitaceae) are cultivated throughout the world for their edible fruits, leaves, shoots and seeds. Among the species of the genus Momordica, there are three selected species that are used as vegetable, and also for medicinal purposes inter alia Momordica charantia L. (Bitter melon), Momordica foetida Schumch. Et Thonn. (Bitter cucumber) and Momordica balsamina L. (African pumpkin). The three species are reputed to possess anti-diabetic, anti-microbial, anthelmintic bioactivity, abortifacient, anti-bacterial, anti-viral, and also play chemo-preventive functions as they are rich in vitamins as well as both primary and secondary metabolites which possess anti-microbial activities. The fruits and leaves of Momordica species consist of nutritional composition rich in primary metabolites; energy releasing biomolecules, proteins, fibres, minerals (calcium, iron, magnesium, zinc), beta-carotene, foliate and ascorbic acid. The extracts from Momordica species are used for the treatment of a variety of diseases and ailments. Several studies have suggested that Momordica species extracts can lower blood sugar and treat Diabetes mellitus due to its hypoglycemic properties. The crop can also be used to treat other diseases including diarrhea, bleeding gums, piles and hemorrhoids; respiratory problems, leukemia, melanoma, liver cancer, skin infections, and solid sarcomas.
Sat, 25 April 2020
ARTICLE | doi:10.20944/preprints202004.0454.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: casein hydrolysate; Val-Pro-Pro; Ile-Pro-Pro; brachial ankle pulse wave velocity; advanced glycation end products; facial pigmentation
Online: 25 April 2020 (02:42:35 CEST)
Casein hydrolysate improves arterial stiffness, as estimated by brachial ankle pulse wave velocity (baPWV), in untreated hypertensive subjects. Facial pigmentation is a useful biomarker for arterial stiffness. This trial evaluated whether casein hydrolysate improves facial pigmentation in association with changes in arterial stiffness. A randomized, double-blind, placebo-controlled trial was conducted in 80 non-hypertensive Japanese participants randomly assigned to receive either active tablets containing casein hydrolysate or placebo for 48 weeks. Facial pigmentation and baPWV were measured at baseline and at the end of the intervention. Other biochemical atherosclerosis-related parameters were also measured, including advanced glycation end products (AGEs). Changes in facial pigmentation showed a significant difference between the groups. Change in baPWV was significantly better in the active than in the placebo group. In contrast, no significant association was seen between changes in facial pigmentation and those in baPWV. Among other atherosclerosis-related factors, changes in advanced glycation products (AGEs) were significantly decreased in the active compared to the placebo group. Further, changes in facial pigmentation were positively correlated with those in AGEs. Changes in AGEs were independently associated with changes in facial pigmentation. Casein hydrolysate improves facial pigmentation in non-hypertensive participants. Casein hydrolysate may have beneficial effects on glycation stress.
Fri, 24 April 2020
ARTICLE | doi:10.20944/preprints202004.0442.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: nutrition status; muscle strength; diabetes; handgrip; insulin resistance; functional tests
Online: 24 April 2020 (13:52:32 CEST)
Background and Aims: We aimed to investigate cross-sectional relationships of relative handgrip strength (RHGS) with presence of diabetes and hypertension in a community setting. Methods and Results: Between 2016 and 2018, we enrolled 601 consecutive women with an average age of 70.7 ± 6.9 years (mean ± SD). Nutritional status was evaluated by the Mini Nutritional Assessment (MNA) score. Muscular strength and level of fitness were assessed by handgrip strength (HGS) and other standardized physical functional tests. The majority of participants were overweight or obese (80% with BMI > 25). Prevalence of diabetes and hypertension was 13 and 60%, respectively. Participants in the lowest quartile of HGS adjusted for BMI (RHGS) had significantly higher prevalence of diabetes and hypertension compared with those in the lower quartile (20.7 vs. 5.3% and 49.3 vs. 39.3%, respectively, p < 0.01 for both), whereas differences in nutritional status were not observed. Likelihood of having diabetes was significantly reduced in women with higher RHGS values (OR 0.77; 0.59–0.86 CI95%; p=0.002), independently of age, abdominal adiposity and presence of hypertension. RHGS was positively correlated with most of the physical functional tests performed. Conclusion: RHGS is an easy-to-obtain and inexpensive measure of muscular strength, independently associated with presence of diabetes in overweight elderly women. Prospective studies are required to assess its predictive value in individuals at risk of new onset or progression of diabetes.
Sun, 19 April 2020
ARTICLE | doi:10.20944/preprints202004.0322.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: fertility; male reproduction; semen parameters; supplements; ingredients
Online: 19 April 2020 (04:18:39 CEST)
Background: Dietary supplements (DS) represent a possible approach to improve sperm parameters and male fertility. A wide range of DS containing different nutrients is now available. Although many authors demonstrated benefits from some nutrients in male infertility, their real effectiveness is still under debate. The aim of this study was to critically review the composition of DS using the Italian market as sample. Materials & Methods: Active ingredients and their minimal effective daily dose (mFED) were identified through literature search. Thereafter, we created a formula to classify the expected efficacy of each DS. Considering active ingredients, their concentration and the recommended daily dose, DS were scored into three classes of expected efficacy: higher, lower and none. Results: Twenty-one DS were identified. Most of them had a large number of ingredients, frequently at doses below mFED or with unproven efficacy. Zinc was the most common ingredient of DS (70% of products), followed by selenium, arginine, coenzyme Q and folic acid. By applying our scoring system, 9.5% of DS fell in higher class, 71.4% in lower class and 19.1% in the class with no expected efficacy. Conclusions: DS marketed in Italy for male infertility frequently include effective ingredients but also a large number of substances at insufficient dose or with no proven efficacy. Manufacturers and physicians should better consider the scientific evidence on effective ingredients and their doses before formulating and prescribing these products.
Fri, 17 April 2020
ARTICLE | doi:10.20944/preprints202004.0292.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Porphyra tenera; immune; clinical trial; natural killer cells; cytokines
Online: 17 April 2020 (02:15:58 CEST)
Objective: The purpose of this study was to determine if Porphyra tenera extract (PTE) has immune-enhancing effects and is safe in healthy adults. Methods: Subjects (3x103 ≤ peripheral blood leukocyte levels < 8x103 cells/μl) who met the inclusion criteria were recruited for this study. Enrolled subjects (n=120) were randomly assigned to either the PTE group (n=60) who were given 2.5 g/day of PTE (as Porphyra tenera extract) in capsule form or the placebo group (n=60) who were given crystal cellulose capsules with the identical appearance, weight, and flavor as the PTE capsules for 8 weeks. Outcomes were assessed by measuring natural killer cell (NK-cell) activity, cytokines, and upper respiratory infection (URI), and safety parameters were assessed at baseline and 8 weeks. Results: Compared to baseline, NK cell activity (%) increased for all effector cell to target cell ratios in the PTE group after 8 weeks, but there were no changes in the placebo group (p<0.1). Subgroup analysis of 101 subjects without an URI revealed that NK-cell activity in the PTE group tended to be increased for all E:T ratios (E:T=12.5:1 p=0.068; E:T=25:1 p=0.036; E:T=50:1 p=0.081) compared to the placebo group. There was a significant difference between these two groups for the E:T=25:1 ratio, which increased from 20.3±12.0% at baseline to 23.2±12.4% after 8 weeks in the PTE group (p=0.036). There was no significant difference in levels of cytokines between these two groups. Conclusions: PTE supplementation appears to enhance immune function by improving NK-cell activity without adverse effects in healthy adults.
Sun, 12 April 2020
ARTICLE | doi:10.20944/preprints202004.0200.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: vitamin D; obesity; weight-loss; body composition
Online: 12 April 2020 (16:44:13 CEST)
Background: Vitamin D was studied in regards to its possible impact on body mass reduction and metabolic changes in adults and children with obesity yet there were no studies assessing the impact of vitamin D supplementation during a weight management programme in children and adolescence. The aim of our study was to assess the influence of 26 weeks of vitamin D supplementation in overweight and obese children undergoing an integrated 12-months’ long weight loss programme on body mass reduction, body composition and bone mineral density. Methods: A double-blind randomized placebo-controlled trial. Vitamin D deficient patients ( <30 ng/ml level of vitamin D) aged 6-14, participating in multidisciplinary weight management programme were randomly allocated to receiving vitamin D (1200 IU) or placebo for the first 26 weeks of the intervention. Results: Out of the 152 qualified patients, 109 (72%) completed a full cycle of four visits scheduled in the programme. There were no difference in the level of BMI change. Although the reduction was greater in the vitamin D vs. placebo group (-4.28 ± 8.43 vs. -2.53 ±6.10) the difference was not statistically significant (p=0.319). Similarly the reduction in fat mass – assessed both using bioimpedance and DEXa was achieved, yet the differences between the groups were not statistically significant. Conclusions: Our study ads substantial results to support the thesis on no effect of vitamin D supplementation on body weight reduction in children and adolescents with vitamin D insufficiency undergoing a weight management programme. Trial registration no: NCT 02828228; trial registration date: 8 June 2016 registered in: ClinicalTrials.gov.
Wed, 8 April 2020
ARTICLE | doi:10.20944/preprints202004.0109.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: insulin-resistance; hyperlipidemia; non alcoholic fatty liver disease (NAFLD); OCTN1; OCTN2
Online: 8 April 2020 (03:22:50 CEST)
Hyperlipidemia and insulin-resistance are often associated with Non Alcoholic Fatty Liver Disease (NAFLD) thereby representing a true issue worldwide, due to increased risk of developing cardiovascular and systemic disorders. Although clear evidence suggests that circulating fatty acids contribute in pathophysiological mechanisms underlying NAFLD and hyperlipidemia, further studies are required for better identify potential beneficial approaches for counteracting such a disease state. Recently, several artichoke extracts have been used for both reducing hyperlipidemia, insulin-resistance and NAFLD, though the mechanism is unclear. Here we used a wild type of Cynara Cardunculus extract (CyC), rich in sesquiterpens and antioxidant active ingredients, in rats fed and High Fat Diet (HFD) compared to Normal Fat Diet (NFD). In particular, in rats fed HFD for four consecutive weeks, we found a significant increase of serum cholesterol, triglyceride and serum glucose. This effect was accompanied by increased body weight and by histopathological features of liver steatosis. The alterations of metabolic parameters found in HFD were antagonised dose-dependently by daily oral supplementation of rats with CyC 10 and 20 mg/Kg over 4 weeks, an effect associated to significant improvement of liver steatosis. The effect of CyC (20 mg/Kg) was also associated to enhanced expression of both OCTN1 and OCTN2 carnitine-linked transporters. Thus, present data suggest a contribution of carnitine system in the protective effect of CyC in diet-induced hyperlipidemia, insulin-resistance and NAFLD.
Tue, 7 April 2020
ARTICLE | doi:10.20944/preprints202004.0108.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: prebiotics; oligosaccharides; GOS; FOS; RNA-seq; transcriptome; differential gene expression; functional pathway analysis; Caco-2; polarized monolayers
Online: 7 April 2020 (13:37:18 CEST)
Prebiotic oligosaccharides are widely used as human and animal feed additives for their beneficial effects on the gut microbiota. However, there are limited data to assess the direct effect of such functional foods on the transcriptome of intestinal epithelial cells. The purpose of this study is to describe the differential transcriptomes and cellular pathways of colonic cells directly exposed to galacto-oligosaccharides (GOS) and fructo-oligosaccharides (FOS). We have examined the differential gene expression of polarized Caco-2 cells treated with GOS or FOS and their respective mock-treated cells using mRNA sequencing (RNA-seq). A total of 89 significant differentially expressed genes were identified between GOS and mock-treated groups. For FOS treatment, a reduced number of 12 significant genes were observed to be differentially expressed relative to the control group. KEGG and Gene Ontology functional analysis revealed that genes up-regulated in the presence of GOS were involved in digestion and absorption processes, fatty acids and steroids metabolism, potential antimicrobial proteins, energy-dependent and -independent transmembrane trafficking of solutes and amino acids. Using our data, we have established complementary non-prebiotic modes of action for these frequently used dietary fibers.
REVIEW | doi:10.20944/preprints202004.0100.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: ellagic acid; oral administration; bioavailability; microformulations; nanoformulations; solubility enhancement
Online: 7 April 2020 (12:02:54 CEST)
Ellagic acid, a polyphenolic compound present in fruits and berries, has recently been object of extensive research for its antioxidant activity, which might be useful for the prevention and treatment of cancer, cardiovascular pathologies, and neurodegenerative disorders. Its protective role justifies numerous attempts to include it in functional food preparations and in dietary supplements not only to limit the unpleasant collateral effects of chemotherapy. However, ellagic acid use as chemopreventive agent has been debated because of its poor bioavailability associated to low solubility, limited permeability, first pass effect, and interindividual variability in gut microbial transformations. To overcome these drawbacks, various strategies for oral administration including solid dispersions, micro-nanoparticles, inclusion complexes, self-emulsifying systems, polymorphs have been proposed. Here, we have listed an updated description of pursued micro/nanotechnological approaches focusing on the fabrication processes and the features of the obtained products, as well as on the positive results yielded by in vitro and in vivo studies in comparison to the raw material. The micro/nano-sized formulations here described might be exploited for pharmaceutical delivery of this active, as well as for the production of nutritional supplements or for the enrichment of novel foods.
Tue, 31 March 2020
ARTICLE | doi:10.20944/preprints202003.0462.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: iron; blood donation; restless legs syndrome; quality of life; sleep; fatigue
Online: 31 March 2020 (22:32:59 CEST)
Background: Besides anemia, iron deficiency may cause more subtle symptoms including those of the restless legs syndrome (RLS), the chronic fatigue syndrome (CFS) or sleeping disorders. Objective: The aim of this pre-planned secondary analysis was to compare the frequency and severity of symptoms associated with iron deficiency before and after (intravenous or oral) iron supplementation in iron deficient blood donors. Methods/Design: Prospective, randomized, controlled, single centre trial. (ClinicalTrials.gov: NCT01787526). Setting: Tertiary care center in Graz, Austria Participants: 138 female and 38 male whole blood and platelet apheresis donors aged ≥18 and ≤65 years with iron deficiency (ferritin ≤30ng/ml at the time of blood donation). Interventions: Intravenous iron (1 g ferric carboxymaltose, n=86) or oral iron supplementation (10 g iron fumarate, 100 capsules, n=90). Measurements: Clinical symptoms were evaluated by a survey before iron therapy (visit 0, V0) and after 8-12 weeks (visit 1, V1) including questions about symptoms of RLS, CFS, sleeping disorders, quality of life and symptoms like headaches, dyspnoea, dizziness, palpitations, pica and trophic changes of fingernails or hair. Results: We found a significant improvement in the severity of symptoms for RLS, fatigue and sleep quality (p<0.001). Furthermore, a significant decrease of headaches, dyspnoea, dizziness and palpitations was reported (p<0.05). There was no difference between the type of iron supplementation (intravenous versus oral) and clinical outcome data. Conclusion: Iron supplementation in iron deficient blood donors may be an effective strategy to improve symptoms related to iron deficiency and the wellbeing of blood donors.
Mon, 30 March 2020
REVIEW | doi:10.20944/preprints202003.0235.v2
Subject: Medicine & Pharmacology, Nutrition Keywords: acute respiratory distress syndrome (ARDS); ascorbic acid; cathelicidin; coronavirus; COVID-19; cytokine storm; influenza; observational; pneumonia, prevention; respiratory tract infection; solar radiation; treatment; UVB; vitamin C; vitamin D
Online: 30 March 2020 (05:48:43 CEST)
The world is in the grips of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increase concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D [25(OH)D] concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome, and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/ml (100–150 nmol/l). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
Sun, 15 March 2020
REVIEW | doi:10.20944/preprints202003.0235.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: ascorbic acid; cahtelicidin; coronavirus; COVID-19; cytokine storm; influenza, pneumonia; prevention; respiratory tract infection; UVB; vitamin C; Vitamn D; solar radiation; treatment; observational; trial
Online: 15 March 2020 (01:47:19 CET)
Low vitamin D status in winter permits viral epidemics. During winter, people who do not take vitamin D supplements are likely to have low serum 25-hydroxyvitamin D [25(OH)D] concentrations. Vitamin D can reduce the risk of viral epidemics and pandemics in several ways. First, higher 25(OH)D concentrations reduce the risk of many chronic diseases, including cancers, cardiovascular disease, chronic respiratory tract infections (RTIs), diabetes mellitus, and hypertension. Patients with chronic diseases have significantly higher risk of death from RTIs than otherwise healthy people. Second, vitamin D reduces risk of RTIs through three mechanisms: maintaining tight junctions, killing enveloped viruses through induction of cathelicidin and defensins, and reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia. Observational and supplementation trials have reported higher 25(OH)D concentrations associated with reduced risk of dengue, hepatitis, herpesvirus, hepatitis B and C viruses, human immunodeficiency virus, influenza, respiratory syncytial virus infections, and pneumonia. Results of a community field trial reported herein indicated that 25(OH)D concentrations above 50 ng/ml (125 nmol/l) vs. <20 ng/ml were associated with a 27% reduction in influenza-like illnesses. From the available evidence, we hypothesize that raising serum 25(OH)D concentrations through vitamin D supplementation could reduce the incidence, severity, and risk of death from influenza, pneumonia, and the current COVID-19 epidemic.
Mon, 24 February 2020
REVIEW | doi:10.20944/preprints202002.0349.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: carotenoids; seaweeds; antioxidants; astaxanthin; fucoxanthin; anti-obesity; oxidative stress
Online: 24 February 2020 (12:26:44 CET)
Present-day lifestyle associated with high calorie-fat intake and accumulation, as well as energy imbalance, has led to the development of obesity and its comorbidities, which have emerged as some of the major health issues globally. To combat the disease, many studies have reported the anti-obesity effects of natural compounds in foods, with some advantages over chemical treatments. Carotenoids, particularly xanthophyll derived from seaweeds, have attracted the attention of researchers due to their notable biological activities, which are associated mainly with their antioxidant properties. Their involvement in oxidative stress modulation, regulation of major transcription factors and enzymes as well as their antagonistic effects on various obesity parameters have been examined in both in-vitro and in-vivo studies. The present review is a collation of published research over the last decade on the anti-oxidant properties of seaweed xanthophyll carotenoids, with a focus on fucoxanthin and astaxanthin and their mechanisms of action in obesity prevention and treatment.
Sun, 23 February 2020
Subject: Medicine & Pharmacology, Nutrition Keywords: citrus flavnoids; naringin; immunoregulation; ACE2; 2019-nCoV
Online: 23 February 2020 (09:49:10 CET)
The most recent outbreak of 2019 novel coronavirus, named as COVID-19, caused pneumonia epidemic in Wuhan with 2,121 deaths cases as of February 20th 2020. Identification of effective antiviral agents to combat the novel coronavirus is urgently needed. Citrus fruit peel or wild citrus are rich in flavonoid, and is clinically documented for roles in relief of cough and promotion of digestive health. Therefore, citrus fruits are assumed to possess antivirus activities or enhance the host immunity. A previous study found that hesperetin could act as a high potent inhibitor of SARS-CoV 3CLpro. We determined six flavonoid compounds content of in three citrus species by using LC-MS technique. The content of naringin and naringenin was at higher levels in pummelo. Hesperetin and hesperidin were highly accumulated in mandarin and sweet orange. The subsequent in vitro and in vivo experiments indicated that naringin could inhibit the expression of the proinflammatory cytokines (COX-2, iNOS, IL-1β and IL-6) induced by LPS in Raw macrophage cell line, and may restrain cytokine through inhibiting HMGB1 expression in a mouse model. The results revealed that naringin may have a potential application for preventing cytokine storm. We simulated molecular docking to predict the binding affinity of those flavonoids to bind Angiotensin-converting enzyme 2 (ACE 2), which is a receptor of the coronavirus. Consideration of the potential anti-coronavirus and anti-inflammatory activity of flavonoids, the citrus fruit or its derived phytochemicals are promising in the use of prevention and treatment of 2019-nCoV infection.
Mon, 17 February 2020
Subject: Medicine & Pharmacology, Nutrition Keywords: Alzheimer’s disease; lactoferrin; cognitive function; gut microbiota; amyloid β
Online: 17 February 2020 (01:00:26 CET)
Existing evidence suggest that lactoferrin might be beneficial for Alzheimer’s disease. We aimed to determine the effects of lactoferrin intervention on cognitive function from APP/PS1 mice, and possible mechanisms involved in. Both young and middle-aged male APP/PS1 mice were divided into control and lactoferrin group with 16 weeks’ intervention. Lactoferrin intervention had no effects on cognitive function from both young and middle-aged mice, and no key markers involved in Aβ, tau pathology, neuro-inflammation and synaptic plasticity were altered post lactoferrin intervention. In regards to gut microbiota profiles, in the young mice, lactoferrin elevated α diversity index including ACE and Chao 1, and reduced the relative abundance of the genera Bacteroides and Alistipes and elevated Oscillibacter, in addition, Oscillibacter, Anaerotruncus, EF096579_g, EU454405_g, Mollicutes_RF39, EU474361_g, EU774448_g, and EF096976_g were specifically abundant post Lf intervention via LEfSe analysis. In the middle-aged mice, the relative abundance of the phylum Proteobacteria, as well as the genera Oscillospira, Coprococcus and Ruminococcus was significantly reduced post Lf intervention, additionally, S24_7, Bacteroidia, Bacteroidetes and Methylobacterium were specific via LEfSe analysis post lactoferrin intervention. In conclusion, dietary lactoferrin might be beneficial for gut microbiota homeostasis although might have no effects on cognition.
Thu, 30 January 2020
REVIEW | doi:10.20944/preprints201912.0165.v2
Subject: Medicine & Pharmacology, Nutrition Keywords: glucose; pentose phosphate pathway; NADPH; redox balance; glycogen; glycolysis; stress resistance; insulin resistance
Online: 30 January 2020 (12:49:19 CET)
A human organism depends on stable glucose blood levels in order to maintain the metabolic needs. Glucose is considered as the most important energy source and glycolysis is postulated as a backbone pathway. However, when glucose supply is limited, ketone bodies and amino acids can be used to produce enough ATP. In contrast, for the functioning of pentose phosphate pathway (PPP) glucose is essential and cannot be substituted by other metabolites. PPP generates and maintains levels of NADPH needed for reduction of oxidized glutathione and protein thiols, synthesis of lipids and DNA as well as for xenobiotic detoxification, regulatory redox signaling and counteracting infections. Flux of glucose into a PPP, particularly under extreme oxidative and toxic challenges is critical for survival, whereas the glycolytic pathway is primarily activated when glucose is abundant, and there is lack of NADP+ that is required for activation of glucose-6 phosphate dehydrogenase. An important role of glycogen stores in resistance to oxidative challenges is discussed. Current evidences explain disruptive metabolic effects and detrimental health consequences of chronic nutritional carbohydrate overload and provides new insights into positive metabolic effects of intermittent fasting, caloric restriction, exercise, and ketogenic diet through modulation of redox homeostasis.
Mon, 20 January 2020
ARTICLE | doi:10.20944/preprints202001.0221.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: triglyceride; uric acid; glucose; fructose; sucrose; solid
Online: 20 January 2020 (09:43:11 CET)
Fructose in beverages has adverse effects on lipids, glucose and insulin sensitivity after acute and chronic ingestion. There is limited data showing that chronic consumption of fructose in solid foods has harmful effects. We hypothesized that a moderate amount of fructose compared with sucrose in solid food consumed for a month would not adversely influence fasting or postprandial lipids and glucose after an acute fat and carbohydrate load. Twenty-five men and women with prediabetes and/or obesity and overweight consumed in random order two acute test meals of muffins sweetened with either fructose or sucrose, followed by 4-week chronic consumption of 42g/day of either fructose or sucrose in low fat muffins after which the 2 meal tests were repeated. Subjects were randomised to sugar type in the chronic feeding period. Sugar type had no effect on the incremental area under the curve for triglyceride or uric acid at either time point (P=0.4 and P=0.9). There was no overall difference between meal tests at baseline and after 1 month and no effect of consuming sucrose or fructose muffins for 1 month. Fasting triglyceride increased after chronic consumption of fructose by 0.31±0.37 mmol/L compared with sucrose in people with IFG/IGT only (P=0.004). Fructose at a moderate intake of <10% of energy in solid food has no different effects on postprandial triglyceride and uric acid compared with sucrose although fasting triglyceride was increased in people with IFG/IGT after 1 month of fructose muffins suggesting the need for caution.
Sun, 19 January 2020
ARTICLE | doi:10.20944/preprints202001.0214.v1
Online: 19 January 2020 (05:16:11 CET)
Acai (Euterpe oleracea Mart. Palmae, Arecaceae) is a palm plant native to the Brazilian Amazon. It contains many nutrients, such as polyphenols, iron, vitamin E, and unsaturated fatty acids, so in recent years, many of the antioxidant and anti-inflammatory effects of acai have been reported. However, the effects of acai on hematopoiesis have not been investigated yet. In the present study, we administered acai extract to mice and evaluated its hematopoietic effects. Acai treatment significantly increased the erythrocytes, hemoglobin, and hematocrit contents compared to controls for four days. We then examined the hematopoietic-related markers following a single injection. Acai administration significantly increased the levels of the hematopoietic-related hormone erythropoietin in blood compared to controls and also significantly upregulated the gene expression of Epo in the kidney. Furthermore, in the mice treated with acai extract, the kidneys were positively stained with the hypoxic probe pimonidazole in comparison to the controls. These results demonstrated that acai increases the number of blood cells through an increased erythropoietin expression via hypoxic action in the kidney. Acai can be expected to improve motility through hematopoiesis.
Thu, 16 January 2020
REVIEW | doi:10.20944/preprints202001.0171.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Dipeptidyl peptidase-4; Fibroblast growth factor; Gastrointestinal peptide; Glucagon-like peptide 1; Glucagon receptor; Peroxisome proliferator-activated receptor; Sodium glucose cotransporter
Online: 16 January 2020 (11:44:49 CET)
Liver related diseases are the 3rd leading causes (9.3%) of mortality in type 2 diabetes mellitus (T2DM) in Japan. T2DM is closely associated with nonalcoholic fatty liver disease (NAFLD) which is the most prevalent chronic liver disease worldwide. Nonalcoholic steatohepatitis (NASH), a severe form of NAFLD, can lead to hepatocellular carcinoma (HCC) and hepatic failure. There are no established pharmacotherapies for NASH patients with T2DM. Though vitamin E is established as a 1st line agent in NASH without T2DM, its efficacy was recently denied in NASH with T2DM. The effects of pioglitazone on NASH histology with T2DM have extensively been established, but several concerns exist such as body weight gain, fluid retention, cancer incidence, and bone fracture. Glucagon-like peptide 1 (GLP-1) receptor agonists and sodium/glucose cotransporter 2 (SGLT2) inhibitors are expected to ameliorate NASH (LEAN study, LEAD trial, and E-LIFT study). Among a variety of SGLT2 inhibitors, dapagliflozin have already entered phase 3 trials (DEAN study). A key clinical question is what kinds of anti-diabetic drugs are the most appropriate for the treatment of NASH to prevent progression of hepatic fibrosis resulting in HCC/liver-related mortality without increasing risk at cardiovascular or renal events. The combination therapies such as glucagon receptor agonist/GLP-1 or gastrointestinal peptide /GLP-1 will be under development. This review focuses on antidiabetic agents and future perspectives on the view of the treatment of NAFLD with T2DM.
Subject: Medicine & Pharmacology, Nutrition Keywords: Andrographis paniculata; 14-deoxy-11,12-didehydroandrographolide; NLRP3 inflammasome; liver injury; steatohepatitis
Online: 16 January 2020 (03:07:25 CET)
14-Deoxy-11,12-didehydroandrographolide (deAND), a diterpenoid in Andrographis paniculata (Burm. f.) Nees, acts as a bioactive phytonutrient that can treat many diseases. To investigate the protective effects of deAND on reducing fatty liver disease, male mice were fed a high-fat and high-cholesterol (HFHC) diet without or with 0.05% and 0.1% deAND supplementation. Cholesterol accumulation, antioxidant and anti-inflammatory activities in liver and liver injury were evaluated after deAND treatment. The results show that deAND treatment for 7 weeks reduced plasma alanine aminotransferase activity and lowered hepatic cholesterol accumulation, tumor nuclear factor-α, and histological lesions. 0.1% deAND treatment reduced HFHC diet-induced apoptosis by lowering the caspase 3/pro-caspase 3 ratio. After 11-weeks of deAND treatment, increased NOD-like receptor protein 3 (NLRP3), capase-1, and interleukin-1β protein levels in liver were suppressed by deAND treatment. In addition, nuclear factor erythroid 2-related factor 2 (Nrf2) mRNA expression, heme oxygenase-1 protein expression, and the activities of glutathione peroxidase and glutathione reductase were increased in mice fed the HFHC diet. However, those activities of antioxidant enzymes or proteins were also upregulated by 0.1% deAND treatment. Furthermore, deAND treatment tended to lower hepatic lipid peroxides. Finally, deAND treatment reversed the depletion of hepatic glutamate level induced by HFHC diet. These results indicate that deAND may ameliorate HFHC diet-induced steatohepatitis and liver injury by increasing antioxidant and anti-inflammatory activities.
Thu, 9 January 2020
ARTICLE | doi:10.20944/preprints202001.0068.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: prebiotics; polyols; short chain fatty acids, Headspace Analysis
Online: 9 January 2020 (04:44:49 CET)
This pilot study of Streptococcus mutans ATCC 35668 grown in media with and without polyols (erythritol) measured the resultant metabolites, including the short chain fatty acids by using head space analysis. Brain Heart Infusion Broth (BHI2 or BHI10) supplemented with 2% or 10% sucrose containing no polyols or either erythritol or xylitol and Streptococcus mutans (ATCC 35668) was grown aerobically. After 48 hours of growth the supernatant were harvested and centrifuged to pellet bacteria. Supernatants were removed from bacterial pellets then submitted for Short Chain Fatty Acid (SCFA) analysis with an Agilent Technologies (Santa Clara, CA 95051) system configured from three components, a 5973 mass selective detector, a 6890N gas chromatographer, and a 7697A headspace sampler. Streptococcus mutans growing in Brain Heart Infusion Broth (BHI2 or BHI10) supplemented with 2% or 10% sucrose but containing no polyols produced the following short chain fatty acids: methyl isovalerate, acetic acid, propionic acid, butanoic acid, pentanoic acid, ethyl butaric acid, 4-methylvaleric acid, hexanoic acid. When the Brain Heart Infusion Broth (BHI2 or BHI10) supplemented with 2% or 10% sucrose containing erythritol was used as media for this Streptococcus mutans strain, the following were produced: ethanol, acetoin, and acetic acid. Our results would suggest that constituents of the media may affect the bacterial metabolite production.
Fri, 20 December 2019
ARTICLE | doi:10.20944/preprints201912.0265.v1
Online: 20 December 2019 (06:44:08 CET)
Excess alcohol consumption is a top risk factor for death and disability. Fatty liver will likely develop and the risk of liver disease increases. We have previously demonstrated that an essential amino acid supplement (EAAS) improved protein synthesis and reduced intrahepatic lipid in the elderly. The purpose of this study was to further evaluate the influence of EAAS on intrahepatic lipid (IHL), body composition, and blood lipids in individuals with mild to moderate alcohol use disorder (AUD). Following consent, determination of eligibility, and medical screening, 25 participants (18 males at 38±15 years/age and 7 females at 34±18 years/age) were enrolled and randomly assigned to one of two dosages: a low dose (LD: 8 grams of EAAS twice/day (BID)) or high dose (HD: 13 grams of EAAS BID). Both groups consumed the supplement for 4 weeks. Pre- and post-EAAS administration, IHL was determined using magnetic resonance imaging/spectroscopy, body composition was analyzed using dual energy x-ray absorptiometry, and blood parameters were measured by LabCorp. T-tests were used for statistical analysis and considered significant at P<0.05. While there was no significant change in IHL in the LD group, there was a significant 23% reduction in IHL in the HD group (p=0.02). Fat mass, lean tissue mass, bone mineral content, and blood lipids were not altered. Post-EAAS phosphatidylethanol was elevated and remained unchanged in LD at 407±141 ng/ml and HD at 429±196 ng/ml, indicating chronic and excess alcohol consumption. Based on these results, we conclude that 13 grams of proprietary EAAS consumed BID lowers IHL in individuals with mild to moderate AUD.
CASE REPORT | doi:10.20944/preprints201912.0264.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: glioblastoma; brain tumor; paleolithic diet; ketogenic diet; paleolithic ketogenic diet; metabolic therapy; intestinal permeability; cancer treatment
Online: 20 December 2019 (06:36:16 CET)
Studies in animal models have suggested that the ketogenic diet may be effective in the treatment of cancer. However, human cohort studies on the ketogenic diet have, thus far, failed to show benefits in cancer survival or in any other hard clinical endpoints of the disease. This paper presents a case report of a patient with glioblastoma multiforme. The patient had initially been treated with standard oncotherapy including surgery, radiotherapy and chemotherapy. Despite standard treatment, the patient experienced a recurrence of the glioblastoma seven months later. Subsequently, the patient refused radiotherapy and chemotherapy and opted to use the paleolithic ketogenic diet (PKD) as a stand-alone therapy. Following the adoption of the PKD, progression of the disease has been completely halted. At the time of writing, the patient has remained in remission for 38 months, is without side-effects and experiences an excellent quality of life without the use of any drugs.
Thu, 12 December 2019
REVIEW | doi:10.20944/preprints201912.0165.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: glucose; pentose phosphate pathway; NADPH; redox balance; glycogen; glycolysis; stress resistance; insulin resistance
Online: 12 December 2019 (05:29:28 CET)
A human organism depends on stable glucose blood levels in order to maintain the metabolic needs. Glucose is considered as the most important energy source and glycolysis is postulated as a backbone pathway. However, when glucose supply is limited, ketone bodies and amino acids can be used to produce enough ATP. In contrast, for the functioning of pentose phosphate pathway (PPP) glucose is essential and cannot be substituted for by other metabolites. PPP generates and maintains levels of NADPH needed for reduction of oxidized glutathione and protein thiols, synthesis of lipids and DNA as well as for xenobiotics detoxification, regulatory redox signaling and counteracting infections. Flux of glucose into a PPP, particularly under extreme oxidative and toxic challenges is critical for survival, whereas the glycolytic pathway is primarily activated when glucose is abundant, and there is lack of NADP+ that is required for activation of glucose-6 phosphate dehydrogenase. An important role of glycogen stores in resistance to oxidative challenges is discussed. Current evidence explains disruptive metabolic effects and detrimental health consequences of chronic nutritional carbohydrate overload and provides new insights into positive metabolic effects of intermittent fasting, caloric restriction, exercise, and ketogenic diet through modulation of redox homeostasis.
Thu, 5 December 2019
ARTICLE | doi:10.20944/preprints201912.0073.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: body composition; triathlon; ageing; energy availability; macronutrients; performance; protein; carbohydrate
Online: 5 December 2019 (11:54:46 CET)
The purpose of this case study was to evaluate the benefits that evidence-based nutritional and training recommendations could have on the time course of reconditioning following hip arthroplasty in a competitive master triathlete. Methods: During 38 weeks (from 6 weeks prior to surgery through to the return to competition), the athlete was provided with detailed training and nutritional recommendations based on the latest research evidence. Dietary intake (via the remote food photographic method), body composition (via DXA), peak oxygen uptake (VO2peak), peak power output (PPO) and cycling efficiency (GE) were assessed 6 weeks pre- and 8, 12, 18, 21 and 25-weeks post-surgery. Training load was quantified (TRIMP score) daily during the retraining. Results: Total body mass increased by 8.2 kg (attributable to a 3.5 and 4.6 kg increase in fat mass and lean mass, respectively) between week -6 and week 8 despite a reduction in carbohydrate (CHO) intake post-surgery (<3.0g/kg/day). This was accompanied with a decrease in VO2peak, PPO, and GE due to a drop in training load. From week 7, the athlete resumed training and was advised to gradually increase CHO intake according to the demands of training. Conclusions: Eventually the athlete was able to return to competition in week 32 with a higher PPO, improved VO2peak and GE. Throughout retraining, energy availability was maintained around 30 kcal/kg LBM/day, protein intake was high while CHO intake was periodised. Such dietary conditions allowed the athlete to maintain and even increase lean mass, which represents a major challenge with ageing.
Tue, 3 December 2019
REVIEW | doi:10.20944/preprints201912.0030.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: red grape polyphenols; immunity; inflammation, obesity; allergy; cancer
Online: 3 December 2019 (12:12:14 CET)
In this review, special emphasis will be placed on red grape polyphenols for their anti-oxidant and anti-inflammatory activities. Therefore, their capacity to inhibit major pathways responsible for activation of oxidative systems and expression and release of pro-inflammatory cytokines and chemokines will be discussed. Furthermore, regulation of immune cells by polyphenols will be illustrated with special reference to the activation of T regulatory cells which support a tolerogenic pathway at intestinal level. Furthermore, the effects of red grape polyphenols will be analyzed in obesity, as a low grade systemic inflammation. Also, possible modifications of inflammatory bowel disease biomarkers and clinical course have been studied upon polyphenol administration, either in animal models or in clinical trials. Moreover, the ability of polyphenols to cross the blood-brain barrier has been exploited to investigate their neuroprotective properties. In cancer, polyphenols seem to exert several beneficial effects, even if conflicting data are reported about their influence on T regulatory cells. Finally, the effects of polyphenols have been evaluated in experimental models of allergy and autoimmune diseases. Conclusively, red grape polyphenols are endowed with a great anti-oxidant and anti-inflammatory potential but some issues, such as polyphenol bioavailability, activity of metabolites and interaction with microbiota, deserve deeper studies.
Sat, 16 November 2019
ARTICLE | doi:10.20944/preprints201911.0189.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: protein; plant-based protein; whey protein; essential amino acids; leucine, healthy men
Online: 16 November 2019 (00:58:01 CET)
This study assessed bio-equivalence of high-quality, plant-based protein blends versus Whey Protein Isolate (WPI) in healthy, resistance-trained men. The primary endpoint was incremental area under the curve (iAUC) of blood essential Amino Acids (eAAs) 4 hours after consumption of each product. Cmax and Tmax of blood leucine were secondary outcomes. Subjects (n=18) consumed three plant-based protein blends and WPI (control). Analysis of Variance model was used to assess for bio-equivalence of total sum of blood eAA concentrations. The total blood eAA iAUC ratios of the three blends were: [90% CI]: #1: 0.66 [0.58-0.76]; #2: 0.71 [0.62-0.82]; #3: 0.60 [0.52-0.69], not completely within the pre-defined equivalence range [0.80-1.25], indicative of 30-40% lower iAUC versus WPI. Leucine Cmax of the three blends was not equivalent to WPI, #1: 0.70 [0.67-0.73]; #2: 0.72 [0.68-0.75]; #3: 0.65 [0.62 – 0.68], indicative of a 28-35% lower response. Leucine Tmax for two blends were similar to WPI (#1: 0.94 [0.73-1.18]; #2: 1.56 [1.28-1.92]; #3: 1.19 [0.95-1.48]). The plant-based protein blends were not bio-equivalent. However, blood leucine kinetic data across the blends approximately doubled from fasting concentrations whereas blood Tmax data across two blends was similar to WPI. This suggests evidence of rapid hyperleucinemia, which correlates with a protein’s anabolic potential.
Tue, 12 November 2019
ARTICLE | doi:10.20944/preprints201911.0133.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: malnutrition; disease related malnutrition; risk factors; nutrition care; mortality; recommendations
Online: 12 November 2019 (16:46:08 CET)
Disease related malnutrition (DRM) is prevalent in hospitals and is associated with increased care needs, prolonged hospital stay, delayed rehabilitation and death. Nutrition care process related activities such as screening, assessment and treatment has been advocated by scientific societies and patient organizations but implementation is variable. We analyzed the cross-sectional nutritionDay database for prevalence of nutrition risk factors, care processes and outcome for medical patients. In 59126 medical patients included between 2006-2015 the prevalence of recent weight loss (45%), history of decreased eating (48%) and low actual eating (53%) was more prevalent than low BMI (8%). Each of these risk factors was associated with a large increase in 30 days hospital mortality. Nutrition care processes increases slightly with presence of risk factors but never done in more than 50% of patients. Only a third of patients not eating in hospital receive oral nutritional supplements or artificial nutrition. We suggest that political action should be taken to raise awareness and formal education on all aspects related to DRM for all stakeholders, to create and support responsibilities within hospitals, and to create adequate reimbursement schemes. Collection of routine and benchmarking data is crucial to tackle DRM.
Wed, 30 October 2019
SHORT NOTE | doi:10.20944/preprints201910.0345.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: veganism; vegan diet; nutrition status; vitamin B12 deficiency; health status disparities
Online: 30 October 2019 (04:01:40 CET)
The vegan diet excludes animal-derived product consumption and health advantages had been reported when followed. However, heterogeneous eating habits, food availability, and sociocultural characteristics among regions could lead to different physiological results. The objective of this case-control cross-sectional pilot study was to analyze body composition, daily nutrients consumption, and basic serum biomarkers as a general overview of the health status of Mexican adults with a vegan diet for ≥3 years, randomly paired with omnivores. Body composition was assessed through bioelectric impedance analysis. Eating patterns were evaluated and daily nutrients intake was calculated. A complete blood count, glycated hemoglobin, cobalamin, and creatinine serum concentrations were analyzed. We hypothesized certain nutrient deficits and specific biomarker impairments originated from cultural particularities driving food selection in Mexicans following a plant-based diet. Body composition did not differ among groups. Lower protein, niacin, pantothenic acid, pyridoxine, cobalamin, calciferol, fluoride, iodine, and selenium intake yet greater fiber, folic acid, vitamin E, copper, and molybdenum were observed in the plant-based group when compared with controls. Vegans presented lower cobalamin and creatinine serum concentrations. Hematologic abnormalities were prevalent in vegans. Insufficient consumption of several nutriments was identified in both dietary groups, suggesting that the local diet may be unbalanced, affecting both vegans and non-vegan individuals. However, vegans might present additional deficiencies, especially vitamin B12, with potential repercussions. Clinical and nutritional guidance is required in this particular population to avoid possible health adverse events.
Tue, 29 October 2019
ARTICLE | doi:10.20944/preprints201910.0328.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Republic of Moldova; salt; sodium; potassium; iodine; population
Online: 29 October 2019 (10:15:58 CET)
In the Republic of Moldova, nearly 90% of all deaths are due to noncommunicable diseases (NCDs), tha majority of which (58%) are caused by cardiovascular disease (CVD). Excess salt (sodium) and inadequate potassium intakes are associated with high CVD. Moreover, salt iodisation is the preferred policy to prevent iodine deficiency and associated disorders. However, there is no survey that has directly measured sodium, potassium and iodine consumption in adults in the Republic of Moldova. The aim is to estimate population sodium, potassium and iodine intakes and explore knowledge, attitudes and behaviour (KAB) towards the use of salt, amongst the adult population in the Republic of Moldova. Proportional random samples of adults were obtained from 28 of the 37 Districts and Municipalities and one Administrative Territorial Unit of Moldova. Participants attended a screening including demographic, anthropometric and physical measurements. Dietary sodium, potassium and iodine intakes were assessed by 24h urinary sodium (UNa), potassium (UK) and iodine (UI) excretions. Creatinine was measured. KAB was collected by questionnaire. Eight hundred and fifty-eight participants (326 men and 532 women, 18–69 years) were included in the analysis (response rate 66%). Mean age was 48.5 yrs (SD 13.8). Mean UNa was 172.7 (79.3) mmoL/day, equivalent to 10.8 g of salt/day and potassium excretion 72.7 (31.5) mmoL/day, equivalent to 3.26 g/day. Men ate more sodium and potassium than women. Only 11.3% of the sample had a salt intake below the World Health Organization (WHO) recommended target of 5 g/day and approximately 39% met WHO targets for potassium excretion (>90 mmoL/day). Whilst 81.7% declared limiting their consumption of processed food and over 70% declared not adding salt at the table, only 8.8% looked at sodium content of food, 31% still added salt when cooking and less than 1% took other measures to control salt consumption. Measures of awareness were significantly more common in urban compared to rural areas. Mean urinary iodine was 225 (SD: 152; median 196) mcg/24h, with no difference between sexes. According to WHO criteria, 41.0% had adequate iodine intake, 28.6% had intake below requirements and 17.8% and 12.6% had above requirement or excessive levels, respectively. Iodine content of salt table was 21.0 (SD: 18.6) mg/kg, with no difference between men and women. However, the content was lower in rural than urban areas (16.7 [SD: 18.6] vs 28.1 [SD: 16.5] mg/kg, p<0.001). There were weak or no correlations between urinary sodium and iodine excretions, and between urinary iodine excretion and iodine concentration in the table salt used in the participants’ households, indicating that in most cases participants were not using iodised salt as their main source of salt, more so in rural areas. In the Republic of Moldova, salt consumption is unequivocally high, potassium consumption is lower than recommended, both in men and in women, whilst iodine intake is still inadequate in 1 in 3 people, although severe iodine deficiency is rare. Salt consumed is often not iodised, with less iodised salt being used in rural areas.
Sun, 27 October 2019
Subject: Medicine & Pharmacology, Nutrition Keywords: high fat diet; metabolic dysregulation; platelets; monocytes; hypercoagulation; inflammation
Online: 27 October 2019 (03:13:45 CET)
High fat-diet (HFD) feeding is known to induce metabolic dysregulation, however less is known on its impact in promoting the hypercoagulable state. The current study aimed to evaluate platelet-monocyte aggregate (PMA) formation following short-term HFD feeding. This is particularly important for understanding the link between inflammation and the hypercoagulable state during the early onset of metabolic dysregulation. To explore such a hypothesis, mice were fed a HFD for 8 weeks, with body weights as well as insulin and blood glucose levels monitored on weekly basis during this period. Basal hematological measurements were determined and the levels of spontaneous peripheral blood PMAs were assessed using whole blood flow cytometry. The results showed that although there were no significant differences in body weights, mice on HFD displayed impaired glucose tolerance and markedly raised insulin levels. These metabolic abnormalities were accompanied by elevated baseline PMA levels as an indication of hypercoagulation. Importantly, it was evident that baseline levels of monocytes, measured using the CD14 monocyte marker were significantly decreased in HFD-fed mice when compared to controls. In summary, the current evidence shows that in addition to causing glucose intolerance, such as that identified in a prediabetic state, HFD-feeding can promote undesirable hypercoagulation, the major consequence implicated in the development of cardiovascular complications.
Thu, 24 October 2019
ARTICLE | doi:10.20944/preprints201910.0280.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: nutrition; plant-based diet; vegan diet; lifestyle; obesity; body composition; weight-loss
Online: 24 October 2019 (15:30:39 CEST)
Failure of various weight-loss programs and long-term maintenance of favorable body composition in all kinds of people is high, since the majority go back to old dietary patterns. Many studies have documented the efficacy of a plant-based diet (PBD) for body mass management, but there are opinions that maintaining a PBD is difficult. We aimed to evaluate the long-term success of a whole-food plant-based (WFPB) lifestyle program. We investigated the differences in the obesity indices and lifestyle of 151 adults (39.6 ± SD 12.5 years), who were on our program for short (0.5–<2 years), medium (2–<5 years), or long term (5–10 years). Body-composition changes were favourable for all three groups, both genders and all participants. There were no differences in relative body-composition changes (BMI, body fat percentage and muscle mass index (MMI)) between the three groups. All participants improved their BMI (baseline mean pre-obesity BMI range (kg/m2): 26.4 ± 5.6 to normal 23.9 ± 3.8, p < 0.001), decreased body mass (–7.1 ± 8.3 kg, p < 0.001) and body fat percentage (–6.4 ± 5.6 % points, p < 0.001). Those with the highest BMI at baseline lost the most of: a) BMI units, b) total body mass and c) body fat (a) (kg/m2) (–5.6 ± SD 2.9, –2.4 ± 1.8 and –0.9 ± 1.5), b) (kg) (–16.1 ± SD 8.8, –7.1 ± 5.4 and –2.5 ± 4.5) and c) (% points) (–9.5 ± SD 5.7, –6.6 ± 4.6 and –4.7 ± 5.3) for participants who had baseline BMI in obese, overweight and normal range, respectively; pbaseline vs. current < 0.001 for all). 85.6% (101 out of 118) of parents of underage children (< 18 years), introduced WFPB lifestyle to their children. WFPB lifestyle program provides long-term lifestyle changes for reversal of obesity and is effective transferred to the next generation.
Tue, 22 October 2019
ARTICLE | doi:10.20944/preprints201910.0256.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: nhanes; foodservice; nutrition assessment; dietary reference intakes; school lunch program
Online: 22 October 2019 (10:31:57 CEST)
The purpose of this study was to select target nutrients to be included in the nutritional standards of school lunches in Korea. The dietary intake data of children and adolescents aged 6-17 years old from the Korea National Health and Nutrition Examination Survey Ⅵ were analyzed for eight groups based on gender and age (6-8, 9-11, 12-14, and 15-17 years old). First, the usual intake of the 3,091 subjects was estimated and assessed to identify nutrients with insufficient or excessive intake prevalence. Along with the nutrients identified by the assessment, the energy and nutrients prioritized in the meal planning procedure of the 2015 Dietary Reference Intakes for Koreans were the initial candidates: energy, the percentages of energy from carbohydrates, protein, and fat, vitamin A, riboflavin, niacin, vitamin C, calcium, phosphorus, sodium, and iron. Phosphorus was excluded due to little evidence of clinical symptoms caused by insufficient intake. Sodium was excluded because reliable data on added salt were not available among the school lunch recipes in Korea. Therefore, energy, the percentages of energy from carbohydrates, protein, and fat, vitamin A, riboflavin, niacin, vitamin C, calcium, and iron were selected to be included in the nutritional standards of school lunches in Korea.
Fri, 18 October 2019
REVIEW | doi:10.20944/preprints201910.0214.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: inflammatory bowel diseases; parenteral nutrition; systematic review; meta-analysis; crohn disease
Online: 18 October 2019 (11:36:07 CEST)
Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and characterized by the inflammation of the gastrointestinal tract. This study is to understand how the use of parenteral nutrition (PN) can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis and a meta-regression. On the different databases, (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, WOS) we found 119 registers, the accuracy was 16% (19 registers); After a Full-text review, only 15 research studies were selected for qualitative synthesis and 10 for Meta-analysis and Meta-regression. The variables used were Crohn’s Disease Activity Index (CDAI), albumin, body weight (BW) and post-operative complications (COM). PN has shown to have efficacy for the treatment of IBD and is compatible with other medicines. The CDAI and albumin improve although the effect of PN are greater after a while. However, the effect on the albumin could be less than the observed value in the meta-analysis, due to a possible publication bias. The BW does not change after intervention. COM utilizing PN has been observed, although the proportion is low.
Thu, 17 October 2019
ARTICLE | doi:10.20944/preprints201910.0205.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: diabetes; vegetarian; diet; nutrition; metabolic syndrome; disparity; child
Online: 17 October 2019 (15:24:37 CEST)
The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparity populations. The objective of our study was to evaluate the efficacy and scalability of the Healthy Eating Lifestyle Program (HELP) – a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino pediatric obesity patients and their families. Our evaluation methods included: 1) a quasi-experimental, one group, longitudinal study to measures changes in BMI at 0, 6, and 18 weeks of follow-up, and 2) A stakeholder analysis consisting of six key informant interviews of HELP program staff. We found a significant decrease in body mass index across all adults (-0.2 kg/m2 p=0.0047), that was much stronger in men. For children ages 5-12 years, there was also a significant decrease in BMI Z score from pre- to post- intervention (p=0.04). Program strengths were the cultural tailoring of the plant-based diet choices, and allowing a tiered approached that did not require adherence to strict vegetarianism. Our pilot study findings from HELP raise the possibility that incorporating plant-based diet choices into the treatment of pediatric obesity patients and their families can be an effective addition to a culturally responsive care model.
Wed, 16 October 2019
ARTICLE | doi:10.20944/preprints201910.0185.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: sodium; potassium; nutrition; diet; urine spot; food frequency questionnaire; cardiovascular disease; childhood cancer survivors; Swiss childhood cancer registry; Europe
Online: 16 October 2019 (10:25:07 CEST)
Risk of cardiovascular disease (CVD), common in childhood cancer survivors (CCSs), may be affected by diet. We assessed sodium (Na) and potassium (K) intake, estimated from food frequency questionnaires (FFQs) and morning urine spots, and its associations with cardiovascular risk in CCSs. We stratified CCS into three risk profiles based on A) personal history (CVD, CVD risk factors, or CVD risk free), B) body mass index (obese, overweight, or normal/underweight), and C) cardiotoxic treatment (anthracyclines and/or chest irradiation, or neither). We obtained a FFQ from 802, and sent a spot urine sample collection kit to 212, of which 111 (52%) returned. We estimated Na intake 2.9 g/day based on spot urine and 2.8 g/day based on FFQ; estimated K intake was 1.6 g/day (spot urine) and 2.7 g/day (FFQ). CCSs with CVD risk factors had a slightly higher Na intake (3.3 g/day), than CCSs risk free (2.9 g/day) or with CVD (2.7 g/day, p = 0.017), and obese participants had higher Na intake (4.2 g/day) than normal/underweight CCSs (2.7 g/day, p<0.001). Daily Na intake was above, and daily K intake below national recommended levels. Adult survivors of childhood cancer need dietary assistance to reduce Na and increase K intake.
Thu, 10 October 2019
ARTICLE | doi:10.20944/preprints201910.0119.v1
Online: 10 October 2019 (15:02:17 CEST)
The aim of this study was to establish the blood glucose response to different cooking methods of pasta. Participants consumed three identical meals in a random order that were freshly cooked (hot), cooled and reheated. Blood glucose concentrations were assessed before, and every 15 minutes after ingestion of each meal for 120 minutes. There was a significant interaction between temperature and time (F(8.46-372.34) = 2.75, p = 0.005), with the reheated (90 minutes) condition returning to baseline faster than both cold (120 minutes) and hot conditions. Blood glucose AUC was significantly lower in the reheated (703 ± 56 mmol L-1 min-1) compared with the hot condition (735 ± 77 mmol L-1 min-1, t(92) = -3.36, pbonferroni = 0.003), with no significant difference with the cold condition (722 ± 62 mmol L-1 min-1). To our knowledge, the current study is the first to show that reheating pasta causes changes in post-prandial glucose response, with a quicker return to fasting levels in both the reheated and cooled conditions compared with the hot condition. The mechanisms behind the changes in post-prandial blood glucose seen in this study are most likely related to changes in starch structure and how these changes influence glycaemic response.
Mon, 30 September 2019
ARTICLE | doi:10.20944/preprints201909.0336.v1
Online: 30 September 2019 (03:21:27 CEST)
Background: Carnitine deficiency is common in patients on dialysis. Serum free carnitine concentration is significantly lower in patients on hemodialysis (HD) than in healthy individuals. However, there are few reports on serum free carnitine concentration in patients on peritoneal dialysis (PD). Methods: We examined serum concentrations of total, free, and acylcarnitine and the acylcarnitine/free carnitine ratio in 34 PD and 34 age-, sex-, and dialysis duration-matched HD patients. We investigated the prevalence of carnitine deficiency and clinical factors associated with carnitine deficiency in the PD group. Results: Prevalence of carnitine deficiency was 8.8% in the PD group and 14.7% in the HD group (P = 0.45). High risk of carnitine deficiency was found in 79.4% of the PD group and 85.3% of the HD group (P = 0.52). Carnitine insufficiency was found in 82.3% of the PD group and 88.2% of HD group (P = 0.49). Multivariate analysis revealed that duration of dialysis and age were independent predictors of serum free carnitine level in the PD group. Conclusions: The prevalence of carnitine deficiency, high risk of carnitine deficiency, and carnitine insufficiency in PD patients was 8.8%, 79.4%, and 82.3%, respectively. These rates were comparable to those in patients on HD.
Fri, 27 September 2019
ARTICLE | doi:10.20944/preprints201909.0309.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: val-phe-val-arg-asn (vfvrn); hypolipidemic effects; transintestinal cholesterol efflux (tice); 3t3-l1 preadipocyte; apoptosis
Online: 27 September 2019 (10:29:29 CEST)
Val-Phe-Val-Arg-Asn (VFVRN) has been identified and screened from lipid-lowering chickpea peptides (ChPs) by using a pharmacokinetic model in our previous experiment. The present study was conducted to investigate its effects and mechanisms on lipid metabolism. A high-fat diet C57BL/6J mice model and 3T3-L1 preadipocyte cell model were used. VFVRN was found to significantly decrease the levels of some blood lipids. The expressions of LDL receptor (LDLR), peroxisome proliferator-activated receptors (PPAR)α, liver X receptor (LXR)α, cholesterol 7α-hydroxylase (CYP7A1) and AMP-activated protein kinase (p-AMPK) in liver were up-regulated by VFVRN treatment. The expressions of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGR), fatty acid synthetase (FAS), 1-aminocyclopropane-1-carboxylate synthetase (ACC), sterol regulatory element-binding protein (SREBP)-1c and SREBP-2 in liver were significantly (P<0.05) down-regulated. Additionally, the expressions of PPARα and PPARγ in adipose tissues were up-regulated by VFVRN significantly (P<0.05). VFVRN might also contribute to transintestinal cholesterol efflux (TICE) by up-regulating the expressions of LXRα and ATP binding cassette G5/8 transporters (ABGC5/8). Moreover, VFVRN promoted 3T3-L1 preadipocyte apoptosis by up-regulating the expressions of BaX, cleaved Caspase-3 and down-regulating Bcl-2. VFVRN had potent effects in reversing metabolic disorders of blood and liver in a high-fat diet mice model, as well as to promote the apoptosis of 3T3-L1 preadipocytes.
Sun, 22 September 2019
Subject: Medicine & Pharmacology, Nutrition Keywords: metabolomics; metabolite profiling; prudent diet; western diet; food provisions; diet records; nutritional epidemiology; mass spectrometry
Online: 22 September 2019 (15:20:34 CEST)
A large body of evidence has linked unhealthy eating patterns with an alarming increase in obesity and chronic disease worldwide. However, existing methods of assessing dietary intake in nutritional epidemiology rely on food frequency questionnaires or dietary records that are prone to bias and selective reporting. Herein, metabolic phenotyping was performed on 42 healthy participants from the Diet and Gene Intervention (DIGEST) pilot study, a parallel two-arm randomized clinical trial that provided complete diets to all participants. Matching urine and plasma specimens were collected at baseline and following 2 weeks of provision of either a Prudent or Western diet with a weight-maintaining menu plan designed by a dietician. Targeted and nontargeted metabolite profiling was conducted using three complementary analytical platforms, where 80 plasma metabolites and 84 creatinine-normalized urinary metabolites were reliably measured (CV < 30%) in the majority of participants (> 75%) after implementing a rigorous data workflow for metabolite authentication with stringent quality control. We classified a panel of metabolites with distinctive trajectories following 2 weeks of food provisions when using complementary univariate and multivariate statistical models. Unknown metabolites associated with contrasting dietary patterns were identified with high resolution MS/MS and/or co-elution after spiking with authentic standards. Overall, 3-methylhistidine and proline betaine concentrations increased consistently after participants were assigned a Prudent diet (q< 0.05) in both plasma and urine samples with a corresponding decrease in the Western diet group. Similarly, creatinine-normalized urinary imidazole propionate, hydroxypipecolic acid, dihydroxybenzoic acid, and enterolactone glucuronide, as well as plasma ketoleucine and ketovaline increased with a Prudent diet (p< 0.05) after adjustments for age, sex and BMI. In contrast, plasma myristic acid, linoelaidic acid, linoleic acid, a-linoleic acid, pentadecanoic acid, alanine, proline, carnitine and deoxycarnitine, as well as urinary acesulfame K increased among participants following a Western diet. Most metabolites were also correlated (r > ±0.30, p< 0.05) to changes in average intake of specific nutrients from self-reported diet records reflecting good adherence to assigned food provisions. Our study revealed robust biomarkers sensitive to short-term changes in habitual diet for accurate monitoring of healthy eating patterns in free-living populations, which is required for validating evidence-based public health policies for chronic disease prevention.
Wed, 18 September 2019
ARTICLE | doi:10.20944/preprints201909.0200.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: trilactic glyceride; intestinal function; gut microbiota; weaned piglet
Online: 18 September 2019 (07:28:51 CEST)
Both lactic acid and short chain fatty acid (SCFA) play important roles in maintenance of intestinal epithelial structure and function. Trilactic glyceride (TLG) obtains both excellences of lactic acid and SCFA. This study was to investigate the effects of trilactic glyceride on growth performance, blood parameters, liver function, intestinal morphology and intestine function of piglets. Twelve weaned piglets (21±2 d) were randomly allocated to two treatment groups: 1) control group, piglets fed the basal diet; 2) TLG group, piglets fed the basal diet supplemented with 0.5 % TLG. On day 21 of the trial, D-xylose (0.1 g/kg·BW) was orally administrated to all piglets and blood samples were collected 1 h thereafter. Then, all the piglets were sacrificed to examine intestinal mucosal morphology and collect fatty tissue, liver and intestinal mucosa for further analysis. The results showed that: compared with the control group, TLG group decreased blood ALB and GGT on day 10 and 20, TLG group decreased blood TP and increased blood TG on day 20 of the trail (p < 0.05); TLG group decreased blood D-xylose and LDL, increased blood HDL (p < 0.05). These data suggested that supplementing trilactic glyceride had beneficial impacts on promoting nutrients’ metabolism, maintaining intestinal integrity, and alleviating oxidative stress and diarrhoea. Further research of molecular mechanisms showed changing expression levels of related proteins and genes, suggesting that these could be involved in the regulation of the impact. The community composition of the gut microbiota was also found to be altered in several operational taxonomic units within the genus, Prevotella (order Bacteroidales), and the order, Clostridiales.
Mon, 16 September 2019
ARTICLE | doi:10.20944/preprints201909.0175.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: water purification; developing countries; SDG-6; microbiological contamination; public health; membrane filtration
Online: 16 September 2019 (17:23:23 CEST)
Introduction: In rural communities in regions with limited resources the provision of clean water remains challenging. Fecal contamination of water is very common and results in a high incidence of diarrhea, subsequent acute kidney injury and mortality particularly in the very young and old. Membrane filtration is a practical solution to this problem and recent innovation allows membrane filtration using recycled hemodialyzers. We, Easy Water for Everyone, have quantified the systematic effect on health outcomes. Material and Methods: Between 02/2018 and 12/2018, 4 communities in rural Ghana (in the Greater-Accra region) were each provided with a high-volume membrane filtration devices (NUF 500; NuFiltration using recycled hemodialyzers). Health data from montly household surveys and chart review in local healthcare facilities were collected with approval from Ghana Health Services. Specifically, data was collected on gastrointestinal disease, acute kidney injury and therapeutic interventions. Incidence rates for a five-months period before and after implementation of the device were calculated and compared to rates during the same months from 4 neighboring communities that were not yet provided with the device. Results: Acceptance of the devices and the purified water in the studied villages was good and self-reported data of 1130 villagers over 10 months from 9 studied communities in rural Ghana (11% younger than 5 years and 14 % older than 65 years) were included in this analysis. The overall monthly incidence rate of diarrhea showed a decline following the implementation of the device in the 4 study villages from a mean of 0.18 to 0.05 cases per person-month for a reduction in rates by 72% (rate ratio = 0.27). By contrast, the control group of 4 villages in the same region showed no decline in mean rates during the same months as the study period with mean rates changing not significantly from 0.11 to 0.08 cases per person-month. Discussion: Provision of a hemodialyzer membrane filtration device markedly improves health outcomes as measured by diarrhea incidence within rural communities. While our data awaits confirmation in a larger population and further statistical analyses accounting for village characteristics, seasonality and subject demographics, the obvious decline in incidence rates supports widespread use of hemodialyzer membrane filtration devices, particularly in rural regions. Rollout of the device in further sites will likely increase our understanding in terms of risk and other preventive factors modifying the incidence of diarrhea and subsequent acute kidney injury.
Sun, 1 September 2019
REVIEW | doi:10.20944/preprints201909.0009.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: inflammatory bowel diseases; enteral nutrition; systematic review; meta-analysis; Crohn disease
Online: 1 September 2019 (10:32:09 CEST)
Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and characterized by the inflammation of the gastrointestinal tract. One of the possible treatments for this pathology is a change in the type of diet, the enteral nutrition (EN) is one of them. This study is to understand how the use of EN can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis and a meta-regression. On the different databases, (MEDLINE, Scopus, Cochrane, LILACS, Cinhal, WOS) we found 363 registers, the accuracy was 12% (44 registers); After a Full-text review, only 30 research studies were selected for qualitative synthesis and 11 for Meta-analysis and Meta-regression. The variables used were Crohn’s Disease Activity Index (CDAI), C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR). EN has shown to have efficacy for the treatment of Crohn’s Disease and is compatible with other medicines. As for the CDAI or the rates of remission, there were no differences between enteral and parenteral nutrition. Polymeric formulas, have shown better results with respect to the CRP. The long-term treatment could dilute the good CDAI results that are obtained at the start of the EN treatment.
Thu, 29 August 2019
ARTICLE | doi:10.20944/preprints201908.0312.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: child; fruit; vegetables; school health services; public policy; environment and public health
Online: 29 August 2019 (17:03:20 CEST)
The School Fruit and Vegetables Scheme (SFVS) implemented by the European Union during 2009/10 aims to improve the diet of school children and to support agricultural markets and environmental sustainability. The objective of this study was to characterize the SFVS implementation in Spain (2009-2017). A descriptive, longitudinal, observational and retrospective study was carried out based on document analysis of annual strategies of the SFVS. We studied the average budget for the EU, the number of students enrolled, the cost of the SFVS by student and by day, the duration of the SFVS, the quantity of fruits and vegetables (FV) per student, the variety of FV, the inclusion of local, seasonal and organic foods, and the education activities (EA). The results were studied by autonomous community (AC). The budget increased from 7.4 million euros in 2009/10 to 14.4 in 2016/17. Since 2014/15, the increase came from EU funds, the number of students increased from 18% in 2009 to 20% in 2016. The quantity of FV went from 2,579 to 4,000 tons, duration increased from 9.8 to 19.6 days and the variety of fruits and vegetables increased from 20 to 21 and from 5 to 6 respectively. In AC there were important variations in EA, in the number of enrolled students (7.4% to 45.6%), in the cost per student (2.3€ to 28€) and in the duration in days (5.6 to 70 days). The inclusion of local, seasonal and organic foods was identified in 5 of the 8 years studied. The development and reach of the SFVS in Spain is still insufficient to influence dietary patterns and health in the school population. However, the SFVS has generated an economic market for agricultural production.
Mon, 26 August 2019
Subject: Medicine & Pharmacology, Nutrition Keywords: renal diets; fiber; renal nutrition; chronic kidney disease; gut microbiota
Online: 26 August 2019 (12:23:22 CEST)
Nutrition is crucial for the management of patients affected by chronic kidney disease (CKD) to slow down disease progression and to correct symptoms. The mainstay of the nutritional approach to renal patients is protein restriction coupled with adequate energy supply to prevent malnutrition. However, other aspects of renal diets, including fiber content, can be beneficial. This paper summarizes the latest literature on the role of different types of dietary fiber in CKD, with special attention to intestinal microbiota and the potential protective role of renal diets. Fibers have been identified based on aqueous solubility, but other features, such as viscosity, fermentability, and bulking effect in the colon should be considered. A proper amount of fiber should be recommended not only in the general population but also in CKD patients, to achieve an adequate composition and metabolism of intestinal microbiota and to reduce the risks connected with obesity, diabetes, and dyslipidemia.
Tue, 13 August 2019
ARTICLE | doi:10.20944/preprints201908.0149.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: metabolomics; metabolite profiling; prudent diet; western diet; food provisions; diet records; nutritional epidemiology; mass spectrometry
Online: 13 August 2019 (04:57:48 CEST)
A large body of evidence has linked unhealthy eating with an alarming increase in obesity and chronic disease worldwide. However, existing methods of assessing dietary intake rely on food frequency questionnaires or dietary records that are prone to bias and selective reporting. Herein, metabolic phenotyping was performed on 42 healthy participants from the Diet and Gene Intervention (DIGEST) pilot study, a parallel two-arm randomized clinical trial that provided complete diets to all participants. Matching urine and plasma specimens were collected at baseline and following 2 weeks of provision of either a Prudent or Western diet with a weight-maintaining menu plan designed by a dietician. Targeted and nontargeted metabolite profiling was conducted using three complementary analytical platforms, where 80 serum metabolites and 84 creatinine-normalized urinary metabolites were reliably measured (CV < 30%) in the majority of participants (> 75%) after implementing a rigorous data workflow for metabolite authentication with stringent quality control. We classified a panel of metabolites with distinctive trajectories following 2 weeks of food provisions when using complementary univariate and multivariate statistical models. Unknown metabolites associated with contrasting dietary patterns were identified with high resolution MS/MS and/or co-elution after spiking with authentic standards. Overall, 3-methylhistidine and proline betaine concentrations increased consistently when participants were assigned a Prudent diet (q < 0.05) in both plasma and urine samples with a decrease in the Western diet group. Similarly, creatinine-normalized urinary imidazole propionate, hydroxypipecolic acid, dihydroxybenzoic acid, and enterolactone glucuronide, as well as plasma ketoleucine and ketovaline increased with a Prudent diet (p < 0.05) after adjustments for age, sex and BMI. In contrast, plasma myristic acid, linoelaidic acid, linoleic acid, α-linoleic acid, pentadecanoic acid, alanine, proline, carnitine and deoxycarnitine, as well as urinary acesulfame K increased among participants following a Western diet. Most metabolites were also correlated (r > ± 0.30, p < 0.05) to changes in average intake of specific nutrients from self-reported diet records reflecting good adherence to food provisions. This study revealed robust biomarkers sensitive to short-term changes in habitual diet that can be used to reliably monitor healthy eating patterns for new advances in nutritional epidemiology, as well as the design of evidence-based public health policies for chronic disease prevention.
Thu, 8 August 2019
ARTICLE | doi:10.20944/preprints201908.0105.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: lifestyle program; 25-hydroxyvitamin D; parathyroid-hormone; anthropometry; cardiometabolic factors
Online: 8 August 2019 (12:16:44 CEST)
Obesity in children is associated with vitamin D (VD) deficiency and cardiometabolic abnormalities. To analyze the effects of VD supplementation in adolescents with obesity enrolled in a weight-loss program. Adolescents with obesity (n=26) and with normal weight (n=23; controls) were matched for age, sex, and puberty stage. The obesity group followed a 3-month weight-loss program that combined a reduced caloric intake with interval training physical activity and during which they received or not VD supplementation (4000 IU/d) (n=13/group; random assignation). The anthropometric parameters (BMI z-score, fat mass); serum levels of 25(OH)D, calcium and parathyroid hormone (PTH), cardiometabolic factors (triglycerides, HDL, and LDL cholesterol), fasting glucose and insulin, and homeostasis model assessment of insulin resistance index; diastolic, systolic and mean blood pressure, and inflammatory status (C-reactive protein, CRP) were measured at baseline and at the end of the 3-month program. At baseline, 25(OH)D concentration was lower and VD insufficiency (25(OH)D levels <50 nmol/L) rate was higher (73% vs 22%) in the obesity than in the normal-weight group. All cardiometabolic factors were altered in the obesity compared with the normal-weight group. After the 3-month weight-loss program, 25(OH)D levels was >50 nmol in all adolescents with obesity, but only in 46% of normal-weight adolescents. Moreover, the weight-loss program improved the cardiometabolic factors, inflammatory status (CRP) and physical performance, but VD supplementation did not have any additional effect. Analysis only of the adolescents with obesity and VD deficiency (25(OH)D <50 nmol/L) at baseline showed a significant correlation between the change in PTH and CRP (p=0.02) in the supplemented obesity group, while the increase in 25(OH)D only tended to be correlated with CRP decrease. Vitamin D supplementation could reduce VD insufficiency in adolescent with obesity, but does not have any additional effect on cardiometabolic factors when combined with a weight-loss program.
Wed, 7 August 2019
ARTICLE | doi:10.20944/preprints201908.0098.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: community food environment; nutrition environment; geographical information systems (GIS); Facility List Coder; Python
Online: 7 August 2019 (16:53:36 CEST)
A community food environment plays an essential role in explaining the healthy life-style patterns of its community members. However, there is a lack of compelling quantitative approaches to evaluate these environments. This study introduces and validates a new tool named the Facility List Coder (FLC), whose purpose is to assess food environments based on data sources and classification algorithms. Using the case of Mataró (Spain), we randomly selected 301 grids areas (100 m2) where we conducted street audits in order to physically identify all the facilities by name, address and type. Then, audit-identified facilities were matched with those automatically-identified and were classified using the FLC in order to determine its quality. Our results suggest that automatically-identified and audit-identified food environments have a high level of agreement. The ICC estimates and their respective 95% confidence intervals for the overall sample, yield the result “excellent” (ICC ≥ 0.9) for the level of reliability of the FLC.
Tue, 6 August 2019
REVIEW | doi:10.20944/preprints201908.0082.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: overview; meta-analyses; stroke; nutrition; geographical areas
Online: 6 August 2019 (16:18:23 CEST)
Stroke is one of the most prevalent cardiovascular diseases worldwide, both in high-income countries and in medium and low-medium income countries. The WHO report on non-communicable diseases (NCDs) indicates that the highest behavioral risk in NCDs is attributable to incorrect nutrition. The objective of our work is to present an overview of meta-analyses that have investigated the impact of different foods and / or drinks in relationship with the risk of stroke events (ischemic/ hemorrhagic). The papers to be included in the overview were sought in the MEDLINE, EMBASE, Scopus, Clinicaltrials.gov, Web of Science, and Cochrane Library and were selected according to PRIMA flow chart. Quality assessment were made according to AMSTAR scale. This overview shows that all primary studies came from countries with high income level. This evidence shows that many countries are not represented. Therefore, different lifestyles, ethnic groups, potentially harmful or virtuous eating habits are not reported. It is important to underline how the choose of foods may help reduce the risk of cardiovascular diseases and stroke in particular.
Wed, 31 July 2019
ARTICLE | doi:10.20944/preprints201907.0344.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: diet quality; neighborhood deprivation; Japanese areal deprivation index; neighborhood socioeconomic status; hazard ratios; mortality; Japanese Food Guide Spinning Top; well-balanced diet; early death
Online: 31 July 2019 (04:26:11 CEST)
Individuals residing in more deprived areas have a lower diet quality. While several studies have shown that individuals with a lower diet quality have a higher mortality risk, a low quality diet might also lead to poor health in highly deprived areas. We aimed to examine the association between deprivation within an area and all-cause mortality risk according to diet quality. Methods: We conducted a population-based prospective study on 27994 men and 33273 women aged 45–75 years. Neighborhood deprivation was assessed using the Japanese areal deprivation index (ADI). Dietary intakes were assessed using a validated 147-item food frequency questionnaire. Subsequently, Japanese Food Guide Spinning Top scores were calculated. Hazard ratios (HR) and 95% confidence intervals (CI) of mortality were calculated according to tertiles of ADI by diet quality score. Results: Individuals residing in the most deprived area had the lowest dietary scores. During the 16.7-year follow-up, compared to individuals with a high quality diet residing in the least deprived area, individuals with a low quality diet had a higher risk of mortality according to increment of ADI (P trend = 0.02); the multivariate adjusted HR (95% CI) was 1.07 (1.00-1.15), 1.15 (1.07-1.24), and 1.18 (1.08-1.29) in those residing in the lowest through the highest third of ADI, respectively. However, individuals with a high quality diet had no significant association between ADI and mortality (P trend =0.87). Conclusion: A well-balanced diet may prevent early death associated with neighborhood socioeconomic status among those residing in highly deprived areas.
Thu, 25 July 2019
REVIEW | doi:10.20944/preprints201907.0289.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: omega-3 polyunsaturated fatty acids; Parkinson’s disease; Alzheimer’s disease; clinical trials
Online: 25 July 2019 (11:38:57 CEST)
A nutritional approach could be a promising strategy to prevent or slow the progression of neurodegenerative diseases such as Parkinson’s and Alzheimer’s disease, since there is no effective therapy for these diseases so far. The beneficial effects of omega-3 fatty acids are now well established by a plethora of studies through their involvement in multiple biochemical functions, including synthesis of antinflammatory mediators, cell membrane fluidity, intracellular signalling and gene expression. This systematic review will consider epidemiological studies and clinical trials that assessed the impact of supplementation or dietary intake of omega-3 polyunsaturated fatty acids on neurodegenerative diseases such as Parkinson’s and Alzheimer’s diseases. Indeed, treatment with omega-3 fatty acids, being safe and well tolerated, represent a valuable and biologically plausible tool in the management of neurodegenerative diseases in their early stages.
Wed, 24 July 2019
ARTICLE | doi:10.20944/preprints201907.0274.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Iodide, salt iodination, ioduria, iodide deficiency, goiter, thyroid cancer
Online: 24 July 2019 (11:59:50 CEST)
Iodide is an essential micronutrient present in very small quantities in the human body, with a fundamental action for the adequate synthesis of thyroid hormones, which are critical for cell differentiation, growth and metabolism. In the form of iodide, iodine is widely distributed in the environment, although in an irregular manner, occurring in abundant amounts in the oceans and in coastal areas and scarcely found on islands and mountains. The diet is the main source of iodine, whose intake varies according to the amount present in soil and water and according to eating habits. Governmental policies have been adopted to satisfy and guarantee the necessary daily supply of iodine, such as fortification of industrialized salt for domestic iodine consumption or addition to the bread commonly consumed in a given region, or the offer of iodized oil to the population, or even iodine supplementation through medications. Iodide deficiency is the main avoidable cause of brain damage to fetuses and children, as well as retardation of psychomotor development. Thyroid hormones are almost universally involved in the development and proliferation of fetal neural tissue. Permanent lesions of the cerebral cortex, hippocampus and cerebellum may occur, with loss of, or damage to the brainstem or spinal cord, affecting cortical areas that integrate highly specialized stimuli, which become poorly defined on an anatomical basis, including silent areas of the associative cortex. One of the more significant metabolic problems due to dietary iodine deficiency is the presence of goiter (increased volume of the thyroid gland). Thyroid carcinoma is the most frequent endocrine neoplasia affecting the human species and plasma iodine concentration is related to the development of specific subtypes of this neoplasia. An increased prevalence of follicular carcinoma, a more aggressive tumor, has been observed in areas of iodine deficiency, while the correction of this deficiency is associated with a higher prevalence of papilliferous carcinoma, a less aggressive form. CONCLUSION: An ideal plasma iodide concentration is necessary to insure the proper mental development of fetuses and young children and to minimize the aggressiveness of thyroid cancer from follicular cells in humans.
Tue, 23 July 2019
ARTICLE | doi:10.20944/preprints201907.0254.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: economic evaluation, micronutrient fortification, iron deficiency anemia, Cote d’Ivoire, model, impact, DALYs
Online: 23 July 2019 (10:25:26 CEST)
Iron deficiency anemia (IDA) is highly prevalent in the Cote d’Ivoire, and has severe health and economic consequences. In this paper, we apply a health economic model to quantify the burden of IDA, and the contribution of nation-wide mandatory iron fortification of wheat flour and voluntary iron fortification of condiments to the reduction of this burden. The analysis for the population from six months to 64 years builds on published reviews and publicly available datasets, and is stratified by age-groups and socio-economic strata. Without the impact of these fortification strategies, the annual burden of IDA is estimated at 242,100 disability adjusted life years (DALYs) and 978.1 million USD. Wheat flour and condiment fortification contributed to a reduction of the IDA burden by approximately 5% each. In places with high prevalence of malaria and environmental factors, such as the Côte D’Ivoire, policy makers should combine nutritional intervention with infectious disease prevention and environmental factors. The findings of this study provide additional input for policy makers about the magnitude of the impact and can support the conception of future fortification strategies.
Mon, 15 July 2019
ARTICLE | doi:10.20944/preprints201907.0179.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: atherogenesis; passiflora edulis sims; lipid profile; free radicals; pre-clinical trial
Online: 15 July 2019 (05:59:18 CEST)
High oxidative stress in cells due to inflammation process or excessive cell proliferation would produce oxidants or free radicals with biomarkers, one of which is malondialdehyde (MDA). Passion fruit seed’s contain high antioxidant and are expected to decrease the level of cholesterol and MDA. The objective is to identify the effect of passion fruit seed’s ethanol extract in Wistar rats that have been fed with atherogenic feed. The method was preclinical trial (post-test control group design) in rats, by administering passion fruit seed’s ethanol extract for 14 days. This study used 26 male rats aged two months, divided into 5 groups. The result showed significant difference in MDA level which was found in group that was given passion fruit seed extract 10mg/kg BW with positive control group that was given standard feed. Passion fruit seed’s extract showed significant difference in level of triglyceride, which was found in negative control group that was given atherogenic feed with group that was given passion fruit seed’s extract 5mg/kg BW (mean±standard deviation: 1.09±0.30 mg/dL vs 0.77±0.25mg/dL; p=0.048). This study showed that passion fruit seed’s ethanol extract had significant lowering effect in level of MDA, total cholesterol, and triglyceride for 14 days.
Sun, 14 July 2019
Subject: Medicine & Pharmacology, Nutrition Keywords: allergy; pulmonary function; allergic rhinitis; asthma; nutritional status; obesity
Online: 14 July 2019 (17:35:01 CEST)
Introduction: The rising trend in allergic diseases has occurred in parallel with an increasing prevalence in obesity, and suggesting a possible association. The increased body mass has numerous health consequences, including an impairment function of the respiratory system. The associations between eating habits and hypersensitivity to allergens have not been clarified sufficiently. Aim: to evaluate pulmonary function, nutritional status, eating habits and risk factors of obesity in children and adolescents with allergic rhinitis. Material and Methods: The study was performed in 106 children with allergic rhinitis (mean age 12.1+/-3.4; M/F 60/46) from the Department of Allergology. 43 (40.6%) of children presented only allergic rhinitis and in 63 (59.4%) additionally diagnosed with asthma bronchiale. Clinical data, detailed interview about allergies, assessment of pulmonary function and nutritional status, allergy skin test (Allergopharma) and spirometry (Jaeger) were evaluated. Nutritional habits were assessed by a food frequency questionnaire. The statistical analysis was done using the program Statistica v 10.0. Results: In the study group the mean centile of BMI was 49.4; underweight presented 25.4% of children, 55.6 % normal BMI and 18.8 % presented overweight or obesity. Multiple regression analysis showed a significant (adjusted R-squared: 0.97; p<0.05) association between high BMI and snacking between meals and low physical activity. No statistical association between the severity of diseases and BMI or body composition was observed. Conclusions: 1. The prevalence of excess body mass in the study group reached 13.5%. Eating habits were incorrect, especially obese children significantly more frequently ate snacks between meals than children with normal body weight. 2. Among the studied group of children and adolescents with allergic rhinitis and asthma bronchiale, the significant risk factors of obesity were snacking and low physical activity.
ARTICLE | doi:10.20944/preprints201907.0173.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: diet composition; food culture; mayan community; type 2 diabetes mellitus.
Online: 14 July 2019 (17:29:13 CEST)
Aim: To perform a descriptive analysis of eating patterns and biophysical conditions of previously diagnosed and currently under treatment individuals from a semi-urban Mayan community of Yucatan, and to contrast them with T2DM therapeutic guidelines. Methods: The present study is derived from a randomized clinical trial conducted at Komchen, Yucatan. Participants’ diagnosed with T2DM were included. A 24-hour dietary recall, anthropometric parameters (weight, visceral fat, height, and waist circumference), biochemical (HbA1c) and clinical (blood pressure) variables were evaluated and compared via hypothesis test with T2DM treatment cut-off points (based on World Health Organization criteria). Results: Anthropometric characteristics differ significantly from the ideal criteria. Obesity prevalence within women with T2DM was 92.9%. Only 21% of the participants were under T2DM control (≤7%). Energy and carbohydrates consumption, significantly exceed therapeutic guidelines, whereas protein, fat, and fiber intake were lower than the recommendations. Conclusions: Komchen’s diet, concomitantly with food characteristics, could be related to glycemic decontrol. There is a disproportion in macronutrients consumption in favor of carbohydrates, probably associated with socioeconomic limitations, food availability, and price. Developing nutritional assistance programs which contemplate cultural and economic factors in this Mayan population must be taken into consideration.
Tue, 9 July 2019
Subject: Medicine & Pharmacology, Nutrition Keywords: Iron, Zinc, Interactions, DMT1, ZIP4, Pancreas, Metabolism, Homeostasis, Intestine, Caco-2 cells
Online: 9 July 2019 (14:32:11 CEST)
Iron and zinc are essential micronutrients required for growth and health. Deficiencies of these nutrients are highly prevalent among populations, but can be alleviated by supplementation. Cross-sectional studies in humans showed positive association of serum zinc levels with hemoglobin and markers of iron status. Dietary restriction of zinc or intestinal specific conditional knock out of ZIP4 (SLC39A4), an intestinal zinc transporter, in experimental animals demonstrated iron deficiency anemia and tissue iron accumulation. Similarly increased iron accumulation has been observed in cultured cells exposed to zinc deficient media. These results together suggest a potential role of zinc in modulating whole body iron metabolism. Studies in intestinal cell culture models demonstrate that zinc induces iron uptake and transcellular transport via induction of divalent metal iron transporter-1 (DMT1) and ferroportin (FPN) expression, respectively. It is interesting to note that intestinal cells are exposed to very high levels of zinc through pancreatic secretions, which is a major route of zinc excretion from the body. Therefore, zinc appears to be modulating the iron metabolism possibly via regulating the DMT1 and FPN1 levels. Herein we critically reviewed the available evidence to hypothesize novel mechanism of Zinc-DMT1/FPN axis in regulating intestinal iron absorption and tissue iron accumulation to facilitate future research aimed at understanding the yet elusive mechanisms of iron and zinc interactions.
Mon, 8 July 2019
ARTICLE | doi:10.20944/preprints201907.0092.v1
Subject: Medicine & Pharmacology, Nutrition Keywords: Type 2 diabetes; urea albumin excretion; food frequency questionnaire survey; β-cryptoxanthin; fruits
Online: 8 July 2019 (14:44:24 CEST)