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Purpose: There have been no reports on the application of salivary iodine concentration (SIC) in evaluating iodine nutrition in pregnant women. This study aimed to clarify the relationship between SIC and indicators of iodine nutritional status and thyroid function during pregnancy, to investigate whether salivary iodine can be applied to the evaluation of iodine nutritional status in pregnant women, and to provide a reference basis for establishing a normal range of salivary iodine values during pregnancy. Methods: Pregnant women were enrolled in the Department of Obstetrics, the people's hospital of Yuncheng Country, Shandong Province, from July 2021 to December 2022, using random cluster sampling. Saliva, urine, and blood samples were collected from pregnant women to assess iodine nutritional status, and venous blood was collected to determine thyroid function. Results: A total of 609 pregnant women were included in this study. The median spot urinary iodine concentration (SUIC) was 261 μg/L. The median SIC was 297 μg/L. SIC was positively correlated with SUIC (r = 0.46, P < 0.0001), 24-h UIC (r = 0.30, P < 0.0001), 24-h urinary iodine excretion (24-h UIE) (r = 0.41, P < 0.0001), and estimated iodine intake (EII) (r = 0.52, P < 0.0001). After adjusting for confounders, there was a weak correlation between SIC and serum total iodine and serum non-protein-bound iodine (P = 0.02, P = 0.04, respectively). Pregnant women with a SIC < 176 μg/L had a higher risk of insufficient iodine status (OR = 2.07, 95% CI 1.35–3.19) and thyroid dysfunction (OR = 2.71, 95% CI 1.18–6.21) compared to those with higher SIC. Those having SIC > 529 μg/L were more likely to have excessive iodine status (OR = 2.82, 95% CI 1.81–4.38) and thyroid dysfunction (OR = 3.04, 95% CI 1.36–6.78) than those with lower SIC values. Conclusion: SIC is associated with urinary iodine concentration and thyroid function in pregnant women. SIC < 176 μg/L was associated with an increased risk for iodine deficiency and hypothyroxinemia, while SIC > 529 μg/L was related to excess and thyrotoxicosis. SIC can be used as a reference indicator for evaluating the iodine nutrition status of pregnant women, but it needs further investigation and verification. Trial registration: NCT04492657(Aug 9, 2022). [ABSTRACT FROM AUTHOR]

Background: Video-assisted thoracoscopic surgery (VATS) often induces significant postoperative pain, potentially leading to chronic pain and decreased quality of life. This study aimed to evaluate the acetaminophen/ibuprofen combination effectiveness in reducing analgesic requirements and pain intensity in patients undergoing VATS. Study design: This is a double-blinded randomized controlled trial. Methods: Adult patients scheduled for elective VATS for lung resection were randomized to receive either intravenous acetaminophen and ibuprofen (intervention group) or 100 mL normal saline (control group). Treatments were administered post-anesthesia induction and every 6 h for three cycles. The primary outcome was total analgesic consumption at 24 h postoperatively. Secondary outcomes were cumulative analgesic consumption at 2 and 48 h; analgesic-related side effects at 2, 24, and 48 h; quality of recovery at 24 h and 48 h postoperatively; pain intensity at rest and during coughing; and rescue analgesics use. Chronic postsurgical pain (CPSP) was assessed through telephone interviews 3 months postoperatively. Results: The study included 96 participants. The intervention group showed significantly lower analgesic consumption at 24 h and 48 h postoperatively (24 h: median difference: − 100 µg equivalent intravenous fentanyl [95% confidence interval (CI) − 200 to − 5 μg], P = 0.037; 48 h: median difference: − 140 μg [95% CI − 320 to − 20 μg], P = 0.035). Compared to the controls, the intervention group exhibited a significantly lower quality of recovery 24 h post-surgery, with no significant difference at 48 h. All pain scores except for coughing at 48 h post-surgery were significantly lower in the intervention group compared to the controls. No significant differences were observed between the groups in postoperative nausea and vomiting occurrence, hospital stay length, and CPSP. Conclusion: Perioperative administration of acetaminophen/ibuprofen significantly decreased analgesic needs in patients undergoing VATS, providing an effective postoperative pain management strategy, and potentially minimizing the need for stronger analgesics. [ABSTRACT FROM AUTHOR]

Background: Topical treatments for atopic dermatitis (AD) used reactively often fail to achieve lasting disease control; many of these therapies are associated with safety concerns that limit long-term use. Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate AD that has potential as a long-term maintenance therapy. Objective: The aim was to evaluate the long-term efficacy and safety of crisaborole once daily (QD) compared to vehicle QD as a maintenance therapy to reduce the incidence of flares in patients with AD who previously responded to crisaborole twice daily (BID). Methods: CrisADe CONTROL was a randomized, double-blind, vehicle-controlled, 52-week, phase III study of patients aged ≥ 3 months with mild-to-moderate AD involving ≥ 5% treatable body surface area. Eligible patients received crisaborole BID during an open-label run-in period of up to 8 weeks. Responders were randomly assigned in the double-blind maintenance period to receive either crisaborole QD or vehicle QD. Responders were defined as patients who achieved Investigator's Static Global Assessment (ISGA) success (ISGA score of 0 [clear] or 1 [almost clear] with a ≥ 2-grade improvement) and ≥ 50% improvement in Eczema Area and Severity Index total score (EASI-50) from baseline. Patients who experienced a flare (ISGA score ≥ 2) during the double-blind maintenance period switched to crisaborole BID for up to 12 weeks. During this period, patients were assessed every 4 weeks; if the flare resolved (ISGA score ≤ 1), patients resumed their assigned treatment. The primary endpoint was flare-free maintenance until onset of the first flare. Key secondary endpoints were number of flare-free days, number of flares, and maintenance of pruritus response until onset of the first flare. The incidence of treatment-emergent adverse events was also analyzed. Results: Overall, 497 patients entered the open-label run-in period with crisaborole BID, of which 270 patients were randomized into the 52-week double-blind maintenance period of the study. Of the 270 patients, 135 were randomly assigned to the crisaborole QD group and 135 were randomly assigned to the vehicle QD group. Median time of flare-free maintenance was longer for patients who received crisaborole versus vehicle (111 vs 30 days, respectively; p = 0.0034). The mean number of flare-free days was higher for patients who received crisaborole versus vehicle (234.0 vs 199.4 days, respectively; p = 0.0346). The mean number of flares was lower for patients who received crisaborole versus vehicle (0.95 vs 1.36, respectively; p = 0.0042). No clear trend was observed in maintenance of pruritus response between crisaborole- and vehicle-treated patients. Crisaborole was well tolerated, with no new or unexpected safety findings when used as maintenance treatment. Conclusions: Crisaborole QD was effective and well tolerated for long-term maintenance treatment and flare reduction in adult and pediatric patients with mild-to-moderate AD. Trial Registration: ClinicalTrials.gov, NCT04040192, 31 July 2019. Plain Language Summary: Atopic dermatitis (AD) is an immuno-inflammatory skin disease that can last a long time. It causes skin lesions and intense itching. Topical AD treatments used reactively often fail to control the disease over a long period of time. Many are associated with safety concerns that limit long-term use. Crisaborole ointment is a nonsteroidal treatment for the skin and is used to treat mild-to-moderate AD. Previous studies showed that using crisaborole twice daily was effective and had few side effects in patients with mild-to-moderate AD. This study evaluated how effective and safe long-term treatment with once-daily crisaborole was compared with an ointment with no drug (vehicle). The study included patients aged ≥ 3 months with mild-to-moderate AD whose AD improved after previous treatment with twice-daily crisaborole. This study was designed to investigate how much crisaborole reduced the incidence of AD flares over 52 weeks in these patients. The study included 270 patients whose AD had improved after treatment with twice-daily crisaborole. Of these patients, 135 were randomly assigned to receive crisaborole once a day and 135 to receive vehicle once a day. Patients who received crisaborole had a significantly longer time before experiencing AD flares than those who received vehicle. Crisaborole was well tolerated, and no new or unexpected side effects were found when used as a once-daily maintenance treatment for 52 weeks. These results indicate that once-daily treatment with crisaborole could be a potential long-term maintenance treatment option in children and adults with mild-to-moderate AD. [ABSTRACT FROM AUTHOR]

Purpose: Increased awareness of the importance of dietary fibre has led to increased interest in 'functional' fibre components like digestion-resistant maltodextrin (RMD). This randomized, placebo-controlled, double-blind study assessed the effects of RMD in the colonic transit time (CTT) and defecation characteristics (frequency, stool volume and consistency). Methods: Sixty-six healthy adult volunteers (32 men) who did not have a daily defecation habit had a 7-day run-in period before the 21-day intervention period with RMD or placebo. CTT and segmental CTT (SCTT) were assessed by a single abdominal X-ray film taken at the end of both periods after radiopaque marker ingestion. Defecation characteristics and intestinal functions were also assessed, which were self-reported by patients. Intragroup comparisons were evaluated by Student's paired t test, Bonferroni test and Chi-square test, while time comparisons by analysis of variance (ANOVA) and time-by-treatment interaction by repeated-measures ANOVA. Results: Fifty-seven subjects were assessed for CTT (placebo, n = 28; RMD, n = 29). In the RMD group, the total CTT, left SCTT and rectosigmoidal SCTT decreased significantly compared to baseline ( p < 0.01 each; −13.3, −4.7, −8.7 h, respectively). Significant differences between groups were observed in total CTT and left SCTT. Significant time-by-treatment interaction was observed in the RMD group for stool volume ( p = 0.014), increasing 56 % compared to baseline ( p < 0.01), while remained unchanged in the placebo group. Stool consistency was improved only in the RMD group ( p < 0.01). No adverse effects related to study products were observed. Conclusions: The results show that RMD improved CTT, stool volume, stool consistency and some intestinal functions in a healthy population. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine whether fenugreek seed powder could reduce the glycemic response and glycemic index (GI) when added to buns and flatbreads. Methods: In a randomised, controlled crossover trial, ten healthy human subjects (five men, five women) were given 50 g glucose (reference food, twice); buns (0 and 10 % fenugreek seed powder); and flatbreads (0 and 10 % fenugreek seed powder) on six different occasions. Finger prick capillary blood samples were collected at 0, 15, 30, 45, 60, 90 and 120 min after the start of the meal. The palatability of the test meals was scored using Likert scales. Results: The incremental areas under the glucose curve value of buns and flatbreads with 10 % fenugreek (138 ± 17 mmol × min/L; 121 ± 16 mmol × min/L) were significantly lower than those of 0 % fenugreek bun and flatbreads (227 ± 15 mmol × min/L; 174 ± 14 mmol × min/L, P = <0.01). Adding 10 % fenugreek seed powder reduced the GI of buns from 82 ± 5 to 51 ± 7 ( P < 0.01) and to the GI of flatbread from 63 ± 4 to 43 ± 5 ( P < 0.01). Conclusions: These results suggest that replacing 10 % of refined wheat flour with fenugreek seed powder significantly reduces the glycemic response and the GI of buns and flatbreads. Thus, fenugreek powder may be a useful functional ingredient to reduce postprandial glycemia. [ABSTRACT FROM AUTHOR]

Purpose: Epidemiological evidence suggests that chronic consumption of fruit-based flavonoids is associated with cognitive benefits; however, the acute effects of flavonoid-rich (FR) drinks on cognitive function in the immediate postprandial period require examination. The objective was to investigate whether consumption of FR orange juice is associated with acute cognitive benefits over 6 h in healthy middle-aged adults. Methods: Males aged 30-65 consumed a 240-ml FR orange juice (272 mg) and a calorie-matched placebo in a randomized, double-blind, counterbalanced order on 2 days separated by a 2-week washout. Cognitive function and subjective mood were assessed at baseline (prior to drink consumption) and 2 and 6 h post consumption. The cognitive battery included eight individual cognitive tests. A standardized breakfast was consumed prior to the baseline measures, and a standardized lunch was consumed 3 h post-drink consumption. Results: Change from baseline analysis revealed that performance on tests of executive function and psychomotor speed was significantly better following the FR drink compared to the placebo. The effects of objective cognitive function were supported by significant benefits for subjective alertness following the FR drink relative to the placebo. Conclusions: These data demonstrate that consumption of FR orange juice can acutely enhance objective and subjective cognition over the course of 6 h in healthy middle-aged adults. [ABSTRACT FROM AUTHOR]

Purpose: The present randomized, double-blind, placebo-controlled study aimed to evaluate the effect of Zingiber officinale (ginger) consumption on some metabolic and clinical features of obesity. Methods: Eighty eligible obese women (aged 18-45 years) were randomly assigned to either ginger or placebo groups (receiving 2 g/day of ginger powder or corn starch as two 1 g tablets) for 12 weeks. Body mass index (BMI) and body composition were assessed every 4 weeks, and serum levels of leptin, adiponectin, resistin, insulin and glucose were determined before and after intervention. The homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were also calculated. Results: Ginger consumption significantly decreased BMI, serum insulin and HOMA-IR index, along with increasing QUICKIs as compared to the placebo. Moreover, significant reductions in serum leptin, resistin and glucose were observed in both groups, especially in ginger group with nonsignificant differences between groups. The body composition and serum levels of adiponectin were not significantly changed in study groups. Conclusion: In conclusion, our findings demonstrate a minor beneficial effect of 2 g ginger powder supplementation for 12 weeks on weight loss and some metabolic features of obesity. However, given the lack of data in this area, ongoing clinical trials are needed to further explore ginger's effectiveness. [ABSTRACT FROM AUTHOR]

Purpose: Previously, anthocyanin-rich blueberry treatments have shown positive effects on cognition in both animals and human adults. However, little research has considered whether these benefits transfer to children. Here we describe an acute time-course and dose-response investigation considering whether these cognitive benefits extend to children. Methods: Using a double-blind cross-over design, on three occasions children ( n = 21; 7-10 years) consumed placebo (vehicle) or blueberry drinks containing 15 or 30 g freeze-dried wild blueberry (WBB) powder. A cognitive battery including tests of verbal memory, word recognition, response interference, response inhibition and levels of processing was performed at baseline, and 1.15, 3 and 6 h following treatment. Results: Significant WBB-related improvements included final immediate recall at 1.15 h, delayed word recognition sustained over each period, and accuracy on cognitively demanding incongruent trials in the interference task at 3 h. Importantly, across all measures, cognitive performance improved, consistent with a dose-response model, with the best performance following 30 g WBB and the worst following vehicle. Conclusion: Findings demonstrate WBB-related cognitive improvements in 7- to 10-year-old children. These effects would seem to be particularly sensitive to the cognitive demand of task. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the effects of age, gender and ethnicity and indirect aggression among children and adolescents in Trinidad, which is known to have the second highest crime rate in the Caribbean region.

Purpose: The optimal macronutrient composition of the diet for the management of type 2 diabetes is debated, particularly with regard to the ideal proportion of fat and carbohydrates. The aim of the study was to explore the association of different proportions of fat and carbohydrates of the diet-within the ranges recommended by different guidelines-with metabolic risk factors. Methods: We studied 1785 people with type 2 diabetes, aged 50-75, enrolled in the TOSCA.IT Study. Dietary habits were assessed using a validated food-frequency questionnaire (EPIC). Anthropometry, fasting lipids, HbA1c and C-reactive protein (CRP) were measured. Results: Increasing fat intake from <25 to ≥35 % is associated with a significant increase in LDL-cholesterol, triglycerides, HbA1c and CRP ( p < 0.05). Increasing carbohydrates intake from <45 to ≥60 % is associated with significantly lower triglycerides, HbA1c and CRP ( p < 0.05). A fiber intake ≥15 g/1000 kcal is associated with a better plasma lipids profile and lower HbA1c and CRP than lower fiber consumption. A consumption of added sugars of ≥10 % of the energy intake is associated with a more adverse plasma lipids profile and higher CRP than lower intake. Conclusions: In people with type 2 diabetes, variations in the proportion of fat and carbohydrates of the diet, within the relatively narrow ranges recommended by different nutritional guidelines, significantly impact on the metabolic profile and markers of low-grade inflammation. The data support the potential for reducing the intake of fat and added sugars, preferring complex, slowly absorbable, carbohydrates. [ABSTRACT FROM AUTHOR]

Purpose: Unmetabolized folic acid (UMFA) is common in serum of elderly individuals receiving folic acid (FA)-fortified foods or supplements. We studied the effect of supplementing FA or B-complex on serum concentrations of (6 S)-5-methyltetrahydropteroylglutamate [(6S)-5-CH-HPte] and UMFA in elderly people and explored factors associated with detectable UMFA post-supplementation. Methods: This is a randomized single-blind non-controlled trial on 58 elderly people using daily 400 µg FA ( n = 31) or 400 µg FA, 10 µg cyanocob(III)alamin and 8 mg pyridoxine ( n = 27) for a median of 23 days. Main outcome includes changes in concentrations of serum (6S)-5-CH-HPte and UMFA. Results: Total homocysteine declined by a median of 1.6 ( p = 0.074) in the FA and 1.3 µmol/L ( p = 0.009) in the B-complex arms ( p = 0.66 between the arms). Serum (6S)-5-CH-HPte significantly ( p < 0.001 vs. baseline) increased by a median of 9.2 and 6.5 nmol/L in the FA and B-complex groups, respectively ( p = 0.152 between the groups). Compared to FA, B-complex reduced cystathionine and caused lower post-intervention serum UMFA, percentage of UMFA to (6S)-5-CH-HPte and prevalence of UMFA ≥ 0.21 nmol/L. Higher serum cystathionine and whole-blood folate predicted higher post-intervention serum UMFA. Conclusions: FA caused higher UMFA as compared to B-complex. Pyridoxine appears to improve folate recycling. Data on serum UMFA should be interpreted in relation to other vitamins involved in folate metabolism. Serum UMFA is suggested to play a sensory role through which the cell recognizes FA available for metabolism via dihydrofolate reductase. [ABSTRACT FROM AUTHOR]

Purpose: Alkylresorcinols (AR) are phenolic lipids present in the bran of wheat and rye. Plasma AR and their urinary metabolites may be suitable biomarkers of whole-grain (WG) wheat and rye consumption. The objective of this study was to examine plasma AR and urinary AR metabolites in response to WG wheat consumption. Methods: In a randomized crossover study, 19 subjects (10 males, 9 females; BMI 22.0 kg/m; age 26 years) incorporated either 3 servings (48 g) or 6 servings (96 g) of WG wheat daily into their regular diet for 1 week. Subjects completed a 2-week washout period, abstaining from all WG consumption, before each intervention. Fasting blood and 24-h urine were collected before and after each intervention. Plasma AR homologues (C19:0, C21:0, C23:0) were quantified by GC-MS after diethyl ether and solid phase extraction and derivatization. Urinary AR metabolites [3,5-dihydroxybenzoic acid and 3-(3,5-dihydroxyphenyl)-propanoic acid] were determined using HPLC with electrochemical detection after enzymatic deconjugation and ethyl acetate extraction. Results: Urinary total AR metabolites were significantly higher after 6 compared with 3 servings of WG wheat (56 vs. 32 μmol/day, P < 0.001). This dose-response relationship was independent of age, sex, energy intake, and baseline urinary AR metabolite concentration. Plasma total AR tended to be higher after 6 compared with 3 servings of WG wheat (103.0 vs. 86.9 nmol/L), but this difference was not significant ( P = 0.42). Conclusion: The results suggest that urinary AR metabolites from 24-h urine collections may be useful as biomarkers of compliance in intervention studies of WG wheat. [ABSTRACT FROM AUTHOR]

Purpose: Controversy exists regarding whether increasing dairy intake without energy restriction would lead to weight loss. We aimed to compare the potential weight-reducing effects of kefir drink (a probiotic dairy product) and milk in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women. Methods: One hundred and forty-four subjects were assessed for eligibility in this single-center, multi-arm, parallel-group, randomized controlled trial. Of these, seventy-five eligible women aged 25-45 years were randomly assigned to three groups, labeled as control, milk, and kefir, to receive an outpatient dietary regimen for 8 weeks. Subjects in the control group received a diet providing a maintenance level of energy intake, containing 2 servings/day of low-fat dairy products, while those in the milk and kefir groups received a weight maintenance diet, containing 2 additional servings/day (a total of 4 servings/day) of dairy products from low-fat milk or commercial kefir drink, respectively. Anthropometric outcomes including weight, body mass index (BMI), and waist circumference (WC) were measured every 2 weeks. Results: Fifty-eight subjects completed the study. Using analysis of covariance models in the intention-to-treat population ( n = 75), we found that at 8 weeks, subjects in the kefir and milk groups had significantly greater reductions in weight, BMI, and WC compared to those in the control group (all p < 0.01). However, no such significant differences were found between the kefir and milk groups. Conclusions: Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women. However, further studies are warranted. [ABSTRACT FROM AUTHOR]

Purpose: Muffins made with wheat flour are a popular snack consumed in western and emerging countries. This study aimed to examine the content of amylose, glycemic response (GR) and glycemic index (GI) of muffins baked with refined wheat and rice flours, as well as wholegrain corn, oat and barley flours. Methods: This study adopted a randomized, controlled, crossover, non-blind design. Twelve healthy participants consumed wheat, rice, corn, oat and barley muffins once and the reference glucose solution three times in a random order on non-consecutive day. Capillary blood samples were taken every 15 min in the first 60 min and every 30 min for the remaining 60 min for blood glucose analysis. The Megazyme amylose/amylopectin assay procedure was employed to measure amylose content. Results: The GR elicited from the consumption of wheat, rice and corn muffins was comparable between these samples but significantly greater when compared with oat and barley muffins. Consumption of wholegrain muffins, apart from corn muffin, blunted postprandial GR when compared with muffins baked with refined cereal flours. Muffins baked with wheat, rice, corn, oat and barley flours gave rise to GI values of 74, 79, 74, 53 and 55, respectively. The content of amylose was significantly higher in corn, oat and barley muffins than wheat and rice muffins. Conclusions: The greater content of amylose and fibre may play a part in the reduced glycemic potency of oat and barley muffins. Wheat flour can be substituted with oat and barley flours for healthier muffins and other bakery products. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to examine the effects of consumption of desserts with low glycemic index (GI) and low glycemic load (GL), as part of a balanced hypo-caloric diet, on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 61 subjects with T2DM were randomly assigned to the intervention ( n = 30) or to the control group ( n = 31). Both groups followed the same hypo-caloric (−500 kcal) diet for 12 weeks. Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group. Results: Thirty subjects in the control and 28 subjects in the intervention group completed the trial. Body weight, body mass index, and waist circumference were reduced significantly in both groups. Arterial blood pressure, fasting blood glucose, glycosylated hemoglobin, insulin, and γ-GT were reduced significantly only in the intervention group; however, there were no significant differences between the two groups at endpoint. C-reactive protein was reduced in the intervention, and HDL cholesterol was also reduced in the control group; the reductions were significantly different at the end of the trial. No significant changes were observed in the other plasma lipids, uric acid, leptin, adiponectin, and interleukin-6 in either study group. Conclusions: Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM. [ABSTRACT FROM AUTHOR]

Purpose: Recent data suggest that chronic low-grade inflammation, a characteristic of obesity, is associated with altered tryptophan (Trp) and tyrosine (Tyr) metabolism and plays a role in neuropsychiatric symptoms. The present study assessed the effect of an extreme short-term diet on Trp breakdown and inflammatory biomarkers in overweight adults. Methods: Thirty-eight overweight participants (16 women, 22 men; average body mass index: 29 kg/m, mean age 52.8 years) were randomized into two diet groups: a very low kcal diet group (VLCD; Ø 600 kcal/day, n = 21) and a low kcal diet group (LCD; Ø 1,200 kcal/day, n = 17). Assays included the measurement of Trp, kynurenine (Kyn), and their ratio, neopterin, phenylalanine (Phe), Tyr, as biologic markers; leptin, plasma insulin, glucose, and homeostatic model assessment-insulin resistance; and interleukin 6, tumor necrosis factor alpha, and C-reactive protein, as biochemical and inflammatory markers at baseline and after 2 weeks of treatment. Results: Weight loss diet lowered leptin levels in both groups by 46 %, although not reaching significance. Trp and Kyn decreased significantly by 21 and 16 % for VLCD and by 15 and 17 % for the LCD group, respectively. A significant reduction in Phe was only seen after VLCD. Inflammatory biomarkers, neopterin, and Tyr were not significantly altered during the study period. Leptin was significantly correlated with Trp breakdown before and after the intervention ( P < 0.02). Conclusions: Since disturbed metabolism of Trp affects biosynthesis of serotonin and might be associated with increased susceptibility for mood disturbances and carbohydrate craving, strategies to supplement Trp while dieting could be highly useful in treating uncontrolled weight gain or in preventing neuropsychiatric symptoms. [ABSTRACT FROM AUTHOR]

Purpose: Guanidinoacetic acid (GAA) is an intermediate in the biosynthesis of creatine (Cr), yet its use in human nutrition is limited due to a lack of a clear understanding of its' dose-response effect. Thus, the purpose of this study was to investigate the effect of three different dosages of GAA (1.2, 2.4 and 4.8 g/day) administered for 6 weeks on serum and urinary variables related to GAA metabolism. Methods: Forty-eight healthy volunteers participated in the randomized, placebo-controlled, double-blind, repeated-measure study. At baseline, after 1, 2, 4 and 6 weeks, participants provided both fasting blood samples and 24-h urine. Results: GAA intervention significantly increased serum and urinary GAA, Cr and creatinine as compared to placebo ( P < 0.05). Differences were found for serum GAA and Cr responses between the three GAA dosages, with high-dose GAA resulting in a greater increase ( P < 0.05) in the plasma concentration of both variables as compared to other GAA dosages. In GAA groups, fasting plasma total homocysteine (T-Hcy) increased by 3.5 μmol/L on average at post-administration, yet no dose-response differences were found between trials. Serum B vitamins were not affected by either placebo or GAA intervention ( P > 0.05). Conclusion: Results indicate that low-to-high dosages of exogenous GAA can increase serum concentrations of Cr and T-Hcy while not depleting the B vitamins pool available for remethylation of homocysteine. Clinical trial registration: ClinicalTrials.gov, identification number NCT01133899. [ABSTRACT FROM AUTHOR]

Purpose: White rice is the main staple for the majority in the world. The effects of protein, fat and vegetables on the glycaemic and insulinaemic responses to a white rice-based meal have not been reported. The aim of this study was to determine the effect of co-ingesting a high-protein food (breast chicken), a fat (ground nut oil), a leafy vegetable or all three on the glycaemic and insulinaemic responses of white rice in healthy adults. Methods: This was a randomized crossover trial conducted at the Clinical Nutrition Research Centre in Singapore. Twelve healthy volunteers were given five test meals (white rice alone, white rice with chicken, white rice with oil, white rice with vegetable and white rice with chicken, oil and vegetable) once and the reference food (glucose solution) three times in a random order at 1-week intervals. Capillary blood samples were then drawn serially for 3 h, and glucose and insulin were analysed. Results: The glycaemic response (GR) to white rice with chicken breast, ground nut oil and vegetable was significantly lower than to white rice alone. The glycaemic index (GI) of pure white rice was 96, whereas combined with chicken breast, ground nut oil and vegetable, it was 50. The addition of oil delayed the peak glucose response and reduced the iAUC, resulting in a GI value of 67. The addition of chicken and vegetable resulted in a GI value of 73 and 82, respectively. The insulinaemic index (II) of the white rice-based meals varied between 54 and 89. Chicken breast in the meal increased the insulinaemic response and decreased the GR. White rice II was lower than the glucose control, which indicated that the former was not as insulinogenic as the latter. White rice with vegetable had the lowest II. Conclusions: Co-ingesting chicken, oil or vegetable with white rice considerably influences its glycaemic and insulinaemic responses. Co-ingesting white rice with all three components attenuates the GR to a greater degree than when it is eaten with any single one of them, and that this is not at the cost of an increased demand for insulin. [ABSTRACT FROM AUTHOR]

Background: Regulatory T cells (Tregs) play a central role in the maintenance of self-tolerance. Animal and in vitro studies suggest that vitamin D is involved in reducing the risk of autoimmunity by modulating Tregs. Methods: In a double-blind, placebo controlled study in 60 healthy volunteers, we assessed the effect of a 12-week high-dose oral cholecalciferol supplementation (140,000 IU/month) on the number and function of CD4CD25FoxP3CD127 Tregs. We also assessed the clinical safety of the supplementation and the effect on the frequency of other immune cells such as monocytes, dendritic cells, natural killer cells, natural killer T cells, B cells and subgroups of T cells. We also tested the in vitro effect of cholecalciferol on Tregs in human cell cultures. Results: By using FACS analysis, ex vivo suppressive co-cultures and apoptosis assays, we were able to show that a cholecalciferol supplementation leads to significantly increased numbers of peripheral Tregs in vivo. Tregs function and the frequency of other immune cells remained unchanged, and no clinically relevant safety concerns were found. The in vitro exposure of human peripheral blood mononuclear cells to cholecalciferol also supported our in vivo findings. Conclusions: Our results indicate a substantial effect of a supplementation with inactive vitamin D on the immune system of healthy humans in vivo and provide a rationale for future studies to investigate the immunomodulatory effects of vitamin D in autoimmune diseases. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to evaluate the long-term influence of l-arginine intake on mineral concentration in patients with obesity and to assess the changes in lipid serum levels, fat content, and insulin resistance that result. Methods: A randomized double-blind placebo-controlled study was conducted. 88 obese patients were randomly assigned to receive either 9 g of l-arginine or placebo daily, for 6 months. At baseline and after 6 months, selected anthropometrical measurements and blood biochemical analyses were performed and mineral levels were assessed. To assess insulin sensitivity, the gold-standard euglycemic clamp methodology was used. Results: We found that 6 months of l-arginine supplementation resulted in significant increases in insulin sensitivity (Δ1.1 mg/kg/min, P < 0.01) and zinc levels (Δ1.5 μmol/L, P < 0.001). Moreover, a positive correlation between the change in zinc concentration in serum and the change in insulin sensitivity was observed ( R = 0.80, P < 0.01). In the group of patients treated with l-arginine, a negative correlation between the change in zinc concentration in serum and the change in body fat content was noted ( R = −0.38, P < 0.05). Conclusions: l-Arginine supplementation affects zinc status in obese patients. One beneficial influence is related to the improvements in insulin sensitivity. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of cocoa powder supplementation on obesity-related inflammation in high fat (HF)-fed obese mice. Methods: Male C57BL/6J ( n = 126) were fed with either low-fat (LF, 10 % kcal from fat) or HF (60 % kcal from fat) diet for 18 weeks. After 8 weeks, mice from HF group were randomized to HF diet or HF diet supplemented with 8 % cocoa powder (HF-HFC group) for 10 weeks. Blood and tissue samples were collected for biochemical analyses. Results: Cocoa powder supplementation significantly reduced the rate of body weight gain (15.8 %) and increased fecal lipid content (55.2 %) compared to HF-fed control mice. Further, cocoa supplementation attenuated insulin resistance, as indicated by improved HOMA-IR, and reduced the severity of obesity-related fatty liver disease (decreased plasma alanine aminotransferase and liver triglyceride) compared to HF group. Cocoa supplementation also significantly decreased plasma levels of the pro-inflammatory mediators interleukin-6 ( IL-6, 30.4 %), monocyte chemoattractant protein-1 (MCP-1, 25.2 %), and increased adiponectin (33.7 %) compared to HF-fed mice. Expression of pro-inflammatory genes ( Il6, Il12b, Nos2, and Emr1) in the stromal vascular fraction (SVF) of the epididymal white adipose tissue (WAT) was significantly reduced (37-56 %) in the cocoa-supplemented mice. Conclusions: Dietary supplementation with cocoa ameliorates obesity-related inflammation, insulin resistance, and fatty liver disease in HF-fed obese mice, principally through the down-regulation of pro-inflammatory gene expression in WAT. These effects appear to be mediated in part by a modulation of dietary fat absorption and inhibition of macrophage infiltration in WAT. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of two dietary patterns in which carbohydrates and proteins were eaten mostly at lunch or dinner on body weight and composition, energy metabolism, and biochemical markers in overweight/obese men. Methods: Fifty-eight men (30.0 ± 7.4 years; 30.8 ± 2.4 kg/m) followed a covert hypocaloric balanced diet (−10 % of daily energy requirements) during 8 weeks. Subjects were randomly assigned to three groups: control diet (CT); diurnal carbohydrate/nocturnal protein (DCNP); and nocturnal carbohydrate/diurnal protein (NCDP). Main analyzed outcomes were weight loss, body composition, diet-induced thermogenesis (DIT), and glucose/lipid profile. Results: In all groups, a significant decrease in body weight, BMI, and fat mass (kg and %) was verified, without differences between groups. Interestingly, within group analyses showed that the fat-free mass (kg) significantly decreased in NCDP and in CT after 8-week intervention, but not in DCNP. A detrimental increase in fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA) was verified only in DCNP, while NCDP and CT groups presented a non-significant reduction. Moreover, significant differences between DCNP and the other groups were detected for fasting insulin and HOMA. After the adjustments, NCDP presented a significantly higher DIT and energy expenditure after lunch, compared with DCNP, but after dinner, there were no differences among groups. Conclusion: Eating carbohydrates mostly at dinner and protein mostly at lunch within a hypocaloric balanced diet had similar effect on body composition and biochemical markers, but higher effect on DIT compared with control diet. Moreover, eating carbohydrates mostly at lunch and protein mostly at dinner had a deleterious impact on glucose homeostasis. [ABSTRACT FROM AUTHOR]

Purpose: Acute antioxidant supplementation may modulate oxidative stress and some immune perturbations that typically occur following prolonged exercise. The aims of the present study were to examine the effects of acutely consuming dark chocolate (high polyphenol content) on plasma antioxidant capacity, markers of oxidative stress and immunoendocrine responses to prolonged exercise. Methods: Fourteen healthy men cycled for 2.5 h at ~60% maximal oxygen uptake 2 h after consuming 100 g dark chocolate (DC), an isomacronutrient control bar (CC) or neither (BL) in a randomised-counterbalanced design. Results: DC enhanced pre-exercise antioxidant status ( P = 0.003) and reduced by trend ( P = 0.088) 1 h post-exercise plasma free [F-isoprostane] compared with CC (also, [F-isoprostane] increased post-exercise in CC and BL but not DC trials). Plasma insulin concentration was significantly higher pre-exercise ( P = 0.012) and 1 h post-exercise ( P = 0.026) in the DC compared with the CC trial. There was a better maintenance of plasma glucose concentration on the DC trial (2-way ANOVA trial × time interaction P = 0.001), which decreased post-exercise in all trials but was significantly higher 1 h post-exercise ( P = 0.039) in the DC trial. There were no between trial differences in the temporal responses (trial × time interactions all P > 0.05) of hypothalamic-pituitary-adrenal axis stress hormones, plasma interleukin-6, the magnitude of leukocytosis and neutrophilia and changes in neutrophil function. Conclusion: Acute DC consumption may affect insulin, glucose, antioxidant status and oxidative stress responses, but has minimal effects on immunoendocrine responses, to prolonged exercise. [ABSTRACT FROM AUTHOR]

Background: There is mounting evidence that an imbalance in oxidant/antioxidant activities plays a pivotal role in fetal development. Aim of the study: To determine the effects of maternal intake of fat and fiber on fetal intrauterine development and antioxidant defense systems of rats. Methods: Virgin female Sprague-Dawley rats were randomly assigned to 4 groups according to diet: the low-fat, low-fiber group (LL); the low-fat, high-fiber group (LH); the high-fat, low-fiber group (HL); and the high-fat, high-fiber group (HH). The diets were fed 4 weeks prior to breeding through day 17.5 of pregnancy. Dietary intakes of fiber (wheat bran and oat) and fat were quantitatively varied, while intakes of energy and essential nutrients were kept constant among the diets. Results: Rats fed a fiber-rich diet had significantly improved fetal numbers, as well as enhanced activity of superoxide dismutase (SOD) and capacity of scavenging free radicals ( p < 0.05). Meanwhile, the placental malondialdehyde and protein carbonyl levels were affected by the diet fat and fiber levels ( p < 0.05). Compared with the LL group, the mRNA abundance of hypoxia-inducible factor 1α (HIF-1α) and thioredoxin-2 (Trx2) in the maternal liver and glutathione peroxidase 1 (GPx1) in the placenta and fetus were significantly downregulated in the HL group ( p < 0.05). Furthermore, rats fed a fiber-rich diet had significantly upregulated mRNA expressions of Cu,Zn-SOD, Mn-SOD, and HIF-1α in the maternal liver ( p < 0.05); Cu,Zn-SOD and Mn-SOD in the placenta ( p < 0.05); and Cu,Zn-SOD in the fetus ( p < 0.05). Conclusion: When energy intakes are equivalent, consumption of fiber in high- or low-fat diets benefits fetal development and growth, through improvements in maternal, placental, and fetal antioxidant defense capacities. [ABSTRACT FROM AUTHOR]

Background: Recent studies have reported that blocking IgE has a potentially beneficial role in the treatment of various allergic diseases. Previously, we found that PG102, a water-soluble extract prepared from the edible fruits of Actinidia arguta, can effectively reduce IgE levels using murine models. Aims: To evaluate the efficacy of PG102 at lowering levels of total IgE in asymptomatic subjects with atopy. Methods: A total of 90 asymptomatic subjects with atopy were randomized equally to a PG102 group or a placebo control group and treated for 8 weeks in a double-blind manner. Total serum IgE, eosinophilic cation protein (ECP), eotaxin, thymus, and activation-regulated chemokine (TARC), IL-4, IL-5, and IL-13 levels were measured. Eosinophil counts were determined before and after treatment, and results were compared. In addition, possible adverse reactions were thoroughly checked in this first human trial. Results: Levels of total IgE significantly increased in the control group but showed no change in the PG102 group, and change differences between the control and PG102 groups were significant (+12.9%, vs.−5.7%, p = 0.015). Levels of ECP and eotaxin and eosinophil counts produced similar results. However, the other variables showed no significant changes after treatment. Conclusion: In this exploratory clinical trial, it was found that 8 weeks of treatment with PG102 effectively reduced the levels of total IgE in apparently asymptomatic subjects with atopy. [ABSTRACT FROM AUTHOR]

Purpose: Excess weight may be related to the development of adverse cardiometabolic risk factors in children. The aim of this study was to evaluate the effect of a lifestyle intervention program (nutrition and exercise counseling) on anthropometric parameters and metabolic syndrome (MS) components in Portuguese overweight/obese children. Methods: A total of 83 overweight/obese children aged 7-9 years were assigned to a 1-year individual or group-based treatment (GT); 61 children (z-score BMI (zBMI): 1.93 ± 0.28; 27 boys and 34 girls) completed the program. Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. Results: The overweight/obese children, compared to normal-weight ones, presented significantly higher blood pressure, total-cholesterol, total-cholesterol/high density lipoprotein cholesterol (HDL) ratio, triglycerides, Apolipoprotein B and C-reactive protein levels, while HDL and Apolipoprotein A-I were significantly lower. At baseline, the prevalence of MS was 16.4% in overweight/obese and 0% in normal-weight children. The number of components of MS was significantly higher in children with higher zBMI. Lifestyle intervention led to a significant improvement in zBMI, waist circumference/height ratio, HDL, triglycerides, Apolipoprotein A-I, and Apolipoprotein B levels. The prevalence of MS decreased to 14.8%. The GT intervention seems to be more successful, with a significant decrease in zBMI and an increase in HDL and a lower drop-out rate. Conclusions: Overweight/obese children have multiple risk factors associated with the MS. Lifestyle intervention, both individual and group-based treatment, led to an improvement in the degree of overweight/obesity and in MS components. [ABSTRACT FROM AUTHOR]

Purpose: The maintenance of an obtained lower weight level is often found to be difficult. The aim of this study was to determine weight maintenance after an initial weight loss by consumption of a meal replacement with a vegetable-oil emulsion associated with prolonged satiety. Methods: After a 6-week weight loss period with very low calorie diet (VLCD), subjects with >5% body weight (BW) loss were randomized to a 12-week weight maintenance follow-up period, comparing a partial meal replacement diet containing a vegetable-oil emulsion (test) or dairy fat (control). Anthropometric data and safety variables were collected at baseline and after 4, 8 and 12 weeks. Results: A significant weight loss was observed during the 12-week weight maintenance diet in the test and control group, respectively; 1.0 ± 2.1 kg ( p < 0.05) versus 1.3 ± 2.1 kg ( p < 0.05) with no significant difference between the groups. Body fat mass (BFM) decreased significantly ( p < 0.05) in the test group (−1.7%) compared to the control group (−0.8%). Conclusions: Addition of a vegetable-oil emulsion to a meal replacement weight maintenance program after an initial weight loss using VLCD was associated with decreased BFM by 0.9% without any change in BW between the two groups. [ABSTRACT FROM AUTHOR]

im: Our group has previously shown that the administration of pasta enriched along with the prebiotic inulin induces a significant reduction in triglyceride and glucose levels with a significant delay in gastric emptying (GE) rates. This protective effect may occur by affecting the release of a number of gut peptides involved in the control of gastrointestinal motility. The aim of the present study was to evaluate the effects of inulin-enriched pasta on the circulating levels of neurotensin (NT), somatostatin (SS), and corticotropin-releasing factor (CRF) in relation to the GE time in young healthy subjects. Methods: Twenty healthy young male volunteers completed a randomized double-blind crossover study consisting of a 2-week run-in period and two 5-week study periods (11% inulin-enriched/control pasta), with an 8-week wash-out period in between. Gut peptide concentrations were evaluated by radioimmunoassay. GE time was evaluated by ultrasonography. Results: The prebiotic treatment significantly increased the area under the curve (AUC) values of both NT and SS ( p < 0.05 Dunn's post-test). With regard to gastric motility, along with a significant delay in both the final time and T gastric emptying time, a positive correlation was found between T and SS AUC values ( r = 0.57, p = 0.009) in the inulin-enriched pasta group. Conclusion: These results support the hypothesis that inulin plays an active role in mechanisms affecting the release of these gut peptides, which may modulate the gastric emptying of digesta. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate whether consumption of Lactobacillus plantarum HEAL 9 (DSM 15312) and Lactobacillus paracasei 8700:2 (DSM 13434) could affect naturally acquired common cold infections in healthy subjects. Methods: A randomised, parallel, double-blind placebo-controlled study was performed to investigate whether intake of this probiotic mixture could reduce the risk of common cold episodes, number of days with common cold symptoms, frequency and severity of symptoms, and cellular immune response in common cold infections. A total of 272 subjects were supplemented daily with either 10 cfu (colony forming units) of probiotics ( N = 135) or control ( N = 137) for a 12-week period. Results: The incidence of acquiring one or more common cold episode was reduced from 67% in the control group to 55% in the probiotic group ( p < 0.05). Also, the number of days with common cold symptoms were significantly ( p < 0.05) reduced from 8.6 days in the control group to 6.2 days, in the probiotic group, during the 12-week period. The total symptom score was reduced during the study period from a mean of 44.4 for the control group to 33.6 for the probiotic group. The reduction in pharyngeal symptoms was significant ( p < 0.05). In addition, the proliferation of B lymphocytes was significantly counteracted in the probiotic group ( p < 0.05) in comparison with the control group. Conclusion: In conclusion, intake of the probiotic strains Lactobacillus plantarum HEAL 9 (DSM 15312) and Lactobacillus paracasei 8700:2 (DSM 13434) reduces the risk of acquiring common cold infections. [ABSTRACT FROM AUTHOR]

Modification of lifestyle habits is a key preventive strategy for many diseases. The role of lifestyle for the onset of headache in general and for specific headache types, such as migraine and tension-type headache (TTH), has been discussed for many years. Most results, however, were inconsistent and data on the association between lifestyle factors and probable headache forms are completely lacking. We evaluated the cross-sectional association between different lifestyle factors and headache subtypes using data from three different German cohorts. Information was assessed by standardized face-to-face interviews. Lifestyle factors included alcohol consumption, smoking status, physical activity and body mass index. According to the 2004 diagnostic criteria, we distinguished the following headache types: migraine, TTH and their probable forms. Regional variations of lifestyle factors were observed. In the age- and gender-adjusted logistic regression models, none of the lifestyle factors was statistically significant associated with migraine, TTH, and their probable headache forms. In addition, we found no association between headache subtypes and the health index representing the sum of individual lifestyle factors. The lifestyle factors such as alcohol consumption, smoking, physical activity and overweight seem to be unrelated to migraine and TTH prevalence. For a judgement on their role in the onset of new or first attacks of migraine or TTH (incident cases), prospective cohort studies are required. [ABSTRACT FROM AUTHOR]

Objective: To study the effects of the dietary fat content on cardiovascular disease risk factors in humans when the fatty acid composition and types of carbohydrates are kept constant. Methods: A controlled dietary study in healthy volunteers with 2 dietary groups and a parallel design consisting of 2 dietary periods was conducted. First, participants received a 2-week wash-in diet rich in saturated fatty acids (SFA; 47% of total fatty acids) and were then randomly assigned to either a high-fat (40% of energy) or a low-fat diet (29% of energy) for 4 weeks. Both diets were isocaloric, rich in monounsaturated fatty acids (MUFA; 51% of total fatty acids) and had similar fatty acid and carbohydrate compositions. Results: Compared to the wash-in diet, the high-fat and low-fat diets significantly lowered LDL-cholesterol (−0.34 and −0.41 mmol/l, respectively; P < 0.001 for time effect in RM-ANOVA), and HDL-cholesterol (−0.13 and −0.18 mmol/l, respectively; P < 0.001 for time), without any differences between the high-fat and low-fat diets ( P = 0.112 and P = 0.085 for time × group interaction in RM-ANOVA, respectively). The size of the major LDL fraction, the LDL susceptibility to oxidation and the plasma concentrations of oxidized LDL (ox-LDL) were significantly reduced by both the high-fat and low-fat diet, again without significant differences between the diets. The ratio of ox-LDL/LDL-cholesterol, serum triacylglycerols and urinary F2-isoprostanes were not significantly affected by the diets. Conclusion: A high-fat and a low-fat diet, both rich in MUFA, had similar effects on lipid-related cardiovascular disease risk factors in metabolically healthy men and women. [ABSTRACT FROM AUTHOR]

Objective is to investigate the relationship between migraine and obstructive sleep apnea in the general population. A cross-sectional population-based study. A random age and gender stratified sample of 40,000 persons aged 20-80 years residing in Akershus, Hedmark or Oppland County, Norway, were drawn by the National Population Register. A postal questionnaire containing the Berlin Questionnaire was used to classify respondents to be of either high or low risk of obstructive sleep apnea. 376 persons with high risk and 157 persons with low risk of sleep apnea aged 30-65 years were included for further investigations. They underwent an extensive clinical interview, a physical and a neurological examination by physicians, and in-hospital polysomnography. Those with apnea hypopnoea index (AHI) ≥5 were classified with obstructive sleep apnea. Migraine without aura (MO) and migraine with aura (MA) was diagnosed according to the International Classification of Headache Disorders. MO and MA occurred in 12.5 and 6.8% of the participants with obstructive sleep apnea. The logistic regression analyses showed no relationship between the two types of migraine and obstructive sleep apnea, with adjusted odds ratios for MO 1.15 (0.65-2.06) and MA 1.15 (0.95-2.39). Further, estimates using cutoff of moderate (AHI ≥ 15) and severe (AHI ≥ 30) obstructive sleep apnea, did not reveal any significant relationship between migraine and the AHI. Migraine and obstructive sleep apnea are unrelated in the general population. [ABSTRACT FROM AUTHOR]

The article focuses on a study related to the use of etomidate by emergency department (ED) for rapid sequence intubation. It informs that etomidate is the most commonly used induction agent for ED rapid sequence intubation (RSI) in North America. It states that the study emphasizes on whether the use of etomidate for ED RSI in critically ill adults is associated with greater morbidity or mortality compared to the use of ketamine. Several charts related to the study are also presented.