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Excess body weight, suboptimal diet, physical inactivity, alcohol consumption, sleep disruption, and elevated stress are modifiable risk factors associated with the development of chronic diseases. Digital behavioural interventions targeting these factors have shown promise in improving health and reducing chronic disease risk. The Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION) study is a parallel group, two-arm, randomized controlled trial evaluating the effects of adding healthcare professional guidance and peer support via group-based sessions to a web-based wellness platform (experimental group, n = 90) compared to a self-guided use of the platform (active control group, n = 90) among individuals with a body mass index (BMI) of 30 to <35 kg/m 2 and aged 40-65 years. Obesity is defined by a high BMI. The web-based wellness platform employed in this study is My Viva Plan (MVP)®, which holistically integrates nutrition, physical activity, and mindfulness programs. Over 16 weeks, the experimental group uses the web-based wellness platform daily and engages in weekly online support group sessions. The active control group exclusively uses the web-based wellness platform daily. Assessments are conducted at baseline and weeks 8 and 16. The primary outcome is between-group difference in weight loss (kg) at week 16, and secondary outcomes are BMI, percent weight change, proportion of participants achieving 5% or more weight loss, dietary intake, physical activity, alcohol consumption, sleep, and stress across the study. A web-based wellness platform may be a scalable approach to promote behavioural changes that positively impact health. This study will inform the development and implementation of interventions using web-based wellness platforms and personalized digital interventions to improve health outcomes and reduce chronic disease risk among individuals with obesity., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: CMP has previously received honoraria and/or paid consultancy from Almased. NM has since become an employee of My Viva Plan. CEO, TG, SV, CFT, IMS, MFP, STJ, AAK, DK, NM, JFM, SENS, MQ, BOS – no conflicts of interest. See Funding section above for additional competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The gut microbiome plays a significant role in physiological functions such as nutrient processing, vitamin production, inflammatory response, and immune modulation, which, in turn, are important contributors to athlete health and performance. To date, the interpretation, discussion, and visualization of microbiome results of athletes are challenging, due to a lack of standard parameters and reference data for collection and comparison. The purpose of this perspective piece is to provide researchers with an easy-to-understand framework for the collection, analysis, and data management related to the gut microbiome with a specific focus on athletic populations. In the absence of a consensus on microbiome research in the sports field, we hope that these considerations serve as foundational "best practice." Adherence to these standard operating procedures will accelerate the path toward improving the quality of data and ultimately our understanding of the influence of the gut microbiome in sport settings., Competing Interests: Declaration of interests R.I. is an employee of the Gatorade Sports Science Institute, a division of PepsiCo, Incorporated. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of PepsiCo, Incorporated., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Inflammation plays a central role in many chronic diseases that characterize modern society. Leptin/adiponectin and adiponectin/leptin ratios have been recognized as notable markers of dysfunctional adipose tissue and, consequently, an inflammatory state. Methods: Blood samples were collected from 41 adult volunteers (40.2 ± 8.3 years) diagnosed with severe obesity (BMI 46.99; 42.98-51.91 kg/m 2 ). The adipokines were quantified using an enzyme-linked immunosorbent assay, while the serum fatty acid analysis was conducted using chromatography. Results: The results unveiled a positive correlation between the leptin/adiponectin ratio and the 20:3n6 fatty acid (r = 0.52, p = 0.001), as well as a similar positive correlation between the adiponectin/leptin ratio and the 22:6n3 fatty acid (r = 0.74, p = 0.001). In the regression analysis, the 22:6n3 fatty acid predicted the adiponectin/leptin ratio (β = 0.76, p < 0.001), whereas C20:3 n-6 was a predictor for inflammatory markers (β = 4.84, p < 0.001). Conclusions: In conclusion, the 22:6n3 fatty acid was demonstrated to be a predictive factor for the adiponectin/leptin ratio and C20:3 n-6 was a predictor for inflammatory markers. This discovery, novel within this population, can help develop new intervention strategies aimed at controlling the inflammatory status in individuals classified as having severe obesity.

Background: The stage of life at the onset of obesity is an important factor in assessing inflammatory state and cardiometabolic risk., Objectives: This study aimed to evaluate the relationship between the obesity onset and the inflammatory profile in women with severe obesity., Setting: Public hospital, Brazil., Methods: Forty-eight women with severe obesity (20-59 yr old) were evaluated according to weight, height, neck circumference (NC), waist circumference (WC), and hip circumference, as well blood metabolic and inflammatory parameters. The participants were grouped according to obesity onset stage of life (early group: ≤19 yr; late group: >19 yr)., Results: The demographic means of the participants were: age of 39.7 years, weight of 122.7 kg and body mass index (BMI) of 48.4 kg/m 2 . The late group presented significantly higher values of leptin (lep)/adiponectin (adipo) ratio and homeostatic model assessment for insulin resistance (HOMA-IR) than the early group. The late group also had a lower adipo/lep ratio. Moreover, the late group showed correlations between the lep/adipo ratio and BMI (r = .460, P = .021), NC (r = .478, P = .016), and WC (r = .535, P = .006). Adipo was also correlated with NC (r = -.418, P = .038), WC (r = -.437, P = .029), and glycated hemoglobin (HbA1C) (r = -.485, P = .019). By contrast, in the early group, the lep/adipo ratio showed correlations with insulin (r = .647, P = .004) and HOMA-B (r = .564, P = .015)., Conclusions: The inflammatory profile is correlated with anthropometric values in women with late-onset obesity. Inflammatory markers seemed to correlate with the glycemic profile in women with early-onset obesity. Furthermore, inflammation was higher in women with late-onset obesity compared to those with early-onset obesity., (Copyright © 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Purpose of Review: The gut microbiome regulates several health and disease-related processes. However, the potential bidirectional relationship between the gut microbiome and physical exercise remains uncertain. Here, we review the evidence related to the gut microbiome in athletes., Recent Findings: The effect of physical exercise on the intestinal microbiome and intestinal epithelial cells depends on the type, volume, and intensity of the activity. Strenuous exercise negatively impacts the intestinal microbiome, but adequate training and dietary planning could mitigate these effects. An increase in short-chain fatty acids (SCFAs) concentrations can modulate signaling pathways in skeletal muscle, contributing to greater metabolic efficiency, preserving muscle glycogen, and consequently optimizing physical performance and recovery. Furthermore, higher SCFAs concentrations appear to lower inflammatory response, consequently preventing an exacerbated immune response and reducing the risk of infections among athletes. Regarding dietary interventions, the optimal diet composition for targeting the athlete's microbiome is not yet known. Likewise, the benefits or harms of using probiotics, synbiotics, and postbiotics are not well established, whereas prebiotics appear to optimize SCFAs production., Summary: The intestinal microbiome plays an important role in modulating health, performance, and recovery in athletes. SCFAs appear to be the main intestinal metabolite related to these effects. Nutritional strategies focusing on the intestinal microbiome need to be developed and tested in well controlled clinical trials., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Aims: Soil endemics have long fascinated botanists due to the insights they can provide about plant ecology and evolution. Often, these species have unique foliar nutrient composition patterns that reflect potential physiological adaptations to these harsh soil types. However, understanding global nutritional patterns to unique soil types can be complicated by the influence of recent and ancient evolutionary events. Our goal was to understand whether plant specialization to unique soils is a stronger determinant of plant nutrient composition than climate or evolutionary constraints., Methods: We worked on gypsum soils. We analyzed whole-plant nutrient composition (leaves, stems, coarse roots and fine roots) of 36 native species of gypsophilous lineages from the Chihuahuan Desert (North America) and the Iberian Peninsula (Europe) regions, including widely distributed gypsum endemics, as specialists, and narrowly distributed endemics and non-endemics, as non-specialists. We evaluated the impact of evolutionary events and soil composition on the whole-plant composition, comparing the three categories of gypsum plants., Key Results: Our findings reveal nutritional convergence of widely distributed gypsum endemics. These taxa displayed higher foliar Sulfur and higher whole-plant Magnesium than their non-endemic relatives, irrespective of geographic location or phylogenetic history. Sulfur and Magnesium concentrations were mainly explained by non-phylogenetic variation among species related to gypsum specialization. Other nutrient concentrations were determined by more ancient evolutionary events. For example, Caryophyllales usually displayed high foliar Calcium, whereas Poaceae did not. In contrast, plant concentrations of Phosphorus was mainly explained by species-specific physiology not related to gypsum specialization or evolutionary constraints., Conclusions: Plant specialization to a unique soil may strongly influence plant nutritional strategies, as we described for gypsophilous lineages. Taking a whole-plant perspective (all organs) within a phylogenetic framework has enabled us to gain a better understanding of plant adaptation to unique soils when studying taxa from distinct regions., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives: Dietary strategies to improve arachidonic acid:eicosapentaenoic acid (AA:EPA) ratios are of interest due to potential reductions in inflammation and oxidative stress following exercise. The aim of this study was to investigate the impact of a novel dietary intervention, that is, the ingestion of 30 g of dark chocolate, on blood lipid profiles and gut microbiota composition in elite male soccer players., Methods: Professional male soccer players were randomly assigned to the experimental group (DC) provided with 30 g of dark chocolate or to the control group (WC), provided with 30 g of white chocolate, for 30 days. Before and after intervention, blood, fecal sample, and anthropometry data were collected. For each outcome, two-way repeated-measure analysis of variance was used to identify differences between baseline and endpoint (Week 4), considering treatment (dark chocolate, white chocolate) as intersubjects' factors. Metagenomic analysis was performed following the general guidelines, which relies on the bioBakery computational environment., Results: DC group showed increased plasma polyphenols (from 154.7 ± 18.6 μg gallic acid equivalents/ml to 185.11 ± 57.6 μg gallic acid equivalents/ml, Δ pre vs. post = +30.41 ± 21.50) and significant improvements in lipid profiles: total cholesterol (Δ -32.47 ± 17.18 mg/dl DC vs. Δ -2.84 ± 6.25 mg/dl WC, Time × Treatment interaction p < .001), triglycerides (Δ -6.32 ± 4.96 mg/dl DC vs. Δ -0.42 ± 6.47 mg/dl WC, Time × Treatment interaction p < .001), low-density lipoprotein (Δ -18.42 ± 17.13 mg/dl vs. Δ -2.05 ± 5.19 mg/dl WC, Time × Treatment interaction p < .001), AA/EPA ratio (Δ -5.26 ± 2.35; -54.1% DC vs. Δ -0.47 ± 0.73, -6.41% WC, Time × Treatment interaction p < .001) compared with WC group. In addition, 4 weeks of intervention showed a significant increase in high-density lipoprotein concentration in DC group (Δ + 3.26 ± 4.49 mg/dl DC vs. Δ -0.79 ± 5.12 mg/dl WC). Microbial communities in the DC group maintained a slightly higher microbial stability over time (exhibiting lower within-subject community dissimilarity)., Conclusion: Ingesting 30 g of dark chocolate over 4 weeks positively improved AA:EPA ratio and maintained gut microbial stability. Dark chocolate ingestion represents an effective nutritional strategy to improve blood lipid profiles in professional soccer players. What Are the Findings? Ingesting 30 g of dark chocolate for 4 weeks positively influences blood lipid AA: EPA ratio while maintaining gut microbial stability. What This Study Adds? Dietary intake of specific foods such as dark chocolate represents an alternative strategy to support the health and recovery of elite soccer players. What Impact Might This Have on Clinical Practice in the Future? From a clinical and translational perspective, dark chocolate ingestion positively modulates favorable blood lipid profiles and polyunsaturated fatty acid metabolism while maintaining gut microbial stability. Dark chocolate ingestion may be considered as an effective nutritional strategy in elite sport environments during periods of high-intensity training and congested competitions. Further research is required to determine functional outcomes associated with the observed improvements in blood lipid profiles.

Chronic wounds are characterized by prolonged non-healing, significantly affecting patients' quality of life. Oral formulas may enhance the wound healing process and contribute to cost reduction in care. This review aimed to evaluate the effects of oral nutritional supplementation on chronic wound healing and provide insights into formula characteristics. A comprehensive search across Cinahl, Embase, PubMed, and Web of Science databases yielded nine studies from the past decade involving 741 patients ages 52 to 81.7 across various care settings: hospitals, long-term care facilities, and home care. Primary wound types included pressure injuries (58%), diabetic foot ulcers (40%), and venous ulcers (2%). The intervention duration ranged from 2 to 16 wk, with sample sizes varying from 24 to 270 patients. Notably, four studies reported a reduction in wound area and an increased healing rate with a hypercaloric, hyperproteic formula enriched with zinc and vitamins A, C, and E. However, two studies found no significant differences compared with control groups. Two other studies investigated a combination of arginine, glutamine, and β-hydroxy-β-methylbutyrate; however, they did not yield significant results, and one study favored a hyperproteic formula instead of a hyperproteic formula with arginine. This review provides evidence supporting the potential of oral nutritional supplementation to enhance the healing process of chronic wounds. Based on our findings, a desirable formula should be characterized by a high calorie and protein content and the inclusion of antioxidant micronutrients, including, but not limited to, vitamins A, E, C, and zinc., Competing Interests: Declaration of competing interest All authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Species-area relationships (SAR) constitute a key aspect of ecological theory and are integral to other scientific disciplines, such as biogeography, which have played a crucial role in advancing biology. The theory of insular biogeography provides a clear example. This theory initially expanded from true islands to other types of systems characterized by their insularity. One such approach was linked to geoedaphic islands, as seen in gypsum outcrops. While these continental areas have been considered insular systems, only limited and mostly indirect evidence thereof has been provided. This study utilized SAR to advance the understanding of gypsum outcrops as insular continental territories. It is hereby hypothesized that gypsum outcrops are edaphic islands, although their insular nature depends on the different functional or ecological plant types, and this nature will be reflected in the potential Arrhenius model z values. The results obtained support both hypotheses and provide insight into the ecological factors that help interpret the insularity of these areas. This interpretation goes beyond their mere extent and the distance among outcrops, emphasizing the importance of environmental filters. Said filters vary in permeability depending on the degree of gypsophily, or preference for gypsum, exhibited by different species.

Background: e-Health interventions can potentially improve health care. My Viva Plan ® (MVP) is a web-based program that focuses on mindfulness, nutrition, and physical fitness. The aim of this study was to evaluate the effects of this platform on stress indicators and diet quality among first-year university students., Methods: Ninety-seven university students were enrolled in a randomized, controlled clinical trial. Participants were randomized into control ( n  = 49) and MVP ( n  = 48) groups. Perceived stress was measured using the self-report Stress Indicator Questionnaire. Diet quality was assessed by the nutrient-rich foods index, and body composition was assessed by a hand-to-foot, multifrequency, bioelectrical impedance analysis., Results: There were no differences in physical, sleep, behavioral, emotional, and personal habit indicators between groups. Diet quality and body composition were similar between groups, except among women in the MVP group with decreased body fat (-1.2 ± 2.6 kg, p  < 0.05). Participant engagement was low: 50% of the MVP group did not access the platform., Conclusions: The MVP web-based intervention was not associated with improvements in stress indicators, diet quality, and body composition, likely due to the characteristics of our cohort of healthy young individuals. Future studies should focus on enhancing motivational approaches to explore the potential of e-health interventions that improve health behavior., Clinical Trial Registration number: NCT03579264A., Competing Interests: No competing financial interests exist., (© Joao F. Mota et al., 2023; Published by Mary Ann Liebert, Inc.)

The ketogenic diet (KD) is, nowadays, considered an interesting nutritional approach for weight loss and improvement in insulin resistance. Nevertheless, most of the studies available in the literature do not allow a clear distinction between its effects on insulin sensitivity per se, and the effects of weight loss induced by KDs on insulin sensitivity. In this review, we discuss the scientific evidence on the direct and weight loss mediated effects of KDs on glycemic status in humans, describing the KD's biochemical background and the underlying mechanisms.

The gut microbiome has a profound influence on host physiology, including energy metabolism, which is the process by which energy from nutrients is transformed into other forms of energy to be used by the body. However, mechanistic evidence for how the microbiome influences energy metabolism is derived from animal models. In this narrative review, we included human studies investigating the relationship between gut microbiome and energy metabolism -i.e., energy expenditure in humans and energy harvest by the gut microbiome. Studies have found no consistent gut microbiome patterns associated with energy metabolism, and most interventions were not effective in modulating the gut microbiome to influence energy metabolism. To date, cause-and-effect relationships and mechanistic evidence on the impact of the gut microbiome on energy expenditure have not been established in humans. Future longitudinal observational studies and randomized controlled trials utilizing robust methodologies and advanced statistical analysis are needed. Such knowledge would potentially inform the design of therapeutic avenues and specific dietary recommendations to improve energy metabolism through gut microbiome modulation., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

This study aimed to investigate the effect of chemotherapy (CT) and its different types of regimens on the anthropometry and body composition of women with breast cancer. Three-hundred-and-four women with breast cancer were enrolled in this multicenter study. The participants were evaluated before the infusion of the first cycle of CT (pre-CT), and until two weeks after CT completion (post-CT), regarding body weight, body mass index (BMI); waist circumference (WC); waist-to-height ratio (WHtR); conicity index (C-index); fat mass index (FMI); and fat-free mass index (FFMI). CT regimens were classified as anthracycline-based (AC-doxorubicin or epirubicin); anthracyclines and taxane (ACT); cyclophosphamide, methotrexate, and 5-fluorouracil (CMF); or isolated taxanes (paclitaxel or docetaxel). Women significantly increased BMI and FMI post-CT ( p < 0.001 and p = 0.007, respectively). The ACT regimen increased FMI ( p < 0.001), while FFMI increased after AC ( p = 0.007). It is concluded that the CT negatively impacted body composition and the type of regime had a strong influence. The ACT regimen promoted an increase in FMI compared to other regimens, and the AC increased FFMI. These findings reinforce the importance of nutritional monitoring of breast cancer patients throughout the entire CT treatment.

Gypsum covers a vast area of the Iberian Peninsula, making Spain a leader in its production. Gypsum is a fundamental raw material for modern societies. However, gypsum quarries have an obvious impact on the landscape and biodiversity. Gypsum outcrops host a high percentage of endemic plants and unique vegetation, considered a priority by the EU. Restoring gypsum areas after mining is a key strategy to prevent biodiversity loss. For the implementation of restoration approaches, understanding vegetation's successional processes can be of invaluable help. To fully document the spontaneous succession in gypsum quarries and to evaluate its interest for restoration, 10 permanent plots of 20 × 50 m were proposed, with nested subplots, in which vegetation change was recorded for 13 years in Almeria (Spain). Through Species-Area Relationships (SARs), these plots' floristic changes were monitored and compared to others in which an active restoration was carried out, as well as others with natural vegetation. Furthermore, the successional pattern found was compared to those recorded in 28 quarries distributed throughout the Spanish territory. The results show that an ecological pattern of spontaneous primary auto-succession is widely recurring in Iberian gypsum quarries, which is capable of regenerating the pre-existing natural vegetation.

Background & Aims: It is well known that dietary fiber positively impacts the microbiome and health as a whole. However, the health effects of β-glucan, a dietary fiber extracted from oats, have been questioned when administered alone or incorporated into other foods. The purpose of this systematic review and meta-analysis was to evaluate the impact of oats or β-glucan supplements on the lipid profile., Methods: Randomized controlled trials with parallel-arm or crossover blinded interventions at least two weeks in duration, for hyperlipidemic or non-hyperlipidemic men and women ≥18 years of age were selected. Only single (participants blinded) or double-blinded studies that compared oat or isolated β-glucan with a placebo/control group were considered for this review. The databases EMBASE, PubMed, Web of science and CINHAL were searched, from the earliest indexed year available online to the end of January 2022. Random-effects models were used to combine the estimated effects extracted from individual studies, and data were summarized as standardized mean difference (SMD) and 95% confidence interval (95%CI)., Results: A total of 811 articles were screened for eligibility, and relevant data were extracted from 28 studies, totaling 1494 subjects. Oat interventions TC (-0.61, 95%CI: -0.84;-0.39, p < 0.00001, and -0.70, 95%CI: -1.07;-0.34, p = 0.0002, respectively) and LDL (-0.51, 95%CI: -0.71;-0.31, p < 0.00001, and -0.38, 95%CI: -0.60;-0.15, p = 0.001, respectively). Moreover, isolated β-glucan interventions from parallel-arm studies decreased TC (-0.73, 95%CI: -1.01;-0.45, p < 0.00001), LDL (-0.58, 95%CI: -0.85;-0.32, p < 0.0001) and triglycerides (-0.30, 95%CI: -0.49;-0.12, p = 0.001). HDL was not altered by either oat or isolated β-glucan (p > 0.05)., Conclusion: Overall, this review showed that both oat and isolated β-glucan interventions improved lipid profiles. Furthermore, the ingestion of oats or isolated β-glucan supplements are effective tools to combat dyslipidemia and should be considered in cardiovascular disease prevention., Competing Interests: Declaration of competing interest The authors report there are no competing interests to declare., (Copyright © 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Context: Strenuous exercise may lead to negative acute physiological effects that can impair athletic performance. Some recent studies suggest that probiotic supplementation can curtail these effects by reducing the permeability of the intestinal barrier, yet results are inconsistent., Objective: The aim of this systematic review is to assess the effects of probiotic supplementation on athletic performance., Data Sources: The PubMed/MEDLINE, Cochrane, and Scopus databases were searched for articles that assessed the effects of probiotic supplementation on athletic performance., Data Extraction This Systematic Review Is Reported According to: PRISMA guidelines. Risk of bias was assessed through the Cochrane RoB 2.0 tool. Seventeen randomized clinical trials assessing athletic performance as the primary outcome were included. In total, 496 individuals (73% male) comprising athletes, recreationally trained individuals, and untrained healthy individuals aged 18 to 40 years were investigated., Data Analysis: Three studies showed an increase or an attenuation of aerobic performance (decline in time to exhaustion on the treadmill) after supplementation with probiotics, while 3 found an increase in strength. However, most studies (n = 11) showed no effect of probiotic consumption on aerobic performance (n = 9) or muscular strength (n = 2). The most frequently used strain was Lactobacillus acidophilus, used in 2 studies that observed positive results on performance. Studies that used Lactobacillus plantarum TK10 and Lactobacillus plantarum PS128 also demonstrated positive effects on aerobic performance and strength, but they had high risk of bias, which implies low confidence about the actual effect of treatment., Conclusion: There is not enough evidence to support the hypothesis that probiotics can improve performance in resistance and aerobic exercises. Further well-controlled studies are warranted., (© The Author(s) 2022. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

To identify how variables such as exercise condition, supplementation strategy, participant characteristics and demographics, and practices that control oral microbiota diversity could modify the effect of inorganic nitrate ingestion (as nitrate salt supplements, beetroot juice, and nitrate-rich vegetables) on exercise performance, we conducted a systematic review with meta-analysis. Studies were identified in PubMed, Embase, and Cochrane databases. Eligibility criteria included randomized controlled trials assessing the effect of inorganic nitrate on exercise performance in healthy adults. To assess the variation in effect size, we used meta-regression models for continuous variables and subgroup analysis for categorical variables. A total of 123 studies were included in this meta-analysis, comprising 1705 participants. Nitrate was effective for improving exercise performance (standardized mean difference [SMD]: 0.101; 95% CI: 0.051, 0.151, P <0.001, I2 = 0%), although nitrate salts supplementation was not as effective (P = 0.629) as ingestion via beetroot juice (P <0.001) or a high-nitrate diet (P = 0.005). Practices that control oral microbiota diversity influenced the nitrate effect, with practices harmful to oral bacteria decreasing the ergogenic effect of nitrate. The ingestion of nitrate was most effective for exercise lasting between 2 and 10 min (P <0.001). An inverse dose-response relation between the fraction of inspired oxygen and the effect size (coefficient: -0.045, 95% CI: -0.085, -0.005, P = 0.028) suggests that nitrate was more effective in increasingly hypoxic conditions. There was a dose-response relation for acute administration (P = 0.049). The most effective acute dose was between 5 and 14.9 mmol provided ≥150 min prior to exercise (P <0.001). An inverse dose-response for protocols ≥2 d was observed (P = 0.025), with the optimal dose between 5 and 9.9 mmol·d-1 (P <0.001). Nitrate, via beetroot juice or a high-nitrate diet, improved exercise performance, in particular, in sessions lasting between 2 and 10 min. Ingestion of 5-14.9 mmol⋅d-1 taken ≥150 min prior to exercise appears optimal for performance gains and athletes should be aware that practices controlling oral microbiota diversity may decrease the effect of nitrate., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.)

Background: The dosage and safety of nutritional supplements for patients with venous ulcers are still not well established. Aim: To evaluate the effects of a high calorie, high protein, arginine-, zinc-, and vitamins A, C, and E-enriched nutritional supplement on the biochemical profile, dietary intake, anthropometry, muscle strength, and characteristics of lesions of patients with venous ulcers. Methods: A controlled before−after clinical trial with a four-week follow-up involved 27 patients with venous ulcers under outpatient treatment in Brazil. It was administered in two to three doses per day (200 mL each) of a high-calorie and high-protein supplement enriched with arginine, zinc, and vitamins A, C, and E. Patients were assessed for anthropometric parameters, dietary intake, biochemical tests, and healing conditions according to the Pressure Ulcer Scale for Healing (PUSH). Results: It was observed that an increase in energy and protein supply led to an adequate intake of immunonutrients (zinc and vitamins A, C, and E), increased body weight, increased body mass index, and stronger handgrip strength. The injury area and the score on the PUSH notably decreased after the intervention (p < 0.001). Conclusions: The administered supplement, at the tested dosage, improved the nutritional status and characteristics of lesions in patients with venous ulcers.

The analysis of plant elemental composition and the underlying factors affecting its variation are a current hot topic in ecology. Ecological adaptation to atypical soils may shift plant elemental composition. However, no previous studies have evaluated its relevance against other factors such as phylogeny, climate or individual soil conditions. We evaluated the effect of the phylogeny, environment (climate, soil), and affinity to gypsum soils on the elemental composition of 83 taxa typical of Iberian gypsum ecosystems. We used a new statistical procedure (multiple phylogenetic variance decomposition, MPVD) to decompose total explained variance by different factors across all nodes in the phylogenetic tree of target species (covering 120 million years of Angiosperm evolution). Our results highlight the relevance of phylogeny on the elemental composition of plants both at early (with the development of key preadaptive traits) and recent divergence times (diversification of the Iberian gypsum flora concurrent with Iberian gypsum deposit accumulation). Despite the predominant phylogenetic effect, plant adaptation to gypsum soils had a strong impact on the elemental composition of plants, particularly on sulphur concentrations, while climate and soil effects were smaller. Accordingly, we detected a convergent evolution of gypsum specialists from different lineages on increased sulphur and magnesium foliar concentrations., (© 2022 The Authors. New Phytologist © 2022 New Phytologist Foundation.)

Protein quality has an important role in increasing satiety. Evidence suggests that whey protein (WP) provides satiety via gastrointestinal hormone secretion. Hydrolysed collagen supplementation can also stimulate the production of incretins and influence satiety and food intake. Thus, we sought to compare the effect of acute supplementation of WP or hydrolysed collagen on post-intervention appetite and energy consumption. This was a randomised, double-blind, crossover pilot study with ten healthy adult women (22·4 years/old) who were submitted to acute intake (single dose) of a beverage containing WP (40 g of concentrated WP) or hydrolysed collagen (40 g). Subjective appetite ratings (feelings of hunger, desire to eat and full stomach) were measured using the Visual Analog Scale (VAS), energy intake was quantified by ad libitum cheese bread consumption 2 hours after supplementation and blood was collected for leptin and glucose determination. There was no difference between treatment groups in the perception of hunger ( P = 0·983), desire to eat ( P = 0·326), full stomach feeling ( P = 0·567) or food consumption ( P = 0·168). Leptin concentrations at 60 min post supplementation were higher when subjects received hydrolysed collagen ( P = 0·006). Acute supplementation with hydrolysed collagen increased leptin levels in comparison with WP, but had no effect on appetite measured by feelings of hunger, desire to eat, full stomach feeling (VAS) or energy consumption.

Given the worldwide epidemic of diet-related chronic diseases, evidence-based dietary recommendations are fundamentally important for health promotion. Despite the importance of the human gut microbiota for the physiological effects of diet and chronic disease etiology, national dietary guidelines around the world are just beginning to capitalize on scientific breakthroughs in the microbiome field. In this review, we discuss contemporary nutritional recommendations from a microbiome science perspective, focusing on mechanistic evidence that established host-microbe interactions as mediators of the physiological effects of diet. We apply this knowledge to inform discussions of nutrition controversies, advance innovative dietary strategies, and propose an experimental framework that integrates the microbiome into nutrition research. The congruence of key paradigms in the nutrition and microbiome disciplines validates current recommendations in dietary guidelines, and the systematic incorporation of microbiome science into nutrition research has the potential to further improve and innovate healthy eating., Competing Interests: Declaration of interests E.C.D. is an employee of AgriFiber Solutions LLC, a manufacturer of upcycled dietary fibers and prebiotics. C.J.F. provides scientific advice to Dairy Farmers of Canada and serves on the scientific advisory board for ByHeart. C.M.P. reports receiving honoraria and/or paid consultancy from Abbott Nutrition, Nutricia, Nestlé Health Science, Fresenius Kabi, Pfizer, and funding from Almased Wellness GmbH. J.W. has received honoraria and/or paid consultancy from Novozymes, Nestlé, and ByHeart and reports research funding from industry sources involved in the manufacture and marketing of prebiotics and dietary fibers. J.W. is further a co-owner of Synbiotic Health, a developer of synbiotic products. All other authors declare no competing interests., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background & Aims: Muscle quality index (MQI) is used to measure the quality of the muscles. It is defined as the ratio of muscle strength per unit of muscle mass, but since this might vary by rage and ethnicity, we aimed to develop sex, and population-specific normative data and cutoff values for MQI (extremally low and low) using the arm or appendicular skeletal muscle mass (ASM) obtained from a population-representative sample., Methods: This cross-sectional analysis included data from 4849 volunteers (aged 20-59 years) from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Measures of handgrip strength (HGS) were performed using a hand dynamometer. ASM was assessed by dual-energy X-ray absorptiometry (DXA). Arm ASM mass was used to calculate MQI Arm [dominant HGS/dominant arm ASM (kg/kg)]; ASM was used to calculate MQI App [dominant HGS/ASM (kg/kg)]; and the sum of the non-dominant hand and dominant hand were used to calculate MQI total [HGS sum/ASM (kg/kg)]. Cutoff values were derived from a young reference subgroup (n = 1625 aged, 20-39 years), with low and extremely low MQI defined as 1 and 2 sex-specific standard deviations below the mean, respectively., Results: MQI Arm, MQI App, and MQI Total differed by sex and population studied. Overall, using the proposed cutoffs, men showed lower values of MQI Arm than women, and higher MQI App, and MQI Total values. Compared to non-Hispanic Whites, non-Hispanic Asians had higher values of MQI while non-Hispanic Black people had lower values., Conclusion: MQIs cutoffs were established for both sexes and different populations studied. MQI Arm , MQI App, and MQI Total values were lower after the fifth-decade in men, but not in women., Competing Interests: Conflict of interest None., (Copyright © 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Chronobiology plays a crucial role in modulating many physiologic systems in which there is nutritional synergism with meal timing. Given that intermittent fasting (IF) has grown as a flexible dietary method consisting of delayed or early eating windows, this scoping review addresses the effects of IF protocols on metabolism as they relate to clinical nutrition and the circadian system. Although nocturnal habits are associated with circadian misalignments and impaired cardiometabolic profile-and nutritional physiology is better orchestrated during the day-most findings are based on animal experiments or human studies with observational designs or acute meal tests. Well-controlled randomized clinical trials employing IF protocols of delayed or early eating windows have sometimes demonstrated clinical benefits, such as improved glycemic and lipid profiles, as well as weight loss. However, IF does not appear to be more effective than traditional diets at the group level, and its effects largely depend on energy restriction. Thus, efforts must be made to identify patient biological rhythms, preferences, routines, and medical conditions before individual dietary prescription in clinical practice., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.)

The aim of this study was to compare two different maximal intensity exercise modality training protocols of similar durations on muscle strength, cardiorespiratory fitness, and lower limb composition in recreationally trained men. Twenty-five trained men (28.9 ± 5.6 years) were randomly divided into Cycle ergometer (4 sets of 30 seconds sprints) and Leg press (4 sets of 10-12 repetitions to momentary failure). Both groups trained three times a week for 5 weeks. Before and after the training period, the participants performed a 10-repetition maximum (10RM) test for knee extension, an incremental exercise test on a treadmill for time to exhaustion (TTE) and peak oxygen consumption ( V ˙ O 2peak ) and underwent dual energy X-ray absorptiometry to assess lower limb composition. Knee extension 10RM and TTE increased in both groups with no statistically significant between group ( p = 0.614 and p = 0.210). Only cycle ergometer group increased V ˙ O 2peak ( p = 0,012). For all lower limb composition outcomes, changes were minimal. The results suggest that 5 weeks of effort and duration matched exercise protocols using cycle ergometer training or leg press may produce similar strength adaptations.

Background: Bioelectrical impedance analysis (BIA) is a widely used method for estimating body composition. Avoiding foods/beverages containing caffeine is a frequently enforced pre-test protocol to ensure reliability of BIA measurements. However, few studies have evaluated whether this is necessary, with conflicting results. We aimed to determine whether the coffee consumption differing in caffeine content influences BIA parameters in healthy adults., Methods: Twenty-five healthy adults were enrolled in a randomized, double-blind cross-over trial. Three amounts of caffeine were given with 200 mL of coffee: 0 mg (11 g of decaffeinated), 200 mg (5.5 g of caffeinated plus 5.5 g of decaffeinated), and 400 mg of caffeine (11 g of caffeinated). BIA measurements were conducted at 6 different times, and coefficient variations (CV) explored., Results: No differences were observed for group × time interaction on impedance, resistance, or reactance (p > 0.05). Values of BIA parameters increased after 30-min of coffee consumption, independently of the caffeine dosage (all p < 0.001). Body fat percentage followed the same pattern and increased after 45-min (p < 0.05). Median CV for consecutive impedance, resistance, and reactance measurements were >95%CI of expected device measurement error over 70-min, without difference between groups. Urine output volume was not different between groups (decaffeinated: 440.45 ± 197.57 mL; 200 mg: 471.80 ± 171.88 mL; 400 mg: 489.30 ± 204.10 mL, p > 0.05)., Conclusion: Coffee consumption influenced BIA-derived results after 70-min but was not related to caffeine content, likely due to water intake., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Objectives: To evaluate the associations of hand grip strength (HGS) with body composition, functional capacity, muscle quality, and inflammatory markers in people receiving maintenance hemodialysis., Methods: This is a cross-sectional study in people receiving maintenance hemodialysis. HGS was measured by hydraulic dynamometer on the upper limb without fistula. Participants were stratified into low or adequate HGS, based on population-specific cutoff points. Body composition was assessed by dual-energy X-ray absorptiometry, and functional capacity by the Short Physical Performance Battery and timed up-and-go tests. In addition, serum creatinine, interleukin-6 (IL-6), IL-10, tumor necrosis factor-α, and ultra-sensitive C-reactive protein (us-CRP) were measured before the dialysis session., Results: A total of 67 participants (41.8% women, 58.2% male; ages 54.1 ± 11.7 y) were included. Those with low HGS had worse functional capacity than those with adequate HGS (timed up-and-go test, 10.7 ± 1.0 versus 8.5 ± 0.8 sec, respectively; P < 0.001). IL-6 and us-CRP were higher in those with low HGS than their counterparts (IL-6: 2.7 ± 0.3 versus 1.9 pg/mL, P = 0.03; us-CRP: 14.8 ± 3.0 versus 4.7 ± 1.9 mg/L, P = 0.03). Multiple linear regression analysis showed that appendicular lean mass, us-CRP, age, sex, and seven-point subjective global assessment score were associated with HGS., Conclusions: Participants with low HGS showed higher inflammation and lower functional capacity. In addition to muscle mass, inflammation and nutritional status also affect HGS.., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Skeletal muscle wasting has been well-documented among hemodialysis patients. This catabolic condition can be induced by numerous factors, including low-grade inflammation, and is associated with impairments in functional capacity and quality of life, as well as an increased mortality risk. We previously showed that 12 weeks of intradialytic resistance training increases lean mass, functional capacity, and the quality of life of hemodialysis patients. This chapter provides the details of a protocol of intradialytic exercise that leads to improvements in inflammatory status, body composition, and functional capacity., (© 2022. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Curcumin is a bioactive compound derived from Curcuma longa L. root, extensively studied due to its antioxidant and anti-inflammatory properties. This study evaluates the effects of different doses of powdered C. longa root on antioxidant capacity in healthy men. In a pilot randomized, double-blinded, crossover experiment, we acutely administered a low dose (1.5 g, LCG), moderate dose (3.0 g, MCG), and high dose (6.0 g, HCG) of C. longa to nine healthy men. There were no differences in plasma curcumin levels ( p = 0.593) and antioxidant capacity ( p = 0.473) for time × group interactions. Plasma curcumin levels increased in all groups after 20 and 90 min of C. longa intake ( p < 0.05). HCG had a lower postprandial incremental area under the antioxidant capacity curve than LCG or MCG ( p < 0.01). A low dose of C. longa increased the antioxidant capacity in healthy men. However, plasma curcumin levels were not dose dependently affected., Competing Interests: There is none to declare., (Copyright © 2021 Tatyanne Letícia N. Gomes et al.)

Background: My Viva Plan (MVP) (https://www.myvivainc.com/) is a web-based application developed by a dietitian that aims to support healthy living by providing resources and self-monitoring tools to help promote a healthy diet, healthy mind, and physical fitness. First-year university students have the potential to benefit because poor dietary choices, limited physical activity, and high stress are prevalent in this population. In addition, they are also active technology users., Objective: This study aims to understand experiences and perception of MVP by first-year university students using this tool as part of a 12-week randomized controlled trial., Design: One-on-one semistructured interviews were conducted following a 12-week intervention involving use of MVP., Participants/setting: First-year university students from the University of Alberta, Edmonton, Canada (n = 32)., Intervention: Participants were instructed to use MVP as much as possible for 12 weeks in either the fall/2018 or winter/2019 semesters., Qualitative Data Analysis: Interviews were audio-recorded, transcribed verbatim, and analyzed abductively using content analysis., Results: Participants reported varied use of MVP across the 12-week period. Data were categorized using the HealthChange Methodology (Behaviors, Emotions, 37 Situations, Thinking) framework. Participants provided various examples of emotions (eg, motivation, stress), situations (eg, time, living arrangements, finances), and thinking (eg, self-awareness, level of satisfaction with MVP, and how MVP was or could be better tailored for students) that acted as either facilitators or barriers to MVP use and explained their behaviors associated with this tool., Conclusions: Overall, participant behaviors regarding MVP varied and were influenced by several factors, including their emotions, situations, and thinking. The Behaviors, Emotions, Situations, Thinking framework may be helpful for dietitians to identify barriers and facilitators affecting their client's use of ehealth tools for lifestyle behavior change. This information can be used to optimize client support when using these tools., (Copyright © 2021 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Purpose: Neuromuscular electrical stimulation (NMES) elicits muscle contraction and has been shown to attenuate muscle atrophy when physical activity is not possible. Thus, we hypothesized that intradialytic NMES would attenuate the loss leg lean mass and improve the phase angle in patients undergoing hemodialysis (HD)., Methods: A randomized controlled trial was performed with twenty-one adult HD patients (n = 8 F, n = 13 M; 45.8 ± 10.6 y) randomly assigned to usual care (control group, n = 11; 4F/7M) or to the NMES group (n = 10; 4F/6M). NMES was applied bilaterally at the origin and insertion points of the quadriceps or gastrocnemius muscles for 40 min during each HD session (3x/wk for one month). Pre-and post-intervention, we measured leg lean mass using dual-energy x-ray absorptiometry and phase angle using bioelectrical impedance analysis., Results: NMES did not change leg lean mass compared to the control group. Phase angle increased in the NMES compared to the control group (Δ: +0.71 ± 0.27° vs. -0.46 ± 0.23°, p = 0.004) with interaction time x treatment (ANOVA p = 0.004)., Conclusion: Short-term intradialytic NMES targeting muscles of the legs improved the phase angle but did not change leg lean mass., Brazilian Registry of Clinical Trials Under the Code: RBR-98wzgn., Competing Interests: Declaration of competing interest All authors declare no conflict of interest., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Gastrointestinal symptoms are common in patients in hemodialysis treatment and were frequently associated with low intake of dietary fibers and liquids, oral iron supplementation, phosphate binders, and low level of physical activity. Thus, the aim of this study was to evaluate the effect of baru almond oil in comparison with mineral oil supplementation on bowel habits of hemodialysis patients. Thirty-five patients on hemodialysis (57% men, 49.9 ± 12.4 years) were enrolled in a 12-week single-blind clinical trial. Patients were allocated (1 : 2) by sex and age into (1) the mineral group: 10 capsules per day of mineral oil (500 mg each) or (2) the baru almond oil group: 10 capsules per day of baru almond oil (500 mg each). Bowel habits were assessed by the Rome IV criteria, Bristol scale, and self-perception of constipation. Food consumption, physical activity level, and time spent sitting were also evaluated at the baseline and at the end of the study. After 12 weeks of supplementation, the baru almond oil group showed reduced Rome IV score (6.1 ± 5.5 vs 2.8 ± 4.3, p =0.04) and the straining on the evacuation score (1.2 ± 1.4 vs 0.4 ± 0.7; p =0.04), while the mineral group did not show any change in the parameters. The frequency of self-perception of constipation was lower in the baru almond oil group after intervention (45.0% vs 15.0%, p =0.04). Baru almond oil improved bowel habit and the straining on evacuation in hemodialysis patients., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Raquel M. Schincaglia et al.)

Background: Evidence suggests that chemotherapy (CT) leads to unfavorable outcomes on nutritional and metabolic profile; however, this is poorly understood., Objective: To evaluate the impact of CT on body composition, bone mineral density (BMD), insulin resistance, lipid markers related to atherosclerotic cardiovascular diseases in women recently diagnosed with breast cancer according to menopausal status., Methods: This is a prospective study that enrolled women newly diagnosed with stage II-III breast cancer (2014-18). Body composition were measured by dual-energy x-ray absorptiometry. Blood samples were collected to assess lipid profile, insulin resistance and sensitivity, visceral adiposity index and lipid accumulation product were calculated. Dietary intake, physical activity and function were also evaluated at the time of breast cancer diagnosis and after CT completion., Results: Ninety-nine women (40.4% in the premenopausal stage) aged 51 ± 1 years took part in this study. CT duration was 197 ± 27 days and main regimen was anthracyclines with taxanes (88.9%). CT was associated with an increase in total and central adiposity, insulin resistance, and all lipid-related markers, and a decrease in appendicular lean mass index, BMD and HDL-c concentration. Premenopausal women experienced greater unfavorable outcomes on adiposity markers and BMD compared to postmenopausal women (p < 0.01). No changes were observed in dietary intake and physical activity after CT., Conclusions: Breast cancer CT negatively impacted body composition and metabolic profile. Premenopausal women experienced greater unfavorable impact on adiposity markers and BMD., Competing Interests: Conflicts of interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Purpose: This study assessed whether caffeine mouth rinsing affects 10-km run performance and vertical jump in recreational runners., Methods: A double-blind, placebo-controlled, crossover study was conducted. Ten well-trained volunteers performed two trials, following caffeine or placebo mouth rinse, separated by seven days. Immediately before the 10-km run, a 10-second mouth rinse with either 300 mg of caffeine (1.2%) or microcrystalline cellulose (placebo) diluted in 25 mL of water was performed. Pre- and post-exercise, participants performed a vertical jump test. A Garmin Forerunner® GPS, was used to measure 10-km running time and an 11-point Borg scale was used post-exercise to measure ratings of perceived exertion. Blood samples were also collected during the visit in the laboratory in the afternoon period to classify individuals according to their CYP1A2 genotype. Vertical jump performance was evaluated using a force plate., Results: Nine runners (90%) were CC homozygotes and one (10%) was an AC heterozygote for CYP1A2. There was no difference in 10-km time-trial performance (Placebo: 47.07 ± 5.18 vs. CAF: 47.45 ± 6.34 min, p = 0.89), ratings of perceived exertion (Placebo: 17 ± 1 vs. CAF: 16 ± 2, p = 0.34) or vertical jump power (Placebo, Pre: 4.5 ± 0.6 W•kg-1 and Post: 4.5 ± 0.7 W•kg-1; CAF: Pre: 4.4 ± 0.7 W•kg-1 and Post: 4.4 ± 0.8 W•kg-1, d = 0.21, p = 0.66) between trials., Conclusion: Acute caffeine mouth rinsing (1.2%) did not improve 10-km performance and showed similar null effects on vertical jump performance in CYP1A2 C-allele carriers., Competing Interests: Declaration of competing interest The authors have no competing interests to declare., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background: First-year university students are at an increased risk for developing mental health issues and a poor nutritional status. Self-care plays an essential role in optimizing mental health and can prevent or manage stress, anxiety, and depression. Web-based self-monitoring of diet and physical activity can lead to similar or improved health outcomes compared with conventional methods. Such tools are also popular among university students., Objective: The primary aim of this 12-week randomized controlled trial is to assess the impact of a web-based wellness platform on perceived stress among first-year university students. The secondary aim is to assess the effects of the platform on diet quality. The exploratory objectives are to explore the effects of the platform on body composition, health-related quality of life, mindfulness, mental well-being, and physical activity., Methods: A total of 97 first-year undergraduate students were randomized to either the intervention (n=48) or control (n=49) group. The intervention consisted of access to a web-based platform called My Viva Plan (MVP), which aims to support healthy living by focusing on the topics of mindfulness, nutrition, and physical activity. The platform is fully automated and guided by the principles of cognitive behavioral theory. Participants in the intervention group were instructed to use the MVP as frequently as possible over 12 weeks. The control group did not receive access to MVP. Perceived stress was assessed using the Stress Indicators Questionnaire at baseline, week 6, and week 12. Three-day food records were used to analyze the dietary intake at baseline and week 12. Health-related quality of life, mindfulness, mental well-being, and physical activity questionnaires were completed at baseline, week 6, and week 12. Body composition was assessed at baseline and week 12. Study assessments were completed in person at baseline and week 12 and electronically at week 6., Results: Study recruitment started in August 2018, with batch enrollment for students registered in the fall (September 2018 to December 2018) and winter (January 2019 to April 2019) academic terms at the University of Alberta, Edmonton, Alberta., Conclusions: This study is the first to explore the impact of a web-based platform designed to promote health and wellness on perceived stress and diet quality among first-year university students., Trial Registration: ClinicalTrials.gov NCT03579264; https://clinicaltrials.gov/ct2/show/NCT03579264., International Registered Report Identifier (irrid): DERR1-10.2196/24534., (©Claire F Trottier, Jessica R L Lieffers, Steven T Johnson, João F Mota, Roshni K Gill, Carla M Prado. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 10.03.2021.)

Optimal nutrition can improve well-being and might mitigate the risk and morbidity associated with coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This review summarizes nutritional guidelines to support dietary counseling provided by dietitians and health-related professionals. The majority of documents encouraged the consumption of fruits, vegetables, and whole grain foods. Thirty-one percent of the guidelines highlighted the importance of minerals and vitamins such as zinc and vitamins C, A, and D to maintain a well-functioning immune system. Dietary supplementation has not been linked to COVID-19 prevention. However, supplementation with vitamins C and D, as well as with zinc and selenium, was highlighted as potentially beneficial for individuals with, or at risk of, respiratory viral infections or for those in whom nutrient deficiency is detected. There was no convincing evidence that food or food packaging is associated with the transmission of COVID-19, but good hygiene practices for handling and preparing foods were recommended. No changes to breastfeeding recommendations have been made, even in women diagnosed with COVID-19., (© The Author(s) 2020. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Gut microbiome influences athletes' physiology, but because of the complexity of sport performance and the great intervariability of microbiome features, it is not reasonable to define a single healthy microbiota profile for athletes. We suggest the use of specific meta-omics analysis coupled with innovative computational systems to uncover the hidden association between microbes and athlete's physiology and predict personalized recommendation.

Objective: To describe the dietary habits and anthropometric and biochemical parameters of patients with active venous leg ulcers and to verify the association of these variables with wound duration and area., Design, Setting, and Participants: A cross-sectional study conducted with 33 participants diagnosed with venous leg ulcers in outpatient care., Main Outcome Measures: Socioeconomic data, anthropometric parameters, biochemical parameters, food consumption, and wound characteristics were analyzed by an interprofessional team., Main Results: Participants were an average of 58 ± 13 years, 57.6% women, 84.8% overweight, and had a median wound duration of 10 months (range, 1-192 months) and an average wound area of 5 cm (range, 0.22-61.1 cm). Diets were typically hypocaloric and hypoproteic, with a low amount of vitamin A and magnesium. Wound duration was negatively associated with polyunsaturated fat intake (P = .032), whereas wound area was significantly associated with lipid intake (P = .002) and C-reactive protein (P = .040)., Conclusions: Patients with active venous leg ulcers were overweight (leading to systemic inflammation) and had low consumption of calories, protein, and micronutrients that could support cicatrization. Wound area was associated with a high-fat diet, whereas wound duration was negatively associated with polyunsaturated fat intake.

Ergogenic strategies have been studied to alleviate muscle fatigue and improve sports performance. Sodium bicarbonate (NaHCO3) has improved repeated sprint performance in adult team-sports players, but the effect for adolescents is unknown. The aim of the present study was to evaluate the effect of NaHCO3 supplementation on repeated sprint performance in semiprofessional adolescent soccer players. In a double-blind, placebo-controlled, crossover trial, 15 male semiprofessional adolescent soccer players (15 ± 1 years; body fat 10.7 ± 1.3%) ingested NaHCO3 or a placebo (sodium chloride) 90 min before performing the running anaerobic sprint test (RAST). A countermovement jump was performed before and after the RAST, and ratings of perceived exertion, blood parameters (potential hydrogen and bicarbonate concentration), and fatigue index were also evaluated. Supplementation with NaHCO3 promoted alkalosis, as demonstrated by the increase from the baseline to preexercise, compared with the placebo (potential hydrogen: +0.07 ± 0.01 vs. -0.00 ± 0.01, p < .001 and bicarbonate: +3.44 ± 0.38 vs. -1.45 ± 0.31 mmol/L, p < .001); however, this change did not translate into an improvement in RAST total time (32.12 ± 0.30 vs. 33.31 ± 0.41 s, p = .553); fatigue index (5.44 ± 0.64 vs. 6.28 ± 0.64 W/s, p = .263); ratings of perceived exertion (7.60 ± 0.33 vs. 7.80 ± 0.10 units, p = .525); countermovement jump pre-RAST (32.21 ± 3.35 vs. 32.05 ± 3.51 cm, p = .383); or countermovement jump post-RAST (31.70 ± 0.78 vs. 32.74 ± 1.11 cm, p = .696). Acute NaHCO3 supplementation did not reduce muscle fatigue or improve RAST performance in semiprofessional adolescent soccer players. More work assessing supplementation in this age group is required to increase understanding in the area.

A high-fat fast-food meal negatively impacts postprandial metabolism even in healthy young people. In experimental studies, epigallocatechin-3-gallate (EGCG), a bioactive compound present in green tea, has been described as a potent natural inhibitor of fatty acid synthase. Thus, we sought to evaluate the effects of acute EGCG supplementation on postprandial lipid profile, glucose, and insulin levels following a high-fat fast-food meal. Fourteen healthy young women 21 ± 1 years and body mass index 21.4 ± 0.41 kg/m 2 were enrolled in a randomized, double-blind, placebo-controlled crossover study. Participants ingested capsules containing 800 mg EGCG or placebo immediately before a typical fast-food meal rich in saturated fatty acids. Blood samples were collected at baseline and then at 90 and 120 min after the meal. The EGCG treatment attenuated postprandial triglycerides ( p = 0.029) and decreased high-density lipoprotein cholesterol (HDL-c) ( p = 0.016) at 120 min. No treatment × time interaction was found for total cholesterol, low-density lipoprotein (LDL-c), and glucose or insulin levels. The incremental area under the curve (iAUC) for glucose was decreased by EGCG treatment ( p < 0.05). No difference was observed in the iAUC for triglycerides and HDL-c. In healthy young women, acute EGCG supplementation attenuated postprandial triglycerides and glucose but negatively impacted HDL-c following a fast-food meal.

Background: The consumption of nuts and edible seeds is associated with the improvement of the metabolic profile and reduction of cardiovascular diseases. However, the effects of its subproducts, such as oil, are still poorly studied. This study aimed to evaluate the effect of the baru almond oil supplementation on inflammation, oxidative stress, body composition, lipid profile, and plasma fatty acids of hemodialysis patients., Methods: In a randomized, double-blind, 12-week placebo-controlled clinical study, hemodialysis patients were supplemented with 5 g of baru oil (BG, n = 17) or 5 g of mineral oil (placebo, BP, n = 12). Body composition, renal function, ultra-sensitive C-reactive protein (us-CRP), oxidative stress, plasma fatty acids, and lipid profile were analysed before and after the intervention., Results: Patients were aged 50.5 ± 2.2 years and the average time of dialyses was 52,1 ± 42,6 months. The BG decreased us-CRP concentration compared to PG (-1.2 ± 0.2 vs. + 0.8 ± 0.2 mg / L,d = 0.88; p =  0.01). Baru almond oil supplementation was not effective in improving body composition, lipid profile, and oxidative stress., Conclusion: Baru almond oil supplementation decreased us-CRP concentration in patients with chronic kidney disease under hemodialysis treatment., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: A chronic, low-grade inflammation is commonly present in older adults and has been associated with the onset of age-related chronic diseases. Resistance training (RT) and creatine (CR) supplementation emerged as promising strategies to reduce circulating pro-inflammatory cytokines. This study aimed to investigate the effects of CR supplementation combined with RT on markers of inflammation and insulin resistance in community-dwelling older adults., Methods: In a pilot randomized, double-blind, placebo-controlled trial, participants were allocated to one of the following groups: 1) Creatine supplementation and resistance training (CR + RT, n = 13); 2) Placebo and resistance training (PL + RT, n = 14). While engaged in a 12-week RT program, participants from CR + RT group received 5 g/day of CR monohydrate and participants from PL + RT group received the same dose of maltodextrin. At baseline and at week 12, blood samples were collected for glucose, insulin, adiponectin, leptin, interleukin 6, interleukin 10, monocyte chemo-attractant protein-1 and C-reactive protein analysis., Results: After 12 weeks of intervention, there were no differences between groups in any of the variables analyzed. Monocyte chemoattractant protein-1 was reduced in both groups (CR + RT: -55.66 ± 48.93 pg/mL, p < 0.01, dz = 1.13; PL + RT: -46.52 ± 55.21 pg/mL, p < 0.01, dz = 0.84)., Conclusion: Resistance training, regardless of CR supplementation, decreased MCP-1 concentration in older adults., Competing Interests: Declaration of Competing Interest None of the authors has any conflict in relation to the study., (Copyright © 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Purpose: Strenuous exercise induces inflammation and muscle damage. Turmeric (Curcuma longa L.) is a widely used spice that exhibits potent anti-inflammatory response and appears to decrease indirect markers of muscle damage. A randomized, double-blind, placebo-controlled trial was conducted to evaluate the effects of Curcuma longa L. extract (CLE) on inflammation and muscle damage after a half-marathon race., Methods: Twenty-eight healthy, normal-weight men were randomly assigned to one of two groups: (1) CLE (3 capsules per day, 500 mg each); or (2) placebo (PLA, 3 capsules per day, 500 mg of microcrystalline cellulose). Participants received the intervention for 4 weeks and immediately before and after the half-marathon race. Creatine kinase, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, myoglobin, interleukins 6 and 10 were assessed at baseline, immediately before, after, and at 2, 24, and 48 h after the half-marathon race., Results: The half-marathon race increased markers of inflammation and muscle damage. A greater increase in interleukin-10 was observed in the CLE group immediately after the competition compared to the PLA group (7.54 ± 1.45 vs 5.25 ± 0.59 pg/mL; p < 0.05; d = 0.55). Myoglobin concentration was lower 2 h after the race in participants from the CLE group compared to the PLA group (62.10 ± 8.26 vs 107.85 ± 18.45 ng/mL; p = 0.01; d = 0.86)., Conclusion: Curcuma longa L. extract supplementation leads to an increase in IL-10 and decreased myoglobin in recreational male runners after a half-marathon race., Trial Registration Number: U1111-1179-6335, February 13, 2016.

Background: Creatine supplementation has been proposed to alleviate muscle loss in various populations, but has not been investigated in hemodialysis (HD) patients. Thus, our objective was to evaluate whether creatine supplementation could attenuate the loss of lean body mass (LBM) and malnutrition-inflammation score (MIS) in HD patients., Methods: A randomized, placebo-controlled, double blind, parallel-design study included HD patients, of both sexes, aged 18-59 years. The patients were allocated to a Placebo Group (PG; n = 15; received maltodextrin, 1st week: 40 g/day and 2nd-4th weeks: 10 g/day) and a Creatine Group (CG; n = 15; received creatine plus maltodextrin, 1st week: 20 g/day of creatine plus 20 g/day of maltodextrin and 2nd-4th weeks: 5 g/day of creatine plus 5 g/day of maltodextrin). Pre and post the intervention, patients were evaluated for food intake, MIS, body composition and biochemical parameters., Results: CG group attenuated the MIS (Pre: 5.57 ± 0.72 vs. Post: 3.85 ± 0.47 score, P = 0.003) compared with PG (Pre: 5.71 ± 0.97 vs. Post: 5.36 ± 0.95 score, P = 0.317) (supplement × time P = 0.017, effect size: 0.964). The change of LBM was greater in CG than in PG (CG: Δ0.95 vs PG: Δ0.13 kg). At post-intervention, 28.6% of PG patients presented LBM loss and 71.4% remain stable. In contrast, 14.4% of CG patients had LBM loss, 42.8% remain stable and 42.8% gained. Food intake and quality of life did not change. CG increased the BMI and gait speed in post-compared to pre-moment, but no difference among the groups., Conclusion: In HD patients, four weeks of creatine supplementation may alleviate the MIS as well as attenuate the LBM loss compared to placebo., (© 2019 American Society for Parenteral and Enteral Nutrition.)

Background and Aims: Caffeine mouth rinsing has emerged as an alternative to oral caffeine consumption for improving performance without provoking lower gastrointestinal distress. However, it remains unclear if hydration status and sweat rate are negatively affected by caffeine mouth rinsing. This study is aimed at evaluating the effects of 10 seconds of caffeine mouth rinsing (1.2% anhydrous caffeine solution) on hydration status and sweat rate following a 10 km run trial., Methods: Ten recreationally trained runners (30.1 ± 6.4 y) volunteered to participate in this double-blind, placebo-controlled, and crossover research study. Participants completed two 10 km run trials separated by approximately one week. Immediately prior to running, participants completed a 10-second mouth rinse protocol with either 300 mg of caffeine or microcrystalline cellulose (placebo) diluted in 25 mL of water. The effects of caffeine mouth rinsing on hydration status and sweat rate were assessed following a 10 km run trial., Results: Sweat rate (placebo: 15.34 ± 9.71 vs. caffeine: 11.91 ± 6.98 mL · min -1 ; p = 0.39), dehydration (placebo: 1.20 ± 0.57 vs. caffeine: 1.49 ± 0.29%; p = 0.15), and hydration (placebo: 15.32 ± 9.71 vs. caffeine: 11.89 ± 6.99 mL · min -1 ; p = 0.37) measures were not significantly different between trials., Conclusion: Caffeine mouth rinse does not appear to alter the hydration status or sweat rate following a 10 km run., Competing Interests: None of the authors have a conflict of interest related to the manuscript., (Copyright © 2020 Adam M. Gonzalez et al.)

Purpose: It has been suggested that restoring gut microbiota alterations with probiotics represents a potential clinical target for the treatment of gut microbiota-related diseases, such as obesity. Here, we apply 16S rDNA microbiota profiling to establish which bacteria in the human gut are associated with obesity and cardiometabolic risk factors, and to evaluate whether probiotic supplementation modulates gut microbiota., Methods: We evaluated the effects of a probiotic mixture (2 × 10 10 CFU/day of Lactobacillus acidophilus LA-14, Lactobacillus casei LC-11, Lactococcus lactis LL-23, Bifidobacterium bifidum BB-06, and Bifidobacterium lactis BL-4) in 32 overweight or obese women in a double-blind, randomized, placebo-controlled study. Using 16S rDNA sequencing, we characterized fecal samples and investigated the relationships between microbiome data and diet, body composition, antioxidant enzymes, and inflammatory profile. In addition, we characterized the degree of variation among fecal communities after the intervention., Results: BMI, weight, fat mass, lean mass, conicity index, protein intake, monounsaturated fat intake, glycated hemoglobin, TNF-α, and IL6/IL10 were significantly correlated with microbiome composition. The candidate division TM7 was strongly associated with all adiposity markers and Clostridiaceae associated negatively with TNF-α. The family Clostridiaceae increased and TM7 tended to decrease after the probiotic mixture supplementation. Subjects were clustered according to body composition, and a higher proportion of TM7 was observed in those with higher adiposity., Conclusions: Ecosystem-wide analysis of probiotic use effects on the gut microbiota revealed a genera specific influence, and one of which (TM7) represents a promising novel target for obesity treatment., Trial Registration Number: U1111-1137-4566.

In sports, curcumin, a substance derived from the rhizome of Curcuma longa (turmeric) plant with antioxidant effect 8 times greater than vitamin E, has attracted the attention of scientists because of its potent antioxidant action, since in athletes subjected to intense exercise the-endogenous mechanisms of neutralization of reactive species are saturated. However, the pharmacokinetic characteristics of curcumin do not favor its medicinal use due to its low absorption, accelerated metabolism and rapid systemic elimination. Thus, the determination of plasma levels in supplemented patients is a crucial step in their pharmacodynamic evaluation. Therefore, the objective of this work was to develop and validate an analytical method by HPLC-FLD for curcumin evaluation in plasma of supplemented athletes. Luna column (C18; 150 × 4 mm; 3 µm), acetonitrile: acetic acid pH 3.2 (45:55 to 60:40) as mobile phase, flow rate of 1 mL min -1 , excitation at 429/285 nm and emission at 529 nm and injection of 10 µL were the chromatographic conditions used. Plasma samples were extracted using ethylacetate and methanol (95: 5, 500 µL) and estradiol (30 µg mL -1 ) as internal standard, with subsequent stirring (3 min) and centrifugation (8 min) (triple extraction). The organic fraction was evaporated under N 2 (20 min) and the dried residue reconstituted in acetonitrile. The method was linear between 44 and 261 ng mL -1 , showing intra-day (2.05.6%) and inter-day (4.0-5.1%) precision with accuracy and selectiveness (curcumin t R  = 8.7 min and internal standard t R  = 13.9 min with relative recovery of 83.2%). So, it can be successfully used for curcumin evaluation in plasma samples from supplemented athletes, as well as being an alternative and advantageous method to UV-Vis and MS/MS in bioavailability studies., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 Published by Elsevier B.V. on behalf of King Saud University.)

Background: Caffeine is a popular nutritional supplement among athletes. It is frequently used as an ergogenic aid to improve physical performance, delay fatigue, and increase muscle power. However, these effects have not been tested in CrossFit athletes. The aim of this study was to evaluate the effects of acute caffeine supplementation on workout performance, power, markers of muscle damage, and soreness in trained CrossFit men., Methods: Nine men (28±2 years) with experience in CrossFit (2±0.3 years) were investigated in a randomized, double-blind, placebo-controlled crossover trial, with a 7-day washout between treatment periods. The athletes received anhydrous caffeine (CAF: 6 mg/kg body mass) or placebo (PLA) 60 minutes before a CrossFit workout with tasks that involved muscle strength, power, gymnastic movements, and metabolic conditioning. Blood samples were collected for creatine kinase (CK), C-reactive protein, and glucose determination. Workout performance, rating of perceived exertion (RPE), delayed-onset muscle soreness (DOMS), muscle strength (handgrip strength) and power (bench throw, jump squat and countermovement jump) were also evaluated., Results: CAF resulted in higher glucose concentration after workout compared to PLA (+3.2 mmol/L, 95% CI: 2.1 to 4.3 vs. +1.5, 95% CI: -0.1 to 3.0 mmol/L, P=0.01). No differences were found between treatments in workout performance, CK, DOMS, RPE, muscle power and strength., Conclusions: Acute CAF supplementation did not alter performance, markers of muscle damage, power, and RPE in trained CrossFit men.

Asthma-obesity is a multifactorial disease with specific asthma phenotypes that aggravate due to overweight and an unbalanced diet. Furthermore, obese asthmatic patients are corticotherapy-resistant. Therefore, the aims of the present study were to evaluate the effects of an interdisciplinary intervention on food consumption, body composition, lung function and adipokines in asthmatic and non-asthmatic obese adolescents and to investigate the influence of nutrients on lung function. Obese non-asthmatic (n 42) and obese asthmatic (n 21) adolescents of both sexes were enrolled in the present study. Food intake, adipokine levels, body composition, asthma symptoms and lung function were assessed across the study. After the intervention of 1 year, there was a reduction (P ≤ 0·01) in BMI, body fat percentage, visceral and subcutaneous fat and an increase (P ≤ 0·01) in lean mass and all lung function variables in both groups, except the relation between forced expiratory volume in 1 s and forced vital capacity (FEV1:FVC) in non-asthmatic patients. Moreover, both groups decreased lipid and cholesterol consumption (P ≤ 0·01). The highest energy consumption (β = -0·021) was associated with lower values of FVC. Similarly, carbohydrate consumption (β = -0·06) and cholesterol were negative predictors (β = -0·05) in FEV1:FVC. However, the consumption of Ca (β = 0·01), fibres (β = 1·34) and vitamin A (β = 0·01) were positive predictors of FEV1:FVC. Asthma-obesity interdisciplinary treatment promoted an improvement on food consumption and lung function in adolescents and demonstrated that the consumption of nutrients influenced an increase in lung function.

Objective: To compare the effects of high vs moderate loads of intradialytic resistance training (RT) on body composition, sarcopenia prevalence, functional capacity, inflammatory markers, and quality of life (QoL) in individuals on hemodialysis., Design: A pilot randomized clinical trial., Setting: Two hemodialysis centers., Participants: Individuals on hemodialysis (N=80; 51% men, aged 30-75y) in treatment for at least 3 months, adequately dialyzed (Kt/V≥1.2, where K is dialyzer clearance in mL/min, t is time, and V is volume of water) with vascular access via arteriovenous fistula., Interventions: The 12 weeks of intradialytic RT was performed 3 times per week. The training groups were: high-load intradialytic group (HLG, 8-10 repetitions), moderate-load intradialytic group (MLG, 16-18 repetitions), and control group (CG, stretching exercise). The total training volume was equalized among training groups., Main Outcome Measures: Lean leg mass was assessed by a dual-energy x-ray absorptiometry; functional capacity was assessed by Short Physical Performance Battery and Timed Up and Go test; and QoL was assessed by Kidney Disease QoL Instrument, inflammatory markers, and sarcopenia., Results: After the training period, the HLG increased lean leg mass compared with the CG. The HLG also displayed improvements in the pain and physical function domains. The skeletal muscle index and functional capacity increased in both RT protocols. The prevalence of sarcopenia was reduced 14.3% and 25% in the MLG and HLG, respectively, while there was an increase of 10% in the CG. No differences were observed in cytokines after intervention., Conclusions: High-load intradialytic RT was associated with gains in lean leg mass and QoL while functional capacity, appendicular muscle mass, and sarcopenia status were improved regardless of the RT load., (Copyright © 2019 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)