Search

The human body, particularly the brain, requires energy, stored in the form of adenosine triphosphate. Energy metabolism during cellular respiration is dependent on the presence of multiple micronutrients, which act as essential components, coenzymes, or precursors at every stage. An adequate supply of multiple micronutrients is vital for efficient energy production. However, micronutrient intakes below the recommended dietary allowance are common, even in industrialized countries. Intakes of vitamins A, D, E, folate, iron, zinc, and selenium are suboptimal across all age groups. Suboptimal micronutrient levels have been shown to contribute to low energy levels, physical and mental fatigue, and impaired cognitive performance and wellbeing - symptoms frequently present in the general population. When supplemented in combination in well-conducted trials, multiple micronutrients ± coenzyme Q10 reduced oxidative stress in chronic fatigue syndrome; in healthy people they increased cerebral blood-flow hemodynamic response, energy expenditure, and fat oxidation; reduced mental and physical fatigue; improved the speed and accuracy of cognitive function during demanding tasks; and reduced stress. The results from these clinical trials suggest that even in industrialized countries, where adults might be assumed to have a healthy, balanced diet, there is a rationale to supplement with multiple micronutrients, including coenzyme Q10, to improve nutritional status, support energy metabolism, and improve subjective wellbeing.El cuerpo humano, particularmente el cerebro, requiere energía, almacenada en forma de adenosina trifosfato. El metabolismo de la energía durante la respiración celular depende de la presencia de múltiples micronutrientes, que actúan como componentes esenciales, coenzimas o precursores en cada etapa. Un aporte adecuado de múltiples micronutrientes es vital para una producción eficiente de energía. Sin embargo, la ingesta de micronutrientes inferior a la recomendada es frecuente, incluso en los países industrializados. Las ingestas de vitaminas A, D, E, folato, hierro, zinc y selenio son subóptimas en todos los grupos de edad. Se ha demostrado que las situaciones subóptimas en relación con diversos micronutrientes contribuyen a tener niveles bajos de energía, fatiga física y mental, y deterioro del rendimiento cognitivo y el bienestar, síntomas presentes a menudo en la población general. Sin embargo, cuando se suplementa en ensayos bien controlados, con una combinación de diversos micronutrientes ± coenzima Q10, se constata una reducción del estrés oxidativo en el síndrome de fatiga crónica y, en las personas sanas, se observa un aumento de la respuesta hemodinámica del flujo sanguíneo cerebral, el gasto energético y la oxidación de la grasa; una reducción de la fatiga mental y física; una mejora de la velocidad y la precisión de la función cognitiva durante la realización de tareas exigentes, y una reducción del estrés. Los resultados de estos ensayos clínicos sugieren que, incluso en los países industrializados, donde se podría suponer que los adultos tienen una dieta saludable y equilibrada, hay motivos para complementarla con múltiples micronutrientes, incluida la coenzima Q10, con el fin de mejorar el estado nutricional, respaldar el metabolismo energético y mejorar el bienestar subjetivo.

Immune support by micronutrients is historically based on vitamin C deficiency and supplementation in scurvy in early times. It has since been established that the complex, integrated immune system needs multiple specific micronutrients, including vitamins A, D, C, E, B6, and B12, folate, zinc, iron, copper, and selenium, which play vital, often synergistic roles at every stage of the immune response. Adequate amounts are essential to ensure the proper function of physical barriers and immune cells; however, daily micronutrient intakes necessary to support immune function may be higher than current recommended dietary allowances. Certain populations have inadequate dietary micronutrient intakes, and situations with increased requirements (e.g., infection, stress, and pollution) further decrease stores within the body. Several micronutrients may be deficient, and even marginal deficiency may impair immunity. Although contradictory data exist, available evidence indicates that supplementation with multiple micronutrients with immune-supporting roles may modulate immune function and reduce the risk of infection. Micronutrients with the strongest evidence for immune support are vitamins C and D and zinc. Better design of human clinical studies addressing dosage and combinations of micronutrients in different populations are required to substantiate the benefits of micronutrient supplementation against infection.

Relatively few studies have explored the possibility of acute cognitive effects of multivitamin ingestion. This report explores the acute brain electrophysiological changes associated with multivitamin and mineral supplementation, with and without guaraná, using the steady-state visually evoked potential (SSVEP).Based on the known SSVEP correlates of A-X continuous performance task (CPT) performance, and sensitivity to acute psychopharmacological manipulations, the A-X CPT was adopted as a task paradigm to explore treatment-related neurophysiological changes in attentional processing. Twenty healthy non-smoking adults aged 21-39 years (mean age = 28.35 years, SD = 5.52) took part in this double-blind, placebo-controlled, randomized, balanced crossover design study.The study demonstrated both transient and tonic changes in the SSVEP response during completion of the A-X CPT following multivitamin and mineral treatment both with and without guaraná. Transient changes in SSVEP response in prefrontal regions were observed after a single dose of a multivitamin and mineral preparation indicative of enhanced activity within brain regions engaged by the attentional demands of the task. This pattern of change in frontal regions was correlated with improved behavioural performance after treatment with the multivitamin and mineral combination. Where tonic shifts in SSVEP response were investigated, multivitamin and mineral treatment was associated with a pattern of increased inhibition across posterior regions, with enhanced excitatory processing in prefrontal regions. In contrast, multivitamin and mineral treatment with additional guaraná showed a tonic shift towards greater excitatory processes after a single treatment, consistent with the caffeine content of this treatment.While preliminary in nature, these findings suggest a single multivitamin/mineral dose is sufficient to impact on functional brain activity in task-related brain regions.

Maternal dietary intake during pregnancy needs to meet increased nutritional demands to maintain metabolism and to support fetal development. Docosahexaenoic acid (DHA) is essential for fetal neuro-/visual development and in immunomodulation, accumulating rapidly within the developing brain and central nervous system. Levels available to the fetus are governed by the maternal diet. In this multicenter, parallel, randomized controlled trial, we evaluated once-daily supplementation with multiple micronutrients and DHA (i.e., multiple micronutrient supplementation, MMS) on maternal biomarkers and infant anthropometric parameters during the second and third trimesters of pregnancy compared with no supplementation. Primary efficacy endpoint: change in maternal red blood cell (RBC) DHA (wt% total fatty acids) during the study. Secondary variables: other biomarkers of fatty acid and oxidative status, vitamin D, and infant anthropometric parameters at delivery. Supplementation significantly increased RBC DHA levels, the omega-3 index, and vitamin D levels. Subscapular skinfold thickness was significantly greater with MMS in infants. Safety outcomes were comparable between groups. This first randomized controlled trial of supplementation with multiple micronutrients and DHA in pregnant women indicated that MMS significantly improved maternal DHA and vitamin D status in an industrialized setting&mdash, an important finding considering the essential roles of DHA and vitamin D.

The immune system is a complex and sophisticated network of specialized tissues, organs, cells, proteins, and chemicals which has evolved in order to protect the host from a range of dangerous agents such as bacteria, virus, fungi, and parasites. There is a close relationship between nutritional status and immune function. Hence, immunocompetence can be regarded as a measure of adequate nutrition. Inter-individual variations in many immune functions exist within the normal healthy population and are due to age, genetics, gender, ethnic background, socio-economic situation, diet, stress, habitual levels of exercise, alcohol consumption, smoking habits, etc. In addition, seasonal and temperature changes as well as being in crowded spaces (e.g., while commuting in public means of transportation, or working in open space offices) pose an additional burden on the immune system. Among the essential micronutrients required to support a normal immune function, vitamin C, vitamin D and the mineral zinc play a central role. Through their complementary and synergistic effects, they support components of both innate and adaptive immunity which comprise epithelial barriers, cellular defense and antibodies constituting the three main lines of immune defense. Furthermore, vitamin C, D and zinc are actively used by cells of the immune system engaged in fighting infections like upper respiratory tract infections and a state of micronutrient deficiency can arise during severe infections. Here we review the literature on the immune supportive properties of vitamins C, D and zinc and the impact of their supplementation in reducing the incidence or ameliorating symptoms of upper respiratory tract infections, which are among the most common infections in humans. Finally, we discuss their relevance in situations known to challenge the immune system such as exposure to temperature changes, to pollutants, or being in crowded spaces which serve as mixers where pathogens can stay suspended and transfer from host to host thereby increasing the risk of spreading infectious diseases because of close contact and long exposure.

As humans age, the risk and severity of infections vary in line with immune competence according to how the immune system develops, matures, and declines. Several factors influence the immune system and its competence, including nutrition. A bidirectional relationship among nutrition, infection and immunity exists: changes in one component affect the others. For example, distinct immune features present during each life stage may affect the type, prevalence, and severity of infections, while poor nutrition can compromise immune function and increase infection risk. Various micronutrients are essential for immunocompetence, particularly vitamins A, C, D, E, B2, B6, and B12, folic acid, iron, selenium, and zinc. Micronutrient deficiencies are a recognized global public health issue, and poor nutritional status predisposes to certain infections. Immune function may be improved by restoring deficient micronutrients to recommended levels, thereby increasing resistance to infection and supporting faster recovery when infected. Diet alone may be insufficient and tailored micronutrient supplementation based on specific age-related needs necessary. This review looks at immune considerations specific to each life stage, the consequent risk of infection, micronutrient requirements and deficiencies exhibited over the life course, and the available evidence regarding the effects of micronutrient supplementation on immune function and infection.

Viability and culturability of eight Dekkera bruxellensis strains in wine along with the accumulation of volatile phenols in response to increasing concentrations of molecular sulphur dioxide (mSO2) were investigated. mSO2 concentrations up to 1 mg/L induced the non-culturable state of a portion of the population in all the strains to a different extent for each strain, although the cells were still viable. At 1.4 mg/L mSO2, cells were non-culturable, though 0.38–29.01 % of cells retained their viability. When exposed to 2.1 mg/L mSO2, viable cells were not detected. Up to 0.24 mg/L 4-vinylguaiacol and up to 0.73 mg/L 4-ethylphenol were accumulated by non-culturable and dead Dekkera bruxellensis strains, respectively. The concentration of mSO2 needed for the transition from viable to non-culturable state of D. bruxellensis strains was higher in wine than in synthetic wine medium. The volatile phenols accumulated in wine were different from those produced in synthetic wine medium, although their accumulation kinetics were similar.

Rationale A significant proportion of the general population report supplementing their diet with one or more vitamins or minerals, with common reasons for doing so being to combat stress and fatigue and to improve mental functioning. Few studies have assessed the relationship between supplementation with vitamins/minerals and psychological functioning in healthy cohorts of non-elderly adults. Objectives The present randomised, placebo-controlled, double–blind, parallel groups trial assessed the cognitive and mood effects of a high-dose B-complex vitamin and mineral supplement (Berocca®) in 215 males aged 30 to 55 years, who were in full-time employment. Methods Participants attended the laboratory prior to and on the last day of a 33-day treatment period where they completed the Profile of Mood States (POMS), Perceived Stress Scale (PSS) and General Health Questionnaire (GHQ-12). Cognitive performance and task-related modulation of mood/fatigue were assessed with the 60 min cognitive demand battery. On the final day, participants also completed the Stroop task for 40 min whilst engaged in inclined treadmill walking and subsequent executive function was assessed. Results Vitamin/mineral supplementation led to significant improvements in ratings on the PSS, GHQ-12 and the ‘vigour’ subscale of the POMS. The vitamin/mineral group also performed better on the Serial 3s subtractions task and rated themselves as less ‘mentally tired’ both pre- and post-completion of the cognitive demand battery. Conclusions Healthy members of the general population may benefit from augmented levels of vitamins/minerals via direct dietary supplementation. Specifically, supplementation led to improved ratings of stress, mental health and vigour and improved cognitive performance during intense mental processing.

Adequate intakes of micronutrients are required for the immune system to function efficiently. Micronutrient deficiency suppresses immunity by affecting innate, T cell mediated and adaptive antibody responses, leading to dysregulation of the balanced host response. This situation increases susceptibility to infections, with increased morbidity and mortality. In turn, infections aggravate micronutrient deficiencies by reducing nutrient intake, increasing losses, and interfering with utilization by altering metabolic pathways. Insufficient intake of micronutrients occurs in people with eating disorders, in smokers (active and passive), in individuals with chronic alcohol abuse, in certain diseases, during pregnancy and lactation, and in the elderly. This paper summarises the roles of selected vitamins and trace elements in immune function. Micronutrients contribute to the body's natural defences on three levels by supporting physical barriers (skin/mucosa), cellular immunity and antibody production. Vitamins A, C, E and the trace element zinc assist in enhancing the skin barrier function. The vitamins A, B6, B12, C, D, E and folic acid and the trace elements iron, zinc, copper and selenium work in synergy to support the protective activities of the immune cells. Finally, all these micronutrients, with the exception of vitamin C and iron, are essential for antibody production. Overall, inadequate intake and status of these vitamins and trace elements may lead to suppressed immunity, which predisposes to infections and aggravates malnutrition. Therefore, supplementation with these selected micronutrients can support the body's natural defence system by enhancing all three levels of immunity.

Exercise undertaken in a fasted state can lead to higher post-exercise mental fatigue. The administration of a vitamin and mineral complex with guaraná (MVM + G) has been shown to attenuate mental fatigue and improve performance during cognitively demanding tasks. This placebo-controlled, double-blind, randomized, balanced cross-over study examined the effect of MVM + G consumed prior to morning exercise on cognitive performance, affect, exertion, and substrate metabolism. Forty active males (age 21.4 ± 3.0 year, body mass index (BMI) 24.0 ± 2.4 kg/m2, maximal oxygen consumption (V̇O2max) 57.6 ± 7.3 mL/min/kg) completed two main trials, consuming either MVM + G or placebo prior to a 30-min run at 60% V̇O2max. Supplementation prior to exercise led to a small but significant reduction in Rating of Perceived Exertion (RPE) during exercise compared to the placebo. The MVM + G combination also led to significantly increased accuracy of numeric working memory and increased speed of picture recognition, compared to the placebo. There were no significant effects of supplementation on any other cognitive or mood measures or on substrate metabolism during exercise. These findings demonstrate that consuming a vitamin and mineral complex containing guaraná, prior to exercise, can positively impact subsequent memory performance and reduce perceived exertion during a moderate-intensity run in active males.

Our bodies are normally well protected against continual attack from pathogens and noxious insult by a complex and integrated immune system. However, daily bombardment from indoor and outdoor air pollutants can compromise immune function and ultimately lead to infection (e.g. acute respiratory tract infections, diarrhoea) and conditions such as sick building syndrome (with mucosal, skin and general symptoms). All of us may be affected by reduced air quality, although certain factors increase the risk of impaired immunity (e.g. young or advancing age, exposure to tobacco smoke, close proximity to areas of high air pollution, office work, commuting). A major exogenous factor modulating immune function is nutrition; even subclinical deficiencies in various nutrients can have adverse effects on the immune system, which may be exacerbated by environmental threats. In particular, the oxidant-antioxidant balance (vital for communication within the immune system) may be affected. Dietary supplementation can help to restore immune function to the normal range, and an antioxidant-containing multivitamin supplement has been shown to ameliorate the symptoms of sick building syndrome, acute respiratory tract infections and diarrhoea. This review looks at the impact of reduced air quality on the oxidant-antioxidant balance and the role of selected micronutrients (vitamins A, D, E, C, B6, B12, folate and the trace elements copper, iron, selenium and zinc) and multivitamin supplementation.

This chapter focuses on the current understanding of vitamin D and immunity, with special attention to the elderly. Vitamin D insufficiency and deficiency are common among the elderly population. Vitamin D plays an immunoregulatory role in innate and adaptive immunity, and low vitamin D status has been implicated in the etiology of immune disorders, such as infectious diseases as well as some autoimmune disorders. As summarized here, the aging of the immune system is well documented and indicates that both innate and adaptive immunity are impaired with increasing age. Nutritional intervention with vitamin D seems to be a valid approach to delay the deterioration of the immune system with increasing age. Based on promising results in targeting some of the impairments of the immune system in older people, supplementation with vitamin D seems to be one strategy in attempting to increase not only the lifespan but also the health span of this increasing elderly proportion of the global population.

Aging is accompanied by physiological, psychological, economic, and social changes. Physiological changes in particular affect the requirements for several micronutrients, and the elderly are at high risk for micronutrient deficiencies. Inadequate intake and status of micronutrients leads to suppressed immunity, predisposing people to infections and aggravating malnutrition. This vicious circle is extremely critical for older adults who have to deal with the age-related impairment of immune function, or immunosenescence. Immunosenescence causes increased susceptibility to infections, cancer, and autoimmune diseases overall, leading to increased morbidity and mortality. This chapter reviews the roles of selected micronutrients and Panax ginseng in relation to immune function support, particularly in the context of aging. Based on their individual properties and synergistic mode of action, a combination of micronutrients and ginseng seems a reasonable association to improve nutritional status and hence the organism’s immune function, the cornerstone of health, in older adults.

Vitamin C concentrations in the plasma and leukocytes rapidly decline during infections and stress. Supplementation of vitamin C was found to improve components of the human immune system such as antimicrobial and natural killer cell activities, lymphocyte proliferation, chemotaxis, and delayed-type hypersensitivity. Vitamin C contributes to maintaining the redox integrity of cells and thereby protects them against reactive oxygen species generated during the respiratory burst and in the inflammatory response. Likewise, zinc undernutrition or deficiency was shown to impair cellular mediators of innate immunity such as phagocytosis, natural killer cell activity, and the generation of oxidative burst. Therefore, both nutrients play important roles in immune function and the modulation of host resistance to infectious agents, reducing the risk, severity, and duration of infectious diseases. This is of special importance in populations in which insufficient intake of these nutrients is prevalent. In the developing world, this is the case in low- and middle-income countries, but also in subpopulations in industrialized countries, e.g. in the elderly. A large number of randomized controlled intervention trials with intakes of up to 1 g of vitamin C and up to 30 mg of zinc are available. These trials document that adequate intakes of vitamin C and zinc ameliorate symptoms and shorten the duration of respiratory tract infections including the common cold. Furthermore, vitamin C and zinc reduce the incidence and improve the outcome of pneumonia, malaria, and diarrhea infections, especially in children in developing countries.

Previous work has identified the positive effects of the acute administration of a multivitamin-guarana preparation during an effortful executive/working memory task. Here, we aimed to differentiate the effects of multivitamins with and without guarana and to examine the neural substrates of such effects using functional magnetic resonance imaging (fMRI). Following a double-blind, placebo-controlled, randomised, balanced crossover design, 20 participants (mean age 29 ± 5.54 years) consumed multivitamin preparations with or without guarana (Berocca® Performance and Boost, respectively) and a placebo. Thirty minutes post-treatment, they underwent neurocognitive assessment, consisting of a 10 min Cognitive Demand Battery, with mood ratings taken immediately before and after the battery. Five additional participants underwent post-treatment fMRI scanning during Rapid Visual Information Processing and Inspection Time activation tasks. The multivitamin with guarana treatment was associated with significantly enhanced Serial Threes performance and self-rated contentment. fMRI revealed that both multivitamin treatments increased activation in areas associated with working memory and attentional processing, with the effect being greater in the multivitamin with guarana condition. These data confirm the acute benefits of multivitamins with guarana on mood and cognitive performance. Furthermore, they demonstrate for the first time increased brain activation from multivitamin preparations both with and without guarana, as measured using fMRI.

A significant minority of the population consume multi-vitamins/minerals for their putative health benefits, including potentially beneficial effects on cognitive performance, fatigue and mood. The current study investigated the effect of supplementation with a multi-vitamin/mineral on fatigue and cognitive function in healthy females.In this placebo-controlled, double blind, randomized, parallel groups trial the effect of a multi-vitamin/mineral (Supradyn) was assessed in 216 females aged 25-50 years. Participants attended the laboratory before and 9 weeks after commencing treatment. During both visits cognitive function and the modulation of task related mood/fatigue were assessed in two discrete 20-min assessment periods during which participants completed a four-module version of the Multi-Tasking Framework.Those in the vitamin/mineral group exhibited an attenuation of the negative effects of extended task completion on mood/fatigue. Multi-tasking performance for this group was also improved in terms of accuracy across all tasks, and on two of the individual tasks (Mathematical Processing and Stroop) in terms of both faster and more accurate responses. Analysis of a subsection (N = 102) demonstrated significant reductions in homocysteine levels following the vitamins/mineral supplement.These findings suggest that healthy members of the general population may benefit from augmented levels of vitamins/minerals via direct dietary supplementation.

Diet and nutrition are important in the promotion and maintenance of good health throughout the entire life. A common denominator playing a role in the prevention of both chronic diseases and infections and hence important for maintaining health is a good functioning immune system. The competence of the immune system is an excellent marker of proper nutrition status and health and several changes in immune functions have been related to longevity. Preservation of a functionally youthful immune system throughout the years, including ensuring adequate vitamin and mineral status, is the best way to preserve health throughout life and to gain longevity accompanied by good quality of life.

Guarana (Paullinia cupana) extracts are most commonly used in Western markets as putatively psychoactive food and drink additives. This double-blind, randomised, placebo-controlled, parallel groups study assessed the acute effects of either a vitamin/mineral/guarana supplement or placebo drink in 129 healthy young adults (18-24 years). Participants completed a 10min version of the Cognitive Demand Battery (comprising: Serial 3s and Serial 7s subtraction tasks, a Rapid Visual Information Processing (RVIP) task, 'mental fatigue' scale). Thirty minutes following their drink participants made six consecutive completions of the battery (i.e. 60 min). The vitamin/mineral/guarana combination resulted in improved task performance, in comparison to placebo, in terms of both increased speed and accuracy of performing the RVIP task throughout the post-dose assessment. The increase in mental fatigue associated with extended task performance was also attenuated by the supplement. This research supports previous findings demonstrating guarana's cognition enhancing properties and provides evidence that its addition to a multi-vitamin-mineral supplement can improve cognitive performance and reduce the mental fatigue associated with sustained mental effort.

COBAS INTEGRA 400 is a random-access analytical system consolidating assays for clinical chemistry analytes, electrolytes, serum proteins, drugs of abuse and therapeutic drugs. Analytical performance and practicability of the instrument were evaluated in seven laboratories over a 2-year period in parallel with system development. Good within-run and total imprecision for all assays was observed with a few exceptions for specimen pools with low concentration or activity. The coefficients of variation for total imprecision were well below 3.0% for clinical chemistry analytes and electrolytes, and below 5.0% for serum proteins and therapeutic drugs. Method comparisons demonstrated a good agreement with the various systems used for comparison, with slopes varying typically from 0.94 to 1.05, and Spearman correlation coefficient generally > 0.975. Accuracy was verified by recovery of controls and certified reference materials within 90 to 110% of target values. Assay ranges were linear within +/- 5%. No carry-over on reagent or sample pipetting systems was observed. Manufacturer-specified interference limits and onboard stabilities of reagents were confirmed. A time study for calculating direct personnel times and total processing time was carried out in three laboratories under different conditions including consolidated, STAT and dedicated use. On a scenario-independent basis, the total working time was shorter on the COBAS INTEGRA 400 than on routine systems in all three laboratories. Personnel time, in particular, was significantly reduced when compared to routine instruments. In general, system practicability was judged very positively in all laboratories. Owing to its versatility, the instrument is best placed as a consolidated workstation in small- to medium-sized laboratories or as an instrument for special determinations such as serum proteins, drugs, urinalysis or emergency analyses in large laboratories.