Mobilization of heavy metals from floodplain sediments of the Yellow River during redox fluctuations.

The floodplain of the Yellow River is a typical area characterized by redox fluctuations and heavy metal pollution. However, the mobilization behavior of heavy metals in floodplain sediments during redox fluctuations remains poorly understood. In this study, reductive mobilization of Fe and Mn was observed under reducing environments through reduction and dissolution, leading to the subsequent release of adsorbed As. In contrast, the mobilization of U occurred under oxic conditions, as the oxidative state of U(VI) has higher solubility. Furthermore, insignificant effects on the mobilization of Cd, Cu, Pb, and Hg were noticed during redox fluctuations, indicating higher stability of these heavy metals. Additionally, we demonstrated that carbon sources can play a key role in the mobilization of heavy metals in floodplain sediments, amplifying the reductive mobilization of Fe, Mn, As and the oxidative mobilization of U. Our findings contribute to the understanding of the biogeochemical cycling of heavy metal in floodplain sediments of the Yellow River and the factors that control this cycling.

Amino Acid Bitterness: Characterization and Suppression.

Amino acids are necessary for life, and many must be consumed because they cannot be endogenously synthesized. Typically, we eat them as proteins and peptides, which have little taste. However, we also directly ingest free amino acids, several of which are aversive because they elicit bitterness. This bitterness often prevents many patient populations from taking formulas and supplements containing free amino acids. Here, we characterize which amino acids are the most bitter, their concentration-intensity functions, and individual differences in bitterness perception, and we explore how sodium salts suppress the bitterness of amino acids. We found that the essential amino acids comprise the most bitter stimuli, with six of them conveying the most bitterness. Clustering and correlating amino acids by individual differences in bitterness perception show that there are approximately four groupings of amino acids and suggest that within these clusters, amino acids may be activating the same or overlapping TAS2Rs. We also show that bitterness can be largely suppressed by sodium salts for 5 of the 6 most bitter amino acids. These results hold promise for managing the bitter taste of nutritional supplements that contain amino acids and improving compliance.

Sirtuin Expression in Insulin-Sensitive Tissues of Rats with Impaired Glucose Tolerance is not Affected by Resistance Training or Zinc Supplementation.

While physical activity and zinc supplementation have shown benefits in diabetes management, little is known about their effect on less severe glucose homeostasis disorders, such as impaired glucose tolerance. On the other hand, sirtuins have an important role in glucose metabolism and insulin sensitivity, but to date, there is no information about the impact of zinc supplementation or physical activity on their regulation in individuals with impaired glucose homeostasis. The aim of this study was to assess the effect of supplemental zinc, muscle-resistance training, and their combination on the expression of selected sirtuins in insulin-sensitive tissues of rats with impaired glucose tolerance. Thirty male Wistar rats with impaired glucose tolerance were fed a high-fat diet for 12 weeks while subjected to zinc supplementation, resistance training, both, or none. Morphometric and metabolic evaluations were performed at the end of the experimental period, and gene expression of sirtuins 1, 2, 4, and 7 was assessed in liver, gastrocnemius muscle, and white adipose tissue. Results showed that zinc supplementation and/or resistance training did not improve metabolic parameters of rats with impaired glucose tolerance, nor did they affect the expression of selected sirtuins in any of the tissues evaluated. However, the expression of some sirtuins was associated with metabolic parameters in a tissue-specific manner. Additional studies are needed to evaluate whether zinc supplementation and/or resistance training can improve metabolic status or modulate sirtuins expression in advanced stages of impaired glucose homeostasis.

Zinc and selenium supplementation on treated HIV-infected individuals induces changes in body composition and on the expression of genes responsible of naïve CD8+ T cells function.

Background and aim: Deficiency of zinc and selenium is common in persons living with human immunodeficiency virus (PLWHIV) and has been associated with the development of non-AIDS related comorbidities, impaired immune system function and mortality. Micronutrient supplementation on long-term-treated PLWHIV could bring potential clinical and immunological benefits improving their health status and quality of life. The aim of the present study is to analyze the effect of zinc and selenium supplementation on body composition, bone mineral density, CD4+ T-cell counts, metabolic profile and immune system status on clinical stable PLWHIV on long-term antiretroviral therapy (ART). Methods: This is a randomized pilot clinical trial in which we recruited 60 PLWHIV on ART who were assigned to the intervention groups: zinc (30 mg of zinc gluconate), selenium (200 µg of selenium yeast), zinc + selenium (same doses and presentations) or to a control group (without nutritional supplementation) who received supplementation during 6 months. Primary outcome was defined as changes in body composition (weight, muscle and fat mass and bone mineral density) and secondary outcomes as changes in biochemical and immunological parameters (CD4+ T-cell count, cholesterol, glucose, triglycerides and seric zinc and selenium seric concentrations) before and after supplementation. Peripheral blood mononuclear cells (PBMCs) of one individual of each intervention group were analyzed for single cell transcriptomics before and after supplementation. Results: BMI (p = 0.03), fat mass (p = 0.03), and trunk fat (p = 0.01) decreased after 6 months of selenium supplementation. No changes were observed for cholesterol, glucose or triglycerides after supplementation (p > 0.05 in all cases). CD4+ T cells percentage increased after 6 months of selenium supplementation (p = 0.03). On the transcriptome analysis, zinc and selenium supplementation induced changes on de expression of genes associated with the function of naive and memory CD8+ T-cells (p < 0.05 in all cases). Conclusion: Zinc and selenium supplementation could represent a complementary intervention that may improve the health status and immune response of treated PLWHIV.

Modelling the influence of vitamin D and probiotic supplementation on the microbiome and immune response.

The intestinal microbiota play a critical role in human health and disease, maintaining metabolic and immune/inflammatory health, synthesising essential vitamins and amino acids and maintaining intestinal barrier integrity. The aim of this paper is to develop a mathematical model to describe the complex interactions between the microbiota, vitamin D/vitamin D receptor (VDR) pathway, epithelial barrier and immune response in order to understand better the effects of supplementation with probiotics and vitamin D. This is motivated by emerging data indicating the beneficial effects of vitamin D and probiotics individually and when combined. We propose a system of ordinary differential equations determining the time evolution of intestinal bacterial populations, concentration of the VDR:1,25(OH)2D complex in epithelial and immune cells, the epithelial barrier and the immune response. The model shows that administration of probiotics and/or vitamin D upregulates the VDR complex, which enhances barrier function and protects against intestinal inflammation. The model also suggests co-supplementation to be superior to individual supplements. We explore the effects of inflammation on the populations of commensal and pathogenic bacteria and the vitamin D/VDR pathway and discuss the value of gathering additional experimental data motivated by the modelling insights.

Microbiome as an endocrine organ and its relationship with eye diseases: Effective factors and new targeted approaches.

Microbiome is an endocrine organ that refers to both the complicated biological system of microbial species that colonize our bodies and their genomes and surroundings. Recent studies confirm the connection between the microbiome and eye diseases, which are involved in the pathogenesis of eye diseases, including age-related macular disorders, diabetic retinopathy, glaucoma, retinitis pigmentosa, dry eye, and uveitis. The aim of this review is to investigate the microbiome in relation to eye health. First, a brief introduction of the characteristics of the gut microorganisms terms of composition and work, the role of dysbiosis, the gut microbiome and the eye microbiome in the progression of eye illnesses are highlighted, then the relationship among the microbiome and the function of the immune system and eye diseases, the role of inflammation and aging and the immune system, It has been reviewed and finally, the control and treatment goals of microbiome and eye diseases, the role of food factors and supplements, biotherapy and antibiotics in relation to microbiome and eye health have been reviewed.

Vitamin D concentration in the blood of women with twin pregnancies and in the umbilical cord blood of newborns in relation to environmental factors.

Background: There is a huge gap in the knowledge of the body's nutrient resources in women with multiple gestations. Due to the increased demand hypothesis and taking into account common vitamin D deficits in women with singleton pregnancies, this issue should also be investigated in twin pregnancies. This study evaluated blood vitamin D concentration in women with twin pregnancies and in the umbilical cord blood of their newborns as well as analyzed environmental factors that may affect the level of this nutrient. Methods: The study included 56 women with twin pregnancies. Venous blood samples were collected from the women before delivery and umbilical cord blood at delivery to determine the total 25(OH)D concentration. The women were interviewed by a dietitian to collect data on their diet and lifestyle. Results: The average maternal 25(OH)D concentrations were 38.4 ± 11.0 ng/mL vs. 23.7 ± 6.1 ng/mL determined in the umbilical cord blood of the newborns. The concentration of 25(OH)D in the umbilical cord blood was strongly correlated with the concentration in the mother (p < 0.001). Vitamin D deficiency was found in 7% of women and 21% of newborns. Factors increasing the risk of too low 25(OH)D concentration in the mothers were age below 27 years (p = 0.002) and short duration of pregnancy (p = 0.011). In newborns, the risk factors included low maternal concentrations (p < 0.001) and delivery before 36 weeks of gestation (p = 0.008). The mean cord blood 25(OH)D levels were almost identical in both twins and amounted to 24.0 ± 6.1 ng/mL in the first-born and 23.4 ± 6.1 ng/mL in the second-born infant. Vitamin D supplementation was declared by 98% of the women, with 85% taking ≤2,000 IU vitamin D daily. Conclusion: Only a small percentage of women with twin pregnancies presented with vitamin D deficiency, which was probably related to the widespread supplementation of this nutrient. It can therefore be assumed that a dose of 2,000 IU vitamin D currently recommended for pregnant women may also be appropriate for twin gestations, although further research is required to validate this finding.

A systematic review of Selenium as a complementary treatment in cancer patients.

BACKGROUND: Selenium, a trace element with antioxidant properties, has been widely studied for its benefits in cancer treatment. This systematic review aims to critically evaluate existing evidence on the effectiveness of selenium as a complementary treatment in cancer patients. METHOD: In May 2023, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies concerning the use, effectiveness and potential harm of selenium substitution therapy on adult cancer patients undergoing cancer treatment. Including and excluding patient criteria were defined beforehand. RESULTS: From 4511 search results, 12 studies in 14 publications with 2483 patients were included in this systematic review. Types of cancer covered in the reviewed studies are non-Hodgkin lymphoma, head and neck cancer, thyroid cancer, acute myeloid or acute lymphocytic leukaemia, stage I non-small lung cancer, breast cancer, cervical and endometrial cancer, prostate cancer and non-invasive urothelial carcinoma. Common outcomes were PSA change, radiotherapy associated toxicities, overall survival (OS), recurrence free interval (RFI) and quality of life (QoL). Most studies showed some concerns in the risk of bias evaluation. The results were heterogeneous: Regarding radiotherapy toxicities, patients with sufficient levels of Se at baseline do not profit of Se supplementation, while those with a deficiency of Se at baseline have significantly reduced toxicities on some scales. Regardless blood levels of Se, no benefit was found for OS, Recurrence Free Interval, Progression Free Interval, Quality of life and PSA compared to control/placebo group. CONCLUSION: Due to the very heterogeneous results and methodical limitations of the included studies, a clear statement regarding the effectiveness of Se supplementation is not possible, whereas cancer patients with a Se deficiency could profit from a Se supplementation during radio- or chemotherapy. Further studies should define Se deficiency as inclusion criterion and analyze levels of Se during time of intervention.

Creatine supplementation does not add to resistance training effects in prostate cancer patients under androgen deprivation therapy: A double-blind randomized trial.

OBJECTIVES: Androgen deprivation therapy (ADT) leads to loss of lean mass (LM) and reduced strength and physical function. Resistance exercise alone can counteract these changes; however, it is unknown if the addition of creatine supplementation can further protect against these ADT-induced toxicities. We compared the effects of creatine supplementation with resistance exercise versus resistance exercise alone in patients with prostate cancer undergoing ADT on LM, muscle strength, and physical function. DESIGN: A 12-week randomized trial. METHODS: Men with prostate cancer receiving ADT (n = 30) were randomized to either resistance exercise + placebo (PLA) or resistance exercise + creatine (SUPP), with both groups undertaking supervised exercise 3 days per week. Outcomes included whole body and appendicular LM and fat mass (FM) assessed by dual-energy X-ray absorptiometry, as well as muscle strength (chest press, seated low, leg press), and physical function (timed up-and-go, chair rise, 400-m walk) assessed at baseline and following the intervention. RESULTS: Patients were aged 59-84 years with a BMI of 28.6 kg·m-2. PLA completed a mean of 30 sessions (83 %) and SUPP a mean of 33 sessions (92 %). Despite similar within-group improvements (p < 0.05) in whole-body LM (PLA +0.6 kg, SUPP +1.3 kg), appendicular LM (PLA +0.5 kg, SUPP +0.6 kg), muscle strength (PLA +8.8-49.3 kg, SUPP +9.4-40.4 kg) and physical function, there were no between group differences (p = 0.078-0.951). No adverse events were reported due to creatine supplementation or resistance exercise. CONCLUSIONS: A short-term program of resistance exercise alone results in meaningful improvements in LM, muscle strength and physical function, with no additional effects of creatine supplementation.

A Comprehensive Review on Understanding Magnesium Disorders: Pathophysiology, Clinical Manifestations, and Management Strategies.

Magnesium is vital in a broad spectrum of physiological processes, including enzyme activity, energy production, and neuromuscular function. Despite its crucial role, magnesium disorders - comprising both deficiency (hypomagnesemia) and excess (hypermagnesemia) - are frequently underrecognized and inadequately managed in clinical practice. Magnesium deficiency is widespread, particularly among populations with chronic illnesses, the elderly, and those experiencing malnutrition, often leading to significant neuromuscular, cardiovascular, and metabolic complications. Conversely, hypermagnesemia, though less common, poses serious risks, especially in individuals with impaired renal function or those receiving high doses of magnesium supplements or medications. This review comprehensively examines magnesium disorders, detailing their pathophysiology, clinical manifestations, and management strategies. It highlights the essential functions of magnesium in maintaining cellular integrity, cardiovascular health, and bone structure and discusses the global prevalence and risk factors associated with magnesium imbalances. By offering insights into the current understanding of magnesium homeostasis and its disruptions, this review aims to enhance the awareness and treatment of magnesium-related conditions, ultimately improving patient outcomes across diverse clinical settings.

Use of multiple micronutrient supplementation integrated into routine antenatal care: A discussion of research priorities.

Optimal maternal nutrition, including adequate intake and status of essential micronutrients, is important for the health of women and developing infants. Currently, the World Health Organization (WHO) Antenatal care recommendations for a positive pregnancy experience recommend daily iron and folic acid (IFA) supplementation as the standard of care. The use of multiple micronutrient supplements (MMSs) is recommended in the context of rigorous research as more evidence was needed regarding the impact of switching from IFA supplements to MMS, including evaluation of critical clinical maternal and perinatal outcomes, acceptability, feasibility, sustainability, equity and cost-effectiveness. WHO convened a technical consultation of key stakeholders to discuss research priorities with the objective of providing guidance and clarity to donors, implementers and researchers about this recommendation. The overarching principles of the research agenda include the use of clinical indicators and impact measures that are applicable across studies and settings and the inclusion of outcomes that are important to women. Future studies should consider using standardized protocols based on current best practices to measure critical outcomes such as gestational age (GA) and birthweight (BW) in studies. As GA and BW are influenced by multiple factors, more research is needed to understand the biological impact pathways, and how initiation and considerations for timing of MMS influence these outcomes. A set of core clinical indicators was agreed upon during the technical consultation. For implementation research, the Evidence-to-Decision framework was used as a resource for discussing components of implementation research. The implementation research questions, key indicators and performance measures will depend on country-specific context and bottlenecks that require further research and improved solutions to enable the successful implementation of iron-containing supplements.

Vitamin B12 deficiency in newborns: impact on individual's health status and healthcare costs.

OBJECTIVES: The identification of vitamin B12 (B12) deficiency in the newborn may prevent neurological damage and a delay in the normal growth. In this study we characterized the incidence of B12 deficiency in newborns, the costs associated to the clinical diagnosis and management, and the relevance to optimize the use of cobalamin biomarkers during treatment follow-up. METHODS: Starting from a continuous case series of 146,470 screened newborns (November, 1st 2021- December, 3rd 2023), the Regional Reference Laboratory for Neonatal Screening identified 87 newborns having altered levels of biomarkers of cobalamin metabolism measured by Newborn Screening. These subjects were confirmed with a nutritional B12 deficiency of maternal origin by performing the serum B12 measurements and plasma homocysteine (Hcy) both on the newborns and respective mothers. A cost analysis was performed to characterize the costs/year of identifying and managing B12 deficiency cases. RESULTS: At baseline, median (interquartile range) serum B12 levels of 185.0 (142.3-246.0) ng/L and threefold increased plasma Hcy concentrations above the normal level confirmed a severe condition of deficiency in the newborns. After intramuscular B12 supplementation, serum B12 measured at the first follow up visit showed a fivefold increase, and the levels of Hcy returned to normal. From the healthcare perspective, the costs for diagnosing and managing all newborns with B12 deficiency is 188,480 €/year. CONCLUSIONS: Preventing B12 depletion in newborns lowers healthcare costs and likely improves their health outcomes. Further studies are however required to address the clinical pathway to identify, treat and monitor pregnant women with marginal and low B12 status, in order to achieve these goals.

Vitamin D in Multiple Sclerosis: A Comprehensive Umbrella Review.

BACKGROUND: Multiple sclerosis (MS) is an inflammatory neuro-immune disease with a multifaceted etiology and long-lasting adverse effects. Several studies have explored the role of 25-hydroxyvitamin D (25(OH)D) serum levels, vitamin D receptor (VDR) gene polymorphisms, and vitamin D supplementation (VDS) in individuals with MS. OBJECTIVE: The aim of this study was to evaluate the relationship of MS with 25(OH)D serum levels, VDR gene polymorphisms, and VDS. METHODS: We assessed relevant papers published in PubMed, Scopus, and Web of Science from the inception up to February 24, 2024. Meta-analyses that investigated the link of 25(OH)D serum levels, VDR gene polymorphisms including Apal (rs7975232), BsmI (rs1544410), Taql (rs731236) and Fokl (rs10735810), and VDS with the risk and clinical manifestations of MS were included. The methodological quality of selected papers was assessed by the Assessment of Multiple Systematic Reviews version 2 (AMSTAR 2). The statistical analysis of this umbrella review was carried out using RStudio version 2023.03.1 and R version 4.3.2, simultaneously. RESULTS: 23 out of 304 records were entered into this umbrella review with a pooled sample size of 37,567 participants. Eleven papers were rated as high quality, one was moderate quality, one was low quality, and ten were critically low quality. The homozygote model of FokI (FF+ff vs. Ff) was significantly associated with an 8% reduction of MS risk (OR: 0.92, 95% CI: 0.86, 0.98; I2= 0%, P>0.99). CONCLUSION: According to existing clinical evidence, the risk of MS may be associated with VDR gene polymorphism. Further studies are needed to explore the association of MS and vitamin D. PROSPERO REGISTRATION CODE: CRD42024521541.

Antioxidant intake and its relationship with generalized anxiety disorder among adults.

Antioxidant intake may contribute to the prevention of numerous diseases, particularly those related to stress-induced psychiatric and stress disorders. The current study aimed to assess the relationship between daily antioxidant intake (DAI) and Generalized Anxiety Disorder (GAD) in adults. It also sought to investigate the correlation between the type of diet in conjunction with DAI and the scores on GAD 7-Item Scale in adults. A cross-sectional design was used to examine if DAI was lower in individuals with GAD; followed by an interventional study of 40 adults with severe GAD, who were exposed to higher DAI for a period of 6 weeks. The results indicated that participants with severe GAD had significantly lower levels of DAI compared to healthy controls (p < 0.001). After 6 weeks of antioxidant supplementation, a significant decrease in GAD-7 scores of participants was observed (p < 0.001). The study found a significant negative relationship between DAI and GAD.

The effects of AG1® supplementation on the gut microbiome of healthy adults: a randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND: This study aimed to examine the effect of a commercially available multi-ingredient powder (AG1Ⓡ) on the gut microbiome and assess the impact of AG1Ⓡ on GI tolerability and other clinical safety markers in healthy men and women. METHODS: Using a double-blind, randomized, two-arm, placebo-controlled, parallel design, we examined a 4-week daily supplementation regimen of AG1Ⓡ vs. placebo (PL). Fifteen men and 15 women provided stool samples for microbiome analysis, questionnaires for digestive quality of life (DQLQ), and completed visual analog scales (VAS) and Bristol stool charts to assess stool consistency and bowel frequency before and after the 4-week intervention. Participant's blood work (CBC, CMP, and lipid panel) was also assessed before and after the 4-week intervention. Alpha diversity was determined by Shannon and Chao1 index scores and evaluated by a two-way ANOVA, beta diversity in taxonomic abundances and functional pathways was visualized using partial least squares-discriminant analyses and statistically evaluated by PERMANOVA. To identify key biomarkers, specific feature differences in taxonomic relative abundance and normalized functional pathway counts were analyzed by linear discriminant analysis (LDA) effect size (LEfSe). Questionnaires, clinical safety markers, and hemodynamics were evaluated by mixed factorial ANOVAs with repeated measures. This study was registered on clinicaltrials.gov (NCT06181214). RESULTS: AG1Ⓡ supplementation enriched two probiotic taxa (Lactobacillus acidophilus and Bifidobacterium bifidum) that likely stem from the probiotics species that exist in the product, as well as L. lactis CH_LC01 and Acetatifactor sp900066565 ASM1486575v1 while reducing Clostridium sp000435835. Regarding community function, AG1Ⓡ showed an enrichment of two functional pathways while diminishing none. Alternatively, the PL enriched six, but diminished five functional pathways. Neither treatment negatively impacted the digestive quality of life via DQLQ, bowel frequency via VAS, or stool consistency via VAS and Bristol. However, there may have been a greater improvement in the DQLQ score (+62.5%, p = 0.058, d = 0.73) after four weeks of AG1Ⓡ supplementation compared to a reduction (-50%) in PL. Furthermore, AG1Ⓡ did not significantly alter clinical safety markers following supplementation providing evidence for its safety profile. CONCLUSIONS: AG1Ⓡ can be consumed safely by healthy adults over four weeks with a potential beneficial impact in their digestive symptom quality of life.

Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study.

BACKGROUND: Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. OBJECTIVE: To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. METHODS: In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. RESULTS: The median (Q1, Q3) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median (Q1, Q3) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3-12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). CONCLUSION: In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection.

Age-related decline of motor unit firing rate in community-dwelling healthy older adults and daily ingestion of fish protein of Alaska pollack: a randomised trial.

Neuromuscular properties decline with ageing and low-level physical activities. Alaska pollack protein (APP) is reportedly effective for improving skeletal muscular functions, even if the amount is small and exercise is not conducted. However, it is unclear whether APP intake without an exercise program affects neuromuscular dysfunction in community-dwelling adults conducting normal, everyday activities. This study aimed to investigate changes in motor unit firing properties by adding APP to daily meals in community-dwelling older adults. They were divided into an APP group or a placebo control (CON) group for randomised, double-blind treatment. Participants in APP (n = 15) and CON (n = 17) groups ingested 4.5 g/d APP and whey protein, respectively, added to daily meals for 3 months without a specific exercise intervention. High-density surface electromyography of the vastus lateralis to assess the individual motor unit firing rate during 70% of maximum voluntary ramp-up contraction (MVC), maximum knee extensor strength, muscle thickness, echo intensity, and a physical function test were evaluated at the baseline, as well as 1.5 and 3 months after the intervention. While muscle strength, muscle thickness, and motor function were not changed, the motor unit firing rate at 50%-70% of MVC showed a significant decline at 1.5 and 3 months in the CON group, but this decline was not observed in the APP group. These findings suggest that neuromuscular properties show a detectable decline on performing daily activities without a specific exercise intervention, but such a decline was not observed in the APP intake group.

Pancreatic Enzyme Replacement Leads to Increased Vitamin D Uptake in Patients Undergoing Sleeve-gastrectomy - A Prospective, Monocentric Trial.

PURPOSE: Metabolic and bariatric surgery (MBS) is often considered to be associated with macro- and micronutrient deficiency. A possible treatment option can be the implementation of pancreatic enzyme replacement (PERT) and may lead to better outcomes. We designed a prospective trial investigating the possible impact of PERT in patients undergoing MBS at a high-volume center. MATERIALS AND METHODS: A prospective two-arm randomized controlled trial was conducted on patients who underwent either sleeve gastrectomy or gastric bypass procedures at a high-volume center. Patients underwent bariatric surgery and follow-up examinations at 3, 6, and 12 months after surgery. Patients were stratified either to the treatment group with PERT or to the control group. The primary endpoint of the study was a change in BMI. Lab testing was carried out to measure secondary endpoints, including albumin and vitamin D levels. RESULTS: Overall, 204 patients were enrolled. Due to missing follow-ups, surgical complications, and side effects due to Kreon medication, 65 were excluded. Analysis of primary endpoints indicates that PERT does not lead to slower weight loss or BMI reduction. Analysis of secondary endpoints showed significantly better vitamin D levels in patients undergoing MBS and PERT. No statistical difference was seen regarding albumin. In both arms, fatty liver disease improved. Quality of life is positively judged as comparable by patients in both groups. CONCLUSION: Herein, we show an association between PERT and higher vitamin D levels in patients undergoing MBS. An optimized enzymatic environment due to PERT may therefore result in higher vitamin D levels and may improve clinical outcomes in patients undergoing MBS.