Effect of vitamin D3 on antiphospholipid antibodies in hospitalized patients with moderate to severe COVID-19.

OBJECTIVE: To investigate the effect of a single oral dose of 200,000 IU of vitamin D3 on antiphospholipid antibodies in hospitalized patients with moderate to severe COVID-19. METHODS: This is a post-hoc, exploratory analysis from a double-blind, placebo-controlled, randomized clinical trial performed in two centers in Sao Paulo, Brazil. Hospitalized patients with COVID-19 were randomly assigned to receive either vitamin D3 (n = 97) or placebo (n = 97). In this post-hoc analysis, the endpoints were titers and frequency of anti-ß2-Glycoprotein-I (aß2-GP) and Anticardiolipin (aCL) antibodies [Immunoglobulin G, M and A (IgG, IgM and IgA)]. RESULTS: Overall mean (SD) age was 55.3 (13.9) years, Body Mass Index (BMI) was 32.2 (7.1 kg/m2), and 106 participants (54.6 %) were male. There was a significant group by time interaction (p = 0.046) for frequency of aCL IgG, with increased values from baseline to discharge in the placebo group [n (%), from 13 (13.4) to 25 (25.8)] compared to the vitamin D3 [from 25 (25.8) to 29 (29.9)]. However, the frequency of aCL IgG did not change between the groups on discharge. No significant differences between vitamin D3 and placebo groups were found for any other autoantibodies. CONCLUSION: These findings do not support the use of a single oral dose of 200,000 IU of vitamin D3 to modulate autoantibodies in hospitalized patients with moderate to severe COVID-19.

Impact of Nutrition Interventions on Vitamin and Mineral Intake among Native American Children and Parents: Insights from Food Resource Equity for Sustainable Health (FRESH) Study.

The Food Resource Equity for Sustainable Health (FRESH) study started as a tribe community-based nutrition education program in 2018, implemented with children and parents in Osage Nation. The purpose of the FRESH study is to examine the effects of a farm-to-school family intervention on diet. The FRESH study did not directly intervene on adult caregiver participants' diet, and, as far as we know, it is the first of its kind to implement a farm-to-school intervention in rural/tribally owned Early Childhood Education. Two communities received intervention and two served as wait-list controls. Outcomes included diet and other secondary health outcomes including vitamin and mineral intake. There were 193 children (n = 106 intervention; n = 87 control) and 170 adults (n = 93 intervention; n = 77 control) enrolled. Among adult caregiver participants, carbohydrate, cholesterol, and caffeine intake significantly decreased after the intervention (p < 0.05). There is a hidden hunger issue among caregivers in Native American populations. The family-based nutritional intervention, which includes educational components for caregivers, might have some effect on improving micronutrient status. Future studies focusing on key micronutrients through efficient methods are warranted.

Lack of Association between Insufficient Intake of Multiple Vitamins and Frailty in Older Adults Who Consume Sufficient Energy and Protein: A Nationwide Cross-Sectional Study.

Frailty is a complex condition that intensifies with age and is marked by decreased physiological function. We rigorously investigated the effects of lower vitamin intake on frailty using data from 665 adults aged over 65 years who consumed sufficient recommended daily energy and protein intakes from the Korean Nutrition and Health Survey, 2016-2019. The definition of frailty was modified based on Fried et al.'s definition of weight loss, exhaustion, weakness, slowness, and low energy expenditure. Based on daily intake, we analyzed vitamins such as vitamin A, thiamine, riboflavin, niacin, folic acid, and vitamin C. Our results of logistic regression showed that increasing multiple deficiencies in several kinds of vitamins (mild to moderate to severe) is not associated with frailty (odds ratio: 1, 1.24 (0.24-3.10), 0.82 (0.28-2.39), p for trend = 0.626) in older adults who consumed sufficient calories and proteins. A subgroup analysis of age and sex, which may interfere with the relationship between vitamin intake and frailty, showed that vitamin intake was not associated with frailty when sufficient energy and proteins were consumed. Furthermore, there was no difference in the prevalence of frailty between the groups with sufficient and insufficient intakes of individual vitamins.

Patterns of Dietary Supplement Use among GBT2Q Men and Non-Binary Individuals in Canada.

There is a lack of research regarding dietary supplement (DS) use among Gay, Bisexual, Transgender, Two-Spirit, Queer (GBT2Q) men and non-binary individuals, despite the higher prevalence of body image issues and societal pressure within this community. This study aimed to investigate patterns and predictors of DS use in this population, including types of DS used, sources of information, and reasons for DS use. A validated and anonymous online questionnaire was completed by 204 participants (52.5% men, 43.1% gay, mean age 29.34 + 6.77 years) across Canada, who were consuming DS at the time of the study. Analyses included descriptive statistics to characterize the sample based on gender, sexuality, age, ethnicity, and other demographic attributes, using Pearson's chi-square tests and multi-way cross-tabulation analyses. Additionally, regression analyses, including binary and logistic regressions, were employed to identify predictors of DS use. Data analysis concluded that vitamins/minerals (92.2%), proteins (84.3%) and carbohydrates (75.5%) were the most consumed types of supplements. Identifying as certain genders and sexualities was significantly associated with supplement preferences, such that men reported higher use of amino acids (p = 0.033) and non-vitamins/mineral antioxidants compared to individuals identifying as other genders (p = 0.006). Moreover, bisexual participants consumed amino acids (p = 0.043) and carbohydrates (p = 0.026) more frequently when compared to non-bisexual participants. The most listed reason for DS use was to improve immunity (60.3%), with health care professionals being listed as the source of information by most participants (51.0%). Findings from this study can serve as a foundation for further research in this area and can guide the formulation and implementation of adequate policies targeting this underserved population.

Nutrient Status and Intakes of Adults with Phenylketonuria.

A phenylalanine-restricted diet, supplemented with protein substitutes (PSs), remains the cornerstone of phenylketonuria (PKU) management. However, adherence is challenging in adulthood, and data on the nutritional status of early and continuously treated adults with PKU (ETAwPKU) are scarce. A total of 34 ETAwPKU (16 females; mean ± SD, age: 28 ± 9 years, phenylalanine concentration: 847 ± 285 µmol/L) and 34 age- and sex-matched control subjects were compared regarding their blood nutrient status, self-reported dietary intake, and cognitive wellbeing. Though diet adherence varied, all ETAwPKU were taking a PS. No significant differences were found for blood DHA, calcium, ferritin, transferrin, and zinc concentrations. However, selenium and ubiquinone concentrations were 16% and 29% lower in ETAwPKU, respectively (p < 0.01 and <0.0001). Vitamin concentrations (D, B12, B6, and folic acid) were significantly higher in ETAwPKU except for alpha-tocopherol. Amino acid (AA) concentrations differed between ETAwPKU and controls: they were significantly lower for 12 AAs and higher for phenylalanine and glycine. ETAwPKU had a significantly higher intake of most minerals and vitamins, except for niacin and phosphorus (no difference). Depending on the nutrient, PSs represented 52-100% of patients' daily intake and 19% of total daily energy intake. Compared with controls, ETAwPKU scored significantly lower in three of the four subscales of the cognitive wellbeing questionnaire. Overall, the blood DHA and micronutrient status of ETAwPKU was adequate, except for selenium, with higher intakes than controls for most micronutrients. Patients relied heavily on PSs to meet the recommended intakes for protein, DHA, and micronutrients. The potential clinical impact of differences found in AA status should be further studied.

Use of Dietary Supplements among Polish Children with Inflammatory Bowel Disease: A Two-Center Pilot Study.

Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). These diseases are characterized by inflammation, which may be a consequence of changes in the intestinal microbiota and lead to mineral and vitamin deficiencies. The aims of this study were to determine the level of dietary supplement intake in children with IBD and to determine the influence of factors such as sex, nutritional status, diet, and other comorbidities on supplement intake. The study was conducted from May 2022 to September 2023 and was a prospective study. The group of children with IBD that ultimately qualified for the study numbered 96, and the control group numbered 30. The children who participated in the study were aged 4-18 years. Most parents of children with IBD (81.4%) declared that they use supplementation for their children, while 75% of parents of children without IBD declared giving their children nutritional supplements. Vitamins in both groups were most often given to children as dietary supplements (p = 0.018), including vitamin D. Depending on the diet used, the intake of vitamin B6 (p = 0.018), vitamin E (p = 0.040) and iron (p = 0.006) was significantly different among children with IBD. Statistical significance (p = 0.021) was observed for supplementation use and disease stage among children with IBD. For 80.2% of parents of children with IBD, the main reason for using supplements was a doctor's recommendation. In the control group, 43.3% of parents indicated that the main reason for using supplements was to correct nutritional deficiencies. Supplementation was common in both groups, but attention should be paid to other current diseases in children with IBD and to nutritional status. In our opinion, educating parents about supplementation is important, especially among parents of children with IBD.

Optimal methods of vitamin D supplementation to prevent acute respiratory infections: a systematic review, dose-response and pairwise meta-analysis of randomized controlled trials.

BACKGROUND: Vitamin D supplementation may prevent acute respiratory infections (ARIs). This study aimed to identify the optimal methods of vitamin D supplementation. METHODS: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and the ClinicalTrials.gov registry were searched from database inception through July 13, 2023. Randomized-controlled trials (RCTs) were included. Data were pooled using random-effects model. The primary outcome was the proportion of participants with one or more ARIs. RESULTS: The analysis included 43 RCTs with 49320 participants. Forty RCTs were considered to be at low risk for bias. The main pairwise meta-analysis indicated there were no significant preventive effects of vitamin D supplementation against ARIs (risk ratio [RR]: 0.99, 95% confidence interval [CI]: 0.97 to 1.01, I2 = 49.6%). The subgroup dose-response meta-analysis indicated that the optimal vitamin D supplementation doses ranged between 400-1200 IU/day for both summer-sparing and winter-dominant subgroups. The subgroup pairwise meta-analysis also revealed significant preventive effects of vitamin D supplementation in subgroups of daily dosing (RR: 0.92, 95% CI: 0.85 to 0.99, I2 = 55.7%, number needed to treat [NNT]: 36), trials duration < 4 months (RR: 0.81, 95% CI: 0.67 to 0.97, I2 = 48.8%, NNT: 16), summer-sparing seasons (RR: 0.85, 95% CI: 0.74 to 0.98, I2 = 55.8%, NNT: 26), and winter-dominant seasons (RR: 0.79, 95% CI: 0.71 to 0.89, I2 = 9.7%, NNT: 10). CONCLUSION: Vitamin D supplementation may slightly prevent ARIs when taken daily at doses between 400 and 1200 IU/d during spring, autumn, or winter, which should be further examined in future clinical trials.

Multivitamin Compliance Reduces Injuries of Female Recruits at Air Force Basic Training: A Randomized Controlled Cohort Study.

INTRODUCTION: Department of the Air Force basic military training (BMT) is the 7.5-week initial entry training for all enlisting U.S. Air Force and Space Force recruits. Overuse musculoskeletal injuries (MSKI) during training threaten success in BMT, and trainees with nutritional deficiencies are at higher risk. Several efforts are made at BMT to mitigate these issues to help trainees graduate on time, such as the distribution of multivitamins (MVI) to female recruits. However, trainee compliance with the prescribed MVI has been reported to be low, calling into question the effectiveness of this intervention. This study evaluated the effect of briefing modality offered to these trainees at the time of distribution on educational effectiveness, MVI compliance, and injury rates. MATERIALS AND METHODS: This was a randomized controlled cohort study of BMT female trainees. Subjects included all female trainees of a single iteration of BMT concurrently completing training within the same squadron. At the outset of training, cohorts were randomly educated in one of two ways regarding the provided MVI. The control cohort (n = 80) was presented with the standard educational video created by BMT-registered dietitians, while the test cohort (n = 79) was presented the video and then also briefed in-person by a group of subject matter experts. At the end of BMT, the trainees completed a questionnaire regarding their knowledge, confidence, and compliance with the MVI. Additionally, a routinely collected training database was queried and analyzed for differences in injuries and training outcomes using the chi-squared test with significance set to α ≤ 0.05. RESULTS: Although both cohorts found their educational presentation useful, the "in-person" cohort reported significantly higher compliance rates and were found to be diagnosed with MSKI and bone stress injuries at significantly lower rates (43% and 66% relative risk reductions, respectively). CONCLUSIONS: Education to female BMT trainees regarding the MVI, which included a face-to-face discussion with subject matter experts, resulted in greater compliance and reduced incidence of MSKI and bone stress injury, compared to a video prepared by registered dietitians alone. Such educational approaches should continue to be strived for in this and other military population health measures. This study's implication of MVI efficacy for injury risk reduction in female trainees should be further studied, verified, and improved upon in this and other populations.

Effects of dietary supplementation in treatment and control of progression and complications of insulin-dependent diabetes mellitus: a systematic review with meta-analyses of randomized clinical trials.

There is no safe and effective prevention for insulin-dependent diabetes (IDDM) mellitus, which makes it highly dependent on its treatment. This systematic review with meta-analyses of randomized clinical trials investigated the overall effects of dietary supplements of vitamins, minerals, trace elements, and non-essential compounds with antioxidant properties, fatty acids, and amino acids in IDDM. Searches of MEDLINE, Embase, CENTRAL, LILACS, The Grey Literature Report, and ClinicaTrials.gov, and citations from previous reviews were used to identify reports published through July 2023. The Risk of Bias 2 (RoB2) tool was used to analyze the risk of bias and GRADE was used to assess the quality of the results. Fifty-eight studies (n=3,044) were included in qualitative analyses and seventeen (n=723) in meta-analyses. Qualitative analyses showed few positive effects on some metabolic function markers, such as endothelial and renal function and lipid profile. Meta-analyses showed a positive effect of omega-3 on glycated hemoglobin (HbA1c) (RMD=-0.33; 95%CI: -0.53, -0.12, P=0.002; I2=0%; GRADE: low quality; 4 studies) and of vitamin D on fasting C-peptide (FCP) (RMD=0.05; 95%CI: 0.01, 0.9, P=0.023; I2=0%; GRADE: very low quality; 4 studies). Most studies showed bias concern or high risk of bias. A recommendation for dietary supplementation in IDDM cannot be made because of the few positive results within different interventions and markers, the serious risk of bias in the included studies, and the low quality of evidence from meta-analyses. The positive result of vitamin D on FCP is preliminary, requiring further investigation.

Analysis of food supplements and sports foods consumption patterns among a sample of gym-goers in Portugal.

BACKGROUND: Gym-goers usually seek methods to improve performance, muscle gain, and overall health. One of the main strategies is including food supplements (FS) into their routine as aids to enhance their athletic capabilities and satisfy their nutritional needs. Thus, this study aimed to investigate and characterize the main FS and Sports Foods (SF) currently consumed, as well as the main reasons for their use and the source of advice in a group of gym-goers in the Lisbon Metropolitan Area (Portugal). METHODS: A cross-sectional study was conducted, including 303 gym-goers from Lisbon, Portugal, who were 133 women and 170 males (30.8 ± 12.9 years old). Face-to-face interviews were used by qualified researchers to gather data. RESULTS: Most of the interviewed athletes (71.95 %) took FS/SF, being men the main consumers. On average, 1.59 supplements were consumed per athlete. Logistic regression models indicated significant associations between age, gender, and motivations for gym attendance. While men and younger groups attended mainly for hypertrophy, women and older groups were focused on well-being. Protein (59.17 %) was the most used FS/SF, followed by creatine (41.28 %) and multivitamins (27.06 %). Men and younger individuals preferred protein and creatine, while older individuals focused more on specific vitamins and minerals. Women seemed to prefer L-carnitine and protein yogurts. Main sources of information included the internet, friends, and dietitians with notable gender and age-based preferences. Online stores were the main place of purchase. Monthly expenditures on FS/SF were not significantly affected by age or gender, but motivations for use had an influence. CONCLUSION: Most of the athletes interviewed took FS/SF, being men the major consumers. Protein was the principal FS/SF used, with online stores being the main place of purchase and the internet the primary source of information. Age and gender were key factors in adopted training, in the FS/SF chosen, and in the source of information selected. It is crucial that health professionals take primary responsibility for providing this guidance.

The Association between Dietary Intakes of Vitamins and Minerals with Tinnitus.

BACKGROUND: Tinnitus is the phantom perception of sound in the ears or head which may result from inflammation of the auditory pathway. A healthy diet consisting of a range of vitamins and minerals may be protective against tinnitus. This study aims to determine the association between intakes of dietary vitamins and minerals and the prevalence and incidence of tinnitus over 10 years. METHODS: In this longitudinal cohort study of 2947 participants (aged ≥ 50 years), 935 (32%) cases of tinnitus were identified and included in prevalence analyses. The remaining 2012 participants were followed to establish 10-year incidence of tinnitus. A validated semi-quantitative food frequency questionnaire was used to determine intakes of dietary vitamins and minerals. RESULTS: No significant associations with tinnitus prevalence were found. However, iron and zinc were significantly associated with incident tinnitus. There was a 44% (multivariate-adjusted HR: 1.44, 95% CI: 1.07-1.93) increased risk of developing incident tinnitus over 10 years with lower zinc intakes and a 35% increased risk with lower iron intakes (multivariate-adjusted HR: 1.35, 95% CI: 1.00-1.80). CONCLUSION: Higher intakes of zinc and iron were significantly associated with lower tinnitus risk. Due to a lack of comparable high-quality data, future research studies should include robust study designs.

Longitudinal Changes in Dietary Supplement Use among United States Military Personnel: The US Military Dietary Supplement Use Study.

Previous studies investigating temporal changes in dietary supplement (DS) use have used representative samples but have not followed the same cohort over time. This study investigated longitudinal patterns of changes in DS use and factors associated with discontinuing DS use in a single group of active-duty United States military service members (SMs). SMs (n = 5778) completed two identical questionnaires on their DS use and demographic/lifestyle characteristics an average ± standard deviation 1.3 ± 0.2 years apart. Prevalences of reported DS use ≥1 times/week in the baseline (BL) and follow-up (FU) phases were: any DS, BL = 77%, FU = 78%; multivitamins/multiminerals (MVM), BL = 50%, FU = 48%; individual vitamins/minerals, BL = 33%, FU 35%; proteins/amino acids, BL = 43%, FU = 39%; combination products, BL = 44%, FU = 37%; prohormones, BL = 5%, FU = 4%; herbal products, BL = 23%, FU = 21%; joint health products, BL = 12%, FU = 12%; fish oils, BL = 25%, FU = 23%; other DSs, BL = 17%, FU = 17%. Among BL users, the proportions reporting use in the FU phase were: any DS 88%, MVM 74%, protein/amino acids 70%, individual vitamin/minerals 62%, combination products 62%, fish oils 61%, joint health products 57%, herbal products 50%, other DSs 50%, and prohormones 37%. Higher odds of discontinuing any DS use in the follow-up were associated with female gender, younger age, higher BMI, and less weekly resistance training. Overall, prevalence of DS use was relatively consistent in the two phases; however, the cohort changed their use patterns in the follow-up with some discontinuing use and others initiating use, thus maintaining use prevalence over the period. These findings have implications for repeated cross-sectional DS studies where different samples are followed over time.

Causal relationships between dietary antioxidant vitamin intake and atopic dermatitis: A two-sample Mendelian randomization study.

OBJECTIVE: Oxidative stress is strongly associated with atopic dermatitis (AD), and increased antioxidant intake could potentially reduce the risk of or alleviate its symptoms. However, the argument is disputed. Therefore, we conducted a Mendelian randomization (MR) analysis to explore the causal relationship between dietary antioxidant vitamin intake and AD. METHODS: We applied MR analysis to examine the causative association between dietary antioxidant vitamin intake (vitamin C, vitamin E, carotene, and retinol) and AD. The genome-wide association study (GWAS) summary data for antioxidant vitamins intake and AD were obtained from the IEU OpenGWAS database and the UK biobank. Our study consisted of two major parts, MR analysis to detect the causal relationship between exposure and outcome, and sensitivity analysis as supplemental evidence to verify the robustness of the results. RESULT: The results revealed a suggestive causal relationship between vitamin E intake and AD (p = 0.038, OR 95% CI = 0.745-0.992). However, there was no causal relationship between the other three vitamins (vitamin C, carotene, and retinol) and AD (p = 0.507, OR 95% CI = 0.826-1.099) (p = 0.890, OR 95% CI = 0.864-1.184) (p = 0.492, OR 95% CI = 0.893-1.264). None of the single nucleotide polymorphisms (SNPs) were detected as heterogeneous and pleiotropy in the sensitivity analysis (p > 0.05). CONCLUSION: The analysis suggested that dietary intake of vitamin E may potentially lower the risk of AD. Conversely, intake of vitamin C, retinol, and carotene is not causally related to AD. Although vitamin E intake could be protective against AD, intake of dietary antioxidant vitamins to prevent or treat AD is not necessary.

Vitamin D supplementation for women during pregnancy.

BACKGROUND: Vitamin D supplementation during pregnancy may help improve maternal and neonatal health outcomes (such as fewer preterm birth and low birthweight babies) and reduce the risk of adverse pregnancy outcomes (such as severe postpartum haemorrhage). OBJECTIVES: To examine whether vitamin D supplementation alone or in combination with calcium or other vitamins and minerals given to women during pregnancy can safely improve certain maternal and neonatal outcomes. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Trials Register (which includes results of comprehensive searches of CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and relevant conference proceedings) (3 December 2022). We also searched the reference lists of retrieved studies. SELECTION CRITERIA: Randomised and quasi-randomised trials evaluating the effect of supplementation with vitamin D alone or in combination with other micronutrients for women during pregnancy in comparison to placebo or no intervention. DATA COLLECTION AND ANALYSIS: Two review authors independently i) assessed the eligibility of studies against the inclusion criteria, ii) assessed trustworthiness based on pre-defined criteria of scientific integrity, iii) extracted data from included studies, and iv) assessed the risk of bias of the included studies. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: The previous version of this review included 30 studies; in this update, we have removed 20 of these studies to 'awaiting classification' following assessments of trustworthiness, one study has been excluded, and one new study included. This current review has a total of 10 included studies, 117 excluded studies, 34 studies in awaiting assessment, and seven ongoing studies. We used the GRADE approach to assess the certainty of the evidence. This removal of the studies resulted in evidence that was downgraded to low-certainty or very low-certainty due to study design limitations, inconsistency between studies, and imprecision. Supplementation with vitamin D compared to no intervention or a placebo A total of eight studies involving 2313 pregnant women were included in this comparison. We assessed four studies as having a low risk of bias for most domains and four studies as having high risk or unclear risk of bias for most domains. The evidence is very uncertain about the effect of supplementation with vitamin D during pregnancy compared to placebo or no intervention on pre-eclampsia (risk ratio (RR) 0.53, 95% confidence interval (CI) 0.21 to 1.33; 1 study, 165 women), gestational diabetes (RR 0.53, 95% CI 0.03 to 8.28; 1 study, 165 women), preterm birth (< 37 weeks) (RR 0.76, 95% CI 0.25 to 2.33; 3 studies, 1368 women), nephritic syndrome (RR 0.17, 95% CI 0.01 to 4.06; 1 study, 135 women), or hypercalcaemia (1 study; no cases reported). Supplementation with vitamin D during pregnancy may reduce the risk of severe postpartum haemorrhage; however, only one study reported this outcome (RR 0.68, 95% CI 0.51 to 0.91; 1 study, 1134 women; low-certainty evidence) and may reduce the risk of low birthweight; however, the upper CI suggests that an increase in risk cannot be ruled out (RR 0.69, 95% CI 0.44 to 1.08; 3 studies, 371 infants; low-certainty evidence). Supplementation with vitamin D + calcium compared to no intervention or a placebo One study involving 84 pregnant women was included in this comparison. Overall, this study was at moderate to high risk of bias. Pre-eclampsia, gestational diabetes, and maternal adverse events were not reported. The evidence is very uncertain about the effect of supplementation with vitamin D and calcium on preterm birth (RR not estimable; very low-certainty evidence) or for low birthweight (RR 1.45, 95% CI 0.14 to 14.94; very low-certainty evidence) compared to women who received placebo or no intervention. Supplementation with vitamin D + calcium + other vitamins and minerals versus calcium + other vitamins and minerals (but no vitamin D) One study involving 1298 pregnant women was included in this comparison. We assessed this study as having a low risk of bias in all domains. Pre-eclampsia was not reported. The evidence is very uncertain about the effect of supplementation with vitamin D, calcium, and other vitamins and minerals during pregnancy compared to no vitamin D on gestational diabetes (RR 0.42, 95% CI 0.10 to 1.73; very low-certainty evidence), maternal adverse events (hypercalcaemia no events and hypercalciuria RR 0.25, 95% CI 0.02 to 3.97; very low-certainty evidence), preterm birth (RR 1.04, 95% CI 0.68 to 1.59; low-certainty evidence), or low birthweight (RR 1.12, 95% CI 0.82 to 1.51; low-certainty evidence). AUTHORS' CONCLUSIONS: This updated review using the trustworthy assessment tool removed 21 studies from the previous update and added one new study for a total of 10 included studies. In this setting, supplementation with vitamin D alone compared to no intervention or a placebo resulted in very uncertain evidence on pre-eclampsia, gestational diabetes, preterm birth, or nephritic syndrome. It may reduce the risk of severe postpartum haemorrhage; however, only one study reported this outcome. It may also reduce the risk of low birthweight; however, the upper CI suggests that an increase in risk cannot be ruled out. Supplementation with vitamin D and calcium versus placebo or no intervention resulted in very uncertain evidence on preterm birth and low birthweight. Pre-eclampsia, gestational diabetes, and maternal adverse events were not reported in the only study included in this comparison. Supplementation with vitamin D + calcium + other vitamins and minerals versus calcium + other vitamins and minerals (but no vitamin D) resulted in very uncertain evidence on gestational diabetes and maternal adverse events (hypercalciuria) and uncertain evidence on preterm birth and low birthweight. Pre-eclampsia was not reported in the only study included in this comparison. All findings warrant further research. Additional rigorous, high-quality, and larger randomised trials are required to evaluate the effects of vitamin D supplementation in pregnancy, particularly in relation to the risk of maternal adverse events.

High composite dietary antioxidant index is associated with reduced risk of kidney stones: a cross-sectional analysis of NHANES 2007-2020.

The composite dietary antioxidant index (CDAI) is commonly utilized to assess antioxidant intake across diseases, but its association with kidney stones is unclear. We hypothesized that higher CDAI is associated with reduced kidney stone risk. Using National Health and Nutrition Examination Survey 2007-2020 data, we calculated CDAI based on vitamins A, C, E, selenium, zinc, and carotenoids intake in 29,280 adults. Stone formers had lower CDAI, with significant gender differences. Restricted cubic spline showed an L-shaped curve, with the steepest decline before CDAI of 1.449. In multivariate logistic regression, moderate and high CDAI tertiles were associated with reduced kidney stone odds compared to the lowest tertile (odds ratio [95% CI]): 0.85 [0.73, 0.99], P = .035 and 0.80 [0.66, 0.95], P = .014, respectively). Vitamin C had the highest negative correlation weight with kidney stones. Significant interactions were found for age and diabetes subgroups. In conclusion, higher CDAI may reduce kidney stone risk, especially with adequate vitamin C intake. Further cohort studies are warranted to confirm the causal association.

Effect of dietary inclusion of 25-hydroxyvitamin D3 and vitamin E on performance, gut health, oxidative status, and immune response in laying hens infected with coccidiosis.

Vitamin D3 (25-hydroxyvitamin D3 (VD)) and vitamin E (VE) have proven to have immunomodulatory and antioxidant functions along with capacities to improve the reproductive function in chickens. Coccidiosis in laying hens at different stages of growth has been shown to negatively affect performance, immune response, and oxidative status, thus increasing the cost of production. A study was conducted to evaluate the influence of dietary VD or VE on performance, gut health, immune response, and oxidative status of laying hens at peak production. Laying hens (23 wk-of-age, n = 225) were randomly allocated into 5 treatment groups (n = 9 hens/replicate) with 5 replicate groups each: 1) unchallenged control (UC), 2) pair-fed control (PF), 3) challenged control (CC), 4) challenged control top-dressed with 5,000 IU of 25-hydroxyvitamin D3 (VD) per kg of diet, and 5) challenged control top-dressed with 100 IU of DL-α-tocopherol (VE). At 25 wk-of-age, hens grouped in CC, VD, and VE were challenged with mixed Eimeria spp. to induce coccidiosis. VD or VE supplemented hens did not impact bird body weight; however, egg production increased by 10.36% and 13.77%, respectively (P < 0.0001). Furthermore, the gut health of the hens was improved with either VD or VE supplementation, as indicated by lowered gut permeability and intestinal lesion scores (P < 0.05). VE significantly reduced the heterophil count (P = 0.0490) alongside numerically increasing the peripheral CD4+ and CD8+ T cells and monocyte counts (P > 0.05). Both VD or VE increased the TAC at 14 DPI compared to UC (P<0.05). Preliminary findings suggest that dietary VD or VE supplementation has the potential to improve gut health, modulate the immune response, and increase egg production in coccidiosis-infected laying hens.

Antioxidants and Fertility in Women with Ovarian Aging: A Systematic Review and Meta-Analysis.

Ovarian aging is a major factor for female subfertility. Multiple antioxidants have been applied in different clinical scenarios, but their effects on fertility in women with ovarian aging are still unclear. To address this, a meta-analysis was performed to evaluate the effectiveness and safety of antioxidants on fertility in women with ovarian aging. A total of 20 randomized clinical trials with 2617 participants were included. The results showed that use of antioxidants not only significantly increased the number of retrieved oocytes and high-quality embryo rates but also reduced the dose of gonadotropin, contributing to higher clinical pregnancy rates. According to the subgroup analysis of different dose settings, better effects were more pronounced with lower doses; in terms of antioxidant types, coenzyme Q10 (CoQ10) tended to be more effective than melatonin, myo-inositol, and vitamins. When compared with placebo or no treatment, CoQ10 showed more advantages, whereas small improvements were observed with other drugs. In addition, based on subgroup analysis of CoQ10, the optimal treatment regimen of CoQ10 for improving pregnancy rate was 30 mg/d for 3 mo before the controlled ovarian stimulation cycle, and women with diminished ovarian reserve clearly benefited from CoQ10 treatment, especially those aged <35 y. Our study suggests that antioxidant consumption is an effective and safe complementary therapy for women with ovarian aging. Appropriate antioxidant treatment should be offered at a low dose according to the patient's age and ovarian reserve. This study was registered at PROSPERO as CRD42022359529.

Effects of vitamin D supplementation on oxidative stress biomarkers of Iranian women with polycystic ovary syndrome: a meta-analysis study.

Objective: To identify the impact of redox imbalance on the clinical evolution of patients with polycystic ovary syndrome and carry out a qualitative and quantitative projection of the benefits of vitamin D supplementation. Data sources: Combinations of the keywords polycystic ovary syndrome, vitamin D, oxidative stress, reactive oxygen species, antioxidant, and free radicals were used in PubMed, Cochrane Library, LILACS, EMBASE, and Web of Science databases. The last search was conducted on August 22, 2023.Selection of studies: Based on the inclusion and exclusion criteria, studies were selected considering a low risk of bias, published in the last 5 years in English, which investigated the effects of vitamin D supplementation in women with PCOS, focusing on oxidative stress markers. Of the 136 articles retrieved, 6 intervention studies (445 women) were included. Data collection: The risk of bias in included studies was assessed using the Jadad scale, and analysis and visualization of continuous data were performed using Review Manager 5.4.1, summarized as standardized mean differences (SMD) with confidence intervals (CI) of 95%. Data synthesis: Vitamin D effectively reduced malondialdehyde (P=0.002) and total testosterone (P=0.0004) levels and increased total antioxidant capacity levels (P=0.01). Although possible improvements in the modified Ferriman-Gallwey hirsutism score, levels of sex hormone-binding globulin, and free androgen index were identified and the results were not statistically significant. Conclusion: Vitamin D is a promising alternative for the treatment of PCOS with a positive influence on the oxidative, metabolic, and endocrine disorders of this syndrome.

Bioactives in Oral Nutritional Supplementation: A Pediatric Point of View.

BACKGROUND: Oral nutritional supplements (ONSs) are crucial for supporting the nutritional needs of pediatric populations, particularly those with medical conditions or dietary deficiencies. Bioactive compounds within ONSs play a pivotal role in enhancing health outcomes by exerting various physiological effects beyond basic nutrition. However, the comprehensive understanding of these bioactives in pediatric ONSs remains elusive. OBJECTIVE: This systematic narrative review aims to critically evaluate the existing literature concerning bioactive compounds present in oral nutritional supplements from a pediatric standpoint, focusing on their types, sources, bioavailability, physiological effects, and clinical implications. METHODS: A systematic search was conducted across the major academic databases, including PubMed, Scopus, and Web of Science, employing predefined search terms related to oral nutritional supplements, bioactives, and pediatrics. Studies published between 2013 and 2024 were considered eligible for inclusion. Data extraction and synthesis were performed according to the PRISMA guidelines. RESULTS: The initial search yielded 558 of articles, of which 72 met the inclusion criteria. The included studies encompassed a diverse range of bioactive compounds present in pediatric ONS formulations, including, but not limited to, vitamins, minerals, amino acids, prebiotics, probiotics, and phytonutrients. These bioactives were sourced from various natural and synthetic origins and were found to exert beneficial effects on growth, development, immune function, gastrointestinal health, cognitive function, and overall well-being in pediatric populations. However, variations in bioavailability, dosing, and clinical efficacy were noted across different compounds and formulations. CONCLUSIONS: Bioactive compounds in oral nutritional supplements offer promising avenues for addressing the unique nutritional requirements and health challenges faced by pediatric populations. However, further research is warranted to elucidate the optimal composition, dosage, and clinical applications of these bioactives in pediatric ONS formulations. A deeper understanding of these bioactive compounds and their interplay with pediatric health may pave the way for personalized and effective nutritional interventions in pediatric clinical practice.