Changes in Bone Mineral Density in Patients With Non-dialysis-Dependent Chronic Kidney Disease Are Associated With Body Composition.

OBJECTIVE: Chronic kidney disease (CKD) and low bone mineral density (BMD) are highly prevalent and can co-exist. Parameters of mineral metabolism are associated with BMD in CKD, but other contributing factors may contribute. The aim of this study was to assess changes in BMD and its determinants in patients with nondialysis-dependent CKD (NDD-CKD). METHODS: Body composition and biochemical profiles were assessed in a retrospective hospital-based cohort study of patients with NDD-CKD. BMD, lean soft tissue (LST), appendicular LST (ALST), and percentage fat mass were assessed by dual-energy X-ray absorptiometry. The ALST index (ALSTI, ALST/height2) and load-capacity index (LCI, fat mass/LST) were calculated. Low BMD was defined as T-score ≤ -1.0. RESULTS: The mean time between assessments was 2.8 ± 1.3 years; 46 patients were included. A reduction in renal function was observed. Changes in body composition included reductions in ALST (P = .031), ALSTI (P = .021), a trend for BMD (P = .053), and an increase in percentage fat mass (P = .044) and LCI (P = .032). Females had a reduction in BMD (P = .034), ALST (P = .026), and ALSTI (P = .037). Patients with low BMD at baseline had lower LST (P = .013), ALST (P = .023), and percentage fat mass (P = .037) than those with normal BMD. Additionally, reductions in LST (P = .041), ALST (P = .006), and ALSTI (P = .008) were observed in patients who had low BMD at baseline, while no significant changes in body composition were observed in those with normal BMD at baseline. The following body composition parameters at baseline were determinants of BMD status at follow-up: LST (odds ratio [OR]: 0.899, 95% confidence interval [CI]: 0.829-0.976, P = .010), ALST (OR: 0.825, 95% CI: 0.704-0.967, P = .017), and ALSTI (OR: 0.586, 95% CI: 0.354-0.968, P = .037), independent of fat mass and LCI. CONCLUSIONS: Detrimental body composition changes were observed without changes in body weight; these were more significant in females. Moreover, this is the first longitudinal study showing a protective effect of LST against BMD loss in patients with NDD-CKD.

Physicochemical Characterization, Antioxidant Capacity, and Sensory Properties of Murici (Byrsonima crassifolia (L.) Kunth) and Taperebá (Spondias mombin L.) Beverages.

Amazonian fruits are excellent sources of bioactive compounds and can be used in beverages to improve the nutritional and sensorial characteristics. The present study aimed to develop a blend of murici (Byrsonima Crassifolia (L.) Kunth) and taperebá (Spondias Mombin L.) through experimental design and investigating the nutritional and sensorial characteristics of fruits and beverages. The murici was highlighted as higher vitamin C content (58.88 mg · 100 g-1) compared to taperebá (25.93 mg · 100 g-1). The murici and taperebá are good sources of total phenolic compounds (taperebá 1304.15 ± 19.14 mgGAE · 100 g-1 and the murici of 307.52 ± 19.73 mg GAE · 100 g-1) and flavonoids (174.87 ± 1.76 µgQE/g and 129.46 ± 10.68 µgQE/g, murici and taperebá, respectively), when compared to other Brazilian fruits. The antioxidant capacity in different methods revealed that the taperebá had a higher average in the results, only in the ORAC method and did not present a significant difference (p > 0.05) in relation to the murici. The beverage development was performed using experimental design 23, showed through sensory analysis and surface response methodology that murici and high sugar content (between 12.5 and 14.2% of sugar) influenced in sensory acceptance. Our findings indicate that beverages with improved nutrition and a sensory acceptance can be prepared using taperebá and murici fruits.

Antiproliferative Activity on Human Colon Adenocarcinoma Cells and In Vitro Antioxidant Effect of Anthocyanin-Rich Extracts from Peels of Species of the Myrtaceae Family.

There is a significant indication of the beneficial health effects of fruit rich diets. Fruits of native plant species have noticeably different phytochemicals and bioactive effects. The aim of this work was to characterize and compare the constituents of jabuticaba (Myrciaria jaboticaba, MJ), jamun-berry (Syzygium cumini, SC), and malay-apple (Syzygium malaccense, SM) extracts and their influence on antioxidant activity in vitro and antiproliferative effects on human colon adenocarcinoma cells. According to the results, dried peel powders (DP) have a high anthocyanin content, phenolic compounds, and antioxidant activity when compared to freeze dried extracts (FD). M. jaboticaba dried peel powder extract had a higher total anthocyanin and phenolic compounds content (802.90 ± 1.93 and 2152.92 ± 43.95 mg/100 g, respectively). A reduction in cell viability of HT-29 cells after treatment with M. jaboticaba extracts (DP-MJ and FD-MJ) was observed via MTT assay. Flow cytometry showed that the treatment with the anthocyanin-rich extracts from MJ, SC, and SM had an inhibitory impact on cell development due to G2/M arrest and caused a rise in apoptotic cells in relation to the control group. The findings of this study highlight the potential of peel powders from Myrtaceae fruits as an important source of natural antioxidants and a protective effect against colon adenocarcinoma.

Metabolite Profiling by UPLC-MSE, NMR, and Antioxidant Properties of Amazonian Fruits: Mamey Apple (Mammea Americana), Camapu (Physalis Angulata), and Uxi (Endopleura Uchi).

The metabolite profiling associated with the antioxidant potential of Amazonian fruits represents an important step to the bioactive compound's characterization due to the large biodiversity in this region. The comprehensive bioactive compounds profile and antioxidant capacities of mamey apple (Mammea americana), camapu (Physalis angulata), and uxi (Endopleura uchi) was determined for the first time. Bioactive compounds were characterized by ultra-performance liquid chromatography coupled to high resolution mass spectrometry (UPLC-MSE) in aqueous and ethanolic extracts. Globally, a total of 293 metabolites were tentatively identified in mamey apple, campau, and uxi extracts. The main classes of compounds in the three species were terpenoids (61), phenolic acids (58), and flavonoids (53). Ethanolic extracts of fruits showed higher antioxidant activity and total ion abundance of bioactive compounds than aqueous. Uxi had the highest values of phenolic content (701.84 mg GAE/100 g), ABTS (1602.7 µmol Trolox g-1), and ORAC (15.04 µmol Trolox g-1). Mamey apple had the highest results for DPPH (1168.42 µmol TE g-1) and FRAP (1381.13 µmol FSE g-1). Nuclear magnetic resonance (NMR) spectroscopy results showed that sugars and lipids were the substances with the highest amounts in mamey apple and camapu. Data referring to chemical characteristics and antioxidant capacity of these fruits can contribute to their economic exploitation.

Estimating Muscle Mass Using D3-Creatine Dilution: A Narrative Review of Clinical Implications and Comparison With Other Methods.

BACKGROUND: The D3-creatine (D3-Cr) dilution method is of emerging interest for estimating total-body skeletal muscle mass. This review explores the association of muscle mass estimated via D3-Cr with various clinical outcomes and provides a summary of the literature comparing D3-Cr with other body composition techniques. METHODS: A literature search was conducted on PubMed/MEDLINE and Web of Science for studies using D3-Cr to measure muscle in adult populations (ie, ≥18 years old) from inception until September 2023. RESULTS: Out of the 23 included studies, 15 investigated the correlation between D3-Cr and clinical outcomes. More consistent associations were reported for mortality (100%, n = 2), mobility disability (100%; n = 5), falls and fractures (100%; n = 3), physical performance (63.3%; n = 11), muscle strength (44.4%; n = 9), and muscle composition (33.3%; n = 3). However, conflicting findings were also reported for such correlations. Among the 23 studies, 14 compared D3-Cr-estimated muscle with other body composition techniques, including magnetic resonance imaging (MRI) as a reference method. Strong and positive correlations were found between D3-Cr and MRI. Nonetheless, variations in muscle measurements were noted, with differences in D3-Cr values ranging from 0.62 kg lower to 13.47 kg higher compared to MRI. CONCLUSIONS: D3-Cr-estimated muscle mass may be a valuable predictor of clinical outcomes showing consistent associations with falls and fractures, mobility disability, and mortality. However, less consistent associations were found with muscle strength and composition, and physical performance. Although a strong correlation exists between D3-Cr-estimated muscle mass and MRI measurements, under- or overestimation may occur.

Exploring the Influence of Gut Microbiome on Energy Metabolism in Humans.

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

Impact of a Powdered Meal Replacement on Metabolism and Gut Microbiota (PREMIUM) in individuals with excessive body weight: a study protocol for a randomised controlled trial.

INTRODUCTION: Excess body weight is associated with a state of low-grade chronic inflammation and alterations of the gut microbiome. Powdered meal replacements (PMR) have been shown to be an effective strategy for weight management; however, their effect on inflammation and the gut microbiome remains unclear. The aim of this 12-week randomised control clinical trial is to investigate the effects of PMR consumption, here given as a soy-yoghurt-honey formula, on inflammation, gut microbiome and overall metabolism in individuals with excessive body weight. METHODS AND ANALYSIS: Healthy adults with excess body weight (n=88) are being recruited and randomly assigned to one of the following groups: (1) Control group (CON): maintaining usual diet for 12 weeks, or (2) PMR group: replacing morning and afternoon snacks daily with a PMR for 12 weeks. Participants are asked to maintain body weight throughout the study and fill out a journal with information about PMR consumption, body weight, food intake, appetite sensations and medications. Three study visits are required: baseline, week 6 and week 12. Outcome measures include systemic inflammatory biomarkers, gut microbiome composition, metabolic blood markers, host energy metabolism, body composition, appetite sensations and host gene expression profile. ETHICS AND DISSEMINATION: This research protocol was approved by the University of Alberta Ethics Board (Pro00070712) and adheres to the Canadian Tri-Council Policy statement on the use of human participants in research. Procedures and potential risks are fully discussed with participants. Study findings will be disseminated in peer-reviewed journals, conference presentations and social media. TRIAL REGISTRATION NUMBER: NCT03235804.

Molecular Mechanisms of Coffee on Prostate Cancer Prevention.

Prostate cancer (PCa) is one of the most common types of cancer among men, and coffee is associated with a reduced risk of developing PCa. Therefore, we aim to review possible coffee molecular mechanisms that contribute to PCa prevention. Coffee has an important antioxidant capacity that reduces oxidative stress, leading to a reduced mutation in cells. Beyond direct antioxidant activity, coffee stimulates phase II enzymatic activity, which is related to the detoxification of reactive metabolites. The anti-inflammatory effects of coffee reduce tissue damage related to PCa development. Coffee induces autophagy, regulates the NF-κB pathway, and reduces the expression of iNOS and inflammatory mediators, such as TNF-α, IL-6, IL-8, and CRP. Also, coffee modulates transcriptional factors and pathways. It has been shown that coffee increases testosterone and reduces sex hormone-binding globulin, estrogen, and prostate-specific antigen. Coffee also enhances insulin resistance and glucose metabolism. All these effects may contribute to protection against PCa development.

Joint attention in infants at high familial risk for autism spectrum disorder and the association with thalamic and hippocampal macrostructure.

Autism spectrum disorder (ASD) is a heritable neurodevelopmental disorder. Infants diagnosed with ASD can show impairments in spontaneous gaze-following and will seldom engage in joint attention (JA). The ability to initiate JA (IJA) can be more significantly impaired than the ability to respond to JA (RJA). In a longitudinal study, 101 infants who had a familial risk for ASD were enrolled (62% males). Participants completed magnetic resonance imaging scans at 4 or 6 months of age. Subcortical volumes (thalamus, hippocampus, amygdala, basal ganglia, ventral diencephalon, and cerebellum) were automatically extracted. Early gaze and JA behaviors were assessed with standardized measures. The majority of infants were IJA nonresponders (n = 93, 92%), and over half were RJA nonresponders (n = 50, 52%). In the nonresponder groups, models testing the association of subcortical volumes with later ASD diagnosis accounted for age, sex, and cerebral volumes. In the nonresponder IJA group, using regression method, the left hippocampus (B = -0.009, aOR = 0.991, P = 0.025), the right thalamus (B = -0.016, aOR = 0.984, P = 0.026), as well as the left thalamus (B = 0.015, aOR = 1.015, P = 0.019), predicted later ASD diagnosis. Alterations in thalamic and hippocampal macrostructure in at-risk infants who do not engage in IJA may reflect an enhanced vulnerability and may be the key predictors of later ASD development.

Osteosarcopenia in patients with non-dialysis dependent chronic kidney disease.

INTRODUCTION: Chronic kidney disease (CKD) is associated with a reduction in bone mineral density (BMD), but less is understood regarding the relation between BMD and muscle mass, especially in non-dialysis dependent-CKD (NDD-CKD). The aim of this study was to explore the prevalence and association of low BMD (osteopenia and osteoporosis) with markers of muscle mass and function in patients with NDD-CKD. METHODOLOGY: This cross-sectional observational study included patients with NDD-CKD. Routine biochemical parameters including those related to mineral and bone metabolism were evaluated. Body composition was assessed by dual energy x-ray absorptiometry (DXA) for BMD (g/cm2), total and trunk body fat (%), total lean soft tissue (LST; kg), and appendicular skeletal muscle mass (ASM; kg) as the sum of the LST from the limbs. The latter two variables were used as markers of muscle mass, together with its height indexed values: ASM/height2 as ASM index (ASMI; kg/m2), and LST/height2 as LST index (LSTI, kg/m2). Muscle quality index (MQI) was calculated as handgrip strength (HGS)/mean ASMarms (kg/kg). Osteosarcopenia was defined according to referenced cut-points for patients presenting with low ASMI, HGS and BMD. RESULTS: Patients (n = 257, 57.6% males) had a mean age = 64.8 ± 12.9 years, estimated glomerular filtration rate (eGFR) = 30.1 ± 12.9 ml/min and body mass index (BMI) = 26.8 ± 4.8 kg/m2. Patients with low BMD (39.4%) presented with lower BMI, LST, LSTI, ASM and ASMI for both sexes. BMD was positively and significantly correlated with LST, LSTI, ASM, ASMI and HGS. Low ASM was associated with low BMD (odds-ratio-OR; 95% confidence interval-CI: males OR = 4.54, 2.02-10.21; females OR = 4.45, 1.66-11.93). Linear multiple regression analysis (adjusted for sex and eGFR) showed significant associations between T-score with HGS (R2 = 0.288, R2 adjusted = 0.272, standardized coefficient ß = 0.536, p < 0.0001) and also with MQI (R2 = 0.095, R2 adjusted = 0.075, standardized coefficient ß = 0.309, p = 0.024). Osteosarcopenia was present in about 7% of participants and similarly distributed between sexes. CONCLUSION: Low BMD was prevalent, and associated with low markers of muscle mass and quality, in NDD-CKD patients of both sexes. In view of the known significance of these conditions, targeted interventions are needed to optimize body composition and functional status of these patients.

Bioactive compounds, antioxidant activity and antiproliferative effects in prostate cancer cells of green and roasted coffee extracts obtained by microwave-assisted extraction (MAE).

Coffee consumption has been investigated as a protective factor against prostate cancer. Coffee may be related to prostate cancer risk reduction due to its phytochemical compounds, such as caffeine, chlorogenic acids, and trigonelline. The roasting process affects the content of the phytochemicals and undesired compounds can be formed. Microwave-assisted extraction is an alternative to conventional extraction techniques since it preserves more bioactive compounds. Therefore, this study aimed to evaluate the phytochemical composition and the putative preventive effects in prostate cancer development of coffee beans submitted to four different coffee-roasting degrees extracted using microwave-assisted extraction. Coffea arabica green beans (1) were roasted into light (2), medium (3) and dark (4) and these four coffee samples were submitted to microwave-assisted extraction. The antioxidant capacity of these samples was evaluated by five different methods. Caffeine, chlorogenic acid and caffeic acid were measured through HPLC. Samples were tested against PC-3 and DU-145 metastatic prostate cancer cell lines regarding their effects on cell viability, cell cycle progression and apoptotic cell death. We found that green and light roasted coffee extracts had the highest antioxidant activity. Caffeine content was not affected by roasting, chlorogenic acid was degraded due to the temperature, and caffeic acid increased in light roasted and decreased in medium and dark roasted. Green and light roasted coffee extracts promoted higher inhibition of cell viability, caused greater cell cycle arrest in S and G2/M and induced apoptosis more compared to medium and dark roasted coffee extracts and the control samples. Coffee extracts were more effective against DU-145 than in PC-3 cells. Our data provide initial evidence that among the four tested samples, the consumption of green and light coffee extracts contributes to inhibit prostate cancer tumor progression features, potentially preventing aspects related to advanced prostate cancer subtypes.

Fruit-based drink sensory, physicochemical, and antioxidant properties in the Amazon region: Murici (Byrsonima crassifolia (L.) Kunth and verbascifolia (L.) DC) and tapereba (Spondia mombin).

Increased fruit consumption due its protective effect on the organism is accompanied by the development of the processing industry of these products. The aim of this work was to optimize fruit pulp-based beverage formulations from the murici and tapereba Amazon region, taking into account their sensory acceptance and antioxidant activity. Total soluble solid content, reducing sugar content, titratable acidity contents, pH, and ascorbic acid content were determined in pulps and formulations. The total content phenolic compounds and antioxidant activity were also evaluated. A 22 factorial experiment was formulated to optimize ingredients for the production of murici and tapereba fruit drinks. The murici pulp had higher acidity and higher ascorbic acid content. The analysis of phenolic compounds and antioxidant activity presented higher quantity in tapereba pulp. Tapereba-based beverages had better acceptance by the evaluated criteria. Fruit-based beverages murici and tapereba are a well-accepted product and have important nutritional characteristics.

Effect of the roasting levels of Coffea arabica L. extracts on their potential antioxidant capacity and antiproliferative activity in human prostate cancer cells.

Coffee, besides being one of the most consumed stimulating beverages in the world, has important bioactive activities, which have been attracting increasing attention from researchers. However, the standard process of roasting causes changes in its chemical composition. In the present study, extracts obtained from green and roasted beans (light, medium and dark) of Coffea arabica Linnaeus were submitted to high-power ultrasonic extraction and atomization by spray drying. Colorimetric analysis was used to classify the roasting levels of the dried extract samples. The effects of the roasting process on the bioactivity of the dried extracts were verified through the following assays: caffeine, chlorogenic acid and caffeic acid, by HPLC-PDA; total phenolics by Folin-Ciocalteu; antioxidant activity by DPPH, FRAP, ABTS and ORAC; antiproliferative activity, using the MTT assay; and cell cycle and apoptosis by flow cytometry in metastatic prostate cancer cell lines from bone (PC-3) and brain (DU-145). The results showed that the lowest levels of caffeine, chlorogenic and caffeic acids were observed in dark roasted coffee. In comparison to medium and dark extracts in PC-3 cells, the green and light coffee extracts had higher antioxidant activities and promoted cytotoxicity followed by cell cycle arrest in phase S and apoptosis induction. Thus, the roasting level of the coffee extracts may be related to the potential chemoprotective effects of Coffea arabica L. in prostate cancer cells.

Efectos de la exposición de adultos mayores peruanos a la infodemia sobre COVID-19: um estudio transversal / Efeitos da exposição de idosos à infodemia sobre COVID-19: um estudo transversal / Effects of the exposure of peruvian older adults to the infodemic on COVID-19: a cross-sectional study

Resumen Objetivo Examinar la asociación entre la exposición a la información sobre COVID-19 y la presencia de síntomas fisiológicos, emocionales y el uso de sustancias en adultos mayores. Métodos Investigación cuantitativa y transversal con 387 adultos mayores que respondieron al web-based survey. Se utilizaron los instrumentos de perfil demográfico, cuestionario de exposición a noticias e información relacionada con la pandemia y el Cuestionario de Identificación de Frecuencia de Signos y Síntomas físicos, emocionales y uso de sustancias. Todas las pruebas estadísticas tuvieron una significancia de p<0.05. Resultados Predominaron participantes del sexo femenino con media de edad de 70.1 años, viven con pareja, con acceso a los servicios de salud gratuitos y quienes disminuyeron sus ingresos económicos durante la pandemia. Existe relación significativa entre el tiempo de exposición a internet y medios de comunicación con las manifestaciones psicofisiológicos; la radio se relacionó con problemas digestivos y nutricionales, y el contacto con personas del entorno provocó dolores musculares. Conclusiones e implicaciones para la práctica Información exagerada sobre COVID-19 provocó síntomas fisiológicos, emocionales y comportamientos nocivos; se sugiere implementar intervenciones sociales post-pandemia para los problemas de salud; utilizar herramientas virtuales y telemedicina en el cuidado; mejorar los programas de acompañamiento intergeneracional.

Resumo Objetivo Examinar a associação entre exposição a informações sobre COVID-19 e a presença de sintomas fisiológicos e emocionais e uso de substâncias em idosos. Métodos Pesquisa quantitativa e transversal com 387 idosos que responderam ao web-based survey. Foram utilizados os instrumentos de perfil demográfico, o questionário sobre exposição a notícias e informações relacionadas à pandemia e o Questionário para Identificação da Frequência de Sinais e Sintomas físicos e emocionais e uso de substâncias. Todos os testes estatísticos tiveram significância de p<0,05. Resultados Predominaram participantes do sexo feminino com média de idade de 70,1 anos, vivendo com companheiro, com acesso a serviços de saúde gratuitos e que diminuíram sua renda econômica durante a pandemia. Existe uma relação significativa entre o tempo de exposição à internet e outros meios de comunicação com manifestações psicofisiológicas; o rádio estava relacionado a problemas digestivos e nutricionais; e o contato com pessoas ao redor causava dores musculares. Conclusões e implicações para a prática Informações exageradas sobre a COVID-19 levaram a sintomas e comportamentos fisiológicos e emocionais nocivos; sugere-se a implementação de intervenções sociais pós-pandemia para problemas de saúde; utilizar ferramentas virtuais e telemedicina no atendimento; melhorar os programas de apoio intergeracional.

Abstract Objective To examine the association between exposure to information about Covid-19 and the presence of physiological and emotional symptoms and substance use in older adults. Methods Quantitative and cross-sectional research with 387 older adults who responded to the web-based survey. Were used the instruments of demographic profile, the questionnaire of exposure to news and information related to the pandemic and, the Questionnaire for the Identification of Frequency of Physical and Emotional signs and symptoms and substance use. All statistical tests had a significance of p<0.05. Results There was a predominance of female participants with an average age of 70.1 years, living with a partner, with access to free health services and had a decrease in their economic income during the pandemic. There is a significant relationship between the time of exposure to the Internet and the media with the psychophysiological manifestations; the radio was related to digestive and nutritional problems and, talking to people around caused muscle pain. Conclusions and implications for practice exaggerated information about Covid-19 led to harmful physiological and emotional symptoms and behaviors; it is suggested to implement post-pandemic social interventions for health problems; use virtual tools and telemedicine in care; improve intergenerational support programs.

A good training based on insufficiency: Work in health care as an ethics.

The article discusses psychology training in health care at the Federal University of São Paulo. It places curriculum guidelines in a changing movement of training for health professions, proposing Work in Health Care as one of its common axes. In the Baixada Santista campus, the course is based on learning by experience, public health services and multidisciplinary team work. Three vectors derived from the experience in this project and its assessment are discussed: a common clinic, work in health care as an ethics and the idea of good training by insufficiency.