Exploring the Influence of Gut-Brain Axis Modulation on Cognitive Health: A Comprehensive Review of Prebiotics, Probiotics, and Symbiotics.

Recent research exploring the relationship between the gut and the brain suggests that the condition of the gut microbiota can influence cognitive health. A well-balanced gut microbiota may help reduce inflammation, which is linked to neurodegenerative conditions. Prebiotics, probiotics, and symbiotics are nutritional supplements and functional food components associated with gastrointestinal well-being. The bidirectional communication of the gut-brain axis is essential for maintaining homeostasis, with pre-, pro-, and symbiotics potentially affecting various cognitive functions such as attention, perception, and memory. Numerous studies have consistently shown that incorporating pre-, pro-, and symbiotics into a healthy diet can lead to improvements in cognitive functions and mood. Maintaining a healthy gut microbiota can support optimal cognitive function, which is crucial for disease prevention in our fast-paced, Westernized society. Our results indicate cognitive benefits in healthy older individuals with probiotic supplementation but not in healthy older individuals who have good and adequate levels of physical activity. Additionally, it appears that there are cognitive benefits in patients with mild cognitive impairment and Alzheimer's disease, while mixed results seem to arise in younger and healthier individuals. However, it is important to acknowledge that individual responses may vary, and the use of these dietary supplements should be tailored to each individual's unique health circumstances and needs.

Improving Cognitive Function with Nutritional Supplements in Aging: A Comprehensive Narrative Review of Clinical Studies Investigating the Effects of Vitamins, Minerals, Antioxidants, and Other Dietary Supplements.

Cognitive impairment and dementia are burgeoning public health concerns, especially given the increasing longevity of the global population. These conditions not only affect the quality of life of individuals and their families, but also pose significant economic burdens on healthcare systems. In this context, our comprehensive narrative review critically examines the role of nutritional supplements in mitigating cognitive decline. Amidst growing interest in non-pharmacological interventions for cognitive enhancement, this review delves into the efficacy of vitamins, minerals, antioxidants, and other dietary supplements. Through a systematic evaluation of randomized controlled trials, observational studies, and meta-analysis, this review focuses on outcomes such as memory enhancement, attention improvement, executive function support, and neuroprotection. The findings suggest a complex interplay between nutritional supplementation and cognitive health, with some supplements showing promising results and others displaying limited or context-dependent effectiveness. The review highlights the importance of dosage, bioavailability, and individual differences in response to supplementation. Additionally, it addresses safety concerns and potential interactions with conventional treatments. By providing a clear overview of current scientific knowledge, this review aims to guide healthcare professionals and researchers in making informed decisions about the use of nutritional supplements for cognitive health.

The Possible Role of Food and Diet in the Quality of Life in Patients with COPD-A State-of-the-Art Review.

Diet has been described as a modifiable risk factor for the development and progression of chronic diseases, and emerging evidence increasingly points to its preventive and therapeutic role in chronic obstructive pulmonary disease (COPD). While the relationship between the underlying disease and diet is natural in conditions such as metabolic disorders, obesity, diabetes, etc., the direct effect is not so evident in chronic obstructive pulmonary disease. Poor diet quality and the development of nutrient deficiencies in respiratory diseases, including COPD, can be associated with disease-specific factors such as the exacerbation of respiratory symptoms. These symptoms can be improved by dietary interventions, leading to positive changes in the pathogenesis of the disease and the quality of life of patients. Therefore, our aim was to review the latest randomized controlled trials (RCTs) of dietary interventions in chronic respiratory patients and describe their effects on respiratory function, physical activity, systemic inflammatory parameters, and quality of life. We conducted a literature search on dietary interventions for COPD patients in the PubMed, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, focusing on publications from 1 July 2018 to 1 July 2023. We used specific keywords and MESH terms, focusing on RCTs. A total of 26 articles and 1811 COPD patients were included in this review. On the basis of our findings, dietary interventions, in particular components of the Mediterranean diet such as protein, omega-3 polyunsaturated fatty acids, and vegetables, appear to have beneficial effects in patients with chronic respiratory diseases, and their application is beneficial. However, long-term follow-up studies are still needed to examine the effects of dietary interventions in this patient population.

Freedive Training Gives Additional Physiological Effect Compared to Pulmonary Rehabilitation in COPD.

INTRODUCTION: Pulmonary rehabilitation (PR) is beneficial for lung mechanics, chest kinematics, metabolism, and inspiratory and peripheral muscle function. Freediving training (FD) can be effective in sportsmen and can improve breath-holding time. AIMS: We sought to determine the effectiveness of freediving training in the pulmonary rehabilitation of COPD patients. PATIENTS AND METHODS: Twenty-three COPD patients (15 men and 8 women; median age 63 years; FEV1: 41% pred; BMI: 28 kg/m2) participated in the FD + PR group (3 weeks PR and 3 weeks FD + PR) and 46 patients with COPD (25 men and 21 women; median age 66 years; FEV1: 43% pred; BMI: 27 kg/m2) participated in an inpatient PR program (6 weeks). Patients performed comfort zone breath holding for 30 min/day. Patients increased their breath-holding time within their comfort zone for 30 min. We detected lung function, chest expansion (CWE), inspiratory muscle pressure (MIP), peripheral muscle function (GS), and exercise capacity (6MWD), and we included breath-holding time (BHT), quality of life score (COPD Assessment Test (CAT)), modified Medical Research Dyspnea Scale (mMRC) score, and the severity of the disease assessed by the BODE index (FEV1, BMI, 6MWD, and mMRC) and an alternative scale (FEV1, BMI, 6MWD, and CAT). RESULT: There were significant differences in the characteristics of the two groups. Significant improvement was detected in all functional and quality of life parameters except lung function in both groups. Significantly higher improvement was detected in CWE, GS, 6MWD, BHT, CAT, mMRC, alternative scale, and MIP. The improvement in forced vital capacity (FVC) was not significant. There were no side effects of FD training. CONCLUSION: The FD method can potentiate the effect of PR, improving not only BHT but also other parameters. TRIAL REGISTRATION: ISRCTN ISRCTN13019180. Registered 19 December 2017.

Effect of interval training with non-invasive ventilation in severe chronic obstructive pulmonary disease-a prospective cohort study with matched control group.

BACKGROUND: In severe chronic obstructive pulmonary disease (COPD), interval training (IT) can be performed with oxygen support, which provides beneficial effect on metabolic processes, tissue perfusion, and peripheral muscle function. METHODS: A prospective cohort study with matched controls was performed on patients in Budapest at the Department of Pulmonary Rehabilitation of the National Koranyi Institute of Pulmonology between January 1, 2020 and March 1, 2020. After a complex condition assessment, both case and control patients participated in a 3-week long complex pulmonary rehabilitation (PR) program that included individual training, education, nutrition, and psychological counseling. Anthropometric and functional data of patients were recorded at both the beginning and end of the PR program. Our research aimed to assess the effect of non-invasive ventilation (NIV) in patients with severe COPD who underwent IT. RESULTS: A total of 18 [male/female: 10 (55.6%)/8 (44.4%)] patients were enrolled in our study. IT with NIV significantly improved the patients' 6-minute walking distance (6MWD) (m) [216.0 (211.5-233.7) vs. 274.0 (247.5-313.5); P<0.001] and quality of life [COPD Assessment Test (CAT): 29.0 (26.9-32.0) vs. 15.0 (13.5-17.5); P<0.001], [modified Medical Research Council (mMRC): 2.0 (1.5-2.0) vs. 1.0 (1.0-2.0); P=0.009]; in addition, there was a significant increase in inspiratory vital capacity (IVC) (ref%) [65.0 (63.0-69.0) vs. 74.7 (70.5-75.0); P=0.015], in chest kinematics (cm) [3.0 (2.5-4.0) vs. 5.5 (4.0-6.5); P<0.001], work rate (Watt) [25.0 (24.0-27.0) vs. 36.0 (35.0-38.0); P<0.001], volume of oxygen consumption [VO2/kg (mL/kg/min): 8.8 (8.5-9.2) vs. 10.3 (10.2-10.7); P<0.001], and Body-mass index, airflow Obstruction, Dyspnea, and Exercise (BODE) index [5.0 (5.0-6.7) vs. 4.0 (3.0-5.0); P=0.006], while the results of the control group were non-significant [6MWD, maximal inspiratory pressure (MIP), CAT, mMRC, BODE index]. CONCLUSIONS: In severe COPD, IT with NIV is well tolerated during PR, it has a significant beneficial effect on the quality of life, improves exercise capacity and respiratory functions, decreases dynamic hyperinflation and dyspnea.