How does coconut oil affect cognitive performance in alzheimer patients? / Influencia del aceite de coco en enfermos de alzhéimer a nivel cognitivo

Introduction: Alzheimer's disease is one of the most prevalent neurodegenerative dementia in developed world. This fact, coupled with the lack cure, makes new no pharmacological therapeutic strategies such as nutrient management to investigate. In this regard, it stresses the possible influence of coconut oil as alternative energy source capable of stopping the progressively neuronal death that occurs in this disease. Objectives: To assess the cognitive impact of coconut oil in Alzheimer's patients, and specifically in orientation, language-building, fixing, calculation-concentration and memory areas. Methods: Prospective, longitudinal, qualitative, analytical and experimental study through a clinical trial where 44 patients with Alzheimer's in region of Ribera (Valencia), of which half was selected to receive during 21 days, 40 ml coconut oil daily divided between breakfast (20 ml) and food (20 ml). Before and after administration of the oil, they were evaluated through cognitive test Mini-Mental State Examination to determine possible changes. Results: It was observed in patients who received coconut oil, that cognitive improvement after completion of the intervention, statistically significant improved in the orientation and language-construction areas. Conclusions: Coconut oil appears to improve cognitive abilities of Alzheimer's patients, with different intensity depending on the cognitive area.

Introducción: la enfermedad de Alzheimer es a día de hoy la demencia neurodegenerativa con mayor prevalencia en el primer mundo. Este hecho, unido a la falta de tratamiento farmacológico que cure la enfermedad, hace que se estudien nuevas estrategias terapéuticas no farmacológicas como es la administración de nutrientes. En este sentido, destaca la posible influencia del aceite de coco como fuente energética alternativa, capaz de frenar la muerte neuronal que se produce de modo progresivo en esta enfermedad. Objetivos: valorar el impacto del aceite de coco a nivel cognitivo en pacientes de alzhéimer, y concretamente en las áreas de orientación, lenguaje-construcción, fijación, cálculo-concentración y memoria. Métodos: estudio prospectivo, longitudinal, cualitativo, analítico y experimental a través de un ensayo clínico, donde se seleccionaron a 44 pacientes con alzhéimer de la zona de la Ribera (Comunidad Valenciana), de los cuales a la mitad se le administró durante 21 días, 40 ml diarios de aceite de coco repartidos entre desayuno (20 ml) y comida (20 ml). Antes y después de la administración del aceite, se les valoró a través del test cognitivo Mini-Examen Cognoscitivo, para determinar los posibles cambios. Resultados: en los enfermos que tomaron el aceite de coco se observó una mejora cognitiva tras finalizar la intervención, siendo estadísticamente significativa en las áreas de orientación y lenguaje-construcción. Conclusiones: el aceite de coco parece mejorar la capacidad cognitiva de los enfermos de alzhéimer, variando la intensidad de la misma en función del área cognitiva.

Gene expression changes in colon tissues from colorectal cancer patients following the intake of an ellagitannin-containing pomegranate extract: a randomized clinical trial.

The clinical evidence of dietary polyphenols as colorectal cancer (CRC) chemopreventive compounds is very weak. Verification in humans of tissue-specific molecular regulation by the intake of polyphenols requires complex clinical trials that allow for the procurement of sufficient pre- and postsupplementation tissue samples. Ellagitannins (ETs), ellagic acid (EA) and their gut microbiota-derived metabolites, the urolithins, modify gene expression in colon normal and cancer cultured cells. We conducted here the first clinical trial with 35 CRC patients daily supplemented with 900 mg of an ET-containing pomegranate extract (PE) and evaluated the expression of various CRC-related genes in normal and cancerous colon tissues before (biopsies) and after (surgical specimens) 5-35 days of supplementation. Tissues were also obtained from 10 control patients (no supplementation) that confirmed a large, gene- and tissue-specific interindividual variability and impact of the experimental protocol on gene expression, with some genes induced (MYC, CD44, CDKN1A, CTNNB1), some repressed (CASP3) and others not affected (KRAS). Despite these issues, the consumption of the PE was significantly associated with a counterbalance effect in the expression of CD44, CTNNB1, CDKN1A, EGFR and TYMs, suggesting that the intake of this PE modulated the impact of the protocol on gene expression in a gene- and tissue-specific manner. These effects were not associated with the individuals' capacity to produce specific urolithins (i.e., metabotypes) or the levels of urolithins and EA in the colon tissues and did not reproduce in vitro effects evidencing the difficulty of demonstrating in vivo the in vitro results.

[PHARMACONUTRITION IN SEVERELY ILL PATIENT]. / FARMACONUTRICIÓN EN EL PACIENTE GRAVE.

"Pharmaconutrient" is a term applicable to those compounds which. in addition to their nutritional function, play a role as aids in the treatment of patients with severe pathologies, including sepsis, trauma, burns and major surgery, In general, enrichment of enteral an parenteral formulas with pharmaconutrients contribute to positively modulate the inflammatory response, infection and controlling the internal milieu, which in turn can be evaluated through lower mortality, hospital and intensive care units stay, days of mechanical ventilation and other parameters allowing to asses their effects. Arginine, glutamine, nucleotides, omega-3 fatty acids and antioxidant micronutrients, make up the nucleus of pharmaconutrients used with that aim, usually as mixtures of them. In the present review current evidence about the effects, indications, limitations, doses, potential adverse risks and even counter-indications is analysed.

El término farmaconutriente se aplica a aquellos compuestos que poseen un efecto añadido al meramente nutricional y que se utilizan como terapia coadyuvante en pacientes con patologías graves que incluyen sepsis, traumatismos, grandes quemados y enfermos quirúrgicos. En general, con su enriquecimiento en las fórmulas enterales o parenterales se pretende modular positivamente la respuesta inflamatoria, la infección y el control del medio interno, valorables a través de mortalidad, tiempo de estancia en hospital y en UCI, días de ventilación mecánica y otros parámetros que permiten dimensionar los efectos de su utilización. Arginina, glutamina, nucleótidos, ácidos grasos omega-3 y micronutrientes antioxidantes constituyen el núcleo de los farmaconutrientes utilizados con la finalidad antedicha, habitualmente en forma de mezclas. En la presente revisión se analiza la evidencia actual acerca de sus efectos, indicaciones, limitaciones, cantidades a aportar, peligros potenciales e incluso contraindicaciones.

MicroRNAs expression in normal and malignant colon tissues as biomarkers of colorectal cancer and in response to pomegranate extracts consumption: Critical issues to discern between modulatory effects and potential artefacts.

SCOPE: MicroRNAs (miRs) are proposed as colorectal cancer (CRC) biomarkers. Pomegranate ellagic acid and their microbiota metabolites urolithins exert anticancer effects in preclinical CRC models, and target normal and malignant colon tissues in CRC patients. Herein, we investigated whether the intake of pomegranate extract (PE) modified miRs expression in surgical colon tissues versus biopsies from CRC patients. METHODS AND RESULTS: We conducted a randomized, double-blind, controlled trial. Thirty-five CRC patients consumed 900 mg PE daily before surgery. Control CRC patients (no PE intake, n = 10) were included. Our results revealed: (1) significant differences for specific miRs between malignant and normal tissues modifiable by the surgical protocols; (2) opposed trends between -5p and -3p isomolecules; (3) general induction of miRs attributable to the surgery; (4) moderate modulation of various miRs following the PE intake, and (5) no association between tissue urolithins and the observed miRs changes. CONCLUSION: PE consumption appears to affect specific colon tissue miRs but surgery critically alters miRs levels hindering the discrimination of significant changes caused by dietary factors and the establishment of genuine differences between malignant and normal tissues as biomarkers. The components responsible for the PE effects and the clinical relevance of these observations deserve further research.

Efecto gastroprotector del jugo de zanahoria (Daucus carota), col (Brassica oleracea ) y papa (Solanum tuberosum) / Effects of carrot (Daucus carota), cabbage (Brassica oleracea) and potato (Solanum tuberosum) juices as gastric mucosal protections

INTRODUCCIÓN: a muchos vegetales se les reconocen acciones beneficiosas sobre el aparato digestivo. A la zanahoria (Daucus carota), la col (Brassica oleracea) y la papa (Solanum tuberosum) la población les atribuye acciones gastroprotectoras. Objetivo: Comprobar experimentalmente la acción gastroprotectora de los jugos de zanahoria, col y papa. MÉTODOS: se utilizaron ratas Sprague-Dawley machos de 190 ± 10 g como modelo biológico; las úlceras gástricas se produjeron con 1 mL de etanol absoluto por cada animal. Los 40 animales fueron distribuidos en cinco grupos de ocho. El grupo 1 fue el control, el 2, el control positivo (atropina 20 mg/Kg), el 3 fue tratado con el jugo de col, el 4 con el de zanahoria y el 5 con el de papa. Media hora antes de la inducción de la úlcera, se administraron los jugos a una dosis de 400 mg/Kg sobre la base de los sólidos totales. Los animales se sacrificaron una hora después de la inducción de las úlceras, las cuales fueron cuantificadas, y se midió el área dañada. RESULTADOS: con todos los jugos empleados, se observó una disminución significativa del área afectada cuando se comparó con el control; sin embargo, solo en el grupo al que se administró el jugo de col, la disminución no presentó significación estadística con relación al grupo control positivo, por lo que el efecto gastroprotector fue similar a él. CONCLUSIONES: los jugos de zanahoria y papa presentaron un moderado efecto gastroprotector, el cual resultó alto en el grupo tratado con jugo de col.

INTRODUCTION: many vegetables are known for their beneficial effects on digestive system. Population attributed the benefits of carrot (Daucus carota), cabbage (Brassica oleracea) and potato (Solanum tuberosum) as gastric mucosal protections. OBJECTIVE: to prove experimentally the action of carrot (Daucus carota), cabbage (Brassica oleracea) and potato (Solanum tuberosum) juices as gastric mucosal protections. METHODS: sprague-Dawley male rats of 190 ± 10 g were used as biological models; ulcers were induced with 1 mL of absolute ethanol for each animal. Forty animals were distributed in five groups of eight. Group 1 was selected as control group, 2 as positive control (atropine 20 mg/Kg), 3 was treated with cabbage juice, 4 with carrot juice and 5 with potato juice. A half hour before the ulcer induction, all juices were administrated at a dose of 400 mg/Kg on the basis of total solids. Animals were sacrificed an hour after the ulcer inductions, ulcers were quantified, as well as, the damage area was measured. Results: a significant decrease of the affected area after using the juices was observed comparing to the control group; however, group which was given cabbage juice, did not show a significant statistical decrease in relation to the positive control group, that is why the effect as gastric mucosal protection was similar to it. CONCLUSIONS: carrot and potato juices had a moderated effect as gastric mucosal protections; on the other hand, group treated with cabbage did show a high effect on the digestive system.

Targeted metabolic profiling of pomegranate polyphenols and urolithins in plasma, urine and colon tissues from colorectal cancer patients.

SCOPE: Urolithins are bioactive metabolites produced by the gut microbiota from ellagitannins (ETs) and ellagic acid (EA). We investigated whether urolithins could be detected in colon tissues from colorectal cancer (CRC) patients after pomegranate extract (PE) intake. METHODS AND RESULTS: CRC patients (n = 52) were divided into controls and PEs consumers (900 mg/day for 15 days) before surgical resection. PEs with low (PE-1) and high (PE-2) punicalagin:EA ratio were administered. Twenty-three metabolites, but no ellagitannins, were detected in urine, plasma, normal (NT) or malignant (MT) colon tissues using UPLC-ESI-QTOF-MS/MS (UPLC, ultra performance liquid chromatography; QTOF, quadrupole TOF). Free EA, five EA conjugates, gallic acid and 12 urolithin derivatives were found in colon tissues. Individual and total metabolites levels were higher in NT than in MT, independently of the PE consumed. The maximal mean concentration (1671 ± 367 ng/g) was found in NT after consumption of PE-1 and the lowest concentration (42.4 ± 10.2 ng/g) in MT with PE-2. Urolithin A or isourolithin A were the main urolithins produced (54 and 46% patients with urolithin A or isourolithin A phenotype, respectively). High punicalagin content (PE-2) hampered urolithins formation. CONCLUSION: Significant levels of EA derivatives and urolithins are found in human colon tissues from CRC patients after consumption of pomegranate. Further studies are warranted to elucidate their biological activity.

Modelo experimental de hiperlipidemia con el empleo de caseína y grasas saturadas / Experimental model of hyperlipidaemia with the use of casein and saturated fats

En el presente trabajo se evaluó el efecto hiperlipídico de una dieta combinada de caseína y grasas saturadas, en un modelo biológico conformado por ratas Wistar. Se integraron tres grupos experimentales de seis animales cada uno: el primero (grupo control) consumió una dieta convencional; el segundo, una dieta convencional combinada con caseína y grasa de cerdo al 20 por ciento y el tercero, la dieta convencional suplementada solamente con grasa de cerdo al por ciento. Fueron cuantificados el colesterol y los triacilglicéridos por métodos enzimáticos en tres momentos diferentes: al comienzo del estudio, a los 15 días y al finalizar este. El incremento de peso corporal, una vez finalizada la investigación, no mostró diferencias significativas entre los grupos de experimentación. El grupo de la dieta combinada elevó el perfil lipídico más eficientemente que el que solo consumió grasas saturadas, lo cual confirma que el modelo experimental de hiperlipidemia inducida por dieta suplementada con caseína y grasas saturadas es el más eficaz para la elevación del perfil lipídico

In the current research it was evaluated the hyperlipidic effect of a combined diet with casein andsaturated fats, in a biological model conformed by Wistar's rats. Three experimental groups wereintegrated with six animals in each one. The first group (control group) consumed a conventionaldiet; the second group, a conventional diet combined with casein and pig fat at 20 %; and the thirdone, the same conventional diet supplemented just with pig fat at 20 %.The cholesterol andtriacylglycerols were quantified by means of enzymatic methods in three different moments: at thebeginning of the study, after 15 days and at the end of this. The increase of body weight, once itwas finished the research, didn't show significant differences among the experimental groups. Thegroup of the combined diet increased its lipidic profile more efficiently than the group that justconsumed saturated fats, which confirms that the experimental model of induced hyperlipidaemiaby supplemented diet with casein and saturated fats is the most effective for the elevation of lipidicprofile.

Occurrence of urolithins, gut microbiota ellagic acid metabolites and proliferation markers expression response in the human prostate gland upon consumption of walnuts and pomegranate juice.

Epidemiology supports the important role of nutrition in prostate cancer (PCa) prevention. Pomegranate juice (PJ) exerts protective effects against PCa, mainly attributed to PJ ellagitannins (ETs). Our aim was to assess whether ETs or their metabolites ellagic acid and urolithins reach the human prostate upon consumption of ET-rich foods and to evaluate the effect on the expression of three proliferation biomarkers. Sixty-three patients with BPH or PCa were divided into controls and consumers of walnuts (35 g walnuts/day) or pomegranate (200 mL PJ/day) for 3 days before surgery. Independently of the ETs source, the main metabolite detected was urolithin A glucuronide, (3,8-dihydroxy-6H-dibenzo[b,d]pyran-6-one glucuronide) (up to 2 ng/g) together with the traces of urolithin B glucuronide, (3-hydroxy-6H-dibenzo[b,d]pyran-6-one glucuronide) and dimethyl ellagic acid. The small number of prostates containing metabolites was likely caused by clearance of the compounds during the fasting. This was corroborated in a parallel rat study and thus the presence of higher quantities of metabolites at earlier time points cannot be discarded. No apparent changes in the expression of CDKN1A, MKi-67 or c-Myc were found after consumption of the walnuts or PJ. Our results suggest that urolithin glucuronides and dimethyl ellagic acid may be the molecules responsible for the beneficial effects of PJ against PCa.

[Quality assessment and improvement in the indication and management of parenteral nutrition in a general surgery unit]. / Evaluación y mejora de la calidad en la indicación y el manejo de la nutrición parenteral en un servicio de cirugía general.

OBJECTIVE: To analyze the degree of compliance with a variety of internationally accepted standards defined for Total Parenteral Nutrition (TPN) quality control in our Surgery Department. PATIENTS AND METHOD: Prospective study of patients treated with TPN over two years in the department of surgery of a university teaching hospital (n = 72). Assessment of quality was performed by measurements of compliance using 19 criteria. The criteria were divided into three groups according to characteristics of TPN standardisation: this must be "appropriate" to the nutritional requirements of the patient, "safe" in order to prevent complications and "accurate" in its daily programming. Corrective measures aimed at resolving the quality problem were applied to the deficient criteria over six months, paying particular attention to those criteria which had the highest percentage of errors in the study carried out using a Pareto analysis. During a third period of six months the information on all 19 criteria was gathered again and the improvement with regard to the standard values and to the compliance in the first period (using the value of z) was evaluated. RESULTS: The compliance with seven criteria was significantly below standard values: all those of the "appropriate" group, except the criteria "type of diet" and "composition of the diet", and the criteria "absence of complications" of the "safe" group, which was also the one with the highest number of grouped non-compliances. In the second period all the below standard criteria improved with compared to the first period. The criteria "time of fasting", "concordance" and "duration" were significantly improved. The criteria "time of fasting", "duration" and "latency" reached the standard. The rest of criteria that reached their standard in the first evaluation maintained the same results. CONCLUSIONS: Corrective measures introduced were effective since all the below standard criteria improved, including metabolic complications. Notwithstanding, it is necessary to continue in this line to improve the criteria still below standard.

Estudio del potencial hemolítico de la loción de melagenina plus por un método alternativo / Study about melagenin plus lotion hemolytic potential for an alternative method

En el presente estudio fue ensayado el test de hemólisis en sangre humana con el objetivo de comprobar el efecto hemolítico de la loción de melagenina Plus y compararlo con los resultados obtenidos en la evaluación de la irritabilidad oftálmica por el método de Draize. El test de hemolisis para la evaluación del potencial hemolítico, implica el empleo de muestras de sangre evitando el sacrificio o sufrimiento de los animales de experimentación sometidos a un ensayo de Draize. A partir de una solución de producto de ensayo de 0.03 por cientose obtuvieron diferentes diluciones que fueron probadas frente a una suspensión de eritrocitos ajustados por hemolisis total en agua destilada y posterior lectura de la absorbancia a 54 0nm, después de una hora de incubación. Los resultados arrojaron una concentración hemolítica 50 del producto (CH50) de 0,00315 por ciento