ABSTRACT
BACKGROUND: A high-fat (HF) diet, diet iron deficiency and iron supplementation may affect inflammatory parameters. Probiotics influence both iron metabolism and inflammation. We compared the inflammatory state in rats on a HF iron-deficient diet receiving oral iron, Lactobacillus plantarum and Lactobacillus curvatus in different combinations. METHODS: This was a two-stage experiment. In groups C (n = 8) and HF (n = 8), rats ate a control or HF diet, respectively, for 16 weeks. In the group HFDEF (n = 48), rats ate a HF iron-deficient diet for 8 weeks (first stage) and were subsequently divided into 6 groups (n = 8 each) receiving the following for a further 8 weeks (second stage): HFDEF - a HF iron-deficient diet; HFDEFFe - a HF iron-deficient diet with iron; HFDEFLp and HFDEFLc - a HF iron-deficient diet with L. plantarum or L. curvatus, respectively; and HFDEFFeLp and HFDEFFeLc - a HF iron-deficient diet with iron and L. plantarum or L. curvatus, respectively. Body composition analysis and blood sampling was performed. Markers of iron status and levels of total antioxidant status (TAS), C-reactive protein (CRP), tumour necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) were measured in the blood. RESULTS: TAS was higher in the HFDEF group (756.57 ± 489.53 ng mL-1) versus the HFDEFLc group (187.04 ± 47.84 ng mL-1; P = 0.022). No more differences were found between groups, or in TAS, CRP, TNF-α and IL-6 concentrations. Also, no differences were found between groups for alanine and aspartate aminotransferases, glucose, total cholesterol, low- and high-density lipoproteins and triglycerides. TAS level was positively correlated with ferritin concentration, IL-6 with TAS and TNF-α with hepcidin level. CONCLUSIONS: Supplementation with L. plantarum, L. curvatus and iron in combinations exerts no influence on inflammatory status, lipid profile, hepatic function and serum fasting glucose in rats on a HF iron-deficient diet. © 2024 Society of Chemical Industry.
Subject(s)
Lactobacillus plantarum , Probiotics , Rats , Animals , Lactobacillus , Iron , Interleukin-6 , Tumor Necrosis Factor-alpha/genetics , Diet, High-Fat/adverse effects , Antioxidants , GlucoseABSTRACT
Obesity is a pandemic disease that poses a serious problem for the entire world population. Preventative and non-pharmacological treatments for obesity include changing eating habits and increasing physical activity. The use of certain dietary supplements also brings beneficial results in the process of reducing excess body weight. There are many options for the treatment of obesity available on the pharmaceutical market. This study aims to review the latest publications on selected dietary supplements in the treatment of excess body weight. Dietary supplements which support a reduction in excess body weight include capsaicin, bitter orange, white bean seeds, green coffee, berberine, and single and multi-strain probiotics. Some of these supplements have additional health benefits. Bitter orange has antioxidant and anti-ulcer properties. Berberine improves lipid metabolism and reduces blood glucose levels. Capsaicin has found application in the treatment of neurodegenerative diseases. Supplements that do not significantly reduce body weight are chitosan and vitamin D. Chitosan can reduce blood pressure, while vitamin D improves the sensitivity of tissue to insulin. An increase in body mass index (BMI) is associated with an increased risk of many diseases, including cardiovascular disease, diabetes mellitus, musculoskeletal disorders, and certain cancers. Dietary supplements with beneficial effects which support a reduction in excess body weight can be used in the treatment of both obesity and its complications.
Subject(s)
Obesity , Weight Loss , Body Mass Index , Body Weight , Dietary Supplements , Humans , Obesity/complications , Obesity/drug therapyABSTRACT
Although probiotics have been discovered in numerous diseases in the last decade, there is little consensus on the relationship between probiotic properties and minerals balance and their distribution in the organism. This research aimed to evaluate the calcium (Ca) and magnesium (Mg) status in rats on a diet containing multispecies probiotics. Thirty male 10-week-old Wistar rats were selected and divided into three groups (n = 10 rats)-a group fed a standard diet (C), a group fed a low-dose of multispecies probiotics with 2.5 × 109 CFU per day (LD), and a group fed high-dose of multispecies probiotics 1 × 1010 CFU per day (HD) for 6 weeks. The results revealed that HD intake significantly increased the Ca concentration in hair and Mg concentration in femur bones. A significant positive correlation was found between calcium and magnesium levels in hair. The Ca/Mg molar ratio was lower in testicles in the groups with probiotics. In conclusion, multispecies probiotics altered the Ca concentration in hair and Mg level in femur bone, and also changed the molar ratio of these elements in testicles in male rats.
Subject(s)
Calcium/metabolism , Magnesium/metabolism , Nutritional Status/drug effects , Probiotics/pharmacology , Animals , Femur/metabolism , Hair/metabolism , Male , Models, Animal , Rats , Rats, Wistar , Testis/metabolismABSTRACT
OBJECTIVE: The impact of multistrain probiotics on iron (Fe) metabolism under Fe-deficient diet conditions remains unknown. The study aimed to compare the effect of 6 weeks simultaneous and exclusive oral multistrain probiotic and iron supplementation on selected parameters of Fe metabolism in rats on an Fe-deficient diet. METHODS: Forty rats were assigned to five groups, with eight animals in each, and for 6 weeks received: the CC group- a standard diet, the DD group- an Fe-deficient diet, the DPB group- an Fe-deficient with a multispecies probiotic, the DFE group- an Fe-deficient diet supplemented with iron, the DPBFE group- an Fe-deficient diet with iron and a multispecies probiotic. The Fe content in blood and tissues; serum concentration of erythroferrone, ferritin (Ft), homocysteine, hepcidin (HEPC) and lactoferrin; liver content of divalent metal transporter 1 (DMT1), transferrin receptor protein 1 (TfR1) and 2 (TfR2) and ZRT/IRT-like protein 14 (ZIP14) and faecal microbiota were assessed. RESULTS: In DPBFE group, unlike in DPB and DFE groups, duodenal Fe content was higher compared to DD group. Similarly, serum Ft level was higher in DPBFE group, but not in DPB and DFE groups, compared to DD group. CONCLUSIONS: Six weeks simultaneous oral multistrain probiotic and Fe supplementation, but not exclusive probiotic or Fe intake, increases duodenal Fe absorption in rats and presents higher effectiveness in increasing tissue Fe stores.
Subject(s)
Anemia, Iron-Deficiency , Dietary Supplements , Iron/metabolism , Probiotics , Animals , Ferritins , Liver/metabolism , RatsABSTRACT
Although simultaneous supplementation of iron and folic acid is justified, the potential interactions between these micronutrients and other elements are poorly known. In this study, we aimed to investigate the effect of iron and folic acid supplementation on the levels of selected essential and toxic elements in the serum of micronutrient-deficient young women. A total of 40 women participated in this study and were divided into two groups: study group (n = 23) (with iron and folate deficiency) and control group (n = 17). The study group received iron and folic acid supplements for 3 months. Blood samples were collected at baseline and after the completion of the study period. Women completed a 3-day food intake record. We calculated the body mass index (BMI) of all the participants. Cellular morphology was analyzed in whole blood, and biochemical parameters were determined in serum. Elements were measured in serum by inductively coupled plasma mass spectrometry (ICP-MS). According to our results, in the case of the study group, the supplementation of iron and folic acid restored their levels; however, it caused a significant decrease in the level of zinc, calcium, and magnesium. In the case of the control group, at the end of the study period, there was a marked decrease in the level of iron. Interestingly, there was an increase in the level of arsenic and vanadium in both groups. In conclusion, simultaneous supplementation of iron and folic acid impairs the level of zinc, calcium, and magnesium in women of childbearing age.
Subject(s)
Iron , Pregnancy Complications , Dietary Supplements , Female , Folic Acid , Humans , Micronutrients , PregnancyABSTRACT
Obesity is associated with increased serum leptin level, endothelial dysfunction and angiogenesis. In vitro studies have shown that vascular endothelial growth factor (VEGF) synthesis is increased by leptin. Animal studies revealed the effectiveness of Plantago supplementation treatment of obesity. The study aim was to evaluate the effect of Plantago major supplementation on serum leptin and VEGF blood concentration, endothelial dysfunction and angiogenesis in obese women. Seventy-two obese women received oral Plantago major supplement (Plantago group, n = 35) or placebo (placebo group, n = 37) for 12 weeks. At baseline and after completion, anthropometric and body composition measurements were performed, and blood samples were collected. Serum concentrations of leptin, VEGF-A, adiponectin, tumour necrosis factor α and soluble intercellular adhesion molecule have been determined. At completion, the leptin level was higher in the Plantago group (39 781.55 ± 20 360.73 pg ml-1) compared to both the baseline (36 138.71 ± 25 401.51 pg ml-1) and placebo group (30 502.81 ± 19 003.18 pg ml-1). Also, leptin concentration in the Plantago group at completion correlated positively with an increase in VEGF-A level (R = 0.45), and baseline VEGF-A level correlated negatively with the increase in leptin concentration (R = -0.47). Plantago major supplementation increases leptin serum level, enhances leptin influence on VEGF-A serum level increase and by this mechanism may intensify endothelial dysfunction and angiogenesis in obese women.
Subject(s)
Leptin/blood , Obesity , Plant Preparations/therapeutic use , Plantago , Vascular Endothelial Growth Factor A/blood , Administration, Oral , Adult , Double-Blind Method , Female , Humans , Middle Aged , Obesity/blood , Obesity/drug therapy , Plant Preparations/administration & dosageABSTRACT
Supplementation with iron and folic acid is widely recommended in women of childbearing age and during pregnancy; however, the effect of such supplementation on mineral status is not well-known. The aim of this study was to determine the effects of oral iron and folic acid, administered together and separately, on copper, zinc, calcium, and magnesium concentrations in the tissues of rats with a deficiency of both these micronutrients. The experiment was performed on 8-week-old female Wistar rats. In the first stage of the experiment, the animals were randomly assigned to a control group of rats fed the standard diet (AIN-93 M), and to a study group of rats fed a diet deficient in iron and folate. The study group was then randomly divided to four groups: group D was fed a deficit diet, group FE was fed a deficit diet with iron gluconate, the FOL group was fed a deficit diet with folate acid, and the FEFOL group was fed a deficit diet with iron gluconate and folate acid. After 2, 10, and 21 days of the intervention, ten animals from each group were killed. Mineral concentrations were assayed in the liver, spleen, pancreas, heart, and kidneys using atomic absorption spectrometry. Statistical analysis was performed using Statistica 12.0 with the ANOVA test (p < 0.05). It was found that separate supplementation with iron and folic acid significantly decreased copper concentrations in tissues. The deficit in iron and folic acid decreased, and their simultaneous supplementation increased calcium content in the organs. Separate and simultaneous supplementation decreased magnesium status in deficient rats. In conclusion, iron and folic acid, supplemented separately or simultaneously, affect the copper, calcium, and magnesium level in tissues.
Subject(s)
Iron , Micronutrients , Animals , Dietary Supplements , Female , Folic Acid , Minerals , Rats , Rats, WistarABSTRACT
The influence of probiotic supplementation on iron metabolism remains poorly investigated. However, a range of studies, especially on Lactobacillus plantarum 299v (Lp229v), have indicated a possible positive impact of probiotics on iron absorption. The aim of the study was to determine the effect of multistrain probiotic supply on iron balance. Thirty Wistar rats were randomized into three groups: placebo (KK group), and multistrain probiotic per os in a daily dose of 2.5 × 109 colony forming units (CFU) (PA group) or 1 × 1010 CFU (PB group). Multistrain probiotic consisted of nine bacterial strains: Bifidobacterium bifidum W23, B. lactis W51, B. lactis W52, Lactobacillus acidophilus W37, L. brevis W63, L. casei W56, L. salivarius W24, Lactococcus lactis W19, and Lc. lactis W58, in equal proportions. After six weeks, blood and organ samples were collected. No differences were found between the three groups in terms of serum concentrations of hepcidin (HEPC), lactoferrin (LTF), homocysteine (HCY), ferritin (Ft), or erythroferrone (ErFe), or in liver content of divalent metal transporter 1 (DMT1), transferrin receptors 1 and 2 (TfR), or ZRT/IRT-like protein 14 (ZIP14) proteins. In the overall sample, positive correlations were noted between the serum concentrations of hepcidin and lactoferrin, and hepcidin and ferritin; serum concentration of hepcidin and DMT1 and TfR1 in the liver; and serum concentration of erythroferrone and TfR2 in the liver. The correlations of serum hepcidin and erythroferrone with liver DMT1 and TfR represent significant mechanisms of Fe homeostasis. Our study has shown that multistrain probiotic supplementation used in the experiment did not disrupt the biochemical and hepatic regulatory processes of Fe balance and did not demonstrate significant influence on selected parameters of Fe metabolism.
Subject(s)
Hepcidins/blood , Liver/metabolism , Peptide Hormones/blood , Animals , Bifidobacterium bifidum/physiology , Dietary Supplements , Ferritins/blood , Homocysteine/blood , Lactobacillus acidophilus/physiology , Lactoferrin/blood , Male , Probiotics/therapeutic use , Rats , Rats, WistarABSTRACT
Although simultaneous supplementation with iron and folic acid is justified, the potential interactions between these micronutrients are unknown. The aim of this study was to determine the effects of oral iron and folic acid, administered together or separately, on iron concentration in tissues in rats with a deficiency of both these micronutrients. In the first stage of the experiment (28 days), 150 8-week-old female Wistar rats were randomly assigned to a control group (C; n = 30) fed the standard diet and to a study group (n = 120) fed a diet deficit in iron and folate. The study group was then randomly divided to four groups: D group fed a deficit diet, FE group fed a deficit diet with iron gluconate, the FOL group fed a deficit diet with folate acid, and the FEFOL group fed a deficit diet with iron gluconate and folate acid. After 2, 10, and 21 days of supplementation, ten animals from each group were killed. Morphological parameters were measured in whole blood. Iron concentration was assayed in serum, liver, spleen, pancreas, heart, and kidneys. Folic acid supplementation more significantly decreased iron concentrations in the pancreas and spleen than in the D group after 10 and 21 days of supplementation. Moreover, the combination of iron with folic acid markedly decreased iron levels in the liver and spleen, in comparison with iron alone, after 10 and 21 days of the experiment. In conclusion, folic acid affects iron status in female rats deficient in these micronutrients in moderate and long-term supplementation.
Subject(s)
Folic Acid/pharmacology , Iron/pharmacokinetics , Micronutrients/pharmacokinetics , Administration, Oral , Animals , Dietary Supplements , Female , Folic Acid/administration & dosage , Iron/administration & dosage , Iron Deficiencies , Micronutrients/administration & dosage , Micronutrients/deficiency , Rats , Rats, Wistar , Tissue DistributionABSTRACT
Obesity leads to detrimental abnormalities of iron (Fe) metabolism. So far, studies have shown that single-strain probiotic supplementation ameliorates the gut microbiota quality disrupted in the obese and improves Fe homeostasis. The effect of multistrain probiotic supplementation and its dose-dependence in obese postmenopausal women remain unknown. The study aimed to investigate the effect of multistrain probiotic supplementation in two doses on selected parameters of Fe metabolism in obese postmenopausal female patients. Three groups of obese postmenopausal women, 30 subjects each, received nine-strain oral probiotic supplement at a daily dose of 2.5 × 109 CFU (LD group), 1 × 1010 CFU (HD group), or placebo for 12 weeks (ClinicalTrails.gov no: NCT03100162). After the intervention, the hair Fe content was lower in both supplemented groups compared to the baseline, the serum zinc (Zn) concentration was higher in the LD group and lower in the HD group vs. the baseline, and the serum erythroferrone (FAM) concentration was lower in the HD group and serum ferritin (FE) concentration was higher in the LD group vs. the baseline. In the whole study population after the completion of the intervention hair Zn correlated positively with serum HEPC and FAM and negatively with serum FE. Hair Fe correlated negatively with serum FE. It is concluded that multistrain probiotic supplementation may influence iron metabolism in obese postmenopausal female patients.
Subject(s)
Iron/metabolism , Obesity/drug therapy , Postmenopause/drug effects , Probiotics/administration & dosage , Aged , Dietary Supplements/analysis , Female , Ferritins/blood , Hair/chemistry , Hair/metabolism , Humans , Middle Aged , Obesity/blood , Obesity/microbiology , Postmenopause/blood , Zinc/metabolismABSTRACT
A range of interactions between gut microbiota and iron (Fe) metabolism is described. Oral probiotics ameliorate host's iron status. However, this has been proven for single-strain probiotic supplements. Dose-dependence of beneficial probiotic supplementation effect on iron turnover remains unexplored. Our study aimed to investigate the effects of oral multispecies probiotic supplementation in two doses on iron status in rats. Thirty rats were randomized into three groups receiving multispecies probiotic supplement at a daily dose of 2.5 × 109 CFU (PA group, n = 10) and 1 × 1010 CFU (PB group, n = 10) or placebo (KK group, n = 10). After 6 weeks, rats were sacrificed for analysis, blood samples, and organs (the liver, heart, kidneys, spleen, pancreas, femur, testicles, duodenum, and hair) were collected. The total fecal bacteria content was higher in the PB group vs. PA group. Unsaturated iron-binding capacity was higher in the PB group vs. KK group. Serum Fe was lower in both PA and PB vs. KK group. Iron content in the liver was higher in the PB group vs. KK group; in the pancreas, this was higher in the PB group vs. the KK and PA group, and in the duodenum, it was higher in both supplemented groups vs. the KK group. A range of alterations in zinc and copper status and correlations between analyzed parameters were found. Oral multispecies probiotic supplementation exerts dose-independent and beneficial effect on iron bioavailability and duodenal iron absorption in the rat model, induces a dose-independent iron shift from serum and intensifies dose-dependent pancreatic and liver iron uptake.
Subject(s)
Iron/blood , Probiotics/pharmacology , Administration, Oral , Animals , Dietary Supplements , Dose-Response Relationship, Drug , Male , Minerals/blood , Probiotics/administration & dosage , Rats , Rats, WistarABSTRACT
BACKGROUND: High gut microflora quality plays a crucial role in cardiovascular protection and undisturbed liver function. Currently, the most effective methods to ameliorate gut microbiota influence on the host’s cardiovascular health state are investigated. Next to low low-density lipoprotein (LDL) and low non-high-density lipoprotein (non-HDL) serum levels, triglycerides (TG) seem to be a new goal of cardioprotective treatment and prevention. Moreover, it has been documented that high serum alanine transaminase (ALT) is a reliable marker of cardiovascular risk. Probiotics are a well proven factor decreasing blood LDL and total cholesterol (TCH) concentrations. However, the effect of probiotics on serum TG and ALT levels remains underinvestigated. The aim of the study was to compare the effect of 6-week-long supplementation with a multispecies probiotic mixture in two doses on body mass, liver function and lipid profile in the rat model. METHODS: Thirty ‘Wistar’ rats were randomly divided into the control group – KK, a group receiving a probiotic in a daily dose of 2.5×109 CFU (PA) and a group receiving a probiotic in a daily dose of 1×1010 CFU (PB) for 6 weeks. After 6 weeks body mass, liver mass, serum concentrations of TCH, LDL, high-density lipoprotein (HDL), TG, ALT and aspartate transaminase (AST) were determined. RESULTS: Neither at baseline nor at the end of the experiment were there any differences in the body mass of rats between all three groups. At the completion of the study the liver mass of the rats was significantly lower in the PA and PB vs. KK group. In group PB a significantly lower serum concentration of TG and ALT compared to the KK group was registered at the end of the trial. CONCLUSIONS: Six-week-long supplementation with multispecies probiotic mixture exerts a favorable and dose-dependent effect on liver function and lipid profile in the rat model and may also have a favorable influ- ence on cardiovascular impairments. Thus, the inclusion of probiotics supplementation in cardiovascular risk management should be considered.
Subject(s)
Lipids/blood , Liver/physiology , Probiotics/administration & dosage , Alanine Transaminase/blood , Animals , Body Composition , Cardiovascular Diseases/prevention & control , Dietary Supplements , Dose-Response Relationship, Drug , Gastrointestinal Microbiome/physiology , Humans , Male , Rats , Rats, Wistar , Risk Factors , Triglycerides/bloodABSTRACT
BACKGROUND: Hypotensive therapy leads to a number of trace elements metabolism disturbances. Zinc balance is frequently affected by antihypertensive treatment. AIM: To evaluate the effect of a hypotensive treatment, modified diet and zinc supplementation on mineral status and selected biochemical parameters in newly diagnosed hypertensive patients on monotherapy. METHODS: In the first stage, arterial hypertension in ninety-eight human subjects was diagnosed. In the second stage, antihypertensive monopharmacotherapy was implemented. In the third stage, patients were randomized into three groups and continued antihypertensive monotherapy: group D received an optimal-mineral-content diet, group S received zinc supplementation, and group C had no changes in diet or zinc supplementation. Iron, zinc, and copper concentrations in serum, erythrocytes, urine, and hair were determined. Lipids, glucose, ceruloplasmin, ferritin, albumin, C-reactive protein (CRP), tumor necrosis factor α (TNF-α), nitric oxide (NO), superoxide dismutase (SOD) and catalase (CAT) were assayed in serum. RESULTS: Antihypertensive monotherapy decreased zinc concentration in serum and erythrocytes and increased the level of zinc in urine, decreased CAT and SOD activity, TNF-α concentration in serum, and increased the level of NO in the serum. Zinc supply led to an increase in zinc concentration in serum, erythrocytes, and hair (in group S only). In the groups with higher zinc intake, decreased glucose concentration in the serum was observed. Significant correlation was seen between the zinc and glucose serum concentrations. CONCLUSION: Hypotensive drugs disturb zinc status in newly diagnosed hypertensive patients. Antihypertensive monotherapy combined with increased zinc supply in the diet or supplementation favorably modify zinc homeostasis and regulate glucose status without blood pressure affecting in patients with hypertension.
Subject(s)
Antihypertensive Agents/therapeutic use , Hypertension/diet therapy , Zinc/blood , Zinc/pharmacology , Aged , Catalase/blood , Dietary Supplements , Female , Humans , Hypertension/drug therapy , Hypertension/metabolism , Male , Middle Aged , Minerals/blood , Superoxide Dismutase/blood , Tumor Necrosis Factor-alpha/blood , Zinc/urineABSTRACT
The aim of this review is to present the most recent scientific evidence of interactions between the intestinal microbiota and minerals, and the effect of this interaction on the health of the host. The Web of Science database from the years 2013-2017 on this topic was reviewed. Numerous in vitro studies have shown that iron significantly affects the intestinal microbiota. However, Bifidobacteriaceae are capable of binding iron in the large intestine, thereby limiting the formation of free radicals synthesized in the presence of iron, and thus reducing the risk of colorectal cancer. Animal studies have revealed that supplementation with probiotics, prebiotics and synbiotics has a significant effect on bone calcium, phosphate and bone metabolism. The dynamic interaction between microbiota and zinc was shown. Human studies have provided evidence of the influence of probiotic bacteria on parathormone, calcium and phosphate levels and thus on bone resorption. Recent studies have produced new information mainly on the impact of the intestinal bacteria on the metabolism of calcium and iron. From a scientific perspective, the most urgent fields that remain to be investigated are the identification of all human gut microbes and new therapies targeting the interaction between intestinal bacteria and minerals. © 2017 Society of Chemical Industry.
Subject(s)
Bacteria/metabolism , Gastrointestinal Microbiome , Minerals/metabolism , Animals , Bacteria/classification , Bacteria/genetics , Bacteria/isolation & purification , Humans , Intestine, Large/metabolism , Intestine, Large/microbiologyABSTRACT
The basic criterion for the diagnosis of anorexia (AN - anorexia nervosa) by ICD-10 (International Classification of Diseases, version 10) is the body weight less than 15% of the expected normal body weight. According to DSM-IV (Diagnostic and Statistical Manual for Mental Disorders, version IV) the basic feature of AN is a refusal to maintain body weight equal or greater than the minimal normal weight. The prevalence of anorexia nervosa is 0.3-0.5% or even 1.3-3.7% if include pre-anorexic states (eg. the phenomenon of pro-ana). The main feature of anorexia is a reduction of caloric intake. According to the recommendations of the American Psychiatric Association (APA) for nutritional treatment of patients with AN the main goals in therapy of AN are: restoration of body weight, normalization of eating patterns, achievement a normal feeling of hunger and satiety and correction of the consequences of improper nutrition. APA suggests that achievable weight gain is about 0.9-1.4 kg per week in the case of hospitalized patients and approximately 0.23-0.45 kg per week in the case of outpatients. During the nutritional treatment of AN numerous side effects including anxiety, phobia, occurrence of obsessive thoughts and compulsive behavior, suicidal thoughts and intentions may occur. According to National Institute for Clinical Excellence (NICE) the most important goal of AN therapy is weight gain in the range of 0.5-1 kg per week in hospitalized patients and 0.5 kg per week for outpatients. A person suffering from anorexia in the initial period of nutritional treatment spends twice more energy to maintain elevated body temperature, which significantly increases during the night rest. This phenomenon is called nocturnal hyperthermia and has a negative effect on the healing process. "Refeeding syndrome" is an adverse effect of nutritional treatment in anorexia. It is caused by too rapid nutrition in a patient suffering from chronic starvation. It can endanger the patient's life.