Photoantimicrobial chitosan-gelatin-pomegranate peel extract films for strawberries preservation: From microbiological analysis to in vivo safety assessment.

This study aimed to investigate the application of biopolymeric materials (chitosan, gelatin, and pomegranate peel extract as photosensitizer) and antimicrobial photodynamic therapy (aPDT) on the physicochemical and microbial safety of strawberries. The photosensitizer potential of the materials was confirmed by a light-dose-dependent photobleaching profile. The application of light (525 nm; 50 J cm-2) decreased by >2 log CFU mL-1 the survival of Staphylococcus aureus on the surface of the photoactive-biopolymeric films. Moreover, the materials did not present in vivo cytotoxicity using Danio rerio (Zebrafish) as well as cytophytotoxic, genotoxic, or mutagenic potentials against Allium cepa plant model, which points out their safety to be used as films without posing a risk to the humans and the environment. The photoactive-polymeric coatings were able to maintain the strawberries weight, and the association with green light was 100 % effective in delaying fungal contamination. These coated-strawberries presented a significant reduction in S. aureus survival after light application (5.47-4.34 log CFU mL-1). The molecular level analysis of the photoactive compound cyanidin-3-glucoside indicates absorption on UV-Vis consistent with aPDT action. Therefore, this study showed that the antimicrobial effects of aPDT combined with photoactive-biopolymeric coatings were enhanced, while the quality of the strawberries was maintained.

Synergic dual phototherapy: Cationic imidazolyl photosensitizers and ciprofloxacin for eradication of in vitro and in vivo E. coli infections.

The emergence of new microorganisms with resistance to current antimicrobials is one of the key issues of modern healthcare that must be urgently addressed with the development of new molecules and therapies. Photodynamic inactivation (PDI) in combination with antibiotics has been recently regarded as a promising wide-spectrum therapy for the treatment of localized topical infections. However, further studies are required regarding the selection of the best photosensitizer structures and protocol optimization, in order to maximize the efficiency of this synergic interaction. In this paper, we present results that demonstrate the influence of the structure of cationic imidazolyl-substituted photosensitizers and light on the enhancement of ciprofloxacin (CIP) activity, for the inactivation of Escherichia coli. Structure-activity studies have highlighted the tetra cationic imidazolyl porphyrin IP-H-Me4+ at sub-bactericide concentrations (4-16 nM) as the most promising photosensitizer for combination with sub-inhibitory CIP concentration (<0.25 mg/L). An optimized dual phototherapy protocol using this photosensitizer was translated to in vivo studies in mice wounds infected with E. coli. This synergic combination reduced the amount of photosensitizer and ciprofloxacin required for full E. coli inactivation and, in both in vitro and in vivo studies, the combination therapy was clearly superior to each monotherapy (PDI or ciprofloxacin alone). Overall, these findings highlight the potential of cationic imidazolyl porphyrins in boosting the activity of antibiotics and lowering the probability of resistance development, which is essential for a sustainable long-term treatment of infectious diseases.

Strategies to Improve the Antimicrobial Efficacy of Photodynamic, Sonodynamic, and Sonophotodynamic Therapies.

BACKGROUND AND OBJECTIVES: This work evaluated antimicrobial photodynamic therapy (PDT), sonodynamic therapy (SDT), and the association of both therapies (sonophotodynamic therapy [SPDT]), mediated by curcumin (Cur) against Staphylococcus aureus biofilm. Next, additional strategies for these treatments were assessed. MATERIALS AND METHODS: S. aureus biofilms received PDT, SDT, and SPDT, mediated by Cur (80 µM), LED light (450 nm), and 1 MHz ultrasound. The same treatments were also performed adding a strategy: Cur with sodium dodecyl sulfate (SDS), Cur with potassium iodide (KI) or a pre-treatment with ultrasound. Cell viability was determined and biofilm architecture was evaluated under confocal microscopy. RESULTS: SPDT was more effective to inactivate the bacteria than PDT and SDT. SDS achieved the greatest viability reductions, followed by KI and ultrasound pre-treatment. Confocal images revealed biofilm disruption and a reduced number of cells in all treatments. However, SPDT exhibited a pronounced effect and it was greater using SDS. CONCLUSION: SPDT was more effective and additional strategies potentiated its effectiveness. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.

The effect of combined curcumin-mediated photodynamic therapy and artificial skin on Staphylococcus aureus-infected wounds in rats.

Healing wounds represent a major public health problem, mainly when it is infected. Besides that, the antibiotics misuse and overuse favor the development of bacterial resistance. This study evaluated the effects of antimicrobial photodynamic therapy (aPDT) combined with artificial skin on disinfection of infected skin wound in rats. Twenty-four Wistar rats were randomly distributed into 4 groups (n = 6): (i) control-untreated; (ii) aPDT-treated with curcumin-mediated aPDT (blue light); (iii) artificial skin-treated with artificial skin alcohol-based; and (iv) aPDT plus artificial skin-treated with aPDT associated with artificial skin alcohol-based. For the in vivo model, a full-thickness biopsy with 0.80 cm was performed in order to inoculate the microorganism Staphylococcus aureus (ATCC 25923). The aPDT was performed with a curcumin gel and a blue LED light (450 nm, 80 mW/cm2) at the dose of 60 J/cm2 and the treatment with alcohol-based artificial skin was done with the topical application of 250 µL. Additional animals were submitted to aPDT combined with the artificial skin. After treatments, the number of colony-forming units (CFU) and the damage area were determined. Data were analyzed by two-way repeated measures ANOVA and Tukey tests. The highest reduction of the bacterial viability was observed in the PDT plus artificial skin group (4.14 log10), followed by artificial skin (2.38 log10) and PDT (2.22 log10) groups. In addition, all treated groups showed higher relative area of wound contraction (36.21% for the PDT, 38.41% for artificial skin, and 35.02% for PDT plus artificial) in comparison with the control group. These findings provide evidence for the positive benefits of aPDT with blue light and curcumin associated with artificial skin to decontaminate and accelerate the wound contraction.

Effects of grape juice consumption on muscle fatigue and oxidative stress in judo athletes: a randomized clinical trial.

Physiological levels of reactive oxygen species (ROS) are important for intracellular and extracellular redox regulation in signaling and defense processes. Strenuous exercise can also contribute to this imbalance, and the muscle fatigue, evidenced by impaired strength or power generation, can be caused by various reasons, including oxidative stress. Antioxidants can prevent the formation of ROS by intercepting free radicals. Twenty judo athletes were included in this randomized, double-blind clinical trial into grape juice and placebo groups, and they consumed grape juice or placebo daily for 14 days in a crossover model. The outcomes were analyzed before and after combat simulations. The upper limb strength was higher in the grape juice group than in the placebo (p [group] = 0.003). The lipid damage levels were 10% higher in the placebo group (p [interaction] = 0.048). During the pre-exercise, the placebo group showed 19% more DNA damage than the grape juice group. The superoxide dismutase activity was 80% lower in the grape juice group (p [interaction] < 0.001). The consumption of grape juice can improve parameters of oxidative stress by reducing the lipid and DNA damage.

Supplementation of Probiotics and Its Effects on Physically Active Individuals and Athletes: Systematic Review.

The aim of this study was to conduct a systematic review of the effects of probiotic supplementation on physically active individuals. The participants, interventions, comparisons, outcome and study design inclusion criteria were (a) studies involving healthy adults or older subjects of both sexes who did physical exercise (including athletes and physically active individuals), (b) interventions with probiotics, (c) inclusion of a control group, (d) outcomes not previously defined, and (e) clinical trials and randomized clinical trials, with no language or date restrictions. The search was conducted in the following scientific databases: MEDLINE, Embase, SciELO, Scopus, and Lilacs. Search terms were "Probiotics" OR "Prebiotics" OR "Microbiota" AND "Exercise" OR "Athletes." The articles were first screened by title and abstract by two independent reviewers and disagreements resolved by a third reviewer. Data were extracted independently by the same two reviewers; results were extracted in duplicate and then compared to avoid errors. A total of 544 articles were retrieved and 24 were included. A total of 1,680 patients were included, most of them being male (n = 1,134, 67.5%), with a mean age of 30.9 ± 6.1 years. Following probiotic supplementation, positive effects have been reported for several outcomes including respiratory tract infection, immunologic markers, and gastrointestinal symptoms in both athletes and nonathletes. However, published studies have distinct protocols and measured outcomes, and some of them have small sample size and failed to prove beneficial effect on probiotic supplementation, leading to inconclusive results for standardized supplementation protocols.

Virulence factors of fluconazole-susceptible and fluconazole-resistant Candida albicans after antimicrobial photodynamic therapy.

This study evaluated the effects of antimicrobial photodynamic therapy (aPDT) mediated by Photodithazine® (PDZ) and LED light on the virulence factors of fluconazole-susceptible (CaS) and fluconazole-resistant (CaR) Candida albicans. Standardized suspensions of strains were prepared (107), and after 48 h of biofilm formation, these strains were incubated with PDZ (100 mg/L) for 20 min and exposed to LED light (660 nm, 37.5 J/cm2). Additional samples were treated with PDZ or light only, and the control consisted of biofilms that received no treatment. After aPDT, the cells were recovered and the virulence factors were evaluated. To analyze the capacity of adhesion, cells were recovered after aPDT and submitted to the adhesion process in the bottom of a 96-well plate. After this, metabolic activity tests (XTT assay) and cell viability (colony forming units per milliliter, CFU/mL) were applied. To evaluate the biofilm-forming ability after aPDT, the cells recovered were submitted to biofilm formation procedures, and the biofilm formed was evaluated by XTT, CFU/mL, and total biomass (crystal violet) tests. Lastly, the capacity for synthesizing protease and phospholipase enzymes after aPDT was evaluated by fluorimetric tests. Data were analyzed by two- or three-way ANOVA tests (p ≤ 0.05). It was verified that aPDT reduced the viability of both strains, fluconazole-susceptible and fluconazole-resistant C. albicans. It was also observed that the CaR strain had lower susceptibility to the aPDT when compared with the CaS strain. However, regarding the virulence factors evaluated, it was demonstrated that aPDT did not alter the adherence and biofilm formation ability and enzymatic production.

Effects of beta-alanine supplementation on performance and muscle fatigue in athletes and non-athletes of different sports: a systematic review.

INTRODUCTION: Beta-alanine (BA) is a non-essential amino acid that can be synthesized in the liver and obtained from diet, particularly from white and red meat. Increased availability of BA via dietary supplement, may improve performance of athletes. The aim of this study was to conduct a review of the use of BA supplementation as an ergogenic aid to improve performance and fatigue resistance in athletes and non-athletes. EVIDENCE ACQUISITION: In this systematic review, a search in PubMed and Bireme databases was performed for the terms "beta-alanine," "beta-alanine and exercise," "carnosine" or "carnosine and exercise" in the titles or abstracts. We included randomized, clinical trials published between 2005 and 2015. EVIDENCE SYNTHESIS: Twenty-three studies were selected. Most of them included physically active individuals. The mean intervention period was 5.2±1.8 weeks, and mean BA dose was 4.8±1.3 g/day. The main outcome measures were blood lactate, pH, perceived exertion, power and physical working capacity at fatigue threshold. After BA supplementation, no statistically significant difference was observed in total work, exercise performance time, oxygen consumption and time to exhaustion. CONCLUSIONS: BA supplementation seems to improve perceived exertion and biochemical parameters related to muscle fatigue and less evidence was found for improvement in performance.

In vitro antibacterial and chemical properties of essential oils including native plants from Brazil against pathogenic and resistant bacteria.

The antimicrobials products from plants have increased in importance due to the therapeutic potential in the treatment of infectious diseases. Therefore, we aimed to examine the chemical characterisation (GC-MS) of essential oils (EO) from seven plants and measure antibacterial activities against bacterial strains isolated from clinical human specimens (methicillin-resistant Staphylococcus aureus (MRSA) and sensitive (MSSA), Escherichia coli, Pseudomonas aeruginosa, Salmonella Typhimurium) and foods (Salmonella Enteritidis). Assays were performed using the minimal inhibitory concentration (MIC and MIC90%) (mg/mL) by agar dilution and time kill curve methods (log CFU/mL) to aiming synergism between EO. EO chemical analysis showed a predominance of terpenes and its derivatives. The highest antibacterial activities were with Cinnamomun zeylanicum (0.25 mg/mL on almost bacteria tested) and Caryophyllus aromaticus EO (2.40 mg/mL on Salmonella Enteritidis), and the lowest activity was with Eugenia uniflora (from 50.80 mg/mL against MSSA to 92.40 mg/mL against both Salmonella sources and P. aeruginosa) EO. The time kill curve assays revealed the occurrence of bactericide synergism in combinations of C. aromaticus and C. zeylanicum with Rosmarinus. officinalis. Thus, the antibacterial activities of the EO were large and this can also be explained by complex chemical composition of the oils tested in this study and the synergistic effect of these EO, yet requires further investigation because these interactions between the various chemical compounds can increase or reduce (antagonism effect) the inhibitory effect of essential oils against bacterial strains.

An in vitro and in vivo study of the α-amylase activity of phaseolamin.

We evaluated the polypeptide profiles, inhibition of human salivary α-amylase activity, and hemagglutination properties of a commercial phaseolamin sample. We also performed an in vivo assay to investigate the effects of a commercial phaseolamin treatment (100, 500, or 1500 mg/kg) over 20 days on the glycemia, body weight, and serum biochemical parameters (total cholesterol, triglycerides, alanine aminotransferase, and aspartate aminotransferase) of nondiabetic and streptozotocin-induced diabetic rats. The in vitro evaluation showed defined protein profiles, low hemagglutination activity, and high α-amylase inhibition. None of the experimental groups treated with phaseolamin or acarbose showed decreases in body weight. Our data demonstrate that phaseolamin inhibits amylase activity in vitro, reduces blood glucose levels, decreases or attenuates some of the renal and hepatic effects of diabetes in streptozotocin-induced rats, and could therefore have therapeutic potential in the treatment or prevention of the complications of diabetes.

Overexpression of myosin-IIB in the brain of a rat model of streptozotocin-induced diabetes.

The Ca(2+)/calmodulin complex interacts with and regulates various enzymes and target proteins known as calmodulin-binding proteins (CaMBPs). This group of proteins includes molecular motors such as myosins. In this study, we show that non-muscle myosin-IIB is overexpressed in the brains of diabetic rats. We isolated CaMBPs from the brains of non-diabetic rats and rats with streptozotocin-induced diabetes and purified them by immobilized-calmodulin affinity chromatography. The proteins were eluted with EGTA and urea, separated by SDS-PAGE, digested and submitted to peptide mass fingerprinting analysis. Thirteen intense bands were found in both types of brains, two were found exclusively in non-diabetic brains and four were found exclusively in diabetic brains. A large fraction of the eluted proteins contained putative IQ motifs or calmodulin-binding sites. The results of the myosin-IIB affinity chromatography elution, western blot and RT-PCR analyses suggest that myosin-IIB protein and mRNA are expressed at high levels in diabetic brains. This is the first study that has demonstrated differential expression of CaMBPs in diabetic and non-diabetic brain tissue through a comparative proteomic analysis, and it opens up a new approach to studying the relationship between the expression of myosins in the brain, hyperglycemia and intracellular calcium regulation.

Perinatal L-arginine and antioxidant supplements reduce adult blood pressure but not ameliorate the altered vascular function in spontaneously hypertensive rats

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Spontaneously hypertensive rat (SHR) offspring from L-arginine- and antioxidant-supplemented SHR dams had persistent lower blood pressure in adulthood. We investigated the influence of vascular mechanism in this effect. We analyzed response to acetylcholine and phenylephrine in aorta and superior mesenteric arteries from Wistar–Kyoto (WKY), SHR, and SHR perinatally supplemented with L-arginine and 4-hydroxy-2,2,6,6-tetramethylpiperidinoxyl (TEMPOL; SHR-suppl). Supplements reduced blood pressure persistently in SHR. Relaxation to acetylcholine was greater in WKY than SHR and remained unmodified in SHR-suppl compared with SHR. Acute TEMPOL did not alter relaxation to acetylcholine in WKY but increased it similarly in SHR and SHR-suppl. Phenylephrine contraction was increased in SHR compared to WKY. In SHR-suppl, this response was similar to SHR. Endothelium removal or N-nitro-L-arginine methyl ester (L-NAME) increased contraction to phenylephrine more in WKY than SHR. In SHR-suppl, this was similar to SHR. In both SHR and SHR-suppl, TEMPOL similarly reduced phenylephrine response. This effect was prevented by L-NAME. Results exposed reinforce the concept that oxidative stress during perinatal period is a contributing factor to the development of hypertension in SHR. Results also reveal that the beneficial effect of this supplementation does not appear to be related to improved endothelial function, suggesting that other regulatory mechanisms of blood pressure may be involved (AU)

Suplemento artesanal oral: uma proposta para recuperação nutricional de crianças e adolescentes com câncer / Homemade oral supplement: a proposal for the nutritional recovery of children and adolescents with cancer

Objetivo Avaliar o impacto do suplemento oral artesanal na recuperação do estado nutricional de pacientes com desnutrição leve, grave e com risco nutricional. Métodos Propuseram-se oito receitas de suplementos visando ofertar entre 30,0 por cento e 35,0 por cento do gasto energético total. Os pacientes com desnutrição grave (grupo B) receberam o suplemento oral por duas semanas, e os demais pacientes (grupo A), por quatro semanas. Para a comparação dos resultados obtidos com o emprego do suplemento oral artesanal, foram utilizados dados referentes a um protocolo anterior, com o mesmo desenho, entretanto, com a utilização de suplemento oral industrializado. Resultados O suplemento oral artesanal fica muito aquém no que diz respeito a alguns micronutrientes, entretanto é cinco vezes mais barato do que a preparação com o suplemento oral industrializado. Os pacientes do grupo A com suplemento oral artesanal apresentaram 88,0 por cento de resposta positiva na semana de avaliação, enquanto os com suplemento oral industrializado tiveram 84,0 por cento. No grupo B, foram recuperados 22,0 por cento dos pacientes com suplemento oral artesanal e 25,0 por cento do grupo com suplemento oral industrializado, não apresentando, portanto, diferença significante. Comparando o impacto do industrializado com o do artesanal na prega cutânea tricipital e circunferência do braço, verificou-se que o suplemento oral industrializado no grupo A apresentou melhores resultados que o suplemento oral artesanal, e no grupo B, esse efeito observado na prega cutânea não foi significante (p=0,16). Os consumos de energia e de proteína, assim como a evolução nutricional, foram semelhantes entre suplemento oral industrializado e suplemento oral artesanal. Apenas a composição corpórea no grupo A com suplemento oral industrializado apresentou melhores resultados. Conclusão Os resultados apresentados neste estudo sugerem que o emprego da terapia com suplemento artesanal seja uma opção capaz de auxiliar na recuperação nutricional de pacientes oncológicos e uma opção para populações financeiramente desfavorecidas.

Objective The aim of this study was to evaluate the impact of homemade oral supplements on the nutritional recovery of patients with mild or severe malnutrition or at nutritional risk. Methods Eight recipes of homemade oral supplements containing 30 percent to 35 percent of the total energy expenditure were proposed. The patients with severe malnutrition (group B) received the oral supplement for 2 weeks and the others for 4 weeks (group A). Oral supplementation with homemade supplements was compared with oral supplementation with store-bought supplements, investigated earlier with a protocol with the same design. Results Homemade oral supplements contain much lower amounts of certain micronutrients but are five times cheaper than store-bought supplements. In group A, 88 percent of the patients taking homemade oral supplements and 84 percent of the patients taking store-bought supplements responded positively to supplementation. In group B, 22 percent of the patients taking homemade oral supplements and 25 percent of the patients taking store-bought supplements recovered. The difference was not significant. The impact of store-bought supplementation on the triceps skinfold thicknesses and arm circumferences of the patients in group A was greater than that obtained with homemade supplements. In group B, the effect on triceps skinfold thickness was not significant (p=0.16). Patients taking homemade or store-bought oral supplements presented similar protein and energy intakes and improvements in nutritional status. Only the body composition of patients in group A taking store-bought oral supplements was better. Conclusion The results obtained by this study suggest that the therapeutic use of homemade oral supplements is an alternative capable of promoting the nutritional recovery of cancer patients, especially those who cannot afford store-bought supplements.

Perinatal L-arginine and antioxidant supplements reduce adult blood pressure but not ameliorate the altered vascular function in spontaneously hypertensive rats.

Spontaneously hypertensive rat (SHR) offspring from L-arginine- and antioxidant-supplemented SHR dams had persistent lower blood pressure in adulthood. We investigated the influence of vascular mechanism in this effect. We analyzed response to acetylcholine and phenylephrine in aorta and superior mesenteric arteries from Wistar-Kyoto (WKY), SHR, and SHR perinatally supplemented with L-arginine and 4-hydroxy-2,2,6,6-tetramethylpiperidinoxyl (TEMPOL; SHR-suppl). Supplements reduced blood pressure persistently in SHR. Relaxation to acetylcholine was greater in WKY than SHR and remained unmodified in SHR-suppl compared with SHR. Acute TEMPOL did not alter relaxation to acetylcholine in WKY but increased it similarly in SHR and SHR-suppl. Phenylephrine contraction was increased in SHR compared to WKY. In SHR-suppl, this response was similar to SHR. Endothelium removal or N-nitro-L-arginine methyl ester (L-NAME) increased contraction to phenylephrine more in WKY than SHR. In SHR-suppl, this was similar to SHR. In both SHR and SHR-suppl, TEMPOL similarly reduced phenylephrine response. This effect was prevented by L-NAME. Results exposed reinforce the concept that oxidative stress during perinatal period is a contributing factor to the development of hypertension in SHR. Results also reveal that the beneficial effect of this supplementation does not appear to be related to improved endothelial function, suggesting that other regulatory mechanisms of blood pressure may be involved.

Suplementos orais artesanais desenvolvidos para pacientes com câncer: análise descritiva / Homemade oral supplements for patients with cancer: descriptive analysis

OBJETIVO: Descrever a elaboração de oito formulações de suplementos artesanais orais desenvolvidos para aumentar o consumo de energia, proteínas e micronutrientes de pacientes com câncer, analisar seu valor nutricional e avaliar a apreciação do sabor, testando dois tipos de lipídeos. MÉTODOS: Os suplementos foram desenvolvidos com base em quatro ingredientes alimentares: leite, ovos, açúcares e óleos para recuperação nutricional. As formulações foram calculadas pelo programa de apoio à nutrição NUTWIN e seu valor nutricional foi comparado às recomendações para pacientes com câncer para macronutrientes e às Ingestões Diárias Recomendadas para micronutrientes. Por meio de degustação, os suplementos foram testados para verificação do sabor quando preparados com óleo ou margarina. RESULTADOS: A quantidade de energia por mililitro variou de 1,35 a 2,17kcal, tendo 39 por cento a 59 por cento de carboidrato, 11 por cento a 13 por cento de proteína e 30 por cento a 49 por cento de lipídeo, fornecendo em média 43 por cento e 77 por cento da recomendação de energia e proteína, respectivamente. Vitaminas C e K, ácido fólico e manganês apresentaram 15 por cento de adequação em relação às recomendações. Com relação ao sabor, 78 por cento dos pacientes que experimentaram com óleo e 85 por cento dos que experimentaram com margarina relataram sabor bom, sem diferença estatística entre os tipos de suplementos. CONCLUSÃO: A avaliação do sabor demonstrou que a maioria dos pacientes considerou o suplemento com sabor bom. Essas taxas foram superiores quando testados com margarina. Os resultados sugerem que o uso de suplementos orais artesanais pode ser uma alternativa viável em situações onde não há recursos suficientes para aquisição dos industrializados.

OBJECTIVE: This study aimed to describe the development of eight formulations of homemade oral supplements that propose to increase the energy, protein and micronutrient intakes of patients with cancer, analyze its nutritional value and assess its taste using two different fat sources. METHODS: The supplements were based on four ingredients: milk, eggs, sugars and oils for nutritional recovery. The formulations were calculated by the nutritional support software NUTWIN. The nutritional value of the formulations was compared with the recommendations for cancer patients for macronutrients and with the Recommended Daily Intakes for micronutrients. The supplements were tested. The supplements underwent taste tests to determine if the patients preferred supplements prepared with oil or margarine. RESULTS: The amount of energy per milliliter varied from 1.35 to 2.17kcal. The carbohydrate content varied from 39 percent to 59 percent, protein content from 11 percent to 13 percent and fat content from 30 percent to 49 percent, providing roughly 43 percent and 77 percent of the recommended energy and protein intake, respectively. The contents of vitamins C and K, folic acid and manganese represented 15 percent of the recommended daily intakes. More patients approved the taste of the supplements prepared with margarine (85 percent) than with oil (78 percent) but the difference was not significant. CONCLUSION: Taste tests showed that most patients liked the taste of the supplements. Supplements prepared with margarine had better acceptance. The results suggest that the use of homemade oral supplements can be a viable alternative for people who do not have the resources to buy commercial oral supplements.