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1.
Crit Rev Food Sci Nutr ; : 1-16, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38733290

RESUMO

Poor oral health can impact an individual's ability to eat and has been associated with an increased risk of non-communicable diseases. While the benefits of nitrate consumption on oral health were first proposed more than 20 years ago, no systematic review has been published examining effects of dietary nitrate on oral health. This systematic review investigated the effects of dietary nitrate on markers of oral health in vivo in randomized controlled trials (RCTs). Five databases (PubMed, The Cochrane Library, CINAHL, MEDLINE, and SPORTDiscus) were searched from inception until March 2023. Nine articles reporting data on 284 participants were included. Dietary nitrate was provided via beetroot juice in most studies. The duration of the interventions ranged from one day to six weeks. Dietary nitrate supplementation increased the relative abundance of several individual bacterial genera including Neisseria and Rothia. Dietary nitrate supplementation increased salivary pH and decreased salivary acidification following consumption of a sugar-sweetened beverage. Furthermore, dietary nitrate supplementation resulted in a decrease in the gingival inflammation index. The results of this systematic review suggest that dietary nitrate could represent a potential nutritional strategy to positively modify oral health by impacting the oral microbiome, altering salivary pH, and minimizing gingival inflammation.

2.
NPJ Sci Food ; 8(1): 8, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38291073

RESUMO

Epidemiological studies have shown associations between whole-grain intake and lowered disease risk. A sufficient level of whole-grain intake to reach the health benefits has not been established, and there is limited knowledge about the impact of whole-grain intake on metabolite levels. In this clinical intervention study, we aimed to identify plasma and urine metabolites associated with two different intake levels of whole-grain wheat and rye and to correlate them with clinical plasma biomarkers. Healthy volunteers (N = 68) were divided into two groups receiving either whole-grain wheat or whole-grain rye in two four-week interventions with 48 and 96 g/d of whole grains consumed. The metabolomics of the plasma samples was performed with UPLC-QTOF-MS. Plasma alkylresorcinols were quantified with GC-MS and plasma and urinary mammalian lignans with HPLC-ECD. The high-dose intervention impacted the metabolite profile, including microbial metabolites, more in the rye-enriched diet compared with wheat. Among the increased metabolites were alkylresorcinol glucuronides, sinapyl alcohol, and pipecolic acid betaine, while the decreased metabolites included acylcarnitines and ether lipids. Plasma alkylresorcinols, urinary enterolactone, and total mammalian lignans reflected the study diets in a dose-dependent manner. Several key metabolites linked with whole-grain consumption and gut microbial metabolism increased in a linear manner between the two interventions. The results reveal that an increase in whole-grain intake, particularly rye, is strongly reflected in the metabolite profile, is correlated with clinical variables, and suggests that a diet rich in whole grains promotes the growth and/or metabolism of microbes producing potentially beneficial microbial metabolites.

3.
Crit Rev Food Sci Nutr ; : 1-13, 2023 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-38104588

RESUMO

Carrots are main dietary sources of several potential anti-cancer compounds, including polyacetylenes, while ß-carotene has shown no benefits in controlled cancer trials. Accordingly, associations between carrot intake and cancer incidence were quantified, where necessary using α-carotene as a non-causal biomarker of carrot consumption, by searching for studies published before June 2022 reporting risk estimates for relationships of cancer incidence with carrot intake or α-carotene intake or α-carotene plasma concentration, supplemented with hand searches of included studies and reviews. Meta-analyses comparing highest and lowest reported intakes in prospective studies using a random-effects model estimated summary relative risks (RRs) with 95% confidence intervals (CIs), separately for carrot intake or α-carotene plasma concentration, and the corresponding dose-responses. Of 198 observational studies, in 50 prospective studies with 52000 cases recording carrot intake, the cancer-risk was substantially reduced (RR 0.90, 95% CI 0.87-0.94, p ˂ 0·00004). In 30 prospective studies with 9331 cases reporting plasma α-carotene levels, summary RR was 0.80 (0.72-0.89, p ˂ 0·00006). For both exposure types, inter-study heterogeneity was moderate, interaction with cancer types insignificant, and the dose-response significant (p ˂ 0·01). In conclusion, carrot consumption is robustly associated with decreased cancer-risk; carrot consumption should be encouraged, and the causal mechanisms further investigated.

4.
Plants (Basel) ; 12(7)2023 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-37050179

RESUMO

Tomatoes (Solanum lycopersicum L.) of the variety Elpida were grown under standard Mediterranean greenhouse conditions during the spring season at three different nitrogen levels (low 6.4, standard 12.8, high 25.9 mM/plant), which were replicated during two consecutive years. Application of high nitrogen significantly increased the colour index a* (p < 0.001) but did not significantly affect yield or quality. The variety exhibited prolonged postharvest storage at room temperature (median survival time of 93 days). The maturation process was delayed by harvest at the breaker stage (2.5 days, p ≤ 0.001) or by super-optimal temperatures in the second year of experimentation (10 days, p ≤ 0.001). The colour indices L* and a* and the hue angle (a/b*) were positively correlated with the sum of total carotenoids, while differences in b* depended on the year of cultivation. The sustainability of this type of tomato production can be improved by reducing the nitrogen supply to less than the current standard practice, with minimal risk or negative effects on yield and quality of tomatoes.

5.
Foods ; 12(6)2023 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-36981118

RESUMO

Polyacetylene phytochemicals are emerging as potentially responsible for the chemoprotective effects of consuming apiaceous vegetables. There is some evidence suggesting that polyacetylenes (PAs) impact carcinogenesis by influencing a wide variety of signalling pathways, which are important in regulating inflammation, apoptosis, cell cycle regulation, etc. Studies have shown a correlation between human dietary intake of PA-rich vegetables with a reduced risk of inflammation and cancer. PA supplementation can influence cell growth, gene expression and immunological responses, and has been shown to reduce the tumour number in rat and mouse models. Cancer chemoprevention by dietary PAs involves several mechanisms, including effects on inflammatory cytokines, the NF-κB pathway, antioxidant response elements, unfolded protein response (UPR) pathway, growth factor signalling, cell cycle progression and apoptosis. This review summarises the published research on falcarinol-type PA compounds and their mechanisms of action regarding cancer chemoprevention and also identifies some gaps in our current understanding of the health benefits of these PAs.

6.
Eur J Nutr ; 61(8): 4191-4203, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35871120

RESUMO

PURPOSE: To compare acute effects on blood pressure (BP) of ingestion of visually similar lettuce with controlled high and low content of either nitrate or phenolic compounds. METHODS: In a randomised cross-over design, 19 healthy participants (22-31 years) received 50 g of lettuce containing either 530 mg (8.4 mmol) nitrate + 11 mg (0.03 mmol) phenolic compounds (HNLP); or 3 mg nitrate (0.05 mmol) + 77 mg (0.2 mmol) phenolic compounds (LNHP), obtained by differential fertilisation. Ambulatory BP was recorded along with plasma, salivary and urinary nitrate and nitrite and plasma concentrations of cyclic guanosine monophosphate (cGMP), phenolic metabolites, Trolox equivalent antioxidant capacity (TEAC) and ferric reducing antioxidant power (FRAP). RESULTS: Compared with LNHP, 3 h post ingestion of HNLP, plasma nitrate increased 0.31 ± (95%CI) 0.12 mM (+ 240%), and salivary nitrate 5.5 ± 1.4 mM (+ 910%); accumulated urinary nitrate excretion increased 188 ± 72 mg (+ 296%) (all P < 0.001). Systolic BP was reduced 4.9 ± 4.2 mmHg (P = 0.031) between 3 and 6 h after ingestion of HNLP compared with LNHP; systolic BP differences were negatively correlated (P = 0.004) with differences in saliva nitrate concentrations. LNHP increased plasma phenolics at 6 h, predominantly 3'-methoxycinnamic acid-4'-glucuronide (ferulic acid-4'-glucuronide), 116%, 204 ± 138 nM more than HNLP (P = 0.001); increased cGMP 14% (P = 0.019); and reduced FRAP 3.1% (P = 0.009). CONCLUSION: The acute BP difference within 6 h of consumption matched the plasma/saliva nitrate peak, not the slower changes of plasma phenolics. This is the first double-blind controlled dietary intervention demonstrating differential effects on human physiology by consumption of an intact plant food, where compositional differences were obtained by controlling growing conditions, indicating potential opportunities for health claims relating to precision/vertical farming. CLINICAL TRIAL REGISTRATION: The trial was retrospectively registered on ClinicalTrials.gov, with identifier NCT02701959, on March 8, 2016.


Assuntos
Beta vulgaris , Nitratos , Adulto Jovem , Humanos , Pressão Sanguínea , Nitritos/metabolismo , Lactuca/metabolismo , Estudos Cross-Over , Antioxidantes , Glucuronídeos , Guanosina Monofosfato , Método Duplo-Cego
8.
J Chromatogr A ; 1643: 462060, 2021 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-33770631

RESUMO

Numerous epidemiological studies have indicated the potential effects of glucosinolates and their metabolites against cancer as well as other non-communicable diseases, such as cardiovascular disease and neurodegenerative disorders. However, information on the presence and quantity of glucosinolates in commonly consumed vegetables and in human fluids is sparse, largely because well-standardised methods for glucosinolate determination are not available, resulting in published data being inconsistent and conflicting. Thus, studies published since 2002 on the most recent developments of glucosinolate extraction and identification have been collected and reviewed with emphasis on determination of the intact glucosinolates by LC-MS and LC-MS/MS. This overview highlights the glucosinolate extraction methods used, the stability of glucosinolates during extraction, the availability of stable isotope labelled internal standards and the use of NMR for purity analysis, as well as the current analytical techniques that have been applied for glucosinolate analysis, e.g. liquid chromatography with mass spectrometric detection (LC-MS). It aims to interpret the findings with a focus on the development of a validated method, which will help to determine the glucosinolate content of vegetative plants and human tissues, and the identification and determination of selected glucosinolate metabolites.


Assuntos
Glucosinolatos/análise , Verduras/química , Cromatografia Gasosa/normas , Cromatografia Líquida de Alta Pressão/normas , Ensaio de Imunoadsorção Enzimática , Glucosinolatos/sangue , Glucosinolatos/normas , Glucosinolatos/urina , Humanos , Extração Líquido-Líquido , Folhas de Planta/química , Folhas de Planta/metabolismo , Raízes de Plantas/química , Raízes de Plantas/metabolismo , Plantas/química , Plantas/metabolismo , Padrões de Referência , Espectrometria de Massas em Tandem/normas , Verduras/metabolismo
9.
Aging Clin Exp Res ; 32(8): 1501-1514, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32162241

RESUMO

AIMS: Safety and tolerability of prolonged supplementation with a vitamin D, calcium and leucine-enriched whey protein medical nutrition drink (WP-MND) was evaluated in sarcopenic older adults. METHODS: A 13-week double-blinded, randomized, isocaloric placebo-controlled trial (PROVIDE study; n = 380) was extended with a voluntary 13-week open-label extension (OLE). OLE participants were randomized to receive daily 1 or 2 servings of WP-MND (21 g protein, 3 g leucine, 10 µg vitD and 500 mg calcium per serving). Gastro-intestinal tolerability, kidney function and serum levels of calcidiol, parathyroid hormone (PTH) and calcium were evaluated at week 0, 13 and 26. RESULTS AND DISCUSSION: In response to the high daily protein intake (median1.5; IQR: 1.3, 1.7 g/kg BW/day), the estimated glomerular filtration rate (eGFR) increased in the test group during the RCT (p = 0.013). The same trend was observed for those participants with moderate chronic kidney disease. During OLE no eGFR change was observed in any of the groups. Serum calcidiol and calcium reached a plateau after 13-week WP-MND supplementation. As expected, PTH significantly changed in the opposite direction, decreasing during RCT in the test group (T vs C: p < 0.001) and during OLE in former control groups. During RCT, 20/366 participants with normal baseline calcidiol reached levels ≥ 100 nmol/L (T: n = 18; C: n = 2) and 6 developed albumin-corrected calcium levels > 2.55 mmol/L (T: n = 3; C: n = 3), without associated adverse events. CONCLUSION: A 6 months intervention with up to 2 servings of WP-MND did neither result in kidney function deterioration nor symptoms of vitamin D or calcium toxicity. The product was overall well tolerated.


Assuntos
Cálcio , Suplementos Nutricionais , Leucina , Sarcopenia , Proteínas do Soro do Leite , Idoso , Método Duplo-Cego , Feminino , Humanos , Leucina/efeitos adversos , Masculino , Sarcopenia/dietoterapia , Vitamina D , Proteínas do Soro do Leite/efeitos adversos
10.
Patient Educ Couns ; 103(5): 1027-1032, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31787406

RESUMO

OBJECTIVE: To understand patients' experiences with condition interactions and develop a taxonomy to inform care for patients with multiple chronic conditions. METHODS: We conducted qualitative and quantitative analysis of free-text data from patient surveys in which respondents were asked to indicate their most bothersome chronic condition and describe how their other conditions affect their self-care for that condition. Using standard content analysis, we developed a taxonomy comprising how patients perceive interactions among their conditions, and examined cross-cutting themes that reflect qualities of these interactions. RESULTS: Among 383 eligible survey respondents, the mean (SD) number of chronic conditions was 4 (2); common conditions included hypertension (60%), chronic pain (49%), arthritis (41%), depression (32%), diabetes (29%), and post-traumatic stress disorder (26%). Patients' perceived condition interactions took four broad forms: 1) unidirectional interactions among conditions and/or treatments, 2) cyclical or multidimensional interactions, 3) uncertain or indistinct interactions, and 4) no perceived interaction. Cross-cutting themes included beliefs about causal relationships between conditions, identification of interactions as negative vs. positive, and interactions between physical and mental health. CONCLUSION: This study presents a novel taxonomy of condition interactions from the patient perspective. PRACTICE IMPLICATIONS: Understanding perceived condition interactions may support patient self-management and shared decision-making efforts.


Assuntos
Múltiplas Afecções Crônicas/terapia , Assistência Centrada no Paciente , Idoso , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Múltiplas Afecções Crônicas/classificação , Percepção , Pesquisa Qualitativa , Inquéritos e Questionários
11.
Food Hydrocoll ; 96: 688-698, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31680713

RESUMO

Inulin is a soluble dietary fibre, also classified as a prebiotic, extracted from chicory roots. The present study aimed to determine the effect of consumption of native chicory inulin on the stool frequency of middle-aged to older adults (40-75 years old) with uncomfortably but not clinically relevant low stool frequency, specified as two to four days without bowel movements per week. Two randomised, double blind, placebo-controlled crossover trials were conducted using similar protocols in differing populations. Trial A was conducted in Amsterdam, The Netherlands and subsequently Trial B was conducted in Newcastle, United Kingdom. Both trials involved supplementation for 5 weeks with 10 g per day of inulin or placebo, a washout period of 2 weeks, and then crossed over to receive the other treatment. In Trial B, faecal gut microbiota composition was assessed using 16S rRNA gene sequencing. In Trial A, which 10 volunteers completed, the stool frequency was significantly increased to an average 4.9 ±â€¯0.23 (SEM) times per week during inulin periods versus 3.6 ±â€¯0.25 in the periods with placebo (p = 0.01). In contrast, in Trial B which 20 volunteers completed, there was no significant effect of the inulin on stool frequency (7.5 ±â€¯2.1 times per week with inulin, 8.1 ±â€¯3.0 with placebo, p = 0.35). However, many subjects in Trial B had a stool frequency >5 per week also for the placebo period, in breach of the inclusion criteria. Combining the data of 16 low stool frequency subjects from Trials A and B showed a significant effect of inulin to increase stool frequency from 4.1 to 5.0 per week (p = 0.032). Regarding secondary outcomes, stool consistency was significantly softer with inulin treatment compared to placebo periods, it increased 0.29 on the Bristol stool scale (p = 0.008) when data from all subjects of Trials A and B were combined. No other differences in bowel habit parameters due to inulin consumption were significant. None of the differences in specific bacterial abundance, alpha or beta diversity were significant, however the trends were in directions consistent with published studies on other types of inulin. We conclude that 10 g per day of native chicory inulin can increase stool frequency in subjects with low stool frequency.

12.
BMJ Open ; 9(10): e030719, 2019 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-31676652

RESUMO

OBJECTIVES: To examine knowledge and beliefs about the biological roles of dietary inorganic nitrate in UK-based nutrition professionals, and to explore potential differences by participants' education level. SETTING: An online questionnaire was administered to UK-based nutrition professionals, exploring knowledge and/or beliefs across five areas: (1) health and performance effects of nitrate; (2) current and recommended intake values for nitrate; (3) dietary sources of nitrate; (4) methods of evaluating nitrate intake and (5) nitrate metabolism. PARTICIPANTS: One hundred and twenty-five nutrition professionals. PRIMARY OUTCOME: Knowledge and beliefs about inorganic nitrate. RESULTS: Most nutrition professionals taking part in the survey had previously heard of inorganic nitrate (71%) and perceived it to be primarily beneficial (51%). The majority believed that nitrate consumption can improve sports performance (59%) and reduce blood pressure (54%), but were unsure about effects on cognitive function (71%), kidney function (80%) and cancer risk (70%). Knowledge of dietary sources of nitrate and factors affecting its content in food were generally good (41%-79% of participants providing correct answers). However, most participants were unsure of the average population intake (65%) and the acceptable daily intake (64%) of nitrate. Most participants (65%) recognised at least one compound (ie, nitric oxide or nitrosamines) that is derived from dietary nitrate in the body. Knowledge of nitrate, quantified by a 23-point index created by summing correct responses, was greater in individuals with a PhD (p=0.01; median (IQR)=13 (9-17)) and tended to be better in respondents with a masters degree (p=0.054; 13 (8-15)) compared with undergraduate-level qualifications (10 (2-14)). CONCLUSIONS: UK-based nutrition professionals demonstrated mixed knowledge about the physiology of dietary nitrate, which was better in participants with higher education. More efficient dissemination of current knowledge about inorganic nitrate and its effects on health to nutrition professionals will support them to make more informed recommendations about consumption of this compound.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Escolaridade , Nitratos , Nutricionistas , Adulto , Idoso , Desempenho Atlético , Pressão Sanguínea , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recomendações Nutricionais , Inquéritos e Questionários , Reino Unido
13.
Calcif Tissue Int ; 105(4): 383-391, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31338563

RESUMO

Alterations in musculoskeletal health with advanced age contribute to sarcopenia and decline in bone mineral density (BMD) and bone strength. This decline may be modifiable via dietary supplementation. To test the hypothesis that a specific oral nutritional supplement can result in improvements in measures of bone health. Participants (n 380) were participants of the PROVIDE study, a 13-week, multicenter, randomized, controlled, double-blind, 2 parallel-group study among non-malnourished older participants (≥ 65 years) with sarcopenia [determined by Short Physical Performance Battery (SPPB; 0-12) scores between 4 and 9, and a low skeletal muscle mass index (SMI; skeletal muscle mass/BW × 100) ≤ 37% in men and ≤ 28% in women using bioelectric impedance analysis] Supplementation of a vitamin D, calcium and leucine-enriched whey protein drink that comprises a full range of micronutrients (active; 2/day) was compared with an iso-caloric control. Serum 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), biochemical markers of bone formation (osteocalcin; OC, procollagen type 1 amino-terminal propeptide; P1NP) and resorption (carboxy-terminal collagen crosslinks; CTX), insulin like growth factor 1 (IGF-1) and total-body BMD were analysed pre- and post-intervention. Serum 25(OH)D concentrations increased from 51.1 ± 22.9 nmol/L (mean ± SD) to 78.9 ± 21.1 nmol/L in the active group (p < 0.001 vs. control). Serum PTH showed a significant treatment difference (p < 0.001) with a decline in the active group, and increase in the control group. Serum IGF-1 increased in the active group (p < 0.001 vs. control). Serum CTX showed a greater decline in the active group (p = 0.001 vs. control). There were no significant differences in serum OC or P1NP between groups during the intervention. Total body BMD showed a small (0.02 g/cm2; ~ 2%) but significant increase in the active group after supplementation (p = 0.033 vs. control). Consuming a vitamin D, calcium and leucine-enriched whey protein supplement for 13 weeks improved 25(OH)D, suppressed PTH and had small but positive effects on BMD, indicative of improved bone health, in sarcopenic non-malnourished older adults.


Assuntos
Densidade Óssea/efeitos dos fármacos , Cálcio/farmacologia , Leucina/farmacologia , Vitamina D/farmacologia , Proteínas do Soro do Leite/farmacologia , Idoso , Envelhecimento/fisiologia , Densidade Óssea/fisiologia , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/metabolismo , Cálcio/metabolismo , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Humanos , Leucina/metabolismo , Masculino , Pessoa de Meia-Idade , Força Muscular/efeitos dos fármacos , Músculo Esquelético/fisiologia , Vitamina D/metabolismo
14.
Aging Clin Exp Res ; 31(6): 845-854, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31049877

RESUMO

BACKGROUND: A chronic low-grade inflammatory profile (CLIP) is associated with sarcopenia in older adults. Protein and Vitamin (Vit)D have immune-modulatory potential, but evidence for effects of nutritional supplementation on CLIP is limited. AIM: To investigate whether 13 weeks of nutritional supplementation of VitD and leucine-enriched whey protein affected CLIP in subjects enrolled in the PROVIDE-study, as a secondary analysis. METHODS: Sarcopenic adults (low skeletal muscle mass) aged ≥ 65 years with mobility limitations (Short Physical Performance Battery 4-9) and a body mass index of 20-30 kg/m2 were randomly allocated to two daily servings of active (n = 137, including 20 g of whey protein, 3 g of leucine and 800 IU VitD) or isocaloric control product (n = 151) for a double-blind period of 13 weeks. At baseline and after 13 weeks, circulating interleukin (IL)-8, IL-1 receptor antagonist (RA), soluble tumor-necrosis-factor receptor (sTNFR)1, IL-6, high-sensitivity C-reactive protein, pre-albumin and 25-hydroxyvitamin(OH)D were measured. Data-analysis included repeated measures analysis of covariance (corrected for dietary VitD intake) and linear regression. RESULTS: IL-6 and IL-1Ra serum levels showed overall increases after 13 weeks (p = 0.006 and p < 0.001, respectively). For IL-6 a significant time × treatment interaction (p = 0.046) was observed, with no significant change over time in the active group (p = 0.155) compared to control (significant increase p = 0.012). IL-8 showed an overall significant decrease (p = 0.03). The change in pre-albumin was a significant predictor for changes in IL-6 after 13 weeks. CONCLUSIONS: We conclude that 13 weeks of nutritional supplementation with VitD and leucine-enriched whey protein may attenuate the progression of CLIP in older sarcopenic persons with mobility limitations.


Assuntos
Leucina/uso terapêutico , Sarcopenia/tratamento farmacológico , Vitamina D/uso terapêutico , Proteínas do Soro do Leite/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Humanos , Proteína Antagonista do Receptor de Interleucina 1/sangue , Interleucina-6/sangue , Leucina/farmacologia , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Músculo Esquelético/efeitos dos fármacos , Sarcopenia/sangue , Vitamina D/farmacologia , Proteínas do Soro do Leite/farmacologia
15.
Chronic Illn ; 14(1): 13-24, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28449592

RESUMO

Objective To characterize diseases that are described as most bothersome by individuals with multiple chronic conditions and to identify themes that characterize their experiences with their most bothersome condition. Methods In a survey of patients at an academic center and a Veterans Affairs hospital, we asked individuals with multiple chronic conditions to identify their most bothersome chronic condition and describe why it is challenging. Standard content analysis methods were used to code responses and identify themes reflecting characteristics of most bothersome conditions. Results The most commonly cited bothersome conditions were chronic pain (52%), diabetes (43%), post-traumatic stress disorder (25%), heart failure (24%), and lung problems (20%). Conditions were described as most bothersome due to: (a) impact on function and quality of life (e.g. active symptoms, activity limitations), (b) health consequences or sequelae (e.g. risk of complications), and (c) challenges associated with treatment or self-management. Patterns of theme dominance varied for conditions with different characteristics. Discussion The conditions that patients with multiple chronic conditions identify as most bothersome vary depending on individuals' diseases and their health-related preferences and priorities. Ascertaining patients' most bothersome conditions and associated challenges, stress, and frustrations may help ensure that management decisions are aligned with patient preferences and priorities.


Assuntos
Pessoas com Deficiência/psicologia , Múltiplas Afecções Crônicas/psicologia , Qualidade de Vida , Centros Médicos Acadêmicos , Atividades Cotidianas/psicologia , Idoso , Feminino , Hospitais de Veteranos , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
16.
Clin Nutr ; 37(2): 551-557, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28132725

RESUMO

BACKGROUND: Inadequate nutritional intake and altered response of aging muscles to anabolic stimuli from nutrients contribute to the development of sarcopenia. Nutritional interventions show inconsistent results in sarcopenic older adults, which might be influenced by their basal nutritional status. OBJECTIVE: To test if baseline serum 25-hydroxyvitamin D (25(OH)D) concentrations and dietary protein intake influenced changes in muscle mass and function in older adults who received nutritional intervention. METHODS AND DESIGN: Post-hoc analysis was performed in the PROVIDE study that was a randomized controlled, double blind trial among 380 sarcopenic older adults. This study showed that those who received a vitamin D and leucine-enriched whey protein medical nutrition drink for 13 weeks gained more appendicular muscle mass (aMM), and improved lower-extremity function as assessed by the chair stand test compared with controls. To define low and high groups, a baseline serum concentration of 50 nmol/L 25(OH)D and baseline dietary protein intake of 1.0 g/kg/d were used as cut offs. RESULTS: At baseline, participants with lower 25(OH)D concentrations showed lower muscle mass, strength and function compared with participants with a high 25(OH)D, while the group with lower protein intake (g/kg/day) had more muscle mass at baseline compared with the participants with higher protein intake. Participants with higher baseline 25(OH)D concentrations and dietary protein intake had, independent of other determinants, greater gain in appendicular muscle mass, skeletal muscle index (aMM/h2), and relative appendicular muscle mass (aMM/body weight × 100%) in response to the nutritional intervention. There was no effect modification of baseline 25(OH)D status or protein intake on change in chair-stand test. CONCLUSIONS: Sufficient baseline levels of 25(OH)D and protein intake may be required to increase muscle mass as a result of intervention with a vitamin D and protein supplement in sarcopenic older adults. This suggests that current cut-offs in the recommendations for vitamin D and protein intake could be considered the "minimum" for adults with sarcopenia to respond adequately to nutrition strategies aimed at attenuating muscle loss.


Assuntos
Proteínas Alimentares/uso terapêutico , Músculo Esquelético/metabolismo , Sarcopenia/dietoterapia , Sarcopenia/tratamento farmacológico , Vitamina D/análogos & derivados , Idoso , Método Duplo-Cego , Feminino , Avaliação Geriátrica/métodos , Humanos , Leucina/uso terapêutico , Masculino , Força Muscular/efeitos dos fármacos , Força Muscular/fisiologia , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/fisiologia , Estado Nutricional , Resultado do Tratamento , Vitamina D/sangue , Vitamina D/uso terapêutico , Vitaminas/sangue , Vitaminas/uso terapêutico , Proteínas do Soro do Leite/uso terapêutico
17.
J Agric Food Chem ; 65(46): 10003-10010, 2017 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-29059519

RESUMO

This study aimed to use different nitrogen fertilizer regimes to produce Butterhead lettuce with such large differences in nitrate content that they could be used as treatment and placebo to study the effect of inorganic nitrate on human health. Plants were grown under controlled conditions at 27/23 °C day/night with a relatively low photosynthetically active radiation (PAR) of 150 µmol m-2 s-1 for 14 h day-1 and nitrogen supplies ranging from 26 to 154 ppm of N as ammonium nitrate in the fertigation solution. This resulted in contrasting high (∼1078 mg nitrate 100 g-1 FW) or low (∼6 mg 100 g-1) nitrate contents in the leaves. Contents of carotenoids and chlorophylls in fresh weight did not differ significantly between the highest and the lowest N-supply levels. However, increased nitrogen supply reduced contents of phenolic compounds from 154 to 22 mg 100 g-1 FW, dry matter content from 8.9% to 4.6%, and fresh weight per plant from 108.52 to 47.57 g/plant FW (all P < 0.001). Thus, while fertilizer treatments can provide lettuce with substantially different nitrate contents, maintaining similar pigment contents (color), they also strongly influence the contents of phenolic acids and flavones.


Assuntos
Clorofila/análise , Hidroxibenzoatos/análise , Lactuca/química , Lactuca/crescimento & desenvolvimento , Nitratos/análise , Carotenoides/análise , Carotenoides/metabolismo , Clorofila/metabolismo , Ambiente Controlado , Fertilizantes/análise , Hidroxibenzoatos/metabolismo , Lactuca/metabolismo , Nitratos/metabolismo , Nitrogênio/análise , Nitrogênio/metabolismo , Fotossíntese , Folhas de Planta/química , Folhas de Planta/crescimento & desenvolvimento , Folhas de Planta/metabolismo
18.
Clin Nutr ; 36(1): 267-274, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-26689868

RESUMO

BACKGROUND & AIM: Sarcopenia, the age-related decrease in muscle mass, strength, and function, is a main cause of reduced mobility, increased falls, fractures and nursing home admissions. Cross-sectional and prospective studies indicate that sarcopenia may be influenced in part by reversible factors like nutritional intake. The aim of this study was to compare functional and nutritional status, body composition, and quality of life of older adults between age and sex-matched older adults with and without sarcopenia. METHODS: In a multi-centre setting, non-sarcopenic older adults (n = 66, mean ± SD: 71 ± 4 y), i.e. Short Physical Performance Battery (SPPB): 11-12 and normal skeletal muscle mass index, were recruited to match 1:1 by age and sex to previously recruited adults with sarcopenia: SPPB 4-9 and low skeletal muscle mass index. Health-related quality of life, self-reported physical activity levels and dietary intakes were measured using the EQ-5D scale and index, Physical Activity Scale for the Elderly (PASE), and 3-day prospective diet records, respectively. Concentrations of 25-OH-vitamin D, α-tocopherol (adjusted for cholesterol), folate, and vitamin B-12 were assessed in serum samples. RESULTS: In addition to the defined components of sarcopenia, i.e. muscle mass, strength and function, reported physical activity levels and health-related quality of life were lower in the sarcopenic adults (p < 0.001). For similar energy intakes (mean ± SD: sarcopenic, 1710 ± 418; non-sarcopenic, 1745 ± 513, p = 0.50), the sarcopenic group consumed less protein/kg (-6%), vitamin D (-38%), vitamin B-12 (-22%), magnesium (-6%), phosphorus (-5%), and selenium (-2%) (all p < 0.05) compared to the non-sarcopenic controls. The serum concentration of vitamin B-12 was 15% lower in the sarcopenic group (p = 0.015), and all other nutrient concentrations were similar between groups. CONCLUSIONS: In non-malnourished older adults with and without sarcopenia, we observed that sarcopenia substantially impacted self-reported quality of life and physical activity levels. Differences in nutrient concentrations and dietary intakes were identified, which might be related to the differences in muscle mass, strength and function between the two groups. This study provides information to help strengthen the characterization of this geriatric syndrome sarcopenia and indicates potential target areas for nutritional interventions.


Assuntos
Composição Corporal , Estado Nutricional , Qualidade de Vida , Sarcopenia/epidemiologia , Idoso , Antropometria , Estudos de Casos e Controles , Estudos Transversais , Dieta , Exercício Físico , Feminino , Fragilidade/sangue , Fragilidade/epidemiologia , Avaliação Geriátrica , Humanos , Masculino , Desnutrição/sangue , Desnutrição/epidemiologia , Micronutrientes/administração & dosagem , Micronutrientes/sangue , Força Muscular/fisiologia , Músculo Esquelético/metabolismo , Avaliação Nutricional , Estudos Prospectivos , Sarcopenia/sangue
19.
Sci Total Environ ; 574: 476-481, 2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27644025

RESUMO

The availability of K, essential for plant growth, from syenite (a silicate rock in which potassium feldspar is the dominant mineral; >90wt%), and phlogopite mica has been demonstrated using carefully designed plant growth pot experiments in which the only added source of K was the mineral of interest, with no loss of nutrients through drainage. Using pure quartz sand as a soil, both growth (increase in diameter) of leek plants and K-content of the plant material showed a dose-dependent positive response to the application (114-43000mgK/pot) of milled syenite with increases in plant diameter of 0.5-0.7mm/week, increasing with application rate. Phlogopite mica (114-6000mgK/pot) supported the highest observed increase in diameter (approx. 1mm/week) and plant K-content, both similar to that observed for a positive control (KCl). These experiments demonstrate that plants can obtain K for growth from milled syenite, in which feldspar is the dominant K-bearing mineral, and confirm previous observations that micas can be an effective source of K.

20.
J Nutr ; 146(11): 2224-2232, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27733522

RESUMO

BACKGROUND: Aging and obesity are associated with raised oxidative stress and a reduction of nitric oxide (NO) bioavailability, with subsequent decline in insulin sensitivity and endothelial function. Inorganic nitrate is converted into NO via a 2-step reduction process and may be an effective nutritional intervention to modify vascular and metabolic functions. OBJECTIVES: This study tested whether inorganic nitrate supplementation improved glucose disposal and attenuated the acute effects of hyperglycemia on oxidative stress, inflammation, and vascular function in young and old obese participants. METHODS: Ten young (aged 18-44 y) and 10 old (aged 55-70 y) obese participants consumed 75 g glucose followed by either potassium nitrate (7 mg/kg body weight) or potassium chloride (placebo) in a randomized, double-blind crossover design. Resting blood pressure (BP), endothelial function, and blood biomarkers were measured for 3 h postintervention. Biomarkers included plasma nitrate/nitrite (NOx), glucose, insulin, cyclic GMP, interleukin 6, 3-nitrotyrosine, E- and P-selectins, intercellular adhesion molecule 3 (ICAM-3), and thrombomodulin, as well as superoxide in freshly isolated peripheral blood mononuclear cells (PBMCs). RESULTS: Inorganic nitrate supplementation did not affect plasma glucose (P = 0.18) or insulin (P = 0.26) responses. The increase in plasma NOx concentrations 3 h after the administration of inorganic nitrate was significantly higher in young than in old participants (234% increase compared with 149% increase, respectively, P < 0.001). Plasma 3-nitrotyrosine concentrations declined significantly after inorganic nitrate supplementation compared with placebo (3 h postdose, 46% decrease compared with 27% increase, respectively, P = 0.04), and a similar nonsignificant trend was observed for superoxide concentrations (3 h postdose, 16% decrease compared with 23% increase, respectively, P = 0.06). Plasma cyclic GMP, ICAM-3, and thrombomodulin concentrations differed between young and old participants (P < 0.01). Inorganic nitrate supplementation did not improve BP or endothelial function. CONCLUSIONS: Oral supplementation with inorganic nitrate did not improve glucose and insulin responses but reduced oxidative stress in old individuals during acute hyperglycemia. This trial was registered at www.controlled-trials.com as ISRCTN42776917.


Assuntos
Envelhecimento , Glicemia/efeitos dos fármacos , Insulina/sangue , Nitratos/farmacologia , Obesidade/metabolismo , Compostos de Potássio/farmacologia , Adolescente , Adulto , Idoso , Biomarcadores , Glicemia/metabolismo , Feminino , Humanos , Inflamação , Insulina/metabolismo , Masculino , Pessoa de Meia-Idade , Nitratos/administração & dosagem , Estresse Oxidativo , Cloreto de Potássio/administração & dosagem , Cloreto de Potássio/farmacologia , Compostos de Potássio/administração & dosagem , Adulto Jovem
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