Seasonal and sex-related variation in vitamin D status and its association with other biochemical markers in young individuals: A cross-sectional study.

BACKGROUND: While several studies have investigated the association between vitamin D deficiency and biochemical parameters, the results are still inconsistent and mostly overlook seasonal variations. This study explored the relationships between 25-hydroxy-vitamin D (25(OH)D) concentrations, biochemical markers, and seasonal variation among young males and females. METHODS: A cross-sectional study was conducted among 203 individuals aged 18-24 years of both sexes residing in Brasilia, Brazil (latitude: 15°S). Sociodemographic variables, season of blood collection, and serum levels of 25(OH)D, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glycated hemoglobin (HbA1c), glucose, insulin, hs-CRP, parathyroid hormone, ionized calcium, and alkaline phosphatase were included. Descriptive statistics and differences among groups, correlations, and linear regression tests were performed. RESULTS: The mean age of the participants was 21.17±1.7 years, and the mean serum 25(OH)D level was 25.76±7.0 ng/mL. Of the participants, 50.7% had vitamin D insufficiency (20 to 29.9 ng/mL), and 23.2% were vitamin D deficient (≤20 ng/mL). Vitamin D deficiency was higher in the spring (53.2%) and among females (29.5%). In young men with vitamin D insufficiency/deficiency (≤29.9 ng/mL) (n = 49), 25(OH)D levels were inversely correlated with HOMA-ß (r = -0.234, p = 0.032) and triglyceride (r = -0.415, p = 0.003) levels. However, there were no significant correlations between 25(OH)D concentrations and biochemical markers among women with insufficient and deficient vitamin D levels. CONCLUSION: This study found a high prevalence of vitamin D insufficiency/deficiency among young individuals living in Brasília, Brazil, particularly women and during the spring season. Our findings suggest that lower 25(OH)D levels (≤29.9 ng/mL) may be associated with insulin resistance and an increased risk of cardiovascular disease in young men studied. However, further studies with larger representative samples are needed to explore the mechanisms underlying the association between vitamin D and biochemical parameters.

Development and Validation of Protocol Based on Brazilian Dietary Guidelines for Adults with Diabetes Mellitus Who Attended Primary Health Care.

BACKGROUND: To date, there is no protocol providing dietary guidelines to assist health care professionals in counseling Brazilian individuals with Diabetes Mellitus (DM) assisted in primary health care (PHC) according to the Dietary Guidelines for the Brazilian Population (DGBP). Therefore, this study aimed to develop and validate a protocol based on the DGBP for health care, non-nutritionist professionals in counseling adults with DM in PHC. METHODS: We systematized the recommendations published in the DGBP, the Diabetes Brazilian Society guidelines, and the scientific literature regarding food and nutrition needs of adults with DM. The clarity and relevance were validated by an expert panel (n = 19) and the understanding and applicability were validated by PHC professionals (n = 12). The degree of agreement of the experts was assessed using a Content Validity Index (CVI). Items receiving CVI > 0.8 were considered appropriate. RESULTS: The protocol consisted of six dietary recommendations that encouraged the daily consumption of beans, vegetables, and fruits, advised the avoidance of sugar-sweetened beverages and ultra-processed foods, stimulated eating in appropriate environments, and gave additional guidance addressed to the particularities of DM. The protocol clarity, relevance, and applicability were successfully validated. CONCLUSION: The protocol supports health care, non-nutritionist professionals in the guidance of dietary recommendations and promoting adequate and healthy eating habits for adults with DM in PHC.

Determinant factors of bone health after long-term of Roux-en-Y gastric bypass surgery: A cross-sectional study.

OBJECTIVES: The aim of this study was to evaluate bone health and the potential influencing factors of bone metabolism disorders in adults ≥5 y after Roux-en-Y gastric bypass (RYGB) surgery. METHODS: In this cross-sectional study, patients who were ≥5 y post-RYGB were invited. Bone health considered as bone mineral content (BMC) and bone mineral density (BMD) in this study was assessed by dual x-ray absorptiometry. We also assessed 25-hydroxy-vitamin D concentrations, individual ultraviolet B radiation levels, serum ionized calcium, alkaline phosphatase, parathyroid, anthropometric, and body composition. RESULTS: The study evaluated 104 adults (90% women; 49.6 ± 9.1 y old; postoperative period 8.7 ± 2.2 y). Lumbar and femoral BMC and BMD were positively correlated to body mass index (BMI), appendicular lean mass (ALM), and negatively to %excess of weight loss (EWL). Femoral BMD was negatively correlated to age, and both femoral BMD and BMC were positively correlated to weekly exposed body part score. Sex, age, BMI, ALM, and weekly exposed body part score explained 35% and 54% of the total variance of femoral BMD and BMC, respectively. CONCLUSIONS: The present findings suggested that older age, lower BMI, higher %EWL, lower ALM, and lower weekly body part exposure score are important determinants in lowering BMD and BMC parameters in long-term post-bariatric surgery individuals, rather than serum 25-hydroxy-vitamin D and parathyroid.

The effect of probiotics on postsurgical complications in patients with colorectal cancer: a systematic review and meta-analysis.

CONTEXT: Clinical trials have investigated the effect of probiotics on postsurgical complications in colorectal cancer (CRC). However, so far, there are no systematic reviews evaluating the effect of probiotics and synbiotics on the clinical or infectious postsurgical complications of colorectal cancer. OBJECTIVE: The objective of this review was to synthesize the best available evidence on the effects of the use of probiotics or synbiotics on pre-, peri-, and post-operative complications of CRC surgical resection. DATA SOURCES: A search of the PubMed, Embase, LILACS, Scopus, Cochrane, Web of Science, ProQuest, and Google Scholar databases was conducted for clinical trials published up until January 2022. DATA EXTRACTION: The population characteristics, period and protocol of supplementation, and postoperative complications were extracted and reported. A random-effects model was used to estimate the effect of probiotic and synbiotic treatment on these variables. DATA SYNTHESIS: In total, 2518 studies were identified, of which 16 were included in the qualitative synthesis and 13 in the meta-analysis. Overall, probiotic supplementation reduced the incidence of ileus (odds ratio [OR] = .13, 95% confidence interval [CI]: .02, .78), diarrhea (OR = .32, 95% CI: .15, .69), abdominal collection (OR: .35, 95% CI: .13, .92), sepsis (OR = .41, 95% CI: .22, .80), pneumonia (OR = .39, 95% CI: .19, .83), and surgical site infection (OR = .53, 95% CI: .36, .78). The results of the subgroup analysis indicated that lower dose (<109 colony-forming units), higher duration of supplementation (>14 days), and being administrated ≤5 days before and >10 days after surgery was more effective at reducing the incidence of surgical site infection. CONCLUSION: Probiotics and synbiotics seem to be a promising strategy for the prevention of postoperative complications after CRC surgery. Larger, high-quality randomized controlled trials are needed to establish the optimal treatment protocol for the use of probiotics and synbiotics in preventing postoperative complications for CRC surgery.

Probiotics, prebiotics, and synbiotics in chronic constipation: Outstanding aspects to be considered for the current evidence.

This integrative aimed to evaluate the effects and the potential mechanism of action of prebiotics, probiotics, and synbiotics on constipation-associated gastrointestinal symptoms and to identify issues that still need to be answered. A literature search was performed in the PubMed database. Animal models (n = 23) and clinical trials (n = 39) were included. In animal studies, prebiotic, probiotic, and synbiotic supplementation showed a decreased colonic transit time (CTT) and an increase in the number and water content of feces. In humans, inulin is shown to be the most promising prebiotic, while B. lactis and L. casei Shirota probiotics were shown to increase defecation frequency, the latter strain being more effective in improving stool consistency and constipation symptoms. Overall, synbiotics seem to reduce CTT, increase defecation frequency, and improve stool consistency with a controversial effect on the improvement of constipation symptoms. Moreover, some aspects of probiotic use in constipation-related outcomes remain unanswered, such as the best dose, duration, time of consumption (before, during, or after meals), and matrices, as well as their effect and mechanisms on the regulation of inflammation in patients with constipation, on polymorphisms associated with constipation, and on the management of constipation via 5-HT. Thus, more high-quality randomized control trials (RCTs) evaluating these lacking aspects are necessary to provide safe conclusions about their effectiveness in managing intestinal constipation.

Frequency of Vitamin D Deficiency and Associated Factors in Long-term Bariatric Surgery Patients: a Cross-sectional Study.

BACKGROUND: Vitamin D deficiency is a common consequence of bariatric surgery (BS). However, few studies have evaluated influential factors and to date there are no studies investigating individual ultraviolet B (UVB) radiation levels in BS patients. This study aimed to evaluate vitamin D deficiency and its associated factors, including UVB radiation, in Roux-Y gastric bypass (RYGB) patients. METHODS: This study included 104 adults (90.4% female) at least 5 years after RYGB. Patients underwent surgery in private hospitals (Private; n = 47) or in two public hospitals, one with ongoing outpatient care (Active; n = 17), and the other with discontinued service for BS (Discontinued; n = 40). 25-hydroxyvitamin D (25(OH)D) concentrations were analyzed by chemiluminescence, individual UVB radiation levels by dosimeter badges. Vitamin D intake, anthropometric, skin phototype, sociodemographic and lifestyle patterns were also assessed. RESULTS: Mean age was 49.6 ± 9.1 years and post-operative period 8.7 ± 2.2 years. The prevalence of 25(OH)D deficiency and insufficiency was 25.0% and 51.9% respectively. 25(OH)D concentration differed among the hospitals (private = 26.2 ± 8.5; active = 28.7 ± 11.4; discontinued = 23.5 ± 6.5 ng/mL; p = 0.038). A total of 26.2% of the variance observed in 25(OH)D concentrations was explained by daily UVB radiation levels (ß = 0.224; p = 0.032) and vitamin D intake (ß = 0.431; p < 0.001), controlling for age and BMI. CONCLUSION: A quarter of the evaluated patients presented vitamin D deficiency, which was associated with the discontinuation of the health care, higher BMI, lower vitamin D intake, and lower individual UVB radiation levels.

Effects of Bifidobacterium animalis subspecies lactis supplementation on gastrointestinal symptoms: systematic review with meta-analysis.

CONTEXT: The effects of probiotics on gastrointestinal (GI) symptoms have been increasingly investigated, particularly that of Bifidobacterium animalis. Clinical trials so far have shown differing evidence regarding these effects in healthy adults. OBJECTIVE: To synthesize the published evidence on the effects of B. animalis subspecies lactis on GI symptoms (GIS) in healthy adults. DATA SOURCE: A search of the Medline, Embase, Lilacs, Scopus, Web of Science, ProQuest, and Google Scholar databases was conducted for reports on randomized controlled trials published up to October 2021. DATA EXTRACTION: Population characteristics and data on colonic transit time (CTT), stool consistency, defecation frequency, abdominal pain, bloating, flatulence, volunteer compliance, and adverse events were extracted. A random-effects model was used to estimate the effect of probiotic treatment on these variables. DATA SYNTHESIS: In total, 1551 studies were identified, of which 14 were included in the qualitative synthesis and 13 in the meta-analysis. Overall, probiotic supplementation increased defecation frequency (standardized mean difference [SMD], 0.26; 95%CI, 0.13-0.39). Subgroup analysis revealed a decrease in CTT (SMD, -0.34; 95%CI, -0.62 to -0.07) in short-term treatment (≤14 d) and an improvement in stool consistency (SMD, 0.76; 95%CI, 0.44-1.08) in individuals without GIS. No improvement in abdominal pain and bloating was found. CONCLUSIONS: B. animalis subspecies lactis supplementation may increase defecation frequency and, in short-term treatment, may reduce CTT in healthy adults and improve stool consistency in individuals without GIS. More high-quality randomized controlled trials are needed to develop a clinical protocol for the use of this strain to improve these symptoms. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020154060.