Conhecimento etnobotânico sobre plantas medicinais utilizadas por moradores de um município ribeirinho no interior do estado do Amazonas, Brasil / Ethnobotanical knowledge of medicinal plants used by residents of a riverside city in the Amazonas state, Brazil

Mesmo com a evolução do conhecimento científico, a utilização de plantas medicinais é uma das práticas mais antigas ainda realizadas pelo homem, especialmente pelos habitantes de comunidades e municípios do interior do Brasil, principalmente em regiões com baixos índices de desenvolvimento humano. O objetivo deste trabalho foi realizar um estudo etnobotânico sobre as plantas medicinais utilizadas pelos moradores de um bairro localizado em um município ribeirinho do interior do estado do Amazonas. Participaram do estudo cem indivíduos, e os dados obtidos pela pesquisa foram compilados por meio de um formulário, contendo 14 questões (objetivas e discursivas). Os resultados demonstraram que 95% dos moradores faziam uso de plantas medicinais. Foram citadas 89 espécies, pertencentes a 48 famílias botânicas, com destaque para a Lamiaceae. As plantas mais citadas foram: Plectranthus barbatus (boldo) ­ 6,1%, Citrus sinensis (laranjeira) ­ 5,8% e Allium sativum (alho) ­ 4,7%. No entanto, quando analisado o índice de concordância (porcentagem de uso principal = CUP), a Citrus sinensis (laranjeira) apresentou um CUP de 80,9%, seguida por Plectranthus barbatus (boldo) e Disphania ambrosioides (mastruz), com 68,1% e 61,5%, respectivamente. Com relação ao modo de preparo, 61,1% citaram infusão, e as principais enfermidades tratadas foram as dores de estômago, com 13,1%. É importante enfatizar a necessidade de mais estudos acerca dos reais benefícios dessas ervas, a fim de que a divulgação de tais informações possa complementar o conhecimento empírico já difundido entre a população local. Dessa forma, será possível ampliar o conhecimento etnobotânico como um todo e, consequentemente, promover saúde e bem-estar.

Despite the evolution of scientific knowledge, the use of medicinal plants is one of the oldest practices still used by men and, especially by the inhabitants of communities and municipalities of the interior of Brazil, mainly in regions with low human development rates. The purpose of this work was to perform an ethnobotanical study on medicinal plants used by residents of a neighborhood located in a riverside city in the interior of the state of Amazonas. A total of 100 individuals participated in the study, with data being obtained through the use of a form containing 14 open and closed-ended questions. The results showed that 95% of the residents used medicinal plants. A total of 89 species, belonging to 48 botanical families were mentioned, with emphasis to Lamiaceae. The plants that were most frequently mentioned were Plectranthus barbatus (locally known as boldo) ­ 6.1%; Citrus sinensis (orange tree) ­ 5.8%; and Allium sativum (garlic) ­ 4.7%. However, when analyzing the agreement index (percentage of main use = CUP), Citrus sinensis (orange tree) presented a CUP of 80.9%, followed by Plectranthus barbatus (boldo) and Disphania ambrosioides (Mexican tea), with 68.1 and 61.5%, respectively. In relation to the method of preparation, 61.1% cited infusion, with the main disorder treated being stomachache, with 13.1%. It is important to emphasize the need for further studies on the actual benefits of these herbs so that the dissemination of the information can complement the already widespread empirical knowledge among the local population. Thus, it will be possible to expand the ethnobotanical knowledge as a whole and, consequently, promote health and well-being.

Efeitos da ingestão do suco de laranja Pera e suco de laranja Moro na microbiota intestinal e marcadores inflamatórios em indivíduos com obesidade / Effect of Pera and Moro orange juice consumption on the gut microbiota and inflammatory parameters in volunteers with obesity

A obesidade é uma doença complexa que está associada inflamação crônica de baixo grau que contribui para o desenvolvimento de diversos distúrbios metabólicos como a resistência à insulina e estudos recentes sugerem a influência da microbiota intestinal no desenvolvimento e manutenção da doença. Diversos estudos apontam para o benefício da ingestão de frutas e vegetais na prevenção e tratamento de doenças crônicas. O suco de laranja contém diversos compostos bioativos com ações anti-inflamatórias, antioxidantes com efeitos na composição da microbiota intestinal. Deste modo, o objetivo principal deste estudo foi avaliar os efeitos da ingestão do suco de laranja Pera e Moro sobre a composição da microbiota intestinal e de parâmetros inflamatórios em voluntários com obesidade e resistência à insulina. Foi realizado um ensaio clínico crossover com suplementação de suco de laranja (400ml/dia) por 15 dias com um período de washout de 40 dias. As análises de sangue, fezes, urina, composição corporal, consumo alimentar foram realizadas antes e após cada intervenção. A comparação entre os tratamentos foi realizada utilizando equações de estimativas generalizadas e adotou-se um nível de significância de 5%. Em relação à microbiota intestinal, em ambos os tratamentos, os dois filos mais abundantes foram Firmicutes e Actinobateria. Dos gêneros analisados, observou-se maior abundância de Bifidobacterium após a suplementação com o suco de laranja Moro. O suco de laranja Pera promoveu uma diminuição da zonulina e o suco de laranja Moro contribuiu para redução de citocinas inflamatórias, diminuição da pressão arterial e aumento nos níveis de acetato nas fezes. Após a separação dos voluntários por grau de obesidade, observamos que o suco de laranja Moro contribuiu para o aumento na abundância de Akkermansia, Alistipes, Bacteroides e Catenibacterium em indivíduos com obesidade grau 3. Além disso, em ambos os sucos encontramos redução da razão Firmicutes/Bacteroidetes e aumento da excreção de metabólitos de flavonoides após os tratamentos. Diante destes resultados, conclui-se que o suco de laranja Pera apresentou ações positivas sobre a permeabilidade intestinal e o suco de laranja Moro promoveu efeitos mais expressivos na modulação da inflamação associada à obesidade e da microbiota intestinal

Obesity is a complex disease that is associated with low-grade chronic inflammation, and it contributes to the development of several metabolic disorders such as insulin resistance, and recent studies suggest the influence of the intestinal microbiota in the development and maintenance of the disease. Several studies have suggested the benefit of fruits and vegetables consumption in the prevention and treatment of chronic diseases. The orange juice contains some bioactive compounds with anti-inflammatory and antioxidant actions with effects in the composition of the gut microbiota. Thus, the main objective of this study was to evaluate the effects of Pera and Moro orange juice consumption on the composition of the gut microbiota and inflammatory parameters in volunteers with obesity and insulin resistance. A crossover clinical trial was carried out with orange juice supplementation (400ml/day) for 15 days with a washout period of 40 days. Blood, feces, urine, body composition, food consumption were analyzed before and after each intervention. Comparison between treatments was performed using generalized estimating equations and a significance level of 5% was adopted. In relation to gut microbiota, in both treatments, the two most abundant phyla were Firmicutes and Actinobateria. In the analysis of bacterial genera, a greater abundance of Bifidobacterium was observed after supplementation with Moro orange juice. The Pera orange juice reduced zonulin and Moro orange juice contributed to a reduction on inflammatory cytokines, a decrease in blood pressure and an increase in acetate levels in the stool. After separating the volunteers by degree of obesity, we observed that Moro orange juice contributed to the increase in the abundance of Akkermansia, Alistipes, Bacteroides and Catenibacterium in individuals with grade 3 obesity. Furthermore, in both juices we found a reduction in the Firmicutes/Bacteroidetes ratio and increased excretion of flavonoid metabolites after treatments. Therefore, we concluded that Pera orange juice had positive actions on intestinal permeability and Moro orange juice promoted more expressive effects on the modulation of inflammation associated with obesity and on the intestinal microbiota

Raw orange intake is associated with higher prevalence of non-alcoholic fatty liver disease in an adult population.

OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is one of the most common public health issues worldwide. Oranges are the most popular fruit consumed in the world. Admittedly, flavonoids in oranges act as antioxidants and improve liver steatosis. However, oranges also are rich in fructose, which is a risk factor in the progress of NAFLD. Therefore, we hypothesize that orange intake may be a double-edged sword in the development of NAFLD. To our knowledge, there currently is little evidence of the effect of dietary orange intake on NAFLD. The aim of this study was to investigate how orange intake is related to NAFLD in a general adult population. METHODS: We randomly recruited 27,214 adults into the Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study. NAFLD was diagnosed by liver ultrasonography. Raw orange intake was assessed by a validated self-administered food frequency questionnaire. Multiple logistic regression analysis was used to evaluate the association between orange intake and the prevalence of NAFLD. RESULTS: There was a 27.18% prevalence of NAFLD among the participants. Consumption of orange was positively associated with the prevalence of NAFLD after adjustment for all potential confounding factors (Ptrend = 0.04). The odds ratios (95% confidence interval) of the categories of orange intake in the NAFLD were 1.00 (reference) for less than once per week, 1.02 (0.95-1.11) for 1 to 6 times per week, and 1.17 (1.03-1.33) for ≥7 times per week, respectively. CONCLUSIONS: The present study demonstrated that orange intake is positively associated with the prevalence of NAFLD.

Estudo comparativo da excreção de flavonoides entre indivíduos eutróficos e obesos, após a ingestão de sucos de laranja, cv. Pera e cv. Moro / Comparative study of excretion of flavonoids among eutrophic and obese individuals, after ingestion of orange juice, cv. Pera and cv Moro

As laranjas e seus derivados, principalmente os sucos, possuem compostos bioativos, tais como os flavonoides, entre eles as flavanonas hesperidina e narirutina, que podem estar relacionados à promoção e benefícios à saúde. A absorção e metabolização de flavonoides podem ser afetadas por diversos fatores como a microbiota e fatores antropométricos, o que pode afetar a sua bioatividade. Assim, o objetivo deste estudo foi comparar o metabolismo e excreção dos flavonoides entre indivíduos eutróficos e obesos após a ingestão de sucos de laranja pasteurizado obtidos das cvs. Pera e Moro. Em um estudo cross-over randomizado 20 voluntárias eutróficas e 10 voluntárias obesas, com idade entre 19 e 40 anos, consumiram em dose única 600 mL de cada suco, que contém as flavanonas narirutina e hesperidina, além das antocianinas no suco Moro. Os metabólitos de flavanonas e de antocianinas foram identificados e quantificados em urina coletada em diferentes períodos de tempo durante 24 horas. Não foi observada diferença significativa na permeabilidade intestinal entre os grupos. Foram detectados e identificados 8 metabólitos de fase II da hesperitina e naringenina, principalmente mono e diglicuronidados e sulfatos, além de três ácidos fenólicos catabólitos de flavanonas formados pela microbiota intestinal, entre elas o ácido hipúrico, ácido protocatecuico e ácido 3-(3-hidroxifenil)-3-hidroxipropiônico. Os ácidos fenólicos foram os metabólitos majoritários recuperados na urina, principalmente o ácido hipúrico. Ainda, os metabólitos de fase II apresentaram maior excreção entre o período de 4-8h e 8-12h (13 a 27% do total de metabólitos excretados). Não foi observada diferença significante (p<0,05) no total de metabólitos de naringenina e hesperitina excretados na urina durante o período de 24 h entre os dois grupos e para os sucos de laranja, nem para o total de metabólitos, provavelmente devido à grande variabilidade interindividual na excreção. Assim, não foi observada diferença entre a metabolização de flavanonas de laranja entre os eutróficos e obesos e nenhuma correlação com os parâmetros antropométricos avaliados

Oranges and orange juices contain bioactive compounds, such as flavonoids, mainly the flavanones hesperidin and narirutin, which may be related to the promotion and health benefits. The absorption and metabolization of flavonoids can be affected by several factors such as the gut microbiota and anthropometric parameters, which may affect its bioactivity. Thus, the aim of this study was to compare the metabolism and excretion of flavonoids among eutrophic and obese people after ingestion of two pasteurized orange juice obtained from cvs. Pera and Moro. In a randomized cross-over study 20 eutrophic volunteers and 10 obese volunteers, aged 19-40 years, consumed a single dose of 600 mL of each juice. The metabolites of flavanones and anthocyanins were identified and quantified in urine collected at different time points for 24 hours. No significant difference in intestinal permeability was observed between groups. Eight Phase II metabolites of hesperitin and naringenin, mainly mono and diglycerides and sulfates, and three phenolic catabolites of flavanones formed by the gut microbiota were detected and identified, among them hippuric acid, protocatecuic acid and 3- (3-hydroxyphenyl) ) -3-hydroxypropionic acid. Phenolic acids were the major metabolites recovered in urine, mainly hippuric acid. Furthermore, phase II metabolites had greater excretion between the period of 4-8h and 8-12h (13-27% of total metabolites excreted). No significant difference (p <0.05) was observed in the total of naringenin and hesperitin metabolites excreted in the urine during the 24 h period between the two groups, probably due to interindividual variability in excretion. Thus, no difference was observed on metabolism of flavanones between the eutrophic and obese and no correlation was observed with the anthropometric parameters evaluated

Efeito da administração dos sucos de laranja, cvs. Pera e Moro, sobre o estresse oxidativo e lipídios plasmáticos em indivíduos obesos com resistência à insulina / Effect of orange juice administration, cvs. Pera and Moro, on oxidative stress and plasma lipid profile in obese individuals with insulin resistance

A obesidade é um dos principais fatores etiológicos do desenvolvimento da resistência à insulina, e ambos são responsáveis, em parte, pelo aumento do estresse oxidativo e diabete mellitus tipo 2. Vários estudos têm mostrado os benefícios de uma dieta rica em vegetais e frutas, devido à ação dos compostos bioativos sobre os parâmetros clínicos e estresse oxidativo. O objetivo deste estudo foi verificar os efeitos dos sucos de laranja, obtido das variedades Pera e Moro, sobre os marcadores bioquímicos e de estresse oxidativo, em indivíduos com resistência à insulina, classificados através do índice HOMA-IR. Os voluntários foram suplementados durante 15 dias com os sucos de laranja em um ensaio crossover, com washout de 40 dias. Nos dias 0 e 16 de cada ensaio, foram registrados parâmetros antropométricos e de consumo alimentar, e coletadas amostras de sangue e urina pra análises bioquímicas e de estresse oxidativo. A composição de flavonoides entre as variedades de suco foi similar, diferindo no conteúdo de ácido ascórbico e antocianinas do suco de laranja Moro. Não foram observadas mudanças nos parâmetros de estresse oxidativo após a administração dos sucos de laranja, com exceção do 8-OHdG urinário, um marcador de dano oxidativo ao DNA que apresentou-se reduzido após ambas as intervenções. Dados clínicos não foram significativamente modificados, entretanto, observou-se grande variabilidade interindividual nos valores de pressão arterial e lipídios séricos. A partir desta premissa, foi realizada a análise lipidômica do plasma com amostras do ensaio com o suco de laranja cv. Pera e observaram-se reduções significativas nos triglicérides, principalmente aqueles compostos de ácidos graxos saturados ou monoinsaturados, ou contendo ao menos uma cadeia de ácido linoleico, além do aumento de espécies de acilcarnitinas de cadeia longa. O consumo de ambos os sucos de laranja parece exercer um efeito protetor contra o dano oxidativo ao DNA, provavelmente por ação não-enzimática. A análise lipidômica do plasma sugere que o suco de laranja cv. Pera pode modular o metabolismo de lipídios, relacionados à lipogênese de novo e beta-oxidação

Obesity is one of the main etiological factors of insulin resistance development, and both are responsible, in part, for the increase on oxidative stress and Diabetes mellitus type 2 development. Several studies have showed the benefits of a diet rich in vegetables and fruits, due to the action of bioactive compounds on biochemical and oxidative stress parameters. The aim of this study was to study the effects of orange juices obtained by varieties Pera and Moro on oxidative stress and clinical biomarkers, in obese subjects with insulin resistance, classified through the HOMA-IR index. The volunteers consumed both orange juices for 15 days with in a crossover design, with 40-day washout period. On days 0 and 16 of each trial, anthropometric and food consumption parameters were registered, and blood and urine samples were collected to analyze biochemical parameters and oxidative stress biomarkers. The flavonoids content of both juices was similar, but only orange juice from Moro variety contained anthocyanins and higher ascorbic acid content. No changes in oxidative stress markers were found after juice administration, except for urinary 8-OHdG, an oxidative DNA damage marker, which was reduced after both interventions. Clinical data were not significantly modified, but a high interindividual difference was observed in blood pressure and serum lipids. From this point of view, plasma lipidomic analysis was performed with samples of clinical trial with orange juice cv. Pera and showed significant decrease in triglycerides, mainly those with saturated or monounsaturated fatty acids, or containing at least one linoleic acid (related with inflammatory processes), besides the increase of long chain acylcarnitines. The intake of both orange juices appears to have a protective effect against DNA damage, probably by non-enzymatic action. Plasma lipidomic analysis suggests that Pera orange juice can modulate lipid metabolism related to de novo lipogenesis and fatty acid beta-oxidation

Identification of gibberellin-regulated protein as a new allergen in orange allergy.

BACKGROUND: To date, three orange allergens have been reported. However, it is still unclear whether gibberellin-regulated proteins (GRPs), identified as new allergens in other fruit allergies, are also involved in orange allergy. OBJECTIVE: To investigate the allergenicity of orange GRP and to determine the clinical characteristics of patients with orange allergy who are sensitized to orange GRP. METHODS: We enrolled 14 patients (four men, 10 women, mean age: 29.6 years) who were diagnosed with orange allergy based on relevant clinical history, positive skin test, and/or positive challenge test. Orange GRP (molecular weight: 6941.6 Da) was purified by ion-exchange column chromatography. To test for orange GRP-specific IgE, we performed ELISA, basophil activation tests, and skin prick tests. Cross-reactivity of orange GRP with native peach allergen nPru p 7 and Japanese apricot nPru m 7 was analysed by ELISA inhibition assays. IgE specific for orange, grapefruit, and peach allergens rPru p 1, rPru p 3, and rPru p 4 was measured using ImmunoCAP. RESULTS: Twelve of the 14 patients (85.7%) were positive for orange GRP allergy in at least one test: 71.4% (10/14) were positive by ELISA, 50% (3/6) were positive in the basophil activation test, and 100% (4/4) were positive in the skin prick test. ELISA inhibition assays revealed cross-reactivity of orange GRP with both nPru p 7 and nPru m 7. The patients showed variable positivity for specific IgE against orange, grapefruit, rPru p 1, rPru p 3, and rPru p 4 (57.1%, 71.4%, 7.1%, 0%, and 21.4%, respectively). The most frequent symptoms of orange GRP allergy were facial swelling and oropharyngeal symptoms. CONCLUSIONS AND CLINICAL RELEVANCE: Orange GRP may be involved in orange allergy and may be a cross-reactive allergen between citrus fruits and the Rosaceae family of fruits.

Are grape juices more erosive than orange juices?

AIMS: To evaluate the chemical characteristics of grape and orange juices, and their erosive potential in the decrease of microhardness and the loss of enamel structure. METHODS: Five grape and orange juices were evaluated for pH, titratable acidity, calcium, phosphate, and fluoride concentration. De-ionised water and Cola soft drink were used as a negative and positive control, respectively. Twelve specimens of bovine enamel were immersed in beverages for 10 min at 37 °C, 3 times/day for 7 days. Erosive potential was quantified using microhardness and loss of enamel structure. Anova One Way, Student's t test, Multiple Regression and Spearman Correlation (p < 0.05) were used to analyse the results. RESULTS: Powdered grape juice showed the lowest pH (3.18 ± 0.03) and pure grape juice presented the highest titratable acidity (5.48 ± 0.06 mL NaOH/100 mL). Fresh orange juice and soya-based grape juice revealed the lowest calcium (0.77 ± 0.12 mmol/L) and phosphate concentrations (0.35 ± 0.06 mmol/L), respectively. Among juices, powdered orange juice caused the greatest decrease in surface microhardness (SMH) (127.99 ± 40.47 ΔSMH) and grape juice from concentrate caused the greatest loss of enamel structure (13.30 ± 3.56 µm). CONCLUSIONS: All of the evaluated juices contributed to dental erosion. Grape juices presented greater erosive potential than orange juices. Pure, powdered and concentrated grape juices showed similar loss of enamel structure to the Cola soft drink. The erosive potential of beverages was statistically correlated to pH, titratable acidity, calcium, phosphate and fluoride concentrations.

Excessive Maternal Orange Intake - A Reversible Etiology of Fetal Premature Ductus Arteriosus Constriction: A Case Report.

Ductus arteriosus (DA) is a crucial element in the fetal circulation. Therefore, premature constriction of DA during the third trimester can have hazardous complications such as right ventricular dysfunction, fetal heart failure, hydrops, and even in utero demise. Normally, premature constriction is prevented by a balance between prostaglandin E2 and fetal oxygenation. Thus, drugs with antiprostaglandin effects are well-known causes for fetal DA constriction. A similar effect was discovered in eating polyphenol-rich food. Here, we report a case of early-detected fetal DA constriction due to a high maternal ingestion of fresh oranges, which are known to be rich in polyphenols. This effect was totally reversed 2 weeks after eliminating oranges from the maternal diet. From the current report, it is concluded that restrictions in the maternal diet regarding polyphenol-rich foods such as oranges can be considered during the third trimester to prevent the harmful effect on DA.

A novel approach to study in situ enamel erosion and abrasion lesions.

OBJECTIVES: This study investigated previous hypotheses that the tongue can abrade acid softened/eroded enamel surfaces. METHODS: Twelve upper removable appliances each retaining 2 anterior and 2 posterior human enamel specimens were constructed. Each specimen was exposed to acid on both surfaces, but only one surface was allowed contact with the tongue. Therefore, 96 surfaces were assessed. Appliances were worn from 9.30 to 17.00 Monday to Friday for 22days. Acid eroded lesions were created by immersing the specimens for 5min in 50ml orange juice three times daily. Enamel loss was measured using Quantitative light- induced fluorescence (QLF) and Non- contact profilometry (NCLP) and the differences (D) between tongue (Dt) and palate facing (DP) surfaces determined. RESULTS: %ΔFD(t-p) from the two anterior specimens were greater than from those placed posteriorly with mean values of 15.9% (±9.1) and 14.4% (±8.4), 5.6% (±8.7) and 4.5% (±6.6) respectively. Similarly, NCLP data showed anterior specimens had greater differences for mean step height (MSH) between tongue- facing and the palate- facing (control) surfaces than posterior specimens. MSHD(t-p) values were 59.4µm (±30.3) for anterior tongue facing surfaces and 55.5µm (±29.4) for posterior palate facing surfaces. For the posterior specimens MSH was 48.1µm (±26.1) and 51.7µm (±30.4) respectively (p<0.05). CONCLUSION: The greater enamel surface loss of the anterior specimens demonstrates that abrasion by the tongue on acid softened/eroded enamel in situ is likely.

A randomised clinical trial to determine the abrasive effect of the tongue on human enamel loss with and without a prior erosive challenge.

OBJECTIVES: To investigate the abrasive effect of the tongue on human enamel loss with and without a prior dietary acid challenge in an in situ model. METHODS: A single centre, single blind, randomly allocated, split mouth, four treatment regimen, in situ study in healthy adult volunteers was undertaken. Twenty four subjects wore two lower intra-oral appliances each fitted with 4 human enamel samples 6h/day for 15 days. The samples were treated with either 50ml orange juice or water for 5min ex vivo 4x/day; prior to being licked or not licked with the subject's tongue for 60s. There were 2 samples per group per subject. Surface loss was measured by contact profilometry. RESULTS: 23 subjects completed the study with no adverse events. The mean loss of enamel at 15days was: 0.08µm for water without licking, 0.10µm with water and licking; 1.55µm with orange juice alone, 3.65µm with orange juice and licking. In the absence of erosive challenge, licking had no detectable effect on enamel loss p=0.28. Without licking, orange juice had a highly significant effect on loss compared to water, p<0.001. Erosive challenge followed by licking more than doubled the loss of enamel p<0.001. CONCLUSIONS: When enamel was exposed to orange juice prior to licking, tissue loss as a result of tongue abrasion of the eroded surface was increased, and double that of the erosive challenge alone. Licking enamel with the tongue had no perceptible effect on enamel loss in the absence of the erosive challenge. CLINICAL SIGNIFICANCE: Enamel wear resulting from tongue abrasion on tooth surfaces softened by acid challenge, can be an unavoidable consequence of oral function. This may account for the pattern of erosive toothwear on palatal and occlusal tooth surfaces, reinforcing the importance of restricting the frequency of dietary acid challenge in susceptible individuals.

100% citrus juice: Nutritional contribution, dietary benefits, and association with anthropometric measures.

Citrus juices such as 100% orange (OJ) and grapefruit juice (GJ) are commonly consumed throughout the world. This review examines the contributions of OJ and GJ to nutrient intake, diet quality, and fruit intake, and supports citrus juices as nutrient-dense beverages. This review also explores the research examining associations between OJ and GJ intake and anthropometric measures. Citrus juices are excellent sources of vitamin C and contribute other key nutrients such as potassium, folate, magnesium, and vitamin A. OJ intake has been associated with better diet quality in children and adults. OJ intake has not been associated with adverse effects on weight or other body measures in observational studies in children and adults. In adults, some observational studies report more favorable body mass index or body measure parameters in OJ consumers compared to nonconsumers. Intervention studies in adults report no negative impacts of OJ or GJ consumption on anthropometric measures, although these measures were typically not the primary outcomes examined in the studies. Moderate consumption of citrus juices may provide meaningful nutritional and dietary benefits and do not appear to negatively impact body weight, body composition, or other anthropometric measures in children and adults.

Kinetics of salivary pH after acidic beverage intake by patients undergoing orthodontic treatment.

The saliva of patients undergoing orthodontic treatment with fixed appliances can potentially present a delay in the diluting, clearing, and buffering of dietary acids due to an increased number of retention areas. The aim of this clinical trial was to compare salivary pH kinetics of patients with and without orthodontic treatment, following the intake of an acidic beverage. Twenty participants undergoing orthodontic treatment and 20 control counterparts had their saliva assessed for flow rate, pH, and buffering capacity. There was no significant difference between salivary parameters in participants with or without an orthodontic appliance. Salivary pH recovery following acidic beverage intake was slower in the orthodontic subjects compared to controls. Patients with fixed orthodontic appliances, therefore, seem to be at higher risk of dental erosion, suggesting that dietary advice and preventive care need to be implemented during orthodontic treatment.

Red ear syndrome precipitated by a dietary trigger: a case report.

INTRODUCTION: Red ear syndrome is a rare condition characterized by episodic attacks of erythema of the ear accompanied by burning ear pain. Symptoms are brought on by touch, exertion, heat or cold, stress, neck movements and washing or brushing of hair. Diagnosis and treatment of this condition are challenging. The case we report here involves a woman whose symptoms were brought on by a dietary trigger: orange juice as well as stress, causing significant physical and psychological morbidity. Avoidance of triggers resulted in symptomatic improvement. CASE PRESENTATION: A 22-year-old Caucasian woman who was a student presented twice to our department with evolving symptoms, the first time with hyperacusis (abnormal sound sensitivity arising from within the auditory system to sounds of moderate volume), intermittent right tinnitus and subjective hearing difficulties. She presented five years later with highly distressing episodes of erythematous ears, which were associated with burning pain around the ear and temporal areas, and intolerance to noise. After keeping a symptom diary, she identified orange juice and stress as triggers of her symptoms. No local head and neck pathology was present. Investigations and imaging were negative. Avoidance of triggers led to great symptomatic improvement. To the best of our knowledge, dietary triggers have not previously been reported as a trigger for this syndrome. This case shows a direct temporal link to a dietary trigger and supports a primary pathogenesis. Recognition and management of primary headache disorder and simple dietary and lifestyle changes brought about symptomatic relief. CONCLUSION: Red ear syndrome is a little-known clinical syndrome of unknown etiology and management. To the best of our knowledge, our present case report is the first to describe primary red ear syndrome triggered by orange juice. Clinical benefit derived from avoidance of this trigger, which is already known to precipitate migraines, gives some insight into the pathogenesis of red ear syndrome.

Profilin as a severe food allergen in allergic patients overexposed to grass pollen.

BACKGROUND: Profilins are ubiquitous proteins that act as panallergens in sensitized patients, considered to be mild or incomplete food allergens. The aim of the study was to evaluate the role of profilins as severe food allergens in allergic patients overexposed to grass who were referred for severe food reactions and were sensitized to profilins. METHODS: After a careful in vitro screening, 26 patients were included, classified into two groups, mild (17) and severe reactors (9), based on clinical history and subsequently provoked orally with purified profilin in a double-blind placebo-controlled food challenge setup. RESULTS: A significant number of patients presented severe positive food challenge test reactions at low doses of the allergen profilin. Patients prone to suffer from severe reactions had lower IgG4/IgE ratio to major grass allergens than those who did not. CONCLUSION: Profilins are complete food allergens in food-allergic patient populations that are exposed to high levels of grass pollen. This type of patient constitutes an optimal model to understand the link between respiratory and food allergies. The nature of the observed reactions and the low level of allergen eliciting the reactions suggest that intake through the oral mucosa might constitute a relevant route of exposure to food allergens.

Cit s 3 as an Occupational Aeroallergen in an Orange Farmer

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[Ileus due to oranges in Meckel's diverticulum]. / Sinaasappelileus bij een Meckel-divertikel.

BACKGROUND: A Meckel's diverticulum is a remnant of the primitive bowel and the yolk sac which occurs in 1-5% of the population. It causes problems in only very few people. CASE DESCRIPTION: A 39-year-old man developed acute abdominal pain after eating two oranges. The cause of the pain was found during a lower abdominal laparotomy - the small bowel was obstructed by a Meckel's diverticulum and a phytobezoar composed of orange fibres. Both were removed surgically. CONCLUSION: A symptomatic Meckel's diverticulum should be removed; however, in an asymptomatic Meckel's diverticulum this approach is controversial. One of the problems that can arise is an obstructive ileus. Patients who in the past have had an obstructive ileus resulting from a phytobezoar are advised to avoid eating large quantities of fruit rich in fibre and to chew very well.

Preventive effects of dentifrice containing 5000ppm fluoride against dental erosion in situ.

OBJECTIVE: To evaluate the effectiveness of a dentifrice with 5000ppm fluoride in preventing dental erosion by orange juice in situ in comparison to a control dentifrice with 1450ppm fluoride. METHODS: This was a double-blind and randomized clinical study with a cross-over design. Sixteen subjects wore an intra-oral appliance containing two enamel disks with an exposed surface of approximately 2mm×5mm. Enamel disks in the study group were treated with a dentifrice with 5000ppm fluoride and in the control group with 1450ppm fluoride. The subjects rinsed with slurries of study dentifrices for one minute before immersing the enamel disks in 250ml orange Juice four times in an 8-h period daily. The treatment procedure was repeated for three 5-day phases for each dentifrice. Enamel erosion was measured after each 5-day treatment phase using a focus-variation 3D scanning microscopy. Medians and inter-quartile ranges (IQR) of mean erosion depth were compared between the groups. RESULTS: The mean erosion depths of enamel varied greatly amongst the subjects. Enamel treated with 5000ppm fluoride had less erosion (median 5.7µm, IQR 4.5µm) as compared to the control (median 12.6µm, IQR 12.3µm) after 15 days of fluoride treatment and erosive challenge cycles (p<0.05). CONCLUSIONS: Enamel treated with 5000ppm fluoride had significantly improved resistance to erosion by orange juice. Periodic application of 5000ppm fluoride may be beneficial in individuals at risk of acidic erosion associated with soft drink consumptions.