Between benefit and risk: The role of dietary supplements in endocrinology.

Use of nitrate as a dietary supplement has gained popularity among athletes and recreationally active individuals to enhance exercise performance. However, the prevalence and patterns of use, and knowledge of nitrate as a dietary supplement are unknown. Individuals (≥16y) completed a 42-item online questionnaire to collect (i) sociodemographic information; (ii) participation in activity and sport; (iii) nitrate supplementation use and reasons; (iv) attitudes and beliefs regarding information sources and the safety of nitrate as a dietary supplement; and (v) knowledge of dietary nitrate supplements. In total, 1,404 active adults (66% female) took part in the study. Only about one in 10 respondents (11.9%) reported they had consumed dietary nitrate ("users") in the past, most commonly as beetroot juice (31.3%). Over two-thirds (69.4%) of users could not correctly identify the correct timing of intake relative to performance time to best improve exercise performance, and most users (82.3%) were unsure of the contraindications to oral consumption of dietary nitrate supplements. Only 3.9% of users experienced adverse effects after ingesting dietary nitrate supplements. Among non-users, the most common reasons respondents selected for not using dietary nitrate supplements were "I do not think I need to" (70.2%) and "I have never thought about it" (69.2%). There is evidence to support the efficacy of dietary nitrate intake in improving exercise performance. However, findings from this study suggest dietary nitrate is under-utilized. Educational messages that target dietary nitrate consumption should be targeted toward nutritionists, coaches, and exercise physiologists to bridge the gap between knowledge-to-practice.

Prevalence, Adverse Events, and Factors Associated with Dietary Supplement and Nutritional Supplement Use by US Navy and Marine Corps Personnel

As defined by the Dietary Supplement Health and Education Act 1997, such substances as herbs and dietary supplements fall under general Food and Drug Administration supervision but have not been closely regulated to date. We examined the thyroid hormone content in readily available dietary health supplements marketed for "thyroid support." Ten commercially available thyroid dietary supplements were purchased. Thyroid supplements were dissolved in 10 mL of acetonitrile and water with 0.1% trifloroacetic acid and analyzed using high-performance liquid chromatography for the presence of both thyroxine (T4) and triiodothyronine (T3) using levothyroxine and liothyronine as a positive controls and standards. The amount of T4 and T3 was measured separately for each supplement sample. Nine out of 10 supplements revealed a detectable amount of T3 (1.3-25.4 μg/tablet) and 5 of 10 contained T4 (5.77-22.9 μg/tablet). Taken at the recommended dose, 5 supplements delivered T3 quantities of greater than 10 μg/day, and 4 delivered T4 quantities ranging from 8.57 to 91.6 μg/day. The majority of dietary thyroid supplements studied contained clinically relevant amounts of T4 and T3, some of which exceeded common treatment doses for hypothyroidism. These amounts of thyroid hormone, found in easily accessible dietary supplements, potentially expose patients to the risk of alterations in thyroid levels even to the point of developing iatrogenic thyrotoxicosis. The current study results emphasize the importance of patient and provider education regarding the use of dietary supplements and highlight the need for greater regulation of these products, which hold potential danger to public health.

Dietary Counseling Versus Dietary Supplements for Malnutrition in Chronic Pancreatitis: A Randomized Controlled Trial

Dietary supplements keep ED pharmacists on their toes

A population-based case-control study in Connecticut was conducted during 2010-2011 among 462 histologically confi rmed incident thyroid cancer cases and 498 population-based controls. Dietary supplement intake was ascertained through in-person interviews and a food frequency questionnaire. Multivariate unconditional logistic regression models were used to estimate the risk of thyroid cancer and dietary supplement use. Overall, no statistically signifi cant associations were observed between dietary supplementation and thyroid cancer risk. Stratifi ed analyses revealed a suggestive protective effect on risk of papillary microcarcinoma among longterm (> 10 years) use of multivitamins (OR = 0.59, 95 % CI: 0.33, 1.04) and calcium supplementation (OR = 0.45, 95 % CI: 0.22, 0.93). An increased risk of large papillary thyroid cancers (tumor size > 1 cm) was observed among short-term (< 5 years) users of calcium supplements (OR = 2.24, 95 % CI: 1.30, 3.88). No signifi cant associations were observed between supplementation and overall thyroid cancer risk. The different associations between calcium supplements and risk of papillary thyroid cancer by tumor size warrant further investigation.

Vitamins and minerals are micronutrients required by the body to carry out a range of normal functions. The regular diet of common man is obtained deficient in certain nutrients, so dietary supplements are commonly prescribed in this study combination of vitamins and minerals in the form of bilayer tablet is proposed as a dietary supplement. The current stud aimed to assess dietary supplement use and determine its associated factors among adult population in southern bangladesh In that we include, various nutraceuticals like prebiotic, probiotics, PUFA (poly unsaturated fatty acid), vitamins, spices, polyphenols and antioxidant vitamins etc. these neutraceuticals are used in eye health, mental health, sleep enhancement, cancer prevention, bone health, skin health and oral health. Dietary supplement used was more common in male as well as female. Common types on dietary supplement used in India are the multivitamin and multi-mineral products and health along with herbs for treatment of health or health promotion. Dietary supplements come in a variety of forms, including tablets, capsules, gummies, and powders as well as drinks and energy bars. Dietary food supplement is intended to provide nutrients that may otherwise not be consumed in sufficient manner. the supplement are generally understood as food they are included, vitamins, minerals, fibers, and fatty acid or amino acid, among other substance.

ABSTRACTBackground: The estimated prevalence of dietary-supplement use among US adults was 73% in 2002. Appropriate use of dietary supplements within the paradigm of evidence-based medicine may be a challenge for medical doctors and non-physician clinicians. Randomized, controlled, clinical trial data, which are considered the gold standard for evidence-based decision making1, are lacking. Standardized guidelines for the use of dietary supplements are lacking, and dietary supplements can bear unsupported claims.Objectives: This article is intended to review clinically-relevant issues related to the widespread use of dietary supplements, with emphasis on regulatory oversight and safety.Methods: Review articles and clinical trial articles published up until December 2007 were selected based on a search of the MEDLINE electronic database using PubMed. The Food and Drug Administration (FDA) Website was also used as a resource. We used the search terms dietary supplement(s), vitamin supplements, mineral supplements, and Dietary Supplement and Health Education Act. Articles discussing dietary supplements and their regulation, prevalence of use, prescription and nonprescription formulations, and/or adverse events were selected for review. Articles discussing one or more of these topics in adults were selected for inclusion.Results: New FDA regulations require dietary-supplement manufacturers to evaluate the identity, purity, strength, and composition of their products. However, these regulations are not designed to demonstrate product efficacy and safety, and dietary-supplement manu­facturers are not required to submit efficacy and safety data to the FDA prior to marketing. Product contamination and/or mislabeling may undermine the integrity of dietary-supplement formulations.Conclusions: The use of dietary supplements may be associated with adverse events. Although there are new regulatory requirements for dietary supplements, these products will not require FDA approval or submission of efficacy and safety data prior to marketing under the new regulation. A limitation to the literature used for this review is the lack of prospective, randomized clinical trials on the safety and efficacy of dietary supplements. Clinicians should be aware of all the dietary supplements that their patients consume, and help their patients make informed decisions appropriate to their medical care.

The prevalence of dietary supplement use among athletes continues to rise with 60–80% of athletes often reporting current or previous use of dietary supplements. While select dietary ingredients have been shown to improve acute performance and enhance training adaptations over time, it is important to still consider the risk vs. reward for athletes before opting to consume a dietary supplement. Previous work has indicated that certain dietary supplements may pose risks for inadvertent doping, may be susceptible to mislabelling, could be banned by certain governing bodies of sport, or pose health risks for certain populations. The purpose of the current narrative review is to summarize the prevalence of adulteration in dietary sport supplement products, outline the risks of inadvertent doping for athletes, and highlight best practices regarding safe supplementation strategies. Analytical studies have found anywhere from 14 to 50% of samples analyzed from dietary supplement products have tested positive for anabolic agents or other prohibited substances. It is important for the consumer to adhere to safe supplementation strategies, which include following serving size recommendations, cross-referencing ingredient profiles with the list of prohibited substances, choosing quality products that have been verified by a third-party certification program, and being cognizant of consuming multiple dietary supplement products with overlapping ingredient profiles. Once these practices have been considered, it is reasonable for an athlete to utilize dietary supplements as a strategy to optimize performance and health, with a low risk of failing a drug test (adverse analytical finding) and experiencing adverse events.

Obesity and its associated complications require various lifestyle changes and treatment options. Dietary supplements are considered an attractive alternative to traditional therapy, mainly because they are accessible to the general population. The aim of this study was to investigate the additive effects of a combination of energy restriction (ER) and four dietary supplements on changes in the anthropometric and biochemical parameters in 100 overweight or obese participants who were randomly assigned one of the dietary fibre supplements containing different dietary fibres or a placebo for 8 weeks. The results confirmed that fibre supplements plus ER significantly (p < 0.01) reduced the body weight, body mass index (BMI), fat mass, and visceral fat and ameliorated the lipid profile and inflammation at 4 and 8 weeks after the start of the study, while in the placebo group, significant differences in some parameters were observed only after 8 weeks of ER. A fibre supplement containing glucomannan, inulin, psyllium, and apple fibre was the most effective at reducing the BMI, body weight, and CRP (p = 0.018 for BMI and body weight and p = 0.034 for CRP compared to placebo at the end of the intervention). Overall, the results suggest that dietary fibre supplements in combination with ER may have additional effects on weight loss and the metabolic profile. Therefore, taking dietary fibre supplements may be a feasible approach to improve weight and metabolic health in obese and overweight individuals.

On the q.t. no more: Exposing the arrhythmic risks of dietary supplements

Introduction Chicken meat is one of the most important foods and its economic production is essential. In industrial poultry farms, about 70 to 75 percent of production costs are related to feed costs. Therefore, one of the most important goals of poultry nutrition researchers, along with improving the performance and characteristics of poultry carcasses, is to reduce the cost of feed. In addition to edible materials, dietary feed includes feed additives that improve feed conversion, maintain bird health and, consequently, reduce costs and earn the most economic benefits. Any substance that can improve the health and safety of the digestive tract is of particular importance in feeding poultry. The presence of minerals in animal feed is necessary for the animal’s metabolic processes. In fact, they are catalyst for many enzymatic systems, and part of hundreds of molecules involved in intermediary metabolism, hormone secretion, antibacterial effects, and immune defense systems; as a result, it influences growth performance, meat quality and appetite of broiler chickens. Traditionally, according to various feeding standards, minerals are supplemented in broiler diet in the form of inorganic salts, i.e.: carbonates, oxides, or sulfates to provide the birds’ requirements.Therefore, one of the ways to reduce the cost of feed rations is to replace useful and low-cost compounds with mineral supplements. In recent decades, the use of feed additives in poultry diets has been considered to increase their production. One of these additives is humic compounds. Humic compounds are a compelex of compounds that are produced from the decomposition of organic matter, especially plants, soil and coal. Biochar is produced by pyrolysis from various types of biomass in a low-to-no oxygenthermal process at temperatures ranging from 350 to 1,000ºC. In addition to its use as a dietary supplement, the use of biochar in nutrition has been considered as a dietary supplement in recent years. It improves nutrition and thus better digestion and absorption of nutrients and limits the activity of toxins such as dioxin, glyphosate, mycotoxins and pesticides and reduces side effects on the gastrointestinal tract. This experiment was carried out to study the effects of replacement different levels of Biochar with the mineral supplement of diet on performance, meat quality, and bone ash in broiler chickens.Materials and Methods This experiment was conducted with 250 male broiler chicks (Ross 308) in a completely randomized design with five treatments, and five replicates (10 birds per replicate) for 42 days. The treatments included: 1) control diet (without Biochar, contain mineral supplement), 2) control diet whit 25% Biochar plus 75% mineral supplement, 3) control diet whit 50% Biochar plus 50% mineral supplement, 4) control diet whit 75% Biochar plus 25% mineral supplement, 5) control diet whit 100% Biochar plus mineral supplement. Birds and feeds were weighed at days 1, 21, and 42 on a cage basis. The body weight gain, body weight, feed intake and feed conversion ratio were determined. The meat lipid oxidation was evaluated by thiobarbituric acid-reactive substances assay described previously. The pH of meat was measured with a pH meter by homogenizing 5 g of sample with 25 ml of distilled. To estimate the water holding capacity, one g of the meat samples were put in tissue paper inside a tube and centrifuged (for 4 min at 1500 g). Then meat samples were dried at 70˚C for 24 h. Cooking loss was determined via the difference between raw weight and cooked weight, and expressed as a percentage of the original weight. The drip loss was determined as the percentage of weight loss of meat samples under standardized conditions. Color values L∗ (lightness), a∗ (redness), and b∗ (yellowness) were determined with a previously described digital imaging method. The hue angle (arc tangent of b*/a*), and chroma (saturation index) √ (a*2 + b*2) were also determined. The crude ash of bone samples was analyzed according to standardized methods.Results and Discussion In the whole period of experiment, the replacement of mineral supplements with Biochar could not make a significant difference on body weight, feed intake, food conversion rate (FCR), European Production Index, bone ash. Meat pH of birds fed 75% Biochar was higher than in all treatments and dripping loss of 75% Biochar was significantly lower than other treatments but here are no significant difference between other treatments. Brightness and yellowness were not affected by the experimental treatment, but the redness index was higher in 75% and 50% Biochar than in other treatments. Therefore, Biochar can replace dietary mineral supplements due to the presence of humic substances and the presence of mineral elements in its composition. Also, due to the low price of Biochar, the use of this substance instead of dietary mineral supplements, makes the use of minerals more desirable and reduces the cost of the diet of broilers. In the present study, the use of Biochar and its substitution with dietary supplements, due to its mineral content and humic acid, improved meat quality of broilers. Despite the lack of a significant difference between the price of a diet ration and a diet containing Biochar, it seems that the use of Biochar can replace dietary minerals and reduce the economic costs of the diet, which is an important issue in the poultry industry.The lack of altered bone ash in broiler chickens fed Biochar containing humic acid in this experiment was probably due to the adequate and balanced levels of calcium and phosphorus in the diet and therefore due to the lack of effect of humic acid in Biochar . This result may be due to adequate supply of minerals in treatments containing Biochar compared to control group treatment that has made no change in bone ash from control group.Conclusion In conclusion, the use of Biochar at 75% level without affecting the performance, improved the meat quality (meat pH, redness color index and dripping loss percentage) of broiler chickens.

The Perils of Pills: Study Cites Lightly Regulated Supplement Industry as Cause of 23,000 Emergency Department Visits a Year

(1) Background: Women bodybuilders use extreme diets, dietary supplementation, and training regimes to sculpt their physiques. Women's participation in bodybuilding competitions has increased since the 1980s. Currently, studies on their dietary intake and supplement use are limited. Their dietary intake may be of poor quality and low in several micronutrients, while supplement use appears to be omnipresent. Thus, the aim of this study was to examine and compare the dietary intake, supplement use, and diet quality of in-season and off-season women bodybuilders. (2) Methods: In a cross-sectional design, we compared dietary intake, supplement use, and diet quality between seasons in women bodybuilders (n = 227). An online questionnaire was developed, validated, and administered to assess all non-dietary and supplement variables. The Automated Self-Administered 24 h Dietary Assessment Tool was used to collect four 24 h dietary recalls. The Healthy Eating Index-2015 (HEI-2015) was used to calculate diet quality. The analysis of covariance and Welch's t-tests were used to assess the differences between in-season and off-season women bodybuilders' dietary intake, supplement, and HEI-2015 variables. (3) Results: In-season competitors reported consuming significantly less energy, carbohydrates, and fat but more protein than off-season competitors. All competitors consumed excess protein, while in-season competitors consumed excess fat and off-season competitors consumed less energy than the physique athlete nutrition recommendations. All competitors' micronutrient intakes were above the Dietary Reference Intakes. Supplements were used by all competitors, and the mean number used was similar between seasons. The HEI-2015 scores were not significantly different between seasons yet were below the US Dietary Guidelines for Americans. (4) Conclusion: Women bodybuilders would benefit from health education to achieve physique athlete nutrition recommendations, improve diet quality, and safe/efficacious supplement use to reach physique goals and improve overall health.

This trail was conducted to study the effect of L-proline on the growth performance, and blood parameter in the weaned lipopolysaccharide (LPS)-challenged pigs. Thirty six pigs (9.13±0.85 kg) were assigned randomly to dietary treatments in a 2×3 factorial arrangement in a 20-d growth assay. Factors were intraperitoneal injection with saline or LPS, and three dietary L-proline supplement levels (0%, 0.5%, or 1.0%). On d 10, blood samples were collected at 3 h after LPS (100 μg LPS/kg body weight [BW]) or saline injection. On d 20 of the trial, all pigs were orally administrated D-xylose (0.1 g/kg BW) at 2 h, and blood samples were collected at 3 h after LPS or saline injection. As a result, dietary supplementation with 0.5% proline had a tendency to increase average daily gain (ADG) in piglets during d 10 to 20 (p = 0.088). Without LPS challenge, dietary supplementation with 1.0% proline had no effect on growth hormone (GH) concentrations on d 10 (p>0.05), but decreased it after LPS challenge (p<0.05). There was LPS challenge×proline interaction for GH concentrations on d 10 (p<0.05). Dietary supplementation with 1.0% proline decreased glucagon concentration on d 10 after LPS challenge (p<0.05). In addition, dietary supplementation with proline increased superoxide dismutase (SOD) activity significantly on d 10 and 20 (p<0.05), and 1.0% proline increased heat shock proteins-70 concentration on d 10 (p<0.05). Moreover, proline supplementation increased diamine oxidase (DAO) concentrations after LPS challenge (p<0.05). There was LPS challenge×proline interaction for DAO (p<0.05). Furthermore, dietary supplementation with 1.0% proline increased the D-xylose level when no LPS challenge (p<0.05). These results indicate that proline supplementation could improve growth performance, increase SOD activities, and has a positive effect on the gastrointestinal tract digestibility in early weaned pigs.