Adequate Supplementation Research Articles

Adequate Nutritional Supplementation for Pregnant Women Post-Bariatric Surgery: a Necessity

Adequate Nutritional Supplementation for Pregnant Women Post-Bariatric Surgery: a Necessity

Integrating Reproductive Health and Nutrition: A Breakthrough Solution to Combat Stunting

Objective: This study aims to explore the importance of integrating reproductive health and nutrition as a strategic approach in addressing stunting in Indonesia. Materials & Methods: Using a qualitative study, this research analyzed findings from observation and from various scientific journals, reports of international and national health organizations, and policies related to stunting, reproductive health, and nutrition. The study emphasizes the importance of comprehensive perinatal interventions and supports the strengthening of maternal and child health systems. Findings: The analysis shows that a comprehensive approach that integrates nutrition interventions and reproductive health initiatives can significantly reduce the prevalence of stunting. This approach highlights the importance of adequate nutritional supplementation, quality perinatal health care, and health education programs for expectant mothers. Conclusion: The findings of this study are expected to contribute to the development of health policies that aim to sustainably reduce stunting rates with a holistic approach that focuses on maternal and child health.

Effect of Dietary Crude Protein Reduction Levels on Performance, Nutrient Digestibility, Nitrogen Utilization, Blood Parameters, Meat Quality, and Welfare Index of Broilers in Welfare-Friendly Environments

We investigated the effects of feeding different levels of crude protein (CP) on broiler performance, blood characteristics, meat quality, nutrient and nitrogen (N) availability, stress levels, and welfare indicators in a welfare environment. A total of 625 eight-day-old male broilers were assigned to five dietary CP levels (control (CON) and 1–4% CP reductions) during the grower (8–21 days) and finisher (22–35 days) periods. The CON diet contained 20% CP in the grower phase and 19% in the finisher phase, while all birds received a 22% CP diet during the starter period (1–7 days). Intriguingly, reducing CP levels in the diet did not significantly affect growth performance. These results may be due to the adequate supplementation of essential amino acids in the diets of all treatments and the compensatory growth observed in the finisher phase. Low-CP diets reduced CP digestibility, N intake, and N excretion, while N retention efficiency improved (p < 0.001). Serum total protein (TP) levels decreased equally with decreasing CP in the diet, and the crude fat content in meat increased linearly (p < 0.01). The litter moisture content and pH decreased with lower CP levels, and the welfare indices (footpad dermatitis (FPD), serum corticosterone, etc.) improved (p < 0.01). In conclusion, an appropriate reduction in CP levels in their diet can enhance broiler welfare by reducing N excretion and improving litter quality without adversely affecting performance.

Productive, Physiological, and Environmental Implications of Reducing Crude Protein Content in Swine Diets: A Review

Pig production is one of the most important providers of high-quality proteins and amino acids (AAs) to human nutrition. In this sector, feeding has an important economic and environmental impact. A strategy to reduce production costs and negative sustainability effects is reducing dietary crude protein (CP) contents with or without AA supplementation. This review addresses the different aspects related to this strategy, particularly the effects on growth performance and pork traits in piglets and growing and finishing pigs, as well as the physiological molecular mechanisms’ underlying effects. Insight is also provided into the effects of dietary CP reduction on the productive performances of alternative pig production systems and breeding boars and sows. Finally, an overview is conducted on the effects of dietary CP reduction on ammonia, odor, and greenhouse gas emissions arising from pig production systems. Overall, CP reduction may lead to production losses, albeit they can be, to some extent, hindered by adequate AA supplementation. Losses are particularly relevant during the post-weaning phase, whereas in finishing pigs, it may bring additional benefits, such as high intramuscular fat contents in some markets or improved gut barrier function with benefits to the animals’ health and welfare, as well as decreased ammonia emissions to the environment.

Assessment of vitamin B12 and homocysteine levels in pregnant women admitted for delivery and cord blood samples of their newborn babies: a multicenter study.

Vitamin B12, an indispensable micronutrient, is pivotal in numerous physiological processes, with particular significance during pregnancy and fetal development. The increasing adoption of vegetarian diets and the economic challenges associated with accessing animal-based food sources contribute to the prevalence of vitamin B12 deficiency. This study aims to examine the levels of vitamin B12 and homocysteine in pregnant women upon admission for delivery and to analyze corresponding cord blood samples from their newborn infants in a substantial sample within the Istanbul metropolitan area. This cross-sectional multicenter study included women aged ≥16 years admitted for delivery and their newborns ≥34 weeks. The demographic data and the results of complete blood counts within the previous 24 hours before birth were recorded. Vitamin B12 and homocysteine levels were measured in maternal and cord blood samples. The study parameters were compared between the groups based on the mothers' and babies' homocysteine and vitamin B12 levels. The study included 832 pregnant women and 832 neonates. Anemia affected 36% of pregnant women, with a higher frequency in mothers with vitamin B12 deficiency. Seventy-eight mothers and 48.9% of neonates showed Vitamin B12 levels below 200 pg/mL, while elevated homocysteine levels were observed in 30% of mothers and 26% of neonates. Maternal vitamin B12 deficiency was significantly correlated with cord blood B12 deficiency and elevated homocysteine. The median cord blood vitamin B12 level was inversely correlated with the number of previous pregnancies. Vitamin B12 deficiency is extremely common in pregnant women before delivery, significantly correlating to cord blood homocysteine and vitamin B12 levels. However, homocysteine alone is not a reliable marker for maternal vitamin B12 status. Implementing strategies to detect vitamin B12 deficiency and supplying adequate vitamin B12 supplementation during pregnancy holds the potential to enhance maternal and neonatal health in Türkiye.

SARS-CoV-2 induced vitamin D deficiency and psychological stress: a manifestation of autoimmune disease onset.

The global SARS-CoV-2 pandemic significantly altered lifestyles, access to healthcare, and social interactions, introducing unprecedented physical and psychological stress all over the world. This study explores the relationship between psychological stress, vitamin D (Vit-D) levels, and autoimmune connective tissue diseases, including systemic lupus erythematosus, systemic sclerosis, polymyositis, dermatomyositis, and rheumatoid arthritis. The analysis was based on over one million patient data points derived from anti-nuclear antibody (ANA) testing conducted both before and during the COVID-19 pandemic 2017-2021. In a subset of patients, longitudinal data were collected bi-yearly to yearly over 5-8 years using the same three-month criteria. The dataset was analyzed using GraphPad Prism9 using paired t-tests or ordinary one-way ANOVA with a significance threshold of p < 0.05 to ensure robust correlations between the variables. Data indicated that Vit-D levels peaked between 2017 and 2019 before declining, while ANA data demonstrated a rise in autoimmune connective tissue disease cases during the pandemic, reaching a peak in 2021. A clear correlation was observed, with autoimmune disease incidence increasing as Vit-D levels decreased. In-depth case analysis revealed that declining Vit-D levels preceded higher ANA titers and increased autoimmune disease severity, whereas improvements in Vit-D levels were associated with reduced ANA titers and less severe disease manifestations. The findings suggest that maintaining mental health and ensuring adequate Vit-D supplementation could be essential strategies for mitigating autoimmune disease risks and maintaining immune stability, particularly in pandemic scenarios. Clinically, these results underscore the need for early interventions targeting both psychological well-being and Vit-D levels to reduce the burden of autoimmune diseases.

The adequate nutritional supplement according to modified nutric score in the critically ill patients

The adequate nutritional supplement according to modified nutric score in the critically ill patients

Effects of Maltodextrin-Fructose Supplementation on Inflammatory Biomarkers and Lipidomic Profile Following Endurance Running: A Randomized Placebo-Controlled Cross-Over Trial.

Managing metabolism for optimal training, performance, and recovery in medium-to-high-level endurance runners involves enhancing energy systems through strategic nutrient intake. Optimal carbohydrate intake before, during, and after endurance running can enhance glycogen stores and maintain optimal blood glucose levels, influencing various physiological responses and adaptations, including transitory post-endurance inflammation. This randomized trial investigates the impact of a high-dose 2:1 maltodextrin-fructose supplementation to medium-to-high-level endurance runners immediately before, during, and after a 15 km run at 90% VO2max intensity on post-exercise inflammatory stress. We evaluated inflammatory biomarkers and lipidomic profiles before the endurance tests and up to 24 h after. We focused on the effects of high-dose 2:1 maltodextrin-fructose supplementation on white blood cell count, neutrophil number, IL-6, cortisol, and CRP levels, as well as polyunsaturated fatty acids, ω-3 index, and AA/EPA ratio. This supplementation significantly reduced inflammatory markers and metabolic stress. Additionally, it may enhance the post-activity increase in blood ω-3 fatty acid levels and reduce the increase in ω-6 levels, resulting in a lower trend of AA/EPA ratio at 24 h in the treated arm. Adequate carbohydrate supplementation may acutely mitigate inflammation during a one-hour endurance activity of moderate-to-high intensity. These effects could be beneficial for athletes engaging in frequent, high-intensity activities.

Sarcopenic Obesity: The Underlying Molecular Pathophysiology and Prospect Therapies

BACKGROUND: Age contributes to body composition alteration, rises a common disorder in elderly known as sarcopenic obesity (SO), which is characterized by the combination of obesity (excess fat mass) and sarcopenia (reduced skeletal muscle mass) clinical form and function.CONTENT: The primary cause of SO is insulin resistance. Glucose transporter 4 (GLUT4) dysfunction results in impaired fatty acids oxidation. Decreased muscle mass results in lower mitochondria number and volume. Both will increase oxidative stress. Together with altered myokines in SO, oxidative stress was promoted and lead to higher M1 macrophages and failure in autophagy. The pro-inflammatory condition and dysbiosis links SO to a variety of cardiometabolic conditions, including non-alcoholic fatty liver disease, type 2 diabetes, and cardiovascular disease. The mortality, comorbidities, cardiometabolic diseases, and disability or impairment of SO is higher compare to obesity or sarcopenia alone. Some treatments have been developed for SO including adequate dietary intake, vitamin D and antioxidant supplementation, and exercises.SUMMARY: SO is more prevalent among the elderly and has a significant negative impact on their quality of life. Therefore, maintaining muscle mass and strength as well as preventing obesity should be the key goals of initiatives to support healthy aging.KEYWORDS: aging, body composition, obesity, sarcopenia, skeletal muscle, metabolic syndrome

Effects of the dietary supplementation of manganese on growth, skeletal development, oxidative stress and bone metabolism related genes in gilthead seabream (Sparus aurata) larvae

Manganese (Mn) is an essential element necessary for normal growth, antioxidant defense and maintaining bone health. Knowledge about the effects of dietary Mn levels in gilthead seabream (Sparus aurata) larvae performance is still scarce. To determine the effects of dietary Mn levels on growth, survival, skeletal development and expression of antioxidant and bone metabolism related genes, gilthead seabream larvae were fed six experimental microdiets supplemented with manganese sulfate monohydrate (MnSO4.H2O) (contained 6.3, 39, 75, 79, 200 and 270 mg Mn/kg diet). After 26 days of feeding, dietary Mn levels had no effect on larval survival. However, larvae fed the non-supplemented diet (6.3 mg Mn/kg) showed signs of Mn deficiency, including growth reduction, low whole body Mn content, lower expression of mnsod, runx2, oc, and reduced bone mineralization. The poor vertebral body mineralization and low bone relative gene expression in seabream larvae was related to a marked increase in the number of fish with total skeletal anomalies and anomalies of the caudal vertebrae region. On the contrary, larvae fed with Mn supplemented diet up to 270 mg Mn/kg showed increased growth and whole body Mn content, up-regulated mnsod, runx2, alp, opn and oc expression, as well as increased bone mineralization, and reduced number of fish with skeletal anomalies. Therefore, the findings suggest that adequate dietary Mn supplementation positively influences the growth, skeletal development, and antioxidant defense of gilthead seabream larvae, preventing the manifestation of Mn deficiency-related issues.

The role of emotional eating as relief mechanism from psychological distress and its impact on overall wellbeing

Emotional eating, characterized by the consumption of highly palatable and calorie dense foods in response to psychological distress and negative emotions, poses a significant challenge to global public health and well-being. Based on the studies showing the complex interplay between emotional states and dietary choices, highlighted the motivational role of relief seeking, which according to a Hull's drive reduction theory, emphasizes the role of internal drives and external cues. Inability to cope with negative feelings and/or high tension indicates that emotion regulation can be a critical factor in maintaining well-being, as adaptive regulation protects against negative emotions and external stressors; which if not developed properly, can lead to avoidant coping strategies, which can contribute to eating disorder symptoms. Therefore, dysregulation of the hedonic and homeostatic food intake, compromised cortical control, and alterations in the gut signaling are implicated in obesity triggered by stress-induced eating. Therefore this review aim to further discuss these observations to provide better understanding of the role of emotional eating in providing a relief from the psychological distress, emphasizing impact of the food on the reward system; while providing insights in emerging holistic mitigating approaches which by promoting alternative coping mechanisms and adequate nutrition and supplementation, may help to aid the emotional eating management and reduce burden on related to that illnesses.

Study of Lipid Accumulation from Chlorococcum Microalga for Biodiesel Conversion

Microalgae-derived biodiesel seems to be a viable substitute for petroleum-based transportation fuels as a renewable biofuel. Raising the lipid content of microalgal strains may therefore provide a low-cost second-generation feedstock for the synthesis of biodiesel. Chlorococcum growth and lipid accumulation were investigated under a range of culture conditions, including CO2 concentration, temperature, and nitrate concentrations. The lipid content increased significantly by 33.1 ± 0.28% of dry cell weight in N-/30 ºC/CO2 cultivation in Bristol medium. The highest biomass productivity was achieved at 30ºC when there was adequate nitrogen and CO2 supplementation (N+/30 oC/CO2). Gas chromatography was employed to determine the proper ratio of fatty acids. The biomass of chlorococcum shows great potential as a feedstock for the manufacture of biodiesel since it is mostly composed of oleic and linoleic fatty acids.

MAPK signaling pathway participates in the regulation of intestinal phosphorus and calcium absorption in broiler chickens via 1,25-dihydroxyvitamin D3

Four experiments were performed to investigate the role of the mitogen-activated protein kinase (MAPK) signaling pathway in intestinal absorption of phosphorus (P) and calcium (Ca) in broiler chickens. Experiment 1 assessed how dietary levels of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) influence the gene expression of intestinal P and Ca transporters in broilers. Experiment 2 evaluated the effects of 1,25(OH)2D3 administered via intraperitoneal injection on the extracellular signal-regulated kinase (ERK) and p38 mitogen-activated protein kinase (p38MAPK) signaling pathways. Experiments 3 and 4 investigated the effect of ERK and p38MAPK inhibitors on the expression of intestinal P and Ca transporters. The findings demonstrated that broilers (1-21 days old) fed a 1,25(OH)2D3-deficient diet (0.625 µg/kg) exhibited reduced body weight, tibia P and Ca levels, and mRNA levels of P transporters (NaPi-IIb, PiT-1, and PiT-2), Ca transporters (NCX1, PMCA1b, and CaBP-D28k), vitamin D receptors (VDR), ERK, and p38MAPK in the duodenum (Experiment 1) (P < 0.05). By comparison, the growth, bone quality, and mRNA levels of genes (except for duodenal NaPi-IIb) in broilers were similar to those in broilers fed the control diet when dietary 1,25(OH)2D3 was adequate (5 µg/kg) (Experiment 1) (P > 0.05). After intraperitoneal injection of 1,25(OH)2D3, the mRNA level of jejunal NaPi-IIb and the protein level of p-p38MAPK/t-p38MAPK in broilers (9-14 days old) decreased (P < 0.05), whereas the mRNA level of CaBP-D28k and the protein level of p-ERK/t-ERK increased (Experiment 2) (P < 0.05). The mRNA and protein expression of jejunal NaPi-IIb and the protein expression of CaBP-D28k in broilers (9-17 days old) treated with the ERK inhibitor PD98059 were greater than those in the control group (Experiment 3) (P < 0.05). Similarly, compared with control broilers, broilers (9-17 days old) treated with the p38MAPK inhibitor SB203580 showed elevated mRNA expression of jejunal NaPi-IIb and CaBP-D28k (Experiment 4) (P < 0.05). These results suggest that adequate supplementation with 1,25(OH)2D3 (5 µg/kg) can restore broiler growth and bone quality by upregulating the transcription of genes involved in intestinal P and Ca absorption. Additionally, the ERK and p38MAPK signaling pathways are implicated in the modulatory effect of 1,25(OH)2D3 on the absorption of P and Ca in broilers.

Exploring the potential of genetic analysis in historical blood spots for patients with iodine-deficient goiter and thyroid carcinomas in Switzerland and Germany (1929–1989)

Iodine deficiency-induced goiter continues to be a global public health concern, with varying manifestations based on geography, patient’s age, and sex. To gain insights into clinical occurrences, a retrospective study analyzed medical records from patients with iodine deficiency-induced goiter or thyroid cancer who underwent surgery at the Community Hospital in Riehen, Switzerland, between 1929 and 1989. Despite today’s adequate iodine supplementation, a significant risk for iodine-independent goiter remains in Switzerland, suggesting that genetic factors, among others, might be involved. Thus, a pilot study exploring the feasibility of genetic analysis of blood spots from these medical records was conducted to investigate and enhance the understanding of goiter development, potentially identify genetic variations, and explore the influence of dietary habits and other environmental stimuli on the disease.Blood prints from goiter patients’ enlarged organs were collected per decade from medical records. These prints had been made by pressing, drawing, or tracing (i.e., pressed and drawn) the removed organs onto paper sheets. DNA analysis revealed that its yields varied more between the prints than between years. A considerable proportion of the samples exhibited substantial DNA degradation unrelated to sample collection time and DNA mixtures of different contributors. Thus, each goiter imprint must be individually evaluated and cannot be used to predict the success rate of genetic analysis in general. Collecting a large sample or the entire blood ablation for genetic analysis is recommended to mitigate potential insufficient DNA quantities. Researchers should also consider degradation and external biological compounds’ impact on the genetic analysis of interest, with the dominant contributor anticipated to originate from the patient’s blood.

Iron and ferritin deficiency in women with hypothyroidism and chronic lymphocytic thyroiditis - systematic review.

Iron is one of the essential microelements necessary for maintaining the body's homeostasis. It serves various roles, including being a crucial component in the proper structure of many enzymes and supporting the transport of oxygen and electrons. Its deficiency can lead to anaemia, which is a common clinical condition often associated with thyroid diseases. Iron deficiency is one of the most common nutritional deficiencies, and its prevalence is strongly associated with socioeconomic status. It is the primary cause of anaemia in 42% of children and 50% of women. Importantly, iron deficiency is placed among the top 5 causes of disability in women. Thyroid peroxidase (TPO) is an enzyme essential for the production of thyroid hormones, and iron is a key factor in its proper functioning. Therefore, in the case of iron deficiency, the activity of this enzyme is also reduced. Iron is also a factor that is important in epigenetic modification processes, and its deficiency may contribute to genomic changes potentially promoting the development of autoimmune thyroid diseases. Adequate supplementation in patients with Hashimoto's disease is one of the crucial elements of effective therapy. In addition to iodine, selenium, and magnesium supplementation, attention should be paid to proper iron intake. Iron is an element that is a component of the heme enzyme- thyroid peroxidase, which owes its activity to the binding of haem, and its function is the production of thyroid hormones. Iron can be delivered to the body in haem and non-haem forms. The haem form is found particularly in haemoglobin-rich red meat, but also in eggs, fish, and poultry. On the other hand, non-haem iron can be found in legumes, grains, fruits, and vegetables. Our study aimed to gather and summarise knowledge from scientific literature regarding iron deficiency anaemia and its association with hypothyroidism in women, as well as the possible mechanisms and pathogenesis of these conditions. The paper also aims to highlight that considering the high risk of iron deficiency, assessing iron status along with ferritin should be an integral part of additional diagnostic measures in cases of hypothyroidism, particularly Hashimoto's disease.

Epidemiology of neural tube defects in Finland: a nationwide register study 1987-2018.

Our aim was to evaluate the prevalence, mortality, regional and sex distribution of neural tube defects (NTDs) in Finland. Data for this population-based study were collected from 1987 to 2018 from the national health and social welfare registers. There were in total 1634 cases of NTDs, of which 511 were live births, 72 pregnancies ended in stillbirth and 1051 were terminations of pregnancy due to fetal anomaly (TOPFA). The total prevalence of NTDs was 8.6 per 10 000 births and it increased slightly annually (OR 1.008; 95% CI: 1.002, 1.013) during the 32-year study period. The birth prevalence of NTDs decreased (OR 0.979; 95% CI: 0.970, 0.987), but the prevalence of TOPFA increased annually (OR 1.024; 95% CI 1.017, 1.031). The perinatal mortality of NTD children was 260.7 per 1000 births and the infant mortality was 184.0 per 1000 live births, whereas these measures in the general population were 4.6 per 1000 births and 3.3 per 1000 live births, respectively. There was no difference in the NTD prevalence between males and females (P-value 0.77). The total prevalence of NTDs varied from 7.1 to 9.4 per 10 000 births in Finland by region. Although the majority of NTDs are preventable with an adequate folic acid supplementation, the total prevalence increased in Finland during the study period when folic acid supplementation was mainly recommended to high-risk families and to women with folic acid deficiency. NTDs remain an important cause of infant morbidity and mortality in Finland.

Revisional Bariatric Surgery After Roux-en-Y Gastric Bypass for Bile Reflux: a Single-Center Long-Term Cohort Study.

Revisional bariatric surgery (RBS) after primary Roux-en-Y gastric bypass (RYGB) is indicated for the efficient management of specific complications such as bile reflux. Published literature on this topic remains scarce as we aim to evaluate the long-term outcomes (10years) of RBS for bile reflux after RYGB. We conducted a single-center retrospective study of patients who underwent primary RYGB complicated by bile reflux and had RBS between 2008 and 2023. Our cohort was divided into two groups based on the etiology of bile reflux. Long-term surgical outcomes and nutritional status were reported and compared between the groups. A total of 41 patients (100% primary RYGB; 90.2% female, 97.6% white) were included. 56.1% (n = 23) of patients underwent Roux limb lengthening and the remaining 43.9% (n = 18) had a gastrogastric fistula takedown, with no significant differences in terms of intraoperative complications, estimated blood loss (p = 0.616), length of hospital stay (p = 0.099), and postoperative complications between the two groups. Long-term resolution of obesity-related medical conditions was demonstrated for all the evaluated comorbidities. Lastly, there was no reported mortality, bile reflux recurrence, or micro- and macro-nutrient deficiencies over the total follow-up period of 10years. In our cohort, RBS after a primary RYGB for bile reflux management demonstrated safe and efficient short- and long-term surgical outcomes without any reported bile reflux recurrence or mortality. Adequate supplementation and close patient follow-up remain essential to decrease the morbidity and mortality associated with RBS as further studies are required to support our findings.

Nutritional Vitamin D deficiency rickets in children – Challenges in diagnosis, management, and prevention

Nutritional rickets are characterized by under mineralization of the skeleton that leads to bone deformities and poor growth. The balance between Vitamin D and calcium intake is critical for the maintenance of bone health. A few risk factors that contribute to a high prevalence of rickets in India include poor maternal nutrition, poor dietary calcium, and Vitamin D intake and poor sunshine practices. Early features of rickets may be asymptomatic and may be missed without biochemical and radiological investigations. Severe rickets may be the first manifestation of an underlying non-nutritional rickets that may be misdiagnosed in the absence of a complete workup. The treatment of rickets requires Vitamin D therapy with adequate calcium supplementation. The schedule of treatment with Vitamin D is not standardized, but daily therapy is preferable compared to weekly/monthly stoss therapy. Both cholecalciferol and ergocalciferol may be used for treatment as they are efficacious and cost-effective instead of active Vitamin D preparations. Periodic monitoring for the resolution of biochemical deficiency and improvement in skeletal changes should be emphasized. Prolonged treatment with Vitamin D and calcium should be avoided for the risk of Vitamin D toxicity and nephrocalcinosis. An impetus is required toward the prevention of Vitamin D deficiency. At present, nutritional strategies should focus on a life-cycle approach during the antenatal period, early infancy, and childhood and adolescence. Food fortification is likely to be an effective option, but the efficacy and logistics of this in the Indian setting will require further research.

Consequences of Maternal Vitamin D Deficiency on Newborn Health.

Maternal-fetal gestational pathology is one of the biggest challenges in the field of health at this moment. The current study is designed to determine the effects of vitamin D on pregnancy, starting with the idea that impairment of vitamin D status is thought to be correlated with impairment of the newborn's health. In this retrospective study, we tried to establish the link between vitamin D deficiency and maternal characteristics and also how it impacted the clinical status of the newborn. We analyzed a group of 260 patients: 130 pregnant women and 130 newborns, in whom vitamin D status was detected using the serum levels of 25-hydroxyvitamin D (25-(OH)D). The results showed that vitamin D deficiency has a high incidence among pregnant women, as was presented in many important international studies. Our study also showed a positive, direct correlation between the mother's and newborn's vitamin D status. Taking into consideration that vitamin D deficiency has been correlated with many complications, both in maternal and newborn health, a serum level determination of 25-(OH)D is necessary in the first trimester of pregnancy, and after that, adequate supplementation is necessary in order to prevent any negative effects.

A Patented Dietary Supplement (Hydroxy-Methyl-Butyrate, Carnosine, Magnesium, Butyrate, Lactoferrin) Is a Promising Therapeutic Target for Age-Related Sarcopenia through the Regulation of Gut Permeability: A Randomized Controlled Trial.

Adequate diet, physical activity, and dietary supplementation with muscle-targeted food for special medical purposes (FSMP) or dietary supplement (DS) are currently considered fundamental pillars in sarcopenia treatment. The aim of this study is to evaluate the effectiveness of a DS (containing hydroxy-methyl-butyrate, carnosine, and magnesium, for its action on muscle function and protein synthesis and butyrate and lactoferrin for their contribution to the regulation of gut permeability and antioxidant/anti-inflammation activity) on muscle mass (assessed by dual X-ray absorptiometry (DXA)), muscle function (by handgrip test, chair test, short physical performance battery (SPPB) test, and walking speed test), inflammation (tumor necrosis factor-alpha (TNF-a), C-reactive protein (CRP), and visceral adipose tissue (VAT)) and gut axis (by zonulin). A total of 59 participants (age 79.7 ± 4.8 years, body mass index 20.99 ± 2.12 kg/m2) were enrolled and randomly assigned to intervention (n = 30) or placebo (n = 28). The skeletal muscle index (SMI) significantly improved in the supplemented group compared to the placebo one, +1.02 (CI 95%: -0.77; 1.26), p = 0.001; a significant reduction in VAT was observed in the intervention group, -70.91 g (-13.13; -4.70), p = 0.036. Regarding muscle function, all the tests significantly improved (p = 0.001) in the supplemented group compared to the placebo one. CRP, zonulin, and TNF-alpha significantly decreased (p = 0.001) in intervention, compared to placebo, -0.74 mg/dL (CI 95%: -1.30; -0.18), -0.30 ng/mL (CI 95%: -0.37; -0.23), -6.45 pg/mL (CI 95%: -8.71; -4.18), respectively. This DS improves muscle mass and function, and the gut muscle has emerged as a new intervention target for sarcopenia.