Administration Of Nutritional Supplements Research Articles

Reduction in Fatigue Symptoms Following the Administration of Nutritional Supplements in Patients with Multiple Sclerosis.

Despite recent advances in immune-modulatory drugs, pharmacological therapies have been proven ineffective in severe presentations of multiple sclerosis (MS), including secondary progressive MS. At present, therapeutic interventions’ performance is primarily focused on ameliorating symptoms to improve the patient’s quality of life (QOL). Among complementary treatments, nutrition has been considered a decisive factor to control symptoms and enhance the wellness of MS patients. Although no special diets are associated with MS, the impact of diet and dietary supplements on the course of progressive forms of the disease has been studied during the last few years. Fatigue is among the most common and disabling symptoms reported by MS patients. Fatigue has been defined in the Multiple Sclerosis Council for Clinical Practice Guidelines (MSCCPG, 1998) as a “subjective lack of physical and/or mental energy that the individual perceives as an interference with habitual and desired activities”. This study aimed to compare the psychometric functioning of the “Fatigue Severity Scale” (FSS) and the “Modified Fatigue Impact Scale” (MFIS) in our sample of people with MS. Specifically, during chronic treatment, the change in these two parameters with two vitamin-rich dietary supplements (Citozym® and Ergozym®) was evaluated. The impact of these nutritional supplements revealed differences in antioxidant and anti-inflammatory parameters among the volunteers in the treatment group, with a subsequent improvement in fatigue. In conclusion, the results obtained have confirmed the effectiveness of complementary nutritional therapies, evaluated essentially based on hematological biomarkers, through which it is possible to act on disability to improve the QOL of MS patients.

14.3 CAUSES AND PREVENTION OF AGGRESSION FROM PSYCHOTIC INPATIENTS

BackgroundPatients with schizophrenia and other psychotic disorders have an increased likelihood of engaging in violent behavior. These increased risks of dangerous and aggressive behavior, in combination with a lack of insight in their own illness, relatively often make involuntary admission of acutely disturbed psychotic patients on locked psychiatric admissions wards often inevitable. On these locked psychiatric admissions wards, aggression from psychotic patients against staff and fellow patients is a prevalent phenomenon, with the mean in the Netherlands being about 18 aggressive incidents per bed per year on locked psychiatric admissions wards.MethodsIn the lecture, a model of what causes or triggers aggressive behavior on (locked) psychiatric wards is presented. In this model, patient, ward and staff variables are integrated to explain why, and in what specific situations, psychotic patients particularly run a high risk of engaging in aggressive behavior.ResultsBased on the presented model, a number of preventive measures can be formulated.On the patient level, the administration of anti-psychotic medication is used to reduce the negative cognitive schemes and delusional thoughts that are depicted in the center of the model. A more novel intervention at the patient level may be the additional administration of nutritional supplements with (among others) high levels of omega 3 fatty acids. The results of two Dutch studies on this topic will be briefly presented in the lecture, among which a RCT on the effects of the use of nutritional supplements on aggressiveness.On the staff level, the use of short-term (daily) risks assessments by the ward nursing staff, among others by means of the six item BrØset Violence Checklist (BVC), has been found to reduce aggressiveness and the use of coercive measures on psychiatric wards in two cluster randomized RCTs.On the ward level, studies indicate that aggression on psychiatric wards can be reduced by preventing overcrowding on psychiatric wards, and by providing more space and privacy to the patients.DiscussionThe proposed model elucidates how certain patient, staff and ward characteristics may interact in causing aggression. The model also emphasizes that repeated inpatient aggression may be the result of a vicious circle, i.e. inpatient violence is often followed by an increase in environmental and/or communication stress on the patient, thereby heightening the risk of a repeated outburst of violence.

Implementing measures to minimize the global incidence of falls and its associated complications.

Sir, Globally, falls are the second most common reason for the accidental deaths, with close to 0.42 million deaths being reported each year, of which four-fifths are in low- and middle-income nations.[1] In fact, the Western Pacific and South East Asian region account for 66% of the overall fatalities, with elderly population being predominantly affected, both in terms of morbidities and mortalities.[1] In addition, in excess of 37 million individuals each year acquire serious injuries, which require medical intervention for the appropriate management.[1,2] Further, there are consequences such as permanent or temporary disabilities, impaired quality of life, sickness absenteeism, reduced productivity, hospitalization, and financial burden on the health system as well as on the households.[1,2,3] The epidemiological trends suggest that among elderly, as the age increases, the risk of a fatal outcome or serious complication also increases, and it is due to the combination of individual attributes and absence of elderly-friendly society (viz., poor construction, slippery floor, uneven sidewalks, etc).[2,3] At the same time, children have also been identified as one of the high-risk groups because of the desire to explore the surroundings, lack of attention from parents, and risk-taking behavior.[2,3] In addition, factors such as male gender; occupational demands; alcohol or substance use; socioeconomic attributes such as poverty, overcrowding, or single parent; co-existing medical illnesses; side effects of therapeutic drugs; physical inactivity and loss of balance; poor mobility-cognition-vision; and exposure to high-risk surroundings have augmented the risk of falls and its associated after-effects.[1,2,3] It is very important to ensure that fall prevention strategies are comprehensive and multi-sectoral and should give adequate priority to research to obtain the precise estimates, potential risk factors, and evaluate the effectiveness of the implemented strategies.[2,4] There is an immense need to formulate supportive policies to create a safe environment and minimize the exposure to predisposing factors, and these measures should be targeted to vulnerable age groups.[2,4] For the elderly, interventions such as screening of the living environment for the potential risk, reducing smoking or alcohol consumption, maintaining weight within recommended living, and motivating them to participate in acceptable form of physical activities will definitely improve the results.[1,2,4,5] In addition, intervening clinically to rule out potential medical risk factors (such as review of drugs, management of low blood pressure or vision, administration of nutritional supplements, offering assistive device to respond to any existing impairments, muscle strengthening or balance retraining exercises, etc.), initiating community-based programs, and modifying home to make it more elder-friendly can be tried to reduce the incidence.[1,2,4,5] On a similar note, for the children, strategies such as ensuring modifications in the furniture of schools, sports equipment, window guards, home visits, training of individuals and communities to offer desired medical attention, in case of a fall, and general public awareness campaigns can be implemented to minimize the incidence in heterogeneous settings.[1,2,5] To conclude, to acknowledge the magnitude of the falls and the associated adverse effects, there is a great need to implement effective fall prevention programs with an aim to minimize the incidence of people who fall and the severity of the injury sustained, should a fall occur. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Supplementation of Diabetic Rats with Leucine, Zinc, and Chromium: Effects on Function and Histological Structure of Testes.

The objective was to study whether leucine, zinc, and chromium supplementations influence function and histological structure of testes in a rat model of type 2 diabetes. Seventy seven adult male rats were categorized into 11 groups of 7 animals each: (1) nondiabetic (negative control); (2) non-treated (positive control); (3) treated with insulin; (4) treated with glibenclamide; (5) treated with leucine; (6) treated with zinc; (7) treated with chromium; (8) treated with leucine + zinc; (9) treated with leucine + chromium; (10) treated with zinc + chromium; (11) treated with leucine + zinc + chromium. In the non-treated group, hyperglycemia severely damaged testes morphology as well as the spermatogenic process. Diabetes induction decreased testicular length, height, width, volume, total number of epididymal sperm, and number of live sperm. Seminiferous tubules of diabetic rats showed a decrease in diameter of tubules and height of epithelium. Diabetes induction decreased the number of cells (spermatogonia, spermatocyte, spermatid, and Sertoli) in cross sections of seminiferous tubules. Administration of nutritional supplements to the diabetic rats improved testes morphology and reversed, although not completely, impairment of spermatogenesis. Treatment with nutritional supplements increased testicular length, height, width, and volume. All treatments increased the number of live sperm and the total number of epididymal sperm. Furthermore, nutritional supplements increased diameter of tubules, height of epithelium, and the number of cells in seminiferous tubules. These alleviating effects were more pronounced in animals treated with the leucine-zinc-chromium combination. The present results demonstrate beneficial effects of zinc, leucine, and chromium supplements to improve testes morphology and to restore spermatogenesis in type 2 diabetic rats.

Effect of phlebodium decumanum and coenzyme Q10 on sports performance in professional volleyball players

Physical training programmes are based on provoking transitory states of fatigue in order to induce super compensation by the biological systems involved in the activity, in order to improve the athlete's medium-long term performance. The administration of nutritional supplements with antioxidant and immunomodulatory properties, such as Phlebodium decumanum and coenzyme Q10, can be a very advantageous means of achieving recovery from the inflammation and tissue damage caused by the stress of prolonged, intense exercise. An experimental, longitudinal, double- blind experiment was conducted, with three randomised groups obtained from a sample of 30 male volleyball players (aged 22-32 years) at the University of Granada, with a high level of training (17 hours a week during the 6 months preceding the study). The effects were then evaluated of a month-long physical training programme, common to all the study groups, associated with the simultaneous administration of the following nutritional supplements: Phlebodium decumanum (4 capsules of 400 mg/capsule, daily), Experimental Group 1; Phlebodium decumanum (same dose and schedule as Group 1) plus coenzyme Q10 (4 capsules of 30 mg/ capsule, daily), Experimental Group 2; a placebo substance, Control Group. The following dependent blood variables were examined to assess the effects of the intervention on the basal immune and endocrine-metabolic profile: cortisol and interleukin-6, both related to the axis of exercise-induced stress; and lactic acid and ammonium, related essentially to the anaerobic metabolism of energy. All the study groups presented favourable adaptive changes with respect to the endocrine-metabolic and immune profile, as reflected by a significant decrease in the post-test concentrations of cortisol, interleukin 6, lactic acid and ammonium, compared to the values recorded before the physical activity with/without nutritional supplement, per protocol. The groups that achieved the most favourable profile were those which had received nutritional supplementation, rather than the placebo, and among the former, those which had received the double- strength supplement with Phlebodium decumanum plus coenzyme Q10. The intake of Phlebodium decumanum plus coenzyme Q10 for 4 weeks produced protective effects on the endocrine-metabolic and immune profile, which we attribute to the immunomodulatory and antioxidant properties of these substances, which are highly beneficial not only in terms of delaying fatigue and improving athletic performance, but also in reducing the risk of injuries associated with high intensity exercise.

Evidências do impacto da suplementação múltipla com micronutrientes no crescimento de pré-escolares: revisão sistemática

Objetivos: agregar evidências sobre o efeito da suplementação múltipla com micronutrientes no crescimento de crianças pré-escolares, com ênfase nos efeitos combinados ou isolados do zinco, ferro e vitamina A. Métodos: foi realizada uma busca por ensaios clínicos aleatorizados e artigos de revisão sistemática com metanálise na base de dados PubMed. Foram selecionados artigos publicados entre 1995 e maio de 2013, considerando a combinação dos descritores (child, preschool OR infant) AND (growth) AND (zinc AND iron AND vitamin A) OR (zinc AND iron) OR (zinc AND vitamin A) OR (iron AND vitamin A). Resultados: foram selecionados 33 artigos para a presente revisão, 29 do tipo ensaio clínico e quatro de revisão sistemática com metanálise. A administração de suplementos nutricionais contendo combinações de zinco, ferro e vitamina A pode aumentar o potencial de crescimento das crianças, sendo mais evidente o efeito quando comparada a suplementação com múltiplos micronutrientes vs placebo ou dieta habitual, e com os esquemas de suplementação dupla e única. A combinação de zinco e vitamina A é a melhor opção de suplementação dupla. O efeito da suplementação tripla em relação às outras opções (placebo, única, dupla, múltipla), bem como os possíveis efeitos diferenciados da suplementação segundo a condição nutricional e/ou idade das crianças, ainda precisam de investigação mais aprofundada para orientar as estratégias de prevenção. Conclusões: a suplementação múltipla com micronutrientes tem efeitos positivos no crescimento linear que dependem do esquema de suplementação adotado.

Nutritional Indicators are Correlated with the Radiological Severity Score in Patients with <i>Mycobacterium avium</i> Complex Pulmonary Disease: A Cross-sectional Study

Body weight loss in patients with Mycobacterium avium complex (MAC) pulmonary disease can be fatal. The administration of nutritional supplements should be an important component in the treatment of this disease. Objective data regarding the association between the nutritional status and disease severity have not been reported. This cross-sectional study aimed to compare the nutritional status and radiological severity scores in MAC pulmonary disease patients. We retrospectively reviewed the records of 40 patients who were admitted to our institution for the treatment of MAC pulmonary disease between July 2008 and July 2010. Nutritional indices, including the ideal body weight ratio, triceps skinfold, mid-upper arm muscle circumference, and percentage of predicted resting energy expenditure, were compared with the radiological severity scores. Quantitative values of the extent of nodules, infiltration shadows, cavities, and bronchiectasis on the computed tomography scans were used to evaluate the radiological severity scores. The patients suffered from a significantly decreased percentage of ideal body weight, body fat and muscle mass. The average radiological score was 17.6±8.4 points. The percentage of ideal body weight (p<0.001), percentage of triceps skinfold (p<0.001) and percentage of mid-upper arm muscle circumference (p<0.002) were negatively correlated with the radiological scores, while the percentage of the predicted resting energy expenditure (p<0.001) was positively correlated with the scores. A poor nutritional status is common in patients with progressive MAC pulmonary disease, which supports the hypothesis that aggressive nutritional interventions are indicated in the treatment of this disease.

Analysis of octopamine in human doping control samples

The biogenic amine octopamine [4-(2-amino-1-hydroxyethyl)phenol] is prohibited in sports owing to its stimulating and performance-enhancing properties. Adverse analytical findings in athletes' doping control samples commonly result from surreptitious applications; however, the occurrence of octopamine in nutritional supplements and in selected invertebrates as well as the assumption that its N-methylated analog synephrine [4-(1-hydroxyethyl-2-methylamino)phenol, not banned by anti-doping authorities but currently monitored in prevalence studies) might be converted in-vivo into octopamine have necessitated a study to investigate the elimination of synephrine and octopamine present in over-the-counter products. Urine samples collected after administration of nutritional supplements containing octopamine and/or synephrine as well as urine samples collected after therapeutic application of octopamine- or synephrine-containing drugs were analyzed using a validated solid-phase extraction-based procedure employing a weak cation exchange resin and liquid chromatographic/tandem mass spectrometric detection with electrospray ionization and multiple reaction monitoring. In the case of therapeutic octopamine application, the urinary concentration of the target compound increased from baseline levels below the lower limit of detection to 142 µg/mL, while urine samples collected after synephrine as well as dietary supplement administration did not yield any evidence for elevated renal excretion of octopamine.

Effect of a BIOcocktail on the Immune Response at the Early Postoperative Period in Mice

Since human subjects and laboratory animals may develop impaired immune response during surgery and the postoperative period, efforts have been made to preserve normal immune functions following surgery by the administration of nutritional supplements and probiotics. The present study was designed to examine the effect of a new nutritional supplement, BIOcocktail, on immune parameters in mice exposed to surgery. Forty mice were assigned to 4 groups containing 10 animals each. Two control groups (with and without subsequent sham laparotomy) were given tap water for 45 min every day for 2 weeks. The remaining 2 groups, with and without laparotomy, received BIOcocktail given orally for the same period of time. The proliferative response of splenic cells (splenocytes) stimulated with phytohemagglutinin (PHA), concanavalin A (Con A) and lipopolysaccharide (LPS) was determined by [3H]thymidine uptake. Cytokine levels were measured in splenocyte supernatants and sera using enzyme-linked immunosorbent assay (ELISA) kits. Natural killer cell activity of splenocytes was evaluated by 51Cr-release assay. Laparotomy, without BIOcocktail administration, was followed by a decreased proliferative response of splenocytes to PHA, Con A, and LPS and an increase in interleukin (IL)-6 serum level. In addition, a decreased secretion of IL-1β, IL-12 and tumor necrosis factor (TNF)-α by the splenocytes was observed. Mice treated with BIOcocktail before laparotomy maintained a preoperative level of splenocyte proliferative response and serum concentrations of IL-12. It is concluded that BIOcocktail administered to mice for 2 weeks before operation resulted in the preservation of T- and B-cell proliferative response to mitogens and in the prevention of postoperative decrease in IL-12 serum level.

Is infection a major risk factor for preeclampsia?

Recently in an open population-based program composed of 15 354 pregnant women in Colombia we applied a biopsychosocial risk model, which permitted us to identify pregnant women at high risk of preeclampsia. 1443 (9.4%) of patients at high risk for developing preeclampsia received 450 mg of linoleic acid, and 1.5 g/day of calcium. Bacteriuria was identified in 1766 (11.5%) and vaginal infections in 2150 (14.0%) of the pregnant women. These women received oral antibiotics for 10 days. The incidence of low birthweight, preterm delivery and preeclampsia were reduced by 53% (6.2% vs 13.2%), 64.7% (1.8% vs 5.1%), and 52.5% (3.8% vs 8.0%) respectively, when compared with the incidence of the preceeding five years. We believe that these dramatic reductions were due to early identification of risk factors, administration of nutritional supplements and principally by treatment of asymptomatic infections. Unfortunately, because of the study design it is not possible to confirm that infection was the major risk factor for preeclampsia in our population. However, we hypothesize that chronic subclinical infections may cause increased maternal cytokine levels sufficient to affect vascular endothelial function, and so prime individuals for the subsequent development of preeclampsia. This hypothesis can be tested in a more appropriately designed clinical trial to assess whether there is a relationship between infection, inflammation and preeclampsia.